Development, Acceptability, and Emotional Responses of Low-Sodium Roasted Peanuts and Flavored Spreads

The objective of this research was to evaluate the feasibility of developing acceptable low-sodium products by using a salt-replacement technique, an oil-in-water emulsion system, and health benefit information to improve consumers’ awareness of low-sodium diets. Three experiments were conducted: (I) Sensory characteristics and optimization of low-sodium roasted peanuts by substitution of NaCl with KCl, and addition of glycine (Gly) as a bitterness blocker; (II) Rejection threshold (RjT) of KCl added to low-sodium roasted peanuts using a 2AC-test; (III) Development of acceptable low-sodium and sodium-free spreads by flavor modification and their use on turkey salad sandwiches. In study I, results showed that sodium content in peanuts decreased from 140mg/50g to 41.7mg/50g without affecting liking scores with positive purchase intent (PI) of \u3e60%. Health messages (HM) related to high-sodium intake risks increased positive emotion responses while decreasing negative ones. The optimal range of 59-100/0-40/0-12.5 of NaCl/KCl/Gly yielded acceptable low-sodium peanuts. From Study II, up to 30-50% KCl did not significantly decrease overall liking (OL) scores, but OL scores decreased at 70-90% KCl; the same was observed for PI. Samples containing 70-90% KCl were perceived by consumers as “too salty,” and was associated with mean drops of 2.2 on the 9-point OL scale. No RjT of added KCl at 90% w/w in low-sodium roasted peanuts was reached under the conditions of this study. In Study III, consumers first indicated their willingness to purchase a sodium-free mayonnaise spread containing 1% KCl after a sodium claim was stated. Three levels of KCl (0.5, 1, and 1.5%) were tested with four selected flavors in the spreads. Acceptability of the flavored spreads increased by flavor modification. Bacon flavor significantly outperformed for all sensory attributes evaluated when compared to the rest of the treatments. Bitterness intensity of the samples was not associated with the mean drops on the OL scores. Low-sodium benefits HM increased PI for 10 treatments. Flavored spreads evaluated on turkey salad sandwiches yielded higher liking scores and PI than the spreads alone. Combination of a sodium HM and salt substitution with KCl increased liking scores, positive emotion responses and willingness to purchase low-sodium products

Microstructure and corrosion evolution of additively manufactured aluminium alloy AA7075 as a function of ageing

Additively manufactured high strength aluminium alloy AA7075 was prepared using selective laser melting. High strength aluminium alloys prepared by selective laser melting have not been widely studied to date. The evolution of microstructure and hardness, with the attendant corrosion, were investigated. Additively manufactured AA7075 was investigated both in the as-produced condition and as a function of artificial ageing. The microstructure of specimens prepared was studied using electron microscopy. Production of AA7075 by selective laser melting generated a unique microstructure, which was altered by solutionising and further altered by artificial ageing - resulting in microstructures distinctive to that of wrought AA7075-T6. The electrochemical response of additively manufactured AA7075 was dependent on processing history, and unique to wrought AA7075-T6, whereby dissolution rates were generally lower for additively manufactured AA7075. Furthermore, immersion exposure testing followed by microscopy, indicated different corrosion morphology for additively manufactured AA7075, whereby resultant pit size was notably smaller, in contrast to wrought AA7075-T6.Comment: 37 pages, includes 4 Tables and 11 Figure

Évaluer la téléréadaptation : la synthèse des effets et l’analyse des changements cliniques et organisationnels

La téléréadaptation, tout comme d’autres champs en télésanté, est de plus en plus interpelée pour la prestation de services. Le but de ce projet de thèse est d’enrichir l’évaluation de la téléréadaptation afin que les connaissances qui en découlent puissent venir soutenir la prise de décision d’acteurs impliqués à différents niveaux en téléréadaptation. Le premier article présente une revue systématique dont l’objectif était de faire synthèse critique des études en téléréadaptation. La revue rassemble 28 études en téléréadaptation, qui confirment l’efficacité de la téléréadaptation pour diverses clientèles dans différents milieux. Certaines des études suggèrent également des bénéfices en termes de coûts, mais ces résultats demeurent préliminaires. Cette synthèse critique est utile pour soutenir la décision d’introduire la téléréadaptation pour combler un besoin. Par contre, les décideurs bénéficieraient aussi de connaissances par rapport aux changements cliniques et organisationnels qui sont associés à la téléréadaptation lorsqu’elle est introduite en milieu clinique. Les deux autres articles traitent d’une étude de cas unique qui a examiné un projet clinique de téléréadaptation dans l’est de la province de Québec, au Canada. Le cadre conceptuel qui sous-tend l’étude de cas découle de la théorie de structuration de Giddens et des modèles de structuration de la technologie, en particulier de l’interaction entre la structure, l’agent et la technologie. Les données ont été recueillies à partir de plusieurs sources (groupes de discussion, entrevues individuelles, documents officiels et observation d’enregistrements) suivi d’une analyse qualitative. Le deuxième article de la thèse porte sur le lien entre la structure, l’agent et la culture organisationnelle dans l’utilisation de la téléréadaptation. Les résultats indiquent que les différences de culture organisationnelle entre les milieux sont plus évidentes avec l’utilisation de la téléréadaptation, entraînant des situations de conflits ainsi que des occasions de changement. De plus, la culture organisationnelle joue un rôle au niveau des croyances liées à la technologie. Les résultats indiquent aussi que la téléréadaptation pourrait contribuer à changer les cultures organisationnelles. Le troisième article examine l’intégration de la téléréadaptation dans les pratiques cliniques existantes, ainsi que les nouvelles routines cliniques qu’elle permet de soutenir et la pérennisation de la téléréadaptation. Les résultats indiquent qu’il y a effectivement certaines activités de téléréadaptation qui se sont intégrées aux routines des intervenants, principalement pour les plans d’intervention interdisciplinaire, tandis que pour les consultations et le suivi des patients, l’utilisation de la téléréadaptation n’a pas été intégrée aux routines. Plusieurs facteurs en lien avec la structure et l’agent ont contraint et facilité l’intégration aux routines cliniques, dont les croyances partagées, la visibilité de la téléréadaptation, le leadership clinique et organisationnel, la disponibilité des ressources, et l’existence de liens de collaboration. La pérennité de la téléréadaptation a aussi pu être observée à partir de la généralisation des activités et le développement de nouvelles applications et collaborations en téléréadaptation, et ce, uniquement pour les activités qui s’étaient intégrées aux routines des intervenants. Les résultats démontrent donc que lorsque la téléréadaptation n’est pas intégrée aux routines cliniques, elle n’est pas utilisée. Par contre, la téléréadaptation peut démontrée certains signes de pérennité lorsque les activités, qui sont reproduites, deviennent intégrées aux routines quotidiennes des utilisateurs. Ensemble, ces études font ressortir des résultats utiles pour la mise en place de la téléréadaptation et permettent de dégager des pistes pour enrichir le champ de l’évaluation de la téléréadaptation, afin que celui-ci devienne plus pertinent et complet, et puisse mieux soutenir les prises de décision d’acteurs impliqués à différents niveaux en téléréadaptation.Telerehabilitation, like other telehealth applications, has been increasingly used to provide health services. The goal of this thesis is to enrich the field of telerehabilitation evaluation such that it can better contribute to informed decision making of those involved in telerehabilitation at different levels. The first article is a systematic review of telerehabilitation studies and it was conducted in order to provide a critical synthesis of the current telerehabilitation literature. The revue included 28 studies of telerehabilitation, which, overall, confirmed the efficacy of telerehabilitation when used with a variety of clienteles in different settings. Some of the studies also suggest that there may be some cost benefits associated with telerehabilitation although the findings remain preliminary. Such a synthesis of the literature can contribute to some decisions regarding the pertinence of introducing telerehabilitation. However, decision makers also need information regarding the clinical and organizational changes that are associated with telerehabilitation when implemented in a clinical setting. The next two articles contain the results of a single case study that was centered on a telerehabilitation clinical project implemented in the eastern part of the province of Quebec, in Canada. A conceptual model was developed to guide this study, and it was based on Giddens’ Theory of Structuration and on models of technology structuration, in particular drawing upon the notion of the interaction between structure, agent and technology. Data was collected from several sources (focus groups, interviews, official documents and observation of recordings) and was analyzed using a qualitative analysis approach. The second article in this thesis examined the relationship between structure, agent and organizational culture with respect to telerehabilitation use. The results indicate that differences in organizational culture between the centres are more visible when telerehabilitation is used, which can in some cases lead to conflicts, while in other cases create opportunities for change. In addition, organizational culture also played a role in shared beliefs linked to the technology. Lastly, the results suggest that telerehabilitation could be used to bring about changes in organizational culture. The third article examined how telerehabilitation became integrated into existing clinical practices, how it contributed to the development of new routines and explored the sustainability of telerehabilitation. The results indicate that some activities, namely interdisciplinary care plans were integrated into clinical routines, while consultations and patient follow-up were not. Several factors related to the structure and agent were found to facilitate or hinder the integration of telerehabilitation into routine practices, including shared beliefs, the visibility of telerehabilitation activities, the clinical and organizational leadership, the availability of resources and the existence of collaborations. Sustainability was also observed when telerehabilitation use became more generalized and novel applications were developed, although this was only found to occur for activities which had integrated into routine practice. The results therefore suggest that when telerehabilitation is not integrated into routine practices, it will not be used, but that, on the other hand, telerehabilitation may be sustainable for activities which are repeated and then integrated into routine day-to-day clinical activities. Together, these studies put forth findings which can be useful when implementing new telerehabilitation programs. They also help elucidate directions for future research in order to enrich the field of telerehabilitation evaluation so that it may become more pertinent and comprehensive to support decision-makers involved at all levels of telerehabilitation

Telerehabilitation for Post-Hospitalized COVID-19 Patients: A Proof-of-Concept Study During a Pandemic

Purpose: Telerehabilitation could prevent sequelae from COVID-19. We aimed to assess the feasibility of telerehabilitation; describe pulmonary and functional profiles of COVID-19 patients; and explore the effect of telerehabilitation on improving pulmonary symptoms and quality of life. Methods: We conducted a pre-experimental, pre-post pilot study. We recruited COVID-19 patients who had returned home following hospitalization. The intervention included eight weeks of supervised physiotherapy sessions. We documented technological issues, success of recruitment strategies, and participants’ attendance to supervised sessions. We measured the impact of pulmonary symptoms on quality of life and functional health. Results: We scheduled 64 supervised sessions with seven participants with few technological issues. Initial scores showed that pulmonary symptoms moderately to highly impacted quality of life. At eight weeks, all patients had improved from 10 to 45 points on the EuroQol-Visual Analog Scale (EQ-VAS) instrument, indicating clinical significance. Conclusion: We developed and administered a telerehabilitation intervention during a global pandemic that targets key symptoms of the relevant disease

Telemedicine in palliative care: a review of systematic reviews

Aims. To evaluate the quality of systematic reviews on telemedicine applications in palliative care. Methods. A structured literature review was conducted to identify systematic reviews dealing with telemedicine in palliative care; the AMSTAR – Assessment of Multiple Systematic Reviews – checklist was used to appraise the evidence related to the systematic reviews. Results: 405 records were initially identified; of these 14 were eligible for full-text analysis. In summary, the research strategy allowed the identification of 6 reviews to be included which showed a medium quality (AMSTAR score in between 4 and 7). All the included systematic reviews considered telemedicine applications as a feasible means to be used in palliative care; however, the positive findings are counterbalanced by several critical issues mainly related to the evidence from the primary studies included in each single review. Conclusions. Results of this first attempt to appraise the evidence in the field of telemedicine applications in palliative care highlighted that there is still limited evidence related to this approach. Strengths and weaknesses that impact on the general quality of the reviews were identified and relevant points to be taken into account for future research were suggested

A quality assessment of systematic reviews on telerehabilitation: what does the evidence tell us?

Aims. To evaluate the quality of systematic reviews on telerehabilitation. Methods. The AMSTAR – Assessment of Multiple Systematic Reviews – checklist was used to appraise the evidence related to the systematic reviews. Results. Among the 477 records initially identified, 10 systematic reviews matched the inclusion criteria. Fifty percent were of high quality; anyway the majority of them did not report the following aspects: i) analysis of the grey literature; ii) a list of the excluded studies and their haracteristics; iii) the identification of possible source of bias and the assessment of its likehood; iv) an appropriate method to combine the findings of the included studies addressing the heterogeneity as well. From the main findings of the highscored systematic reviews telerehabilitation resulted at least as effective as usual care: 1) in the short term treatment of mental health related to people affected by spinal cord injury; 2) in rural communities for treating patients affected by chronic conditions; 3) in treating common pathologies (mainly asthma) affecting children and adolescents. As for stroke, evidence is currently insufficient to reach conclusions about its effectiveness. As for costs, there is insufficient evidence to confirm that telerehabilitation is a cost-saving or cost-effective solution. Conclusions. In the authors’ knowledge this is the first attempt to evaluate the quality of systematic reviews on telerehabilitation. This work also identified the main findings related to the high-scored systematic reviews; the analysis confirms that there is a mounting evidence concerning the effectiveness of telerehabilitation, at least for some pathologies

Creating a rehabilitation living lab to optimize participation and inclusion for persons with physical disabilities

AbstractWe present an on-going multidisciplinary and multisectorial strategic development project put forth by the Centre for Interdisciplinary Research in Rehabilitation of greater Montréal (CRIR) in Quebec, Canada and its members, in collaboration with a Montréal “renovation-ready” shopping mall, local community organizations, and local, national and international research and industrial partners. Beginning in 2011, within the context of the Mall as Living Lab (MALL), more than 45 projects were initiated to: (1) identify the environmental, physical and social obstacles and facilitators to participation; (2) develop technology and interventions to optimize physical and cognitive function participation and inclusion; (3) implement and evaluate the impact of technology and interventions in vivo. Two years later and working within a participatory action research (PAR) approach, and the overarching WHO framework of the International Classification of Functioning, Disability and Health (ICF), we discuss challenges and future endeavors. Challenges include creating and maintaining partnerships, ensuring a PAR approach to engage multiple stakeholders (e.g. people with disabilities, rehabilitation and design researchers, health professionals, community members and shopping mall stakeholders) and assessing the overall impact of the living lab. Future endeavors, including the linking between research results and recommendations for renovations to the mall, are also presented

Fair play:Perceived fairness in crowdsourcing competitions and the customer relationship-related consequences

TeleRehab enables the rehabilitation services to be delivered in distance by providing information exchange between patient with disabilities and the clinical professionals. The readiness step in any adoption of healthcare services should always be one of the requirements for a successful implementation of an innovation. However, little scholarly has been undertaken to study its influence on TeleRehab and the various barrier factors that influence its adoption. This research explores the barrier factors that influence the readiness of healthcare institution to adopt TeleRehab. This paper presents a semi-structured interview involving 23 clinical professionals of a case study on the issues of TeleRehab readiness in one rehabilitation centre in Malaysia. By applying thematic analysis, the study uncovers seven barriers that affect the TeleRehab readiness. This includes barriers of no urgency to change, less awareness, less involvement in planning, not enough exposure on e-Healthcare knowledge, resistance to change, low usage of hardware and software, and less connectivity. The study contributes to both TeleRehab management and technology readiness research in hospitals

Improving the usefulness of evidence concerning the effectiveness of implementation strategies for knowledge products in primary healthcare: protocol for a series of systematic reviews

The literature on the implementation of knowledge products is extensive. However, this literature is still difficult to interpret for policymakers and other stakeholders when faced with choosing implementation strategies likely to bring about successful change in their health systems. This work has the particularity to examine the scope of this literature, and to clarify the effectiveness of implementation strategies for different knowledge products. Consequently, we aim to (1) determine the strengths and weaknesses of existing literature overviews; (2) produce a detailed portrait of the literature on implementation strategies for various knowledge products; and (3) assess the effectiveness of implementation strategies for each knowledge product identified and classify them

The effectiveness and satisfaction of web-based physiotherapy in people with spinal cord injury: a pilot randomised controlled trial

Study Design: Pilot randomised controlled trial. Objectives: The aims of this study were to evaluate the effectiveness and participant satisfaction of web-based physiotherapy for people with Spinal Cord Injury (SCI). Setting: Community patients of a national spinal injury unit in a university teaching hospital, Scotland, UK. Methods: Twenty-four participants were recruited and randomised to receive eight weeks of web-based physiotherapy (intervention), twice per week, or usual care (control). Individual exercise programmes were prescribed based upon participant’s abilities. The intervention was delivered via a website (www.webbasedphysio.com) and monitored and progressed remotely by the physiotherapist. Results: Participants logged on to the website an average of 1.4±0.8 times per week. Between-group differences, although not significant were more pronounced for the 6 minute walk test. Participants were positive about using web-based physiotherapy and stated they would be happy to use it again and would recommend it to others. Overall it was rated as either good or excellent. Conclusions: Web-based physiotherapy was feasible and acceptable for people with SCI. Participants achieved good compliance with the intervention, rated the programme highly and beneficial for health and well-being at various states post injury. The results of this study warrant further work with a more homogenous sample