The perceived effectiveness of traditional and faith healing in the treatment of mental illness: a systematic review of qualitative studies.

PURPOSE: This work complements a quantitative review by Nortje et al. (Lancet Psychiatry 3(2):154-170, 2016) by exploring the qualitative literature in regard to the perceived effectiveness of traditional and faith healing of mental disorders. METHOD: Qualitative studies focusing specifically on traditional and/or faith healing practices for mental illness were retrieved from eight databases. Data were extracted  into basic coding sheets to facilitate the assessment of the quality of eligible papers using the COREQ. RESULTS: Sixteen articles met the inclusion criteria. Despite methodological limitations, there was evidence from the papers that stakeholders perceived traditional and/or faith healing to be effective in treating mental illness, especially when used in combination with biomedical treatment. CONCLUSION: Patients will continue to seek treatment from traditional and/or faith healers for mental illness if they perceive it to be effective regardless of alternative biomedical evidence. This provides opportunities for collaboration to address resource scarcity in low to middle income countries.

Bacterial populations associated with bulk packaged beef supplemented with dietary vitamin E.

Five Simmentaler type calves were fed diets supplemented with 500 mg vitamin E per day and five fed control diets, Rump steaks from each carcass were PVC-overwrapped and bulk packaged in 100% CO2 or 20% CO2:80% O2. Bulk packs were stored up to 42 days at 4 degrees C and PVC-overwrapped samples subsequently displayed up to 7 days at 4 degrees C. After display the Aerobic Plate Count (APC) of steaks was determined and four colonies were randomly selected from the highest dilution APC plates showing growth. A total of 627 colonies were obtained. Gram-reaction, catalase, oxidase, morphology and motility of the isolates were determined. The gram-negative and gram-positive isolates were then identified using a dichotomous identification key. Enterobacteriaceae, Pseudomonas spp. and Acinetobacter spp. predominated on rump steaks from both feeding treatments and in packaging treatments. After 42 days bulk storage Enterobacteriaceae, Pseudomonas spp., lactic acid bacteria and Acinetobacter spp. predominated in 20% CO2:80% O2 and 100% CO2 bulk packaging. Enterobacteriaceae, Pseudomonas spp. and Acinetobacter spp. predominated on rump steaks, from both feeding and packaging treatments, during the aerobic display period of 7 days.

Combined effect of modified atmosphere bulk packaging, dietary vitamin E supplementation and microbiological contamination on colour stability of Musculus gluteus medius.

Ten Simmentaler type calves were fed diets supplemented with 500 mg vitamin E per day and ten fed control diets. After completion of a 100 day feeding period the cattle were slaughtered and rump steaks (M. gluteus medius) from each carcass PVC-overwrapped and subsequently bulk packaged in 100% CO(2) or 20% CO(2): 80% O(2). Steaks with low levels of bacteriological contamination were also prepared and packaged. Bulk packs were stored at 4°C for 0, 14, 28 and 42 days and the PVC-overwrapped samples subsequently displayed for 0, 4 and 7 days at 4°C. After display saturation, surface metmyoglobin and oxymyoglobin accumulation of the steaks were determined and acceptability of the steaks assessed by sensory evaluation using a trained panel. The dietary vitamin E supplemented steaks were more acceptable than the steaks from cattle not supplemented with vitamin E. Steaks prepared with low levels of bacteriological contamination, supplemented with dietary vitamin E, were more acceptable and discoloured less than all the other treatments. Beef rump steaks bulk packaged in 20% CO(2): 80% O(2) or 100% CO(2) were acceptable and colour stable for up to 14 days bulk storage at 4°C and a subsequent 2 days retail display at 4°C.

Microbiological shelf life of bulk-packaged Musculus gluteus medius supplemented with dietary vitamin E.

Five Simmentaler type calves were fed diets supplemented with 500 mg vitamin E per day and five fed control diets. Rump steaks from each carcass were PVC-overwrapped and bulk packaged in 100% CO, or 20% CO(2):80% O(2). Bulk packs were stored up to 42 days at 4°C and steaks displayed up to 7 days at 4°C. Bacterial counts of rump steaks from either packaging treatment were not significantly influenced during bulk storage or retail display by supplementation with dietary vitamin E. Both packaging treatments delayed bacterial growth during bulk storage. Aerobic plate counts of rump steaks stored in 100% CO(2) were lower than those of rump steaks stored in 20% CO(2): 80%: O(2). This study showed that rump steaks supplemented with dietary vitamin E can be bulk packaged in 20% CO(2): 80% O(2) or 100% CO(2) and stored for up to 42 days with shelf life of 4-7 days.

Effects of electrical and mechanical stunning methods on meat quality in ostriches.

The effect of electrical and captive needle air pressure stunning methods on some meat quality parameters was examined in ostriches under practical conditions. One hundred and fifteen ostriches were used in three experiments. The ostriches were stunned either electrically (head only) or by using a captive needle with air pressure. In the first experiment the ostriches were stunned at 90 V (∼effectively 52 V), 200 V and by captive needle using air pressure. In the second experiment voltages of 175 and 200 V were applied and a captive needle stunning method using air pressure. In the third experiment the birds were stunned at 175 V with a short stun/stick interval. Experiments 2 and 3 were performed in a different slaughterhouse from experiment 1. Meat quality was assessed by measuring the pH, temperature and colour at 45 min and 18 h post mortem and by determining water binding capacity and haemorrhage score at 18 h post mortem in the big drum, tender loin and triangular filet muscles. The measured stunning parameters in the first experiment were 204±96 mA (∼52 V) during 11±1 s and 556±85 mA (∼200 V) during 6±0 s. The stun/stick interval was 136±38 s. The rigor mortis value in the tender loin and both pH(1) and pH(2) in the big drum, tender loin and triangular filet muscles were (p<0.05) lower when stunned with air pressure compared with electrical stunning. Moreover internal light scattering remained higher. The measured currents in the second experiment were 561±226 mA (∼173 V) during 6±2 s and 518±120 mA (∼200 V) during 6 s. The stun/stick interval was 39±12 s. The pH at 45 min and 18 h differed (p<0.05) in the tender loin and triangular filet muscles as did the temperature at 45 min in the three muscles between the different stunning groups. The stunning in the third experiment was carried out with 548±180 mA during 6±2 s. The stun/stick interval was 5±2 s. After the short stun/stick interval the pH(2) was lower (p<0.05) for the tender loin and triangular filet muscles and the wetness of the filter paper of the big drum was (p<0.05) lower compared with the other groups. Our experiments showed that stunning methods affected several meat quality parameters. Using a high electrical stunning current, captive needle stunning or a short stun/stick interval may positively affect some parameters. More research is necessary to examine effects of pre slaughter handling on meat quality.

Some neural and behavioural aspects of electrical and mechanical stunning in ostriches.

Different electrical and mechanical stunning procedures were studied in ostriches to determine the effectiveness of the method. Fifty-eight South-African Black ostriches were equipped with EEG electrodes and stunned with three different electrical head-only methods and with a new captive needle pistol, using air pressure. The first stunning procedure consists of two trials. In the first trial a total of 45 ostriches were stunned with a voltage of 200V (spiked electrodes) during 1s. Unfortunately, in 10 animals the electrodes were disconnected. A general epileptiform insult on the EEG followed by recovery was observed in 20 ostriches. Another eight animals died after recovery and five showed an iso-electric line and were dead. The total duration of the insult was 25±10s. The measured current was 463±120mA. In the second trial a constant current of 400mA was administered to 13 ostriches. In one animal the electrodes were disconnected. Eight out of 12 animals showed a general epileptiform insult, two of them showed an iso-electric line and two did not show the characteristics of a general epileptiform insult. The total duration of the insult on the EEG was 21±8s. The measured current was 365±91mA and the voltage 191±27V. During the second stunning procedure four and seven ostriches were stunned with 200V (spiked electrodes) and 48V (blunt electrodes), respectively, during approx. 6s. They all died. In addition, a group of 20 ostriches stunned with captive needle pistol using air pressure showed unconsciousness after stunning by the appearance of theta and delta waves tending to an iso-electric line on the EEG trace. It is recommended to use at least 500mA to stun ostriches effectively and to use a short stun-stick interval or to kill them by a long stunning duration. The captive needle pistol, using air pressure, can be an alternative for electrical head-only stunning.

Influence of aging treatment on the bacterial quality of South African springbok (Antidorcas marsupialis marsupialis) wholesale cuts.

The left sides of 20 springbok carcasses were aged with the skin on (treatment 1), while the right sides were aged without the skin (treatment 2). Another 20 carcasses were skinned, halved and cut into wholesale cuts. The loin and leg cuts from the right sides were deboned before vacuum packaging (treatment 3), while the loin and leg cuts from the left sides were vacuum packed with the bone in (treatment 4). All the carcass sides (36 h post mortem) and vacuum packed cuts (36 h post mortem) were aged for either 2, 5, 12 and 19 days respectively (ca. 0 degrees C). The examined groups of bacteria indicate that, for an ageing period of 12 days or less, vacuum packaging does not have an advantage over the hung in air method. However, when considering an extended ageing period ( > 12 days) vacuum packaging ensures that spoilage bacteria are inhibited and that the Enterobacteriaceae group of bacteria do not increase (ca. 0 degrees C), while the results clearly show that this is not the case with the hung in air ageing treatments (1 and 2).

Incidence of Staphylococcus aureus and Escherichia coli in Ground Beef, Broilers and Processed Meats in Pretoria, South Africa.

Three types of processed meats (vienna sausages, shoulder ham, and cervelat), ground beef and broilers were purchased from 17 different supermarkets in the Pretoria area (South Africa) during 1991. The 232 samples were analyzed for the presence of Escherichia coli and Staphylococcus aureus , with total aerobic plate counts (APCs) also being determined. Escherichia coli was found in 74.5% of the ground beef samples, in 79.1% of the broilers, and in 27.7% of the processed meats. Staphylococcus aureus was found in 23.4% ground beef, 39.5% broiler and 7.1% processed meat samples. The total APCs ranged from as low as log10 1 CFU/g of sample (shoulder ham) to as high as log10 12.1 CFU/g (ground beef). No identifiable relationship between the total APCs and the occurrence of E. coli and/or S. aureus was evident. This study confirms the view that E. coli and S. aureus are frequent contaminants of meat, with South Africa being no exception.

Centralised bulk pre-packaging of fresh pork retail cuts in various gas atmospheres.

A centralised bulk pre-packaging technique (laboratory method), utilising various gas mixtures (c. 100% CO(2); c. 75% CO(2):25% N(2); c. 80% O(2): 20% CO(2) and c. 25% CO(2):50% N(2):25% O(2)), was evaluated in terms of quality attributes such as microbiology, colour, odour and consumer acceptability. According to the bacterial counts recorded, all four packaging treatments were successful in prolonging the storage life (21 days c. 0°C) of centralised bulk pre-packaged pork retail cuts, while still ensuring a subsequent shelf life of at least 3 days (c. 0°C). The gas mixture comprising c. 25% CO(2):50% N(2):25% O(2) was the most successful treatment in terms of acceptability and colour scores.

The influence of different centralised pre-packaging systems on the shelf-life of fresh pork.

The influence of different centralised pre-packaging systems (PVC, modified atmosphere packaging (MAP), 25% CO(2) and 75% O(2), vacuum skin packaging (VSP) and the mother bag concept, 100% CO(2)) on the shelf-life (0, 7, 14 and 21 days at 0°C) of fresh pork was determined using microbiological, colour, odour and acceptability characteristics. All the packaging treatments were equally efficient for the first 4 days of retail display. In the extended shelf-life study (7, 14 and 21 days) the mother bag centralised packaging system gave the most promising shelf-life results (21 days) and was also judged superior in terms of odour. Modified atmosphere packaging (14 days) and VSP (7 days) may be considered as other possible options.

The aerobic psychotrophic populations on meat and meat contact surfaces in a meat production system and on meat stored at chill temperatures.

At a city abattoir, a wholesaler and 10 different supermarkets, surface microbiological samples were taken of carcasses, hands and apron fronts of members of staff and equipment (mincers and saws). In addition, minced meat, packaged and displayed in chilled cabinets, was also sampled. Carcasses, personnel surfaces and equipment were monitored by a modified agar sausage technique. From each of the highest dilution psychotrophic plate counts, five colonies were selected randomly, isolated and identified (1265 in total). Microbes developing on chilled meat were also isolated from other surfaces in the production chain. On chilled meat (51%) and at the abattoir (36%) pseudomonads were the predominant organisms followed by the Gram-positive cocci on chilled meat and by Acinetobacter, Moraxella and Alcaligenes spp. at the abattoir. At the wholesaler Gram-positive cocci (32%) predominated, followed by Alcaligenes, Moraxella and Alcaligenes spp. Pseudomonas, Alcaligenes, Neisseriaceae and related genera, Gram-positive cocci, species from the coryneform groups of bacteria and yeasts were identified from all the surfaces monitored. Identification with the API NE20 was unsatisfactory. Enterbacteriaceae, lactobacilli and endospore-forming bacteria were identified occasionally, but their significance as contaminating organisms seems low. No Salmonella spp. were identified.

The Influence of Incubation Temperature on Bacterial Counts in a Meat Production System.

Samples for microbial evaluation were taken from various surfaces including those on carcasses, and equipment at an abattoir, a wholesaler, and 10 different supermarkets. Samples were also taken of minced meat in retail display cabinets. These surfaces were monitored by means of a modified agar sausage technique. A total aerobic plate count (30°C for 24 - 48 h), a psychrotrophic count (5°C for 7 d), and a total aerobic plate count (25°C for 2 to 3 d) were investigated. Counts obtained at 30°C, yielded higher numbers than those acquired at 25°C. The accuracy of predicting the psychrotrophic population by means of a 25°C count, depends on the habitat and environmental conditions. To predict the spoilage population, a count at 25°C for 2 to 3 d can be a time saving and fairly accurate tool, provided that some equation is used to account for inherent differences. The conditions regarding habitat, environmental temperatures, and vectors should also be accounted for in the interpretation of results. The present work proved that to study a specific population, the quantitative study should be conducted at the revelant temperature (30°C for the total population, 7°C for a psychrotrophic population, and 37°C for a mesophilic population). Hence, to study the cold tolerant spoilage population encountered in a certain habitat (e. g. meat), it is advisable to do the quantitative survey at 7°C and further studies on the isolates made at this incubation temperature, could be done at 20 to 25°C.

A Quantitative Survey of a Meat Production Chain to Determine the Microbial Profile of the Final Product.

Samples from carcasses, personnel surfaces, equipment, and minced meat, packaged and displayed in cabinets were taken at a city abattoir, a wholesaler, and 10 different supermarkets. Bacteria enumerated were 1) psychrotrophs; 2) Enterobacteriaceae ; 3) enterococci; 4) micrococci; 5) Pseudomonas spp; and 6) Brochothrix thermosphacta . The non integrated production system of abattoirs, wholesalers, and retailers yielded psychrotrophic and enterococci counts at retail which compared fairly well with those reported in literature, while the Enterobacteriaceae and micrococci counts were higher. Besides the psychrotrophs the pseudomonads were the most numerous group in the final product. Different surfaces were not sanitized with the same efficacy, while a general tendency towards lower counts at one supermarket group was monitored. The counts described 96% of the variation in the psychrotrophic count at the abattoir, while the success in using these counts in estimating the psychrotrophic count at the wholesaler and retailers was not as significant. At the abattoir the Enterobacteriaceae and psuedomonads were the biggest contributors to the psychrotrophic count, at the wholesaler the Enterobacteriaceae and micrococci counts, and at the retailers the micrococci and pseudomonads respectively. This indicates that Enterobacteriaceae might be common psychrotrophs in the meat production chain, maybe originating from the abattoir and wholesale environments.

The effect of ageing treatment on the microbiology and storage characteristics of beef in modified atmosphere packs containing 25% CO(2) plus 75% O(2).

The influence of different ageing treatments (1 week hung in air; 1 and 3 weeks in vacuum packs) on the microbiological, colour, odour and rancidity characteristics of beef loin steaks during storage at 1° and 6°C in modified atmosphere packs (MA) containing 25% CO(2) + 75% O(2) was determined. Steaks from the 3-week ageing treatment discoloured more rapidly and developed off-odours sooner than those from the 1-week ageing treatments at both storage temperatures. Evidence of rancidity, using the thiobarbituric acid assay, was only observed in the 3-week aged steaks stored at 6°C. The poorer storage stability of the 3-week aged steaks was explained by higher initial levels of bacteria resulting from growth during ageing. Leuconostocs were the dominant bacteria on most MA samples following storage and appeared the main cause of spoilage, although B. thermosphacta and Pseudomonas spp may have contributed to off-odours on samples aged hung and stored at 6°C.

A microbiological survey of fresh meat in the supermarket trade. Part 1: Carcasses and contact surfaces.

Sanitary conditions were monitored at eleven supermarkets (from two major chains, Sup groups A & B) in the South African butcher industry. The variables measured were the temperature of carcasses and environments, the muscle pH of carcasses and the microbiological status of carcasses and human or personal and equipment contact surfaces (chillers-three surfaces, delivery trucks-five surfaces, cutting rooms-16 surfaces). All supermarkets, except one, received beef carcasses, distributed by one of two wholesale organizations from the same abattoir. No consistency was found in the contamination level of different parts of carcasses at different supermarkets, although there was a tendency for fore quarters to be more contaminated than hind quarters. Chiller surfaces, delivery truck surfaces and equipment had significantly different microbial counts at the different supermarkets. Sup group B received carcasses with higher mean surface temperatures and microbial counts than those of the carcasses received by Sup group A, but the mean microbial count of equipment was lower than that encountered at Sup group A. The result was less contaminated meat at the supermarkets in Sup group B, illustrating how a combination of the microbial quality of carcasses received by such supermarkets, and the sanitary programme in operation at such supermarkets affects the contamination level of retail premises. It could furthermore be shown that personnel surfaces (hands and clothes) and equipment like saws and mincers are consistent contributors to contamination at the retail level of the meat industry.

A microbiological survey of fresh meat in the supermarket trade. Part 2: beef retail cuts.

An assessment was made of the microbiological quality of the final product (different retail cuts), produced by two different retail supermarket groups (A & B). The influence of sanitary conditions on the microbiological quality of the final product was evaluated, and the possible influences on shelf life were determined. Supermarket group A (Sup group A) received carcasses with significantly lower surface counts of micro-organisms than supermarket group B (Sup group B), while the latter had a more efficient overall sanitation programme than supermarket group A. Five cuts were monitored for the presence of total aerobic counts, psychrotrophic counts, lactobacilli, Enterobacteriaceae and numbers of Pseudomonadaceae present. A shelf life study was also executed by repeating these enumerations on the same meat samples after refrigerated storage at 5°C for 2 and 4 days, respectively. It is generally accepted that a good refrigeration or chilling regime will preserve the inherent meat quality, but in this study it was found that neither served as a guarantee of quality. The more stringent hygiene at retail level of Sup group B yielded consistently lower mean counts of the different bacterial groups for all the meat cuts monitored and, thus meat with an extended shelf life. The total count (at 30°C) on meat cuts was the highest, followed by the psychrotrophs, the Pseudomonadaceae the Enterobacteriaeae and the lactobacilli. Minced meat generally had the highest mean aerobic total microbial counts. This count on minced meat might be a suitable indicator for monitoring the overall sanitary condition of a retail premises. The results re-emphasized the multi-factorial complexity of fresh meat quality and shelf life. The microbial quality of the raw material (carcasses), the maintenance of the cold chain, sanitary condition of premises, equipment and personnel surfaces and general management practices are factors that collectively determine the microbiological quality of the product.

Effects of Exercise, Electrical Stimulation and Vacuum Packaging on Bacterial Counts and Tenderness of Fresh Beef Primal Cuts.

Two wholesale cuts, the silverside ( M biceps femoris ) and bolo, (outside round and clod) from 8 steers were used in this study. Four steers were artificially stressed and the right side of all carcasses was electrically stimulated. Primals were cut into 3 equal portions after 72 h post slaughter, chilling at approximately 4°C, and were vacuum packaged. No microbial differences (P>0.05) were found between primals within treatments. Primals from stressed carcasses had higher pH values (P<0.01) and psychrotrophic, lactobacillus, anaerobic and aerobic counts than from nonstressed carcasses. Lactobacilli did not dominate the microbial population. Electrical stimulation (ES) and the cuts used had an influence on shear force values (P<0.05). ES cuts were significantly more tender than controls. Results suggest that animals should be well rested before slaughter.

Evaluation of Three Carcass Surface Microbial Sampling Techniques.

Three carcass surface microbial sampling techniques were evaluated: a double swab, an excision and an agar sausage technique. In each instance, a sampling area of 6,42 cm2 was used. For the double swab technique, two sterile dry swabs were used. A sterile meat borer was used to cut out the area of 6,42 cm2 for the excision technique. For the agar sausage technique, 50-cm3 medical syringes were used to take impression plate samples. All the samples obtained with the different techniques were subjected to serial dilutions, whereafter they were spread-plated in duplicate on prepoured plates. Results of the study indicated that there was a significant difference (P<0,05) between the three techniques. The excision technique was the most reliable while the agar sausage technique had a higher coefficient of determination (r2 value) with the excision technique than did the swab technique.

Microbiology of Beef Carcass Surfaces.

In a survey at a local abattoir, agar sausage samples were taken at 10 carcass sites on each of 156 beef carcasses at different positions along the dressing line. The carcasses were selected to include all carcass types, viz. small (< 200 kg) and large (> 200 kg) as well as lean and fat carcasses. The 156 carcasses were divided into three groups of 52 carcasses each. Samples were incubated at three different temperatures to determine the aerobic count, mesophilic count and psychrotrophic count. Results of the survey showed that despite mean initial counts of 4,5-7,7 × 102, intermediate handling and the subsequent contamination that took place along the dressing-line, the final chilling process rendered carcasses with acceptable bacterial levels(< 2,5 × 102).