The potential of herbs and spices to reduce lipid oxidation during heating and gastrointestinal digestion of a beef product.

Here we tested the potential of ten culinary herbs (basil, oregano, rosemary and thyme) and spices (black pepper, cayenne pepper, cumin, curcuma, garlic and sweet paprika) to limit oxidation during cooking of a high-fat beef product, and during its subsequent in vitro gastrointestinal digestion. The herbs and spices were added separately at 0.5% and 1% (w/w), either during meat processing before heating of the product or after heating of the meat as a seasoning. Lipid oxidation was evaluated by malondialdehyde, 4-hydroxy-2-nonenal and hexanal quantification in the meat products and gastrointestinal digests. In general, adding the herbs and spices before heating of the meat was more effective at limiting oxidation during digestion, compared to adding these compounds after heating. Doses of 1% were more effective than 0.5%. The four herbs and curcuma displayed antioxidant activity in all treatments and were more effective in limiting oxidation than the other culinary compounds, resulting in negligible concentrations of 4-hydroxy-2-nonenal and hexanal in the meat and digests. Black pepper, cayenne pepper and cumin moderately reduced or had no effect on oxidation during digestion when added following heating of the meat, but had a more pronounced antioxidant effect when added before heating. Sweet paprika and garlic exerted some pro-oxidant effects during cooking. During digestion, sweet paprika had an antioxidant effect, but garlic did not. The extent to which the herbs and spices limited oxidation, showed a strong correlation with their phenolic content, and lower correlations with α-tocopherol and chlorophyll.

Nurses' decision-making process in cases of physical restraint in acute elderly care: a qualitative study.

BACKGROUND: The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented. A thorough understanding of nurses' decision-making process could be useful to understand how nurses reason and make decisions in ethically laden situations. OBJECTIVES: The aims of this study were to explore and describe nurses' decision-making process in cases of physical restraint. DESIGN: We used a qualitative interview design inspired by the Grounded Theory approach. Data analysis was guided by the Qualitative Analysis Guide of Leuven. SETTING: Twelve hospitals geographically spread throughout the five provinces of Flanders, Belgium. PARTICIPANTS: Twenty-one acute geriatric nurses interviewed between October 2009 and April 2011 were purposively and theoretically selected, with the aim of including nurses having a variety of characteristics and experiences concerning decisions on using physical restraint. RESULTS: In cases of physical restraint in acute elderly care, nurses' decision making was never experienced as a fixed decision but rather as a series of decisions. Decision making was mostly reasoned upon and based on rational arguments; however, decisions were also made routinely and intuitively. Some nurses felt very certain about their decisions, while others experienced feelings of uncertainty regarding their decisions. CONCLUSIONS: Nurses' decision making is an independent process that requires nurses to obtain a good picture of the patient, to be constantly observant, and to assess and reassess the patient's situation. Coming to thoughtful and individualized decisions requires major commitment and constant critical reflection.

Heterochromia of the irides and a motility disorder of the oesophagus: a coincidence or a defect during embryogenesis?

We present an infant with heterochromia of the irides and a motility disorder of the oesophagus. The association between Hirschsprung's disease and heterochromia of the irides has been reported in the past and has been explained by the common origin during embryogenesis of the parasympathetic ganglion cells and the stroma of the iris.