The impact of consumer phase models in microbial risk analysis.

In quantitative microbiological risk assessment (QMRA), the consumer phase model (CPM) describes the part of the food chain between purchase of the food product at retail and exposure. Construction of a CPM is complicated by the large variation in consumer food handling practices and a limited availability of data. Therefore, several subjective (simplifying) assumptions have to be made when a CPM is constructed, but with a single CPM their impact on the QMRA results is unclear.

Automatic evaluations in clinically anxious and nonanxious children and adolescents.

Automatic evaluations of clinically anxious and nonanxious children (n = 40, aged 8-16, 18 girls) were compared using a pictorial performance-based measure of automatic affective associations. Results showed a threat-related evaluation bias in clinically anxious but not in nonanxious children. In anxious participants, automatic evaluations of anxiety-relevant stimuli were more negative than those of negative stimuli.

Updating parameters of the chicken processing line model.

A mathematical model of chicken processing that quantitatively describes the transmission of Campylobacter on chicken carcasses from slaughter to chicken meat product has been developed in Nauta et al. (2005). This model was quantified with expert judgment.

Evaluation of the "testing and scheduling" strategy for control of Campylobacter in broiler meat in The Netherlands.

"Testing and scheduling" has been proposed as a strategy for control of Campylobacter in broiler meat. By this strategy, flocks with high numbers of Campylobacter in fecal samples would be diverted away from fresh meat production at the entrance of the broiler meat processing plant. Risk assessment studies suggest that this would effectively decrease human health risks, if these flocks are responsible for the meat products with the highest Campylobacter numbers.

Risk analysis by FMEA as an element of analytical validation.

We subjected a Near-Infrared (NIR) analytical procedure used for screening drugs on authenticity to a Failure Mode and Effects Analysis (FMEA), including technical risks as well as risks related to human failure. An FMEA team broke down the NIR analytical method into process steps and identified possible failure modes for each step. Each failure mode was ranked on estimated frequency of occurrence (O), probability that the failure would remain undetected later in the process (D) and severity (S), each on a scale of 1-10.

Behavioral parent training as an adjunct to routine care in children with attention-deficit/hyperactivity disorder: moderators of treatment response.

Objective: To investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone.

Methods: We randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC or RCC alone. Outcome was based on parent-reported behavioral problems and ADHD symptoms.

Effectiveness of an emotion regulation group training for adolescents--a randomized controlled pilot study.

Emotion Regulation Training (ERT) was developed for adolescents with symptoms of borderline personality disorder (BPD) and emotion dysregulation. ERT is an adaptation of the Systems Training for Emotional Predictability and Problem Solving (STEPPS) programme. This paper describes the background of the programme, and gives an outline of the treatment programme.

Codeine-acetaminophen versus nonsteroidal anti-inflammatory drugs in the treatment of post-abdominal surgery pain: a systematic review of randomized trials.

Background: Cesarean section, episiotomy, and third and perineal tears are associated with significant tissue damage, causing pain in the immediate postpartum period. The current standard in North America is to prescribe oral acetaminophen/codeine (A + C) for postpartum pain. Codeine has opioid-related adverse effects and may not be safe during breastfeeding in the postpartum period for all neonates.

The unbooked mother: a cohort study of maternal and foetal outcomes in a North London Hospital.

Objective: The aim of the study was to determine the pregnancy outcome of unbooked compared to booked women of similar parity and ethnic background over a period of 18 months at the North Middlesex University Hospital (NMUH), London.

Methods: A retrospective cohort study from September 2006 to March 2008 comparing the socio-demographics, foetal and maternal outcomes of pregnancies of unbooked versus booked women. Women who received no antenatal care or who delivered within 3 days of the initial booking visit were categorized as 'unbooked' while the next delivered women on the labour ward register (matched for ethnicity and parity) who booked prior to the second trimester served as comparison.

Transcultural considerations in obstetrics and gynaecology: what the clinician needs to know.

Healthcare professionals working in the field of obstetrics and gynaecology may encounter patients from a variety of cultural backgrounds, particularly in our inner cities. These women may have similar cultural beliefs and values about aspects of care they experience compared with native women, but they may also have differing beliefs and may present with preconceptions about the care they expect to receive. In our experience, traditional medical training has limited core teaching on the existence of such cultural variations, and professionals often only experience them through working in the clinical setting.

Cooking practices in the kitchen-observed versus predicted behavior.

Cross-contamination and undercooking are major factors responsible for campylobacteriosis and as such should be incorporated in microbiological risk assessment. A previous paper by van Asselt et al.((1)) quantified cross-contamination routes from chicken breast fillet via hand, cutting board, and knife ending up in a prepared chicken-curry salad in the domestic kitchen.

A comparison of risk assessments on Campylobacter in broiler meat.

In recent years, several quantitative risk assessments for Campylobacter in broiler meat have been developed to support risk managers in controlling this pathogen. The models encompass some or all of the consecutive stages in the broiler meat production chain: primary production, industrial processing, consumer food preparation, and the dose-response relationship. The modelling approaches vary between the models, and this has supported the progress of risk assessment as a research discipline.

Child versus family cognitive-behavioral therapy in clinically anxious youth: an efficacy and partial effectiveness study.

Objective: The efficacy and partial effectiveness of child-focused versus family-focused cognitive-behavioral therapy (CBT) for clinically anxious youths was evaluated, in particular in relation to parental anxiety disorders and child's age.

Method: Clinically referred children with anxiety disorders (N = 128) and their parents were randomly assigned to child or family CBT and evaluated at pretreatment, posttreatment, and 3-month follow-up. Twenty-five families were measured before and after a 2- to 3-month waitlist period.

Costs and cost-effectiveness of family CBT versus individual CBT in clinically anxious children.

The objective of this study was to investigate the cost-effectiveness of family cognitive-behavioral therapy (CBT) compared with individual CBT in children with anxiety disorders. Clinically anxious children (aged 8-18 years) referred for treatment were randomly assigned to family or individual CBT and were assessed pre-treatment, post treatment, and at 3 months and 1 year after treatment. Cost-effectiveness ratios were calculated expressing the incremental costs per anxiety-free child and the incremental costs per Quality Adjusted Life Year (QALY) for the referred child.

Cross-contamination in the kitchen: estimation of transfer rates for cutting boards, hands and knives.

Aims: To quantify cross-contamination in the home from chicken to ready-to-eat salad.

Methods And Results: Based on laboratory scenarios performed by de Jong et al. (2008), transfer rates were estimated for Campylobacter jejuni and Lactobacillus casei as a tracer organism.

Cross-contamination in the kitchen: effect of hygiene measures.

Aims: To determine the effect of hygiene measures on cross-contamination of Campylobacter jejuni at home and to select a safe tracer organism for C. jejuni.

Methods And Results: Comparative tests were conducted with nonpathogenic Escherichia coli and Lactobacillus casei and L.

Food safety in the domestic environment: the effect of consumer risk information on human disease risks.

The improvement of food safety in the domestic environment requires a transdisciplinary approach, involving interaction between both the social and natural sciences. This approach is applied in a study on risks associated with Campylobacter on broiler meat. First, some web-based information interventions were designed and tested on participant motivation and intentions to cook more safely.

Food safety in the domestic environment: an interdisciplinary investigation of microbial hazards during food preparation.

It has been established that, to a considerable extent, the domestic hygiene practices adopted by consumers can result in a greater or lesser microbial load in prepared meals. In the research presented here, an interdisciplinary study is reported in which interviews, observations of consumers preparing a recipe, and microbial contamination of the finished meals were compared. The results suggest that, while most consumers are knowledgeable about the importance of cross-contamination and heating in preventing the occurrence of foodborne illness, this knowledge is not necessarily translated into behavior.

A risk assessment model for Campylobacter in broiler meat.

A quantitative microbiological risk assessment model describes the transmission of Campylobacter through the broiler meat production chain and at home, from entering the processing plant until consumption of a chicken breast fillet meal. The exposure model is linked to a dose-response model to allow estimation of the incidence of human campylobacteriosis. The ultimate objective of the model is to serve as a tool to assess the effects of interventions to reduce campylobacteriosis in the Netherlands.

Effectiveness and efficiency of controlling Campylobacter on broiler chicken meat.

Campylobacter bacteria are an important cause of foodborne infections. We estimated the potential costs and benefits of a large number of possible interventions to decrease human exposure to Campylobacter by consumption of chicken meat, which accounts for 20-40% of all cases of human campylobacteriosis in the Netherlands. For this purpose, a farm-to-fork risk assessment model was combined with economic analysis and epidemiological data.

Cross-contamination during food preparation: a mechanistic model applied to chicken-borne Campylobacter.

We develop a model for bacterial cross-contamination during food preparation in the domestic kitchen and apply this to the case of Campylobacter-contaminated chicken breast. Building blocks of the model are the routines performed during food preparation, with their associated probabilities of bacterial transfer between food items and kitchen utensils. The model is used in a quantitative microbiological risk assessment (QMRA) of Campylobacter in the Netherlands.

Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London.

Aims: The aim of this study was to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants.

Background: Peridontal disease is associated with an increased risk of adverse pregnancy outcomes. The aim of this study is to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants.

Effectiveness of behavioral parent training for children with ADHD in routine clinical practice: a randomized controlled study.

Objective: To investigate the effectiveness of behavioral parent training (BPT) as adjunct to routine clinical care (RCC).

Method: After a first phase of RCC, 94 children with attention-deficit/hyperactivity disorder (ADHD) ages 4-12, all referred to a Dutch outpatient mental health clinic, were randomly assigned to 5 months of BPT plus concurrent RCC (n = 47) or to 5 months of RCC (n = 47) alone. BPT consisted of 12 sessions in group format; RCC included family support and pharmacotherapy when appropriate.