measuring the cost of a pediatric vaccine administration in the uk

Abstract The administration of a vaccine dose involves a series of activities prior to and on the day of vaccine delivery. Total vaccination cost should include the cost of each activity, which is often not done or poorly reported. To calculate those costs a field study was performed in 6 United Kingdom (UK) sites (General Practitioner (GP) practices) during a 4-month period (April–June 2015). First, a workflow map of all the relevant vaccine-related activities per site was obtained through interviews. Second, time estimates for activities happening prior to the vaccination day were obtained through interviews and associated costs were calculated. A prospective, non-interventional study using Time & Motion (T&M) methodology was used to measure time for activities happening on the day of vaccination. Consumables, wastage, and guardian time were also collected. Third, the time for each task and for all tasks combined during the T&M study was analyzed using a random intercept model to account for site effect. Hundred and twenty-three T&M observations with approximately 20 per site were collected and were equally stratified by vaccination visit during the first year of a baby's life. Total cost per visit was £11.9 (site range: £8.6–£17.0) when supply cost and time for activities prior to the vaccination day were included. Time per dose administrated was 7.1 min (site range: 5.7–9.2) and the associated cost was £4.3 (site range: £3.1–£6.2). The study demonstrates an accurate reflection of the time and cost involved in a vaccine dose administration in a pediatric setting in the UK. The amount measured is consistent with the current National Health Services fee schedule

Ecophysiological approaches to production and formulation of the biocontrol yeast Pichia anomala

To produce commercial biocontrol agents (BCAs) successfully, it is important that cheap and economic substrates are used which support high numbers of good quality inoculum. Production of formulations conserving ecological competence and shelf-life should also be ensured. With this in mind, studies focusing on yeast ecophysiology were conducted to produce and formulate ecologically competent P. anomala cells for controlling spoilage of moist cereal grain. The liquid culture systems used were synthetic, nutrient yeast dextrose broth (NYDB), and a complex (industry byproduct, cane molasses) media. Manipulation of cultural conditions by means of imposing water-stress with several solute additions to the media had an impact on yield, cell water potentials (Ψc), viability and endogenous sugar/polyol accumulation. Glucose addition resulted in higher yeast yield (6.15 and 3.4 mg cell ml-1 medium for NYDB and molasses, respectively). Water activity (aw) modifications of the media resulted in modification of Ψc so that Ψc ≤ Ψw (medium water potential). The change in yeast Ψc was attributed to the intracellular accumulation/synthesis of polyols, mostly glycerol and arabitol and sugars, mostly trehalose. In molasses-based medium cells accumulated/synthesized trehalose [32 mg g-1 fresh weight (f.w.) yeast cell]. Higher amounts of endogenous trehalose (up to 140 mg g-1 f.w. yeast cell) were retained intracellularly when modified yeast cells were isotonically washed compared to those subjected to hypo-osmotic shock by washing with water. The pattern was similar for endogenous arabitol. Trehalose retention doubled and quadrupled, and arabitol increased by 65 and 100% in proline and NaCl treatments respectively. The molasses control medium gave high [>1010 colony forming units (CFU) ml-1] cell viability, which was further increased by addition of NaCl and proline (≈ 3x1010CFU ml-1). Fluidised bed drying of yeast cells showed that drying at 50oC for 20 min resulted in high cell viability (67%) and low moisture content (7%). Osmoprotection and several carriers and adjuvants affected viability and moisture content. Cotton seed flour (CSF) + 10% skimmed milk (SM) resulted in the highest cell protection (74%) during the drying process, with a final moisture content of about 5% and this was easy to resuspend. Storage stability of the formulation was 50% at 4oC and ambienta temperatures for up to 150 days. P. anomala cells grown in NaCl ii modified molasses-media, when osmoprotected, retained four times more trehalose and resulted in significantly increased survival after drying and storage stability for 150 days. When SM + sucrose at 10% (w/v) was used as a protective solution, P. anomala cells were highly resistant to freezing, thawing and freeze drying processes. Storage stability at 4oC of freeze dried P. anomala cells was particularly high (>86%) over a period of 150 days while storage at 22oC resulted in a rapid decrease in cell viability to 2.2 activity units), low chitinase (<0.9 activity units) and β-glucosidase (<3 nmol 4-nitrophenol min µg protein of specific enzyme activity)-1-1 amounts. The role of the first hydrolase in biocontrol activity is possibly important while that of the other two is not clear for P. anomala. In lab-scale bioassays using wheat grain under aerobic conditions, populations of P. verrucosum 22625 were significantly reduced by formulated P. anomala cells at both 0.93 and 0.95 aw levels while OTA production was significantly reduced at 0.93 aw only.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Effect of different coating-forming agents on the efficacy of the biocontrol agent Candida sake CPA-1 for control of Botrytis cinerea on grapes

[EN] Multiple formulations of known biocontrol agent (BCA) Candida sake, containing different coatingforming polymers and surfactants were tested at different polymer:BCA ratios, in order to improve control of Botrytis cinerea on grapes. The BCA cell viability on the grape surface was analyzed and reduction in disease incidence and severity was determined. Coating-forming solids improved the survival and effi- cacy of C. sake as a BCA against B. cinerea, depending on the polymer type and ratio. The incorporation of surfactants did not improve survival or disease control, although they promoted a better cell dispersion on the grape surface. Cell growth of the antagonist during incubation led to the formation of aggregates, even when surfactants were present. Sodium caseinate and starch were the most suitable polymers to formulate C. sake preparations to obtain coating-forming systems with this BCA and to increase its survival and efficacy at the minimum economic cost of the ingredients. 2016 Elsevier Inc. All rights reservedThe authors are grateful to the Spanish Government for the financial support from the national project RTA2012-00067-C02 (Instituto Nacional de Investigacion y Tecnologia Agraria y Alimentaria, Spain and FEDER founds) and to the Conselleria d'Educacio of the Generalitat Valenciana, (Spain) for A. Marin's PhD grant.Marín-Gozalbo, A.; Cháfer Nácher, MT.; Atarés Huerta, LM.; Chiralt, A.; Torres, R.; Usall, J.; Teixidó, N. (2016). Effect of different coating-forming agents on the efficacy of the biocontrol agent Candida sake CPA-1 for control of Botrytis cinerea on grapes. Biological Control. 96:108-119. https://doi.org/10.1016/j.biocontrol.2016.02.012S1081199

Edible films and coatings as carriers of living microorganisms: a new strategy towards biopreservation and healthier foods

Edible films and coatings have been extensively studied in recent years due to their unique properties and advantages over more traditional conservation techniques. Edible films and coatings improve shelf life and food quality, by providing a protective barrier against physical and mechanical damage, and by creating a controlled atmosphere and acting as a semipermeable barrier for gases, vapor, and water. Edible films and coatings are produced using naturally derived materials, such as polysaccharides, proteins, and lipids, or a mixture of these materials. These films and coatings also offer the possibility of incorporating different functional ingredients such as nutraceuticals, antioxidants, antimicrobials, flavoring, and coloring agents. Films and coatings are also able to incorporate living microorganisms. In the last decade, several works reported the incorporation of bacteria to confer probiotic or antimicrobial properties to these films and coatings. The incorporation of probiotic bacteria in films and coatings allows them to reach the consumers gut in adequate amounts to confer health benefits to the host, thus creating an added value to the food product. Also, other microorganisms, either bacteria or yeast, can be incorporated into edible films in a biocontrol approach to extend the shelf life of food products. The incorporation of yeasts in films and coatings has been suggested primarily for the control of the postharvest disease. This work provides a comprehensive review of the use of edible films and coatings for the incorporation of living microorganisms, aiming at the biopreservation and probiotic ability of food products.Ana Guimaraes received support through grant SFRH/BD/ 103245/2014 from the Portuguese Foundation for Science and Technology (FCT). Luís Abrunhosa was supported by grant UMINHO/BPD/51/2015 from project UID/BIO/04469/2013 financed by FCT/MEC (OE). This study was supported by FCT under the scope of the strategic funding of UID/BIO/04469/2013 unit and COMPETE 2020 (POCI-01-0145-FEDER-006684), and of BioTecNorte operation (NORTE-01-0145-FEDER000004) funded by European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte. Vectors used in Figure were designed by Freepik.info:eu-repo/semantics/publishedVersio

Physiological manipulation and formulation of the biocontrol yeast Pichia anomala for control of Penicillium verrucosum and ochratoxin A contamination of moist grain.

The major hurdle in the production of commercial biocontrol agents (BCAs) has been the lack of production of appropriate formulations. Of particular importance is the conservation of viability and ecological competence after application. With this in mind studies were conducted to develop formulations of P. anomala which would have these attributes. Cells were grown in molasses-based medium modified with proline to different water availability levels (0.98 and 0.96) which significantly increased (up to 50%) the content of trehalose and arabitol in the yeast cells during liquid broth fermentation. The use of isotonic solutions for harvesting the yeast cells further increased the endogenous content of these compatible solutes as well as glycerol. Fluidised bed drying of cells at 30-80°C was carried out for 10 and 20 min and showed that viability was significantly decreased at 70-80°C. A temperature of 50°C for 20 min was found to be best for viability (70%) and moisture content of <10%. Several additives for conservation of viability showed that cotton seed flour+skimmed milk was the best treatment when dried at 50°C. The biocontrol efficacy of formulated P. anomala cells was tested in laboratory scale studies and this showed that they inhibited growth of Penicillium verrucosum and reduce ochratoxin A production in moist wheat grain under some combinations of water availability. Physiologically modified formulated yeast cells with increased levels of trehalose and arabitol gave similar efficacy as fresh cells. This suggests that ecophysiological manipulation of such BCAs can result in improved ecological competence of such formulations and effective biocontrol

Ecophysiological approaches to production and formulation of the biocontrol yeast Pichia anomala

To produce commercial biocontrol agents (BCAs) successfully, it is important that cheap and economic substrates are used which support high numbers of good quality inoculum. Production of formulations conserving ecological competence and shelf-life should also be ensured. With this in mind, studies focusing on yeast ecophysiology were conducted to produce and formulate ecologically competent P. anomala cells for controlling spoilage of moist cereal grain. The liquid culture systems used were synthetic, nutrient yeast dextrose broth (NYDB), and a complex (industry byproduct, cane molasses) media. Manipulation of cultural conditions by means of imposing water-stress with several solute additions to the media had an impact on yield, cell water potentials (Ψc), viability and endogenous sugar/polyol accumulation. Glucose addition resulted in higher yeast yield (6.15 and 3.4 mg cell ml-1 medium for NYDB and molasses, respectively). Water activity (aw) modifications of the media resulted in modification of Ψc so that Ψc ≤ Ψw (medium water potential). The change in yeast Ψc was attributed to the intracellular accumulation/synthesis of polyols, mostly glycerol and arabitol and sugars, mostly trehalose. In molasses-based medium cells accumulated/synthesized trehalose [32 mg g-1 fresh weight (f.w.) yeast cell]. Higher amounts of endogenous trehalose (up to 140 mg g-1 f.w. yeast cell) were retained intracellularly when modified yeast cells were isotonically washed compared to those subjected to hypo-osmotic shock by washing with water. The pattern was similar for endogenous arabitol. Trehalose retention doubled and quadrupled, and arabitol increased by 65 and 100% in proline and NaCl treatments respectively. The molasses control medium gave high [>1010 colony forming units (CFU) ml-1] cell viability, which was further increased by addition of NaCl and proline (≈ 3x1010CFU ml-1). Fluidised bed drying of yeast cells showed that drying at 50oC for 20 min resulted in high cell viability (67%) and low moisture content (7%). Osmoprotection and several carriers and adjuvants affected viability and moisture content. Cotton seed flour (CSF) + 10% skimmed milk (SM) resulted in the highest cell protection (74%) during the drying process, with a final moisture content of about 5% and this was easy to resuspend. Storage stability of the formulation was 50% at 4oC and ambienta temperatures for up to 150 days. P. anomala cells grown in NaCl ii modified molasses-media, when osmoprotected, retained four times more trehalose and resulted in significantly increased survival after drying and storage stability for 150 days. When SM + sucrose at 10% (w/v) was used as a protective solution, P. anomala cells were highly resistant to freezing, thawing and freeze drying processes. Storage stability at 4oC of freeze dried P. anomala cells was particularly high (>86%) over a period of 150 days while storage at 22oC resulted in a rapid decrease in cell viability to 2.2 activity units), low chitinase (<0.9 activity units) and β-glucosidase (<3 nmol 4-nitrophenol min µg protein of specific enzyme activity)-1-1 amounts. The role of the first hydrolase in biocontrol activity is possibly important while that of the other two is not clear for P. anomala. In lab-scale bioassays using wheat grain under aerobic conditions, populations of P. verrucosum 22625 were significantly reduced by formulated P. anomala cells at both 0.93 and 0.95 aw levels while OTA production was significantly reduced at 0.93 aw only