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Introduction: The purpose of this cross-sectional survey was to examine the possession of low vision reading devices and factors associated with possession of these devices among residents living in a continuing care retirement community. Low vision reading devices are devices other than eyeglasses that aid in reading at near distances. Methods: One hundred and two usable questionnaires were received from residents, ages 65–97 years old, living in the independent and assisted living units of a retirement community. Results: Data indicated that 47% the participants reported having an eye disease, and 53% of the participants owned at least one low vision reading device. The two most common types of devices were handheld magnifiers (40%) and gooseneck lamps with or without a magnifier (26%). Of the 48 participants reported to have eye disease diagnoses, 65% owned a reading device. Forty-six percent of the participants reported having trouble with reading when performing one of the six daily activities even with their reading eyeglasses. The final multivariable logistic regression model indicated that participants who reported having trouble with reading in near distance were significantly more likely to own one of the reading devices. Discussion: This study identified a discrepancy between the high prevalence of visual impairment (i.e., blindness and low vision) among residents living in a retirement community setting and a relatively low number of residents owning low vision reading devices. Findings suggested the key factor contributing to residents’ decision to own reading devices is their level of visual impairment. Implications for Practitioners: Knowing the factors to owning low vision reading devices, occupational therapists may assist residents in continuing care retirement facilities to obtain the appropriate devices.

The purpose of this study is to explore physiological and psychological changes immediately after a short-term visit to urban parks in an uncontrolled condition. Sixty park visitors completed a short questionnaire evaluating their subjective well-being (SWB) and donated a saliva sample immediately before and after their park visit. In addition, participants wore a pedometer to track their physical activity level during the park visit. Results indicated the levels of all biomarkers (cortisol, dehydroepiandrosterone [DHEA], and cortisol/DHEA ratio) decreased while SWB scores increased after the park visit. The duration of park visit was identified as a key variable significantly associated with cortisol reduction, and changes in SWB scores after the park visit were significantly associated with changes in cortisol level. A park visit duration of 21.8 min has the predictive ability to discriminate park visitors who exhibit reductions in cortisol levels after the park visit from those who do not.

This pilot randomized controlled trial (RCT) examined preliminary effects of an 8-week videoconferencing acceptance and commitment therapy (ACT) program supplemented with psychoeducation materials on distressed family caregivers of persons living with dementia (PLWD) compared to the control group provided with psychoeducation materials only. Nineteen family caregivers of PLWD in the USA were randomly assigned to the ACT group or the control group. Data was collected at pretest, posttest, and 1-month follow-up (F/U). Compared to the control group, the ACT group showed a significantly larger reduction in grief at posttest, with a medium effect size. Small effects of ACT were found in anxiety, psychological quality of life, and engagement in meaningful activities at posttest and grief, engagement in meaningful activities, and psychological flexibility at F/U compared to the control group. These promising findings warrant a full-scale RCT with adequate power to measure the efficacy of videoconferencing ACT for caregivers of PLWD.

Cardiovascular disease (CVD) in the United States disproportionally affects people who are homeless. This disparity is a critical concern that needs to be addressed to improve the health of individuals who are homeless. The connections between a history of homelessness, i.e., its duration and frequency, and CVD risk are not well understood. The present study sought to investigate how a history of homelessness is correlated with CVD risk factors in a sample of homeless persons in the Deep South. This study recruited participants who were homeless from two local adult homeless shelters in Birmingham, AL. Participants (n = 61) underwent interviews, physical measurements, and a capillary blood draw. Their mean age was 47 years, and 82% were men. Results showed the duration of homelessness was positively associated with several CVD risk factors (diabetes mellitus, total cholesterol, and low-density lipoprotein). However, there was no significant association between frequency of homelessness and any CVD risk factors. To get the more accurate estimate of CVD risk in this population, future research should incorporate additional risk factors related to homelessness and seek to develop a robust strategy to collect an accurate history of homelessness.

This qualitative study explored ex-offender’s community reintegration experiences following a prison sentence. Fourteen ex-offenders from the Offender Alumni Association participated in an in-person in-depth individual interview regarding their current roles, daily routines, living situation, activity participation, and current and future plans. A phenomenological approach using thematic analysis was employed for data collection and interpretation. The emerged themes were categorized under facilitators and barriers that influence healthy community reintegration. The facilitators included visualizing and committing to an ideal future, establishing a daily routine, upholding life balance, and discovering and connecting to external supports. The barriers included impediments to employment opportunities, lack of financial resources, social stigma, regulations imposed by the judicial system, disconnection from social advancements, and addiction to drugs and alcohol. The themes identified from the interviews suggest that current reintegration strategies and programs need to be improved in order to benefit ex-offenders seeking these services.

This study seeks to examine the effect of the characteristics of park users, park characteristics, and the neighborhood environment on park visits and the resultant perceived health status of residents living in Alabama, US. One hundred and eighty-nine participants, representing residents from 49 counties in Alabama, were recruited via a random-digit dial method to complete a telephone survey related to park visits. Data collection spanned 11 months. Results from the path analysis indicated a few significant direct effects: park location and body mass index (BMI) were the only two factors significantly associated with park visits, with race being marginally significant; and work status was significantly associated with perceived health. Our findings suggest park proximity, and high BMI are related to park visits and work status is related to perceived health among Alabamians. It is recommended that more neighborhood parks are needed for promoting Alabamians to visit them more frequently.

This study aims to explore the opinions of dental hygienists and diabetes educators on improving oral health for people with diabetes.Registered dental hygienists (RDHs) and certified diabetes educators (CDEs) who provided written responses to the same open-ended question from two state-wide mailing surveys (one for RDHs and the other for CDEs) "what more can you tell us to help improve oral health for people with diabetes?" were included in this study. The surveys were sent to all RDHs (n=2237) and CDEs (n=250) in the state of South Carolina, United States.Of the 1125 valid returned questionnaires from both surveys, 474 provided written responses to this question. Qualitative analysis revealed three main themes from participants' written responses which were: Education (3 subthemes: resources for patients, educate the public, and professional practice resources), interprofessional collaborative care (3 subthemes: role of medical and dental professionals in oral health promotion for people with diabetes, and role of dental and diabetes professional organizations, and companies in the oral healthcare industry), and dental insurance.The three themes that emerged are interrelated indicating that strategies to improve oral health for people with diabetes are multi-faceted.

Homelessness is associated with an increased risk of cardiometabolic morbidities. However, few studies have been performed to evaluate the racial differences on these morbidities commonly seen in the homeless. A retrospective chart review was conducted to examine the racial differences in the prevalence of cardiometabolic morbidities among the homeless men served at a local health care screening clinic. Medical information was extracted and collated into a single Excel spreadsheet. Racial differences in cardiometabolic morbidities were evaluated using multivariable binary or ordinal logistic regression analyses, adjusting for age, body mass index, and smoking status. Of the 551 homeless men, 377 (68.4%) were Black, and 174 (31.6%) were White. The mean age (47.8±11.9 years) of Black homeless men was significantly older than that (45.4±13.0 years) of White homeless men (p=0.03). Blacks were 2.7 (95% CI = 1.75, 4.16) times more likely to be in the less desirable HbA1c categories than Whites. By contrast, Blacks were less likely to have non-desirable lipid profile than Whites. Blacks were 0.42 (95% CI = 0.29, 0.62) times and 0.51 (95% CI = 0.28, 0.94) times likely to be in the non-desirable high-density lipoprotein (HDL) and low-density lipoprotein (LDL) categories than Whites, respectively. Black homeless men are more likely to have pre-diabetes or diabetes than White counterparts. On the other hand, Black homeless men have better lipid profiles of HDL or LDL than their White counterparts. Our findings reveal the health challenges of the homeless men and can provide guidance on policy changes related to diet and nutrition of meal programs provided by homeless shelters and congregate meal program to address the health disparities by race in this population.

Previous studies have examined the quantitative results of using an organized approach of teaching and learning magic tricks-a therapeutic magic camp-but set aside the qualitative aspect. The purpose of this qualitative study is to explore the interpretation of the lived experience of children with hemiparesis after they have participated in a therapeutic magic camp. Six children, aged between 11 and 14 years old, with hemiparesis who completed the magic camp program 3 months prior were invited to participate in an in-person individual semistructured interview. The interviews were audio-recorded and transcribed verbatim for content analysis. Results from the initial qualitative analysis yielded categories of enjoyment, positive social and learning experience from participation in the camp, increased confidence, and self-motivation to use the affected upper limb. These categories were grouped into two themes: "having fun with others while learning" and "helping my arm perform." Having fun with others while learning was an amalgamation of fun, and positive social and learning experience. Helping my arm perform reflected a sense of increased competence and self-belief, and a willingness and motivation of the children to attempt challenging daily activities. The lived experiences of children with hemiplegia who participated in an organized delivery of learning to perform magic tricks yield-ed positive outcomes. These themes are consistent with the limited literature that is available suggesting that further research is needed to confirm the efficacy of the therapeutic magic camp intervention.

Acceptance and commitment therapy (ACT) is an emerging evidenced-based practice based on a psychological flexibility model encompassing six processes, including acceptance, cognitive defusion, self-as-context, being present, values, and committed action. ACT aims to improve overall psychological flexibility and the six processes. This systematic review and meta-analysis examined the effects of ACT on measures of purported processes among family caregivers. Four electronic databases were searched from the date of inception of each database to March 30, 2020. A total of 18 studies met the eligibility criteria, including 8 randomized controlled trials (RCTs), 1 nonrandomized control group pretest-posttest design study, and 9 one group pretest-posttest design studies. A meta-analysis of 8 RCTs found a moderate effect of ACT on psychological flexibility among family caregivers at the immediate posttest and follow-up. A meta-analysis of 9 one group pretest-posttest design studies showed a large effect of ACT on psychological flexibility at the immediate posttest and follow-up. No significant effect was found in measures of cognitive fusion, valued living, and mindfulness except for a meta-analysis of 2 RCTs showing a small effect of ACT on cognitive fusion at follow-up. This review discusses synthesized findings, a gap in the literature, and suggestions for future studies.

Introduction Although circumstantial evidence suggests children with tic disorders (TD) experience challenges in handwriting which may be attributed to their tics, few studies have systematically investigated handwriting performance among children with TD. This study examined the relationship between handwriting deficits and TD using a causal comparative research design. Methods Thirty-four children with TD completed the Test of Handwriting Skills-Revised (THS-R). The overall percentile ranks of the THS-R were analysed to determine if children with TD have lower scores compared to the test's normative values. Writing speed, letter reversals, touching letters and case errors were also evaluated. Results Data revealed the median percentile rank of the THS-R for the participants was significantly lower than the median percentile score of the THS-R for the normative sample. Close to 80% (n = 27) of writing samples were scored below 50th percentile. More than one-third (35.3%, n = 12) of the writing samples were scored greater than one standard deviation below the normative mean on the THS-R. Of the four ancillary scores, 82.4% (n = 28) of the participants' writing samples scored below 50th percentile (in the categories of watch or test further) on case errors and 67.6% (n = 23) scored below 50th percentile on writing speed. Conclusion Findings suggested that children with TD took longer to complete the writing task, and committed more case substitution errors than the normative sample of the THS-R and were likely to exhibit handwriting deficits.

Acceptance and commitment therapy is an emerging evidenced-based practice, but no systematic review regarding the effects of ACT on family caregivers has been conducted. This article examined the effects of ACT on family caregivers by conducting meta-analysis with a random effects model. Twenty-four articles were identified from four electronic databases searched up to 30 March 2020. Meta-analyses found moderate effects of ACT on depressive symptoms and quality of life, small effects on anxiety, and small to moderate effects on stress. Further ACT studies should be conducted to measure effects on different outcomes for various family caregiver populations.

One hundred seventy-two occupational therapists in Alabama completed an online survey to identify factors associated with their orientation toward rehabilitating people who are incarcerated. The level of the respondents' rehabilitation orientation toward people who are incarcerated was assessed using the Rehabilitation Orientation Scale (ROS). Results indicated that the respondents' attitudes were favorable and comparable to those on the prison rehabilitation team. Respondents who considered working in prison settings had 2 times greater odds of favoring rehabilitation intervention than those who did not consider working in prison settings. None of the respondents' personal attributes and professional experience variables were significantly associated with the ROS score. Findings provide an initial direction indicating that resources should be placed on recruitment of occupational therapists to work in the correctional setting.

This study examined effects of coach-guided videoconferencing acceptance and commitment therapy (ACT) accompanied by psychoeducation on distressed individuals with spinal cord injury (SCI) and explored participants’ experiences in the intervention. Ten people with SCI participated in 8 individual videoconferencing sessions delivered by trained coaches. Data using self-reported questionnaires and individual interviews was collected at pretest and posttest and analyzing using Wilcoxon signed-rank tests and interpretative phenomenological analysis (ClinicalTrials.gov ID: NCT04670406). Statistically significant improvements were found in depression, anxiety, stress, grief, engagement in meaningful activities, and self-compassion with medium to large effect sizes. There was no significant change in quality of life, resilience, and ACT processes. Participants gained a new way of thinking by: being aware of thoughts and emotions; exploring perceptions of others; and focusing on the present. Also, the intervention equipped participants to deal with challenges by: improving coping with SCI-related conditions; practicing self-compassion, acceptance, and meditation; and acquiring skills of value-based decision making and committed action. Findings contribute to the limited evidence as the first study that measured effects of videoconferencing ACT on people with SCI. Future randomized controlled trials are needed to measure efficacy of internet-delivered ACT for people with SCI.IMPLICATIONS FOR REHABILITATIONGuided videoconferencing ACT may reduce depressive symptoms, anxiety, stress, and grief and increase engagement in meaningful activities and self-compassion in people with SCI.Professionals may consider ACT as a supportive or adjunct service for people with SCI who experience psychological distress. Guided videoconferencing ACT may reduce depressive symptoms, anxiety, stress, and grief and increase engagement in meaningful activities and self-compassion in people with SCI. Professionals may consider ACT as a supportive or adjunct service for people with SCI who experience psychological distress.

To evaluate the adherence and effectiveness of a home-based exergame program for patients with idiopathic pulmonary fibrosis (IPF).Patients with IPF were randomly assigned to a relatively unsupervised Wii Fit exergame intervention group or Wii video game control group (with no active whole-body movement involved). Participants in both groups were instructed to play their respective games 30 min/d, 3 d/wk for 12 wk. In addition, they were asked to perform their usual exercise/physical activities. Outcome measures were 6-min walk distance (6MWD), exercise-related dyspnea, and St George's Respiratory Questionnaire (SGRQ).The 20 participants differed significantly between intervention and control groups in baseline characteristics (forced vital capacity = 2.0 ± 0.5 vs 3.1 ± 0.7 L; forced expiratory volume in 1 sec = 1.7 ± 0.4 vs 2.5 ± 0.6 L, respectively). Participant adherence rate to the exergame program was very low (20%). There was no significant improvement in the outcome measures in either group. In fact, both the intervention and control groups had a deterioration in 6MWD (-22 ± 56 m vs -60 ± 111 m), respectively and SGRQ scores (3 ± 9 vs 1 ± 11), respectively.The home-based exergame intervention for patients with IPF did not show improvement in functional performance, dyspnea, or health-related quality of life at the completion of the 12-wk program in our 2 heterogeneous groups. In addition to the low adherence rate, insufficient frequencies and durations of exergaming may contribute to the lack of improvement. A lack of effectiveness of home-based pulmonary rehabilitation using exergaming for patients with IPF appears consistent with prior observational studies that used more traditional modes of home-based exercise.

BACKGROUND: Employee wellness programs (EWPs) aim to support positive changes in employees’ modifiable behavioral health risk factors for disease prevention and management. OBJECTIVE: This study described the prevalence and characteristics of EWPs in US accredited college and university campuses. METHODS: Identification of the prevalence of EWPs and programming activities offered in 3039 accredited higher education institutions/campuses, and characteristics of these institutions/campuses were conducted, mainly through searching the institution’s web page. RESULTS: Overall, 36%of the institutions/campuses offered EWPs, with a significantly larger percentage of 4-year public colleges/universities providing EWPs and wellness programming activities than the 4-year private colleges/universities and community colleges. When limiting the institutions/campuses to 4-year colleges and universities with at least 500 employees, the percentage of these institutions/campuses offering EWPs increased to 57.7%, which was comparable to the findings in the literature. The percentage of the institutions/campuses offering wellness programming activities ranged from 18.1%for injury prevention and ergonomics to 30.2%for stress management. The percentage of institutions/campuses offering injury prevention and ergonomics was significantly lower than the percentage of institutions/campuses offering other typical wellness activities. CONCLUSIONS: The prevalence of EWPs offered in accredited college and university campuses do not meet the national goal of 75%, which was set by Healthy People 2010.

This study examined the effects of a guided online acceptance and commitment therapy (ACT) intervention on distressed family caregivers of persons living with dementia and explored the experiences of these caregivers in the ACT intervention.Seven family caregivers experiencing psychological distress individually participated in 10 ACT videoconference sessions guided by a trained coach. Quantitative data, such as psychological distress, burden, and ACT processes, were collected at pretest and posttest and analyzed using the Wilcoxon signed-rank test. Individual interviews were conducted at posttest and analyzed using interpretative phenomenological analysis.Statistically significant reductions were found in depressive symptoms, anxiety, stress, and burden (Findings contribute to the limited evidence in guided online ACT for caregivers of persons living with dementia. Further studies with a larger sample size are needed to evaluate the efficacy of guided online ACT.Guided online ACT may reduce depressive symptoms, anxiety, stress, and burden of family caregivers of persons living with dementia.

This study aimed to explore the amenable factors contributing to the improvement in subjective well-being (SWB) immediately after a short-term visit to an urban park in an uncontrolled condition. Ninety-four park visitors from three urban parks completed a short questionnaire evaluating SWB (with two components: affect and life satisfaction) immediately before and after their park visit. In addition, their level of physical activity was tracked by wearing an accelerometer during the park visit. Results indicated a significant improvement in SWB, affect, and life satisfaction scores of park visitor participants from before and after their visit. Duration of park visit was bivariately associated with SWB scores, and independently associated with the improvement in life satisfaction scores, controlling for parks and age, after the visit; a 20.5-min park visit predicted the highest overall accuracy (64%) improvement in life satisfaction. It is recommended that design of the park space should attract visitors to stay for at least 20 min in the park.

This single-group open trial was designed to evaluate the effectiveness of a two-week magic camp as a means of hand-arm motor skills training to improve upper limb motor function (unilateral and bilateral) in children with hemiparesis. Seven children with hemiparesis participated in a magic camp program which met 3 days a week, 4 hours each day, for two consecutive weeks for a total of 24 hours. Participants completed three assessments at the beginning of the camp, post-camp, and at a three-month follow-up: the Jebsen Hand Function Test (JHFT), Children's Hand Experience Questionnaire (CHEQ), and a box opening task that required coordination of both upper limbs. A Wilcoxon signed-rank test revealed significant improvement in JHFT composite scores of the affected limb at post-camp (

BACKGROUND Service-learning (SL) has been widely implemented and grown as a pedagogy in the rehabilitation professions. However, assessment on the quality of evidence for the effectiveness of SL related to student learning outcomes and the scope of SL activities related to the occupation of work in the rehabilitation professions is not available. OBJECTIVE This systematic review was to evaluate the rigor of the methodological quality of SL studies and the scope of SL activities related to the occupation of work in the rehabilitation professions. METHODS We performed a systematic on-line electronic literature search of nine bibliographic databases available through the university library system to identify peer-reviewed journal articles on SL provided by the tri-alliance of rehabilitation professional students, with the primary or secondary outcome on the evaluation of student SL experiences. Twenty-two SL articles using experimental design between 1995 and 2016 were extracted as they qualified for the methodological appraisal. Appraisal of each article was performed independently by four investigators using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. RESULTS In six of the 22 SL studies (27%), service provided by the rehabilitation professional students was related to the occupation of work (i.e., assessment, prevention of illness, injury, and disability, and intervention). There was a significant increase in the number (and percent) of SL studies related to the occupation of work compared to that of a previous systematic review (0%, P = 0.03, Fisher's exact test). Results from the evaluation of the methodological quality of these 22 reviewed articles revealed that all received a global rating score of weak. The low methodological quality rating of the reviewed articles was mainly attributed to not controlling for confounders (22 articles), non-blinding (21), and using outcome measures which did not have evidence to support their validity (14). Inability to control for confounders was related to weak research design as more than 77% of the reviewed articles used quasi-experimental designs without a control group. Non-blinding was related to the self-report nature of the outcome measures. CONCLUSIONS A significant increase in the number of SL studies related to the occupation of work was found, which may provide an indirect indication on an increase in the capacity to provide (work) rehabilitation services. However, selected studies demonstrated high risk of bias which limited firm conclusions to be drawn on reported findings from SL in the tri-alliance of rehabilitation professions curricula.

Supplemental material, Supplemental_material for Acceptance and commitment therapy for family caregivers: A systematic review and meta-analysis by Areum Han, Hon K Yuen and Jeremy Jenkins in Journal of Health Psychology

Objectives: Determine the effects of varying frequency, phase duration, and interphase interval (IPI) of symmetrical, biphasic pulsed current (SBPC) on quadriceps femoris muscle torque production, ...

Purpose: This study was conducted to describe the development and validation of the Hocus Focus Magic Performance Evaluation Scale (HFMPES), which is used to evaluate the competency of health professions personnel in delivering magic tricks as a therapeutic modality. Methods: A 2-phase validation process was used. Phase I (content validation) involved 16 magician judges who independently rated the relevance of each of the 5 items in the HFMPES and established the veracity of its content. Phase II evaluated the psychometric properties of the HFMPES. This process involved 2 magicians using the HFMPES to independently evaluate 73 occupational therapy graduate students demonstrating 3 magic tricks.Results: The HFMPES achieved an excellent scale-content validity index of 0.99. Exploratory factor analysis of the HFMPES scores revealed 1 distinct factor with alpha coefficients ≥0.8 across the 3 magic tricks. The construct validity of the HFMPES scores was further supported by evidence from a known-groups analysis, in which the Mann–Whitney U-test showed significant difference in HFMPES scores between participants with different levels of experience in delivering the 3 magic tricks. The inter-rater reliability coefficients were ≥0.75 across the 3 magic tricks, indicating that the competency of health professions personnel in delivering the 3 magic tricks could be evaluated precisely.Conclusion: Preliminary evidence supported the content and construct validity of the HFMPES, which was found to have good internal consistency and inter-rater reliability in evaluating health professions personnel’s competency in delivering magic tricks.

Purpose: This study was to examine occupational therapy (OT) students’ attitudes toward rehabilitating inmates and validate an instrument used to measure their attitudes. Methods: OT students (n=128) from one university in Alabama, United States, completed an online survey exploring their attitudes toward rehabilitating inmates, which was assessed using the Rehabilitation Orientation Scale (ROS), a 7-point scale. Dimensional structure, internal consistency reliability, construct validity, and relations to other variables of the ROS was evaluated using factor analyses, Cronbach’s alpha, known-groups method, and univariable correlations, respectively. Results: Unidimensionality of the ROS was confirmed with an alpha coefficient of 0.90. The mean ROS score of the respondents was 5.1; a score toward 7 indicated a more supportive attitude. About 60% of the respondents reported supportive attitudes (i.e., an ROS score ≥5). Respondents’ ROS scores were significantly higher than those of the public and criminal justice professionals. Female students reported a more supportive attitude than males. Multiple regression analysis indicated that respondents’ consideration of working in prison settings after graduation and their perception that OT has a role in prison settings were significantly associated with support for rehabilitating inmates, after controlling for gender and an acquaintance with someone who has been incarcerated. Conclusion: Results indicated that the ROS demonstrated adequate psychometric properties as it applied to this population. The majority of respondents reported supportive attitudes toward rehabilitating inmates. Consideration of working in prison settings after graduation and the perception that OT has a role in prison settings were 2 independent factors associated with respondents’ attitudes toward rehabilitating inmates.

This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

Background The impact of multi-morbidity and disability on the use of adaptation strategies in older adults has not been well researched. Objective This study investigated categories of adaptation strategies that community-dwelling older adults use to complete their daily activities, identified factors that are associated with the use of behavioral adaptations, and examined the relationship among multi-morbidity, disability and adaptation strategies in this population. Methods A mixed methods research design was used. 105 community-dwelling older adults with ages ranging from 75 to 94 years completed a questionnaire and semi-structured interview on types of chronic illnesses (multi-morbidity), amount of difficulty in completing daily activities (degree of disability), and types of behavioral efforts made to complete daily activities that are challenging (adaptation strategies). The model of selective optimization with compensation (SOC) was used to categorize these strategies. Results The findings revealed that older adults use a wide range of adaptations with compensation and selection the most (40.4%) and least (16.5%) frequently reported respectively. Degree of disability was uniquely associated with the frequency of using SOC strategies while controlling for other factors. Furthermore, degree of disability was a mediator for multi-morbidity in predicting frequency of using SOC strategies. Conclusions The findings support that older adults using behavioral adaptations to cope with functional decline is prevalent. Knowing the types of adaptation that older adults employed and the indirect relationship between multi-morbidity and frequency of using SOC strategies, with degree of disability as the mediator will be helpful in planning interventions and prevention programs for educating older adults.

Objective To preliminarily validate the Visual Skills for Reading Test (VSRT) for assessing reading performance in persons with homonymous hemianopia (HH) or quadrantanopia. Design Retrospective chart review. Setting University-based outpatient low vision rehabilitation center. Participants Persons (N=38) with HH or quadrantanopia who completed the VSRT. Interventions Validation procedures included testing for equivalence of the 3 test versions, estimation of internal consistency reliability, and known-group comparison using VSRT results from previous studies of adults with normal vision and central field loss. Main Outcome Measures Corrected reading rate, reading accuracy rate, type and number of reading errors, and completion time were recorded and evaluated. Results Cronbach α for the VSRT across all participants was .80, which indicated good internal consistency. A known-group comparison showed that persons with a visual field deficit read significantly slower than did normally sighted adults ( t 580 =10.13; P t 36 =2.25; P =.03) or those with central field loss ( t 48 =3.17; P =.0027). These findings confirmed that the VSRT correctly discriminated between groups in terms of reading performance. Conclusions Preliminary validation results indicate that the VSRT demonstrates adequate evidence of reliability and validity to evaluate reading performance in adults with HH or quadrantanopia.

Date Presented 03/27/20 A growing body of evidence suggests that individuals who engage in a short-term visit to an urban park experience physiological and psychological restorative benefits. This study was designed to identify factors associated with the improvement in subjective well-being immediately after a short-term visit to an urban park in an uncontrolled condition, and to determine the optimal park-visit duration that can provide an improvement in subjective well-being. Primary Author and Speaker: Hon Yuen Additional Authors and Speakers: Gavin Jenkins

Date Presented 03/28/20 Studies have reported high prevalence of children with TS having difficulties in academic performance. The exact mechanism contributing to poor academic performance is not known. Circumstantial evidence suggests children with TS experience challenges in handwriting that may be attributed to their tics. The purpose of this study was to examine the link between TS and handwriting in children. Primary Author and Speaker: Hon Yuen Additional Authors and Speakers: Karmen Mitchell, Heather Simpson

OBJECTIVE. Our objective was to validate the construct of the Revised Self-Report Assessment of Functional Visual Performance (R–SRAFVP) for older adults with low vision resulting from age-related eye disease. METHOD. The 50-item draft of the R–SRAFVP was administered to 87 older adults with low vision. Construct validation included principal-components analysis and the known-groups method. RESULTS. Principal-components analysis revealed nine components (comprising 33 items): Personal Care, Oral Care, Meal/Laundry Preparation, Financial Management, Telephone Usage, Personal Preference Activities, Reading, Writing, and Functional Mobility. Cronbach’s α ranged from .72 to .84 for individual components and was .92 overall. Known-groups comparisons showed that participants with moderate to profound acuity loss or contrast sensitivity deficits reported significantly greater difficulty completing tasks on the R–SRAFVP than those with milder acuity loss or normal contrast sensitivity. CONCLUSION. The 33-item R–SRAFVP demonstrates adequate evidence of reliability and validity to evaluate the ability of older adults with low vision to complete vision-dependent activities of daily living.

Aims To investigate what dental hygienists' practice characteristics and oral health topics are associated with additional time dental hygienists spent on educating patients with diabetes. Methods A one-page survey was mailed to 2237 registered dental hygienists in South Carolina. Survey questions focused on perceptions of dental hygienists regarding their oral health preventive education for patients with diabetes. After two follow-up mails, we received 995 usable questionnaires. Results Multivariable logistic regression modeling showed dental hygienist respondents who spent additional time educating patients with diabetes about oral health felt they had adequately covered the topics on effects of periodontal disease related to diabetes, effects of uncontrolled diabetes on periodontal disease, and nutrition and dietary counseling. In addition, a higher number of patients with diabetes treated per week, and a shorter recall interval for patients were also associated with more likelihood of respondents spending additional time educating patients with diabetes. Conclusion Results suggest that the additional time that dental hygienist respondents spent on educating patients with diabetes was related to oral health issues associated with diabetes, not just repetition of routine oral hygiene and plaque control instructions.

This study investigated the differences in the quality of park play spaces between an affluent and a non-affluent community in a large US Southeastern metropolitan area. Two cities were purposefully selected to reflect differences in household income and race/ethnicity characteristics. Using the Playable Space Quality Assessment Tool (PSQAT), all parks (n = 11, with six in the affluent city, and five in the non-affluent city) in these two cities were evaluated. The data were analyzed across three aspects of environmental features of the PSQAT: Location, Play Value and Care and Maintenance between parks in the two cities. The Mann-Whitney U test was used to test the study hypotheses. Results indicated significant differences between parks in the two cities in all three aspects of the PSQAT with p-values ≤ 0.03 and effect sizes of &gt, 0.65, suggesting that the affluent city had parks of a higher quality than the non-affluent city. Significant disparity in Play Value (p = 0.009) in parks between these two communities suggests that children and young people are likely to have different experiences of the play spaces in their locality and therefore may experience different physical and psychological health benefits.

Purpose: The purpose of this study was to cross-validate the factor structure of the previously developed Student Perceptions of Team-Based Learning (TBL) Scale among students in an entry-level doctor of physical therapy (DPT) program in the United States.Methods: Toward the end of the semester in 2 patient/client management courses taught using TBL, 115 DPT students completed the Student Perceptions of TBL Scale, with a response rate of 87%. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were conducted to replicate and confirm the underlying factor structure of the scale. Results: Based on the PCA for the validation sample, the original 2-factor structure (preference for TBL and preference for teamwork) of the Student Perceptions of TBL Scale was replicated. The overall goodness-of-fit indices from the CFA suggested that the original 2-factor structure for the 15 items of the scale demonstrated a good model fit (comparative fit index, 0.95; non-normed fit index/Tucker-Lewis index, 0.93; root mean square error of approximation, 0.06; and standardized root mean square residual, 0.07). The 2 factors demonstrated high internal consistency (alpha= 0.83 and 0.88, respectively). DPT students taught using TBL viewed the factor of preference for teamwork more favorably than preference for TBL.Conclusion: Our findings provide evidence supporting the replicability of the internal structure of the Student Perceptions of TBL Scale when assessing perceptions of TBL among DPT students in patient/client management courses.

BACKGROUND To identify physical measures that predict maximal handgrip strength (MHGS) and provide evidence for identifying lack of sincerity of effort when assessing upper extremity weakness. OBJECTIVE This study investigated anthropometric measurements associated with MHGS of healthy young adults. METHODS A convenience sample of 150 healthy adults ages 19 to 34 years old completed the MHGS assessment, which was measured using a Jamar dynamometer according to the protocol of the American Society of Hand Therapists, for both dominant and non-dominant hands. Several anthropometric data were collected, which included height, body weight, forearm length, forearm circumference, hand length, and hand width. RESULTS Multivariable linear regression analysis indicated gender and hand width were uniquely and significantly associated with participants' MHGS for dominant and non-dominant hand and accounted for more than 60% of the variance, with R2 = 0.60, P

OBJECTIVE. We describe the perceived adequacy of educational preparation for and comfort level of occupational therapy practitioners in providing services to clients with low vision and identify factors associated with the practitioners’ comfort level. METHOD. One hundred occupational therapists who were not specialists in low vision rehabilitation completed a survey. RESULTS. Fifty-two percent of the respondents perceived that they had received adequate preparation in occupational therapy school to address low vision. Between 54% and 63% of respondents were comfortable performing visual screening and providing interventions for clients with low vision. Multivariable analyses indicated that having received adequate preparation in occupational therapy school, having a partnership with an eye-care professional, and having provided services to a larger percentage of clients with low vision were significantly associated with perceived comfort in providing services to this population. CONCLUSION. Findings provide an initial direction to improve low vision content in occupational therapy education curricula.

Purpose To assess the test–retest reliability of the Oral Health Impact Profile (OHIP) in 3-month intervals among people with systemic sclerosis (SSc). Methods Thirty-nine adults with SSc completed the OHIP-49 at baseline, 3 and 6 months. Intraclass correlation (ICC), standard error of measurement (SEM), SEM%, coefficient of repeatability (CoR), and 95% limits of agreement (LoA) were used to assess test–retest reliability and measurement variability. Results The ICC of the OHIP for the first time point (baseline to 3-month) was excellent (>.80), and the second time point (3-month to 6-month) demonstrated good reproducibility (>.60). However, the large SEM, SEM%, CoR, and 95% LoA indicated that the OHIP was neither a precise measurement nor sensitive to change in response to interventions. Conclusion The values of the ICC indicated that the OHIP scores demonstrated acceptable stability across each of the two 3 months’ retest duration, supporting the reliability of the OHIP for group-level comparisons. However, using the OHIP as a measure of an individual's oral health-related quality of life in adults with SSc is not recommended.

Purpose: The purpose of this retrospective study was to evaluate students’ academic outcomes after implementation of the team-based learning (TBL) approach in patient/client management courses in an entry-level doctor of physical therapy (DPT) curriculum. Methods: The research design of this study involved comparing written and practical exam scores from DPT student cohorts taught with the traditional instructional methods (lecture-based) to those of students from subsequent cohorts taught using the TBL approach in two patient/client management courses: basic skills and cardiopulmonary. For this comparison, the exams used, the number of contact hours and labs, and the instructors who taught these courses remained the same during the transition between these two instructional methods (traditional vs. TBL). The average of all individual course exam scores was used for data analysis. Results: In both courses, there were no meaningful differences in the mean exam scores among students across years of cohorts receiving the same instructional method, which allowed clustering students from different years of cohorts in each course receiving the same instructional method into one group. For both courses, the mean exam score was significantly higher in the TBL group than in the traditional instruction group: basic skills course (P

Study design one group pre- and post-test design Objective The primary aim was to examine both the short- and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia. Methods Eight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using PC-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15 to 30 min sessions across three months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Löe-Silness gingival index (LSGI) was conducted at baseline, six months and 12 months. Results From baseline to six months, participants showed statistically significant differences (i.e., improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (i.e., improvement, z=2.03; P=.04) in their LSGI scores. Conclusion This study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at six and 12 months among adults with tetraplegia.

Background and Purpose. Community-based service learning (CBSL) has been identified in the literature as an educational strategy that may be helpful in the development of student physical therapist (SPT) behaviors consistent with the core values of professionalism in physical therapy. However, little is known of the effect of CBSL on SPTs' professional behaviors. The purpose of this paper is to describe the change in perceived frequency of demonstrated professional behaviors, using the American Physical Therapy Association's Professionalism in Physical Therapy: Core Values Self-Assessment (SA), among a group of third-year SPTs following participation in CBSL versus participation in standard classroom learning.Methods. The SA was administered on 3 occasions at 5-week intervals over a 10-week time period to 54 third-year SPTs. During the first 5 weeks, the students received standard didactic classroom instruction. From weeks 6-10, the students prepared and participated in a community-based health education presentation.Forty-two SPTs completed the SA on all 3 occasions. Paired t tests were used to compare the respective difference in perceived frequency of demonstrating these professional behaviors following participation in CBSL and participation in standard classroom learning, and to compare the changes in the scores between the baseline and after the classroom instruction. Statistical significance was set at P Results. After the CBSL, there were positive changes in the scores for all 7 core values, with a significant difference in the change scores between the standard classroom instruction and CBSL in 3 core values: altruism (P = .009), compassion/caring (P = .022), and integrity (P = .029). Cronbach α was .96 for the SA and ranged from .70-.94 for the 7 core values representing professionalism in physical therapy.Discussion and Conclusion. Self-assessment is a key component of professionalism and can be used to monitor student perceptions regarding change in frequency of behaviors with CBSL. The SA demonstrates acceptable reliability when measuring perceived changes in each of the core values associated with professionalism. Additional psychometric properties of the SA need to be established so that interpretation of scores and amount of score changes will have practical educational meaning.Key Words: Service learning, Professional development, Professional issues, PT content/teaching areas, Student outcomes.BACKGROUND AND PURPOSEThe promotion of professional behavior is critical to the physical therapy profession as it transitions to a doctoring profession. In 2003, the American Physical Therapy Association (APTA) published the Professionalism in Physical Therapy: Core Values (PPTCV)1 to help define and describe the professional behaviors of the physical therapist (PT) in daily practice. Seven core values (accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility) were identified as critical elements that comprise professionalism in physical therapy practice, education, and research. A Self-Assessment (SA) accompanies the PPTCV and includes indicators or behaviors for each of the values, which are scored on a rating scale representing the frequency of demonstrating those behaviors.2APTA adopted the PPTCV as a core document in 2003 and the 7 core values have been incorporated as contemporary practice expectations into APTA's Code of Ethics for the Physical Therapist,3 A Normative Model of Physical Therapist Professional Education: Version 2004 (NMV2004);4 and the Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists, published by the Commission on Accreditation in Physical Therapy Education (CAPTE).1,3"5 The NMV2004 provides examples of classroom and clinical instructional objectives related to the achievement of the knowledge, skills, and behaviors related to each of the core values. …