ENSURING FOOD SAFETY OF THE REPUBLIC OF KAZAKHSTAN

This article analyzes the scientific and technical information, as well as experimental studies on the application of the principles of HACCP. By applying, the HACCP principles for chopped semi-finished products, the description of the investigated product has been developed, which includes following information: product name, composition, quality and safety indicators, main stages of the technological process; packing method; conditions of storage, transportation and sale, as well as information on labeling. the HACCP plan will allow food (meat) industry production of safe and high-quality goods. Thus, the general consumer will not have doubts about the quality of purchased semi-finished products

What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? METHODS: Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. RESULTS: Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. CONCLUSION: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes.The study had a Grant of 8000 Euros from the EGPRN

External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered

General practitioners' deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries

BACKGROUND: General practitioners (GPs) should regularly review patients' medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients' health. However, deprescribing can be challenging for physicians. This study investigates GPs' deprescribing decisions in 31 countries. METHODS: In this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs' deprescribing decisions. RESULTS: Of 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57). INTERPRETATION: The majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD

One consensual depression diagnosis tool to serve many countries: a challenge! A RAND/UCLA methodology

Objective From a systematic literature review (SLR), it became clear that a consensually validated tool was needed by European General Practitioner (GP) researchers in order to allow multi-centred collaborative research, in daily practice, throughout Europe. Which diagnostic tool for depression, validated against psychiatric examination according to the DSM, would GPs select as the best for use in clinical research, taking into account the combination of effectiveness, reliability and ergonomics? A RAND/UCLA, which combines the qualities of the Delphi process and of the nominal group, was used. GP researchers from different European countries were selected. The SLR extracted tools were validated against the DSM. The Youden index was used as an effectiveness criterion and Cronbach’s alpha as a reliability criterion. Ergonomics data were extracted from the literature. Ergonomics were tested face-to-face. Results The SLR extracted 7 tools. Two instruments were considered sufficiently effective and reliable for use: the Hospital Anxiety and Depression Scale and the Hopkins Symptoms Checklist-25 (HSCL-25). After testing face-to-face, HSCL-25 was selected. A multicultural consensus on one diagnostic tool for depression was obtained for the HSCL-25. This tool will provide the opportunity to select homogeneous populations for European collaborative research in daily practice

Researching the functional and technological characteristics of model forcemeat, enriched with iodine

Асенова Бахыткуль Кажкеновна – кандидат технических наук, и.о. профессора, заведующая кафедрой «Технология пищевых продуктов и изделий легкой промышленности», Государственный университет имени Шакарима города Семей (Казахстан); [email protected] Окусханова Элеонора Курметовна, магистрант кафедры «Технология пищевых продуктов и изделий легкой промышленности», Государственный университет имени Шакарима города Семей (Казахстан); [email protected] Ребезов Максим Борисович, доктор сельскохозяйственных наук, профессор, заведующий кафедрой «Прикладная биотехнология» Института экономики, торговли и технологий, Южно-Уральский государственный университет (г. Челябинск), [email protected]. Assenova Bakhytkul Kazhkenovna, candidate of technical sciences, associate professor, head of the department “Technology of foodstuff and products of light industry” of Shakarim State University of Semey, Kazakhstan, [email protected] Okuskhanova Eleonora Kurmetovna, master student of the department “Technology of foodstuff and products of light industry” of Shakarim State University of Semey, Kazakhstan, [email protected] Rebezov Maxim Borisovich, Doctor of Agricultural Sciences, Professor, head of Applied Biotechnology Department of the Institute of Economy, Trade and Technology, South Ural State University, Chelyabinsk, [email protected]В статье представлены результаты исследования функционально-технологических свойств модельных фаршевых систем, обогащенных йодом. В рецептуру модельных фаршевых систем вводили морскую капусту, пищевую добавку «Ламинария» и «Йодактив». Проведен анализ результатов исследования степени влияния растительного компонента и пищевых добавок на изменение функционально-технологических характеристик готового продукта. Результаты эксперимента показали, что использование в соотношениях растительного компонента 0,05–0,10 % морская капуста; пищевых добавок ламинарии и йодактива 0,23–0,29 %; 0,48–0,55 %, соответственно, от рецептуры приводит к изменению ряда биотехнологических характеристик фарша по сравнению с контролем. Так, при введении жира до 10 % к массе обезжиренного мяса способность фарша удерживать влагу, жир и его стабильность увеличивается благодаря образованию системы вода – белок – жир, в качестве стабилизатора которым выступает белок. При исследовании величины рН установлено, что, несмотря на изменение кислотности рН, изменение функционально-технологических свойств системы не произошло, что вызвано введением с растительным сырьем дополнительного количества катионов натрия, магния, фосфора, способных влиять на заряд белковой молекулы. При исследовании влияния добавок на водосвязывающую способность установлено, что уровень прочносвязанной влаги во всех опытных образцах был ниже по сравнению с контролем. Содержание прочносвязанной влаги в контрольном образце составило 79,4 %, а в опытных образцах всех вариантов от 72,4 до 73,5 %. При изменении рН жироудерживающая способность оказалась максимальной при его значении, равном 5. Это свидетельствует о том, что в кислой среде растительный компонент морской капусты и пищевых добавок имеют наибольшую удерживающую способность. Стабильность эмульсии достигает максимального значения при величине рН, близкой к 5,5. The paper presents the results of studying the functional and technological characteristics of model forcemeat, enriched with iodine. Laminaria, food additive “Laminaria” and “Iodactiv” have been added during preparing the forcemeat. The results of the analysis of impact of plant and food additive on the functional and technological characteristics of the final product have been studied. The results show, that adding 0,05–0,10 % of laminaria, 0,23–0,29 % of food additive “Laminaria” and 0,48–0,55 % food additive “Iodactiv” leading to the change of some biotechnological characteristics of forcemeat comparing with the control sample. Thus, in adding until 10 % of fat to the nonfatted meat the capability of the forcemeat holds the moisture, fat and its stability increases through the creation of the system water-protein-fat, where the protein is a stabilizer. While analyzing pH it is recognized, that notwithstanding the change of pH the functional and technological characteristics has not been changed. This is caused by introducing external amount of cations of sodium, magnesium, phosphorus which are capable to influence on the charge of protein molecule. The impact of additive to the water bound ability have been discovered. The level of bounded moisture in all test samples were below the level of control sample. The content of bounded misture in the control sample was 79,4 %, but in all test samples were from 72,4 to 73,5 %. Due to pH change the fat holding capacity has reached the maximul level at pH 5. This demonstrates that in acidic medium the plant component of laminaria and food additives have their maximum holding capacity. Stability of emulsions reached maximal level at pH close to 5,5

Which positive view of general practice do medical students and trainees have? A systematic literature review

International audienceBackground: Despite several studies focusing on the negative aspects of general medicine, the speciality seems attractive for students. Researchers from the European General Practice Research Network created a group to study job satisfaction in general practice. The aim of this eight-country European study was to determine which positive view students have about general practice.Method: Systematic review of the literature from Pubmed, Embase and Cochrane databases. Articles published between 01/01/2000 and 12/31/2018 were searched and analysed by two researchers working blind. The data on satisfaction factors were extracted from the full text article used as verbatims. Then the data were coded with a thematic analysis.Results: 24 articles out of 414 were selected. Satisfaction factors were classified: teaching of general practice, workplace and organisational freedom, quality of life, variety in practice, workload balance and income. The analysis highlighted intellectual stimulation and the relationship built with patients and other professionals.Conclusion: Literature on the appeal of general practice for students revealed many factors of job satisfaction in general practice. It is possible to create a global view of a satisfied GP on the students' opinion. Courses and clerkships in general practice with positive role models are determining factors in career choice