Participation In Rehabilitation Program Research Articles

The Clinical Outcome of Cardiac Rehabilitation in Coronary Artery Disease Patients with Regard to the Presence of Left Ventricular Systolic Dysfunction.

Background: Despite the use of advanced treatment techniques, coronary artery disease (CAD) still remains the main cause of left ventricular (LV) dysfunction and heart failure. Participation in cardiac rehabilitation (CR) programs can lead to a number of beneficial effects, but some patients do not demonstrate the expected improvement. The aim of this study is to evaluate the impact of CR on changes in exercise capacity with regard to the presence of LV dysfunction. Methods: A group of 428 patients with CAD were consecutively admitted to an outpatient comprehensive cardiac rehabilitation program comprising 24 exercise sessions of interval training on cycle ergometers, three times a week for 45 min, and a health education. The patients were compared in two subgroups, i.e., with LV systolic dysfunction (LVEF < 50%, n = 175) and LVEF ≥ 50% (n = 253). Results: In the LVEF < 50% group, the exercise capacity improved by 1 ± 0.78 MET (median 1.15 MET), and 0.86 ± 0.77 MET (median 1.08 MET) in the LVEF ≥ 50% group. Women with LVEF < 50% demonstrated a significant increase in exercise capacity by 1.2 MET, while those with LVEF ≥ 50% did not display any such increase. All men, regardless of LVEF, exhibited a similar improvement in exercise capacity greater than 1 MET. Conclusions: An outpatient eight-week cardiac rehabilitation program based on 45 min aerobic interval training sessions three times a week appears less effective for women with CAD and EF ≥ 50%. In this group, the proposed training intervention is insufficient in improving exercise capacity to an extent that could indicate a reduction in mortality risk.

Socioeconomic profile of families with spina bifida children in Turkey

BackgroundSpina bifida’s prevalence and incidence vary across geographical regions with sociodemographic characteristics and socioeconomic status of the populations having a significate influence over its epidemiology. This study aimed to outline the socioeconomic profile of families with spina bifida children, based on sociodemographic characteristics.MethodsBetween August and December 2022, 86 surveys completed by parents of children that underwent spina bifida repair in our institution were included in this analysis. The first part of the survey included questions based on sociodemographic characteristics. The second part of the survey was based on care provided by the families, regular follow-ups, participation in rehabilitation programs, and type of burdens perceived by the caregivers.ResultsA close look at the highest level of parent education showed that more than half of them were only middle school graduates. Occupational status in the perioconceptional period revealed that 77% of mothers were housewives/unemployed. 23% had a history of induced or spontaneous abortion. A high number of consanguine marriages were registered with 58% of the subjects being biologically related. 53% of the spina bifida children came from families with low household income. Only 15% of the spina bifida children had access to physiotherapy and 18% to rehabilitation programs.ConclusionsChildren with spinal dysraphism were more likely to come from families resulted from consanguineous marriages, with at least two children, low level of parent education and household income. Emotional and financial burden perceived by caregivers should be addressed in order to diminish the numerous challenges that this group of families encounter.

Patients' experiences and perspectives regarding the use of digital technology to support exercise-based cardiac rehabilitation: a qualitative interview study.

Despite the well-known benefits of exercise-based cardiac rehabilitation for the secondary prevention of cardiovascular disease, participation in cardiac rehabilitation programmes and adherence to secondary prevention recommendations remain limited. Digital technologies have the potential to address low participation and adherence but attempts at implementing digital health interventions in real-life clinical practice frequently encounter various barriers. Studies about patients' experiences and perspectives regarding the use of digital technology can assist developers, researchers and clinicians in addressing or pre-empting patient-related barriers. This study was therefore conducted to investigate the experiences and perspectives of cardiac rehabilitation patients in Austria with regard to using digital technology for physical activity and exercise. Twenty-five current and former cardiac rehabilitation patients (18 men and 7 women, age range 39 to 83) with various cardiac conditions were recruited from a clinical site in Salzburg, Austria. Semi-structured qualitative interviews were audio-recorded and transcribed verbatim. The analysis followed a descriptive phenomenological approach, applying the framework analysis method. The sample was diverse, including interviewees who readily used digital devices to support their physical activity, exercise and health monitoring, and interviewees who did not. Simplicity, convenience and accessibility were highlighted as important facilitators for the use of digital technology, while annoyance with digital devices, concerns about becoming dependent on them, or simply a preference to not use digital technology were commonly stated reasons for non-use. Interviewees' views on data protection, data sharing and artificial intelligence revealed wide variations in individuals' prior knowledge and experience about these topics, and a need for greater accessibility and transparency of data protection regulation and data sharing arrangements. These findings support the importance that is attributed to user-centred design methodologies in the conceptualisation and design of digital health interventions, and the imperative to develop solutions that are simple, accessible and that can be personalised according to the preferences and capabilities of the individual patient. Regarding data protection, data sharing and artificial intelligence, the findings indicate opportunity for information and education, as well as the need to offer patients transparency and accountability in order to build trust in digital technology and digital health interventions.

Adoption of community-based land rehabilitation programs (CBLRP) and its effect on livelihoods in Offa district, south Ethiopia

Land degradation is a major issue in Ethiopia and has a significant impact on agriculture and subsistence. Community-based land restoration projects are essential to address this issue. This study aimed to evaluate the implementation of a community-based land restoration programs and its impact on livelihoods in the Offa District of south Ethiopia. Four Kebeles were randomly selected for the study and 133 household heads (52 program participants and 81 non-participants) were selected using a simple random sampling method. Data was collected by using an interview schedule, focus-group discussions, and key informant interviews. Data were analyzed using a binary logistic regression model, propensity score matching, participation index (PI), t-test, and chi-square test. The results showed that the implemented land rehabilitation measures had higher crop production and farm income for most adopter households compared to their counterparts. The logistic regression model revealed that the slope of farmland, gender of household heads, family size, perception of rehabilitation, access to training, and farm experience positively influenced household participation in the community-based land rehabilitation programme (CBLRP) in the study area. However, the age of the respondents, access to education, size of farmland, frequency of extension contact positively and ownership of livestock negatively influenced household participation. Propensity score matching revealed that CBLRP resulted in higher crop output and farm revenue for most participating families than counterparts. Based on these findings, it is recommended that agricultural and rural development offices, non-governmental organizations, and other stakeholders should consider the factors that influence household participation in rehabilitation programs in the study area to effectively address the issue of the households’ participation at various levels of rehabilitation programs.

Optimization of Cardiorespiratory Fitness and Quality of Life in Women with Chronic Heart Failure after a Cardiac Rehabilitation Program

Introduction: Women with heart failure (HF) tend to experience a greater symptom burden and lower quality of life, possibly due to phenotypic differences and unique gender-associated risk factors. Despite evidence on the effects of cardiac rehabilitation programs (CRP) in the general population, there is underrepresentation of women in these programs. Additionally, the impact of CRP on cardiorespiratory variables obtained through cardiopulmonary exercise testing (CPET) and health-related quality of life (HRQoL) in women with HF remains unknown. Objective: To assess the impact of a CRP on cardiorespiratory fitness (CRF) in cardiorespiratory variables obtained through CPET and HRQoL in women with HF. Methods: A quasi-experimental study included HF patients who completed a CRP from June 2019 to December 2023. The CRP involved nutritional assessment, psychosocial evaluation, educational sessions, and concurrent training. It comprised 30 minutes of aerobic resistance training at 65-80% of heart rate reserve (HRR) and 30 minutes of strength training at 30-50% of 1-repetition maximum (1RM), with a frequency of 3 sessions per week for 4 to 6 weeks. CPET was conducted at the beginning and end of the program, analyzing cardiorespiratory variables. HRQoL was assessed using the SF-36 questionnaire. Gains in CRF and HRQoL at the end of the program in both men and women were analyzed. Results: Out of 217 included patients, 29.9% were women. At the program's onset, women showed lower exercise tolerance than men (workload 5.4±2.57 METs vs. 6.62±2.53 METs) and worse HRQoL (62.03%±18.37 vs. 68.38%±18.37). However, post-intervention, they optimized their CRF (%predicted VO2 [%VO2p] initial 56.62%±20.11 vs final 80.12%±30.32, p=&lt;0.001). Significant improvements in cardiorespiratory variables were observed in both cases: delta METs-load 3.02, p=&lt;0.001, delta peak oxygen consumption (VO2peak) 1.83 ml/kg/min, p=&lt;0.001, delta oxygen pulse (PO2) 1.21, p=0.021, delta cardiac power output (CPO) 1917, p=0.004, with a rightward shift in ventilatory thresholds and improvement in HRQoL (62.03%±18.37 vs. 78.81%±12.9, p=&lt;0.001) post-CRP. The only variable with no significant changes in either case was VE/VCO2 slope (delta -0.51, p=0.736). Additionally, in women with reduced left ventricular ejection fraction (&lt;50%), variables with no significant improvement included CPO (delta 959.22, p=0.283) and time to recovery of VO2 kinetics (TRCVO2) (delta -0.74, p=0.957). In patients with preserved left ventricular ejection fraction (≥50%), variables with no significant change included PO2 (delta 1.08, p=0.173), TRCVO2 (delta 26.82, p=0.099), and the first ventilatory threshold (VT1) (delta 0.09, p=0.504). Program attendance was 87.5% in both groups. Conclusion: Implementing a CRP in women with HF resulted in significant improvements in all evaluated cardiorespiratory variables (except for VE/VCO2 slope) and quality of life. These findings support the importance of ensuring women's access and participation in cardiac rehabilitation programs. Addressing existing barriers is crucial to maximize the long-term benefits of CRP in the female population with HF.

Scientific and Practical Conference with International Participation «Mental Health of the Family: Russian Traditions and Modern Approaches to Assistance», 26.01.2024, Moscow

Scientific and Practical Conference with international participation «Mental Health of the Family: Russian Traditions and Modern Approaches to Assistance»м тир, held FSBSI «Mental Health Research Centre» on January 26, 2024 in Moscow as part of the XXXII International Christmas Educational Readings «Orthodoxy and Domestic Culture: Losses and Gains of the Past, the Image of the Future». The conference comprehensively covered the traditional values of families in Russian society, as well as the problems that arise in families whose members suffer from mental disorders and behavioral disorders. The achievements and possibilities of helping family members with mental and behavioral disorders, as well as the provision of psychiatric, psychological, social and spiritual assistance by various institutions through the prism of biopsychosocial, spiritual and family-oriented approaches were discussed. The issues of volunteer participation in rehabilitation programs for families, the contribution of public organizations and their interaction with state and religious institutions in the aspect of psychosocial rehabilitation of patients with mental disorders and behavioral disorders, as well as issues of multidisciplinary interaction of specialists in the field of family prevention of mental disorders were considered. The exchange of scientific and practice-oriented achievements of domestic and foreign psychiatry in the field of family prevention of mental disorders, behavioral disorders and addiction diseases, the introduction of new technologies of assistance allows to improve the quality and effectiveness of psychiatric and narcological care provided to families that include persons with mental disorders and behavioral disorders.

Feasibility of tele-rehabilitation in low resource setting: perceived barriers and facilitators among physiotherapy professionals

Background: Robust evidence illustrates the significance and efficacy of telerehabilitation to optimize the participation in rehabilitation program taking into account organisational, geographical and transportation aspects. Despite knowing the remarkable benefits, there exist an array of challenges to implement telerehabilitation services in a setting with meagre resources. In order to augment the uptake of telerehabilitation services, our study aims to explore the perceived barriers and facilitators to telerehabilitation among Physiotherapy professional in a resource limited setting. Methods: A cross-sectional survey was conducted among physiotherapy professionals in Maharashtra using a questionnaire with a content validation index of 0.95. The survey sought to ascertain the awareness, barriers, facilitators and strategies to improve practice of telerehabilitation. Results: A total of 450 Physiotherapists were invited, of which, 201 participated in the study. The major barriers to telerehabilitation were inaccuracy in obtaining adequate information (n=149, 74%), lack of face-to-face monitoring (n=131, 65%) and physical limitation in older adults (n=114, 57%); on the other hand, the facilitators were reduced transportation time to hospital/clinic (n=132, 67%) and improved accessibility to healthcare services (n=125, 62%). The factors that enabled the patients to participate were flexible appointment schedule (n=139, 69%) and minimal transportation costs (n=129, 64%). Furthermore, the participants majorly considered encouraging patients’ appropriate environment, insurance coverage, training and upskilling of clinicians as the strategies to improve practice. Conclusions: The implementation of telerehabilitation program has been limited due to perceived constraints associated with various organizational, geographical and patient factors. However, physiotherapists reported strategies to improve practices could be implemented to accelerate the utilization of telerehabilitation services.

Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities.

Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.

The effects of employers’ disability and unemployment insurance costs on benefit inflows

In Finland, large firms are partially liable for the costs of disability and unemployment benefits paid to their former workers. To estimate the effects of such cost liabilities, we exploit a reform that extended this cost-sharing to cover a new group of blue-collar workers. We show that experience rating in disability insurance reduces inflows to sickness and disability benefits and increases participation in vocational rehabilitation programs, whereas employers’ unemployment insurance costs reduce excess layoffs of older workers who can qualify for extended unemployment benefits until retirement age. We find no evidence of spillover effects: employers’ cost liabilities in one benefit type do not affect inflows to other types of the benefits.

Benefits from Incorporating Virtual Reality in Pulmonary Rehabilitation of COPD Patients: A Systematic Review and Meta-Analysis.

Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation. Patient participation in Pulmonary Rehabilitation (PR) programs has a beneficial effect on disease management, improving patients' functional capacity and quality of life. As an alternative to traditional programs or as a complementary activity, the inclusion of virtual reality (VR) games is proposed. The aim of this research study was to investigate the effectiveness of incorporating VR in the pulmonary rehabilitation program of patients with COPD. A systematic literature search was performed for randomized controlled trials (RCTs) in the electronic databases Google Scholar, PubMed, and Pedro from January 2014 to March 2022. The search involved screening for studies examining the effectiveness of enhancing PR with VR. The PEDro (Physiotherapy Evidence Database) scale was chosen as the tool to assess the quality of studies. A meta-analysis was performed where possible. Six studies were included in this systematic review. The PEDro scale showed five studies of good methodological quality and one of fair quality. The variables examined were: aerobic capacity for exercise, lung function, anxiety and depression, with non-significant improvement for the MRC Dyspnea scale, marginally non-significant improvement regarding 6MWT (p = 0.05) and significant improvement for FEV1 (p < 0.05). There was variability noted in the VR applications and the proposed rehabilitation that the experimental groups followed. The application of VR is recommended for COPD patients, in combination with conventional PR. VR was found to be effective in increasing therapeutic effect and should be considered as a mean of increasing accessibility to PR. Therefore, further research, as well as additional RCTs regarding the effectiveness of VR in patients with COPD, seems necessary.

Parent-reported health-related quality of life in pediatric childhood cancer survivors and factors associated with poor health-related quality of life in aftercare

PurposeDespite advances in cancer treatment, there is a prevalence of pediatric childhood cancer survivors still at risk of developing adverse disease and treatment outcomes, even after the end of treatment. The present study aimed to (1) explore how mothers and fathers assess the health-related quality of life (HRQoL) of their surviving child and (2) evaluate risk factors for poor parent-reported HRQoL in childhood cancer survivors about 2.5 years after diagnosis.MethodsWe assessed parent-reported HRQoL of 305 child and adolescent survivors < 18 years diagnosed with leukemia or tumors of central nervous system (CNS) with the KINDL-R questionnaire in a prospective observational study with a longitudinal mixed-methods design.ResultsIn agreement with our hypotheses, our results show that fathers rate their children’s HRQoL total score as well as the condition-specific domains family (p = .013, d = 0.3), friends (p = .027, d = 0.27), and disease (p = .035, d = 0.26) higher than mothers about 2.5 years after diagnosis. Taking variance of inter-individual differences due to family affiliation into account, the mixed model regression revealed significant associations between the diagnosis of CNS tumors (p = .018, 95% CI [− 7.78, − 0.75]), an older age at diagnosis, (p = .011, 95% CI [− 0.96, − 0.12]), and non-participation in rehabilitation (p = .013, 95% CI [− 10.85, − 1.28]) with poor HRQoL in children more than 2 years after being diagnosed with cancer.ConclusionBased on the results, it is necessary for health care professionals to consider the differences in parental perceptions regarding children’s aftercare after surviving childhood cancer. High risk patients for poor HRQoL should be detected early, and families should be offered support post-cancer diagnosis to protect survivors’ HRQoL during aftercare. Further research should focus on characteristics of pediatric childhood cancer survivors and families with low participation in rehabilitation programs.

Evaluation of women's participation and empowerment in community land rehabilitation programs: Lesson drawn from Wera District, Southern Ethiopia

Local people’s socio-economic and natural resources, especially forest resources, have been affected by land degradation in Ethiopia in the past years. To combat this problem, rehabilitation of community-based degraded land has been performed since 1979. Rehabilitation of degraded land (RDL) is important for forest management strategy regarding the regeneration of degraded forests and related resources through women’s empowerment. Because empowered women are key users and managers of resources from rehabilitated land such as forest resources, which leads to sustainable utilization of forest products. The aim of the study was to evaluate women’s participation and empowerment in decision-making regarding the rehabilitation intervention. A total of 120 women households (60 user and 60 non-user women) were selected using a stratified random sampling method. Data were collected using a household survey, focus group discussion and key informant interviews. The results revealed that there is a significant difference between user and non-user women in fetching water and fuelwood collection time. Furthermore, RDL contributes to improving user women’s economic status and social relationships such as livelihood opportunity, social network, build-up of trust and changes in social assets. The result also indicated that women able to participate in forest-related meetings, land use management, use and control of assets, decision-making, and in soil and water conservation measures. Further, user women had greater awareness compared to non-users due to participation in different meetings and other decision-making activities. The findings suggest that consideration of women’s participation in decision-making regarding the community land rehabilitation program is important to empower women equally with men.

Criminal records versus rehabilitation and expungement: a randomised controlled trial

AbstractPurposeWhat is the effect of having a criminal record compared to having the criminal record expunged in exchange for participating in a rehabilitative programme? The available evidence focuses on programmes comprised of the criminal record for the offence (i.e. labelling) and a punitive sanction or rehabilitative scheme. The interaction between the labelling and the sanction has made distinguishing the effect of each penological approach a challenge.MethodsWe use a pretest–posttest control group design with a cohort of 341 low-harm offenders randomly assigned to either a simple, unconditional, caution or a 16-week rehabilitation treatment programme (after which the criminal record was automatically expunged). New crimes and a measure of harm were used as outcome variables.ResultsIntention-to-treat analysis shows no significant difference in prevalence, crime count or crime harm. Factoring in those individuals who actually completed the programme changes this story. An instrumental variables analysis used to adjust for treatment compliance suggests that the offer to expunge the criminal record following participation in rehabilitation programmes reduces both crime count and crime harm.ConclusionsWe conclude that as evidence on the adverse effects of criminal records on recidivism mounts, out of court disposals that lead to an expungement of the label ‘offender’ may provide promising intervention for low-harm offences. The experiment also highlighted the importance of secondary analytic strategies in experiments alongside the standard intention-to-treat model.

Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization

High mortality from cardiovascular diseases (CVD) requires improved approaches to the treatment of this socially significant pathology. Wide implementation of surgical myocardial revascularization makes it possible to improve significantly both life quality and expectancy in patients with coronary heart disease. The aim of this work was to analyze the literature on the impact of preoperative, operative and postoperative factors on the long-term prognosis after coronary artery bypass grafting (CABG). The review refers to both recent and earlier informative works. The target groups for this article are therapists, cardiologists, rehabilitologists, who work with patients in the short and long term after CABG. Data of Russian and foreign literature show that the long-term prognosis after CABG is largely determined by preoperative factors, in particular – age, set of cardiovascular risk factors (RF) and comorbidity, specifically – severity of coronary and systemic atherosclerosis, incident cardiovascular complications, structural and functional state of the heart. In the aggregate these factors reflect the cumulative effect and further potential of actual cardiovascular RFs, affect longterm risk of adverse events, and determine the therapeutic targets of secondary prevention. Priority of arterial conduits and completeness of revascularization are the main operative factors that determine the course of the long-term period after CABG. Among the postoperative factors, the efficiency of secondary CVD prevention is of paramount importance, in particular – achievement of target RF levels, compensation of cardiac and extracardiac pathology, adherence to the long-term medical therapy, known to improve outcomes based on specific comorbidity. Efficiency of secondary CVD prevention largely depends on patient's health attitudes, the key influence on which beyond attending physician can be provided by participation in rehabilitation programs, teaching patients the meaning and essentials of lifestyle modification and cardiovascular RFs’ control.

122 EVALUATING THE IMPLEMENTATION OF CLINICAL PHARMACIST SERVICES IN A POST DISCHARGE HOSPITAL-BASED REHABILITATION WARD IN IRELAND

Abstract Background The number of people over 60 years is predicted to double by 2050. Medicines play a significant role in a patient’s recovery and in the management of many acute and long-term conditions. Patients are living with chronic diseases which require management with medication, such as diabetes, stroke, and cancer. Patients over 60 years are more vulnerable to adverse effects of poly-pharmacy due to declining renal and hepatic function, reduced lean body mass and functional capabilities. Medications should be prescribed appropriately with the intention to have a favourable outcome, to improve mortality, morbidity, and the quality of life of the patient. Inappropriate prescribing of medications leads to poly pharmacy, adverse drug reactions, poor adherence, prolonged recovery time and poor participation in rehabilitation programmes. Methods Clinical pharmacy services were provided to patients in the rehabilitation ward. Medication reconciliation, clinical medication review of medications, participation in MDT meetings, discharge planning including education on medication regimes with patient and primary care services. All interventions were recorded at each stage. Results The average number of medications on admission was eleven. On completion of medicine reconciliation, many changes were intentional. 19% of patients had an unintentional change to their medications. On completion of a clinical review 156 drug related problems were identified. 77% of recommendations were accepted by medical team. 57.5 % of medications were deemed a STOPP medication and 20.8 % were deemed a START medication. On discharge the average number of medications prescribed was six. This represented a 40% reduction in the number of medicines prescribed on discharge. Conclusion The inclusion of a clinical pharmacist as a member of the multidisciplinary team on a rehabilitation ward allows for a comprehensive review of patient’s medications. This optimises medications, identifies drug related problems, reduces the pill burden, aids adherence, reduces the possibility of adverse drug reactions and promotes medication safety.

Barriers and facilitators to older adults’ engagement in healthy aging initiatives

Objectives. To identify the facilitators and barriers to older adults’ participation in healthy aging or cardiovascular rehabilitation programs. Methods. We conducted a scoping review to identify healthy aging program evaluations which identified participant barriers and facilitators. We developed a search strategy in the following databases: MEDLINE, Embase, APA PsycInfo, and Cochrane CENTRAL, all on the Ovid platform and Ebsco CINAHL.Results. We included 17 articles in this review. Our team categorized the barriers and facilitators of older adults’ participation in healthy aging programs into seven themes: attitudes, organizational structure, accessibility, social structure, knowledge, demographics, and program specifics.Conclusions. Understanding the facilitators and barriers that older adults face when deciding whether or not to participate or to continue participating in, healthy aging programs to promote in, cardiovascular health can help healthcare professionals provide optimal guidance for their patients and clients.

Community Community Participation Program in Forest and Land Rehabilitation in the Batutegi Forest Management Unit

Restoration of critical land so that its products can increase and contribute to the community's welfare is a special challenge at this time. One of the efforts made by the government in overcoming this problem is by carrying out Forest and Land Rehabilitation activities by involving farmers as local workers. This study analyses community participation in forest and land rehabilitation programs in Datar Lebuay Village, Air Naningan District, Tanggamus Regency. The research was conducted in June 2021. Data collection was carried out through interviews, observation, and documentation techniques. Respondents were determined using the Slovin formula with an error limit of 10%. The interview process uses a proportional simple random sampling technique. The data obtained were then analyzed descriptively quantitatively using a Likert scale. The results showed that there was several activities rehabilitation forest, namely: the planning subsystem with field technical design activities had a final value of 3, the implementation subsystem with a seedling, planting, and plant maintenance activities, with each final value of 3, except for plants which had a final value of 4 Monitoring and evaluation subsystem with monitoring and evaluation activities, with a final score of 3. The Forest and Land Rehabilitation (FLR) activities with community participation levels have Ordinary criteria (B). This shows that forest rehabilitation activities involving farmers are implemented correctly so that the land on which farmers are involved in rehabilitation activities is expected to be more sustainable.

The relationship between anxiety sensitivity and clinical outcomes in cardiac rehabilitation: A scoping review

BackgroundDespite well-established efficacy for patients with a cardiovascular diagnosis or event, exercise-based cardiac rehabilitation program participation and completion has remained alarmingly low due to both system-level barriers and patient-level factors. Patient mental health, particularly depression, is now recognized as significantly associated with reduced enrollment, participation, attendance, and completion of a cardiac rehabilitation program. More recently, anxiety sensitivity has emerged as an independent construct, related to but distinct from both depression and anxiety. Anxiety sensitivity has been reported to be adversely associated with participation in exercise and, thus, may be important for patients in cardiac rehabilitation. Accordingly, the objective of this study was to conduct a scoping review to summarize the evidence for associations between anxiety sensitivity and cardiovascular disease risk factors, exercise, and clinical outcomes in cardiac rehabilitation. MethodsA formal scoping review, following PRISMA-ScR guidelines, was undertaken. Searches of MEDLINE, Web of Science, CINAHL, PSYCINFO, and Scopus databases were conducted, supplemented by hand searches; studies published through December of 2020 were included. The initial screening was based on titles and abstracts and the second stage of screening was based on full text examination. ResultsThe final search results included 28 studies. Studies reported statistically significant associations between anxiety sensitivity and exercise, cardiovascular disease, and participation in cardiac rehabilitation. Many studies, however, were conducted in non-clinical, community-based populations; there were few studies conducted in cardiovascular disease and cardiac rehabilitation clinical patient populations. Additionally, significant gaps remain in our understanding of the sex-based differences in the complex relationships between anxiety sensitivity, exercise and cardiac rehabilitation. ConclusionMore research is needed to understand specific associations between anxiety sensitivity and clinical outcomes among clinical cardiovascular disease patients and participants in cardiac rehabilitation programs. Treatment of anxiety sensitivity to optimize clinical outcomes in cardiac rehabilitation programs should be investigated in future studies.

Production and persistence of criminal skills: Evidence from a high-crime context

We study criminal skills production and persistence by looking at the universe of incarceration spells and violent and non-violent property crime reports in Colombia. Leveraging detailed and geo-coded information, we find that property crime reports are higher around prisons on the days inmates are released. Two types of offenders drive the impacts: (i) property crime specialists—inmates with a prior conviction for violent or non-violent theft; and (ii) trainees—inmates with different criminal records but who interacted heavily with specialists during incarceration. We examine whether participation in rehabilitation programs or longer prison spells mitigate these effects and find no evidence for either type of offender. Although we are unaware of how many crimes these offenders would commit absent incarceration, these results suggest that incarceration’s specific deterrence or rehabilitation effects might be weak for these populations and that, in some circumstances, prison can foster rather than prevent crime.

Future Patient: Telerehabilitation of Patients With Heart Failure Empower Patients

Background Heart failure is one of the most common cardiovascular diseases that causes mortality, and patients’ participation in rehabilitation programs is often low. During the COVID-19 pandemic, the Future Patient Telerehabilitation Program developed for patients with heart failure offered a new approach. The aim of the Future Patient program has been to increase the quality of life and educate patients to monitor any worsening of their symptoms. Patients used self-tracking devices for monitoring their physical activity, blood pressure, sleep, respiration, and pulse, with their data transmitted to a shared web platform (called the Heart Portal), which could be accessed by patients, their relatives, and health care professionals across sectors. Objective The aim of this paper is to determine whether the Future Patient Telerehabilitation Program has increased the quality of life of patients with heart failure and to empower them to manage their own disease. Methods A randomized controlled trial (n=140) was conducted. Data from the intervention group (n=70, 50%) on patient-reported outcomes were collected and analyzed using the Kansas City Cardiomyopathy Questionnaire and Spiegel Sleep Questionnaire. Semistructured interviews with 12 patients (n=6, 50% men and n=6, 50% women) were conducted and analyzed. Results The patients participating in the Future Patient program experienced a significant increase in clinical and social well-being as well as in quality of life. The patients participating in the program articulated their experiences in terms of the following themes: a sense of security and an increased sense of empowerment in managing their disease using the Heart Portal. The Heart Portal proved to be a valuable tool for remote monitoring and better communication with health care professionals across sectors. Conclusions Telerehabilitation of patients with heart failure can improve their quality of life and empower them to manage their own disease remotely.