Quality Evaluation Of Gluten-Free Rice Donut Incorporated With Eggplant Flour And Xanthan Gum

Incorporating functional ingredients for producing a healthy gluten-free product is necessary to assess the impact on product characteristics and acceptability. This study aimed to determine the effect of eggplant flour and xanthan gum on gluten-free rice donuts. Four donut formulations were prepared by replacing rice flour with 10% and 20% eggplant flour and adding 0.5% and 1% xanthan gum (flour weight basis). The rice donut was the control. Physical properties on specific volume, firmness, and color, as well as sensory evaluation on a 9-point hedonic scale, were investigated. When replacing rice flour with 10% eggplant flour, the donut with 1% xanthan gum showed better specific volume and firmness but was darker and received more acceptable than that with 0.5% xanthan gum. The 20% eggplant flour replacement deteriorated rice donuts’ physical properties and sensory attributes. The preference mapping indicated that the rice donut with 10% eggplant flour and 1% xanthan was the best formulation.&nbsp

Rapid assessment of injection practices in Cambodia, 2002

BACKGROUND: Injection overuse and unsafe injection practices facilitate transmission of bloodborne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Anecdotal reports of unsafe and unnecessary therapeutic injections and the high prevalence of HBV (8.0%), HCV (6.5%), and HIV (2.6%) infection in Cambodia have raised concern over injection safety. To estimate the magnitude and patterns of such practices, a rapid assessment of injection practices was conducted. METHODS: We surveyed a random sample of the general population in Takeo Province and convenience samples of prescribers and injection providers in Takeo Province and Phnom Penh city regarding injection-related knowledge, attitudes, and practices. Injection providers were observed administering injections. Data were collected using standardized methods adapted from the World Health Organization safe injection assessment guidelines. RESULTS: Among the general population sample (n = 500), the overall injection rate was 5.9 injections per person-year, with 40% of participants reporting receipt of ≥ 1 injection during the previous 6 months. Therapeutic injections, intravenous infusions, and immunizations accounted for 74%, 16% and 10% of injections, respectively. The majority (>85%) of injections were received in the private sector. All participants who recalled their last injection reported the injection was administered with a newly opened disposable syringe and needle. Prescribers (n = 60) reported that 47% of the total prescriptions they wrote included a therapeutic injection or infusion. Among injection providers (n = 60), 58% recapped the syringe after use and 13% did not dispose of the used needle and syringe appropriately. Over half (53%) of the providers reported a needlestick injury during the previous 12 months. Ninety percent of prescribers and injection providers were aware HBV, HCV, and HIV were transmitted through unsafe injection practices. Knowledge of HIV transmission through "dirty" syringes among the general population was also high (95%). CONCLUSION: Our data suggest that Cambodia has one of the world's highest rates of overall injection usage, despite general awareness of associated infection risks. Although there was little evidence of reuse of needles and syringes, support is needed for interventions to address injection overuse, healthcare worker safety and appropriate waste disposal

Case management of malaria fever in Cambodia: results from national anti-malarial outlet and household surveys

BACKGROUND: Continued progress towards global reduction in morbidity and mortality due to malaria requires scale-up of effective case management with artemisinin-combination therapy (ACT). The first case of artemisinin resistance in Plasmodium falciparum was documented in western Cambodia. Spread of artemisinin resistance would threaten recent gains in global malaria control. As such, the anti-malarial market and malaria case management practices in Cambodia have global significance. METHODS: Nationally-representative household and outlet surveys were conducted in 2009 among areas in Cambodia with malaria risk. An anti-malarial audit was conducted among all public and private outlets with the potential to sell anti-malarials. Indicators on availability, price and relative volumes sold/distributed were calculated across types of anti-malarials and outlets. The household survey collected information about management of recent "malaria fevers." Case management in the public versus private sector, and anti-malarial treatment based on malaria diagnostic testing were examined. RESULTS: Most public outlets (85%) and nearly half of private pharmacies, clinics and drug stores stock ACT. Oral artemisinin monotherapy was found in pharmacies/clinics (9%), drug stores (14%), mobile providers (4%) and grocery stores (2%). Among total anti-malarial volumes sold/distributed nationally, 6% are artemisinin monotherapies and 72% are ACT. Only 45% of people with recent "malaria fever" reportedly receive a diagnostic test, and the most common treatment acquired is a drug cocktail containing no identifiable anti-malarial. A self-reported positive diagnostic test, particularly when received in the public sector, improves likelihood of receiving anti-malarial treatment. Nonetheless, anti-malarial treatment of reportedly positive cases is low among people who seek treatment exclusively in the public (61%) and private (42%) sectors. CONCLUSIONS: While data on the anti-malarial market shows favourable progress towards replacing artemisinin monotherapies with ACT, the widespread use of drug cocktails to treat malaria is a barrier to effective case management. Significant achievements have been made in availability of diagnostic testing and effective treatment in the public and private sectors. However, interventions to improve case management are urgently required, particularly in the private sector. Evidence-based interventions that target provider and consumer behaviour are needed to support uptake of diagnostic testing and treatment with full-course first-line anti-malarials

Drug utilization patterns in the global context: A systematic review

Objectives Standard drug use indicators have been developed by the World Health Organization/International Network for Rational Use of Drugs (WHO/INRUD). The purpose of this systematic review was to examine and report the current status of health facilities in different regions of the world in terms of drug use based on WHO/INRUD core drug use indicators. Design Systematic review of the literature following PRISMA guidelines. Methods The INRUD bibliography, WHO archives, Google Scholar, Medline, PubMed, SpringerLink, ScienceDirect and Management Sciences for Health (MSH) resource databases were searched between 1985 and 2015 for studies -containing 12 WHO/INRUD core drug use indicators. Secondary data sources were also searched. Results Four hundred and sixty three studies were retrieved and 398 were excluded as they did not provide relevant information or fulfill the selection criteria. Sixty articles met the criteria and were selected for final review. With respect to prescribing indicators, studies of “drug use” showed mixed patterns across geographic regions. Overall trends in “patient-care” and “facility-specific” indicators were similar across most of the World Bank regions. However, based on the Index of Rational Drug Use (IRDU) values, East Asia and the Pacific region demonstrated relatively better drug use practices compared with other regions. Conclusions This systematic review revealed that the drug use practices in all regions of the world are suboptimal. A regulated, multi-disciplinary, national body with adequate funding provided by governments throughout the world are a basic requirement for coordination of activities and services, to improve the rational use of drugs at a local level

Staying competitive with co-creation: Elements to succeed

In today’s marketplace, competitions among companies have increased due to the expanding of the global market. More than ever it has become extremely important to meet customers’ needs and demands in order to stay competitive on the increasing market competition. Customers nowadays want to be a part of the co-creation process, have influence and be involved in the services and products the company offers. However this high urge to get involved in the co-creation process does not stop with customers only. Also internally different stakeholders want to influence the company. Suppliers and employees are becoming more open toward co-creation within the company and want to take their involvement to the next level. The purpose of the study is to create an understanding for the process of co-creation from the company’s point of view and the customers’ point of view as well as the leadership archetype and traits that would work best in the complex processes of co-creation. The focus is to generate an understanding of the elements to succeed in co-creation internally (with stakeholders) as well as externally (with other companies). In order to understand which elements of the successful co-creation are, case studies were conducted. Complementary to this, two interviews were held in order to show the reality of cocreation process, giving deep insight and knowledge in the subject. From the thesis research we found out that to be able to implement co-creation both internally and externally it is of great importance to create trust, mutual benefits, commitment, knowledge about partner and mutual respect among the partners involved. Moreover it is also important to mention that all the parts involved needs to be open towards sharing knowledge and information with each other in order to help facilitate the relationship. Keywords: Co-creation, Leadership, Collaboration, Alliance, Customer Relationship Management, Value creation, Supplier Relationship Managemen

Bloodstream infection among adults in Phnom Penh, Cambodia: key pathogens and resistance patterns.

BACKGROUND: Bloodstream infections (BSI) cause important morbidity and mortality worldwide. In Cambodia, no surveillance data on BSI are available so far. METHODS: From all adults presenting with SIRS at Sihanouk Hospital Centre of HOPE (July 2007-December 2010), 20 ml blood was cultured. Isolates were identified using standard microbiological techniques; antibiotic susceptibilities were assessed using disk diffusion and MicroScan®, with additional E-test, D-test and double disk test where applicable, according to CLSI guidelines. RESULTS: A total of 5714 samples from 4833 adult patients yielded 501 clinically significant organisms (8.8%) of which 445 available for further analysis. The patients' median age was 45 years (range 15-99 y), 52.7% were women. HIV-infection and diabetes were present in 15.6% and 8.8% of patients respectively. The overall mortality was 22.5%. Key pathogens included Escherichia coli (n = 132; 29.7%), Salmonella spp. (n = 64; 14.4%), Burkholderia pseudomallei (n = 56; 12.6%) and Staphylococcus aureus (n = 53; 11.9%). Methicillin resistance was seen in 10/46 (21.7%) S. aureus; 4 of them were co-resistant to erythromycin, clindamycin, moxifloxacin and sulphamethoxazole-trimethoprim (SMX-TMP). We noted combined resistance to amoxicillin, SMX-TMP and ciprofloxacin in 81 E. coli isolates (62.3%); 62 isolates (47.7%) were confirmed as producers of extended spectrum beta-lactamase. Salmonella isolates displayed high rates of multidrug resistance (71.2%) with high rates of decreased ciprofloxacin susceptibility (90.0%) in Salmonella Typhi while carbapenem resistance was observed in 5.0% of 20 Acinetobacter sp. isolates. CONCLUSIONS: BSI in Cambodian adults is mainly caused by difficult-to-treat pathogens. These data urge for microbiological capacity building, nationwide surveillance and solid interventions to contain antibiotic resistance