Barriers to mental health treatment: results from the WHO World Mental Health surveys

BACKGROUND

To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.

METHOD

Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity.

RESULTS

Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).

CONCLUSIONS

Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.

Investigation of bacterial diversity in the feces of cattle fed different diets

The objective of this study is to investigate individual animal variation of bovine fecal microbiota including as affected by diets. Fecal samples were collected from 426 cattle fed 1 of 3 diets typically fed to feedlot cattle: 1) 143 steers fed finishing diet (83% dry-rolled corn, 13% corn silage, and 4% supplement), 2) 147 steers fed late growing diet (66% dry-rolled corn, 26% corn silage, and 8% supplement), and 3) 136 heifers fed early growing diet (70% corn silage and 30% alfalfa haylage). Bacterial 16S rRNA gene amplicons were determined from individual fecal samples using next-generation pyrosequencing technology. A total of 2,149,008 16S rRNA gene sequences from 333 cattle with at least 2,000 sequences were analyzed. Firmicutes and Bacteroidetes were dominant phyla in all fecal samples. At the genus level, Oscillibacter, Turicibacter, Roseburia, Fecalibacterium, Coprococcus, Clostridium, Prevotella, and Succinivibrio were represented by more than 1% of total sequences. However, numerous sequences could not be assigned to a known genus. Dominant unclassified groups were unclassified Ruminococcaceae and unclassified Lachnospiraceae that could be classified to a family but not to a genus. These dominant genera and unclassified groups differed (P < 0.001) with diets. A total of 176,692 operational taxonomic units (OTU) were identified in combination across all the 333 cattle. Only 2,359 OTU were shared across 3 diet groups. UniFrac analysis showed that bacterial communities in cattle feces were greatly affected by dietary differences. This study indicates that the community structure of fecal microbiota in cattle is greatly affected by diet, particularly between forage- and concentrate-based diets.

Off-resonance energy absorption in a linear Paul trap due to mass selective resonant quenching

Linear Paul traps (LPT) are used in many experimental studies such as mass spectrometry, atom-ion collisions, and ion-molecule reactions. Mass selective resonant quenching (MSRQ) is implemented in LPT either to identify a charged particle's mass or to remove unwanted ions from a controlled experimental environment. In the latter case, MSRQ can introduce undesired heating to co-trapped ions of different mass, whose secular motion is off resonance with the quenching ac field, which we call off-resonance energy absorption (OREA). We present simulations and experimental evidence that show that the OREA increases exponentially with the number of ions loaded into the trap and with the amplitude of the off-resonance external ac field.

Fate of naturally occurring Escherichia coli O157:H7 and other zoonotic pathogens during minimally managed bovine feedlot manure composting processes

Reducing Escherichia coli O157:H7 in livestock manures before application to cropland is critical for reducing the risk of foodborne illness associated with produce. Our objective was to determine the fate of naturally occurring E. coli O157:H7 and other pathogens during minimally managed on-farm bovine manure composting processes. Feedlot pen samples were screened to identify E. coli O157:H7-positive manure. Using this manure, four piles of each of three different composting formats were constructed in each of two replicate trials. Composting formats were (i) turned piles of manure plus hay and straw, (ii) static stockpiles of manure, and (iii) static piles of covered manure plus hay and straw. Temperatures in the tops, toes, and centers of the conical piles (ca. 6.0 m(3) each) were monitored. Compost piles that were turned every 2 weeks achieved higher temperatures for longer periods in the tops and centers than did piles that were left static. E. coli O157:H7 was not recovered from top samples of turned piles of manure plus hay and straw at day 28 and beyond, but top samples from static piles were positive for the pathogen up to day 42 (static manure stockpiles) and day 56 (static covered piles of manure plus hay and straw). Salmonella, Campylobacter spp., and Listeria monocytogenes were not found in top or toe samples at the end of the composting period, but E. coli O157:H7 and Listeria spp. were recovered from toe samples at day 84. Our findings indicate that some minimally managed composting processes can reduce E. coli O157:H7 and other pathogens in bovine manure but may be affected by season and/or initial levels of indigenous thermophilic bacteria. Our results also highlight the importance of adequate C:N formulation of initial mixtures for the production of high temperatures and rapid composting, and the need for periodic turning of the piles to increase the likelihood that all parts of the mass are subjected to high temperatures.

Hyperuricaemia and gout in New Zealand rural and urban Māori and non-Māori communities

BACKGROUND

There are few current data on the prevalence of hyperuricaemia and gout in New Zealand, particularly among the indigenous Māori population.

AIMS

To determine the prevalence of gout and hyperuricaemia in rural and urban Māori and non-Māori community samples and describe the treatment and comorbidities of participants with gout.

METHODS

Participants aged 20-64 years were recruited by random selection from the electoral roll. Māori samples were selected from among those identified as being of Māori descent on the roll and who self-identified as being of Māori ethnicity at interview. Personal medical history, blood pressure, anthropometrics, fasting lipids, glucose, HbA1c and urate were recorded.

RESULTS

There were 751 participants. Mean serum urate (SU) was 0.30 mmol/L (0.06-0.69 mmol/L). Māori had a significantly higher prevalence of hyperuricaemia (SU > 0.40 mmol/L) compared with non-Māori (17.0% vs 7.5%, P = 0.0003). A total of 57 participants had a history of gout, with a higher prevalence in Māori compared with non-Māori (10.3% vs 2.3%, P < 0.0001). Of the participants, 18/57 (31.6%) with gout were receiving urate-lowering therapy, but in 38.9%, SU was >0.36 mmol/L. Participants with gout were more likely to have metabolic syndrome, diabetes, cardiac disease or hypertension.

CONCLUSIONS

Gout and hyperuricaemia were more prevalent in Māori, and participants with gout were more likely to have comorbidities. There was not a higher overall adjusted cardiovascular disease risk in Māori participants with gout. Despite the high prevalence of gout, management remains suboptimal.

Lysozyme as an alternative to antibiotics improves growth performance and small intestinal morphology in nursery pigs

Lysozyme is a 1,4-β-N-acetylmuramidase that has antimicrobial properties. The objective of this experiment was to determine if lysozyme in nursery diets improved growth performance and gastrointestinal health of pigs weaned from the sow at 24 d of age. Two replicates of 96 pigs (192 total; 96 males, 96 females) were weaned from the sow at 24 d of age, blocked by BW and gender, and then assigned to 1 of 24 pens (4 pigs/pen). Each block was randomly assigned 1 of 3 dietary treatments for 28 d: control (two 14-d phases), control + antibiotics (carbadox/copper sulfate), or control + lysozyme (100 mg/kg diet). Pigs were weighed and blood sampled on d 0, 14, and 28 of treatment. Blood was analyzed for plasma urea nitrogen (PUN) and IgA. At 28 d, pigs were killed, and samples of jejunum and ileum were collected and fixed for intestinal morphology measurements. An additional jejunum sample was taken from the 12 pigs with the median BW per treatment to determine transepithelial electrical resistance (TER). Pigs consuming antibiotics or lysozyme grew at a faster rate than control pigs (0.433 ± 0.009 and 0.421 ± 0.008 vs. 0.398 ± 0.008 kg/d, respectively; P < 0.03), which resulted in heavier ending BW (20.00 ± 0.31, 19.8 ± 0.29, and 18.83 ± 0.32 kg, respectively; P < 0.03). Feed intake was not different (P > 0.48), but G:F was improved in pigs consuming antibiotics or lysozyme (0.756 ± 0.014, 0.750 ± 0.021, and 0.695 ± 0.019 kg/kg; P < 0.05). Immunoglobulin A (P < 0.03) and PUN (P < 0.01) increased during the experiment, regardless of dietary treatment (P > 0.48). Dietary treatment did not affect TER (P > 0.37), but gilts had lower TER compared with barrows (P < 0.04). No differences in villi height or crypt depth were observed in the ileum (P > 0.53). However, jejunum villi height was increased and crypt depth was decreased in pigs consuming antibiotics or lysozyme (P < 0.001), resulting in an increased villi height:crypt depth of 72% (P < 0.001). Thus, we concluded that lysozyme is a suitable alternative to carbadox/copper sulfate diets fed to pigs weaned from the sow at 24 d of age.

Chromogenic agar medium for detection and isolation of Escherichia coli serogroups O26, O45, O103, O111, O121, and O145 from fresh beef and cattle feces

Non-O157 Shiga toxin-producing Escherichia coli (STEC) strains are clinically important foodborne pathogens. Unlike E. coli O157:H7, these foodborne pathogens have no unique biochemical characteristics to readily distinguish them from other E. coli strains growing on plating media. In this study, a chromogenic agar medium was developed in order to differentiate among non-O157 STEC strains of serogroups O26, O45, O103, O111, O121, and O145 on a single agar medium. The ability of this chromogenic agar medium to select and distinguish among these pathogens is based on a combination of utilization of carbohydrates, b -galactosidase activity, and resistance to selective agents. The agar medium in combination with immunomagnetic separation was evaluated and successfully allowed for the detection and isolation of these six serogroups from artificially contaminated fresh beef. The agar medium in combination with immunomagnetic separation also allowed successful detection and isolation of naturally occurring non-O157 STEC strains present in cattle feces. Thirty-five strains of the top six non-O157 STEC serogroups were isolated from 1,897 fecal samples collected from 271 feedlot cattle. This chromogenic agar medium could help significantly in routine screening for the top six non-O157 STEC serogroups from beef cattle and other food.

Isolation and characterization of Clostridium difficile associated with beef cattle and commercially produced ground beef

The incidence of Clostridium difficile infection has recently increased in North American and European countries. This pathogen has been isolated from retail pork, turkey, and beef products and reported associated with human illness. This increase in infections has been attributed to the emergence of a toxigenic strain designated North America pulsed-field gel electrophoresis type 1 (NAP1). The NAP1 strain has been isolated from calves as well as ground meat products, leading to speculation of illness from consumption of contaminated meat products. However, information on C. difficile associated with beef cattle during processing and commercially produced ground beef is limited. To address this data gap, samples from various steps during beef production were collected. Samples from hides (n = 525), preevisceration carcasses (n = 475), postintervention carcasses (n = 471), and 956 commercial ground beef samples were collected from across the United States. The prevalence of C. difficile spores on hides was 3.2%. C. difficile spores were not detected on preevisceration and postintervention carcasses or in commercially produced ground beef. Phenotypic and genetic characterizations were carried out for all 18 isolates collected from hide samples. Twenty-two percent of the isolates were nontoxigenic strains, while 78% of the isolates were toxigenic. Toxinotyping and PCR ribotyping patterns revealed that 6 and 33% of the isolates were identified as NAP1 and NAP7 strains, respectively. This article evidences that the prevalence of C. difficile, specifically pathogenic strains, in the U.S. beef production chain is low.

Effect of bedding materials on concentration of odorous compounds and in beef cattle bedded manure packs

The objectives of this study were to determine the effect of bedding material (corn stover, soybean stover, wheat straw, switchgrass, wood chips, wood shavings, corn cobs, and shredded paper) on concentration of odorous volatile organic compounds (VOC) in bedded pack material and to determine the effect of bedding material on the levels of total in laboratory-scaled bedded manure packs. Four bedded packs of each bedding material were maintained for two 6-wk periods ( = 64). Straight- and branched-chained fatty acids and aromatic compounds were measured. Corn cob bedding had the highest concentration of odorous VOC, and wood shavings had the lowest ( < 0.01). Calculated odor activity values were highest for corn cob bedding and shredded paper and lowest for wood shavings ( < 0.01). concentrations decreased from week to week for all treatments from Week 2 to Week 6. At Week 6, levels in bedded packs with shredded paper were higher ( < 0.05) than bedded packs containing wood shavings, wood chips, or switchgrass ( < 0.05). At Weeks 4, 5, and 6, concentrations in bedded packs with wood shavings were lower ( < 0.05) than bedded packs of all treatments except wood chips. Results of this study indicate that ground corn cobs or shredded paper may increase odor production and shredded paper may increase when used in deep-bedded livestock facilities, whereas wood shavings may have the least impact on air quality and .

Effects of antimicrobials fed as dietary growth promoters on faecal shedding of Campylobacter, Salmonella and shiga-toxin producing Escherichia coli in swine

AIMS

To determine whether antimicrobials commonly used in swine diets affect zoonotic pathogen shedding in faeces.

METHODS AND RESULTS

Barrows (n = 160) were sorted into two treatments at 10 weeks of age (week 0 of the study), and fed growing, grow finishing and finishing diets in 4-week feeding periods. For each feeding phase, diets were prepared without (A-) and with (A+) dietary antimicrobials (chlortetracycline, 0-8 week; bacitracin, 9-12 week) typical of the United States. At week 0, 4, 8, 9, 10 and 12 of the study, faecal swabs or grabs were collected for analyses. Campylobacter spp. was absent at week 0, but prevalence increased over time with most isolates being identified as Campylobacter coli. When chlortetracycline was used in A+ diets (week 4 and 8), prevalence for Campylobacter spp., pathogenic Escherichia coli O26 and stx genes was lower in faeces. On week 12 after the shift to bacitracin, Campylobacter spp. and stx genes were higher in faeces from piglets fed A+ diet. Pathogenic E. coli serogroups O103 and O145 were isolated throughout the study and their prevalence did not differ due to diet. Pathogenic E. coli serogroups O111 and O121 were never found in the piglets, and Salmonella spp. prevalence was low.

CONCLUSIONS

In production swine, growing diets with chlortetracycline may have reduced pathogen shedding compared with the A-growing diets, whereas finishing diets with bacitracin may have increased pathogen shedding compared with the A-finishing diet.

SIGNIFICANCE AND IMPACT OF THE STUDY

Inclusion of antimicrobials in the diet can affect zoonotic pathogen shedding in faeces of swine.

Harmful drinking and talking about alcohol in primary care: New Zealand population survey findings

OBJECTIVE

Existing evidence suggests low recognition of alcohol problems in primary care. This study aimed to determine the 12-month prevalence of harmful or hazardous drinking (HHD) in a population sample and to measure the relationship between HHD and talking about alcohol in primary care consultations in that period.

METHOD

A New Zealand population survey of 12 488 adults. Alcohol use in the past 12 months was assessed by the Alcohol Use Disorders Identification Test (AUDIT), with HHD defined as a total score of eight or above. Talking about alcohol was self-reported.

RESULTS

HHD was present in 17.7% and was commoner in men and in younger age groups, with the highest prevalence 53.6% in men aged 18-24. Three per cent of those who attended their usual primary care provider in the past 12 months reported being talked to about alcohol. Talking about alcohol increased with AUDIT score, but was not commoner in young people despite their higher prevalence of HHD. Overall, 9.4% of attendees with HHD reported talking about alcohol.

CONCLUSION

HHD is common but largely not detected in primary care. Improved detection would permit the delivery of effective treatments such as brief interventions.

Comparison of bacterial communities in faeces of beef cattle fed diets containing corn and wet distillers' grain with solubles

AIM

The mammalian intestinal microflora has been shown to impact host physiology. In cattle, intestinal bacteria are also associated with faecal contamination of environmental sources and human illness via foodborne pathogens. Use of wet distillers' grains with solubles (WDGS) in cattle feed creates a gastrointestinal environment where some bacterial species are enriched. Here, we examine if a diet containing 40% WDGS results in fundamentally different microbial community structures.

METHODS AND RESULTS

The 20,002 16S r-RNA gene sequences from 20 beef cattle were analysed using Sanger sequencing methods. At the genus level, Prevotella (Gram negative) and Anaerobacter (Gram positive) were the most frequently occurring bacteria in our beef cattle faecal samples. Diet-associated differences in prevalence were noted for Prevotella but not Anaerobacter.

CONCLUSIONS

Diet affects community structure. Faecal communities of co-housed beef cattle are not identical.

SIGNIFICANCE AND IMPACT OF THE STUDY

It is known that a diet of 40% corn-based WDGS increases the generic Escherichia coli in the faeces and enriches E. coli O157:H7. The results from the current study suggest that in addition to previously observed changes in E. coli, the entire bacterial community structure is different for animals fed 40% corn-based WDGS compared to a traditional corn-finishing diet.

Effects of different fresh-cut forages and their hays on feed intake, digestibility, heat production, and ruminal methane emission by Boer x Spanish goats

Twenty-four yearling Boer × Spanish wethers were used to assess effects of different forages, either fresh (Exp. 1) or as hay (Exp. 2), on feed intake, digestibilities, heat production, and ruminal methane emission. Treatments were: 1) Sericea lespedeza (SER; Lespedeza cuneata), a legume high in condensed tannins (CT; 20% and 15% in fresh forage and hay, respectively), 2) SER supplemented with polyethylene glycol (SER-PEG; 25 g/d), 3) alfalfa (Medicago sativa), a legume low in CT (ALF), and 4) sorghum-sudangrass (Sorghum bicolor), a grass low in CT (GRASS). Experiments were 22 d, which included 16 d for acclimatization followed by a 6-d period for fecal and urine collection, and gas exchange measurement (last 2 d). Intake of OM was 867, 823, 694, and 691 g/d (SEM = 20.1) with fresh forage, and 806, 887, 681, and 607 g/d with hay for SER, SER-PEG, ALF, and GRASS, respectively (SEM = 46.6). Apparent total tract N digestion was greater for SER-PEG vs. SER (P < 0.001) with fresh forage (46.3%, 66.5%, 81.7%, and 73.2%; SEM = 1.71) and hay (49.7%, 71.4%, 65.4%, and 54.8% for SER, SER-PEG, ALF, and GRASS, respectively; SEM = 1.57). Intake of ME was similar among treatments with fresh forage (8.24, 8.06, 7.42, and 7.70 MJ/d; SEM = 0.434) and with hay was greater for SER-PEG than ALF (P < 0.03) and GRASS (P < 0.001) (8.63, 10.40, 8.15, and 6.74 MJ/d for SER, SER-PEG, ALF, and GRASS, respectively; SEM = 0.655). The number of ciliate protozoa in ruminal fluid was least for SER with fresh forage (P < 0.01) (9.8, 20.1, 21.0, and 33.6 × 10(5)/ml; SEM = 2.76) and hay (P < 0.02) (6.3, 11.4, 13.6, and 12.5 × 10(5)/ml for SER, SER-PEG, ALF, and GRASS, respectively; SEM = 1.43). Methane emission as a percentage of DE intake was lower (P < 0.01) for SER vs. ALF and GRASS with fresh forage (6.6, 8.3, 9.4, and 9.2%; SEM = 0.64) and hay (4.3, 4.9, 6.4, and 6.7% for SER, SER-PEG, ALF, and GRASS, respectively; SEM = 0.38). In summary, methane emission in this short-term experiment was similar between a legume and grass low in CT as fresh forage and hay. The CT in SER markedly decreased N digestibility and elicited a moderate decline in ruminal methane emission. Supplementation with PEG alleviated the effect of CT on N digestibility but not ruminal methane emission, presumably because of different modes of action. In conclusion, potential of using CT-containing forage as a means of decreasing ruminal methane emission requires further study, such as with longer feeding periods.

Soil solarization reduces Escherichia coli O157:H7 and total Escherichia coli on cattle feedlot pen surfaces

Feedlot pen soil is a source for transmission of Escherichia coli O157:H7, and therefore a target for preharvest strategies to reduce this pathogen in cattle. The objective of this study was to determine the ability of soil solarization to reduce E. coli O157:H7 in feedlot surface material (FSM). A feedlot pen was identified in which naturally occurring E. coli O157:H7 was prevalent and evenly distributed in the FSM. Forty plots 3 by 3 m were randomly assigned such that five plots of each of the solarization times of 0, 1, 2, 3, 4, 6, 8, and 10 weeks were examined. Temperature loggers were placed 7.5 cm below the surface of each plot, and plots to be solarized were covered with clear 6-mil polyethylene. At each sampling time, five FSM samples were collected from each of five solarized and five unsolarized plots. E. coli concentrations and E. coli O157:H7 presence by immunomagnetic separation and plating were determined for each FSM sample. Initial percentages of E. coli O157:H7-positive samples in control and solarized FSM were 84 and 80%, respectively, and did not differ (P > 0.05). E. coli O157:H7 was no longer detectable by 8 weeks of solarization, but was still detected in unsolarized FSM at 10 weeks. The average initial concentration of E. coli in FSM was 5.56 log CFU/g and did not differ between treatments (P > 0.05). There was a 2.0-log decrease of E. coli after 1 week of solarization, and a >3.0-log reduction of E. coli by week 6 of solarization (P, 0.05). E. coli levels remained unchanged in unsolarized FSM (P > 0.05). Daily peak FSM temperatures were on average 8.7°C higher for solarized FSM compared with unsolarized FSM, and reached temperatures as high as 57°C. Because soil solarization reduces E. coli O157:H7, this technique may be useful for reduction of persistence and transmission of this pathogen in cattle production, in addition to remediation of E. coli O157:H7-contaminated soil used to grow food crops.

Impact of reducing the level of wet distillers grains fed to cattle prior to harvest on prevalence and levels of Escherichia coli O157:H7 in feces and on hides

Cattle fed finishing diets with wet distillers grains with solubles (WDGS) have been shown to harbor increased Escherichia coli O157:H7 populations in the feces and on the hides. To determine if feeding a lower level of WDGS at the end of the feeding period reduces E. coli O157:H7 load at harvest, 608 heifers were sorted into one of five treatments and fed 0, 40, or 70% WDGS (dry matter basis). For three of the treatments, WDGS was reduced midway through the study. Treatment 0W0W heifers (positive control) were fed a corn grain-based diet continuously, and 40W40W heifers (negative control) were fed 40% WDGS continuously. Heifers subjected to treatments 40W0W, 40W15W, and 70W15W were fed either 40 or 70% WDGS for the first 56 days and switched to 0 or 15% WDGS, respectively, for the last 56 days. Prior to the switch in diets, animals fed diets with 40 or 70% had higher prevalence and percent enumerable fecal samples for E. coli O157:H7. After the dietary switch, animals fed 40W0W, 40W15W, and 70W15W diets had fecal prevalence and percent enumerable samples (33.4 and 6.3%, 31.0 and 9.7%, and 34.9 and 8.4%, respectively) similar to those of animals fed 0W0W diets (10.2 and 3.2%, respectively; P > 0.05), whereas animals fed 40W40W had the highest fecal prevalence and percent enumerable samples (70.1 and 29.2%, respectively; P < 0.05). Similar relationships between the treatments were observed for hide samples. Time after dietary switch was important, as animals fed lower levels had significantly lower fecal prevalence and percent enumerable samples after 56 days, but not after 28 days. The study indicates that cattle can be switched to lower levels of dietary WDGS (15% or less) 56 days prior to harvest to significantly reduce E. coli O157:H7 in feces and on hides.

A latent class analysis of psychosis-like experiences in the New Zealand Mental Health Survey

OBJECTIVE

To describe the underlying structure of psychosis-like experiences in the New Zealand Mental Health Survey.

METHOD

A nationwide survey of household residents aged 16+ years was undertaken (n = 7435), using the Composite International Diagnostic Interview (3.0), including a six question lifetime screener for psychosis. Participants were grouped in three ways: by the number of 'symptoms' (occurring when not dreaming, half-asleep or under the influences of drugs) and by latent classes derived from binary responses (no/yes) or ordinal responses (never/sub-threshold/few times/many times).

RESULTS

Psychosis-like events were not uncommon (7.3%; 95% CIs 6.5-8.1), particularly experiences of visual (5.3%; 95% CIs 4.7-6.0) or auditory hallucinations (2.8%; 95% CIs 2.3-3.3). Both latent class analyses indicated a 'normal' class, a 'hallucinatory class' and a 'psychotic' class. The lifetime probability of anxiety, mood or substance disorders and the lifetime probability of seeking help for mental health problems increased from 'normal' to 'hallucinatory' to 'psychotic' classes and with the 'symptom' count.

CONCLUSION

The presence of sub-threshold events and variation in the number of times a 'symptom' is experienced suggest a psychosis continuum. However, the latent classes labelled 'hallucinatory' and 'psychotic' differ markedly in symptomatology, which suggests some form of discrete clustering.

Association of angiopoietin-2, C-reactive protein and markers of obesity and insulin resistance with survival outcome in colorectal cancer

Background:

This study investigated the relationship of obesity, insulin resistance, inflammation and angiogenesis with cancer progression and survival in a colorectal cancer cohort.

Methods:

Clinical and pathological data, along with anthropometric and follow-up data, were collected from 344 consecutive colorectal cancer patients. Serum samples at diagnosis were analysed by immunoassay for adiponectin, C-reactive protein (CRP), vascular endothelial growth factor-A (VEGF-A), angiopoietin-2 (Ang-2), insulin-like growth factor-1 (IGF-1), insulin and C-peptide.

Results:

Serum Ang-2 and VEGF-A levels increased with tumour T stage (P=0.007 and P=0.025, respectively) and N stage (P=0.02 and P=0.03, respectively), and correlated with CRP levels (r=0.43, P<0.001 and r=0.23, P<0.001, respectively). Angiopoietin-2 correlated with C-peptide (r=0.14, P=0.007) and VEGF-A with IGF-1 in males (r=0.25, P=0.001). Kaplan–Meier analysis showed that patients with high serum levels of CRP and Ang-2 had significantly reduced survival (both P⩽0.001). After adjusting for tumour stage and age, Ang-2 remained a significant predictor of survival. The CRP levels were inversely associated with survival in American Joint Committee on Cancer stage II patients (P=0.038), suggesting that CRP could be used to support treatment decisions in this subgroup. Serum markers and anthropometric measures of obesity correlated with each other, but not with survival.

Conclusion:

Our study supports the concept that obesity-related inflammation, rather than obesity itself, is associated with colorectal cancer progression and survival. The study confirms serum Ang-2 as a predictive marker for outcome of colorectal cancer.

Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders

BACKGROUND

Prior research on whether marriage is equally beneficial to the mental health of men and women is inconsistent due to methodological variation. This study addresses some prior methodological limitations and investigates gender differences in the association of first marriage and being previously married, with subsequent first onset of a range of mental disorders.

METHOD

Cross-sectional household surveys in 15 countries from the WHO World Mental Health survey initiative (n=34493), with structured diagnostic assessment of mental disorders using the Composite International Diagnostic Interview 3.0. Discrete-time survival analyses assessed the interaction of gender and marital status in the association with first onset of mood, anxiety and substance use disorders.

RESULTS

Marriage (versus never married) was associated with reduced risk of first onset of most mental disorders in both genders; but for substance use disorders this reduced risk was stronger among women, and for depression and panic disorder it was confined to men. Being previously married (versus stably married) was associated with increased risk of all disorders in both genders; but for substance use disorders, this increased risk was stronger among women and for depression it was stronger among men.

CONCLUSIONS

Marriage was associated with reduced risk of the first onset of most mental disorders in both men and women but there were gender differences in the associations between marital status and onset of depressive and substance use disorders. These differences may be related to gender differences in the experience of multiple role demands within marriage, especially those concerning parenting.

Soil versus Pond Ash Surfacing of Feedlot Pens: Occurrence of Escherichia coli O157:H7 in Cattle and Persistence in Manure

Reducing Escherichia coli O157:H7 in cattle and their manure is critical for reducing the risk for human foodborne and waterborne illness. The objective of this study was to evaluate the effects of soil and pond ash surfaces for feedlot pens on the prevalence, levels, and/or persistence of naturally occurring E. coli O157:H7 and total E. coli in cattle (feces and hides) and manure. Cattle (128 beef heifers) were sorted among 16 pens: 8 surfaced with soil and 8 surfaced with pond ash. The prevalence of E. coli O157:H7 in feces decreased (P < 0.0001) during the study from 57.0% on day 0 to 3.9% on day 84 but did not differ (P > or = 0.05) between cattle on soil and on pond ash pens at any sampling period. The prevalence of the pathogen on hides and in feedlot surface material (FSM) also decreased (P < 0.0001), with no effect of soil or pond ash surface (P > or = 0.05). Similarly, levels of E. coli in FSM did not differ (P > or = 0.05) at any sampling period, and there were no clear trends for survival differences of E. coli O157:H7 or E. coli in FSM between pond ash and soil surfaces, although E. coli populations survived at 5.0 log CFU/g of FSM on the pen surfaces 6 weeks after the cattle were removed. These results indicate that housing cattle on pens surfaced with pond ash versus pens surfaced with soil does not affect E. coli O157:H7 in cattle or their manure.

Manure odor potential and Escherichia coli concentrations in manure slurries of feedlot steers fed 40% corn wet distillers grains

This study evaluated feeding 0 and 40% wet distillers grains with solubles (WDGS) diets to cattle and the effects on feedlot manure collected from soil-based pens and incubated for 28 d. Steers (n = 603; 261 +/- 32 kg) were fed in eight pens (15 x 150 m) of 75 to 77 steers per pen. Two consecutive experiments were conducted with WDGS--one in which the corn source fed with WDGS was high-moisture and one in which WDGS was fed with dry-rolled corn. We compared odorants (volatile fatty acids [VFAs], aromatic compounds, NH3, H2S) and persistence of Escherichia coli in feedlot manure slurries stored from 0 to 28 d. From both experiments, manure collected from cattle fed 40% WDGS had lower (P < 0.05) total VFAs, including acetate, propionate, and butyrate, all of which continued to be lower to 28 d. However, these slurries had greater concentrations (P < 0.05) of branched-chained VFAs (isobutyrate and isovalerate), especially after 14 d of incubations. Similarly, p-cresol and skatole concentrations tended to be greater in slurries originating from 40% WDGS diets and increased with incubation time. Indole was initially greater in the slurries from 40% WDGS diets; however, it was metabolized by microbes during incubation. Manure slurries from the 40% WDGS diets had greater quantities of H2S, NH3, and P (P < 0.05). Levels of E. coli in 0 and 40% WDGS manure slurries were similar when high-moisture corn was used in the diets. However, when dry-rolled corn was used, E. coli persisted longer in 40% WDGS manure slurries in comparison to 0% WDGS. Results here support earlier studies that suggest feeding WDGS increases odor emissions, N loss, E. coli survival, and surface water contamination due to greater potential P runoff.

The effects of dietary additives on faecal levels of Lactobacillus spp., coliforms, and Escherichia coli, and faecal prevalence of Salmonella spp. and Campylobacter spp. in US production nursery swine

AIMS

In the United States, carbadox and copper sulfate are growth promoters commonly used in combination in nursery swine diets. Our aim was to determine how selected dietary additives affect selected bacterial populations and pathogens in nursery swine, and compare to larch extract, which contains potential antibacterial activities.

METHODS AND RESULTS

Piglets were weaned and sorted into one of the four treatments: (i) basal diet without antimicrobials; (ii) basal diet with carbadox + copper sulfate; (iii) basal diet + 1000 ppm larch extract; or (iv) basal diet + 2000 ppm larch extract. Diets were fed for a 4-week period after weaning. In both trials, the carbadox + copper sulfate group consumed more feed over the 4-week period relative to the other three diet groups (P < 0.05), but did not gain significantly more weight. Faecal shedding of Salmonella spp. was not affected by dietary supplement in either trial, but faecal shedding of Campylobacter spp. was the lowest for the carbadox + copper sulfate diet. In faecal samples collected at the end of each trial, Lactobacillus spp. cell counts for the basal and larch extract diets were nearly 1.0 log(10) g(-1) faeces greater (P < 0.05) than the carbadox + copper sulfate group, whereas the coliforms and Escherichia coli were nearly 1.0 log(10) g(-1) faeces lower (P < 0.05).

CONCLUSIONS

Compared to basal fed animals, supplementation with carbadox + copper sulfate significantly altered faecal E. coli, coliform bacteria and Lactobacillus spp. Larch extract has no benefit up to 0.2% of diet in regard to pathogen shedding, whereas carbadox + copper sulfate decreased faecal shedding of Campylobacter spp.

SIGNIFICANCE AND IMPACT OF THE STUDY

Current swine management practices in the United States may be beneficial to managing Campylobacter spp. shedding in nursery swine, but also result in significant changes in the resident gastrointestinal microflora.

Evaluation of a direct-fed microbial product effect on the prevalence and load of Escherichia coli O157:H7 in feedlot cattle

Direct-fed microbials (DFM) have been identified as potential preharvest interventions for the reduction of foodborne bacterial pathogens such as Escherichia coli O157:H7. This study evaluated the efficacy of a DFM consisting of Bacillus subtilis strain 166 as an antimicrobial intervention strategy for the reduction of prevalence and load of E. coli O157:H7 in feces and on hides of feedlot cattle. Cattle (n = 526) were divided among 16 feedlot pens. Half of the pens received the DFM, and the other half did not. Hide and fecal samples were collected from each animal on days 28, 63, and 84 of the feeding trial. Over the course of the 84-day feeding period, there were no significant differences observed between treatments for either hide or fecal prevalence of E. coli O157:H7, or for the percentage of animals that were shedding E. coli O157:H7 at high levels (> or =200 CFU/g) in their feces or harboring E. coli O157:H7 at high levels (> or =40 CFU/cm(2)) on their hides. In addition, there was no significant difference between the average daily gains for the treated and control groups, with both groups averaging 1.3 kg/day. We concluded that the DFM tested would not be an effective preharvest intervention against E. coli O157:H7.

Escherichia coli O157:H7: recent advances in research on occurrence, transmission, and control in cattle and the production environment

Escherichia coli O157:H7 is a zoonotic pathogen that is an important cause of human foodborne and waterborne disease, with a spectrum of illnesses ranging from asymptomatic carriage and diarrhea to the sometimes fatal hemolytic uremic syndrome. Outbreaks of E. coli O157:H7 disease are often associated with undercooked beef, but there are other sources of transmission, including water, produce, and animal contact, which can often be linked directly or indirectly to cattle. Thus, preharvest control of this pathogen in cattle production should have a large impact on reducing the risk of human foodborne illness. In this review, we will summarize preharvest research on E. coli O157:H7 in cattle and the production environment, focusing on factors that may influence the transmission, prevalence, and levels of this pathogen, such as season, diet, high-level shedders, and animal stress. In addition, we will discuss recent research on the reduction of this pathogen in cattle production, including vaccination, probiotics, bacteriophage, and manure treatments.