"A lot of moving parts": Recovery home challenges linking and housing individuals with criminal legal system involvement.

INTRODUCTION: There are high rates of substance use disorder (SUD) among people released from carceral settings and, upon release, many of these people also face unstable housing situations, posing challenges to connecting with resources to facilitate SUD recovery. Recovery homes provide a temporary sober living environment for those seeking both SUD recovery and transition back to the community after carceral release. However, successful recovery home placement for this population can prove difficult, and there is a need for research to identify ways to overcome them. METHODS: The current qualitative study seeks to understand barriers to recovery home access for people leaving carceral settings and identify potential best practices for overcoming these barriers from the perspective of recovery home directors. The study conducted semi-structured interviews at two data collection points with eight recovery home directors from sites participating in a housing linkage and placement intervention pilot. The research team used qualitative software to identify and organize directors' experiences and practices in housing and supporting this population. RESULTS: Recovery home directors identified significant barriers to linkage from carceral settings, including difficulties communicating and coordinating placement with potential residents while still incarcerated. Interviews also revealed approaches recovery home directors take to improve recovery home placement, such as sharing information and resources with carceral settings prior to release and helping residents avoid reincarceration by managing relationships with court agents and parole. CONCLUSION: Recovery resident directors have considerable insight into the most significant placement challenges faced by recovery homes upon carceral release as well as experience with potential solutions for overcoming them. Directors can be the key to direct seamless support and continuity of care for criminal legal system involved individuals through coordination with jails, prisons, and other community resources. Directors can also play a significant role in the successful completion of probation and parole by helping residents avoid further issues with the legal system. These directors view working cooperatively with residents as an effective approach to ensuring clients adhere to court orders and are successful in recovery and reentry.

The role and effectiveness of occupational therapy in prison rehabilitation programs: systematic review.

PURPOSE: The purpose of this study was to research studies in the literature regarding the role of the occupational therapist within penitentiary facilities. DESIGN/METHODOLOGY/APPROACH: The study design is a systematic review using five different databases. FINDINGS: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society. RESEARCH LIMITATIONS/IMPLICATIONS: It is necessary for clinical practice, and especially to increase the health of people within prisons, to update the occupational therapist interventions in the literature that are effective within prisons. PRACTICAL IMPLICATIONS: According to this study, the intervention of occupational therapists in the prison setting reduces recidivism and contributes to social and work reintegration. This has positive effects in terms of costs related to incarceration. ORIGINALITY/VALUE: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society.

Social reintegration of cisgender and transgender women post-incarceration in Brazil: policies and challenges.

BACKGROUND: Social reintegration relies on the support given to prisoners not only during their reentry into society but also throughout their imprisonment. Our goal was to analyze the expectations reported by cisgender and transgender women returning to society and of the justice and social welfare professionals from the Brazilian prison system. METHODS: A qualitative analysis using saturation sampling was conducted. The participants were selected through a non-probabilistic sampling technique. Data was collected through semi-structured interviews with professionals involved in the management of the prison system and female former inmates. Interviews were transcribed and analyzed using an open and focused coding process. Textual data was stored, organized, and coded using Atlas software according to emerging themes. RESULTS: The study involved 15 professionals and 13 female former inmates, five of them identified as transgender women. Among the professionals, the age range went from 38 to 65 years old; they reported a work history in their respective fields, from 10 to 35 years, with an equal distribution across genders. As for the female former inmates, their ages ranged from 24 to 42 years old, and the most reported crime was drug trafficking. Their incarceration time varied from 1 to 8 years. Female inmates were vulnerable to abuse and violence, including physical, sexual, and emotional violence. Women in situations of prior vulnerability faced additional challenges during their sentences. Transgender women were even more neglected and discriminated against by the system. Despite the professionals being aware and concerned about vulnerabilities and the need to improve the reintegration process, in general, they were not sensitive to the gender perspective. There were no specific policies able to support social integration for this public. CONCLUSIONS: Data showed multifaceted challenges faced by female former inmates within the Brazilian prison system, highlighting the insufficient policies for both cisgender and transgender women. Additionally, the results revealed a lack of sensitivity among professionals regarding gender issues and their particularities in the prison system and social reintegration. These findings emphasize the need for a more comprehensive and intersectional approach that addresses the diverse socio-economic backgrounds of these individuals.

Social support and trauma experiences of imprisoned men in Northern Ireland.

BACKGROUND: Social Support has multiple benefits for health and mental wellbeing. Its existence, and the extent to which it can be beneficial, is dependent upon the context in which it is provided, and the recipients' view of it. Social support has long been established as a 'buffer' to the negative impact of stressful life experiences. Trauma can negatively impact upon social support, reducing the extent of social networks and ability of some trauma experienced individuals to sustain extensive social support networks. However, some trauma experiences can also strengthen social relationships. Imprisoned men are disproportionately likely to have experienced a traumatic event when compared with the general population. Past research has found that traumatic events can lead to a decrease in social support among imprisoned men but more research is needed to understand the variations in perceived social support experienced by imprisoned men and to determine how different types of trauma may be related to perceived social support. METHOD: A cross-sectional survey of 384 adult men detained in the Northern Ireland Prison Service was conducted between November 2022 and January 2023. The survey collected data on the men's demographics, mental health, substance use, and criminal history. Respondents were also asked to complete a Trauma History Questionnaire (THQ) and the Multi-dimensional Scale of Perceived Social Support (MSPSS). Regression analysis was then used to investigate the possible associations between individual characteristics, different types of trauma experiences and perceived social support. RESULTS: Most types of trauma experiences were not associated with lower levels of perceived social support. Only those who had experienced crime related trauma were more likely to report lower levels of social support. Older imprisoned men and those using substances were more likely to report lower levels of perceived social support, while those who had served a sentence of less than one year reported higher levels of perceived social support. DISCUSSION: Crime related trauma experiences were found to be associated with lower levels of perceived social support. There were no significant findings around perceived social support and any of the other trauma types i.e. physical, sexual and general disaster experiences. Trauma informed policy responses should be cognisant of this, as those with experiences of crime related victimisation are less likely to have the social support needed to buffer against future trauma experiences. The findings demonstrate that some individuals experience lower levels of perceived social support and several factors are associated with this including age, time served and substance use history. This will potentially impact upon them during release and affect their reintegration into society. Specific policies aimed at these groups should be considered to prevent them from experiencing a lack of support and any accompanying adversity upon release.

Pre-injury psychiatric history, subacute symptoms and personality traits predict social reintegration at 3-month post-mild traumatic brain injury.

BACKGROUND: The purpose of the study was to identify whether the presence of a pre-injury psychiatric history, subacute post-concussive symptoms (PCS) and personality traits were predictive of less favorable social reintegration for 3 months following a mild traumatic brain injury (mTBI). METHOD: A total of 76 patients with mTBI were included, and the presence of a pre-injury psychiatric history was identified from the medical chart. One-month post-accident, these patients completed the Millon Multiaxial Clinical Inventory, 3rd Edition assessing personality traits and the Rivermead Post-Concussion Symptoms Questionnaire to measure subacute PCS. Social reintegration was measured using the Mayo-Portland Adaptability Inventory, 4th Edition at 3-month post-accident. RESULTS: The presence of pre-injury psychiatric history, high levels of subacute PCS and Cluster B personality traits such as histrionic and borderline features were significant predictors of social reintegration quality at 3-month post injury. CONCLUSION: This study provides new insights on cluster B personality traits and its influence on recovery and social reintegration at 3-month post mTBI.

Perspectives and Experiences of Public Safety Personnel Engaged in a Peer-Led Workplace Reintegration Program Post Critical Incident or Operational Stress Injury: A Qualitative Thematic Analysis.

INTRODUCTION: Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process may contribute to further personal challenges for PSP and their families as well as staffing shortages that adversely affect PSP organizations. The Canadian Workplace Reintegration Program (RP) has seen a global scale and spread in recent years. However, there remains a lack of evidence-based literature on this topic and the RP specifically. The current qualitative study was designed to explore the perspectives of PSP who had engaged in a Workplace RP due to experiencing a potentially psychologically injurious event or OSI. METHODS: A qualitative thematic analysis analyzed interview data from 26 PSP who completed the RP. The researchers identified five themes: (1) the impact of stigma on service engagement; (2) the importance of short-term critical incident (STCI) program; (3) strengths of RP; (4) barriers and areas of improvement for the RP; and (5) support outside the RP. DISCUSSION: Preliminary results were favorable, but further research is needed to address the effectiveness, efficacy, and utility of the RP. CONCLUSION: By addressing workplace reintegration through innovation and research, future initiatives and RP iterations can provide the best possible service and support to PSP and their communities.

Her village: experiences of drug-involved women in a female-only aftercare program in the Philippines.

PURPOSE: Women are exposed to vulnerabilities that can lead to drug use or hinder recovery. However, there is a dearth of studies on recovery programs for women. This study aims to add to the literature by examining the feasibility of a women-only aftercare program for recovering users in the Philippines. DESIGN/METHODOLOGY/APPROACH: The study used a mixed-method design with pre and post-program surveys used to measure changes in participants' recovery capital. Focused group discussions elicited participants' context, their reactions, perceived outcomes and suggestions on the program. FINDINGS: Women in the program shared narratives of pain, trauma and abuse before treatment. Participants reported significant improvements in personal, community and family recovery capital dimensions. The program enabled personal growth in the form of new knowledge, skills and self-confidence. The women-only program also provided a safe space for women, to receive support from other women, community members and family. However, the women continue to face continuing challenges related to stigma and discrimination and a lack of livelihood opportunities. RESEARCH LIMITATIONS/IMPLICATIONS: A limitation of the study was its small sample size and the lack of a control group. Another limitation was the variability in treatment received by the women, which could have affected overall outcomes. Future studies using a randomized control trial and longitudinal designs may provide more robust conclusions on the effectiveness of the program. PRACTICAL IMPLICATIONS: Given punitive contexts, gender-sensitive and trauma-informed programs and services for women involved in drug use could potentially mitigate the abuse, stigma and vulnerabilities they experience. ORIGINALITY/VALUE: This study contributes to the sparse literature on women-only aftercare, particularly in countries that criminalize drug use.

Evolution and challenges of DDR: A policy review through the prism of Colombia's DDR experience.

Disarmament, demobilization, and reintegration (DDR) processes have undergone significant evolution in recent decades, reflecting the complex dynamics of the transition from conflict to peace. This paper presents a comparative analysis of three generations of DDR processes, illustrating the shift from a primarily security-focused approach to a comprehensive strategy that includes socioeconomic development, political participation, and community engagement. In Colombia, a country with a long history of armed conflict, the process of DDR has undergone significant changes. These changes were made to adapt to the intricate realities of war, peace agreements, and social integration. During its evolution, DDR in Colombia has encountered challenges in expanding beyond the traditional scope of disarmament and demobilization to include the crucial aspect of reintegration. This highlights the significance of addressing the varied needs of ex-combatants and ensuring their sustainable integration into civilian life. The findings emphasize the importance of flexible and context-sensitive DDR frameworks that acknowledge the distinct challenges and opportunities of each post-conflict scenario. This provides valuable insights for future peacebuilding efforts worldwide.

The effect of professional reintegration of stroke survivors on their quality of life: A scoping review: Professional Integration and QoL after stroke.

BACKGROUND: Professional reintegration is an indicator of recovery and a common goal for many stroke survivors. However, data on the effect of professional reintegration on the quality of life (QoL) of stroke survivors is scarce. AIMS: To assess and synthesize the available evidence, and identify the gaps on the effect of professional reintegration on the QoL of stroke survivors. METHODS: A scoping review was performed, following PRISMA-ScR guidelines. The electronic databases PubMed, ISI Web of Science, PsycINFO, and SciELO were searched for empirical, peer-reviewed, original, and full-length studies on the effect of professional reintegration on QoL of stroke survivors. The main quantitative findings were synthesized and qualitative data was explored by thematic content analysis. RESULTS: The included studies, 7 quantitative, 1 qualitative, and 1 mixed-methods, were published between 2009 and 2021. The assessment of QoL was highly heterogenic but globally most studies reported a significant and positive association between return to work (RTW) and QoL, 3 to 36 months post-stroke. For some stroke survivors, being able to focus on their rehabilitation was more important for their QoL than RTW. CONCLUSIONS: The results highlight the importance of investing in professional reintegration after stroke to improve survivors' QoL. Further mixed-methods longitudinal research, performed in different countries and settings, with higher, homogeneous, and comparable samples, providing a broader approach to professional reintegration and the use of specific and standardized instruments to assess subjective domains of stroke survivors' QoL, is needed.

Movement patterns of two reintegrated African elephant (Loxodonta africana) herds: transitioning from captivity to free-living.

With the escalating challenges in captive elephant management, the study of elephant reintegration emerges as a pivotal area of research, primarily addressing the enhancement of animal welfare. The term 'reintegration' refers to the process of rehabilitating captive elephants to a natural system, allowing them to roam freely without intensive human intervention. There is a relative paucity of research addressing the behavioural adaptations post-reintegration, despite reintegration of over 20 elephants across various fenced reserves in South Africa. Our study centres on two distinct herds of reintegrated African elephants, monitoring their movement patterns in two South African reserves over a 57-month period post-release. The primary goal of the study was to establish whether the flexibility and adaptability of movement behaviour of reintegrated elephants can be considered as one of the indicators of determining the success of such an operation. The second aim of our study was to investigate if the reintegrated elephants demonstrated an adaptability to their environment through their hourly, daily, and seasonal ranging patterns after a period of free roaming that exceeded 4 years. Our findings indicated that reintegrated elephants, much like their wild counterparts (movement based on literature), displayed notable seasonal and diurnal variations in key movement parameters, such as utilisation distribution areas and reserve utilization. These patterns changed over time, reflecting an adaptive shift in movement patterns after several years of free roaming. Notably, the trajectory of changes in movement parameters varied between herds, indicating unique adaptation responses, likely resulting from differences in the reintegration process (familiarity of reserve, season of release, presence of wild elephants). Although our study is constrained by the limited number of reintegrated herds available for analysis, it underscores the potential of captive elephants to successfully adapt to a free-living environment, emphasising the promising implications of reintegration initiatives.

Colorimetric Evaluation of a Reintegration via Spectral Imaging-Case Study: Nasrid Tiling Panel from the Alhambra of Granada (Spain).

Color reintegration is a restoration treatment that involves applying paint or colored plaster to an object of cultural heritage to facilitate its perception and understanding. This study examines the impact of lighting on the visual appearance of one such restored piece: a tiled skirting panel from the Nasrid period (1238-1492), permanently on display at the Museum of the Alhambra (Spain). Spectral images in the range of 380-1080 nm were obtained using a hyperspectral image scanner. CIELAB and CIEDE2000 color coordinates at each pixel were computed assuming the CIE 1931 standard colorimetric observer and considering ten relevant illuminants proposed by the International Commission on Illumination (CIE): D65 plus nine white LEDs. Four main hues (blue, green, yellow, and black) can be distinguished in the original and reintegrated areas. For each hue, mean color difference from the mean (MCDM), CIEDE2000 average distances, volumes, and overlapping volumes were computed in the CIELAB space by comparing the original and the reintegrated zones. The study reveals noticeable average color differences between the original and reintegrated areas within tiles: 6.0 and 4.7 CIEDE2000 units for the yellow and blue tiles (with MCDM values of 3.7 and 4.5 and 5.8 and 7.2, respectively), and 16.6 and 17.8 CIEDE2000 units for the black and green tiles (with MCDM values of 13.2 and 12.2 and 10.9 and 11.3, respectively). The overlapping volume of CIELAB clouds of points corresponding to the original and reintegrated areas ranges from 35% to 50%, indicating that these areas would be perceived as different by observers with normal color vision for all four tiles. However, average color differences between the original and reintegrated areas changed with the tested illuminants by less than 2.6 CIEDE2000 units. Our current methodology provides useful quantitative results for evaluation of the color appearance of a reintegrated area under different light sources, helping curators and museum professionals to choose optimal lighting.

Community Reintegration After Traumatic Brain Injury.

Achieving effective community reintegration is important to maximize recovery in patients with traumatic brain injury, simultaneously limiting caregiver burden and improving satisfaction with quality of life. Certain medical complications that are common after brain injury may impact community reintegration, and should be addressed by the physician in a systematic approach. Additionally certain social and environmental factors such as mobility or return to work or school may arise, and should be addressed proactively by the physician. Inpatient/residential or outpatient programs with case management and a multi-disciplinary team can facilitate community reentry for patients, and should be considered when available.

Development and Pilot Test of a Multi-Component Intervention to Support Women's Recovery from Female Genital Fistula.

INTRODUCTION AND HYPOTHESIS: We evaluated a pilot multi-component reintegration intervention to improve women's physical and psychosocial quality of life after genital fistula surgery. METHODS: Twelve women undergoing fistula repair at Mulago Specialized Women and Neonatal Hospital (Kampala, Uganda) anticipated in a 2-week multi-component intervention including health education, psychosocial therapy, physiotherapy, and economic investment. We assessed feasibility through recruitment, retention, and adherence, acceptability through intervention satisfaction, and preliminary effectiveness through reintegration, mental health, physical health, and economic status. We collected quantitative data at enrollment, 6 weeks, 3 months, and 6 months. We conducted in-depth interviews with six participants. Quantitative data are presented descriptively, and qualitative data analyzed thematically. RESULTS: Participants had a median age of 34.5 years (25.5-38.0), 50% were married/partnered, 42% were separated, 50$ had completed less than primary education, and 67% were unemployed. Mean number of sessions received was 12 for health education (range 5-15), 8 for counseling (range 8-9), and 6 for physiotherapy (range 4-8). Feasibility was demonstrated by study acceptance among all those eligible (100%); comfort with study measures, data collection frequency and approach; and procedural fidelity. Acceptability was high; all participants reported being very satisfied with the intervention and each of the components. Participant narratives echoed quantitative findings and contributed nuanced perspectives to understanding approach and content. CONCLUSIONS: Our results suggest that the intervention and associated research were both feasible and acceptable, and suggested certain modifications to the intervention protocol to reduce participant burden. Further research to determine the effectiveness of the intervention above and beyond surgery alone with regard to the health and well-being of women with fistulas is warranted.

A recovery-oriented day hospital in psychiatry: A springboard for reintegration.

Psychiatric disorders are common and can cause psychological disabilities. While the creation of day hospitals (DHs) was intended to direct psychiatric care towards community settings, they may have paradoxically contributed to a form of chronicity. Furthermore, the heterogeneity and lack of evaluation of care within DHs prevent the availability needed to collect objective data on users outcomes. In this article, we aim to describe and measure the effects of a transformation of practice within a sector-based DH initially focused on traditional institutional psychiatry towards a rehabilitation model of care which offers different therapeutic tools, structured in three stages, and whose main objective is professional integration. This retrospective mirror study compares, before and after the transformation of this DH, several indicators including the rate of professional integration and its maintenance after two years. We found that this psychosocial rehabilitation model for care allowed a very clear increase in the professional integration rate and its maintenance at two years while reducing the length of stay to around 18 months. These promising results therefore highlight the pivotal role of DHs as "stepping stones" in addressing psychological disabilities towards recovery.

Predictors of social risk for post-ischemic stroke reintegration.

After stroke rehabilitation, patients need to reintegrate back into their daily life, workplace and society. Reintegration involves complex processes depending on age, sex, stroke severity, cognitive, physical, as well as socioeconomic factors that impact long-term outcomes post-stroke. Moreover, post-stroke quality of life can be impacted by social risks of inadequate family, social, economic, housing and other supports needed by the patients. Social risks and barriers to successful reintegration are poorly understood yet critical for informing clinical or social interventions. Therefore, the aim of this work is to predict social risk at rehabilitation discharge using sociodemographic and clinical variables at rehabilitation admission and identify factors that contribute to this risk. A Gradient Boosting modelling methodology based on decision trees was applied to a Catalan 217-patient cohort of mostly young (mean age 52.7), male (66.4%), ischemic stroke survivors. The modelling task was to predict an individual's social risk upon discharge from rehabilitation based on 16 different demographic, diagnostic and social risk variables (family support, social support, economic status, cohabitation and home accessibility at admission). To correct for imbalance in patient sample numbers with high and low-risk levels (prediction target), five different datasets were prepared by varying the data subsampling methodology. For each of the five datasets a prediction model was trained and the analysis involves a comparison across these models. The training and validation results indicated that the models corrected for prediction target imbalance have similarly good performance (AUC 0.831-0.843) and validation (AUC 0.881 - 0.909). Furthermore, predictor variable importance ranked social support and economic status as the most important variables with the greatest contribution to social risk prediction, however, sex and age had a lesser, but still important, contribution. Due to the complex and multifactorial nature of social risk, factors in combination, including social support and economic status, drive social risk for individuals.

Workplace Reintegration Programs, Policies, and Procedures for Nurses Experiencing Operational Stress Injury: A Scoping Literature Review.

BACKGROUND: Nurses experience elevated rates of operational stress injuries (OSIs). This can necessitate taking leave from work and subsequently engaging in a workplace reintegration process. An unsuccessful process can have long term impacts on a nurse's career, affecting the individual, their family, and broader community, while contributing to nursing shortages. A knowledge gap regarding the workplace reintegration of nurses experiencing mental health challenges, impedes the development and implementation of initiatives that might increase the success of nurses reintegrating into the workplace. This scoping review explored the existing literature concerning workplace reintegration for nurses experiencing OSIs. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines were utilized. Three key search terms across six databases were employed followed by a qualitative content analysis of the resulting literature. RESULTS: Eight documents were included. The literature exhibited high heterogeneity in objectives, content, and article types. The content analysis revealed five themes: (1) recognizing stigma, (2) elements of successful workplace reintegration, (3) considerations for military nurses, (4) considerations for nurses with substance use disorders, and (5) gaps in the existing literature. CONCLUSION: A paucity of programs, policies, procedures, and research exists regarding workplace reintegration for nurses facing mental health challenges. It is imperative to recognize that nurses may experience OSIs, necessitating mental health support, time off work, and operationally/culturally-specific assistance in returning to work. Innovative and evidence-based approaches to workplace reintegration are needed to enhance the retention of a skilled, experienced, compassionate, and healthy nursing workforce.

Programs supporting incarcerated and previously incarcerated indigenous peoples: a scoping review protocol.

The overincarceration of Indigenous peoples and its impacts on individual and community health is a growing concern across Canada and the United States. Federally run Healing Lodges in Canada are an example of support services for incarcerated and previously incarcerated Indigenous peoples to reintegrate into community and support their healing journey. However, there is a need to synthesise research which investigates these programmes. We report a protocol for a scoping review that is guided by the following research question: What is known about culturally informed programmes and services available to incarcerated and previously incarcerated Indigenous peoples in Canada and the US? This scoping review will follow guidelines published by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. This review will only identify programmes that are guided by Indigenous ways of being and knowing in order to best serve Indigenous communities and our community partners. The results of this review will support the development of programmes that are necessary for understanding and addressing the diverse needs of incarcerated and previously incarcerated Indigenous peoples.

Transitioning to home and beyond following stroke: a prospective cohort study of outcomes and needs.

INTRODUCTION: Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter. METHODS: A prospective cohort study recruiting individuals with stroke, from three hospitals, who transitioned home, either directly, through rehabilitation, or with early supported discharge teams. Their outcomes (global-health, cognition, function, quality of life, needs) were described using validated questionnaires and a needs survey, at 7-10 days, and at 3-, and 6-months, post-discharge. RESULTS: 72 patients were available at hospital discharge; mean age 70 (SD 13); 61% female; median NIHSS score of 4 (IQR 0-20). 62 (86%), 54 (75%), and 45 (63%) individuals were available respectively at each data collection time-point. Perceived disability was considerable at hospital discharge (51% with mRS ≥ 3), and while it improved at 3-months, it increased thereafter (35% with mRS ≥ 3 at 6-months). Mean physical health and social functioning were "fair" at hospital discharge and ongoing; while HR-QOL, although improved over time, remained impaired at 6-months (0.69+/-0.28). At 6-months cognitive impairment was present in 40%. Unmet needs included involvement in transition planning and care decisions, with ongoing rehabilitation, information, and support needs. The median number of unmet needs at discharge to home was four (range:1-9), and three (range:1-7) at 6-months. CONCLUSION: Stroke community reintegration is challenging for people with stroke and their families, with high levels of unmet need. Profiling outcomes and unmet needs for people with stroke at hospital-to-home transition and onwards are crucial for shaping the development of effective support interventions to be delivered at this juncture. ISRCTN REGISTRATION: 02/08/2022; ISRCTN44633579.

Fostering Alignment and the Catalytic Potential of Community-Engaged Research With US Military Veterans and Advocates.

This paper explores the concept of "community-engaged research" (CEnR) within the context of Veteran health care delivery and reintegration programs. A multi-sector expert panel (msExP) was formed to evaluate and make recommendations on Veteran community reintegration research and programs. The panel consisted of Veterans, care partners, clinical providers, researchers, community stakeholders, and subject matter experts. The paper examines the composition and lifecycle of the panel, highlighting the characteristics and experiences of the participants. Shifts in the panel's purpose and engagement levels occurred in response to unanticipated disruptions, particularly the COVID-19 pandemic. The transformation of the panel emphasizes the importance of aligning individual and group needs and deepening intrapersonal relationships Findings based on observations, surveys, and interviews with panel members contribute to the field of community-engaged research by demonstrating the utility of catalytic validity that balances group and individual development. As part of a broader study on Veteran reintegration, the panel and its development over time allowed for various perspectives on Veteran experiences and reintegration within the community that shaped the overall project. Despite the challenges of developing and maintaining a panel alongside a research study, feedback from the panel members on their participation provides insight into the potential for future working alliances in community-engaged health research.

Reintegration of cyber veterans: challenges and strategies for post-war transition.

Battles in the cyber domain often lack visibility compared to the physical domain, which can lead to insufficient appreciation of its actors' achievements by the general public and society. Nonetheless, it has become a crucial area of modern warfare in which cyber professionals defend the nation's critical infrastructure, support other military operations and achieve military objectives that could not be attained in other domains. Although cyber combatants might not have as high a risk of injury or death as those on the front lines, they still can face traumatic events and suffer from the same types of issues after the war as any other veteran. Earlier studies on war veterans have shown they have elevated risks of mental health issues, substance use, social problems and financial difficulties which might push some individuals towards a path of crime. The cyber domain is also not limited by time or place, which has given rise to cyber volunteerism in which skilled individuals around the globe decide to assist their own country or friendly nations. This publication aims to identify the challenges cyber veterans might face when transitioning back to civilian life and develop appropriate strategies to facilitate their reintegration. It also raises the awareness of the hundreds of thousands of volunteers who can develop similar problems after the war. Without proper awareness, support and dialogue, some of these individuals can also drift towards harmful social implications such as cybercrime.