The effects of eye movements on the content and characteristics of unpleasant autobiographical memories: an extended replication study.

Experimental studies show that vividness and emotionality of aversive memories decrease after recall with eye movements. We aimed at replicating this finding. Relatedly, consistent with Conway's view that memory retrieval is constructive, we examined changes in the content of the memories. If eye movements render a memory less aversive, it may be avoided less, stimulating recall and increasing the opportunity to infer (contextual) details. Two experiments (N = 97 and N = 250) examined whether eye movements affect the number of central and peripheral memory details and characteristics. Female undergraduate students were randomly allocated to either eye movements with recall (EM) or recall only (RO). Before and after the experimental task, participants rated the vividness and emotionality, provided a detailed description and evaluated other memory characteristics. We replicated earlier findings that vividness (both experiments) and emotionality (experiment 2) were reduced more after EM compared to RO. However, conditions did not statistically significantly differ with respect to content details and other memory characteristics. Overall, findings support the idea that eye movements decrease the experience of the memory as vivid and emotional. Results are inconclusive regarding the idea that eye movements alter the number of recalled central and peripheral memory details.

Anger Responses in Adolescents: Relationship with Punishment and Reward Sensitivity.

A substantial proportion of youth with anxiety disorders shows comorbid behavioral (anger) problems. Such comorbid profile is associated with low treatment effectiveness and negative (longterm) outcomes. This study was therefore designed to examine trait factors that may promote anger responding in adolescents. By presenting participants (N = 158, mean age = 15.7, 56% female) with a series of common anger-eliciting situations, we tested whether high reward sensitivity would be associated with anger via perceived non-reward, and high punishment sensitivity via perceived threat. In line with the hypotheses, an indirect effect of reward sensitivity on anger was found via perceived non-reward, and an indirect effect of punishment sensitivity on anger via perceived threat. The latter association also had an indirect effect via perceived non-reward. High punishment and reward sensitivity may thus set adolescents at risk for developing (comorbid) anger problems via heightened threat and non-reward perceptions.

Critical review of methods for risk ranking of food-related hazards, based on risks for human health.

This study aimed to critically review methods for ranking risks related to food safety and dietary hazards on the basis of their anticipated human health impacts. A literature review was performed to identify and characterize methods for risk ranking from the fields of food, environmental science and socio-economic sciences. The review used a predefined search protocol, and covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references deemed relevant, on the basis of predefined evaluation criteria, were included in the review, and the risk ranking method characterized. The methods were then clustered-based on their characteristics-into eleven method categories. These categories included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, health adjusted life years (HALY), multi-criteria decision analysis, risk matrix, flow charts/decision trees, stated preference techniques and expert synthesis. Method categories were described by their characteristics, weaknesses and strengths, data resources, and fields of applications. It was concluded there is no single best method for risk ranking. The method to be used should be selected on the basis of risk manager/assessor requirements, data availability, and the characteristics of the method. Recommendations for future use and application are provided.

Control of human pathogenic Yersinia enterocolitica in minced meat: Comparative analysis of different interventions using a risk assessment approach.

This study aimed to evaluate the effect of different processing scenarios along the farm-to-fork chain on the contamination of minced pork with human pathogenic Y. enterocolitica. A modular process risk model (MPRM) was used to perform the assessment of the concentrations of pathogenic Y. enterocolitica in minced meat produced in industrial meat processing plants. The model described the production of minced pork starting from the contamination of pig carcasses with pathogenic Y. enterocolitica just before chilling. The endpoints of the assessment were (i) the proportion of 0.5 kg minced meat packages that contained pathogenic Y. enterocolitica and (ii) the proportion of 0.5 kg minced meat packages that contained more than 10³ pathogenic Y. enterocolitica at the end of storage, just before consumption of raw pork or preparation. Comparing alternative scenarios to the baseline model showed that the initial contamination and different decontamination procedures of carcasses have an important effect on the proportion of highly contaminated minced meat packages at the end of storage. The addition of pork cheeks and minimal quantities of tonsillar tissue into minced meat also had a large effect on the endpoint estimate. Finally, storage time and temperature at consumer level strongly influenced the number of highly contaminated packages.

A QMRA Model for Salmonella in Pork Products During Preparation and Consumption.

As part of a quantitative microbiological risk assessment (QMRA) food chain model, this article describes a model for the consumer phase for Salmonella-contaminated pork products. Three pork products were chosen as a proxy for the entire pork product spectrum: pork cuts, minced meat patties, and fermented sausages. For pork cuts cross-contamination is considered the most important process and therefore it is modeled in detail. For minced meat, both cross-contamination and undercooking are the relevant processes. For those commodities bacterial growth during transport and storage is also modeled. Fermented sausages are eaten raw and the production may be defective. Variability between consumers' behavior and the impact of variability between production processes at the farm and abattoir are taken into account. Results indicate that Salmonella levels on products may increase significantly during transport and storage. Heating is very efficient at lowering concentrations, yet cross-contamination plays an important role in products that remain contaminated. For fermented sausage it is found that drying is important for Salmonella reduction. Sensitivity analysis revealed that cross- contamination factors "knife cleaning" and "preparation of a salad" are important parameters for pork cuts. For minced meat cleaning of the board, salad consumption, refrigerator temperature, and storage time were significant.

Intestinal colonization of broiler chickens by Campylobacter spp. in an experimental infection study.

Consumption of poultry meat is considered as one of the main sources of human campylobacteriosis, and there is clearly a need for new surveillance and control measures based on quantitative data on Campylobacter spp. colonization dynamics in broiler chickens. We conducted four experimental infection trials, using four isolators during each infection trial to evaluate colonization of individual broiler chickens by Campylobacter jejuni over time. Individual and pooled faecal samples were obtained at days 4, 7 and 12 post-inoculation (p.i.) and caecal samples at day 12 p.i. There were large differences between broiler chickens in the number of C. jejuni in caecal and faecal material. Faecal samples of C. jejuni ranged from 4·0 to 9·4 log c.f.u./g and from 4·8 to 9·3 log c.f.u./g in the caeca. Faecal c.f.u./g decreased with time p.i. Most variation in c.f.u. for faecal and caecal samples was attributed to broiler chickens and a minor part to isolators, whereas infection trials did not affect the total variance. The results showed that pooled samples within isolators had lower c.f.u./g compared to the arithmetic mean of the individual samples. There was a significant correlation between faecal c.f.u./g at days 4 and 7 p.i., days 7 and 12 p.i. and for caecal and faecal c.f.u./g at day 12 p.i.

Estimating the true incidence of campylobacteriosis and salmonellosis in the European Union, 2009.

We estimated the true incidence of campylobacteriosis and salmonellosis in the European Union (EU) in 2009. The estimate was based on disease risks of returning Swedish travellers, averaged over the years 2005-2009, and anchored to a Dutch population-based study on incidence and aetiology of gastroenteritis. For the 27 EU member states the incidence of campylobacteriosis was about 9·2 (95% CI 2·8-23) million cases, while the incidence of salmonellosis was 6·2 (95% CI 1·0-19) million cases. Only 1/47 (95% CI 14-117) cases of campylobacteriosis and one 1/58 (95% CI 9-172) cases of salmonellosis were reported in the EU. The incidence rate of campylobacteriosis in EU member states varied between 30 and 13 500/100 000 population and was significantly correlated with the prevalence of Campylobacter spp. in broiler chickens. The incidence rate of salmonellosis in EU member states varied between 16 and 11 800/100 000 population and was significantly correlated with the prevalence of Salmonella Enteritidis in laying hens.

Obstetric outcome of ethnic Turkish women in London: a retrospective case-control study.

There is concern that the maternal mortality in ethnic minority women is significantly greater than that of Caucasian British women. The objective of this study was to compare the demographic and obstetric outcomes between these two groups. Data were collected retrospectively over a 2-year period from 148 index and 148 control cases. The study group had statistically similar maternal age, labour duration, blood loss and mode of delivery compared with Caucasian British women (p > 0.05). A total of 68% of Turkish women spoke little or no English; were more likely to be non-smokers and also more likely to be married to unemployed spouses (p = 0.0001). This is the first study comparing obstetric outcomes of immigrant Turkish women with their Caucasian British counterparts. There was no significant difference in maternal or fetal outcomes, which could be attributed to the 'healthy migrant' theory, coupled with increased vigilance in ethnic minority pregnancies.

Co-occurrence of social anxiety and depression symptoms in adolescence: differential links with implicit and explicit self-esteem?

BACKGROUND: Social anxiety and depression often co-occur. As low self-esteem has been identified as a risk factor for both types of symptoms, it may help to explain their co-morbidity. Current dual process models of psychopathology differentiate between explicit and implicit self-esteem. Explicit self-esteem would reflect deliberate self-evaluative processes whereas implicit self-esteem would reflect simple associations in memory. Previous research suggests that low explicit self-esteem is involved in both social anxiety and depression whereas low implicit self-esteem is only involved in social anxiety. We tested whether the association between symptoms of social phobia and depression can indeed be explained by low explicit self-esteem, whereas low implicit self-esteem is only involved in social anxiety. METHOD: Adolescents during the first stage of secondary education (n=1806) completed the Revised Child Anxiety and Depression Scale (RCADS) to measure symptoms of social anxiety and depression, the Rosenberg Self-Esteem Scale (RSES) to index explicit self-esteem and the Implicit Association Test (IAT) to measure implicit self-esteem. RESULTS: There was a strong association between symptoms of depression and social anxiety that could be largely explained by participants' explicit self-esteem. Only for girls did implicit self-esteem and the interaction between implicit and explicit self-esteem show small cumulative predictive validity for social anxiety, indicating that the association between low implicit self-esteem and social anxiety was most evident for girls with relatively low explicit self-esteem. Implicit self-esteem showed no significant predictive validity for depressive symptoms. CONCLUSIONS: The findings support the view that both shared and differential self-evaluative processes are involved in depression and social anxiety.

Modelling transfer of Salmonella Typhimurium DT104 during simulation of grinding of pork.

AIMS: The aim of this study was to develop a model to predict cross-contamination of Salmonella during grinding of pork. METHODS AND RESULTS: Transfer rates of Salmonella were measured in three experiments, where between 10 and 20 kg meat was ground into 200-g portions. In each experiment, five pork slices of about 200 g per slice were inoculated with 8-9 log-units of Salmonella Typhimurium DT104 and used for building up the contamination in the grinder. Subsequently, Salmonella-free slices were ground and collected as samples of c. 200 g minced pork. Throughout the process, representative samples were quantitatively analysed for Salmonella. A model suggested by Nauta et al. (2005) predicting cross-contamination of Campylobacter in poultry processing and two modified versions of this model were tested. CONCLUSIONS: The present study observed a tailing phenomenon of transfer of Salmonella during a small-scale grinding process. It was, therefore, hypothesized that transfer occurred from two environmental matrices inside the grinder and a model was developed. The developed model satisfactorily predicted the observed concentrations of Salmonella during its cross-contamination in the grinding of up to 110 pork slices. SIGNIFICANCE AND IMPACT OF THE STUDY: The proposed model provides an important tool to examine the effect of cross-contamination in quantitative microbial risk assessments and might also be applied to various other food processes where cross-contamination is involved.

The obstetric performance of Chinese immigrants residing in the UK.

Although the Confidential Enquiry into Maternal Deaths raised concerns that immigrant women have significantly poorer obstetric outcomes when compared to native women, there is little published data on the obstetric outcomes of Chinese immigrants living in the UK. This retrospective, case-control study compared maternal demographics and obstetric outcomes of Chinese with British Caucasian women matched for parity and age, who served as controls. Data from 125 index and 125 control cases were analysed. A total of 74% of the Chinese women had little or no understanding of English. The Chinese women were more likely to be non-smokers, have a lower BMI and be unemployed than their British counterparts (p<0.001). They booked later (21.01 vs 15.35 weeks, p<0.0001) and attended on average one less antenatal clinic than controls (p<0.001). Chinese women were also less likely to deliver by caesarean section (p<0.05), but more likely to have a perineal tear (p<0.005). Pre-defined risk, gestation at delivery, birth weight, duration of labour, estimated blood loss and mean 5 min Apgar scores were comparable in both groups (p>0.05). In conclusion, there are significant differences in access to healthcare and the method of delivery, but overall, the obstetric outcomes of both ethnic groups are highly similar. This may be due to the 'healthy immigrant effect' or the increased use of interpreters and linkworkers in obstetric healthcare.

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. Fischer's exact test (two-tailed), student's t test and Pearson's chi-square test, odds ratio and 95% confidence interval were used to compare the two groups statistically. RESULTS: There were 91 unbooked births in the 18 month study period. Unbooked mothers were younger (26.0 +/- 6.68 vs. 29.2 +/- 6.10 years, p < 0.0001), more likely to be unemployed, unmarried and non-English speaking compared to matched booked mothers (all p < 0.01). The rate of Caesarean sections ([OR] = 0.85, 95% [CI] = 0.39-1.88), p > 0.05), birth asphyxia, Apgar scores <7 at 1 min ([OR] = 1.10, 95% [CI] = 0.52-2.35, p = 0.80) and intrauterine foetal death (stillbirth) ([OR] = 2.03, 95% [CI] = 0.28-14.60, p = 0.60) were comparable between the two groups. However, unbooked mothers were five times more likely to have preterm delivery ([OR] = 6.44, 95% [CI] = 2.24-18.50, p < 0.0002); three times more likely to have low birth weight babies (<2,500 g) ([OR] = 2.87, 95% [CI] = 1.21-6.82, p < 0.02) and twice as likely to have postpartum haemorrhage ([OR] = 1.85, 95% [CI] = 0.69-4.98, p = 0.3). CONCLUSION: Unbooked women were more at risk of adverse foetal and maternal outcomes than booked women, even within a population of young, relatively healthy immigrant women.

Growth of Listeria monocytogenes in ready-to-eat "shrimp cocktail": Risk assessment and possible preventive interventions.

The present study investigated the presence, growth potential, and public health risk posed by Listeria monocytogenes in a ready-to-eat "shrimp cocktail". The pathogen was detected in 4 out of the 104 samples, and there were no counts above the enumeration limit (1 Log colony-forming unit (CFU)/g); the product was a suitable substrate for pathogen growth owing to its chemical/physical properties. A stochastic quantitative microbial risk assessment (QMRA) was performed to estimate the expected number of invasive listeriosis cases caused by the consumption of 10,000 servings of the product on the last day of its shelf life, considering a population comprising healthy consumers, those susceptible, and transplant recipients. The model predicted no cases for this scenario. Uncertainties were included by considering alternative scenarios; even when considering an increased mean bacterial concentration (up to 3-4 Log CFU/g), no cases were estimated. Following a producer's demand, the exposure assessment model was also used to estimate the probability of the product exceeding the threshold of 2 log CFU/g during the shelf life. The possibility of Listeria growth in the product could not be avoided. Therefore, a modification of the production process was tested to re-classify the product as unsuitable for Listeria growth (EC Reg. 2073/2005). The shrimps were conditioned in three different organic acid solutions comprising: acetic acid (1500 ppm) (A); benzoic acid (1500 ppm) + acetic acid (500 ppm) + lactic acid (750 ppm) (BLA); and lactic acid (4500 ppm) + sodium acetate (2500 ppm) (LSA). Testing was conducted over various treatment durations (1 day-5 days). Treatment for 2 days in the LSA solution was selected based on efficacy, the absence of consumer-perceptible sensorial modifications, and the producers' production rate requirements. The concentration of L. monocytogenes decreased when the new process was applied, which confirmed the usefulness and effectiveness of the treatment relative to the traditional process. Thus, the product obtained by the modified production process did not support the growth of L. monocytogenes.

Attentional Bias for Cues Signaling Punishment and Reward in Adolescents: Cross-Sectional and Prognostic Associations with Symptoms of Anxiety and Behavioral Disorders.

Heightened reward sensitivity has been proposed as a risk factor for developing behavioral disorders whereas heightened punishment sensitivity has been related to the development of anxiety disorders in youth. Combining a cross-sectional (n = 696, mean age = 16.14) and prospective (n = 598, mean age = 20.20) approach, this study tested the hypotheses that an attentional bias for punishing cues is involved in the development of anxiety disorders and an attentional bias for rewarding cues in the development of behavioral disorders. A spatial orientation task was used to examine the relation between an attentional bias for punishing cues and an attentional bias for rewarding cues with anxiety and behavioral problems in a subsample of a large prospective population cohort study. Our study indicates that attentional biases to general cues of punishment and reward do not seem to be important risk factors for the development of anxiety or behavioral problems respectively. It might be that attentional biases play a role in the maintenance of psychological problems. This remains open for future research.

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. This review was, therefore, undertaken with the aim of increasing awareness of such variations, in order to promote more holistic management, and ultimately to enhance patient care.

Risk-Benefit Assessment of Foods.

Food is an elementary requirement for human life, providing nutrients and essential energy needed for optimal health. But at the same time, food can also be a vehicle of hazardous substances or pathogens that could affect human health negatively. Risk-benefit assessment (RBA) of foods, a relatively new methodology for decision support, integrates nutrition, toxicology, microbiology, chemistry and human epidemiology for a comprehensive health impact assessment. By integrating health risks and benefits related to food consumption, RBA facilitates science-based decision-making in food-related areas and the development of policies and consumer advice. The present work programme aimed to allow the fellow to become acquainted with the process of RBA and the associated tools needed to assess quantitatively the risks and the benefits through three main activities (i) to learn the different methodologies used for RBA; (ii) to apply these methodologies to a specific case-study - RBA of raw milk consumption; and (iii) to participate in the main activities of the Risk-Benefit research group at DTU Food regarding risk-benefit issues. For the RBA of raw milk consumption, microbiological pathogens (Listeria monocytogenes, Salmonella spp., Campylobacter jejuni and Shiga toxin-producing Escherichia coli), probiotic bacteria and nutritional components (vitamins B2 and A) were considered, as well as the potential impact of raw milk consumption in the reduction of the allergies' prevalence. Two major approaches were applied: the bottom-up (estimating the disease incidence due to the exposure) and the top-down (using epidemiological and incidence data to the estimate the number of cases attributable to a certain exposure). Through all the training and hands-on activities performed, the present work programme enabled the fellow to extend the knowledge on the quantitative RBA, specifically in the context of raw milk consumption. EU-FORA programme also provided an exceptional opportunity of networking and establishment of future research lines of collaboration.

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. casei was chosen as the safe tracer organism. Salads containing chicken breast fillet contaminated with a known number of C. jejuni and L. casei were prepared according to different cross-contamination scenarios and contamination levels of salads were determined. Cross-contamination could be strongly reduced when cleaning cutting board and cutlery with hot water (68 degrees C), but generally was not prevented using consumer-style cleaning methods for hands and cutting board. CONCLUSIONS: Dish-washing does not sufficiently prevent cross-contamination, thus different cutting boards for raw meat and other ingredients should be used and meat-hand contact should be avoided or hands should be thoroughly cleaned with soap. Lactobacillus casei can be used as a safe tracer organism for C. jejuni in consumer observational studies. SIGNIFICANCE AND IMPACT OF THE STUDY: Cross-contamination plays an important role in the transmission of food-borne illness, especially for C. jejuni. This study delivers suitable data to quantitatively assess the risk of campylobacteriosis caused by cross-contamination and it shows the effect of different preventive hygiene measures.

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. This study showed that transfer characteristics for both micro-organisms were comparable when washing regimes and transfer via items (cutting board, hands and knives) were compared. Furthermore, the study showed that the use of separate transfer rates for transfer from chicken to items and from items to salad will lead to an overestimation of campylobacteriosis risk. Applying good hygienic practices resulted in final levels of bacteria in the salad below the detection limit. Our study showed that it is important to include these data points in model fitting. CONCLUSIONS: Results obtained in observational studies with Lact. casei can be translated to Camp. jejuni using the transfer rates obtained in this study. Cross-contamination by hands, cutting boards and knives was equally important. SIGNIFICANCE AND IMPACT OF THE STUDY: Cross-contamination should be incorporated in microbiological risk assessments. The present study contributes to this by quantifying transfer of Camp. jejuni and Lact. casei from raw chicken via various contact surfaces into the ready-to-eat product.

Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes.

Anxiety-focused cognitive-behavioral therapy (CBT) effectively reduces anxiety in children and adolescents. An important remaining question is to what extent anxiety-focused CBT also affects broader outcome domains. Additionally, it remains unclear whether parental involvement in treatment may have impact on domains other than anxiety. A meta-analysis (nstudies = 42, nparticipants = 3239) of the effects of CBT and the moderating role of parental involvement was conducted on the following major secondary outcomes: depressive symptoms, externalizing behaviors, general functioning, and social competence. Randomized controlled trials were included when having a waitlist or active control condition, a youth sample (aged<19) with a primary anxiety disorder diagnosis receiving anxiety-focused CBT and reported secondary outcomes. Controlled effect sizes (Cohen's d) were calculated employing random effect models. CBT had a large effect on general functioning (-1.25[-1.59;0.90], nstudies = 17), a small to moderate effect on depressive symptoms (-0.31[-0.41;-0.22], nstudies = 31) and a small effect on externalizing behaviors (-0.23[-0.38;-0.09], nstudies = 12) from pre-to post-treatment. Effects remained or even further improved at follow-up. Social competence only improved at follow-up (nstudies = 6). Concluding, anxiety-focused CBT has a positive effect on broader outcome domains than just anxiety. Higher parental involvement seemed to have beneficial effects at follow-up, with improvements in general functioning and comorbid symptoms.