Microwave-assisted acid extraction of high-methoxyl kinnow (Citrus reticulata) peels pectin: Process, techno-functionality, characterization and life cycle assessment

The present study assessed the efficacy of kinnow peel pectin-acetic acid extraction using microwave heating at 110 °C, pH 2.2 for 10 min with a 1:2 ratio supernatant to ethanol for higher yield. The kinnow peel was freeze dried and grinded to fine powder for pectin extraction. The microwave extracted (ME) kinnow pectin showed 833 mg equivalent weight, 7.44 % methoxyl content, 66.67 % degree of esterification, 63.15 % galacturonic acid content and evinced higher purity than commercial citrus pectin. ME kinnow pectin exhibited shear thinning behaviour while higher apparent viscosity (Pa. s) at 20 % concentration. The ME kinnow pectin showed characteristic functional groups and a less crystalline structure as deduced from FT-IR, SEM and XRD respectively, and a higher thermal decomposition analysed from TGA. Further, life cycle assessment (LCA) predicted that the ethanol and acetic acid were major contributors toward climate change in this study. ME kinnow pectin has the potential to be used as a commercial pectin in various food applications.

Unraveling the genetic and epigenetic landscape governing intramuscular fat deposition in rabbits: Insights and implications

Intramuscular fat (IMF) content is a predominant factor recognized to affect rabbit meat quality, directly impacting flavor, juiciness, and consumer preference. Despite its significance, the major interplay of genetic and epigenetic factors regulating IMF in rabbits remains largely unexplored. This review sheds light on this critical knowledge gap, offering valuable insights and future directions. We delve into the potential role of established candidate genes from other livestock (e.g. PPARγ, FABP4, and SCD) in rabbits, while exploring the identified novel genes of IMF in rabbits. Furthermore, we explored the quantitative trait loci studies in rabbit IMF and genomic selection approaches for improving IMF content in rabbits. Beyond genetics, this review unveils the exciting realm of epigenetic mechanisms modulating IMF deposition. We explored the potential of DNA methylation patterns, histone modifications, and non-coding RNA-mediation as fingerprints for selecting rabbits with desirable IMF levels. Additionally, we explored the possibility of manipulating the epigenetic landscape through nutraceuticals interventions to promote favorable IMF depositions. By comprehensively deciphering the genomic and epigenetic terrain of rabbit intramuscular fat regulation, this study aims to assess the existing knowledge regarding the genetic and epigenetic factors that control the deposition of intramuscular fat in rabbits. By doing so, we identified gaps in the current research, and suggested potential areas for further investigation that would enhance the quality of rabbit meat. This can enable breeders to develop targeted breeding strategies, optimize nutrition, and create innovative interventions to enhance the quality of rabbit meat, meet consumer demands and increase market competitiveness.

Unveiling the oxidative stability, phytochemical richness, and nutritional integrity of cold-pressed Linum usitatissimum oil under UV exposure

This study examines the effect of UV irradiation on the oxidation stability of Linum usitatissimum oil, presenting possible changes in the phytochemical profile due to photo-oxidation. GC-MS analysis of the oils identified 11 fatty acid compounds with a high percentage of unsaturated fatty acids, the most important of which is α-linolenic acid (ALA), known as omega-3 (48.88 %), also significant profiles of phytosterol and tcocopherol isomers rich in β-Sitosterol and γ-tocopherols respectively. As well as physicochemical properties such as free fatty acids (FFA %), peroxide value (PV) and iodine value (IV), and nutritional indexes that determine the significant changes observed during the oxidation process, the most important of which is the progressive increase in acidity, peroxide, conjugated dienes and trienes and degrees of unsaturation over 8 h of UV exposure. High levels of carotenoids and phenolic compounds (TPC) protect and enhance oil quality in the face of irradiation, so a significantly small difference is observed between irradiated and non-irradiated oil during photo-oxidation.

Effective extraction and detection of aflatoxins in cereals using nitrogen-rich benzodiimidazole linkage magnetic covalent organic framework based solid phase extraction and HPLC-MS/MS analysis

Cereals are frequently contaminated by aflatoxins (AFs). The objective of this study was to develop an efficient extraction materials for rapidly extracting and detecting AFs. A novel amino-functionalized benzodiimidazole linkage magnetic covalent organic framework (Fe3O4@BB-COF) was simply fabricated by one-step cyclization and aromatization. The Fe3O4@BB-COF, having multiple N-containing active sites, exhibited excellent extraction capability towards AFs due to synergistic interactions, including the π-π interactions, hydrogen bonding interactions, polar interactions, electrostatic interactions and Lewis acid-base interactions. The Fe3O4@BB-COF based MSPE method for detecting aflatoxins has advantages of simple operation, short extraction time (6 min), and low material consumption (2 mg). This method exhibited satisfactory linearity (0.05-20 μg/kg), and sensitivity (0.01-0.45 μg/L for the detection limits) and accuracy (76.8-97.1 % for recovery) and was successfully applied for extracting and detecting AFs in cereals.

Innovative technology integration: E tongue, near infrared grain tester & machine vision approaches for amylose content & quality characterization

E-tongue, machine vision and NIR systems were used to standardize the quality measurements in twenty rice genotypes grown in Highland Himalayan regions of Kashmir, in order to overcome the constraints of manual measurements. IRCTN-312 showed highest amylose content of 20.74 % and 20.70 % using iodometric method and NIR tester, which was validated by the highest norm value of 34.158 by E-tongue. From these results, genotypes such as GSR-43, GS-103, GSR-23B, GSR-60, SR-4, GSR-46, Koshihikari, GSR-64, GSR-32, GSR-49, GSR-4, GSR-42, GS-459, SKUA-494 and SKUA-540 were classified as low amylose and C-3, K-332, M4-22 and IRCTN-312 were classified as intermediate amylose in the present study. Lowest percentage of damaged grains and chalk ratio was found in GSR-23B. SKUA-494 recorded highest L/W ratio using both the systems. Highest head rice yield and elongation ratio was found in GSR-23B and SKUA-494 genotypes respectively. Highest lightness (L*) value was recorded for Koshihikari genotype.

Enhancing emulsion, texture, rheological and sensory properties of plant-based meat analogs with green tea extracts

Plant-based meat analogs require improvements in taste and texture to better replicate traditional meat. L-theanine and tannin, abundant in green tea, influence food taste and physicochemical properties. This study evaluated the quality characteristics of green tea extract (GE)-supplemented plant-based patties (PP) and the mechanisms affecting taste and texture. Green tea was extracted with water (GWE) or 70 % ethanol (GEE). GEE contained higher tannin and lower L-theanine levels than GWE. Both GWE and GEE reduced protein deterioration and lipid oxidation in PP throughout the 28-day storage period. PP with 1.0 % GEE (PP-GEE1.0) showed improved emulsion stability and texture due to non-covalent interactions including hydrophobic interaction and hydrogen bonds, and increased β-sheet structures between tannin and pea protein. PP-GEE1.0 also had superior sensory characteristics due to an optimal balance of L-theanine and tannin. Overall, the incorporation of GE, particularly GEE significantly improved physicochemical properties, sensory quality, and storage stability of PP.

Optimization of pulsed electric fields-assisted thawing process conditions and its effect on the quality of Zhijiang duck meat

Freezing storage is a common preservation method for industrialized duck meat. However, both the frozen storage and thawing processes of meat can affect meat quality. Therefore, appropriate thawing methods are crucial for maintaining good meat quality. In this study, a pulsed electric field (PEF) was used for thawing zhijiang duck meat and the freshed duck meats were used as control. Optimization of the PEF-assisted thawing process and its effect on the quality of zhijiang duck meat were analyzed. Our data showed that the shear force in the 2 kV/cm PEF-assisted thawing group was the lowest in PEF-assisted thawing groups. The color of zhijiang duck meat in the 2 kV/cm PEF-assisted thawing group was optimal. The 2 kV/cm PEF-assisted thawing could improve the texture characteristics of zhijiang duck meat and enhance water holding capacity of zhijiang duck meat. PEF-assisted thawing could better maintain the microstructure of zhijiang duck meat. Our data showed that if the intensity or duration of PEF treatment is too high, the quality of duck meat will actually decrease. Therefore, appropriate parameters should be selected in practical applications, which will provide a reference for the application of PEF-assisted thawing on the market.

Anthocyanin modified by chondroitin sulphate and tannic acid improved the quality-indicating properties of gelatin-based intelligent film

A highly pH-responsive gelatin film incorporating purple cabbage anthocyanin (PCA) and chondroitin sulphate (CS)/tannic acid (TA) was developed. Co-pigmentation of PCA via CS/TA improved its photothermal stability and visibility of color change in gelatin film. The morphological and structural properties of CS-PCA and TA-PCA films revealed that a more stable network was formed as new hydrogen bonds were generated by the co-pigmentation. Meanwhile, the co-pigmentation improved film's mechanical and hydrophobic properties, expressed as higher tensile strength (16.65 and 17.97 Mpa) and lower water vapor permeability (1.45 and 1.41) in CS-PCA and TA-PCA films, compared to PCA film. CS-PCA and TA-PCA films showed distinct color transitions for chilled fish fillets during storage. Total color difference (ΔE) of CS-PCA and TA-PCA films correlated well with the deterioration indexes of total volatile base nitrogen (TVB-N). All the results provided a novel pH-sensitive intelligent packaging strategy by co-pigmenting CS/TA with PCA for freshness monitoring.

Comparative analysis of phenolic compounds in different thinned unripe kiwifruits and their biological functions

Thinned unripe kiwifruits (TUK) are considered the major agro by-products in kiwifruit production. To promote their potential applications, polyphenols and biological effects of unripe fruits from nine commercial kiwifruit cultivars were compared. Our findings showed that TUK were rich in bioactive polyphenols, which varied greatly by different cultivars. Indeed, catechin, epicatechin, procyanidin PB1, procyanidin B2, protocatechuic acid, neochlorogenic acid, and gallic acid were measured as the major phenolic components in most TUK, with the highest levels observed in 'Hongao' and 'Cuiyu' cultivars. Furthermore, TUK exerted strong in vitro antioxidant capacities, inhibitory effects on digestive enzymes, and anti-inflammatory activities. Particularly, their stronger antioxidant effects and inhibitory effects on digestive enzymes were probably attributed to their higher contents of phenolic compounds, especially procyanidin B2. Collectively, our findings reveal that TUK are potential resources of valuable polyphenols, which can be exploited as natural antioxidants and natural inhibitors of α-glucosidase and α-amylase.

Simultaneous determination of glyphosate, glufosinate and their metabolites in soybeans using solid-phase analytical derivatization and LC-MS/MS determination

Glyphosate and glufosinate are the most widely used herbicides worldwide. We developed a simple and rapid analytical method for detecting glyphosate, glufosinate, and their metabolites (N-acetyl glyphosate: Gly-A, N-acetyl glufosinate: Glu-A, and 3-(hydroxymethylphosphinyl)propanoic acid: MPPA) in soybeans. The method involved extraction with water, trapping in a mini-column containing polymer-based resin with strong anion exchange groups, dehydration with acetonitrile, and solid-phase analytical derivatization at ambient temperature for 1 min using N-(tert-butyldimethylsilyl)-N-methyl trifluoroacetamide (MTBSTFA), followed by Liquid chromatography-tandem mass spectrometry (LC-MS/MS) determination. This method offers a straightforward and rapid analysis, using on-solid phase dehydration and rapid derivatization at an ambient temperature with MTBSTFA, yielding reliable results for glyphosate, glufosinate, and their metabolites. The method was applied to both domestic and imported soybean samples. Glyphosate, glufosinate, and Glu-A were detected in imported feed soybeans and processed soybean meal for feed use, reflecting the current conditions of GM soybean cultivation.

UPLC-MS/MS and HS-SPME-GC-MS reveal the flavor profiles of two geographical indications woody vegetables: Staphylea bumalda and Staphylea holocarpa

Staphylea bumalda (SHC) and Staphylea holocarpa (PGG) were recognized as geographical indication agricultural products due to unique flavor. 1218 differential non-volatile compounds and 536 differential volatile compounds were detected and identified through UPLC-MS/MS and HS-SPME-GC-MS methods. In SHC samples, catechins, epicatechins, proanthocyanidins, quinic acid derivatives, and kaempferol glycoside derivatives were the main flavor compounds, with bitter and harsh taste. L-tartaric acid, citraconic acid and citric acid were contributed to increase acidity. 4-Hexen-1-ol acetate, butanoic acid butyl ester, 3-Hexen-1-ol acetate, (E)-, and 3-Hexen-1-ol acetate, (Z)- were identified as characteristic odor compounds with strong floral, fruity and sweet odor. In PGG samples, epicatechin gallate, quercetin glycoside derivatives, L-histidine, and L-tyrosine were the leading contributors to bitter and harsh taste. The spicy, herbal, and bad smell odor were mainly brought by 2-octanol, and 3-Octen-1-ol, (Z)-. Our results offered comprehensive insights into the flavor and quality characteristics differences between PGG and SHC.

Peanut (Arachis hypogaea L.) flour and oilcake flour: Exploring the influence of roasting and varietal differences on proximal composition, elemental profiling, antimicrobial and antioxidant properties

Peanuts are highly valued for their abundance of essential nutrients and health-promoting phenolic compounds. Peanut press cake, an inexpensive and underutilized agro-industrial by-product of oil production, is typically discarded or used as animal feed. This study investigated the influence of thermal processing and varietal disparities on the nutritional composition, phenolic content, and biological properties of peanut flour and oilcake flour, aiming to enhance their value as food ingredients. The findings showed that roasting significantly increased the oil (9.98 ± 0.11-44.13 ± 0.10 %), ash (1.28 ± 0.01-5.45 ± 0.05 %), carbohydrate contents (0.90 ± 0.01-28.09 ± 0.28 %), and energy value (406.69 ± 0.09-609.13 ± 1.08 kcal/100 g), along with the total polyphenol content (28.64 ± 0.19-62.79 ± 1.18 mg GAE/g), total flavonoid content (4.20 ± 0.07-18.35 ± 0.06 mg QE/g) and antioxidant activity in both peanut flour and its oilcake. Conversely, it led to a reduction in the moisture (1.48 ± 0.09-6.25 ± 0.15 %) and protein content (49.50 ± 0.05-54.24 ± 0.01 %). Notable variations were found between the two peanut varieties in terms of these nutritional parameters. Elemental analysis unveiled significant discrepancies among peanut varieties and with roasting, with potassium (12,237.56 ± 101.36-14,513.34 ± 168.62 mg/kg) emerging as the predominant macro-element followed by phosphorus (6156.86 ± 36.19-8815.22 ± 130.70 mg/kg) and magnesium (3037.92 ± 13.87-4096.44 ± 8.54 mg/kg), while zinc (53.98 ± 0.61-81.77 ± 0.44 mg/kg) predominated among the microelements. Moreover, peanut and oilcake flours demonstrated antibacterial activity against several bacteria. It can be inferred that roasted peanut and oilcake flours offer substantial nutritional value, making them promising candidates for addressing protein-energy malnutrition and serving as valuable ingredients in developing new food products.

Bioactive metabolites identification of the foxnut and broken millet-based nutritional bar using HR-MS

The by-products of the grain processing industry are a vital resource for the valorization methods in the food industry. In comparison to the whole grain, the broken kernels and seeds own similar nutrient and bioactive compounds having multifaceted health properties. This study aims to develop a nutritional bar by utilizing the by-products from barnyard millet and foxnut with added sweeteners. Furthermore, high-resolution mass spectrometry (HR-MS) metabolomics was carried out in positive and negative both ion modes to identify the major bioactive compounds formed in the matrix of the best-optimized valorized bar. The formulation of the bar having 15 % foxnut flour and the barnyard flour each, was elucidated highest rheological and sensory scores. A sum of 29 bioactive metabolites has been observed in the obtained metabolome. Major metabolites were palmitoyl serinol, glycitein, persin, bufagargarizin, apigenin, carvone, etc. covering a wide area in the mass spectrum. The therapeutic value of these compounds is heart health promotion, anti-inflammatory, anti-carcinogenic, anti-diabetic, anti-microbial, etc. This work highlights the bioactivity of the valorized nutritional bar employing robust and accurate tool of mass spectrometry. The developed snack is a functional food for the consumers.

Use of genomics & proteomics in studying lipase producing microorganisms & its application

In biotechnological applications, lipases are recognized as the most widely utilized and versatile enzymes, pivotal in biocatalytic processes, predominantly produced by various microbial species. Utilizing omics technology, natural sources can be meticulously screened to find microbial flora which are responsible for oil production. Lipases are versatile biocatalysts. They are used in a variety of bioconversion reactions and are receiving a lot of attention because of the quick development of enzyme technology and its usefulness in industrial operations. This article offers recent insights into microbial lipase sources, including fungi, bacteria, and yeast, alongside traditional and modern methods of purification such as precipitation, immunopurification and chromatographic separation. Additionally, it explores innovative methods like the reversed micellar system, aqueous two-phase system (ATPS), and aqueous two-phase flotation (ATPF). The article deals with the use of microbial lipases in a variety of sectors, including the food, textile, leather, cosmetics, paper, detergent, while also critically analyzing lipase-producing microbes. Moreover, it highlights the role of lipases in biosensors, biodiesel production, tea processing, bioremediation, and racemization. This review provides the concept of the use of omics technique in the mechanism of screening of microbial species those are capable of producing lipase and also find the potential applications.

A ratiometric fluorescent electrospun film with high amine sensitivity and stability for visual monitoring of livestock meat freshness

Ratiometric fluorescent films with high amine sensitivity and stability were developed to monitor the freshness of beef and pork. Fluorescein isothiocyanate (FITC) and red carbon quantum dots (R-CQD) were used as the amine-responsive indicator and internal reference, respectively. The electrospun films prepared by immobilizing FITC and R-CQD complex (F-R) into polyvinylidene fluoride (PVDF) under 35 %, 55 % and 75 % of relative humidity (RH) were named F-R@PVDF-1, F-R@PVDF-2 and F-R@PVDF-3, respectively. In comparison, the F-R@PVDF-2 film exhibited the highest sensitivity to trimethylamine (TMA), demonstrating a limit of detection (LOD) value of 1.59 μM, and meanwhile high stability during storage with ΔE value of 1.99 after 14 days of storage at 4 °C. The F-R@PVDF-2 film also showed a significant fluorescent red-to-brown color change during meat freshness monitoring at 4 °C. Conclusively, this study reported a new ratiometric fluorescent film that can be used to track the freshness of meats in food packaging.

Effect of different nitrogen source and Saccharomyces cerevisiae strain on volatile sulfur compounds and their sensory effects in chardonnay wine

Three commercial Saccharomyces cerevisiae strains with low, medium, and high H2S-producing capacity were chosen to investigate the effect of yeast assimilable nitrogen (YAN) levels and composition on volatile compounds in a chemically defined medium, specifically high, medium, and low initial YAN levels with varying proportions of DAP or sulfur-containing amino acids (cysteine and methionine). The results revealed that the initial YAN containing a larger proportion of diammonium phosphate resulted in a higher YAN consumption rate during the early stages of fermentation. The yeast strain had a greater effect on the volatiles than the YAN level and composition. Keeping the total YAN constant, a higher proportion of sulfur-containing amino acids resulted in a considerably higher production of 3-methylthiopropanol. The sensory impact of three key volatile sulfur compounds was investigated in a Chardonnay wine matrix, indicating that 3-methylthiopropanol at subthreshold or greater concentrations was effective in enhancing the cantaloupe aroma.

Exploring perceptions of online calculators for identifying community-dwelling older people at risk of dying: A qualitative study

Objectives

This study aimed to assess the acceptability, value, and perceived barriers of using electronic risk calculators for predicting and communicating the risk of death in community-dwelling older adults.

Methods

One focus group and eight interviews were conducted with 16 participants with experience caring for patients or family members at end of life. A prototype mortality risk tool was used to anchor discussions. Data were analysed using a qualitative content analysis approach.

Results

Five themes emerged: acceptability, communication, barriers to use, broadening the circle of care, and tool limitations. Participants found the tool helpful for preparation, planning, and providing care, but disagreed on its community availability. Personalized risk estimates were valued for facilitating early goals of care conversations and normalizing discussions about death. However, concerns were raised about the tool's interpretation for individuals with different language, cultural, or educational backgrounds.

Conclusions

While electronic risk calculators were found to be acceptable, balancing autonomy with varying preferences for receiving the information and potential need for support is crucial.

Innovation

Providing patient-oriented life-expectancy estimates can enhance decisional capacity and facilitate shared decision-making between patients, their families, and healthcare professionals. Further research is needed to explore effective communication of personalized risk tools and additional benefits, harms, and barriers to implementation.

A self-management package for pulmonary fibrosis: A feasibility study

Background and objective

There is currently no self-management package designed to meet the needs of people with pulmonary fibrosis (PF). This study evaluated the feasibility and acceptability of a PF-specific self-management package.

Methods

Adults with PF were randomly allocated (1:1) to either receive the self-management package with healthcare professional (HCP) support or standardised PF information. Primary outcomes were feasibility and acceptability of the intervention. Secondary outcomes included health-related quality of life, self-efficacy, breathlessness, daily steps, use of PF-related treatments, and healthcare utilisation. Participants' experiences of using the package were explored using qualitative interviews.

Results

Thirty participants were included. Recruitment rate was 91% and 100% of those recruited were randomised. Eighty-seven percent of participants who received the package read ≥1 module and set a goal. Secondary outcomes were feasible to collect with high assessment completion rates (87%). Most participants reported the package was easy to use and enhanced knowledge, but suggested some improvements, while HCP support was highly valued.

Conclusion

A PF-specific self-management package was feasible to deliver and requires further testing in a trial powered to detect changes in clinical outcomes.

Innovation

This is the first self-management package designed specifically for people with PF, informed by patient experience and expert consensus.

Development of a decision aid with cost information for heart failure medication in Singapore

Objective

This study presents the development process of a heart failure (HF) medication decision aid (DA) specific to Singapore context, with the objective of promoting cost conversations.

Methods

Phase 1 was to create a DA prototype, where two HF clinicians were consulted on their input and needs. Phase 2 was pilot testing where the prototype was tested on HF patients and revised based on their feedback.

Results

The DA is a one-page poster that compares only two classes of HF medications. It encompasses seven attributes for comparison, including route of administration, treatment duration, frequency of use, hospitalization rate, survival rate, low blood pressure probability with personalized subsidized cost being the key attribute. A total of 48 patients participated in the pilot testing with only 2 patients (4.2 %) finding the DA difficult to understand. Almost all patients agreed that the DA provided greater clarity in the medication options.

Conclusion

By integrating the needs of both clinicians and patients and conducting user testing, we developed a novel HF medication DA. Patients found the tool easy to understand and acceptable.

Innovation

This innovative DA aims to improve cost conversations by providing tailored, concise, and locally relevant information for efficient use.

Evaluating iSibWorks: A virtual cognitive-behavioural intervention for siblings of children with disabilities

Objectives

1) Examine if participation in iSibWorks, a group-based virtual intervention for siblings of children with disabilities, impacted siblings' perception of quality of life (QoL) and social support; and 2) Explore siblings' feedback on iSibWorks.

Methods

Thirty-eight children participated in iSibWorks and completed questionnaires (Pediatric Quality of Life [PedsQL™], Social Support Scale for Children [SSSC]) one week pre- and post-intervention. Conventional content analysis was used to explore siblings' open-ended responses on a post-participation feedback form.

Results

No significant differences in PedsQL™ and SSSC scores were observed after participating in iSibWorks. Despite this, siblings had positive feedback about iSibWorks and discussed: 1) Engaging in group learning and activities, 2) Meeting other siblings, and 3) Applying iSibWorks content to their daily life.

Conclusion

Factors related to the COVID-19 pandemic such as family stress, school closures, virtual learning, and social distancing likely impacted study results. Although there were no significant changes in QoL and social support, siblings found iSibWorks to be fun, meaningful, and engaging.

Innovation

Siblings of children with disabilities can experience psychosocial challenges and there are few virtual interventions designed for this population. iSibWorks was adapted to address this gap and increase access and support for siblings of children with disabilities.

A combined diabetes and continuous glucose monitoring education program for adults with type 2 diabetes

Objective

The lack of descriptions for education programs in studies evaluating the efficacy of continuous glucose monitoring (CGM) compared to blood glucose monitoring (BGM) for individuals with T2DM makes it difficult to compare results across trials. This study aimed to develop and evaluate a new education program for adults with insulin-treated T2DM and HbA1c ≥58 mmol/mol (7.5 %) initiating CGM.

Methods

A 3-h education program was created to provide information on diabetes self-management and CGM or BGM based on international guidelines and a pre-evaluation based on user needs assessment. Questionnaires were used to post-evaluate participant-rated benefits from the program.

Results

Seven individuals attended a user needs assessment of the program and 96 participated in the final education program (61.5 % men, mean age 61 (59.5;63) years, mean diabetes duration 18.2 (16.9;19.5) years, and median HbA1c 69 (63-78)mmol/mol (8.5 (7.9-9.3)%). Benefit from this program was rated good/very good by 95.5 % with no statistically significant difference between glucose monitoring groups.

Conclusions

This study presents a new well-received education program for T2DM for both the CGM and BGM group.

Innovation

The description of the development process and the education provided for both glucose monitoring groups may be useful for CGM initiation in clinics and trials.

Improving asthma self-management education through inhaler labeling

Objective

Improper use and poor understanding of asthma medications can lead to poorly controlled asthma, emergency department visits, and hospitalizations for children with asthma. Pharmacists play a critical role in improving asthma medication adherence through education on asthma self-management. The use of color-coded labels applied at pharmacies to help patients differentiate between rescue and maintenance inhalers has not been explored.

Methods

Pharmacies were recruited to join a community pharmacy asthma coalition. Pharmacists provided patient education and labeled inhalers with two types of color-coded stickers. A red sticker labeled "RESCUE" was used for short-acting β-2 agonist medication inhalers. A green sticker labeled "USE EVERY DAY" was used for inhaled corticosteroids (ICS) or combination ICS/long-acting β-2 agonist medication inhalers.

Results

During the two years of the pilot program, 25 pharmacy locations participated. Pharmacies labeled over 6000 rescue and 9000 controller medications using color-coded labels. Over 1000 children and 7000 adults were served by the coalition.

Conclusion

Color-coded asthma medication labels can be successfully utilized by pharmacies. This low-cost tool provides vital information regarding the proper use of asthma medications.

Innovation

The color-coded labeling of asthma medications is a novel innovation that can be successfully used by pharmacists to improve asthma self-management education.

Associations between physicians' SDM behaviour and participation of older patients and family members in triadic decision-making: An observational study

Background

Medical consultations with older patients often include triadic conversations and decision-making processes involving physicians, patients, and family members. The presence of family members may change the communication dynamics and therefore increase the complexity of the consultation and decision-making process.

Objective

This study explored associations between physicians' shared decision-making (SDM) behaviour and patients' and family members' participation in the decision-making process.

Methods

Using an observational design, we analysed 95 recorded consultations between medical specialists, patients aged ≥65 years, and accompanying family members at a Dutch hospital. The OPTIONMCC was used to assess the physicians' SDM behaviour and patients' and family members' levels of involvement in SDM.

Results

We found a strong positive correlation between physicians' behaviour and patients' and family members' participation in SDM (0.68 and 0.64, respectively, p < .01). Family members were more involved in SDM for patients aged 80 and older.

Conclusion

While not asserting causation, our study suggests physicians potentially play a facilitating role in shaping the SDM process together with proactive contributions from patients and family members.

Innovation

The results offer new insights into triadic SDM and provide suggestions for refining the OPTIONMCC. Further research is recommended into participants' mutual directional influences in triadic SDM.

Prioritising Key Concepts for informed health choices in cancer: An evidence-based online educational programme

Objective

The overabundance of health misinformation has undermined people's capacity to make evidence-based, informed choices about their health. Using the Informed Health Choices (IHC) Key Concepts (KCs), we are developing a two-stage education programme, Informed Health Choices-Cancer (IHC-C), to provide those impacted by cancer with the knowledge and skills necessary to think critically about the reliability of health information and claims and make well-informed choices. Stage 1 seeks to prioritise the most relevant Key Concepts.

Methods

A project group and a patient and carer participation group completed a two-round prioritisation process. The process involved disseminating pre-reading materials, training sessions, and a structured judgement form to evaluate concepts for inclusion. Data from each round were analysed to reach a consensus on the concepts to include.

Results

Fourteen participants were recruited and completed the first-round prioritisation. Fifteen participants undertook the second-round prioritisation. Nine Key Concepts were selected for the programme across five training sessions and two consensus meetings.

Conclusion

The prioritised concepts identified represent the most pertinent aspects of cancer-related information for those impacted by the disease. By incorporating these concepts into educational materials and communication strategies, healthcare providers and organisations can potentially help cancer patients, survivors, and their loved ones to recognise and combat cancer-related misinformation more effectively.

Innovation

This study introduces a participatory prioritisation process, which integrates the expertise of healthcare professionals with the insights of patients and carers, thereby enhancing the programme's relevance and applicability.

Was priority setting considered in COVID-19 response planning? A global comparative analysis

Background

The COVID-19 pandemic forced governments across the world to consider how to prioritize resource allocation. Most countries produced pandemic preparedness plans that guide and coordinate healthcare, including how to allocate scarce resources such as ventilators, human resources, and therapeutics. The objective of this study was to compare and contrast the extent to which established parameters for effective priority setting (PS) were incorporated into COVID-19 pandemic response planning in several countries around the world.

Methods

We used the Kapriri and Martin framework for effective priority setting and performed a quantitative descriptive analysis to explore whether and how countries' type of health system, political, and economic contexts impacted the inclusion of those parameters in their COVID-19 pandemic plans. We analyzed 86 country plans across six regions of the World Health Organization.

Results

The countries sampled represent 40% of nations in AFRO, 54.5% of EMRO, 45% of EURO, 46% of PAHO, 64% of SEARO, and 41% of WPRO. They also represent 39% of all HICs in the world, 39% of Upper-Middle, 54% of Lower-Middle, and 48% of LICs. No pattern in attention to parameters of PS emerged by WHO region or country income levels. The parameters: evidence of political will, stakeholder participation, and use of scientific evidence/ adoption of WHO recommendations were each found in over 80% of plans. We identified a description of a specific PS process in 7% of the plans; explicit criteria for PS in 36.5%; inclusion of publicity strategies in 65%; mention of mechanisms for appealing decisions or implementing procedures to improve internal accountability and reduce corruption in 20%; explicit reference to public values in 15%; and a description of means for enhancing compliance with the decisions in 5%.

Conclusion

The findings provide a basis for policymakers to reflect on their prioritization plans and identify areas that need to be strengthened. Overall, there is little consideration for explicit prioritization processes and tools and restricted attention to equity considerations; this may be a starting point for policymakers interested in improving future preparedness and response planning. Although the study focused on the COVID-19 pandemic, priority setting remains one of the policymakers' most prominent challenges. Policymakers should consider integrating systematic priority setting in their routine decision-making processes.