Food safety issues and information needs: an online survey of public health inspectors.

In the study described in this article, the authors investigated the perceptions and needs of public health inspectors (PHIs) in the province of Ontario, Canada, with regard to food safety issues and information resources. A cross-sectional online survey of 239 Ontario PHIs was conducted between April and June 2009. Questions pertained to their perceptions of key food safety issues and foodborne pathogens, knowledge confidence, available resources, and resource needs. All respondents rated time-temperature abuse, inadequate hand washing, and cross contamination as important food safety issues. Salmonella, Campylobacter, and E. coli O157:H7 were pathogens reported to be of concern to 95% of respondents (221/233). Most respondents indicated that they were confident in their knowledge of food safety issues and foodborne pathogens, but wanted a central, online resource for food safety information and ongoing food safety education training for PHIs. The data from the authors' study can be used in the development of information resources targeted to the needs of PHIs involved in food safety.

A qualitative exploration of the perceptions and information needs of public health inspectors responsible for food safety.

BACKGROUND: In Ontario, local public health inspectors play an important frontline role in protecting the public from foodborne illness. This study was an in-depth exploration of public health inspectors' perceptions of the key food safety issues in public health, and their opinions and needs with regards to food safety information resources. METHODS: Four focus group discussions were conducted with public health inspectors from the Central West region of Ontario, Canada during June and July, 2008. A questioning route was used to standardize qualitative data collection. Audio recordings of sessions were transcribed verbatim and data-driven content analysis was performed. RESULTS: A total of 23 public health inspectors participated in four focus group discussions. Five themes emerged as key food safety issues: time-temperature abuse, inadequate handwashing, cross-contamination, the lack of food safety knowledge by food handlers and food premise operators, and the lack of food safety information and knowledge about specialty foods (i.e., foods from different cultures). In general, participants reported confidence with their current knowledge of food safety issues and foodborne pathogens. Participants highlighted the need for a central source for food safety information, access to up-to-date food safety information, resources in different languages, and additional food safety information on specialty foods. CONCLUSIONS: The information gathered from these focus groups can provide a basis for the development of resources that will meet the specific needs of public health inspectors involved in protecting and promoting food safety.

Specialty food safety concerns and multilingual resource needs: an online survey of public health inspectors.

The province of Ontario, Canada, has a highly diverse and multicultural population. Specialty foods (i.e., foods from different cultures) are becoming increasingly available at retail food outlets and foods service establishments across the province; as a result, public health inspectors (PHIs) are increasingly required to assess the safety of foods with which they may be unfamiliar. The aim of this study was to investigate the concerns, perceptions, and self-identified needs of PHIs in Ontario with regard to specialty foods and food safety information resources in languages other than English. A cross-sectional online survey of 239 PHIs was conducted between April and June 2009. The study found that while some food safety information resources were available in languages other than English, fewer than 25% of respondents (56/239) were satisfied with the current availability of these resources. With regard to specialty foods, 60% of respondents (143/239) reported at least one specialty food with which they were not confident about their current food safety knowledge, and 64% of respondents (153/239) reported at least one specialty food with which they were dissatisfied with the current availability of food safety information. Therefore, the development of additional food safety information resources for specialty foods, and food safety resources in additional languages may provide enhanced support to PHIs involved in protecting and promoting a safe food supply.

Infectious disease outbreaks related to drinking water in Canada, 1974-2001.

BACKGROUND: Recent public attention on drinking water supplies in the aftermath of waterborne infection outbreaks in Walkerton and North Battleford raises questions about safety. We analyzed information on waterborne outbreaks occurring between 1974 and 2001 in order to identify apparent trends, review the current status of monitoring and reporting, and gain a better understanding of the impact of drinking water quality on public health and disease burden. METHODS: Data from outbreak investigations, published and unpublished, were categorized by the type of drinking water provider and were assessed to be definitely, probably or possibly waterborne in nature. RESULTS: The final data set consisted of 288 outbreaks of disease linked to a drinking water source. There were 99 outbreaks in public water systems, 138 outbreaks in semi-public systems and 51 outbreaks in private systems. The main known causative agents of waterborne disease outbreaks were (in descending frequency of occurrence) Giardia, Campylobacter, Cryptosporidium, Norwalk-like viruses, Salmonella and hepatitis A virus. SUMMARY: We found that severe weather, close proximity to animal populations, treatment system malfunctions, poor maintenance and treatment practices were associated with the reported disease outbreaks resulting from drinking water supplies. However, issues related to the accuracy, co-ordination, compatibility and detail of data exist. A systematic and coordinated national surveillance system for comparison purposes, trend identification and policy development is needed so that future waterborne disease outbreaks can be avoided.

Case Report on Calciphylaxis: An Early Diagnosis and Treatment May Improve Outcome.

This is a case report of a patient who presented to the wound care center with LE ulcerations that were subsequently diagnosed with calciphylaxis. She was an insulin dependent diabetic with renal disease, but unaware of her critical kidney status. She was treated with local wound care, a partial parathyroidectomy, and started on dialysis. She is currently healed with no recurrence of ulcerations. Her ulcerations were controlled with conservative wound care and no surgical debridement.

Epidemiology of enteric disease in C-EnterNet's pilot site - Waterloo region, Ontario, 1990 to 2004.

OBJECTIVE: The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario's Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available. METHODS: Descriptive analyses were performed on reportable disease data for 13 enteric diseases collected in the Waterloo region from 1990 to 2004. Poisson and negative binomial regression analyses were used to investigate differences in incidence rates among age, sex, the 15 years of data and seasons. Disease-specific incidence rates were calculated and compared with the literature, where possible. Under-reporting ratios from the literature were applied to estimate the number of cases of campylobacteriosis, nontyphoidal salmonellosis and verotoxigenic Escherichia coli infection at the community level. RESULTS: Over the study period, the average annual age- and sex-adjusted incidence rates per 100,000 population were highest for campylobacteriosis (49.69 cases), followed by giardiasis (31.87 cases) and nontyphoidal salmonellosis (25.97 cases). The incidence of most enteric illnesses peaked in the summer. The highest incidence occurred in young children, followed by adults in their 20s. Diarrhea (85.4%) was the most frequently reported symptom, food (57.4%) was the most commonly reported probable source, and home (41.7%) and travel (37.0%) were the two most frequently reported risk settings. CONCLUSIONS: Enteric illness was a significant health burden in the Waterloo region from 1990 to 2004. Because reportable disease data are subject to under-reporting, it is likely that the true burden is greater than estimated in the present study.

The California Scale of Appreciation: a new instrument to measure the appreciation component of capacity to consent to research.

Capacity to consent is one of the linchpins of the ethical conduct of clinical care and research, and it needs to be reliably measured. The authors describe the development of a new measure of the "appreciation" component of capacity, the California Scale of Appreciation (CSA), 18 items rated according to the concept of "patently false belief" (a belief that is grossly improbable); 39 patients with schizophrenia or a related psychotic disorder (27 outpatients and 12 inpatients) and 15 normal-comparison subjects participated. Each subject's audiotaped interview was rated by three evaluators. Answers to each item were scored as "capable," "incapable," or "uncertain capacity." Also, each subject was given an overall rating of one of these three categories by each rater. Total scores on the CSA were calculated and correlated with scores on standardized instruments for assessing psychopathology and cognitive impairment. The mean total CSA score was significantly lower in the patients than in the normal-comparison subjects; however, a majority of the patients were found to be fully "capable" on the CSA. The CSA is a potentially useful instrument for measuring the appreciation component of capacity in persons with psychotic disorders. Its generalizability to other patient populations and to other types of protocols needs to be determined.