We have attempted to evaluate quantitative changes in the mental health delivery system in Greece, dictated by a fiveyear program to reform psychiatric care. By the end of the program, a number of psychiatric units in general hospitals, as well as community mental health centres, had been created, while the number of beds in psychiatric hospitals have been significantly reduced. Mental health services have become more accessible to the population, and served more patients. However, not all the objectives of the program have been met. Only about half of the initially proposed number of beds in the psychiatric units in general hospitals have been actually developed. The catchment area, a basic pre-requisite of the program, has not been put into effect. Finally, the noticeable trend towards a restriction of the role of psychiatric hospitals did not coincide with the development of adequate new services.

Yukon Territory (YT) is a remote region in northern Canada with ongoing spread of tuberculosis (TB). To explore the utility of whole genome sequencing (WGS) for TB surveillance and monitoring in a setting with detailed contact tracing and interview data, we used a mixed-methods approach. Our analysis included all culture-confirmed cases in YT (2005–2014) and incorporated data from 24-locus Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) genotyping, WGS and contact tracing. We compared field-based (contact investigation (CI) data + MIRU-VNTR) and genomic-based (WGS + MIRU-VNTR + basic case data) investigations to identify the most likely source of each person's TB and assessed the knowledge, attitudes and practices of programme personnel around genotyping and genomics using online, multiple-choice surveys (n = 4) and an in-person group interview (n = 5). Field- and genomics-based approaches agreed for 26 of 32 (81%) cases on likely location of TB acquisition. There was less agreement in the identification of specific source cases (13/22 or 59% of cases). Single-locus MIRU-VNTR variants and limited genetic diversity complicated the analysis. Qualitative data indicated that participants viewed genomic epidemiology as a useful tool to streamline investigations, particularly in differentiating latent TB reactivation from the recent transmission. Based on this, genomic data could be used to enhance CIs, focus resources, target interventions and aid in TB programme evaluation.

Few studies have used genomic epidemiology to understand tuberculosis (TB) transmission in rural and remote settings – regions often unique in history, geography and demographics. To improve our understanding of TB transmission dynamics in Yukon Territory (YT), a circumpolar Canadian territory, we conducted a retrospective analysis in which we combined epidemiological data collected through routine contact investigations with clinical and laboratory results. Mycobacterium tuberculosis isolates from all culture-confirmed TB cases in YT (2005–2014) were genotyped using 24-locus Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) and compared to each other and to those from the neighbouring province of British Columbia (BC). Whole genome sequencing (WGS) of genotypically clustered isolates revealed three sustained transmission networks within YT, two of which also involved BC isolates. While each network had distinct characteristics, all had at least one individual acting as the probable source of three or more culture-positive cases. Overall, WGS revealed that TB transmission dynamics in YT are distinct from patterns of spread in other, more remote Northern Canadian regions, and that the combination of WGS and epidemiological data can provide actionable information to local public health teams.

GravityCam is a new concept of ground-based imaging instrument capable of delivering significantly sharper images from the ground than is normally possible without adaptive optics. Advances in optical and near-infrared imaging technologies allow images to be acquired at high speed without significant noise penalty. Aligning these images before they are combined can yield a 2.5–3-fold improvement in image resolution. By using arrays of such detectors, survey fields may be as wide as the telescope optics allows. Consequently, GravityCam enables both wide-field high-resolution imaging and high-speed photometry. We describe the instrument and detail its application to provide demographics of planets and satellites down to Lunar mass (or even below) across the Milky Way. GravityCam is also suited to improve the quality of weak shear studies of dark matter distribution in distant clusters of galaxies and multiwavelength follow-ups of background sources that are strongly lensed by galaxy clusters. The photometric data arising from an extensive microlensing survey will also be useful for asteroseismology studies, while GravityCam can be used to monitor fast multiwavelength flaring in accreting compact objects and promises to generate a unique data set on the population of the Kuiper belt and possibly the Oort cloud.

Disks around young stars are the sites of planet formation. As such, the physical and chemical structure of disks have a direct impact on the formation of planetary bodies. Outflowing winds remove angular momentum and mass and affect the disk structure and therefore potentially planet formation. Until very recently, we have lacked the facilities to provide the necessary observational tools to peer into the wind launching and planet forming regions of the young disks. Within the framework of the Resolving star formation with ALMA program, young protostellar systems are targeted with ALMA to resolve the disk formation, outflow launching and planet formation. This contribution presents the first results of the program. The first resolved images of outflow launching from a disk were recently reported towards the Class I source TMC1A (Bjerkeli et al. 2016) where we also present early evidence of grain growth (Harsono et al. 2018).

Our ALMA observations of HCO+ and HCN show such redshifted absorption toward an isolated core, BHR 71. Both lines show a similar redshifted absorption profile. We also found emissions of complex organic molecules (COMs) around 345 GHz from a compact region centered on the continuum source, which is barely resolved with a beam of 0″27, corresponding to ∼50 AU.

The purpose of this study was to investigate the microbiological quality of liver pâté. During 2012–13, a total of 870 samples, unrelated to the investigation of food-poisoning outbreaks, were collected either at retail (46%), catering (53%) or the point of manufacture (1%) and were tested using standard methods to detect Salmonella spp. or Campylobacter spp., and to enumerate for Listeria spp., including Listeria monocytogenes, Clostridium perfringens, coagulase-positive staphylococci including Staphylococcus aureus, Bacillus spp., including Bacillus cereus, Escherichia coli, Enterobacteriaceae, and aerobic colony counts (ACCs). Seventy-three percent of samples were of satisfactory microbiological quality, 18% were borderline and 9% unsatisfactory. Salmonella spp. or Campylobacter spp. was not recovered from any sample. The most common causes of unsatisfactory results were elevated ACCs (6% of the samples) and high Enterobacteriaceae counts (4% of samples). The remaining unsatisfactory results were due to elevated counts of: E. coli (three samples); B. cereus (one sample at 2·6 × 105 cfu/g); or L. monocytogenes (one sample at 2·9 × 103 cfu/g). Pâté from retail was less likely to be contaminated with L. monocytogenes than samples collected from catering and samples from supermarkets were of significantly better microbiological quality than those from catering establishments.

The incidence of reported infections of non-typhoid Salmonella is affected by biases inherent to passive laboratory surveillance, whereas analysis of blood sera may provide a less biased alternative to estimate the force of Salmonella transmission in humans. We developed a mathematical model that enabled a back-calculation of the annual seroincidence of Salmonella based on measurements of specific antibodies. The aim of the present study was to determine the seroincidence in two convenience samples from 2012 (Danish blood donors, n = 500, and pregnant women, n = 637) and a community-based sample of healthy individuals from 2006 to 2007 (n = 1780). The lowest antibody levels were measured in the samples from the community cohort and the highest in pregnant women. The annual Salmonella seroincidences were 319 infections/1000 pregnant women [90% credibility interval (CrI) 210–441], 182/1000 in blood donors (90% CrI 85–298) and 77/1000 in the community cohort (90% CrI 45–114). Although the differences between study populations decreased when accounting for different age distributions the estimates depend on the study population. It is important to be aware of this issue and define a certain population under surveillance in order to obtain consistent results in an application of serological measures for public health purposes.

Congress has consistently failed to solve some serious problems with the cost, effectiveness, and safety of pharmaceuticals. In part, this failure results from the pharmaceutical industry convincing legislators to define policy problems in ways that protect industry profits. By targeting campaign contributions to influential legislators and by providing them with selective information, the industry manages to displace the public’s voice in developing pharmaceutical policy.

LOFT (Large Observatory For X-ray Timing) is one of the four candidate missions currently under assessment study for the M3 mission in ESAs Cosmic Vision program to be launched in 2024. LOFT will carry two instruments with prime sensitivity in the 2–30 keV range: a 10 m2 class large area detector (LAD) with a <1° collimated field of view and a wide field monitor (WFM) instrument. The WFM is based on the coded mask principle, and 5 camera units will provide coverage of more than 1/3 of the sky. The prime goal of the WFM is to detect transient sources to be observed by the LAD. With its wide field of view and good energy resolution of <500 eV, the WFM will be an excellent instrument for detecting and studying GRBs and X-ray flashes. The WFM will be able to detect ~150 gamma ray bursts per year, and a burst alert system will enable the distribution of ~100 GRB positions per year with a ~1 arcmin location accuracy within 30 s of the burst.

The success of childhood vaccination against hepatitis B relies on persistence of immunity into adolescence and adulthood. In 2000, two hexavalent vaccines with a hepatitis B component (Hexavac®, Infanrix hexa®) were introduced in Germany. Hexavac was withdrawn in 2005 amidst concerns about its long-term hepatitis B protection. We compared hepatitis B surface antibody (anti-HBs) levels in children fully vaccinated with Hexavac or Infanrix hexa (n=477) in a secondary data analysis of a large cross-sectional health survey in Germany. On average 2·4 years after vaccination, 25·3% of Hexavac vaccinees had anti-HBs levels <10 mIU/ml (95% CI 19·0–32·8) compared to 4·7% of Infanrix hexa vaccinees (95% CI 2·4–8·9). These findings suggest that short-term hepatitis B immunogenicity in Hexavac vaccinees may also be weaker. Further studies are warranted to assess whether Hexavac vaccinees should be re-vaccinated or receive a booster vaccination before these birth cohorts reach adolescence.

The aim was to evaluate the effect of heat-treatment, microbial phytase addition and feeding strategy (dry feeding v. fermented liquid feeding) on degradation of phytate (myo-inositol hexakisphosphate, InsP6) and formation and further degradation of lower inositol phosphates (myo-inositol pentakisphosphate–myo-inositol bisphosphate, InsP5–InsP2) at the distal ileum of pigs. Furthermore, the apparent ileal digestibility/degradability (AID) of phosphorus (P), InsP6–P and calcium (Ca) and the apparent total tract digestibility (ATTD) of P and Ca were studied. Pigs were fitted with a T-shaped ileal cannula for total collection of digesta at 2 h intervals during an 8 h sampling period after feeding the morning meal. Each period lasted for 2 weeks: 8 days of adaptation followed by 3 days of total collection of faeces and 3 days of total collection of ileal digesta. The experiment was designed as a 4 × 4 Latin square with four pigs fed four diets. A basal wheat/barley-based diet was fed either as non-heat-treated or heat-treated (steam-pelleted at 90°C). The heat-treatment resulted in an inactivation of plant phytase below detectable level. Diet 1 (non-heat-treated basal diet fed dry); diet 2 (heat-treated basal diet fed dry); diet 3 (as diet 2 but with microbial phytase (750 FTU/kg as fed) fed dry); diet 4 (as diet 3 fed liquid (fermented for 17.5 h nighttime and 6.5 h daytime at 20°C with 50% residue in the tank)). Chromic oxide (Cr2O3) was included as marker and ATTD was determined both by total collection of faeces (ATTDTotal) and Cr2O3 (ATTDCr). InsP6 was completely degraded in diet 4 before feeding resulting in no InsP6–P being present in ileal digesta. InsP6–P concentration in ileal digesta decreased with increasing dietary levels of plant or microbial phytase in pigs fed the dry diets. Consequently, AID and ATTD of P and Ca were greatest for pigs fed diet 4 followed by diets 3, 1 and 2. The ATTD of P depended on the used method as ATTDTotal of P was 72%, 61%, 44% and 34%, whereas ATTDCr of P was 65%, 52%, 38% and 23% for diets 4, 3, 1 and 2, respectively. In all pigs the ileal concentration of InsP5–InsP2–P was extremely small, and thus unimportant for maximisation of ATTD of plant P. In conclusion, fermented liquid feeding with microbial phytase seems to be an efficient approach to improve ATTD of plant P compared with dry feeding. This opens up for further reductions in P excretion.

Infections by Campylobacter spp. are a major cause of gastrointestinal disease in the United Kingdom. Most cases are associated with the consumption of chicken that has become contaminated during production. We investigated the epidemiology of Campylobacter spp. in chickens in a 3-year longitudinal study of flocks reared on 30 farms in the United Kingdom. We used Generalized Linear Mixed Effect Models (GLMM) to investigate putative risk factors associated with incidence and prevalence of flock infection arising from farm and flock management and local environmental conditions during rearing. We used survival analysis to investigate infection events and associated risk factors over the course of the study using two marginal models – the independent increment approach, which assumed that individual infection events were independent; and a conditional approach, which assumed that events were conditional on those preceding. Models of flock prevalence were highly overdispersed suggesting that infection within flocks was aggregated. The key predictors of flock infection identified from the GLMM analyses were mean temperature and mean rainfall in the month of slaughter and also the presence of natural ventilation. Mean temperature in the month of slaughter was also a significant predictor of flock infection, although the analyses suggested that the risk in flocks increased in a unimodal way in relation to temperature, peaking at 12°C. The extent of pad burn was also identified as a predictor in these analyses. We conclude that predicting prevalence within flocks with linear modelling approaches is likely to be difficult, but that it may be possible to predict when flocks are at risk of Campylobacter infection. This is a key first step in managing disease and reducing the risks posed to the human food chain.

Small-angle scattering (SAS) and ultra small-angle scattering techniques, employing x-rays and neutrons, were used to characterize six different aluminum nanopowders and nanopowders composed of molybdenum trioxide and tungsten trioxide nanoparticles. Each material has different primary particle morphology and aggregate and agglomerate geometry, and each is important to the development of nano-energetic materials. The combination of small-angle and ultra small-angle techniques allowed a wide range of length scales to be probed, providing a more complete characterization of the materials. For the aluminum-based materials, differences in the scattering of x-rays and neutrons from aluminum and aluminum oxide provided sensitivity to the metal core and metal oxide shell structure of the primary nanoparticles. Small-angle scattering was able to discriminate between particle size and shape and agglomerate and aggregate geometry, allowing analysis of both aspects of the structure. Using the results of these analyses and guided by scanning electron microscopy (SEM) images, physical models were developed, allowing for a quantitative determination of particle morphology, mean nanoparticle size, nanoparticle size distribution, surface layer thickness, and aggregate and agglomerate fractal dimension. Particle size distributions calculated using a maximum entropy algorithm or by assuming a log-normal particle size distribution function were comparable. Surface area and density determinations from the small-angle scattering measurements were comparable to those obtained from other, more commonly used analytical techniques: gas sorption using Brunauer–Emmett–Teller analysis, thermogravimetric analysis, and helium pycnometry. Particle size distribution functions derived from the SAS measurements agreed well with those obtained from SEM.