Individual Programs Research Articles

LINC00365 as a potential biomarker for total nephrectomy in advanced-stage renal cell carcinoma patients

BackgroundRenal cell carcinoma (RCC) is one of the most frequent urological cancers globally that has a good prognosis in the early tumor stages. However, there is a poor prognosis in metastatic RCC patients. Therefore, it is needed to evaluate the molecular biology of RCC progression to introduce the efficient diagnostic and therapeutic markers in these patients. Long non-coding RNAs (lncRNAs) have key roles in regulation of molecular mechanisms during RCC progression. In the present study, we assessed the levels of LINC00365 expressions in RCC patients to suggest that as a tumor marker in these patients. MethodsFifty fresh RCC tumor tissues and their normal margins were collected to assess the levels of LINC00365 expressions and probable correlations with clinicopathological features of RCC patients. ResultsThere was significant LINC00365 up regulation in females compared with males (p=0.050). Among the RCC patients with total nephrectomy, there was a significant LINC00365 up regulation in advanced stage compared with primary stage tumors (p=0.035). RCC patients older than 60 years old who were undergone the total nephrectomy had also significant LINC00365 up regulation compared with RCC patients younger than 60 years old (p=0.039). Conclusionsgiven the significant increase in LINC00365 expression in advanced stage RCC tumors and patients over 60 years old who had total nephrectomy; it could serve as a useful diagnostic marker in screening programs for old high-risk individuals. It was also noticed that female RCC patients had elevated levels of LINC00365 expressions in their tumor samples, suggesting its potential use as a gender-specific diagnostic marker for high-risk females. Nevertheless, evaluating the levels of LINC00365 in serum samples of RCC patients is necessary to suggest that as a reliable diagnostic marker in clinical settings.

Інноваційні методологічні підходи до оцінки психофізичних здібностей гандболістів на етапі попередньої базової підготовки

The article deals with the psychophysical abilities of young handball players at the stage of preliminary basic training. Particular attention is paid to the analysis of the level of formation of such abilities as reaction speed, coordination of movements, concentration of attention and the ability to make decisions in stressful situations. The scientific relevance of the study is due to the need to improve training methods aimed at increasing the effectiveness of athletes' preparation for competitions. The purpose of the study is to analyze and evaluate the psychophysical abilities of young handball players, which will help to determine the effectiveness of the applied training methods and contribute to the development of new approaches to the training of athletes. Material and methods of research. Handball players at the stage of preliminary basic training (103 people) at the age of 15-16 years old, involved in the championship of Ukraine among boys, took part in the pedagogical experiment. To implement the goals and objectives of the study used a set of methods: theoretical analysis, synthesis and generalization; pedagogical observation; pedagogical testing; mathematical and statistical data processing. Research Results. It was found that the psychophysical abilities of young handball players who are at the stage of preliminary basic training correspond to a satisfactory level. However, in order to achieve high results in the future it is necessary to improve training programs taking into account the individual characteristics of each athlete. Analysis of the test results showed that the majority of handball players, both from the experimental and control groups, demonstrate similar results on the complex index of psychophysical abilities, which allowed us to conclude that there were no significant differences in the levels of development of psychophysical abilities between the groups at the beginning of the study. It was revealed that the average characteristics of different psychophysical tests in the majority of athletes correspond to a satisfactory level. For example, the speed of reaction to visual stimuli, reaction speed in game conditions, as well as the results of specialized handball tests showed that the level of formation of these abilities is sufficient for participation in competitions, but requires improvement to achieve high results. It is important to note that the highest average values of complex indicators of psychophysical abilities were observed in point guard players, which corresponds to the average level of formation. Line players also showed the results corresponding to the average level, while half-middle and edge players showed slightly lower values corresponding to the satisfactory level. Conclusions. The conducted study showed that at the stage of preliminary basic training most young handball players have a satisfactory level of development of psychophysical abilities, which indicates that there is a potential to improve their sports training by improving training methods. Given that different players demonstrate different levels of development of psychophysical abilities, especially among midfield and edge players, it is necessary to develop and implement individual training programs, which will optimize the training of each player in accordance with his individual characteristics and increase the overall effectiveness of the team.

Strengthening the Multiple-Choice Assessment: Improving Item-Writing Skills of Physician Assistant Educators.

Physician assistant (PA) educators are tasked with the challenging privilege of ensuring future PAs are knowledgeable and competent to practice medicine. Most enter academia without formal education in providing education. They learn as they go-a treacherous and steep learning curve. This study provides PA educators literature and skills to bolster the strength and validity of multiple-choice examination items to measure learner progress and identify knowledge gaps. Skills can be improved at the level of the individual educator and program or institution. Approaching item writing and item revision in a stepwise, evidence-based manner can improve the quality of the items, strengthening multiple-choice examinations. This process can yield improved assessments of students' medical knowledge and competence. This study aims to provide the PA educator with techniques to improve their item-writing skills.

M-MAT Meta: Treatment of Self-Awareness and Language for Individuals With Severe Wernicke's Aphasia.

In this study, we evaluated the feasibility and efficacy of language plus goal management training program for individuals with aphasia. The intervention targeted expressive language, while concurrently integrating tasks designed to improve executive function and error awareness. A single-subject repeated-measures design was utilized to determine whether a combined treatment (Multi-Modal Aphasia Therapy PLUS Goal Management Training [M-MAT Meta]) would be efficacious for individuals with aphasia. This article reports on two participants with severe Wernicke's aphasia, who comprised one of the four dyads of the study. Treatment was administered in a small group setting (N = 2) for 2 hr per day, 3 days per week for 4 weeks. Individual video feedback sessions were conducted once a week. Analysis of outcomes included visual inspection and calculation of Tau-U effect sizes of probed treatment data as well as statistical analysis of standardized language and executive function assessments. Visual inspection indicated improvements in naming and discourse skills, which were maintained at the 1-month follow-up. Both participants' standardized scores indicated a significant decrease in aphasia severity, which was maintained 1 month posttreatment. Error awareness improved for one of the two participants, but this improvement was not maintained. Participants demonstrated increased inhibition of unwanted responses and took longer on the planning and problem-solving time required to complete the assessment, indicating a decrease in impulsivity. The results of this preliminary study suggest that M-MAT Meta may be an effective way to increase self-awareness and communication in individuals with severe Wernicke's aphasia.

On the Journey: a qualitative study of a community-based, client-centred eating disorder recovery group

BackgroundCommunity-based eating disorder (ED) treatment frequently includes manualized group-based psychoeducation facilitated by a mental health clinician. Body Brave, a non-profit ED organization, developed a novel, participant-guided, community-based virtual healthcare provider (HCP)-facilitated support program called On the Journey (OtJ). The program was designed for people with longstanding EDs who had previously participated in group or individual ED programs but require continued support in their recovery. The purpose of the study was to describe the development and components of OtJ and to understand participant perceptions of the program and its effect on their recovery.MethodsUsing a formative and community-engaged research design, we conducted semi-structured interviews with three OtJ facilitators and focus groups with twelve OtJ clients. Transcripts were analyzed using Braun and Clarke’s six-stage approach to reflexive thematic analysis.ResultsFour main themes were generated from the data (1) “Designing and Evolving OtJ” (2) “Is OtJ a Treatment or Support Group?” (3) “Fostering a Safe Environment throughout Program Delivery” and (4) “The Power of Lived Experience.” Clients noted several strengths of the OtJ program: fostering a sense of community, valuing client autonomy, and providing accessible ED support.ConclusionsKey considerations for other organizations looking to offer programming similar to OtJ include having skilled and clinically trained facilitators and prescreening discussion topics to ensure that conversations are productive towards recovery. OtJ supports people with longstanding EDs, and other organizations could consider adopting a similar model of care. This study contributes to the growing body of including lived ED experience in research.

Telerehabilitation in post-tuberculosis lung disease: a protocol for a randomized controlled clinical trial

Background: Few studies have evaluated structured telerehabilitation programs for individuals with post-tuberculosis lung disease (PTLD), resulting in a lack of specific guidelines. This protocol aims to evaluate the physical capacity and quality of life (QoL) of PTLD patients undergoing telerehabilitation. Methods: This randomized, controlled clinical trial has received internal review board approval and will recruit participants between December 2024 and June 2025, from a referral center in Brazil. Individuals thought to have PTLD, with a mini-mental state examination score >24 and no physical limitations or comorbidities unrelated to pulmonary tuberculosis (TB) will be screened using imaging, total blood count, and biochemical profile. Those with confirmed PTLD will undergo the assessments of: QoL, and physical capacity (spirometry, body composition, calf circumference, six-minute walk test (6MWT), five-times-sit-to-stand test (FTSST), handgrip and isokinetic dynamometry). After that, the participants will be randomly allocated to control or intervention groups. While both groups will receive general guidance on health education and TB prevention, the intervention group will also receive a physiotherapy booklet with instructions for exercises to be performed five times a week for eight weeks. Participants of both groups will be monitored by videoconference, and the same assessment tools will be used to reevaluate QoL and physical capacity outcomes. Conclusions: The results may demonstrate the benefits of a telerehabilitation program on the physical capacity and QoL of PTLD patients, and may improve accessibility, cost savings, and personalized care through home-based therapy by videoconferencing. Trial registration: CAAE: 10481219.9.0000.5257. This study was registered at ClinicalTrials.gov (NCT04844502).

Multidisciplinary approach to asylum seekers health assessment: a 5-year experience in Modena, Italy

Abstract Background Asylum seekers’ well-being represents a global health issue. They face significant challenges to their physical and mental health due to their migratory path. In the Modena province (Northern Italy), a multidisciplinary approach has been applied to the care of asylum seekers by Department of Public Health (DPH), with a team of specialists in infectious diseases, dermatology, gynaecology, obstetrics, psychology and preventive medicine. Asylum seekers receive a first visit, including medical and psychological assessment and screening for infectious diseases. Ad hoc pathways are also active for asylum seekers who need secondary-level care. This study aims to investigate the health status of asylum seekers referred to Modena Centre. Methods This cohort study enrolled asylum seekers hosted in Modena between November 2018 and May 2023. During the first visit, personal and anamnestic data were collected aided by cultural mediators, along with clinical assessment. Furthermore, Tuberculin-Skin-Test (TST) and blood tests for HBV-HCV-HIV-Syphilis were performed. Results A total of 646 migrants were included, 94% were males with a median age of 26 years (range: 15-50), the majority from Bangladesh (39%). Females were mostly from Ivory Coast (36%), median age of 30 years (range: 17-45). Most conditions were treated at the primary care level and were related to cutaneous disease (22%), only 11% of subjects required second-level diagnostics. Positive TSTs were 41% (N = 265). Of them, 55.5% (N = 147) also tested positive for QuantiFERON-TB. Screening for infectious diseases revealed positivity rates of 4% for HBsAg, 1% for HCVAb, 0.8% for HIV and 1.4% for TPPA+RPR. Conclusions The multidisciplinary approach is the innovative and strength point of this protocol for asylum seekers’ health ensuring prompt management of pathologies after their arrival. Moreover, data collection is useful for improving intake services and implementing public health programs for vulnerable individuals. Key messages • The innovation of this protocol for asylum seekers’ health lies in its multidisciplinary approach. • Clinical data collection will support health policies’ choices to protect vulnerable individuals.

Physical fitness in youth: a systematic review of changes during and after the COVID-19 pandemic

Abstract Background Restrictions during the COVID-19 pandemic induced changes in the fitness behavior of children and adolescents, which may be associated with long-term public health challenges. This systematic review analyses how physical fitness has changed during the pandemic and to what extent the changes remain in the aftermath of the pandemic. Methods We conducted a systematic search in seven databases with a peer-reviewed search string for studies until Dec 2023. Our inclusion criteria encompassed studies with children and adolescents ≤19 years living in the WHO European Region and in which validated measurements were used (single measurements or test batteries). Eligibility screening, data extraction and risk of bias assessment (using ROBINS-E instrument) were all carried out independently by two reviewers. We published an a priori protocol in a peer-review journal and conducted reporting in accordance with the PRISMA 2020 statement. Trial registration: PROSPERO: CRD42023395871. Results Our search retrieved 28 studies from 15 WHO European Region countries with an age range from 5 to 19 years. Physical fitness was reported in 21 validated single measurements (e.g. 20 m shuttle run, handgrip strength, standing long jump) and 9 validated test batteries (e.g. Alpha-Fitness Battery, German Motor Test, International Physical Performance Test Profile). The preliminary analyses pointed to a sharp decline in youth physical fitness during the COVID-19 pandemic. After restrictions were eased, physical fitness improved, but remained under pre-pandemic levels, particularly in boys. Conclusions The findings indicate a potential suboptimal behavioral adaptation of children and adolescents after the COVID-19 pandemic. Medium and long-term programs to change passive behavior and improve physical fitness are urgently needed. In addition to individual prevention programs, stronger consideration should also be given to schools and sport clubs regarding activities promoting physical fitness. Key messages • Physical fitness in children and adolescents remains below pre-pandemic levels after restrictions removal. • Initiating immediate public health action to increase physical fitness is urgently needed.

A randomized controlled trial of an eight-week cardiac rehabilitation home verse hospital exercise programme for post coronary cardiac bypass patients

Abstract Background The prevalence and morbidity and mortality rates of coronary heart disease (CHD) continue to increase towards epidemic proportions in the Kingdom of Saudi Arabia (KSA). Despite the advances in Cardiac surgery, currently there are no established out-patient phase program of Cardiac Rehabilitation (CR) for CHD participants in KSA. Aim of the study To evaluate the effectiveness of a home-based CR (Home CR) program using individualized exercise (Physiotools-R) and out-patient phase of CR (Hospital CR) program compared to standard care of home instructions on physical function, physiological and psychological status, body composition and the quality of life of the CHD participants post Coronary Artery Bypass Graft (CABG) surgery. Methods 73 participants post-CABG surgery were randomly assigned to one of three groups: Hospital CR group (n=25), Home CR group (n=24) and Control group (n=24). Outcome measures include Incremental Shuttle Walk Test (ISWT), Metabolic Equivalent Tasks (METs), Psychosocial outcomes and body composition were recorded at baseline, eight weeks of CR intervention, and after four weeks of observation follow up. Intervention: Hospital CR program comprised of group based Aerobic Circuit Training, home based structured individualized exercise program. Each programme had 2 hours’ sessions, 3 times a week for 8 weeks, followed by four weeks of observation follow-up. The control group followed standard care comprised usual advice on post-operation precautions. Results Post intervention, there was an increase in mean ISWT score from baseline in both the home-based cardiac rehabilitation and outpatient-based cardiac rehabilitation groups (66 [0.58] m and 71 [9.19] m, respectively). No difference was observed in the control group. At the 4-week follow-up, both intervention groups showed statistically significant improvements in all outcome measures (ISWT, metabolic equivalence tasks, HADS-A, HADS-D, and Short Form-36) compared with baseline (all P < .001). The home-based cardiac rehabilitation group showed statistically continuous improvement compared with the outpatient-based cardiac rehabilitation group. The control group did not show any significant changes across time in outcome measures Conclusion Home-based CR is as effective as hospital-based CR at improving exercise capacity in patients following CABG surgery. Home-based CR appears to be more effective at maintaining these improvements with no further input in the longer term.

Exploring the effects of a real-time cardiac telerehabilitation using wearable devices in people with coronary artery disease following a recent myocardial infarction: a randomised controlled trial

Abstract Background Exercise-based cardiac rehabilitation (CR) is a non-pharmacological multidisciplinary program for individuals after myocardial infarction (MI), that offers multiple health benefits. One of the greatest barriers to CR participation is the travelling distance to the rehabilitation centre. Remotely monitored CR appears to be at least as effective in improving cardiovascular risk factors and exercise capacity as traditional centre-based CR. Nevertheless, the efficacy of a remotely monitored CR in people with recent MI has yet to be examined. Purpose The aim of this randomised controlled trial was to assess the effects of a real-time cardiac telerehabilitation monitored by wearable devices in people with recent MI. Methods Thirty people (8 women, 22 men) with CAD following a recent (i.e., < 4 week) MI were randomly allocated into two groups (online home-based and gym-based groups). The groups underwent a 26-week CR, thrice per week. All patients performed the baseline and 24 weeks follow up measurements where peak oxygen uptake (VO2peak), mean daily steps, distance and calories were assessed. Results The online group showed improved in mean daily steps (P<0.05) and mean daily distance (P<0.05) at 24 weeks compared to the gym-based group. The paired sample t-test showed that all the assessed variables were statistically (P<0.001) improved for both groups at 24 weeks. Pearson’s r demonstrated positive correlations between VO2peak and mean daily distance (r= .375), and negative correlations between VO2peak and muscle (r= -.523) and fat masses (r= -.460). There was no exercise-induced adverse events during the study. Conclusion Our findings might indicate that a real-time online supervised CR exercise programme using wearable technology to monitor the hemodynamic responses in CAD post MI patients is equally effective to a gym-based exercise programme.Individualized scanwatch report

Adapting a cultural dance program to prevent cognitive decline: insights from experts and educators

Abstract Leveraging activities such as cultural dance shows promise as an effective basis for chronic disease prevention and management with at-risk populations. In fact, recent WHO reports and resolutions advocate utilizing cultural context to achieve health equality. Hula, the Native Hawaiian indigenous dance has been successfully utilized in interventions with statistically significant improvement in medication resistant hypertension management and heart disease prevention. In this study, Alzheimer’s Disease and Related Dementia (ADRD) experts and kumu hula (hula experts and educators) provide insights to developing a hula-based lifestyle program for prevention of cognitive decline. Informant interviews were used to collect information for developing a hula-based program for individuals with mild cognitive impairment from 4 ADRD experts and clinicians, and 4 kumu hula. The 60-90 minute semi-structured interviews were conducted, recorded, then transcribed. Separate thematic analysis allowed distinct themes for each group to emerge. Themes with greatest between group alignment informed the adaptation of an existing hula-based chronic disease intervention. The clinical and cultural experts were unanimous on multiple themes. First, a hula-based program was well positioned to promote social functioning. Second, hula facilitated integrated multi-dimensional benefits including physical, cognitive, social, and cultural. Third, facilitating learning included: repetition done in creative forms; utilization of aids such as dance notation and audio recordings; and educational approaches such as project-based learning. Cultural activities such as dance have been underutilized in health promotion initiatives. A significant challenge in health promotion programs is engagement and retention of participants. Cultural dance programs are popular and can be effective interventions, particularly when both clinical and cultural experts are engaged in program development. Key messages • Inclusion of clinical and cultural experts in health promotion program development leads to unique collaboration and impactful insights. • ADRD clinicians and Hawaiian cultural dance educators identify social, cultural, physical, and cognitive benefits of hula as instrumental for individuals with mild cognitive impairment.

Exploring frailty: muscle strength, functional capacity, activities of daily living and cognition in adult congenital heart disease

Purpose The study aimed to assess frailty in adults with congenital heart disease (ACHD) and to compare muscle strength, functional capacity, activities of daily living (ADL), and cognition between frail and non-frail ACHD patients. Materials and methods A cross-sectional study design was used. Sixty people with ACHD aged between 18 and 45 years were included. Frailty was determined according to the Fried criteria. Peripheral muscle strength was assessed with a digital dynamometer, functional capacity with the 6-min walk test (6MWT), ADL with the Glittre ADL test, and cognition with the Montreal Cognitive Assessment (MoCA) test. Results Frailty was seen in 38.33% (frail = 23 and non-frail = 37) of the participants. In the frail patients, dominant knee extensor strength (p = 0.002), shoulder abductor strength (p = 0.005), 6MWT distance (p = 0.021), and MoCA score (p = 0.005) were significantly lower than those in the non-frail patients. Glittre ADL test (p = 0.002) was significantly higher in the frail patients. Conclusions Muscle strength, functional capacity, ADL, functional mobility, and cognition were lower in the frail participants with ACHD. Early assessment of frailty in ACHD and planning individualized exercise training programs for frail individuals may be a strategy to reduce the impact of frailty on adverse clinical outcomes.

PRevention Intervention and Support in Mental health for people with aphasia (Aphasia PRISM): protocol and mixed methods analysis plan for two feasibility studies

BackgroundPeople with aphasia commonly experience depression and anxiety. The individual therapy program, Aphasia PRevention Intervention and Support in Mental health (Aphasia PRISM) offers low intensity psychotherapeutic interventions using communication supports. Trained stroke clinicians from disciplines other than psychology (e.g., allied health professional, nurse, doctor) can deliver such interventions. The aim of the planned studies is to test the acceptability, feasibility and preliminary effectiveness of Aphasia PRISM for preventing depression and anxiety and supporting wellbeing in people with aphasia after stroke.MethodThis protocol describes two feasibility studies of the Aphasia PRISM using parallel, convergent, mixed methods designs. Participants will be adults with aphasia after stroke from a metropolitan healthcare site (Study A, pre-post case series, approximate n = 6) and two regional/rural sites (Study B, randomised controlled trial, n = 30; random allocation to either: treatment arm Aphasia PRISM + usual care; or attention control of secondary stroke prevention information + usual care) in Victoria, Australia. Eligible participants will be offered 7 weekly intervention sessions (via telehealth or in person). Other participant groups include stroke clinicians / site managers and family members. Feasibility will be assessed with treatment acceptability ratings (primary outcome) and secondary outcomes such as recruitment rate and participant clinical response. Participant clinical responses to intervention will be collected pre-intervention (baseline), concurrently (4 week acceptability measure), immediately post (8 weeks), follow-up (3 months) and follow-up at 6 months (Study B only). Descriptive statistics will be used to analyse quantitative data based on the type and distribution of data. Reflexive thematic analysis, an inductive approach will be used to analyse qualitative data.DiscussionAphasia PRISM offers the potential for trained stroke clinicians to deliver low intensity psychotherapeutic interventions with communication supports to people with aphasia. Studies A and B were registered with the Australian New Zealand Clinical Trials registry under one registration (ACTRN12620000209998) 20th February 2020.

Group-based versus individual parenting programs: A meta-analysis of effects on parents.

Parenting programs aim to motivate change in parents' behaviors, perceptions, and knowledge to promote desirable changes in children's adjustment and behavior. Parenting programs are typically delivered in a group-based or individual format, and it is unknown which format most effectively supports parents. On the one hand, group-based programs may be more effective since they provide access to peer-based support. On the other hand, individual programs may be more successful since they offer a tailored approach. Therefore, this meta-analysis investigated which delivery format is most effective in optimizing child behavior management (i.e., positive reinforcement and nonviolent discipline), parenting stress, and parental depressive symptoms. Studies were selected from the systematic review by Backhaus et al. (2023). Our sample included evaluations of 121 group-based and 41 individual programs based on social learning theory principles. Robust variance estimation indicated that parents' child behavior management and parenting stress improved in both delivery formats. In contrast, parental depressive symptoms improved only in group-based programs. Our findings suggest that whether parents benefit more from a group-based or individual program in part depends on the outcome examined. Therefore, it is important for clinicians to understand parents' goals to effectively guide them toward the most appropriate parenting program delivery format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sustainability and Efficiency in the Implementation of Technical Infrastructure Projects in an Urban Environment

The individual national programs through which part of the common policies of the EU are implemented contain strict requirements regarding the scope of measures financed by means of funds from the Union budget. In general, the programs are structured in such a way as to ensure both demarcation and complementarity between them, in order to achieve a certain degree of synergism accompanied by long-term investment. There are some opportunities to increase sustainability and efficiency in the implementation of technical infrastructure projects in urban environments financed by EU funds. The same are revealed when analyzing the scope of the specific measures implemented by different beneficiaries. They arise mainly from technological features, incl. consistency in the implementation of individual construction operations. The present study focuses on such possibilities, incl. specific actions contributing to increasing the efficiency of investments and saving public funds in the conditions of their limited amount. Two specific programs are covered, the implementation of which is forthcoming within the 2021-2027 programming period.

Advocacy Skill Development in Public Health Education Curriculum: A Pilot Study.

The National Commission for Health Education Credentialing (NCHEC) released updated Responsibilities and Competencies for Health Education Specialists based on the 2020 HESPA II. For the first time, advocacy is a standalone area of responsibility (Area V: Advocacy) for health education specialists. Although this is exciting for the field of health education, there is limited consensus on how to effectively teach advocacy or what content and skills to include. Furthermore, while the HESPA II was updated, the Council on Education for Public Health (CEPH) criteria for advocacy have not been. This pilot study examined how CEPH-accredited programs in the United States are addressing the profession-wide advocacy competency in their health education curricula. A cross-sectional research design with single-point data collection was used to assess how CEPH-accredited university programs (including Standalone Baccalaureate Programs, Public Health Programs, and Schools of Public Health) are preparing health education students to meet the national advocacy responsibility. The survey included items from the Advocacy Area of Responsibility and potential barriers for faculty teaching advocacy. Results indicate that most programs are teaching something about advocacy, but there is no program teaching all listed sub-competencies. Barriers to including all components of the advocacy responsibility were largely related to faculty motivation, knowledge, and time. With a full responsibility area devoted to advocacy, it is reasonable to expect that programs will adjust with the profession. However, program administrators must be catalysts for these changes in their individual programs.

Dynamics of the functional state of the cardiovascular system in individuals after cholecystectomy under the influence of a rehabilitation program in sanatorium-resort conditions.

The article discusses the dynamics of the functional state of the cardiovascular system (CVS) in individuals after laparoscopic cholecystectomy (LCС) under the influence of a rehabilitation program in SANATORIUM-RESORT CONDITIONS. The study involved 79 individuals after LCC aged 45 to 59 years. The individuals were divided into 2 groups: group A (n=39) and group B (n=40). Individuals in group A received rehabilitation services according to the clinical protocol (diet, hydrotherapy, mineral or coniferous baths, and physical therapy, etc.) In group B, individual rehabilitation programs were formed depending on the existing dysfunctions and the tolerance of the CVS to physical activity. In group B, the rehabilitation intervention to increase the function of endurance and physical performance was applied Nordic walking (NW). The initial examination in both groups revealed an increase in resting heart rate (RHR), diastolic (DBP) and systolic (SBP) blood pressure, a decrease in the performance of a 6- minute walk test and the presence of a feeling of shortness of breath during the test. The implementation of a physical rehabilitation (physical therapy) program in group B, which used Nordic walking to increase physical activity, tolerance to physical activity, and improve cardiovascular function, was effective. The use of NW in sanatorium-resort conditions of rehabilitation (lasting at least 18 days) has a positive effect and leads to a statistically significant decrease in RHR, SBP, DBP, an increase in walking distance in 6 minutes and a decrease in the feeling of shortness of breath when walking, compared to the control group. It was established that diet therapy, hydrotherapy, mineral or coniferous baths, and other water procedures, classical abdominal and back massage, group daily therapeutic gymnastics in group A did not have a positive effect on increasing the level of physical activity tolerance, CVS functioning in patients after LCC.

Große Transformation für eine Nachhaltige Raumentwicklung als Herausforderung für die raumbezogene Hochschullehre

Climatic and ecological changes across the globe represent a challenge for humanity that can only be solved through a great transformation, that is, a widespread shift toward sustainable spatial development. This means addressing transformation needs in all systems to recognize that civil society, economies and politics are all predetermined by planetary boundaries. This transformation demands that the fields of applied spatial science and spatial planning identify strategies and solutions. This paper examines the extent to which these topics are already being addressed by the university-level spatial studies programs currently training future planners. It develops and examines criteria for evaluating these programs using guideline-based interviews and literature research to perform detailed analysis of selected programs. The study demonstrates that not only specialist knowledge, but also personal and methodological skills are crucial to the success for far-reaching change processes and, ultimately, a society-wide paradigm shift. In some cases, these skills are already being addressed by individual spatial studies programs, especially planning programs. However, there remains a need to accelerate the cultivation of independent learning skills and collaboration in inter- and transdisciplinary teams. Accordingly, this paper proposes a differentiated view of teaching and learning formats in higher education and encourages deepening the focus of spatial studies programs on sustainability and transformation issues.

Multidisciplinary Home-Based Rehabilitation Program for Individuals With Disabilities: Longitudinal Observational Study.

Disability affects a significant portion of the global population nowadays, necessitating innovative approaches to access rehabilitation processes. Home-based rehabilitation has emerged as a beneficial approach, offering comfort and context-specific therapy. This study aims to evaluate the impact of a multidisciplinary home-based rehabilitation program for individuals with moderate neuromusculoskeletal disabilities in terms of motor function and mood. A total of 270 participants with median age of 66 (IQR 20-98) years were recruited from the National Disability Registry of Chile. The intervention involved a multidisciplinary team composed of 49 health care professionals providing personalized treatment plans over 4 months (32 sessions for physical therapy, 8 sessions for occupational therapy, 4 sessions for nutrition, 8 sessions for psychology, and 4 sessions for nursing and podiatry). This program also included 2 medical evaluations (at the beginning and the end) to monitor clinical progress in terms of motor function and mental health, using the Berg Balance Scale and Beck Depression Inventory, respectively. The home-based rehabilitation program showed significant improvements (P<.001) in motor function and balance with a reduction in fall risk. Specifically, the Berg Balance Scale score decreased close to 15% after the home-based rehabilitation program for all enrolled participants. On the other hand, depression levels showed no significant changes (P=.27), with percentages of variation less than 8% between the 2 assessed conditions. In this sense, participants remained with the same mild depression level (14 of 63) concerning the Beck Depression Inventory score. This study concludes that personalized home-based rehabilitation programs are effective in enhancing motor function and balance, particularly in individuals with neurological conditions. On the other hand, the findings in terms of mood advocate for further exploration of psychological support within such programs to enhance overall patient well-being. ClinicalTrials.gov NCT06537791; https://clinicaltrials.gov/study/NCT06537791.

Conducting Assessments of Community-Based Programs for Individuals with Dementia and their Family Caregivers.

While the gold standard for intervention science is the randomized controlled trial (RCT), there is growing emphasis on the practical implementation and evaluation of evidence-based programs into community agencies. Assessment of program efficacy by community-based organizations can confirm planned delivery of services, implementation fidelity, and demonstrate positive outcomes, which can provide justification for funding. Methods and measures used in an RCT, however, often cannot be implemented in non-research settings and different approaches are needed. This manuscript reviews the emerging literature on program evaluation work and draws upon the authors' experiences conducting evaluations with three community-based organizations funded by Administration for Community Living to implement programs for individuals with dementia and their family care partners. This manuscript argues for an examination of the expectations of evaluation efforts for translation of research-based trials to practice and emphasizes three main strategies for assessment: (1) Development of brief tailored assessments; (2) Measuring fidelity of implementation of the program; and (3) Measuring acceptability of the program to clients.