Search Results (80)

This paper addresses education in adult prisons for learners age 18 and over. Global concerns exist about the quality of education in prisons. Studies highlight a range of issues including weak curricula, lack of access to technology-enabled learning, lack of learner engagement and an over-emphasis on the role of education in serving employment-related goals. The result of this across a range of jurisdictions is a curriculum that is dominated by English and mathematics and a lack of focus on vocational skills and training. Although the issues associated with education in prisons are well-documented, there is a significant research gap in relation to the effective delivery of functional literacy and numeracy skills. To address this research gap, this paper outlines the Global Integrated Learning and Engagement (GILE) Framework which has been developed from synthesizing the principles of social learning theory, rehabilitation theory and adult learning theory. The GILE framework extends the existing literature on education in prisons by presenting a coherent model which is underpinned by five over-arching principles; embedded skills development, contextual learning, empowered agency, growth identity and interactive social learning. These principles are subsequently synthesised to produce a potential pathway to reduce reoffending. Full article

Background: The purpose of this paper is to describe lessons learned from a clinical program that was developed to serve adolescents who experienced ABI in childhood during their transition to adulthood by providing insights to achieve good health and assessment of needs in both healthcare and educational/career areas. Methods: Participatory Action Research methods were utilized for program development by collaborating with focus groups of teen participants and stakeholders following each year. Activities were devised based on best practices for cognitive rehabilitation, direct instruction, and practice of cognitive and metacognitive strategies, technology use, peer coaches and incorporation of multiple stakeholders, including family members. Results: We learned the importance of technology utilization, completing surveys of vocational interests, peer coaches, and post program follow-up to better understand both healthcare and career needs of adolescents who experienced TBI and are transitioning to adulthood. Conclusions: Adolescents who experience a childhood ABI benefit from education about the injury effects, technology use for self-management, peer coaches and connection to both healthcare and career opportunities following high school graduation. Full article

Youth drug abuse is a persistent public health concern in China. Community-based drug rehabilitation (CBDR), the final three-year stage of China’s official rehabilitation system, aims to help people who use drugs (PWUD) reintegrate into society, but reintegration remains limited, particularly among young PWUD. This study explores the social reintegration challenges faced by young PWUD aged 18 to 35 during the CBDR stage in Guangzhou, China. Semi-structured interviews were conducted with 16 participants and analyzed using reflexive thematic analysis (RTA). Three themes were identified: stigma and relational struggles, socioeconomic marginalization and daily life disruption, and limitations of the CBDR service model. These challenges were not separate but reinforced one another, with difficulties in one domain spilling into others and narrowing the space in which reintegration could occur. These findings suggest that addressing the reinforcing linkages between stigma, economic hardship, and service limitations requires a more coordinated approach to CBDR service provision, one that integrates vocational support into relapse prevention, builds flexibility into surveillance procedures, and provides participants and their families with realistic, evidence-based information about the prospects of recovery. Full article

Vocational integration (VI) services aim to support sustainable employment for persons with disabilities. However, in individuals with spinal cord injury, evidence on effective intervention targets and the evaluation of sustainable integration remains limited. The Work–Life Study aims to build an evidence base for supporting sustainable employment in Switzerland by (1) identifying typical work–life trajectories; (2) examining key work–life transitions and their predictors; (3) establishing a multi-state model for intervention targets; (4) exploring individual work–life narratives; and (5) developing guidelines for personalized VI practice. The study combines a mixed methods design with a collaborative Integrated Knowledge Translation approach, actively involving VI professionals and individuals with spinal cord injury. Participants are recruited from the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Work–life history data are collected through a Biographical Survey and Biographical Interviews and analyzed alongside SwiSCI data. Guideline development includes a stakeholder meeting with representatives from the Swiss Paraplegic Group, spinal cord injury clinics, individuals with spinal cord injury, employers, and disability insurers. Of 2041 eligible SwiSCI participants, 478 (23.4%) completed the Biographical Survey (median age 57.5 years; median time since injury 19.1 years), with responders and non-responders showing comparable characteristics. Work–life data closely matched existing SwiSCI data (rho > 0.8), indicating good recall. The resulting guidelines will help VI providers coordinate rehabilitation services to optimally promote sustainable employment for individuals with spinal cord injury. Full article

Background: Quality of life (QoL) after spinal cord injury (SCI) is influenced by psychosocial factors, yet less is known about how these factors are examined across national contexts. Objective: This scoping review mapped studies examining depression, employment, and social participation in relation to QoL or health-related QoL (HRQoL) among individuals with SCI in the United States and South Korea. Methods: Following PRISMA-ScR guidelines, five databases were searched for peer-reviewed English- and Korean-language studies published between 2007 and 2025. Results: Sixteen studies were included: nine from South Korea and seven from the United States. Depression and psychological distress were associated with lower QoL/HRQoL in both countries, although South Korean studies more often examined depression with stress and functional concerns, whereas U.S. studies situated depression within participation, spirituality, and youth psychosocial functioning. Employment was linked to QoL/HRQoL in both contexts, with South Korean studies emphasizing economic activity, vocational rehabilitation, and financial strain, and U.S. studies emphasizing employment status and vocational outcomes. Social participation was important in both countries, but South Korean studies focused more on community transition, functional independence, and social attitudes, whereas U.S. studies emphasized participation contexts, accessibility, and social relationships. Conclusions: Across the three domains, depression, employment, and social participation emerged as recurring psychosocial domains associated with QoL/HRQoL after SCI in both countries. These differences suggest that psychosocial adaptation after SCI should be understood within cultural and rehabilitation contexts. Full article

People with disabilities face multiple challenges in the labor sphere, including barriers to access, discrimination, lower job stability, and limited opportunities for development, all of which restrict their economic and social participation. In response to this reality, public policies aimed at labor inclusion have gained increasing relevance due to their potential to reduce inequalities and strengthen social sustainability. The aim of this study was to analyze public policies designed for the labor inclusion of people with disabilities by identifying their main characteristics, target populations, implementation barriers, and their relationship with social sustainability. The PRISMA methodology was applied, and, as a result of the search, selection, and evaluation process, 75 primary studies were included in the analysis. The results show that policies are mainly concentrated on measures to facilitate access to employment, incentives for employers, and vocational training, while entrepreneurship receives less attention. Most policies are directed toward people with disabilities in general, with limited attention to specific subgroups. Persistent barriers were identified, including prejudice, weak institutional coordination, and a gap between regulatory frameworks and their effective implementation. It is concluded that, although these policies show progress in terms of inclusion, their contribution to social sustainability depends on more effective, better coordinated, and more responsive implementation that takes into account the diversity of needs within this population. Full article

Complex psychosis is a clinically relevant rehabilitation construct rather than a formal diagnostic category and refers to psychotic illness associated with treatment-resistant symptoms, functional impairment, and additional cognitive, psychiatric, neurodevelopmental, or physical health complexity. In this clinician-oriented narrative review, we synthesised current evidence on rehabilitation interventions for adults with complex psychosis, integrating direct evidence from specialist rehabilitation settings with indirect evidence from schizophrenia-spectrum studies when clinically informative. We searched major clinical databases, prioritised guidelines, systematic reviews, meta-analyses, and controlled studies, and organised the synthesis by functional domain and pathway relevance. Evidence was strongest for cognitive remediation, particularly when combined with broader psychiatric rehabilitation or vocational support, for family interventions in relapse prevention, and for individual placement and support in competitive employment. Social–cognitive and metacognitive interventions appear clinically valuable, although transfer to real-world functioning is more variable. Community-based rehabilitation, supported accommodation, illness self-management, and ecological adaptation strategies remain central to functional recovery when embedded within multidisciplinary pathways. Digital and virtual interventions are promising adjuncts, but their efficacy remains heterogeneous and implementation challenges include engagement, privacy, and service integration. Overall, rehabilitation in complex psychosis is most convincing when it is personalised, measurement-based, and delivered through integrated service models linking assessment, intervention selection, supported living, and recovery-oriented care. Full article

Background: Return to work (RTW) after acute coronary syndrome (ACS) or acute heart failure (HF) is a pivotal outcome reflecting functional recovery and quality of life (QoL). While survival after cardiac events has improved through reperfusion and guideline-directed pharmacotherapy, sustainable RTW depends on an integrated set of clinical, psychological, social, and occupational determinants. Objective: This study aimed to synthesize and expand the evidence on predictors of RTW, delineate practical workload-matching rules using METs and CPET, and position multidisciplinary cardiac rehabilitation (CR) as the bridge from clinical recovery to durable vocational reintegration. Key findings: Beyond left ventricular ejection fraction (LVEF), depression, anxiety, illness perceptions, and RTW self-efficacy are robust predictors of vocational outcomes. CPET-guided exercise prescriptions and MET-based job matching ensure adequate metabolic reserve; sustained task demand should remain at ≤35–40% of maximal capacity, with peak capacity ≥2× average job demand. CR (Class IA in the 2023 ESC ACS Guidelines) improves exercise tolerance, medication adherence, psychosocial well-being, and deployment of vocational support, including stepwise reintegration plans and ergonomic adaptations. Telerehabilitation extends monitoring and counseling into the workplace and maintains adherence after RTW. Conclusions: Comprehensive CR that integrates exercise training, psychosocial counseling, lifestyle modification, and vocational interventions offers the most effective pathway to stable RTW, improved QoL, and reduced socio-economic burden. Early identification of vulnerable subgroups and personalized, digitally supported follow-up are essential for long-term job retention. Full article

Background/Objectives: The study examines the characteristics of reading written texts depending on the type of hearing aid (monaural or binaural) and the individual hearing compensatory device used (cochlear implant or hearing aid) by students studying engineering fields of study in inclusive higher education. Methods: The identification of the students’ characteristics while reading was carried out using an eye-tracker. Results: The data obtained by eye-tracking technology indicate that there are no significant differences in the gaze point indicators when reading everyday text between students with binaural hearing aids and students without hearing impairments. At the same time, students with monaural cochlear implants showed different gaze point indicators when reading everyday text compared to the results of groups of students without hearing impairments and students with binaural hearing aids. Significant differences were found in indicators related to pupil diameter, in particular between the groups of students with monaural cochlear implants and students with binaural hearing aids. Conclusions: The results demonstrate the need to adapt written teaching materials not only to take into account the characteristics caused by the hearing impairment itself, but also to take into account individual characteristics caused by the type of hearing aid. However, given the small sample size (13–14 people in each group) and multiple variables included (types of devices and number), the results should be interpreted with caution and considered preliminary—additional studies involving a larger number of participants are needed to confirm the identified patterns. Full article

Background/Objectives: Global disability scales such as the Glasgow Outcome Scale-Extended (GOS-E) may not fully capture real-life participation after traumatic brain injury (TBI). This secondary analysis quantified mismatch between global disability and participation 5 years after moderate-to-severe TBI and identified predictors of a “good recovery, poor participation” profile. Methods: We analysed the TBIMS National Database Public Use Data Set, including adults ≥ 16 years with moderate-to-severe TBI, 5-year follow-up, and valid GOS-E, PART-O, and employment data. High versus low global outcome was defined as GOS-E 7–8 versus 3–6; good versus poor participation was defined using PART-O total (≥median vs. ≤25th percentile) plus productive role engagement. Four outcome profiles were derived and compared using 2 × 2 factorial analyses and regression. Results: The analytic cohort included 6363 participants; among those with high GOS-E, 16.8% met criteria for poor participation. Profiles with poor participation showed lower participation and lower life satisfaction and higher mood symptoms than Group A (high GOS-E, good participation), whereas those with low GOS-E but good participation showed preserved participation with greater emotional burden. Older age, lower education, minority race/ethnicity, pre-injury unemployment or retirement, longer post-traumatic amnesia, and lower 2-year GOS-E independently predicted mismatch. Sensitivity analyses using alternative GOS-E and participation cut-offs and life-satisfaction outcomes yielded similar patterns. Conclusions: Five years after moderate-to-severe TBI, good global recovery does not guarantee successful reintegration, and some individuals maintain participation despite persisting disability. Routine assessment of participation and life satisfaction alongside global disability is needed to identify high-risk profiles and target vocational and psychosocial interventions. Full article

Background: Kidney transplantation enables not only longer survival but also reintegration into professional and social life. Understanding the determinants of post-transplant employment is crucial for optimizing rehabilitation programs. Methods: A cross-sectional study was conducted between 2019 and 2021 among 94 kidney transplant recipients treated in two outpatient clinics. Data were collected using a structured interview and medical record analysis. Sociodemographic and clinical variables were assessed. Statistical analysis included chi-square tests, Spearman’s correlation, and logistic regression. All variables that demonstrated statistical significance in the univariate analysis were entered into the multivariate logistic regression model to identify independent predictors of post-transplant employment. A p-value < 0.05 was considered significant. Results: Prior to transplantation, 67.0% of patients were professionally inactive. After transplantation, 66.0% resumed employment, with 41.9% returning to work within six months. Return to work was positively correlated with higher education (p < 0.009), good financial status (p < 0.040), and longer time since transplantation (p < 0.001). Employment prior to transplantation, donor type, and duration of dialysis also significantly influenced outcomes. In the multivariate logistic regression, only marital status and place of residence remained independent predictors of return to work. Conclusions: More than half of transplant recipients successfully returned to work. Sociodemographic (education, marital status, financial situation, residence) and medical factors (dialysis duration, donor type, time since transplantation, prior employment) determined vocational reintegration. Further multicenter, longitudinal studies are needed to identify modifiable factors and design interventions enhancing post-transplant employability. Full article

Objectives: This study aimed to evaluate differences in parental satisfaction with healthcare provided to children undergoing inguinal hernia repair, comparing two organizational models of treatment: conventional hospitalization (CH) and day surgery (DS). Secondary objectives were to examine demographic characteristics, postoperative pain intensity, hospital stay duration, and clinical outcomes across groups. Methods: A prospective cohort study was conducted at the Department of Pediatric Surgery, University Hospital of Split, between 1 May 2024 and 1 May 2025. A total of 133 parents of children who underwent primary inguinal hernia repair completed the study questionnaire. The sample included 105 boys and 28 girls, with a median age of 5 years (IQR 3–7). Participants were assigned to either CH (n = 65) or DS (n = 68). Pain intensity was measured using a Visual Analogue Scale (VAS), while parental satisfaction was assessed using the Croatian version of the PedsQL™ 3.0 Healthcare Satisfaction–Parent Report instrument. Results: Postoperative pain levels did not differ significantly between the CH and DS groups (p = 0.439). Parental satisfaction scores were high in both settings. However, CH was associated with significantly greater satisfaction in the domains of information provision (p = 0.042), family participation (p = 0.012), communication (p = 0.017), and emotional support (p = 0.031). No significant differences were observed in general satisfaction (p = 0.945), technical skills (p = 0.054), or total satisfaction scores (p = 0.055). Conclusions: Day surgery represents a safe and efficient treatment model for pediatric inguinal hernia, with comparable pain outcomes to conventional hospitalization. Although overall parental satisfaction was high in both groups, lower ratings in the DS group for communication, emotional support, and information provision highlight areas for targeted organizational and educational improvements to enhance the family experience in ambulatory pediatric surgical care. Full article

Background/Objectives: Inpatient psychiatric rehabilitation plays a critical role in the recovery of adults with serious mental illness (SMI), offering structured, supportive care to improve functioning and community integration. Despite its clinical relevance, there is considerable heterogeneity in how these programs are structured, delivered, and evaluated. This scoping review aimed to map the core components and reported outcomes of adult inpatient psychiatric rehabilitation programs and to identify elements associated with program effectiveness. Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Four electronic databases (MEDLINE, Web of Science, PsycINFO, and Google Scholar) were systematically searched for articles published between inception and 2024. Studies were eligible if they described inpatient psychiatric rehabilitation programs for adults and reported on clinical, functional, or system-level outcomes. Data extraction included program characteristics, intervention components, effectiveness indicators, and study limitations. A qualitative thematic synthesis was conducted, and methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: Fifteen studies met the inclusion criteria. Core rehabilitation components included structured psychosocial interventions (e.g., CBT, psychoeducation), vocational and occupational support, recovery-oriented goal setting, and transitional care planning. Most programs demonstrated positive outcomes, including reduced readmissions, improved functional and psychosocial functioning, and enhanced quality of life. Effectiveness appeared to be influenced by the duration of rehabilitation, multidisciplinary team involvement, and continuity of care post-discharge. However, outcome measures varied considerably, and few studies used standardized assessment tools or included long-term follow-up. Conclusions: This review highlights common features of effective inpatient psychiatric rehabilitation programs and underscores the need for standardized outcome measures, implementation fidelity assessments, and longitudinal research. Findings can guide service planning, inform policy development, and support recovery-oriented inpatient care. Full article

Background: Youth with intellectual disabilities are often marginalised and discriminated against regarding skills development and work opportunities as society seems to place high value on an individual’s intellect. Unemployment levels for youth with intellectual disabilities are significantly higher than youth in the general population, yet youth with intellectual disabilities can become valuable employees. This paper explores the untapped potential for youth with disabilities to access skill development opportunities through participation in sports organisations and events that enable them to become economically active. Methodology: A critical ethnographic approach was adopted as the research design. The sample included six youth with intellectual disabilities, five parents, two vocational trainers, two sports coaches, and two golf managers. Data was gathered through participant observations, semi structured interviews, and reflective journaling. Data was analysed using thematic analysis. Findings: The theme “Hidden treasures in a disabling environment” emerged, highlighting the untapped potential of youth with intellectual disabilities to engage in livelihood activities through participation in sports events. One subtheme was “Invisible and well-hidden resources” reflecting remote training centres leading to missed work opportunities. Research findings highlighted that youth with intellectual disabilities possessed marketable skills, alongside the discovery of substantial unexplored livelihood opportunities in the workforce of sports events. Full article

This study examines the employment of persons with disabilities in small- and medium-sized enterprises (SMEs) in rural Japan. An online survey of 40 SME owners was conducted to assess their understanding, experiences, and challenges in employing persons with disabilities. The results indicate that many SMEs lack awareness of employment systems, but those with prior contact experience demonstrate greater understanding. Key challenges include difficulties in job creation, workplace acceptance, and inadequate environments. To address these issues, it is essential to enhance information on job creation, share successful cases, and establish mentoring systems for knowledge exchange between SMEs. These findings provide insights for policy development and practical strategies to promote the employment of persons with disabilities in SMEs. Full article