Steatite Powder Additives in Wood-Cement Drywall Particleboards.

The objective of this study was to develop a new drywall wood-based particleboard as an alternative to gypsum board. Various development iterations have led to the use of wood particles, steatite powder and Portland cement. The resulting outcome shows that screw withdrawal resistance was improved by 37% and bending properties by 69% compared to gypsum board of a similar density (0.68-0.70). The raw surface of the boards is of good quality and comparable to the paper-faced surface of gypsum board. Furthermore, the reaction to fire was evaluated through bench-scale test with a cone calorimeter. The investigated particleboard did not reveal visual signs of combustion after 20 min when exposed to a radiant heat of 50 kW/m2, while burning of the overlay paper of gypsum board occurred at about 57 s, suggesting that wood-cement-steatite powder particleboard could be classified as a quasi non-combustible material.

The Effect of Wood Ash as a Partial Cement Replacement Material for Making Wood-Cement Panels.

The aim of this study was to consider the use of biomass wood ash as a partial replacement for cement material in wood-cement particleboards. Wood-cement-ash particleboards (WCAP) were made with 10%, 20%, 30%, 40%, and 50% of wood ash as a partial replacement for cement with wood particles and tested for bending strength, stiffness, water absorption, and thermal properties. Test results indicate that water demand increases as the ash content increases, and the mechanical properties decrease slightly with an increase of the ash content until 30% of replacement. On the other hand, the heat capacity increases with the wood ash content. The WCAP can contribute to reducing the heat loss rate of building walls given their relatively low thermal conductivity compared to gypsum boards. The replacement of cement to the extent of approximately 30% by weight was found to give the optimum results.

Surface Chemical Changes of Sugar Maple Wood Induced by Thermo-Hygromechanical (THM) Treatment.

The aim of this study was to investigate the effects of heat and steam on the chemical properties of thermo-hygromechanical (THM)-densified sugar maple wood. The THM densification process was performed at two different temperatures (180 °C and 200 °C) with and without steam. The functional groups, surface chemical composition and internal structure and components of the control and densified samples were investigated using attenuated total reflection Fourier transform infrared (ATR-FTIR), X-ray photoelectron (XPS) spectroscopy and pyrolysis gas chromatography-mass spectrometry (Py-GC/MS). The obtained results suggest that the THM densification treatment resulted in significant chemical changes on the wood surface. The results of the ATR-FTIR spectra confirmed the decomposition of hemicelluloses and the relative increase of cellulose and lignin contents on the wood surface. The Py-GC/MS and XPS results show an increase of the oxygen/carbon atomic (O/C) ratio, which indicated that chemical substances containing oxygenated functionality were formed through the densification process. The densification treatment favored the depolymerization of hemicelluloses and cellulose as indicated by an increased anhydrous sugar (levoglucosan) release during the pyrolysis process. Densification also facilitated the cleavage of the lignin side chains, resulting in increased phenyl units with short chains released during the pyrolysis process.

Estudio preliminar de las grietas internas en anillos de madera inicial y su relación con características de la estructura anatómica y densidad en Eucalyptus nitens / Preliminary study of internal checks within growth-rings and their relationship with anatomical features and density in Eucalyptus nitens / preliminar das fissuras internas em anéis de madeira inicial e sua relação com características da estrutura anatômica e densidade em Eucalyptus nitens

La presencia de grietas internas dentro de los anillos de crecimiento fue relacionada con la densidad y las características anatómicas de un árbol de Eucalyptus nitens. El diseño experimental incluyó como variables la posición radial y apical. Las grietas internas fueron evaluadas después del secado al aire y a 60ºC. Las características anatómicas y la densidad fueron determinadas mediante métodos normalizados y apoyo de rayos X. La intensidad de las grietas internas fue condicionada por la posición radial y apical en el árbol. Las grietas internas fueron más intensas entre los anillos 4 a 9, y se relacionaron inversamente con la densidad de la madera y directamente con la proporción y diámetro de vasos.

Internal checks within growth rings were correlated with density and anatomical characteristics of Eucalyptus nitens. The radial and longitudinal positions in the tree were the experimental variables. Internal checks were characterized after air drying and after conventional drying at 60°C. The anatomical characteristics and density were determined using standardized methods and the X-ray technique. The size of internal checks was influenced by their radial and longitudinal positions in the tree. Internal checks were larger in growth rings 4 to 9, and were inversely related to wood density and directly related to the proportion and diameter of the vessels.

A presença de fissuras internas dentro dos anéis de crescimento foi relacionada com a densidade e as características anatômicas de uma árvore de Eucaliptus nitens. O desenho experimental incluiu como variáveis a posição radial e apical. As fissuras internas foram avaliadas depois da secagem ao ar e a 60ºC. As características anatômicas e a densidade foram determinadas mediante métodos normalizados e apoio de raios X. A intensidade das fissuras internas foi condicionada pela posição radial e apical na árvore. As fissuras internas foram mais intensas entre os anéis 4 a 9, e se relacionaram inversamente com a densidade da madeira e diretamente com a proporção e diâmetro de vasos.

Impact of exercise training on muscle function and ergoreflex in Fontan patients: a pilot study.

BACKGROUND: Several studies have demonstrated persistent reduced exercise capacity in Fontan patients even after surgical intervention. The purpose of this study was to evaluate if the skeletal muscle function of these patients is abnormal, if it correlates with exercise tolerance and if it can be improved by exercise training. METHODS: We evaluated the functional capacity of seven patients who underwent Fontan procedure (age:16+/-5 years, mean+/-SD) and seven healthy children (19+/-7 years) paired for age, sex, height and weight. Evaluation included pulmonary evaluation, neuromuscular function and exercise tolerance. Secondly, an 8-week exercise training program was performed by five of these patients. RESULTS: The ergoreflex contribution to absolute diastolic blood pressure was higher (12.5+/-4.8 vs. 5.6+/-4.2 mmHg; p=0.04) in Fontan patients vs. healthy subjects whereas a trend was encountered regarding the ergoreflex contribution to absolute systolic blood pressure (9.0+/-7.0 vs. 0.4+/-9.0 mmHg; p=0.09). Furthermore, time to fatigue of the non-dominant forearm muscles was shorter in Fontan patients vs. healthy subjects (431+/-290 vs. 847+/-347 s; p=0.03). Following exercise training, there was a significant reduction of the ergoreflex contribution to absolute values of systolic blood pressure (9.8+/-0.9 vs. 0.3+/-2.7 mmHg; p<0.05). There was an association between muscle strength and VO2 peak in Fontan patients (upper limb: r=0.895; p<0.01; lower limb: r=0.838; p<0.05, respectively). CONCLUSIONS: Skeletal muscle function in Fontan patients is abnormal which may have an impact in the reduced exercise tolerance encountered in these patients. Exercise training may have beneficial impacts on the skeletal muscle function in this population.

Telehealth adoption in hospitals: an organisational perspective.

PURPOSE: The purpose of this study is to explore the influence of hospitals' organisational characteristics on telehealth adoption by health-care centres involved in the extended telehealth network of Quebec (French acronym RQTE) DESIGN/METHODOLOGY/APPROACH: The article is based on a review of the literature and a questionnaire, which was administered via telephone interviews to the 32 hospitals involved in the Extended Telehealth Network of Quebec. Contingency analyses were performed to determine which organisational factors have influenced telehealth adoption. Subsequently, a multiple case study was conducted among nine hospitals representative of different categories of telehealth adopters. In-depth interviews with various actors involved in telehealth activities have permitted a deepening of one's understanding of the impact of clinical and administrative contexts on telehealth adoption. FINDINGS: The results from both the questionnaire and interviews support the observation made by Whitten and Adams in 2003 that telehealth programs are not isolated, but located within larger health organisations. Moreover, health-care organisations are also positioned in a larger geographical, economical and socio-political environment. Therefore, it is important to investigate the context in which telehealth projects are taking place prior to experimentation. ORIGINALITY/VALUE: This study has highlighted the relevance of considering the characteristics and the dynamics of health-care organisations at each stage of telehealth implementation in order to take their specific needs into account.

Quebec population and telehealth: a survey on knowledge and perceptions.

Telehealth is widely considered to be a promising tool that addresses many of the challenges currently facing the health care system in Canada. However, diffusion of telehealth will ultimately depend on its acceptance among health care professionals and the general population. This study explores public understanding and perceptions of telehealth in the Province of Quebec (Canada). A telephone survey involving interviews with a random sample of 1242 individuals was conducted in various Quebec regions. Only 8.9% of respondents were familiar with the term "telehealth," whereas telehealth applications, especially teletriage, appeared to be more commonly known. A large majority of respondents believed telehealth could facilitate access to health care services, improve quality of care, and reduce health care expenditures. Legal responsibility in cases of medical error was reported as the leading public concern related to telehealth. Furthermore, nearly 50% of Quebec's population would use telehealth services when offered to them. The principal factors weighing in favor of willingness to use telehealth services were: knowledge of telehealth applications perception of telehealth benefits, reduced barriers to telehealth, and the fact of being female. Promoting the use of telehealth in the general population and dissipating concerns related to its applications will require global educational strategy that will inform the public about the benefits of telehealth as well as addressing ethical and legal issues.

Telepediatric cardiology practice in Canada.

Telemedicine was introduced in Canadian pediatric cardiology practice in 1987 in the Maritime provinces with real-time echocardiography transmissions. This early experience was adopted progressively by other provinces, and, with technological progress, many different applications are now available. Telemedicine has now become an essential tool in providing access to one of the 15 pediatric cardiology centers for the entire Canadian population from coast to coast. This includes teleconsultations and surgical discussions. Additionally, a teleeducation program links all 15 centers for professional education. Indeed, 16 years after its introduction, telemedicine has become as essential component in the delivery of pediatric cardiology. We will likely see further development in this field consistent with technological advances and patient demand as well as expanded networks and newer applications.

Implanting telehealth network for paediatric cardiology: learning from the Quebec experience.

The implementation committee of the Quebec Child Telehealth Network was formed in 1997, with a mandate to build a network dedicated to the diagnosis of congenital cardiac disease via telemedicine. We devised criterions for selection to determine which peripheral centres would be linked by telemedicine to the university-based services for paediatric cardiology provided in the Canadian Province of Quebec. The criterions included: distance from a university centre, number of births per year, and presence of an already-established outreach clinic for paediatric cardiology. The Quebec Network became operational in 2000, and was composed of 32 peripheral centres and 4 university centres. A total of 363 transmissions of echocardiograms occurred over a 3-year period from January 2000 to December 2002. Peripheral centres located at a distance greater than 100 kilometres from a university centre were 8.5 times more likely to use the network. Criterions other than distance did not influence whether or not a peripheral centre used the network. Cardiac abnormalities were identified in almost two-thirds of the transmissions. The use of the Quebec Network resulted in the avoidance of transfers or clinic visits to university hospitals in seven-tenths of cases. We conclude that distance greater than 100 kilometres from a centre offering subspecialty services in paediatric cardiology is the most important criterion for choosing the peripheral centres that are most likely to use a telehealth network. In its first three years of operation, the telehealth network had a major impact on the delivery of paediatric cardiac care, improving access to subspecialty services across the province.

An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians.

Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (beta=1.08; P<0.001) and self identity (beta=-0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper.

Evaluation of a telemedicine demonstration project in the Magdalene Islands.

The Magdalene Islands are an archipelago located in the middle of the Gulf of St Lawrence, more than 1000 km away from supra-regional medical referral centres. We have implemented and evaluated a telemedicine network for the local hospital on the Magdalene Islands. During a 13-month study period, 118 transmissions were made. Orthopaedics and radiology were the medical specialties that used telemedicine most frequently. Store-and-forward imaging was the technique used most often because of the large number of transmissions in orthopaedics and radiology. Various medical specialties and psychosocial services used videoconferencing, while realtime imaging (ultrasound) was used in gynaecology and obstetrics. A combination of videoconferencing and imaging was used for otolaryngology. A total of 101 individual patients benefited from a teleconsultation during the study period. Eight emergency transfers were avoided and 15 patients who would have required elective transfer were managed locally by telemedicine. For health-care providers, telemedicine seemed to be an acceptable way of delivering specialized services. Nevertheless, demonstration projects in telemedicine are quite different to 'real life' telemedicine utilization. Deployment of telemedicine in the health-care system as a whole will require a more structured approach.

Baroreflex resetting after successful surgical repair of tetralogy of Fallot.

BACKGROUND: Tetralogy of Fallot (TOF) and its surgical repair are associated with alterations in right ventricular systolic and diastolic functions. The cardiopulmonary baroreflex describes the peripheral vasoconstriction response to the volume-unloading deactivation of left and possibly right ventricular receptors. Alterations in cardiac geometry or distensibility and pulmonary vasculature of operated TOF may affect the mechanical stimulation of sensitive cardiopulmonary receptors leading to an impaired baroreflex function. There has to date been no report on the integrity of baroreflex function in postoperative TOF. OBJECTIVE: To characterize the combined cardiopulmonary and baroreflex response of patients successfully operated for TOF in early childhood to central volume unloading using graded lower body negative pressure (LBNP) application. METHODS: Fifteen patients operated on for TOF (mean+/-SEM) 15.7+/-1.4 years previously and 13 healthy age-matched control subjects were submitted to four consecutive 5 min LBNP applications at -10, -20, -30 and -40 mmHg. Forearm blood flow and vascular resistance, left ventricle end-diastolic diameter (LVEDD), arterial blood pressure and heart rate were obtained. RESULTS: TOF exhibited a lower LVEDD (42.7+/-1.5 mm) than control subjects (51.9+/-1.6). The forearm vascular resistance to LVEDD relationship was shifted left and upward in TOF compared with that of control subjects, but the slope of the relationship was not different between groups. LBNP -40 mmHg induced a lesser change in heart rate in TOF (+10.6+/-1.5%) than in control subjects (+14.7 +/-2.4%) and an increase (P<0.05) in diastolic blood pressure in TOF (-2.4+/-2.5%), which was not seen in control subjects (+4.3+/-2.9%). CONCLUSIONS: Young adults successfully operated on for TOF in early childhood exhibit a resetting of the cardiopulmonary baroreflex to operate at smaller LVEDD and at a higher level of forearm vascular resistance. The blunted heart rate response to LBNP -40 mmHg is consistent with previous observations pointing to disturbances in the efferent arm of the baroreflex.

La telemedicina: dos modelos de implementacion / The telemedicine: two implementation models

El uso de medios de comunicacion avanzados para intercambiar informacion de salud y para agregar servicios de atencion mas alla de las barreras geograficas, temporales, sociales y culturales..." En el presente, sera cuestion unicamente de la telemedicina

La telemedicina: dos modelos de implementacion / The telemedicine: two implementation models

El uso de medios de comunicacion avanzados para intercambiar informacion de salud y para agregar servicios de atencion mas alla de las barreras geograficas, temporales, sociales y culturales..." En el presente, sera cuestion unicamente de la telemedicina(AU)