Search

Effective cardiac rehabilitation (CR) programming is essential to minimizing cardiovascular disease (CVD) burden. Although high levels of stress are associated with increased onset and progression of CVD, stress management training (SMT) is not routinely included in traditional CR. This dual approach study explored the potential added benefits of combining SMT with exercise-based CR from both a quantitative and qualitative perspective. First, anonymized data from 1184 participants (Mean (M) ± Standard Deviation (SD); Age: 65.1±10.4 years) were extracted from the participating CR program's database and grouped into CR-alone (n=1003; Age: 64±11.1 years) and CR+SMT (n=181; Age: 64.0±10.1 years). Significant increases (p=0.029) in the CR+SMT group (pre: 6.83±3.03 to post: 9.27±3.49) was observed in MET levels compared to the CR-alone group (pre: 6.19±2.68 to post: 8.31±3.18). Comparable improvements (all p>0.05) were found between groups in all other CR outcome measures (e.g., HDL, LDL, DBP, SBP, non-HDL, TG). Next, semi-structured interviews were conducted in a sub-set of CR+SMT participants (n=9; Age: 69.6 years±12.2 years). Following the thematic analysis, three key themes emerged. Participants: 1) had developed and sustained a healthier lifestyle, 2) valued the support provided to them, and 3) vocalized a wish for more (e.g., more flexibility in scheduling, more proof, and more guidance) throughout SMT programming. The results of this study are encouraging, demonstrating that the inclusion of SMT in CR programming may benefit participants beyond the physical and clinical outcomes, and provides an opportunity for intellectual, perceived, and social improvements. These findings indicate that the widespread inclusion of SMT offers much promise as a standard care practice and should be included routinely in CR programming.

Horse riding and horse-related interactions are inherently dangerous. When they occur on public roads, the risk profile of equestrian activities is complicated by interactions with other road users. Research has identified speed, proximity, visibility, conspicuity and mutual misunderstanding as factors contributing to accidents and near misses. However, little is known about their significance or incidence in Australia. To explore road safety issues amongst Australian equestrians, we conducted an online survey. More than half of all riders (52%) reported having experienced at least one accident or near miss in the 12 months prior to the survey. Whilst our findings confirm the factors identified overseas, we also identified issues around rider misunderstanding of road rules and driver misunderstanding of rider hand signals. Of particular concern, we also found reports of potentially dangerous rider-directed road rage. We identify several areas for potential safety intervention including (1) identifying equestrians as vulnerable road users and horses as sentient decision-making vehicles (2) harmonising laws regarding passing horses, (3) mandating personal protective equipment, (4) improving road signage, (5) comprehensive data collection, (6) developing mutual understanding amongst road-users, (7) safer road design and alternative riding spaces, and (8) increasing investment in horse-related safety initiatives.