There is increasing research on the role of savouring positive emotional experience in the context of stress. As such, we need a better understanding of how savouring and coping relate to each other ...and to psychological adjustment outcomes following a stressful life event. In particular, this study seeks to understand whether savouring is better conceptualized as a coping resource or a coping response. Three hundred people who experienced a highly stressful event in the past year completed measures of impact of event, savouring, coping, positive emotions, depression, anxiety, and life satisfaction. Results of bivariate correlations showed that savouring is positively correlated with positive coping (i.e., mastery and meaning‐based coping) and socially‐supported coping (i.e., using emotional and instrumental support) and negatively correlated with negative coping (i.e., self‐judgement and avoidance coping). The results of path analyses support a model that positions savouring as a coping response that relates to other coping responses and indirectly relates to better psychological adjustment through positive emotions (when psychological adjustment is conceptualized as depression or life satisfaction but not anxiety). Findings provide preliminary support for conceptualizing savouring as a coping response; future research should consider measuring savouring as a coping response to further our understanding of savouring following a stressful life event.
Salmonella Infantis is a major public health concern and has become established in the broiler sector in some European countries, as well as globally, and is frequently multidrug resistant (MDR). ...Three broiler farms in England and Wales, which had incursions of MDR S. Infantis between 2013 and 2017, were investigated longitudinally. The company feed mill and two associated hatcheries were intensively sampled. Following each visit, advice on cleaning, disinfection and other control measures for Salmonella was given to help eliminate S. Infantis from the premises. Four samples collected from inside the broiler houses after cleaning and disinfection were Salmonella-positive, indicating cleaning and disinfection within houses was generally effective. However, the exterior of persistently infected houses remained substantially contaminated and feeding systems could not be sampled. Clearance of S. Infantis from affected houses requires additional attention to decontamination of these aspects. Sixty S. Infantis isolates were tested for antimicrobial susceptibility by disk diffusion tests. All isolates were MDR, with resistance to at least nalidixic acid (Na), tetracycline (T), compound sulphonamide (Su), streptomycin (S) and furazolidone. This is a similar resistance pattern to the previously identified MDR (NaSSuT) clone in some European countries. The study shows that to remove S. Infantis from premises effectively, a combined approach to poultry houses and the surrounding farm environment is necessary. A revised cleaning and disinfection programme was developed that was associated with the clearance of MDR S. Infantis from persistently infected and newly infected broiler flocks, and UK livestock remains free of MDR S. Infantis.
RESEARCH HIGHLIGHTS
Standard cleaning and disinfection protocols did not completely eliminate infection.
A revised cleaning and disinfection programme was developed.
Disinfecting feeder lines and external areas was key to eliminating S. Infantis.
Identified similar antimicrobial resistance pattern to MDR epidemic S. Infantis.
Salmonella is a major cause of foodborne illness across Europe but there has been little recent research on its control in broiler production in Great Britain. Investigations of Salmonella presence ...on 20 broiler farms and a separate exploratory risk factor analysis involving 36 Salmonella-positive farms and 22 Salmonella-negative farms were carried out to investigate Salmonella contamination and control on broiler farms in Great Britain. Sources of Salmonella persistence on farm and potential risk factors for on-farm contamination were identified, enabling provision of up-to-date advice on Salmonella control to farmers.
Twenty broiler farms across England and Wales were intensively sampled over time. Most farms were included in the study after routine testing as part of the Salmonella National Control Programmes (NCPs) identified regulated Salmonella serovars or potential associations with outbreak cases of significance for human health.
Across all farms and visits, the highest proportion of Salmonella-positive samples were from areas exterior to broiler houses compared to anterooms or house interiors. Exterior Salmonella-positive samples were primarily collected from the immediate areas around the houses, with the highest proportions being from drainage, farm tracks/driveways, and pooled water. Elimination of Salmonella was variable but was most successful inside affected houses (compared to exterior areas) and for regulated Salmonella serovars under the Salmonella NCPs and high priority Salmonella strains with multi-drug resistances.
It is likely that the financial and reputational concerns associated with regulated Salmonella serovars and those of greater public health significance underlie the reason that these serovars were more effectively controlled at farm level, as effective elimination of Salmonella can involve a considerable investment in infrastructure, time and resources. Without perceived direct benefits in eliminating non-regulated Salmonella serovars at farm level it can be challenging to maintain the required motivation and investment.
A separate farm-level risk factor analysis was carried out using data collected from 58 broiler farms representing six GB broiler companies. Risk of testing positive for Salmonella via NCP sampling in the previous year was greater in the absence of house-specific anterooms and if at least some poultry houses were surrounded by soil/grass compared to if all were surrounded by concrete or a mixture of concrete and stones/gravel. Odds of testing positive for Salmonella in the previous year was also greater for farms whose maximum holding capacity was >100,000 birds, and farms where the usual number of visitors per day was 0−1 compared to 2−3. The analysis was exploratory and caution is required with interpretation, but results provide preliminary insight into aspects of farm management that may be important, practicable targets for Salmonella control on broiler farms in GB.
Data on teaching awards in undergraduate medical education are sparse. The benefits of an awards system may seem obvious at first glance. However, there are also potential problems relating to ...fairness, avoidance of bias, and alignment of the awards system with a wider strategy for quality improvement and curriculum development. Here, we report five- year single center experience with establishing undergraduate teaching awards in a large academic teaching hospital. Due to lack of additional funding we based our awards not on peer review but mainly on existing and very comprehensive quality assurance (QA) data. Our 12 tips describe practical points but also pitfalls with awards categories and criteria, advertising and disseminating the awards, the actual awards ceremony and finally embedding the awards in the hospital's wider strategy. To be truly successful, teaching awards and prizes need to be carefully considered, designed and aligned with a wider institutional strategy of rewarding enthusiastic educators.
Salmonella can enter hatcheries via contaminated eggs and other breaches of biosecurity. The study examined the prevalence and distribution of Salmonella in commercial hatcheries and assessed the ...effects of providing advice on Salmonella control. Intensive swab sampling was performed throughout 23 broiler hatcheries in Great Britain (GB). Swabs were cultured using a modified ISO6579:2017 method. After each visit, tailored advice on biosecurity and cleaning and disinfection procedures was provided to the hatchery managers. Repeat sampling was carried out in 10 of the 23 hatcheries. Salmonella prevalence ranged between 0% and 33.5%, with the chick handling areas, hatcher areas, macerator area, tray wash/storage areas, external areas and other waste handling areas being more contaminated than the setter areas. Salmonella Senftenberg and Salmonella 13,23:i:‐ were the most commonly isolated serovars. There was a reduction in Salmonella prevalence at the second visit in eight out of 10 premises, but prevalence values had increased again in all of the improved hatcheries that were visited a third time. One hatchery harboured a difficult‐to‐control resident Salmonella 13,23:i:‐ strain and was visited six times; by the final visit, Salmonella prevalence was 2.3%, reduced from a high of 23.1%. In conclusion, the study found low‐level Salmonella contamination in some GB broiler hatcheries, with certain hatcheries being more severely affected. Furthermore, it was shown that Salmonella typically is difficult to eradicate from contaminated hatcheries, but substantial reductions in prevalence are possible with improvements to biosecurity, cleaning and disinfection.
•Low-level Salmonella contamination was found in some commercial broiler hatcheries.•The most common serovars detected are known hatchery colonisers.•Having more hatchers and an open waste system may ...increase odds of contamination.•Hatchery hygiene protocols must be effective and implemented consistently.•Regular monitoring for Salmonella and robust staff training is important.
Salmonellosis is the second most commonly reported zoonosis in the European Union and contaminated meat from broiler chickens (Gallus gallus) is an important source of human infection. In Great Britain (GB), prevalence of Salmonella enterica in broiler flocks is low, having declined considerably since the introduction of the Salmonella National Control Programme in 2010. However, this decreasing trend has stabilised in recent years and serovars with known ability to persistently colonise hatcheries have been isolated from broiler flocks with increasing frequency, indicating that further controls on hatchery contamination are required. The broiler industry in GB has changed dramatically over the last 15 years, with greater intensification and dominance by a small number of very large companies which rely on relatively few hatcheries. An investigation of risk factors for Salmonella contamination in GB broiler hatcheries was therefore carried out so that relevant up-to-date advice on Salmonella control can be provided. Twenty-two hatcheries, representing most commercial scale GB broiler hatcheries, were visited between 2015 and 2018. Salmonella contamination was comprehensively investigated at each hatchery by collecting between 108 and 421 environmental swab samples per hatchery (6990 samples in total from all hatcheries). An in-depth questionnaire on hatchery operations was completed for each hatchery, and results were incorporated into a risk factor analysis (univariable followed by multivariable mixed effects logistic regression) to identify factors associated with Salmonella occurrence. Overall, 6.0 % (416/6990) of environmental samples were Salmonella-positive and Salmonella was isolated from 17/22 hatcheries. Ten different serovars were isolated, the most common being S. Senftenberg and S. Mbandaka which are known hatchery colonisers. Sixty-four risk factor variables were investigated. Twenty-two of these were initially retained based on univariable analyses (p ≤ 0.25) and six were ultimately left in the final multivariable model (p ≤ 0.05). Salmonella detection was positively associated with having ≥30 hatchers in regular use compared to fewer (Odds ratio OR 23.7, 95 % confidence interval CI 6.7–84.2), storing trays in process rooms (OR 28.8, CI 7.8–106.3), drying set-up trolleys in corridors (OR 15.6, CI 5.9–41.4) and having skips located in enclosed areas (OR 8.99, CI 5.89–41.35). Using a closed waste disposal system was negatively associated with Salmonella detection (OR 0.08, CI 0.04−0.18) and the odds of detecting Salmonella in hatcheries with 31−60 total workers was lower compared to hatcheries with ≤30 staff (OR 0.16, CI 0.06−0.40). Despite the complexities of hatchery enterprises, changes to a relatively small number of features may significantly reduce the occurrence of hatchery contamination.
The Timed Up and Go (TUG) and Two-Minute Walk Test (2MWT) are clinically appropriate mobility measures in amputee rehabilitation. Despite the tests being routinely performed, reference values for ...amputees have yet to be established. This study aimed to establish and trial a method for estimating normative values of the TUG and 2MWT for transtibial and transfemoral amputees. Thirty-seven established prosthetic users aged 40-69 years (28 unilateral transtibial amputees and nine unilateral transfemoral) performed two recorded trials of the TUG and 2MWT. Participant characteristics were collected using the Trinity Amputation and Prosthesis Experience Scale. Preliminary normative data for the TUG and 2MWT were produced for three age cohorts and the two amputee subpopulations. Poorer mobility performance with transfemoral amputation was evident for both mobility measures. Multivariate analysis displayed relationships between age, length of time with a prosthesis and performance of both tests. In conclusion, normative values for the TUG and 2MWT for transtibial and transfemoral amputees may be calculated. Preliminary results indicate that higher levels of amputation relate to poorer performance on both the TUG and 2MWT. Studies with larger samples are required to further develop these values for use in rehabilitation.
Abstract
Medical Admission Units (MAUs) were introduced in the UK in the 1980s primarily driven by a governance and service improvement agenda. In the UK this has led to the development of Acute ...Medicine as a specialty in its own right, together with a strong role of this specialty in postgraduate teaching. In contrast, the role of MAUs, if any, in undergraduate medical education is currently unclear. Prompted by an expansion of our undergraduate student numbers, our aim was to establish a Year 3 undergraduate firm on a 33-bedded MAU in a large academic teaching hospital in the National Health Service (NHS). Despite initial scepticism from clinicians, managers, and educators, the new firm placement on MAU became an instant success and continues to attract excellent feedback from our Year 3 undergraduate students. Students enjoy the bedside teaching with a high percentage of consultant-delivered teaching and also liked the involvement of Foundation Doctors. Here, we report our experience on how to make such a firm work, based on student feedback and the tutors' experience. We provide an overview and a step-by-step guide of how to construct a successful new undergraduate firm on a busy MAU. We also discuss opportunities and challenges and discuss the relevant literature. We conclude that undergraduate teaching is feasible and rewarding in an extremely busy MAU setting. We note that identifying enthusiastic educators within the MAU team, utilisation of peripheral learning opportunities, structured timetables and induction, and a robust framework for quality assurance are all crucial to success.
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