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BACKGROUND: Spinal cord injury (SCI) leads to various physical, psychological, and social challenges. Sport is a holistic physical activity that may target these challenges. No literature systematically summarizes the overall impact of sport participation for those with SCI. OBJECTIVE: To comprehensively report the findings of quantitative studies investigating the impact of sport on the physical, psychological, and social health of individuals with SCI. METHODS: Six databases were searched: APA PsycInfo, CINAHL, Embase, Emcare, Ovid Medline, and PubMed (non-Medline). Studies were included if (a) participants were adults with SCI for ≥12 months, (b) outcomes resulting from ≥3 months of sport participation were investigated, (c) sport occurred in the community setting, and (d) comparisons of sport and non-sport conditions were analyzed. Details regarding study characteristics, participants, sport(s), and outcomes were extracted. Methodological quality was assessed using the Modified Downs and Black checklist. RESULTS: Forty-nine studies were included. Study quality ranged from poor to moderate. Sport participation showed favourable results for outcomes including function, quality of life, and community integration. Mixed results were found for outcomes including cardiac function, depressive symptoms, and employment. No significant associations were found for postural control, resilience, and education. CONCLUSIONS: The review findings suggest sport may be a promising intervention for addressing some challenges associated with SCI.

Resumo Este artigo contribui com o estudo sobre subjetividade dos moradores de ecovilas a partir do conceito de complexo cultural. A pesquisa foca nos complexos que emergiram em relação ao indivíduo, ao coletivo e à natureza, procurando entender como eles se desenvolveram e foram trabalhados. Contamos com a noção de complexos culturais para compreendermos as relações dos indivíduos consigo, com os outros e com o meio ambiente em contextos comunitários. Fizemos observações participantes em três ecovilas. As análises nos mostram que a vida em ecovilas desenvolve complexos coletivos que mediam as relações dos indivíduos com os seus respectivos grupos no que tange aos aspectos da individualidade e da coletividade, bem como aos modos de se relacionar com a natureza. Contudo, em cada comunidade, o contexto físico e a presença ou ausência de trabalhos de autorreflexão desenvolviam os complexos culturais de formas distintas, produzindo relações específicas de cada indivíduo com seu contexto. Abstract This article aims to contribute to the subjectivity study of ecovillage dwellers based on the concept of cultural complex. The investigation focused on the complexes that emerged with regard to the individual, collective, and nature, how they developed and were worked on. We rely on the notion of cultural complexes to understand the relationships of individuals with themselves, with others, and with the environment in the community framework. We observed the participants in two ecovillages in Switzerland and one in Brazil. The analyses evidenced that life in ecovillages develops collective complexes that mediate the relationships of individuals with their relevant groups regarding aspects of individuality and collectivity and ways of relating to nature. However, in each community, the physical context and the presence or absence of self-reflection works developed cultural complexes in different ways, producing specific relationships between each individual and their context.

Olmstead v. L.C. ex rel Zimring (1999) was a landmark U.S. Supreme Court decision holding that unjustified segregation of people with disabilities is impermissible discrimination; specifically, if the clinician and client believe community integration to be appropriate, the state must have reasonable accommodations in place for the client to be in the community. Enforcement of the Olmstead decision for people with serious mental illness (SMI) has taken many shapes, from the U.S. Department of Justice's (DOJ) settlement agreements requiring substantive development of community mental health services and aggressive community integration protocols, to the Third Circuit approach which requires only lower census numbers in the state psychiatric hospital (SPH). The question of whether Olmstead is being differentially enforced is addressed in an empirical, qualitative analysis of legal documents, including court opinions and settlement agreements. Through legal research spanning all U.S. jurisdictions, five distinct Olmstead enforcement approaches in ten different states were identified. The enforcement approaches are described, and limitations and future directions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BACKGROUND: Despite policies promoting transport inclusivity, persons with disabilities in South Africa experience difficulties when accessing public transport. Poor community mobility hampers community integration and participation in occupations outside the home. This article describes the psychosocial community mobility experiences, of stroke survivors using wheelchairs in a town in the Western Cape province of South Africa METHOD: The study used a descriptive qualitative design. The study population were community dwelling stroke survivors, from Worcester, using wheelchairs. Data was collected from eight participants through semi-structured telephonic interviews. Inductive thematic analysis was used FINDINGS: The four themes derived from the data were: Freedom of movement (My power chair, my Ferrari'), Social anxiety (People stare at you like they do not have a heart), Dependency (I must dance along to his fiddle), and Social isolation (You feel done in, dejected). Participants identified wheelchairs, private vehicles, and mini-bus taxis as modes of community mobility CONCLUSION: When transport barriers prevent dignified, spontaneous community integration negative psychosocial consequences (social anxiety, dependency, and social isolation) followed. Community mobility barriers hampered participants' ability to participate in meaningful occupations and left them isolated. Occupational therapists should take cognisance of the community mobility challenges wheelchair users might experience and implement intervention strategies to mediate these Implications for practice • Community mobility is essential to perform occupations outside the residential setting and must be included in occupational therapy assessment and intervention strategies. • Occupational therapists can empower individuals with mobility impairments with the life skills to manage psychological challenges caused by accessing public transport and decreased community mobility. • Occupational therapy intervention for wheelchair users accessing public transport should include effective, appropriate transfer strategies to embark and disembark from minibus taxis. • In certain circumstances the occupational therapist should consider the possibility of a motorised wheeled mobility device to facilitate community integration.

To investigate the mediating roles of community integration and positive thinking on the relationship between depression and mental health recovery among community dwelling people with mental disorders in South Korea. A cross-sectional, descriptive study was utilized. Data were collected from 167 community-dwelling people with mental disorders who did not use the day program at community mental health centers. Data were collected from November 20, 2018, to February 15, 2019. Both community integration and positive thinking were found to mediate the effects of depression on mental health recovery. The mediating effect of positive thinking was significantly greater than that of community integration. This study added evidence for a significant multiple mediating effect of community integration and positive thinking on the relationship between depression and mental health recovery in community-dwelling people with mental disorders. Although the consumer-centered recovery paradigm of people with mental health difficulties is of global importance, little research has been conducted on mental health recovery among community-dwelling people with mental disorders who do not use the day program at community mental health centers. It was found that community integration and positive thinking mediated the effects of depression on mental health recovery, with positive thinking mediating this relationship the most. Thus, these results suggest a specific direction of community mental health services to promote mental health recovery for people with mental disorders who do not have access to community mental health services.

Individuals with intellectual and developmental disabilities (IDD) are at high risk of co-occurring mental health conditions, including major depressive disorder, bipolar disorder, anxiety disorders, psychotic illnesses, impulse control disorders, and others. Because of symptoms associated with these illnesses and with the disabilities themselves, these individuals are often served in a mental health service system framework. However, treatment for them in these settings has typically not been sufficiently nimble, knowledgeable, or adept. Most mental health professionals receive little training about the needs of this population, and system structures typically bifurcate care, when, in reality, conditions can be complex and overlapping. In this first of two articles on care for persons with IDD in the mental health system, the authors provide a clinical overview of these neurodevelopmental disorders and of mental health and other conditions that co-occur with IDD. Considerations and challenges for treating this population in the mental health system include early recognition of mental health conditions, which often requires caregiver and family input, as well as information from a variety of additional collateral sources; the importance of trauma-informed and person-centered care; the promotion of self-determination through use of decision supports; use of approaches such as applied behavior analysis to develop a frame to address challenging behaviors; and the need to properly assess and provide thoughtful pharmacologic intervention when appropriate. The ability of individuals with IDD to thrive in a wide range of community integration opportunities depends on many factors, and clinicians must understand and use the available approaches for treating them.

The objective of this study is to analyze social and solidary economics as a component of entrepreneurial activities in Ecuador, based on motivation theory, communication theory, and leadership theory. The research took place with a qualitative approach and participative action as the research methodology including 4 phases: diagnosing of needs, planning, information gathering, and public considerations. The information was collected directly from Grupo Salinas, with key informers all being part of the communityof the cooperative society for entrepreneurship and development. For data collection, a participative observation approach was used. The results showed that organizations lack a means to integrate government and private entities, which has a direct effect onthe achievement of goals of the cooperative societies. Thus, this research has helped plan and develop actions that help achieve the process of integration and development to the entrepreneurial activities via the Integral Community Education Project (PEIC)promoting a sense of belonging and commitment with the institutions. It was possible to plan and apply a strategic action plan, managing to integrate the various actors involved in the domain of education, which was later expressed and recorded during the public considerations phase. El propósito de la presente investigación es analizar la economía social y solidaria como elemento de emprendimiento en el Ecuador, sustentado en la teoría de la motivación, la teoría de la comunicación y la teoría del liderazgo. La indagación se desarrolló bajo un enfoque cualitativo con una metodología de investigación acción participativa en cuatro fases: diagnóstico de necesidades; planificación; levantamiento de la información y reflexiones públicas. La información fue recolectada directamente en el Grupo Salinas, los informantes claves pertenecen a la comunidad de cooperativas de emprendimiento y desarrollo. Para la recolección de información se empleó la observación participativa. Los resultados proyectaron que las organizaciones carecen de una integración entre los distintitos entes gubernamentales y privados, lo que influye directamente en el logro de las metas de las cooperativas por lo que a través de esta investigación se planifican y desarrollan acciones que permiten lograr el proceso de integración y el desarrollo al emprendimiento a través del Proyecto Educativo Integral Comunitario (PEIC) incentivando el sentido de pertenencia y el compromiso con las instituciones. Se planificó y aplicó un plan de acción estratégico que logró la integración entre los actores que conforman el ámbito educativo, expresado y recogido en la fase de reflexión pública. O objetivo dessa pesquisa é fazer uma análise da economia social e solidária como parte dos empreendimentos no Equador, respaldado na teoria de motivação, a teoria de comunicação e a teoria de liderança. A investigação foi feita baixo uma abordagem qualitativo com uma metodologia de investigação com ação participativa em quatro estágios: diagnostico de necessidades, planificação, coleta de informação e considerações públicas. A informação foi coletada diretamente no Grupo Salinas, os informantes chave são parte da comunidade de cooperativos de empreendimento e desarrolho. Para a coleta de informação, usou-se a observação participativa. Os resultados mostraram que as organizações carecem de uma integração entre os vários órgãos governamentais e privados, o qual tem efeitos direitos sobre o cumprimento das metas dos cooperativos. Por essa razão, a pesquisa pretende planejar e desarrolhar ações que permitam chegar em um processo de integração e desarrolho ao empreendimento por meio do Projeto Educativo Integral Comunitário (PEIC), incentivando um sentido de pertença e um compromisso com as instituições. Um plano de ação estratégico foi feito e usado, conseguindo uma integração dos atores que conformam o campo educativo, expressadas e coletadas durante a fase das considerações públicas.

Introduction: Individuals with lived experiences of homelessness report social exclusion and struggle to belong in their communities. I conducted this research to fill a gap in existing research by addressing the research question: “What are the experiences of belonging for individuals as they leave homelessness?” Methods: I conducted this research in two phases: 1) a systematic review and meta-aggregation of qualitative literature using the Joanna Briggs Institute methodology; and 2) a secondary analysis of existing qualitative data from a study focusing on the experience of transitioning from homelessness using thematic analysis (Braun & Clarke, 2006). Findings: The findings from both of these studies indicate that attaining belonging following homelessness is a difficult process; yet having housing, social networks and engaging in meaningful activities facilitates this experience. Conclusion: Belonging is critical following homelessness and supporting individuals in supporting this outcome is a key homelessness prevention strategy.

Introduction: The World Health Organization has been working with the premise of equity with universal respect for human dignity, making a commitment to “leave no one behind,” and for this reason, it directs special attention to the lesbian, gay, bisexual, transgender, queer, and intersex population. The transgender population is especially affected by several social stigmas that impact their health and illness processes. Understanding Primary Health Care as an essential space for guaranteeing the rights of this population, Health Centers must intensify efforts to welcome these people, and an important step may be to understand their family relationship and community insertion. Objective: To assist in raising visibility of the representations that travestis and transgender women seen at a Health Center have about their social relationships. Methods: Travestis and transgender women living in a community assisted by the Health Center were interviewed. In-depth interviews were conducted with the elaboration of the ecomap, which were systematized with the participants and later sent for their approval. The individual ecomaps were synthesized in a single ecomap. Results: All five travestis and transgender women residing in the area were interviewed. The average age was 27.5 years. As for self-reported ethinicity/skin color, one is white, two are mixed-race, and two are black. Two of them were formally employed and three were unemployed. Regarding level of education, four of the interviewees held a high school degree and one had some elementary school. For most travestis and transgender women in this community, family support is noteworthy. Concerning social protection equipment, the most cited were the Public Defender’s Office, a Nongovernmental Organization, and the Social Assistance Reference Center. All participants are followed up at the Health Center, and one reported being absent for having no demands. The Candomblé religion also consisted in a support factor for two of the interviewees. The greatest difficulty was in relation to employability, with the report of transphobia situations. One of the interviewees identified that she has a problem related to drug addiction. Conclusions: There is still much to improve in public policies that promote equity and health for travestis and transgender women, especially in guaranteeing health care, incentives for employability, and combating transphobia. Nevertheless, women in the studied community and their families indicate how welcoming and support can be differentiating factors in these life trajectories. Introducción: La Organización Mundial de la Salud ha venido trabajando con la premisa de equidad con respeto universal a la dignidad humana, comprometiéndose a “no dejar a nadie atrás”, y por ello, aporta una mirada especial a la población lesbiana, gay, bisexual, transgénero, queer e intersexual. Se sabe que la población transexual se ve especialmente afectada por varios estigmas sociales que impactan en su proceso de salud y enfermedad, entendiendo la Atención Primaria de Salud como un espacio primordial para garantizar los derechos de esta población, es necesario que los Centros de Salud intensifiquen los esfuerzos para acogerlos, un paso importante puede ser comprender cómo es su relación familiar e inserción comunitaria. Objetivo: Contribuir a la visibilidad de las representaciones que tienen las mujeres trans y travestis atendidas en un centro de salud sobre sus relaciones sociales. Métodos: Se entrevistaron a travestis y mujeres transgénero residentes en una comunidad asistida por el Centro de Salud, se realizaron entrevistas en profundidad con la elaboración del Ecomapa, se sistematizaron con las participantes y posteriormente se enviaron para su aprobación, los ecomapas individuales se sintetizaron en un solo Ecomapa. Resultados: Se entrevistó a las 5 travestis y transgénero residentes. La edad promedio fue de 27,5 años, según la autodeclaración de raza / color: 1 es blanca, 2 marrón y 2 negra. 2 estaban empleadas formalmente y 3 sin empleo. 4 habían completado la escuela secundaria y 1 escuela primaria incompleta. Para la mayoría de travestis y mujeres trans de esta comunidad, el apoyo familiar es notable. En cuanto al equipo de protección social, los más citados fueron la Defensoría Pública, una ONG y el Centro de Referencia de Asistencia Social. Todo tiene seguimiento en el Centro de Salud, y uno informó estar más alejado, ya que no había demanda. La religiosidad candomblécista también fue un factor de apoyo para dos de los entrevistados. La mayor dificultad fue con relación a la empleabilidad, con reportes de situaciones de transfobia. Una de las entrevistadas identificó que tiene un problema relacionado con la adicción a las drogas. Conclusiones: Aún queda mucho por evolucionar en las políticas públicas que promuevan la equidad y la salud de las mujeres trans y travestis, especialmente en garantizar la atención de la salud, incentivos a la empleabilidad trans y el combate a la transfobia, sin embargo, las mujeres de la comunidad estudiada y sus familias indican lo acogedoras y el apoyo puede ser un factor diferenciador en estas trayectorias de vida. Introdução: A Organização Mundial da Saúde tem trabalhado com a premissa da equidade com respeito universal pela dignidade humana, assumindo o compromisso de “não deixar ninguém para trás”, e por esse motivo direciona um olhar especial para a população de lésbicas, gays, bissexuais, transgêneros, queer e intersexuais. Sabe-se que a população transgênero é especialmente atingida por diversos estigmas sociais que impactam seu processo de saúde e adoecimento. Entendendo a Atenção Primária à Saúde como espaço primordial para a garantia de direitos dessa população, é necessário que os Centros de Saúde intensifiquem os esforços para acolher essas pessoas; um passo importante pode ser entender como é seu relacionamento familiar e sua inserção comunitária. Objetivo: Auxiliar na construção da visibilidade das representações que as mulheres transgênero e travestis assistidas em um Centro de Saúde têm sobre suas relações sociais. Métodos: Foram entrevistadas as travestis e mulheres transgênero moradoras de comunidade assistida pelo Centro de Saúde. As entrevistas foram feitas em profundidade e com a elaboração de ecomapa, sistematizadas com as participantes e posteriormente enviadas para sua aprovação. Os ecomapas individuais foram sintetizados em um único. Resultados: Todas as cinco travestis e mulheres transgênero que residiam na área foram entrevistadas. A média de idade foi de 27,5 anos. Sobre a autodeclaração de raça/cor, uma é branca, duas são pardas e duas, negras. Duas encontravam-se com vínculo de trabalho formal e três sem ocupação. Quatro apresentavam ensino médio completo e uma, ensino fundamental incompleto, conforme indicado na Tabela 1. Para a maioria das travestis e mulheres trans dessa comunidade, é notável o suporte familiar como ponto de apoio. No que concerne a equipamentos de proteção social, o mais citado foi a Defensoria Pública, uma organização não governamental e o Centro de Referência da Assistência Social. Todas fazem seu acompanhamento no Centro de Saúde, e uma referiu estar mais afastada por não ter demanda. A religiosidade candomblecista também foi fator de suporte para duas das entrevistadas. A maior dificuldade foi relativa à empregabilidade, com relatos de situações de transfobia. Uma das entrevistadas identificou que tem um problema relacionado à drogadição. Conclusões: Ainda há muito a evoluir em políticas públicas que promovam equidade e saúde para as mulheres trans e travestis, especialmente na garantia de cuidados com a saúde, de incentivos à empregabilidade trans e de combate à transfobia, porém as mulheres da comunidade estudada e suas famílias indicam-nos como o acolhimento e o apoio podem ser fatores diferenciais nessas trajetórias de vida.

Objective: Social participation in daily living the activities requires the maintenance of a variety of social relationships with others and engagement in various social activities. Proper social participation increases the feeling of attachment, provides a stable sense of identity, and increases one’s sense of worth, belonging, and dependence on society. Lack of social participation leads to anxiety, loneliness, depression, panic, mental disorders and many other mental problems and affects society in general. A new coronavirus, called COVID-19, was identified in late December 2019 in China. After just one year, it has been reportedly infected more than 85 million people (up to January 1, 2021) worldwide, and more than 1.8 million have died. Two public health measures to break the transmission chain include quarantine and social distancing. These measures restrict gatherings or separate individuals. Due to these measures in many countries, people’s participation in many social activities has been disrupted. The purpose of this study is to survey the negative effects of the COVID-19 pandemic on home integration, community integration and productive activities. Materials & Methods: This cross-sectional study was conducted in June 2020 by using the Community Integration Questionnaire (CIQ) which measures home integration, community integration, and productive activities, along with a demographic form which were sent to 461 participants in Iran (Mean ±SD age= 36.86±5.8 years) on WhatsApp or via email and completed online. Participants were selected from among college students, patients, people with disabilities, their families and relatives, and others who could use smartphones, computers, tablets, and laptops. The effects of Covid-19 were evaluated by analyzing the CIQ scores before and after the pandemic in SPSS v. 22 software. Results: Comparing the CIQ scores before and after the pandemic, results showed that it significantly reduced home integration (P

Community participation following spinal cord injury/disease (SCI/D) can be challenging due to associated primary impairments and secondary health conditions as well as difficulties navigating both the built and social-emotional environment. To improve the quality of SCI/D rehabilitation care to optimize community participation, the SCI-High Project developed a set of structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. A pan-Canadian Working Group of diverse stakeholders: (1) defined the community participation construct; (2) conducted a systematic review of available outcomes and their psychometric properties; (3) constructed a Driver diagram summarizing available evidence associated with community participation; and (4) prepared a process map. Facilitated meetings allowed selection and review of a set of structure, process and outcome indicators. The structure indicator is the proportion of SCI/D rehabilitation programs with availability of transition living setting/independent living unit. The process indicators are the proportion of SCI/D rehabilitation inpatients who experienced: (a) a therapeutic community outing prior to rehabilitation discharge; and, (b) those who received a pass to go home for the weekend. The intermediary and final outcome measures are the Moorong Self-Efficacy Scale and the Reintegration to Normal Living Index. The proposed indicators have the potential to inform whether inpatient rehabilitation for persons with SCI/D can improve self-efficacy and lead to high levels of community participation post-rehabilitation discharge.

Although the era of Palestinian migration to France is relatively recent, and began in the 1970s, Palestinians have significantly integrated into French society. The social, economic, and political situations in their homeland have played an essential role in Palestinian migration from that homeland or, in some cases, from the refugee camps of Jordan, Syria, and Lebanon. Palestinian migrants/refugees have integrated into French society despite their economic classes or categories. As this paper analyses, students and businessmen were the types of Palestinian migrants with the highest level of integration in French society. They are the two main categories making up the Palestinian community in France. Marriage also plays a significant role as a crucial integration mechanism for both women and men. Despite the fact that the French Jacobin system obliges all migrants/refugees to assimilate into French society, this has not affected the understanding of original Palestinian identity. These migrants/refugees still introduce themselves as Palestinians.

PURPOSE To assess whether meeting criteria for community ambulation and ambulatory self-confidence on discharge from inpatient rehabilitation are associated with participation in community activities. METHODS Prospective longitudinal observational study design. Participants were assessed within 48-hours of discharge on ability to complete tasks reflective of community ambulation (walking 315 m, ascending/descending three stairs, a ramp, and a street curb and walking at 0.44 m/s) and ambulatory self-confidence. At 8 weeks post-discharge frequency of participation in domestic, leisure/work and outdoor activities was measured using the Frenchay Activities Index (FAI). Multivariable regression analysis determined factors associated with total and outdoor FAI score. RESULTS Seventy-four of 79 participants were followed up at 8 weeks post-discharge. Meeting all ambulation criteria was positively associated with FAI outdoor score (β = 1.85, 95%CI 0.01-3.69, p = 0.049). Ambulatory self-confidence was positively associated with FAI outdoor score (β = 0.03, 95%CI 0-0.05, p = 0.032) and FAI total score (β = 0.05, 95%CI 0-0.1, p = 0.040). Age (β= -0.22, 95%CI -0.36 to -0.08, p = 0.003) and living alone (β = 3.36, 95%CI 0.10-6.61, p = 0.044) were associated with FAI total score. CONCLUSIONS Capacity to meet ambulation criteria and ambulatory self-confidence are modifiable factors that could be targeted during rehabilitation to improve participation in community activities.Implications for rehabilitationMeeting community ambulation criteria and confidence with walking on discharge from inpatient rehabilitation are positively associated with performance of outdoor community activities 8 weeks after discharge.Capacity to meet community ambulation criteria and ambulatory confidence may be useful measures for rehabilitation teams to consider when discharging patients home.Meeting ambulation criteria and ambulatory confidence are modifiable factors that could be addressed through targeted therapy to improve community integration following hospitalisation.

Introduction Existing research has addressed the importance of community integration (CI) and its benefits of dwelling in a community but has yet to address the methods and efficiency of improving these activities among older people. Thus, it is vital to understand how healthcare workers can integrate the benefits of CI among older people, especially with the use of occupational therapists (OTs). The latter are actively working to improve ageing individuals mobility within the community. Objective This study aims to identify Malaysian OTs’ perspectives on CI’s and its implication on older people. Method Occupational therapist from different states of Malaysia participated in a semi-structured interview, through a virtual medium (Zoom Cloud Meetings). The interview guide encapsulated the theory of critical incident technique (CIT). Results Thematic content analysis, over fourteen participants from 13 states of Malaysia, provided insights into CI’s barriers for older people in Malaysia. The findings revealed that multifaceted factors from an individual, organisational and socio-environmental perspective limit older people’s active CI engagement. Conclusion South-East Asia hierarchal and collectivist culture play a significant role in influencing all factors of CI. OTs must understand and incorporate appropriate cultural norms during CI practice development for the older population in Malaysia.

El objetivo del estudio fue analizar a través de una revisión sistemática el enfoque que se le viene dando en el periodo comprendido entre 2016-2021 a la cualificación del recurso humano en el gobierno municipal en el contexto internacional, nacional y regional. La investigación es básica, su diseño la revisión sistemática, la muestra fueron 21 artículo por su aporte al tema investigado, los mismos que fueron encontrados en Google académico, ProQuest y EBSCO Discovery, considerando además una antigüedad no mayor de 5 de años. Se determinó que las investigaciones que más prevalecen en la revisión sistemática han sido las de tipo básico, enfoque cualitativo y diseño descriptivo. Siendo importante precisar que los estudios en su mayoría fueron encontrados en países europeos, donde se práctica activamente la cualificación del recurso humano en el sector público, siendo esta una herramienta importante para aminorar las informalidades en el contexto laboral del sector público. Se han identificado y demostrado las deficiencias asociadas con las prácticas de la cualificación de los recursos humanos, entre ellas se encuentra la contratación de personal sin previa licitación abierta, contratación de personal no previsto en el presupuesto analizado, y personal que no cumple con los requisitos mínimos establecidos en los correspondientes manuales de personal, funciones y organización requeridos para el puesto, estos problemas limitan el desarrollo de personal eficaz debido a la falta de capacidad intelectual y herramientas para fomentar la formación integral de los individuos para mejorar los beneficios de los servicios públicos. Claro está que disponer de posibilidades de desarrollo y preparación no asegura el acceso a un empleo digno o la inserción comunitaria, no obstante, estas pueden optimizar su empleabilidad al relacionarse con tácticas de reinserción y de prevención.

Purpose: The purpose of this study was to identify interprofessional competencies for the integrated community care of older people.Methods: This study used a methodological approach, and the specific process aimed to identify the components of interprofessional competencies for integrated community care using a scoping review and validating the identified competencies with the Delphi method. The scoping review first identified relevant studies through the following electronic databases: PubMed, CINAHL, Embase, and the Cochrane Library. We then selected studies that met the inclusion criteria and analyzed their results to identify a draft version of the competencies. Expert panels validated the list of competencies through two rounds of the Delphi survey.Results: The two rounds of the Delphi survey revealed consensus. Finally, we developed an interprofessional competency for integrated community care comprising 19 interprofessional core competencies, 20 integrated core care competencies for community care administrators, 13 integrated core care competencies for care coordinators, 13 integrated core care competencies for local service providers, and 12 integrated core care competencies for community health leaders.Conclusion: This study can help inform job descriptions, evaluate the relevant professionals’ performance, and develop a competency-based curriculum for better practice.

Objective: Experiencing a life of meaning is considered fundamental to “what makes life worth living,” yet investigation of life meaning among persons with lived experiences of homelessness is lack...

Research calls for community health worker (CHW) integration within health systems, yet there is no agreement regarding what CHW integration is or guidance for how it can be achieved. This study examines factors associated with CHW integration in community and health care settings using a qualitative descriptive multiple-embedded case study of CHW teams at the University of Illinois at Chicago. Data were collected via semistructured interviews/document review and analyzed using thematic coding and quantitative content analysis. Factors associated with higher clinical integration included culture, communication, protocols, and training while higher community integration was associated with accessibility, relationships, and empathy.

Objective To develop and validate a scale to assess people’s attitudes and perspectives toward persons with disabilities.Methods The three-stage development of the scale included a preliminary version drafted from the literature review and a nominal group process. Thereafter, the draft was examined further and revised through two rounds of Delphi survey by 16 disability experts. Lastly, the psychometric properties of the scale were assessed through an online survey of 1,359 employees at three university hospitals.Results A 32-item scale, defined after two Delphi surveys, was refined into 14 items with four subcategories: community integration, discomfort, charitability, and sense of burdening. The Cronbach’s alpha coefficient was 0.839 and domain reliability from 0.638 to 0.845. Recent education on disabilities yielded more positive attitudes toward persons with disabilities. Meaningful acquaintances with disabilities yielded more positive attitudes toward persons with disabilities.Conclusion This newly developed scale that measures attitudes toward persons with disability is reliable and valid. A future use of the scale could be to measure attitudinal improvements toward persons with disabilities after awareness education.

Refugees endure tremendous trauma during migration and resettlement. Despite the wide range of needs and challenges refugees have, previous research on refugee mental health has concentrated on the clinical treatment of certain common mental disorders related to premigration trauma. This narrow attention creates an environment in which positive mental health and social functioning are seen merely as a lack of mental illness among refugee populations. The consequences of such a focus are increased stigma of mental health issues and a negligence of other psychosocial needs critical to the community integration of refugee newcomers. There are few models and studies that focus on service delivery and systematic approaches to guide coordination of mental health services and psychosocial supports for refugee newcomers. To fill such gaps, this paper provides a framework to align stratified interventions and addresses the multilayered mental health needs in refugee communities. We have adopted and applied a multitier mental health and psychosocial support (MHPSS) model developed by the Inter-Agency Standing Committee to provide a holistic framework for a system of care. We have also proposed a two-pillar approach, trauma-informed and culture-informed care, which is embedded into each tier of the MHPSS program. This approach is designed to fill the gaps between mainstream mental health services and refugee resettlement programs, both of which tend to work in silos. Using the case of a statewide refugee mental health initiative in Virginia, we discuss the challenges and opportunities of programs to build capacity and partnerships for coordinated care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: Prevalence of methamphetamine use is rising in North America. Peers and social relationships are known to influence substance use patterns, but fewer studies have examined the role of early initiation on later social integration. We aimed to understand the relationship between age of first use and social integration. Methods: Bivariate analyses were performed to assess the relationship between age of first use and social integration before performing a sex-based analysis. Multivariable linear regressions were used to help to understand this relationship. Results: There was no significant association between age of first use and social integration scores for the sample. Sex, age of first use, and the interaction between the two were not significantly associated with social integration scores. Conclusions: Researchers and those working with current or past methamphetamine users should perform larger population-based studies to better address the gap in the literature between social integration and age of first methamphetamine use.

Objective To systematically review evidence on the coverage, content validity and internal structure of self-report measures capturing subjective aspects of participation for adults with disabilities. Data sources EMBASE, MEDLINE and reference lists were searched until July 10th, 2022 for articles on measurement properties of instruments measuring participation as defined in the International Classification of Functioning, Disability and Health, from a subjective perspective. Method Each instrument was assessed for its coverage of subjective aspects of participation. The Consensus-based Standards for the Selection of Health Measurement Instruments were used to assess the quality of each study. Content validity and internal structure (structural validity, internal consistency and cross-cultural validity) were rated against published standards and qualified by the adapted Grading of Recommendations Assessment, Development and Evaluation. Results Thirty-eight studies regarding 10 instruments were analysed. Most instruments mix activity and participation items. Only the Measure of Experiential Aspects of Participation (with high-quality evidence of sufficient structural validity and generally sufficient internal consistency), the Participation Enfranchisement and the Community Integration Measure showed adequate coverage. For all instruments, evidence of content validity is of low- to very low quality. There is high-quality evidence that the Participation Scale is not unidimensional. Conclusion In general, the coverage and the evidence for content validity and internal structure of measures capturing experiential aspects of participation are limited. The Measure of Experiential Aspects of Participation has the best level of evidence in support of its use. The score of the Participation Scale cannot be considered an adequate reflection of participation.

Community participation is an important aspect of individuals’ functioning. This construct is defined as an individual’s “active involvement in activities that are intrinsically social and either occur outside the home or are part of a nondomestic role” (Chang et al., 2013, p.772). One of the dimensions of community participation is the “attendance” in activities performed outside home. Traditionally, individuals’ attendance has been measured by means of self-report questionnaires, through which many parameters can be examined. Such parameters include frequency, intensity and length of attendance, as well as the variety of activities in which an individual takes part. A promising technology that can be used to map an individual’s displacement in the community consists of geoprocessing tools and methods (Brusilovskiy et al., 2016). Researchers from several countries, such as Australia, Canada, USA, Israel and Germany, have been using geographic intelligence to understand factors related to accessibility and community integration of different clinical populations. The applicability of this technology in understanding individuals’ community participation is the main focus of this scoping review, which aims to synthesize the unique contributions of these tools and methods in measuring this construct. The results of our study may elucidate how geographic intelligence is being applied in the study of community participation and highlight the validity, meaningfulness and possible limitations of this technology’s application.

This study aimed to focus on how adults ages 18-65 with spinal cord injuries (SCI) integrate in the community and how that affects their quality of life (QOL) and participation in occupations. The MOHO and Humanistic model relates to our thesis because for an individual with an SCI to integrate back into their community they will work on gaining motivation, developing new habits and exploring new roles. We believe this will be done to meaningful occupations by successfully integrating into the community. The vision for AOTA 2025 is “As an inclusive profession, occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living.” Consequently, the AOTF believes that there is a need for significant investment to address community populations across the lifespan in order to achieve better outcomes for all people and improve quality of life. Throughout our research we have gaps in research of few programs that help individuals with an SCI integrate back into the community, there is not one specific highly recommended and commonly used program for tailored for community integration. Another gap we have found is in regards to the Covid-19 pandemic of SCI being isolated with mandated home-order to avoid spreading of infection. There are also gaps in studies regarding reimbursement for individuals with an SCI. This scoping review will answer questions based on adults with SCI and the correlation related to community integration and quality of life. This will be compared to those with a SCI who do not participate in their community. This scoping review is beneficial and significant to assess the evidence in community integration for SCI in improving their QOL. The purpose of this research is to enhance interventions and treatments that target specific areas to improve QOL in individuals with an SCI. We utilized multiple databases to gather the information including Ebscohost, Academic Search Complete Google Scholar, and ProQuest. We also used key search terms such as “community integration,” “quality of life,” “spinal cord injury,” “occupations,” and “participation” to select our articles. From these databases and key words, we were able to find preliminary articles with Levels 1, 2, and 3 evidences in analyzing themes of community integration, factors contributing in QOL, assessment for QOL and barriers inhibiting QOL. We included many gaps in our research pertaining to the lack of structured programs, COVID 19 and isolation, and poor reimbursement with no allocated insurance payment to individuals with an SCI. We will test our hypothesis stating that patients with an SCI will integrate into their community more effectively and have a better QOL. The overall importance of this review is to implement community integration in OT interventions with any population in our future practice.

Traumatic brain injury (TBI) affects cognitive, behavioral and physical function, influencing community reintegration.To describe the level of community reintegration and the associated influencing factors post-TBI in South Africa.A cross-sectional analysis of patients living with TBI was done, using the Community Integration Questionnaire (CIQ), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and the Quality of Life after Brain Injury Overall Score (QOLIBRI-OS).Of the 80 participants 54.0% presented with mild TBI. The median (IQR) score of the CIQ, WHODAS 2.0 and QOLIBRI-OS was 22 (7.5)/29, 31(18)/100 and 73 (45.5)/100. There was a moderate inverse relationship between the WHODAS 2.0 and CIQ scores (r = -0.68; p 0.001) and a moderate positive correlation between the QOLIBRI-OS and CIQ scores (r = 0.54; p 0.001). The WHODAS 2.0 scores also showed a strong inverse correlation with the QOLIBRI-OS scores (r = -0.76; p 0.001).The participants had high levels of functioning and low levels of disability, both of which were found to be in tandem with high CIQ scores and generally good quality of life. Post-TBI patients are capable of achieving good community integration provided they attain high levels of functioning.

The rising number of foreign residents in Japan has caused the number of children with foreign backgrounds in Japanese schools to increase. The present Japanese education system does not adequately support children whose mother language is not Japanese, and their educational problems have turned into social issues. We have conducted an action research project in collaboration with several schools and one university to determine how to develop a support system through online media that would soften the impact of the COVID-19 pandemic. We argue that language assessment is the key to driving the project and sharing the results of the assessment analysis with all project participants works effectively to promote collaboration between schools, families, and the university.

Introduction Stigmatization impedes the social integration of persons recovering from mental illnesses. Little is known about characteristics of the stigmatized person that lessen or aggravate public stigma. Purpose This study investigates which characteristics of persons with mental illnesses (i.e. with a depression or a psychotic disorder) might increase or decrease the likelihood of public stigma. Methods Over 2,000 adults read one of sixteen vignettes describing a person with a depressive disorder or a psychotic disorder and answered a set of items measuring social distance. Results The person who was employed (vs. unemployed), or whose neighbors did not experience domestic noise disturbance (vs. disturbance) elicited significantly less social distance. Also persons with a depressive disorder elicited less social distance, vs. persons with a psychotic disorder. Conclusion Employment and good housing circumstances may destigmatize persons coping with mental illnesses. Mental health and social services should encourage paid employment, quality housing and other paths to community integration.

Objective To assess governmental and nongovernmental stakeholders' perceived impacts of a Medicaid home- and community-based services (HCBS) rebalancing initiative, the Balancing Incentive Program (BIP). Data sources Governmental stakeholders (Medicaid administrators) and nongovernmental stakeholders (service providers and consumer advocates) (n = 30) from eight states that participated in BIP. Study design We conducted key informant interviews. Data collection Interviews followed a semi-structured guide and were professionally transcribed. We thematically coded transcripts using an iterative codebook with a priori and emergent codes. Principal findings Stakeholders reported that BIP participation had a range of impacts on the HCBS ecosystem, often beyond the mandated structural reforms. BIP activities were believed to have changed the culture of HCBS in some states, for example, at the level of state administration or in the provision of HCBS to consumers. Stakeholders also described significant improvements in cross-stakeholder relationships and communication, for example, in the context of troubleshooting consumers' unmet needs or improvements in the states' responsiveness to providers' inquiries. Stakeholders believed that within-state data harmonization undertaken through Core Standardized Assessment (CSA) was a positive impact of BIP, particularly with regard to its utility for administrative data, care planning, and patient-centeredness. Two stakeholders also voiced concerns regarding the validity of spending-based rebalancing metrics. The impacts that stakeholders attributed to BIP may help create a more sustained rebalancing environment through their changes to the ecosystem, including infrastructure upgrades, data harmonization, collaboration across stakeholders and agencies, more patient-centeredness, and greater recognition of HCBS. Conclusions Our findings highlight additional BIP impacts to monitor over the longer term and to consider in evaluations of future rebalancing efforts. Some potential impacts of BIP are more readily quantified (e.g., HCBS spending), while others are less likely to be formally assessed (e.g., improved stakeholder cooperation). These latter impacts are likely instrumental to future rebalancing efforts.

Community integration is preferred by people with intellectual and developmental disabilities; community integration is also associated with positive outcomes. Yet, many people with intellectual and developmental disabilities, especially with higher support needs, remain isolated. This exploratory study examined the relationship between community integration, significant support needs, and emergency department utilization of people with intellectual and developmental disabilities (n = 251) by analyzing secondary Personal Outcome Measures® interview data. We found an interaction between community integration and comprehensive behavior support needs, wherein people with intellectual and developmental disabilities with comprehensive behavior support needs who participated in the life of the community had 78% fewer emergency department visits than those people with comprehensive behavior support needs who did not participate in the community. Not only is community integration preferred by people with intellectual and developmental disabilities, our research suggests it can also produce improved health outcomes for those with comprehensive behavior support needs.

Virtual reality (VR) is a technology frequently used for both recreation and healthcare service delivery. Yet, little is known about the applicability and use of specific VR applications in recreational therapy (RT) practice. Google Earth VR is a popular application that allows users to virtually travel to different locations around the world. It could have relevance in patient-centered treatment that addresses a variety of RT treatment goals. Using a focus group of RTs (N = 8), this study examined possible uses of Google Earth VR in RT treatment. Following an education and training session providing an overview of VR equipment and the Google Earth VR application, participants engaged in clinical role play from both a therapist and client perspective. This was followed by a focus group discussion where therapists were asked to identify possible treatment uses for Google Earth VR with the clients they serve. Four main themes emerged, including reminiscing, community integration/leisure education, social skills development, and distraction/pain management. Findings indicate RTs view Google Earth VR as a resource with potential therapeutic applications for new and innovative treatment. The identified treatment focus areas also provide guidance for professional resource development and future research studies.

Cette recherche a été guidée par l’objectif de déterminer l’impact des propriétaires et des employés des ressources non institutionnelles en santé mentale sur l’intégration communautaire des résidents. Pour accomplir cet objectif, des entretiens semi-directifs ont été réalisés auprès de propriétaires, d’employés et de résidents de ces ressources. Les données recueillies lors de ces entrevues ont fait l’objet d’une analyse thématique de contenu. Le modèle de l’intégration communautaire de Segal et Aviram (1978) a servi de cadre conceptuel à l’étude. L’utilisation de ce modèle a permis de nuancer l’analyse des données en amenant une différenciation entre l’intégration ayant lieu à l’intérieur de la ressource d’hébergement, et celle existant à l’extérieur de ce milieu. Les résultats mentionnent que les interventions du personnel de ces ressources visent généralement l’une de ces deux cibles : l’acquisition de l’autonomie des résidents et leur protection. Pour intervenir auprès des résidents, les propriétaires et les employés s’appuient sur leur statut d’autorité. Cependant, lorsque l’autorité est utilisée pour promouvoir l’autonomie ou assurer la sécurité des résidents, cette action a un impact négatif sur l’autre cible, générant des ambivalences., This study aims to determine how owners and employees of community residential mental health resources impact community integration of their residents. Semi-structured interviews were conducted with owners, employees and residents of these resources. The data collected were analyzed using a thematic content analysis. Segal and Aviram’s (1978) model of community integration was used as a conceptual framework. This model has been useful to analyze the data as it helped differentiate integration taking place within the residence, and integration outside this environment. Results show that owners’ and employees’ interventions have two targets: developing residents’ autonomy and ensuring their protection. Owners’ and employees’ authority status plays an important role in the interventions they have with their residents. However, whenever authority is used to either promote autonomy of the residents or ensure their protection, it usually has an opposite effect on the other target of intervention, creating ambiguity.

Objective Successful community integration involves active participation in the community, broadly defined as having independence, relationships, and engagement in meaningful activities. This review aims to identify the literature focusing on community integration of individuals with stroke aged 18 years and older in the community over the past two decades. Methods This review will be based on the methodological framework given by Arksey and O’Malley (2005). We will include studies from SCOPUS, PubMed, Web of Science, Google Scholar, CINAHL, EBSCO, ClinicalKey, Wiley Online, ProQuest, and Cochrane Library databases published from January 2000 onwards. Both quantitative and qualitative data will be analyzed separately to identify various assessments, interventions, and factors that influence the community integration of individuals with stroke. Conclusion This scoping review will help to explore studies focusing on community integration among individuals with stroke aged 18 and older living in the community. It can further assist professionals who are addressing the concerns of individuals with stroke in the community.

Individuals with intellectual disabilities (ID) are an expanding population that confronts multiple disadvantages from social and environmental determinants of health. Deinstitutionalization and community integration have improved the lives of individuals with ID in many ways. However, deinstitutionalization may increase their access to alcohol and drugs and the potential for developing Substance Abuse Disorders (SUD). It is estimated that 7–8 million people in the United States with an intellectual disability (ID) suffer disproportionately from substance use problems [1] . There is a lack of empirical evidence to inform prevention and treatment efforts in this population and more research needs to be done in order to address these issues.

The COVID-19 pandemic has upended the lives of everyone in the United States, negatively impacting social interactions, work, and living situations, and potentially exacerbating mental health issues in vulnerable individuals. Within the Department of Veterans Affairs (VA) healthcare system, two vulnerable groups include those with a psychotic disorder (PSY) and those who have recently experienced homelessness (recently housed Veterans, RHV). We conducted phone interviews with PSY (n = 81), RHV (n = 76) and control Veterans (CTL, n = 74) between mid-May - mid-August 2020 ("initial") and between mid-August - mid-October 2020 ("follow-up"). At the initial period, we also collected retrospective ratings relative to January 2020 ("pre-COVID-19"). We assessed clinical factors (e.g., depression, anxiety, loneliness) and community integration (e.g., social and role functioning). All groups reported worse clinical outcomes after the onset of the COVID-19 pandemic. However, PSY and RHV exhibited improvements in depression and anxiety from initial to follow up, whereas CTL continued to exhibit elevated levels. There was little change in community integration measures. Our results indicate that all groups reported increased mental health problems after the onset of the pandemic, but vulnerable Veterans were not disproportionately affected and had better mental health resilience (i.e., for depression and anxiety) as the pandemic progressed compared to CTL. This effect could be due to the availability and utilization of VA services for PSY and RHV (e.g., housing and financial support, medical and mental health services), which may have helped to mitigate the impact of the pandemic.

Stroke is an acute condition that requires immediate care and long-term community-based chronic care supports. Communities vary in their ability to support the complex needs of this population.To bring stroke recovery stakeholders together to discuss the needs of community-based stroke recovery and develop possible solutions across one province in Canada.The participatory research approach of the World Café was used to explore topics related to community-based stroke recovery. Three World Cafés were held in three communities, including rural, urban-multicultural, and indigenous communities. Sixty-one stakeholders participated in this study. The data was analyzed following an inductive approach for all three Word Cafés.Four main themes were revealed from the data. First,While some similarities in needs and solutions were identified for stroke survivors across three diverse communities, differences between them were also reported. Approaches to enhance better communication among all stakeholders and facilitate a continuous transition from hospital to community are needed. Co-creating solutions with each local community should be considered as individual needs, and challenges are specific to each community.

IntroductionThere have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19.MethodsData were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses.ResultsA total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective.ConclusionPsychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.

Urban-rural integrated communities (URICs) are transitional areas for agricultural transfer population (ATP) in the process of urbanization in China. In the current urban renewal context, the demolition and renovation of communities often result in ATP living in a precarious situation and being marginalized in the city. Sustainable urban renewal should change this situation, take the transformation of URICs as a breakthrough, and promote the urban integration of the ATP. Based on the survey of the National Health Commission of China in 2017, this paper investigates the effects of community participation and community identity on community integration, using the ordered probit model with data of the ATP living in URICs. The results show that both community identity and community participation positively influence community integration, and there are intergenerational differences. The mediating effect test shows that community identity plays a mediating role in the process of community participation, influencing community integration. The findings of the study provide possible ideas for the practical promotion of community integration and urban integration of the ATP, facilitate the implementation of sustainable urban regeneration to reduce the costs of citizenship, and maximize the benefits of the cumulative effects of urbanization for all segments of the population.

This qualitative study explored ex-offender’s community reintegration experiences following a prison sentence. Fourteen ex-offenders from the Offender Alumni Association participated in an in-person in-depth individual interview regarding their current roles, daily routines, living situation, activity participation, and current and future plans. A phenomenological approach using thematic analysis was employed for data collection and interpretation. The emerged themes were categorized under facilitators and barriers that influence healthy community reintegration. The facilitators included visualizing and committing to an ideal future, establishing a daily routine, upholding life balance, and discovering and connecting to external supports. The barriers included impediments to employment opportunities, lack of financial resources, social stigma, regulations imposed by the judicial system, disconnection from social advancements, and addiction to drugs and alcohol. The themes identified from the interviews suggest that current reintegration strategies and programs need to be improved in order to benefit ex-offenders seeking these services.

The article entitled "The Function of Music in Tiban Rituals in Purwokerto Village, Ngadiluwih District, Kediri Regency" focused on the issue of Tiban ritual forms, Tiban ritual music performance and the function of Tiban ritual music. The results showed that the Tiban ritual was held during the long dry season with the aim for asking for rain through whipping by the perpetrators or what is called petiban. The people believe that the Tiban ritual can bring rain by means of media of blood dripping on the ground. Tiban music has several motifs in the wasp structure that characterizes it. Tiban music has an important function in Tiban rituals. The functions of music include the function of emotional expression, aesthetics, communication, physical reaction, legalization of social institutions and religious ceremonies, cultural sustainability, and community integration.

As scholarship increasingly focuses on the q uestion of a nationalized media ecosystem, the question of why audiences choose a local option often goes unaddressed. This paper addresses two gaps in ...

Introduction Interprofessional education (IPE) offers relevant theoretical, conceptual and methodological approaches to the development of effective teamwork competencies. Objective To analyse an interprofessional experience of teaching-service-community integration carried out at a public university in the South of Brazil. Methods A case study with a qualitative approach was carried out. The study's participants were thirty-eight undergraduate dental students who attended the IPE activity between 2012 and 2019. Data collection was developed in two sequential steps that included the application of an online instrument and semi-structured interviews. The textual material was interpreted by content analysis, considering Kirkpatrick's evaluation levels (reaction, learning and behaviour). Results In the reaction level, students highlighted the contents provided by the National Curricular Guidelines regarding public health system and teamwork, as well as the pedagogical teaching proposal by tutoring groups, which stimulated students' autonomy. It was observed that the learning was geared towards the development of collaborative teamwork competencies and cultural competencies. In the behaviour level, students perceived positive changes in their attitudes and behaviours towards patients, focused on needs related to life conditions, realising that dentists may work within a team. The elective/optional nature of the experience allied with the absence of other IPE activities in the curricular grid showed to be challenging. Conclusion IPE in undergraduate education presented positive results related to the reaction, learning and behaviour of dental students. We recommend the inclusion of interprofessional activities of teaching-service-community integration in Dentistry curricular structure to complement uniprofessional education.

본 연구는 지역사회 정신건강서비스가 정신장애인의 지역사회통합을 목적으로 한다는 전제하에 우리나라 지역사회서비스 이용여부에 따른 지역사회통합 수준의 차이를 분석하고자 하였다. 이를 위해 지역사회에 거주하는 정신장애인 중 정신건강서비스를 이용하는 자 142명과 서비스를 이용하지 않고 정신의료기관에서 외래치료만 받는 비이용자 140명의 지역사회통합(물리적, 사회적, 심리적 통합) 수준을 조사하였다. 먼저 지역사회통합의 예측요인을 분석한 결과, 대상자의 연령, 직업유무, 자원접근성이 통합을 의미 있게 예측하는 요인이었다. 이러한 예측요인들을 공변인으로 설정하고 이를 통제하여 두 집단의 세 가지 영역의 통합수준을 비교하였다. 그 결과 물리적 통합에서만 이용자의 통합수준이 의미 있게 높았고, 사회적 통합의 사회관계망 크기는 비이용자가 더 높았다. 그리고 사회적 통합의 두 번째 차원인 접촉빈도와 심리적 통합은 집단 간 차이가 없었다. 이러한 결과를 바탕으로 연구자들은 우리나라 지역사회서비스 이용여부가 지역사회통합에 의미 있는 기여를 하지 못하고 있음을 지적하며 정신장애인 회복에 특히 중요한 사회적 통합을 높이기 위한 가능한 대안을 제안하였다.

Loneliness is an important health issue facing older people due to its association with poor quality of life and poor health outcomes. This paper aimed to clarify key issues around loneliness among older adults and draw attention to innovative programs and the translation of emerging research into practice. Loneliness is a mismatch between a person's actual and desired social connections, experienced as negative emotions. Older adults are vulnerable to loneliness because of changes associated with ageing. As such, identifying as older is often seen as a burden, negatively impacting self-esteem, sense of purpose and relevance, culminating in loneliness. Interventions combatting loneliness can target individuals, relationships, communities or societies. We advocate for an intersectoral approach to support healthy ageing and reduce loneliness. This will require further research to evaluate new approaches with loneliness as the primary outcome, and additional funding to translate evidence into an integrated multi-level approach to addressing loneliness.

Purpose: Compared to studies on moderate and severe traumatic brain injury (TBI), less literature exists concerning the consequences of mild traumatic brain injury (mTBI) on community integration a...

Employment enhances community integration and overall quality of life for individuals with intellectual and developmental disabilities (IDD). Rapidly evolving and widely used handheld technologies (e.g., tablets and smart phones) may empower improved outcomes of vocational training for individuals with IDD. This systematic review summarizes and evaluates peer-reviewed studies that involved handheld technology to facilitate vocational training in authentic community-based settings for people with IDD. Eleven studies involving 32 participants with IDD were systematically located and analyzed in terms of key variables, study rigor, and Tau-U effect size estimates. Overall, Tau-U score suggested a large to a very large effect for interventions involving handheld technologies to teach vocational skills. Results are used to offer preliminary guidance for practitioners and to suggest directions for future research and practice.

Purpose Currently, people leaving prisons face concurrent risks from the COVID-19 pandemic and the overdose public health emergency. The closure or reduction of community services people rely on after release such as treatment centres and shelters has exacerbated the risks of poor health outcomes and harms. This paper aims to learn from peer health mentors (PHM) about changes to their work during overlapping health emergencies, as well as barriers and opportunities to support people leaving prison in this context. Design/methodology/approach The Unlocking the Gates (UTG) Peer Health Mentoring Program supports people leaving prison in British Columbia during the first three days after release. The authors conducted two focus groups with PHM over video conference in May 2020. Focus groups were recorded and transcribed, and themes were iteratively developed using narrative thematic analysis. Findings The findings highlighted the importance of peer health mentorship for people leaving prisons. PHM discussed increased opportunities for collaboration, ways the pandemic has changed how they are able to provide support, and how PHM are able to remain responsive and flexible to meet client needs. Additionally, PHM illuminated ways that COVID-19 has exacerbated existing barriers and identified specific actions needed to support client health, including increased housing and recovery beds, and tools for social and emotional well-being. Originality/value This study contributes to our understanding of peer health mentorship during the COVID-19 pandemic from the perspective of mentors. PHM expertise can support release planning, improved health and well-being of people leaving prison and facilitate policy-supported pandemic responses.

OBJECTIVE: For individuals with serious mental illness, work can play an important role in improving quality of life and community integration. Since the 1960s, demand has shifted away from routine cognitive (e.g., clerical work) and manual skills (warehouse picking and packing) toward nonroutine analytical (computer coding), interpersonal (nursing), and manual skills (home health attendant). This study aimed to determine whether individuals with serious mental illness are likely to hold the types of jobs that are in decline and to assess their ability to compete for the types of jobs that have been in increased demand. METHODS: Using data from the National Health Interview Survey and the Occupational Information Network database on occupational skills (N=387,240 person-year responses), this study explored changes in patterns of employment from 1997 to 2017 for people with mental illnesses. RESULTS: Individuals with any mental health condition experienced a 10.9 percentage point decline in employment in jobs requiring routine cognitive or any manual skills. Much of this decline was offset by an increase in employment in jobs involving nonroutine cognitive skills. However, individuals with serious psychological distress experienced a 7.9 percentage point decline in employment in jobs requiring routine cognitive or any manual skills, and about 75% of this decline coincided with reduced levels of employment rather than a shift toward employment in nonroutine cognitive jobs. These patterns were more striking among men. CONCLUSIONS: Likely directions for interventions include renewed efforts at workplace accommodations, greater investment in evidence-based return-to-work programs, and efforts to popularize early intervention programs.

OBJECTIVES: To assess perceived levels of community reintegration, and examine whether self-efficacy relates to community reintegration among persons with a TSCI. DESIGN: A cross-sectional exploratory survey. SETTINGS: Cape Metropolitan Area. Western Cape Province, South Africa. PARTICIPANTS: A hundred and eight (108) conveniently selected community-dwelling adults between the ages of 19 and 71 years old, who sustained a TSCI more than 1-year post-injury. OUTCOMES MEASURES: Community Integration Measure (CIM) and the Moorong Self-Efficacy (MSES). RESULTS: The CIM score ranged between 10 and 50 with an overall mean score of 31.48; SD = 12.5. CIM item 10 “I have something useful and productive to do in this community” was the least scored by participants (M = 2.50, SD = 1.4). Multivariate analysis demonstrated that social functioning factor of self-efficacy, accommodation type, and level of injury were the only variables influencing perceived community reintegration that explained 47.3% of the total variance, of which social functioning factor of self-efficacy was the strongest predictor that alone explained 33% of the variance in the model after controlling for the influence of accommodation and the level of injury. CONCLUSION: Community reintegration achieved by individuals with a TSCI in this study is generally low. Individuals’ perceptions about community reintegration are affected by the community in which one lives. Self-efficacy plays a major role in community reintegration following a TSCI. However, reintegration is largely dependent on social functioning rather than the activity of daily living factors of self-efficacy.

Hospital and residential treatment bed utilization rates were measured before and after foster home placement in individuals with serious mental illness. Medical records of all Veterans consecutively enrolled in a Department of Veterans Affairs Community Residential Care (CRC) program during a 6 year period (N = 140) were reviewed retrospectively. Treatment bed days were tabulated by bed type (psychiatric hospital, inpatient detoxification, medical hospital, physical rehabilitation, and psychosocial residential treatment) for each patient during symmetric pre- and post-placement time intervals. Pre- and post-placement bed days were compared using the paired-sample t test in a naturalistic one-group pretest–posttest analytic design. Psychiatric hospital and residential treatment bed days were significantly reduced post-placement (−77.5% and −99.8%, respectively). Most patients (89.0%) had fewer psychiatric hospital bed days post-placement, and all patients with pre-placement residential treatment program bed days had fewer of those days post-placement. Longer CRC placements were associated with greater reductions in bed utilization.

Objective: The objective of the study is to evaluate functional outcomes and community reintegration of disaster survivors in Pakistan. Methods: This was a cross-sectional descriptive study of community-based participants at the Armed Forces Institute of Rehabilitation Medicine, Pakistan. The medical records were screened for eligibility of adults with disaster-related disability. Participants were interviewed in ambulatory clinics using validated measures: Neurological-Trauma Impairment Scale (NIS-Trauma), International Classification of Functioning, Disability, and Health-Generic Set, Community Integration Measure (CIM), Community Integration Questionnaire (CIQ), and EuroQol 5-Dimension 5-Level. Results: Participants were (n = 117, mean age = 35 years) with postdisaster injury up to 17 years; the majority had spinal cord injury (n = 62; 53%) and amputations (n = 44; 38%). At assessment, 80% were independent with mobility (with aids) and 29% with everyday living activities. They reported ongoing fatigue (54.7%), altered sensations (51.28%), and pain (50.43%), but fewer problems with mood and emotions. The impairment severity negatively impacted community activities (NIS-Trauma vs. CIQ: P < 0.001). As impairments improved with time (NIS-Trauma vs. time since injury: P = 0.003), so did community reintegration (time since injury vs. CIQ; P < 0.001) and perceived health status (time since injury vs. EuroQol; P = 0.001). Conclusion: Many participants reported various ongoing disability-related issues; however, majority were dependent with everyday living activities and well adapted in the community. Further robust studies are needed for evaluation of longer-term impact of the disability in disaster victims for the comprehensive healthcare in the community.