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This study was an initial step toward planning tele-practice in a South Indian state's public-sector services for childhood hearing and speech-language problems. The aim was to understand the perceptions public-sector health care professionals (HCPs) regarding their willingness and need for tele-practice-based diagnostics and rehabilitation services. Focus group discussions (FGD), semi-structured interviews (SSI), and geo-spatial analysis were employed in a cross-sectional study. Different public-sector HCPs participated in the qualitative study. Data sufficiency was assessed using theoretical saturation and cross-case variance. Data was analyzed using hybrid deductive-inductive thematic analysis. Geo-tags and geo-locations of all children with disabilities and all the public-sector service providers were used to generate geospatial maps. HCPs felt that childhood hearing and speech-language disorder services were inadequate and lacked sufficient qualified professionals. There was inconsistent equipment and professional availability in district-level facilities. HCPs were comfortable using technology, and were willing to investigate tele-practice, but they required training in tele-practice.

Perceptual restoration occurs when the brain restores missing segments from speech under certain conditions. It is investigated in the auditory modality, but minimal evidence has been collected during speechreading tasks. The authors measured perceptual restoration in speechreading by individuals with hearing loss and compared it to perceptual restoration in auditory speech by normally hearing individuals. Visual perceptual restoration for speechreading was measured in 33 individuals with profound hearing loss by blurring the keywords in silent video recordings of a speaker uttering a sentence. Auditory perceptual restoration was measured in 33 normally hearing individuals by distorting the keywords in spoken sentences. It was found that the amount of restoration was similar for speechreading through the visual modality by individuals with hearing loss and speech perception through the auditory modality by normally hearing individuals. These findings may facilitate understanding of speech processing by individuals with hearing loss.

This article investigates the impact of arts-based therapies on incarcerated individuals within the Presidency Correctional Home in Kolkata with specific reference to Alokananda Roy's project 'Culture Therapy'. This programme for the rehabilitation of incarcerated individuals through the arts is arguably the first of its kind in the Indian context. By employing personal observations, non-structured interviews and performance reviews, this article provides a close reading of Roy's experimental methodologies and highlights how public performances involving prisoners help to humanise participants and deconstruct mutually exclusive notions of civic and criminal spaces.

This case study describes services for students with disabilities at Karuna Home in Bylakuppe, Karnataka, India, a residential facility established to address the needs of individuals whose parents are primarily Tibetan immigrants. Interview, observation, and document review data collected over three months were used to describe and explain sociocultural and educational aspects of the school. Findings indicate that service providers embrace Tibetan Buddhist beliefs about individual worth and charitable service that can benefit the children and their caregivers in this life and the next, and that karma and other factors play roles in disability. Areas of concern and needed professional development are described, including effective assessment of academic and behavioral needs, improved planning and instruction using data-based objectives, and reliable monitoring of student progress toward intended learning and behavioral outcomes. Study findings can inform others who endeavor to provide similar services to individuals with disabilities in small or unique populations.

This study with families caring for an individual with an intellectual disability in a mid-sized Indian city explored the diverse explanatory models that parents constructed of causes, preferred treatment approaches and perceived social effects of their child's intellectual disability. Seventeen mothers and three fathers rank ordered 48 disability related statements and participated in a qualitative interview. The intercorrelations and factor analysis of participant sorts helped to generate three parental explanatory models which were named religious resilience, in search of treatment and social change, and it is a burden to bear. The three models extracted 23%, 20% and 9% variance respectively. Interpretations based on factor arrays, consensus and differentiating statements, and qualitative interviews indicated that the first explanatory model utilised religion and spirituality to positively frame their child's intellectual disability. The second explanatory model rejected religious notions and did not dwell on the cause of disability, but rather focused on optimal rehabilitation of individuals with an intellectual disability. The third model was characterised by maladaptive religious attributions and rehabilitation approaches.

As part of an ongoing ethnographic study, this paper aims to consider the practice of poetry, "sher-o-shayari", as naturalistic peer learning among a group of heroin addicts in Yamuna Bazaar, New Delhi. By examining meanings given to "sher-o-shayari" and experiences of participating in the practice, this article makes the claim that the practice of poetry involved three learning processes. First, it entailed "legitimate peripheral participation" during group sessions in which implicit performance rules were created, evolved, and transferred to newcomers. Second, it included "meaning negotiation" in which participants "break" and "join" different lines, images, or themes in group improvisation or individual creation events. Third, it contained "reflective learning", which enabled development of the "whole" person and helped situate the individual in the social world. Such data are important for the creation of "organic" peer education programs that utilize naturalistic peer learning mechanisms.

The aim of this study was to determine: (a) whether children with visual and additional impairments show any non-verbal behaviors, and if so what were the common behaviors; (b) whether two rehabilitation professionals interpreted the non-verbal behaviors similarly; and (c) whether a speech pathologist and a rehabilitation professional interpreted the behaviors similarly. Twelve children, aged from two to eight years, with visual and additional impairments, were videotaped during their play sessions to observe their non-verbal behavior. A rehabilitation professional observed the tapes and identified and interpreted 131 non-verbal behaviors. The study found that the children showed 33 common behaviors. There was 98.4 per cent agreement between the two rehabilitation professionals, and there was 88.5 per cent agreement between the first rehabilitation professional and the speech therapist. The authors go on to suggest strategies for developing the non-verbal behaviors of children with visual and additional impairments. (Contains 4 tables.)

Special educational services for children with intellectual disabilities in India are mostly provided by nongovernmental organizations. Described is a study designed to assess the impact of professional "teamwork" in special schools run by such nongovernmental organizations in India. The sample consisted of 112 rehabilitation professionals who attended a short-term training program at the National Institute for the Mentally Handicapped, and who were randomly selected from a range of nongovernmental organizations running such schools representing various parts of the country. Comparison of the teamwork scores in relation to the functional area of work using a F-test for unequal "n" revealed greater teamwork present among regular (line function) professionals (such as the educators and therapists) than among support staff (such as administrators), supporting the hypothesis that the application of professional teamwork is a useful device in special school settings. The results were interpreted against the background of organizational effectiveness in the context of special education services and it was suggested that additional research needs to be directed at the dynamics of the teamwork process and to better understanding why support staff reflect low involvement in teamwork in India.

Though the Constitution of India guarantees the right to be educated and to work, only a minority of visually handicapped/blind citizens attain these rights. A new education policy includes integration of blind children at every educational level, followed by vocational training and job placement. Problems, possible solutions, and progress are discussed. (Author/JDD)

Rehabilitation services for visually impaired adults in India are described, both historically and currently. The paper examines the magnitude of the problem, vocational training and placement, services for newly blind persons and for blind/visually handicapped women, rural rehabilitation projects, information access, legislation, professional development of staff, research, and priorities. (JDD)

A project of the Poona (India) District Leprosy Committee offers training in the industrial sector to leprosy patients, orthopedically handicapped individuals, and socioeconomically disadvantaged individuals, under a common roof. The project aims to combat the leprosy stigma and to aid rehabilitation by making the trainees economically self-sufficient. (Author/JDD)

The special issue focuses on problems of developing nations in blindness prevention, program development, and rehabilitation of the blind. Included are reports of programs in Indonesia, Jordan, Korea, and India; activities of the World Council for the Welfare of the Blind; and descriptions of 24 organizations serving the blind in developing countries.

This report examines why parents of visually impaired children in India sometimes fail to assume appropriate roles in the rehabilitation process. It describes the media available to educate parents and discusses two direct training programs in rural villages, which teach rehabilitation techniques to parents and children. (Author/DB)

Purpose: This study aimed to investigate the limitations in transport use among stroke survivors in rural India and examine its impact on their social participation. Materials and methods: A cross-sectional survey assessed transport patterns, post-stroke changes, and limitations among patients with stroke (N = 77). Social participation was measured with the Stroke Impact Scale (SIS 3.0). Results: Following stroke, there was a significant decrease (28–41%) in the proportion of participants who could use various modes of transport unassisted, particularly in driving a motorbike or scooter and using a bus or train. Post-stroke changes in transport use showed that many participants ceased or decreased their use of different modes of transport. Independent users consistently had higher social participation scores than dependent users across all transport modes, indicating better social participation. The mean differences in various transport modes ranged from 6 to 11 points (p < 0.01). Conclusions: Independent use of different modes of transport, particularly public transportation, reduced among rural Indian stroke survivors. These transport limitations are significantly associated with reduced social participation, highlighting the need for interventions to improve accessibility and fostering greater community engagement for stroke survivors in this population. IMPLICATIONS FOR REHABILITATION: Limited transportation access limits social participation for stroke survivors in rural India. Study results show a significant decrease in independent transport use among stroke survivors, affecting their social participation. Rehabilitation interventions should focus on improving transportation accessibility to enhance social engagement for rural stroke survivors. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONPurpose: The world is approaching the sustainable development goals deadline, but many countries still do not produce the data required to track their indicators by disability. Integrating valid and relievable disability measurement tools into existing data platforms is key to ensuring that “no one is left behind.” In this paper, we aim to demonstrate that it is possible to gather valid data on disability for disaggregation using the WHO Functioning and Disability Disaggregation Tool.Materials and methods: Using representative data from India, Lao PDR, and Tajikistan collected through the Gallup World Poll, we estimated the likelihood of a positive sustainable development indicator by disability level. Logit regression was used, adjusted for age, sex, household size, number of children, marital status, urban or rural area, and country-fixed effects.Results: Our estimates showed a consistent disability gradient across all countries and indicators: the higher the level of disability, the lower the probability of having a positive outcome in barely any sustainable development goal.Conclusion: Our study demonstrates that it is not too late to generate sound and precise data about inequalities faced by persons with mild, moderate, or severe disability. This data is essential for reducing inequalities through evidence-based policymaking.The disability gradient observed across all countries and indicators included in this study showed that the higher the level of disability (mild, moderate, or severe), the lower the probability of having a positive outcome in any sustainable development goal.An underestimation of inequalities is observed when people with no, mild and moderate disability are combined into a group called “no severe disability” and used as the comparator to people with “severe disability.”Rehabilitation policy and planning must consider the disability gradient and respond to the different needs of persons with mild, moderate, and severe disability.The disability gradient observed across all countries and indicators included in this study showed that the higher the level of disability (mild, moderate, or severe), the lower the probability of having a positive outcome in any sustainable development goal.An underestimation of inequalities is observed when people with no, mild and moderate disability are combined into a group called “no severe disability” and used as the comparator to people with “severe disability.”Rehabilitation policy and planning must consider the disability gradient and respond to the different needs of persons with mild, moderate, and severe disability. [ABSTRACT FROM AUTHOR]

Background: In this new era of cancer management, the quality of life (QOL) is given more importance than the quantity of life. QOL evaluation studies are widely used in oncology to assess the patient's performance in different cancer types and treatment modalities. Objective: To evaluate cancer patients' QOL after various chemotherapy cycles. Methods: An observational study was performed on cancer patients receiving chemotherapy in the daycare setting of a South Indian Tertiary Care Hospital for 6 months. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire was employed to study the QOL. Results: Precisely, 102 patients participated in the study, out of which the majority were in the 51 to 60 age group (24%). Female participants (65%) were more. Functional scale domains especially physical ability (P = 0.004), role (P = 0.033), and emotional functioning (P = 0.01) were significantly decreased in patients treated with 4 to 6 chemotherapy cycles. Cognitive ability (P = 0.043) significantly improved in patients treated with more than 6 chemotherapy cycles. Dyspnea (P = 0.036) was significantly increased in patients treated with 4 to 6 chemotherapy cycles and decreased significantly with the further addition of chemotherapy cycles. Conclusion: Dyspnea is a commonly observed symptom among cancer patients and is often neglected by physicians. Chronic dyspnea can negatively impact a patient's functional ability. Cancer symptoms such as dyspnea should also be given priority and need appropriate treatment. Based on the findings, further interventions can be made to improve the functional ability of cancer patients. Also, studies can be conducted to correlate with cancer rehabilitation programs to improve functional ability and complete the entire chemotherapy cycle. [ABSTRACT FROM AUTHOR]

Continuum-of-care is crucial following knee replacement. This is an understudied area in the context of low- and middle-income countries. We report findings of a mixed-methods study conducted to understand patient's postoperative experiences in following unsupervised home-based physiotherapy protocols and healthcare provider's experiences in providing rehabilitation care. Consecutive adults (n = 79) scheduled or had undergone knee replacement, attending an urban tertiary care hospital in India completed a 22-item questionnaire to gauge attitude towards physical rehabilitation. We conducted in-depth interviews with nine patients, ten physiotherapists, and three surgeons using a phenomenology approach. Data were interpreted using the capability, opportunity, and motivation-behaviour (COM-B) framework. Patients were motivated to do exercises and valued family support during the recovery period. However, they desired physiotherapy support, especially during the early recovery period due to post-operative pain. Healthcare providers reported poor adherence with the exercise regimen and desired a mechanism to monitor patient progress after discharge. Patients and health care providers identified accessibility to rehabilitation centre as a major barrier in availing affordable and reliable physiotherapy services. There is a need for a continuum of care to improve patient experience during recovery and for health care providers to monitor progress and provide personalised progressive exercise therapy. In India, regular monitoring following knee replacement is essential in home-based rehabilitation protocols necessitating clinic visits. Barriers to rehabilitation included post-surgical pain and difficulty in accessing physiotherapy services, while patient motivation and family support were facilitators to rehabilitation adherence. There is a need for remote monitoring mechanisms to facilitate health care providers in India, to monitor progress and reduce out of pocket expenditure for patients. [ABSTRACT FROM AUTHOR]

A library of Virtual Reality (VR) tasks has been developed for targeted post-stroke rehabilitation of distal upper extremities. The objective of this pilot study was to evaluate the clinical potential of the targeted VR-based therapeutic intervention in a small cohort of patients specifically with chronic stroke. Furthermore, our aim was to explore the possible neuronal reorganizations in corticospinal pathways in response to the distal upper limb targeted VR-intervention. Five patients with chronic stroke were enrolled in this study and were given VR-intervention of 20 sessions of 45 min each. Clinical Scales, cortical-excitability measures (using Transcranial Magnetic Stimulation): Resting Motor Threshold (RMT), and Motor Evoked Potential (MEP) amplitude, task-specific performance metrics i.e., Time taken to complete the task (TCT), smoothness of trajectory, relative % error were evaluated pre- and post-intervention to evaluate the intervention-induced improvements. Pre-to post-intervention improvements were observed in Fugl-Meyer Assessment (both total and wrist/hand component), Modified Barthel Index, Stroke Impact Scale, Motor Assessment Scale, active range of motion at wrist, and task-specific outcome metrics. Pre-to post-intervention ipsilesional RMT reduced (mean ∼9%) and MEP amplitude increased (mean ∼29µV), indicating increased cortical excitability at post-intervention. VR-training exhibited improved motor outcomes and cortical-excitability in patients with stroke. Neurophysiological changes observed in terms of improved cortical-excitability might be a consequence of plastic reorganization induced by VR-intervention. Post-stroke rehabilitation of distal upper extremities is crucial and needs targeted intervention to rehabilitate in the chronic phase of recovery. Virtual reality (VR) has emerged as a supplemental approach in post-stroke rehabilitation. However, its customization as per clinical need is still under research. This pilot study provides preliminary evidence of the clinical utility of the developed VR tasks targeted for distal upper extremities. [ABSTRACT FROM AUTHOR]

Pain management constitutes a pivotal aspect of palliative care. Certain instances of distressing pain are significantly relieved through interventional pain methodologies, demanding the expertise of pain specialists. Our perspective revolves around the integration of these 2 facets, envisaging a symbiotic relationship that could enhance patient outcomes. A prospective assessment was carried out within a collaborative clinic, uniting the realms of pain management and palliative medicine. Anonymized patient information was scrutinized to grasp the advantages of this amalgamation and identify strategies to address any inherent deficiencies. Furthermore, an illustrative case study was delineated, spotlighting the collaborative dynamics at a systemic level. During the period spanning from November 2020 to June 2021, a total of 43 patients received consultations at this collaborative clinic. Each patient was exposed to a comprehensive pain management regimen, with the most frequently conducted procedure being an intercostal nerve block, which was administered in 9.30% of cases. For the provision of effective pain relief within the palliative care context, the confluence of joint consultations from cancer pain specialists emerges as a requisite measure. This approach carries the promise of optimizing pain control and augmenting the quality of palliative care. [ABSTRACT FROM AUTHOR]

Background: Subtotal petrosectomy (STP) has attracted massive interest over last two decades. The aim is to present our experience of this uncommon surgery. The indications, outcomes, and our variation in surgical technique would be presented and literature reviewed. Methods: A retrospective observational study of all patients who underwent STP at a tertiary care center in India was analyzed. Results: A total of 9 ears (in 8 patients) underwent STP over last 5 years at our center. The pathological conditions for which STP was done included chronic otitis media squamous (four ears), middle ear tumors (three ears), petrous apicitis (one ear), and traumatic cerebrospinal fluid (CSF) otorhinorrhea (one ear). The indication of STP included disease clearance (eight ears), unserviceable hearing (seven ears), hearing rehabilitation with otological implants (six ears), and intraoperative CSF gusher (one ear). Intraoperative indications included CSF gusher, large tegmen defect with erosion of apical turn of cochlea, and erosion of anterior bony wall of external auditory canal. The mean follow-up period was 36 months (range of 6 months to 60 months). None of the patients had any dehiscence of blind sac closure or secondary acquired cholesteatoma on imaging. Conclusions: STP facilitates disease clearance by providing unmatchable exposure in difficult otological scenarios and additionally isolates middle ear cleft from external environment, thereby eliminating problems of mastoid cavity. Furthermore, it also prepares ear for second stage otological implants. It is a safe surgery with minimal complications. [ABSTRACT FROM AUTHOR]

Purpose: Investigating the causes of visual loss and the best corrected visual acuity (BCVA) is crucial for identifying avoidable eye problems and planning appropriate rehabilitation and assistive technology (AT) services. The study aimed to identify various causes of vision loss and determine AT required for vision rehabilitation (VR). Methods: The electronic records of patients who attended the VR clinic at a tertiary eyecare for the past 2 years were reviewed. Information such as demographics, BCVA, and causes of visual impairment were retrieved from the records. BCVA was categorized into better than or equal to 1/60 and less than <1/60 for AT services. Results: In total, 1723 patients, mostly male (71.2%), visited the rehabilitation clinic from 2018 to 2019. Around 58.6% of patients belonged to the age group 16-49 years, whereas 25.6% were less than 15 years old. The most frequent eye problems were retinal disorders (63.5%), followed by retinitis pigmentosa (15.2%) and rod-cone dystrophy (4.7%). In contrast, congenital disorders were the most common cause of vision loss among younger groups. Approximately 36.0% of patients had <1/60 blindness and 16.6% had =1/60. Around 17.1% of patients would benefit from large prints (near vision acuity N18-N12). Conclusion: Early detection and timely management will prevent a significant proportion of patients from developing irreversible vision loss. Around one-third of patients would benefit from visual substitution AT. [ABSTRACT FROM AUTHOR]

Study design: We conducted a mixed-methods sequential explanatory study. In India, most spinal cord injuries (SCI) occur within low socioeconomic status populations, typically resulting in poor vocational outcomes post-injury and difficulty reintegrating into the community. This study will increase our understanding of how vocational rehabilitation affects patients with SCI. Objectives: This study aims to understand the factors affecting vocational outcomes, quality of life and social inclusion for patients who have completed the Amar Seva Sangam (ASSA's) rehabilitation program, by examining both quantitative and qualitative measures. Methods: Conducted at the University of Toronto, we used self-administered questionnaires via REDCap for quantitative data collection and semi-structured interviews for qualitative data collection to capture aspects of lived SCI experience for five participants. Results: Thirty-two participants completed the quantitative phone questionnaire of which 17 were paraplegic and 15 were quadriplegic. Four themes emerged including physical barriers to employment, social inclusion of SCI patients, low income, and state of mental health. Conclusion: This study provided a detailed examination of demographic information and lived experiences of ASSA participants. The findings will be relevant and applicable to both clinical and public health sectors in SCI rehabilitation in India and other low- and middle-income countries by directing rehabilitation programs to better address areas of function that allow patients to find success following rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: The aims of the study are to assess the quality of sleep in recently recovered COVID-19 and long-COVID cases and to determine its associations with fatigue and pain. Methods: Post–COVID-19 cases (n = 201) and controls (n = 206) were assessed using the Pittsburgh Sleep Quality Index questionnaire for sleep quality, Fatigue Severity Scale for fatigue, and Numeric Pain Rating Scale for pain in this observational study. Results: Global Pittsburgh Sleep Quality Index score was higher (P ≤ 0.001) among cases (5.7 ± 5.1; 95% confidence interval, 5.0–6.4) than controls (2.1 ± 2.0; 95% confidence interval, 1.8–2.4). Normal sleep latency was observed in 56 (27.9%) patients and 164 (79.6%) controls (P < 0.001). Fatigue Severity Scale score was higher (P ≤ 0.001) among cases (16.8 ± 10.2; 95% confidence interval, 15.4, 18.2) against controls (10.9 ± 4.1; 95% confidence interval, 10.3–11.4). The Fatigue Severity Scale scores in mild, moderate, and severe COVID-19 were 14.3 ± 8.1, 22.1 ± 10.8, and 22.8 ± 13, respectively (P < 0.001) and higher in the older (20.7 ± 12.1) and middle-aged (19.6 ± 10.3) than in younger (13.9 ± 8.3) (P ≤ 0.001) cases. The global Pittsburgh Sleep Quality Index score was positively correlated with the Fatigue Severity Scale (r = 0.755, P < 0.001) and Numeric Pain Rating Scale scores (r = 0.657, P < 0.001). Numeric Pain Rating Scale score correlated with Fatigue Severity Scale score (r = 0.710, P < 0.001). Fatigue Severity Scale and global Pittsburgh Sleep Quality Index scores were higher in the long-COVID group (P < 0.001). Conclusions: Significantly poor sleep quality was observed in post–COVID-19 individuals including long COVID being positively associated with fatigue and pain. [ABSTRACT FROM AUTHOR]

Objectives: This study was done to find the effect of multichannel transcranial direct current stimulation (M-tDCS) on motor and cognitive outcomes in individuals with subacute survivors by modulating the cortex of cognitive and motor functions simultaneously. Methods: This is a two-group, randomized control trial conducted on 40-75-year-old stroke individuals. A total of... [ABSTRACT FROM AUTHOR]

This study examines the multifaceted challenges faced by mentally ill women in developing countries, with a particular focus on India. Drawing on research from various sources, including studies conducted in India, the paper highlights several critical issues affecting mentally ill women, such as societal misconceptions about mental illness, legal vulnerabilities, caregiving burdens, and the absence of state-supported programs. The study underscores the urgent need for comprehensive government interventions to address these challenges, including legal protections, access to healthcare and support services, efforts to combat stigma, and targeted interventions for vulnerable populations, such as homeless individuals with mental illness. Despite ongoing efforts, gaps in the availability and utilization of rehabilitation services persist, especially for women. The paper calls for continued advocacy, policy reform, and community support to address gender disparities and improve the effectiveness of rehabilitation services, ultimately striving for a future where mental health is prioritized and all individuals have the opportunity to thrive. [ABSTRACT FROM AUTHOR]

Background: Employment has a therapeutic impact, enhances community integration and improves the quality of life of persons with mental illness (PwMI). Vocational rehabilitation (VR) models must be sensitive to existing needs and resources. Several VR models have been tested in high income countries. Mapping different VR models in India would help both practitioners and policymakers. Aim: The study aimed to comprehensively review VR models tested among PwMI in India. Methods: We adhered to the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews. We included interventional studies, case studies and grey literature carried out for the VR of PwMI in India. The search was done in PubMed, PsychInfo, worldwide science and Web of Science. Google Scholar was used to supplement the search. A Boolean search using MeSH terms was carried out for the period January 2000 to December 2022. Results: A total of twelve studies (one feasibility study, four case studies, four institute-based intervention studies and two studies reporting NGOs' role) were included in the final synthesis. The studies included in the review were either quasi-experimental studies or case based. Types of VR included supported employment or place and train or train and place models, case management and prevocational skills training. Conclusion: Limited studies exist on VR in PwMI from India. Most studies assessed a restricted set of outcomes. The experiences of NGOs should be published so that practical challenges can be understood. There is a need for public-private partnerships in designing and testing services and should involve all the stakeholders. [ABSTRACT FROM AUTHOR]

Objective: To assess, analyse, and infer the impact of the coronavirus disease 2019 (COVID-19) pandemic on people living with locomotor disability in North India. Methods: Patients with locomotor disabilities who met the inclusion criteria received a questionnaire that had already undergone testing and validation. It covered topics highlighting the effect of the pandemic on general health, financial burden, psychological and mental health, social life and behaviour, disability and comorbidity management, transportation, and healthcare accessibility during the pandemic. In order to gauge the pandemic's effects on the population of people with locomotor disabilities, the answers to the questions were collected and analyzed. Results: The COVID-19 pandemic has adversely affected people living with locomotor disability, ranging from loss of wages and financial crisis to anxiety, depression and lack of sleep. People with disabilities had limited reach to health and community services that were vital for them, including basic life and functional needs, besides risks of mistreatment and other psychological consequences. Conclusion: This analysis suggests that the root cause of pandemic disparities is the lack of disability-inclusive planning and, more significantly, the pre-existing socioeconomic disparities and challenges that disabled people have been experiencing for a long time. We suggest that unambiguous public health and policy responses should be incorporated, and health, social participation, and socioeconomic disparity causes for disabled people should be addressed in tandem. [ABSTRACT FROM AUTHOR]

In India, where institutional-based mental health care is common, gender and other intersecting marginalized identities along with absent familial support contribute to women's admission and prolonged confinement to psychiatric institutions. However, an intersectional analysis of factors that prevent women with limited familial support from returning to their communities is lacking. This article is based on narratives of eleven women residing at a halfway home in an urban city in India, awaiting return to their communities. We include descriptions and an intersectional analysis of women's pathways to psychiatric institutions, their experiences receiving institutional-based mental health care, and the challenges they face as they contemplate returning to their communities. This study adds to the minimal research examining women's gendered pathways to psychiatric institutions in India. Women's narratives highlight that gender and illness-related disadvantages coupled with economic adversity that led to the initial admission also serve as deterrents to reentering the community. [ABSTRACT FROM AUTHOR]

Introduction: One of India's most valuable resources is its young people, and this generation needs to be nurtured for the bright future of the nation. However, when the young generation is affected by chronic mental disorders, families find it difficult to take care of them and are burdened with the responsibility for several years. Aim: To explore the lived experiences of Family Caregivers (FCGs) of young adults with chronic mental disorders. Materials and Methods: This qualitative study was conducted at the selected mental inpatient and outpatient Department of a selected mental health facility in Urban Bangaluru, Karnataka, India from April 2021 to December 2021. The authors used a phenomenological qualitative study to explore the lived experiences of family caregivers of young adults with chronic mental disorders {mania, depression, Bipolar Affective Disorder (BPAD), schizophrenia} aged between 18-40 years. The Family Caregivers of young adults undergoing treatment were approached for written informed consent and recruited through purposive sampling. Data were collected using face-to-face, indepth, semi-structured interviews. Each interview lasted around 45 minutes to one hour, and data saturation was achieved with 15 samples. Interviews were conducted over a period of nine months. The audio-recorded interviews were transcribed, interpreted, and investigated using Colaizzi's data analysis framework. Baseline variables were analysed using descriptive statistics. Results: In the present, the family caregivers' ages ranged from 28 to 60 years, with the majority (67%) being females and employed. One of the family members was affected by a mental disorder. A rehabilitation facility was unavailable to the majority (67%) of them near their residence. Regarding the young adults with chronic mental disorders, the majority (74%) were unemployed and diagnosed with affective disorders. The maximum duration of illness was 20 years, with onset typically at the age of 17-21 years. From the analysis, six main themes and 36 subthemes emerged. The main themes were as follows: family caregivers experience difficulty in identifying the responsible person and support system, providing physical care, tackling emergencies, problems with medication and early identification of relapse, problems with indecent behaviour, and knowledge deficit related to mental disorders and their management. Conclusion: The study concludes that family caregivers of young adults with chronic mental disorders experience various psychosocial and economic issues and problems while caring for a young adult with chronic mental disorders. The knowledge generated from the present study can be utilised by mental health professionals to plan home-based care strategies to improve the quality of life and reduce the burden of care for FCGs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Aphasia is an impaired ability to use language for communication after a brain damage. The primary means of intervention for aphasia – Speech-Language therapy (SLT) – usually involves didactic interaction between the Speech-Language therapist and the client, often without regard to the real-life environments in which the communication occurs. The provision of SLT in natural environments is beyond the scope of the conventional, clinic-based intervention setups. Using the technological advances, the Mixed Reality in Aphasia Rehabilitation (MiRAR) aims to make persons with aphasia (PwA) use their language in an ecologically valid and meaningful manner in natural communication contexts. AIM: This report aims to delineate the design and development of a Mixed Reality environment (MR: i.e., augmented + virtual realities (i.e., AR + VR)) to provide social communicative intervention for PwA. METHODS: We describe the concept and provide the details of the development and deployment of a communication-based mixed reality application for PwA in the Indian context. For this purpose, we generated 20 distinct communication scenarios and their scripts. These scenarios were implemented into the Mixed Reality environment with the help of a hired technical team. RESULTS: The 20 scenarios were successfully developed and deployed into the Mixed Reality environment for the purpose of communication intervention for PwA. The program consists of a web-based admin panel (for SLPs) and a Mixed Reality application (for the PwA). CONCLUSIONS: The MiRAR program is expected to foster the delivery of speech-language therapy in a meaningful, controlled and simulated environments by the SLPs, thus alleviating the practical restraints of conventional clinical setups. The clinical trial of this intervention program is planned in the next phase of this ongoing project. [ABSTRACT FROM AUTHOR]

Introduction: Spinal cord injury (SCI) individuals face challenges in community reintegration due to various factors. This study explores the barriers and facilitators affecting their reintegration, aiming to understand and address their diverse needs and challenges in different cultural contexts. Methods: The present qualitative study was conducted between December 2021 to June 2022 among 71 SCI individuals as data saturation was achieved. Data was collected via structured in-depth interview. Participants were identified through purposive sampling method, admitted, or visited to rehabilitation center, India. Data was analyzed according to Braun and Clarke's thematic analysis method using MAXQDA 2020. Results: Data analysis led to the emergence of four major themes and several sub-themes specific to the single problem domain. The four major themes of barriers included environmental, cultural, psychological and health-related barriers. However, four facilitators (Family support, financial stability, religious practices, friends and leisure activity) came up which may help in overcoming from the challenges faced by the SCI individuals. Conclusion: People with SCI face various problems in their care, management and social lives. It is important to give attention to their needs along with comprehensive health support and strengthen the patient-provider interaction. This may generate a sense of self efficacy, self-esteem and promotes the mental well-being of people with spinal cord injuries. Working on the above mentioned issues can help SCI people in low- and middle-income countries become more integrated into their communities. [ABSTRACT FROM AUTHOR]

Justification: Neurodevelopmental disorders, as per DSM-V, are described as a group of conditions with onset in the development period of childhood. There is a need to distinguish the process of habilitation and rehabilitation, especially in a developing country like India, and define the roles of all stakeholders to reduce the burden of neurodevelopmental disorders. Process: Subject experts and members of Indian Academy of Pediatrics (IAP) Chapter of Neurodevelopmental Pediatrics, who reviewed the literature on the topic, developed key questions and prepared the first draft on guidelines. The guidelines were then discussed by the whole group through online meetings, and the contentious issues were discussed until a general consensus was arrived at. Following this, the final guidelines were drafted by the writing group and approved by all contributors. Objectives: These guidelines aim to provide practical clinical guidelines for pediatricians on the prevention, early diagnosis and management of neurodevelopmental disorders (NDDs) in the Indian settings. It also defines the roles of developmental pediatricians and development nurse counselor. Statement: There is a need for nationwide studies with representative sampling on epidemiology of babies with early NDD in the first 1000 days in India. Specific learning disability (SLD) has been documented as the most common NDD after 6 years in India, and special efforts should be made to establish the epidemiology of infants and toddlers at risk for SLD, where ever measures are available. Preconception counseling as part of focusing on first 1000 days; Promoting efforts to organize systematic training programs in Newborn Resuscitation Program (NRP); Lactation management; Developmental follow-up and Early stimulation for SNCU/NICU graduates; Risk stratification of NICU graduates, Newborn Screening; Counseling parents; Screening for developmental delay by trained professionals using simple validated Indian screening tools at 4, 8, 12, 18 and 24 months; Holistic assessment of 10 NDDs at child developmental clinics (CDCs)/district early intervention centre (DEICs) by multidisciplinary team members; Confirmation of diagnosis by developmental pediatrician/developmental neurologist/child psychiatrist using clinical/diagnostic tools; Providing parent guided low intensity multimodal therapies before 3 years age as a center-based or home-based or community-based rehabilitation; Developmental pediatrician to seek guidance of pediatric neurologist, geneticist, child psychiatrist, physiatrist, and other specialists, when necessary; and Need to promote ongoing academic programs in clinical child development for capacity building of community based therapies, are the chief recommendations. [ABSTRACT FROM AUTHOR]

Tardive Dyskinesia (TD) is a medication induced movement disorder characterised by involuntary athetoid or choreiform movements generally of the tongue, lower face and jaw, and extremities developing in association with the use of a neuroleptic medication for at least a few months that persists despite discontinuation or change of the medications. This study was done to help in the early recognition and management of tardive dyskinesia and to obtain useful data to help prevent the same. The study aimed to estimate the prevalence of tardive dyskinesia in patients with psychiatric illness having more than 3 months cumulative exposure to neuroleptics, and to determine the clinical correlates of tardive dyskinesia in them. Methodology: This cross sectional observational study was carried out after obtaining clearance from the Institution's Ethics Committee (YEC2/658) between January 1st, 2021 and April 2022. A total of 207 participants were enrolled who were patients with psychiatric illness having more than 3 months of cumulative exposure to neuroleptics. Participants were then evaluated using the Schooler Kane criteria, Abnormal Involuntary Movement Scale and various sociodemographic and clinical variables were assessed. Results: Patients with schizophrenia are most at risk of developing tardive dyskinesia (67.1%). It was also discovered that chlorpromazine comparable dosages were significantly higher among participants with tardive dyskinesia. Orofacial tardive dyskinesia had the highest overall prevalence (23.2%). Conclusion: Many patients with psychotic diseases experienced movement difficulties brought on by conventional antipsychotics, which are viewed as burdensome and stigmatizing events. Designing treatment guidelines, expanding the availability of medications with minimum adverse effects, and providing psychoeducation on related aspects are crucial. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to trace Tata Group's role in responding to disability in the decades immediately following India's independence until the preliberalization period of the Indian economy, i.e. from the 1950s to the 1990s. Design/methodology/approach: This study's methodology entailed a historiographical approach and archival engagement at Tata Archives (Pune, India) of the company documents. Materials and records of the Tata Company between 1942 and 1992. Findings: Adopting the corporate culture lens, the study findings show that Tata Group demonstrated an active prosocial corporate approach toward disability. In a period governed by the ideology of a state-dominated developmental approach, Tata Group's initiatives were related to medical interventions for a wide spectrum of disabilities, rehabilitation and efforts to ensure persons with disabilities (PWDS)' livelihood. Originality/value: Disability, in the neoliberalized economic landscape of India, is an emergent business issue for companies espousing workplace diversity. The historical understanding of business engagement with disability from postindependence to liberalization in India remains, however, limited. In postindependence India, the passive business response to disability emerged within an ethical and discretionary framework, with charity and philanthropy as the main modes of engagement. In this background, this paper explores Tata's response to disability and PWDs, which was distinct. [ABSTRACT FROM AUTHOR]

Community Re Entry Program (CREP) is a specialized rehabilitation program for individuals with mental disorders, recovering from mental illness. This program is specifically designed to develop and integrate the skills that enable individuals to relearn the skills necessary to fully participate in activities of daily living successfully and return to home or community. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) presents a variety of ethical difficulties for an oncologist involved in screening, diagnosis, treatment, and rehabilitation that are challenging to address, especially for those professionals/people who are not trained in medical ethics. The bioethics department has spent the last ten years compiling information and rating the seriousness of numerous niche ethical concerns and their effects on healthcare professionals practising in India. Based on these findings, the current analysis makes an effort to outline the different challenges faced by oncologists when screening, diagnosing, treating, and rehabilitating people affected with HNC, particularly in a traditional nation like India. According to the authors, this is the first overview to address these issues from an Indian viewpoint, and it represents a small effort to document a crucial but unaddressed component of cancer treatment. It is hoped that these endeavours would aid in educating upcoming healthcare professionals on how to effectively handle the difficulties. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a common disease with pulmonary & extra-pulmonary symptoms. It is a leading cause of mortality & disability. In India, the crude estimate of COPD burden is over 30 million. Methods: Study was conducted over a period of 18 months in clinically diagnosed 70 cases (35 patients each in group I and II) of COPD of all ages and both gender. Results: Mean age of patients was 64.14±5.94 years in Group I and 65.05±5.58 in Group II. Majority of patients were males in our study, 30 (75.72%) patients were male in Group I and 28(80%) patients in Group II. In Group I (82.85%) & Group II (77.15%) patients were smoker. In Group I statistically significant decrease in mean mMRC after 6 weeks & 12 weeks of PR (baseline 2.57±0.50; 6 Wks 1.68±0.47; 12Wks 1.02±0.16) was observed. In group II, mean mMRC decrease was not statistically significant (baseline 2.54±0.50; at 6 weeks 2.51±0.50 & 2.48±0.50 at 12 weeks). In Group I statistically significant increase in mean 6MWD after 6 weeks & 12 weeks of PR (baseline 285.88±32.11 meter; 320.82±32.52 meter at 6 Wks; 345.48±32.10 meter at 12Wks) was found. In group II, mean 6MWD increase was not statistically significant (baseline 296.34±28.17 meter; 294.62±30.23 at 6 weeks & 297.02±28.89 at 12 weeks). In Group I statistically significant decrease in mean SGRQ after 6 weeks & 12 weeks of PR (baseline 68.05±5.54; at 6 Wks 53.74±5.79; at 12Wks 38.22±8.66). Decrease in SGRQ indicated improvement in quality of life whereas in group II, there was no significant decrease in mean SGRQ (baseline 66.28±3.97; at 6 weeks 65.2±3.88 & at 12 weeks 65.11±4.70). Conclusion: COPD patients had reduced exercise capacity (low 6 MWD), high dyspnea score and impaired quality of life as indicated by high SGRQ at baseline. Pulmonary rehabilitation results in statistically significant improvement in 6MWT, decrease in dyspnea score & improvement in quality of life at 6 & 12 weeks while no improvement was noted in the group not given pulmonary rehabilitation. Pulmonary rehabilitation found to be an effective non-pharmacological intervention for COPD patients. [ABSTRACT FROM AUTHOR]

Trafficking is a transnational legal problem that has attracted considerable attention since the adoption of the UN Convention against Transnational Organized Crime. In derogation of a robust indigenous jurisprudence on forced labour, the Indian state has, since 2000, imported the criminal law model of the Convention culminating in the Trafficking in Persons (Prevention, Care and Rehabilitation) Bill 2021. This Bill is a hypercarceral law, the relationship of which with pre-existing labour laws is unclear even as it seeks to abolish sex work. In its zeal to crack down on criminals, its provisions violate fundamental principles of criminal liability and Articles 14, 19, and 21 of the Constitution even while it casts the net of the criminal law wide, threatening to freeze sections of the economy and render the Indian worker a victim who is confined to rehabilitation homes. The article argues for a fundamental rethink of the Bill. [ABSTRACT FROM AUTHOR]

Background: Cassia auriculata L., is an imperative medicinal and traditional neutral colour leaf hair dye yielding in India. This is a multipurpose and indigenous, perennial leguminous shrub and widely used as traditional medicine to cure diabetics by the rural peoples. Tanner's cassia is also used as neutral henna and its yields natural golden blonde colouring to hair through the dried leaf powder. Young buds are used for yellow colour dye extraction by textile industries. Screening of high tolerance and best performing genotypes is highly essential in this imperative woody legume shrub to rehabilitate the mass erosion prone gullied and ravine lands for productive purpose of the wasteland and degraded lands. Methods: Thirty different accessions of Cassia auriculata were assembled and numbered from CA-1 to CA-30 from arid and semiarid regions of Rajasthan (India). The experimental trial was conducted at ICAR-IISWC, Research Centre, Kota-Rajasthan, India during 2019-2022. After evaluation, CA-4 genotype was selected as an elite genotype. The elite genotype was used for high density plantation development with resource conservation for green cover development in non-arable ravine lands. Result: Genetic variation studies of Cassia auriculata indicated that considerable and significant variability, abundant morphometric variations in assembled genotype progenies. Further, genetic divergence analysis was also revealed that nine clusters segregated from 30 genotypes. Thirty genotypes were grouped into nine clusters according overall performance with geographical identity. Finally, C. auriculata (CA-4) genotype was identified and selected as an elite genotype based on its overall superiority in terms of plant growth, higher green biomass, leaf litter biomass, more number branching behaviour and plant coppicing ability which are directly relevant and imperative in soil erosion control, resource conservation and potential rehabilitation effect in resource poor dry regions of non-arable lands. [ABSTRACT FROM AUTHOR]

Background: An increase in the on-field intensity in modern cricket, results in an increased number of player injuries. Integration and easy access to professional physiotherapy, technology, rehab protocols, and mental/physical conditioning aid in early return to sports in the injured; however, at the grassroots, these facilities may not be available with untrained support staff and limited funds. Injuries can go unnoticed and, therefore, there is a need for an easy process of identification and documentation of such injuries. We devised a questionnaire-based survey to evaluate its effectiveness at the junior level of professional cricket. Materials and Methods: An Online self-administered questionnaire was prepared and the link was given to active Union Territory Cricket Academy (UTCA), Chandigarh, cricketers of any gender between 15 and 35 years of age, through different online platforms like WhatsApp, Telegram and emails, for the submission of their responses. Results: The questionnaire was administered to 98 participants out of which 77 participants' responses were evaluated (41 males and 36 females). 74/77 participants were below 30 years of age. There were 18 wicketkeepers, 33 bowlers and 26 batsmen as per their major role in the team. 37/77 cricketers (20 males, 17 females) had injuries during the previous 2 years; this included 17 bowlers, 11 batsmen and 9 wicketkeepers. The most common body part injured in the survey were fingers (12) followed by the back (7). The amount of training time lost, reported in the survey ranged from a week up to 1 year. Conclusion: Online surveys could be the first step to accumulating data and making initial player profiles, starting even at junior levels of cricket. Further detailed evaluations may be performed after this, and coaches and administrators could potentially profile cricket injuries and identify chronic issues. [ABSTRACT FROM AUTHOR]

Objective: Preventive measures and appropriate rehabilitation are important in reducing the social burden of blindness. This study was to evaluate the etiologies, proportions, and level of rehabilitation for patients with blindness. Materials and Methods: A prospective observational study with 1000 visually impaired patients was conducted. The data regarding age, gender, socioeconomic status (SES), etiologies, curable or incurable blindness (IB), treatments, awareness, and state of rehabilitation were collected and reviewed. Results: The ratio of curable to IB was 0.82:1. The proportion of blindness rises after 40, even while the proportion of curable blindness (CB) increases after 60. The male–female ratios were 1.25:1 and 1:1.66 in the cases of CB and IB, respectively. On the other hand, the male–female ratio for childhood blindness was 1.66:1. Cataracts (78.22%) were the most common cause of CB, whereas diabetic retinopathy (24%), corneal opacity (17.5%), and trauma (12.4%) were causes of IB. Patients with illiteracy, low SES, and female gender were more likely to develop IB. There were low enrollment rates at the blind school and poor rehabilitation, mainly because of a lack of knowledge. Conclusion: Diabetic retinopathy, corneal opacity, and trauma are the major causes of IB. IB and poor rehabilitation were more profound in women and were associated with illiteracy, low SES, and a lack of awareness. [ABSTRACT FROM AUTHOR]