Second Opinion is a vital dose of the week's news in health and medicine from reporter Kelly Crowe and CBC Health.

This week: the dangers of cookie dough; questionable research practices; and when it comes to hospital gowns is it time to end the draft?

The risk of eating raw dough

It started with a single case of food poisoning last November. Then five more cases appeared in a single week later that month. Throughout December there were two new cases every week. By mid-January an unmistakable pattern had emerged. And that's when the Public Health Agency of Canada made its first public announcement that an unusual strain of E.coli was causing a sporadic pattern of infections in Western Canada and in Newfoundland.  

The first PHAC announcement received almost no publicity. Neither did the four updates that followed every few weeks after that. By the end of March, 25 people had been infected with E. coli O121.  Six were hospitalized.

Finally this week investigators announced they'd found a suspected source of the contamination — uncooked flour. One infection has been definitively linked to a batch of Robin Hood flour distributed by a Smucker Foods of Canada facility in Saskatoon, Sask.

Robin Hood Flour recall

The Public Health Agency of Canada says the investigation into the E. coli O121 contamination is continuing and that additional products affected may be identified. (CFIA)

Officials made the link because the sick person still had some of the flour at home, which tested positive for E.coli O121. The remaining 24 cases have the identical bacterial fingerprint. And PHAC says some of those people also report having contact with Robin Hood flour. PHAC said it's possible that additional products will be linked to the outbreak.

This is the first multi-provincial outbreak of E.coli O121 in Canada.

University of Guelph food pathogen researcher Keith Warriner said the key question now is whether this is an isolated contamination or if it's the beginning of what could become a chronic risk with flour. In other words, should we approach flour with the same care that we handle undercooked meat?

Last year 63 people in 24 states in the U.S. were sickened after exposure to two dangerous E.coli strains in uncooked flour from General Mills. The U.S. Centers for Disease Control and Prevention told CBC News there is no evidence linking the two outbreaks.

Warriner said these flour-related strains of E.coli are called "non-O157 E.coli" to distinguish them from the hamburger bug we're used to hearing about (E.coli O157:H7). For years the non-O157 E. coli were considered curious but not dangerous.

Now, Warriner said, they're becoming increasingly virulent and seem to be specially adapted to contaminate vegetables and other produce, along with water, and now flour. Like the hamburger bug, they produce a Shiga toxin that can damage human kidneys, leaving some victims needing lifelong dialysis.

How does flour become contaminated with E.coli? Warriner said it could happen in the wheat fields, where both animal and human waste is used as fertilizer. Because flour is usually cooked before eating, any bacteria are killed.

The bottom line is that people shouldn't lick the cake batter spoons and they should avoid eating raw cookie dough.

More scientists admit to questionable research

It's a fundamental principle in science — research findings must be reproducible. But there's evidence lately that much of the scientific literature can't be reproduced. Some researchers suspect part of the problem could be in the research methods.

Back in 2012, a survey revealed that the number of U.S. psychologists admitting to questionable research practices was "surprisingly high."

When an Italian group gave the same survey to a group of Italian research psychologists they found that most also admitted to using controversial techniques, including the frowned-upon practice of declaring that a surprise finding was something they had predicted from the beginning.

Other questionable practices included:

  • Deciding to collect more data after checking to see if what they had already collected was significant.
  • Stopping data collection early because they found what they were looking for.
  • Crunching the data first and then deciding what to leave out.
  • Only reporting the studies that worked.

Only a fraction of the scientists admitted to the outright falsification of data.

The Italian researchers trace the current confidence crisis in science to a 2005 study concluding that over half of the published research results are false because of bias and research flaws.

Fixing a crack in the system

How to close the back door on hospital gowns? It's more challenging than it might seem. That's what a group of medical and design students in Halifax have discovered.

"We began to realize how difficult it was to balance what clinicians need and what patients would like," Saif Syed told CBC News.

Syed is a medical student at Dalhousie University and he decided to remake the conventional open-back hospital gown after working in a Toronto hospital and realizing that loss of dignity is one of the key complaints from patients.

Hospital gown prototype

The goal is to design a hospital gown that is affordable, effective, and would protect the dignity of patients. (Saif Syed)

He teamed up with students at the Nova Scotia College of Art and Design and they started creating prototypes. Their current ideas include gowns that can be adjusted depending on the need, made longer or shorter, or closing at the front instead of the back. They're also trying to replace the fasteners with silicon clasps that can be squeezed shut, because patients with arthritis have trouble tying existing gowns.

They're also testing a variety of cotton and linen fabrics, and toying with colour options. Syed said he believes there's more than just comfort at stake. He thinks it could improve patient outcomes, noting that there's evidence that hospital patients feel additional disorientation because they're wearing unfamiliar clothes.

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