Chorleywood bread process last requirement means that it is difficult to reproduce CBP in a small-scale kitchen. The CBP is only a method of producing quick-ripened bread dough. Large-scale bread-making with automated processes pre-dates the CBP by at least a century. Flour, water, yeast, salt, fat, and, where used, minor ingredients common to many bread-making techniques such as Vitamin C, emulsifiers and enzymes are mechanically mixed for about three minutes. The high-shear mixing generates high temperatures in the dough, which is cooled in some advanced mixers using a cooling jacket. Chilled water or ice may also be used to counteract the temperature rise
Shared decision-making in medicine Shared decision-making in medicine Shared decision-making in medicine (SDM) is a process in which both the patient and physician contribute to the medical decision-making process. Health care providers explain treatments and alternatives to patients and help them choose the treatment option that best aligns with their preferences as well as their unique cultural and personal beliefs. In contrast to SDM, the traditional biomedical care system placed physicians in a position of authority with patients playing a passive role in care. Physicians instructed patients about what to do, and patients rarely took part in the treatment decision. One of the first