An integrated model of palliative care in the emergency department (ED) of an inner city academic teaching center utilized existing hospital resources to reduce hospital length of stay (LOS) and reduce overall cost. Benefits related to resuscitation rates, intensity of care, and patient satisfactionare attributed to the ED-based palliative team’s ability to provide real time consults, and utilize InterQual criteria to admit to a less costly level of care or transfer directly to home or hospice. [West J Emerg Med.14(6):633–636.]   

The effects of wall composition and heat treatment on the formation and properties of core-in-wall emulsions (CIWEs) consisting of whey protein-coated milkfat (AMF) droplets and a dispersion of non-fat milk solids (MSNF) were investigated. Microcapsules were prepared by spray drying these CIWEs. The d3.2 of the CIWEs ranged from 0.36 to 0.54 μm. Surface excess of the CIWEs ranged from 1.39 to 6.57 mg/m2, and was influenced by concentration of whey proteins and heat treatment (30 min at 90 °C). Results indicated a preferential adsorption of β-lg at the O/W interface. Whey proteins accounted for up to 90% of the proteins adsorbed at the O/W interface. The core retention during spray drying ranged from 90.3% to 97.6% and microencapsulation efficiency ranged from 77.9% to 93.3%. The microcapsules exhibited an excellent long-term oxidative stability at 20 and 30 °C that was superior to that of microcapsules consisting of milkfat and MSNF, where the O/W interface was populated mainly by caseins. The superior oxidative stability could be attributed to the formation of dense whey-proteins-based films at the O/W interfaces of the CIWEs that isolated the core domains from the environment. The results open new opportunities in developing highly stable lipids-containing microcapsules and dairy powders.

This study investigated the in-vitro digestibility of cold-set whey protein (WP) microgels prepared by two gelation methods (external and internal) containing lipids (0%, 10% or 20% w/w). The incorporation of lipids into these matrices achieved higher entrapment of the bioactive vitamin riboflavin, as well as significant reductions in rates of both the digestion of the protein matrix, and the subsequent diffusion of the water-soluble bioactive. A biexponential model accounted for the contribution of digestion- and diffusion-driven mechanisms in describing the release of riboflavin into enzyme containing simulated gastrointestinal fluids. In particular, for external gelation microgels, as the lipid load within the matrices increased, the contribution of a faster diffusion-driven release was almost completely negated by a slower digestion-assisted release. Lipid loads provided a composite matrix capable of alternating from a burst to a sustained release of bioactive.

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