Enhanced Recovery After Surgery (ERAS) represents evidence-based transformation in perioperative care, which has been demonstrated to reduce both recovery times and postoperative complication rates. The aim of the present study was to evaluate the clinical significance of the ERAS program in comparison with conventional postoperative care. This longitudinal cohort observational study enrolled 120 consecutive patients diagnosed with intestinal obstruction caused by colorectal cancers, with 40 patients in the ERAS group and 80 patients receiving conventional postoperative care forming the non-ERAS group. Our study compares the effectiveness of ERAS protocols to non-ERAS methods, focusing on the time to first flatus, defecation, the resumption of normal diet, and early mobilization. The main endpoints are morbidity and hospitalization length. The results showed that despite a longer admission-to-surgery interval in the ERAS group, median hospitalization was significantly shorter compared to the non-ERAS group (p = 0.0002). The ERAS group showed a tendency towards a lower incidence of overall postoperative complications, indicating that implementing the ERAS protocol does not increase the risk of postoperative complications, ensuring the safety of enhanced recovery strategies for patients. Also, ERAS patients had notably fewer stomas than those in the non-ERAS group, indicating the potential effectiveness of reducing stoma necessity. This study shows that ERAS surpasses conventional care for colonic or rectal surgery patients, reducing hospital stays and costs while enhancing recovery. This highlights the comprehensive advantages of adopting ERAS in surgical settings.

This study investigates employment rates and their determinants among individuals with spinal cord injury (SCI) in Romania using data from the Romanian National Spinal Cord Injury Survey (RO-InSCI), part of the International Spinal Cord Injury (InSCI) Community Survey. The cross-sectional study included 215 adults with traumatic or non-traumatic SCI living in the community. Participants were recruited through rehabilitation hospitals and patient organizations. Employment status, demographic characteristics, and injury-related factors were assessed. The observed employment rate was 25.35%, with a 39.45% employment gap compared to the general population. Barriers to employment included health status, disability, inadequate transport, and insufficient access to infrastructure, particularly for those with traumatic SCI. Vocational rehabilitation participation was low (18.7%), despite a strong desire to return to work (82% for traumatic SCI, 61.1% for non-traumatic SCI). Before injury, participants were primarily employed in elementary occupations, with higher rates among those with paraplegia. The findings highlight the need for targeted interventions, inclusive labor market policies, and improved accessibility to vocational rehabilitation to support workforce reintegration and address the specific needs of individuals with SCI in Romania.

Background: Stroke remains a leading cause of long-term disability worldwide. Post-stroke spasticity (PSS) is increasingly recognized as a complex complication resulting from the interaction between neural hyperexcitability and non-neural muscular adaptations, including fibrosis, altered muscle architecture, and increased stiffness. Consequently, effective management requires a comprehensive approach targeting both components. Musculoskeletal ultrasound (MSK US) has emerged as a practical tool for muscle characterization, treatment targeting, and longitudinal monitoring within neurorehabilitation programs. Aim: To propose a clinical practice framework integrating serial MSK US into multimodal PSS management and to illustrate its application through a proof-of-concept clinical case. Methods: The proposed framework combines standardized clinical assessment, serial MSK US evaluation, BoNT-A injections, physical modalities (neuromuscular electrical stimulation and extracorporeal shock wave therapy), and task-oriented rehabilitation. Ultrasound findings, including muscle echogenicity, architecture, and Modified Heckmatt Scale (MHS) characteristics, were integrated with clinical outcomes and rehabilitation goals to support individualized decision-making. Results: Serial MSK US provided complementary information regarding muscle quality and potential non-neural contributors to spasticity syndrome, supporting treatment planning and follow-up. Although only modest morphological changes were observed over time, the illustrative case showed favorable changes in clinical assessments including spasticity, motor performance, gait, and functional independence following the multimodal intervention. Conclusions: This proof-of-concept framework highlights the potential role of serial MSK US as a practical decision-support and monitoring tool within multimodal PSS management. Integrating clinical assessment with ultrasound-informed evaluation of both neural and non-neural components may facilitate more individualized rehabilitation strategies and optimize functional outcomes. Further studies are warranted to validate and standardize this approach.

Introduction: Rapid technological development requires continuous learning and adaptation, yet many older adults (OAs) face difficulties using digital technologies. The AGAPE project (Active aGeing And Personalised service Ecosystem) aimed to promote active and healthy ageing (AHA) among adults aged 65+ by supporting independent functioning reducing caregiver burden, and improving eHealth literacy through personalized, user-friendly digital services co-created and tested in Italy, Portugal, and Romania. Objective: AGAPE pilot phase evaluated the effectiveness and usability of innovation adoption strategies designed to improve technology acceptance, digital literacy, and behavioural change among older adults and caregivers. This study examined participants’ perceptions of digital technologies and self-reported digital efficacy during a multicomponent intervention combining repeated technology use, personalized coaching, digital literacy and health education, technical assistance, and support from informal and formal caregivers. Material and Methods: The multiple-sites uncontrolled pilot study combined home-based use of the AGAPE digital technologies with long-term combined personalized support. Data were collected at baseline (T0), intermediate (T1), and final (T2) assessments using the System Usability Scale (SUS), technostress questionnaire, digital adoption questionnaire (TAM-derived), EQ-5D-5L, CarerQoL-7D, and the UCLA Loneliness Scale, complemented by participant feedback, technology usage, and activity data. Results: The study included 217 participants, of whom 146 were OAs. Over the course of the intervention, participants showed reductions in technostress and improvements in perceived digital efficacy, although the magnitude and direction of change varied across pilot sites. The findings also indicated that contextual and social factors contributed to technology adoption and engagement. Conclusions: Participation in the multicomponent AGAPE intervention was associated with positive longitudinal changes in technology-related perceptions, technostress, and digital self-efficacy. The findings support the feasibility and potential of combining digital technologies with personalized coaching and broader interpersonal support to facilitate technology adoption among older adults. However, given the uncontrolled study design and the integrated nature of the intervention, the observed changes cannot be attributed independently to coaching or to any single intervention component.