Short-term Evaporative Cooling Extends Shelf Life of Two Sweet Pepper Cultivars, ‘Sweet Cayene’ and ‘Sultan’

In the Philippines, postharvest losses for vegetables are estimated to reach 40%, which can be attributed to improper handling and lack of adequate storage facilities. Although refrigeration is the best storage option, it is expensive and energy extensive. An alternative short-term non-refrigerated storage option is through the use of evaporative coolers. A 60 × 40 × 29–inch wood cabinet with outer framing and three shelves made of aluminum and two layers of jute sack for walls served as evaporative cooler for this study. Water flowed from a container placed on top of the cabinet wetting the walls. Two sweet pepper cultivars (‘Sweet Cayenne’ and ‘Sultan’) at mature green stage were stored under ambient (28.74±0.94 °C, 65.68±7.43% RH) and evaporative cooling (23.91±3.85 °C, 93.84±9.33% RH) conditions to assess their effects on the physico-chemical properties of the produce. Both cultivars stored in the evaporative cooler significantly showed reduced weight loss, slower decline in moisture content, longer retention of firmness, and better visual quality rating. On the other hand, rapid changes were observed in titratable acidity, total soluble solids, and ascorbic acid in both cultivars stored at ambient condition indicating a faster rate of ripening. Very slight decay with longer shelf life were observed in both cultivars stored in the evaporative cooler as ‘Smooth Cayenne’ and ‘Sultan’ reached its end of shelf life at days 18 and 15, respectively, while this was only at days 9 and 6 for those that were stored in ambient conditions

How safe is primary care? A systematic review

Improving patient safety is at the forefront of policy and practice. While considerable progress has been made in understanding the frequency, causes and consequences of error in hospitals, less is known about the safety of primary care.We investigated how often patient safety incidents occur in primary care and how often these were associated with patient harm.We searched 18 databases and contacted international experts to identify published and unpublished studies available between 1 January 1980 and 31 July 2014. Patient safety incidents of any type were eligible. Eligible studies were critically appraised using validated instruments and data were descriptively and narratively synthesised.Nine systematic reviews and 100 primary studies were included. Studies reported between <1 and 24 patient safety incidents per 100 consultations. The median from population-based record review studies was 2-3 incidents for every 100 consultations/records reviewed. It was estimated that around 4% of these incidents may be associated with severe harm, defined as significantly impacting on a patients well-being, including long-term physical or psychological issues or death (range <1% to 44% of incidents). Incidents relating to diagnosis and prescribing were most likely to result in severe harm.Millions of people throughout the world use primary care services on any given day. This review suggests that safety incidents are relatively common, but most do not result in serious harm that reaches the patient. Diagnostic and prescribing incidents are the most likely to result in avoidable harm.This systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42012002304)

Disease-specific health-related quality of life (HRQL) instruments for food allergy: protocol for a systematic review

BACKGROUND: The European Academy of Allergy and Clinical Immunology is in the process of developing its Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management, and impact on quality of life, which will be used to inform clinical recommendations. The aim of this systematic review will be to determine which validated instruments can be employed to enable assessment of the impact of, and investigations and interventions for, food allergy on health-related quality of life.METHODS: Seven bibliographic databases were searched from their inception to September 30, 2012 for disease-specific HRQL questionnaires that were specifically designed for use with patients/carers and any articles relating to the description, development and/or the validation of the above identified HRQLs. There were no language or geographic restrictions. We will assess the development of the instruments identified and their performance properties including: validity; generalizability; responsiveness; managing missing data; how variation in patient demography was managed; and cross-cultural and linguistic adaptation, using a previously reported quality assessment tool.DISCUSSION: Using appropriately developed and validated instruments is critical to the accurate evaluation of HRQL in people with food allergy. This review will systematically appraise the evidence on the subject and help to identify any gaps

Parental perception of their child's Quality of Life in children with non-Immunoglobulin-E mediated gastrointestinal allergies

BACKGROUND: Food allergy can have a significant impact on health related quality of life (HRQoL). Parental proxy questionnaires are commonly used when children are too young to complete questionnaires themselves. Little data is available on HRQoL in children with non-IgE-mediated gastrointestinal food allergy (GIFA). The aim of this study was to evaluate HRQoL in these children by parent proxy. METHODS: A cross-sectional questionnaire study was conducted with children 2-16 years old with confirmed (GIFA). Parents of these children completed the Paediatric Quality of Life Inventory (PedsQL(™) ) and the Family Impact module of the PedsQL. The PedsQL scores were compared to two published cohorts: functional abdominal pain (FAP) and IgE-mediated food allergy. RESULTS: Fifty-two parents of children with GIFA completed the PedsQL(™) parent proxy. The GIFA cohort had significantly better overall HRQoL compared to the FAP cohort, but lower emotional functioning scores. The GIFA cohort also had poorer physical QoL compared to the IgE cohort (all p<0.05). The more foods excluded, comorbidity of nasal congestion, abdominal pain, back arching, the persistence of flatus and gastrointestinal symptom severity after elimination diet were related to poorer QoL in this non-IgE cohort. Regression analyses showed that number of foods and nasal congestion significantly predicted total QoL score as perceived by parents. CONCLUSIONS: This study has shown that different areas of HRQoL of children with GIFA are affected compared to children with FAP or IgE-mediated food allergy, highlighting the need for a specific GIFA HRQoL questionnaire to better understand the impact on these children. This article is protected by copyright. All rights reserved

Patient reported outcome measures for allergy and asthma in children:PROMS for allergy and asthma in children

There is increasing recognition of the importance of patient's perceptions of disease and their assessments of heathcare processes. Patient‐reported outcome measures (PROMs) are therefore now regarded as at least as important as the traditional objective measures of disease. For minors, parental and, except in the very young and severally cognitively impaired, the child's perspectives are important because they provide unique and complementary information. In this review, we summarize the evidence on PROMs for allergy and asthma for use in children. Overall, there are fewer PROMs available for use in children than in adults. We were able to identify some validated pediatric PROMs that have been developed for use in atopic eczema/dermatitis, food allergy, allergic rhinitis/rhinoconjunctivitis, and asthma. There is very limited evidence on deploying these instruments out with research settings. There is therefore a pressing need to report on the experiences of using PROMs for allergy and asthma in routine clinical care. In particular, there is a need to understand how acceptable these are to children/carers, whether they can be incorporated into routine clinical assessments and if they are responsive to changes in treatment made in routine clinical practice

Global Research Priorities to Better Understand the Burden of Iatrogenic Harm in Primary Care: An International Delphi Exercise

There is a need to identify and reach agreement on key foci for patient safety research in primary care contexts and understand how these priorities differ between low-, middle-, and high-income settings. We conducted a modified Delphi exercise, which was distributed to an international panel of experts in patient safety and primary care. Family practice and pharmacy were considered the main contexts on which to focus attention in order to advance patient safety in primary care across all income categories. Other clinical contexts prioritised included community midwifery and nursing in low-income countries and care homes in high-income countries. The sources of patient safety incidents requiring further study across all economic settings that were identified were communication between health care professionals and with patients, teamwork within the health care team, laboratory and diagnostic imaging investigations, issues relating to data management, transitions between different care settings, and chart/patient record com- pleteness. This work lays the foundation for a range of research initiatives that aim to promote a more comprehensive appreciation of the burden of unsafe primary care, develop understanding of the main areas of risk, and identify interventions that can enhance the safety of primary care provision internationall