Evaluation of a dill (Anethum graveolens L.) gene bank germplasm collection using multivariate analysis of morphological traits, molecular genotyping and chemical composition to identify novel genotypes for plant breeding.

Dill (Anethum graveolens L.) is an aromatic herb widely used in the food industry, with several commercial cultivars available with different qualitative characteristics. Commercial cultivars are usually preferred over landraces due to their higher yield and also the lack of improved landraces than can be commercialized. In Greece, however, traditional dill landraces are cultivated by local communities. Many are conserved in the Greek Gene Bank and the aim here was to investigate and compare the morphological, genetic, and chemical biodiversity of twenty-two Greek landraces and nine modern/commercial cultivars. Multivariate analysis of the morphological descriptors, molecular markers, and essential oil and polyphenol composition revealed that the Greek landraces were clearly distinguished compared with modern cultivars at the level of phenological, molecular and chemical traits. Landraces were typically taller, with larger umbels, denser foliage, and larger leaves. Plant height, density of foliage, density of feathering as well as aroma characteristics were desirable traits observed for some landraces, such as T538/06 and GRC-1348/04, which were similar or superior to those of some commercial cultivars. Polymorphic loci for inter-simple sequence repeat (ISSR) and start codon targeted (SCoT) molecular markers were 76.47% and 72.41% for landraces, and 68.24% and 43.10% for the modern cultivars, respectively. Genetic divergence was shown, but not complete isolation, indicating that some gene flow may have occurred between landraces and cultivars. The major constituent in all dill leaf essential oils was α-phellandrene (54.42-70.25%). Landraces had a higher α-phellandrene and dill ether content than cultivars. Two dill landraces were rich in chlorogenic acid, the main polyphenolic compound determined. The study highlighted for the first-time Greek landraces with desirable characteristics regarding quality, yield, and harvest time suitable for breeding programs to develop new dill cultivars with superior features.

Palliative Care, Intimacy, and Sexual Expression in the Older Adult Residential Care Context: "Living until You Don't".

Commonly, frail older adults move to residential care, a liminal space that is their home, sometimes a place of death, and a workplace. Residential facilities typically espouse person-centred values, which are variably interpreted. A critical approach to person-centred care that focuses on social citizenship begins to address issues endemic in diminishing opportunities for intimacy in the end-of-life residential context: risk-averse policies; limited education; ageism; and environments designed for staff convenience. A person-centred approach to residents' expressions of intimacy and sexuality can be supported throughout end-of-life care. The present study utilised a constructionist methodology to investigate meanings associated with intimacy in the palliative and end-of-life care context. There were 77 participants, including residents, family members and staff, from 35 residential facilities. Analysis identified four key themes: care home ethos and intimacy; everyday touch as intimacy; ephemeral intimacy; and intimacy mediated by the built environment. Residents' expressions of intimacy and sexuality are supported in facilities where clinical leaders provide a role-model for a commitment to social citizenship. Ageism, restrictive policies, care-rationing, functional care, and environmental hindrances contribute to limited intimacy and social death. Clinical leaders have a pivotal role in ensuring person-centred care through policies and practice that support residents' intimate reciprocity.

Cancer incidence, stage at diagnosis and outcomes among Manitoba First Nations people living on and off reserve: a retrospective population-based analysis.

BACKGROUND: Substantial cancer-related disparities exist between First Nations and non-Indigenous Canadians. The objectives of this study were to compare cancer incidence, stage at diagnosis and mortality outcomes between Status First Nations people living on reserve and off reserve in Manitoba. METHODS: We conducted a retrospective analysis of population-level administrative health databases in Manitoba. Cancers diagnosed between Apr. 1, 2004, and Mar. 31, 2011, were linked with the Indian Registry System and 5 provincial databases. We compared differences in baseline characteristics, cancer incidence, site and stage at diagnosis between Status First Nations patients living on and off reserve. Linear regression models examined trends in annual cancer incidence. Cox proportional hazard regression models examined mortality. RESULTS: There were 1524 newly diagnosed cancers among Status First Nations people in Manitoba between Apr. 1, 2004, and Mar. 31, 2011. First Nations people living on reserve were significantly older than those living off reserve (p < 0.001) and had higher Charlson Comorbidity Index scores at diagnosis (p = 0.01). A lower proportion of on-reserve patients than off-reserve patients were diagnosed with stage I cancers (21.7% v. 26.9%, p = 0.02). There were no differences in annual cancer incidence between groups. The adjusted incidence of cancer over the combined study years was higher in the off-reserve group than in the on-reserve group (287.9 v. 247.9 per 100 000, p = 0.02). No significant differences in mortality were found. INTERPRETATION: The lower proportion of on-reserve patients diagnosed with cancer at stage I is concerning, as it suggests less access to screening services or delays in diagnosis. Further research is needed to understand patterns in diagnosis and differences in cancer site and overall cancer incidence between First Nations people living on and off reserve.

Comparing cancer incidence, stage at diagnosis and outcomes of First Nations and all other Manitobans: a retrospective analysis.

BACKGROUND: Globally, epidemiological evidence suggests cancer incidence and outcomes among Indigenous peoples are a growing concern. Although historically cancer among First Nations (FN) peoples in Canada was relatively unknown, recent epidemiological evidence reveals a widening of cancer related disparities. However evidence at the population level is limited. The aim of this study was to explore cancer incidence, stage at diagnosis, and outcomes among status FN peoples in comparison with all other Manitobans (AOM). METHODS: All cancers diagnosed between April 1, 2004 and March 31, 2011 were linked with the Indian Registry System and five provincial healthcare databases to compare differences in characteristics, cancer incidence, and stage at diagnosis and mortality of the FN and AOM cohorts. Cox proportional hazard regression models were used to examine mortality. RESULTS: The FN cohort was significantly younger, with higher comorbidities than AOM. A higher proportion of FN people were diagnosed with cancer at stages III (18.7% vs. 15.4%) and IV (22.4% vs. 19.9%). Cancer incidence was significantly lower in the FN cohort, however, there were no significant differences between the two cohorts after adjusting for age, sex, income and area of residence. No significant trends in cancer incidence were identified in either cohort over time. Mortality was generally higher in the FN cohort. CONCLUSIONS: Despite similar cancer incidence, FN peoples in Manitoba experience poorer survival. The underlying causes of these disparities are not yet understood, particularly in relation to the impact of colonization and other determinants of health.

Effect οf Genotype and Growing Year on the Nutritional, Phytochemical, and Antioxidant Properties of Industrial Hemp (Cannabis sativa L.) Seeds.

Cannabis sativa L. seeds have been an important source of protein, oil, and dietary fiber for human and animals. Currently, there is a growing interest in the commercial products of these seeds, which are recognized as a legitimate source of medicaments, cosmeceuticals, and nutraceuticals. The objective of this study was to investigate the nutritional, phytochemical composition, and antioxidant properties of seeds from seven hemp cultivars grown in Greece for three consecutive years. All the measured parameters strongly varied under the influence of growing year and genotype. In particular, protein, oil, and carbohydrates' content of hemp seeds as well as fatty acids' composition were mainly affected by genotype, whereas the growing year had a major effect on phytochemical components and antioxidant activity, which was determined by the 2,2'-azino-bis (3-ethylbenzthiazoline sulfonate) (ABTS) and ferric-reducing antioxidant power (FRAP) assays. Moreover, a predominant effect of the year was observed for phenolic profiles as determined by high-performance liquid chromatography and total carotenoids' content. This study suggests that hemp seeds could be a promising food crop as a result of their high nutritive traits and antioxidant potential. A comparison of the studied cultivars, showed that Finola seeds had the highest oil and protein contents and, thus, appeared to be the most promising cultivar for cultivation in Greece.

Occupational engagement of people living with a life-limiting illness: Occupational therapists' perceptions.

BACKGROUND/AIM: Occupational therapists working in palliative care aim to enable clients living with a life-limiting illness to continue participating in meaningful activities for as long as possible. However, little is published about the occupations people living with a life-limiting illness wish to engage in, and how occupational therapists can best enable occupational engagement. Therefore, this study aimed to gain an in-depth understanding of occupational therapists' perceptions on clients' occupational engagement post-diagnosis of a life-limiting condition. METHODS: Occupational therapists working in Australia with people with a life-limiting illness were recruited to participate in a national online survey over the period of a month. Recruitment used a purposive, snowball sampling technique, resulting in 144 survey responses. Data were analysed using modified grounded theory methods. RESULTS: Findings revealed two interrelated categories and four subcategories. The first category, focusing on life is concerned with therapists' perceptions of how clients continue to focus on living post diagnosis and encompasses two subcategories: (i) prioritised engagement and (ii) altered engagement. The second category, preparing for death, centres on therapists' perceptions of what clients do to practically prepare for death and find closure as their illness progresses, and is comprised of the two subcategories: (i) practical preparation for death and (ii) "facilitating closure". CONCLUSION: Therapists perceived that meaningful occupational engagement changes over time as occupational performance levels decrease and clients prepare for death.

Exploring communication during the journey from noticing bodily changes to a diagnosis of endometrial cancer.

AIMS AND OBJECTIVES: To understand women's perspectives about the trajectory from first bodily changes to diagnosis. BACKGROUND: With endometrial cancer, as with all gynaecological cancers, early diagnosis is key to successful outcomes. However, women do not always seek clinical advice early. Previously, this gap has been referred to as a "delay," blamed on fear or refusal to acknowledge symptoms. METHODS: A qualitative research project which involved face-to-face interviews with 16 women who had presented with symptoms of endometrial cancer. The paucity of research in the trajectory of women who experience a diagnosis of endometrial cancer required an exploratory overview of the data. Accordingly, an inductive thematic analysis was conducted using the framework of Braun and Clarke (Qualitative Research in Psychology, 3, 2006, 77). RESULTS: Women and health professionals both resorted to satisficing, using heuristics to make decisions about the importance of symptoms depending on their severity and duration. Most women initially determined that the bodily changes were within the realms of normal. Time to diagnosis was also affected by the following: women's long-standing assumptions; communication with health professionals; liminality-women oscillating between their self-assessment that these changes were something significant or nothing important; and gaps in health literacy. CONCLUSIONS: The journey from noticing bodily changes to diagnosis was a nonlinear trajectory. Women worked to make sense of what was happening to them, informed by their sociocultural environment. In particular, confusion about the purpose of cervical screening led a number of participants who had regular smears to assume they were "safe" from cancer worries. RELEVANCE TO CLINICAL PRACTICE: Women and some health professionals may be unfamiliar with symptoms potentially indicative of endometrial cancer. There may be structural and communication barriers for women navigating healthcare systems. It is vital that nurses take time both to listen to women and to provide them with resources to enhance their health literacy.

Workforce profile of Australian occupational therapists working with people who are terminally ill.

BACKGROUND/AIM: The role played by Australian occupational therapists with clients living with terminal illness has recently been highlighted in the Occupational Therapy Australia () position paper on palliative care. To date, little evidence exists about the work profile of these therapists, the type of clients seen, their practice settings and how long therapists are planning to remain in this clinical role. This paper presents results from a national survey of Australian occupational therapists working with people who are terminally ill. METHODS: The largest ever sample (n = 171) of Australian occupational therapists working with clients who are terminally ill were purposively surveyed in this national mixed-method study, which was analysed using descriptive statistics and grounded theory. RESULTS: Results revealed a predominantly full-time, publicly employed (81%), female (93%) workforce, with an average six years of experience in this setting. Most therapists treated clients in the community (49%), with slightly fewer working in inpatient settings (40%). Many had dual caseloads, employed in palliative care clinical roles, aged care or oncology settings. Neoplasms of varying kinds represented the dominant clinical diagnostic category. The majority of respondents planned to remain in their current role on average seven more years, citing job satisfaction as the main reason for doing so. CONCLUSIONS: Results from this study reveal important data for future workforce planning in this clinical area. The information gathered about client diagnoses and practice contexts will enable more targeted preparation of students for graduation.

Pastoral power and gynaecological examinations: a Foucauldian critique of clinician accounts of patient-centred consent.

Invasive non-sedated clinical procedures such as gynaecological examinations are normalised; however, there is limited research highlighting the relational and technical skills required for clinicians to ensure patients' continued consent. A considerable body of research emphasises that women dislike examinations, leading to their non-compliance or a delayed follow up for gynaecological and sexual health problems. However, medical research focuses on 'problem' women; the role of clinicians receives limited appraisal. This article draws on interviews with sexual health clinicians in New Zealand, from metropolitan and provincial locations. The gynaecological care of women in New Zealand attained international notoriety with the 1988 publication of Judge Cartwright's inquiry into ethical shortcomings in cervical cancer research at the National Women's Hospital. Judge Cartwright's recommendations included patient-centred care in order to ensure informed consent had been received for clinical procedures and research participation. This article's critical analysis is that, although clinicians' language draws on humanistic notions of patient-centredness, Foucault's notion of secularised pastoral power enables a more nuanced appreciation of the ethical work undertaken by clinicians when carrying out speculum examinations. The analysis highlights both the web of power relations present during examination practices and the strategies clinicians use to negotiate women's continued consent; which is significant because consent is usually conceptualised as an event, rather than an unfolding, unstable process.

The influence of the Cartwright report on gynaecological examinations and nurses' communication.

The Cartwright Report of the Cervical Cancer Inquiry of 1987/8 made detailed recommendations about the primacy of communication with respect to informed consent, specifically for women undergoing gynaecological examinations. This paper reports findings from a wider study into women's experiences of what makes examinations go well. The data are specific to nurses and a subset of women participants. Data are from semi-structured interviews with six nurses, and seven women who had attended a sexual health clinic and had a speculum examination. These data are a portion of a larger study about women and gynaecological examinations, in which a total of 16 women patients and 16 clinicians (including 10 doctors) were interviewed. Clinicians were recruited through self-selection in response to a request for participants who believed that for the most part, women were satisfied with the clinical care they received, and re-attended. Subsequently, women who had been examined by these nurses and doctors were recruited. The recently developed concept of 'shared mind' was employed to analyse the data, using an iterative content analysis to identify which clinical communication strategies were used, and the way in which women responded. The findings demonstrate that nurses, through a shared mind process, can provide an environment to meet both the physical and emotional needs of women and enhance the likelihood of their re-attendance. This paper highlights Cartwright's legacy as it is enacted by a group of nurses in New Zealand.

The sexual health consultation as a moral occasion.

Sexually transmitted infections (STIs) are socially constructed as more 'dirty' than other gynaecological conditions. This article analyses women's accounts of interactions with clinicians, subsequent to a diagnosis of genital herpes simplex virus or human papilloma virus. Women conceptualised consultations as a 'moral event,' different from other consultations. This moral component is highlighted drawing on Foucault's notion of 'the confessional.' Additionally, Douglas' anthropological construction of 'dirt' is used to consider why these consultations are 'confessional' experiences. Email interviews were conducted with 26 women diagnosed with a viral STI and 12 sexual health clinicians. Data were analysed thematically using a feminist, poststructuralist approach. Findings indicated that discourses of morality shape sexual health consultations. Five themes were identified in relation to the moral 'work' in clinical consultations about a viral STI diagnosis: the particular 'dirtiness' of viral STIs, clinicians as moral agents, the 'non-judgmental' clinician, women juggling truth-telling and risk and clinicians prescribing moral work. Clinicians support and educate women more effectively if they recognise subjective, moral aspects of sexual health consultations rather than assuming that effective clinical teaching is rational, scientific and non-judgmental.

Diagnostic classification, viral sexually transmitted infections and discourses of femininity: limits of normalisation to erase stigma.

Clinicians in the field of women's sexual health typically classify the two most common viral sexually transmitted infections (STIs), the human papilloma virus and the herpes simplex virus, as relatively innocuous infections. Teaching interventions include 'normalising' adult sexual activity and the epidemiological ordinariness of infection. Normalising is intended to disarm the potential stigma of the diagnosis. In this study, in-depth email interviews were conducted with 26 women with a viral STI diagnosis and 12 sexual health clinicians. Data were analysed thematically using a feminist, poststructuralist approach. Normalising is contextualised as an example of the workings of western philosophical thought whereby dualistic classifications privilege certain terms and subordinate other terms. In this instance, the relative medical normalcy of viral STIs is given primacy compared to the social abnormality experienced by women. Although these viral STIs infect women and men, this research concentrates on women's learning about viral STIs. For women, beliefs about femininity, sexuality, health, morality and responsibility influence effects of a viral STI diagnosis. These discourses are clinically significant because beliefs that specifically link to ideas about how to be a woman are overlooked when clinicians devise educational interventions.

Email interviewing: generating data with a vulnerable population.

AIMS: This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. BACKGROUND: Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. METHODS: In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. RESULTS: Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. CONCLUSION: This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value.

'About as comfortable as a stranger putting their finger up your nose': speculation about the (extra)ordinary in gynaecological examinations.

In public health education, gynaecological examinations are presented as a routine and ordinary procedure. Medical research addressing women's reasons for screening reluctance emphasises underlying psychological categories of 'anxiety' and 'poor coping'. Minimal attention is paid to the effects of clinicians' interventions upon women's decision-making. Normalising promotes women's participation as speculum examinations are an essential part of many contemporary diagnostic and treatment procedures. In-depth email interviews were conducted with 26 women with diagnosis of either of the two commonest viral sexually transmitted infections, human papilloma virus and herpes simplex virus, and 12 sexual health clinicians. Data were analysed thematically. Findings indicate that women's screening compliance is influenced by clinicians' (in)attention to power relations, rapport-building, attentiveness to bodily (dis)comfort, technical skill and gender. Women's feedback is a valuable resource in devising interventions that may promote participation in examinations.

Human papilloma virus vaccines and their role in cancer prevention.

The introduction of the human papilloma virus (HPV) vaccine is the single most important advance in the prevention of cervical cancer since the introduction of cervical cytology half a century ago. Vaccination should ideally occur prior to a female's first sexual experience. This article suggests that the HPV vaccine should be publicly funded in New Zealand.