Psychosocial services provided by licensed cardiac rehabilitation programs

BackgroundProfessional health organizations recommend that outpatient cardiac rehabilitation programs include activities to optimize the physical, mental, and social well-being of patients. The study objectives were to describe among cardiac rehabilitation programs (1) mental health assessments performed; (2) psychosocial services offered; and (3) leadership's perception of barriers to psychosocial services offerings.MethodsA cross-sectional survey of North Carolina licensed outpatient cardiac rehabilitation programs on their 2018 services was conducted. Descriptive statistics were used to summarize survey responses. Thematic analysis of free text questions related to barriers to programmatic establishment or expansion of psychosocial services was performed by two team members until consensus was reached.ResultsSixty-eight programs (89%) responded to the survey. Forty-eight programs (70%) indicated offering psychosocial services; however, a majority (73%) of programs reported not directly billing for those services. At program enrollment, mental health was assessed in 94% of programs of which 92% repeated the assessment at discharge. Depression was assessed with the 9-item Patient Health Questionnaire by a majority (75%) of programs. Psychosocial services included individual counseling (59%), counseling referrals (49%), and educational classes (29%). Directors reported lack of internal resources (92%) and patient beliefs (45%) as the top barriers to including or expanding psychosocial services at their facilities.ConclusionsCardiac rehabilitation programs routinely assess mental health but lack the resources to establish or expand psychosocial services. Interventions aimed at improving patient education and reducing stigma of mental health are important public health opportunities

The Commonweal of Life: Aldo Leopold and Land Health

485 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2004.Aldo Leopold (1887--1948) is known for his "land ethic," which presented land use as a matter of moral right and wrong, not merely of prudence. What Leopold meant by "land ethic," however, is not well understood because few have appreciated its ecological, ethical, and aesthetic foundation. This study probes that foundation as it emerged in Leopold's thought and work. It attends particularly to the key words he used when he proclaimed, as right, those actions on the land that preserved "the integrity, stability, and beauty" of the "biotic community." Central to Leopold's ethic was his idea of "land health," an ideal that Leopold clarified over time and proposed as an overall, much-needed goal for conservation work. Land health was the culmination of Leopold's mature conservation thought; it shaped not just his ethic but his on-the-ground land management ideas. Land was healthy, Leopold decided, when it retained its productive capacity over the long-run, thereby meeting long-term human needs. Health was complexly interwoven in particular with the land's retention of the biological parts needed to cycle nutrients and to retain and build soils. Land health built upon a specific concept of land as a dynamic, evolving, interdependent system, a concept that emerged from field studies and interactions with numerous ecologists. Land health also incorporated Leopold's ruminations about evolving ethical and aesthetic norms. To live rightly, Leopold concluded, humans needed to identify what was right and true and to respect objective values---the values that withstood the tests of endurance and harmony. Leopold's conservation thought was distinctly holistic in that it promoted the well-being of the land community overall, humans included, rather than merely flows of natural resources. Yet his holism was not linked to a static or ideal view of nature, nor did it call humans to minimize alterations of land. In land health and in his land ethic Leopold expressed an alluring, integrated understanding of human home-making in nature, still valuable today, one in which ecology, aesthetics, human needs, objective value, and right living all converged.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

U.S. Immigration and Customs Enforcement (ICE) deports tens of thousands of people each year through a system in which abuse is endemic and oversight is nonexistent. By failing to either regulate ICE or hold it accountable for abuse, the U.S. Federal Government is violating the human rights of deportees. This report focuses on the final link in the deportation process: ICE Air Operations deportation flights. We begin with an analysis of ICE Air data released through the Freedom of Information Act (FOIA) from FY 2011-2018. In conjunction with analysis of this data, investigation into federal agency policy demonstrates that ICE Air Operations procedure is inconsistent, ambiguous, and unregulated. Secondly, we describe human rights abuses that have occurred aboard flights and analyze the efficacy of external accountability mechanisms, finding that while such abuses likely violate numerous U.S. statutes and international human rights agreements, privatized chains of contracting and subcontracting relationships mean there is virtually no accessible channel for oversight or remedy. The opacity of these private business relationships is demonstrated through the case study of King County, an immigrant-friendly jurisdiction that is nonetheless complicit in deportation flights, with an average of 300 deportees picked up from King County International Airport each month.Flight risk: ICE Air’s secrecy and systemic abuse in King County and beyond

U.S. Immigration and Customs Enforcement (ICE) deports tens of thousands of people each year through a system in which abuse is endemic and oversight is nonexistent. By failing to either regulate ICE or hold it accountable for abuse, the U.S. Federal Government is violating the human rights of deportees. This report focuses on the final link in the deportation process: ICE Air Operations deportation flights. We begin with an analysis of ICE Air data released through the Freedom of Information Act (FOIA) from FY 2011-2018. In conjunction with analysis of this data, investigation into federal agency policy demonstrates that ICE Air Operations procedure is inconsistent, ambiguous, and unregulated. Secondly, we describe human rights abuses that have occurred aboard flights and analyze the efficacy of external accountability mechanisms, finding that while such abuses likely violate numerous U.S. statutes and international human rights agreements, privatized chains of contracting and subcontracting relationships mean there is virtually no accessible channel for oversight or remedy. The opacity of these private business relationships is demonstrated through the case study of King County, an immigrant-friendly jurisdiction that is nonetheless complicit in deportation flights, with an average of 300 deportees picked up from King County International Airport each month

A defect in KCa3.1 channel activity limits the ability of CD8+T cells from cancer patients to infiltrate an adenosine-rich microenvironment

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