Stakeholder perceptions of factors contributing to effective implementation of exercise cardiac telerehabilitation in clinical practice.

AIMS: Cardiac exercise telerehabilitation is effective and can be cost-effective for managing ischaemic heart disease, but implementation of evidence-based interventions in clinical practice remains a challenge. We aimed to identify factors that cardiac rehabilitation stakeholders perceived could influence the effectiveness of implementing an evidence-based, real-time remotely monitored cardiac exercise telerehabilitation intervention (REMOTE-CR). METHODS AND RESULTS: Online interviews and focus groups were conducted with cardiac rehabilitation consumers (n = 16, 5 female, 61.1 ± 10.0 years), practitioners (n = 20, 14 female; 36.6 ± 11.8 years), and health service managers (n = 11, 7 female; 46.2 ± 9.2 years) recruited from one metropolitan and three inner-regional healthcare services in Western Victoria, Australia. Discussions were guided by two theoretical frameworks (Non-adoption, Abandonment, Scale-up, Spread, and Sustainability; Consolidated Framework for Implementation Research), and analysed thematically. Factors perceived to influence effective implementation of REMOTE-CR spanned all domains of the theoretical frameworks, related to six major themes (resources, change management, stakeholder targeting, knowledge, intervention design, security) and were largely consistent across study sites; however, the relative importance of each factor may vary between sites. CONCLUSION: Effective implementation of exercise telerehabilitation interventions like REMOTE-CR will require a coordinated context-specific approach that considers factors across all levels of the healthcare system and implementation science frameworks. Key requirements include prioritizing resources, managing change, selecting target stakeholders, developing digital health capabilities, and selecting fit-for-purpose technologies that enable programme delivery objectives.

A Descriptive Assessment of Social Validity Source, Timing, and Direct Consumer Inclusion in Behavior Analytic Research.

Applied behavior analysis (ABA) is the application of behavioral principles to affect socially important behavior change with social importance, or social validity, being defined by the consumers of the intervention. (Schwartz & Baer, Journal of Applied Behavior Analysis 24, 189-204, 1991) provided several suggestions to improve the implementation of the social validity assessment including engaging in ongoing assessment, increasing the type and psychometric rigor of social validity measures, and extending participation in the social validity assessment to include direct and indirect consumers. The purpose of this article is to explore the current implementation of social validity assessments used in behavioral research. This article also explores key demographics among consumers with disabilities and/or mental health disorders who are included and excluded from social validity assessments. The most common social validity assessment source was author-created and implemented at a single time point. In addition, consumers with disabilities were often excluded from the social validity assessments. The implications of the social validity assessment implementation and consumer exclusion are discussed.

The telehealth surge: Speech-language pathology mode of service delivery and consumer characteristics during COVID-19.

PURPOSE: To examine the characteristics of speech-language pathology (SLP) consumers prior to and during the COVID-19 pandemic, with respect to the mode of service delivery within a local health district in New South Wales, Australia, to inform future health service planning. METHOD: Observational study examining SLP occasions of service data pre-COVID-19 (2019-2019; n = 6413) and during the COVID-19 pandemic (2020-2021; n = 6908). Spatial mapping and multilevel models were used to examine associations between sociodemographic characteristics, telehealth utilisation, and videoconferencing. RESULT: During COVID-19, SLP occasions of service increased by 7.7% compared to pre-COVID-19. Model 1 found odds of adopting telehealth (telephone or videoconference) during COVID-19 were significantly higher for those aged 0-4 and 5-17 years compared to older age groups. Consumers in inner regional areas were significantly less likely to adopt telehealth than in major city areas, whereas females were significantly more likely to adopt telehealth. Those living in areas experiencing higher relative disadvantage were less likely to use telehealth. Model 2 found odds of adopting videoconferencing only were also significantly higher for the younger age groups (0-4 and 5-17 years) and females. CONCLUSION: A rapid transition to a virtual model of care was critical to the successful delivery of SLP services during COVID-19. Immediate prioritisation and integration of targeted models of care, where suitability is high and benefits most likely to be experienced, is feasible.

Consumer versus expert opinions on bowel cancer screening videos: Findings from a co-design study.

OBJECTIVE: To describe compare and assess expert and consumer evaluations of videos the National Bowel Cancer Screening Program in Australia to inform the future development of effective promotional materials. METHODS: From July to November, 2022 consumers (n = 487) were randomly assigned to see 3 of 15 videos and 34 "experts" (i.e., researchers, clinicians, and health promotion specialists) viewed all 15 videos. Participants completed 22 items reflecting positive and negative perceptions and perceived efficacy in encouraging screening participation. Multiple analyses of covariance assessed mean differences in expert and consumer ratings controlling for age and gender differences. RESULTS: Experts and consumers reported similar perceptions about videos, with no difference in the degree to which each would encourage kit completion. However, compared to those containing personal stories, experts rated instructional and informational videos significantly lower than consumers in terms of encouraging actions that facilitate kit completion. CONCLUSIONS: Experts may underestimate the degree to which information and personal narratives resonate with consumers viewing bowel cancer screening videos. PRACTICAL IMPLICATIONS: It is valuable to consult consumers when designing bowel cancer screening promotion and education videos as opposed to relying solely on expert opinion especially in the context of encouraging actions that lead to kit completion.

Impact of COVID-19 on Chinese urban consumers' food safety knowledge and behavior - A comparative study between pre and post pandemic eras.

The COVID-19 pandemic caused notable changes to the food-related habits of consumers worldwide due to their concerns about the risk of infection and the requirement to follow government mandates. To investigate the impact of the pandemic on Chinese consumers' food safety knowledge, food safety behaviors, and their most recent food poisoning experiences, we compared the results from an online survey (n = 583, Dec 2019) conducted before the pandemic was officially announced with an identical survey (n = 599, Aug 2023) conducted seven months after the Chinese government downgraded restrictions related to COVID-19. Post-pandemic there was a significant decrease in consumers' food safety knowledge and self-reported food safety behaviors and a significant increase in their self-reported experiences of food poisoning. Despite respondents stating that their food safety knowledge and behaviors had improved since the start of the pandemic, the data obtained from the two surveys and the respondents self-reporting of foodborne illness suggest that in fact their safety knowledge and behaviors had decreased. These findings highlight the need to reinforce food safety education and behaviors during times when the food system is disrupted, and consumers are focusing on what they perceive to be more immediate issues.

Tailoring meat products for the elderly: A comprehensive review.

The population of the elderly is projected to grow significantly in most of the developed countries in the near future. This should earn this demographic the title of 'Consumer of the future'. Meat has high quality proteins and essential vitamins which are important for all demographics but more so for the elderly due to their susceptibility to sarcopenia. This review explored the landscape of meat research and product development that meets the distinctive requirements of the elderly, drawing from published refereed articles, industry reports, and unpublished grey literature. The review emphasised the importance of understanding the evolving dietary and sensory requirements associated with ageing and how they intersect with meat consumption. One notable aspect observed is the diversity within the elderly population, which underscores the necessity for tailored approaches in meat product development to cater to the varying preferences and nutritional needs of different individuals. This review also highlights the ongoing efforts in developing meat-based products that span a spectrum of consistencies, ranging from solid to liquid forms, to accommodate the diverse needs of elderly consumers. Despite these advancements, the review found a discrepancy between the pace of meat product development for the elderly and the rapid advancements in kitchen-level technologies and suggests that further research is needed to bridge this gap and align product innovation with emerging technological trends.

Decision Making of Healthcare Consumers Based on Factors Associated with Online Review and Ratings.

The study deals with understanding of the factors associated with online ratings and reviews that help the healthcare consumers in better decision making. Data was collected from 303 participants using mixed methods. The results indicate the factors that help in decision making which includes use of ratings as a reference, impact of positive and negative ratings, whether these ratings depict the actual worth of healthcare service provider and the relevance of these websites in decision making. This study concludes that there is significant relevance of online rating and review websites on healthcare consumers in selecting a healthcare provider.

Quality Measurement of Consumer Health Questions: Content and Language Perspectives.

BACKGROUND: Health information consumers increasingly rely on question-and-answer (Q&A) communities to address their health concerns. However, the quality of questions posted significantly impacts the likelihood and relevance of received answers. OBJECTIVE: This study aims to improve our understanding of the quality of health questions within web-based Q&A communities. METHODS: We develop a novel framework for defining and measuring question quality within web-based health communities, incorporating content- and language-based variables. This framework leverages k-means clustering and establishes automated metrics to assess overall question quality. To validate our framework, we analyze questions related to kidney disease from expert-curated and community-based Q&A platforms. Expert evaluations confirm the validity of our quality construct, while regression analysis helps identify key variables. RESULTS: High-quality questions were more likely to include demographic and medical information than lower-quality questions (P<.001). In contrast, asking questions at the various stages of disease development was less likely to reflect high-quality questions (P<.001). Low-quality questions were generally shorter with lengthier sentences than high-quality questions (P<.01). CONCLUSIONS: Our findings empower consumers to formulate more effective health information questions, ultimately leading to better engagement and more valuable insights within web-based Q&A communities. Furthermore, our findings provide valuable insights for platform developers and moderators seeking to enhance the quality of user interactions and foster a more trustworthy and informative environment for health information exchange.

Consumer Awareness, Perceptions and Avoidance of Ultra-Processed Foods: A Study of UK Adults in 2024.

BACKGROUND: Ultra-processed food (UPF) is currently not included in most countries' dietary guidance. However, there may be growing public interest and consumer avoidance of UPF due to media reporting of studies on the negative health outcomes associated with UPFs. METHODS: We surveyed 2386 UK adults (M age = 45 years, 50% female) during February-April 2024. Participants completed measures on awareness of the term UPF, whether the UPF status of foods affects their dietary decision-making, and confidence in identifying UPFs. Participants categorised a list of 10 foods (5 UPFs and 5 non-UPFs) as UPF vs. not, before rating whether information about studies linking UPF to worse health impacts on their negative affect and acts as a deterrent to consuming UPFs. RESULTS: Most participants (73%) were aware of the term UPF and 58% reported that their food choices are determined by whether they believe a food is ultra-processed or not. Participants with the highest income and education levels were most likely to report both being aware of, and, avoiding consuming UPFs. Most participants could not accurately categorise whether foods were UPFs. Some sociodemographic groups (e.g., higher education levels) were more likely to accurately categorise UPFs but were also more likely to incorrectly believe that non-UPFs were UPFs. Participants tended to report that UPF-health risk information increases negative affect and acts as a deterrent to consuming UPFs. CONCLUSIONS: In this study, a large number of UK adults reported avoiding consuming UPFs. This was particularly pronounced among those with the highest education and income levels.

Emotional response to sherry wines and its relationship with emotional intelligence, level of expertise and gender.

Emotional elicitation during wine consumption is a complex fenomena based on subjective experience and influence by physiological, cognitive and behavioural changes. The present study used a quasi-experimental design to examine consumers' emotional responses during blind tastings of sherry wines, considering variables such as consumer experience, gender and Emotional Intelligence (EI). 66 participants were classified as non-expert (34) and expert (32) consumers to participate in blind tastings. Their emotional responses were measured using the EsSense25 Scale and the Perceived Emotional Intelligence was assessed through the Trait Meta-Mood Scale. Few differences were observed on emotional elicitation based on gender or consumer experience (non-expert vs expert), however the interaction of these variables was a good predictor of emotional response variance. Wine type also has an effect on emotional response, emphasising the role of sherry wine characteristics in consumer emotions. Furthermore, the Emotional Attention, one of the three dimensions of Emotional Intelligence, was found as a good predictor for the emotional responses to wine consumption. This relationship may be a key factor in understanding the differences between responsible consumption and excessive consumption, as indicated by research focused on binge drinking.

Firewood as a tool to valorize meat: A sensory and instrumental approach to grilled veal, lamb, and pork meat.

Two firewood species (beech and olive) were used for grilling three meat types (lamb, pork, and veal) to assess their influence on the sensorial properties of meat. A multimethod approach was adopted, including sensory evaluation with consumers and two analytical techniques to characterize the volatile fraction (Solid-Phase Micro-Extraction Gas Chromatography-Mass Spectrometry [SPME-GC/MS] and electronic nose [e-nose]). The sensory session included three pairwise preference tests (one for each type of meat), an overall liking test, a Rate-All-That-Apply test, and a questionnaire on the interest and perceived value of using sustainably certified firewood in food preparation. The firewood species significantly affected the perception of a few crucial attributes. In particular, olive wood increased the roasted meat flavor perception in lamb and veal, while beech wood increased the perceived intensity of a vegetable/herbaceous flavor in veal. No effect of firewood was observed on preference within each pair of meat samples. Lamb was the significantly most liked meat by consumers, followed by pork; veal was the least liked meat type. Positive and negative drivers of preference were discussed. 36 volatile organic compounds were identified from SPME-GC/MS in meats. Congruently with sensory data, the two veal samples showed a greater distance in terms of volatile composition. Relative distances among samples on maps obtained from SPME-GC/MS and the e-nose were similar. This multi-method approach innovatively showed the potential of using firewood as a 'gastronomic' tool to sensorially characterize and valorize cooked meat.

Fostering sustainable consumer behaviour: Unravelling the determinants of repair intentions for smart appliances.

Consumer demand for repair services is vital for prolonging product lifespan, yet factors influencing the repair intention for smart appliances remain unclear. Addressing this gap, we propose an extended theory of planned behaviour, incorporating four additional constructs: environmental knowledge, cost of repair, financial benefit, and data security. We collected data from 383 participants in the United Kingdom, which we analysed using a partial least squares approach. Results reveal that the cost of repair, perceived behavioural control, attitude, and financial benefit directly impact repair intention, while subjective norms do not. Environmental knowledge indirectly influences repair intention through attitude mediation, and data security's impact is not moderated by attitude. This extended theory offers a theoretical foundation for future related studies, providing insights for repair providers, environmental NGOs, and policymakers. Our findings can inform interventions promoting repair behaviour and guide policies incentivising consumers, thus increasing the demand for repair services.

Mental Healthcare Consumers' Experiences of Mental Health Care: Variation in Knowledge by the Family Members and Support.

Introduction: Knowledge and support by members of the family towards the care of the consumers of mental health services is the core priority and is noticeable by the users as it gives and eases the life of the users during therapy and rehabilitation. However, there have been documented instances of families that neglect their relatives with mental illnesses. Objective: This study explored the experiences of mental healthcare consumers regarding family members' knowledge of mental disorders and support. Methods: Participants who were granted leave of absence were selected through nonprobability, purposive sampling. Data were collected using face-to-face unstructured discussions. Data were analyzed using Colaizzi's technique. Results: Findings revealed misconceptions versus insight on the cause of mental disorders, knowledge deficit on the effect of treatment, poor support from family members, financial challenges perceived as a source of poor support, and lack of psychological support and its consequences. Mental healthcare consumers verbalized limited support from family members. They reported variation in terms of family members' knowledge of their mental condition. Conclusion: Training family members on mental health illness is critical to the future of health care as there will be no misunderstanding between them and the consumers of mental health care. Healthcare consumers' feelings of sadness and anxiety could be avoided by avoiding conflicts over their social grants. The government should invest in assisting family members of mental healthcare consumers.

Evaluation of Consumer Perception of New Aquaculture Products through Applying Focus Group and Check-All-That-Apply Methodologies.

A growing interest in healthy diets has increased demand for fish and seafood, with aquaculture playing a crucial role in meeting this need. Developing new aquaculture products can enhance their commercial value and address consumer demand, but it is unclear which products will be well-received. This study aimed to generate ideas for new products derived from sea bream and prawns, and to gather consumer opinions on these ideas, segmented by gender and age. Two methodologies were used: focus groups and Check-All-That-Apply (CATA). In the focus groups, with two sessions per species and 10 participants each, ideas for aquaculture products were generated and categorized as fresh, dehydrated, fermented, marinated, and canned. The CATA technique, applied to 387 individuals, assessed the acceptability of fresh species, yielding average scores of 6.6 for sea bream and 6.8 for prawns. Sea bream was associated with products like fillets and long-shelf-life loins, while prawns were linked to snacks and toppings. In conclusion, the use of tools like focus groups has shown promising results for developing new aquaculture products. CATA analysis indicated that sea bream should be minimally processed with a long shelf life, and prawns should be processed into dehydrated products. Women preferred traditional products, while men favoured innovative options.

Empirical Study on the Usage of Telemedicine by Rural and Urban Health Care Consumers in Taiwan: Integrating the Perspectives of Technology Acceptance Model and Theory of Planned Behavior.

Introduction: The outbreak of the novel coronavirus disease-19 posed significant challenges globally, impacting various sectors and health care systems profoundly. In response, telemedicine has emerged as a vital solution to address health care demands and resource shortages. However, there is a lack of comprehensive research on telemedicine usage among health care consumers in urban and rural areas of Taiwan. Methods: This study aimed to investigate the usage, attitudes, and intentions of telemedicine utilization among health care consumers in Taiwan, integrating the Technology Acceptance Model and Theory of Planned Behavior. A cross-sectional study was conducted from April 2023 to May 2024, involving 1,053 participants who utilized telemedicine services. Structured questionnaires were used for data collection, and statistical analyses were performed using SPSS 21.0 software. Results: The results revealed significant disparities in telemedicine utilization between urban and rural areas, with urban residents exhibiting higher levels of perceived ease of use, perceived usefulness, attitude toward use, trust, and intention to use telemedicine. Regression analysis indicated a significant association between urban residence and male gender with telemedicine utilization, contrary to previous research findings. These disparities may stem from differences in health care accessibility and cultural norms prevalent in urban and rural areas. Conclusions: Further investigation into gender differences and interventions to promote telemedicine usage among females, particularly in urban areas, are recommended. This study provides valuable insights for future research and health care policy formulation.

Why are Indonesian consumers buying on live streaming platforms? Research on consumer perceived value theory.

Along with the economic and technological development in Indonesia, one of the innovations is in the field of social media commerce and it has managed to attract the attention of Indonesian consumers. Different from other social media, TikTok offers a new feature, namely TikTok Live, participants can use this social media for their entertainment as well as a buying and selling platform. At the same time, live streaming also faces several factors where consumers are not yet sure about buying it. However, the marketing strategy has recently become a hot topic of discussion. Therefore, this empirical research aimed to investigate why Indonesian consumers buy on live streaming using perceived trust as a mediating variable, such as trust in the products and trust in the sellers. The factors used to analyse the influence on consumers' purchase intention include utilitarian value, hedonic value and social value. This study collected data in a questionnaire created in Google Forms and performed data analysis using SPSS 26 and SPSS Amos software, using structural equation models to analyse validation and theoretical hypotheses. The results of this analysis are expected to provide knowledge to social commerce providers, especially in the area of live streaming. This study shows that perceived values such as utilitarian, hedonic and social values have a significant positive impact on purchase intention. Utilitarian value and social value both have a significant and positive influence on both consumer trust in the products and consumer trust in the platform, but not on hedonic value, where hedonic value only has a significant positive influence on trust in the platform, but an insignificant effect on trust in the product. Even though hedonic value has no influence on the product, sellers still need to provide a more pleasant atmosphere to attract the attention of users or consumers. And for further research, this study hopes to uncover additional elements that influence consumer behaviour on the TikTok live streaming platform.

Challenging trophic position assessments in complex ecosystems: Calculation method, choice of baseline, trophic enrichment factors, season and feeding guild do matter: A case study from Marquesas Islands coral reefs.

Assessments of ecosystem functioning are a fundamental ecological challenge and an essential foundation for ecosystem-based management. Species trophic position (TP) is essential to characterize food web architecture. However, despite the intuitive nature of the concept, empirically estimating TP is a challenging task due to the complexity of trophic interaction networks. Various methods are proposed to assess TPs, including using different sources of organic matter at the base of the food web (the 'baseline'). However, it is often not clear which methodological approach and which baseline choices are the most reliable. Using an ecosystem-wide assessment of a tropical reef (Marquesas Islands, with available data for 70 coral reef invertebrate and fish species), we tested whether different commonly used TP estimation methods yield similar results and, if not, whether it is possible to identify the most reliable method. We found significant differences in TP estimates of up to 1.7 TPs for the same species, depending on the method and the baseline used. When using bulk stable isotope data, the choice of the baseline significantly impacted TP values. Indeed, while nitrogen stable isotope (δ15N) values of macroalgae led to consistent TP estimates, those using phytoplankton generated unrealistically low TP estimates. The use of a conventional enrichment factor (i.e. 3.4‰) or a 'variable' enrichment factor (i.e. according to feeding guilds) also produced clear discrepancies between TP estimates. TPs obtained with δ15N values of source amino acids (compound-specific isotope analysis) were close to those assessed with macroalgae. An opposite seasonal pattern was found, with significantly lower TPs in winter than in summer for most species, with particularly pronounced differences for lower TP species. We use the observed differences to discuss possible drivers of the diverging TP estimates and the potential ecological implications.

Exploring Telemedicine Usage Intention Using Technology Acceptance Model and Social Capital Theory.

Telemedicine technology has emerged as a pivotal solution to enhance the accessibility and efficiency of healthcare services. This study investigates the factors influencing the acceptance of telemedicine technology among healthcare professionals in Taiwan. Employing a quantitative research approach, we utilized a survey instrument adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Data were collected from 325 healthcare professionals across diverse medical fields. The results indicate that perceived usefulness, ease of use, social influence, and convenience significantly influence intention to use telemedicine. Moreover, age moderates the relationship between perceived usefulness and usage intention. These findings underscore the importance of addressing both technological and social factors in promoting the adoption of telemedicine among healthcare professionals. Policy implications and recommendations for enhancing telemedicine implementation are discussed based on the study findings. Specifically, our findings highlight that perceived usefulness, ease of use, social influence, and convenience significantly impact the intention to use telemedicine technology. Age significantly moderates the relationship between perceived usefulness and usage intention. These results not only theoretically support the UTAUT model but also provide practical strategies to advance the application of telemedicine technology.

Health risk assessment by consumption of commercial biota contaminated with heavy metals in Tampamachoco coastal lagoon, Gulf of Mexico.

Metal pollution is a significant environmental and health problem in aquatic ecosystems worldwide, particularly in coastal systems impacted by emissions from thermoelectric plants, as is the case of the Tampamachoco lagoon. To evaluate the seasonal contamination levels of Cd, Pb, Cr, and Cu in species of commercial interest in the Tampamachoco lagoon and estimate the health risk associated with their consumption, a total of 180 fish, 90 oysters (Crassostrea virginica), 27 crabs (Callinectes sapidus), and 24 shrimp (Litopenaeus setiferus) were sampled. Metal concentrations in the species analyzed were Cu > Pb > Cr > Cd. According to the Target Hazard Quotient and the health risk index, consumption of the marine species examined should be considered safe for human health, as both values are <1. However, Carcinogenic risk values for Pb and Cr indicated that consumers may be at risk of cancer (10-3), due to exposure from the thermoelectric emissions.