Microbial contamination of food refrigeration equipment

Refrigeration systems in chilled rooms in 15 plants processing a variety of foods were studied. These included plants processing raw meat and salads, Chinese ready meals, dairy products, slicing and packing of cooked meats and catering establishments. An initial survey of total numbers of microbes at a total of 891 sites on evaporators, drip trays and chilled room walls was followed up with a more detailed examination of 336 sites with high counts, selecting for Listeria spp., coliforms, enterococci, Staphylococcus aureus and Bacillus cereus. Temperatures (particularly air on and air off, maximum and near defrost heaters) relative humidity, airflow, layout and cleaning regimes were surveyed. In general, no correlation could be found between any of the physical measurements and the numbers and types of bacteria detected. Maximum mean temperatures in the chilled rooms varied from -1 to +16.9 °C and few chilled units were regularly cleaned. Twenty five percent of sites examined had more than 105 colony-forming units per cm2, although, very few pathogens or faecal indicator bacteria were detected. Listeria spp. were not found and coliforms were found only once, in low numbers. Low numbers of S. aureus or B. cereus were present in 9 of the 15 plants, B. cereus was found on evaporators and associated drip trays in two catering plants and two plants processing cooked meat. Enterococci and S. aureus were found most frequently in a raw red meat slaughterhouse (always in low numbers). In general, microbial contamination was lower in rooms where wrapped rather than unwrapped products were stored. The type of product also affected the degree of contamination, with raw red meat and poultry or dry ingredients giving highest counts, and raw vegetables and cooked products lowest. The work demonstrated that bacteria were present on evaporator cooling coils in all factory cold rooms visited. Although evaporator-cleaning procedures were carried out in some factories as part of routine maintenance these were not shown to be effective at maintaining low levels of bacteria on evaporators. To maintain evaporator hygiene it is suggested that more regular cleaning procedures, possibly by means of automated cleansing systems, should be considered. © 2003 Elsevier Ltd. All rights reserved

The effects of incisional bupivacaine infusions on postoperative opioid consumption and pain scores after total abdominal hysterectomy

Background: The aim of this study was to determine opioid requirements and pain intensity scores in patients after a total abdominal hysterectomy (TAH) administered with a bupivacaine infusion for a 30-hour period, and then to compare the data with that of a control group. Method: This was a prospective, parallel, single-blinded randomised trial which took place at the Rahima Moosa Mother and Child Hospital, Johannesburg. Thirty-six consenting patients, who underwent a TAH, were randomised to either having a 0.39% bupivacaine infusion in the incisional site or not. Morphine was administered via a patient-controlled analgesia pump (PCA) for rescue analgesia. Dynamic, static and worst pain scores were assessed one, six and 30 hours after surgery by using a visual analogue scale (VAS). Morphine consumption was recorded at set intervals. Results: There were statistically significant differences between the two groups’ dynamic VAS scores in the first hour and at 24 hours and 30 hours; in the static VAS score in the first hour; and in the VAS scores for the worst pain experienced since the patients were last seen in the first hour and six hours after the operation. There was no statistical difference between the two groups’ opioid consumption at all set observation points. Conclusion: The opioid requirements of the two groups were comparable, although participants who had the bupivacaine infusion experienced reduced pain intensity which lasted until six hours postoperatively, and also had reduced pain intensity when moving around 30 hours after the operation.Keywords: incisional bupivacaine infusions, total abdominal hysterectomy, postoperative pain contro

Development and characterisation of a decellularised bovine osteochondral biomaterial for cartilage repair.

It is proposed that an acellular natural osteochondral scaffold will provide a successful repair material for the early intervention treatment of cartilage lesions, to prevent or slow the progression of cartilage deterioration to osteoarthritis. Here, we investigated the efficacy of methods for the decellularisation of bovine osteochondral plugs. The plugs were subject to four freeze/thaw cycles followed by two cycles of washes in hypotonic solution and low concentration (0.1 % w/v) sodium dodecyl sulphate with protease inhibitors. Plugs were treated with nuclease (DNase and RNase) treatment followed by sterilization in peracetic acid. Full tissue decellularisation was achieved as confirmed by histological analysis and DNA quantification, however the resultant acellular matrix had reduced glycosaminoglycan content which led to an increased percent deformation of cartilage. Furthermore, the acellular scaffold was not reproducibly biocompatible. Additional terminal washes were included in the process to improve biocompatibility, however, this led to visible structural damage to the cartilage. This damage was found to be minimised by reducing the cut edge to cartilage area ratio through decellularisation of larger cuts of osteochondral tissue

Drugs, dogs, and driving: the potential for year-round thermal stress in UK vehicles

Background: Dogs are regularly transported or housed in vehicles, with guidelines for housing dogs suggesting that the ambient temperature should be maintained between 15°C and 24°C. Veterinary drugs are routinely stored and carried in vehicles providing ambulatory veterinary care. Non-refrigerated medications typically require storage between 8°C and 25°C. Aim: This study aims to investigate the potential for thermal stress associated with vehicular storage and transportation of drugs and dogs in a temperate climate, such as the United Kingdom. Methods: The study used data loggers to continuously record internal temperatures of four vehicles at 15-minute intervals over a two-year period, to investigate the effect of seasonality and time of day on the internal car temperature. Results: The internal car temperature ranged from −7.4°C to 54.5°C during the study period. Temperatures fell below 8°C every month, except June and July. The internal car temperature exceeded typical drug storage recommendations (>25°C) during every month, and exceeded the canine thermoneutral zone (>35°C) from April to September. Peak temperatures occurred between 14:00 and 17:00 hours. Conclusion: The results demonstrate the year-round potential for thermal stress of both dogs and drugs left in cars. Public awareness campaigns highlighting the risks of leaving dogs in hot cars are typically launched in late spring, but should consider launching earlier in light of these findings. Veterinary surgeons transporting drugs should take measures to ensure that drugs are stored within the manufacturer’s temperature range year-round. This will limit the potential for drug degradation and decreased efficacy

Quality of private and public ambulatory health care in low and middle income countries: systematic review of comparative studies

Paul Garner and colleagues conducted a systematic review of 80 studies to compare the quality of private versus public ambulatory health care in low- and middle-income countries

Target product profiles for protecting against outdoor malaria transmission.

BACKGROUND\ud \ud Long-lasting insecticidal nets (LLINs) and indoor residual sprays (IRS) have decimated malaria transmission by killing indoor-feeding mosquitoes. However, complete elimination of malaria transmission with these proven methods is confounded by vectors that evade pesticide contact by feeding outdoors.\ud \ud METHODS\ud \ud For any assumed level of indoor coverage and personal protective efficacy with insecticidal products, process-explicit malaria transmission models suggest that insecticides that repel mosquitoes will achieve less impact upon transmission than those that kill them outright. Here such models are extended to explore how outdoor use of products containing either contact toxins or spatial repellents might augment or attenuate impact of high indoor coverage of LLINs relying primarily upon contact toxicity.\ud \ud RESULTS\ud \ud LLIN impact could be dramatically enhanced by high coverage with spatial repellents conferring near-complete personal protection, but only if combined indoor use of both measures can be avoided where vectors persist that prefer feeding indoors upon humans. While very high levels of coverage and efficacy will be required for spatial repellents to substantially augment the impact of LLINs or IRS, these ambitious targets may well be at least as practically achievable as the lower requirements for equivalent impact using contact insecticides.\ud \ud CONCLUSIONS\ud \ud Vapour-phase repellents may be more acceptable, practical and effective than contact insecticides for preventing outdoor malaria transmission because they need not be applied to skin or clothing and may protect multiple occupants of spaces outside of treatable structures such as nets or houses

Piperidinols that show anti-tubercular activity as inhibitors of arylamine N-acetyltransferase: an essential enzyme for mycobacterial survival inside macrophages

Latent M. tuberculosis infection presents one of the major obstacles in the global eradication of tuberculosis (TB). Cholesterol plays a critical role in the persistence of M. tuberculosis within the macrophage during latent infection. Catabolism of cholesterol contributes to the pool of propionyl-CoA, a precursor that is incorporated into cell-wall lipids. Arylamine N-acetyltransferase (NAT) is encoded within a gene cluster that is involved in the cholesterol sterol-ring degradation and is essential for intracellular survival. The ability of the NAT from M. tuberculosis (TBNAT) to utilise propionyl-CoA links it to the cholesterol-catabolism pathway. Deleting the nat gene or inhibiting the NAT enzyme prevents intracellular survival and results in depletion of cell-wall lipids. TBNAT has been investigated as a potential target for TB therapies. From a previous high-throughput screen, 3-benzoyl-4-phenyl-1-methylpiperidinol was identified as a selective inhibitor of prokaryotic NAT that exhibited antimycobacterial activity. The compound resulted in time-dependent irreversible inhibition of the NAT activity when tested against NAT from M. marinum (MMNAT). To further evaluate the antimycobacterial activity and the NAT inhibition of this compound, four piperidinol analogues were tested. All five compounds exert potent antimycobacterial activity against M. tuberculosis with MIC values of 2.3-16.9 µM. Treatment of the MMNAT enzyme with this set of inhibitors resulted in an irreversible time-dependent inhibition of NAT activity. Here we investigate the mechanism of NAT inhibition by studying protein-ligand interactions using mass spectrometry in combination with enzyme analysis and structure determination. We propose a covalent mechanism of NAT inhibition that involves the formation of a reactive intermediate and selective cysteine residue modification. These piperidinols present a unique class of antimycobacterial compounds that have a novel mode of action different from known anti-tubercular drugs

Stigma of living as an autism carer: a brief psycho-social support intervention (SOLACE). Study protocol for a randomised controlled feasibility study.

Stigma is prominent in the lives of autistic individuals and their families and contributes significantly to the challenges faced by families raising an autistic child. Parents and carers can feel blamed for their child's behaviour, feel socially excluded and isolated and suffer from low self-esteem and poor psychological well-being. This increases the risk of experiencing self-stigma which further exacerbates these and other negative consequences. Therefore, there is a need for interventions that help parents/family carers cope with autism-related stigma as well as prevent the internalisation of stigma. The primary objective of this study is to assess the feasibility and acceptability of a stigma support intervention for parents and carers of autistic children titled 'Stigma of Living as an Autism Carer (SOLACE)'. The secondary objective is to explore the preliminary impact of the intervention on the mental health of the parents and carers. tests for differences within the group. Other outcomes of interest are stigma, self-stigma, self-esteem, self-blame, social isolation, self-compassion and perceived responsibility and control. Results from the feasibility randomised controlled trial will be used to refine the study protocol and inform the design of an intervention for future use in a larger, powered trial. SOLACE could potentially improve the psychological well-being of parents/family carers of autistic children through increased resistance to stigma. ISRCTN Registry number ISRCTN61093625 (October 13, 2017)