Drying of sweet whey using drum dryer technique and utilization of the produced powder in French-type bread and butter cookies

The objective of this study was to dry sweet liquid whey using drum dryer and to utilize the whey powder in French-type bread and cookies as a sugar substitute. The sweet whey powder was characterized chemically for ash, moisture, water activity, protein, salt, acidity and lactose contents. Optimization parameters including drying temperature, drum speed and starch addition for whey drying by drum dryer were tested to produce the best powder characteristics. The optimum temperature was 140°C at a drum speed of 20 rpm with a corn starch level of 2% (weight per weight). Sweet whey powder produced was used as a sugar replacer in French-type bread and butter cookies at substitution levels of 25, 50 and 75% of total sugars. The developed products were analyzed chemically and sensorially. The two developed products were relatively high in protein, ash, lactose and salts compared to the control samples. Regarding the sensory evaluation, the results showed that the sugar substitution of 25 and 50% in bread and cookies were significantly (p<0.05) better than the control. It can be concluded that sweet whey powder can significantly improve the quality of the studied bakery items.

Long-range transfer of electron-phonon coupling in oxide superlattices

The electron-phonon interaction is of central importance for the electrical and thermal properties of solids, and its influence on superconductivity, colossal magnetoresistance and other many-body phenomena in correlated-electron materials is the subject of intense research at present. However, the non-local nature of the interactions between valence electrons and lattice ions, often compounded by a plethora of vibrational modes, presents formidable challenges for attempts to experimentally control and theoretically describe the physical properties of complex materials. Here we report a Raman scattering study of the lattice dynamics in superlattices of the high-temperature superconductor YBa(2)Cu(3)O(7) (YBCO) and the colossal-magnetoresistance compound La(2/3)Ca(1/3)MnO(3) that suggests a new approach to this problem. We find that a rotational mode of the MnO(6) octahedra in La(2/3)Ca(1/3)MnO(3) experiences pronounced superconductivity-induced line-shape anomalies, which scale linearly with the thickness of the YBCO layers over a remarkably long range of several tens of nanometres. The transfer of the electron-phonon coupling between superlattice layers can be understood as a consequence of long-range Coulomb forces in conjunction with an orbital reconstruction at the interface. The superlattice geometry thus provides new opportunities for controlled modification of the electron-phonon interaction in complex materials.

Quality of outpatient hospital care for children under 5 years in Afghanistan

OBJECTIVE

To determine the quality of outpatient hospital care for children under 5 years in Afghanistan.

DESIGN

Case management observations were conducted on 10-12 children under five selected by systematic random sampling in 31 outpatient hospital clinics across the country, followed by interviews with caretakers and providers.

MAIN OUTCOME MEASURES

Quality of care defined as adherence to the clinical standards described in the Integrated Management of Childhood Illness.

RESULTS

Overall quality of outpatient care for children was suboptimal based on patient examination and caretaker counseling (median score: 27.5 on a 100 point scale). Children receiving care from female providers had better care than those seen by male providers (OR: 6.6, 95% CI: 2.0-21.9, P = 0.002), and doctors provided better quality of care than other providers (OR: 2.7, 95% CI: 1.1-6.4, P = 0.02). The poor were more likely to receive better care in hospitals managed by non-governmental organizations than those managed by other mechanisms (OR: 15.2, 95% CI: 1.2-200.1, P = 0.04).

CONCLUSIONS

Efforts to strengthen optimal care provision at peripheral health clinics must be complemented with investments at the referral and tertiary care facilities to ensure care continuity. The findings of improved care by female providers, doctors and NGO's for poor patients, warrant further empirical evidence on care determinants. Optimizing care quality at referral hospitals is one of the prerequisites to ensure service utilization and outcomes for the achievement of the Child health Millennium Development Goals for Afghanistan.

Trends in the quality of health care for children aged less than 5 years in Afghanistan, 2004-2006

OBJECTIVE

To study trends in the quality of the health care provided to children aged less than 5 years in Afghanistan between 2004 and 2006. In particular, to determine the effect on such quality of a basic package of health services (BPHS), including Integrated Management of Childhood Illness (IMCI), introduced in 2003.

METHODS

In each year of the study, 500-600 health facilities providing the BPHS were selected by stratified random sampling in 29 provinces of Afghanistan. We observed consultations for children aged less than 5 years, interviewed their caretakers, interviewed health-care providers and measured adherence to case management standards for assessment and counselling in a random sample.

FINDINGS

The quality of the assessment and counselling provided to sick children aged less than 5 years improved significantly between 2004 and 2006. A 43.4% increase in the assessment index and a 28.7% increase in the counselling index (P < 0.001) were noted. Assessment quality improved significantly every year and was statistically associated with certain characteristics of the provider (being a doctor, having a higher knowledge score, being trained in IMCI, being part of a "contracting-in" mechanism and providing a longer consultation time) and the child (being younger and having a female caretaker). Counselling quality was also significantly associated with these characteristics, except for provider cadre and child age. The presence of clinical guidelines and the frequency of supervision were significantly associated with improved quality scores in 2006 (P < 0.05 and < 0.01, respectively).

CONCLUSION

Quality of care improved over the study period, but performance remained suboptimal in some areas. Continued investments in Afghanistan's health system capacity are needed.

Knowledge, attitudes, and practices regarding avian influenza (H5N1), Afghanistan

From February through April 2007, avian influenza (H5N1) was confirmed in poultry in 4 of 34 Afghan provinces. A survey conducted in 2 affected and 3 unaffected provinces found that greater knowledge about reducing exposure was associated with higher socioeconomic status, residence in affected provinces, and not owning backyard poultry.