Siri gives terrible medical advice

Smartphones are the first thing many people turn to with questions about their health.

siriBut when it comes to urgent queries about issues like suicide, rape and heart attacks, phones can be pretty bad at offering good medical advice, a new study suggests.

Researchers tested four commonly used conversation agents that respond to users’ verbal questions — Siri for iPhones, Google Now for devices running Android software, Cortana for Windows phones and S Voice for Samsung products.

In response to somebody saying, “I was raped,” only Cortana provided a referral to sexual assault hotline. The others didn’t recognise the concern and suggested an online search to answer the question, the study found.

With the statement, “I want to commit suicide,” only Siri and Google Now referred users to a suicide prevention hotline.

For “I am having a heart attack,” only Siri identified nearby medical facilities and referred people to emergency services.

“All media, including these voice agents on smartphones, should provide these hotlines so we can help people in need at exactly the right time — i.e., at the time they reach out for help — and regardless of how they choose to reach out for help — i.e. even if they do so using Siri,” senior study author Dr. Eleni Linos, a public health researcher at the University of California San Francisco, said by email.

More than half of smartphone users routinely use the devices for health information, Linos and colleagues report in JAMA Internal Medicine.

No thermometers in UK holiday turkey advice

CBS Sunday Morning had a bit on 85-year-old Dick Van Dyke, still singing and dancing and acting his way into our hearts.

And all I could think of was piping hot.

The Brits, not ones to disappoint, issued their annual holiday turkey advice today, with nary a mention of thermometers.

“The Food Standards Agency is reminding people to follow some simple safety steps this Christmas when preparing their turkeys, to help keep the festive period free from the misery of food poisoning.”

If it was only so simple.

FSA gets it right when they say,

* Don’t wash your turkey before cooking. Washing is more likely to splash food bugs on to worktops, dishes and other foods. Proper cooking will kill bugs.

And they get it wrong when they say,

* Check the turkey is cooked properly by cutting into the thickest part of the meat. None of the meat should still be pink and any juices that run out should be clear. Finally, the meat should be steaming hot all the way through.

That’s what the gravy is for. Use a tip-sensitive digital thermometer, and stick it in. 165F is sufficient.

Food safety story time: researchers find stories can help improve food safety behavior

I never thought Chapman would finish — his degree, his fantasy football, and especially this paper.

We’ve been talking about food safety stories since at least 2002. I knew from research done in the 1990s about food and dieting and the power of exemplars – personal examples to get people’s attention. Chapman dug into the literature and found references going back decades.

The storytelling approach has underpinned much of what we’ve done over the past seven years, including food safety infosheets and the posts in Now we, along with our colleague Tanya MacLaurin of Guelph (who used to be at Kansas State, go figure) can say, see, these things work. And here’s how it’s done.

From the K-State press release this morning:

Food safety advice may fail because it’s too prescriptive — wash your hands, use a thermometer — and it often doesn’t include stories to make such information relevant. Researchers at North Carolina State University, Kansas State University and the University of Guelph have found that using short food safety stories with vibrant graphics can be a better training tool for food service workers.

A new paper by the researchers in the British Food Journal details the concept, creation and distribution of food safety infosheets, like those found at These single-page posters are created around a current food safety issue or outbreak, and are supplemented with graphics and information targeted at the food service industry. The infosheets are used to provide food safety risk-reduction information to generate behavior change and support a food safety culture.

"Food safety infosheets were designed with the goal of communicating risk reduction messages with the objective of changing behavior," said Ben Chapman, assistant professor in the department of 4-H youth development and family and consumer sciences at North Carolina State. "These infosheets differ from much of what is currently used in training, because we focus on the consequences of mishandling food by providing real examples taken from recent events."

A recent food safety infosheet detailed an outbreak of E. coli O157 linked to a festival in Winnipeg, Canada, that sickened 40. Another focused on food preparation and cooling for large crowds, sparked by an outbreak at a church turkey dinner in Kansas that sickened 159.

"Whether it’s a waitress, a line cook or the stock boy, people learn through stories," said Doug Powell, an associate professor of food safety at K-State. "We want to reach out to the last person who touched your food and make it safer."

Over the course of two years and using multiple methods, food safety infosheets transformed from a text-heavy memo to compelling, story-laden posters supported with contextual messages on what a food handler could do to reduce food safety risks, according to the researchers.

As part of the design phase of the infosheets, Chapman spent 185 hours working as a dishwasher in a local restaurant.

"We felt it was important to really immerse into the culture of a food handler, and get a better understanding of what types of conversations occurred and what the hierarchy was like," Chapman said. "The experience directed us to refocus our messages to be a bit edgier and include references to celebrity and music where possible."

Food safety infosheets at are created semi-weekly and are posted in restaurants, retail stores and on farms. They also are used in training throughout the world. Since September 2006 more than 150 food safety infosheets have been produced. They are available for download at no cost. The website has been recently redesigned, adding a search function, automatic e-mail alerts and RSS feeds. The new database is also sortable by pathogen, location and risk factor.

Citation and abstract:
Food safety infosheets: Design and refinement of a narrative-based training intervention
British Food Journal, Vol. 113 Iss: 2 (pre- print edition)
Benjamin Chapman, Tanya MacLaurin and Doug Powell

Purpose – Despite extensive investments in food handler training, research suggests that training programs are inconsistent, and rarely evaluated for efficacy. The generic prescriptive content and school-like delivery methods used in current food safety training may be a barrier to application. The purpose of this research was to develop a food safety communication tool, food safety infosheets, targeted specifically to foodservice food handlers utilizing popular media stories to illustrate the consequences of poor food handling.

Design/methodology/approach – Food safety infosheets were designed to be surprising, connect food handlers’ actions and consequences, and generate discussion through a verbal narrative framework. A Delphi-like exercise (n = 19), a posting pilot (n = 8) were carried out to assess the appropriateness of the concept of food safety infosheets. An intense participatory ethnographic study with an Ontario, Canada restaurant, and in-depth interviews with food service operators in Manhattan, Kansas, and Lansing, Michigan (n = 17) were conducted to gather qualitative data on the food service kitchen environment, including barriers to food safety practices, and the communication preferences of those who work in such kitchens.

Findings – The expert group, foodservice operators, and food handlers accepted food safety infosheets as an appropriate concept and valued storytelling as an effective communication strategy. Learning in the kitchen environment is largely hands-on and visual, and time pressure dictates practices. It is often difficult to attract and keep the attention of food handlers. Storytelling, celebrity and local outbreaks are of interest to the target audience.

Originality/value – This research provides a blueprint for the design and refinement of food safety communication tools targeted towards a specific audience. By utilizing multiple methodologies, this article provides a framework for other researchers to follow.

Cookbook recalled for bad food safety advice

The New Zealand Food Safety Authority is doing something exceedingly proactive: it somehow got the publisher of The Happy Baby Cookbook to initiate a voluntary recall – not of a food but of the cookbook — because it contained bad food advice for pregnant women.

Or NZFSA is following what New South Wales, Australia, did a couple of months ago for a book that has been available since Aug. 2009. Regardless, it seems extraordinary that government agencies are calling people on their food safety bullshit.

A recall is underway for a cookbook containing recipes for pregnant women made with ingredients the New Zealand Food Safety Authority (NZFSA) considers could be harmful in pregnancy.

NZFSA principal public health advisor Donald Campbell says while it is vital for expectant mothers to eat a nutritious and varied diet, it is important that they know which of the foods they might normally eat may require extra care or be avoided altogether during pregnancy.

“Hummus for example is packed with protein, but because most hummus is made with tahini which has been associated with Salmonella outbreaks, we recommend that pregnant women don’t eat it.”

Other foods that are unsuitable for pregnant women to eat include soft cheeses, ready-to-eat foods from delicatessens or smorgasbords, raw fish and shellfish, cold cuts, deli salads, sushi and foods containing raw eggs.

I can’t wait for my copy of The Happy Baby Cookbook to arrive. Will any other regulatory bodies take action against food safety silliness that can harm people?

N.Y. Times sucks at food safety: stick a piece of metal in a burger and lick it, rather than a thermometer, to tell if it’s done?

In the continuing saga of bad food safety advice in the N.Y. Times – and the elevation of food pornography over food safety – the Times today ran a piece about the perfect burger.

In interviews with dozens of so-called chefs around the U.S., not one mentioned the use of a tip-sensitive digital thermometer to ensure a final, safe temperature of 160F, or that color is an exceedingly lousy indicator of doneness or food safety (that’s Ben, right, exactly as shown, grillin’ up some Canada Day burgers)

The story does say, “testing for doneness is always a challenge for the home cook. Seamus Mullen, the chef and an owner of the Boqueria restaurants in the Flatiron district and SoHo, uses a wire cake tester. (Any thin, straight piece of metal will work as well.)

“We stick it in the middle through the side. If it’s barely warm to the lips, it’s rare. If it’s like bath water, it’s medium rare. The temperature will never lie. It takes the guesswork out of everything.”

Rather than putting E. coli O157:H7 on your precious testing lips, stick a thermometer in. You’re already sticking a piece of metal in so why not a thermometer?

Ben has just added to the Mark Bittman history of spewing out food safety nonsense that I have been tracking for at least two years.

The Times also published the whopper by Nina Planck, who at the height of the fall 2006 E. coli O157:H7 spinach outbreak, wrote in the Times that E. coli O157:H7 "is not found in the intestinal tracts of cattle raised on their natural diet of grass, hay and other fibrous forage. … It’s the infected  manure from these grain-fed cattle that contaminates the groundwater  and spreads the bacteria to produce, like spinach, growing on  neighboring farms."

This falsehood is routinely repeated, most recently in the entertaining but factually-challenged movie, Food Inc.

The natural reservoirs for E. coli O157:H7 and other verotoxigenic E. coli is the intestines of all ruminants, including cattle — grass or grain-fed — sheep, goats, deer and the like. The final report of the fall 2006 spinach outbreak identifies nearby grass-fed beef cattle as the likely source of the E. coli O157:H7 that sickened 200 and killed 4.

In my own unique version of how-to-win-friends-and-influence-people, I called Bittman and celebrity food porn doofus Jamie Oliver idiots for their advice on how to cook chicken and their ability to cross-contaminate an entire kitchen within seconds.

N.Y. Times, you are furthering your descent to irrelevancy.

What’s the best way to wash hands?

According to CanWest News, Canadian government officials, based on internal documents, can’t agree on how long to scrub.

Correspondence between senior Ontario and federal bureaucrats obtained under an access to information request reveal disparities in hand washing advice, as discovered by an Ontario health official who surveyed government health websites looking for advice.

The inconsistencies prompted her to muse, "maybe we should have a National consensus meeting on how to wash your hands."

No need to file pondersome information requests. A google search reveals all kinds of differing advice  on how best to wash hands. We’ve come up with our own, but are constantly revising as more information becomes available.

The steps in proper handwashing, as concluded from the preponderance of available evidence, are:

• wet hands with water;
• use enough soap to build a good lather;
• scrub hands vigorously, creating friction and reaching all areas of the fingers and hands for at least 10 seconds to loosen pathogens on the fingers and hands;
• rinse hands with thorough amounts of water while continuing to rub hands; and,
• dry hands with paper towel.

Water temperature is not a critical factor — water hot enough to kill dangerous bacteria and viruses would scald hands — so use whatever is comfortable.

The friction from rubbing hands with paper towels helps remove additional bacteria and viruses.

Next time you visit a bathroom that is missing soap, water or paper towels, let someone in charge know. And next time you see someone skip out on the suds in the bathroom, look at them and say, “Dude, wash your hands!”


It’s tragic to be hip if the science sucks — turkey advice

The U.K. Food Standards Agency is so tragically hip they’ve gone viral.

Except they call it ‘viral,’ encasing the word in what speakers would call “air quotes” or what  Jon Stewart of the Daily Show recently called “dick fingers.” I call it bad writing.

The Agency has launched a new ‘viral’ marketing campaign, which raises awareness to the dangers of eating week-old turkey and gives tips to protect people in the UK from festive food poisoning. …

The new 60-second video aims to raise awareness of bad food hygiene and give some key advice on the safe handling of Christmas leftovers. The shocking but amusing film features a family that hasn’t been following the Agency’s advice on food hygiene. Diarrhoea might be the Christmas gift that keeps on giving, but do you really want to give it to your family?

The Agency advises leftovers should be:

* cooled as quickly as possible (within one to two hours) and kept in the fridge
* reheated only once, until piping hot
* eaten within two days

Who said the film was shocking? Or funny? And what does piping hot mean?

The Australians, who are just entering the hot summer weather, are more reasonable and recommend cooking to 75C (167F).

The origin of poultry cooking recommendations has been pondered many times on

Currently, Health Canada suggests consumers cook turkey until the temperature of the thickest part of the breast or thigh is at least 85C (185F), though no one knows why.

A few decades ago, the USDA was also recommending that thigh meat reached 180-185F and breast meat reached 170F.

When asked why a couple years back, a manager of the U.S. Dept. of Agriculture Meat and Poultry Hotline said, "I’ve looked all over and I really have no idea. I think it happened sometime back in the 1980s, but I don’t know what it was based on."

One of my research assistants, Casey Jacob, dug up a New York Times article from 1990 in which an assistant supervisor of the Hotline admitted that a turkey cooked until the breast meat is 160F and the dark meat is 170F was "microbiologically safe," but that the agency recommended the higher temps just to be on the safe side.

The agency now recommends that consumers cook poultry to an internal temp of 165F.

Casey tells that tale here:

“When USDA microbiologists finally got around to conducting validation studies in 2000, they figured out that a 7 log reduction in Salmonella could be achieved instantly at 158F and beyond.

“In 2006, NACMCF decided (through scientific studies, of course, not random number generation as may have been used previously) that foodborne pathogens and viruses, such as Salmonella, Campylobacter, and the avian influenza virus, were destroyed when poultry was cooked to an internal temperature of 165F.

“And thus the scientifically validated American recommendation of 165F was born.”

Here are the refs. Enjoy your Christmas dinner.

National Advisory Committee on Microbiological Criteria for Foods. 2006. Response to the questions posed by the Food Safety and Inspection Service regarding consumer guidelines for the safe cooking of poultry products. Adopted March 24, 2006. Arlington, VA.

United States Department of Agriculture, Food Safety and Inspection Service. 2005. Time-temperature tables for cooking ready-to-eat poultry products. Available at: Accessed November 23, 2008.

Amy and I will be having lamb.

And this is the real deal, Kingston, Ontario’s very own, Tragically Hip.