Good Acceptance Research Articles

Provider Perceptions and Use of Audit-Feedback and Communication Strategies to Improve Human Papillomavirus Vaccine Uptake

ObjectiveHuman papillomavirus (HPV) vaccine uptake remains suboptimal among US adolescents. A cluster randomized trial was conducted at six primary care practices in southeast Minnesota to assess the impact of parent reminder-recall letters and provider audit-feedback reports on 11-12-year-old HPV vaccine uptake. Audit-feedback reports included access to a web toolkit with instruction on two communication approaches. We evaluated the process of the audit-feedback report intervention to inform future adaptations. MethodsWe sent a survey to providers assigned to the intervention and asked about their use and perceptions of the reports, web toolkit, the communication approaches, and HPV vaccine recommendation. ResultsSurveys from 95 providers were analyzed. Most (97.9%) recalled receiving audit-feedback reports, with 92.4% finding them somewhat to very easy to understand, 86% somewhat to very familiar with their content and objectives, and 69.9% using them five or more times in the past year. Few respondents (11.6%) recalled receiving access to the web toolkit. Web analytics showed that the toolkit was rarely used. Most reported familiarity with communication approaches but less than half reported that these positively impacted the tone of the clinical encounter. Higher familiarity with audit-feedback reports (OR=2.58) and perceived peer approval about using presumptive language (the first of two communication approaches) to recommend HPV vaccination (OR=2.16) correlated with higher frequency of vaccine recommendation. ConclusionsImplementation of the audit-feedback reports showed good acceptability. Low utilization of the web toolkit suggests a need to further examine provider preferences on delivery and usability of training materials.

ESPORTES ADAPTADOS COMO CONTEÚDO DA EDUCAÇÃO FÍSICA ESCOLAR: PERCEPÇÕES DOS PROFESSORES DE UMA ESCOLA DE MARINGÁ – PARANÁ

This research aims to analyze how Adapted Sports are worked in Physical Education classes at a Public College in the city of Maringá - PR. In addition, it aims to verify the pedagogical methodologies adopted by the teachers, pointing out the difficulties and facilities of dealing with this content in formal education. Therefore, the research was based on a qualitative approach of the descriptive type, in which a questionnaire was applied to six Physical Education teachers from the referred school. After application, an analysis of the collected data was carried out and from these results, it was verified that not all teachers of the chosen schoolwork this content in their classes, and those who do report difficulties, but also good acceptance by the students. Such data allow a series of reflections on how this topic is still challenging. Received: 2024/07/04 Reformulated: 2024/08/27 Accepted: 2024/08/30

Ervas medicinais: Promovendo sustentabilidade e renda na agricultura familiar

The research aimed to analyze the costs and feasibility of the cultivation of medicinal herbs Melissa (Melissa officinalis) from Passion Fruit (Passiflora edulis) in a rural property in the municipality of Prudentópolis, Paraná. It is based on the premise that crop diversification is essential for the economic self-sufficiency of small properties characterized as family farming. In addition to the economic aspects, the choice of plants for analysis is intrinsically linked to the symbolic and cultural value that medicinal herbs carry, being widely recognized for their therapeutic and healing properties. The cultivation of medicinal plants, therefore, not only contributes to physical health, but also acts as a practice that values the connection with nature and ancestral knowledge, promoting a balance between the physical, emotional, and spiritual well-being of farmers and the local community. Methodologically, the research is applied, descriptive, documentary, bibliographic and based on case studies. The locus of the research was defined by convenience and accessibility. After data collection and analysis, it was found that both crops are profitable, with a financial return of approximately 30.5% per year. In addition to their economic viability, these plants offer a holistic approach to well-being, contributing to the mental and emotional balance of farmers, who, through cultivation, also rescue traditional practices and strengthen the bond with the land and local culture. The cultivation of medicinal herbs, such as Melissa and Passion Fruit, thus stands out not only as an excellent option for generating income and work, but also as a path to sustainability and the rescue of harmony between human beings and nature, presenting plant alternatives with simple management, good acceptance in the market, ease of sale and attractive prices

Sensory profile of cream cheese and plant‐based analogues: an approach through flash‐profile, CATA and RATA tests

SummaryThe distinct techno‐functional and sensory attributes conferred by milk proteins and fat are fundamental in defining the structure, texture and flavour of dairy products. Thus, reproducing cheese‐like characteristics in plant‐based alternatives while ensuring consumer acceptance is a major challenge. This study aimed to evaluate the sensory profile of commercial cream cheese and plant‐based analogues, quantifying consumer perception and discrimination, and correlating with instrumental texture analysis. For that, two milk‐based (MB1 and MB2) and three plant‐based products (PB1, PB2 and PB3) were evaluated for their proximate composition, texture profile (spreadability and firmness) and sensory properties by combining Flash Profile method (n = 13), Check‐All‐That‐Apply (CATA) test, and Rate‐all‐that‐apply (RATA) test (n = 102) with global acceptance. Milk‐based cream cheeses (MB1 and MB2) did not differ significantly from each other and presented greater spreadability when compared to all plant‐based cream cheeses (PB1, PB2 and PB3). The texture parameters of the samples were inversely related: the greater the firmness, the lower the spreadability. All forty‐two sensory attributes allowed discrimination of the samples into three distinct clusters, with no difference between the milk‐based products. The results of the CATA test showed that the attributes most correlated with the sample MB1 were the most desirable for good acceptance of the product. In turn, PB3 showed lower acceptance scores when compared to the plant‐based samples PB1 and PB2, and the attributes rancid flavour, vegetable oil aroma and nut aroma mostly contributed to the lower acceptance of PB3. Milk‐based products were very close to the ideal product, presenting a creamy and spreadable texture as key attributes for product characterisation and acceptance. The results of RATA test showed a significant difference (P < 0.05) in the intensity of nineteen sensory attributes. Milk‐based cream cheeses were more accepted than their plant‐based counterparts. The instrumental assessments of firmness and spreadability exhibited a negative correlation, once they were inversely proportional and strongly correlated to sensory data of firm and spreadable texture, respectively. The sensory characteristics of cream cheese analogues may present a barrier to their acceptance by consumers. Attributes such as coconut and flour flavour, artificial cheese aroma and flavour, and spreadable texture played a key role in differentiating dairy products from plant‐based ones, contributing to the lower acceptance of the latter.

Effect on Satiety-Related Biomarkers of Bar Snacks Containing Chickpea Flour and Pork Protein.

Randomised, crossover, double-blind, controlled post-prandial trial involving 24 participants (18-30 years), with two interventions: (a) a hybrid snack containing plant protein derived from chickpeas and 6.6% lean high-quality pork meat; and (b) a meat-based snack containing 90% lean pork meat. General, life-style, sensory acceptability questionnaire, and the following laboratory analyses were performed: lipid profile, endocannabinoids, and related compounds. Sensory questionnaires showed in general good acceptability for both bars. Additionally, there was a greater increase in glycemia at 30, 60, and 90 min after consuming the hybrid snack compared to the meat-based snack, with no changes in the lipid profile. Regarding the endocannabinoid compounds and related compounds, the compound N-palmitoleoyl ethanolamine in the acylethanolamide group showed higher levels overall following the consumption of the hybrid snack compared to the meat-based snack, particularly at 2 h. The hybrid snack was associated with changes in endocannabinoid-like compounds. Therefore, it may provide a lasting satiating effect, while complementing the protein profile of plant-based foods with the quality of animal protein.

Prospective acceptability of mass drug administration for malaria in Kedougou region in Senegal: a mixed method study

BackgroundIn Senegalese high-burden regions, the existing package of interventions is insufficient to reach the malaria elimination goal. Asymptomatic carriers of Plasmodium contribute significantly to malaria persistence and are not targeted by current interventions. The systematic treatment of all individuals in a community (mass drug administration, MDA) is a relevant intervention to tackle asymptomatic infections. The intervention can only be effective with a high participation of the population and, therefore, depends largely on its acceptability. This study aims to investigate the prospective acceptability of MDA in the Kedougou region to inform its potential use in a future strategy.MethodsFollowing a 7-construct theoretical framework, prospective acceptability of MDA implemented in the rainy season was studied. In four villages, a sequential mixed design, from qualitative to quantitative, was used. In November 2021, interviews with healthcare professionals and focus groups with villagers were conducted. Findings from thematic analysis informed the development of a questionnaire administered to individuals aged ≥ 15 years in March 2022. Based on the questionnaire, an acceptability score was constructed and associations with socio-demographic factors were investigated using a linear mixed model.ResultsThe 7 interviews, the 12 focus groups, and the questionnaire administered to 289 individuals demonstrated a good acceptability of MDA. Two potential barriers were identified: the contradiction of taking a medication without feeling sick and the occurrence of side effects; and four facilitators: the perception of malaria as a burden, a good understanding of MDA, a good perceived effectiveness, and the resulting economic benefits. The average acceptability score was 3.5 (range from -7 to + 7). Young adults aged 15 to 21 had a lower acceptability score compared to the other age groups, indicating an additional barrier to acceptability (β = -0.78 [-1.67;0.1]).ConclusionMDA is a priori acceptable to communities of Kedougou region in Senegal. Sensitization campaigns co-constructed with the communities, especially targeting young adults, are essential to ensure good acceptability.

Effect of virtual reality-based visual training for myopia control in children: a randomized controlled trial

BackgroundTo assess the efficacy and safety of virtual reality-based visual training (VRVT) in myopia control among children.MethodsThe randomized, parallel-group, single-blind clinical trial conducted at the Department of Ophthalmology of Shanghai Tenth People’s Hospital enrolled 65 low-myopic children (aged 8 to 13 years) with cycloplegic spherical equivalent (SE) between − 0.50 and − 3.00 diopters (D), astigmatism less than − 1.00 D, anisometropia less than 1.50D, and best corrected visual acuity (BCVA) more than 0.0 logarithm (LogMAR) of the minimum angle of resolution. The participants were enrolled in December 2020, and the follow-up of this study concluded on August 2021. Children were assigned randomly to the intervention group (VRVT plus single-vision spectacle [SVS]) and the control group (only SVS without receiving VRVT). The intervention group was administered for 20 min per day with VRVT under parental supervision at home. The primary outcome was changes in axial length (AL) at 3 months. Macular choroidal thickness (mCT) was regarded as a key secondary outcome.ResultsAmong 65 participants (mean age: 10.8 years, 52.3% male), 60 children (92.3%) who completed the 3-month intervention and 6-month follow-up were included in the analysis (30 in the intervention group and 30 in the control group). The changes of AL were 0.063 ± 0.060 mm (95% confidence interval [CI], 0.074 to 0.119 mm) in the intervention group and 0.129 ± 0.060 mm (95% CI, 0.107 to 0.152 mm) and in the control group at 3 months (t = − 2.135, P = 0.037), and the mean difference between the two groups was 0.066 mm. The change of mCT were 22.633 ± 36.171 μm (95% CI, 9.127 to 36.140 μm) in the intervention group and − 3.000 ± 31.056 μm (95% CI, − 14.597 to 8.597 μm) in the control group at 3 months (t = 2.945, P = 0.005). VR vertigo was the most common adverse event which was occurred in two children (2/30, 6.67%) in the intervention group.ConclusionsVRVT is a promising method for myopia control in children with good user acceptability. Among children aged 8 to 13 years with low-myopia, nightly use of VRVT resulted in slowing myopia progression.Trial registrationThis protocol was registered with ClinicalTrials.gov (NCT06250920), retrospectively registered on 01 February 2024.

Cookies Fortified with Clitoria ternatea Butterfly Pea Flower Petals: Antioxidant Capacity, Nutritional Composition, and Sensory Profile.

This study aimed to fortify cookies to be functional food by adding Clitoria ternatea flower (CT) at concentrations ranging from 0 to 8%. Sensory profiling identified 6% CT as optimal for organoleptic attributes. The addition of CT did not significantly impact protein, lipid, and ash content but decreased energy value and increased insoluble and soluble fibre levels. The inclusion of 6% CT had a significant effect on the overall total phenolic content (TPC), which increased compared to the control sample. Antioxidative activity analyses showed enhanced antioxidative activity in ABTS, DPPH, ORACFL, and PCL assays. The addition of 6% CT inhibited hydroperoxide production in cookies. However, over a period of 6 weeks, a significant rise in peroxide value was observed during the 4th and 6th weeks of storing fortified cookies. All assessed products met the high microbiological quality standards. The sensory evaluation scores showed that CT can create cookies with health benefits and a good overall acceptance score. The texture of the cookies gradually became softer, but no significant changes in visual appearance were observed. CT can be extensively used in baked cookies as a rich source of polyphenols with strong antioxidant properties and high fibre content, as well as a fortification source for the development of functional foods.

Does sexual rehabilitation work for gay and bisexual prostate cancer patients? Acceptability, feasibility, and efficacy results from the Restore-2 randomized controlled trial.

Sexual minority prostate cancer patients have worse health-related quality of life outcomes than heterosexual patients. We conducted the first study to test whether sexual and urinary rehabilitation tailored for sexual minority patients was acceptable, feasible, and efficacious at improving their sexual and urinary function. Restore-2 was a 24-month randomized controlled trial of an online biopsychobehavioral rehabilitation study for sexual minority men treated for prostate cancer experiencing sexual and/or urinary problems. Participants were 401 US sexual minority men treated for prostate cancer and experiencing sexual and/or urinary problems at baseline. Intervention components included phosphodiesterase-5 inhibitors, sexual aids, a pelvic floor exercise regimen and video, a guide to good gay sex following treatment, and coaching. Quality of life assessments were completed at baseline, 3, 6, 12, 18, and 24months. We confirmed good acceptability and feasibility, but only minimal improvement was observed over time and no differences were found between treatment and control arms. We found no evidence that the intervention improved sexual or urinary outcomes for participants. However, we confirmed excellent acceptability and feasibility for a sexual rehabilitation program tailored to sexual minority participants. In addition, participants reported enduring usage and acceptability of sexual aids (including vacuum pump, anal dilators, and penile constriction rings) as well as masturbation and pelvic floor exercises to accommodate their sexual challenges. Sexual "accommodation," rather than "rehabilitation," may be a more accurate and realistic goal for this population. Patients should be provided sexual aids to help accommodate their sexual and urinary challenges. This study was retrospectively registered with ClinicalTrials.gov, study number: NCT03923582; date: 22/04/2019.

Music listening for improvement of sleep in post-acute rehabilitation of adults with acquired brain injury: A feasibility study

ABSTRACT Introduction Acquired brain injury (ABI) often leads to sleep disturbances impacting recovery. Previous research has shown that listening to music at bedtime can have a beneficial effect on sleep quality in various populations, but the impact of bedtime music on sleep problems related to ABI has not been studied. This feasibility study investigates the acceptability and effectiveness of music listening for sleep improvement in ABI patients. Methods In a within-subjects crossover design with repeated measures for 28 days, ABI patients with sleep disturbance were allocated to a control or music condition, switching conditions after 14 days. Acceptability was assessed with questionnaires on compliance and attrition. The effect was evaluated with the Pittsburgh Sleep Quality Index (PSQI) at baseline, day 14 and 28, daily sleep ratings, and actigraphy. Results The intervention was well-liked, and participants listened to the music most of the intervention nights. A descriptive statistical comparison of outcome data on PSQI and daily sleep ratings regarding how well participants slept indicated that participants (n = 4) experienced better sleep with the music intervention. The objective sleep measures reflected a slightly longer time to fall asleep with the music intervention. Discussion The results suggest good acceptability and a potential beneficial effect of the intervention. Music listening may be a safe and effective tool, and a full RCT is recommended to evaluate the efficacy of music listening for sleep improvement in ABI patients. https://www.clinicaltrials.gov, Identification number: NCT05620069.

Virtual patients with substance use disorders in healthcare professional education: a scoping review

Background and Objective: Virtual patient simulations are cost-effective methods for training health professionals. Yet, this teaching method is rarely used with clinicians who work or plan on working with people with substance use disorders. This scoping review summarizes the current state of the literature concerning virtual substance use disorder patient simulations in health professionals’ training and provides suggestions for future directions. Methods: Online databases were searched for peer-reviewed articles published between January 2010 and June 2024. Results: Twelve studies were included. The development, administration, and evaluation of performance of the simulations are diverse. Most simulations aim to develop screening, brief interventions or referring skill, they target a variety of health professionals’ disciplines and report positive learning outcomes. Virtual simulations have good acceptance rates from learners. Conclusions: Enhancing the diversity of clinical skills and patient populations portrayed in simulations, alongside adherence to best practices in simulation development and implementation is suggested to optimize training outcomes in this critical area of healthcare education.

Improved antioxidant properties and sustainability of whole‐fruit yellow tomato puree

SummaryIn this study, a new process was proposed to make the yellow tomato puree more sustainable, avoiding any waste during production and including peels and seeds in it. In addition, as raw material tomatoes grown without irrigation and fertilisation procedures were used to increase the sustainability. With respect to a traditional puree, the whole‐fruit yellow tomato puree contained more β‐carotene and polyphenols, exhibiting greater antioxidant capacity, and showed greater consistency due to the high content of pectin in peels. Moreover, a higher content of glutamic acid, responsible for the umami taste, was detected particularly in products from GiaGiù ecotype. Sensory analysis assessed that whole‐fruit yellow tomato puree has good acceptability and consumers preferred it for the texture. In conclusion, the whole‐fruit yellow tomato puree is not only a sustainable product but can be also used as an excellent ingredient in food formulation with antioxidant properties.

Astaxanthin and chia oil encapsulated in gel beads: Evaluation of the impact of their addition in a commercial yogurt by a consumer-based sensory analysis

The addition of encapsulated bioactive compounds in food matrices allows obtaining foods with improved nutritional characteristics. In this study, chia oil (a source of omega-3) and astaxanthin were encapsulated in beads and added to commercial yogurt. Particles formulated using only sodium alginate (100SA) or mixed with whey protein aggregates (25WPA75SA) with incorporated chia oil and astaxanthin were added to yogurt. The stability of bioactive compounds added was evaluated, and consumer-based sensory analysis was applied using both a hedonic scale and Check-All-That-Apply method. The content of bioactive compounds in yogurts did not change after 28 days of storage. Yogurts exhibited good acceptability and the terms with high positive impact in all samples were sweet, pleasant flavor, smooth, creamy, pleasant particles, pleasant, and easy to swallow. Yogurt added with 25WPA75SA beads showed greater acceptance indicating that this matrix may be a good option to improve the consumption of astaxanthin and omega-3.

Utilization and Effect of Apple Pomace Powder on Quality Characteristics of Turkey Sausages.

The present study was conducted to develop turkey sausages by incorporating freeze-dried apple pomace (FDAP) at 3, 5, and 8% by replacing turkey breast meat. Three sausage formulations and the control of turkey sausages were subjected to physicochemical properties: proximate content, water-holding capacity (WHC), cooking yield, pH, color, textural parameters, antioxidant activity, and microbiological and sensory properties. The parameters were analyzed during storage from days 0 to 7. The addition of FDAP to turkey sausages resulted in a significant (p ≤ 0.05) decrease in moisture and protein contents, whereas no significant difference was found in fat and ash contents. The increased incorporation of FDAP resulted in decreased pH, cooking loss, lightness, redness, and yellowness in turkey sausages, whereas an increase in total phenolic content, fiber content, ABTS, and DPPH values was observed. FDAP, as a low-cost source of valuable phenolic content, strongly inhibited microorganism growth during the storage of turkey sausages. The sensory scores of turkey sausages containing 3% FDAP for other sensory traits, such as flavor, texture, juiciness, tenderness, and overall acceptability, were comparable to those of the control. Scores for sensory attributes declined significantly with a further increase in FDAP in turkey sausages. It is concluded that turkey sausages with very good acceptability can be prepared by incorporating freeze-dried apple pomace each at a 3% level.

Use of virtual reality in bipolar disorder: a systematic review.

Virtual reality (VR) is a technology that allows to interact with recreated digital environments and situations with enhanced realism. VR has shown good acceptability and promise in different mental health conditions. No systematic review has evaluated the use of VR in Bipolar Disorder (BD). This PRISMA-compliant systematic review searched PubMed and Web of Science databases (PROSPERO: CRD42023467737) to identify studies conducted in individuals with BD in which VR was used. Results were systematically synthesized around four categories (cognitive and functional evaluation, clinical assessment, response to VR and safety/acceptability). Eleven studies were included (267 individuals, mean age = 36.6 years, 60.7% females). Six studies using VR to carry out a cognitive evaluation detected impairments in neuropsychological performance and delayed reaction times. VR was used to assess emotional regulation. No differences in well-being between VR-based and physical calm rooms were found. A VR-based stress management program reduced subjective stress, depression, and anxiety levels. VR-based cognitive remediation improved cognition, depressive symptoms, and emotional awareness. 48.7% of the individuals with BD considered VR-based cognitive remediation 'excellent', whereas 28.2% considered it 'great'. 87.2% of individuals did not report any side effects. 81.8% of studies received a global quality rating of moderate. Emerging data point towards a promising use of VR in BD as an acceptable assessment/intervention tool. However, multiple unstudied domains as comorbidity, relapse and prodromal symptoms should be investigated. Research on children and adolescents is also recommended. Further research and replication of findings are required to disentangle which VR-interventions for which populations and outcomes are effective.

P044 TEAM-BASED CARE TO MANAGE COMPLEX CASES OF HYPERTENSION

Background and Objectives: Team-based care that uses home blood pressure (BP) telemonitoring to facilitate hypertension management is safe and effective in lowering BP in routine primary care. However, its usefulness to manage more complex cases of hypertension is uncertain. This 6-month study explores its use in such patients attending a hypertension clinic. Methods: BP telemonitoring consisted of smartphone with BP app paired with wireless home BP device to transmit BP readings to a central server, accessible to patients and clinic staff. Patients were asked to contact the clinic about worrisome home BP readings, treatment problems and technical issues. Home readings were integrated into clinical decision-making. Outcomes were patients’ experience and clinical measures. Results: Of 90 enrolled patients, 38% had grade 3 or 4 chronic kidney disease, 23% diabetes, 31% heart disease, 12% stroke and 12% aortic dissection. Mean number (standard deviation) of co-morbid conditions was 4.2 (2.0). Most patients were at very high (30%) or high risk (50%) for a cardiovascular event. During follow-up, one patient died and one dropped-out of care. Mean number of in-person and virtual assessments by a physician were 1.6 (0.6) and 2.0 (1.8), respectively. Eighty-three percent (n=75) contacted clinic staff. Mean number of contacts for technical reasons was 1.2 (1.8), treatment-related issues 0.5 (1.0) and personal support 4.2 (5.9). From baseline to exit mean automated office BP fell (p<0.001), BP control improved (p<0.001) and mean number of antihypertensive drug classes increased (p=0.049). Most patients, 91% (80/88), felt BP telemonitoring to be a valuable tool for managing their hypertension. Nonetheless, 38% also considered cost to be potentially a barrier to long-term use. Only 6% had data security concerns. Conclusions: Team-based care was highly rated by patients to manage their hypertension and may account for the low drop-out rate, high number of patient-provider contacts, good patient acceptance of more intensified pharmacological treatment and better BP control. However, cost potentially may be a barrier for long-term use.

Reformulation of snacks offered to children and adolescents at school kiosks: is this strategy enough or just the tip of the iceberg?

Several studies have reported high overweight and obesity incidence among schoolchildren and adolescents, who mostly consume packaged snacks with critical nutrients exceeding the criteria of international profiling systems during school breaks. Then, the objectives of this work were to reformulate a snack consumed by Argentinian schoolchildren and adolescents (aged 6–13 years) to decrease its critical nutrient contents and to determine if this product would still be accepted. Chocolate chip vanilla cookies were selected for reformulation considering each recommended cut-off point for critical nutrients, since a prohibition of products with warning octagons being offered at schools would come into effect in Argentina. These cookies received good acceptability scores (above 3 of 5 points) and would be consumed by 8 of 10 schoolchildren in a sample of 200 participants. These findings underscore the importance of legislation promoting awareness of healthier eating habits and increasing the availability of healthier food options in schools.

Development and evaluation of an interactive information system in technical assistance and rural extension

The state of Espírito Santo has a wide diversification of rural activities, such as family agribusinesses and activities related to rural tourism. However, diagnosing the rural zone presents some challenges, such as the difficulty of access and location, long distances, and excessive costs, combined with the scarcity of human and financial resources inherent to public services. In this sense, it is necessary to restructure the communication and technical assistance and rural extension model established by public institutions to reinforce the trend towards the use of Information and Communication Technology (ICT) tools and the implementation of concepts such as e-government (e-Gov). In this context, we propose an interactive computational tool, focusing on diagnosing, planning, and addressing the different current demands the rural sector presents. To achieve this, we have developed a consulting and data analysis system that also employs artificial intelligence concepts, aiming to increase the efficiency and quality of public services in rural areas. The proposed system is called Agrolegal Ater Digital and includes functionalities such as registration, diagnosis, virtual library, event registration, news, and funding opportunities. The objective is to facilitate access to information for rural entrepreneurs regarding the public services offered and to increase the speed of communication with public agents. The results obtained through the conducted diagnoses are promising, with good acceptance from the test group regarding the proposed tool and the use of information technology in addressing requests in rural areas.

Feasibility of hand grip tests during and after hospitalization in geriatric patients: an observational study

BackgroundMonitoring the recovery trajectory during and after hospitalization can be a valuable method to observe whether additional care is needed to optimize recovery. Hand grip strength tests are commonly used to measure an individual’s physical condition. Eforto® is a system to monitor hand grip strength and grip work as measures of recovery. We examined the feasibility of daily repeated hand grip tests measured with Eforto® in geriatric inpatients, during hospitalization and at home after discharge.MethodsGeriatric inpatients (n = 191) were evaluated for grip strength and grip work with Eforto®, twice daily during their admission. We calculated attempt and success rates. Participants were divided into complete, high, moderate, and low attempt/success rate groups to study differences in patient characteristics. Reasons for non-attempt and unsuccessful tests were categorized and analyzed. Nine participants were interviewed about acceptability and user experience within the hospital setting. Four out of twenty participants accepted the invitation to continue the measurements after discharge at home for 4 weeks and were interviewed about acceptability and user experience.ResultsAcross the 191 participants, the attempt rate was 85% and 86% of the attempted tests was successful. The main reasons for non-attempt were that the patient felt physically unwell (41%), and that the patient was otherwise engaged, for example receiving care or undergoing medical tests (40%). Measurements were unsuccessful mostly because of the patient not having enough strength to reach the 80% threshold needed for the grip work test (60%). Participants in the complete and high attempt/success rate groups had a shorter length of stay (p<0.05) and a lower mortality (p<0.05) than participants in the moderate/low groups. The interview data showed good acceptability and user experience during hospitalization. The acceptability was strengthened by experienced usefulness. Self-monitoring at home resulted in low inclusion rate (20%) and low success rate (25%), with the uncertain time after discharge from the hospital as the main barrier.ConclusionsFor most patients, the tests were feasible in the supervised hospital setting. At-home testing with Eforto® is challenging, primarily because of the uncertain time after discharge from the hospital.

Heat-extracted jaboticaba juice blended with apple juice has good sensory acceptance and the addition of Zn2+ delays the degradation of its anthocyanins during storage at room temperature

Our objectives were to develop a blend of heat-extracted jaboticaba juice and apple juice, and to investigate the protective effect of the addition of metallic cations on the stability of its anthocyanins during storage at 25 °C, 45 °C and 80 °C. Jaboticaba juice yields were similar when extracted at 70 °C and 90 °C. However, juice extracted at the higher temperature exhibited higher ideal proportions of apple juice for the attributes “sweetness” and “color” compared to that extracted at the lower temperature. The blended juice containing 55 % of jaboticaba juice extracted at 90 °C was sensory well-accepted (overall acceptance score of 7.1 in a 9-point scale), but the addition of apple juice resulted in 10 % higher losses in total anthocyanins contents after 30 days at 25 °C. The addition of Ca2+, Mg2+, Fe2+ and Fe3+ led to a less fast degradation of anthocyanins of jaboticaba juice only at 80 °C. At 45 °C, Zn2+ was the sole metallic cation which addition reduced total anthocyanins degradation of JAJ, while the other cations increased anthocyanins degradation. At 25 °C, Zn2+addition delayed anthocyanins degradation of both jaboticaba and blended juices, but better in the absence of apple juice. Although the use of apple juice instead of sucrose as a sweetener was detrimental to anthocyanins protection, it should be considered from the nutritional point of view.