A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Analysis of domestic refrigerator temperatures and home storage time distributions for shelf-life studies and food safety risk assessment

In the framework of food safety, when mimicking the consumer phase, the storage time and temperature used are mainly considered as single point estimates instead of probability distributions. This singlepoint approach does not take into account the variability within a population and could lead to an overestimation of the parameters. Therefore, the aim of this study was to analyse data on domestic refrigerator temperatures and storage times of chilled food in European countries in order to draw general rules which could be used either in shelf-life testing or risk assessment. In relation to domestic refrigerator temperatures, 15 studies provided pertinent data. Twelve studies presented normal distributions, according to the authors or from the data fitted into distributions. Analysis of temperature distributions revealed that the countries were separated into two groups: northern European countries and southern European countries. The overall variability of European domestic refrigerators is described by a normal distribution: N (7.0, 2.7) °C for southern countries, and, N (6.1, 2.8) °C for the northern countries. Concerning storage times, seven papers were pertinent. Analysis indicated that the storage time was likely to end in the first days or weeks (depending on the product use-by-date) after purchase. Data fitting showed the exponential distribution was the most appropriate distribution to describe the time that food spent at consumer's place. The storage time was described by an exponential distribution corresponding to the use-by date period divided by 4. In conclusion, knowing that collecting data is time and money consuming, in the absence of data, and at least for the European market and for refrigerated products, building a domestic refrigerator temperature distribution using a Normal law and a time-to-consumption distribution using an Exponential law would be appropriate

Variability of Escherichia coli and Enterobacteriaceae counts on pig carcasses: A systematic review

Background: Indicator bacteria are considered an interesting target for microbiological analysis in order to obtain information about the hygiene of processes and products. Quantitative analysis targeting in- dicator bacteria offers several advantages over pathogenic bacteria since indicator bacteria prevalence and counts are higher, and their distribution is more homogeneous, than pathogens. However, although microbiological criteria addressing indicator bacteria are already in place in industrialised countries such as the EU and US, information on factors affecting their counts on carcasses at slaughter is scattered. Objectives: The aim of this review was to provide valuable information about the variability of indicator bacteria along the pig slaughterline, and to suggest suitable means for the implementation of GMP (Good Manufacturing Practices) and process hygiene in pig slaughterhouses. Conclusions: Along the slaughterline, scalding and chilling stages effectively reduce both Escherichia coli and Enterobacteriaceae counts on pig carcasses and have to be considered in the implementation of HACCP systems. Surface pasteurisation under experimental slaughter conditions was also effective; in contrast, washing did not reduce microbial contamination on pig carcasses. Evisceration was confirmed as a key contamination point, in particular regarding Enterobacteriaceae, but it has been suggested that bacterial load can be controlled by anal plugging if it is performed according to good manufacturing practices (GMP)

A systematic review of studies on Escherichia coli and Enterobacteriaceae on beef carcasses at the slaughterhouse

European legislation has defined as process hygiene criteria for themain livestock species (cattle, sheep, goats, horses and pigs) themonitoring of aerobic colony count and Enterobacteriaceae. Detected values above the de- fined criteria require an improvement in slaughter hygiene and the reviewof process control. Themain source of microbiological contamination of beef carcasses along the slaughterline is of fecal origin, therefore Escherichia coli and Enterobacteriaceae seemto be themost suitable indicators to assess the hygienic status of the slaughter process. Althoughmicrobiological criteria addressing indicator bacteria have beeninplace inindustrializedcoun- tries for several years, scattered information still exists on factors affecting their counts on beef carcasses along the slaughterline. Therefore, a systematic literature review, covering the period 2000\u20132012, was conducted to gather information concerning: 1) counts of E. coli and Enterobacteriaceae on beef carcasses linked to different stages of the slaughterline; 2) factors influencing presence/counts of E. coli and Enterobacteriaceae on beef car- casses; and 3) the relationship between indicator bacteria (E. coli and Enterobacteriaceae) counts and visual fecal contamination of beef carcasses. According to the 41 retrieved papers the following conclusions were drawn. A decrease of the indicator bacteria counts was recorded after sequential decontamination treatments, such as pasteurization and hot water washing. Slaughterhouse characteristics influenced bacterial load of beef carcasses, although it was difficult to assess which factors (i.e., slaughterhouse throughput, design of the plant, surveillance system in place) had the greatest effect. Finally, carcasses from fecal contaminated animals had higher bacterial loads than those fromclean animals. Therefore, the development of a visual classification system of the level of dirtiness of carcasses and the application of effective treatments on the carcasses classified as dirty along the slaughterline can lead to a contamination level for these carcasses comparable to or lower than that of originally clean ones at the end of the slaughterline

Survival of Salmonella Typhimurium in poultry-based meat preparations during grilling, frying and baking

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Effects of domestic storage and thawing practices on Salmonella in poultry-based meat preparations

Among consumer food handling practices, time-temperature abuse has been reported as one of the most common contributory factors in salmonellosis outbreaks where the evidence is strong. The present study performed storage tests of burgers, sausages, and kebabs and investigated (i) the effect of refrigerator temperatures (4 degrees C versus 8 or 12 degrees C, which were the temperatures recorded in 33 and 3%, respectively, of domestic refrigerators in Italy), with or without prior temperature abuse (25 degrees C for 2 h, simulating transport of meats from shop to home), and (ii) the impact of the thawing method (overnight in the refrigerator at 8 degrees C versus on the kitchen countertop at 23 degrees C) on the presence and numbers of Salmonella bacteria. Storage tests were carried out on naturally or artificially (Salmonella enterica serovar Typhimurium at ca. 10 CFU/g) contaminated products, while freezing-thawing tests were conducted only on artificially contaminated products (Salmonella Typhimurium at ca. 10, 100, and 1,000 CFU/g). The results from the artificially contaminated products showed significant (P 710 MPN/g) in kebabs after 7 and 10 days but more moderate growth in sausages (i.e., from ca. 14 MPN/g to a maximum of 96 MPN/g after 9 days of storage). Storage of naturally contaminated burgers or sausages (contamination at or below 1 MPN/g) at 4, 8, or 12 degrees C and a short time of temperature abuse (2 h at 25 degrees C) did not facilitate an increase in the presence and numbers of Salmonella bacteria. Thawing overnight in the refrigerator led to either a moderate reduction or no change of Salmonella Typhimurium numbers in burgers, sausages, and kebabs. Overall, this study showed that domestic storage and thawing practices can affect food safety and that time-temperature abuse can cause a substantial increase of Salmonella numbers in some types of poultry-based meat preparations, highlighting that efforts for the dissemination of consumer guidelines on the correct storage and handling of meats need to be continued

Effects of domestic storage and thawing practices on Salmonella in poultry-based meat preparations

The study performed storage tests of burgers, sausages, and kebabs and investigated (i) the effect of refrigerator temperatures (4\ub0C versus 8 or 12\ub0C, which were the temperatures recorded in 33 and 3%, respectively, of domestic refrigerators in Italy), with or without prior temperature abuse (25\ub0C for 2 h, simulating transport of meats from shop to home), and (ii) the impact of the thawing method (overnight in the refrigerator at 8\ub0C versus on the kitchen countertop at 23\ub0C) on the presence and numbers of Salmonella bacteria. Storage tests were carried out on naturally or artificially (Salmonella enterica serovar Typhimurium at ca. 10 CFU/g) contaminated products, while freezing-thawing tests were conducted only on artificially contaminated products (Salmonella Typhimurium at ca. 10, 100, and 1,000 CFU/g). The results from the artificially contaminated products showed significant (P 710 MPN/g) in kebabs after 7 and 10 days but more moderate growth in sausages (i.e., from ca. 14 MPN/g to a maximum of 96 MPN/g after 9 days of storage). Storage of naturally contaminated burgers or sausages (contamination at or below 1 MPN/g) at 4, 8, or 12\ub0C and a short time of temperature abuse (2 h at 25\ub0C) did not facilitate an increase in the presence and numbers of Salmonella bacteria. Thawing overnight in the refrigerator led to either a moderate reduction or no change of Salmonella Typhimurium numbers in burgers, sausages, and kebabs. Overall, this study showed that domestic storage and thawing practices can affect food safety and that time-temperature abuse can cause a substantial increase of Salmonella numbers in some types of poultry-based meat preparations, highlighting that efforts for the dissemination of consumer guidelines on the correct storage and handling of meats need to be continued