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1.
Heliyon ; 10(4): e25798, 2024 Feb 29.
Article in English | MEDLINE | ID: mdl-38380033

ABSTRACT

Purpose: Food handlers working in food service establishments need to perform appropriate and consistent food safety practices to ensure that the prepared food is safe for consumers to eat, as a failure to do so may lead to foodborne illness. It is important to have an in-depth understanding of food handler food safety behaviour in the food service sector to design targeted educational interventions and approaches to safeguard consumers. The purpose of this review is to provide insight to the existing body of research regarding food handler food safety in the food service sector, and to identify future research needs in terms of methods and measures. Methods: This study is a review of published food safety research studies (n = 118) focusing on food handlers in the food service sector conducted between 2001 and 2021. Data were collated regarding the methods used and the measures assessed in published studies to identify the gaps in current knowledge related to food safety in food service. Findings: The majority of studies were conducted in the United States (29%), Brazil (17%) and United Kingdom (7%). A large proportion were carried out in restaurants (70%). Less than a third of studies (28%) relied on a mixed method approach for data collection; and only 12% of studies assessed a combination of cognitive and behavioural measures. Observation was used in only 29% of studies. A lack of observational data detailing food safety practices such as handwashing, temperature control, separation and cleaning was determined. Significance: Such findings indicate a greater need for mixed method approach in future food safety research. It is recommended that the understanding of food handler food safety performance is best obtained through a combined assessment of cognitive and behavioural measures with subsequent triangulation of findings to reduce bias and to obtain reliable results.

2.
J Food Prot ; 87(1): 100203, 2024 01.
Article in English | MEDLINE | ID: mdl-38043792

ABSTRACT

Registered dietitians can play an important role in delivering food safety information to vulnerable population groups. Although dietetic students are reported to perceive food safety to be important for vulnerable population groups, little is known regarding their attitudes toward their role in the delivery of food safety information. Therefore, the purpose of this study was to determine and evaluate the perceptions of dietetic students regarding their role in food safety communication to vulnerable populations from three international institutions. A total of 208 dietetics students participated in the study from Columbus, Ohio, USA (n = 100), Cardiff, Wales, UK (n = 78), and Beirut, Lebanon (n = 30). Predominantly, the students in this study had positive attitudes toward the importance of food safety for vulnerable groups, although more students from Lebanon were skeptical that vulnerable patients were more susceptible to foodborne infections than the general populations (p < 0.001). Data indicated confidence and understanding of food safety principles and a willingness to learn more about food safety for these groups, however, some students in the UK (30%) and USA (31%) were not confident that they could effectively communicate food safety to vulnerable patients. Based on the findings in this and previous studies, adjustments are recommended to the requirements for food safety knowledge among dietetic students to include food safety counseling competency.


Subject(s)
Dietetics , Humans , Dietetics/education , Surveys and Questionnaires , Students/psychology , Food Safety , Communication
3.
J Food Prot ; 86(11): 100162, 2023 11.
Article in English | MEDLINE | ID: mdl-37714272

ABSTRACT

Home-delivered meal-kit recipe boxes provide consumers with fresh, measured ingredients requiring storage, preparation, and cooking by following a recipe card.Previous literature has suggested that including food safety information within recipes may positively impact behavior. Therefore, there is a need to better understand what food safety information is included on the meal-kit recipe cards. Content analysis was performed on U.K. meal-kit provider recipe cards (n = 359) obtained using citizen science methods. Although 46% of recipes referred to handwashing at the start of recipe preparation, these stated 'wash hands' with no further advice regarding hand hygiene, and half (48%) did not refer to handwashing during recipe preparation. Most recipes included produce (99%) and referred to washing fruit and vegetables (88%). For meal-kits that provided animal proteins (n = 332), 50% referred to storing ingredients in the fridge, and only one recipe referred to recommended temperatures (≤5°C). Where applicable (n = 346), food safety advice to prevent cross-contamination was present in 51% of recipes.Statements concerning cooking adequacy of animal proteins (n = 1306) included subjective cooking guidance, with 35% referring to visual assessment of color and 26% cooking duration. For best practice food safety guidance, two recipes referred to end-point temperature, and one stated to use a temperature probe. While all meal-kit providers provided some food safety-related information in reviewed recipes, information was often not sufficient to inform consumers about food safety risk-reducing behaviors in the domestic setting. Observational research is needed to understand consumer engagement with how food safety information in meal-kit recipes impacts the behavior of consumers.


Subject(s)
Cooking , Food Safety , Animals , Cooking/methods , Vegetables , Fruit , Nutritive Value
4.
Int J Environ Health Res ; 32(3): 638-651, 2022 Mar.
Article in English | MEDLINE | ID: mdl-32633547

ABSTRACT

Observation of behaviour is superior to cognitive data, which does not equate to behaviour. Covert-observation is seldom used in food manufacturing to assess behaviour. In this case study, closed-circuit-television footage (15 h) in a business were reviewed to assess hand hygiene compliance using an electronic-checklist. Hand hygiene attempts were observed prior to entering high-risk (cake/pie)(n= 47) and high-care (sandwich/salad)(n= 153) production areas. Business hand hygiene protocol required handwashing durations ≥ 20 s. Observed durations ranged 1-71 s, <96% of attempts were <20 s. Significantly longer durations were observed when food handlers were in the presence of others (12 s) than when alone (9 s). Although <99% utilised soap, only 56-69% wetted hands first. Failure to rub all parts of hands was commonplace (<87%) and 24-35% failed to apply sanitiser after drying. Consequently, >98% of observed attempts before entering production areas did not comply with the protocol. Observed non-compliant practices may have implications for food safety in manufacturing.


Subject(s)
Hand Hygiene , Food , Food Safety , Hand Disinfection , Soaps
5.
Equine Vet J ; 54(2): 368-378, 2022 Mar.
Article in English | MEDLINE | ID: mdl-33527473

ABSTRACT

BACKGROUND: African horse sickness (AHS) is endemic in sub-Saharan Africa posing a threat to equine populations in non-endemic regions. Available vaccine technologies have limitations, creating barriers to horse movement, AHS control and, in non-endemic areas or countries, rapid elimination of virus after incursion. The literature lacks an economic assessment of the benefits of bringing a new, more effective AHS vaccine to market. OBJECTIVES: The study assesses the economic impact of AHS and tests the hypothesis that investment in a safer, more effective AHS vaccine would give an economic return. STUDY DESIGN: Cost-benefit analysis. METHODS: Primary and secondary data were collected to populate the cost-benefit analysis model. A literature review was followed by a questionnaire survey and interviews to gather primary data. At-risk populations were defined and qualitative assessment completed to narrow the target populations for quantitative assessment. A deterministic cost-benefit model was developed in Excel and different scenarios tested. Break-even and sensitivity analysis were conducted on key parameters. RESULTS: The economic impact of AHS was estimated to be US$95 million per annum, and this was mainly in endemic regions with domestic equine industries and involved in international trade. Investment required to bring a new AHS vaccine to market was estimated to be up to US$3.5 million, which was very small relative to the benefits estimated in this study. The economic return on investment in bringing a new AHS vaccine to market was predicted to be positive and the analysis demonstrates this result was robust. MAIN LIMITATIONS: Data for the analysis were scarce, requiring expert opinion and extrapolation by the authors. Sensitivity analysis with the deterministic modelling structure indicated there was no justification for stochastic modelling, given the robustness of the return on investment. CONCLUSIONS: The analysis predicts a strong and robust economic return on the investment in bringing a new AHS vaccine to market. Main economic beneficiaries would be the high value horse sectors, specifically the equine industries in Republic of South Africa (RSA) and in non-endemic countries. In addition, major benefits would be captured in poor communities in sub-Saharan Africa where working equids are of high economic and social importance.


Subject(s)
African Horse Sickness Virus , African Horse Sickness , Horse Diseases , Vaccines , African Horse Sickness/epidemiology , African Horse Sickness/prevention & control , Animals , Commerce , Cost-Benefit Analysis , Horse Diseases/prevention & control , Horses , Internationality
6.
J Food Prot ; 85(2): 287-310, 2022 02 01.
Article in English | MEDLINE | ID: mdl-34648623

ABSTRACT

ABSTRACT: Because the incidence of foodborne infection is more prevalent among cancer patients and the domestic kitchen is a contributor to foodborne infection, appropriate domestic food safety practices are needed to safeguard this at-risk population. Although patients are aware of the increased risk of infection, previous self-reported data indicate potential food safety malpractices among patients and family caregivers, thus suggesting the need for targeted food safety information. However, existing United Kingdom resources provide inconsistent and insufficient food safety information. Involvement of intended end users in the cocreation of interventions increases potential effectiveness. Qualitative data were collated from in-depth interviews and a focus group with United Kingdom chemotherapy patients and family caregivers (n = 35) to determine perceptions and preferences for food safety information by evaluating existing food safety resources from international providers (n = 12). Although participants liked digital interventions (e.g., Web sites and videos), traditional paper-based leaflets were perceived as the most beneficial because they could be referred to on repeated occasions. Despite the drawbacks associated with some resources, combining approaches in a multiresource intervention was favored by patients and family caregivers. Ensuring patients are not overwhelmed with excessive information was important. Short, logical, engaging, educational, and entertaining information to evoke an interest in the topic was preferred. Utilization of graphics to supplement descriptive information may enhance comprehensibility. Interventions need to be appropriate for patients and caregivers, and delivery by trusted health care professionals may enhance the credibility of the message. Preferred approaches to facilitate targeted food safety communication were identified, and these findings can be utilized to cocreate targeted food safety interventions for chemotherapy patients and family caregivers.


Subject(s)
Caregivers , Food Safety , Humans , Self Report , United Kingdom
7.
Foods ; 10(8)2021 Aug 13.
Article in English | MEDLINE | ID: mdl-34441655

ABSTRACT

Allied health professionals such as dietitians can play a critical role in providing food safety advice to vulnerable consumers. To maximize food-related health and wellbeing, food needs to be safe and nutritious; consequently, food safety is referred to in international curricula for the training of dietitians. The purpose of this study was to explore the awareness and attitudes of student dietitians from three international institutions towards food safety. A total of 207 student dietitians participated in the study from Columbus, OH, USA (n = 99), Cardiff, Wales, UK (n = 78) and Beirut, Lebanon (n = 30). Completion of the study established that the students in three dietetic training programs lacked awareness of key food safety concepts. Close to half (43%) were not familiar with Campylobacter, with the USA students being significantly less knowledgeable (p < 0.001) with 58% being unaware of the pathogen. Understanding of safe handling of leftovers was the lowest for the students in all institutions; only 46% described appropriate reheating practices, with significantly lower (p < 0.001) understanding in Lebanon (28%). The students reported a good understanding of vulnerable populations and perceived food safety to be important for these groups. However, the knowledge of certain high-risk foods was lacking. For instance, 69% of students thought that fresh squeezed juices and smoothies made with raw fruits and vegetables were safe for vulnerable patients, with the UK students being the least familiar with this risk (16%). This is the first study of its kind to take an international perspective of student dietitian food safety awareness and attitudes; the findings are important to dietetic food safety educators and recommendations are made to further explore the interpretation of food safety requirements in international dietetic curricula. Future studies should extend student dietetic research to address attitudes, self-efficacy and the overall readiness to deliver food safety advice to the patients and the community.

8.
J Food Prot ; 84(9): 1640-1647, 2021 09 01.
Article in English | MEDLINE | ID: mdl-33984141

ABSTRACT

ABSTRACT: New Zealand (NZ) has a high rate of reported campylobacteriosis cases. Cross-contamination in home kitchens during poultry handling is considered the main factor in campylobacteriosis transmission. The main aim of this study was to measure NZ consumers' food safety awareness and self-reported food safety practices associated with handling raw poultry. This study will contribute to the existing knowledge to explain the reasons behind the increase of campylobacteriosis incidents. Findings can help inform future consumer education campaigns to help reduce the incidence of campylobacteriosis in NZ. A cross-sectional survey composed of 31 multiple-choice questions was designed, piloted, and used to collect information about the last time consumers purchased and prepared raw poultry at home. A street-intercept survey in public places, such as supermarkets in the Canterbury region, was used to recruit respondents for this study. A descriptive and inferential data analysis was performed, including a one-way analysis of variance test used to compare the mean scored responses of the respondents among different sociodemographics. Overall, 301 valid responses were obtained. Scores representing reported safe food practices ranged between 2 and 19 (maximum 21), with a mean score of 9.83 (standard deviation of 3.50 with a standard error of 0.20). There was some variation in correctly answered questions by respondents for food hygiene (25%), cross-contamination prevention (55%), temperature control and storage practices (49%), and food safety (52%). Approximately 30% of the respondents reported symptoms of a foodborne disease experienced once to four times during the past 12 months. The study identified low adherence to current recommended food safety practices, including safe food storage and temperature control. The findings can be used to inform a communication campaign regarding food safety needs to be designed urgently in NZ to reduce the rate of campylobacteriosis.


Subject(s)
Campylobacter Infections , Animals , Campylobacter Infections/epidemiology , Campylobacter Infections/prevention & control , Cooking , Cross-Sectional Studies , Food Handling , Food Microbiology , Food Safety , Humans , New Zealand/epidemiology , Poultry , Risk Factors , Surveys and Questionnaires
9.
J Food Prot ; 82(8): 1326-1335, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31313964

ABSTRACT

Because of increased susceptibility, older adults have an increased risk of foodborne infection, and data suggest elevated incidence; therefore, food hygiene is essential to reduce the risk. Research suggests older adults' inadequate knowledge and negative attitudes toward food hygiene may increase implementation of unsafe food practices. Data on microbiological contamination of domestic kitchens of older adults are lacking. Therefore, this study aimed to determine microbiological contamination of domestic kitchens of older adults. Food contact surfaces and equipment (n = 1,292) in domestic kitchens (n = 100) of older adults (≥60 years) were analyzed to isolate aerobic bacteria, Enterobacteriaceae, Staphylococcus aureus, and Listeria spp.; self-reported hygiene practices were also recorded. Highest contamination levels were determined on in-use cleaning equipment (dish brushes, dishcloths, sponges) with aerobic bacteria <9.3 log CFU per item, Enterobacteriaceae <8.8 log CFU per item, and S. aureus <7.0 log CFU per item. Reported usage length of dish brushes was significantly correlated (P < 0.05) with Enterobacteriaceae contamination. Significant correlations (P < 0.05) were determined between contamination and reported cleaning frequency of refrigerators. Contamination of hand towels in single-occupant households was significantly greater (P < 0.05) than in multioccupant households. The study facilitates novel comparison between reported hygiene practices with microbial contamination, suggesting older adults fail to implement adequate and regular hygiene practices that may increase the possibility of cross-contamination in the domestic kitchen and the associated risk of foodborne illness. Data from this study have determined a need for older adults to improve food hygiene practices in the domestic kitchen.


Subject(s)
Bacterial Physiological Phenomena , Food Handling , Food Microbiology , Aged , Food Handling/statistics & numerical data , Household Articles , Humans , Hygiene/standards , Middle Aged , Self Report
10.
J Food Prot ; 82(3): 371-378, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30767674

ABSTRACT

Although vast amounts of consumer food safety knowledge and self-reported data exist, attitudinal data detailing perceptions of risk, control, and responsibility are lacking. Such data relating to vulnerable groups, including older adults, are particularly scarce. Perception determination is essential in consumer food safety research to facilitate a comprehensive understanding of the cognitive factors that may impact behavior. Previous research has indicated a relationship between food safety perceptions and behavior. Perceptual data can inform the development of targeted food safety educational interventions. This study was conducted to ascertain older adult consumers' cognitive perceptions regarding food safety. Older adults (≥60 years, n = 100) participated in a computer-assisted personal interview to determine perceived risk, control, and responsibility associated with food safety. Although the potential severity of foodborne illness may be understood, the association between foodborne illness and domestic food preparation may be underestimated. Significant differences were found between perceived personal risk, control, and responsibility and the risks, control, and responsibilities of others ( P > 0.001). Older adults perceived themselves to have lower levels of risk than other individuals have, suggesting perceptions of optimistic bias and personal invulnerability. Perceived greater levels of personal control and responsibility, compared with those of others, suggest perceptions associated with the illusion of control. Correlations were evaluated between personal perceptions of risk, control, and responsibility ( P < 0.05). Low levels of risk were correlated with high levels of control. Those respondents ≥80 years of age perceived higher levels of risk and lower levels of control and responsibility. Cumulatively, older adult consumers expressed perceptions of invulnerability, optimistic bias, and the illusion of control regarding food safety. Such perceptions may undermine attempts to provide education regarding food safety. Food safety messages for this audience must be tailored to overcome such perceptions.


Subject(s)
Food Safety , Foodborne Diseases/psychology , Health Knowledge, Attitudes, Practice , Aged , Aged, 80 and over , Female , Food Handling/methods , Food Microbiology , Foodborne Diseases/prevention & control , Humans , Male , Perception , Risk Factors
11.
Int J Environ Health Res ; 29(6): 593-606, 2019 Dec.
Article in English | MEDLINE | ID: mdl-30569758

ABSTRACT

Food-handler hand-hygiene can be a contributory factor for food-borne illness. Cognitive data (knowledge/attitudes/self-reported practices), while informative, are not indicative of behaviour, and are subject to biases. Consequently, observation of behaviour is superior to survey data. However, researcher presence in direct observation increases reactivity, whereas video observation gives comprehensive analysis over a longer period, furthermore, familiarity reduces reactivity. Although video observation has been used to assess food safety at retail/foodservice, this valuable method is under-utilized in food-manufacturing environments. For the study, footage (24 h) was reviewed to assess compliance in a food-manufacturing site with company protocol. Video observation of food-handlers entering production (n = 674) was assessed; upon 70 occasions no attempt to implement hand-hygiene was observed. Of attempted hand-hygiene practices (n = 604), only 2% implemented compliant practices. Although 78% of attempts utilized soap, only 42% included sanitizer. Duration ranged from 1 to 69 s (Median 17 s). The study provides hand-hygiene data in an area that observational data is seldom captured.


Subject(s)
Food Handling/standards , Food Industry/statistics & numerical data , Guideline Adherence/statistics & numerical data , Hand Hygiene/standards , Video Recording , Bread , Food Handling/statistics & numerical data , Food Safety , Hand Hygiene/methods , Hand Hygiene/statistics & numerical data , Health Behavior , Humans
12.
Oncol Nurs Forum ; 45(5): E98-E110, 2018 09 01.
Article in English | MEDLINE | ID: mdl-30118447

ABSTRACT

OBJECTIVES: To explore awareness of foodborne infection risk during chemotherapy treatment, to assess knowledge of risk-reducing food safety practices in patients with cancer and their family caregivers, and to determine self-reported food-handling practices. SAMPLE & SETTING: A convenience sample of 121 patients receiving chemotherapy and 51 family caregivers of patients receiving chemotherapy in the United Kingdom recruited in the community and using online advertising. METHODS & VARIABLES: Participants completed a self-report questionnaire to determine food safety knowledge and self-reported food-handling practices. RESULTS: Although patients receiving chemotherapy and family caregivers reported awareness of food safety practices, self-reported practices indicated that potentially unsafe practices may be used in relation to temperature control, handwashing, safe cooking, and adherence to use-by dates. Such practices may increase the risk of foodborne illness to patients receiving chemotherapy treatment. IMPLICATIONS FOR NURSING: Nursing research is required to explore the food safety training and awareness of healthcare providers. Highly focused and specifically targeted food safety interventions need to be developed and delivered to increase awareness and to implement food safety practices.


Subject(s)
Antineoplastic Agents/therapeutic use , Caregivers/psychology , Food Handling/standards , Food Safety/methods , Foodborne Diseases/prevention & control , Neoplasms/drug therapy , Patients/psychology , Adult , Aged , Aged, 80 and over , Female , Guidelines as Topic , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Self Report , Surveys and Questionnaires , United Kingdom
13.
J Food Prot ; 81(4): 569-581, 2018 04.
Article in English | MEDLINE | ID: mdl-29517353

ABSTRACT

The incidence of foodborne illness is higher in older adults because of their increased susceptibility; therefore, food safety practices are important. However, inadequate knowledge and negative attitudes toward food safety have been reported, which may increase use of unsafe food handling practices. Data on the actual food safety behaviors of older adults are lacking. In this study, food safety practices of older adults were observed and linked to microbiological analysis of kitchen surfaces to identify suspected routes of contamination. Older adults (≥60 years, n = 100) prepared a set meal in a model domestic kitchen sanitized according to a validated protocol to ensure minimal and consistent microbiological loads. Food safety behaviors were observed using ceiling-mounted cameras and recorded using a predetermined behavioral checklist. Surface microbiological contamination also was determined after food preparation. Overall, older adults frequently implemented unsafe food handling practices; 90% failed to implement adequate hand decontamination immediately after handling raw chicken. For older adults who used a larger number of adequate hand decontamination attempts, microbiological contamination levels in the kitchen following the food preparation session were significantly lower ( P < 0.001). The novel utilization of behavioral observation in conjunction with microbiological analysis facilitated identification of potentially unsafe food handling practices as suspected routes of microbiological cross-contamination in a model domestic kitchen. Findings indicate the potential impact on domestic food safety of unsafe food handling practices used by older adult consumers. This innovative approach revealed that a large proportion of older adults implement behaviors resulting in microbiological cross-contamination that may increase the risk of foodborne illness in the home.


Subject(s)
Behavior Observation Techniques , Cooking , Food Contamination , Aged , Animals , Chickens/microbiology , Food Contamination/analysis , Food Handling/methods , Food Safety , Humans
14.
J Food Prot ; 79(2): 263-72, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26818987

ABSTRACT

Consumer implementation of recommended food safety practices, specifically relating to time and temperature control of ready-to-eat (RTE) food products associated with listeriosis are crucial. This is particularly the case for at-risk consumers such as older adults, given the increased listeriosis incidence reported internationally among adults aged ≥60 years. However, data detailing older adults' cognitive risk factors associated with listeriosis are lacking. Combining data about knowledge, self-reported practices, and attitudes can achieve a cumulative multilayered in-depth understanding of consumer food safety behavior and cognition. This study aims to ascertain older adults' cognition and behavior in relation to domestic food handling and storage practices that may increase the risks associated with L. monocytogenes. Older adults (≥60 years) (n = 100) participated in an interview and questionnaire to determine knowledge, self-reported practices, and attitudes toward recommended practices. Although the majority (79%) had positive attitudes toward refrigeration, 84% were unaware of recommended temperatures (5°C) and 65% self-reported "never" checking their refrigerator temperature. Although most (72%) knew that "use-by" dates indicate food safety and 62% reported "always" taking note, neutral attitudes were held, with 67% believing it was safe to eat food beyond use-by dates and 57% reporting doing so. Attitudes toward consuming foods within the recommended 2 days of opening were neutral, with 55% aware of recommendations and , 84% reporting that they consume RTE foods beyond recommendations. Although knowledgeable of some key practices, older adults self-reported potentially unsafe practices when storing RTE foods at home, which may increase risks associated with L. monocytogenes. This study has determined that older adults' food safety cognition may affect their behaviors; understanding consumer food safety cognition is essential for developing targeted food safety education.


Subject(s)
Fast Foods/microbiology , Health Knowledge, Attitudes, Practice , Listeriosis/psychology , Aged , Aged, 80 and over , Consumer Product Safety , Female , Food Contamination/analysis , Food Safety , Food Storage , Humans , Listeriosis/epidemiology , Male , Middle Aged , Refrigeration , Risk Factors , Surveys and Questionnaires , Temperature
15.
J Food Prot ; 79(12): 2119-2127, 2016 12.
Article in English | MEDLINE | ID: mdl-28221951

ABSTRACT

Increased consumer demand for convenience and ready-to-eat food, along with changes to consumer food purchase and storage practices, have resulted in an increased reliance on refrigeration to maximize food safety. Previous research suggests that many domestic refrigerators operate at temperatures exceeding recommendations; however, the results of several studies were determined by means of one temperature data point, which, given temperature fluctuation, may not be a true indicator of actual continual operating temperatures. Data detailing actual operating temperatures and the effects of consumer practices on temperatures are limited. This study has collated the time-temperature profiles of domestic refrigerators in consumer kitchens (n = 43) over 6.5 days with concurrent self-reported refrigerator usage. Overall, the findings established a significant difference (P < 0.05) between one-off temperature (the recording of one temperature data point) and mean operating temperature. No refrigerator operated at ≤5.0°C for the entire duration of the study. Mean temperatures exceeding 5.0°C were recorded in the majority (91%) of refrigerators. No significant associations or differences were determined for temperature profiles and demographics, including household size, or refrigerator characteristics (age, type, loading, and location). A positive correlation (P < 0.05) between room temperature and refrigerator temperature was determined. Reported door opening frequency correlated with temperature fluctuation (P < 0.05). Thermometer usage was determined to be infrequent. Cumulatively, research findings have established that the majority of domestic refrigerators in consumer homes operate at potentially unsafe temperatures and that this is influenced by consumer usage. The findings from this study may be utilized to inform the development of shelf-life testing based on realistic domestic storage conditions. Furthermore, the data can inform the development of future educational interventions to increase safe domestic refrigeration practices.


Subject(s)
Refrigeration , Temperature , Animals , Food Safety , United Kingdom
16.
Int J Health Care Qual Assur ; 28(1): 40-54, 2015.
Article in English | MEDLINE | ID: mdl-26308401

ABSTRACT

PURPOSE: The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. DESIGN/METHODOLOGY/APPROACH: Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. FINDINGS: The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. RESEARCH LIMITATIONS/IMPLICATIONS: Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. PRACTICAL IMPLICATIONS: The paper identifies opportunities for enhancing hospital food production systems. ORIGINALITY/VALUE: The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.


Subject(s)
Food Service, Hospital/organization & administration , Hospitals, Private/organization & administration , Hospitals, Public/organization & administration , Patient Satisfaction , Food Handling , Food Service, Hospital/standards , Food Supply , Humans , Menu Planning
17.
J Food Prot ; 78(4): 738-45, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25836399

ABSTRACT

Increased listeriosis incidence among older adults (≥ 60 years) has been reported internationally, with many cases reported to be sporadic and associated with ready-to-eat (RTE) food products with extended refrigerated shelf life. Given that the home kitchen is recognized as a significant location where foodborne illnesses are acquired, it is important that consumers implement safe food practices to minimize risks. This is crucial for vulnerable consumers, such as older adults. Consumer food safety recommendations in the United Kingdom to reduce the risk of listeriosis at home include (i) following "use-by" dates on unopened prepacked RTE food products, (ii) consuming RTE food products within 2 days of opening, and (iii) ensuring the safe operating temperatures of domestic refrigerators (≤ 5 °C). This study utilized observation, self-reporting, and microbiological analysis to determine actual food storage practices to identify behavioral risk factors. A domestic kitchen survey was conducted in older adult (≥ 60 years) consumers' domestic kitchens (n = 100) in South Wales, United Kingdom. Forty-one percent of foods in home refrigerators were beyond the use-by date, of which 11% were unopened RTE food products commonly associated with listeriosis. Sixty-six percent of opened RTE foods had been or were intended to be stored beyond the recommended 2 days after opening. Older adults failed to ensure safe refrigeration temperatures, with 50% of central storage and 85% of door storage areas operating at temperatures >5 °C. Older refrigerators operated at significantly (P < 0.05) higher temperatures. Given that Listeria monocytogenes was isolated in 2% of kitchens, these findings suggest that storage malpractices may have a greater effect on the potential risk of listeriosis than its presence alone. The study has determined that many older adults fail to adhere to recommendations and subject RTE foods associated with L. monocytogenes to prolonged storage at unsafe temperatures which may render food unsafe for consumption.


Subject(s)
Food Storage/standards , Listeriosis/epidemiology , Cold Temperature , Colony Count, Microbial/standards , Consumer Product Safety/standards , Female , Food Contamination/analysis , Food Microbiology/standards , Food Safety , Humans , Listeria monocytogenes/growth & development , Listeria monocytogenes/isolation & purification , Male , Middle Aged , Refrigeration/standards , Risk Factors , Surveys and Questionnaires , United Kingdom/epidemiology
18.
J Food Prot ; 77(3): 510-21, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24674447

ABSTRACT

Listeria monocytogenes causes human listeriosis, which is associated with the highest hospitalization and mortality rates of all foodborne illnesses. In recent years, the incidence of listeriosis has doubled in Europe, almost exclusively among older adults (≥ 60 years of age). Food safety factors associated with increased risk of listeriosis include lack of adherence to "use by" dates and ineffective refrigerated storage of foods. Consequently, older adult consumers' implementation of safe food practices should be evaluated. This article is a review of consumer food safety cognitive and behavioral data relating to risk factors associated with listeriosis in the home as reported in 165 consumer food safety studies. Overall, only 41% of studies included assessment of consumer cognitive or behavioral data associated with listeriosis; of these studies 59% included data on safe refrigeration, 54% included data on storage time for opened ready-to-eat foods, and 49% included data on adherence to use-by dates. In most (83%) of the studies, survey-based data collection methods (questionnaires/interviews) were used; thus, the majority of findings were based on self-report (74%) and knowledge (44%). Observation (31%) and focus groups (12%) were less commonly used, resulting in a lack of actual behaviors and attitudinal data relating to listeriosis risk factors. Only 7% of studies included food safety data for older adults. Although older adults may fail to implement recommended practices, this review reveals a need for in-depth research to determine food safety attitudes and actual behaviors of older adults in conjunction with knowledge and selfreport of practices linked to increased risks of listeriosis. Such data combined with review findings would inform targeted food safety education to reduce risks associated with listeriosis in the home.


Subject(s)
Consumer Product Safety , Food Handling/methods , Food Safety , Health Knowledge, Attitudes, Practice , Listeriosis/epidemiology , Food Microbiology , Health Behavior , Humans , Listeria monocytogenes/isolation & purification , Listeria monocytogenes/pathogenicity , Listeriosis/prevention & control , Risk Factors
19.
Glob Adv Health Med ; 1(2): 32-6, 2012 May.
Article in English | MEDLINE | ID: mdl-24278816

ABSTRACT

Heart disease (HD) is the number one killer in the United States.(1) In 2006, the direct and indirect costs associated with cardiovascular disease in the United States were estimated at 400 billion dollars.(2) Statin therapy for cholesterol reduction is a mainstay intervention for cardiovascular disease (CVD) as reflected in atorvastatin's status as the number one prescribed medication in the United States.(3) Statin therapy, however, is also associated with side effects that signal mitochondrial distress. A commonly reported statin-induced symptom is myalgia, which is defined as muscle pain without an associated elevation of serum creatine kinase (CK). In clinical trials, the reports of myalgia vary from less than 1% to 25% of patients.(4) Myopathy is a general term defined as an abnormal condition or disease of muscle tissue. Myopathy includes myalgia, myositis (inflammation of muscle tissue associated with elevated CK) and the very serious condition rhabdomyolysis (extreme myositis). Histological findings in statin-induced myopathy demonstrate electron chain dysfunction making "mitochondrial myopathy" the more precise term.(5) Mitochondrial myopathy has been associated with statin-induced CoQ10 depletion.(5) Given the density of mitochondria in cardiomyocytes, and CoQ10's role in mitochondrial energy production, depletion has long been associated with increased risk for heart disease.(6-7) In the case below, mitochondrial-specific organic acids, serum CoQ10, vitamin D and clinical history all suggest statin-induced mitochondrial myopathy, despite normal serum CK.


Las enfermedades coronarias (EC) constituyen la cause número uno de muerte en los Estados Unidos.1 En el 2006, los costes directos e indirectos relacionados con las enfermedades cardiovasculares en los Estados Unidos se estimaron en unos 400.000 millones de dólares.2 La terapia con estatinas para reducir el colesterol es una intervención principal para las enfermedades cardiovasculares (ECV), como se refleja en el estatus de la atorvastatina como el principal medicamento recetado en los Estados Unidos.3 El tratamiento con estatinas, sin embargo, está asociado a efectos secundarios que indican insuficiencia mitocondrial. Un síntoma inducido por las estatinas que se notifica con frecuencia es la mialgia, definida como un dolor muscular sin un incremento asociado de creatina quinasa (CK) sérica. En los ensayos clínicos, las comunicaciones de mialgia varían desde menos del 1% hasta el 25% de los pacientes.4 La miopatía es un término general, definido como una condición anormal o enfermedad del tejido muscular. La miopatía incluye mialgia, miositis (inflamación del tejido muscular asociada a niveles elevados de CK) y la condición extremadamente grave de rabdomiólisis (miositis extrema). Los resultados histológicos en la miopatía inducida por estatinas demuestran una disfunción de la cadena de electrones, por lo que "miopatía mitocondrial" es un término más preciso.5 La miopatía mitocondrial se ha asociado a una reducción del CoQ10 inducida por estatinas.5 Dada la densidad de mitocondrias en los cardiomiocitos y el papel del CoQ10 en la producción de energía mitocondrial, esa reducción se ha asociado a un incremento del riesgo de enfermedades coronarias.6­7 En el caso que se indica más abajo, los ácidos orgánicos específicos mitocondriales, el CoQ10 sérico, la vitamina D y los antecedentes médicos sugieren una miopatía mitocondrial inducida por estatinas, a pesar de la CK sérica normal.

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