Evaluation of QMRA performance for Listeria monocytogenes in cold smoked salmon

Food-borne listeriosis, caused by Listeria monocytogenes (Lm), is relatively rare but the relatively high rate of fatality (20-30%) compared to other food-borne microbial pathogens such as Salmonella makes it a serious disease. The foodstuff is recognised as the primary route of transmission for human exposure. A wide variety of food or raw material may become contaminated with Lm but the majority of listeriosis cases are related to ready-to-eat (RTE) food. The important factor related to food-borne listeriosis is that Lm can grow under low (refrigerated) temperatures when given sufficient time. Therefore, RTE products with long shelf life are under risk with respect to growth of Lm to critical concentrations. A stochastic model for the growth of Lm with the inhibiting effect of lactic acid bacteria (LAB) in cold smoked salmon (CSS) was developed. An existing deterministic model for the growth of Lm was adapted by adding the Winner stochastic process in order to simulate the growth of Lm. The Poisson distribution is used to represent the initial count (occurrence) of Lm. A deterministic model for growth of LAB is used and the inhibiting effects of Lm and LAB on each other are taken into account. The Beta-Poisson model is used for estimating the dose response. The model has been tested during field trials with CSS performed in August 2010. The salmon was slaughtered in Norway and transported to France where it was processed. The model, implemented within the QMRA module, indicated that growth of Lm would occur in the CSS samples investigated. However, the data obtained during the field trial showed that microbial cell counts implied a reduction in the population of Lm with storage time, which means that a different model to describe the growth of Lm in presence of LAB may be required, especially for lower concentrations of Lm

The Reality of Neandertal Symbolic Behavior at the Grotte du Renne, Arcy-sur-Cure, France

The question of whether symbolically mediated behavior is exclusive to modern humans or shared with anatomically archaic populations such as the Neandertals is hotly debated. At the Grotte du Renne, Arcy-sur-Cure, France, the Châtelperronian levels contain Neandertal remains and large numbers of personal ornaments, decorated bone tools and colorants, but it has been suggested that this association reflects intrusion of the symbolic artifacts from the overlying Protoaurignacian and/or of the Neandertal remains from the underlying Mousterian

Assessing and managing concurrent hearing, vision and cognitive impairments in older people: an international perspective from healthcare professionals

Background: there is a significant gap in the understanding, assessment and management of people with dementia and concurrent hearing and vision impairments. / Objective: from the perspective of professionals in dementia, hearing and vision care, we aimed to: (1) explore the perceptions of gaps in assessment and service provision in ageing-related hearing, vision and cognitive impairment; (2) consider potential solutions regarding this overlap and (3) ascertain the attitudes, awareness and practice, with a view to implementing change. / Methods: our two-part investigation with hearing, vision, and dementia care professionals involved: (1) an in-depth, interdisciplinary, international Expert Reference Group (ERG; n = 17) and (2) a wide-scale knowledge, attitudes and practice survey (n = 653). The ERG involved consensus discussions around prototypic clinical vignettes drawn from a memory centre, an audiology clinic, and an optometry clinic, analysed using an applied content approach. / Results: the ERG revealed several gaps in assessment and service provision, including a lack of validated assessment tools for concurrent impairments, poor interdisciplinary communication and care pathways, and a lack of evidence-based interventions. Consensus centred on the need for flexible, individualised, patient-centred solutions, using an interdisciplinary approach. The survey data validated these findings, highlighting the need for clear guidelines for assessing and managing concurrent impairments. / Conclusions: this is the first international study exploring professionals’ views of the assessment and care of individuals with age-related hearing, vision and hearing impairment. The findings will inform the adaptation of assessments, the development of supportive interventions, and the new provision of services

Rhythms of walking : history and presence in a city street

Peer reviewedPostprin

A core outcome set for nonpharmacological community-based interventions for people living with dementia at home: A systematic review of outcome measurement instruments

YesIt is questionable whether existing outcome measurement instruments (OMIs) in dementia research reflect what key stakeholders' value. We attained consensus from over 300 key stakeholders, including people living with dementia, and identified 13 core outcome items for use in nonpharmacological and community-based interventions for people with dementia living at home. In this systematic review we review OMIs that have previously been used in dementia care research to determine how, or even if, the 13 core outcome items can be measured. We extracted self-reported OMIs from trials, reviews and reports of instrument development. Searches were undertaken in the ALOIS database, Medline, PsycINFO, CINAHL, socINDEX and COSMIN database. We aimed to assess the psychometric properties of OMI items for face validity with the core outcome items, content validity, internal consistency and responsiveness. We held a co-research workshop involving people living with dementia and care partners in order to ratify the findings. In total 347 OMIs were located from 354 sources. Of these 76 OMIs met the inclusion criteria. No OMIs were deemed to have sufficient face validity for the COS items, and no OMIs proceeded to further assessment. The 'best' available OMI is the Engagement and Independence in Dementia Questionnaire (EID-Q). This study provides a practical resource for those designing dementia research trials. Being able to measure the COS items would herald a paradigm shift for dementia research, be responsive to what key stakeholders value and enhance the ability to make comparisons.This study was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR). ESRC is part of UK Research and Innovation (UKRI)

What is important to people with dementia living at home? A set of core outcome items for use in the evaluation of non-pharmacological community-based health and social care interventions

YesObjectives: Inconsistency in outcome measurement in dementia care trials impedes the comparisons of effectiveness between trials. The key aim of this study is to establish an agreed standardised core outcome set (COS) for use when evaluating non-pharmacological health and social care interventions for people with dementia living at home. Method: We used a mixed-methods research design, including substantive qualitative research with five key stakeholders groups. We consulted with people living with dementia for many aspects of this research. We applied a modified two-round 54 item Delphi approach to attain consensus on core outcomes. The COS was finalised in a face-to-face consensus meeting in 2018. Results: Of the 288 who completed round 1 (21 people living with dementia, 58 care partners, 137 relevant health and social care professionals, 60 researchers, 12 policy makers), 246 completed round 2 (85% response rate). Twenty participants attended the consensus meeting. We reached consensus for the inclusion of 13 outcome items. Conclusion: We identified 13 outcome items which are considered core; many relate to social health. Providing there are adequate measures, measuring these core outcome items will enhance comparisons for effectiveness making trial evidence more useful. The items will provide commissioners and service planners with information on what types of interventions are most likely to be valued highly by people living with dementia.This study was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR). ESRC is part of UK Research and Innovation