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The 21st century learning demanded students to master the 4C competencies: critical thinking and problem-solving, communication, collaboration, and creativity and innovation, with problem-solving skills significantly influencing students' cognitive learning outcomes. This study utilized the Flipped Classroom instructional model, assisted by the Khan Academy application, as a key factor in educational change. This research aimed to determine the effects related to the implementation of the Flipped Classroom instructional model with the assistance of the Khan Academy application on students' problem-solving abilities and cognitive learning outcomes. The research design employed was quasi-experimental with data collection through observation, interviews, tests, and documentation. The results obtained through Independent Sample t-Test in measuring problem-solving abilities indicated that the Sig. value (2-tailed) was 0.028 for the first indicator (understanding the problem); 0.028 for the second indicator (planning the solution); 0.000 for the third indicator (implementing the solution plan); and 0.001 for the last indicator (checking back). This meant that the results were < 0.05 for each indicator. Another result, namely the Analysis of Covariance (ANCOVA) for cognitive learning outcomes was 0.000. This result showed that the Sig. value was < 0.05. Both results indicated that there was an influence of implementing the Flipped Classroom instructional model with the assistance of the Khan Academy application on student’s problem-solving abilities and cognitive learning outcomes of class X students at SMAN 1 Kutorejo regarding the topic of viruses and their roles.

Abstract Background Depression affects 20–30% of individuals with heart failure (HF), and it is associated with worse health outcomes independent of disease severity. One potential explanation is the adverse impact of depression on HF patients’ adherence to the health behaviors needed to self-manage their condition. The aim of this study is to identify characteristics associated with lower adherence in this population, which could help to recognize individuals at higher risk and eventually tailor health behavior interventions to their needs. Methods Using data from a randomized, controlled, collaborative care treatment trial in 629 patients with HF and comorbid depression, we performed mixed effects logistic regression analyses to examine the cross-sectional and prospective relationships between medical and psychosocial variables and health behavior adherence, including adherence to medications, a low-sodium diet, and physician appointments. Results In cross-sectional analyses, married marital status and higher physical health-related quality of life (HRQoL) were associated with greater overall adherence (compared to married, single Odds Ratio [OR] = 0.46, 95% Confidence Interval [CI] = 0.26–0.80; other OR = 0.60, CI = 0.38–0.94; p = .012. Physical HRQoL OR = 1.02, CI = 1.00-1.04, p = .047). Prospectively, greater levels of social support were associated with improved overall adherence one year later (OR = 1.04, 95% CI = 1.00-1.08, p = .037). Social support, HF symptom severity, race and ethnicity, and age were predictors of specific types of adherence. Neither depression nor optimism was significantly associated with adherence outcomes. Conclusions These results provide important preliminary information about risk factors for poor adherence in patients with both HF and depression, which could, in turn, contribute to the development of interventions to promote adherence in this high-risk population. Trial registration https://clinicaltrials.gov/ct2/show/NCT02044211 ; registered 1/21/2014.

BackgroundPatients with post–COVID-19 condition (PCC) experience a wide range of complaints (physical, cognitive, and mental), sometimes with high levels of disability in daily activities. Evidence of effective interdisciplinary rehabilitation treatment is lacking. A person-centered, biopsychosocial, interdisciplinary rehabilitation program, adapted to expert opinions and the patient’s needs, was therefore developed. ObjectiveThis study aims to present a study protocol for a clinical trial to evaluate the effect of a new, person-centered, interdisciplinary rehabilitation treatment for PCC. It is aimed at improving participation in society and health-related quality of life in patients with PCC who perceive a high level of disability in daily activities or participation. MethodsA total of 20 Dutch adults, aged 18 years or older, with high levels of disability in daily activities and participation in society will be included in this replicated and randomized single-case experimental design study, from October 2023 onward. The replicated and randomized single-case experimental design consists of 3 phases. The baseline phase is the observational period, in which no specific treatment will be given. In the intervention phase, patients will receive the new outpatient treatment 3 times a week for 12 weeks, followed by a 12-week follow-up phase. During the intervention phase, the treatment will be personalized according to the patient’s physical, mental, and cognitive symptoms and goals. The treatment team can consist of a rehabilitation physician, physiotherapist, occupational therapist, speech therapist, and psychologist. The primary outcomes of the study are daily diaries, which consist of 8 questions selected from validated questionnaires (Utrecht Scale for Evaluation of Rehabilitation-Participation, EQ-5D-5L, and the Hospital Anxiety and Depression Scale). The other primary outcome measurements are participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation) and health-related quality of life (EQ-5D-5L). The secondary outcomes are physical tests and validated questionnaires aimed at physical, mental, and cognitive complaints. Effect evaluation based on daily assessments will include visual analysis, calculation of effect sizes (Nonoverlap of All Pairs), randomization tests, and multilevel analysis. In addition, other analyses will be based on ANOVA or a 2-tailed Student t test. ResultsData collection for this study started in October 2023 and is planned to be completed in July 2024. The results will be published in peer-reviewed journals and presented at international conferences. ConclusionsThis is the first study investigating the effect of an interdisciplinary rehabilitation treatment with a person-centered, biopsychosocial approach in patients with PCC. Our findings will help to improve the treatment and support of patients with PCC. Trial RegistrationGerman Clinical Trials Register DRKS00032636; https://drks.de/search/en/trial/DRKS00032636 International Registered Report Identifier (IRRID)DERR1-10.2196/63951

Key Clinical Message A surgical MDT approach to high‐complexity surgeries can allow maximal resection in order to achieve disease control and excellent functional outcomes, as demonstrated here for a case of hidradenitis suppurativa in a patient with Crohn's disease. Abstract Hidradenitis suppurativa is an autoimmune disease characterized by abscess and fistula formation with purulent discharge in intertriginous zones, and is associated with inflammatory bowel disease. We present the case of a patient with severe ongoing hidradenitis suppurativa causing osteomyelitis and affecting the perineum, on a background of Crohn's disease previously treated with panprotocolectomy and permanent ileostomy. The hidradenitis suppurativa was having a severe impact on the patient's quality of life, and she had failed to respond to conservative management. The patient opted for a radical two‐step procedure: first her coccyx and sacrum were removed. The second step was a radical bilateral anterior vulvectomy and posterior vaginectomy, with preservation of the uterine body and cervix. An anterolateral thigh flap was used to reconstruct the perineum. This complex procedure required the expertise of multiple surgical specialties, including plastic, general, spinal, and gynecological oncology surgeons to achieve maximal disease resection, minimizing the risk of recurrence.

Perpendicular magnetic anisotropy (PMA), spin pumping-induced damping, and interfacial Dzyaloshinskii–Moriya interaction (iDMI), which are spin–orbit coupling-related phenomena of utmost importance for applications, were experimentally investigated in as-grown and 225 °C annealed CoFeB/PtOx, CoFeB/TaOx, and Ta/CoFeB/TaOx systems by means of vibrating sample magnetometry, microstrip ferromagnetic resonance, and Brillouin light scattering techniques. By varying Co8Fe72B20 (CoFeB) thickness in the range of 0.8–10 nm, the effect of Ta buffer layer on anisotropy and damping was first studied, where a large surface magnetic anisotropy ($K_{s}=2.1\,\,\pm \,\,0.16$ erg/cm2) was measured in the unbuffered CoFeB/TaOx(0.8 nm) system most likely due to their higher roughness induced by the substrate. $K_{s}$ degrades significantly for CoFeB film thickness below 2 nm where spontaneous perpendicular magnetization was found to be impossible without Ta buffer layer. PMA, iDMI, and damping of as-deposited and 225 °C annealed CoFeB (1.5 nm)/PtOx systems were measured as a function of PtOx thickness in the range of 0.7–1.6 nm. Their strong dependence versus the PtOx thickness was attributed to the decrease of the magnetic dead layer as PtOx thickness increases. Linear dependence of damping versus PMA constant was obtained, confirming their relation with the spin–orbit coupling. Moreover, annealing increases PMA and the effective mixing conductance probably due to the enhancement of the CoFeB crystal structure and interfaces. [ABSTRACT FROM AUTHOR]

Problem-solving skills have many benefits, especially for lifelong learning. Learners are equipped with these abilities to be able to survive in life and in their profession. Problem-solving skill is closely related to cognitive ability and critical thinking skill. This research aims at determining the contribution of students’ cognitive ability and critical thinking skill on their problem-solving skill. This correlational research included 127 students taking education profession courses. The collected data were analyzed using correlation regression SPSS Version 23 software. The results of the data analysis showed that students’ cognitive abilitys and critical thinking skills had a significant correlation with their problem-solving skills. The relative contribution of the cognitive ability and the critical thinking skill was 94.8%. While the effective contribution of cognitive ability and critical thinking skills toward the students’ problem-solving skills was 68.4% and 26.4% respectively. The positive correlation among these variables can be used as a basis for implementing the case method in classroom learning activities in that the implementation of the case method has positive effects on the student’s cognitive abilitys, critical thinking skills, and problem-solving skills in Biology Education students.

This study aims to test the level of validity of Digital Assessment based Moodle as an assessment instrument to measure scientific literacy skills possessed by SMP/MTs students, especially on environmental pollution material. This method of research was development research with a 4D model consisting of a defining stage (Define), planning level (Design), development stage (Develop), and spread level Disseminate. At the development stage or development validation was carried out Digital Assessment based Moodle by expert validators consisting of 2 Lecturers in Science Education Master’s Degree at the University of Jember and 3 Science Teachers from SMPN 1 Jember, SMPN 2 Jember and SMPN 1 Probolinggo. The data analysis technique used was descriptive analysis and percentage calculation of validation results. The validation results in Digital Assessment-based Moodle obtained an average of 94.1% with a very valid category so that Digital Assessment-based Moodle met the quality and could be applied to students of class VII SMP SMP/MTs to measure students' scientific literacy skills, especially on environmental pollution material.

BackgroundA previously reported study examined the treatment of primary care patients with at least moderate severity depressive or anxiety symptoms via an evidence-based computerized cognitive behavioral therapy (CCBT) program (Beating the Blues) and an online health community (OHC) that included a moderated internet support group. The 2 treatment arms proved to be equally successful at 6-month follow-up. ObjectiveAlthough highly promising, e-mental health treatment programs have encountered high rates of noninitiation, poor adherence, and discontinuation. Identifying ways to counter these tendencies is critical for their success. To further explore these issues, this study identified the primary care patient characteristics that increased the chances patients would not initiate the use of an intervention, (ie, not try it even once), initiate use, and go on to discontinue or continue to use an intervention. MethodsThe study had 3 arms: one received access to CCBT (n=301); another received CCBT plus OHC (n=302), which included a moderated internet support group; and the third received usual care (n=101). Participants in the 2 active intervention arms of the study were grouped together for analyses of CCBT use (n=603) because both arms had access to CCBT, and there were no differences in outcomes between the 2 arms. Analyses of OHC use were based on 302 participants who were randomized to that arm. ResultsSeveral baseline patient characteristics were associated with failure to initiate the use of CCBT, including having worse physical health (measured by the Short Form Health Survey Physical Components Score, P=.01), more interference from pain (by the Patient-Reported Outcomes Measurement Information System Pain Interference score, P=.048), less formal education (P=.02), and being African American or another US minority group (P=.006). Characteristics associated with failure to initiate use of the OHC were better mental health (by the Short Form Health Survey Mental Components Score, P=.04), lower use of the internet (P=.005), and less formal education (P=.001). Those who initiated the use of the CCBT program but went on to complete less of the program had less formal education (P=.01) and lower severity of anxiety symptoms (P=.03). ConclusionsThis study found that several patient characteristics predicted whether a patient was likely to not initiate use or discontinue the use of CCBT or OHC. These findings have clear implications for actionable areas that can be targeted during initial and ongoing engagement activities designed to increase patient buy-in, as well as increase subsequent use and the resulting success of eHealth programs. Trial RegistrationClinicalTrials.gov NCT01482806; https://clinicaltrials.gov/study/NCT01482806

The characteristics of students who go to school in a coffee plantation environment tend to be less active in learning, resulting in student saturation and low cognitive learning outcomes of students. This study aims to analyze the effect of collaborative learning models combined with video media on critical thinking skills and biology learning outcomes of class X SMAN Jenggawah with a quasi-experimental research type using a pre-test post-test control group design. The learning design by forming the class into small groups observing videos of arthropods found in the coffee plantation environment. Data collection was obtained from the implementation of observations, tests, and questionnaires. Data analysis was tested using the ANACOVA test for critical thinking skills and learning outcomes in the cognitive domain of students, and independent sample t-test for learning outcomes in the affective and psychomotor domains of students. The results showed a significance value of 0.000 0.05 in the affective domain of learning outcomes, and a significance value of 0.213 > 0.05 in the psychomotor domain of learning outcomes, so that the collaborative learning learning model has no significant effect on critical thinking skills and cognitive learning outcomes of class X students high school in a coffee plantation area.

Abstract Background Major depressive disorder (MDD) is a leading cause of disease morbidity. Combined treatment with antidepressant medication (ADM) plus psychotherapy yields a much higher MDD remission rate than ADM only. But 77% of US MDD patients are nonetheless treated with ADM only despite strong patient preferences for psychotherapy. This mismatch is due at least in part to a combination of cost considerations and limited availability of psychotherapists, although stigma and reluctance of PCPs to refer patients for psychotherapy are also involved. Internet-based cognitive behaviorial therapy (i-CBT) addresses all of these problems. Methods Enrolled patients (n = 3360) will be those who are beginning ADM-only treatment of MDD in primary care facilities throughout West Virginia, one of the poorest and most rural states in the country. Participating treatment providers and study staff at West Virginia University School of Medicine (WVU) will recruit patients and, after obtaining informed consent, administer a baseline self-report questionnaire (SRQ) and then randomize patients to 1 of 3 treatment arms with equal allocation: ADM only, ADM + self-guided i-CBT, and ADM + guided i-CBT. Follow-up SRQs will be administered 2, 4, 8, 13, 16, 26, 39, and 52 weeks after randomization. The trial has two primary objectives: to evaluate aggregate comparative treatment effects across the 3 arms and to estimate heterogeneity of treatment effects (HTE). The primary outcome will be episode remission based on a modified version of the patient-centered Remission from Depression Questionnaire (RDQ). The sample was powered to detect predictors of HTE that would increase the proportional remission rate by 20% by optimally assigning individuals as opposed to randomly assigning them into three treatment groups of equal size. Aggregate comparative treatment effects will be estimated using intent-to-treat analysis methods. Cumulative inverse probability weights will be used to deal with loss to follow-up. A wide range of self-report predictors of MDD heterogeneity of treatment effects based on previous studies will be included in the baseline SRQ. A state-of-the-art ensemble machine learning method will be used to estimate HTE. Discussion The study is innovative in using a rich baseline assessment and in having a sample large enough to carry out a well-powered analysis of heterogeneity of treatment effects. We anticipate finding that self-guided and guided i-CBT will both improve outcomes compared to ADM only. We also anticipate finding that the comparative advantages of adding i-CBT to ADM will vary significantly across patients. We hope to develop a stable individualized treatment rule that will allow patients and treatment providers to improve aggregate treatment outcomes by deciding collaboratively when ADM treatment should be augmented with i-CBT. Trial registration ClinicalTrials.gov NCT04120285 . Registered on October 19, 2019.

Pandemi COVID-19 telah melanda Indonesia sejak Maret tahun 2020. Sejak saat itu kegiatan diubah dari luring menjadi daring termasuk kegiatan praktikum. Siswa hanya melihat kegiatan praktikum melalui tayangan video yang telah dibuat oleh guru dan laboran. Di bulan September 2021, angka kasus COVID-19 terus turun. Hal ini menyebabkan sekolah – sekolah mulai untuk melakukan kegiatan belajar mengajar secara tatap muka secara terbatas. Perlu dilakukan pengukuran motivasi siswa saat pertama kali melakukan praktikum luring di sekolah. Metode yang dilakukan saat kegiatan praktikum kepada 11 siswa SMAN Rambipuji Jember adalah Participatory Action Research (PAR) dengan tahapan umum berupa Perencanaan, Kegiatan, Refleksi dan Evaluasi. Tingkat motivasi siswa terhadap pembelajaran Biologi khususnya praktikum pembuatan preparat apusan darah adalah sebesar 86%. Motivasi siswa yang sangat tinggi ini dikarenakan siswa dilibatkan dan terjun langsung dalam proses pembuatan preparat sehingga melatih kecerdasan psikomotorik dan kognitif.

Background: Health literacy (HL) is the degree to which individuals can obtain, process, and understand basic health information and services. Although low HL portends greater risk for clinical events, its association with heart failure (HF)-specific health status– patients' symptoms, function and quality of life– is poorly understood. We thus explored the association of low HL with health status outcomes in depressed patients with HF, for whom treatment regimens can be complex. Methods: Participants with HF with reduced ejection fraction and depression, from the Hopeful Heart trial, were categorized as having low or adequate HL at baseline using a validated, 1-item HL screen. HF-specific health status was measured at baseline, 3, 6, and 12 months using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Using serial risk-adjusted linear regression models, we assessed the association of HL with baseline, 12-month and 12-month change in the KCCQ Overall Summary (OS) scores (range 0–100; lower scores = worse health status). Results: Among 629 participants, 35 % had low HL. Those with low HL had lower health status at all time points, including at 12 months after discharge (−9.8 points, 95%CI [−14.3, −5.3], p

Abstrak. Pembelajaran yang bermakna adalah pembelajaran yang dapat dengan mudah dipahami oleh peserta didik dan informasi-informasi yang diperoleh bisa bertahan lama di dalam Long Term Memory (LTM) peserta didik. Pembelajaran di masa pandemic Covid-19 yang dilakukan secara daring tentu tidak berbeda dengan pembelajaran yang dilakukan secara luring. Suatu model/strategi pembelajaran tetap bisa digunakan dalam pembelajaran, termasuk juga model pembelajaran RQAAD (Reading, Questioning, Answering, Analyzing, Discussing). Penelitian ini bertujuan untuk mengetahui pengaruh model pembelajaran RQAAD terhadap motivasi belajar dan keterampilan metakognisi mahasiswa. Penelitian ini menggunakan penelitian kuasi eksperimen yang membandingkan kelas yang diberi perlakuan menggunakan model pembelajaran RQAAD dan yang tidak menggunakannya. Motivasi belajar mahasiswa diukur dengan skala motivasi sedangkan keterampilan metakognitif diukur dengan rubrik keterampilan metakognitif. Penelitian dilakukan pada mahasiswa semester 3 tahun akademik 2020/2021 yang terdiri dari 62 mahasiswa. Pembelajaran RQAAD terbukti berpengaruh signifikan terhadap motivasi belajar dan keterampilan metakognitif mahasiswa yang menempuh matakuliah Strategi Belajar Mengajar Biologi. Rerata skor terkoreksi motivasi belajar kelas eksperimen 5,61 persen lebih tinggi dari kelas kontrol dan rerata terkoreksi keterampilan metakognitif kelas eksperimen 16,01 persen lebih tinggi dibanding kelas kontrol. Abstract. Learning during the COVID-19 pandemic that is done online is certainly no different from learning that is done offline. A learning model/strategy can still be used in learning, including the RQAAD (Reading, Questioning, Answering, Analyzing, Discussing) learning model. This study aims to determine the effect of the RQAAD learning model on student motivation and metacognitive skills. The research method used is quasi-experimental by comparing classes that are treated using the RQAAD learning model and those who do not. Student learning motivation is measured by the motivation scale while metacognitive skills are measured by the metacognitive skills rubric. The research was conducted on 3rd semester students of the 2020/2021 academic year consisting of 62 students. Learning RQAAD proved to have a significant effect on learning motivation and metacognitive skills of students taking Biology Teaching and Learning Strategies Course. The mean score of corrected learning motivation in the experimental class is 5.61 percent higher than the control class and the average corrected metacognitive skill in the experimental class is 16.01 percent higher than the control class.

We investigate the behaviour of spin transfer torque (STT) and tunnelling magnetoresistance (TMR) in epitaxial antiferromagnetic-based tunnel junctions using tight binding calculations in the framework of the Keldysh formalism. We find that the STT out-of-plane component exhibits a staggered spatial distribution similar to its in-plane component. This behaviour is specific to the use of a tunnel barrier and significantly differs from the out-of-plane torques reported in previous works using a metallic spacer. Additionally, we show that unlike conventional ferromagnetic-based tunnel junctions, the TMR can increase with applied bias and reach values comparable to typical magnetoresistances found for usual spin valves. [ABSTRACT FROM AUTHOR]

Previous research has reported mixed findings regarding the relationship between therapeutic alliance, engagement and outcomes in e-mental health. This study aims to overcome some of the methodological limitations of previous research and extend our understanding of alliance-outcome relationships in e-mental health by exploring the nature of the relationship triangle between the patient, their care manager and their computerized cognitive behavioural therapy (CCBT) program, accessed with or without an Internet Support Group (ISG). Positive patient-rated alliance with both their care manager and the CCBT program itself was found and these were significantly associated with measures of engagement and clinical outcome. The magnitude of this association was moderate, and within the range of that reported for traditional face-to-face psychotherapies in recent meta-analyses. Limitations of the study, including the reliance on completer data and a cross-sectional design, and directions for future research are presented. Our findings suggest that both the training and supervision of support staff and the optimization of CCBT interventions themselves to enhance alliance and experience may lead to improved engagement and outcomes. Trial Registration: Clinicaltrials.gov Identifier: NCT01482806 https://www.clinicaltrials.gov/ct2/show/NCT01482806?term=rollman&rank=4

Background Computerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans. Aims We studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18–75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety. Method Patients with moderate levels of mood and/or anxiety symptoms (PHQ-9 or GAD-7≥10) were randomised to receive either care-manager-guided access to the proven-effective Beating the Blues® CCBT programme or usual care from their primary care doctor. Results Compared with White participants, African Americans were less likely to start the CCBT programme (P=0.01), and those who did completed fewer sessions and were less likely to complete the full programme (P=0.03). Despite lower engagement, however, African Americans who started the CCBT programme experienced a greater decrease in self-reported depressive symptoms (estimated 8-session change: −6.6 v. −5.5; P=0.06) and similar decrease in anxiety symptoms (−5.3 v. −5.6; P=0.80) compared with White participants. Conclusions CCBT may be an efficient and scalable first-step to improving minority mental health and reducing disparities in access to evidence-based healthcare.

BACKGROUND:Multidisciplinary rehabilitation has been recommended for multi-trauma patients, but there is only low-quality evidence to support its use with these patients. This study examined whether a Supported Fast track multi-Trauma Rehabilitation Service (Fast Track) was cost-effective compared to conventional trauma rehabilitation service (Care As Usual) in patients with multi-trauma from a societal perspective with a one-year follow-up. METHODS:An economic evaluation alongside a prospective, multi-center, non-randomized, controlled clinical study, was conducted in the Netherlands. The primary outcome measure was the Functional Independence Measure (FIM). Generic Quality of Life and Quality Adjusted Life Years (QALYs) of the patients were derived using the Short-form 36 Health Status Questionnaire. Incremental Cost-Effectiveness Ratios (ICERs) were stated in terms of costs per unit of FIM improvement and costs per QALY. To investigate the uncertainty around the ICERs, non-parametric bootstrapping was used. RESULTS:In total, 132 patients participated, 65 Fast Track patients and 67 Care As Usual patients. Mean total costs per person were €18,918 higher in the Fast Track group than in the Care As Usual group. Average incremental effects on the FIM were 3.7 points (in favor of the Fast Track group) and the incremental (extra) bootstrapped costs were €19,033, resulting in an ICER for cost per FIM improvement of €5,177. Care As Usual dominated Fast Track in cost per QALY as it gave both higher QALYs and lower costs. All sensitivity analyses attested to the robustness of our results. CONCLUSIONS:This study demonstrated that a multidisciplinary rehabilitation program for multi-trauma patients according to the supported fast track principle is promising but cost-effectiveness evidence remains inconclusive. In terms of functional outcome, Fast Track was more expensive but yielded also more effects compared to the Care As Usual group. Looking at the costs per QALYs, unfavorable ICERs were found. Given the lack of a willingness-to-pay threshold for functional recovery and the relatively short time horizon, it is not possible to draw firm conclusions about the first. TRIAL REGISTRATION:(Current Controlled Trials register: ISRCTN68246661).

The effects on health related outcomes of a newly-developed rehabilitation program, called 'supported Fast Track multi-trauma rehabilitation service' (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual).Prospective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score ≥16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures. The Fast Track program involved: integrated coordination between trauma surgeon and rehabilitation physician, shorter stay in hospital with faster transfer to a specialized trauma rehabilitation unit, earlier start of multidisciplinary treatment and 'non-weight bearing' mobilization. Primary outcomes were functional status (FIM) and quality of life (SF-36) measured through questionnaires at baseline, 3, 6, 9 and 12 months post-trauma. Outcomes were analyzed using a linear mixed-effects regression model.The FIM scores significantly increased between 0 and 3 months (p