scholarly journals Developing a risk management framework to improve public health outcomes by enumerating Salmonella in ground turkey

2018 ◽  
Vol 147 ◽  
Author(s):  
F. Sampedro ◽  
S. J. Wells ◽  
J. B. Bender ◽  
C. W. Hedberg
Keyword(s):  
Public Health ◽  
Risk Management ◽  
Health Outcomes ◽  
Management Strategies ◽  
Health Impact ◽  
Median Number ◽  
Assessment Model ◽  
Quantitative Risk Assessment ◽  
Contamination Levels ◽  
The Impact

AbstractSalmonella spp. continue to be a leading cause of foodborne morbidity worldwide. To assess the risk of foodborne disease, current national regulatory schemes focus on prevalence estimates of Salmonella and other pathogens. The role of pathogen quantification as a risk management measure and its impact on public health is not well understood. To address this information gap, a quantitative risk assessment model was developed to evaluate the impact of pathogen enumeration strategies on public health after consumption of contaminated ground turkey in the USA. Public health impact was evaluated by using several dose–response models for high- and low-virulent strains to account for potential under- or overestimation of human health impacts. The model predicted 2705–21 099 illnesses that would result in 93–727 reported cases of salmonellosis. Sensitivity analysis predicted cooking an unthawed product at home as the riskiest consumption scenario and microbial concentration the most influential input on the incidence of human illnesses. Model results indicated that removing ground turkey lots exceeding contamination levels of 1 MPN/g and 1 MPN in 25 g would decrease the median number of illnesses by 86–94% and 99%, respectively. For a single production lot, contamination levels higher than 1 MPN/g would be needed to result in a reported case to public health officials. At contamination levels of 10 MPN/g, there would be a 13% chance of detecting an outbreak, and at 100 MPN/g, the likelihood of detecting an outbreak increases to 41%. Based on these model prediction results, risk management strategies should incorporate pathogen enumeration. This would have a direct impact on illness incidence linking public health outcomes with measurable food safety objectives.

scholarly journals A Quantitative Risk Assessment of Human Salmonellosis from Consumption of Pistachios in the United States

2018 ◽  
Vol 81 (6) ◽  
pp. 1001-1014 ◽  
Author(s):  
SOFIA M. SANTILLANA FARAKOS ◽  
RÉGIS POUILLOT ◽  
GORDON R. DAVIDSON ◽  
RHOMA JOHNSON ◽  
JUDITH SPUNGEN ◽  
...  
Keyword(s):  
United States ◽  
Risk Assessment ◽  
The United States ◽  
Assessment Model ◽  
Quantitative Risk Assessment ◽  
Exposure Model ◽  
Log Reduction ◽  
Pest Infestation ◽  
Contamination Levels ◽  
The Impact

ABSTRACT We developed a quantitative risk assessment model to assess the risk of human nontyphoidal salmonellosis from consumption of pistachios in the United States and to evaluate the impact of Salmonella treatments (1- to 5-log reductions). The exposure model estimating prevalence and contamination levels of Salmonella at consumption included steps in pistachio processing such as transport from grower to huller, removal of the hull through wet abrasion, separation of pistachio floaters (immature, smaller nuts) and sinkers (mature, larger nuts) in a flotation tank, drying, storage, and partitioning. The risks of illness per serving and per year were evaluated by including a Salmonella dose-response model and U.S. consumption data. The spread of Salmonella through float tank water, delay in drying resulting in growth, increased Salmonella levels through pest infestation during storage (pre- and posttreatment), and a simulation of the 2016 U.S. salmonellosis outbreak linked to consumption of pistachios were the modeled atypical situations. The baseline model predicted one case of salmonellosis per 2 million servings (95% CI: one case per 5 million to 800,000 servings) for sinker pistachios and one case per 200,000 servings (95% CI: one case per 400,000 to 40,000 servings) for floater pistachios when no Salmonella treatment was applied and pistachios were consumed as a core product (>80% pistachio) uncooked at home. Assuming 90% of the pistachio supply is sinkers and 10% is floaters, the model estimated 419 salmonellosis cases per year (95% CI: 200 to 1,083 cases) when no Salmonella treatment was applied. A mean risk of illness of less than one case per year was estimated when a minimum 4-log reduction treatment was applied to the U.S. pistachio supply, similar to the results of the Salmonella risk assessment for almonds. This analysis revealed that the predicted risk of illness per serving is higher for all atypical situations modeled compared with the baseline, and delay in drying had the greatest impact on consumer risk.

DAMPAK PENGELOLAAN SAMPAH PADA KESEHATAN MASYARAKAT DI TPA

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Emilda Emilda
Keyword(s):  
Public Health ◽  
Hand Hygiene ◽  
Waste Management ◽  
Qualitative Data ◽  
Water Storage ◽  
Health Impact ◽  
Clean Water ◽  
The People ◽  
Clean Environment ◽  
The Impact

The limitations of waste management in the Cipayung Landfill (TPA) causing a buildup of garbage up to more than 30 meters. This condition has a health impact on people in Cipayung Village. This study aims to analyze the impact of waste management at Cipayung Landfill on public health in Cipayung Village, Depok City. The research is descriptive qualitative. Data obtained by purposive sampling. Data was collected by interviews, observation and documentation. Based on interviews with 30 respondents, it was found that the most common diseases were diarrhea, then other types of stomach ailments, subsequent itching on the skin and coughing. This is presumably because the environmental conditions in the form of unhealthy air and water and clean and healthy living behaviors (PHBS) have not become the habit of the people. The results indicated that there were no respondents who had implemented all of these criteria. In general respondents have implemented  3 criteria, namely maintaining hair hygiene, maintaining skin cleanliness, and maintaining hand hygiene. While maintaining clean water storage is the most often overlooked behavior. To minimize this health impact, improvements in waste management in Cipayung landfill are needed along with continuous socialization and education to develop PHBS habits and the importance of maintaining a clean environment.

scholarly journals More Than Shelter: Housing for Urban Maternal and Infant Health

2021 ◽  
Vol 18 (7) ◽  
pp. 3331
Author(s):  
Jason Reece
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Outcomes ◽  
City Planning ◽  
Infant Health ◽  
The United States ◽  
Housing Quality ◽  
Housing Discrimination ◽  
Maternal Health Outcomes ◽  
The Impact

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.

scholarly journals Impact of the Affordable Care Act’s Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

2017 ◽  
Vol 75 (2) ◽  
pp. 131-152 ◽  
Author(s):  
Joshua Breslau ◽  
Bradley D. Stein ◽  
Bing Han ◽  
Shoshanna Shelton ◽  
Hao Yu
Keyword(s):  
Public Health ◽  
Health Status ◽  
Insurance Coverage ◽  
Health Impact ◽  
Care Utilization ◽  
The Public ◽  
Behavioral Health Treatment ◽  
Coverage Expansion ◽  
Dependent Coverage ◽  
The Impact

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

scholarly journals Using RE-AIM to examine the potential public health impact of an integrated collaborative care intervention for weight and depression management in primary care: Results from the RAINBOW trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248339
Author(s):  
Megan A. Lewis ◽  
Laura K. Wagner ◽  
Lisa G. Rosas ◽  
Nan Lv ◽  
Elizabeth M. Venditti ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Collaborative Care ◽  
Health Impact ◽  
Public Health Impact ◽  
Integrative Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Intervention ◽  
The Impact

Background An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential. Methods The trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Results At baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance. Conclusions RE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.

scholarly journals Did people really drink bleach to prevent COVID-19? A tale of problematic respondents and a guide for measuring rare events in survey data

2020 ◽  
Author(s):  
Leib Litman ◽  
Zohn Rosen ◽  
Cheskie Rosenzweig ◽  
Sarah L. Weinberger-Litman ◽  
Aaron J. Moss ◽  
...  
Keyword(s):  
Public Health ◽  
Best Practices ◽  
Health Outcomes ◽  
Survey Research ◽  
Iron Content ◽  
Heart Attack ◽  
Public Health Research ◽  
Similar Rate ◽  
The Impact ◽  
The Relationship

AbstractSociety is becoming increasingly dependent on survey research. However, surveys can be impacted by participants who are non-attentive, respond randomly to survey questions, and misrepresent who they are and their true attitudes. The impact that such respondents can have on public health research has rarely been systematically examined. In this study we examine whether Americans began to engage in dangerous cleaning practices to avoid Covid-19 infection. Prior findings reported by the CDC have suggested that people began to engage in highly dangerous cleaning practices during the Covid-19 pandemic, including ingesting household cleansers such as bleach. In a series of studies totaling close to 1400 respondents, we show that 80-90% of reports of household cleanser ingestion are made by problematic respondents. These respondents report impossible claims such as ‘recently having had a fatal heart attack’ and ‘eating concrete for its iron content’ at a similar rate to ingesting household cleaners. Additionally, respondents’ frequent misreading or misinterpreting the intent of questions accounted for the rest of such claims. Once inattentive, mischievous, and careless respondents are taken out of the analytic sample we find no evidence that people ingest cleansers to prevent Covid-19 infection. The relationship between dangerous cleaning practices and health outcomes also becomes non-significant once problematic respondents are taken out of the analytic sample. These results show that reported ingestion of household cleaners and other similar dangerous practices are an artifact of problematic respondent bias. The implications of these findings for public health and medical survey research, as well as best practices for avoiding problematic respondents in surveys are discussed.

FDA-iRISK—A Comparative Risk Assessment System for Evaluating and Ranking Food-Hazard Pairs: Case Studies on Microbial Hazards

2013 ◽  
Vol 76 (3) ◽  
pp. 376-385 ◽  
Author(s):  
YUHUAN CHEN ◽  
SHERRI B. DENNIS ◽  
EMMA HARTNETT ◽  
GREG PAOLI ◽  
RÉGIS POUILLOT ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Case Studies ◽  
Assessment System ◽  
Process Models ◽  
Control Measures ◽  
Quantitative Risk Assessment ◽  
The Public ◽  
Life Years ◽  
The Impact

Stakeholders in the system of food safety, in particular federal agencies, need evidence-based, transparent, and rigorous approaches to estimate and compare the risk of foodborne illness from microbial and chemical hazards and the public health impact of interventions. FDA-iRISK (referred to here as iRISK), a Web-based quantitative risk assessment system, was developed to meet this need. The modeling tool enables users to assess, compare, and rank the risks posed by multiple food-hazard pairs at all stages of the food supply system, from primary production, through manufacturing and processing, to retail distribution and, ultimately, to the consumer. Using standard data entry templates, built-in mathematical functions, and Monte Carlo simulation techniques, iRISK integrates data and assumptions from seven components: the food, the hazard, the population of consumers, process models describing the introduction and fate of the hazard up to the point of consumption, consumption patterns, dose-response curves, and health effects. Beyond risk ranking, iRISK enables users to estimate and compare the impact of interventions and control measures on public health risk. iRISK provides estimates of the impact of proposed interventions in various ways, including changes in the mean risk of illness and burden of disease metrics, such as losses in disability-adjusted life years. Case studies for Listeria monocytogenes and Salmonella were developed to demonstrate the application of iRISK for the estimation of risks and the impact of interventions for microbial hazards. iRISK was made available to the public at http://irisk.foodrisk.org in October 2012.

scholarly journals Management of bio-psycho-social frailty to reduce hospital use and improve survival of older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Liotta ◽  
N Accarino ◽  
S Orlando ◽  
S Gentili ◽  
E Terracciano ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Hospital Care ◽  
Admission Rate ◽  
Term Care ◽  
Hospital Admission Rate ◽  
Starting Point ◽  
The Impact

Abstract Background Ageing of population is associated to the increase of care demand. Many health systems are still centered on hospital care, that sometime is not appropriate. The shift from hospital to community care requires a new model of service delivery. Aim of this paper is to assess the impact of a community service based on the assessment of frailty, on mortality and use of hospital care by older adults. Methods A cohort made up by 8,592 over-75 subjects (67.1% female, mean age 84.5; SD ± 5.29) has been assessed once a year for bio-psycho-social frailty by the administration of the Short Functional Geriatric Evaluation questionnaire. The enrolled subjects were involved in a Community-based pro-Active Monitoring Program which provides interventions aimed at reducing social isolation. Mortality, use of hospital care and use of residential long-term care have been recorded during the follow up and separate and cumulative incidence rate was measured. Results The sample was stratified in Robust (37.5%), Pre-frail (24.0%), Frail, (29.5%) and Very Frail (9.1%) individuals. Mortality, Hospital admission rate and Residential LTC admission rate were higher in the very frails than among the other groups. However, according to social isolation, the integrated subjects at the baseline assessment, showed the highest incidence of negative events: 29.5%, 20.8%, 21.0%, .and 20.8% for integrated, mild isolated, moderate isolated and severely isolated individuals respectively (p < 0.001). The logistic regression analysis, adjusted for age, gender and level of frailty, confirmed the protective role of reducing social isolation among isolated individuals compared with integrated ones (OR: 0.729; CL95% 0.673-0.720). Conclusions The assessment of bio-psycho-social frailty could be the starting point for effective intervention at community level, like the program mentioned above. Management of frailty may lead to an improvement of public health outcomes. Key messages Intervention dealing with social isolation are able to revert the increase of mortality related to the lack of social resources. Management of frailty may lead to an improvement of public health outcomes.

Possible Increase of Human Taenia saginata Infections through Import of Beef to Norway from a High Prevalence Area

1999 ◽  
Vol 62 (11) ◽  
pp. 1314-1319 ◽  
Author(s):  
EYSTEIN SKJERVE
Keyword(s):  
Public Health ◽  
Heat Treatment ◽  
Health Impact ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Taenia Saginata ◽  
The Public ◽  
High Prevalence ◽  
Epidemiological Pattern ◽  
Human Infections

A Monte Carlo risk assessment model was developed to estimate the public health risk of importing prime cuts of beef infested with Taenia saginata to Norway from an endemic area in southern Africa. The model predicted that 21 (lower 5% = 1, upper 95% = 56) viable cysts would be present in domestic prime cuts during 1996 and 1997, with 8 (0 to 21) of them being ingested without sufficient heat treatment to kill the parasite. These cysts were expected to cause 2 (0 to 7) human infections. Corresponding figures for the imported prime cuts were 1,260 (99 to 2,900) viable cysts, 462 (37 to 1,065) ingested without sufficient heat treatment, causing 132 (8 to 361) human infections. The model was sensitive to the uncertainties related to the estimates of probabilities of cysts being viable and the probability of their causing infection in humans. The public health impact from consuming imported beef is not large, but the model illustrates how imported cuts may change the epidemiological pattern of a disease even when the import constitutes only 3% of the prime cuts consumed.

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