86 research outputs found

    Are food exposures obtained through commercial market panels representative of the general population? Implications for outbreak investigations

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    Current methods of control recruitment for case-control studies can be slow (a particular issue for outbreak investigations), resource-intensive and subject to a range of biases. Commercial market panels are a potential source of rapidly recruited controls. Our study evaluated food exposure data from these panel controls, compared with an established reference dataset. Market panel data were collected from two companies using retrospective internet-based surveys; these were compared with reference data from the National Diet and Nutrition Survey (NDNS). We used logistic regression to calculate adjusted odds ratios to compare exposure to each of the 71 food items between the market panel and NDNS participants. We compared 2103 panel controls with 2696 reference participants. Adjusted for socio-demographic factors, exposure to 90% of foods was statistically different between both panels and the reference data. However, these differences were likely to be of limited practical importance for 89% of Panel A foods and 79% of Panel B foods. Market panel food exposures were comparable with reference data for common food exposures but more likely to be different for uncommon exposures. This approach should be considered for outbreak investigation, in conjunction with other considerations such as population at risk, timeliness of response and study resources

    Healthier diets for all? A systematic review and meta-analysis examining socioeconomic equity of the effect of increasing availability of healthier foods on food choice and energy intake

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    Widespread availability of unhealthy food and drink products may contribute to socioeconomic patterning in obesity. Therefore, increasing the availability of healthier foods may be one approach to reducing obesity without widening existing inequalities. This systematic review and meta-analysis examined the impact of increasing the availability of healthier food and drink on consumer behavior among individuals with higher and lower socioeconomic position (SEP). Eligible studies were required to use experimental designs to compare conditions of higher vs lower availability of healthier vs less healthy options on food choice-related outcomes and measure SEP. Thirteen eligible studies were included. Odds of choosing a healthy item were higher when availability was increased for higher (OR = 5.0, 95% CI: 3.3, 7.7) and lower (OR = 4.9, CI: 3.0, 8.0) SEP. Increased availability of healthier foods was also associated with a decrease in energy content of selections for higher (−131 kcal; CI: −76, −187) and lower (−109 kcal; CI: −73, −147) SEP. There was no SEP moderation. Increasing the relative availability of healthier foods may be an equitable and effective approach to improve population-level diet and address obesity, though more research is required testing this in real-world environments

    An outbreak of norovirus GI-6 infection following a wedding in North West England.

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    In August 2015 a gastroenteritis outbreak occurred following a wedding. An outbreak investigation was undertaken and a cohort study was conducted using an online survey. Of 140 guests, 134 received the survey and 113 responded (84·3% response rate). Seventy respondents met the case definition of vomiting and/or diarrhoea within 72 h of the wedding (61·9% attack rate). Fifteen exposures were associated with illness; on stratification, all were confounded by the ham hock starter. Multivariable analysis showed a significant association with exposure to ham hock (risk ratio 6·62, 95% confidence interval 2·19-20·03). Eight guests and two catering staff submitted stool samples. All tested positive for norovirus GI-6 infection, including a food handler who had vomiting less than 48 h before the wedding. A single genotype was detected among all samples, suggesting a single source of contamination. The transmission pattern suggested point-source exposure. The most plausible cause of the outbreak was transmission from an infected food handler via contaminated food. This highlights the importance of appropriate exclusions for symptomatic food handlers. Additionally, the food handler's stool sample was submitted 7 days after symptom resolution. The potential for extended viral excretion, and the extremely low infective dose of norovirus, may mean that current exclusion guidelines are not of sufficient duration

    Organization theory and military metaphor: time for a reappraisal?

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    A ‘conventional’ use of military metaphor would use it to convey attributes such as hierarchical organization, vertical communication and limited autonomy. This is often used in contrast to a looser form of organization based on the metaphor of the network. However, this article argues that military practice is more complex, with examples of considerable autonomy within the constraints of central direction. It is suggested that not only might this be a more useful metaphor for many contemporary organizations, but also that simplistic uses of military metaphor divert our attention away from the functions that management hierarchies play. The discussion is embedded within a critical realist account of metaphor, arguing for both its value and the need for its further development
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