Measuring Environmental Factors: Unique and Overlapping International Classification of Functioning, Disability and Health Coverage of 5 Instruments.

Objectives: To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments.

Design: Cross-sectional, observational cohort.

Setting: Community.

Using the ICF's environmental factors framework to develop an item bank measuring built and natural environmental features affecting persons with disabilities.

Objectives: To develop a measure of natural environment and human-made change features (Chapter 2 of the international classification of functioning, disability, and health) and evaluate the influence of perceived barriers on health-related quality of life.

Methods: A sample of 570 adults with stroke, spinal cord injury, and traumatic brain injury residing in community settings reported their functioning in home, outdoor, and community settings (mean age = 47.0 years, SD = 16.

Important wheelchair skills for new manual wheelchair users: health care professional and wheelchair user perspectives.

Purpose: The purpose of this project was to identify wheelchair skills currently being taught to new manual wheelchair users, identify areas of importance for manual wheelchair skills' training during initial rehabilitation, identify similarities and differences between the perspectives of health care professionals and manual wheelchair users and use the ICF to organize themes related to rehabilitation and learning how to use a manual wheelchair.

Method: Focus groups were conducted with health care professionals and experienced manual wheelchair users. ICF codes were used to identify focus group themes.

Environmental barriers and supports to everyday participation: a qualitative insider perspective from people with disabilities.

Objective: To describe environmental factors that influence participation of people with disabilities.

Design: Constant comparative, qualitative analyses of transcripts from 36 focus groups across 5 research projects.

Setting: Home, community, work, and social participation settings.

Theoretical foundations for the measurement of environmental factors and their impact on participation among people with disabilities.

The ascendance of the World Health Organization's International Classification of Functioning, Disability and Heath (ICF) as the global standard for describing and characterizing aspects of disability has refocused attention on the role that environmental factors (EFs) have on the health and participation of people with disabilities, both as individuals and as a group. There has been a rise in the development of instruments designed to measure EFs alone and in relation to participation. Some instrument developers have used the ICF as a theoretical base for instrument development and to substantiate content validity claims.

Person factors and work environments of workers who use mobility devices.

Background: Nearly 25% of people with mobility impairments and limitations who are of working age are employed, yet few studies have examined their perspectives on their jobs or work environments required to complete job tasks.

Objective: The purpose of this study was to describe the factors that contribute to successful employment for those who use mobility devices.

Participants: A convenience sample of 132 workers who use power wheelchairs, manual wheelchairs, canes, crutches or walkers.

The development of an instrumented wheelchair propulsion testing and training device.

Researchers have used several types of testing devices and training surfaces to examine wheelchair propulsion. Testing and training wheelchair users on the actual surface of interest, such as tile floors or ramps, is ideal but difficult. Devices such as treadmills, dynamometers, and ergometers allow for researchers and clinicians to observe wheelchair users in a controlled space.

Environmental factors item development for persons with stroke, traumatic brain injury, and spinal cord injury.

Objectives: To describe methods used in operationalizing environmental factors; to describe the results of a research project to develop measures of environmental factors that affect participation; and to define an initial item set of facilitators and barriers to participation after stroke, traumatic brain injury, and spinal cord injury.

Design: Instrument development included an extensive literature review, item classification and selection, item writing, and cognitive testing following the approach of the Patient-Reported Outcomes Measurement Information System.

Setting: Community.

Work environments of people with mobility impairments and limitations: Mobility Device User Work Survey (MWS).

Background: Few studies of employed people who use wheelchairs, canes, crutches or walkers have been reported in the literature. One reason for this paucity of research reports is that surveys are most often made of unemployed individuals with disabilities a defined broadly. Understanding the work site of successfully employed people who use mobility devices requires the development of as survey that can be used to examine the important features of worksite from employees who use mobility devices at their worksites.

Interviews with employed people with mobility impairments and limitations: environmental supports impacting work acquisition and satisfaction.

Background: Less than 40% of people with disabilities work. Many studies have detailed the barriers to employment but few have examined the work experiences of those who are employed.

Objective: A description of work conditions valued by a specific segment of employed people with disabilities is provided.

Measuring impact of environmental factors on human functioning and disability: a review of various scientific approaches.

Purpose: The objective of this paper is to present a framework for systematically describing different approaches to measure environmental factors (EF) and to discuss some strengths and weaknesses of these approaches.

Methods: Identification of suitable criteria for ordering measurements of EF was based on an analysis of existing reviews, a qualitative literature review and feedback from experts. Items of selected EF measures were linked to the International Classification of Functioning, Disability and Health.

Development of an item bank for a computerised adaptive test of upper-extremity function.

Purpose: The purpose of this study was to determine the psychometric characteristics of an upper-extremity item bank as a precursor to developing a computer adaptive patient reported outcome instrument. The Activity dimension of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) provided the conceptual framework for the items.

Method: Factor and Rasch analyses were used to evaluate the psychometric properties of the item bank, including: monotonicity, local independence, dimensionality, item difficulty hierarchy and match between sample ability and item difficulty.

Development of a community mobility skills course for people who use mobility devices.

Objective: We assessed mobility device skills in a lived-in environment on a community mobility skills course (CMSC) and related those skills to previously demonstrated skills in a controlled environment on an inside mobility skills course (IMSC).

Method: Six mobility device users were selected from 91 adults who had previously completed the IMSC. Each of the following device groups was represented: power wheelchair, manual wheelchair, scooter, cane, crutch, and walker.

Structural equation modeling of the relationships between participation in leisure activities and community environments by people with mobility impairments.

Objective: To examine the linkages between the constructs of participation and the environment for a set of leisure activities (attending concerts, attending movies, attending sporting events).

Design: Self-report surveys of the influence of the environment on participation were analyzed using structural equation modeling. Temporal, evaluative, and health-related aspects of leisure activities were selected as latent variables associated with participation.

Influence of a Consumer-Directed Personal Assistance Services Program on the lives of persons with mobility impairments.

Objective: To examine the effects of a consumer-directed personal assistance services (CDPAS) program on the lives of persons with disabilities.

Methods: Thirteen individuals receiving paid agency-directed PAS services before enrollment in a CDPAS program (Agency Group) and 40 individuals receiving only unpaid PAS before enrollment (Informal Group) participated in this prospective study. In-home interviews were conducted just prior to CDPAS enrollment and again 6 months after CDPAS enrollment.

The influence of verbal training and visual feedback on manual wheelchair propulsion.

Purpose: To determine if verbal training with visual feedback improved manual wheelchair propulsion; to examine propulsion differences between an individual with paraplegia and an individual with tetraplegia.

Method: Quasi-experimental study: Nine manual wheelchair-using adults participated in propulsion assessments and training. Baseline propulsion performance was measured on several tasks on different surfaces.

The interrater reliability of the Community Health Environment Checklist.

Objective: The purpose of this preliminary study was to examine the interrater reliability of the Community Health Environment Checklist.

Design: Thirty buildings were randomly selected. Three trained raters assessed each destination with the Community Health Environment Checklist.

People with mobility impairments: Physical activity and quality of participation.

Background: we sought to describe the characteristics of physical activity levels, health, community integration, and social participation of people with mobility impairments.

Methods: based on responses to a participation survey, respondents, located primarily in the Midwestern United States, were divided into 3 physical activity groups: high, low, and inactive. We chose a purposeful sample of 604 people with mobility limitations who had a diagnosis of spinal cord injury, multiple sclerosis, cerebral palsy, stroke, or poliomyelitis.

Assessment of segregation potential of powder blends.

Pharmaceutical blends consist of several components each with its own unique characteristics, with different size, shape, density, and particle-particle interactions. With so many degrees of complexity, prediction of segregation behavior becomes intractable. The objective of this study was to develop a segregation test method or a segregation tool that would assess the segregation potential of blends.

A subjective measure of environmental facilitators and barriers to participation for people with mobility limitations.

Purpose: The aim of this paper is to describe the development and psychometric properties of a self-report survey of environmental facilitators and barriers to participation by people with mobility impairments.

Method: A measure called the Facilitators And Barriers Survey of environmental influences on participation among people with lower limb Mobility impairments and limitations (FABS/M) was developed using items based on focus groups to ensure content validity. Discriminant validity was assessed on 604 individuals who completed the FABS/M once.

Development of a measure of receptivity of the physical environment.

Purpose: New models of disability identify the importance of measuring the influence of the environment (environmental barriers) on the performance of persons with disabilities. The objective of this paper is to present a new measure of the receptivity of the physical environment for persons with mobility impairments and to offer preliminary information about its psychometric properties.

Methods: The measure, The Community Health Environment Checklist (CHEC), was developed and validated in a community setting with a group of persons with mobility impairments.

Formulation of solid dosage forms to overcome gastric pH interaction of the factor Xa inhibitor, BMS-561389.

Purpose: The purpose of the study was to investigate the specific mechanism by which elevated gastric pH reduces the absorption of BMS-561389, a factor Xa inhibitor, and to develop a solid formulation strategy to overcome this gastric pH interaction.

Methods: A dissolution method in an acetate buffer at pH 5.5 was used to evaluate the dissolution behavior of the tablet formulation.

Participation survey/mobility: psychometric properties of a measure of participation for people with mobility impairments and limitations.

Objective: To describe the development and psychometric properties of a self-report survey of participation by people with mobility limitations, the Participation Survey/Mobility (PARTS/M).

Design: The information obtained during interviews and focus groups was used to develop items for the PARTS/M. Demographics and measures of disability, health, and functioning were collected.

A study on the effect of wet granulation on microcrystalline cellulose particle structure and performance.

Purpose: The aim of this study was to investigate the mechanism of the effect of wet granulation process on the compaction properties of microcrystalline cellulose (MCC).

Methods: MCC alone and with hydroxypropyl cellulose (HPC) as a binder were wet granulated by a high-shear process using different granulation parameters (over- and undergranulated). Overgranulated batches were also ball milled after drying and compared to the unmilled material.

Validation of the Reintegration to Normal Living Index in a population of community-dwelling people with mobility limitations.

Objective: To validate the Reintegration to Normal Living Index (RNLI) in a population of community-dwelling adults with mobility limitations.

Design: Cross-sectional survey.

Setting: Community.