Effects of heat processing on product quality of sous-vide broccoli packs

Thesis (MTech (Food technology))--Cape Technikon, Cape Town,1998To establish the optimum pasteurisation procedure, the effects of sous-vide heat processing on the pH, ascorbic acid and sensory aspects of broccoli (Brassica oleracea var. Italica) were studied. Broccoli florets were blanched using steam and ammonia(NH3)-steam, chilled to <2°C in ice water at O°C, and vacuum packaged. Sous-vide processing proceeded immediately at pasteurisation temperatures 73°, 76°, 79°, 82° and 85°C to a p~ = 100. Directly afterwards, the pH of the processed sous-vide broccoli was measured and percentage L-ascorbic acid loss calculated, by comparing sous-vide broccoli with unprocessed controls from the same broccoli head. Objective colour measurements were made using CIELAB L*, a* and b* co-ordinates. Consumer acceptance was tested using paired preference analysis. The same analyses were repeated after storage at 2° - 4°C for 21 days. Suitable statistical analyses showed significantly higher (P<0.05) pH-values in the case of NHrsteam-blanched broccoli, with the result that the ascorbic acid retention of NH3-steam broccoli was significantly lower (P<0.05) than that of steam blanched broccoli. Higher pasteurisation temperatures, and resulting shorter heat processing times, ii showed a significant reduction (P<O.05) in ascorbic acid losses. NHa-steam blanched broccoli was significantly (P<O.05) greener after pasteurisation than steam-blanched broccoli. Steam blanched broccoli deteriorated further significantly (P<O.05) towards a more yellow colour during a 21 day storage period at 2° - 4°C. Sensory analysis showed a significant consumer preference (P<O.05) for the greener NHa-steam- blanched broccoli but showed a significant preference (P<O.05) for the texture of steam blanched broccoli. No significant (P>O.05) taste preference was detected for broccoli from either blanching method

A health insurance company-initiated multifaceted intervention for optimizing acid-suppressing drug prescriptions in primary care: A randomized controlled trial

Objective: To evaluate the effectiveness of a health insurance company-initiated intervention strategy aimed at optimizing acid-suppressing drug (ASD) prescriptions in primary care. Methods: In a cluster randomized controlled trial design, 112 primary care physician (PCP) peer review groups (993 PCPs)in the central region of the Netherlands were randomized. The PCPs in the intervention group received an ASD prescription optimization protocol, a list of their patients taking ASDs frequently on a long-term basis, and financial compensation for additional consultations with these patients. The PCPs in the control group did not receive any of these interventions. Prescription data on 23 433 patients were extracted from the database of the regional health insurance company. The main outcome measures were the proportion of patients who reduced ASD consumption by more than 50% and changes in annual volume and costs of ASD prescriptions. Differences in ASD reduction and in volume were analyzed applying multilevel regression analyses. Results: At baseline, 2.4% of the patients (n=967 506) of the participating practices used ASDs frequently on a long-term basis (>180 daily defined doses [DDDs] annually). During the 6-month intervention, 14.1% of the patients in the intervention group reduced ASD consumption compared with 13.7% in the control group (adjusted relative risk, 1.04; 95% confidence interval [CI], 0.97-1.11). Changes in intervention and control group in mean volume of ASD prescription per patient were similar (β=0.33 for DDD; 95% CI -3.00 to 3.60). Conclusions: A health insurance company-initiated multifaceted intervention, including practical tools and financial incentives, did not alter ASD prescription practice in primary care. More tailored interventions, including patient-targeted initiatives, are required to optimize ASD prescription