ABSTRACT
The increasingly interconnected, fast-moving, unmanageable and unpredictable world brings with it an unprecedented variety of known and as yet unknown challenges and risks. Some of the global risks have a direct impact on critical infrastructures as well as those of energy supply in particular. A high level of functionality of critical infrastructures (CRITIS), which include the sectors of energy, information technology and telecommunications, transportation and traffic, health, water, food, finance and insurance, government and administration, as well as media and culture, is indispensable for a modern industrial society. In the context of the Corona crisis of 2020/2021, the worldwide inadequate preparation for pandemics became obvious, although the probability of epidemic outbreaks and their global spread has increased significantly in recent decades and was thus predictable to a certain extent. Moreover, it has been shown that in a globally interconnected world, complex crisis phenomena can mutually amplify and thus escalate within a short period of time. In particular, the deficits in preparedness for major risks that became apparent in the course of the Corona pandemic cannot be managed by nation states alone, especially since the probability of such events has risen continuously in recent decades and will continue to increase with growing globalization and urbanization and, in particular, as a result of climate change and its consequences. This publication addresses the challenges of energy resilience and climate protection, which will require immense attention in the future. © Springer Fachmedien Wiesbaden GmbH, part of Springer Nature 2022. All rights reserved.
ABSTRACT
Introduction: COVID-19 significantly affected outpatient cardiac rehabilitation which is a central resource for patients recovering from cardiovascular disease. The aim of the study was to examine the impact of COVID-19 on Cardiac Rehabilitation (CR) Phase II clinical outcomes. Method(s): A single-site retrospective chart review of CR Phase II patients who completed 12 or more visits during 2019 (pre-COVID) and 2020 (COVID) was performed. Depression was measured using the PHQ-9, functional capacity was measured by the 6-minute walk in distance (ft) and metabolic equivalents (METs), and quality of life (QOL) was measured by the Ferrans and Powers Index. Descriptive and linear mixed methods were used to analyze the data. Result(s): A total of 212 patients who were predominately male 67% and 66.5 (SD=10.8) years old were included. PHQ-9 results showed a significant interaction COVID*pre-post scores F(1, 119.66) = 4.66, p = 0.03. For the remaining scores, all results showed significant improvements in pre-post: distance F(1, 151.90) = 226.92, p <.001;METs F(1, 180.13) = 138.7, p <.001;and QOL F(1, 145.32) = 5.89, p =0.02. Interactions were not significant for the three variables. QOL results showed significant differences in the COVID group with F(1, 239.12) = 6.13, p = 0.01. Conclusion(s): All four outcomes improved significantly in the pre-COVID and COVID sample. COVID significantly impacted depression PHQ-9 score change, with a pre-post improvement of 0.62 points in the pre-COVID group and 2.08 points during COVID. Finally, the mean overall QOL score was significantly lower in the COVID group than the pre-COVID group.