Suchergebnisse

Purpose: Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability. Methods: MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomized controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery. Results: Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorized as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation was high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported. Conclusion(s): This review synthesizes the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area. Impact: Given the rapid widespread adoption of telerehabilitation services, in response to the COVID-19 pandemic, this systematic review was necessary to allow for a deeper understanding of the factors influencing telerehabilitation delivery and its translation into stroke practice to ultimately improve patient experience and service quality. Funding acknowledgements: AS's time was co-funded by Royal College of Surgeons in Ireland (School of Physiotherapy) and the European Union's Horizon 2020 Research and Innovation Programme under grant agreement no. 687228, MAGIC PCP.

Following the discovery of horsemeat in beef products in Europe in 2013, restoring consumers' confidence in processed meat products as well as in all the agencies involved - producers, food safety authorities, retailers - soon became a key priority. However, the European public's confidence in processed meat products and their views about government and industry actions to manage fraudulent practices in the wake of this incident are poorly understood. The objective of this study was to identify the core issues affecting consumers' confidence in the food industry, particularly in the meat processing sector, and to explore the impact of the horsemeat incident on consumers' purchasing and eating behaviour. It involved the use of an online deliberation tool VIZZATA™ to collect detailed views of 61 consumers in the UK and the Republic of Ireland. Many participants reported buying fewer products containing processed meat as a result of the horsemeat incident. These respondents also claimed that their confidence in processed foods containing meat was lower than before the incident. Participants suggested restoring consumer confidence through improved traceability, sourcing local ingredients, providing clearer and correct labelling and stating the origin of meat on pack. Overall, findings indicate that rebuilding consumer confidence in processed meat products following a food adulteration episode is a multifaceted and difficult process. Food authorities and the food industry can benefit from the insights provided by this study to address issues affecting consumer confidence and to improve their communication strategies during future food adulteration incidents.