Search results for: rehabilitation and retribution

Authors: Getamesay Kassaye Dimru

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The cultivation of fruit tree in degraded areas has two-fold importance. Firstly, it improves food availability and income, and secondly, it promotes the conservation of soil and water improving, in turn, the productivity of the land. The main objectives of this study are to identify the determinant of farmer's fruit trees plantation decision and to major fruit production challenges and opportunities of the study area. The analysis was made using primary data collected from 60 sample household selected randomly from the study area in 2016. The primary data was supplemented by data collected from a key informant. In addition to the descriptive statistics and statistical tests (Chi-square test and t-test), a logit model was employed to identify the determinant of fruit tree plantation decision. Drought, pest incidence, land degradation, lack of input, lack of capital and irrigation schemes maintenance, lack of misuse of irrigation water and limited agricultural personnel are the major production constraints identified. The opportunities that need to further exploited are better access to irrigation, main road access, endowment of preferred guava variety, experience of farmers, and proximity of the study area to research center. The result of logit model shows that from different factors hypothesized to determine fruit tree plantation decision, age of the household head accesses to market and perception of farmers about fruits' disease and pest resistance are found to be significant. The result has revealed important implications for the promotion of fruit production for both land degradation control and rehabilitation and increasing the livelihood of farming households.

Keywords: degradation, fruit, irrigation, pest

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Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

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Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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Authors: Anne Heirman, Vincent van der Noort, Rob van Son, Marije Petersen, Lisette van der Molen, Gyorgy Halmos, Richard Dirven, Michiel van den Brekel

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Objective: Voice prosthesis leakage significantly impacts laryngectomies patients' quality of life, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. Study Design: A retrospective cohort study. Setting: Tertiary hospital. Methods: Device lifetimes and voice prosthesis replacements of a retrospective cohort, including all patients with laryngectomies between 2000 and 2012 in the Netherlands Cancer Institute, were used to calculate the number of needed voice prostheses per patient per year when preventing 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: Adaptive strategies based on the individual patient’s history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. Results: Patients used a median of 3.4 voice prostheses per year (range 0.1-48.1). We found a high inter-and intrapatient variability in device lifetime. When applying prophylactic replacement, this would become a median of 9.4 voice prostheses per year, which means replacement every 38 days, implying more than six additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients, and only a median of 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high Coefficient of Variation (Standard Deviation/Mean) in device lifetime. Conclusion: Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter-and intrapatient variation in device lifetime.

Keywords: voice prosthesis, voice rehabilitation, total laryngectomy, prosthetic leakage, device lifetime

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Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

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This abstract intends to demonstrate multiple strategies of autism management in Ghana by exploring the possibilities. The advantages of adopting creative art forms as a therapeutic method. Autism is a developmental disorder that includes social interaction, communication, and repetitive behaviours. In Ghana, as in many other countries, there is a rising demand for effective intervention and support for people with autism and their families. Creative arts such as music, dance, drama and visual arts have shown promise in promoting communication, social interaction and inclusion of people with autism. These art forms provide alternative channels for self-expression and can be powerful tools for autistic people to interact with the world, their friends and families around them. Creative art forms interventions have been found to improve social skills, improve emotion regulation, promote creativity and increase self-confidence in people with autism. This study examines existing programs and interventions in Ghana involving creative art forms for people with autism through a comparative analysis. It explores the different approaches, methods and results of these interventions. By comparing and evaluating these programs, the study aims to identify best practices, challenges and areas for development in managing autism through the creative arts in Ghana. Although many schools and rehabilitation centres employ various forms in therapeutic approaches for autism. There is no comparative analysis of which type of autism and which creative art forms is suitable. The results of this study will contribute to the development of evidence-based practices for the management of autism in Ghana. It provides valuable information about the effectiveness of creative arts interventions and helps inform policy makers, educators, therapists and other stakeholders involved in autism support. Ultimately, the goal is to improve the well-being and quality of life of people with autism in Ghana and their families by promoting inclusive and accessible interventions that harness the power of creative art forms.

Keywords: autism, therapeutic, creative art, art form

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Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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Authors: Portia Muehlbauer

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This paper examines the evolving landscape of preventing and countering violent extremism (PCVE) by delving into the growing importance of integrating human rights principles into violence prevention strategies on the local, community level. This study sheds light on the underlying theoretical frameworks of violent extremism and the influence of gender while investigating the intersection between human rights preservation and violent extremism prevention. To gain practical insight, the research focuses on two prominent international non-governmental organizations, Women without Borders (WwB) and Hedayah, and their distinct PCVE initiatives. WwB adopts a gender-sensitive approach, implementing parental education programs that empower mothers in at-risk communities to prevent the spread of violent extremism. In contrast, Hedayah takes an indirect route, employing capacity building programs that enhance the capabilities of educators, social workers, and psychologists in early intervention, rehabilitation and reintegration efforts. Qualitative data for this comparative analysis was collected through an extensive four-month internship at WwB during the fall of 2020, a three-month internship at Hedayah in the spring of 2021, a thought-provoking semi-structured interview with the executive director of WwB, personal field notes, and a comprehensive discourse analysis of the prevailing literature on human rights considerations in PCVE practices. This study examines the merits and challenges of integrating human rights into PCVE programming through the lens of both organizations, WwB and Hedayah. The findings of this study will inform policymakers, practitioners, and researchers on the intricate relationship between human rights protection and effective PCVE strategies.

Keywords: preventing and countering violent extremism, human rights, counterterrorism, peacebuilding, capacity building programs, gender studies

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Authors: Roger-Claude Liwanga

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This article reflects on the normative aspects of the jurisprudence on the protection of human rights in times of war that the International Court of Justice (ICJ) developed in 2005 in the Case Concerning Armed Activities on the Territory of the Congo (Democratic Republic of Congo v. Uganda). The article focuses on theories raised in connection with the Democratic Republic of Congo (DRC)'s claim of the violation of human rights of its populations by Uganda as opposed to the violation of its territorial integrity claims. The article begins with a re-visitation of the doctrine of state extraterritorial responsibility for violations of human rights by suggesting that a state's accountability for the breach of its international obligations is not territorially confined but rather transcends the State's national borders. The article highlights the criteria of assessing the State's extraterritorial responsibility, including the circumstances: (1) where the concerned State has effective control over the territory of another State in the context of belligerent occupation, and (2) when the unlawful actions committed by the State's organs on the occupied territory can be attributable to that State. The article also analyzes the ICJ's opinions articulated in DRC v. Uganda with reference to the relationship between human rights law and humanitarian law, and it contends that the ICJ had revised the traditional interaction between these two bodies of law to the extent that human rights law can no longer be excluded from applying in times of war as both branches are complementary rather than exclusive. The article correspondingly looks at the issue of reparations for victims of human rights violations. It posits that reparations for victims of human rights violations should be integral (including restitution, compensation, rehabilitation, satisfaction, and guarantees of non-repetition). Yet, the article concludes by emphasizing that reparations for victims were not integral in DRC v. Uganda because: (1) the ICJ failed to set a reasonable timeframe for the negotiations between the DRC and Uganda on the amount of compensation, resulting in Uganda paying no financial reparation to the DRC since 2005; and (2) the ICJ did not request Uganda to domestically prosecute the perpetrators of human rights abuses.

Keywords: human rights law, humanitarian law, civilian protection, extraterritorial responsibility

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Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

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Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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Authors: Javier Ascanio Villabona, Brayan Eduardo Tarazona Romero, Camilo Leonardo Sandoval Rodriguez, Arly Dario Rincon, Omar Lengerke Perez

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Efficient energy consumption in the housing sector in relation to refrigeration is a concern in the construction and rehabilitation of houses in tropical areas. Thermal comfort is aggravated by heat gain on the roof surface by heat gains. Thus, in the group of passive cooling techniques, one of the practices and technologies in solar control that provide improvements in comfortable conditions are thermal insulation or geometric changes of the roofs. On the other hand, methods with reflection and radiation are the methods used to decrease heat gain by facilitating the removal of excess heat inside a building to maintain a comfortable environment. Since the potential of these techniques varies in different climatic zones, their application in different zones should be examined. This research is based on the experimental study of a prototype of a roof radiator as a method of passive cooling in homes, which was developed through an experimental research methodology making measurements in a prototype built by means of the paradigm of appropriate technology, with the aim of establishing an initial behavior of the internal temperature resulting from the climate of the external environment. As a starting point, a selection matrix was made to identify the typologies of passive cooling systems to model the system and its subsequent implementation, establishing its constructive characteristics. Step followed by the measurement of the climatic variables (outside the prototype) and microclimatic variables (inside the prototype) to obtain a database to be analyzed. As a final result, the decrease in temperature that occurs inside the chamber with respect to the outside temperature was evidenced. likewise, a linearity in its behavior in relation to the variations of the climatic variables.

Keywords: appropriate technology, enveloping, energy efficiency, passive cooling

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Authors: A. Barratt, M. H. Granat, S. Buttress, B. Roy

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Introduction: Physiotherapy is an essential part of the treatment of patients with shoulder problems. The focus of treatment is usually centred on addressing specific physiotherapy goals, ultimately resulting in the improvement in pain and function. This study investigates if computerised physiotherapy using gamification principles are as effective as standard physiotherapy. Methods: Physiotherapy exergames were created using a combination of commercially available hardware, the Microsoft Kinect, and bespoke software. The exergames used were validated by mapping physiotherapy goals of physiotherapy which included; strength, range of movement, control, speed, and activation of the kinetic chain. A multicenter, randomised prospective controlled trial investigated the use of exergames on patients with Shoulder Impingement Syndrome who had undergone Arthroscopic Subacromial Decompression surgery. The intervention group was provided with the automated sensor-based technology, allowing them to perform exergames and track their rehabilitation progress. The control group was treated with standard physiotherapy protocols. Outcomes from different domains were used to compare the groups. An important metric was the assessment of shoulder range of movement pre- and post-operatively. The range of movement data included abduction, forward flexion and external rotation which were measured by the software, pre-operatively, 6 weeks and 12 weeks post-operatively. Results: Both groups show significant improvement from pre-operative to 12 weeks in elevation in forward flexion and abduction planes. Results for abduction showed an improvement for the interventional group (p < 0.015) as well as the test group (p < 0.003). Forward flexion improvement was interventional group (p < 0.0201) with the control group (p < 0.004). There was however no significant difference between the groups at 12 weeks for abduction (p < 0.118067) , forward flexion (p < 0.189755) or external rotation (p < 0.346967). Conclusion: Exergames may be used as an alternative to standard physiotherapy regimes; however, further analysis is required focusing on patient engagement.

Keywords: shoulder, physiotherapy, exergames, gamification

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Authors: Anita Ghai

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The present paper explores the imperative to establish disability studies as an independent area of academic inquiry in India through the establishment of specific programmes in disability studies. The case study of the efforts made by the Ambedkar University, Delhi, to develop such programs and courses shall be used to substantiate this imperative as well as to explore some of the challenges entailed. The paper shall explore the certain extent aspects of relevant scholarship in the area of disability studies in India today and critically reflect on the perspectives of disability in this scholarship. The study of disability in India has hitherto been the prerogative of special education, rehabilitation psychology, and social work departments. While instances of these departments adopting critical approaches to disability can be identified, their empirical focus has perpetuated the production of disability as the site of suffering and oppression. The complex cultural, phenomenological, historical and economic discourses within which disability is embedded can be better captured within distinctive programmes that have disability sui generis as their focus. Such programs would foreground disability as an epistemology, which universalizes the study of disability from disabled people alone to an analysis of various other groups who have been historically marginalized. It will also play an important role in recuperating disability from a state of alterity. The interdisciplinary nature of disability studies offers an opportunity to integrate perspectives from the humanities and the social sciences in the proposed programs. Some of the challenges or rather aspects of reflection that emerge in the course of developing these programs are the criteria for determining the suitability of faculty to teach these programs and the challenges in identifying faculty and in addressing any apprehensions about career prospects that prospective students might have. The manner in which these concerns are being addressed through the collaboration of expertise as well as through the interdisciplinary and flexible nature of the program shall be addressed in the course of the paper. In conclusion, the paper shall foreground the need for disability studies programs in India, the re-appropriation of existing scholarship in the process of formulation these programs, emerging concerns and the manner in which these concerns will be addressed.

Keywords: academia, disability studies, epistemology, India

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Authors: Radhwane Boudjelthia

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The most recent earthquakes that occurred in the world and particularly in Algeria, have killed thousands of people and severe damage. The example that is etched in our memory is the last earthquake in the regions of Boumerdes and Algiers (Boumerdes earthquake of May 21, 2003). For all the actors involved in the building process, the earthquake is the litmus test for construction. The goal we set ourselves is to contribute to the implementation of a thoughtful approach to the seismic protection of structures. For many engineers, the most conventional approach protection works (buildings and bridges) the effects of earthquakes is to increase rigidity. This approach is not always effective, especially when there is a context that favors the phenomenon of resonance and amplification of seismic forces. Therefore, the field of earthquake engineering has made significant inroads among others catalyzed by the development of computational techniques in computer form and the use of powerful test facilities. This has led to the emergence of several innovative technologies, such as the introduction of special devices insulation between infrastructure and superstructure. This approach, commonly known as "seismic isolation" to absorb the significant efforts without the structure is damaged and thus ensuring the protection of lives and property. In addition, the restraints to the construction by the ground shaking are located mainly at the supports. With these moves, the natural period of construction is increasing, and seismic loads are reduced. Thus, there is an attenuation of the seismic movement. Likewise, the insulation of the base mechanism may be used in combination with earthquake dampers in order to control the deformation of the insulation system and the absolute displacement of the superstructure located above the isolation interface. On the other hand, only can use these earthquake dampers to reduce the oscillation amplitudes and thus reduce seismic loads. The use of damping devices represents an effective solution for the rehabilitation of existing structures. Given all these acceleration reducing means considered passive, much research has been conducted for several years to develop an active control system of the response of buildings to earthquakes.

Keywords: earthquake, building, seismic forces, displacement, resonance, response

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Jared Cheves, Amanda DeChent, Joyce Pan

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Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu

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Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.

Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values

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Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Oropharyngeal dysphagia is prevalent in children with cerebral palsy (CP). There are many studies concerning this problem, however, studies examining long term outcomes of dysphagia using videofluoroscopic study (VFSS) are very rare. The Aim of this study is to investigate long-term outcomes of dysphagia in children with severe CP using initial VFSS. It was a retrospective study and chart review was done from January 2000 to December 2013. Thirty one patients under 18 years who have been diagnosed as CP in outpatient clinic of Rehabilitation Medicine, and who did VFSS were included. Long-term outcomes such as feeding method, height percentile, weight percentile, and body mass index (BMI) were tracked up for at least 3 years by medical records. Significant differences between initial and follow-up datas were investigated. The patients consisted of 18 males and 13 females, and the mean age was 31.0±18.0 months old. 64.5% of patients were doing oral diet, and 25.8% of patients were doing non-oral diet. When comparing VFSS findings among oral feeding patients, oral and non-oral feeding patients, and non-oral feeding patients at initial period, dysphagia severity, supraglottic penetration, and subglottic aspiration showed significant differences. Most of the patients who could feed orally at initial period were found to have the same feeding method at follow-up. But among eight patients who required non-oral feeding initially, three patients became possible to feed orally, and one patient was doing oral and non-oral feeding method together at follow-up. Follow up feeding method showed correlation with dysphagia severity by initial VFSS. Weight percentile was decreased in patients with GMFCS level V at follow up, which may represent poor nutritional status due to severe dysphagia compared to other patients. Initial VFSS severity would play a significant role in making an assumption about future diet in children with severe CP. Patients with GMFCS level V seem to have serious dysphagia at follow up and have nutritional deficiency over time, therefore, more careful nutritional support is needed in children with severe CP are suggested.

Keywords: cerebral palsy, child, dysphagia, videofluoroscopic study

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

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The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

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Authors: Morteza Naderi

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The Persian fallow deer was considered as a globally extinct species until 1956 when a small population was rediscovered from Dez Wildlife Refuge and Karkheh Wildlife Refuge in southwestern parts of Iran. After long species rehabilitation process, the species was transplanted to Dasht-e-Naz Wildlife Refuge in northern Iran, and from where, follow deer was introduced to the different selected habitats such as Ashk Island in Lake Uromiyeh National Park. During 12 years, (from 1978 to 1989) 58 individuals (25 males and 33 females) were transferred to Ask Island. The main threat to the established population was related to the freshwater shortage and existing just one single trough such as high mortality rate of adult males during rutting season, snake biting and dilutional hyponatremia. Desiccation of Lake Uromiyeh in recent years raised new challenges to the conservation process, as about 80 individuals, nearly one third of the population were died in 2011. Connection of Island to the mainland caused predators’ accessibility (such as wolf and Jackal) to the Ask Island and higher mortality because of follow deer attraction to the surrounding mainland farms. Conservation team faced such new challenges that may cause introduction plan to be probably failed. Investigations about habitat affinities and carrying capacity are the main basic researches in the management and conservation of the species. Logistic regression analysis showed that the presence of the different fresh water resources as well as Allium akaka and Pistacia atlantica are the main environmental variables affect Follow deer habitat selection. Habitat carrying capacity analysis both in summer and winter seasons indicated that Ashk Island can support 240±30 of Persian follow deer.

Keywords: carrying capacity, follow deer, lake Uromiyeh, microhabitat affinities, population oscillation, predation, sex ratio

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Authors: Ayo Osisanya, Promise Ebuka Okonkwo

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Reduced hearing sensitivity among the elderly has been attributed to some risk factors and influence of age-related degenerative conditions such as diabetes, cardiovascular disease, Alzheimer’s disease, bipolar disorder, and hypertension. Hearing loss; especially the age-related type (presbycusis), has been reported as one of the global burden affecting the general well-being and quality of life of the elderly with hypertension. Thus, hearing loss has been observed to be associated with hypertension and functional decline in elderly, as this condition makes them experience poor communication, fatigue, reduced social functions, mood-swing, and withdrawal syndrome. Emerging research outcomes indicate a strong relationship between hypertension and reduced auditory performance among the elderly. Therefore, this study determined the prevalence, types, and patterns of hearing loss associated with hypertension, with a bid to suggesting comprehensive management strategies and a model of creating awareness towards promoting good healthy living among the elderly in Nigeria. One hundred and seventy-two elderly, aged 65–85 with hypertension were purposively selected from patients undergoing treatment for hypertension in some tertiary hospitals in southwest Nigeria for the study. Participants were suggested to Pure-Tone Audiometry (PTA) through the use of Maico 53 Diagnostic Audiometer to determine the degree, types ad patterns of hearing loss among the elderly with hypertension. Results showed that 148 (86.05%) elderly with hypertension presented with different degrees, types, and patterns of hearing loss. Out of this number, 123 (83.11%) presented with bilateral hearing loss, while 25 (16.89%) had unilateral hearing loss. Degree of hearing loss, 74 moderate hearing loss, 118 moderately severe and 50 severe hearing loss. 36% of the hearing loss appeared as flat audiometric configuration, 24% were slopping, 19% were rising, while 21% were tough-shaped audiometric configurations. The findings showed high prevalence of hearing loss among the elderly with hypertension in Southwest, Nigeria. Based on the findings, management of elderly with hypertension should include regular audiological rehabilitation and total adherence to hearing conservation principles, otological management, regulation of blood pressure and adequate counselling / follow-up services.

Keywords: auditory performance, elderly, hearing loss, hypertension

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Authors: A. Gagat-Matuła

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There is a definite lack – in Poland, as well as around the world – of empirical studies of families raising handicapped child, in which one parent migrates. In diagnostics of the functioning of such families emphasis should be placed not only on the difficulties, but most of all it should be indicated what possibilities are there for the family and how it overcomes the difficulties. Migration of a parent on the one hand is a chance to improve the family’s material situation. In certain circumstances this may only be an “escape” into work from the issues associated with the upbringing and rehabilitation of a handicapped child. The aim of the study was to learn the functioning of a temporarily single parent family system as a result of migration of a parent from the perspective of adolescents with cerebral palsy. The study was conducted in the year 2013 in the area of Eastern Poland. It involved an analysis of 70 persons (with cerebral palsy in an intellectual capacity) from families in which at least one of the parents migrates. The study incorporated the diagnostic survey method. These tools were used: Family Evaluation Scales (SOR) adapted for Poland by Andrzej Margasiński. The explorations in this study indicate, that 47% of studied temporarily single parent families are balanced models. This is evidence of the resources at the disposal of the family which, despite the disability of the child and temporary separation, is able to function properly. The conducted studies show, that 37% of temporarily single parent families are imbalanced models in the perception of adolescents with cerebral palsy. These families experience functional difficulties and require psychological and pedagogical support. There is a need for building skills related to effective coping with family stress. Especially considering, that families of an imbalanced type do not use the internal and external resources of the family system. Such a situation may deepen the disarrangement of family life. In intermediate families (16%) there are also temporary difficulties in functioning. Separation anxiety experienced by mothers may disrupt relations and introduce additional stress factors. For that reason it is important to provide support for women with difficulties coping with the emotions associated with raising handicapped adolescents and migratory separation.

Keywords: child with cerebral palsy, family, migration, parents

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Authors: Milad Pirali, Sohrab Keyhani, Mohhamad Ali Sanjari, Ali Ashraf Jamshidi

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Purpose: The effect of hamstring antagonist activity on the knee extensors torque of the Anterior Cruciate Ligament reconstruction (ACLR) is not clear and persistent muscle weakness is common after ACLR. Hamstring activation when acting as antagonist is considered very important for knee strengths. Therefore the purpose of this study was to examine hamstring antagonist coactivation during maximal effort of the isokinetic knee extension in ACLR athletes with hamstring autograft. Materials and Methods: We enrolled 20 professional athletes who underwent primary ACLR (hamstring tendon autograft)with 6-24 months postoperative and 20 healthy subjects as control group. Each subjects performed maximal effort isokinetic knee extension and flexion in 60/˚ s and 180/˚ s velocities for the involved and uninvolved limb. Synchronously, surface electromyography (EMG) was recorded of vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) and biceps femoris (BF). The antagonist integrated EMG (IEMG) values were normalized to the IEMG of the same muscle during maximal isokinetic eccentric effort at the same velocities and ROM. Results: A one-way analysis of variance designs shows significantly greater IEMG coactivation of hamstring and decreased activation of Vm in ACLR when compared to uninvolved and control group leg in 60/˚ s and 180/˚ s velocities. Likewise peak torque to body weight was decreased in ACLR compared to uninvolved and control group during knee extension in both velocities (p < 0.05). Conclusions: Decreased extensors moment caused by decreased quadriceps inhibition and increased hamstring coactivation. In addition, these result indicated to decrease of motor unit recruitment in the VM (as a kinesiologicmonitore of the knee). It is appearing that strengthening of the quadriceps to be an important for rehabilitation program after ACLR for preparation in athletes endeavors. Therefore, we suggest that having more emphasis and focus on quadriceps strength and less emphasis on hamstring following ACLR.

Keywords: ACLR-coactivation, dynamometry, electromyography, isokinetic

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Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

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Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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Authors: Naznine Anwar, Kim Cornish, Izelle Labuschagne, Nellie Georgiou-Karistianis

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Falls and subsequent injuries are common features in symptomatic Huntington’s disease (symp-HD) individuals. As part of daily walking, navigating around obstacles may incur a greater risk of falls in symp-HD. We designed obstacle-crossing experiment to examine adaptive gait dynamics and to identify underlying spatiotemporal gait characteristics that could increase the risk of falling in symp-HD. This experiment involved navigating around one or two ground-based obstacles under two conditions (walking while navigating around one obstacle, and walking while navigating around two obstacles). A total of 32 participants were included, 16 symp-HD and 16 healthy controls with age and sex matched. We used a GAITRite electronic walkway to examine the spatiotemporal gait characteristics and inter-trail gait variability when participants walked at their preferable speed. A minimum of six trials were completed which were performed for baseline free walk and also for each and every condition during navigating around the obstacles. For analysis, we separated all walking steps into three phases as approach steps, navigating steps and recovery steps. The mean and inter-trail variability (within participant standard deviation) for each step gait variable was calculated across the six trails. We found symp-HD individuals significantly decreased their gait velocity and step length and increased step duration variability during the navigating steps and recovery steps compared with approach steps. In contrast, HC individuals showed less difference in gait velocity, step time and step length variability from baseline in both respective conditions as well as all three approaches. These findings indicate that increasing spatiotemporal gait variability may be a possible compensatory strategy that is adopted by symp-HD individuals to effectively navigate obstacles during walking. Such findings may offer benefit to clinicians in the development of strategies for HD individuals to improve functional outcomes in the home and hospital based rehabilitation program.

Keywords: Huntington’s disease, gait variables, navigating around obstacle, basal ganglia dysfunction

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Authors: Leslie M. Mullins

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In the face of dramatically shifting demographic trends and macroeconomic pressures on affordable housing in high-cost cities, municipalities and developers have been forced to develop new models of sustainable development that integrates elements of substantial rehabilitation and new construction while controlling for relocation and mass displacement. Community development partners in the San Francisco Bay Area of Northern California are starting to prioritize anti-displacement strategies when rehabilitating severely neglected public housing developments. This study explored the community-driven efforts to transform four dilapidated public housing sites (N=2,600 households) into thriving mixed-income housing communities. Eight interviews were conducted with frontline workers (property managers and service providers), who directly worked with residents throughout critical stages of the relocation and leasing process. Interviews were audio-recorded, transcribed, and analyzed by a systematic procedure for qualitative analysis to identify key themes on the topics of interest. Also, an extensive literature analysis was conducted to determine promising practices throughout the industry. This study highlighted that resident’s emotional attachment to their homes (regardless of the deteriorating conditions of their unit) could both a) impede the relocation process and substantially impact the budget and timeline, while b) simultaneously providing a basis for an enhanced sense of belonging and community cohesion. This phenomenon often includes the welcoming of new residents and cultures. Resident centered workshops, healing centered rituals, and extensive 'hands-on' guidance was highlighted as promising practices that resulted in residential retention rates that were two to three times the national average and positively impacted the overall project’s budget and timeline.

Keywords: anti-displacement strategies, community based practices, community cohesion, cultural preservation, healing-centered, public housing, relocation, trauma-informed

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Authors: Sara S. Fouad, Omneya Messallam

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In 1818, a seventy-five kilometer long canal was dug (called the Mahmoudiyah canal) connecting between Alexandria city in Egypt and the western branch of the Nile. It was a productive resource and vital to its environment, context, transportation, and recreation. It played a significant role in people’s lives and Alexandria city’s shape. The canal, which was the main vein of goods’ transporting from Alexandria’s seaport to the different parts of Egypt, was still in use today as a major source of clear water in the city. But nowadays, Mahmoudiyah canal is converting into ‘dead waterway’. The canal became sources of pollution as a result of solid and industrial waste thus causing many diseases, destroying communities and biodiversity, with urban invasion, the loss of community aesthetic value and healthy environment. Therefore, this paper aims to propose an urban strategy, as a solution to revive the forgotten canal, through recreating a cultural promenade on its shore. The main aim of this research is to formulate decent quality of life, unpolluted space, an area gathering the city space for nature, tourism and investments. As a case study, this paper investigates Mahmoudiyah canal through urban and ecological analyses, aiming to design an urban strategy for reviving it by creating a cultural promenade enriched with public spaces and green areas, which can most probably enhance the quality of life, city re-living and development. Community participation is also considered as vital and intrinsic implementation stage. The empirical research involved using several data assembly methods such as interviews, mental mapping, structural observations and questionnaires. The paper ends with a set of conclusions leading to proposals for the Mahmoudiyah canal revitalization considering the complex challenges and processes of sustainable regeneration focusing on city’s rehabilitation and lost identity.

Keywords: Mahmoudiyah canal, community aesthetic value, city re-living, cultural promenade

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Authors: Esther Mafunda, Simbarashe Muparangi

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The present paper tests the applicability of the Regression Hypothesis on the pathological language dissolution of a Shona male adult with Broca’s aphasia. It particularly assesses the prediction of the Regression Hypothesis, which states that the process according to which language is forgotten will be the reversal of the process according to which it will be acquired. The main aim of the paper is to find out whether mirror symmetries between L1 acquisition and L1 dissolution of tense in Shona and, if so, what might cause these regression patterns. The paper also sought to highlight the practical contributions that Linguistic theory can make to solving language-related problems. Data was collected from a 46-year-old male adult with Broca’s aphasia who was receiving speech therapy at St Giles Rehabilitation Centre in Harare, Zimbabwe. The primary data elicitation method was experimental, using the probe technique. The TART (Test for Assessing Reference Time) Shona version in the form of sequencing pictures was used to access tense by Broca’s aphasic and 3.5-year-old child. Using the SPSS (Statistical Package for Social Studies) and Excel analysis, it was established that the use of the future tense was impaired in Shona Broca’s aphasic whilst the present and past tense was intact. However, though the past tense was intact in the male adult with Broca’s aphasic, a reference to the remote past was made. The use of the future tense was also found to be difficult for the 3,5-year-old speaking child. No difficulties were encountered in using the present and past tenses. This means that mirror symmetries were found between L1 acquisition and L1 dissolution of tense in Shona. On the basis of the results of this research, it can be concluded that the use of tense in a Shona adult with Broca’s aphasia supports the Regression Hypothesis. The findings of this study are important in terms of speech therapy in the context of Zimbabwe. The study also contributes to Bantu linguistics in general and to Shona linguistics in particular. Further studies could also be done focusing on the rest of the Bantu language varieties in terms of aphasia.

Keywords: Broca’s Aphasia, regression hypothesis, Shona, language dissolution

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Authors: Karen Miner-Romanoff

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Few art programs for incarcerated juveniles exist; however, evaluation results indicate decreased recidivism and behavior problems. This paper reports on an on-going study of a promising art program for incarcerated adolescents with community exhibits and charitable sale of their work. Voices from Inside, a partnership between Franklin University and the Ohio Department of Youth Services, sponsored three exhibits in 2012, 2013, and 2014. In 2013, youth exhibitor survey results (response rate 47%, 16 of 34) showed that 81% cited as benefits cooperation with others, task completion, and increased self-esteem from public recognition and art sales. Community attendee survey results (response rate 29.5%, 59 of 200) showed positive attitude changes toward juvenile offenders, from 40% to 53%. Qualitative responses were similarly positive. The 2014 youth exhibitor sample was larger (response rate 58%, 29 of 50) and showed that 93% cited positive benefits including increase in self-esteem, decrease in stress, pride or recognition of the ability to reach a goal from completing, exhibiting and selling their art to benefit a charity for at-risk youth. This year, the research was able to conduct ten one-on-one interviews inside of the youth facilities, and qualitative responses were even more positive with one youth explaining, “This art represents my joy, my tears, my pain and my hope.” Community attendee survey results (response rate 50%, 86 of 170) were transformative in that that they indicated significant impression on attitudes toward juvenile offenders and their rehabilitative needs with one attendee stating that the event had an, “Immense impact for me bringing into focus the humanity and value these youth still have for us and society.” Future research indicates a need for a correlation study to determine the extent to which these art programs reduce behavioral incidents inside of the facility and long-term reduction in reoffending rates. Generally, further study of juvenile offenders’ art for rehabilitation and restorative justice, the power of art to transform, and university-community partnerships implementing art programs for juvenile offenders should continue.

Keywords: art, juvenile, incarcerated, restorative justice

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