A qualitative risk assessment for visual-only post-mortem meat inspection of cattle, sheep, goats and farmed/wild deer

The UK Food Standards Agency is currently funding research to build the evidence base for the modernisation of meat inspection. This includes an assessment of the risks to public health and animal health/welfare of moving to a visual-only post-mortem meat inspection (PMMI), where routine mandatory palpation and incision procedures are omitted. In this paper we present the results of a risk assessment for a change from current to visual-only PMMI for cattle, sheep/goats and farmed/wild deer. A large list of hazard/species pairings were assessed and prioritised by a process of hazard identification. Twelve hazard/species pairings were selected for full consideration within the final risk assessment. The results of the public health risk assessment indicated that all hazard/species pairings were Negligible with the exception of Cysticercus bovis in cattle, which was judged to be of low-medium increased risk for systems not conforming to criteria as laid down by EC Regulation 1244/2007, compared to systems that do conform to Regulations for visual-only PMMI. Most hazard/species pairings were concluded to pose a potential increased risk to animal health/welfare, including Mycobacterium bovis (very low – low increase in risk, but with considerable uncertainty), Fasciola hepatica (negligible – very low) and Cysticercus bovis (very low – low). Due to low feedback rates to farmers, the real risk to animal health/welfare for F. hepatica and C. bovis, including animals in non-conforming systems under visual-only PMMI, is probably negligible. That then leaves M. bovis as the only confirmed non-negligible animal health and welfare risk

Cultural specificity versus institutional universalism: a critique of the National Integrity System (NIS) methodology

This article provides an assessment and critique of the National Integrity System approach and methodology, informed by the experience of conducting an NIS review in Cambodia. It explores four key issues that potentially undermine the relevance and value of NIS reports for developing democracies: the narrowly conceived institutional approach underpinning the NIS methodology; the insufficient appreciation of cultural distinctiveness; a failure properly to conceptualise and articulate the very notion of ‘integrity’; and an over emphasis on compliance-based approaches to combating corruption at the expense of the positive promotion of integrity. The article seeks to offer some pointers to how the NIS approach could be adapted to broaden its conceptualisation of institutions and integrity, and thereby provide reports that are more theoretically informed as well as being more constructive and actionable

Vulnerability to natural disasters in Serbia: spatial and temporal comparison

The frequency of natural disasters and the extent of their consequences at a global level are constantly increasing. This trend is partially caused by increased population vulnerability, which implies the degree of population vulnerability due to high magnitude natural processes. This paper presents an analysis of vulnerability to natural disaster in Serbia in the second half of the twentieth and the early twenty-first century. Vulnerability changes were traced on the basis of demographic–economic indicators derived from statistical data for local government units (municipalities) provided by the Statistical Office of the Republic of Serbia. Calculations were performed in the geographical information system environment. The results of the study show that spatial and temporal vulnerability variations are causally correlated with changes in the selected components. Significant rise of vulnerability is related to urban areas, while lower values are characteristic for other areas of Serbia; this is primarily a consequence of different population density

Cluster analysis of higher-education competitiveness in selected European countries

The subject of research in this paper is higher-education competitiveness on account of its impact on the enhancement of social and economic competitiveness, as well as on the growth of human capital and creation of social knowledge. The purpose of this paper is to group the selected European countries according to higher-education competitiveness, by means of the hierarchical cluster analysis method, with a special focus on the position of Serbia. Higher-education competitiveness in the chosen countries is analysed by means of three indicators of competitiveness: the ratio of the number of students per number of inhabitants, the number of students per number of employed, as well as the amount of budgetary funds allocated per student. The research results indicate different higher-education competitiveness in the analysed countries and also the fact that, according to this analysis, Serbia is in the group of countries with low competitiveness of higher education

Head and neck cancer surgery during the COVID-19 pandemic: An international, multicenter, observational cohort study

Background: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19–positive patients and infections in the surgical team were determined by univariate analysis. Results: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. Conclusions: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Lay Summary: Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross-infection controls and effective personal protective equipment

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes