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The access of rural societies to welfare opportunities and resources is at the core of policy and research agendas. The persistent ruralurban gap increases the risks of exclusion and is a challenge that rural dwellers tackle by bolstering their mobility to access labour markets, resources and services. The car has become a vector in the connections and transformations that sustain rural life; however, this mobility is also a source of new fractures in social and territorial cohesion. This paper explores how the rural mobility system has been shaped and analyses its impact on these societies. The results suggest integrating the issue of mobility into rural policies from a more complex sociological perspective, addressing demographic challenges, regional development and territorial cohesion. [ABSTRACT FROM AUTHOR]

Objective Patient-centered care is the cornerstone of the healthcare system’s priorities. Attaining this goal necessitates a comprehensive understanding of patients’ encounters within the healthcare system to identify areas for quality improvement. To achieve this, healthcare providers and regulators require dependable, cost-effective, and user-friendly tools to assess and report the quality of patients’ healthcare experiences as part of ongoing service quality audits. The Waterloo Wilfrid Laurier University rehabilitation patient experience instrument (WatLX) is a valid and reliable instrument for measuring patients’ experiences in outpatient rehabilitation services. Accordingly, this study explores the psychometric properties of the Persian version of the WatLX in Persian-speaking people receiving outpatient rehabilitation services. Materials & Methods In this descriptive methodological study, we enrolled 115 adults aged 18 and above, possessing a suitable cognitive level, who had undergone at least one program of musculoskeletal, neurological, stroke, speech, and language rehabilitation services on an outpatient basis. The research targeted 10 centers and clinics specializing in physiotherapy, occupational therapy, and speech therapy, strategically selected across five geographical areas of Tehran (North, South, East, West, and Center) in the year 2023, utilizing an available sampling method. The participants were asked to complete the following three questionnaires: WatLX, abbreviated mental test, and the Medrisk instrument for measuring patient satisfaction with physical therapy care. Additionally, participants’ background information was collected. The Persian-translated questionnaire was examined for face and content validity using the Lavashe method. The convergent validity was established through comparison with the Medrisk questionnaire. The Cronbach α value was computed to evaluate the internal consistency, while the test re-test reliability involved 39 subjects completing the questionnaire again 15 days after the initial test, with calculating the intraclass correlation coefficient. Data analysis was performed using the SPSS software, version 23. Results The questionnaire underwent rigorous scrutiny for content validity by experts in physiotherapy, occupational therapy, speech therapy, rehabilitation management, and statistics. The results revealed strong internal consistency (Cronbach α=0.802), high test re-test reliability (intraclass correlation coefficient=0.974), and satisfactory convergent validity, demonstrated by the significant Spearman correlation coefficient of 0.503 with the Medrisk questionnaire. Conclusion The Persian version of the WatLX tool exhibits commendable psychometric properties, making it a reliable instrument for assessing the experiences of Persian-speaking Iranian patients in outpatient rehabilitation services. Its robustness suggests its applicability in both clinical settings and future research studies. [ABSTRACT FROM AUTHOR]

Objective Proper physical activities play an important role in reducing disease and mortality in old age, and is one of the main causes of active aging; however, the fear of falling is a barrier to having proper physical activity. Due to the difference between the elderly living in urban and rural areas regarding the risk factors of fear of falling and the amount and type of physical activity, this study aims to investigate and compare the fear of falling, physical activity, and activities of daily living (ADL) in the elderly living in urban and rural areas of Konarak County, Iran. Materials & Methods In this analytical cross-sectional study, 350 elderly people aged ≥60 years, who were under the coverage of comprehensive rural and urban health service centers in Konarak, Sistan and Baluchestan province (224 from rural areas and 126 from urban areas) were selected using a random sampling method and based on the inclusion and exclusion criteria. In addition to recording their demographic information, their fear of falling, physical activity, and ADL were measured by the Persian version of falls efficacy scale-international (FES-I), Rapid Assessment of Physical Activity (RAPA), ADL scale, and Instrumental ADL scale (IADL), respectively. Results The mean overall age of the elderly was 68.48±7.84 years (69.53±8.29 years in the rural group and 66.62±6.61 years in the urban group), and there was a significant difference between the two groups in terms of age (P<0.001). Pearson correlation test results showed that the FES-I score had a statistically significant negative relationship with the scores of ADL, IADL, and RAPA1 in total and in each group (P<0.001), but there was no statistically significant relationship between the FES-I score and the RAPA2 neither in total (P=0.40) and nor in rural (P=0.38) and urban (P=0.81) groups. Conclusion The fear of falling is significantly higher in the elderly living in rural areas of Konarak county compared to those living in urban areas. The RAPA1 and basic ADL of the elderly living in urban areas are higher compared to those living in rural areas, but there is no significant difference between them in RAPA2 and IADL. In addition, fear of falling has a significant relationship with physical activity of the elderly in overall and in rural and urban groups. [ABSTRACT FROM AUTHOR]

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