Tomato handling practices in restaurants.

In recent years, multiple outbreaks of Salmonella infection have been associated with fresh tomatoes. Investigations have indicated that tomato contamination likely occurred early in the farm-to-consumer chain, although tomato consumption occurred mostly in restaurants. Researchers have hypothesized that tomato handling practices in restaurants may contribute to these outbreaks. However, few empirical data exist on how restaurant workers handle tomatoes. This study was conducted to examine tomato handling practices in restaurants. Members of the Environmental Health Specialists Network (EHS-Net) observed tomato handling practices in 449 restaurants. The data indicated that handling tomatoes appropriately posed a challenge to many restaurants. Produce-only cutting boards were not used on 49% of tomato cutting observations, and gloves were not worn in 36% of tomato cutting observations. Although tomatoes were washed under running water as recommended in most (82%) of the washing observations, tomatoes were soaked in standing water, a practice not recommended by the U.S. Food and Drug Administration (FDA), in 18% of observations, and the temperature differential between the wash water and tomatoes did not meet FDA guidelines in 21% of observations. About half of all batches of cut tomatoes in holding areas were above 41 degrees F (5 degrees C), the temperature recommended by the FDA. The maximum holding time for most (73%) of the cut tomatoes held above 41 degrees F exceeded the FDA recommended holding time of 4 h for unrefrigerated tomatoes (i.e., tomatoes held above 41 degrees F). The information provided by this study can be used to inform efforts to develop interventions and thus prevent tomato-associated illness outbreaks.

Reversing the decreasing peritoneal dialysis (PD) trend in Ontario: a government initiative to increase PD use in Ontario to 30% by 2010.

In September 2005, the Ontario Ministry of Health and Long-Term Care established the Provincial PD Coordinating Committee to make recommendations to increase the use of PD among prevalent dialysis patients in Ontario from the present 18% to 30% by 2010. In the present paper, we describe the process through which the Committee produced its recommendations and we highlight the proposed implementation plan.

Death in the family and HIV risk-taking among intravenous drug users.

The objective of this study was to ascertain the relationship among intravenous drug users between high levels of HIV risk-taking and both (a) deaths of significant others experienced before age 15, and (b) unresolved mourning; 592 out-of-treatment intravenous drug users (71.4% male; mean age = 40.5), stratified as to zip code, were recruited in San Jose, CA, as part of a CDC multisite investigation of access to sterile needles and HIV infection. HIV serostatus tests were obtained and an individual, structured interview administered covering demographics, employment, mental health, HIV risk-taking behavior, family contacts/closeness, and family deaths/mourning. Multivariate analyses indicated that the extent of HIV risk-taking in adulthood was highly and positively related to (a) the number of close-family-member deaths participants experienced as youth, (b) the extent to which respondents effectively mourned sudden family losses, (c) the extent to which those lost were emotionally close to the respondent, and (d) whether or not the respondent attended the funerals of lost relatives. Canonical correlations between sets of death/mourning and HIV risk-taking variables were .55 for the total sample (p < .001) and .70 for the subsample who experienced early and sudden family deaths (p < .001). In both analyses, it made little difference if age and gender were partialed out. These findings give credence to the importance of (a) unexpected deaths experienced early in life, and (b) related, inadequate mourning, as factors in progressively higher adult HIV risk-taking. They suggest that treatment for such individuals and their families should involve grief work dealing with unresolved losses within the family of origin. In addition, prevention efforts may have to revise their modus operandi toward both more focused and more family-based methods of outreach and engagement.

Building empowering partnerships for interprofessional care.

While partnership approaches have the potential to achieve cost-effective quality health care, several attributes of the current context make partnerships difficult to achieve. This paper provides an analysis of the socio-cultural, structural and human challenges to building partnerships at both personal and organizational levels, together with an empowering interdisciplinary approach for overcoming these barriers. Premised on empirical evidence, 'flexible client-driven care', currently being tested in the home care sector in Canada, encompasses structures and processes that promote relationship-building and conscientious critical application of individual and collective potential for achieving health care. Strategies for implementing empowering partnership-building at both personal and organizational levels are elaborated, together with the challenges encountered. The practical issues addressed afford insights and ideas for others who may be attempting to achieve similar partnership aims.