Microbiological risk assessment aimed at devising measures of hazard management, should take into account all perceived hazards, including those not empirically identified. It should also recognise that safety cannot be "inspected into" a food. Rather hazard management should be the product of intervention strategies in accordance with the approach made mandatory in the EU Directive 93/43 and the USDA FSIS Pathogen Reduction HACCP system; Final Rule. It is essential too that the inherent variability of the biological attributes affecting food safety is recognised in any risk assessment. The above strategic principles may be conceptualised as a four-step sequence, involving (i) identification and quantification of hazards; (ii) design and codification of longitudinally integrated ("holistic") technological processes and procedures to eliminate, or control growth and metabolism of, pathogenic and toxinogenic organisms; (iii) elaboration of microbiological analytical standard operating procedures, permitting validation of "due diligence" or responsible care, i.e. adherence to adopted intervention strategies. This should be supported by empirically assessed reference ranges, particularly for marker organisms, while the term "zero tolerance" is refined throughout to tolerable safety limit; (iv) when called for, the need to address concerns arising from lay perceptions of risk which may lack scientific foundation. In relation to infectious and toxic hazards in the practical context the following general models for quantitative holistic risk assessment are presented: (i) the first order, basic lethality model; (ii) a second approximation taking into account the amount of food ingested in a given period of time; (iii) a further adjustment accounting for changes in colonization levels during storage and distribution of food commodities and the effects of these on proliferation of pathogens and toxin production by bacteria and moulds. Guidelines are provided to address: (i) unsubstantiated consumer concern over the wholesomeness of foods processed by an innovative procedure; and (ii) reluctance of small food businesses to adopt novel strategies in food safety. Progress here calls for close cooperation with behavioural scientists to ensure that investment in developing measures to contain risk deliver real benefit.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/s0168-1605(97)00115-3 | DOI Listing |
Ann Intern Med
January 2025
Durham VA Health Care System, Durham; and Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina (K.M.G.).
Background: Tissue-based genomic classifiers (GCs) have been developed to improve prostate cancer (PCa) risk assessment and treatment recommendations.
Purpose: To summarize the impact of the Decipher, Oncotype DX Genomic Prostate Score (GPS), and Prolaris GCs on risk stratification and patient-clinician decisions on treatment choice among patients with localized PCa considering first-line treatment.
Data Sources: MEDLINE, EMBASE, and Web of Science published from January 2010 to August 2024.
J Med Internet Res
January 2025
Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Background: Delayed cerebral ischemia (DCI) is a primary contributor to death after subarachnoid hemorrhage (SAH), with significant incidence. Therefore, early determination of the risk of DCI is an urgent need. Machine learning (ML) has received much attention in clinical practice.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Department of Basic and Community Nursing, School of Nursing, Nanjing Medical University, NanJing, China.
Background: Telehealth interventions can effectively support caregivers of people with dementia by providing care and improving their health outcomes. However, to successfully translate research into clinical practice, the content and details of the interventions must be sufficiently reported in published papers.
Objective: This study aims to evaluate the completeness of a telehealth intervention reporting in randomized controlled trials (RCTs) conducted for caregivers of people with dementia.
J Clin Psychiatry
January 2025
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan, Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan.
Although antipsychotics are used commonly for delirium, they increase the risk of mortality in elderly patients and those with dementia. As hydroxyzine has sedative and anxiolytic effects, it can be used in the treatment of delirium. We performed a retrospective study to compare the effects of intravenous hydroxyzine and haloperidol monotherapy on delirium.
View Article and Find Full Text PDFGac Med Mex
January 2025
Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom.
FRAX, a risk calculator that provides individualized 10-year probabilities of hip and major osteoporotic fracture, has been widely used for fracture risk assessment since its launch in 2008. It is now incorporated into very many guidelines worldwide to inform osteoporosis management. In this review, we explore the development of FRAX and how it enhances fracture risk prediction as compared to use of bone mineral density alone, as well as approaches to utilizing FRAX in determining intervention and assessment thresholds.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!