The “Health Benefit Basket” in France

The French “Health Benefit Basket” is defined principally by positive lists of reimbursed goods and services; however, global budget-financed hospital-delivered services are more implicitly defined. The range of reimbursable curative care services is defined by two coexisting positive lists/fee schedules: the Classification Commune des Actes Médicaux (CCAM) and the Nomenclature Générale des Actes Professionnels (NGAP). The National Union of Health Insurance Funds has been updating these positive lists since August 2004, with the main criterion for inclusion being the proposed procedure’s effectiveness. This is assessed by the newly created High Health authority (replacing the former ANAES). In addition, complementary health insurers are consulted in the inclusion process due to their important role in French healthcare financing

Relative effects of sensory modalities and importance of fatty acid sensitivity on fat perception in a real food model

Fat can be perceived through mouthfeel, odour and taste, but the influence of these modalities on fat perception remains undefined. Fatty acids are stimuli. Individual’s sensitivity to fatty acids varies. Studies show association between fatty acid sensitivity, dietary intake and BMI, but results are conflicting. Therefore, this study examined this association, and the effects of modalities on fat perception. Two sub-studies conducted. In Study 1 (n=46), fat intensity was assessed by milk/cream mixtures varying by five fat levels. Fat intensity was rated under four conditions: mouthfeel-odour masked, mouthfeel masked, odour masking and no masking. Mouthfeel masking was achieved using thickener and paraffin, odour masking using nose-clips. Fatty acid sensitivity was measured by 3-AFC-staircase method using milk containing oleic acid (0.31-31.4mM). In Study 2 (n=51), more fat levels were added in fat intensity rating. A 2-AFC discrimination test was used to confirm whether fat levels could be distinguished. In the sensitivity test, a wider range of oleic acid was included. Fat intensity was rated higher without nose-clips (p<0.0001), implying that odour increased fat perception. Samples with mouthfeel-masked were rated higher, showing that increased viscosity and lubricity enhanced fat perception (p<0.0001). Participants could distinguish fat levels based on “taste” in rating tests and 2-AFC-tests. Participants were divided into high/medium/low-sensitivity groups. No significant difference found in fat intensity between groups, however, high-sensitivity group discriminated more fat levels. No association between sensitivity groups, nutrient intake or BMI found

Coping with stress in medical students: results of a randomized controlled trial using a mindfulness-based stress prevention training (MediMind) in Germany

BACKGROUND: High prevalence rates of psychological distress in medical training and later professional life indicate a need for prevention. Different types of intervention were shown to have good effects, but little is known about the relative efficacy of different types of stress management interventions, and methodological limitations have been reported. In order to overcome some of these limitations, the present study aimed at evaluating the effect of a specifically developed mindfulness-based stress prevention training for medical students (MediMind) on measures of distress, coping and psychological morbidity. METHODS: We report on a prospective randomized controlled trial with three study conditions: experimental treatment (MediMind), standard treatment (Autogenic Training) and a control group without treatment. The sample consisted of medical or dental students in the second or eighth semester. They completed self-report questionnaires at baseline, after the training and at one year follow-up. Distress (Trier Inventory for the Assessment of Chronic Stress, TICS) was assessed as the primary outcome and coping (Brief COPE) as a co-primary outcome. Effects on the psychological morbidity (Brief Symptom Inventory, BSI) as a secondary outcome were expected one year after the trainings. RESULTS: Initially, N = 183 students were randomly allocated to the study groups. At one year follow-up N = 80 could be included into the per-protocol analysis: MediMind (n =31), Autogenic Training (n = 32) and control group (n = 17). A selective drop-out for students who suffered more often from psychological symptoms was detected (p = .020). MANCOVA’s on TICS and Brief COPE revealed no significant interaction effects. On the BSI, a significant overall interaction effect became apparent (p = .002, η2partial = .382), but post hoc analyses were not significant. Means of the Global Severity Index (BSI) indicated that MediMind may contribute to a decrease in psychological morbidity. CONCLUSION: Due to the high and selective dropout rates, the results cannot be generalized and further research is necessary. Since the participation rate of the trainings was high, a need for further prevention programs is indicated. The study gives important suggestions on further implementation and evaluation of stress prevention in medical schools. TRIAL REGISTRATION: This trial is recorded at German Clinical Trials Register under the number DRKS00005354 (08.11.2013)

Sensory Texture and Mastication Physics of Multi-Phase Meat Products

Food products often consist of several phases. Comminuted meat products, for example, are multiphase systems consisting of structured meat particles and unstructured batter-like substance. To develop and understand the processing of these products, it is important to understand the sensory and mechanical perception principles. To this end, two-phase food prototypes consisting of mixtures of ground beef and beef batter were prepared and subjected to sensory, texture, and oral processing analysis. The oral processing analysis focused on the biomechanical data of the chewing process, namely the kinematics of jaw movement and electromyographic activity. The ground meat served as the anisotropic phase and the meat dough as the isotropic phase. A significant increase in muscle activity, duration per bite, and occlusion time with increasing proportion of fibrous particles was demonstrated (p &lt; 0.05). In contrast, a higher proportion of isotropic substance resulted in significantly higher amplitudes of jaw movement and faster jaw kinetics (p &lt; 0.05). In mixed regimes, the system responded mainly according to the dominant phase, with sensory or mechanical response changing at a critical point. In combination with texture and sensory data, a holistic characterization of the food models could be performed

Sensory Texture and Mastication Physics of Multi-Phase Meat Products

Food products often consist of several phases. Comminuted meat products, for example, are multiphase systems consisting of structured meat particles and unstructured batter-like substance. To develop and understand the processing of these products, it is important to understand the sensory and mechanical perception principles. To this end, two-phase food prototypes consisting of mixtures of ground beef and beef batter were prepared and subjected to sensory, texture, and oral processing analysis. The oral processing analysis focused on the biomechanical data of the chewing process, namely the kinematics of jaw movement and electromyographic activity. The ground meat served as the anisotropic phase and the meat dough as the isotropic phase. A significant increase in muscle activity, duration per bite, and occlusion time with increasing proportion of fibrous particles was demonstrated (p p < 0.05). In mixed regimes, the system responded mainly according to the dominant phase, with sensory or mechanical response changing at a critical point. In combination with texture and sensory data, a holistic characterization of the food models could be performed

Inhibitory effect of liposomal solution of grape seed extract on the formation of heterocyclic amines

Nutrition plays a vital role on maintaining good health. There have been several studies that highlight the role of cause and effect between diet and disease, particularly if harmful substances are present in foods. Heterocyclic aromatic amines (HAA), which are formed in meat and fish cooked at high temperatures (&#8804; 150\ub0C), have shown to exhibit carcinogenic and mutagenic activities. Their formation appears to be dependent on time, frying temperature, and food composition. Several studies have demonstrated the progressive decrease of HAA in the presence of compounds with antioxidant activity, such as vitamine E or polyphenolic compounds. Our studies have shown that the activity of such antioxidants may be maintained and/or enhanced by encapsulation. One potential system for the delivery of polyphenolic compounds is liposomes, which are vesicles composed of a lipid bilayer