The interest for producing wheat flour with health promoting effect and improved functionality has led to investigate new milling techniques that can provide finer flours. In this study, jet milling treatment was used to understand the effect of ultrafine size reduction onto microstructure and physicochemical properties of wheat flour. Three different conditions of jet milling, regarding air pressure (4 or 8 bars) feed rate and recirculation, were applied to obtain wheat flours with different particle size (control, F1, F2 and F3 with d50 127.45, 62.30, 22.94 and 11.4 μm, respectively). Large aggregates were gradually reduced in size, depending on the intensity of the process, and starch granules were separated from the protein matrix. Damaged starch increased while moisture content decreased because of milling intensity. Notable changes were observed in starch hydrolysis kinetics, which shifted to higher values with milling. Viscosity of all micronized samples was reduced and gelatinization temperatures (To, Tp, Tc) for F2 and F3 flours increased. Controlling jet milling conditions allow obtaining flours with different functionality, with greater changes at higher treatment severity that induces large particle reduction.
Η σχιζοφρένεια ανήκει στις διαταραχές που προκαλούν τη μεγαλύτερη αναπηρία σε παγκόσμιο επίπεδο με σημαντική επίπτωση στην επαγγελματική, κοινωνική και προσωπική λειτουργικό τητα των ασθενών. Η θνησιμότητα υπολογίζεται 2-2,5 φορές μεγαλύτερη απ' ό,τι στον γενικό πληθυσμό και συχνά εκτός από τον αυξημένο κίνδυνο αυτοκτονίας, αποδίδεται σε σωματικά νοσήματα όπως καρδιαγγειακά, μεταβολικά ή φλεγμονώδη. Οι ανάγκες επίσης των ασθενών σε υπηρε σίες υγείας είναι αυξημένες και ποικίλλουν ανάλογα με τη φάση της ασθένειας και τον τρόπο που η δια ταραχή επηρεάζει τον ασθενή και τη ζωή του. Σημαντικό μέρος του κόστους της διαταραχής αποδίδεται στις αυξημένες απαιτήσεις που προκύπτουν για τα συστήματα υγείας τόσο για την αντιμετώπιση της ί διας της διαταραχής όσο και των επιπτώσεών της. Σε αυτό το άρθρο παρουσιάζεται το τμήμα των προ σαρμοσμένων κλινικών οδηγιών για τη σχιζοφρένεια που εκπόνησε η ομάδα εργασίας του Υπουργείου Υγείας το 2015, με τις συνοπτικές προτάσεις για τον ρόλο της Πρωτοβάθμιας Φροντίδας Υγείας (ΠΦΥ) στη δια χείριση της σχιζοφρένειας και τις υπηρεσίες ψυχικής υγείας στην κοινότητα καθώς έχει προηγηθεί το άρθρο που αφορά στο γενικό μέρος των κλινικών οδηγιών με την περιγραφή των στόχων και των περι ορισμών των. Για τη διαμόρφωση των κλινικών οδηγιών, χρησιμοποιήθηκε ως κύριος οδηγός, ο οδηγός για τις βασικές παρεμβάσεις στη θεραπευτική αντιμετώπιση και διαχείριση της σχιζοφρένειας στους ενη Οι κατευθυντήριες οδηγίες για την αντιμετώπιση της σχιζοφρένειας (ΙΙ):Yπηρεσίες στην κοινότητα και ο ρόλος της Πρωτοβάθμιας Φροντίδας Yγείας
The initiative for the development of national treatment guidelines, dates back to the '90s. In Greece, however, National Clinical Guidelines for the management of schizophrenia were first formulated in 2014 when a Working Group was set up for this purpose by the Greek Ministry of Health. The objective of this Working Group was to provide evidence-based recommendations covering the pharmacological and psychosocial treatment of schizophrenia as well as the development of appropriate treatment services. The Working Group utilized the NICE Guideline (National Institute of Clinical Excellence, 2010, 2014) for the management of Psychosis & Schizophrenia as the main guide to develop the Greek National Guidelines , and in addition the American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Schizophrenia (APA 2004), the Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders (Royal Australian and New Zealand College of Psychiatrists 2005) , as well as other relevant sources. The Working Group also took into consideration the available Greek bibliography as well as the external evaluations of the Greek psychiatric reform programs. A special effort was made to adapt the international experience to the current Greek landscape with the constraints resulting from the uneven dispersion of mental health services, the lack of coordination between services, the incomplete sectorization of mental health services provided as part of the National Health System, the still underdeveloped Primary Care Health Service, and last but not least the difficult economic situation in Greece. After the preparation of the draft guidelines, a thorough consultation followed with the relevant stakeholders, including mental health professionals, user associations and representatives of the Greek Ombudsman. Additionally, the Hellenic Psychiatric Association established an Expert Committee in Spring 2016, that contributed with its observations to the final exercise. This article will be followed by two further publications (incorporating the Hellenic Psychiatric Association comments) which include: (1) the summary recommendations regarding the pharmacological, psychological and psychosocial interventions in the treatment of schizophrenia, and (2) the summary recommendations regarding: (a) the role of primary health care service and the role of the family physician in the treatment of schizophrenia (b) the summary recommendations regarding continuity of care and c) the summary recommendations regarding community interventions with documented effectiveness in the treatment of schizophrenia.
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