Organic Diets Reduce Exposure to Organophosphate Pesticides

To determine whether consuming a largely organic diet reduces OP pesticide exposure in adults, a prospective, randomised, single-blinded, crossover, biomonitoring study was performed. The study involved 13 Australian adults who consumed a largely (>80%) organic diet or a largely conventional diet for 7 days and were then crossed over to the alternate diet for a further 7 days. Urinary levels of six dialkylphosphate (DAP) metabolites produced from OP pesticides, were analysed in first-morning voids collected on day 8 of each phase using GC-MS/MS, with limits of detection at 0.11-0.51 μg/L. Results, which were creatinine corrected to account for urine dilution or concentration, revealed that consumption of organic food for 7 days resulted in a statistically significant reduction in urinary OP metabolites. The mean total DAP results in the organic phase were 89% lower than in the conventional phase (M=0.032 and 0.294 respectively, p=.013). There was a significant 96% reduction in urinary dimethyl DAPs in the organic vs. conventional phase (M=0.011 and 0.252 respectively, p=.005), and a 49% reduction in diethyl DAPs which was not significant (M=0.021 and 0.042 respectively, p=.170). Overall the consumption of organic food resulted in a statistically significant reduction total DAPs and total dimethyl DAPs in urine indicating reduced exposure to organophosphate pesticides. Large scale studies are now required to confirm these results and determine their clinical relevance

Dancing double binds : feminine virtue and women’s work in Kinshasa

Les femmes de Kinshasa, en République Démocratique du Congo, ont toujours été actives dans le commerce local. L’élévation de leur niveau d’études, ainsi que des circonstances économiques difficiles nécessitant deux salaires par famille, les poussent aujourd’hui vers de nouveaux métiers. Alors qu’elles deviennent plus visibles dans les sphères politiques et économiques, elles sont sujettes à de nouvelles formes de méfiance et d’accusation morale. C'est dans ce contexte que les notions de féminité et de vertu féminine sont définies aujourd'hui. Lorsque les femmes congolaises émigraient vers la ville de Léopoldville à l’ère coloniale, elles étaient confrontées à de nouvelles attentes sociales. Il était attendu qu’elles se « modernisent » et se « civilisent » tout en gardant leur rôle « traditionnel » au foyer et auprès de leur famille. Je voudrais démontrer que ce paradoxe continue d’influencer les représentations de la vertu féminine à Kinshasa aujourd'hui, notamment en établissant une distinction entre la femme « vertueuse » et « non vertueuse ». Cette thèse explore les façons dont les femmes participent et négocient leur nouveau statut et rôle à la lumière de ce paradoxe. Plutôt que de réifier la dichotomie locale entre la femme « vertueuse » et « non vertueuse », j’explore les causes sous-jacentes et les résultats inattendus de ces catégorisations. Je porte une réflexion sur la vertu féminine comme étant construite et influencée par ce qu'on pourrait nommer le « triple patriarcat » alimenté par des valeurs « traditionnelles », par des initiatives coloniales et postcoloniales menées par l'état, ainsi que par des discours pentecôtistes. J’examine d’autre part comment ces facteurs ont engendré une double contrainte, un dilemme en la forme d’injonctions contradictoires, encourageant les femmes à jouer simultanément des rôles opposés, et à devoir soigneusement gérer leur image en public. Je montre enfin que cette double posture des femmes alimente la méfiance entre les deux sexes, impactant sur la perception des femmes au travail et dans la société de manière générale, de même que les projections qu’en fait la culture populaire. Car c'est une des professions les plus visibles pour les femmes de Kinshasa, le rôle de danseuse de concert est très utile pour illuminer les défis auxquels ces femmes sont confrontées. Cette thèse fournit donc un portrait ethnographique des danseuses, et se penche sur leur statut d’objets publics de désir afin de révéler la façon dont leur visibilité met en évidence les conceptions locales de la liberté, du pouvoir et de la féminité.While women in Kinshasa, Democratic Republic of Congo have historically participated in commerce at the local level, with an increase in higher education levels, and with dire economic circumstances putting additional pressure on already limited family incomes, women are increasingly entering new professions. In so doing, and as they become more visible in political and economic spheres, women are subjected new forms of moral suspicion. It is within this context that notions of femininity and female virtue in Kinshasa continue to be redefined. Historically, as Congolese women migrated to the city of Léopoldville, they were confronted with new demands to become “modern” and “civilized” they were also expected to remain “traditional” by staying home and tending to their families. I suggest that these binaries continue to inform conceptions of female virtue in Kinshasa today, namely in the form a distinction between “virtuous” and “non-virtuous” women, and this dissertation explores the ways in which women actively negotiate new gender roles and expectations influenced by such binaries. Rather than of falling into the trap of the local dichotomy drawn between “virtuous” and “non-virtuous” women, I focus on the underlying causes and the unexpected outcomes of these local categories. I discuss how notions of female virtue have been shaped and influenced by what can be referred to as a “triple patriarchy,” consisting of “traditional” values, colonial and post-colonial state-led initiatives, and Christian Pentecostal discourse. I also examine how these factors have engendered new perceptions of female virtue that put women in a position of double bind, having to carefully manage impressions of themselves in public. Further, I show how this kind of impression management fuels problems of trust between and across the genders, ultimately impacting perceptions of women in the workplace and in society more generally through the performance of popular culture. Because it is one of the most visible occupations among women in Kinshasa, the role of the popular concert danseuse is useful in illuminating the new challenges faced by women in Kinshasa. As such, this dissertation provides an ethnographic account of danseuses, their particular status as public objects of desire, and how this visibility comes to bear on local notions of freedom, power and femininity

Performing the city : an ethnography of popular dance in Kinshasa, DRC

Kinshasa's dance music, bands comprising male musicians and female dancers, is a local creation with roots in Congolese Rumba. During its rapid urbanization, with concerts held daily throughout the city, Kinshasa's popular culture has been vital to the city's international musical reputation and cosmopolitan identity. Although the social relevance of the popular musicians has been studied (White, 2009), how female dancers inform or are informed by contemporary perspectives on gender relations, marginality, modernity and socio-economic realities, has yet to be explored. This thesis illustrates the . finding and analysis following three months of observing, interviewing female dancers and performing with a popular Kinshasa musical act. The gaze directed at concert dancers is. a recent phenomenon as "traditional" performance was more participatory. Through this gaze at dancers who occupy the lowest position within the band and perform sexually suggestive lyrics and dance gestures, the familiar accepted binaries of public and private, "traditional" and "modern", sacred and profane, appropriate and inappropriate, sensual and sexual are called into question. When concert dancers incorporate "modern" references into their choreographies, they build on "traditional" dance movement. Paradoxically, although female dancers set aesthetic trends seen even in church settings, they are stigmatized on a moral level for assuming "vulgar" roles. It is precisely this marginality that dancers in their concerts, perform and re-affirm

Massage therapy for cardiac surgery patients—a randomized trial

ObjectivesTo determine whether massage significantly reduces anxiety, pain, and muscular tension and enhances relaxation compared with an equivalent period of rest time after cardiac surgery. The feasibility of delivering the treatment, effects on heart rate, blood pressure, and respiratory rate, and patient satisfaction were also assessed.MethodsElective cardiac surgery patients were randomized to receive massage or rest time at 2 points after surgery. Visual analog scales were used to measure pain, anxiety, relaxation, muscular tension, and satisfaction. Heart rate, respiratory rate, and blood pressure were measured before and after treatment. Focus groups and feedback were used to collect qualitative data about clinical significance and feasibility.ResultsA total of 152 patients (99% response rate) participated. Massage therapy produced a significantly greater reduction in pain (P = .001), anxiety (P < .0001), and muscular tension (P = .002) and increases in relaxation (P < .0001) and satisfaction (P = .016) compared to the rest time. No significant differences were seen for heart rate, respiratory rate, and blood pressure. Pain was significantly reduced after massage on day 3 or 4 (P < .0001) and day 5 or 6 (P = .003). The control group experienced no significant change at either time. Anxiety (P < .0001) and muscular tension (P < .0001) were also significantly reduced in the massage group at both points. Relaxation was significantly improved on day 3 or 4 for both groups (massage, P < .0001; rest time, P = .006), but only massage was effective on day 5 or 6 (P < .0001). Nurses and physiotherapists observed patient improvements and helped facilitate delivery of the treatment by the massage therapists on the ward.ConclusionsMassage therapy significantly reduced the pain, anxiety, and muscular tension and improves relaxation and satisfaction after cardiac surgery

Moral dilemmas and abortion decision-making: Lessons learnt from abortion research in England and Wales

This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women's pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism

Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice

BACKGROUND: Complementary medicines (CMs) are popular amongst Australians and community pharmacy is a major supplier of these products. This study explores pharmacy customer use, attitudes and perceptions of complementary medicines, and their expectations of pharmacists as they relate to these products. METHODS: Pharmacy customers randomly selected from sixty large and small, metropolitan and rural pharmacies in three Australian states completed an anonymous, self administered questionnaire that had been pre-tested and validated. RESULTS: 1,121 customers participated (response rate 62%). 72% had used CMs within the previous 12 months, 61% used prescription medicines daily and 43% had used both concomitantly. Multivitamins, fish oils, vitamin C, glucosamine and probiotics were the five most popular CMs. 72% of people using CMs rated their products as 'very effective' or 'effective enough'. CMs were as frequently used by customers aged 60 years or older as younger customers (69% vs. 72%) although the pattern of use shifted with older age. Most customers (92%) thought pharmacists should provide safety information about CMs, 90% thought they should routinely check for interactions, 87% thought they should recommend effective CMs, 78% thought CMs should be recorded in customer's medication profile and 58% thought pharmacies stocking CMs should also employ a complementary medicine practitioner. Of those using CMs, 93% thought it important for pharmacists to be knowledgeable about CMs and 48% felt their pharmacist provides useful information about CMs. CONCLUSIONS: CMs are widely used by pharmacy customers of all ages who want pharmacists to be more involved in providing advice about these products

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

The prevalence and experience of Australian naturopaths and Western herbalists working within community pharmacies

<p>Abstract</p> <p>Background</p> <p>Naturopaths and Western herbal medicine (WHM) practitioners were surveyed to identify their extent, experience and roles within the community pharmacy setting and to explore their attitudes to integration of complementary medicine (CM) practitioners within the pharmacy setting.</p> <p>Method</p> <p>Practising naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations.</p> <p>Results</p> <p>479 practitioners participated. 24% of respondents (n = 111) reported they had worked in community pharmacy, three-quarters for less than 5 years. Whilst in this role 74% conducted specialist CMs sales, 62% short customer consultations, 52% long consultations in a private room and 51% staff education. This was generally described as a positive learning experience and many appreciated the opportunity to utilise their specialist knowledge in the service of both customers and pharmacy staff. 14% (n = 15) did not enjoy the experience of working in pharmacy at all and suggested pharmacist attitude largely influenced whether the experience was positive or not. Few practitioners were satisfied with the remuneration received. 44% of the total sample provided comment on the issue of integration into pharmacy, with the main concern being the perceived incommensurate paradigms of practice between pharmacy and naturopathy. Of the total sample, 38% reported that they would consider working as a practitioner in retail pharmacy in future.</p> <p>Conclusions</p> <p>The level of integration of CM into pharmacy is extending beyond the mere stocking of supplements. Naturopaths and Western Herbalists are becoming utilised in pharmacies</p

Community responses to communication campaigns for influenza A (H1N1): a focus group study

<p>Abstract</p> <p>Background</p> <p>This research was a part of a contestable rapid response initiative launched by the Health Research Council of New Zealand and the Ministry of Health in response to the 2009 influenza A pandemic. The aim was to provide health authorities in New Zealand with evidence-based practical information to guide the development and delivery of effective health messages for H1N1 and other health campaigns. This study contributed to the initiative by providing qualitative data about community responses to key health messages in the 2009 and 2010 H1N1 campaigns, the impact of messages on behavioural change and the differential impact on vulnerable groups in New Zealand.</p> <p>Methods</p> <p>Qualitative data were collected on community responses to key health messages in the 2009 and 2010 Ministry of Health H1N1 campaigns, the impact of messages on behaviour and the differential impact on vulnerable groups. Eight focus groups were held in the winter of 2010 with 80 participants from groups identified by the Ministry of Health as vulnerable to the H1N1 virus, such as people with chronic health conditions, pregnant women, children, Pacific Peoples and Māori. Because this study was part of a rapid response initiative, focus groups were selected as the most efficient means of data collection in the time available. For Māori, focus group discussion (hui) is a culturally appropriate methodology.</p> <p>Results</p> <p>Thematic analysis of data identified four major themes: personal and community risk, building community strategies, responsibility and information sources. People wanted messages about specific actions that they could take to protect themselves and their families and to mitigate any consequences. They wanted transparent and factual communication where both good and bad news is conveyed by people who they could trust.</p> <p>Conclusions</p> <p>The responses from all groups endorsed the need for community based risk management including information dissemination. Engaging with communities will be essential to facilitate preparedness and build community resilience to future pandemic events. This research provides an illustration of the complexities of how people understand and respond to health messages related to the H1N1 pandemic. The importance of the differences identified in the analysis is not the differences per se but highlight problems with a "one size fits all" pandemic warning strategy.</p