Playing chicken: Theology, economics, politics and ethics in the campaign for better conditions for poultry

This is the author's pdf version of an article published in Epworth Review© 2008. Epworth Review © Trustees for Methodist Church Purposes.This article discusses animal welfare and Christian ethics within the context of the campaign by celebrity chefs to encourage people to eat free range chicken

Association between obstructive apnea syndrome during sleep and damages to anterior labyrinth: Our experience

The obstructive sleep apnea syndrome is a chronic condition characterized by frequent episodes of collapse of the upper airways during sleep. It can be considered a multisystem disease. Among the districts involved, even the auditory system was seen to be concerned. It was enrolled a population of 20 patients after polysomnographic diagnosis of OSAS (Apnea Hypopnea Index > 10) and a control group of 28 healthy persons (Apnea Hypopnea Index < 5). Each patient has been subjected to Pure Tone Audiometry, Tympanometry, study of Acoustic Reflex, Otoacoustic Emissions and Auditory Brainstem Response. Moreover they were submitted to endoscopy of upper airway with Muller Maneuver and Epworth Sleepiness Scale (ESS). The values of ESS was 13.5 in OSAS group and 5.4 in control group. The tone audiometry is worse in all frequencies analyzed in OSAS patients, but within the normal range for both groups analyzed by 250 to 1000 Hertz. Otoacoustic emissions show a reduced reproducibility and a lower signal/ noise ratio in OSAS group (P <0.01)

The contribution of fatigue and sleepiness to depression in patients attending the sleep laboratory for evaluation of obstructive sleep apnea

Purpose: A high prevalence of depressive symptomatology has been reported amongst sufferers of obstructive sleep apnea (OSA), but it remains unclear as to whether this is due to their OSA or other factors associated with the disorder. The current study aimed to assess the incidence and aetiology of depression in a community sample of individuals presenting to the sleep laboratory for diagnostic assessment of OSA. Methods: Forty-five consecutive individuals who presented to the sleep laboratory were recruited; of those, 34 were diagnosed with OSA, and 11 were primary snorers with no clinical or laboratory features of OSA. Nineteen control subjects were also recruited. Patients and controls completed the Beck Depression Inventory, the Profile of Mood States (POMS), and the Epworth Sleepiness Scale to assess their mood and sleepiness, prior to their polysomnography. Results: All patients reported significantly more depressive symptoms compared with healthy controls, regardless of their degree of OSA. There were no significant differences between OSA patients and primary snorers on any of the mood and self-rated sleepiness measures. Depression scores were not significantly associated with any of the nocturnal variables. Regression analysis revealed that the POMS fatigue subscale explained the majority of the variance in subjects' depression scores. Conclusions: Fatigue was the primary predictor of the level of depressive symptoms in patients who attended the sleep laboratory, regardless of the level of severity of sleep disordered breathing. When considering treatment options, practitioners should be aware of the concomitant occurrence of depressive symptoms and fatigue in patients presenting with sleep complaints, which may not be due to a sleep disorder

Risk factors for high-altitude headache upon acute high-altitude exposure at 3700 m in young Chinese men: a cohort study.

BackgroundThis prospective and observational study aimed to identify demographic, physiological and psychological risk factors associated with high-altitude headache (HAH) upon acute high-altitude exposure.MethodsEight hundred fifty subjects ascended by plane to 3700 m above Chengdu (500 m) over a period of two hours. Structured Case Report Form (CRF) questionnaires were used to record demographic information, physiological examinations, psychological scale, and symptoms including headache and insomnia a week before ascending and within 24 hours after arrival at 3700 m. Binary logistic regression models were used to analyze the risk factors for HAH.ResultsThe incidence of HAH was 73.3%. Age (p =0.011), physical labor intensity (PLI) (p =0.044), primary headache history (p <0.001), insomnia (p <0.001), arterial oxygen saturation (SaO2) (p =0.001), heart rate (HR) (p =0.002), the Self-Rating Anxiety Scale (SAS) (p <0.001), and the Epworth Sleepiness Scale (ESS) (p <0.001) were significantly different between HAH and non-HAH groups. Logistic regression models identified primary headache history, insomnia, low SaO2, high HR and SAS as independent risk factors for HAH.ConclusionsInsomnia, primary headache history, low SaO2, high HR, and high SAS score are the risk factors for HAH. Our findings will provide novel avenues for the study, prevention and treatment of HAH

The Association between Daytime Napping and Cognitive Functioning in Chronic Fatigue Syndrome

OBJECTIVES The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS) has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length) and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience. METHODS 118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale), sleepiness (Epworth Sleepiness Scale), cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire), and mood (Hospital Anxiety and Depression Scale). RESULTS Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001). Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001). Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001). When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group. CONCLUSIONS Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies

Relationship between obstructive sleep apnea severity and sleep, depression and anxiety symptoms in newly-diagnosed patients.

Obstructive sleep apnea (OSA) occurs in at least 10% of the population, and leads to higher morbidity and mortality; however, relationships between OSA severity and sleep or psychological symptoms are unclear. Existing studies include samples with wide-ranging comorbidities, so we assessed relationships between severity of OSA and common sleep and psychological disturbances in recently diagnosed OSA patients with minimal co-morbidities. We studied 49 newly diagnosed, untreated OSA patients without major co-morbidities such as mental illness, cardiovascular disease, or stroke; subjects were not using psychoactive medications or tobacco (mean +/- std age: 46.8+/-9.1 years; apnea/hyponea index [AHI]: 32.1+/-20.5 events/hour; female/male: 12/37; weight &lt;125 kg). We evaluated relationships between the AHI and daytime sleepiness (Epworth Sleepiness Scale; ESS), sleep quality (Pittsburg Sleep Quality Index; PSQI), depressive symptoms (Beck Depression Inventory-II; BDI), and anxiety symptoms (Beck Anxiety Inventory; BAI), as well as sex and body mass index (BMI). AHI was similar in females and males. Mean levels of all symptoms were above normal thresholds, but AHI was not correlated with age, ESS, PSQI, BDI, or BAI; only BMI was correlated with OSA severity. No differences in mean AHI appeared when subjects were grouped by normal versus elevated values of ESS, PSQI, BDI, or BAI. Consistent with other studies, a strong link between OSA severity and psychological symptoms did not appear in these newly diagnosed patients, suggesting that mechanisms additional to the number and frequency of hypoxic events and arousals occurring with apneas contribute to adverse health effects in OSA. OSA patients presenting with mild or moderate severity, and no major co-morbidities will not necessarily have low levels of sleep or psychological disturbances

On handling urban informality in southern Africa

In this article I reconsider the handling of urban informality by urban planning and management systems in southern Africa. I argue that authorities have a fetish about formality and that this is fuelled by an obsession with urban modernity. I stress that the desired city, largely inspired by Western notions of modernity, has not been and cannot be realized. Using illustrative cases of top–down interventions, I highlight and interrogate three strategies that authorities have deployed to handle informality in an effort to create or defend the modern city. I suggest that the fetish is built upon a desire for an urban modernity based on a concept of formal order that the authorities believe cannot coexist with the “disorder” and spatial “unruliness” of informality. I question the authorities' conviction that informality is an abomination that needs to be “converted”, dislocated or annihilated. I conclude that the very configuration of urban governance and socio-economic systems in the region, like the rest of sub-Saharan Africa, renders informality inevitable and its eradication impossible

Food Remittances: Rural-urban Linkages and Food Security in Africa

The need for a new research agenda Globally, the transfer of funds by migrants to their home countries or areas (cash remittances) is at an all-time high. By 2017, it is predicted to rise to US$500 billion – and there is a growing policy consensus that cash remittances can be mainstreamed into development. Equally, food remitting also has a role to play in urban and rural food security. Yet despite its importance, researchers and policymakers tend to ignore food remitting. The growing literature on rural-urban linkages highlights their complex, dynamic nature in the context of rapid urbanisation and growing rural-urban migration in Africa. Food remitting cannot be treated in isolation from the ‘complex web of relations and connections incorporating rural and urban dimensions and all that is in between’ (Tacoli, 2007). Yet the remitting of goods, and especially foodstuffs, across international boundaries and within countries has received little attention, particularly in Africa, where it seems that ‘transfers of food are invisible in the sense that they run within the family and outside market channels’ (Andersson Djurfeldt 2015a: 540). This report is aimed at researchers and policymakers interested in transforming rural-urban linkages and the implications for food security of rural and urban residents. The current rural-urban binary is arbitrary, outdated and unhelpful. At a time of rapid urbanisation in the South, a wider lens is needed: focusing on rural-urban linkages and moving beyond cash-based, market transactions to consider the bidirectional flows of goods – including food – and their impact on food security. This report contributes to the study of changing rural-urban linkages by: Expanding the geographic and thematic scope of research, Demonstrating the value of examining the links between informal food transfers and urban-based household food security, and Arguing for a new research and policy agenda focused on food remitting. Using case studies from Zimbabwe and Namibia, this report also demonstrates how lessons related to food remitting can be applied in other African contexts – and highlights the urgent need for a new research agenda. The report concludes with recommendations for policymakers and researchers. What are the main lessons? Rural-urban linkages in a rapidly urbanising world require much more attention from researchers and policymakers. As this report shows, several key findings have emerged from the existing literature on food remitting. The importance of bidirectional food remittances: Most studies overlook food remitting as a key link between rural and urban areas and food security. Understanding these linkages must move beyond cash-based, market transactions to consider bidirectional flows of goods, including foodstuffs, and their impact on food security. Concepts of the divided or stretched household (Francis, 2000) and multi-local household livelihoods (Andersson Djurfeldt, 2015a) should guide any analysis of the dynamics of food remitting. Cross-border migration and food remittances: Food remitting is an important livelihood strategy. Remittances across international boundaries are important to food security (Crush, 2013) and there is a massive informal trade in food in Africa. Internal migration and food remittances: Reciprocal rural-urban-rural remitting is ‘fundamental to the ability of poor urban households to survive’ (Frayne, 2004). Many urban migrant households rely on informal, non-marketed food from rural counterparts. But we still know little about what it means for rural food security in terms of food sent and received. Comparing rural-urban and urban-urban food remittances: For food-insecure households, food remittances from both rural and urban sources are important. In one study around a third of poor urban households received food remittances from outside the city the year before (Frayne et al., 2010). But while rural-urban food remitting was significant, urban-urban food remitting was greater still. This phenomenon suggests that we need a much more nuanced notion of linkages and flows. Frequency and types of food remitting: Frayne et al. (2010) also showed that households receiving food from another urban area did so far more often. This might suggest that urban-urban networks and support mechanisms are stronger than rural-urban ties. What impact this has on the food security of producers and purchasers requires additional research. Food remitters in rural areas: Rural-urban food flows tend to focus more on poor urban neighbourhoods and households and are important to food security. There is some evidence that better-off rural households remit more than their less well-off counterparts – and that the effects of food remitting are much more severe on poorer rural households. Food remittances can be seen as ‘social security’ (Andersson Djurfeldt and Wambugu, 2011) but also as having an important cultural dimension (Kuuire et al. 2013). Lessons from the Zimbabwe and Namibia case studies These case studies highlight different facets of food remitting with potentially broader applicability. The first, of Harare in Zimbabwe, looks at the significance of food remittances under conditions of extreme economic and political duress. It allows an assessment of the impact of macro-economic and political stability on food remitting. The Windhoek case study provides an important example of cash remittances for food remittances reciprocity. It also raises important hypotheses about food remittances that need further elaboration and testing, such as the relationship between urban poverty and the level of food remitting and whether the volume and frequency of food remitting is related to the strength of links between urban and rural residents. What are the main recommendations for researchers and policymakers? The massive global attention paid to cash remittances over the past decade provides a solid evidence base for policymaking and advocacy at international, regional and national levels. Policy prescriptions for maximising the flow and impacts of cash remittances on development are now legion and part of a growing policy consensus that remittances can be mainstreamed into development planning and the practices of the private sector, for the benefit of both senders and recipients, whether individuals, communities or whole countries. Yet no equivalent knowledge base or policy dialogue exists with regard to food remittances. A new research agenda and policy dialogue are urgently required relating to food remittances and urban and rural food security. Food remitting is a major research gap that demands much greater attention and a systematic, comparative programme of primary research. The case studies from Zimbabwe and Namibia in this report highlight how a deeper understanding of food remitting can be applied in other African contexts: the nature of rural-urban linkages under conditions of state failure and crisis (Zimbabwe) and the importance of reciprocal cash and food remittances for food security (Namibia). The notion of a rural-urban divide is outdated and oversimplifies the issues. Food remitting cannot be treated in isolation from the complex web of relations and connections between both rural and urban contexts. An extremely useful starting point is to explore how stretched or multi-nodal households drive and impact on food remitting at both urban and rural ends of the spectrum. Much additional research on this important, yet much-neglected, aspect of urban-rural linkages and informal cross-border transactions is urgently required. By drawing attention to the importance of food remittances for urban and rural food security and identifying the current knowledge gaps, this report creates a platform for the design of a new research agenda

No. 72: Food Remittances: Migration and Food Security in Africa

By drawing attention to the importance of food remittances for urban and rural food security and identifying the current knowledge gaps, this report contributes to the study of the relationship between migration and food security and creates a platform for the design of a new research agenda. Across Africa, there is considerable evidence of a massive informal trade in food, including staples, fresh and processed products. While most cross-border trade in foodstuffs is a result of commercial transactions by small-scale traders who buy in one country and sell in another, an unknown proportion is actually food remittances on their way from migrants to kin in their country of origin. A SAMP survey of 4,765 migrant-sending households in five SADC countries found that goods remitting was a significant component of overall remittance flows within the region. Within countries there is now considerable evidence that urban migrant households rely to varying degrees on an informal supply of food from their rural counterparts to survive in precarious urban environments. The two case studies presented in this report are designed to highlight different facets of food remitting with potentially broader applicability. The Harare study looks at food remittances under conditions of extreme economic and political duress, and the Windhoek research provides an important example of cash remittances for food remittances reciprocity