Functional and Anatomical Outcomes Following Intravitreal Bevacizumab in Treatment-Naïve Centre-Involving Diabetic Macular Edema: A 3-Month Prospective Evaluation

Sanjay Kumar Mishra 

Nims College of Allied and Health Care Sciences, Nims University Rajasthan, Jaipur Rajasthan, India

https://orcid.org/0009-0003-0636-7727

Tejinder Singh Ahluwalia 

Department of Ophthalmology, Nims University, Rajasthan, Jaipur, India

https://orcid.org/0009-0002-3527-061X

Rajpal Vohra 

Vitreo-Retina Services at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India

https://orcid.org/0000-0003-3308-969X

Rohan Chawla 

Vitreo-Retina Services at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India

https://orcid.org/0000-0002-6791-4435

https://doi.org/10.33700/jhrs.4.2.172

Abstract

Introduction: Diabetic macular edema (DME) remains a major cause of vision impairment worldwide. Intravitreal bevacizumab, though used off-label, is an established therapy for centre-involved DME (CI-DME). This study evaluated how effectively microperimetry complements standard measures—best-corrected visual acuity (BCVA) and central macular thickness (CMT)—in assessing treatment outcomes.

Methods: In this prospective observational study, 52 eyes with treatment-naïve CI-DME received three monthly bevacizumab injections. BCVA, CMT (via OCT), and mean retinal sensitivity (by microperimetry) were recorded at baseline, one month, and three months. Statistical analyses included the Wilcoxon signed-rank test for repeated measures and Spearman’s rank correlation for structure–function relationships.

Results: After three months, mean BCVA improved from 0.50 ± 0.095 to 0.67 ± 0.088 (p < 0.001), while CMT decreased from 401.9 ± 87.6 µm to 329.5 ± 23.2 µm (p < 0.001). Mean retinal sensitivity rose from 14.96 ± 1.01 dB to 16.50 ± 1.39 dB (p < 0.001). Improvement in BCVA correlated positively with both CMT reduction (ρ = 0.340, p = 0.014) and sensitivity gain (ρ = 0.412, p = 0.004), while CMT reduction correlated inversely with sensitivity improvement (ρ = –0.367, p = 0.009).

Conclusion: Three consecutive bevacizumab injections resulted in significant anatomical and functional recovery in eyes with CI-DME. The consistent correlations between macular structure and function underscore the value of microperimetry as a sensitive, complementary tool for evaluating therapeutic response beyond standard acuity and OCT metrics.

Keywords: Diabetic Macular Edema, Bevacizumab, Central Macular Thickness, Anti-VEGF, Retinal Sensitivity, Microperimetry, OCT, Intravitreal Injection

Full Text Article

The latest issue (Vol.4, No.2, 2025) has been published

Dear Colleagues and Readers,

We are pleased to announce that Volume 4, Issue 2 of the Journal of Health and Rehabilitation Sciences (JHRS) has been published online today, December 20, 2025. This issue comprises a total of seven peer-reviewed articles. The forthcoming issue, Volume 5, Issue 1 (2026), is scheduled for publication by June 30, 2026.

 
Access to JHRS

The current issue and all published articles are available online via the journal platform. Readers, researchers, and students may access full-text PDF, HTML and XML versions of all articles without restriction. Journal of Health and Rehabilitation Sciences is an open-access, international, peer-reviewed, and non-profit journal, ensuring free and unlimited access to its scholarly content.
Citation of Articles and Use of DOI

When citing articles published in JHRS, authors are strongly encouraged to include the Digital Object Identifier (DOI) alongside standard bibliographic information. The DOI represents an international standard for persistent identification of digital content and ensures long-term accessibility, even if the article’s web location changes. Accordingly, the DOI should be used preferentially over direct URLs when referencing JHRS articles.
Online Features for Authors

By registering on the JHRS online submission system
(https://jhrs.almamater.si/index.php/jhrs/user/register), authors gain continuous access to information related to manuscript submission, review processes, and publication updates. We encourage authors and readers to disseminate JHRS publications within their academic networks and through social media platforms, thereby enhancing the visibility and impact of published research.

We warmly invite you to explore the content of Journal of Health and Rehabilitation Sciences and to consider JHRS as a venue for disseminating your scholarly work.

Call for Papers

The Call for Papers for Volume 5, Issue 1 is open until January 31, 2026.
Suggested thematic areas include:

• Rehabilitation Research
• Health Research
• Special Education Research
• Psychological Research
• Neuropsychological Research
• Autism Spectrum Disorders
• Disability Research
• Medical Aspects of Disability
• Social Aspects of Disability
• Master’s and Doctoral (PhD) Theses in the Field
• Book Reviews relevant to the scope of the journal

If you have any questions or you face problems with paper submission, please feel free to contact us: editorjhrs@almamater.si. We look forward to your valuable contributions and continued engagement with JHRS.

With kind regards,
Editorial Team
Journal of Health and Rehabilitation Sciences

Assessing Health-Related Quality of Life Outcomes Through Sensory Modulation Profiles in Adults with Atypical Sensory Processing: A Cross-Sectional Study

Patricija Goubar
Alma Mater Europaea University, Maribor, Slovenia
https://orcid.org/0009-0008-7420-9460

Tomaž Velnar
Department of Neurosurgery, University Medical Centre, Ljubljana, Slovenia
https://orcid.org/0000-0002-6283-4348

https://doi.org/10.33700/jhrs.4.1.153

Abstract

Background: Sensory integration dysfunction (SID) often involves sensory modulation difficulties that can significantly impair daily functioning and health-related quality of life (HRQoL) in adults. Despite its prevalence, the relationship between sensory modulation profiles and HRQoL in adults with SID remains underexplored. Understanding this link is essential for developing targeted interventions to address diverse symptom profiles.

Objectives: This study examined the association between sensory modulation difficulties and multiple HRQoL dimensions in adults with SID.

Methods: A cross-sectional quantitative study included 86 adults aged 23–54 years, divided into two groups: adults with SID and healthy controls. Sensory modulation was assessed using the Adolescent/Adult Sensory Profile Questionnaire, and HRQoL was measured with the SF-36 instrument. Statistical analyses included the Kolmogorov-Smirnov test, Mann-Whitney U test, and Pearson’s correlation. The null hypothesis tested for no differences in HRQoL scores between groups.

Results: Significant differences were found between groups across all eight SF-36 domains and the overall HRQoL score (p < 0.001), with controls consistently scoring higher in each domain. Correlation analyses showed no significant associations between HRQoL outcomes and demographic variables (age, gender).

Conclusion: These findings confirm a strong association between SID and reduced HRQoL in adults, affecting both physical and mental health. The consistent impact across age and gender groups highlights the importance of personalized therapeutic approaches.

Keywords: Sensory Modulation Disorder, Sensory Integration Dysfunction, Sensory Processing Disorder, Health-Related Quality of Life, Health Status Indicators, Adults, SF-36 Questionnaire, Cross-Sectional Study

Full Text Article

Residential care staff working knowledge of reporting restrictive practices within Intellectual Disability and Older Persons care settings: A scoping review

Veronica Mukwashi 

HSE, Waterford Residential Care Centre, Waterford, Ireland

https://orcid.org/0009-0006-6200-3495

Brian Sharvin 

Department of Nursing and Health Care, School of Health Sciences, Cork Road, South East Technological University (SETU), Ireland

Ruth Maher 

Department of Nursing and Health Care, School of Health Sciences, Cork Road, South East Technological University (SETU), Ireland

https://orcid.org/0000-0002-9556-3142

Michelle Davitt 

HSE, Wexford Residential Intellectual Disability Services, St. John’s Hospital, Munster Hill, Enniscorthy, Co. Wexford, Ireland

https://orcid.org/0009-0005-9383-2846

Louise Bennett 

Department of Nursing and Health Care, School of Health Sciences, Cork Road, South East Technological University (SETU), Ireland 

https://orcid.org/0000-0003-0311-2959

https://doi.org/10.33700/jhrs.4.1.143

Abstract

Introduction: This Restrictive practice is an intentional restriction of an individual’s voluntary movement or behaviour. Given the impingement of human rights associated with restrictive practice, many jurisdictions all over the world have advocated for a reduction in their use, highlighting the importance of reporting restrictive practice. However, a paucity of literature exists examining the knowledge of residential care staff regarding reporting restrictive practice.

Aim: To examine the knowledge of residential care staff regarding the reporting of restrictive practices in intellectual disability and older persons care settings.

Methods: A scoping review referenced to JBI and PRISMA guidelines was used. The studies were retrieved from a library multi-search function of various databases. Sixteen studies were included in the final analysis.

Findings: Findings demonstrate that residential staff lack knowledge of what defines a restrictive practice and find the reporting system as unnecessary, time consuming and burdensome. The identified barriers to reporting restrictive practice included: fear, lack of clear guidelines and awareness of the reporting system, lack of time, and staff shortages. While the facilitators included awareness campaigns, availability of appropriate reporting structures, and managerial support.

Conclusion: This review suggests that improvements in terms of residential staff understanding of and reporting of restrictive practice is required. Moreover, this review has the potential to assist policymakers to understand the individual, organisational and regulatory barriers and facilitators to reporting restrictive practice within intellectual disability and older persons care settings.

Keywords: residential care staff, residential care, reporting, incidents, restrictive practices, older persons, intellectual disability, knowledge

Full Text Article

Clinical Application of the Bulgarian Version of the SCCAN: Pilot Data From Patients with Alzheimer’s Disease and Ischemic Stroke

Kostadin Chompalov
Department of Neurology, Medical University of Plovdiv, Plovdiv, Bulgaria
https://orcid.org/0000-0002-4636-1384

Penka Atanassova 

1. Department of Neurology, Medical University of Plovdiv, Plovdiv, Bulgaria 2. Research Institute at Medical Univeristy of Plovdiv, Plovdiv, Bulgaria

https://orcid.org/0009-0002-2410-4114

Dobrinka Georgieva 

1. Department of Neurology, Medical University of Plovdiv, Plovdiv, Bulgaria 2. Research Institute at Medical Univeristy of Plovdiv, Plovdiv, Bulgaria

https://orcid.org/0000-0001-5029-9723

https://doi.org/10.33700/jhrs.4.1.149

Abstract

Aim: This study evaluated the clinical utility of the Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN) upon assessing Bulgarian in-patients who present with either ischemic stroke or Alzheimer's disease (AD). The aim was to determine whether this tool could detect cognitive-communicative problems that may be missed by customary screening tools.

Methods: We conducted two independent pilot studies: one with 14 AD patients, and a second with 19 stroke patients and 31 healthy controls. All participants completed the Bulgarian SCCAN, which assesses eight domains including oral expression, orientation, memory, auditory and reading comprehension, writing, attention, and problem-solving. Stroke and control participants also underwent the Mini-Mental State Examination (MMSE). Descriptive statistics were used so group performance and correlations could be examined. Tests that are non-parametric were also used.

Results: SCCAN revealed domain-specific deficits in clinical cohorts. In the AD group, memory and orientation were the most impaired domains. Stroke patients, on the other hand, showed significant impairments, particularly in memory, oral expression, and auditory comprehension, while orientation and attention were relatively preserved. Overall, stroke patients performed significantly better on the SCCAN than the AD group. These findings reveal distinct cognitive–communicative profiles in AD versus stroke populations.

Conclusion: SCCAN's Bulgarian version identified cognitive-communicative deficits with clinical sensitivity in patients with AD as well as with those with ischemic stroke. The tool may guide individualized neurorehabilitation and complement standard screening methods. Additional verification is advised.

Keywords: SCCAN, cognitive-communicative disorders, Alzheimer’s disease, ischemic stroke, neurorehabilitation, screening

Full Text Article

Effect of Unilateral Application of Timolol 0.5% on Systemic Cardiovascular Parameters and Intraocular Pressure and Perfusion

Galina Dimitrova 

City General Hospital "September 8th", Skopje, Macedonia

https://orcid.org/0000-0003-3537-4363

Ana Gjorgjiovska 

City General Hospital "September 8th", Skopje, Macedonia

 https://orcid.org/0009-0007-0945-7540

Antonela Ljubic 

Polyclinic Medika Plus, Skopje, Macedonia

https://orcid.org/0000-0002-4221-0124

Dushan Kemera 

City General Hospital "September 8th", Skopje, Macedonia

https://orcid.org/0009-0000-4768-409X

Olivera Lazarova 

City General Hospital "September 8th", Skopje, Macedonia

https://orcid.org/0000-0002-3550-5696

Dejan Shekerinov 

City General Hospital "September 8th", Skopje, Macedonia

https://orcid.org/0009-0008-8736-0020

Sofija Jordanovska Milanovska 

City General Hospital "September 8th", Skopje, Macedonia

https://orcid.org/0009-0005-8047-2490

Ivana Petkovska 

City General Hospital "September 8th", Skopje, Macedonia

https://orcid.org/0009-0007-6821-7723

https://doi.org/10.33700/jhrs.4.1.127

Abstract

Aim: To study the effect of unilaterally applied timolol 0.5% on systemic blood pressure (BP), heart rate (HR), cerebrospinal fluid pressure (CSFP), intraocular pressure (IOP), ocular perfusion pressure (OPP) and translaminar pressure difference (TLPD).

Methods: This is an experimental clinical study of 14 healthy subjects. Ophthalmic examination included best corrected visual acuity (BCVA), slit lamp examination and autorefractometry. Systemic BP, HR and IOP were taken after the basic examination. Two drops of ophthalmic solution timolol 0.5% were instilled in the right eye (RE) of the subjects. Systemic BP and IOP were measured 30 minutes, one hour, one and a half hour and two hours after the local application. We evaluated the following parameters: systolic blood pressure (SBP) (mmHg), diastolic blood pressure (DBP) (mmHg), mean blood pressure (MBP) (mmHg), HR (bpm), estimated CSFP, IOP (mmHg), estimated TLPD (mmHg) and (OPP) (mmHg).

Results: After unilateral topical application of timolol 0.5%, there was a significant reduction of IOP and TLPD in both eyes (IOP RE p<0.001, IOP LE p=0.006; TLPD RE p<0.001, TLPD LE p=0.006) and a significant decrease of HR (p=0.003). OPP significantly increased only in the treated eye (p=0.021). There was a statistically significant correlation between IOP and HR in both eyes (RE R=0.95, p=0.01; LE R=0.85, p=0.04).

Conclusion: Unilateral application of timolol 0.5% significantly reduced IOP and TLPD in both treated and untreated eyes, but OPP significantly increased only in the treated eye. HR decreased after unilateral application of timolol 0.5% and was significantly associated with IOP reduction.

Keywords: timolol, intraocular pressure, systemic blood pressure, heart rate, ocular perfusion pressure

Full Text Article

Health Psychology Paradigm shift in the Hungarian Rehabilitation Psychology and Clinical Special Education

Dóra Szanati 

ELTE Bárczi Gusztáv Faculty of Special Needs Education, Instititute for the Methodology of Special Needs Education and Rehabilitation, Budapest, Hungary

https://orcid.org/0000-0001-7192-2545

https://doi.org/10.33700/jhrs.4.1.133

Abstract

Aim: The aim of this study is to provide readers with insights into the paradigm shift that has occurred and is still ongoing in the field of clinical psychology in Hungary over the past 20 years, particularly in relation to rehabilitation.

Methods: This study is a theoretical overview that offers a new perspective on the relationship between rehabilitation psychology, health psychology and clinical special education. It processes and compares Hungarian-language studies of the past 20 years with some recent English-language studies.

Results: I do not aim to achieve this by describing methods or empirical research but by using examples and insights from practice, primarily from key clinical areas where special educators are involved in rehabilitation teams.

Conclusion: This text demonstrates how current factors can shape professional diversity in the field of clinical rehabilitation, and how the long-discussed issue of multidisciplinarity and interdisciplinarity, have become more prominent. These changes, resulting from the paradigm shift, also significantly affect the work of special educators within clinical teams.

Keywords: rehabilitation psychology, health psychology, clinical special education, multidisciplinary team, resilience, social support

Full Text Article

Relative Bias in Health Estimates from Probability-Based Online Panels: Systematic Review and Meta-Analysis

Andrea Ivanovska 

Faculty of Social Sciences, University of Ljubljana
https://orcid.org/0009-0008-2653-2503

Michael Bosnjak
Department of Psychology, University of Trier, Germany
https://orcid.org/0000-0002-1431-8461

Vasja Vehovar
Faculty of Social Sciences, University of Ljubljana
https://orcid.org/0000-0002-3253-7959

https://doi.org/10.33700/jhrs.4.1.137

Abstract

Introduction: Health surveys require the highest data quality, especially when they inform public health policies. With recent technological developments, probability-based online panels (PBOPs) are becoming an attractive cost-effective alternative to traditional surveys. They are also beginning to be used for official health statistics. However, PBOPs still face concerns about bias, especially for health-related estimates.

Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, we conducted a systematic review and meta-analysis of PBOP PBOP health survey data quality, with relative bias (RB) of the estimates as the effect size. We analysed 137 health-related survey items from 14 studies and used a linear regression model to examine factors that moderate RB.

Results: The RB varied considerably across the subjects, and its overall median was 12.7%. The highest RBs were exhibited by disabilities (23.6%), mental illnesses (23.2%), personal mental health conditions (20.8%) and drug use (20.7%), and the lowest, by doctor’s treatment (2.24%). The measurement levels with ordinal scales (25.8%) showed higher RB, and certain country effects were also observed.

Conclusion: This moderate bias of the health estimates raises concerns about the accuracy of PBOP estimates regarding sensitive health topics. Therefore, PBOP should be used cautiously for official health statistics; and when designing PBOP surveys for health subjects, the item and study characteristics should be included as methodological considerations.

Keywords: Probability-based online panels, Data quality, Relative bias, Meta-analysis, Health research

Full Text Article

Family Quality of Life from the Perspective of Parents of Children with Intellectual Disabilities

Dajana Bulić 

Center for Rehabilitation Zagreb, Zagreb, Croatia

https://orcid.org/0000-0003-4143-9426

Tomislav Ljutic 

Kindergarten Potočnica

https://orcid.org/0000-0002-2766-8372

Renata Pinjatela 

University of zagreb, Faculty of Education and Rehabilitation sciences

https://orcid.org/0000-0002-5601-1425

https://doi.org/10.33700/jhrs.4.1.154

Abstract

Aim: The quality of life of families with children with intellectual disabilities has been frequently analysed in recent research. There are numerous factors that influence the quality of life of families. The aim of the study was to determine the quality of life of families of children with intellectual disabilities who are cared for by the Sloboština Rehabilitation Centre.

Methods: The study used the Beach Center Family Quality of Life Scale questionnaire, which was completed online by the parents. 51 parents of children and adolescents with intellectual disabilities took part in the study.

Results: The results of the study show that the overall quality of life is satisfactory. However, parents of children with intellectual disabilities are least satisfied with emotional well-being and disability-related support. They are not satisfied with the time they have to pursue their interests or with outside help for all family members. They also consider the support a child with disabilities receives at school to be mediocre. No statistically significant differences in quality of life were found in relation to the age and gender of parents and children, except for the family interaction subscale, where families with girls had a better quality of life.

Conclusion: The results of the study show that although the overall quality of life is satisfactory, families of children with intellectual disabilities need external support that provides them with some free time but also aims to support all family members.

Keywords: family quality of life, intellectual disability, parents, children, support

Full Text Article

Call for Papers Vol.4, Issue 2, 2025

Dear colleagues and readers,

We would like to inform you that the first issue of the 4th volume of Journal of Health and Rehabilitation Sciences was published online on August 3d, 2025. A total number of 7 papers are published. We have opened the call for papers for Issue 2, Vol. 4 of JHRS.

Volume 4, Issue 1 Table of Contents

 Rehabilitation Research
Article: Family Quality of Life from the Perspective of Parents of Children with Intellectual Disabilities
Dajana Bulić, Tomislav Ljutic, Renata Pinjatela
Journal of Health and Rehabilitation Sciences, 4(1), 1–9. https://doi.org/10.33700/jhrs.4.1.154
 

Psychology Research
Article: Relative Bias in Health Estimates from Probability-Based Online Panels: Systematic Review and Meta-Analysis
Andrea Ivanovska, Michael Bosnjak, Vasja Vehovar
Journal of Health and Rehabilitation Sciences, 4(1), 10–23. https://doi.org/10.33700/jhrs.4.1.137


Article: Health Psychology Paradigm shift in the Hungarian Rehabilitation Psychology and Clinical Special Education
Dóra Szanati
Journal of Health and Rehabilitation Sciences, 4(1), 24–31. https://doi.org/10.33700/jhrs.4.1.133

 Health Research

Article: Effect of Unilateral Application of Timolol 0.5% on Systemic Cardiovascular Parameters and Intraocular Pressure and Perfusion
Galina Dimitrova, Ana Gjorgjiovska, Antonela Ljubic, Dushan Kemera, Olivera Lazarova, Dejan Shekerinov, Sofija Jordanovska Milanovska, Ivana Petkovska
Journal of Health and Rehabilitation Sciences, 4(1), 32–38. https://doi.org/10.33700/jhrs.4.1.127


Article: Clinical Application of the Bulgarian Version of the SCCAN: Pilot Data From Patients with Alzheimer’s Disease and Ischemic Stroke
Kostadin Chompalov, Penka Atanassova, Dobrinka Georgieva
Journal of Health and Rehabilitation Sciences, 4(1), 39–47. https://doi.org/10.33700/jhrs.4.1.149


Article: Residential care staff working knowledge of reporting restrictive practices within Intellectual Disability and Older Persons care settings: A scoping review.
Veronica Mukwashi, Brian Sharvin, Ruth Maher, Michelle Davitt, Louise Bennett
Journal of Health and Rehabilitation Sciences, 4(1), 48–61. https://doi.org/10.33700/jhrs.4.1.143

Article: Assessing Health-Related Quality of Life Outcomes Through Sensory Modulation Profiles in Adults with Atypical Sensory Processing: A Cross-Sectional Study
Patricija Goubar, Tomaž Velnar

Journal of Health and Rehabilitation Sciences, 4(1), 62–68. https://doi.org/10.33700/jhrs.4.1.153

 

Call for papers for Vol.4, Issue 2 is now open.
Suggested topics include:

• Rehabilitation Research,
• Health Research,
• Special Education Research,
• Neuropsychological Research,
• Autism Spectrum Disorders,
• Disability Research,
• Medical Aspects of Disability,
• Social Aspects of Disability,
• Master theses and PhD theses in the field,
• Book Reviews in the field.

Submit your manuscript here.