Impact of caregivers' unmet needs for supportive care on quality of terminal cancer care delivered and caregiver's workforce performance.

GOALS OF WORK: Family caregivers play an important role in caring for cancer patients, but the impact of caregivers' unmet needs on the quality of end-of-life (EOL) care they deliver and on their workplace performance are less understood. PATIENTS AND METHODS: We identified 1,662 family caregivers of cancer patients who had died at any of 17 hospitals in Korea during 2004. The caregivers answered a telephone questionnaire about needs that were not met when they delivered terminal cancer care and how those unmet their needs affected their workplace performance; they also answered the Quality Care Questionnaire-End of Life (QCQ-EOL). RESULTS: Compared with caregivers who did not have unmet needs, caregivers who had unmet needs for symptom management, financial support, or community support showed poorer QCQ-EOL scores (P < 0.01). Caregivers who had unmet needs for financial support (adjusted odds ratio (aOR) = 7.55; 95% confidential interval (CI) 3.80-15.00), psychosocial support (aOR = 6.24; 95% CI 2.95-13.05), symptom management (aOR = 3.21; 95% CI 2.26-4.54), community support (aOR = 3.82; 95% CI 2.38-6.11), or religious support (aOR = 4.55; 95% CI 1.84-11.26) were more likely to experience work limitations. Caregivers of patients receiving conventional hospital care were more likely to have unmet needs for symptom management (aOR = 1.21; 95% CI 1.00-1.47), psychosocial support (aOR = 1.99; 95% CI 1.37-2.88), and religious support (aOR = 1.73; 95% CI 1.08-2.78) than those of patients receiving palliative hospice care. CONCLUSIONS: Caregivers' unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.

Potential of a lactic acid bacterial starter culture with gamma-aminobutyric acid (GABA) activity for production of fermented sausage.

The ability of lactic acid bacterial starter cultures to produce gamma-aminobutyric acid (GABA) during sausage fermentation was studied. Among 305 strains of lactic acid bacteria isolated from kimchi samples, 11 strains were selected as starter candidates based on the following criteria: growth speed, pH lowering ability, and biogenic amine productivity including GABA-producing activity. During in vitro tests, the Y8 (Lactobacillus brevis), O52, and KA20 strains produced 39.00 ± 1.36, 49.73 ± 3.80, and 64.59 ± 0.61 mg/kg of GABA, respectively. Interestingly, although isolate Y8 showed low productivity in vitro, the GABA content it produced during in situ tests (61.30 ± 2.61 mg/kg) was similar to that produced by isolate PM3 (L. brevis) used as positive control (69.64 ± 2.20 mg/kg). Therefore, isolate Y8 was selected as the best functional starter culture for the production of fermented sausage because it exhibited rapid growth, safety, and abundant GABA productivity.

Application of Baechu-Kimchi Powder and GABA-Producing Lactic Acid Bacteria for the Production of Functional Fermented Sausages.

This study was carried out to determine the physicochemical, microbiological, and quality characteristics of a new type of fermented sausage manufactured by incorporating Baechu-kimchi powder and gamma-aminobutyric acid (GABA)-producing lactic acid bacteria (LAB). The LAB count was at the maximum level by day nine of ripening in inoculated sausages, accompanied by a rapid decrease in the pH. The addition of kimchi powder decreased the lightness (L*) and increased the redness (a*) and, yellowness (b*) values, while also significantly increasing the hardness and chewiness of the sausage (p<0.05). Moreover, although the thiobarbituric acid reactive substances values increased in all samples during the study period, this increase was lower in the kimchi-treated samples, indicating a reduction in lipid oxidation. Overall, our results show that the addition of Baechu-kimchi powder to sausages reduced the off-flavor properties and improved the taste profile of the fermented sausage in sensory evaluations. The GABA content of all fermented sausages increased from 17.42-25.14 mg/kg on the third day of fermentation to 60.95-61.47 mg/kg on the thirtieth day. These results demonstrate that Baechu-kimchi powder and GABA-producing LAB could be functional materials in fermented sausage to improve quality characteristics.