Background and objectives The effect of defatting four oilseed protein concentrates (safflower, sunflower, canola, and hemp) on the surface and functional properties of the proteins was investigated as a function of pH (pH 3, 5, 7). The functionality of commercial protein concentrates (soy, faba bean, lentil, pea, northern great bean, whey) already in the marketplace was also tested for comparative purposes. Findings Defatting with hexane increased the protein content from 77.3% to 92.9% for safflower, 67.5 to 75.5% for sunflower, 58.0–66.0% for canola, and 71.0–83.2% for hemp. The approximate isoelectric point (pI) of safflower increased with defatting (5.4–5.8), whereas for canola the pI decreased with defatting (4.7–4.3), and sunflower and hemp protein concentrates had similar pI for defatted or full fat. Certain functional properties were improved with defatting, whereas others showed the opposite trend; this was highly dependent on protein type and pH. Conclusions The oilseed concentrates were comparable to the concentrates in the marketplace with canola and sunflower proteins having the greatest oil‐holding capacity and defatted safflower having the highest foaming capacity of all the proteins tested. Significance and novelty Based on their functionality, the oilseed protein concentrates have potential to be used by the food ingredient industry.
Introduction In order to foster dental and dental hygiene practices that are inclusive, sensitive to diversity, equitable, and without prejudice, a call to broadly teach cultural diversity within dental and dental hygiene education has been made. The research question of this study was "to what extent can an interactive and open dialogue about substance use, queer health, and social responsibility foster transformative learning?" Methods A collaborative and interdisciplinary project engaged the community as a teacher over the Summer and Fall of 2019 to address issues of substance use, queer health, and social responsibility and was delivered to 55 first-year undergraduate dental and 23 third-year dental hygiene students over three educational sessions. Dental and dental hygiene students were asked to reflect, in writing, on each session using between 200 and 400 words. Textual information from students' self-reflections and from the community's feedback were analyzed thematically for content (e.g., codes and themes). Results In total, 128 written reflections-for an average of 42 reflections per session-were gathered and analyzed interactively by the authors. Three major themes emerged: feeling privileged, breaking stereotypes, and coalescing learning. Feedback from the participating community members highlighted changes to be implemented in these sessions in the future, including more opportunities for small group activities in class.
BackgroundDoor-to-needle time (DTN) has an important impact on thrombolysis and reperfusion outcomes in the treatment of acute ischaemic stroke. This systematic review is a critical synthesis of studies evaluating DTN reduction strategies.MethodOvid MEDLINE, PubMed, Cochrane Database of Systematic Reviews, CINAHL, ProQuest dissertations and LILACS were used as bibliographic databases for primary literature. CIHI, Health Quality Council of Alberta, Health Quality Ontario and websites of heart and stroke associations in Canada, USA, UK, Australia and New Zealand were used as sources of grey literature. Searched reports were screened by title and abstract, and full texts were located for review. Articles quality was evaluated using National Institute of Health’s Study Quality Assessment tools. Methods for improving DTN were categorised under 13 DTN reduction strategies, primarily adapted from the Target: Stroke Phase II recommendations, and including two additional categories: Strategies not encompassed by any Target: Stroke recommendation, and Combinations of Interventions.Results96 studies (4 randomised control trials, 1 review, 91 observational pre/post studies) were included in the review. All strategies and interventions resulted in a reduction of DTN. Approaches using combinations of interventions were the most effective at reducing DTN (33.77% DTN reduction, standard mean difference=1.857, 95% CI=1.510–2.205), and were more effective than approaches using only a single strategy (p=0.040). DTN reduction was associated with the duration of the DTN reduction programme at each facility (p=0.006).InterpretationThe greatest reductions in DTN were observed when implementing combinations of DTN reduction strategies, although there was no significant advantage to implementing more than two strategies simultaneously.PROSPERO registration number42016036215.
Objective Older patients with complex care needs and limited personal and social resources are heavy users of emergency department (ED) services and are often admitted when they present to the ED. Updated information is needed regarding the most effective strategies to appropriately avoid ED presentation and hospital admission among older patients. Methods This systematic review aimed to identify interventions that have demonstrated effectiveness in decreasing ED use and hospital admissions in older patients. We conducted a comprehensive literature search within Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials from database inception to July 2019 with no language restrictions. Interventional study designs conducted in populations of 65 years and older were included. Primary outcomes were ED visits and hospital admissions. Secondary outcomes included hospital readmission, mortality, cost, and patient-reported outcomes. Results Of 7,943 citations reviewed for eligibility, 53 studies were included in our qualitative synthesis, including 26 randomized controlled trials (RCT), 8 cluster-RCTs, and 19 controlled before-after studies. Data characterization revealed that community-based strategies reduced ED visits, particularly those that included comprehensive geriatric assessments and home visits. These strategies reported decreases in mean ED use (for interventions versus controls) ranging from -0.12 to -1.32 visits/patient. Interventions that included home visits also showed reductions in hospital admissions ranging from -6% to -14%. There was, however, considerable variability across individual studies with respect to outcome reporting, statistical analyses, and risk of bias, which limited our ability to further quantify the effect of these interventions. Conclusion Various interventional strategies to avoid ED presentations and hospital admissions for older patients have been studied. While models of care that include comprehensive geriatric assessments and home visits may reduce acute care utilization, the standardization of outcome measures is needed to further delineate which parts of these complex interventions are contributing to efficacy. The potential effects of multidisciplinary team composition on patient outcomes also warrant further investigation.
PurposeIntegrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care.Design/methodology/approachThe scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes.FindingsOverall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used.Research limitations/implicationsDespite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended.Originality/valueThe originality of this study is to provide evidence on integrated oral healthcare during pregnancy.
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