Swine Health Impact on Carcass Contamination and Human Foodborne Risk

Size: px
Start display at page:

Download "Swine Health Impact on Carcass Contamination and Human Foodborne Risk"

Transcription

1 Reserch Articles Swine Helth Impct on Crcss Contmintion nd Humn Foodorne Risk H. Scott Hurd, DVM, PhD Jen Brudvig, DVM, MPH Jmes Dickson, PhD Jovn Mircet, DVM c Miroslv Polovinski c Nel Mtthews, MS, PhD d Ronld Griffith, DVM, PhD SYNOPSIS Ojective. This study mesured the reltionship etween lesions suggestive of suclinicl pig illness t hrvest to crcss contmintion nd humn foodorne risk. Methods. Over the course of eight visits (Decemer 2005 to Jnury 2006), we swed 280 rndomly selected crcsses, during norml slughter opertions, t three points in the slughter line: skin pre-scld; the ung or pelvic cvity following removl of the distl colon nd rectum; nd pleurl cvity, immeditely efore the finl crcss rinse. Ech sw sponge ws used on five crcsses in ung nd pleurl cvity smpling. Sw sponges were cultured quntittively for Cmpylocter spp., Enterococcus spp., nd Enteroctericee spp., nd qulittively for Slmonell spp. Dt on helth indictors were collected for ll pigs in the study (2,625 pigs) y experienced plnt qulity ssurnce personnel. Results. Cmpylocter spp. were recovered from the pleurl cvity in 58.9% (33/56) of pools (five crcsses/pool), nd in 44.6% (25/56) of pools from the ung cvity. Enterococcus spp. were recovered from 66.1% (37/56) nd 35.7% (20/56) of pleurl nd ung pools, respectively. The most common lesion identified ws the peel-out (pleuritis or dhesions), with totl of 7.1% (186/2,625 totl hed). Liner regression showed tht for every percentge point increse in peel-outs, Enterococcus spp. contmintion incresed y 4.4% nd Cmpylocter spp. incresed y 5.1% (p 0.05). Conclusions. This study showed correltion etween niml helth nd humn helth risk, s mesured y crcss contmintion. Therefore, niml mngement decisions on-frm, such s housing, ntiiotic use, environment, nd level of veterinry cre, my directly impct pulic helth. Iow Stte University, College of Veterinry Medicine, Ames, IA Iow Stte University, College of Agriculture, Ames, IA c University of Novi Sd, Novi Sd, Seri Montenegro d Premium Stndrd Frms, Miln, MO Address correspondence to: H. Scott Hurd, DVM, PhD, College of Veterinry Medicine, Iow Stte University, VMRI Building 4, Ames, IA 50011; tel ; fx ; e-mil <shurd@istte.edu> Assocition of Schools of Pulic Helth 343

2 344 Reserch Articles Since the pssge of the Food nd Drugs Act in 1906, the pulic hs greed tht the consumption of helthy food nimls is in the est interest of pulic helth. 1 Tody, pulic helth risks not detected y trditionl visul inspection procedures in the pcking plnt include chemicl or ntiiotic residues nd foodorne pthogens. The one medicine concept, or the close ssocition of the medicl nd veterinry professions for the helth of ll species, 2 is often discussed; however, it is uncler how veterinry cre specificlly impcts pulic helth risks. Accurte quntifiction of this risk-risk reltionship etween niml helth nd pulic helth is essentil for effective policy-mking. The risk-risk pproch hs een pplied to some pulic helth issues in the U.S., such s the Environmentl Protection Agency s ssessment of cncer risk from chlorinted wter reltive to cteril risk from nonchlorinted wter. 3,4 To conduct these types of nlyses in the food sfety ren, the link etween niml nd humn helth needs to e mesured. Antemortem inspection usully removes cliniclly ill nimls from the humn food supply. However, sucliniclly ill nimls ppering helthy t slughter my hve internl lesions ffecting processing. These lesions my impct the eviscertion process leding to cross-contmintion nd incresed pthogen lod. Enterococcus is n indictor of fecl contmintion on the crcss. Cmpylocter spp. nd Slmonell spp. re common humn foodorne pthogens, nd thus indicte the level of pulic helth risk. Additionlly, these lesions often indicte chronic or resolved illnesses in the growing or finishing pig. 5 The ojective of this study ws to quntify the reltionship etween lesions detected t slughter nd cteril crcss contmintion. METHODS For cteriologicl evlution, we selected crcsses during norml slughter opertions in modern, verticlly integrted pork production compny. We swed three loctions on the crcsses t three different points in the slughter line: (1) the skin immeditely efore scld; (2) the ung (pelvic) cvity immeditely fter removl of the ung (distl colon nd rectum) ut efore eviscertion; (3) nd the pleurl cvity following complete eviscertion nd immeditely prior to finl crcss rinse. Becuse crcsses were not identified t the point of smple collection, it is likely tht we did not otin smples from ll three res on the sme crcss; i.e., we took only one smple from one of the three sites per crcss. We otined dt on eight different visits during Decemer 2005 nd Jnury 2006, with n verge of 328 pigs per group. In this opertion, pigs re mrketed from single rn on two or three seprte occsions. The first pigs mrketed re those first chieving cceptle weight. We smpled these first pull pigs the fstest-growing nd likely the helthiest first thing in the morning to minimize cross-contmintion mong workers, crcsses, nd mchinery. On Mondy, we collected smples from conventionl pigs, nd on Tuesdy from ntiiotic-free pigs. CON-rised pigs received ntiiotics for disese prevention or tretment, or performnce enhncement from lte nursery until ner slughter. ABF pigs were rised without performnce-enhncing/preventive or tretment ntiiotics. Cliniclly ill nimls requiring tretment were moved to seprte pens in the sme uilding nd were sent to mrket seprte from their ABF cohorts. Mngement of the two groups, excepting ntiiotic tretment, ws similr in veterinry cre, housing, environment, nd feed. Microiologicl comprison etween ABF nd CON pigs ws secondry ojective in this study, nd is not reported here. Helth indictors Experienced plnt qulity ssurnce (QA) personnel reported cses of the following helth indictors per group ( group represented ll pigs processed from one rn on tht dy): Ascessed heds: condemned heds due to visile scesses. Peel-outs (pleuritis or dhesions): the pleurl lining is removed fter eviscertion due to dhesions etween the pleur nd portions of the lung. Portions of the lung were usully ttched. Ftigued: nimls exhiit signs of neroic metolism, including respirtory distress (open-mouth rething), reluctnce to move, or recumency. Bcteriology Specimen collectors wore ltex gloves nd chnged gloves etween ech smpling. We swed the crcsses with Whirl-Pk Speci-Sponges (Nsco, Ft. Atkinson, Wisconsin) sws hydrted with 10m sterile 0.1% peptone wter. For the pre-scld smples, one sponge ws used for ech crcss. However, for the ung (pelvic) nd pleurl cvity smpling, one sponge ws used for five crcsses pooling method commonly used in Denmrk to llow for the incresed efficiency needed to detect the expected low numer of Slmonell spp. positive crcsses. 6 The interior surfce of the pelvic, dominl, nd thorcic cvity ws swed, covering s much re s possile in the short time ville, s crcsses were still moving down the line. Sponges were

3 Swine Helth Impct on Crcsses nd Humns 345 mintined on ice during trnsport to the lortory. We minimized differences in storge times etween the two groups y immeditely trnsporting smples to the lortory on Mondy nd Tuesdy fternoons. In the lortory, we enriched sponges with 15mL sterile 0.1% peptone wter, stomched the sponges (Sewrd Stomcher 3500, Worthing, West Sussex, UK) for one minute, serilly diluted the smples in 0.1% peptone wter, nd then plted on selective grs for Cmpylocter spp., Enteroctericee spp., nd Enterococcus spp. We complied with Nnnpneni 7 in Cmpylocter gr (CA) preprtion y comining Cmpylocter enrichment roth (Bolton formul, LAB 135; J&K Microiologics, Inc., North Ridgeville, Ohio) with 1.5% gr (Becton Dickinson Microiology Systems, Sprks, Mrylnd), mixing Cmpylocter selective ntiiotic supplement (X132, J&K Microiologics, Inc.) nd 5% lysed defirinted horse lood (MT 59074; Qud Five, Ryegte, Montn) thoroughly efore pouring CA pltes. We septiclly spred 100µL of diluted smples onto CA pltes in duplicte. The pltes were incuted in Form Tri-gs incutor (5% O 2, 10% CO 2, 85% N 2 ) t 42 C nd evluted t 24 nd 48 hours. To isolte Enterococcus spp., we septiclly spred 100µL of diluted smple onto Enterococcosel gr (Difco, Becton Dickinson Microiology Systems) in duplicte nd incuted for 24 hours t 35 C. Similrly, we isolted Enteroctericee spp. y septiclly spreding 100µL of diluted smple onto violet red ile gr with glucose (VRBG, Difco, Becton Dickinson Microiology Systems) in duplicte (24 hours t 37 C). For Slmonell spp., we enriched the remining uffer nd sponge sw in uffered peptone wter, nd screened these with n ntigen-cpture enzyme-linked immunosorent (Revel Slmonell; Neogen, Lnsing, Michign) ssy to determine presumptive Slmonell spp. positives. Presumptive positive smples were enriched in tetrthionte roth (24 hours t 37 C) nd streked for isoltion on XLD gr (24 hours t 37 C). Colonies exhiiting typicl slmonell morphology nd phenotypic rections were trnsferred to Triple Sugr Iron gr (TSI) nd Lysine Iron gr (LIA) slnts. Colonies showing typicl slmonell-like rections on TSI nd LIA were confirmed using the BBL Crystl Enteric/ Nonfermenter ID kit, following the mnufcturer s instructions. Slmonell spp. colonies were serotyped t the U.S. Deprtment of Agriculture (USDA) Animl nd Plnt Helth Inspection Service (APHIS) Ntionl Veterinry Services Lortory. Sttisticl nlysis We compred the mens of the vriles etween the CON nd ABF groups with t-tests nd the Wilcoxon rnk sum test. We did not use the nonprmetric Chi-squre test s it requires comining ll the CON smples into single group, nd there ws sustntil vrince etween the oservtions y replicte. We evluted the ssocition etween helth (percent lesions) nd contmintion (percent of pools positive) with liner regression using ivrite liner regression etween ll possile pirs of contmintion nd helth. Contmintion ws the response vrile. For the regression, the helth nd the contmintion vriles tht were percentges (rnge50 100) were treted s unounded continuous vriles. Becuse the helth nd the contmintion vrile vlues in the CON group differed sustntilly from those in the ABF group, we used multivrite regression y forcing the ntiiotic use group (ABF or CON) indictor vrile into the model. We lso utilized multivrite liner regression to determine whether the quntity of cteri (log of the most prole numer) ws ssocited with niml helth indictors. RESULTS On ech visit, 35 crcsses were swed t ech loction (ung [pelvic] cvity, pleurl cvity, skin pre-scld). One sponge ws used for five crcsses, resulting in seven pools of crcsses swed per replicte, except for pre-scld, where only one sponge ws used. A totl of 280 crcsses over eight replictes were swed, resulting in 56 pools for culture. Tle 1 shows the results of cteril contmintion y loction on the crcss. In Tle 1, n represents the numer of crcsses ville for swing in prticulr replicte nd the numer oserved for helth indictors (Tle 2). Enteroctericee spp. ws recovered in high percentge of the pools, rnging from men of 82.1% pre-scld (46/56 pools) to 96.4% (54/56 pools) of ung sws. Slmonell spp. ws recovered in reltively low percentge of pools, rnging from men of 8.9% in oth the ung nd pleurl cvities (5/56 pools) to 17.9% (10/56 pools) pre-scld. Becuse the level of cteri on the skin pre-scld is less mesure of food sfety nd more n indictor of how dirty the pigs re t slughter, we excluded this pre-scld mesure from further nlyses. One experienced plnt QA person oserved ll crcsses (2,625 hed) for helth-relted lesions. Results re shown in Tle 2. The most common lesion identified ws the peel-out, with totl of 7.1% (186/2,625 totl hed). Ascessed heds were found in 1.7% (44/2,625) of crcsses. Antemortem signs of ftigue were recorded in 0.5% (13/2,625) of oserved nimls. Similr to contmintion rtes, vritions in helth sttus existed etween replictes. Tle 3 shows

4 346 Reserch Articles Tle 1. Bcteril contmintion of swine crcsses t slughter collected from three different points in the slughter process: skin pre-scld, pelvic (ung), nd pleurl cvities Numer positive out of 7 pools Orgnism nd loction Rep. 1 n 337 Rep. 1 n 326 Rep. 2 n 332 Rep. 2 n 338 Rep. 3 n 320 Rep. 3 n 320 Rep. 4 n 316 Rep. 4 n 336 Percent of positive pools (n 56) Slmonell pre-scld Slmonell ung Slmonell pleur Enterococcus pre-scld Enterococcus ung Enterococcus pleur Enteroctericee pre-scld Enteroctericee ung Enteroctericee pleur Cmpylocter pre-scld Cmpylocter ung Cmpylocter pleur CON nimls received ntiiotics for growth promotion nd disese prevention nd tretment; ABF nimls never received ntiiotics. n numer of crcsses ville for testing in ech Rep. CON conventionlly rised ABF ntiiotic-free Rep. replicte comprison of helth nd contmintion etween ntiiotic use groups. There ws no sttisticlly significnt (p 0.05) difference in helth indictors etween groups. While ABF pigs hd more scessed heds thn CON pigs (2.7% compred with 0.7%, p=0.06), cteril contmintion ws consistently higher in the CON pigs. For only this reson, the ntiiotic use group ws included s covrite in the regression models mesuring the reltionship etween helth nd contmintion. Tle 4 shows the results for regression nlysis etween helth indictors nd percent of crcsses contminted. Although some confidence intervls (CIs) re estimted s less thn zero, ll of the predicted Tle 2. Helth indictors for swine t hrvest Numer positive (out of n hed oserved) Helth indictor Rep. 1 n 337 Rep. 1 n 326 Rep. 2 n 332 Rep. 2 n 338 Rep. 3 n 320 Rep. 3 n 320 Rep. 4 n 316 Rep. 4 n 336 Totl (n 2,625) (percent) 95% CI Peel-out c (7.10) 6.10, 8.07 Ascessed heds d (1.70) 1.20, 2.20 Ftigue e (0.50) 0.20, 0.76 CON nimls received ntiiotics for growth promotion nd disese prevention nd tretment; ABF nimls never received ntiiotics. n numer of crcsses ville for testing in ech Rep. c Pleuritis or pleurl dhesions usully requiring removl of the cvity lining d Heds condemned due to visile scess(es) e Aneroic metolism, respirtory distress, recumency CON conventionlly rised ABF ntiiotic-free Rep. replicte CI confidence intervl

5 Swine Helth Impct on Crcsses nd Humns 347 Tle 3. Comprison of the key helth indictors nd contmintion rtes etween ABF nd CON pigs Vrile Totl percent in CON groups (n 1,305 pigs) Totl percent in ABF groups (n 1,320 pigs) P-vlue for two-sided t-test Peel-out Ascessed heds c Ftigue d Cmpylocter in pleurl cvity Cmpylocter in ung cvity Enterococcus in ung cvity CON pigs received ntiiotics for growth promotion nd disese prevention nd tretment; ABF pigs never received ntiiotics. Pleuritis nd pleurl dhesions c Heds condemned due to visile scess(es) d Aneroic metolism, respirtory distress, recumency ABF ntiiotic-free CON conventionlly rised Rep. replicte vlues were within the intervl (rnge50 100). These results indicte tht s the percentge of sucliniclly ill nimls (evidenced y peel-outs [pleuritis or dhesions] nd ftigue) increses, so does the percentge of crcsses with cteril contmintion. We found the strongest positive reltionships etween the percentge of peel-outs nd Cmpylocter spp. contmintion in the pleurl cvity (β55.7) nd etween peel-out percent nd Enterococcus spp. contmintion in the ung (pelvic) cvity (β55.1). In the multivrite model (ntiiotic use s covrite), these reltionships were sttisticlly significnt (p 0.05), s shown y the 95% CIs tht do not include zero. We lso identified nother positive reltionship etween the percentge of ftigued pigs nd Cmpylocter spp. contmintion in the ung cvity. The Figure grphiclly shows the reltionship etween helth nd contmintion: s the percentge of peel-outs in group increses y 1 percentge point, the pleurl Cmpylocter spp. contmintion increses 5 percentge points, nd Enterococcus spp. contmintion in the ung increses 4.4 percentge points. We identified negtive reltionships etween cteril contmintion nd the percentge of scessed heds in the group. In the multivrite regression, s the percentge of scessed heds incresed, Cmpylocter spp. contmintion in the pleur decresed (β5 6.2), s did Enterococcus spp. in the ung (β5 2.5). Tle 4. Regression coefficients (univrite nd multivrite with ntiiotic use group s covrite) etween percentge of representtive helth vriles nd percentge of crcsses positive for Enterococcus spp. or Cmpylocter spp. in the ung or pleurl cvities, Helth indictor Bcteril contmintion Loction on crcss Regression coefficient (ß) (univrite) 95% CI Regression coefficient (ß) (multivrite) 95% CI Ftigued c Cmpylocter Bung 41.0 ( 19.0, 102.0) 10.0 ( 50.0, 70.0) Peel-outs d Cmpylocter Pleur 5.7 ( 0.3, 11.7) 5.1 (0.4, 9.9) Peel-outs Enterococcus Bung 5.1 ( 1.3, 11.5) 4.4 (1.3, 7.4) Ascessed heds e Cmpylocter Pleur 12.7 ( 31.0, 5.0) 6.2 ( 33.0, 21.0) Ascessed heds Enterococcus Bung 13.3 ( 31.0, 0.5) 2.5 ( 24.0, 19.0) All helth nd contmintion reltionships were tested. Only those with p 0.2 in the univrite comprison re shown. Conventionlly rised nimls received ntiiotics for growth promotion nd disese prevention nd tretment; ntiiotic-free nimls never received ntiiotics. c Aneroic metolism, respirtory distress, recumency d Pleuritis nd pleurl dhesions e Heds condemned due to visile scess(es) CI confidence intervl

6 348 Reserch Articles Neither of these negtive correltions ws sttisticlly significnt in this dtset. Additionlly, Tle 5 shows sttisticlly significnt reltionships etween the percentge of peel-outs in the group nd the quntity (log of the men colony forming units, log 10 CFU) of Enterococcus spp. present in the ung cvity (β50.38). A positive correltion ws lso identified etween the quntity of Cmpylocter spp. in the pleurl cvity nd the percentge of peel-outs. DISCUSSION This study shows correltion etween lesions suggestive of suclinicl niml illness nd humn helth risk, s mesured y crcss contmintion (Cmpylocter spp., Enterococcus spp.). 5 The rtionle cn e understood from the impct of niml helth on the eviscertion process: ntemortem inspection processes typiclly remove cliniclly ill nimls. However, if disese is not outwrdly evident or hs resolved, leving old lesions, these ill nimls my go undetected until eviscertion. In previous studies, 50% of normlities went undetected y Europen Commission inspection methods. 8 Insufficient or imprecise eviscertion ws shown to impct the proility of crcss contmintion nd microil lod more thn other processes in slughter. For exmple, Enteroctericee spp. contmintion incresed from 4% to 40% during processing from polishing (eginning) to post-eviscertion (end). 8 Dressing, splitting, nd met inspection cn ccount for 85% to 90% of crcss contmintion. 9,10 Therefore, lesions ffecting eviscertion qulity will ffect pulic helth risk y incresing crcss hndling nd crosscontmintion. Helth conditions tht ffect eviscertion qulity include peritonitis, pleuritis, dhesions, volume nd fluidity of gut contents, gut friility, nd ny helth condition tht leds to dditionl hndling (skin lesions, ruises, scesses, rthritis). Helth indictors One experienced plnt QA person recorded the helth indictors used in this study, which reflect orgnoleptic (ssessment y sight nd touch) inspection issues tht must e ddressed in the slughter process. The definition of peel-out, or ftigued pig, is specific from met-inspection perspective, ut is not specific veterinry pthologicl dignosis. The precise pthologicl mening of the indictors needs to e defined. The Figure. Reltionship (multivrite liner regression) etween percentge of peel-outs nd crcss contmintion with Cmpylocter spp. in the pleur (%Cmpy PL) nd Enterococcus spp. in the ung cvity (%Ecocc B) in pig crcsses cultured during processing

7 Swine Helth Impct on Crcsses nd Humns 349 Tle 5. Regression coefficients of the quntity (log10cfu/ml) of Cmpylocter spp. nd Enterococcus spp. present in the pleur nd ung, nd the percentge of peel-outs in slughter pigs Bcteril contmintion Log men CFU Log men CFU Regression coefficient (multivrite) 95% CI Cmpy pleur ( 0.27, 1.05) Ecocci ung ( 0.1, 0.86) Ecocci pleur ( 0.35, 0.85) CON nimls received ntiiotics for growth promotion nd disese prevention nd tretment. ABF nimls never received ntiiotics. CFU colony-forming units CON conventionlly rised nimls ABF ntiiotic-free nimls Cmpy Cmpylocter spp. Ecocci Enterococcus spp. CI confidence intervl 13 ftigued pigs in this study exhiited signs of rethlessness nd difficulty in moving. After dditionl rest in the pens, they were multory, nd pssed USDA Food Sfety nd Inspection Service (USDA:FSIS) veterinry inspection for norml slughter. Future reserch should etter define the specific pthologicl dignosis of these helth indictors. Reserch hs shown tht pthology in the thorx, such s pleuritis nd dhesions, is likely due to respirtory disese erlier in life. 5 Crcsses requiring peel-out typiclly hve portions of the lung ttched to the pleur. Although ftigue nd peel-outs re indirect mesures of pig helth, oth of these vriles were correlted with n incresed mount of cteril crcss contmintion, nd thus wrrnt further explortion. The ojective of this study ws not to compre ABF nd CON pigs. These groups were studied s prt of n ojective, reported elsewhere, to compre ntiiotic resistnce ptterns. 11 Given the dt collected, comprison etween these two groups is tenuous. Although ABF nd CON nimls were rised with similr mngement, feed, nd housing, ABF pigs likely represent different popultion thn CON pigs. The ABF group included only fster-growing nimls tht were never treted with ny ntiiotic, representing the est of the est. Ill nimls in the ABF group were removed from tht group nd treted, remining in seprte pens until slughter. CON pigs my hve received previous tretment for clinicl illness. Consequently, in these dt, comprison of helth prmeters etween ABF nd CON is to e voided, especilly without more detiled dt such s moridity/mortlity rtes, rte of gin, nd feed efficiency. However, due to the higher contmintion rtes in the CON group, this vrile proved to e n importnt confounder in our regression models. Bcteril contmintion The loctions tested for contmintion (ung [pelvic] nd pleurl cvities) reflect two temporl extremes of the slughter process nd the crcss itself. The ung cvity ws swed erly in processing, while the pleurl cvity ws swed t the end of the slughter process, when the crcss represents ner-finl product entering the cutting nd friction process. Higher levels of Enterococcus spp. contmintion might e expected in the ung, which lies in close proximity to the nl orifice. However, Cmpylocter spp. hve een recovered from tonsils, stomch, ileum, cecum, colon, nd lymph nodes. 12 The ssocition etween pthology, such s peel-outs nd Cmpylocter spp. contmintion, does not suggest tht Cmpylocter cuses swine respirtory disese. Pssive inhltion of scld wter hs een implicted in contmintion of the lungs. Tering of the lungs during eviscertion my llow tht pssive contmintion onto the pleur. 13 Regression reltionships We descrie reltionships in these dt etween percent of group of pooled smples nd percent helth lesions oserved in trucklod of pigs. Smple pooling is n efficient mens to test more crcsses, which cn e used to estimte individul crcss prevlence of Slmonell spp. 5 However, in this study, we compred the percent positive pools rther thn estimting crcss prevlence. The sttisticl results reflect the reltively lower power of only seven oservtions (pools) per replicte. Therefore, it is noteworthy tht sttisticlly significnt correltions were detected with such smll study. The helth mesures, such s peel-outs, re not specific veterinry pthologicl dignoses; however, if there is ny misclssifiction, it would hve occurred nondifferentilly, mong the contminted nd noncontminted crcsses.

8 350 Reserch Articles The liner regression models suggest tht for every percentge point increse in lesions, there is 4 to 5 percentge point increse in contmintion. The Figure nd the CIs in Tles 4 nd 5 show the uncertinty round these predicted increses. This uncertin informtion cn e used in risk-risk models to estimte the impct of veterinry cre on humn helth risk. While it is uncler why cteril contmintion rtes were so much higher in the CON group (Tle 3), multivrite nlysis with ntiiotic use s covrite djusted for this oservtion. Therefore, the multivrite regression coefficients shown in Tle 4 illustrte the reltionship etween helth nd contmintion, even though contmintion in CON pigs ws higher. An insignificnt negtive ssocition ws noted etween scessed heds nd cteril crcss contmintion (Tle 4). A hed ws condemned if there were visile scesses (pockets of inflmmtory cells in res such s muscles or lymph nodes). Crcsses with visile hed scesses were more likely to e removed from the processing line for further inspection or condemntion. Given our study design, these crcsses would not e ville for cteriologicl exmintion t either the ung or pleurl loctions, producing negtive ssocition. While few studies hve reported miniml correltion etween lesions nd pthogen contmintion within the lesion, 14,15 these studies use different method. They focused on detecting the pthogen in the lesion site, not on pprently helthy prts of the crcss. Pulic helth implictions Implictions to humn helth found in this study uild on the ssumption tht swine crcss contmintion is resonle proxy for humn helth risk. USDA: FSIS inspection stndrds ccept this ssumption. The prevlence of Slmonell positive swine crcsses is the stndrd for meeting Hzrd Anlysis nd Criticl Control Point requirements. 16 In Denmrk, gols for swine Slmonell control re set reltive to crcss contmintion rtes, nd the sme stndrds re used in the Europen Union community. 17 Creful modeling of the swine slughter process corroorted this ssumption. Both Dutch nd Dnish scientists report tht reducing crcss contmintion is the most effective wy to reduce pulic helth risk Notly, some of these studies reported tht control methods fter crcss rinse (e.g., friction nd cutting) would not e effective due to dditionl cross-contmintion. 18 CONCLUSION This study gives preliminry indiction of risk-risk reltionship etween niml nd humn helth, which hs een explored y others. Russell showed tht decresed poultry helth t processing increses the proility of crcss contmintion with Cmpylocter spp. nd Slmonell spp. 22 Others hve shown tht smll chnges in niml helth cn hve lrge impcts on the numer of foodorne illness dys, even when djusting for the hypotheticl increse in illness dys from resistnt infections. 23,24 If the findings from this study cn e supported y further reserch nd repetition, then humn foodorne illness risk is impcted y swine helth. Therefore, niml mngement decisions onfrm such s housing, ntiiotic use, environment, nd veterinry cre directly impct pulic helth. The uthors thnk Ssidhr Mlldi for ssistnce in dt nlysis; Brend Ptton, Deprtment of Animl Science, for dt collection nd cteriology; nd Elnco Animl Helth, Greenfield, Indin, for prtil funding. At the time of puliction, Dr. Hurd ws serving s Deputy Undersecretry for Food Sfety t the U.S. Deprtment of Agriculture (USDA) Food Sfety nd Inspection Service. The opinions expressed in this rticle do not necessrily reflect those of the USDA. REFERENCES 1. U.S. Food nd Drug Administrtion. Federl Food nd Drugs Act of 1906 (The Wiley Act ) [cited 2007 My 31]. Aville from: URL: 2. Eston G, Alder M. Editor s choice: one medicine? BMJ 2005; 331: Environmentl Protection Agency (US). Drinking wter criteri document for chlormines [cited 2006 Dec 9]. Aville from: URL: dwchlormine.pdf 4. Kennedy D. Risks nd risks. Science 2005;309: Rdostits OM. Herd helth: food niml production medicine, 3rd ed. Phildelphi: W.B. Sunders Compny; p Sørensen LL, Aln L, Nielsen B, Dhl J. The correltion etween Slmonell serology nd isoltion of Slmonell in Dnish pigs t slughter. Vet Microiol 2004;100: Nnnpneni R, Story R, Wiggins KC, Johnson MG. Concurrent quntittion of totl cmpylocter nd totl ciprofloxcin-resistnt cmpylocter lods in rinses from retil rw chicken crcsses from 2001 to 2003 y direct plting t 42 degrees C. Appl Environ Microiol 2005;71: Berends BR, Snijders JM, vn Logtestijn JG. Efficcy of current EC met inspection procedures nd some proposed revisions with respect to microiologicl sfety: criticl review. Vet Rec 1993;133: Berends BR, Snijders JMA. Risk fctors nd control mesures during slughter nd processing. Proceedings of the Second Interntionl Symposium on Epidemiology nd Control of Slmonell in Pork; 1997 Aug 20 22; Cophenhgen, Denmrk. 10. Botteldoorn N, Heyndrickx M, Rijpens N, Grijspeerdt K, Hermn L. Slmonell on pig crcsses: positive pigs nd cross contmintion in the slughterhouse. J Appl Microiol 2003;95:

9 Swine Helth Impct on Crcsses nd Humns Ptton BS, Cse WR, Kocher ME, Mtthews JO, Griffith RW, Hurd HS, et l. The effect of swine production system on cteril prevlence nd ntiiotic resistnce. Interntionl Assocition for Food Protection Annul Meeting; 2006 Aug 13 16; Clgry, Alert. 12. Neskken T, Eckner K, Høidl HK, Røtterud OJ. Occurrence of Yersini enterocolitic nd Cmpylocter spp. in slughter pigs nd consequences for met inspection, slughtering, nd dressing procedures. Int J Food Microiol 2003;80: Borch E, Neskken T, Christensen H. Hzrd identifiction in swine slughter with respect to foodorne cteri. Int J Food Microiol 1996;30: Pointon AM, Hmilton D, Koleg V, Hthwy S. Risk ssessment of orgnoleptic postmortem inspection procedures for pigs. Vet Rec 2000;146: Mousing J, Kyrvl J, Jensen TK, Alæk B, Buttenschøn J, Svensmrk B, et l. Met sfety consequences of implementing visul postemortem met inspection procedures in Dnish slughter pigs. Vet Rec 1997;140: U.S. Deprtment of Agriculture, Food Sfety nd Inspection Service. Progress report on Slmonell testing of rw met nd poultry products, [cited 2007 Fe 5]. Aville from: URL: Borck B, Hld T. Annul report on zoonoses in Denmrk Ministry of Food, Agriculture nd Fisheries. 18. Berends BR, vn Knpen F, Mossel DAA, Burt SA, Snijders JMA. Slmonell spp. on pork t cutting plnts nd t the retil level nd the influence of prticulr risk fctors. Int J Food Microiol 1998;44: Aln L, Stärk KD. Where should the effort e put to reduce the Slmonell prevlence in the slughtered swine crcss effectively? Prev Vet Med 2005;68: Nielsen B, Dhl J, Goldch S, Christensen H. Cost-effectiveness nlysis of the Dnish Slmonell control strtegy. Proceedings of the 6th Interntionl Symposium on the Epidemiology nd Control of Foodorne Pthogens in Pork; 2005 Sep 6 9; Rohnert Prk, Cliforni. 21. Goldch SG, Aln L. A cost-enefit nlysis of Slmonell-control strtegies in Dnish pork production. Prev Vet Med 2006;77: Russell SM. The effect of irscculitis on ird weights, uniformity, fecl contmintion, processing errors, nd popultions of Cmpylocter spp. nd Escherichi coli. Poult Sci 2003;82: Cox LA Jr., Popken DA. Quntifying potentil humn helth impcts of niml ntiiotic use: enrofloxcin nd mcrolides in chickens. Risk Anl 2006;26: Singer RS, Cox LA Jr., Dickson JS, Hurd HS, Phillips I, Miller GY. Modeling the reltionship etween food niml helth nd humn foodorne illness. Prev Vet Med 2007;79:

Small Businesses Decisions to Offer Health Insurance to Employees

Small Businesses Decisions to Offer Health Insurance to Employees Smll Businesses Decisions to Offer Helth Insurnce to Employees Ctherine McLughlin nd Adm Swinurn, June 2014 Employer-sponsored helth insurnce (ESI) is the dominnt source of coverge for nonelderly dults

More information

Treatment Spring Late Summer Fall 0.10 5.56 3.85 0.61 6.97 3.01 1.91 3.01 2.13 2.99 5.33 2.50 1.06 3.53 6.10 Mean = 1.33 Mean = 4.88 Mean = 3.

Treatment Spring Late Summer Fall 0.10 5.56 3.85 0.61 6.97 3.01 1.91 3.01 2.13 2.99 5.33 2.50 1.06 3.53 6.10 Mean = 1.33 Mean = 4.88 Mean = 3. The nlysis of vrince (ANOVA) Although the t-test is one of the most commonly used sttisticl hypothesis tests, it hs limittions. The mjor limittion is tht the t-test cn be used to compre the mens of only

More information

Utilization of Smoking Cessation Benefits in Medicaid Managed Care, 2009-2013

Utilization of Smoking Cessation Benefits in Medicaid Managed Care, 2009-2013 Utiliztion of Smoking Cesstion Benefits in Medicid Mnged Cre, 2009-2013 Office of Qulity nd Ptient Sfety New York Stte Deprtment of Helth Jnury 2015 Introduction According to the New York Stte Tocco Control

More information

Enterprise Risk Management Software Buyer s Guide

Enterprise Risk Management Software Buyer s Guide Enterprise Risk Mngement Softwre Buyer s Guide 1. Wht is Enterprise Risk Mngement? 2. Gols of n ERM Progrm 3. Why Implement ERM 4. Steps to Implementing Successful ERM Progrm 5. Key Performnce Indictors

More information

DlNBVRGH + Sickness Absence Monitoring Report. Executive of the Council. Purpose of report

DlNBVRGH + Sickness Absence Monitoring Report. Executive of the Council. Purpose of report DlNBVRGH + + THE CITY OF EDINBURGH COUNCIL Sickness Absence Monitoring Report Executive of the Council 8fh My 4 I.I...3 Purpose of report This report quntifies the mount of working time lost s result of

More information

Health insurance exchanges What to expect in 2014

Health insurance exchanges What to expect in 2014 Helth insurnce exchnges Wht to expect in 2014 33096CAEENABC 02/13 The bsics of exchnges As prt of the Affordble Cre Act (ACA or helth cre reform lw), strting in 2014 ALL Americns must hve minimum mount

More information

COVER CROP VARIETY AND SEEDING RATE EFFECTS ON WINTER WEED SEED PRODUCTION

COVER CROP VARIETY AND SEEDING RATE EFFECTS ON WINTER WEED SEED PRODUCTION COVER CROP VARIETY AND SEEDING RATE EFFECTS ON WINTER WEED SEED PRODUCTION Nthn S. Boyd nd Eric B. Brennn, USDA-ARS, Orgnic Reserch Progrm, 1636 E. Alisl Street, Slins, CA 93905 Astrct Weed mngement is

More information

Reasoning to Solve Equations and Inequalities

Reasoning to Solve Equations and Inequalities Lesson4 Resoning to Solve Equtions nd Inequlities In erlier work in this unit, you modeled situtions with severl vriles nd equtions. For exmple, suppose you were given usiness plns for concert showing

More information

Health insurance marketplace What to expect in 2014

Health insurance marketplace What to expect in 2014 Helth insurnce mrketplce Wht to expect in 2014 33096VAEENBVA 06/13 The bsics of the mrketplce As prt of the Affordble Cre Act (ACA or helth cre reform lw), strting in 2014 ALL Americns must hve minimum

More information

ARTICLE IN PRESS. i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s x x x ( 2 0 1 2 ) xxx xxx

ARTICLE IN PRESS. i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s x x x ( 2 0 1 2 ) xxx xxx IJB-2938; No. of Pges 12 i n t e r n t i o n l j o u r n l o f m e d i c l i n f o r m t i c s x x x ( 2 0 1 2 ) xxx xxx j ourn l homepge: www.ijmijournl.com Description nd comprison of qulity of electronic

More information

EQUATIONS OF LINES AND PLANES

EQUATIONS OF LINES AND PLANES EQUATIONS OF LINES AND PLANES MATH 195, SECTION 59 (VIPUL NAIK) Corresponding mteril in the ook: Section 12.5. Wht students should definitely get: Prmetric eqution of line given in point-direction nd twopoint

More information

The Effect of Crumb Rubber Modifier (CRM) on the Performance Properties of Rubberized Binders in HMA pavements

The Effect of Crumb Rubber Modifier (CRM) on the Performance Properties of Rubberized Binders in HMA pavements The Effect of Crum Ruer Modifier (CRM) on the Performnce Properties of Ruerized Binders in HMA pvements Soon-Je Lee* Ph.D. Grdute Student Deprtment of Civil Engineering Clemson University Clemson, SC 29634-0911

More information

Polynomial Functions. Polynomial functions in one variable can be written in expanded form as ( )

Polynomial Functions. Polynomial functions in one variable can be written in expanded form as ( ) Polynomil Functions Polynomil functions in one vrible cn be written in expnded form s n n 1 n 2 2 f x = x + x + x + + x + x+ n n 1 n 2 2 1 0 Exmples of polynomils in expnded form re nd 3 8 7 4 = 5 4 +

More information

Serial Testing Using QuantiFERON TB Gold In tube

Serial Testing Using QuantiFERON TB Gold In tube Seril Testing Using QuntiFERON TB Gold In tue Assy in High Risk Popultion Richrd S. Grfein, PhD, MPH Professor Division of Glol Pulic Helth, School of Medicine University of Cliforni Sn Diego rgrfein@ucsd.edu

More information

Health insurance exchanges What to expect in 2014

Health insurance exchanges What to expect in 2014 Helth insurnce exchnges Wht to expect in 2014 33096CAEENABC 11/12 The bsics of exchnges As prt of the Affordble Cre Act (ACA or helth cre reform lw), strting in 2014 ALL Americns must hve minimum mount

More information

Helicopter Theme and Variations

Helicopter Theme and Variations Helicopter Theme nd Vritions Or, Some Experimentl Designs Employing Pper Helicopters Some possible explntory vribles re: Who drops the helicopter The length of the rotor bldes The height from which the

More information

1. Find the zeros Find roots. Set function = 0, factor or use quadratic equation if quadratic, graph to find zeros on calculator

1. Find the zeros Find roots. Set function = 0, factor or use quadratic equation if quadratic, graph to find zeros on calculator AP Clculus Finl Review Sheet When you see the words. This is wht you think of doing. Find the zeros Find roots. Set function =, fctor or use qudrtic eqution if qudrtic, grph to find zeros on clcultor.

More information

Survival of Non-small Cell Lung Cancer Patients with Postoperative Recurrence at Distant Organs

Survival of Non-small Cell Lung Cancer Patients with Postoperative Recurrence at Distant Organs Survivl of Non-smll Cell Cncer Ptients with Postopertive Recurrence t Distnt Orgns Ichiro Yoshino, MD, 1,2 Tomofumi Yohen, MD, 1 Mschik Kitjim, MD, 1 Chie Ushijim, MD, 1 Kenichi Nishiok, MD, 1 Yukito Ichinose,

More information

Operations with Polynomials

Operations with Polynomials 38 Chpter P Prerequisites P.4 Opertions with Polynomils Wht you should lern: Write polynomils in stndrd form nd identify the leding coefficients nd degrees of polynomils Add nd subtrct polynomils Multiply

More information

The Determinants of Private Medical Insurance Prevalence in England

The Determinants of Private Medical Insurance Prevalence in England The Determinnts of Privte Medicl Insurnce Prevlence in Englnd Derek R. King, Elis Mossilos LSE Helth nd Socil Cre, London School of Economics nd Politicl Science LSE Helth nd Socil Cre Discussion Pper

More information

2015 EDITION. AVMA Report on Veterinary Compensation

2015 EDITION. AVMA Report on Veterinary Compensation 2015 EDITION AVMA Report on Veterinry Compenstion AVMA Report on Veterinry Compenstion 2015 EDITION Copyright 2015 by the All rights reserved. ISBN-13: 978-1-882691-31-9 AVMA Report on Veterinry Compenstion

More information

Effect of viscosity on C sugar in Beet sugar factories

Effect of viscosity on C sugar in Beet sugar factories ANNUAL TRANSACTIONS OF THE NORDIC RHEOLOGY SOCIETY, VOL. 16, 2008 Effect of on C sugr in Beet sugr fctories Mohmmd Hojjtoleslmy 1, Rez Shokrni 2 nd Ahmd Krsi 3 1 Deprtment of food technology, College of

More information

Economics Letters 65 (1999) 9 15. macroeconomists. a b, Ruth A. Judson, Ann L. Owen. Received 11 December 1998; accepted 12 May 1999

Economics Letters 65 (1999) 9 15. macroeconomists. a b, Ruth A. Judson, Ann L. Owen. Received 11 December 1998; accepted 12 May 1999 Economics Letters 65 (1999) 9 15 Estimting dynmic pnel dt models: guide for q mcroeconomists b, * Ruth A. Judson, Ann L. Owen Federl Reserve Bord of Governors, 0th & C Sts., N.W. Wshington, D.C. 0551,

More information

MAX. As an increasingly larger share of Medicaid enrollees MEDICAID POLICY BRIEF

MAX. As an increasingly larger share of Medicaid enrollees MEDICAID POLICY BRIEF MAX CENTERS FOR MEDICARE & MEDICAID SERVICES MEDICAID POLICY BRIEF Brief 14 December 2012 The Avilbility nd Usbility of Behviorl Helth Orgniztion Encounter Dt in MAX 2009 Jessic Nysenbum, Ellen Bouchery,

More information

July 2005, NCJ 209588 Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002. Highlights. No dependence or abuse 53 47 32.

July 2005, NCJ 209588 Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002. Highlights. No dependence or abuse 53 47 32. U.S. Deprtment of Justice Office of Justice Progrms Bureu of Justice Sttistics Specil Report By Jennifer C. Krerg nd Doris J. Jmes BJS Sttisticins In 2002 more thn two-thirds of jil inmtes were found to

More information

Small Business Cloud Services

Small Business Cloud Services Smll Business Cloud Services Summry. We re thick in the midst of historic se-chnge in computing. Like the emergence of personl computers, grphicl user interfces, nd mobile devices, the cloud is lredy profoundly

More information

Humana Critical Illness/Cancer

Humana Critical Illness/Cancer Humn Criticl Illness/Cncer Criticl illness/cncer voluntry coverges py benefits however you wnt With our criticl illness nd cncer plns, you'll receive benefit fter serious illness or condition such s hert

More information

Recent health policy efforts have targeted healthcare

Recent health policy efforts have targeted healthcare Medicre Clim Processors Reimursement nd G-CSF Choice Among Non-Hodgkin Lymphom Ptients At Glnce Prcticl Implictions p 148 Author Informtion p 153 Full text nd PDF www.jplive.com Originl Reserch Xioyun

More information

Or more simply put, when adding or subtracting quantities, their uncertainties add.

Or more simply put, when adding or subtracting quantities, their uncertainties add. Propgtion of Uncertint through Mthemticl Opertions Since the untit of interest in n eperiment is rrel otined mesuring tht untit directl, we must understnd how error propgtes when mthemticl opertions re

More information

Corporate Compliance vs. Enterprise-Wide Risk Management

Corporate Compliance vs. Enterprise-Wide Risk Management Corporte Complince vs. Enterprise-Wide Risk Mngement Brent Sunders, Prtner (973) 236-4682 November 2002 Agend Corporte Complince Progrms? Wht is Enterprise-Wide Risk Mngement? Key Differences Why Will

More information

JaERM Software-as-a-Solution Package

JaERM Software-as-a-Solution Package JERM Softwre-s--Solution Pckge Enterprise Risk Mngement ( ERM ) Public listed compnies nd orgnistions providing finncil services re required by Monetry Authority of Singpore ( MAS ) nd/or Singpore Stock

More information

Navy Asbestos Medical Surveillance Program 1990 1999: Demographic Features and Trends in Abnormal Radiographic Findings

Navy Asbestos Medical Surveillance Program 1990 1999: Demographic Features and Trends in Abnormal Radiographic Findings MILITARY MEDICINE, 171, 8:717, 2006 Nvy Asbestos Medicl Surveillnce Progrm 1990 1999: Demogrphic Fetures nd Trends in Abnorml Rdiogrphic Findings Gurntor: Dnielle M. Dell, MPH Contributors: Dnielle M.

More information

Active & Retiree Plan: Trustees of the Milwaukee Roofers Health Fund Coverage Period: 06/01/2015-05/31/2016 Summary of Benefits and Coverage:

Active & Retiree Plan: Trustees of the Milwaukee Roofers Health Fund Coverage Period: 06/01/2015-05/31/2016 Summary of Benefits and Coverage: Summry of Benefits nd Coverge: Wht this Pln Covers & Wht it Costs Coverge for: Single & Fmily Pln Type: NPOS This is only summry. If you wnt more detil bout your coverge nd costs, you cn get the complete

More information

Asbestosis is a fibrosing lung disease caused by exposure

Asbestosis is a fibrosing lung disease caused by exposure Asestos Fier Content of Lungs With Diffuse Interstitil Firosis An Anlyticl Scnning Electron Microscopic Anlysis of 249 Cses Frnk Schneider, MD; Thoms A. Sporn, MD; Victor L. Roggli, MD Context. Asestosis

More information

How To Set Up A Network For Your Business

How To Set Up A Network For Your Business Why Network is n Essentil Productivity Tool for Any Smll Business TechAdvisory.org SME Reports sponsored by Effective technology is essentil for smll businesses looking to increse their productivity. Computer

More information

Distributions. (corresponding to the cumulative distribution function for the discrete case).

Distributions. (corresponding to the cumulative distribution function for the discrete case). Distributions Recll tht n integrble function f : R [,] such tht R f()d = is clled probbility density function (pdf). The distribution function for the pdf is given by F() = (corresponding to the cumultive

More information

Study on enzyme-assisted aqueous extraction of oil from soybean

Study on enzyme-assisted aqueous extraction of oil from soybean 8 Journl Scientific & Industril Reserch J SCI IND RES VOL 69 NOVEMBER 2010 Vol. 69, November 2010, pp. 8-865 Study on enzyme-ssisted queous extrction oil from soyben Jun-Qing Qin*, De-Hui Qin, Xing-Mo

More information

Anthem Blue Cross Life and Health Insurance Company University of Southern California Custom Premier PPO 800/20%/20%

Anthem Blue Cross Life and Health Insurance Company University of Southern California Custom Premier PPO 800/20%/20% Anthem Blue Cross Life nd Helth Insurnce Compny University of Southern Cliforni Custom Premier 800/20%/20% Summry of Benefits nd Coverge: Wht this Pln Covers & Wht it Costs Coverge Period: 01/01/2015-12/31/2015

More information

July 22, 2009. The Honorable Henry A. Waxman Chairman Committee on Energy and Commerce House of Representatives

July 22, 2009. The Honorable Henry A. Waxman Chairman Committee on Energy and Commerce House of Representatives United Sttes Government Accountbility Office Wshington, DC 20548 July 22, 2009 The Honorble Henry A. Wxmn Chirmn Committee on Energy nd Commerce House of Representtives The Honorble John D. Dingell Chirmn

More information

Prepared for. U.S. Department of the Interior Bureau of Land Management Wyoming State Office, Cheyenne, and Rawlins and Rock Springs Field Offices

Prepared for. U.S. Department of the Interior Bureau of Land Management Wyoming State Office, Cheyenne, and Rawlins and Rock Springs Field Offices MAPPING ACCURACY, ACTIVITY, AND BURROW DENSITY OF WHITE-TAILED PRAIRIE DOG COMPLEXES COMPRISING POTENTIAL HABITAT FOR BLACK-FOOTED FERRETS IN THE CONTINENTAL DIVIDE/WAMSUTTER II PROJECT AREA. Prepred for

More information

Recognition Scheme Forensic Science Content Within Educational Programmes

Recognition Scheme Forensic Science Content Within Educational Programmes Recognition Scheme Forensic Science Content Within Eductionl Progrmmes one Introduction The Chrtered Society of Forensic Sciences (CSoFS) hs been ccrediting the forensic content of full degree courses

More information

Additional Protocol to the Convention on Human Rights and Biomedicine concerning Genetic Testing for Health Purposes

Additional Protocol to the Convention on Human Rights and Biomedicine concerning Genetic Testing for Health Purposes Council of Europe Trety Series - No. 203 Additionl Protocol to the Convention on Humn Rights nd Biomedicine concerning Genetic Testing for Helth Purposes Strsourg, 27.XI.2008 2 CETS 203 Humn Rights nd

More information

ClearPeaks Customer Care Guide. Business as Usual (BaU) Services Peace of mind for your BI Investment

ClearPeaks Customer Care Guide. Business as Usual (BaU) Services Peace of mind for your BI Investment ClerPeks Customer Cre Guide Business s Usul (BU) Services Pece of mind for your BI Investment ClerPeks Customer Cre Business s Usul Services Tble of Contents 1. Overview...3 Benefits of Choosing ClerPeks

More information

Unit 29: Inference for Two-Way Tables

Unit 29: Inference for Two-Way Tables Unit 29: Inference for Two-Wy Tbles Prerequisites Unit 13, Two-Wy Tbles is prerequisite for this unit. In ddition, students need some bckground in significnce tests, which ws introduced in Unit 25. Additionl

More information

Treating Prostate Cancer

Treating Prostate Cancer CHAPTER 4 Treting Prostte Cncer here is controversy bout the optiml tretment for cliniclly loclized prostte cncer (i.e., cncer tht ppers not to hve spred beyond the prostte bsed on informtion vilble without

More information

Rapid critical appraisal. using GATE. GATE: Graphic Appraisal Tool for Epidemiology. One picture: the GATE frame. 1 picture, 2 formulas & 3 acronyms 2

Rapid critical appraisal. using GATE. GATE: Graphic Appraisal Tool for Epidemiology. One picture: the GATE frame. 1 picture, 2 formulas & 3 acronyms 2 Rpid criticl pprisl GA: Grphic Apprisl ool for pidemiology using GA Rod Jckson University of Aucklnd, NZ Ferury 2011 1 1 picture, 2 formuls & 3 cronyms 2 ne picture: the GA frme British doctors smoking

More information

Lump-Sum Distributions at Job Change, p. 2

Lump-Sum Distributions at Job Change, p. 2 Jnury 2009 Vol. 30, No. 1 Lump-Sum Distributions t Job Chnge, p. 2 E X E C U T I V E S U M M A R Y Lump-Sum Distributions t Job Chnge GROWING NUMBER OF WORKERS FACED WITH ASSET DECISIONS AT JOB CHANGE:

More information

How To Network A Smll Business

How To Network A Smll Business Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd processes. Introducing technology

More information

FDIC Study of Bank Overdraft Programs

FDIC Study of Bank Overdraft Programs FDIC Study of Bnk Overdrft Progrms Federl Deposit Insurnce Corportion November 2008 Executive Summry In 2006, the Federl Deposit Insurnce Corportion (FDIC) initited two-prt study to gther empiricl dt on

More information

P.3 Polynomials and Factoring. P.3 an 1. Polynomial STUDY TIP. Example 1 Writing Polynomials in Standard Form. What you should learn

P.3 Polynomials and Factoring. P.3 an 1. Polynomial STUDY TIP. Example 1 Writing Polynomials in Standard Form. What you should learn 33337_0P03.qp 2/27/06 24 9:3 AM Chpter P Pge 24 Prerequisites P.3 Polynomils nd Fctoring Wht you should lern Polynomils An lgeric epression is collection of vriles nd rel numers. The most common type of

More information

National Diabetes Audit. Report 1: Care Processes and Treatment Targets

National Diabetes Audit. Report 1: Care Processes and Treatment Targets Ntionl Dietes Audit 2012 2013 Report 1: Cre Processes nd Tretment Trgets The Ntionl Dietes Audit is commissioned y The Helthcre Qulity Improvement Prtnership (HQIP) The Ntionl Dietes Audit is commissioned

More information

Appendix D: Completing the Square and the Quadratic Formula. In Appendix A, two special cases of expanding brackets were considered:

Appendix D: Completing the Square and the Quadratic Formula. In Appendix A, two special cases of expanding brackets were considered: Appendi D: Completing the Squre nd the Qudrtic Formul Fctoring qudrtic epressions such s: + 6 + 8 ws one of the topics introduced in Appendi C. Fctoring qudrtic epressions is useful skill tht cn help you

More information

Test Management using Telelogic DOORS. Francisco López Telelogic DOORS Specialist

Test Management using Telelogic DOORS. Francisco López Telelogic DOORS Specialist Test Mngement using Telelogic DOORS Frncisco López Telelogic DOORS Specilist Introduction Telelogic solution for Requirements Mngement DOORS Requirements mngement nd trcebility pltform for complex systems

More information

** Dpt. Chemical Engineering, Kasetsart University, Bangkok 10900, Thailand

** Dpt. Chemical Engineering, Kasetsart University, Bangkok 10900, Thailand Modelling nd Simultion of hemicl Processes in Multi Pulse TP Experiment P. Phnwdee* S.O. Shekhtmn +. Jrungmnorom** J.T. Gleves ++ * Dpt. hemicl Engineering, Ksetsrt University, Bngkok 10900, Thilnd + Dpt.hemicl

More information

A COMPARISON OF ALCOHOL SCREENING INSTRUMENTS AMONG UNDER-AGED DRINKERS TREATED IN EMERGENCY DEPARTMENTS

A COMPARISON OF ALCOHOL SCREENING INSTRUMENTS AMONG UNDER-AGED DRINKERS TREATED IN EMERGENCY DEPARTMENTS Alcohol & Alcoholism Vol. 37, No. 5, pp. 444 450, 2002 A COMPARISON OF ALCOHOL SCREENING INSTRUMENTS AMONG UNDER-AGED DRINKERS TREATED IN EMERGENCY DEPARTMENTS THOMAS M. KELLY 1 *, JOHN E. DONOVAN 1, JANET

More information

THE EFFECTS OF INCREASED PROTEIN INTAKE ON KIDNEY SIZE AND FUNCTION

THE EFFECTS OF INCREASED PROTEIN INTAKE ON KIDNEY SIZE AND FUNCTION The Journl of Experimentl iology 21, 281 29 (1998) Printed in Gret ritin The Compny of iologists Limited 1998 JE1492 281 THE EFFECTS OF INCRESED PROTEIN INTKE ON KIDNEY SIZE ND FUNCTION KIMERLY. HMMOND

More information

INITIATION OF THERAPY Patient-specific considerations for initiation of apixaban therapy include the following:

INITIATION OF THERAPY Patient-specific considerations for initiation of apixaban therapy include the following: UNC HEALTH CARE GUIDELINE Mngement of Apixn in Adults Apixn (Eliquis ) is n orl nticogulnt tht cts s fctor X inhiitor. It is pproved y the FDA for the prevention of stroke nd systemic emolism in ptients

More information

Trade liberalization and per capita income convergence: a difference-in-differences analysis

Trade liberalization and per capita income convergence: a difference-in-differences analysis Journl of Interntionl Economics 55 (2001) 203 228 www.elsevier.nl/ locte/ econbse Trde liberliztion nd per cpit income convergence: difference-in-differences nlysis Mtthew J. Slughter* Drtmouth College

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd processes. Introducing technology

More information

Objective: Erectile dysfunction and depression are highly associated. Previous studies have shown benefits of phosphodiesterase-5

Objective: Erectile dysfunction and depression are highly associated. Previous studies have shown benefits of phosphodiesterase-5 Article Efficcy nd Tolerbility of Vrdenfil in Men With Mild Depression nd Erectile Dysfunction: The Depression-Relted Improvement With Vrdenfil for Erectile Response Study Rymond Rosen, Ph.D. Ridwn Shbsigh,

More information

MEDICAL SURVEILLANCE MONTHLY REPORT

MEDICAL SURVEILLANCE MONTHLY REPORT AUGUST 2015 Volume 22 Number 8 msmr MEDICAL SURVEILLANCE MONTHLY REPORT PAGE 2 PAGE 9 Updte: Routine screening for ntibodies to humn immunodeficiency virus, civilin pplicnts for U.S. militry service nd

More information

Turfgrass and Environmental Research Online

Turfgrass and Environmental Research Online Turfgrss nd Environmentl Reserch Online...Using Science to Benefit Golf USGA s Turfgrss nd Environmentl Reserch Progrm jointly funded coopertive study with GCSAA s Environmentl Institute for Golf to evlute

More information

Improving Library Users' Perceived Quality, Satisfaction and Loyalty: An Integrated Measurement and Management System

Improving Library Users' Perceived Quality, Satisfaction and Loyalty: An Integrated Measurement and Management System Improving Librry Users' Perceived Qulity, Stisfction nd Loylty: An Integrted Mesurement nd Mngement System by Anne Mrtensen nd Lrs Gr0nholdt This rticle describes the development nd ppliction of structurl

More information

GAO IRS AUDIT RATES. Rate for Individual Taxpayers Has Declined But Effect on Compliance Is Unknown

GAO IRS AUDIT RATES. Rate for Individual Taxpayers Has Declined But Effect on Compliance Is Unknown GAO United Sttes Generl Accounting Office Report to the Chirmn, Subcommittee on Oversight, Committee on Wys nd Mens, House of Representtives April 2001 IRS AUDIT RATES Rte for Individul Txpyers Hs Declined

More information

A generic Decision Support System for integrated weed management

A generic Decision Support System for integrated weed management A generic Decision Support System for integrted weed mngement By: Per Rydhl, IPM Consult, Denmrk nd: Nicols Munier-Jolin (INRA), Frnce Robert Msin, University of Pdov, Itly Murizio Sttin (IBAF-CNR), Itly

More information

Introducing Kashef for Application Monitoring

Introducing Kashef for Application Monitoring WextWise 2010 Introducing Kshef for Appliction The Cse for Rel-time monitoring of dtcenter helth is criticl IT process serving vriety of needs. Avilbility requirements of 6 nd 7 nines of tody SOA oriented

More information

Factoring Polynomials

Factoring Polynomials Fctoring Polynomils Some definitions (not necessrily ll for secondry school mthemtics): A polynomil is the sum of one or more terms, in which ech term consists of product of constnt nd one or more vribles

More information

Assessing the Burden of Disease and Injury in Los Angeles County Using Disability-Adjusted Life Years

Assessing the Burden of Disease and Injury in Los Angeles County Using Disability-Adjusted Life Years Reserch Articles Assessing the Burden of Disese nd Injury in Los Angeles County Using Disbility-Adjusted Life Yers Gerld F. Kominski, PhD,b Pul A. Simon, MD, MPH c,d Alex Ho, MD, MPH c Jeffrey Luck, PhD,

More information

Impact of the National School Lunch Program on Fruit and Vegetable Selection in Northeastern Elementary Schoolchildren, 2012 2013

Impact of the National School Lunch Program on Fruit and Vegetable Selection in Northeastern Elementary Schoolchildren, 2012 2013 Brief Reports Impct of the Ntionl School Lunch Progrm on Fruit nd Vegetble Selection in Northestern Elementry Schoolchildren, 2012 2013 Srh A. Amin, MPH Bethny A. Yon, PhD Jennifer C. Tylor, MS b Rchel

More information

Combined Liability Insurance. Information and Communication Technology Proposal form

Combined Liability Insurance. Information and Communication Technology Proposal form Comined Liility Insurnce Informtion nd Communiction Technology Proposl form Comined Liility Insurnce Informtion nd Communiction Technology - Proposl form This proposl form must e completed nd signed y

More information

Basic Analysis of Autarky and Free Trade Models

Basic Analysis of Autarky and Free Trade Models Bsic Anlysis of Autrky nd Free Trde Models AUTARKY Autrky condition in prticulr commodity mrket refers to sitution in which country does not engge in ny trde in tht commodity with other countries. Consequently

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd business. Introducing technology

More information

Patient Perceptions of Reimbursement for Arthroscopic Meniscectomy and Anterior Cruciate Ligament Reconstruction

Patient Perceptions of Reimbursement for Arthroscopic Meniscectomy and Anterior Cruciate Ligament Reconstruction Ptient Perceptions of Reimursement for Arthroscopic nd Anterior Crucite Ligment Reconstruction Kelechi R. Okoroh, MD; Roert A. Keller, MD; Nthn E. Mrshll, MD; Jonthn R. Lynch, MD; John-Michel Guest, BS;

More information

An Undergraduate Curriculum Evaluation with the Analytic Hierarchy Process

An Undergraduate Curriculum Evaluation with the Analytic Hierarchy Process An Undergrdute Curriculum Evlution with the Anlytic Hierrchy Process Les Frir Jessic O. Mtson Jck E. Mtson Deprtment of Industril Engineering P.O. Box 870288 University of Albm Tuscloos, AL. 35487 Abstrct

More information

2. Transaction Cost Economics

2. Transaction Cost Economics 3 2. Trnsction Cost Economics Trnsctions Trnsctions Cn Cn Be Be Internl Internl or or Externl Externl n n Orgniztion Orgniztion Trnsctions Trnsctions occur occur whenever whenever good good or or service

More information

improved (2, 3, 4, 5, 7, 8, 9, 10, 11). Some of the

improved (2, 3, 4, 5, 7, 8, 9, 10, 11). Some of the 8 FLORIDA STATE HORTICULTURAL SOCIETY, 963 EVALUATING SPRAY EQUIPMENT FOR FLORIDA CITRUS R. F. Brooks, W. L. Thompson nd P. T. Jutrs Florid Citrus Experiment Sttion Lke Alfred The first successful, lrge,

More information

2 DIODE CLIPPING and CLAMPING CIRCUITS

2 DIODE CLIPPING and CLAMPING CIRCUITS 2 DIODE CLIPPING nd CLAMPING CIRCUITS 2.1 Ojectives Understnding the operting principle of diode clipping circuit Understnding the operting principle of clmping circuit Understnding the wveform chnge of

More information

PEARLS MONITORING SYSTEM

PEARLS MONITORING SYSTEM WORLD COUNCIL OF CREDIT UNIONS TOOLKIT SERIES Number 4 PEARLS MONITORING SYSTEM by: Dvid C. Richrdson World Council of Credit Unions October 2002 2001 The World Council of Credit Unions The World Council

More information

Psychological health and safety in the workplace Prevention, CAN/CSA-Z1003-13/BNQ 9700-803/2013

Psychological health and safety in the workplace Prevention, CAN/CSA-Z1003-13/BNQ 9700-803/2013 Psychologicl helth nd sfety in the workplce Prevention, CAN/CSA-Z1003-13/BNQ 9700-803/2013 promotion, nd guidnce to stged implementtion This smple udit tool is n nnex of the Ntionl Stndrd of Cnd on Psychologicl

More information

Rate and Activation Energy of the Iodination of Acetone

Rate and Activation Energy of the Iodination of Acetone nd Activtion Energ of the Iodintion of Acetone rl N. eer Dte of Eperiment: //00 Florence F. Ls (prtner) Abstrct: The rte, rte lw nd ctivtion energ of the iodintion of cetone re detered b observing the

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd processes. Introducing technology

More information

Free Serum Testosterone Level in Male Rats Treated with Tribulus Alatus Extracts

Free Serum Testosterone Level in Male Rats Treated with Tribulus Alatus Extracts Investigtive Urology Triulus Altus Extrcts nd Testosterone Level Interntionl Brz J Urol Vol. 33 (4): 554-559, July - August, 2007 Free Serum Testosterone Level in Mle Rts Treted with Triulus Altus Extrcts

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd business. Introducing technology

More information

Bayesian Updating with Continuous Priors Class 13, 18.05, Spring 2014 Jeremy Orloff and Jonathan Bloom

Bayesian Updating with Continuous Priors Class 13, 18.05, Spring 2014 Jeremy Orloff and Jonathan Bloom Byesin Updting with Continuous Priors Clss 3, 8.05, Spring 04 Jeremy Orloff nd Jonthn Bloom Lerning Gols. Understnd prmeterized fmily of distriutions s representing continuous rnge of hypotheses for the

More information

Why is the NSW prison population falling?

Why is the NSW prison population falling? NSW Bureu of Crime Sttistics nd Reserch Bureu Brief Issue pper no. 80 September 2012 Why is the NSW prison popultion flling? Jcqueline Fitzgerld & Simon Corben 1 Aim: After stedily incresing for more thn

More information

Lecture 3 Gaussian Probability Distribution

Lecture 3 Gaussian Probability Distribution Lecture 3 Gussin Probbility Distribution Introduction l Gussin probbility distribution is perhps the most used distribution in ll of science. u lso clled bell shped curve or norml distribution l Unlike

More information

Regular Sets and Expressions

Regular Sets and Expressions Regulr Sets nd Expressions Finite utomt re importnt in science, mthemtics, nd engineering. Engineers like them ecuse they re super models for circuits (And, since the dvent of VLSI systems sometimes finite

More information

CHARACTERIZATION OF HASS AVOCADO PROLEPTIC AND SYLLEPTIC SHOOT PROPORTION IN VALPARAISO REGION, CHILE

CHARACTERIZATION OF HASS AVOCADO PROLEPTIC AND SYLLEPTIC SHOOT PROPORTION IN VALPARAISO REGION, CHILE Proceedings VI World Avocdo Congress (Acts VI Congreso Mundil del Agucte) 2007. Viñ Del Mr, Chile. 12 16 Nov. 2007. ISBN No 978-956-17-0413-8. CHARACTERIZATION OF HASS AVOCADO PROLEPTIC AND SYLLEPTIC SHOOT

More information

Understanding Life Cycle Costs How a Northern Pump Saves You Money

Understanding Life Cycle Costs How a Northern Pump Saves You Money Understnding Life Cycle Costs How Nrn Pump Sves You Money Reference: Hydrulic Institute (www.s.g) Introduction Wht Life Cycle Cost (LCC) Clculting Totl LCC LCC Components Wht Life Cycle Cost Life Cycle

More information

UNIVERSITY OF NOTTINGHAM. Discussion Papers in Economics STRATEGIC SECOND SOURCING IN A VERTICAL STRUCTURE

UNIVERSITY OF NOTTINGHAM. Discussion Papers in Economics STRATEGIC SECOND SOURCING IN A VERTICAL STRUCTURE UNVERSTY OF NOTTNGHAM Discussion Ppers in Economics Discussion Pper No. 04/15 STRATEGC SECOND SOURCNG N A VERTCAL STRUCTURE By Arijit Mukherjee September 004 DP 04/15 SSN 10-438 UNVERSTY OF NOTTNGHAM Discussion

More information

2013 Flax Weed Control Trial

2013 Flax Weed Control Trial 2013 Flx Weed Control Tril Dr. Hether Drby, UVM Extension Agronomist Susn Monhn, Conner Burke, Eric Cummings, nd Hnnh Hrwood UVM Extension Crops nd Soils Technicins 802-524-6501 Visit us on the web: http://www.uvm.edu/extension/cropsoil

More information

Cooperative Extension Service College of Agricultural, Consumer and Environmental Sciences. Page

Cooperative Extension Service College of Agricultural, Consumer and Environmental Sciences. Page Pest Control in Crops Grown in Northwestern New Mexico, 2014 Annul Dt Report 100-2014 Richrd N. Arnold, Michel K. O Neill, Dniel Smel, Kevin Lomrd, nd Mrgret West 1 Coopertive Extension Service College

More information

How To Find Out How A Worker'S Work Ethic Is Related To The Ability To Get A Job

How To Find Out How A Worker'S Work Ethic Is Related To The Ability To Get A Job RtSWD Reserch Notes Reserch Note No. 11 Previously relesed s RtSWD Working Pper No. 15 Popultion Aging nd Trends in the Provision of Continued Eduction Regin T. Riphhn, Prvti Trübswetter 2007 Reserch Notes

More information

All pay auctions with certain and uncertain prizes a comment

All pay auctions with certain and uncertain prizes a comment CENTER FOR RESEARC IN ECONOMICS AND MANAGEMENT CREAM Publiction No. 1-2015 All py uctions with certin nd uncertin prizes comment Christin Riis All py uctions with certin nd uncertin prizes comment Christin

More information

Tort Trials and Verdicts in Large Counties, 2001

Tort Trials and Verdicts in Large Counties, 2001 U.S. Deprtment of Justice Office of Justice Progrms Bureu of Justice Sttistics Bulletin Civil Justice Survey of Stte Courts, 2001 Novemer 200, NCJ 20620 Tort Trils nd Verdicts in Lrge Counties, 2001 By

More information

The LENA TM Language Environment Analysis System:

The LENA TM Language Environment Analysis System: FOUNDATION The LENA TM Lnguge Environment Anlysis System: Audio Specifictions of the DLP-0121 Michel Ford, Chrles T. Ber, Dongxin Xu, Umit Ypnel, Shrmi Gry LENA Foundtion, Boulder, CO LTR-03-2 September

More information

Antibody Screening. Antibody Screening in Pre-transfusion Testing and Antenatal Screening

Antibody Screening. Antibody Screening in Pre-transfusion Testing and Antenatal Screening Antiody Screening in Pre-trnsfusion Testing nd Antentl Screening Antiody Screening in Pre-trnsfusion Testing nd Antentl Screening Q. Wht re nturlly occurring or expected ntiodies? Q. Wht re typicl or unexpected

More information

Econ 4721 Money and Banking Problem Set 2 Answer Key

Econ 4721 Money and Banking Problem Set 2 Answer Key Econ 472 Money nd Bnking Problem Set 2 Answer Key Problem (35 points) Consider n overlpping genertions model in which consumers live for two periods. The number of people born in ech genertion grows in

More information

Quantitative relationship of two viruses (MrNV and XSV) in white-tail disease of Macrobrachium rosenbergii

Quantitative relationship of two viruses (MrNV and XSV) in white-tail disease of Macrobrachium rosenbergii DISEASES OF AQUATIC ORGANISMS Vol. 71: 11 17, 26 Pulished July 11 Dis Aqut Org Quntittive reltionship of two viruses (MrNV nd XSV) in white-til disese of Mcrorchium rosenergii Hujun Zhng 1, Jinmin Wng

More information

Quality and Cost Evaluation of a Medical Financial Assistance Program

Quality and Cost Evaluation of a Medical Financial Assistance Program Qulity nd Cost Evlution of Medicl Finncil Assistnce Progrm Dougls A Conner, PhD; Arne Beck, PhD; Christin Clrke; Leslie Wright, MA; Koml Nrwney, MD, PhD; Neys W Berminghm Perm J 2013 Winter;17(1):31-37

More information