“We can’t handle things we don’t know about”: perceived neurorehabilitation challenges for Malawian paediatric cerebral malaria survivors

Background We sought to identify perceptions of neurorehabilitation challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Methods An exploratory approach was used to qualitatively investigate the perceived neurorehabilitation challenges for paediatric CM survivors. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs). Results FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care. At a community-level, rehabilitation infrastructure, including trained staff, equipment, and programmes, is extremely limited. Rehabilitation services are inequitably accessible, and community-based rehabilitation remains largely unavailable. Conclusions There is an urgent need to establish further training of rehabilitation personnel at all levels and to build accessible rehabilitation infrastructure in Malawi for post-CM patients. Additional work is required to expand this study across multiple regions for a holistic understanding of neurorehabilitation needs.

“We can’t handle things we don’t know about”: Perceived neurorehabilitation challenges for Malawian paediatric cerebral malaria survivors

Background: We sought to identify perceptions of neurorehabilitation challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.Methods: An exploratory approach was used to qualitatively investigate the perceived neurorehabilitation challenges for paediatric CM survivors. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs).Results: FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care. At a community-level, rehabilitation infrastructure, including trained staff, equipment, and programmes, is extremely limited. Rehabilitation services are inequitably accessible, and community-based rehabilitation remains largely unavailable.Conclusions: There is an urgent need to establish further training of rehabilitation personnel at all levels and to build accessible rehabilitation infrastructure in Malawi for post-CM patients. Additional work is required to expand this study across multiple regions for a holistic understanding of neurorehabilitation needs.

“We Can’t Handle Things We don’t Know About”: Perceived Neurorehabilitation Needs and Challenges for Malawian Paediatric Cerebral Malaria Survivors

Background: We sought to identify perceptions of neurorehabilitation needs and challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Methods: An exploratory approach was used to qualitatively investigate current available neurorehabilitation services; investigate the needs of caregivers, CM survivors, providers, and the community; and identify challenges and methods to accessing neurorehabilitation services. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs).Results: Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs). FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care. At a community-level, rehabilitation infrastructure, including trained staff, equipment, and programmes, is extremely limited. Rehabilitation services are inequitably accessible, and community-based rehabilitation remains largely unavailable.Conclusions: There is an urgent need to establish further training of rehabilitation personnel at all levels and to build accessible rehabilitation infrastructure in Malawi for post-CM patients. Additional work is required to expand this study across multiple regions for a holistic understanding of neurorehabilitation needs.

State-Federal Vocational Rehabilitation in Traumatic Brain Injury: What Predictors Are Associated With Employment Outcomes?

This study identified predictors of employment for individuals with traumatic brain injury (TBI). Data from 4,923 individuals with TBI were extracted from the Rehabilitation Services Administration’s Case Service Report (RSA-911) database. A multiple logistic regression model using demographics, disability-related variables, vocational rehabilitation (VR) service variables, and their interactions correctly classified 69.5% of the cases as successfully employed or not successfully employed. The model explained approximately 27.1% of the variance in employment outcomes. Results indicated that level of education, race/ethnicity, age at application, preemployment status, Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), comorbid depression, and case expenditure were significantly associated with employment outcomes (all p ≤ .05). VR variables that showed the most significant positive effect on employment outcomes were on-the-job support, job placement, and on-the-job training. Race/ethnicity moderated the effect of college training, supported employment, transportation, and extended evaluation or work trial assessment services on employment outcomes. The findings have implications for promoting the use of those VR services that are strongly related to employment outcomes for persons with TBI. They also point to the need for rehabilitation personnel to address some of the demographic and disability-related barriers to successful employment.

A Commentary on Telerehabilitation Services in Pakistan: Current Trends and Future Possibilities

A 2014 World Health Organization (WHO) study reported that almost 27 million people with disability live in Pakistan with fewer than one allied rehabilitation professional per 10,000 people. The current study sought to determine the attitudes toward telerehabilitation via a survey administered to 329 Pakistani rehabilitation professionals. Study results indicate that rehabilitation professionals in Pakistan are knowledgeable about telerehabilitation and Information and Communication Technology (ICT), and are receptive to employing telerehabilitation programs and applications. Therefore, we can infer that the future of telerehabilitation can be bright in Pakistan but requires the attention of policy makers and non-government organizations to launch an appropriate program nationwide. The authors suggest that a range of telerehabilitation services (e.g., consultation, assessment, and therapy) could alleviate the shortage of rehabilitation personnel in Pakistan.

(The relationship between electronic accounting information systems and the degree of bank credit risk (Field study on specialized Sudanese banks: العلاقة بين انظمة المعلومات المحاسبية الإلكترونية ودرجة مخاطر الائتمان المصرفي (دراسة ميدانية على البنوك السودانية المتخصصة )

The study examined the role of accounting information systems to reduce the risk of electronic credit bank. The problem with the study is that the banks are exposed to the failures , in the event of failed management in the recruitment of accounting information systems , electronic tapped to serve and support its own operations in making investment decisions in general, and the decisions of the granting of credit in the banks , in particular the most part due failures in the field of credit to the problems in the measurement of risk credit , which represents state banks face at the present time which makes it tough in the granting of credit . This study is important from the importance of accounting information systems electronic as a strategy has become a strategic resource dependent upon the banks to deal with the market conditions when making decisions to grant credit, as banks must stand on the degree of credit risk for credit operations that have been granted to customers, so before making a decision to grant loans new in order to stand on the truth and put . The study aimed to identify the characteristics of the electronic accounting information systems in terms of speed in providing information and in terms of the accuracy of information and reflection on the measurement of credit risk in banks, the formulation of the theoretical aspects of the accounting information systems and electronic use them to improve the process of measuring credit risk. The study relied on deductive approach and inductive and historical approach descriptive and concluded several results, most important , study results indicated accounting information systems electronic affect the credit risk of the bank, confirmed the findings of the study and a relationship with a significance between rehabilitation personnel information systems, accounting and reduce the credit risk of the bank, results indicated study indicated that the accounting information systems electronic increase the credibility of accounting information . The study recommended a number of recommendations, including the need to make sure the loan guarantee granted by the credit risk faced by the bank through electronic accounting information system, focusing on the importance of the information system of accounting -mail addresses for being immediate loans when due.

Living with disabled children in Malawi: Challenges and rewards

Background: Rehabilitation personnel need to be sensitive to the cultural aspects that constitute the environment of a disabled child’s family life.Objectives: The aim of this study was to gain insight on how families experience parenting of disabled children and how the families experience the support provided by the rehabilitation system in Malawi.Method: An anthropological field study combining interviews and observations was conducted in a rural district of Malawi in 2011. Permission was granted to follow four families, and this study presents the stories of two families, whose children have severe disabilities. We used phenomenological and narrative analyses to make sense of the stories. Results: The findings indicate that families with disabled children invest time and emphasise care for their disabled children. They feel enriched by their experience despite challenging situations with little support from the rehabilitation services. High standards of care demonstrating positive and moral attitudes have earned these families respect in their communities. Storytelling has created an opportunity for the families to understand and interpret their challenging situation with inherent contextual meaning.Conclusion: This study shows that families with disabled children draw on cultural and structural strengths that rehabilitation professionals should be aware of in their support to mothers and other caregivers of children with disabilities.

Distance Learning Rehabilitation of Autistic Reasoning

Recent psychological studies have revealed that autistic children can neither reason properly about mental states of themselves and others, nor understand emotions (Leslie, 1987; Perner 1991; Pilowsky, Yirmiya, Arbelle, & Mozes 2000). Autism is a multifactor disorder that is characterized by impaired social interaction and communication, combined with repetitive and stereotyped patterns of behavior, and affects up to 1% of school-aged children in some geographic areas. In this article we are concerned with the strategies of rehabilitation of reasoning to improve communication skills of children with autism. It has been confirmed by multiple clinical studies that the properly timed treatment is essential for the autistic patient to increase the chance for recovery. An early behavioral intervention is highly beneficial for autistic children (Green, 1996; Jensen & Sinclair, 2002; Rogers, 1998). There is an opinion with increasing support by multiple researchers that intensive behavioral intervention (that can be stimulated in distance learning) may result in a dramatic improvement of autistic reasoning (McEachin, Smith, & Lovaas, 1993). From the viewpoint of autism experts who believe that there is no alternative to behavioral intervention (thought of as the only way to facilitate compensatory learning; see, e.g., Frith, 2001; Howlin, 1998), distance learning may be a useful aid for the education of parents and rehabilitation personnel.