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Neerland C, Slaughter-Acey J, Behrens K, Claussen AM, Usset T, Bilal-Roby S, Bashir H, Westby A, Wagner B, McAlpine D, Dixon M, Xiao M, Avila D, Butler M. An Evidence Map for Social and Structural Determinants for Maternal Morbidity and Mortality: A Systematic Review. Obstet Gynecol 2024; 143:383-392. [PMID: 38128105 PMCID: PMC10863663 DOI: 10.1097/aog.0000000000005489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To identify the social-structural determinants of health risk factors associated with maternal morbidity and mortality in the United States during the prenatal and postpartum periods. DATA SOURCES We searched MEDLINE, CINAHL, and Social Sciences Citation Index through November 2022 for eligible studies that examined exposures related to social and structural determinants of health and at least one health or health care-related outcome for pregnant and birthing people. METHODS OF STUDY SELECTION After screening 8,378 unique references, 118 studies met inclusion criteria. TABULATION, INTEGRATION, AND RESULTS We grouped studies by social and structural determinants of health domains and maternal outcomes. We used alluvial graphs to summarize results and provide additional descriptions of direction of association between potential risk exposures and outcomes. Studies broadly covered risk factors including identity and discrimination, socioeconomic, violence, trauma, psychological stress, structural or institutional, rural or urban, environment, comorbidities, hospital, and health care use. However, these risk factors represent only a subset of potential social and structural determinants of interest. We found an unexpectedly large volume of research on violence and trauma relative to other potential exposures of interest. Outcome domains included maternal mortality, severe maternal morbidity, hypertensive disorders, gestational diabetes, cardiac and metabolic disorders, weathering depression, other mental health or substance use disorders, and cost per health care use outcomes. Patterns between risk factors and outcomes were highly mixed. Depression and other mental health outcomes represented a large proportion of medical outcomes. Risk of bias was high, and rarely did studies report the excess risk attributable to a specific exposure. CONCLUSION Limited depth and quality of available research within each risk factor hindered our ability to understand underlying pathways, including risk factor interdependence. Although recently published literature showed a definite trend toward improved rigor, future research should emphasize techniques that improve the ability to estimate causal effects. In the longer term, the field could advance through data sets designed to fully ascertain data required to robustly examine racism and other social and structural determinants of health, their intersections, and feedback loops with other biological and medical risk factors. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42022300617.
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Affiliation(s)
- Carrie Neerland
- School of Nursing, the School of Public Health, the Minnesota Evidence-based Practice Center, Division of Health Policy & Management, School of Public Health, and the Medical School, University of Minnesota, Minneapolis, the Amherst H. Wilder Foundation, St. Paul, and the MHealth Fairview Women's Clinic, Burnsville, Minnesota; and the Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado
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Okah E, Cronholm PF, Crow B, Persaud A, Westby A, Bonham VL. Race-Based Care and Beliefs Regarding the Etiology of Racial Differences in Health Outcomes. Am J Prev Med 2023; 64:477-482. [PMID: 36935165 PMCID: PMC10031413 DOI: 10.1016/j.amepre.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/12/2022] [Accepted: 10/28/2022] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Physicians' perspectives regarding the etiology of racial health differences may be associated with their use of race in clinical practice (race-based practice). This study evaluates whether attributing racial differences in health to genetics, culture, or social conditions is associated with race-based practice. METHODS This is a cross-sectional analysis, conducted in 2022, of the Council of Academic Family Medicine Education Research Alliance 2021 general membership survey. Only actively practicing U.S. physicians were included. The survey included demographic questions; the Racial Attributes in Clinical Evaluation (RACE) scale (higher scores imply greater race-based practice); and 3 questions regarding beliefs that racial differences in genetics, culture (e.g., health beliefs), or social conditions (e.g., education) explained racial differences in health. Three multivariable linear regressions were used to evaluate the relationship between RACE scores and beliefs regarding the etiology of racial differences in health. RESULTS Of the 4,314 survey recipients, 949 (22%) responded, of whom 689 were actively practicing U.S. physicians. In multivariable regressions controlling for age, gender, race, ethnicity, and practice characteristics, a higher RACE score was associated with a greater belief that differences in genetics (β=3.57; 95% CI=3.19, 3.95) and culture (β=1.57; 95% CI=0.99, 2.16)-in but not social conditions-explained differences in health. CONCLUSIONS Physicians who believed that genetic or cultural differences between racial groups explained racial differences in health outcomes were more likely to use race in clinical care. Further research is needed to determine how race is differentially applied in clinical care on the basis of the belief in its genetic or cultural significance.
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Affiliation(s)
- Ebiere Okah
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, Minnesota.
| | - Peter F Cronholm
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania; The Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Brendan Crow
- Family Medicine Residency Program, Mountain Area Health Education Center (MAHEC), Asheville, North Carolina
| | - Anitra Persaud
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Andrea Westby
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Vence L Bonham
- National Human Genome Research Institute, NIH, Bethesda, Maryland
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Slattengren AH, Westby A. In Response to "Promotion Preparation Tips for Academic Family Medicine Educators". Fam Med 2023; 55:69. [PMID: 36656892 PMCID: PMC10681338 DOI: 10.22454/fammed.55.332361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Andrew H Slattengren
- Department of Family Medicine and Community Health, North Memorial Family Medicine Residency Program, University of Minnesota Medical School, Minneapolis, MN
| | - Andrea Westby
- Department of Family Medicine and Community Health, North Memorial Family Medicine Residency Program, University of Minnesota Medical School, Minneapolis, MN
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Okah E, Thomas J, Westby A, Cunningham B. Colorblind Racial Ideology and Physician Use of Race in Medical Decision-Making. J Racial Ethn Health Disparities 2022; 9:2019-2026. [PMID: 34491564 PMCID: PMC8898981 DOI: 10.1007/s40615-021-01141-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Colorblindness is a racial ideology that minimizes the role of systemic racism in shaping outcomes for racial minorities. Physicians who embrace colorblindness may be less likely to interrogate the role of racism in generating health disparities and less likely to challenge race-based treatment. This study evaluates the association between physician colorblindness and the use of race in medical decision-making. METHODS This is a cross-sectional survey study, conducted in September 2019, of members of the Minnesota Academy of Family Physicians. The survey included demographic and practice questions and two measures: Color-blind Racial Attitudes Scale (CoBRAS; measuring unawareness of racial privilege, institutional discrimination, and blatant racial issues) and Racial Attributes in Clinical Evaluation (RACE; measuring the use of race in medical decision-making). Multivariable regression analyses assessed the relationship between CoBRAS and RACE. RESULTS Our response rate was 17% (267/1595). In a multivariable analysis controlling for physician demographic and practice characteristics, CoBRAS scores were positively associated with RACE (β = 0.05, p = 0.02). When CoBRAS subscales were used in place of the overall CoBRAS score, only unawareness of institutional discrimination was positively associated with RACE (β = 0.18, p = 0.01). CONCLUSIONS Physicians who adhere to a color blind racial ideology, particularly those who deny institutional racism, are more likely to use race in medical decision-making. As the use of race may be due to a colorblind racial ideology, and therefore due to a poor understanding of how systemic racism affects health, more physician education about racism as a health risk is needed.
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Affiliation(s)
- Ebiere Okah
- Department of Family Medicine, University of North Carolina School of Medicine, 590 Manning Dr, Chapel Hill, NC, 27514, USA.
| | - Janet Thomas
- Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Andrea Westby
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Brooke Cunningham
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Fertig AR, Trofholz AC, Loth K, Tate AD, Miner M, Neumark-Sztainer D, Westfall EC, Westby A, Berge JM. Kitchen Adequacy and Child Diet Quality in a Racially/Ethnically Diverse Sample. Ecol Food Nutr 2022; 61:81-89. [PMID: 34409899 PMCID: PMC8821113 DOI: 10.1080/03670244.2021.1968848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study examined kitchen adequacy in a racially/ethnically diverse low-income sample and associations with child diet quality. Families with children age five to seven years old (n = 150) from non-Hispanic white, non-Hispanic Black, Hispanic, Native American, Hmong, and Somali families were recruited through primary care clinics. More than 85% of families had 15 of the 20 kitchen items queried, indicating that the sample had adequate kitchen facilities. Only one item (a kitchen table) was associated with higher overall diet quality of children. In contrast, children living in households with can openers and measuring spoons consumed more sodium and added sugars, respectively.
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Affiliation(s)
- Angela R. Fertig
- Humphrey School of Public Affairs, University of Minnesota, Minneapolis, USA
| | - Amanda C. Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, USA
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, USA
| | - Allan D. Tate
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, USA
| | - Michael Miner
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, USA
| | - Erin C. Westfall
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, USA
| | - Andrea Westby
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, USA
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Westby A, Miller L. Fetal Growth Restriction Before and After Birth. Am Fam Physician 2021; 104:486-492. [PMID: 34783495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Fetal growth restriction, previously called intrauterine growth restriction, is a condition in which a fetus does not achieve its full growth potential during pregnancy. Early detection and management of fetal growth restriction are essential because it has significant clinical implications in childhood. It is diagnosed by estimated fetal weight or abdominal circumference below the 10th percentile on formal ultrasonography. Early-onset fetal growth restriction is diagnosed before 32 weeks' gestation and has a higher risk of adverse fetal outcomes. There are no evidence-based measures for preventing fetal growth restriction; however, aspirin used for the prevention of preeclampsia in high-risk pregnancies may reduce the likelihood of developing it. Timing of delivery for pregnancies affected by growth restriction must be adjusted based on the risks of premature birth and ongoing gestation, and it is best determined in consultation with maternal-fetal medicine specialists. Neonates affected by fetal growth restriction are at risk of feeding difficulties, glucose instability, temperature instability, and jaundice. As these children age, they are at risk of abnormal growth patterns, as well as later cardiac, metabolic, neurodevelopmental, reproductive, and psychiatric disorders.
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Affiliation(s)
- Andrea Westby
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Laura Miller
- University of Minnesota Medical School, Minneapolis, MN, USA
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Affiliation(s)
- Ebiere Okah
- University of North Carolina Chapel Hill North Carolina USA
| | - Janet Thomas
- University of Minnesota Minneapolis Minnesota USA
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Peek CJ, Allen M, Pacala JT, Nickerson W, Westby A. Coming Together in Action for Equity, Diversity, and Inclusion. Fam Med 2021; 53:786-795. [PMID: 34287818 DOI: 10.22454/fammed.2021.569762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
THE CHALLENGE Family medicine departments see elevating equity, diversity, and inclusion (EDI)* as socially necessary and as powerful in achieving core missions. The importance and timeliness of this longstanding issue in medicine are magnified by the COVID-19 pandemic with its disproportionate effect on communities of color and by civil unrest focused on racial justice. EDI plays out in three pillars: (1) care delivery and health, (2) workforce recruitment and retention, and (3) learner recruitment and training. People are at very different places with EDI work with regard to knowledge, experience, comfort and confidence. This is a wide-ranging developmental challenge, not a narrow, technical, or quick fix. The Immediate Goal: To make a strong start in taking all faculty and staff on a participatory journey that brings changes in everything they do, using inclusive means to this inclusive end. Initial Achievements: An inclusive process that resulted in (1) a shared intellectual framework-definitions with "north star" goals across the three pillars of EDI action, (2) shared acceptance of need for change, (3) top growth areas with actions to take, and (4) harnessing the energy for action-many volunteers, a visible leader, and charge. Ongoing Action: Application of an equity lens to department relationships, specific incidents, tools and education, policy review, and measures development. Invitation to Further Conversation Among Departments: EDI work can quickly create a shared intellectual framework and broadly engage people in taking a department down its developmental path. Operating principles for undertaking such work are offered for conversation among departments.
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Affiliation(s)
- C J Peek
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Michele Allen
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - James T Pacala
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Wendy Nickerson
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Andrea Westby
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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Westby A, Jones CM, Loth KA. The Role of Weight Stigma in the Development of Eating Disorders. Am Fam Physician 2021; 104:7-9. [PMID: 34264621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Abstract
The uprisings for racial justice that followed the brutal murder of George Floyd on May 28, 2020 in Minneapolis, Minnesota damaged the physical building where a family medicine residency is situated. We discuss the emotions that follow that event and reflect on ways that family medicine should address racism and discrimination. We also call on those in family medicine to work more in the communities that we serve, and to make advocacy a core part of the identity of family medicine.
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Affiliation(s)
- Shailendra Prasad
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Andrea Westby
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Renee Crichlow
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
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Tsai J, Cerdeña JP, Khazanchi R, Lindo E, Marcelin JR, Rajagopalan A, Sandoval RS, Westby A, Gravlee CC. There is no 'African American Physiology': the fallacy of racial essentialism. J Intern Med 2020; 288:368-370. [PMID: 32808368 DOI: 10.1111/joim.13153] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- J Tsai
- From the, Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - J P Cerdeña
- Department of Anthropology, Yale University, New Haven, CT, USA.,Yale University School of Medicine, New Haven, CT, USA
| | - R Khazanchi
- University of Nebraska Medical Center, Omaha, NE, USA.,University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - E Lindo
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - J R Marcelin
- University of Nebraska Medical Center, Omaha, NE, USA
| | - A Rajagopalan
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Veteran Affairs Boston Healthcare System, Boston, MA, USA
| | - R S Sandoval
- Harvard Medical School, Boston, MA, USA.,Harvard Kennedy School, Boston, MA, USA
| | - A Westby
- Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C C Gravlee
- Department of Anthropology, University of Florida, Gainesville, FL, USA
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Westby A, Okah E, Ricco J. Race-Based Treatment Decisions Perpetuate Structural Racism. Am Fam Physician 2020; 102:136-137. [PMID: 32735444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Ricco J, Westby A. Syphilis: Far from Ancient History. Am Fam Physician 2020; 102:91-98. [PMID: 32667172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Rates of primary, secondary, and congenital syphilis are increasing in the United States, and reversing this trend requires renewed vigilance on the part of family physicians to assist public health agencies in the early detection of outbreaks. Prompt diagnosis of syphilis can be challenging, and not all infected patients have common manifestations, such as a genital chancre or exanthem. The U.S. Preventive Services Task Force recommends screening for syphilis in all patients at increased risk, particularly those who reside in high-prevalence areas, sexually active people with HIV infection, and men who have sex with men. Other groups at increased risk include males 29 years or younger and people with a history of incarceration or sex work. All pregnant women should be screened for syphilis at the first prenatal visit, and those at increased risk should be screened throughout the pregnancy. The Centers for Disease Control and Prevention recommends the traditional screening algorithm for most U.S. populations. Penicillin is the preferred treatment across all stages of syphilis, although limited research suggests a possible role for other antibiotics in penicillin-allergic patients with primary or secondary syphilis. Pregnant women with syphilis who are allergic to penicillin should undergo penicillin desensitization before treatment.
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Affiliation(s)
- Jason Ricco
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Andrea Westby
- University of Minnesota Medical School, Minneapolis, MN, USA
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Kozhimannil KB, Westby A. What Family Physicians Can Do to Reduce Maternal Mortality. Am Fam Physician 2019; 100:460-461. [PMID: 31613573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | - Andrea Westby
- University of Minnesota Medical School, Minneapolis, MN, USA
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Westby A. Leslie's story. When there is nothing more to be done, a physician offers compassion and wonders whether it was enough. Minn Med 2014; 97:28-31. [PMID: 25651650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Dziedzoave N, Graffham A, Westby A, Otoo J, Komlaga G. Influence of variety and growth environment on β-amylase activity of flour from sweet potato (Ipomea batatas). Food Control 2010. [DOI: 10.1016/j.foodcont.2009.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Westby A, Nuraida L, Owens J, Gibbs P. Inability ofLactobacillus plantarumand other lactic acid bacteria to grow on D-ribose as sole source of fermentable carbohydrate. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1365-2672.1993.tb02763.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Obadina A, Oyewole O, Sanni L, Tomlins K, Westby A. Identification of hazards and critical control points (CCP) for cassava fufu processing in South-West Nigeria. Food Control 2008. [DOI: 10.1016/j.foodcont.2007.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sparringa RA, Kendall M, Westby A, Owens JD. Effects of temperature, pH, water activity and CO2 concentration on growth of Rhizopus oligosporus NRRL 2710. J Appl Microbiol 2002; 92:329-37. [PMID: 11849362 DOI: 10.1046/j.1365-2672.2002.01534.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To investigate the effects of temperature, pH, water activity (aw) and CO2 concentration on the growth of Rhizopus oligosporus NRRL 2710. METHODS AND RESULTS Hyphal extension rates from mycelial and spore inocula were measured on media with different aw (approximately 1.0, 0.98 and 0.96) and pH (3.5, 5.5 and 7.5) incubated at 30, 37 or 42 degrees C in atmospheres containing 0.03, 12.5 or 25% (v/v) CO2. The effects of environmental conditions on hyphal extension rate were modelled using surface response methodology. The rate of hyphal extension was very sensitive to pH, exhibiting a pronounced optimum at pH 5.5-5.8. The hyphal extension rate was less sensitive to temperature, aw or CO2, exhibiting maximum rates at 42 degrees C, a(w) approximately 1.0 and 0.03% (v/v) CO2. CONCLUSIONS The fastest hyphal extension rate (1.7 mm h(-1)) was predicted to occur at 42 degrees C, pH 5.85, a(w) approximately 1.0 and 0.03% CO2. SIGNIFICANCE AND IMPACT OF THE STUDY The present work is the first to model the simultaneous effects of temperature, pH, aw and CO2 concentration on mould growth. The information relates to tempe fermentation and to possible control of the microflora in Tanzanian cassava heap fermentations.
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Affiliation(s)
- R A Sparringa
- School of Food Biosciences, The University of Reading, Reading, UK
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Abstract
A manually operated machine for chipping cassava was evaluated. Six farmers took part in the study, with physiological, postural, and subjective measurements being taken. Using the machine resulted in drudgery and postural discomfort. Following an iterative design process and using appropriate anthropometric measurements, an improved, adjustable prototype was developed. This was tested with the six farmers and six novice users. It was found to reduce discomfort and physiological strain, allowed a faster work-rate (with novice users) and was preferred by all users. The study demonstrated how ergonomics can play an important role in reducing drudgery and improving user satisfaction in technology development and transfer in developing countries.
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Affiliation(s)
- M McNeill
- Department of Human Sciences, Loughborough University, Leics., UK.
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