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BackgroundHome adaptation processes enhancing occupational engagement rely on identifying environmental barriers, generally during time-consuming home visits performed by occupational therapists (OTs). Relevance of a 3D model to the OT’s work has been attested, but a convenient and consumer-available technology to map the home environment in 3D is currently lacking. For instance, such a technology would support the exploration of home adaptations for a person with disability, with or without an OT visit. ObjectiveThe aim of this study was to document the development and acceptability of a 3D mapping eHealth technology, optimizing its contribution to the OT’s work when conducting assessments in which home representations are essential to fit a person’s needs. MethodsA user-centered perspective, embedded in a participatory design framework where users are considered as research partners (not as just study participants), is reported. OTs, engineers, clinicians, researchers, and students, as well as the relatives of older adults contributed by providing ongoing feedback (eg, demonstrations, brainstorming, usability testing, questionnaires, prototyping). System acceptability, as per the Nielsen model, is documented by deductively integrating the data. ResultsA total of 24 stakeholders contributed significantly to MapIt technology’s co-design over a span of 4 years. Fueled by the objective to enhance MapIt’s acceptability, 11 iterations lead to a mobile app to scan a room and produce its 3D model in less than 5 minutes. The app is available for smartphones and paired with computer software. Scanning, visualization, and automatic measurements are done on a smartphone equipped with a motion sensor and a camera with depth perception, and the computer software facilitates visualization, while allowing custom measurement of architectural elements directly on the 3D model. Stakeholders’ perception was favorable regarding MapIt’s acceptability, testifying to its usefulness (ie, usability and utility). Residual usability issues as well as concerns about accessibility and scan rendering still need to be addressed to foster its integration to a clinical context. ConclusionsMapIt allows to scan a room quickly and simply, providing a 3D model from images taken in real-world settings and to remotely but jointly explore home adaptations to enhance a person’s occupational engagement.

Introduction: Visiting a patient's living environment is important for occupational therapists, albeit costly and time consuming. MapIt is a mobile app producing a 3D representation of a home with the possibility of taking measurements. The purpose of this study was to explore the utility of a 3D representation of a patient's home for the clinical practice of occupational therapists. Methods: Case study in which the unit of analysis was the utility of MapIt as defined by ISO 9241‐11:2018 and as perceived by occupational therapists in four different occupational therapy clinical settings (Canada). Onsite observations with 10 occupational therapists (and their patients) were triangulated with data from interviews, diaries, and logbooks. Inductive thematic condensation led to emerging conclusions for each clinical setting, fuelling the next case data collection and analysis. Inter‐case analysis was corroborated by additional occupational therapists, through crowdsourcing and expert review. Results: Occupational therapists' clinical reasoning was supported by the MapIt app, enhancing and streamlining their work and inducing adjustments to treatment plans. Occupational therapists saw and measured the patient's environment remotely, to better match person‐environment‐occupation and promote occupational engagement. MapIt's 3D representations were judged useful to communicate between occupational therapists and stakeholders, to educate, allow continuity, optimise resources, minimise the patient's time on a waitlist for homecare, and save time for everyone. Discussion: MapIt allowed occupational therapists who performed home visits to bring a little of the patients' home to their office, whereas occupational therapists without access to the home could see it and take measurements. MapIt's utility was confirmed for practice in clinical settings and for better continuity of care between settings. Conclusion: MapIt makes it possible for occupational therapists to 'walk around' the patient's home remotely, but the possibility of measuring environmental elements is a 3D model's true added value over currently used photos or short videos. PLAIN LANGUAGE SUMMARY: This study explored how a mobile app called MapIt could help occupational therapists in their work. Visiting a patient's home takes a lot of time. This app creates a 3D model of a room, making it easier for occupational therapists to see and measure the home environment remotely. The research was conducted with 10 occupational therapists working in four different contexts in Quebec, Canada. Researchers studied how useful MapIt was to the occupational therapists. The latter each used MapIt with their patients, kept track of their experience in a diary and were interviewed throughout the duration of the study. The results showed that MapIt helped occupational therapists in understanding their patients' living environment and planning treatments accordingly. Occupational therapists who could not visit the homes in person found it useful. The 3D models created by MapIt were also judged helpful for communicating with other people involved in the patient's care, like family members or other health‐care professionals. MapIt could make occupational therapy more efficient and help patients get the care they need faster. Overall, the researchers concluded that MapIt is a useful tool for occupational therapists. It allows them to virtually visit patients' homes and take measurements, which is important when evaluating how to adapt a home to a patient's needs. [ABSTRACT FROM AUTHOR]

Tephra layers preserved in marine sediments are strong tools to study the frequency, magnitude and source of past major explosive eruptions. Thirty‐seven volcanoes from the Ecuadorian and Colombian arc, in the northern Andes, experienced at least one eruption during the Holocene. The volcanic hazard is therefore particularly high for the populated areas of the Andes and in particular cases for the coastal region, and it is crucial to document such events to improve hazard assessment. The age and distribution of deposits from major Holocene eruptions have been studied in the Cordillera, but no descriptions of distal fallouts have been published. In this study, we focused on 28 Holocene tephra layers recorded in marine sediment cores collected along the northern Ecuador—Southern Colombia margin. New lithological, geochemical and isotope data together with 14C datings on foraminifers allow us to determine the age and volcanic source of marine tephra, and to propose a first land‐sea correlation of distal tephra fallouts. We show that at least seven explosive eruptions from Guagua Pichincha, Atacazo‐Ninahuilca, Cotopaxi, and Cerro Machín volcanoes left tephra deposits recorded in marine cores over 250 km away from their source. Volume estimates of emitted tephra range between 1.3 and 6.0 km3 for the tenth century Guagua Pichincha, ∼5 ka Atacazo‐Ninahuilca, ∼6.7 and ∼7.9 ka Cotopaxi events, suggesting that they were eruptions of Volcanic Explosivity Index of 5. The distribution of these deposits also brings new constraints for a better evaluation of the volcanic hazard in Ecuador. Plain Language Summary: During major explosive eruptions, large volumes of gases and tephra (lapilli and ash particles) are thrown into the atmosphere and can be spread by winds over 100 km and more. Tephra fallouts can impact the population, infrastructures and climate. It is therefore essential to document the age and magnitude of past major eruptions to better assess the volcanic hazards. In this study, we use the mineralogy, glass shard morphology, and the geochemical composition of tephra settled in marine sediments off Ecuador and Colombia to investigate their source. Thickness of tephra layers and radiocarbon ages performed on under‐ and over‐lying marine fauna allow us to determine the age of the eruptions, whereas the distribution of tephra yields constraints on the volume of fallout deposits. We show that the largest explosive eruptions from Ecuadorian and Colombian volcanoes reached the Pacific Ocean with a recurrence rate of about 1.5 events per millennium over the past 8 kyr. Key Points: We propose a first land‐sea correlation of distal Holocene tephra off Ecuador based on 14C age and geochemical dataProducts from at least seven explosive Holocene eruptions in Ecuador and south Colombia reached the Pacific OceanVolumes of tephra emitted by largest eruptions vary between 1.3 and 6.0 km3, suggesting they were VEI‐5 eruptions [ABSTRACT FROM AUTHOR]

Introduction: Access to public rehabilitation services for patients with non‐urgent conditions ‐ which suffer mainly from musculoskeletal disorders ‐ is problematic around the world. Remote rehabilitation services are recognized as effective means to increase accessibility. Patient acceptability is an important element in the successful implementation of such clinical innovations and has not yet been studied thoroughly in this context. Thus, the aim of this study was to evaluate and compare the acceptability of two remote consultation modalities ‐ phone and teleconsultation ‐ for patients waiting for public outpatient non‐urgent rehabilitation services. Methods: We conducted a qualitative descriptive study nested within a randomized clinical trial in which participants received either phone or teleconsultation follow‐ups with a physiotherapist after a first systematic face‐to‐face evaluation. Semi‐structured interviews were conducted with participants of both groups selected with purposive sampling. Sekhon's acceptability metaframework was used and interviews were transcribed and coded with thematic analysis. Ethic approval: The research protocol was approved by the Research Ethics Board of the Centre intégré universitaire de santé et de services sociaux – Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie – CHUS) (#2019–2919). Results: Twenty participants were recruited. Results show both follow‐up modalities have a good level of acceptability for participants; however, teleconsultation stands out because its visual dimension offers higher quality human contact and satisfactorily meets greater needs for support. Conclusion: Systematic in‐person assessment and advice combined with telephone or teleconsultation follow‐up can contribute to diversifying the services offered in physiotherapy outpatient clinics. Offering a range of service modalities with different resource requirements may shorten wait times. Such an approach seems to be well accepted by patients, especially with teleconsultation. ClinicalTrials.gov ID: NCT03991858 [ABSTRACT FROM AUTHOR]