Rehabilitation Support Research Articles

Factors of Career Development Impacting Transition for Young Adults with Autism Spectrum Disorder

Factors related to career development impacting the transition from high school to early adulthood were examined for young adults with autism spectrum disorder (ASD). Participants included five individuals with ASD who had recently graduated from a high school in a north-central U.S. state and nine parents of those individuals. Participants completed a survey, which was analyzed and used to conduct focus groups. Seven parents participated in focus groups. The study revealed that the individuals with ASD had several barriers to gaining employment or attending post-secondary education and that individuals’ career paths were continuously changing. Additional areas of importance that emerged were job interviews, Division of Vocational Rehabilitation (DVR) support, and knowledge of ASD. Results indicated that, at the time of the study, 56% of participants were not employed nor were they attending post-secondary schooling, 22% were unemployed and enrolled in college, and 22% were employed. This study revealed that there is a need to improve supports and services available both in high school and upon graduation in order to address as many barriers as possible. Areas to consider include the post-secondary transition plan (PTP), transition services in high school (i.e., interview skills), summary of performance document, increasing student independence while in high school, and improving DVR services.

ДОЦІЛЬНІСТЬ АДАПТАЦІЇ ДО ЄВРОПЕЙСЬКИХ СТАНДАРТІВ МЕДИЧНОЇ ТА ЮРИДИЧНОЇ ТЕРМІНОЛОГІЇ, ЩО СТОСУЄТЬСЯ НАРКОТИЧНОЇ ЗАЛЕЖНОСТІ

The article touches upon the need to move away from outdated terms such as “drug addiction” and “drug addict.” These terms carry a stigmatizing connotation and are linked to the criminalization of individuals struggling with substance use. It highlights the issue of drug addiction as a socio-legal phenomenon, especially in light of current trends and approaches to terminology in legal and medical literature. The article emphasizes the importance of eliminating the terms “drug addiction” and “drug addict,” advocating for their replacement with “substance use disorders” and “person with substance use disorders.” This shift is particularly relevant in the context of Ukraine’s integration into the European Union. In line with European standards that view drug addiction as a chronic disease, it is essential to adopt a comprehensive approach to treatment and to impose proportionate criminal penalties for offenses committed by individuals struggling with addiction. The author assesses contemporary legal and medical practices, which are crucial for reducing the stigma surrounding substance use disorders and upholding the rights of affected individuals, thereby aligning with European values and human rights principles. Given the significance of aligning Ukrainian legislation and social practices with European standards—especially the decriminalization of addiction—we emphasize the importance of treatment, rehabilitation, and social support for drug users. This article highlights the advantages and challenges of a compassionate approach towards drug users. While some may resist such initiatives due to concerns about the financial burdens of rehabilitation and social support programs, the long-term benefits are undeniable. Embracing a humane perspective can lead to decreased crime rates, the reintegration of recovering addicts as valuable community members, and an overall enhancement of legal culture and compassion within society. Ultimately, this approach supports the implementation of fair and proportionate criminal sanctions, fostering a more just and empathetic environment for all.Reducing stigma and discrimination against drug addicts is essential for improving their access to medical care and enabling their successful reintegration into society. It’s vital to examine the legal implications of addiction, as it profoundly impacts an individual’s capacity to make informed choices and control their behaviors – often leading to criminal activities. Keywords: drug addiction, drug addiction, background phenomenon for crime, substance use disorders, stigmatization, European standards, humanity, terminology, criminalization, social integration, legal awareness, legal culture, integration into the European Union, prevention.

Parental Support in Psychological Rehabilitation of Child Victims of Sexual Violence: A Qualitative Study

Background: Sexual violence was the most common, Data from the Regional Technical Services Unit for the Protection of Women and Children (UPTD PPA) of Jember Regency showed that there were 75 cases of sexual violence against children in 2022 and 73 cases of sexual violence against children in 2023. This research aimed to analyse aspects of parental social support in the psychological rehabilitation of child victims of sexual violence in the Jember Regency. Methods: This research was qualitative research with a case study approach. Data were collected through in-depth interviews with 3 main informants, which are parents of child victims of sexual violence with the age criteria of 7-18 years, 2 additional informants, which are family members or closest people from the victim's parents and 1 key informant, which the Regional Technical Services Unit for the Protection of Women and Children (UPTD PPA) of Jember Regency. Informants of this research are based on the willingness of informants to be interviewed in accordance with an ethical review of the confidentiality of informant information. Results: The results showed that parents had provided emotional support to child victims of sexual violence by reporting to the police; providing affection, instrumental support by fulfilling daily needs, informative support by giving advice to children, and providing appreciation support by accepting the child's condition, providing support to children to undergo rehabilitation so as not to experience prolonged trauma. Conclusion: Providing aspects of parental social support has been given to their children who are victims of sexual violence.

Errorless and errorful learning in people with aphasia across novel-object pairing and word retrieval tasks

ABSTRACT Background While linguistic deficits are key to diagnosing and treating aphasia, there is growing interest in the cognitive processes important for rehabilitation outcomes, particularly the role of learning. Of relevance to the current study, research has manipulated instructional methods (errorless vs. errorful) to assess their effects on outcomes. However, it is still unclear whether individualized profiles of errorless and errorful learning exist in aphasia and whether they might be meaningful for clinical practice. Aims The current study aimed to examine learning in people with aphasia, manipulating instruction method (errorless, errorful) and linguistic demands of learning. Methods & procedures Nine people with stroke-induced aphasia participated in this preliminary study. Participants engaged in errorless and errorful novel object pairing and word retrieval tasks. Learning outcomes were assessed on the same day, next day, and after one week. Participants also completed cognitive-linguistic assessments to investigate the contribution of memory, language, and executive functioning abilities on learning outcomes. Outcomes & results At the group level, participants performed significantly better following errorful training for novel object pairing (p = 0.001) relative to errorless training. An errorful advantage was observed at the individual level in 7 participants during same day testing, with the highest overall performers on the task showing the most persistent errorful learning benefits. In the word retrieval practice task, group and individual-level differences in scores following errorless and errorful practice were minimal. Scores in errorful novel object pair learning correlated with verbal short-term memory and nonverbal long-term memory assessments, while no other correlations were found between learning scores and cognitive-linguistic variables. Conclusions Findings are consistent with prior research that suggests that successful effortful retrieval may pose an advantage over errorless learning when acquiring novel information and the potential contributions of verbal short-term memory and nonverbal long term memory on learning. Results from the word retrieval practice task draw attention to differences between practicing lexical access and novel learning. The lack of an errorful advantage in word retrieval may alternatively be due to task design and merits further research. Results support the hypothesis that people with aphasia display variable learning profiles that may stem from differences in underlying cognitive-linguistic abilities. Continuing research is needed to characterize learning in aphasia to consider its potential influence on rehabilitation outcomes and support speech-language pathologists in considering and accounting for different learning and cognitive-linguistic abilities when individualizing treatment decisions.

A Network Analysis of Depression and Cognitive Impairments in Fibromyalgia: A Secondary Analysis Study.

Fibromyalgia is a chronic condition often accompanied by cognitive impairments, such as difficulties with sustained attention, and emotional disturbances, particularly depression and anxiety. Understanding how these emotional and cognitive factors interact is crucial to improving treatment for fibromyalgia patients. This study aimed to investigate the network structure of these interactions, focusing on the relationship between depression, anxiety, and cognitive performance. A total of one hundred ten participants diagnosed with fibromyalgia completed self-reported assessments of depression and anxiety, alongside cognitive performance tests. Key measures included Continuous Performance Tasks (CPT) for impulsivity and sustained attention, the Stroop Interference Index (StI), Stroop Color Naming (StC), and Stroop Word Reading (StW). Network analysis was conducted to estimate the relationships between emotional and cognitive variables and assess their centrality within the network. Errors in CPT emerged as the most significant indicators of the relationship between depression and cognitive performance, with high centrality values observed for the Stroop tasks (StI, StC, and StW). Additionally, Trait Anxiety (A_T) and Beck Depression Inventory (BDI) measures showed high centrality, underscoring the critical role of emotional states in the network of cognitive and emotional variables. The centrality values for cognitive flexibility, processing speed, and inhibitory control were found to be 0.85, 0.78, and 0.72, respectively. This study highlights the strong association between depression symptoms and deficits in cognitive domains, emphasizing the need for integrated care approaches that address both cognitive and emotional health. Multidisciplinary treatment programs, including cognitive rehabilitation and psychological support, could improve patient outcomes by targeting the most influential variables in the cognitive-emotional network.

Leaving the Norwegian opioid maintenance treatment program - patient experiences

BackgroundOpioid maintenance treatment (OMT) saves lives and makes it possible to start a process of health and social rehabilitation. Previous research shows that those who leave OMT after years of a drug free life and a reasonable level of health and social rehabilitation can have a good chance of living a stable drug free life after leaving the treatment. The aim of this study was to gain more knowledge about how patients who were in the process of leaving, or who had left OMT, experienced the leaving process.MethodsThe study was based on a thematic analysis of transcripts from individual in-depth interviews with 24 patients who had experience with leaving the Norwegian OMT program. Results: The participants in this study had a strong motivation to endure a demanding substitution medication tapering process and leave the OMT program. The tapering benefited strongly from adaptive routines based on ongoing dialog between patients and service providers throughout the process, based on individualized goals and patient experiences each step on the way. The participants had varied experiences regarding the quality and relevance of the support and meeting the need for further treatment and services.ConclusionsGiven a high level of rehabilitation and good support, this study shows that some OMT program patients are in a good position to successfully leave the OMT program or continue the substitution treatment on a low dosage in a less OMT program-dominated life.

"What should a rehabilitation hospital be like?" Priorities and expectations of people with spinal cord injury in Türkiye.

Survey study OBJECTIVES: To understand the priorities and expectations of individuals with disabilities caused by spinal cord injuries(SCI) who require long-term inpatient rehabilitation at a rehabilitation hospital. Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye METHODS: This cross-sectional clinical study included individuals over the age of 18 with SCI who had previously been hospitalized in a rehabilitation hospital. The 18-question survey, titled "What should a rehabilitation hospital be like according to persons with spinal cord injuries?" was administered to individuals hospitalized in the inpatient service of Çam Sakura City Hospital. It was also disseminated to people with SCI through social media. The participants' demographic data was recorded. The survey was completed by 120 participants, comprising 70 males and 50 females. The mean age was 37.47 ± 11.63 years. The time since the SCI was less than one year for 20 individuals and more than one year for 100 individuals. The results showed that robotic rehabilitation and psychological support were the most requested rehabilitation domains, while interest in sexual rehabilitation was less than that in other rehabilitation domains. Furthermore, in the correlation analysis, elderly participants indicated that there should be more specialized services and outpatient clinics exclusive to the SCI. The study revealed a striking trend - participants expressed a strong desire for SCI-specific rehabilitation units and robotic rehabilitation. Additionally, the significance and necessity of sexual rehabilitation should be conveyed to people with SCI.

Functions of a Complex Variable with a Large Parameter and Construction of Regions

In this article, the aim of the study is to assess the importance of psychological support in the early rehabilitation of patients after a stroke. The study involved 30 patients who had suffered an ischemic stroke. From the results, we see that a stroke dramatically changes a person's life and upon admission, 10% had a severe degree of depression, moderate depression was observed in 73%, and mild depression was in 17%. Daily work with a psychologist during the rehabilitation process significantly improved their psychoemotional state, reducing the level of depression. It also gave motivation for further rehabilitation. So, upon discharge, we observe that 67% of patients increased strength in the affected limbs to a mild degree, the Rivermead mobility index increased significantly and amounted to 12.83.36 points, out of a maximum of 15 points. This suggests that patients have become more mobile and independent. Effective rehabilitation after a stroke requires not only medical and physical therapy, but also the mandatory inclusion of psychological support as part of a comprehensive approach. This increases the chances of successful recovery and adaptation of the patient.

Design and development of a mobile health intervention for rehabilitation support after knee arthroplasty: TeleRehabilitation after knee ArThroplasty (TReAT) project

BackgroundThe steep increase in knee arthroplasties in lower- and middle-income countries has increased demand for personalised rehabilitation care. Technology-based rehabilitation programs offer potential to replace or augment conventional face-to-face rehabilitation for providing continuum of care. We aimed to systematically develop a theory, evidence-driven, contextualised, and user-centred mobile health platform for people undergoing knee arthroplasty to facilitate monitoring progress during rehabilitation.MethodsWe followed the UK Medical Research Council’s framework and adopted a behaviour design thinking approach, consisting of five steps; (1) conduct multiple literature reviews and cross-sectional surveys to determine the needs and problems experienced during the rehabilitation phase by healthcare professionals and individuals with replaced knees, (2) identify target behaviours along with barriers and facilitators, integrated within the Capability, Opportunity, Motivation-Behaviour (COM-B) framework, (3) identify intervention functions and components, behaviour change techniques, and features for the mobile application, selected after discussions with orthopaedic surgeons, physiotherapists and behavioural experts, (4) develop a prototype application for end-users, and a web-based platform for healthcare professionals, and (5) pilot test the intervention for end-users’ feedback on usability of the application and to identify possible strategies for implementing the intervention package.ResultsUsing the COM-B model, education, training, persuasion, enablement, and modelling were chosen as intervention functions for improving adherence to exercise protocol during early-phase of rehabilitation. The application featured five interlinked components; education, training, goal setting and self-management, communication, and a personalized therapy plan utilising 13 behaviour change techniques. An education booklet, exercise videos, text messaging, video consultation, and a digital tool for measuring range of motion were incorporated into the application. Feedback on the interactive prototype and education material was sought from ten patient volunteers and a physiotherapist. Pilot testing in a convenient sample with broad eligibility criteria (n = 30) indicated importance of digital literacy and dedicated time for remote consultation by healthcare provider within the existing clinical work. Overall, the intervention was well received and valued by the end users.ConclusionThis paper demonstrates the development of a contextualised digital behavioural intervention grounded in behavioural theory and evidence from literature to improve end-user’s engagement with rehabilitation protocols after knee arthroplasty in lower- and middle-income country context.Trial registrationStudy registered prospectively (on 16 February 2023) at Clinical Trials Registry of India (CTRI/2023/02/049792).

Interprofessional Team Staffing in U.S. Intensive Care Units.

There is a paucity of data, and no consensus, about the composition of interdisciplinary teams of healthcare worker (HCW) that provide care in intensive care units (ICU). Delineate the nature and variation of HCW staff composition in US adult ICUs before the COVID-19 pandemic. A national survey of 574 adult ICUs inquired about ICU staffing. Two sets of survey items asked about: (a) "availability to provide care" in ICU for 11 HCW types, collapsed into six groupings, and (b) presence in formal ICU clinical rounds of nine HCW types, collapsed into six groupings; bedside nurses were assumed to be involved in both categories. Analysis was descriptive, seeking to examine the predominant and full range of staffing patterns. Of surveyed ICUs: 94% were in metropolitan areas, 63% in teaching hospitals, 74% had >250 beds, 66% cared for mixed adult patient types (e.g. medical-surgical), median ICU bed count was 20 (interquartile range 12-25), 27% used some form of telemedicine. In addition to bedside nurses, the core staffing group comprised intensivists, respiratory therapists and pharmacists; in 88% of ICUs all were available to provide care. However, there were 28 different combinations of the six groupings (intensivists, respiratory therapists, pharmacists, attending physician support, advanced bedside nurse support, nurse aides), with the most common one, present in 38% of ICUs, including all six. 96% of ICUs had interprofessional rounds at least five days a week; 78% had them on weekends. Among the ICUs with rounds, 61% of weekday rounding teams included all of intensivists, respiratory therapists and pharmacists. Nutrition, rehabilitation and social support practitioners each participated in rounds in 35-80% of ICUs, and altogether in 28% of ICUs. Except for intensivists, all HCW types participated much less commonly in weekend than in weekday rounds. ICU care almost always included a core team of bedside nurses, intensivists, respiratory therapists, and pharmacists. Beyond that core, great variability was seen in the presence of many other HCW types. Almost all ICUs had interprofessional rounds, with three-quarters also having them on weekends.

Prehabilitative/rehabilitative exercise, nutrition, and psychological support for bladder cancer: A scoping review of randomized clinical trials.

The study of prehabilitation and rehabilitation ([p]rehabilitation) to alleviate the sequelae of bladder cancer and its treatment has generated numerous opportunities to improve the quality of life of bladder cancer survivors. The authors conducted a scoping review of randomized clinical trials (RCTs) to identify knowledge gaps in and research directions for (p)rehabilitative support for those affected by bladder cancer. The authors systematically searched six databases and synthesized key findings from RCTs conducted from January 1, 2004, through March 15, 2022, that enrolled participants with bladder cancer, survivors, or caregivers in outpatient (p)rehabilitative programs (e.g., exercise, nutrition, or psychological support). Outcomes were characterized according to eight prespecified, clinically relevant categories. The search retrieved 10,968 records, 27 of which met the inclusion criteria, and 24 described unique RCTs with 2471 enrolled participants. Of 24 interventions, 17 (71%) yielded statistically significant results for the outcome of interest. Only one RCT included a cost-effectiveness analysis, and only two characterized the efficacy of interventions for caregivers. Of 11 RCTs involving psychological support, eight yielded statistically significant results, as did nine of 11 RCTs with physical exercise interventions, three of four RCTs with educational interventions, three of four RCTs with nutritional support interventions, one of two RCTs with pharmacologic medications, and zero of one RCT with physical therapy. The most promising interventions for inclusion in multimodal, personalized (p)rehabilitation programs included exercise, stress management training, cognitive training, smoking and alcohol cessation counseling, immunonutrition, stoma education, and penile rehabilitation. Further studies of the cost effectiveness and efficacy for caregivers of such interventions are needed. PLAIN LANGUAGE SUMMARY: In a scoping review of all randomized clinical trials involving prehabilitative or rehabilitative diet, exercise, and psychological support interventions for patients with bladder cancer, survivors, and their caregivers, 17 of 24 (71%) interventions yielded statistically significant improvements in the outcome of interest. Clinicians should consider implementing such interventions for those affected by bladder cancer.

The burden of executive dysfunction after ischemic stroke (Bulgaria, 2019-2021)

Abstract Background Executive dysfunctions have great impact on behavior and quality of life in elderly. They also play important role for post-stroke functional outcome. The aim of our study was to examine the frequency, severity and types of executive dysfunctions at the third month after the ischemic stroke. Methods We examined 108 patients 3 months after ischemic stroke (66.67±9.03 years old, 66 males and 42 females) via 128-Wisconsin Card Sorting Test (WCST). WCST is a standardized instrument for detecting various executive dysfunctions. It is applicable for patients after stroke, because the test doesn’t require preserved arm motor functions. It measures global executive functioning (GEF), inhibitory control system (ICS), executive attention (EA), cognitive flexibility (CF) and working memory (WM). Our patients’ results were compared to the normal population test results. SPSS 24 was used for statistical analysis. Results Impaired GEF were found in 46% of our patients, most of them had mild or moderate impairment. One fourth of them showed impaired ICS, although the impairment in most of the cases was mild. EA deficits were found in 43% of our cases (17% had mild, 15% mild to moderate, 7% moderate and 4% severe impairment). WM dysfunction was found in 1/3 of them (the average result was about 27 percentiles; 29% had mild and 5% had mild to moderate deficits) and about ¼ of our patients had borderline results. CF was impaired in 68% of our patients (11% had mild, 28% mild to moderate, 16% moderate and 13% severe impairment). Conclusions GEF impairment is frequent after stroke. Patients had problems in ICS, EA, CF and WM. However, in most of the cases the dysfunction is mild or moderate and can be found only if it is actively searched and accessed. The most impaired functions were CF and EA. Patients with executive dysfunction require cognitive rehabilitation and specific social support. Key messages • Executive dysfunctions are frequent after ischemic stroke. The impairment is mild or moderate, but however it impacts the quality of life, behavior, prognosis and outcome of post-stroke survivors. • Patients with executive dysfunctions require specific cognitive rehabilitation and social support.

Socio-demographic portrait of the applicant and the main motives for choosing the "Therapy and rehabilitation" speciality

Rehabilitation and psychological support are becoming today's most urgent issues due to russian armed aggression. These needs will be long-lasting and increasingly significant. Since 2023, the Program of Medical Guarantees in Ukraine has been expanded regarding rehabilitation assistance. Additionally, volumes of the state-commissioned training of bachelors and masters in the speciality of "Therapy and rehabilitation" have been increased. It is well known that the quality of specialists trained by higher educational institutions largely depends on the motives behind the career choice. Knowledge about a student's socio-demographic status and his/her motivations to become a physical therapy and occupational therapy specialist can help understand future challenges and opportunities for the profession's development. This information can aid in elaborating strategies to promote the profession in the educational services market and to attract more applicants to choose the speciality 227 "Therapy and rehabilitation". The research aimed to compose the socio-demographic characteristics of the applicant for training in the speciality 227 "Therapy and rehabilitation", to investigate the motivational aspects of career choice and to establish the factors significant for motivation formation. To achieve this goal, a voluntary anonymous survey of 39 domestic applicants enrolled to complete the bachelor's degree program in speciality 227 "Therapy and rehabilitation" at Dnipro State Medical University was conducted. It was determined that the contingent of applicants is represented mainly by persons aged 16-18 (74%) with an active life position (90%). Additionally, most are familiar with the specifics of medical professions (62%) and have had previous personal or professional contact with physical therapy and occupational therapy (78%). The future career decision was mostly independent (84%), conscious, and influenced by the balance of internal and external motivational factors. It was typically made one to two years before taking degree course (72%). The primary motives for choosing the speciality 227 "Therapy and rehabilitation" while understanding its demand in today's conditions by applicants (82%) were "interest in medical science" (95%), "the desire to help others" (95%), "the opportunity to obtain a prestigious profession" (90%), "possibility of guaranteed employment" (90%) and "material interest/financial independence" (87%). Future specialists are aware of the importance of controlled acquisition of knowledge and skills (90%), the need for daily independent work (80%), and the significance of gaining practical experience during training (95%). They aim to achieve professionalism (59%), enhance communication skills (31%), build endurance (31%), and cultivate persistence (28%) and empathy (28%). Most applicants entering the speciality 227 "Therapy and rehabilitation" are goal-oriented, highly motivated, and prepared for rigorous study, which is the key to developing into competent and competitive specialists.

An integrated approach to the treatment of Rheumatic diseases: the role of psychological interventions.

Rheumatic diseases are chronic conditions that often result in significant physical and psychological challenges, reducing patients' quality of life and increasing the economic burden on healthcare systems. This study examines the vital role of psychological interventions in the comprehensive treatment of rheumatic diseases. The findings reveal a high prevalence of psycho-emotional disorders such as depression, anxiety, and stress among these patients, which can worsen disease progression and hinder treatment adherence. The review highlights the bidirectional relationship between the central nervous and immune systems, showing how psychological stress influences the pathophysiology of inflammatory diseases. Various psychological interventions are explored, including mind-body therapies, cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based practices such as meditation, yoga, and tai chi. These approaches improve emotional well-being, help reduce pain, and enhance overall quality of life. The article emphasizes a holistic treatment model incorporating pharmacological care, physical rehabilitation, and psychological support. This integrated approach fosters more effective management of rheumatic diseases by addressing their complex nature and promoting better functional outcomes. The study advocates for the seamless incorporation of psychological support into routine clinical practice tailored to the biopsychosocial profile of each patient. Future research should focus on identifying the most effective psychological interventions for different patient groups to enhance the quality of life for individuals with rheumatic diseases.

Regulatory and legal component of administrative regulation of probation

The article examines the normative-legal component of the administrative regulation of probation.Itwasdeterminedthattheadministrative and legal regulation of probation is a set of legal norms and mechanisms that determine the order of organization and implementation of probation measures in the state, the competence of state bodies, their duties and rights regarding control over the implementation of probation measures and interaction in this area with the courts , law enforcement agencies and social services. It is noted that probation is a system of supervision, control and social-educational measures applied by court decision to offenders instead of imprisonment or as a substitute for punishment, includes individual supervision, assistance in resocialization and measures aimed at preventing repeated crimes and ensuring safety society, while integrating the offender into social life without isolation. It is emphasized that the NPA system of administrative and legal regulation of probation includes international legal standards, national NPAs, including Acts of central executive bodies, local normative acts, agreements, methodological recommendations, etc., the norms of which are aimed at the development of alternative punishments, provision of rehabilitation and social support of offenders, regulation of the organization and implementation of probation in Ukraine, determine the legal basis for the activity of probation authorities, and also establish the procedure for providing probation services for persons who have committed a criminal offense. It was determined that the shortcomings of the administrative and legal regulation of probation are: the imperfection of the legislative framework, violation of the probation procedure, clear criteria for assessing the convicted person and the system for assessing the risks of recidivism, the mismatch of resources and the burden on the system, the low level of coordination between subjects of probation, the prevalence of ineffective methods of psychological works; society is not aware of the purpose and mechanism of probation, etc. It has been stated that the prospects for improving the normative-legal basis of the administrative-legal regulation of probation in Ukraine are: harmonization of legislation with international standards, institutional strengthening of the probation system, expansion of various approaches to probation, improvement of mechanisms for rehabilitation and support of offenders, involvement of public organizations, development of electronic monitoring systems , expanding educational programs for probation officers, increasing funding, research and analysis of probation effectiveness, etc.

Determinants of Low Coverage of the Free Surgical Care Programme for Trachomatous Trichiasis in Rural Guinea in 2022.

This study aimed to describe the experiences of healthcare personnel and patients in the organization of free surgical campaigns and care for trachomatous trichiasis in the health district of Siguiri in Guinea, including challenges experienced in providing surgical care. This was an explanatory qualitative study conducted in 2022 in the health district of Siguiri. A total of 20 participants were interviewed including patients (n = 7; 35%), community health workers (n = 4; 20%), health services managers, and healthcare providers (n = 8; 40%). Two main data collection technics were used: documentary review and in-depth individual interviews. All interviews were transcribed and manually coded using an Excel extraction spreadsheet. Data were analysed using inductive and deductive approaches. The results showed several organizational, structural, and community challenges that underlined the low surgical coverage of trachomatous trichiasis in the health district of Siguiri. Organizational challenges included the low involvement of local actors in planning activities, the limited timeframe of the campaigns, and the lack of logistics for activities supervision and patients' transportation to surgery sites. Structural challenges included the inadequacy of health centres to provide surgical services, poor health infrastructures, and sanitation conditions in some areas. Individual challenges included remoteness of surgical sites and costs associated with services provision including medicines. Community challenges included fear of surgery and the coincidence of the campaigns with agricultural and mining activities. The results of the study call on the national neglected tropical disease program and its partners to adopt and promote micro-planning of trachomatous trichiasis surgical activities, with the effective participation of local stakeholders in endemic health districts. They should also envision integrating the management of surgical treatment including costs associated with care (transportation, food, rehabilitation support for patients who have undergone surgery) and complications of surgical procedures for an expansion of the trachomatous trichiasis free surgical care coverage in endemic health districts in Guinea.

Implementing and Evaluating a Mobile Phone-Supported and Family-Centered Rehabilitation Program for People With Stroke in Uganda (F@ce 2.0): Protocol for a Randomized Controlled Trial.

Stroke is a global societal challenge. Annually, 13 million people experience stroke, and the prevalence of stroke is increasing in low-income countries; hence, accessible rehabilitation needs to be developed. Information and communication technology can help by providing access to rehabilitation support through information, self-evaluation, and self-management of rehabilitation. The F@ce 2.0 rehabilitation program provides support in goal-setting and problem-solving strategies through phone calls from the interventionist twice a week and daily SMS text message reminders over 8 weeks to improve performance in valued activities in everyday life. Our hypothesis is that F@ce 2.0 will increase functioning in daily activities and participation in everyday life as well as improve performance and satisfaction in valued daily activities and self-efficacy (ie, confidence in own ability to perform activities) among people living with the consequences of stroke. This study aims to implement F@ce 2.0, a mobile phone-supported and family-centered rehabilitation program, and evaluate its effects on performance in daily activities and participation in everyday life in comparison to ordinary rehabilitation among persons with stroke and their family members in Uganda. An additional aim is to explore experiences of participating in F@ce 2.0 and plausible mechanisms of impact that might explain the potential effects of F@ce 2.0. A randomized controlled trial will be conducted to compare the outcomes of the F@ce 2.0 group and a control group receiving ordinary rehabilitation. Health care professionals will recruit 90 clients from both urban and rural areas. The primary outcomes for persons with stroke are perceived performance in daily activities assessed using the Canadian Occupational Performance Measure and self-efficacy assessed using the Self-Efficacy Scale; for family members, the primary outcome is caregiver burden evaluated using the Caregiver Burden Scale. Descriptive statistics will be used to present characteristics and outcomes at 3 and 6 months. All statistical analyses comparing the outcomes at the different time points between the F@ce 2.0 and control groups will be performed using intention-to-treat analysis. Qualitative interviews will be used to explore the experiences of persons with stroke and their family members participating in F@ce 2.0, using a grounded theory approach to data collection and analysis. A process evaluation will be conducted using a single-case study design with mixed methods to explore the implementation process. Recruitment and data collection in the randomized controlled trial were initiated in January 2022 and have been completed. The intervention has been provided to 51 participants in the intervention group. Interviews of persons with stroke, family members, and health care professionals have been conducted. Data analysis will be performed during autumn 2024 and spring 2025. This study will provide evidence of the plausible effects of F@ce 2.0 and the process of implementing the program in low-income countries. DERR1-10.2196/60955.

The program of comprehensive personalized rehabilitation after surgical treatment for endometrial cancer: the results of a prospective randomized comparative study

Background. The problems of diagnosis, treatment and rehabilitation of patients with endometrial cancer (EC) remain relevant for the entire medical community. Radical surgical intervention shows high efficiency among the existing methods of EC treatment. However, it causes many complications that require rehabilitation support for patients. The development of new instruments and protocols for rehabilitation of EC patients is necessary.Objective: to evaluate the effectiveness of comprehensive personalized rehabilitation program in patients after radical surgical EC treatment.Material and methods. A prospective randomized comparative study included 61 patients with histologically verified stage IA endometrioid adenocarcinoma of high or moderate differentiation degree. The patients were divided into two groups: the group of “active” rehabilitation (n=29), and the group of “passive” rehabilitation (n=32). During 1 year, their physical, mental health and social engagement were assessed using questionnaires.Results. The survey showed a low level of physical, functional, emotional and social well-being of EC patients at the first 3–7 days after surgery. After 12 months, a recovery in the quality of life of all participants was observed. However, patients undergoing “active” rehabilitation recovered significantly faster, and their quality of life was significantly higher compared to patients undergoing “passive” rehabilitation.Conclusion. The obtained results indicate the effectiveness of a personalized approach in rehabilitation of EC patients. It is expected that its implementation will considerably reduce the incidence of complications and the burden on the healthcare system.

Examining Perceptions and Attitudes of Prison Visitation on Behavior Change and Recidivism in Nairobi County, Kenya

This study investigates the impact of prison visitation on perceptions, attitudes, behavior change, and recidivism rates among incarcerated individuals. Utilizing a mixed-methods approach, data was gathered through surveys, interviews, and official records from a sample of incarcerated individuals and their visitors. The analysis focused on understanding the role of visitation in shaping attitudes towards rehabilitation and family support and its influence on post-release behavior. Findings reveal a significant correlation between the frequency and quality of visitation and positive behavioral changes among inmates. Inmates who received regular visits reported higher levels of motivation for rehabilitation, improved mental health, and increased feelings of connection with their families and communities. Moreover, visitation played a pivotal role in strengthening family bonds and social support networks, which are crucial factors in successful reintegration post-release. Furthermore, the study explored the perceptions and experiences of both inmates and visitors regarding the visitation process, including logistical challenges, emotional dynamics, and barriers to maintaining contact. Understanding these perspectives is essential for enhancing visitation programs and addressing systemic issues that hinder family engagement in the correctional system. The study also examined recidivism rates among participants and found a notable decrease among those who received frequent and meaningful visitation compared to those who did not. These findings underscore the significance of visitation programs in reducing recidivism and promoting successful reentry into society. In conclusion, this research highlights the importance of fostering supportive relationships through visitation programs to facilitate positive behavior change and reduce recidivism rates among incarcerated individuals. Implementing policies that prioritize and improve access to visitation can contribute to more effective rehabilitation efforts and ultimately lead to safer communities.

Prevalence of post-intensive care syndrome: Observations from a tertiary care hospital in Eastern India

ABSTRACT Background: Post-intensive care syndrome (PICS) refers to physical, cognitive and psychological symptoms that occur after a patient is discharged from the intensive care unit (ICU). Aims: The present study aimed to explore the prevalence of PICS among ICU survivors of a tertiary care setup in Eastern India. Methods: A single-centre prospective cohort study was conducted amongst patients admitted to the ICU. A predefined, structured interview in 1st month, 3rd month, 6th month after ICU admission was done. Baseline characteristics were noted. Physical and cognitive impairment, psychological distress and general health were assessed using the Barthel Index (BI), mini-mental state examination (MMSE) tool, Hospital Anxiety and Depression Scale (HADS) and EuroQoL Visual Analogue Scale. Results: Of the 150 patients included in the study, the mean Acute Physiology and Chronic Health Evaluation II score was 20.87. The leading cause of ICU admission was sepsis (40.7%), followed by acute exacerbation of chronic obstructive pulmonary disease and pneumonia (14%). The median stay in the ICU was 8 days. Mean BI significantly decreased from 79.20 at baseline to 60.17 and 64.33 in the 3rd and 6th months, respectively. The mean HADS-Depression score increased from 3.79 at baseline to 7.08 at 3rd and 5.92 at 6th month. Similarly, the mean HADS-Anxiety score increased from 4.37 at baseline to 7.44 at 3rd and 6.31 at 6th month. The mean MMSE score decreased from 24.61 at baseline to 22.26 at the 3rd and 6th months, respectively. Thus, PICS was recorded in 90% of cases in the 3rd month and 89.3% in the 6th month. Conclusion: The management of PICS involves a multidisciplinary approach, including physical rehabilitation, cognitive rehabilitation and psychological support.