The impact of an educational DVD on pregnant women with gestational diabetes mellitus: a randomised controlled trial

Background The diagnosis of gestational diabetes (GDM) during pregnancy can lead to anxiety. Little research has focused on the education these women receive and how this is best delivered in a busy clinic. Aim This study evaluated the impact of an innovative patient-centred educational DVD on anxiety and glycaemic control and in newly diagnosed women with GDM. Method 150 multi-ethnic women, aged 19-44 years, from three UK hospitals were randomised to either standard care plus DVD (DVD group, n=77) or standard care alone (control group, n=73) at GDM diagnosis. Women were followed up at their next clinic visit at a mean ± SD of 2.5 ± 1.6 weeks later. Primary outcomes were anxiety (State-Trait Anxiety Inventory) and mean 1-hour postprandial capillary self-monitored blood glucose for all meals, on day prior to follow-up. Secondary outcomes included pregnancy specific stress (Pregnancy Distress Questionnaire), emotional adjustment to diabetes (Appraisal of Diabetes Scale), self-efficacy (Diabetes Empowerment Scale) and GDM knowledge (non-validated questionnaire). Other outcomes included mean fasting and 1-hour postprandial blood glucose at each meal, on day prior to follow-up. Women in the DVD group completed a feedback questionnaire on the resource. Results No significant difference between the DVD and control group were reported, for anxiety (37.7 ± 11.7 vs 36.2 ± 10.9; mean difference after adjustment for covariates (95%CI) 2.5 (-0.8, 5.9) or for mean 1-hour postprandial glucose (6.9 ± 0.9 vs 7.0 ± 1.2 mmol/L; -0.2 (-0.5, 0.2). Similarly, no significant differences in the other psychosocial variables were identified between the groups. However, the DVD group had significantly lower postprandial breakfast glucose compared to the control group (6.8 ± 1.2 vs 7.4 ± 1.9 mmol/L; -0.5 (-1.1, -<0.1; p=0.04). Using a scale of 0-10, 84% rated the DVD 7 or above for usefulness (10 being very useful), and 88% rated it 7 or above when asked if they would recommend to a friend (10 being very strongly recommend). Women described the DVD as ‘reassuring’, ‘a fantastic tool’, that ‘provided a lot of information in a quick and easy way’ and ‘helped reinforce all the information from clinic’. Discussion While no significant change was observed in anxiety or mean postprandial glucose, the DVD was rated highly by women with GDM and may be a useful resource to assist with educating newly diagnosed women. This project is supported by BRIDGES, an IDF programme supported by an educational grant from Lilly Diabetes.

Effect of high-pressure processing on the shelf life, safety and organoleptic characteristics of lasagne ready meals during storage at refrigeration and abuse temperature

The effect of different pressure levels (500 and 600. MPa for 1. min at ambient temperature) on lasagne ready meal as a means of increasing the safety and shelf life during storage at refrigeration (4. °C) and abuse temperature (8. °C) was investigated. High-pressure processing (500 and 600. MPa for 1. min) was able to significantly reduce the total aerobic and lactic acid bacteria counts and prolong the microbiological shelf life of lasagne at both refrigeration and abuse temperatures. Pressure at 600. MPa was a useful tool to reduce the safety risks associated with Staphylococcus aureus and Listeria monocytogenes. However, abuse storage temperature facilitated the recovery of L. monocytogenes towards the end of storage. Organoleptic evaluation revealed that HPP did not negatively influence the quality attributes of lasagne and prolonged its organoleptic shelf life. HPP treatment can serve as a useful additional step to enhance safety and increase the shelf life of multicomponent ready meals, such as lasagne. Industrial relevance: The ready meals sector of the food industry has been experiencing increasing growth in the past years. This comprehensive study explored the effects of HPP on a very popular multicomponent ready meal i.e., lasagne after treatment and during storage. The results showed that HPP can be successfully applied to lasagne ready meals to decrease the risk from S. aureus and L. monocytogenes and also significantly prolong its shelf life without affecting its organoleptic properties. The utilisation of HPP by the industry can significantly increase safety and also provide the opportunity for this product to reach markets further away.

Patients on H2-receptor antagonists--are we investigating them?

A survey was made of patients receiving H2-receptor antagonists in a group practice serving 8600 patients. Two hundred and twelve patients (2%) who had received at least one prescription for H2 antagonists in a 12 month period were identified. When compared with the practice population, men and patients over 50 years old were more likely to be taking these drugs (P less than 0.01 and P less than 0.001, respectively). One hundred and fifty-seven patients (74%) were investigated before commencing therapy; 114 (73%) of these patients were investigated via the hospital outpatient department, despite the general practitioners having full open access to barium meals. Only 23 (15%) of the patients investigated were found to have no active pathology. Twenty-nine (14%) of the 212 study patients had received one or more gastrointestinal investigations in the 18 months subsequent to starting H2-antagonist therapy. Twenty-five of these patients had also received an investigation before starting therapy. One hundred and eleven patients (52%) had had their H2 antagonist therapy initiated by their general practitioner.

Financial Taxes and the Sand in the Wheels of Financialization:Legal Challenges for the EU Directive Implementing Enhanced Cooperation in the Area of Financial Transaction Tax

One of the many results of the Global Financial Crisis was the insight that the financial sector is under-taxed compared to other industries. In light of the huge bailouts and continued subsidies for financial institutions that are characterized as too-big-to-fail demands came on the agenda to make finance pay for the mega-crisis it caused. The most prominent examples of such taxes are a Financial Transaction Tax (FTT) and a Financial Activities Tax (FAT). Possible effects of such taxes on the economic constitution and increasingly in particular on the European Single Market have been discussed controversially over the last decades already. Especially with the decision of eleven EU member states to adapt an FTT using the enhanced cooperation procedure a number of additional legal challenges for implementing such a tax have emerged. This paper analyzes how tax measures of indirectly regulating the financial industry differ, what legal challenges they pose, and what their overall contribution would be in making the financial system more stable and resilient. It also analyzes the legal arguments against enhanced cooperation in this area and the legal issues related to the British lawsuit against the Commission’s Directive proposal in the European Court of Justice on grounds of the extra-territoriality application of tax. The paper concludes that the feasibility of an FTT is legally sound and given the FTT’s advantages over a FAT the EU Directive should be implemented as a first step for a European-wide FTT. However, significant uncertainties about its implementation remain at this stage.

Whole-Vehicle modelling of exhaust energy recovery on a diesel-electric hybrid bus

Hybrid vehicles can use energy storage systems to disconnect the engine from the driving wheels of the vehicle. This enables the engine to be run closer to its optimum operating condition, but fuel energy is still wasted through the exhaust system as heat. The use of a turbogenerator on the exhaust line addresses this problem by capturing some of the otherwise wasted heat and converting it into useful electrical energy.

This paper outlines the work undertaken to model the engine of a diesel-electric hybrid bus, coupled with a hybrid powertrain model which analysed the performance of a hybrid vehicle over a drive-cycle. The distribution of the turbogenerator power was analysed along with the effect on the fuel consumption of the bus. This showed that including the turbogenerator produced a 2.4% reduction in fuel consumption over a typical drive-cycle.

The hybrid bus generator was then optimised to improve the performance of the combined vehicle/engine package and the turbogenerator was then shown to offer a 3.0% reduction in fuel consumption. The financial benefits of using the turbogenerator were also considered in terms of fuel savings for operators. For an average bus, a turbogenerator could reduce fuel costs by around £1200 per year.

Suitability, efficiency and microbiological safety of novel physical technologies for the processing of ready-to-eat meals, meats and pumpable products

Consumer studies and market reports show an increase in consumption of ready-to-eat (RTE) foods. Although conventional processing technologies can in most cases produce safe products, they can also lead to the degradation of nutritional compounds and negatively affect quality characteristics. Consumers strongly prefer food that is minimally processed with the maximum amount of health-promoting substances. Novel processing technologies as pre- or post-treatment decontamination methods or as substitutes of conventional technologies have the potential to produce foods that are safe, rich in nutrient content and with superior organoleptic properties. Combining novel with conventional processes can eliminate potential drawbacks of novel technologies. This review examines available scientific information and critically evaluates the suitability and efficiency of various novel thermal and nonthermal technologies in terms of microbial safety, quality as well as nutrient content on the production of RTE meals, meats and pumpable products.

Consumer Behaviour towards Organic Ready-to-Eat Meals: A Case of Quality Innovation

This paper reviews literature on alternative convenience food choices and analyses the findings from consumer behaviour and manufacturing/retailing perspective. As consumers’ demand for easy prepared and healthier food products has gradually increased, so has the related research activity. This address provides a synopsis of 60 relevant peer-review publications based on an online research carried out using related to organic ready-to-eat meals search terms. An overview of topic’s most important outcomes is presented, compared and evaluated. Results reveal positive attitudes, increased interest and willingness to purchase such products. Research gaps are identified in the field of personal and social norms as well as in the regulation and seeking information process. Policy making implications and recommendations are also discussed in conjunction with future research opportunities