Socio-economic Rehabilitation Research Articles

The impact of the strategy of socio-economic recovery of rural areas on the management of agricultural enterprises

This study was aimed at analysing the effectiveness of comprehensive recovery strategies in rural areas and their impact on management practices in the agricultural sector. The article considered the socio-economic recovery of rural areas as an important and multifaceted task that is becoming increasingly relevant in the world. The process of recovery includes a set of measures aimed at improving the economic, social and environmental conditions of rural regions. The introduction of modern technologies into production processes increases the productivity and competitiveness of the local economy. The article considered the role of different approaches to recovery, including multi-sectoral, resource-based, innovative, inclusive, ecosystem, political and administrative, and sustainable development approaches. Each of them can be adapted to the specific conditions and needs of rural regions, creating a basis for comprehensive and sustainable recovery. The article analysed the impact of the war in Ukraine on the agricultural sector, which is one of the key components of rural development. As a result, the need for further support and investment in the agricultural sector for its recovery and sustainable development was highlighted. Successful socio-economic rehabilitation of rural areas depends on coordinated actions of various stakeholders, including the state, local authorities, business and civil society. An important component is the development and implementation of strategies that take into account local characteristics and needs, ensuring sustainable development and improving the quality of life in rural areas. Only a comprehensive approach to recovery can ensure long-term and sustainable development that will become the basis for future prosperity in rural areas

Interventions to reduce leprosy related stigma: A systematic review.

Stigmatisation is a major issue faced by those affected by leprosy globally. Reducing stigmatisation encourages care seeking behaviour to occur earlier and can help reduce harm and spread of leprosy. This systematic literature review aimed to summarise what effective stigma reducing interventions exist for leprosy, and as a secondary question explore what evidence exists regarding their cost. A systematic literature review was conducted. Three databases-PubMed, Embase and Web of science-were searched using the search terms "leprosy", "interven*", "reduc*", and "stigma*".Seventeen publications were eligible for inclusion in the review. The current manuscript identified interventions under 6 main categories (i) Information, education, and communication (IEC) (ii) community led projects, (iii) Socioeconomic rehabilitation, (iv) mixed interventions, (v) integration of leprosy within the health system and (vi) Cosmetic or surgical care. Specific evidence regarding cost was only provided by one out of the seventeen papers. Multiple interventions were shown to successfully reduce leprosy related stigma, however, information on their cost is not readily available. The evidence uncovered by this review is restricted to three Asian countries; Nepal, India and Indonesia. To ensure the success of stigma reduction in leprosy interventions worldwide these interventions need to be tried in other leprosy endemic areas to test their effectiveness across contextual and cultural scenarios.

Mental wellbeing among people affected by leprosy in the Terai region, Nepal

Objectives: The relationship between leprosy, stigma and poor mental health is well recognized. The overall objective of this study was to help improve mental wellbeing in people affected by leprosy by gaining more insight into what factors related to cultural, social and personal life influence mental wellbeing amongst people affected by leprosy in the Terai region, Nepal. Methods: We adopted a qualitative approach with purposive sampling to include people affected by leprosy in the Terai region of Nepal. Fourteen people with various leprosy disability grades and two healthcare workers were recruited for in-depth interviews. We used a framework analysis method with characteristics of the Grounded Theory Approach. Predetermined themes were explored, and new themes brought up during the interviews were also analysed. Results: Leprosy-related stigma still persists in the Terai region, negatively influencing mental wellbeing. A higher disability grade can result in a poorer mental wellbeing. Additional key factors influencing mental wellbeing include: people’s feelings and experiences regarding leprosy, family and community, work and culture. Conclusions: The mental wellbeing of the respondents was negatively influenced by direct and indirect consequences of being affected by leprosy. Stigma, disability grade, family, community, work and culture are very important factors that influence mental wellbeing in the Terai region, Nepal. We recommend that interventions should include a combination of strategies, including lay and peer counselling, socio-economic rehabilitation and involvement of community and family to improve the mental wellbeing of those affected. We also recommend using a holistic and gender-specific approach when developing these interventions.

Current problems of protecting the rights and freedoms of socially unprotected citizens in the new economic realities

in the article, the authors consider the main directions of economic and social protection of persons with disabilities (disabled people, children), analyze the problems of socio-economic rehabilitation of low-mobility groups of the population, children, and suggest the main directions for optimizing economic policy in the field of support for particularly vulnerable citizens in difficult economic realities. Based on General theoretical methods of analysis and synthesis, generalization, citation, and axiomatic method, the authors conclude that if until now law enforcement practice has focused only on the principle of the best interests of the child, then in the new economic realities, the principle and the right of children to participate in decision-making on all issues that affect them should be of crucial importance. In this regard, the authors believe that in the sphere of social and economic protection of the rights of socially vulnerable citizens at the present stage, it is necessary to increase the effectiveness of law enforcement agencies in the field of prevention and suppression of violations of economic and social rights of the studied category of citizens, including the right to education, rehabilitation, economic support, which requires improvement of legal mechanisms that provide for a system of measures for the implementation of medical, vocational rehabilitation, secondary and higher professional education.

Strategi Mengurangi Stigma Penyakit Kusta di Komunitas

Background: The impact of the stigma caused people with leprosy not only suffer physically but also psychologically because they were isolated and ignored by family members and the surrounding community. Aims this study is to describe strategy to decrease stigma for leprae patient. Methods: The type of research design included in the literature review. The studies will be reviewed in English using qualitative, quantitative, and mixed methods. Searches were carried out using Science direct, PubMed (Medline), Google Search and Proquest with keywords for each variable. Keywords in leprosy search, AND (Stigma or discrimination) AND (Intervention or IEC or counseling). Results: The stigma is explained in five categories, namely the integration of leprosy services into health care, communication, information and education programs, socio-economic rehabilitation, change in name of leprosy, and counseling. Conclusion: The interventions carried out provide at least evidence of success in efforts to deal with stigma with various strategies, namely the integration of leprosy programs into health care, IEC and SER interventions.

REHABILITASI SOSIAL EKONOMI BERBASIS SYARIAH BAGI KORBAN NAPZA DI YAYASAN GRAPIKS KABUPATEN BANDUNG

The purpose of the implementation of sharia-based social economic rehabilitation PKM activities for drug victims in the Grapiks foundation in the village of Cimekar, Cileunyi, Bandung, Bandung, is to provide solutions to the problems that have been faced, namely the tendency of former drug users to re-use very large. Rejection from families and the environment against drug victims, this rejection is related to their survival in economic terms, so they need skills development and how to socialize again with the surrounding community. Therefore the application of the sharia system in socio-economic rehabilitation is very important for drug victims who have an impact on the level of the economy and the welfare of former drug victims. It is clear that the psychic and economic condition of the former victim of this drug needs to be developed with sharia-based social economic rehabilitation. The specific target to be achieved is the change in behavior of former victims of drugs. Increasing the quality of SDI victims of drugs. The method used is the first approach to assisting behavioral change carried out continuously by involving family or spouse. Second, business / skill assistance is by exploring the potential of a former drug victim. The activities carried out are assisting with behavioral change by instilling Islamic principles so that they can go back to the community, explore the potential of drug victims by providing entrepreneurial training in accordance with Islamic law. Assistance is carried out until the end of the PKM program and after the PKM program ends. As a result of the PKM there was an increase in understanding of diversity regarding drugs and increasing the skills of drug victims.

Brain-Immune Interactions and Neuroinflammation After Traumatic Brain Injury.

Traumatic brain injury (TBI) is the principal cause of death and disability in children and young adults. Clinical and preclinical research efforts have been carried out to understand the acute, life-threatening pathophysiological events happening after TBI. In the past few years, however, it was recognized that TBI causes significant morbidity weeks, months, or years after the initial injury, thereby contributing substantially to the overall burden of TBI and the decrease of life expectancy in these patients. Long-lasting sequels of TBI include cognitive decline/dementia, sensory-motor dysfunction, and psychiatric disorders, and most important for patients is the need for socio-economic rehabilitation affecting their quality of life. Cerebrovascular alterations have been described during the first week after TBI for direct consequence development of neuroinflammatory process in relation to brain edema. Within the brain–immune interactions, the complement system, which is a family of blood and cell surface proteins, participates in the pathophysiology process. In fact, the complement system is part of the primary defense and clearance component of innate and adaptive immune response. In this review, the complement activation after TBI will be described in relation to the activation of the microglia and astrocytes as well as the blood–brain barrier dysfunction during the first week after the injury. Considering the neuroinflammatory activity as a causal element of neurological handicaps, some major parallel lines of complement activity in multiple sclerosis and Alzheimer pathologies with regard to cognitive impairment will be discussed for chronic TBI. A better understanding of the role of complement activation could facilitate the development of new therapeutic approaches for TBI.

Social participation of persons affected by leprosy in an endemic district, West Bengal, India

Objective: The aim of the study was to assess the level of social participation and the factors associated with it, among persons affected by leprosy reporting at the leprosy referral centre in Purulia, West Bengal, India. Methods: A cross sectional study was conducted among persons affected by leprosy who were reporting at Purulia Leprosy Mission Hospital, West Bengal. A semistructured questionnaire was used to interview the participants concerning their socio-economic and disease status. The Participation Scale was used to measure participation restriction. Results: Of the 358 respondents, 41% were female, 60% were aged between 18 to 45 years and 58% were literate. Half the participants (55%) had an occupation as farmer or labourer, 75% of the participants’ family income was below 5000 rupees per month. 144 (40%) participants had a physical disability. 88 (25%) had restrictions in social participation, and of these 35 had severe or extreme restriction. There is a significant association between the presence of physical disability and participation restriction (p < 0.01). Conclusion: The study found that physical disability was associated with restriction in social participation. In addition, the disease duration and economical status was associated with restriction in social participation. Early detection and management would reduce the risk of participation restriction. Socioeconomic rehabilitation is needed, particularly for physically disabled persons, to improve their social participation and their quality of life.

The relationship between labor pain management, cortisol level and risk of postpartum depression development: a prospective nonrandomized observational monocentric trial

210 women were investigated and divided into two groups. In the first group for labor pain management in natural delivery, patient-controlled epidural analgesia was used (bolus - 10.0 - 0.08% ropivacaine hydrochloride, lockout - 30 min, limit - 120 ml/6 h) with a background of continuous-flow infusion of local anesthetic 0.08% ropivacaine hydrocluoride solution. Patients in the second group had no pain relief in delivery. The stress level was evaluated using blood plasma cortisol level in the early stages of labor, 6 hours and 3 days after delivery. The assessment of depression development was carried out step-by-step: Before the delivery, 6 hours after, 3 days and 6 weeks after the delivery. The baby blues frequency 6 hours after the delivery in the group where the pain relief was conducted was 29.91%, with cortisol level below and equal to 2310.91 nmol/l. In the group with no pain relief 6 hours after delivery, baby blues was found in 15.53% of puerperas (p < 0.05) and the cortisol level was 2673.82 nmol/l (p < 0.05). Six weeks after the birth, postpartum depression was diagnosed in 4.67% of women who received epidural analgesia during delivery, in comparison to 6.79% with no pain relief during delivery. However, the difference was not statistically significant (p < 0.05). The use of epidural analgesia leads to a significant reduction of pain syndrome and stress response during natural delivery, increases the risk of baby blues in the early postnatal period, but slightly influences the frequency of postpartum depression.

Community Involvement in the Care of Persons Affected by Podoconiosis-A Lesson for Other Skin NTDs.

Podoconiosis is a neglected tropical disease (NTD) characterized by lower-leg swelling (lymphedema), which is caused by long-term exposure to irritant red-clay soils found within tropical volcanic high-altitude environments with heavy rainfall. The condition places a substantial burden on affected people, their families and communities, including disability, economic consequences, social exclusion, and stigma; mental disorders and distress are also common. This paper focuses on community-based care of podoconiosis, and, in particular, the role that community involvement can have in the reduction of stigma against people affected by podoconiosis. We first draw on research conducted in Ethiopia for this, which has included community-based provision of care and treatment, education, and awareness-raising, and socioeconomic rehabilitation to reduce stigma. Since people affected by podoconiosis and other skin NTDs often suffer the double burden of mental-health illness, which is similarly stigmatized, we then point to examples from the mental-health field in low-resource community settings to suggest avenues for stigma reduction and increased patient engagement that may be relevant across a range of skin NTDs, though further research is needed on this.

THE AKKI CHECHENS: HISTORICAL INFORMATION

The problem of rehabilitation of repressed peoples became topical in the post-Soviet period on the back of cardinal social, economic and political transformations of the Russian society. In the post-Soviet Dagestan, the proclamation of the principles of openness, democracy and perestroika in the 1990s sharply revealed interethnic problems. The Law “On Rehabilitation of Repressed Peoples” (1991) was aimed at solving the most difficult problem in the national policy of the Soviet state, when people were repressed on the basis of evidence-free accusations. Among them there were the Akki Chechens, who lived in Dagestan and along with the entire population of the Chechen-Ingush ASSR were forcibly evicted from their historical places of residence to the republics of Central Asia. Despite the fact that in 1957 the Akki Chechens were rehabilitated, the issues of their socio-economic and territorial rehabilitation remained unsolved, and this fact worsened the interethnic climate in the republic. It should be noted that the adoption of the above-mentioned act of law also contributed to the deterioration of the nature of interethnic interaction in places of residence of the repressed Akki Chechens and the Avars and Laks who were forcibly resettled to this territory in 1944. Consequently, it is important to study the historical aspect of this issue, therefore, in the framework of this article, basing on archival materials, the authors analyze resettlement, number and role of the Akki Chechens in the political, administrative and territorial structure of the republic, as well as the formation of the Aukhovsky District on the eve of their repression.

Multi-stakeholder collaboration in community post-disaster reconstruction: case study from the Longmen Shan Fault area in China

ABSTRACTWhile multi-stakeholder collaboration is critical for effective community post-disaster reconstruction (CPDR), it is often very difficult in practice. The Longmen Shan Fault active seismic zone in China has experienced several recent earthquakes with the 2008 Wenchuan earthquake and 2013 Lushan earthquake, both of which caused extensive and widespread damage to many communities, presenting unprecedented challenges for post-disaster reconstruction. This paper develops a multi-cycle field research method that involves three interconnected cycles: internet research, field visits, and extensive surveys: to examine multi-stakeholder collaboration for the CPDR following the Wenchuan earthquake. It was found that there were 12 types of active stakeholders engaged across four main areas: infrastructure rebuilding, psychological recovery, socio-economic rehabilitation, and ecological restoration. Specifically, local community participation and effective collaboration between the community and the external stakeholders were found to be the most crucial elements for successful reconstruction. Multi-stage field research after the Lushan earthquake verified that CPDR was effective and that multi-stakeholder collaboration had improved from the lessons learnt from the Wenchuan earthquake reconstruction experience. Some advantages and limitations of this research are also given.

ベトナムにおけるハンセン病元患者自立支援プログラムの事例とハンセン病元患者によるプログラムへの評価

One of the leprosy treatment centers (hospital X) in Vietnam offers loan programs to start work as part of the socio-economic rehabilitation program for ex-leprosy patients. The aim of this study is to examine and evaluate the contents of the program from the ex-leprosy patients’ perspective. The interview group was sub-divided into three groups: male/female and the younger group. A focus group interview method was used to collect qualitative data. The participant program group revealed that their income increased and their health condition improved; moreover, they evaluated the program highly as they can borrow business loan at no interest. Meanwhile, the participants were challenged with a few problems: the frequency in the illness of the livestock and the forcible discounting in the livestock’s price by the customers who use the excuse that the livestock has been raised by ex-leprosy patients. The younger group had concerns regarding the program; they were worried about the repayment of the business loan. Both groups noted points to improve the current program especially in terms of changing the loan repayment schedule and loan volume. Therefore, the program has to be adapted to the needs of ex-leprosy patients.

Socioeconomic rehabilitation of successful renal transplant patients and impact of funding source: Indian scenario.

Introduction:Socio-economic rehabilitation is an important outcome parameter in successful renal transplant recipients, particularly in developing countries with low income patients who often depend on extraneous sources to fund their surgery costs. We studied the socioeconomic rehabilitation and changes in socioeconomic status (SES) of successful renal allograft recipients among Indian patients and its correlation with their source of funding for the surgery.Materials and Method:A cross-sectional, questionnaire-based study was conducted on 183 patients between January 2010 to January 2013. Patients with follow up of at least 1 year after successful renal transplant were included. During interview, two questionnaires were administered, one related to the SES including source of funding before transplantation and another one relating to the same at time of interview. Changes in SES were categorized as improvement, stable and deterioration if post-transplant SES score increased >5%, increased or decreased by <5% and decreased >5% of pre-transplant value, respectively.Results:In this cohort, 97 (52.7%), 67 (36.4%) and 19 (10.3%) patients were non-funded (self-funded), one-time funded and continuous funded, respectively. Fifty-six (30.4%) recipients had improvement in SES, whereas 89 (48.4%) and 38 (20.7%) recipients had deterioration and stable SES. Improvement in SES was seen in 68% patients with continuous funding support whereas, in only 36% and 12% patients with non-funded and onetime funding support (P = 0.001) respectively. Significant correlation was found (R = 0.715) between baseline socioeconomic strata and changes in SES after transplant. 70% of the patients with upper and upper middle class status had improving SES. Patients with middle class, lower middle and lower class had deterioration of SES after transplant in 47.4%, 79.6% and 66.7% patients, respectively.Conclusions:Most of the recipients from middle and lower social strata, which included more than 65% of our patient's population, had deteriorating SES even after a successful transplant. One-time funding source for transplant had significant negative impact on SES and rehabilitation.

How to reduce stigma in leprosy – a systematic literature review

Interventions to reduce leprosy-related stigma reduce the manifestations of stigma that cause so much suffering to individuals and their families. This systematic review aims to identify interventions that have been used to reduce such stigma and to summarise what is known about their efficacy. Electronic searches were undertaken using PubMed (Medline), CINAHL and PsycInfo databases. The internet was searched using Google Scholar for papers not published in these databases. All relevant papers written in Thai or English were included. After reading 55 papers, three duplications and parallel literatures were removed, 18 were removed on abstract screening and nine after reading the full papers; eventually, 25 were included in this review. Interventions with some evidence of effectiveness in terms of stigma reduction comprise the integration of leprosy programmes into general health care; Information Education and Communication (IEC) programmes; and socio-economic rehabilitation. More evaluations are needed of the effect of the integration of leprosy programmes into general health services. The design and implementation of IEC interventions need to be preceded by careful study of the target area and population and should be undertaken in combination with other activities.

Health related quality of life amongst people affected by leprosy in South Ghana: A needs assessment

This study examined Health Related Quality of Life (HRQOL) among leprosy-affected elderly people at three leprosoria located in South Ghana. Seventy elderly people who have been cured of leprosy but were undergoing socio-economic rehabilitation at three selected Leprosaria in the southern part of Ghana, were involved in this study. They comprised 31 female and 39 male adults with leprosy-related residual impairment and disability. The main outcome measure was a standardised HRQOL questionaire which comprised physical functioning, role functioning, social functioning, cognitive functioning, health perception and pain. Descriptive statistics of mean and standard deviation were used to summarize the data whilst relationships and comparisons among and between the variables were evaluated using linear regression analysis and independent t-test respectively. Alpha level was set at P < 0.05. The mean age of the participants was 59.7 +/- 13-5 years. The overall mean score of the subjects (40.9 +/- 7.6) on the six domains of the questionnaire was below average. The highest and lowest mean scores were obtained in social functioning (56.9 +/- 20.1) and physical functioning (15.0 +/- 25.1) domains respectively. All the domains were significantly and positively correlated (P < 0.05) with the overall HRQOL scores. Age had no significant relationship (P > 0.05) on any of the domains and the overall HRQOL scores. Male participants scored signicantly higher (P < 0.05) than their female peer on cognitive functioning and HRQOL. This study demonstrated low QOL among the sampled elderly people affected by leprosy at the selected leprosoria, thus stressing the need for measures that could improve their health and socio-economic status within the settlements.

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

Background: Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment.Methods: We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation.Results: Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts.Discussion: The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment.

Breaking up and Going Home? Contesting Two Assumptions in the Demobilization and Reintegration of Former Combatants

This article argues that the common assumptions that lie behind efforts to break the command and control structures of armed groups, and working on ‘community reintegration’, are not necessary prerequisites for a successful disarmament, demobilization and reintegration (DDR) process. Former fighters may encounter troubles going home, as their communities of origin may not be as open to them as is often assumed. They may also have no other choice than to keep their military structures intact. However, this may not necessarily impede their social integration. In fact, the structures emerging from war may be relatively constructive for the socio-economic rehabilitation of former fighters.

‘Money is the vehicle of interaction’: Insight into social integration of people affected by leprosy in Northern Nigeria

This paper proposes a mechanism by which socio-economic rehabilitation (SER) reduces stigma in northern Nigeria following are-analysis of the transcripts of interviews conducted to evaluate the impact of SER on leprosy-related stigma. The evaluation combined quantitative questionnaire (P-scale) with qualitative interviews of 20 individuals affected by leprosy, five focus group discussions and 10 key informant interviews. From our data, we developed a leprosy-related stigma framework by integrating emerging themes with the construct of threat to group functioning to describe stigma processes experienced by people affected by leprosy in northern Nigeria. Findings revealed people affected by leprosy are less likely to be stigmatised because of leprosy impairments than for their incapacity to contribute to family/community finances. We also identified micro-credit loans and vocational training as elements of SER for reducing stigma through the mechanism of protecting individuals against the loss of social value, and by facilitating their continued engagement in daily social roles in the family/community. We propose that SER stimulates attitudinal change towards, and inclusion of people affected by leprosy by protecting individuals against the loss of social value and increasing their contributive capacity. We recommend further empirical testing of the proposed framework to ascertain its utility in other cultures.

Assistive devices for people affected by leprosy: Underutilised facilitators of functioning?

People affected by leprosy and their families face social and economic problems. The focus of interventions is often on prevention of disabilities and socioeconomic rehabilitation. The objective of this study was to explore to what extent the potential of assistive devices to facilitate activities and participation of people affected by leprosy has been utilised. Published literature was reviewed and the findings analysed. Considerable attention has been given to the protecting role of assistive devices. The focus of assistive devices facilitating functioning has been on mobility aspects of self-care and domestic life. The findings indicate that the potential of assistive devices to facilitate activities and participation in life areas such as work and employment is still waiting to be utilised on a broad scale.