Exploring the risk factors for Salmonella in the ten biggest Belgian pig slaughterhouses

The goal of this work is to identify the risk factors related to Salmonella in the porcine die at the stage of the slaughterhouse. Thanks to investigations carried out into the ten biggest Belgian slaughterhouses, data concerning the manufacturing process and the working methods were gathered. Moreover, an access to the microbiological results carried out on these companies within the framework of the official plans of monitoring was asked to the Belgian Food Agency. A data base allowing to test the influence of risk factors on the presence of Salmonella was established. To quantify a relation between a risk factor and the presence of Salmonella, statistical methods such as the logistic regressions were used

Effect of the use of organic acids in drinking water during the last two weeks prior to slaughter on salmonella shedding

In this study we investigated the effect of adding organic acids to the drinking water of finishing pigs two weeks prior to slaughter on the shedding and prevalence rate of Salmonella at slaughter. One hundred animals from 4 Belgian pig herds infected with Salmonella were included. Fifty of these ammals received drinking water supplemented with a mixture of different organic acids during 14 days prior to slaughter. Non-treated animals served as controls. Different samples were taken: contents of ileum and rectum, mesenteric lymph nodes and carcass swabs. All samples were submitted to Salmonella isolation using standard procedures. The results could not reveal a significant difference between both groups. This may be due to the limited power of the study (only 50 animals sampled in each group) or due to the fact that the treatment duration was insufficient to prove the benefit of the used organic acids

The visibility of environmental rights in the EU legal order: eurolegalism in action?

The current article responds to a key puzzle and a question. First, why, given the potential for ‘rights talk’ that has been seen in other countries and other policy areas, have environmental rights in the EU legal order been relatively invisible until recently? And second, with Daniel Kelemen’s influential work on Eurolegalism arguing that the EU has become much more reliant on US-style adversarial legalism, including a shift towards rights-based litigation, do EU environmental rights fit the picture Kelemen has painted, or are they an exception? The article explores the visibility of EU environmental rights at EU level and then seeks to explain the possible reasons for visibility/invisibility

A qualitative risk assessment for human salmonellosis due to the consumption of fresh pork in Belgium

Although pigs contaminated with Salmonella rarely show clinical symptoms, control is important because of the public health concern. Both producers and consumers are interested in procedures for minimizing the risk of Salmonella infections. This study outlines the entire production path for fresh pork in Belgium, from farm to fork. Additionally, it describes the different critical points for Salmonella contamination, with emphasis on those steps that need extra attention and/or improvement. The data was collected by means of questionnaires at the different steps of the process. In total, 3658 questionnaires were collected, which made it possible to draw up a nationwide image of the pork production process. In the primary production phase, there are several points relating to biosecurity that can be improved in order to minimize the risk for Salmonella in fattening pigs that are sent to slaughter. In the slaughterhouse, there has been an increase in the number of pigs or carcasses that become infected with Salmonella. Attention should be paid to avoiding contact of the feces and tonsils of contaminated pigs with the carcass, and strict hygienic measures should be taken to avoid cross-contamination. During the transformation and distribution of the carcasses, there is a low risk of further spreading of Salmonella spp. Finally, during the consumer phase, the risk for Salmonella contamination increases because of inappropriate temperature conditions during storage, manipulation of the meat and possible cross-contamination with other food products, and the consumption of insufficiently heated and/or raw meat. The present study illustrates that the risk of Salmonella infection by consumption of fresh pork is relatively low under Belgian conditions. Nevertheless, it can be further decreased by implementing additional control measures, mainly in the slaughterhouse and in the domestic kitchen

Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review.

Background: Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods: We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI) in children under five years of age. Results: 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68) and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8). None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR), as an alternative to micturating cystourethrography (MCUG) (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29); these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion: There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required

Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases

Although these conditions are rare, a proportion of patients with interstitial lung diseases (ILDs) may develop a progressive-fibrosing phenotype. Progressive fibrosis is associated with worsening respiratory symptoms, lung function decline, limited response to immunomodulatory therapies, decreased quality of life and, potentially, early death. Idiopathic pulmonary fibrosis may be regarded as a model for other progressive-fibrosing ILDs. Here we focus on other ILDs that may present a progressive-fibrosing phenotype, namely idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, connective tissue disease-associated ILDs (e.g. rheumatoid arthritis-related ILD), fibrotic chronic hypersensitivity pneumonitis, fibrotic chronic sarcoidosis and ILDs related to other occupational exposures. Differential diagnosis of these ILDs can be challenging, and requires detailed consideration of clinical, radiological and histopathological features. Accurate and early diagnosis is crucial to ensure that patients are treated optimally

How does study quality affect the results of a diagnostic meta-analysis?

Background: The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods: This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results: Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion: Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited

Cost Recovery for Water Services and the Polluter Pays Principle

This paper considers the general rationale for cost recovery pricing in respect of water services and examines the specific provision that is made for this, and related obligations, in Article 9 of the European Community Water Framework Directive. Despite guidance drawn from the Common Implementation Strategy, uncertainties remain, particularly with regard to the need to recover environmental and resource costs and how account should be taken of the polluter pays principle. Given the intractable character of these difficulties, it is suggested that the some of the practical outcomes and environmental benefits of implementation are speculative