Chocolate storage is critical to final product quality. Inadequate storage, especially with temperature fluctuations, may lead to rearrangement of triglycerides that make up the bulk of the chocolate matrix; this rearrangement may lead to fat bloom. Bloom is the main cause of quality loss in the chocolate industry. The effect of storage conditions leading to bloom formation on texture and flavor attributes by human and instrumental measures has yet to be reported. Therefore, the impact of storage conditions on the quality of dark chocolate by sensory and instrumental measurements was determined. Dark chocolate was kept under various conditions and analyzed at 0, 4, and 8 wk of storage. Ten members of a descriptive panel analyzed texture and flavor. Instrumental methods included texture analysis, color measurement, lipid polymorphism by X-ray diffraction and differential scanning calorimetry, triglyceride concentration by gas chromatography, and surface properties by atomic force microscopy. Results were treated by analysis of variance, cluster analysis, principal component analysis, and linear partial least squares regression analysis. Chocolate stored 8 wk at high temperature without fluctuations and 4 wk with fluctuations transitioned from form V to VI. Chocolates stored at high temperature with and without fluctuations were harder, more fracturable, more toothpacking, had longer melt time, were less sweet, and had less cream flavor. These samples had rougher surfaces, fewer but larger grains, and a heterogeneous surface. Overall, all stored dark chocolate experienced instrumental or perceptual changes attributed to storage condition. Chocolates stored at high temperature with and without fluctuations were most visually and texturally compromised. Practical Application: Many large chocolate companies do their own "in-house" unpublished research and smaller confectionery facilities do not have the means to conduct their own research. Therefore, this study relating sensory and instrumental data provides published evidence available for application throughout the confectionery industry.

Objective: Up to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction. Methods: This study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim. Results: Sixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups' pre- and posttest anxiety scores ( p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future. Conclusion: We demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.

Chocolate storage is critical to the quality of the final product. Inadequate storage, especially with temperature fluctuations, may lead to a change in crystal structure, which may eventually cause fat bloom. Bloom is the main cause of quality loss in the chocolate industry. The impact of various storage conditions on the flavor quality of dark chocolate was determined. Dark chocolate was stored in different conditions leading to either fat or sugar bloom and analyzed at 0, 4, and 8 weeks of storage. Changes in chocolate flavor were determined by volatile analysis and descriptive sensory evaluation. Results were analyzed by analysis of variance (ANOVA), cluster analysis, principal component analysis (PCA), and linear partial least-squares regression analysis (PLS). Volatile concentration and loss were significantly affected by storage conditions. Chocolates stored at high temperature were the most visually and texturally compromised, but volatile concentrations were affected the least, whereas samples stored at ambient, frozen, and high relative humidity conditions had significant volatile loss during storage. It was determined that high-temperature storage caused a change in crystal state due to the polymorphic shift to form VI, leading to an increase in sample hardness. Decreased solid fat content (SFC) during high-temperature storage increased instrumentally determined volatile retention, although no difference was detected in chocolate flavor during sensory analysis, possibly due to instrumental and sensory sampling techniques. When all instrumental and sensory data had been taken into account, the storage condition that had the least impact on texture, surface roughness, grain size, lipid polymorphism, fat bloom formation, volatile concentrations, and sensory attributes was storage at constant temperature and 75% relative humidity.

Background: The study focused on perceptions of older adults toward the healthcare processes they experienced during a clinical trial for back pain that involved family medicine residents and licensed chiropractors. Methods: Individual semi-structured interviews were conducted with 115 older adults after a 12-week, 3-arm, randomized controlled trial. Two researchers conducted thematic analysis with inductive coding using qualitative software to identify participants’ salient experiences of the doctor–patient relationship, healthcare process, and collaboration between study providers. Investigators categorized thematic codes within an existing framework of clinical excellence in primary care. Results: Participants emphasized provider communication and interpersonal relationships, professionalism and passion for patient care, clinical and diagnostic acumen, and skillful negotiation of the health-care system. Older adults also described the importance of interdisciplinary collaboration and their preferences for receiving hands-on treatments for musculoskeletal conditions. Conclusion: These older adults valued doctors who communicated clearly and spent time listening to their concerns. Many participants appreciated clinicians who supported an active role for patients in their health-care and who provided touch-based care for musculoskeletal conditions.

Objective Technology-enhanced learning is on the rise within healthcare education. This pilot study evaluated the relationship between the use of online review videos and students' performance and satisfaction in gross anatomy. Methods For this quasi-experimental study, we developed a series of online gross anatomy review videos, and surveyed students enrolled in a doctor of chiropractic program regarding use of the videos and their attitudes towards using the videos. Ordinal regression was used to evaluate the relationship between students' video use and course performance and the Mann-Whitney U test was used to determine whether there was a difference in course performance between students who did and did not report using the review videos. Results We received 143 responses to our survey, resulting in a 73.3% response rate. Most students (71%) had engaged with the online review videos. No significant differences in course performance were detected between students who did and did not report using the videos. Many students (82%) reported the review videos as being “helpful” and 73% perceived them as “an enjoyable way to study.” Conclusion While chiropractic students perceived a series of online gross anatomy review videos as being an enjoyable and helpful way to study, engagement with this form of technology-enhanced learning did not have an impact on their overall gross anatomy course performance.