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Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Internet use predicts greater social participation after tetraplegia injury. • Adding computer assistive technology further increases social participation rates. • Ethnic and racial disparities exist for technology use, income, and education. • Income and race inequities contribute to lower socialization after tetraplegia spinal cord injury. The first aim of this study was to determine whether the use of computers, internet, and computer assistive technology (AT) increased social participation after tetraplegia spinal cord injury. The second aim was to determine whether racial or ethnic disparities of technology use were experienced. A secondary analysis of data collected by the National Spinal Cord Injury Models Systems Study (NSCIMS), an ongoing observational cohort study, was performed on a sample of 3096 participants who experienced a traumatic tetraplegic injury. Participants included were at least 1-year posttraumatic tetraplegia injury and participated in NSCIMS between 2011 and 2016 (N=3096). NSCIMS observational data were originally collected via in-person or phone interviews. Not applicable. A binary logistic regression was conducted to determine whether self-reported use of computers or similar device, the internet, computer AT, race, ethnicity, and other demographics predicted high (≥80) vs low/medium (<80) social participation, measured by the Craig Handicap and Reporting Technique social integration standardized measure. Combined use of a computer, AT, and the internet predicted greater social integration by almost 175% (95% confidence interval [CI], 2.0-3.78; P <.001) compared with no device or internet use. Racial and ethnic disparities were discovered. Black participants had 28% lower odds of high social integration than White participants (95% CI, 0.56-0.92; P <.01). Hispanic ethnicity predicted 40% lower odds of high social integration compared with non-Hispanic participants (95% CI, 0.39-0.91; P =.018). The internet presents an opportunity to reduce barriers to social participation and increase overall social integration after tetraplegia. However, race, ethnic, and income inequities prevent or limit access to the internet, computers, and AT after tetraplegia for Black and Hispanic people. [ABSTRACT FROM AUTHOR]

Introduction: Reviews within the field of assistive technology have shown that a client-centered approach is important for user satisfaction, and that assistive technology service delivery should be evidence-based, systematic, and structured. However, client-centered instruments and systematic, structured models are not used consistently. As part of a larger research project, an evidence-based, client-centered assistive technology service delivery process was developed and piloted. The purpose of this study was to investigate occupational therapists' perspectives on this evidence-based, client-centered assistive technology intervention. Method: Ten occupational therapists, from two Danish municipalities, participated in focus groups. Data were analyzed based on a hermeneutic approach. Results: Three themes emerged from the analysis: a more refined collaboration with clients; advantages of using theoretical frameworks, structured models and instruments and challenges in using the intervention. Conclusion: By using the evidence-based, client-centered intervention, the occupational therapists found that the collaboration with the clients was refined—more emphasis was placed on shared responsibility. They found that the intervention was time-efficient in the long run; however, there seems to be a particular challenge in designing services that are inclusive of clients with cognitive limitations. [ABSTRACT FROM AUTHOR]

To quantify mobility scooter performance when traversing snow, ice, and concrete in cold temperatures and to explore possible performance improvements with scooter winter tires. Cross-sectional. Hospital-based research institute. Two drivers (50 and 100 kg) tested 8 scooter models (N=8). Two mobility scooters were used for winter tire testing. Scooters were tested on 3 different conditions in a random sequence (concrete, 2.5-cm depth snow, bare ice). Ramp ascent and descent, as well as right-angle cornering up to a maximum of 10° slopes on winter conditions, were observed. Winter tire testing used the same slopes with 2 scooters on bare and melting ice surfaces. Maximum achievable angle (MAA) and tire traction loss for ramp ascent and descent performance. The ability to steer around a corner on the ramp. All scooters underperformed in winter conditions, specifically when traversing snow- and ice-covered slopes (χ2 [2, N=8]=13.87-15.55, P <.001) and corners (χ2 [2, N=8]=12.25, P <.01). Half of the scooters we tested were unable to climb a 1:12 grade (4.8°) snow-covered slope without losing traction. All but 1 failed to ascend an ice-covered 1:12 grade (4.8°) slope. Performance was even more unsatisfactory for the forward downslopes on both snow and ice. Winter tires enhanced the MAA, permitting 1:12 (4.8°) slope ascent on ice. Mobility scooters need to be designed with winter months in mind. Our findings showed that Americans with Disabilities Act–compliant built environments, such as curb ramps that conform to a 1:12 (4.8°) slope, become treacherous or impassible to mobility scooter users when covered in ice or snow. Scooter manufacturers should consider providing winter tires as optional accessories in regions that experience ice and snow accumulation. Additional testing/standards need to be established to evaluate winter mobility scooter performance further. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs. Retrospective cohort study. Data were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business). A data set of 4743 cases was included in the analysis (N=4743). Not applicable. FMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area. Ordinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P <.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ220=1739.18, P <.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P <.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain. The relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes. [ABSTRACT FROM AUTHOR]

[Display omitted] Current approaches for generating high-quality research evidence for technology-based interventions in the field of disability and rehabilitation are inappropriate. Prevailing approaches often focus on randomized controlled trials as standard and apply clinical trial practices designed for pharmaceuticals; such approaches are unsuitable for technology-based interventions and are counterproductive to the goals of supporting people with disabilities and creating benefits for society. This communication is designed to: (1) advocate for the use of alternative approaches to generating evidence in the development and evaluation of technology-based interventions; (2) propose an alternative framework and guiding principles; and (3) stimulate action by multiple disciplines and sectors to discuss, adopt, and promote alternative approaches. Our Framework for Accelerated and Systematic Technology-based intervention development and Evaluation Research (FASTER) is informed by established innovation design processes, complex intervention development, evaluation, and implementation concepts as well as our collective experiences in technology-based interventions research and clinical rehabilitation practice. FASTER is intended to be meaningful, timely, and practical for researchers, technology developers, clinicians, and others who develop these interventions and seek evidence. We incorporate research methods and designs that better align with creating technology-based interventions and evidence for integration into practice. We propose future activities to improve the generation of research evidence, enable the selection of research methods and designs, and create standards for evidence evaluation to support rigor and applicability for technology-based interventions. With this communication we aim to improve and advance technology-based intervention integration from conception to use, thus responsibly accelerating innovation to have greater positive benefit for people and society. [ABSTRACT FROM AUTHOR]

To investigate the impact of assistive technologies (AT) on caregiver involvement for persons with disabilities to identify needs and knowledge gaps. This will inform the implementation of an online resource hub designed to facilitate access to AT. This study involves conducting semi-structured interviews with caregivers of persons living with disabilities to collect qualitative data to investigate the impact of AT on each health-related domain of the WHO-ICF. A participatory action research approach was used in this initiative to inform the development of a multi-faceted resource hub that seeks to (1) facilitate the exchange of AT; and (2) provide AT-related resources. Interviews were conducted using an online platform to inform the design and development of a web-based resource hub with community outreach in Ontario, Canada. A semi-structured interview guide was created by a team of researchers, persons with lived experience and trainees to examine the impact and role of assistive devices on caregivers who help to manage the care and daily living activities of persons with disabilities. Not Applicable. Through adopting an interpretative phenomenological approach, a thematic analysis of the caregiver interview responses was used to understand the impact of AT (interviews are continuing until saturation is reached). Many patient-caregiver partnerships encounter financial and access-related barriers to obtaining the AT required to promote independence and participation. Preliminary themes include, (1) AT as a means to alleviate caregiver stressors; (2) barriers to the access of AT; and (3) AT to promote the quality of living for persons with disabilities and subsequent partners in care. Through gathering the perspectives of caregivers, an online solution that seeks to promote access and affordability of AT will ensure that all partners in care are well-supported in managing their own health, and the health of others. None to disclose. [ABSTRACT FROM AUTHOR]

To assess potential positive and negative impacts of implementing Possibilities Project Plus, a free assistive technologies marketplace and information hub for persons with disabilities. Health equity impact assessments (HEIA) are being conducted iteratively through a participatory approach using the HEIA tool developed by the Ontario Ministry of Health and Long-Term Care (MOHLTC). Methods to collect data consisted of broad streams of evidence including, literature reviews, consultations, and environmental scans. Academic health center based in London, Ontario partnering with community members and organizations across the province. The interdisciplinary program team consists of students, clinicians, researchers, end-users, and policy directors. Participants include individuals with lived experience, caregivers for individuals with disabilities, service providers, stakeholder organizations supporting marginalized populations, and various affected groups as identified. Not applicable. The main outcomes will be identified through the HEIA tool's framework for analysis which includes the following categories: Determinants of Health, Potential Impacts, Mitigation, Monitoring and Dissemination. Results from analysis provided positive and negative impacts of the program that can be respectively addressed. One potential risk identified was the limited accessibility of a strictly online platform for individuals with limited internet access. A mitigation strategy was created by collaborating with the affected groups to ensure a commitment to equity. The two-part solution included the identification of an in-person hub for the program and the creation of partnerships with similar organizations to enable province wide, in-person access. The Possibilities Project Plus intends to address a gap in assistive technology service delivery for individuals with disabilities. As such, it is necessary to identify and avoid any unintended disparities in its creation. The HEIA provides a powerful framework to ground this program on principles of equity, inclusion, and diversity with a focus on the marginalized groups we aim to serve. None to disclose. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement. [ABSTRACT FROM AUTHOR]

Background: Launched in 2006 for patients with amyotrophic lateral sclerosis, PatientsLikeMe is an online community offering patient-reported outcomes, symptom tracking, and social features. Every member of the site can see all the data reported by every other member, view aggregated reports, identify "patients like them," and learn about treatment options in order to live better with their condition. In previous studies, members reported benefits such as improved condition knowledge, increased medication adherence, and better management of side effects. However, the site evolved in 2011 from condition-specific "vertical" communities consisting only of people with the same disease to a "generalized platform," in which every patient could connect with every other patient regardless of condition and with generic, rather than condition-specific, data tools. Some, but not all, communities received further custom tracking tools.Objective: We aimed to understand (1) whether members of PatientsLikeMe using the generalized platform still reported similar benefits and (2) assess factors associated with benefits, such as community customization, site use, and patient activation.Methods: A cross-sectional retrospective custom survey was fielded to 377,625 members between 2016 and 2017 including the Patient Activation Measure (PAM). A benefit index was developed for comparability across conditions.Results: The invitation was viewed by 26,048 members of whom 11,915 did not respond, 5091 opted out, 1591 provided partial data, and 17 were screened out. Complete responses were received from 7434 participants. Users perceived greatest benefit in understanding how their condition may affect them (4530/6770, 66.91% participants, excluding "does not apply" answers), understanding what might help them live better with their condition (4247/6750, 62.92%), which treatments were available (4143/6898, 60.06%), understanding treatment side effects (4182/6902, 60.59%), and important factors in making treatment decisions (3919/6813, 57.52%). The benefit index was 29% higher for the "most activated" patients (PAM level 4 vs PAM level 1; relative risk [RR]=1.29, P<.001), 21% higher for conditions with some community customization versus none (RR=1.21, P<.001), and 11% higher in those using the site most often versus least (RR=1.11, P<.001).Conclusions: Members of the generalized platform reported a range of benefits related to improved knowledge and understanding of their condition and treatment management. Condition-specific customization may improve their experience still further. Future studies will explore longitudinal changes to patient activation. [ABSTRACT FROM AUTHOR]

Copyright of Scientia Medica is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective The purpose of this study was to perform a needs assessment to determine whether short-term use of BackJoy SitSmart Relief and Spine Buddy LT1 H/C chair supports influences neck, upper back, and lower back pain. Methods Forty-eight college students (age, 27.5 ± 6.3 years; height, 1.72 ± 0.08 m; body mass, 78.7 ± 19.8 kg; time seated that day, 4.3 ± 2.8 hours; means ± SD) were recruited for this study. The Nordic Musculoskeletal Questionnaire was used to measure pain for the neck, upper back, and lower back regions. Subjects were randomized to sit in a stationary office chair for a single 12-minute period under 1 of 4 conditions: office chair only (control group), BackJoy SitSmart Relief and chair, freezer-cooled Spine Buddy LT1 H/C and chair, or microwave-heated Spine Buddy LT1 H/C and chair. Participants then completed a posttest Nordic Musculoskeletal Questionnaire. A between-within repeated-measures analysis of variance using the between-subject factor intervention (group) and within-subject factor time (baseline and posttest) was used to analyze study data. Results The main effect of time across the whole sample was statistically significant for neck ( P = .000), upper back ( P = .032), and lower back ( P = .000) pain; however, there was no statistically significant interaction effect between intervention and time. Thus, as long as participants sat down and rested, symptoms improved similarly across the different groups. Conclusions In this preliminary study, short-term and single use of a support product for an office chair had no additive effect on reducing neck and back pain. [ABSTRACT FROM AUTHOR]

Copyright of Revista CEFAC is the property of Revista CEFAC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To determine whether differences could be detected in mobility outcomes during community mobility and home mobility tasks according to type of mobility assistive device. Design Randomized, repeated measures. Setting Community mobility task: traversing 341.4m between the rehabilitation clinic and hospital entrance; home mobility task: traversing 39m into and out of a patient training bathroom and bedroom. Participants Community-dwelling, cognitively intact ambulatory veterans (N=59) who used a mobility device within the 14 days prior to the study. Interventions Participants tested 3 types of mobility assistive devices with wheels: 4-wheeled walker (WW), manual wheelchair (MWC), and powered wheelchair (PWC). The first and last devices used by each participant were randomly assigned as either MWC or WW. The PWC was always the second device. Main Outcomes Measures Speed (m/s), collisions (total), fatigue (0–10 Likert scale), and pain (0–10 Likert scale, diagram). Results The community mobility task was performed with all 3 devices by 52 (88%) veterans, and the home mobility task was performed with all 3 devices by 53 (90%) participants. In each task, 28 participants used the WW and 28 participants used the MWC as the final device. In the community mobility task, statistically significant differences ( P <.05) were seen with ≥1 device comparison for all studied outcomes (eg, standardized mean difference for the MWC compared with the PWC showed −.67 fewer collisions for the MWC). In the home mobility task, speed, collisions, and fatigue showed statistically significant ( P <.05) device-related differences (eg, standardized mean difference for the WW compared with the MWC showed −.88 fewer collisions for the WW). Conclusions We found statistically significant and substantively different effects from 3 commonly used mobility assistive devices with wheels on diverse mobility outcomes when used in typical community mobility and home mobility tasks, providing proof of concept support for a research methodology applicable to comparative outcome studies of diverse mobility aids. [ABSTRACT FROM AUTHOR]

Copyright of Revista CEFAC is the property of Revista CEFAC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: To determine the parent-reported functional outcomes associated with adaptive seating devices for wheeled mobility devices used by young people aged 1 to 17 years. Design: Longitudinal case series. Setting: Homes of participating parents. Participants: Parents (N=70, 63 mothers, 6 fathers, 1 grandmother) who had children with adaptive seating needs. Intervention: Adaptive seating system for wheeled mobility devices. Main Outcome Measure: Family Impact of Assistive Technology Scale for Adaptive Seating (FIATS-AS). Results: All parents completed the FIATS-AS 4 times—2 times before and 2 times after their child received a new adaptive seating system. Mixed-design analysis of variance did not detect significant mean differences among the FIATS-AS scores measured at baseline and 2 and 8 months after receiving the seating system (F2,134=.22, P=.81). However, the FIATS-AS detected a significant interaction between age cohort and interview time (F4,134=4.5, P<.001, partial η2=.16). Post hoc testing confirmed that 8 months after receiving the seating system was associated with a large improvement in child and family functioning for children <4 years, maintenance of functioning for children between 4 and 12 years, and a moderate decline in functioning for youth between 13 and 17 years. Conclusions: Adaptive seating interventions for wheeled mobility devices are associated with functional changes in the lives of children and their families that interact inversely with age. Future controlled longitudinal studies could provide further empirical evidence of functional changes in the lives of children and their families after the introduction and long-term use of specific adaptive seating interventions. [Copyright &y& Elsevier]

Abstract: Objective: To describe the characteristics across all ages of powered wheelchair users and the assistive technology prescribed by a regional specialist wheelchair service. Design: Cross-sectional study. Setting: Regional wheelchair service. Participants: Electric-powered indoor/outdoor wheelchair (EPIOC) users (N=544) with 262 boys and men (mean age ± SD, 41.7±20.7y; range, 8–82y) and 282 girls and women (mean age ± SD, 47.2±19.7y; range, 7–92y). Interventions: Not applicable. Main Outcome Measures: Demographic, clinical/diagnostic details of EPIOC recipients, including pain, (kypho)scoliosis, and ventilators. Technical features, including specialized (adaptive) seating, tilt in space, and modified control systems. Factors were related to age groups: 1 (0–15y), 2 (16–24y), 3 (25–54y), 4 (55–74y), and 5 (≥75y). Results: Neurologic/neuromuscular conditions predominated (81%) with cerebral palsy (18.9%) and multiple sclerosis (16.4%). Conditions presenting at birth or during childhood constituted 39%. Of the participants, 99 had problematic pain, 83 had (kypho)scoliosis, and 11 used ventilators. Specialized (adaptive) seating was provided to 169 users (31%); most had cerebral palsy or muscular dystrophy. Tilt in space was used by 258 (53%) participants. Younger people were more likely to receive tilt in space than older ones. Only 92 had specialized (adaptive) seating and tilt in space (mean age ± SD, 29±17.8y; range, 8–72y). Of the participants, 52 used modified control systems. Conclusions: The diversity of EPIOC users across age and diagnostic groups is shown. Their complex interrelations with these technical features of EPIOC prescriptions are explored. Younger users were more complex because of age-related changes. This study provides outcomes of the EPIOC prescription for this heterogeneous group of very severely disabled people. [Copyright &y& Elsevier]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE. We identified the extent of the need for interventions and assistive technology to prevent computer use problems in people with systemic sclerosis (SSc) and the accommodation strategies they use to alleviate such problems. METHOD. Respondents were recruited through the Scleroderma Foundation. Twenty-seven people with SSc who used a computer and reported difficulty in working completed the Computer Problems Survey. RESULTS. All but 1 of the respondents reported one problem with at least one equipment type. The highest number of respondents reported problems with keyboards (88%) and chairs (85%). More than half reported discomfort in the past month associated with the chair, keyboard, and mouse. Respondents used a variety of accommodation strategies. CONCLUSION. Many respondents experienced problems and discomfort related to computer use. The characteristic symptoms of SSc may contribute to these problems. Occupational therapy interventions for computer use problems in clients with SSc need to be tested. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Mortenson WB, Miller WC, Backman CL, Oliffe JL. Predictors of mobility among wheelchair using residents in long-term care. Objective: To identify predictors of mobility among long-term care residents who use wheelchairs as their main means of mobility. Based on the Matching Person to Technology Model, we hypothesized that wheelchair-related, personal, and environmental factors would be independent predictors of mobility. Design: Cross-sectional study. Setting: Eleven long-term residential care facilities in the lower mainland of British Columbia, Canada. Participants: Residents (N=268): self-responding residents (n=149) and residents who required proxy respondents (n=119). Interventions: Not applicable. Main Outcome Measures: Mobility was measured using the Nursing Home Life-Space Diameter. Standardized measures of personal, wheelchair-related, and environmental factors were administered and sociodemographic data were collected as independent variables. Results: Independent mobility decreased as the distance from the resident''s room increased: 63% of participants were independently mobile on their units, 40% were independently mobile off their units within the facilities, and 20% were independently mobile outdoors. For the total sample, the significant predictors of mobility, in descending order of importance, were: wheelchair skills (including the capacity to engage brakes and maneuver), functional independence in activities of daily living, having 4 or more visits per week from friends or family, and use of a power wheelchair. This regression model accounted for 48% of variance in mobility scores. Conclusions: Limited independent mobility is a common problem among facility residents. Residents may benefit from interventions such as wheelchair skills training or provision of powered mobility, but the effectiveness of these interventions needs to be evaluated. [Copyright &y& Elsevier]

Abstract: McClure LA, Boninger ML, Oyster ML, Roach MJ, Nagy J, Nemunaitis G. Emergency evacuation readiness of full-time wheelchair users with spinal cord injury. Objectives: To determine the percentage of full-time wheelchair users with spinal cord injuries who felt they could evacuate from various locations, and the percentage who have a plan for evacuation. Study results will help clinicians and emergency officials understand needs related to evacuation preparedness. Design: Convenience sample survey. Setting: Six Spinal Cord Injury Model System centers, part of the national database funded through the Department of Education, National Institute on Disability and Rehabilitation Research. Participants: People (N=487) with spinal cord injuries who use a wheelchair more than 40 hours a week. Interventions: Not applicable. Main Outcome Measures: The percentage of wheelchair users who felt they would be able to safely evacuate, had a plan for safe evacuation, or reported a need for assistive technology and human assistance to evacuate from various locations in the event of an emergency. Results: The highest percentage of participants felt they would be able to safely evacuate and had a plan for work evacuation. The lowest percentage of participants reported they could evacuate from their city/town in the event of an emergency and had a plan to evacuate their city/town in the event of a natural disaster. A large difference exists between the percentage of participants who felt they could evacuate and those who have a plan for evacuation. Conclusions: A large discrepancy exists between the perception that one can evacuate and actually having a plan. The perception that one can evacuate without a plan or the use of assistive technology is an area of concern that must be further addressed by educators. Education must emphasize the need to have a defined evacuation plan and effective utilization of assistive technology. [Copyright &y& Elsevier]

Abstract: Ganesh SP, Fried LP, Taylor DH Jr, Pieper CF, Hoenig HM. Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women. Objective: To describe the relationship between lower extremity physical performance, self-reported mobility difficulty, and self-reported use of compensatory strategies (CSs) for mobility inside the home. Design: Cross-sectional exploratory study. Setting: Community-dwelling elders. Participants: Disabled, cognitively intact women 65 years or older (N=1002), from the Women''s Health and Aging Study I. Interventions: Not applicable. Main Outcome Measures: CS scale: no CS, behavioral modifications (BMs) only, durable medical equipment (DME) with or without use of BMs, and any use of human help (HH); and 3 dichotomous CS measures: any CS (vs none); DME+HH (vs BMs only, among users of any CS); any HH (vs DME only, among users of any DME/HH). Results: Self-reported mobility difficulty and physical performance were significantly correlated with one another (r=−.57, P<.0001) and with the CS scale ([r=.51, P<.001] and [r=−.54, P<.0001], respectively). Sequential logistic regressions showed self-reported difficulty and physical performance were significant independent predictors of each category of CS. For the any CS and DME+HH models, the odds ratio for self-reported difficulty decreased by approximately 50% when physical performance was included in the model, compared with difficulty alone ([18.0 to 8.6] and [7.3 to 3.8], respectively), but both physical performance and difficulty remained significant predictors (P<.0001). The effects of covariates differed for the various CS categories, with some covariates having independent relationships to CS, and others appearing to have moderating or mediating effects on the relationship of self-reported difficulty or physical performance to CS. Conclusions: Physical performance, self-reported difficulty, health conditions, and contextual factors have complex effects on the way elders carry out mobility inside the home. [Copyright &y& Elsevier]

Davies TC, Chau T, Fehlings DL, Ameratunga S, Stott NS. Youth with cerebral palsy with differing upper limb abilities: how do they access computers? Objective: To identify the current level of awareness of different computer access technologies and the choices made regarding mode of access by youth with cerebral palsy (CP) and their families. Design: Survey. Setting: Two tertiary-level rehabilitation centers in New Zealand and Canada. Participants: Youth (N=60) with CP, Manual Ability Classification Scale (MACS) levels I to V, age 13 to 25 years. Interventions: Not applicable. Main Outcome Measure: Questionnaire. Results: Fifty (83%) of the 60 youth were aware of at least 1 available assistive technology (AT), such as touch screens and joysticks. However, only 34 youth (57%) were familiar with the accessibility options currently available in the most common operating systems. Thirty-three (94%) of 35 youth who were MACS I and II used a standard mouse and keyboard, while few chose to use assistive technology or accessibility options. In contrast, 10 (40%) of 25 youth who were MACS III to V used a variety of assistive technologies such as touch screens, joysticks, trackballs, and scanning technologies. This group also had the highest use of accessibility options, although only 15 (60%) of the 25 were aware of them. Conclusion: Most youth with CP were aware of, and used, assistive technologies to enhance their computer access but were less knowledgeable about accessibility options. Accessibility options allow users to modify their own computer interface and can thus enhance computer access for youth with CP. Clinicians should be knowledgeable enough to give informed advice in this area of computer access, thus ensuring that all youth with CP can benefit from both AT and accessibility options, as required. [Copyright &y& Elsevier]

We examined the effect that long-handled shoehorn (LHSH) length and body mass index (BMI) have on hip range of motion (ROM) in female adults. Thirty-eight female participants were asked to don a shoe using 18-, 24-, and 30-in. LHSHs. Significant differences in hip flexion were found between the 18- and the 24-in. shoehorns and between the 18- and the 30-in. shoehorns. A significant positive relationship was found between BMI and internal rotation for each of the LHSHs. The results suggest that healthy women with low BMIs using a 24- or 30-in. LHSH have the greatest chance of not violating hip flexion or hip internal rotation ROM precautions. Implications suggest that therapists consider individual BMI and available hip ROM before prescribing an LHSH. A follow-up study is needed involving populations who would likely benefit from using LHSHs. [ABSTRACT FROM AUTHOR]

Abstract: Auger C, Demers L, Gélinas I, Miller WC, Jutai JW, Noreau L. Life-space mobility of middle-aged and older adults at various stages of usage of power mobility devices. Objective: To examine whether the impact of power mobility devices (PMDs) varies as a function of stage of usage and to explore key factors associated with greater life-space mobility for middle-aged and older adults. Design: Multicohort study with respondents grouped as a function of stage of PMD usage (reference group with mobility impairments, n=42; initial users, 1–6mo, n=35; long-term users, 12–18mo, n=39). Cohorts were compared with respect to life-space mobility in a continuum of environments ranging from home to outside town, using analysis of variance and chi-square tests. Baseline personal, assistive device, intervention, and environmental factors associated with life-space mobility were explored with age-adjusted linear regression models. Setting: Four Canadian rehabilitation centers. Participants: Random sample of middle-aged and older adults (N=116; 50–89y) living in the community or residential care. Intervention: Procurement of a powered wheelchair or scooter. Main Outcome Measure: Life-Space Assessment composite score. Results: Cohort comparisons showed higher frequency of outings for PMD users in the neighborhood (P<.001) and around home (P<.05) and significantly greater Life-Space Assessment composite scores for initial and long-term users than for the reference group (P<.05). Factors such as sex, the nature of activities, and device type explained variances in Life-Space Assessment composite score ranging from 15.9% to 18.0% (P<.006). Conclusions: Life-space mobility increases after PMD use and remains stable across the stages of initial and long-term use. To appreciate the impact of PMDs, clinicians should consider the environment and a combination of personal and device factors that are associated with the range of life-space mobility in the first 18 months after procurement. [Copyright &y& Elsevier]

Abstract: Ward AL, Sanjak M, Duffy K, Bravver E, Williams N, Nichols M, Brooks BR. Power wheelchair prescription, utilization, satisfaction, and cost for patients with amyotrophic lateral sclerosis: preliminary data for evidence-based guidelines. Objectives: To determine the features most frequently selected in a power wheelchair (PWC), level of satisfaction with the selections, and how often the PWC features are used by patients diagnosed with amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). Design: Internally generated questionnaire. Setting: An ALS/Muscular Dystrophy Association center. Participants: Convenience sample of current patients (N=45) of our clinic with ALS/MND who are PWC users (men, n=27; women, n=18; age range, 27–85y). Intervention: Self-administered survey. Main Outcome Measure: Thirty-two patients completed a 31-question survey investigating patients'' patterns of selection, satisfaction, and frequency of PWC use; technical and psychometric influences; and other aspects of decision-making processes that patients experience before, during, and after acquiring a PWC. Results: Ninety percent of respondents received their evaluations at a multidisciplinary ALS clinic, 1 via the Department of Veterans Affairs, and 1 was unknown. Sixty-six percent of patients thought the chair evaluation was timed correctly, and 19% wished they had started sooner. Forty-five percent of people were able to walk a few steps, and 55% were able to stand when their chairs arrived. When they first received the chair, 79% were satisfied with the overall comfort of the chair, and 86% were satisfied with the ease of use; currently, 69% are satisfied with the overall comfort, and 72% are satisfied with ease of use. There was a statistically significant difference in how patients used their wheelchair features initially and currently in terms of seat elevate and attendant control, but not tilt, recline, and elevating leg rests. The average cost for the power chairs was $26,404 (range, $19,376–$34,311), and the average cost a month is $917. Overall, 88% of respondents said they would get the same type of chair with the same features again, and 81% felt that the chair was a good value for the cost. Conclusions: We obtained first-hand knowledge from 32 patients with ALS/MND who are current PWC users on their use and satisfaction with their PWCs from initial to current use. Based on this survey, patients with ALS/MND seen for their wheelchair evaluation with experienced clinicians exhibit high use and satisfaction with their PWCs. [Copyright &y& Elsevier]

The article presents a study which investigates the motor control and muscle activation differences between grasping naturally and grasping with a reacher in people without disability. It cites that 41 healthy participants without experience using a reacher were subjected to a series of four conditions. It notes that a three-dimensional Qualisys camera system was used to record the movements of wrist and fingers for reach and grasp assessment.

The Individuals With Disabilities Education Improvement Act of 2004 (IDEA) requires assistive technology (AT) be considered at the yearly individualized education program (IEP) meeting of every student in special education. IDEA also directs that AT be implemented on the basis of peer-reviewed literature despite a paucity of research on AT's effectiveness in the public schools. This repeated-measures quasi-experimental study explored AT's effect in a public school special education setting. Participants (N = 13) were a heterogeneous group of students in 1 school system who had newly provided AT to address academic and communication goals in one school year. Results suggest that relative to other interventions, AT provided by a multidisciplinary team may have a significant effect on IEP goal improvement (t[12] = 5.54, p = .00) for students in special education (F[2] = 9.35, p = .00), which may support AT's use in special education by occupational therapists as directed by IDEA. [ABSTRACT FROM AUTHOR]

Assistive technology (AT) devices enable people with disabilities to function in multiple contexts and activities. The usability of such devices is fundamentally indicative of the user's level of participation in multiple roles and occupations. Seventy people who used power wheelchairs were interviewed using a novel tool, the Usability Scale for Assistive Technology (USAT). The USAT uses a human factors science framework to investigate the wheelchair user's perceived independence in mobility-related activities within home, workplace, community, and outdoors in accordance with the characteristics of the wheelchair, environmental factors, and abilities and skills of the user to operate the wheelchair. Descriptive analysis of the data revealed usability issues with the use of power wheelchairs in all contexts. Users confronted far more significant issues within the community and outdoor environment compared with those at home and in the workplace. These issues have been elucidated and applied to an intervention framework with relevance to a multitude of AT stakeholders. [ABSTRACT FROM AUTHOR]

Abstract: Kristensen MT, Bandholm T, Holm B, Ekdahl C, Kehlet H. Timed Up & Go test score in patients with hip fracture is related to the type of walking aid. Objective: To determine the relationship between Timed Up & Go (TUG) test scores and type of walking aid used during the test, and to determine the feasibility of using the rollator as a standardized walking aid during the TUG in patients with hip fracture who were allowed full weight-bearing (FWB). Design: Prospective methodological study. Setting: An acute orthopedic hip fracture unit at a university hospital. Participants: Patients (N=126; 90 women, 36 men) with hip fracture with a mean age ± SD of 74.8±12.7 years performed the TUG the day before discharge from the orthopedic ward. Interventions: Not applicable. Main Outcome Measures: The TUG was performed with the walking aid the patient was to be discharged with: a walker (n=88) or elbow crutches (n=38). In addition, all patients also performed the TUG using a rollator. Results: Patients who performed the TUG with a walker were on average 13.6 (95% confidence interval [CI], 11.2–16.1) seconds faster using a rollator compared with the walker (P<.001). Correspondingly, patients who performed the TUG with crutches were on average 3.5 (95% CI, 1.5–5.4) seconds faster using a rollator compared with elbow crutches (P=.001). In both patient groups, the between walking-aid scores were strongly correlated (r>.833, P<.001). Conclusions: TUG scores are significantly related to the type of walking aid used during the test in patients with hip fracture who are allowed FWB when discharged from the hospital, but all patients were able to perform the TUG using the rollator as a standardized walking aid. Our findings indicate the importance of using a standardized walking aid when evaluating changes or comparing TUG scores in patients with hip fracture. [Copyright &y& Elsevier]

OBJECTIVE. The use and nonuse of assistive technology devices in school by students with physical disabilities was investigated, and the students' experiences in using these devices is described. METHOD. We used a mixed-methods approach with predominantly qualitative methods to collect and analyze data, which included observations of and interviews with 20 students with physical disabilities and the number and type of assistive technology devices provided. RESULTS. It is vital that devices be integrated into educational practice and that students experience immediate benefits for their function in everyday school activities without detrimental effects on their social participation. The latter was often more important than being able to perform activities independently. CONCLUSION. The students adopted both a functional and a psychosocial perspective of their devices, and providers should neglect neither. Children and youth need both verbal information and practical experience using devices to be able to make informed decisions. [ABSTRACT FROM AUTHOR]

Intermittent self-catheterization is common for patients who have neurogenic bladder associated with traumatic brain injury (TBI). Intermittent self-catheterization is considered the gold standard for bladder drainage because of the significantly decreased incidence of urinary tract infection in comparison with other catheterization methods. Occupational therapists educate patients in how to complete intermittent self-catheterization and assist them with adaptive equipment so that they may catheterize themselves independently. This case study describes adaptive equipment fabricated to allow a male patient with TBI who was independent with intermittent self-catheterization to continue independent intermittent self-catheterization after a second injury resulting in hemiplegia. Without the use of his left hand, the patient could not complete self-catheterization; therefore, a trough-shaped prop was fabricated to maintain the penis in an upright, lengthened position. [ABSTRACT FROM AUTHOR]

Abstract: Ganesh S, Hayter A, Kim J, Sanford J, Sprigle S, Hoenig H. Wheelchair use by veterans newly prescribed a manual wheelchair. Objective: To describe the characteristics of the wheelchairs, the users, and their wheelchair use among persons newly prescribed a manual wheelchair. Design: Cohort study. Setting: Veterans Affairs teaching hospital. Participants: Ninety-nine consecutive, cognitively intact veterans prescribed a manual wheelchair. Interventions: Not applicable. Main Outcome Measures: Self-reported difficulty transferring into and propelling the wheelchair; and bathroom mobility method. Results: Study patients had a mean age of 66 and a mean of 10 comorbid medical conditions. Parkinsonism, osteoporosis, joint replacement, and amputation were uncommon (<30% of patients), but had a high impact on need for a wheelchair (when present were reported by >50% of patients as causing need for a wheelchair). Falls and arthritis were common (>50% of patients) and highly impacted need for a wheelchair. At 1 month, over 30% of patients had wheelchairs that did not meet common criteria for wheelchair fit; 36% and 61%, respectively, reported difficulty transferring and propelling the wheelchair. The wheelchairs were used for bathroom mobility by 38% of the patients. Conclusions: The typical manual wheelchair recipient in this study sample was old with multiple medical problems. Despite provision of manual wheelchairs by trained professionals and availability of diverse wheelchair types, new wheelchair users commonly reported difficulty using the wheelchair. [Copyright &y& Elsevier]

To explore the lived experiences of new mobility scooter users. Data were collected as part of a larger mixed-methods intervention study. Based on critical phenomenology1,2 each participant was interviewed multiple times before and after their scooter training. Examples of the questions included: What kind of problems do you have getting around currently (using manual wheelchair/walker/cane, if applicable)? How do you feel about using a manual wheelchair/power wheelchair/walker/cane? How do other people respond to you when you are using your scooter? Metro Vancouver, British Columbia, Canada. Participants were a convenience sample of 20 community dwelling, scooters users (with less than one-month experience using their devices) who were able to transfer in and out of a scooter independently. Not applicable. Not applicable. The analysis revealed five themes. Transitioning to scooter use described how participants struggled to embrace scooters into their daily lives. Experiencing accessibility challenges revealed the challenges of navigating the outdoor and the indoor spaces in a scooter. Strategic and personalized use of devices for mobility illustrated how and why participants rely on other mobility devices. Navigating the social environment and being (un)seen demonstrated the stigma that participants experience from other people. Scooter appropriation over time revealed how participants see themselves and their use of scooters over time. The experiences of new scooter users reflected the complexities of navigating the structural barriers and the challenges of integrating scooters into their lives3, 4, 5. The tension between the lived spaces and the scooters suggests that the design and specifications of some of these spaces do not meet the needs of modern wheeled mobility devices. There are no conflicts of interest for any author. [ABSTRACT FROM AUTHOR]

To describe the self-reported scooter-skill scores of new mobility scooter users and to identify significant correlations with other characteristics and measures. Survey, cross-sectional. General community of Greater Vancouver, British Columbia, Canada. Participants were a convenience sample of 22 new scooters users (with less than one-month experience using their devices) who were able to transfer in and out of a scooter independently. Not applicable. Participants completed the Wheelchair Skills Test Questionnaire (WST-Q) Version 4.3 [1] for scooters users. It measures the users' perceived capacity (what they can do), performance (what they actually do), and confidence (or self-efficacy). Participants completed standardized measures of cognition [2], hearing, vision [3], life space mobility[4], visual attention and task switching [5], and confidence negotiating the social environment [6] using their scooters. Their scooter skills were also measured objectively with the Wheelchair Skills Test (WST). Mean total WST-Q capacity scores were 83% and performance scores were 25%. WST-Q capacity scores were significantly positively correlated with WST-Q performance (r=0.321) and confidence scores (r=0.787), WST capacity scores (r=0.488), and confidence negotiating the social environment (r=0.463). WST-Q capacity scores were significantly negatively correlated with visual attention and task switching (r=-0.591) and age (r=-0.531). Most correlations between WST-Q scores and other variables are similar to those found in studies of experienced scooters and power mobility device users. However, the gap between capacity and performance scores highlights the potential need for additional skills training in this population, which should be evaluated in future intervention studies. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. [ABSTRACT FROM AUTHOR]

Background: A clinical algorithm (Algo) in paper form is used in Quebec, Canada, to allow health care workers other than occupational therapists (OTs) to make bathroom adaptation recommendations for older adults. An integrated knowledge transfer process around Algo suggested an electronic version of this decision support system (electronic decision support system [e-DSS]) to be used by older adults and their caregivers in search of information and solutions for their autonomy and safety in the bathroom.Objective: This study aims to (1) create an e-DSS for the self-selection of bathroom-assistive technology by community-dwelling older adults and their caregivers and (2) assess usability with lay users and experts to improve the design accordingly.Methods: On the basis of a user-centered design approach, the process started with content identification for the prototype through 7 semistructured interviews with key informants of various backgrounds (health care providers, assistive technology providers, and community services) and 4 focus groups (2 with older adults and 2 with caregivers). A thematic content transcript analysis was carried out and used during the creation of the prototype. The prototype was refined iteratively using think-aloud and observation methods with a clinical expert (n=1), researchers (n=3), OTs (n=3), older adults (n=3), and caregivers (n=3), who provided information on the usability of the e-DSS.Results: Overall, 4 themes served as the criteria for the prototype of the electronic Algo (Hygiene 2.0 [H2.0]): focus (safety, confidentiality, well-being, and autonomy), engage, facilitate (simplify, clarify, and illustrate), and access. For example, users first pay attention to the images (engage and illustrate) that can be used to depict safe postures (safety), illustrate questions embedded in the decision support tool (clarify and illustrate), and demonstrate the context of the use of assistive technology (safety and clarify).Conclusions: The user-centered design of H2.0 allowed the cocreation of an e-DSS in the form of a website, in line with the needs of community-dwelling older adults and their caregivers seeking bathroom-assistive technology that enables personal hygiene. Each iteration improved usability and brought more insight into the users' realities, tailoring the e-DSS to the implementation context. [ABSTRACT FROM AUTHOR]

Background: To experience external objects in such a way that they are perceived as an integral part of one's own body is called embodiment. Wearable technology is a category of objects, which, due to its intrinsic properties (eg, close to the body, inviting frequent interaction, and access to personal information), is likely to be embodied. This phenomenon, which is referred to in this paper as wearable technology embodiment , has led to extensive conceptual considerations in various research fields. These considerations and further possibilities with regard to quantifying wearable technology embodiment are of particular value to the mobile health (mHealth) field. For example, the ability to predict the effectiveness of mHealth interventions and knowing the extent to which people embody the technology might be crucial for improving mHealth adherence. To facilitate examining wearable technology embodiment , we developed a measurement scale for this construct. Objective: This study aimed to conceptualize wearable technology embodiment, create an instrument to measure it, and test the predictive validity of the scale using well-known constructs related to technology adoption. The introduced instrument has 3 dimensions and includes 9 measurement items. The items are distributed evenly between the 3 dimensions, which include body extension, cognitive extension, and self-extension. Methods: Data were collected through a vignette-based survey (n=182). Each respondent was given 3 different vignettes, describing a hypothetical situation using a different type of wearable technology (a smart phone, a smart wristband, or a smart watch) with the purpose of tracking daily activities. Scale dimensions and item reliability were tested for their validity and Goodness of Fit Index (GFI). Results: Convergent validity of the 3 dimensions and their reliability were established as confirmatory factor analysis factor loadings (>0.70), average variance extracted values (>0.50), and minimum item to total correlations (>0.40) exceeded established threshold values. The reliability of the dimensions was also confirmed as Cronbach alpha and composite reliability exceeded 0.70. GFI testing confirmed that the 3 dimensions function as intercorrelated first-order factors. Predictive validity testing showed that these dimensions significantly add to multiple constructs associated with predicting the adoption of new technologies (ie, trust, perceived usefulness, involvement, attitude, and continuous intention). Conclusions: The wearable technology embodiment measurement instrument has shown promise as a tool to measure the extension of an individual's body, cognition, and self, as well as predict certain aspects of technology adoption. This 3-dimensional instrument can be applied to mixed method research and used by wearable technology developers to improve future versions through such things as fit, improved accuracy of biofeedback data, and customizable features or fashion to connect to the users' personal identity. Further research is recommended to apply this measurement instrument to multiple scenarios and technologies, and more diverse user groups. [ABSTRACT FROM AUTHOR]

Aim: validate Braille booklet and sound media on prevention and transmission of sexually transmitted infections (STIs) and acquired immunodeficiency syndrome (AIDS). Method: this is a descriptive and methodological study using a quantitative approach. The research will be developed in Mossoró/RN and Natal/RN, through three stages: identification of blind people's knowledge on STI/AIDS prevention and transmission; development of a Braille booklet and sound media on STI/AIDS; and validation of assistive technologies (AT), adopting population census or non-probabilistic sampling for convenience, depending on the specificities of each stage of the study. The collected data will be processed and analyzed using descriptive and analytical statistics. Expected results: the research will allow the validation of a booklet in Braille and sound media for blind people on STI/AIDS. These ATs may serve as strategies for health education by nurses and may promote greater access to STI/AIDS information for blind people. [ABSTRACT FROM AUTHOR]

Background: Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so.Objective: The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples.Methods: Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically.Results: Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent.Conclusions: A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes. [ABSTRACT FROM AUTHOR]

Abstract: Rehabilitation engineering is concerned with technology innovations and technology-mediated treatments for the improvement of quality of care and quality of life of individuals with disability. Unlike many other fields of health research, the knowledge translation (KT) cycle of rehabilitation engineering research and development (R&D) is often considered incomplete until a technology product or technology-facilitated therapy is available to target clientele. As such, the KT journey of rehabilitation engineering R&D is extremely challenging, necessarily involving knowledge exchange among numerous players across multiple sectors. In this article, we draw on recent literature about the knowledge trichotomy in technology-based rehabilitation R&D and propose a knowledge ecosystem to frame the rehabilitation engineering KT process from need to product. Identifying the principal process of the ecosystem as one of knowledge flow, we elucidate the roles of repository and networked knowledge, identify key consumers and producers in a trinity of communities of practice, and draw on knowledge management literature to describe different knowledge flows. The article concludes with instantiations of this knowledge ecosystem for 2 local rehabilitation engineering research-development-commercialization endeavors. [Copyright &y& Elsevier]

Background: PatientsLikeMe is an online quantitative personal research platform for patients with life-changing illnesses to share their experience using patient-reported outcomes, find other patients like them matched on demographic and clinical characteristics, and learn from the aggregated data reports of others to improve their outcomes. The goal of the website is to help patients answer the question: "Given my status, what is the best outcome I can hope to achieve, and how do I get there?" Objective: Using a cross-sectional online survey, we sought to describe the potential benefits of PatientsLikeMe in terms of treatment decisions, symptom management, clinical management, and outcomes. Methods: Almost 7,000 members from six PatientsLikeMe communities (amyotrophic lateral sclerosis [ALS], Multiple Sclerosis [MS], Parkinson's Disease, human immunodeficiency virus [HIV], fibromyalgia, and mood disorders) were sent a survey invitation using an internal survey tool (PatientsLikeMe Lens). Results: Complete responses were received from 1323 participants (19% of invited members). Between-group demographics varied according to disease community. Users perceived the greatest benefit in learning about a symptom they had experienced; 72% (952 of 1323) rated the site "moderately" or "very helpful." Patients also found the site helpful for understanding the side effects of their treatments (n = 757, 57%). Nearly half of patients (n = 559, 42%) agreed that the site had helped them find another patient who had helped them understand what it was like to take a specific treatment for their condition. More patients found the site helpful with decisions to start a medication (n = 496, 37%) than to change a medication (n = 359, 27%), change a dosage (n = 336, 25%), or stop a medication (n = 290, 22%). Almost all participants (n = 1,249, 94%) were diagnosed when they joined the site. Most (n = 824, 62%) experienced no change in their confidence in that diagnosis or had an increased level of confidence (n = 456, 34%). Use of the site was associated with increasing levels of comfort in sharing personal health information among those who had initially been uncomfortable. Overall, 12% of patients (n = 151 of 1320) changed their physician as a result of using the site; this figure was doubled in patients with fibromyalgia (21%, n = 33 of 150). Patients reported community-specific benefits: 41% of HIV patients (n = 72 of 177) agreed they had reduced risky behaviors and 22% of mood disorders patients (n = 31 of 141) agreed they needed less inpatient care as a result of using the site. Analysis of the Web access logs showed that participants who used more features of the site (eg, posted in the online forum) perceived greater benefit. Conclusions: We have established that members of the community reported a range of benefits, and that these may be related to the extent of site use. Third party validation and longitudinal evaluation is an important next step in continuing to evaluate the potential of online data-sharing platforms. [ABSTRACT FROM AUTHOR]

Background: This project investigates the ways in which patients respond to the shared use of what is often considered private information: personal health data. There is a growing demand for patient access to personal health records. The predominant model for this record is a repository of all clinically relevant health information kept securely and viewed privately by patients and their health care providers. While this type of record does seem to have beneficial effects for the patient-physician relationship, the complexity and novelty of these data coupled with the lack of research in this area means the utility of personal health information for the primary stakeholders--the patients--is not well documented or understood. Objective: PatientsLikeMe is an online community built to support information exchange between patients. The site provides customized disease-specific outcome and visualization tools to help patients understand and share information about their condition. We begin this paper by describing the components and design of the online community. We then identify and analyze how users of this platform reference personal health information within patient-to-patient dialogues. Methods: Patients diagnosed with amyotrophic lateral sclerosis (ALS) post data on their current treatments, symptoms, and outcomes. These data are displayed graphically within personal health profiles and are reflected in composite community-level symptom and treatment reports. Users review and discuss these data within the Forum, private messaging, and comments posted on each other's profiles. We analyzed member communications that referenced individual-level personal health data to determine how patient peers use personal health information within patient-to-patient exchanges. Results: Qualitative analysis of a sample of 123 comments (about 2% of the total) posted within the community revealed a variety of commenting and questioning behaviors by patient members. Members referenced data to locate others with particular experiences to answer specific health-related questions, to proffer personally acquired disease-management knowledge to those most likely to benefit from it, and to foster and solidify relationships based on shared concerns. Conclusions: Few studies examine the use of personal health information by patients themselves. This project suggests how patients who choose to explicitly share health data within a community may benefit from the process, helping them engage in dialogues that may inform disease self-management. We recommend that future designs make each patient's health information as clear as possible, automate matching of people with similar conditions and using similar treatments, and integrate data into online platforms for health conversations. [ABSTRACT FROM AUTHOR]

Background: Advances in ubiquitous computing, smart homes, and sensor technologies enable novel, longitudinal health monitoring applications in the home. Many home monitoring technologies have been proposed to detect health crises, support aging-in-place, and improve medical care. Health professionals and potential end users in the lay public, however, sometimes question whether home health monitoring is justified given the cost and potential invasion of privacy. Objective: The aim of the study was to elicit specific feedback from health professionals and laypeople about how they might use longitudinal health monitoring data for proactive health and well-being. Methods: Interviews were conducted with 8 health professionals and 26 laypeople. Participants were asked to evaluate mock data visualization displays that could be generated by novel home monitoring systems. The mock displays were used to elicit reactions to longitudinal monitoring in the home setting as well as what behaviors, events, and physiological indicators people were interested in tracking. Results: Based on the qualitative data provided by the interviews, lists of benefits of and concerns about health tracking from the perspectives of the practitioners and laypeople were compiled. Variables of particular interest to the interviewees, as well as their specific ideas for applications of collected data, were documented. Conclusions: Based upon these interviews, we recommend that ubiquitous "monitoring" systems may be more readily adopted if they are developed as tools for personalized, longitudinal self-investigation that help end users learn about the conditions and variables that impact their social, cognitive, and physical health. [ABSTRACT FROM AUTHOR]