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Background: Moving a wheelchair over a low threshold is an entry-level mobility skill. Observation is critical to the assessment and training of this skill. The primary objective of this exploratory pilot study was to determine if a difference between novice and expert visual attention allocation pattern was linked to the accuracy of rating skill performance and decision confidence. Methods: Twelve expert occupational therapists and nine non-expert occupational therapy students observed 30 first-attempt recordings of able-bodied persons learning the low threshold skill. Randomized recordings included 10 recordings from each rating group of "pass," "pass with difficulty" (pwd), and "fail." Skill ratings, confidence ratings, time to decision, and SR Eyelink 1000+ monitored eye movements were recorded. Results: No significant group differences were found in the correct identification skill rating, though significant relationships were found with experts rating higher confidence in their decision-making and generally faster reaction times. While trends of eye movements differences were found between groups, only the number of areas of interest viewed in pwd videos was a potential rating correctness predictor. Conclusion: Improved confidence in decision-making did not mean improved assessment accuracy. The pwd video stimuli created the opportunity for assessing observation patterns differences. Further study is recommended. [ABSTRACT FROM AUTHOR]

Objective: Language that implies a conclusion not supported by the evidence is common in the medical literature. The hypothesis of the present study was that medical journal publications are more likely to use misleading language for the interpretation of a demonstrated null (i.e. chance or not statistically significant) effect than a demonstrated real (i.e. statistically significant) effect. Methods: This was an observational study of the medical literature with a systematic sampling method. Articles published in The Journal of the American Medical Association, The Lancet and The New England Journal of Medicine over the last two decades were eligible. The language used around the P‐value was assessed for misleadingness (i.e. either suggesting an effect existed when a real effect did not exist or vice versa). Results: There were 228 unique manuscripts examined, containing 400 statements interpreting a P‐value proximate to 0.05. The P‐value was between 0.036 and 0.050 for 303 (75.8%) statements and between 0.050 and 0.064 for 97 (24.3%) statements. Forty‐four (11%) of the statements were misleading. There were 40 (41.2%) false‐positive sentences, implying statistical significance when the P‐value was >0.05, and four (1.3%) false‐negative sentences, implying no statistical significance when the P‐value <0.05 (relative risk 31.2; 95% confidence interval 11.5–85.1; P < 0.0001). The proportion of included manuscripts containing at least one misleading sentence was 16.2% (95% confidence interval 12.0–21.6). Conclusions: Among a random selection of sentences in prestigious journals describing P‐values close to 0.05, 1 in 10 are misleading (n = 44, 11%) and this is more prevalent when the P‐values are above 0.05 compared to below 0.05. Caution is advised for researchers, clinicians and editors to align with the context and purpose of P‐values. [ABSTRACT FROM AUTHOR]

Purpose: The tilt-rest skill consists of tipping the wheelchair back and allowing it to rest against a solid object with the wheel locks applied (e.g., for pressure redistribution, neck comfort or hands-free activities). The objective of this study was to determine the proportion of experienced manual wheelchair users who are aware of this skill and who can perform it. Materials and methods: We conducted a cross-sectional survey of 49 manual wheelchair users using a questionnaire developed for the purpose. The tilt-rest skill was attempted by those who reported that they were capable of performing it. Results: Participants' mean (SD) age was 55.1 (18.2) years, 38 (77.6%) were male, their median (IQR) duration of wheelchair use was 2 (7.2) years and their mean (SD) daily time spent in the wheelchair was 9.5 (4.6) hours. Twenty-seven (55.1%) participants were aware of the skill, 19 (38.8%) reported being able to perform the skill and 16 of 47 (34.0%) were able to demonstrate the skill. Multivariate modelling with the question "Can you complete the tilt-rest skill?" as the dependent measure revealed an inverse relationship with age – Odds Ratio (95% Confidence Interval) of 0.476 (0.293, 0.774) (p =.0028) for each 10 year increase in age. Conclusions: Only just over half of manual wheelchair users are aware of the tilt-rest skill and one-third of users can perform it. Older people are less likely to report being able to complete the skill. These findings have implications for wheelchair skills training during the wheelchair-provision process. Only just over half of manual wheelchair users are aware of the tilt-rest skill and only about one-third of users can perform it. Older people are less likely to report being able to complete the skill. These findings have clinical implications for wheelchair skills training during the, specifically that clinicians responsible for manual wheelchair-provision process should ensure that appropriate wheelchair users have the opportunity to learn this skill. [ABSTRACT FROM AUTHOR]

Purpose:To investigate the score distribution, reliability, and validity of the objective Wheelchair Skills Test (WST) for scooter users. Method:A study using a test–retest design was conducted with 20 people who had mobility limitations that prevented them from ambulating more than one city block without a mobility aid, and who had owned a scooter for ≥3 months. Objective scooter skills, confidence, and physical accessibility were measured at both time points, while anxiety, depression, visual attention and task switching, functional independence, and visual acuity were measured only at baseline. Results:The mean total WST scores at Time 1 and Time 2 were 86.3% and 87.5%. The WST ICC was 0.889. The WST had a SEM of 2.50 and a Cronbach’s alpha of 0.74. The total WST scores were significantly correlated with total subjective WST-Q scores (r = 0.547,p = 0.013), scooter confidence (r = 0.466,p = 0.038), and were affected by gender (p = 0.005). Conclusion:The WST for scooters has good test–retest reliability and generally varies as anticipated with other measures. Although further study is needed, the WST for scooters appears to have promise for use in research and clinical practice. Implications for RehabilitationIt is important to understand the measurement properties of the tools we use in rehabilitation so the results can be interpreted correctly.As scooter use increases, better measurement of skills is required. [ABSTRACT FROM PUBLISHER]

OBJECTIVES: Report the 8-year impact on body size, physical activity, and diet of a community-based diabetes prevention program for elementary-school children in a Kanien'keha:ka (Mohawk) community in Canada. METHODS: Follow-up (1994-1996) of subjects in the intervention and comparison community and repeat cross-sectional measurements in the intervention community alone from 1994 to 2002. Measures included triceps and subscapular skinfold thicknesses, body mass index (BMI), weekly number of 15-minute episodes of physical activity, run/walk test times, television watching, and consumption of sugared foods, fatty foods, and fruits and vegetables. RESULTS: The longitudinal data of 1994-1996 showed some early positive effects of the program on skinfold thickness but not on BMI, physical activity, fitness, or diet. Repeat cross-sectional measures from 1994 to 2002 showed increases in skinfold thickness and BMI. Physical activity, fitness, and television watching showed favorable trends from 1994 to 1999 that were not sustained in 2002. Key high-fat and high-sugar foods consumption decreased, as did consumption of fruits and vegetables. CONCLUSIONS: Although early results showed some successes in reducing risk factors for type 2 diabetes, these benefits were not maintained over 8 years. [ABSTRACT FROM AUTHOR]