Purpose: To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. Methods: Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. Results: Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. Conclusions: A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
In this paper, we test path models that study the interrelations between primary health careprovider attitudes towards working with drinkers, their screening and brief advice activity, and theirreceipt of training and support and financial reimbursement. Study participants were 756 primaryhealth care providers from 120 primary health care units (PHCUs) in different locations throughoutCatalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training andsupport and financial reimbursement to providers. Our design was a randomized factorial trial withbaseline measurement period, 12-week implementation period, and 9-month follow-up measurementperiod. Our outcome measures were: attitudes of individual providers in working with drinkers asmeasured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion ofconsulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudesthrough its impact on higher intervention activity. We conclude that improving primary health careproviders’ screening and brief advice activity for heavy drinking requires a combination of trainingand support and on-the-job experience of actually delivering screening and brief advice activity.
MULTIFILE
Differentiating perfectionistic strivings and perfectionistic concerns, the present study examined how perfectionism predicts what coping strategies people use, when dealing with failures, and how perfectionism and coping influence people's satisfaction. A sample of 149 students completed daily reports for 3-14 days, reporting the most bothersome failure they experienced during the day, what strategies they used to cope with the failure, and how satisfied they felt at the end of the day. Multilevel regression analyses showed that perfectionistic concerns predicted more frequent use of self-blame, less frequent use of active coping and acceptance, and higher satisfaction at the end of the day, whereas perfectionistic strivings predicted less frequent use of self-blame and higher satisfaction. Although positive reframing, acceptance, and humor predicted higher satisfaction for all students, further analyses showed that positive reframing coping was particularly helpful for students high in perfectionistic concern. The findings suggest that accommodative coping strategies are generally helpful in dealing with personal failures, with positive reframing being a coping strategy that works particularly well for people high in perfectionistic concerns (who are prone to dissatisfaction) to achieve higher satisfaction at the end of the day.
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