An Investigation Into The Quality of Meal Service in the NHS Acute Trusts.

The aim of this research was to investigate the discrepancies between in-patients and service providers (hospital caterers and ward staff) on perceptions of the quality of meal services in NHS Acute Trusts. This aim was achieved through comprehensive secondary research into the implications of the NHS’s continued reforms of hospital catering services, the complexity of patients’ food consumption and the nutritional implications of consumption, and the importance of patients satisfaction linked with the models of service quality. After analysing the literature, a framework structured around service gap theory was adopted. Primary research using multimethods and a modified SERVQUAL instrument was carried out on-site at four NHS Acute Trusts in three phases: Phase I- in-patients questionnaire (43.72% response rate, 662 valid returns); Phase II- hospital staff questionnaire (78.24% response rate, 283 valid returns); and Phase III- face-to-face interviews with catering managers (4 participants). The results found that: Patients’ expectations were higher than their perceptions on 17 meal service attributes; Through a path analysis, the best predictor of patient satisfaction was found to be the food properties dimension (of three meal service dimensions from factor analysis), and the regularity of finishing food was found to have a reciprocal interaction with patient satisfaction; The three gaps between the competing interests proposed in the theoretical framework were confirmed: the service gap between patients and service personnel, the quality assurance gap between patients and catering managers, and the managerial gap between service personnel and catering managers. The study has evaluated and provided a greater understanding of meal service in a group of NHS hospitals. Hospital meal services need to review their policies on the provision of food to patients, which should be made more appropriate to the needs of the sick. Eight managerial implications are offered to aid future hospital caterers in understanding some of the underlying complexities of patient satisfaction toward the meal services. Through the development of industry-specific models, a platform has been constructed that can be used for further research into the gaps between the expectations and perceptions of patients, service staff and catering management. This study synthesises concepts from three distinct academic fields (Healthcare Management, Food Choice, and Service Quality) into a coherent instrument, and applies it to the acute hospital meal service field

A Microwave-Assisted Extraction Method for Determining Hot Water Solubility of Wood

A microwave-assisted extraction method is proposed as an alternative to the conventional method for determining the hot water solubility of wood. In this alternative method, microwave heating substitutes for the boiling water to extract part of the extraneous components as well as starches in wood tissues. Experimental results indicate that 100 mL water can be heated to boiling in only 75 s under the microwave radiation. Hence, only 15-20 min are required to complete the extraction procedure for Liquidambar formosana Hance and Swietenia mahagoni Jacq., 10 min and 5 min for Taiwania cryptomerioides and Cunninghamia lanceolata (Lamb) Hook, respectively. In general, a 15-min microwave heating has the potential to be an alternative to the conventional method, which requires 3 h for the hot water solubility determination

Plate versus bulk trolley food service in a hospital: comparison of patients’ satisfaction

Objective The aim of this research was to compare plate with bulk trolley food service in hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods A consumer opinion card (n = 180), concentrating on the quality indicators of core foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict food service style on the basis of the food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each food attribute within food service style. Results Results showed that the bulk trolley method of food distribution enables all foods to have a more acceptable texture, and for some foods (potato, P = 0.007; poached fish, P = 0.001; and minced beef, P ≤ 0.0005) temperature, and for other foods (broccoli, P ≤ 0.0005; carrots, P ≤ 0.0005; and poached fish, P = 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two service systems. Conclusion This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Temperature and texture were the most important attributes that measure patient satisfaction with food, thus defining the focus for hospital food service managers. To date, a model predicting patient satisfaction with the quality of food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the service style of dishes for improving the quality of food and thus enhancing patient satisfaction

Prognosis of ductal adenocarcinoma of pancreatic head with overexpression of CD44

SummaryBackgroundThe long-term survival rate of patients with pancreatic ductal adenocarcinoma (PDAC) is very low. Cancer stem cells have been identified in PDAC based on the expression of the surface markers CD24, CD44, CD133, and epithelial specific antigen. The prognosis of PDAC may be related to the presence or absence of tumor cells with cancer stem cell surface markers.MethodsEighty-six PDAC patients (51 male and 35 female patients) who underwent surgical treatment at Chang Gung Memorial Hospital—Lin-Kou Medical Center, Lin-Kou, Taiwan between 1998 and 2007 were included in this study. The patients' ages ranged from 30 years to 84 years. All their surgical specimens showed invasive ductal cancer. Immunohistochemical staining with CD44 antibodies was performed. The differences in clinical data, cell types of tumors, tumor staging, and survival rates between patients with CD44− (Group A; n = 33) and CD44+ (Group B; n = 53) were compared.ResultsClinical data, cell types of tumors, and tumor staging between the two groups showed no significant differences. The 3- and 5-year survival rates were, respectively, 51.5% and 19.8% in patients with CD44− tumor cells and 4.0% and 2.0% in those with CD44+ tumor cells. The differences were statistically significant (p < 0.0001). The median overall survival times of the two groups were also different (36.9 months vs. 12.2 months, p < 0.0001). Multivariate analysis showed that the CD44 as well as lymph node status, and differentiation of tumor cells were prognostic factors for patients with PDAC.ConclusionThe results suggested that CD44 expression in patients with PDAC after surgery was significantly associated with decreased survival, whereas patients with CD44− tumor cells survived significantly longer

JNK suppression is essential for 17β-Estradiol inhibits prostaglandin E2-Induced uPA and MMP-9 expressions and cell migration in human LoVo colon cancer cells

<p>Abstract</p> <p>Background</p> <p>Epidemiological studies demonstrate that the incidence and mortality rates of colorectal cancer in women are lower than in men. However, it is unknown if 17β-estradiol treatment is sufficient to inhibit prostaglandin E2 (PGE2)-induced cellular motility in human colon cancer cells.</p> <p>Methods</p> <p>We analyzed the protein expression of urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA), matrix metallopeptidases (MMPs), plasminogen activator inhibitor-1 (PAI-1) and tissue inhibitor of metalloproteinases (TIMPs), and the cellular motility in PGE2-stimulated human LoVo cells. 17β-Estradiol and the inhibitors including LY294002 (Akt activation inhibitor), U0126 (ERK1/2 inhibitor), SB203580 (p38 MAPK inhibitor), SP600125 (JNK1/2 inhibitor), QNZ (NFκB inhibitor) and ICI 182 780 were further used to explore the inhibitory effects of 17β-estradiol on PGE2-induced LoVo cell motility. Student's t-test was used to analyze the difference between the two groups.</p> <p>Results</p> <p>Upregulation of urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA) and matrix metallopeptidases (MMPs) is reported to associate with the development of cancer cell mobility, metastasis, and subsequent malignant tumor. After administration of inhibitors including LY294002, U0126, SB203580, SP600125 or QNZ, we found that PGE2 treatment up-regulated uPA and MMP-9 expression via JNK1/2 signaling pathway, thus promoting cellular motility in human LoVo cancer cells. However, PGE2 treatment showed no effects on regulating expression of tPA, MMP-2, plasminogen activator inhibitor-1 (PAI-1), tissue inhibitor of metalloproteinase-1, -2, -3 and -4 (TIMP-1, -2, -3 and -4). We further observed that 17β-estradiol treatment inhibited PGE2-induced uPA, MMP-9 and cellular motility by suppressing activation of JNK1/2 in human LoVo cancer cells.</p> <p>Conclusions</p> <p>Collectively, these results suggest that 17β-estradiol treatment significantly inhibits PGE2-induced motility of human LoVo colon cancer cells.</p

Foodservice in hospital: development of a theoretical model for patient experience and satisfaction using one hospital in the UK National Health Service as a case study

Hospital foodservice does not operate in isolation but requires the cooperation and integration of several disciplines to provide the ultimate patient experience. The objective of this research was to explore the antecedents to patient satisfaction and experience, including the service element. Accordingly, focus groups were conducted with doctors (n = 4), nurses (n = 5), ward hostesses (n = 3) and patients together with their visitors (n = 10), while open-ended interviews were conducted with the foodservice manager, facilities manager, chief dietitian, orthopaedic ward dietitian and chief pharmacist. Themes centred on ‘patients’, ‘foodservice’ and ‘mealtimes’, and results show that food qualities, particularly temperature and texture, are important factors impinging on patient satisfaction, and the trolley system of delivery is an acceptable style of service. Service predisposition demonstrates little relevance to patient satisfaction towards overall meal enjoyment. A theoretical model has been developed that identifies hospital foodservice in a cyclic relationship with the community primary healthcare team

FLJ10540 is associated with tumor progression in nasopharyngeal carcinomas and contributes to nasopharyngeal cell proliferation, and metastasis via osteopontin/CD44 pathway

BACKGROUND: Nasopharyngeal carcinoma (NPC) is well-known for its highly metastatic characteristics, but little is known of its molecular mechanisms. New biomarkers that predict clinical outcome, in particular the ability of the primary tumor to develop metastatic tumors are urgently needed. The aim of this study is to investigate the role of FLJ10540 in human NPC development. METHODS: A bioinformatics approach was used to explore the potentially important regulatory genes involved in the growth/metastasis control of NPC. FLJ10540 was chosen for this study. Two co-expression strategies from NPC microarray were employed to identify the relationship between FLJ10540 and osteopontin. Quantitative-RT-PCR, immunoblotting, and immunohistochemistry analysis were used to investigate the mRNA and protein expression profiles of FLJ10540 and osteopontin in the normal and NPC tissues to confirm microarray results. TW01 and Hone1 NPC cells with overexpression FLJ10540 or siRNA to repress endogenous FLJ10540 were generated by stable transfection to further elucidate the molecular mechanisms of FLJ10540-elicited cell growth and metastasis under osteopontin stimulation. RESULTS: We found that osteopontin expression exhibited a positive correlation with FLJ10540 in NPC microarray. We also demonstrated comprehensively that FLJ10540 and osteopontin were not only overexpressed in NPC specimens, but also significantly correlated with advanced tumor and lymph node-metastasis stages, and had a poor 5-year survival rate, respectively. Stimulation of NPC parental cells with osteopontin results in an increase in FLJ10540 mRNA and protein expressions. Functionally, FLJ10540 transfectant alone, or stimulated with osteopontin, exhibited fast growth and increased metastasis as compared to vehicle control with or without osteopontin stimulation. Conversely, knockdown of FLJ10540 by siRNA results in the suppression of NPC cell growth and motility. Treatment with anti-CD44 antibodies in NPC parental cells not only resulted in a decrease of FLJ10540 protein, but also affected the abilities of FLJ10540-elicited cell growth and motility in osteopontin stimulated-NPC cells. CONCLUSIONS: These findings suggest that FLJ10540 may be critical regulator of disease progression in NPC, and the underlying mechanism may involve in the osteopontin/CD44 pathway

A Novel Design of Grooved Fibers for Fiber-Optic Localized Plasmon Resonance Biosensors

Bio-molecular recognition is detected by the unique optical properties of self-assembled gold nanoparticles on the unclad portions of an optical fiber whose surfaces have been modified with a receptor. To enhance the performance of the sensing platform, the sensing element is integrated with a microfluidic chip to reduce sample and reagent volume, to shorten response time and analysis time, as well as to increase sensitivity. The main purpose of the present study is to design grooves on the optical fiber for the FO-LPR microfluidic chip and investigate the effect of the groove geometry on the biochemical binding kinetics through simulations. The optical fiber is designed and termed as U-type or D-type based on the shape of the grooves. The numerical results indicate that the design of the D-type fiber exhibits efficient performance on biochemical binding. The grooves designed on the optical fiber also induce chaotic advection to enhance the mixing in the microchannel. The mixing patterns indicate that D-type grooves enhance the mixing more effectively than U-type grooves. D-type fiber with six grooves is the optimum design according to the numerical results. The experimental results show that the D-type fiber could sustain larger elongation than the U-type fiber. Furthermore, this study successfully demonstrates the feasibility of fabricating the grooved optical fibers by the femtosecond laser, and making a transmission-based FO-LPR probe for chemical sensing. The sensor resolution of the sensor implementing the D-type fiber modified by gold nanoparticles was 4.1 × 10−7 RIU, which is much more sensitive than that of U-type optical fiber (1.8 × 10−3 RIU)