Pulse flaking: Opportunities and challenges, a review.

Pulses provide economic and health benefits to people in many countries around the world; however, their adoption in western diets, particularly in processed and formulated foods, is limited. One strategy to increase the level of pulses in western diets is to improve pulse accessibility to the ready-to-eat (RTE) food market sector. Pulses have compositional and structural differences when compared to cereals and behave differently during processing. While there have been numerous studies on pulses processed using traditional processing methods, there are limited studies describing processing of pulses as a major ingredient in RTE forms such as flakes. To understand the full processing potential of pulses, systematic studies are required using commercial-scale RTE pilot processing equipment coupled with fundamental property determination techniques to evaluate the effects of processing and pulse material on pulse flake attributes. In-depth studies of pulse properties and their processability are likely to result in the production of high-quality pulse-based foods with superior health benefits. This review explores the current and potential opportunities for processing pulses with a focus on flake products. The roles of pulse type and major structure-forming components such as fiber, carbohydrates, and proteins on end-product quality of processed pulses are discussed.

Secondary transfer of emergency stroke patients eligible for mechanical thrombectomy by air in rural England: economic evaluation and considerations.

BACKGROUND: Mechanical thrombectomy (MT) is a time-sensitive emergency procedure for patients who had ischaemic stroke leading to improved health outcomes. Health systems need to ensure that MT is delivered to as many patients as quickly as possible. Using decision modelling, we aimed to evaluate the cost-effectiveness of secondary transfer by helicopter emergency medical services (HEMS) compared with ground emergency medical services (GEMS) of rural patients eligible for MT in England. METHODS: The model consisted of (1) a short-run decision tree with two branches, representing secondary transfer transportation strategies and (2) a long-run Markov model for a theoretical population of rural patients with a confirmed ischaemic stroke. Strategies were compared by lifetime costs: quality-adjusted life years (QALYs), incremental cost per QALY gained and net monetary benefit. Sensitivity and scenario analyses explored uncertainty around parameter values. RESULTS: We used the base case of early-presenting (<6 hours to arterial puncture) patient aged 75 years who had stroke to compare HEMS and GEMS. This produced an incremental cost-effectiveness ratio (ICER) of £28 027 when a 60 min reduction in travel time was assumed. Scenario analyses showed the importance of the reduction in travel time and futile transfers in lowering ICERs. For late presenting (>6 hours to arterial puncture), ground transportation is the dominant strategy. CONCLUSION: Our model indicates that using HEMS to transfer patients who had stroke eligible for MT from remote hospitals in England may be cost-effective when: travel time is reduced by at least 60 min compared with GEMS, and a £30 000/QALY threshold is used for decision-making. However, several other logistic considerations may impact on the use of air transportation.

Manifesto for a healthy and health-creating society.

Brexit and the troubled state of the NHS call for re-thinking the UK's approach to health. The EU referendum vote reveals deep social divisions as well as presenting the country with important decisions and negotiations about the future. At the same time, health problems are growing; the NHS faces severe financial constraints and appears to lurch from crisis to crisis, with leaving the European Union likely to exacerbate many problems including staffing issues across the whole sector. However, new scientific developments and digital technology offer societies everywhere massive and unprecedented opportunities for improving health. It is vital for the country that the NHS is able to adopt these discoveries and see them translated into improved patient care and population health, but also that the UK benefits from its capabilities and strengths in these areas.