Impact of the team wheels ehealth manual wheelchair training program : study protocol for a randomized controlled trial

Background Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform. Objective This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group. Setting The study will be implemented in a community setting in three Canadian cities. Participants Individuals ≥ 18 years of age within one year of transitioning to use of a MWC. Intervention Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75–150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants’ training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection. Measurements Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group. Impact statement We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control grou

Development of the Standardized Navigation Of Winter Mobility & Accessibility Network (SNOWMAN) course

IntroductionManual wheelchairs (MWC) users have limited mobility during winter months as they encounter many environmental barriers that restrict their community participation. This paper outlines the creation and standardization of an outdoor environment designed to simulate the real-life conditions and obstacles experienced by MWC users in winter.Methods and resultsThis study consisted of four phases. In Phase 1, researchers used a qualitative ethnographic approach to document the specific challenges and adaptive strategies used by MWC users in winter conditions. In Phase 2, key informants with expertise in MWC winter mobility were invited to co-design the Standardized Navigation Of Winter Mobility & Accessibility Network (SNOWMAN) course. Participants reviewed draft design solutions and offered their input and suggestions to expand upon the initial design. A second co-design workshop included additional key informants, including service providers, policymakers, and professionals with expertise in landscape architecture and engineering, to validate the design solution. The workshops resulted in a detailed illustration of the SNOWMAN course, including five sections: platforms with side slopes, a miniature ice rink, curbs and curb cuts, a path with uneven winter surfaces, and modular ramps at various slopes. Phases 3 and 4 marked the conclusion of the study and involved fabrication of the SNOWMAN course and establishment of a standardized protocol for course setup and maintenance.DiscussionThe project aimed to offer several additional potential benefits, supported by the various stakeholders across the study phases, that extend beyond creation of a controlled and safe environment for wheelchair users to develop their winter mobility skills. Practicing wheelchair skills in this area may assist wheelchair users in gaining confidence which may ultimately translate to increased participation in the community

Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review

Purpose This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings. Methods The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised. Results A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package – Basic Level. Conclusion Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized. Implications for Rehabilitation This is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries. Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs. Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized

Health promotion programs related to the Athens 2004 Olympic and Para Olympic games

BACKGROUND: The Olympic Games constitute a first-class opportunity to promote athleticism and health messages. Little is known, however on the impact of Olympic Games on the development of health-promotion programs for the general population. Our objective was to identify and describe the population-based health-promotion programs implemented in relation to the Athens 2004 Olympic and Para Olympic Games. METHODS: A cross-sectional survey of all stakeholders of the Games, including the Athens 2004 Organizing Committee, all ministries of the Greek government, the National School of Public Health, all municipalities hosting Olympic events and all official private sponsors of the Games, was conducted after the conclusion of the Games. RESULTS: A total of 44 agencies were surveyed, 40 responded (91%), and ten (10) health-promotion programs were identified. Two programs were implemented by the Athens 2004 Organizing Committee, 2 from the Greek ministries, 2 from the National School of Public Health, 1 from municipalities, and 3 from official private sponsors of the Games. The total cost of the programs was estimated at 943,000 Euros; a relatively small fraction (0.08%) of the overall cost of the Games. CONCLUSION: Greece has made a small, however, significant step forward, on health promotion, in the context of the Olympic Games. The International Olympic Committee and the future hosting countries, including China, are encouraged to elaborate on this idea and offer the world a promising future for public health

Turbidity currents can dictate organic carbon fluxes across river-fed fjords: example from Bute Inlet (BC, Canada)

The delivery and burial of terrestrial particulate organic carbon (OC) in marine sediments is important to quantify, because this OC is a food resource for benthic communities, and if buried it may lower the concentrations of atmospheric CO2 over geologic timescales. Analysis of sediment cores has previously shown that fjords are hotspots for OC burial. Fjords can contain complex networks of submarine channels formed by seafloor sediment flows, called turbidity currents. However, the burial efficiency and distribution of OC by turbidity currents in river-fed fjords had not been investigated previously. Here, we determine OC distribution and burial efficiency across a turbidity current system within Bute Inlet, a fjord in western Canada. We show that 62% ± 10% of the OC supplied by the two river sources is buried across the fjord surficial (30–200 cm) sediment. The sandy subenvironments (channel and lobe) contain 63% ± 14% of the annual terrestrial OC burial in the fjord. In contrast, the muddy subenvironments (overbank and distal basin) contain the remaining 37% ± 14%. OC in the channel, lobe, and overbank exclusively comprises terrestrial OC sourced from rivers. When normalized by the fjord’s surface area, at least 3 times more terrestrial OC is buried in Bute Inlet, compared to the muddy parts of other fjords previously studied. Although the long-term (>100 years) preservation of this OC is still to be fully understood, turbidity currents in fjords appear to be efficient at storing OC supplied by rivers in their near-surface deposits

Organic carbon measurements on Bute Inlet river samples

This dataset includes organic carbon measurements on sediment samples collected in Bute Inlet (British Columbia, Canada) in October 2016 (cruise number PGC2016007) and October 2017 (cruise number PGC2017005) aboard the research vessel CCGS Vector. The cruise PGC2016007 took place between 7 October and 17 October 2016 and was led by Gwyn Lintern. The cruise PGC2017005 took place between 19 and 29 October and was led by Cooper Stacey. River samples were taken in the Homathko and Southgate rivers using Niskin bottles in the water column and a grab sampler in the river beds and the river delta