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Expanding mental health services in low- and middle-income countries: A task-shifting framework for delivery of comprehensive, collaborative, and community-based care
- Paul Bolton, Joyce West, Claire Whitney, Mark J.D. Jordans, Judith Bass, Graham Thornicroft, Laura Murray, Leslie Snider, Julian Eaton, Pamela Y. Collins, Peter Ventevogel, Stephanie Smith, Dan J. Stein, Inge Petersen, Derrick Silove, Victor Ugo, John Mahoney, Rabih el Chammay, Carmen Contreras, Eddy Eustache, Phiona Koyiet, Esubalew Haile Wondimu, Nawaraj Upadhaya, Giuseppe Raviola
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- Journal:
- Cambridge Prisms: Global Mental Health / Volume 10 / 2023
- Published online by Cambridge University Press:
- 27 February 2023, e16
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This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommodates integration of stand-alone mental health programs with health and non-health community-based services. It addresses gaps in previous models including lack of community-based psychotherapeutic and social services, difficulty in addressing comorbidity of mental and physical conditions, and how workers interact with respect to referral and coordination of care. The framework is based on task-shifting of services to non-specialized workers. While the framework draws on the World Health Organization’s Mental Health Gap Action Program and other global mental health models, there are important differences. The C4 Framework delineates types of workers based on their skills. Separate workers focus on: basic psychoeducation and information sharing; community-level, evidence-based psychotherapeutic counseling; and primary medical care and more advanced, specialized mental health services for more severe or complex cases. This paper is intended for individuals, organizations and governments interested in implementing mental health services. The primary aim is to provide a framework for the provision of widely accessible mental health care and services.
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis – ERRATUM
- Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Yeates Conwell, Janneke M. de Manvan Ginkel, Jesse R. Fann, Felix H. Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, Patricia A. Harrison, Martin Härter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Yunxin Kwan, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Anthony McGuire, Sherina Mohd-Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Henk C. van Weert, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Andrea Benedetti, Brett D. Thombs
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- Psychological Medicine / Volume 50 / Issue 16 / December 2020
- Published online by Cambridge University Press:
- 19 August 2019, p. 2816
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Andrew Norman, A Church Observed: Being Anglican as Times Change (Malton: Gilead, 2018), pp. 428, ISBN 978-0-9932090-7-9. RRP £9.98 or US$16.
- John Inge
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- Journal:
- Journal of Anglican Studies / Volume 18 / Issue 1 / May 2020
- Published online by Cambridge University Press:
- 16 July 2019, pp. 116-117
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Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis
- Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Yeates Conwell, Janneke M. de Man-van Ginkel, Jesse R. Fann, Felix H. Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, Patricia A. Harrison, Martin Härter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Yunxin Kwan, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Anthony McGuire, Sherina Mohd-Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Henk C. van Weert, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Andrea Benedetti, Brett D. Thombs
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- Psychological Medicine / Volume 50 / Issue 8 / June 2020
- Published online by Cambridge University Press:
- 12 July 2019, pp. 1368-1380
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Background
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
MethodsWe conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
ConclusionsPHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews
- Brooke Levis, Andrea Benedetti, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Matthew J. Chiovitti, Tatiana A. Sanchez, Pim Cuijpers, Simon Gilbody, John P. A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Russell J. Steele, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Anna Beraldi, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Neerja Chowdhary, Kerrie Clover, Yeates Conwell, Janneke M. de Man-van Ginkel, Jaime Delgadillo, Jesse R. Fann, Felix H. Fischer, Benjamin Fischler, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, John Hambridge, Patricia A. Harrison, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Khalida Ismail, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Laura Marsh, Anthony McGuire, Sherina Mohd Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Christina M. van der Feltz-Cornelis, Henk C. van Weert, Paul A. Vöhringer, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Yuying Zhang, Brett D. Thombs
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- Journal:
- The British Journal of Psychiatry / Volume 212 / Issue 6 / June 2018
- Published online by Cambridge University Press:
- 02 May 2018, pp. 377-385
- Print publication:
- June 2018
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Background
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
MethodData collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
ResultsA total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
ConclusionsThe MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
The Last Glacial Maximum on Spitsbergen, Svalbard
- Jan Mangerud, Magne Bolstad, Anne Elgersma, Dag Helliksen, Jon Y. Landvik, Ida Lønne, Anne Katrine Lycke, Otto Salvigsen, Tom Sandahl, John Inge Svendsen
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- Journal:
- Quaternary Research / Volume 38 / Issue 1 / July 1992
- Published online by Cambridge University Press:
- 20 January 2017, pp. 1-31
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Most scientists have concluded previously that the west coast of Spitsbergen, Svalbard, remained ice-free during the late Weichselian, between 25,000 and 10,000 yr B.P. We conclude that the glaciation was more extensive. Terraces that were postulated to have been ice-free are covered by a thin, late Weichselian till. Sudden drop in the marine limit and basal radiocarbon dates of raised glaciomarine sediments demonstrates that the glaciers in the main fjords, Isfjorden and Van Mijenfjorden, terminated west (outside) of the fjord mouths. Basal radiocarbon dates from glaciomarine clay above till in cores from the continental shelf west of Spitsbergen yielded ages of about 12,500 yr B.P., from which we conclude that the ice extended to the shelf edge. Based on the extent of amino acid diagenesis in radiocarbon-dated molluscs, the duration of the maximum extension of the late Weichselian glaciation was short, certainly less than 10,000 years. During the ice-free period preceding that glaciation, at least back to 40,000 yr B.P., the glaciers on Svalbard were not significantly larger than at present, as shown by marine deposits close to the glacier snouts. Many radiocarbon dates place deglaciation of the outer coast at about 12,500 yr B.P. At about 10,000 yr B.P., the rest of the archipelago rapidly became ice-free.
The Growth and Decay of the Late Weichselian Ice Sheet in Western Svalbard and Adjacent Areas Based on Provenance Studies of Marine Sediments
- Anders Elverhøi, Espen S. Andersen, Trond Dokken, Dierk Hebbeln, Robert Spielhagen, John Inge Svendsen, Marit Sørflaten, Arnt Rørnes, Morten Hald, Carl Fredrik Forsberg
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- Quaternary Research / Volume 44 / Issue 3 / November 1995
- Published online by Cambridge University Press:
- 20 January 2017, pp. 303-316
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The history of the Late Weichselian northwestern Barents Shelf, including western Svalbard, has been investigated by provenance/sedimentologist studies of five cores from the continental shelf and slope west of Svalbard. The chronostratigraphy of the cores is based on AMS 14C dates and oxygen isotope analyses. Interpretations of the cores suggest that the ice sheets of western Svalbard and northwestern Barents Sea experienced advances and retreats in two steps. The first significant ice advance beyond the present coastline occurred ca. 22,000 14C yr B.P. and was followed by an ice advance to the shelf edge ca. 18,000 14C yr B.P. Ice recession from the outer shelf and the southwestern Barents Sea began 14,800 14C yr B.P. and was followed by a second ice recession between 13,000 and 12,000 14 C yr B.P. during which ice withdrew from the inner shelf. A minor readvance of the ice sheet on the shelf west of Svalbard occurred close to 12,400 14C yr B.P. The first deglaciation event was associated with release of icebergs containing ice-rafted detritus, while the later episode also included significant amounts of meltwater and fine-grained sediment.
Validity Evidence based on Internal Structure of Scores of the Emotional Quotient-Inventory: Youth Version Short (EQ-i: YV-S) in a Spanish Sample
- Igor Esnaola, John Freeman, Marta Sarasa, Arantza Fernández-Zabala, Inge Axpe
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- The Spanish Journal of Psychology / Volume 19 / 2016
- Published online by Cambridge University Press:
- 14 March 2016, E12
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The purpose of this study was to analyze the reliability and validity evidence of scores on the Spanish version of EQ-i: YV-S in Spanish adolescents. The total sample was comprised of 508 participants from Grades 7 to 12, 241 males (47.4%) and 267 females (52.6%), each of whom completed the questionnaires on two separate occasions. Three [intrapersonal (α = .83, CR = .86, and McDonald Omega = .86), stress management (α = .83, CR = .86, and McDonald Omega = .85) and adaptability (α = .82, CR = .85, and McDonald Omega = .85)] of the four scales had acceptable internal consistency. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used with FACTOR and EQS version 6.1 software to examine validity evidence based on internal structure drawn from the scores on the EQ-i: YV-S, supporting the multidimensionality of the questionnaire. Three models were tested; the best fit to the data was the hierarchical model (S-Bχ2/ df = 2.11, CFI = .93 and RMSEA = .047), which hypothesized that the four specific factors (interpersonal, intrapersonal, stress management, and adaptability) were explained with a second-order factor, Emotional-Social-Intelligence (ESI). Finally, significant positive correlations were found between general self-concept and EQ-i: YV-S [interpersonal (r = .153, p < .001), intrapersonal (r = .235, p < .001), stress management (r = .145, p < .001), adaptability (r = .311, p < .001) and ESI (r = .360, p < .001)]; ESI showed significant direct power prediction of the general self-concept (.52) as demonstrated through structural equation modeling.
Contributors
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- By Masoud Azodi, Patricia Baetens, Steven Bayer, Joel Bernstein, Jonathan D. Black, Christophe Blockeel, Carolien M. Boomsma, Birgit Borgström, Mark Bowman, Nicholas Brook, Elisabeth Carlsen, Peter Carne, Ying Cheong, Jen-Ruei Chen, Erin Clark, S. Alberto Dávila Garza, Sunita De Sousa, Michel De Vos, Leo Doherty, Patricio Donoso, Cindy M. P. Duke, Human M. Fatemi, Alison Fernbach, Juan A. Garcia-Velasco, Elizabeth S. Ginsburg, Dorothy A. Greenfeld, William M. Hague, Daniel Hajioff, Tristan Hardy, Catherine Henry, Outi Hovatta, John Hutton, Gordana Ivanovic, Sameer Jatkar, Shilpa Jesudason, Theo Joseph, Amanda Kallen, Sonal Karia, Bala Karunakaran, Jenneke C. Kasius, Ben Kroon, Dimitra Kyrou, Robert Lahoud, Jennifer M Levine, Inge Liebaers, Shane T. Lipskind, Derek Lok, Nick S. Macklon, Manveen (Manny) Mangat, Tom P. Manolitsas, S. McDowell, Cherise Mooy, Mark R. Morton, Andrew Murray, Robert J. Norman, Sara Ornaghi, Israel Ortega, Michael J. Paidas, Evaggelos Papanikolaou, Pasquale Patrizio, Sofie Piessens, Biljana Popovic Todorovic, Luk Rombauts, Katrina Rowan, Denny Sakkas, P. Sanhueza, Kirsten Tryde Schmidt, Mark Teoh, Hammed A. Tijani, Jelena Todorovic, Saioa Torrealday, Herman Tournaye, Geoffrey Trew, W. Verpoest, Veerle Vloeberghs, A. Yazdani
- Edited by Nick S. Macklon, University of Southampton, Human M. Fatemi, Robert J. Norman, University of Adelaide, Pasquale Patrizio
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- Case Studies in Assisted Reproduction
- Published online:
- 05 February 2015
- Print publication:
- 22 January 2015, pp ix-xiv
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Contributors
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- By Magdalena Anitescu, Charles E. Argoff, Arash Asher, Nyla Azam, Nomen Azeem, Sachin K. Bansal, Jose E. Barreto, Rodrigo A Benavides, Niteesh Bharara, Justin B. Boge, Robert B. Bolash, Thomas K. Bond, Christopher Centeno, Zachariah W. Chambers, Jonathan Chang, Grace Chen, Hamilton Chen, Jeffry Chen, Jianguo Cheng, Natalia Covarrubias, Claire J. Creutzfeldt, Gulshan Doulatram, Amirpasha Ehsan, Ike Eriator, Jeff Ericksen, Mark Etscheidt, Frank J. E. Falco, Jack Fu, Timothy Furnish, Annemarie E. Gallagher, Kingsuk Ganguly, Eugene Garvin, Cliff Gevirtz, Scott E. Glaser, Brandon J. Goff, Harry J. Gould, Christine Greco, Jay S. Grider, Maged Guirguis, Qiao Guo, Justin Hata, John Hau, Garett J. Helber, Eric R. Helm, Lori Hill Marshall, Dean Hommer, Jeffrey Hopcian, Eric S. Hsu, Jakun Ing, Tracy P. Jackson, Gaurav Jain, Chrystina Jeter, Alan David Kaye, James Kelly, Soorena Khojasteh, Ankur Khosla, Daniel Krashin, Monika A. Krzyzek, Prasad Lakshminarasimhiah, Steven Michael Lampert, Garrett LaSalle, Quan D. Le, Ankit Maheshwari, Edward R. Mariano, Joaquin Maury, John P. McCallin, John Michels, Natalia Murinova, Narendren Narayanasamy, Rebekah L. Nilson, Elliot Palmer, Vikram B. Patel, Devin Peck, Donald B. Penzien, Danielle Perret Karimi, Tilak Raj, Michael R. Rasmussen, Mohit Rastogi, Rahul Rastogi, Nashaat N. Rizk, Rinoo V. Shah, Paul A. Sloan, Julian Sosner, A. Raj Swain, Minyi Tan, Natacha Telusca, Santhosh A. Thomas, Andrea Trescot, Michael Truong, Jason Tucker, Richard D. Urman, Brandon A. Van Noord, Nihir Waghela, Irene Wu, Jiang Wu, Jijun Xu, Jinghui Xie, William Yancey
- Edited by Alan David Kaye, Louisiana State University, Rinoo V. Shah
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- Case Studies in Pain Management
- Published online:
- 05 October 2014
- Print publication:
- 16 October 2014, pp xi-xv
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Simulation of the effect of maize porridge fortified with grain amaranth or micronutrient powder containing NaFeEDTA on iron intake and status in Kenyan children
- Catherine W Macharia-Mutie, Agnes M Omusundi, John M Mwai, Alice M Mwangi, Inge D Brouwer
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- Journal:
- Public Health Nutrition / Volume 16 / Issue 9 / September 2013
- Published online by Cambridge University Press:
- 06 December 2012, pp. 1605-1613
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Objective
Simulating the probable impact of grain amaranth and highly absorbable, low-Fe micronutrient powder (MNP) on Fe status in a potential target population is an essential step in choosing and developing an appropriate actual intervention.
DesignWe simulated the potential effect of fortifying maize porridge with grain amaranth or MNP on the prevalence of inadequate Fe intake and Fe deficiency using data from two cross-sectional surveys. In the first survey (2008), dietary intake data were collected by two 24 h recalls (n 197). Biochemical data (n 70) were collected in the second survey (2010). A simulation with daily consumption for 80 d of non-fortified maize porridge (60 g of maize flour), amaranth-enriched porridge (80 g of grain amaranth–maize flour, 70:30 ratio) or maize porridge fortified with MNP (2·5 mg Fe as NaFeEDTA) was done.
SettingMwingi District, Kenya.
SubjectsPre-school children aged 12–23 months.
ResultsPrevalence of anaemia, Fe deficiency and Fe-deficiency anaemia was 49 %, 46 % and 24 %, respectively. Consumption of non-fortified, amaranth-enriched and MNP-fortified maize porridge was estimated to provide a median daily Fe intake of 8·6 mg, 17·5 mg and 11·1 mg, respectively. The prevalence of inadequate Fe intake was reduced to 35 % in the amaranth-enriched porridge group and 45 % in the MNP-fortified porridge group, while ferritin concentration was increased in both (by 1·82 (95 % CI 1·42, 2·34) μg/l and 1·80 (95 % CI 1·40, 2·31) μg/l, respectively; P < 0·005) compared with the non-fortified maize porridge group, resulting in a decreased prevalence of Fe deficiency (27 %) in the two fortification groups.
ConclusionsAddition of grain amaranth or low-Fe MNP to maize-based porridge has potential to improve Fe intake and status in pre-school children.
Fibre intake among the Belgian population by sex–age and sex–education groups and its association with BMI and waist circumference
- Yi Lin, Inge Huybrechts, Stefanie Vandevijvere, Selin Bolca, Willem De Keyzer, Stephanie De Vriese, Anja Polet, Melissa De Neve, Herman Van Oyen, John Van Camp, Guy De Backer, Stefaan De Henauw
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- Journal:
- British Journal of Nutrition / Volume 105 / Issue 11 / 14 June 2011
- Published online by Cambridge University Press:
- 29 March 2011, pp. 1692-1703
- Print publication:
- 14 June 2011
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The objectives of the present study were to assess total dietary fibre intake and the main contributors to fibre intake in the Belgian population by sex–age and sex–education groups and to investigate its relationship with BMI and waist circumference (WC). The participants of the Belgian food consumption survey (2004) were randomly selected. Information about food intake was collected using two repeated, non-consecutive 24 h recall interviews. A total of 3083 individuals ( ≥ 15 years; 1546 men and 1537 women) completed both interviews. The main contributors to total fibre intake (17·8 g/d) were cereals and cereal products (34 %; 5·9 g/d), potatoes and other tubers (18·6 %; 3·3 g/d), fruits (14·7 %; 2·8 g/d) and vegetables (14·4 %; 2·6 g/d). Legume fibre intake was extremely low (0·672 %; 0·139 g/d). In all sex–age and sex–education groups, total fibre intake was below the recommendations of the Belgian Superior Health Council. Men (21 g/d) consumed significantly more fibre than women (17·3 g/d) (P < 0·001). Lower educated men and higher educated women reported the highest fibre intake. A significant inverse association was found between total fibre intake and WC (β = − 0·118, P < 0·001). Fruit-derived fibre was positively associated with WC (β = 0·731, P = 0·001). In summary, total fibre intake was inversely associated with WC, whereas fruit-derived fibre intake was positively associated with WC in the Belgian population.
Consumption of plant sterols in Belgium: estimated intakes and sources of naturally occurring plant sterols and β-carotene
- Isabelle Sioen, Christophe Matthys, Inge Huybrechts, John Van Camp, Stefaan De Henauw
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- Journal:
- British Journal of Nutrition / Volume 105 / Issue 6 / 28 March 2011
- Published online by Cambridge University Press:
- 02 March 2011, pp. 960-966
- Print publication:
- 28 March 2011
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The objective of the present study was to assess the intake of naturally occurring plant sterols and β-carotene via the overall diet of Belgian pre-school children and adults. Two different Belgian food consumption databases were used: (1) one with consumption data of pre-school children (2·5–6·5 years old) and (2) one with consumption data of adults ( ≥ 15 years old). These consumption data were combined with a newly developed database containing the plant sterol and β-carotene content in all relevant food items based on international food composition databases and scientific literature. The results show that Flemish pre-school children have a median plant sterol intake of 172 (interquartile range (IQR) = 47) and 184 (IQR = 52) mg/d for girls and boys, respectively. Their median β-carotene intake was 1857 (IQR = 1250) μg/d, without significant difference between girls and boys. Belgian women and men have a median plant sterol intake of 218 (IQR = 113) and 280 (IQR = 158) mg/d, respectively, and a median β-carotene intake of 2086 (IQR = 1254) μg/d (not significantly different between the sexes). The main food source of naturally occurring plant sterols was bread and other cereal products. For β-carotene, the main food source was vegetables.
Consumption of plant sterols in Belgium: consumption patterns of plant sterol-enriched foods in Flanders, Belgium
- Isabelle Sioen, Christophe Matthys, Inge Huybrechts, John Van Camp, Stefaan De Henauw
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- Journal:
- British Journal of Nutrition / Volume 105 / Issue 6 / 28 March 2011
- Published online by Cambridge University Press:
- 27 January 2011, pp. 911-918
- Print publication:
- 28 March 2011
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The present study describes the consumption of foods enriched with plant sterols (PS) and supplements containing PS, and evaluates PS intakes via the current consumption and for specific consumption scenarios. A market inventory was performed to collate different PS-enriched food items and supplements available in Belgium. An FFQ was developed to investigate the consumption of PS-enriched foods and supplements. A total of 139 pre-school children (2·5–7 years old) and 569 adults (308 women and 261 men) living in Flanders (the northern, Dutch-speaking part of Belgium) participated in the study. Of these, 21 % (Flemish pre-school children) and 28·5 % (Flemish adults) consume PS-enriched food products, leading to a mean PS intake in the consumer group of 0·70 (sd 0·61) g/d for pre-school children and 1·51 (sd 1·42) g/d for adults. Of the adult PS consumers, 23·2 % did not suffer from elevated blood cholesterol levels; 50 % of them had a PS intake less than or equal to 1 g/d and 16·4 % had a PS intake above 3 g/d and 7·8 % even had an intake above 4 g/d. Scenario studies assessed the intake when all Belgian adults would consume PS-enriched margarines without (scenario 1) or with (scenario 2) a daily consumption of a PS-enriched yoghurt drink. This resulted in an intake above 3 g/d in 17 % (women) and 29 % (men) for scenario 1 and 40 % (women) and 53 % (men) for scenario 2. The results indicate that PS-enriched food products are also consumed by the non-target group. Efficient communication tools are needed to inform consumers better about the target group of PS-enriched products, the advised dose per day and alternative dietary strategies to lower the blood cholesterol level.
Plant and animal protein intake and its association with overweight and obesity among the Belgian population
- Yi Lin, Selin Bolca, Stefanie Vandevijvere, Stephanie De Vriese, Theodora Mouratidou, Melissa De Neve, Anja Polet, Herman Van Oyen, John Van Camp, Guy De Backer, Stefaan De Henauw, Inge Huybrechts
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- Journal:
- British Journal of Nutrition / Volume 105 / Issue 7 / 14 April 2011
- Published online by Cambridge University Press:
- 09 December 2010, pp. 1106-1116
- Print publication:
- 14 April 2011
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The objective of the present study was to assess animal and plant protein intakes in the Belgian population and to examine their relationship with overweight and obesity (OB). The subjects participated in the Belgian National Food Consumption Survey conducted in 2004. Food consumption was assessed by using two non-consecutive 24 h dietary recalls. About 3083 participants ( ≥ 15 years of age; 1546 males, 1537 females) provided completed dietary information. Animal protein intake (47 g/d) contributed more to total protein intakes of 72 g/d than plant protein intake, which accounted for 25 g/d. Meat and meat products were the main contributors to total animal protein intakes (53 %), whereas cereals and cereal products contributed most to plant protein intake (54 %). Males had higher animal and plant protein intakes than females (P < 0·001). Legume and soya protein intakes were low in the whole population (0·101 and 0·174 g/d, respectively). In males, animal protein intake was positively associated with BMI (β = 0·013; P = 0·001) and waist circumference (WC; β = 0·041; P = 0·002). Both in males and females, plant protein intake was inversely associated with BMI (males: β = − 0·036; P < 0·001; females: β = − 0·046; P = 0·001) and WC (male: β = − 0·137; P < 0·001; female: β = − 0·096; P = 0·024). In conclusion, plant protein intakes were lower than animal protein intakes among a representative sample of the Belgian population and decreased with age. Associations with anthropometric data indicated that plant proteins could offer a protective effect in the prevention of overweight and OB in the Belgian population.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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An exploration of cognitive subgroups in Alzheimer’s disease
- JULIE E. DAVIDSON, MICHAEL C. IRIZARRY, BETHANY C. BRAY, SALLY WETTEN, NICHOLAS GALWEY, RACHEL GIBSON, MICHAEL BORRIE, RICHARD DELISLE, HOWARD H. FELDMAN, GING-YUEK HSIUNG, LUIS FORNAZZARI, SERGE GAUTHIER, DANILO GUZMAN, INGE LOY-ENGLISH, RON KEREN, ANDREW KERTESZ, PETER ST. GEORGE-HYSLOP, JOHN WHERRETT, ANDREAS U. MONSCH
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- Journal:
- Journal of the International Neuropsychological Society / Volume 16 / Issue 2 / March 2010
- Published online by Cambridge University Press:
- 04 December 2009, pp. 233-243
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Heterogeneity is observed in the patterns of cognition in Alzheimer’s disease (AD). Such heterogeneity might suggest the involvement of different etiological pathways or different host responses to pathology. A total of 627 subjects with mild/moderate AD underwent cognitive assessment with the Mini-Mental State Examination (MMSE) and the Dementia Rating Scale-2 (DRS-2). Latent class analysis (LCA) was performed on cognition subscale data to identify and characterize cognitive subgroups. Clinical, demographic, and genetic factors were explored for association with class membership. LCA suggested the existence of four subgroups; one group with mild and another with severe global impairment across the cognitive domains, one group with primary impairments in attention and construction, and another group with primary deficits in memory and orientation. Education, disease duration, age, Apolipoprotein E-ε4 (APOE ε4) status, gender, presence of grasp reflex, white matter changes, and early or prominent visuospatial impairment were all associated with class membership. Our results support the existence of heterogeneity in patterns of cognitive impairment in AD. Our observation of classes characterized by predominant deficits in attention/construction and memory respectively deserves further exploration as does the association between membership in the attention/construction class and APOE ε4 negative status. (JINS, 2010, 16, 233–243.)
n-6 and n-3 PUFA intakes of pre-school children in Flanders, Belgium
- Isabelle Sioen, Inge Huybrechts, Wim Verbeke, John Van Camp, Stefaan De Henauw
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- Journal:
- British Journal of Nutrition / Volume 98 / Issue 4 / October 2007
- Published online by Cambridge University Press:
- 03 August 2007, pp. 819-825
- Print publication:
- October 2007
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In this study, the intake of n-6 and n-3 PUFA of pre-school children in Flanders, Belgium, was evaluated, and recommendations to address the very low intake of long-chain PUFA are presented. Food consumption data (based on parentally reported 3 d dietary records obtained from October 2002 to February 2003) of 661 children (338 boys, 323 girls) between 2·5 and 6·5 years of age and the PUFA concentrations obtained from various food composition databases were used. The actual PUFA intake levels were compared to Belgian, European and American recommendations. Only the intake of linoleic acid (LA) fell within the recommended ranges. Margarine, bread, biscuits and chocolate products contributed most to LA intake. The intake of α-linolenic acid (LNA) was low compared to the recommendations and was obtained mostly from the consumption of margarines and fatty sauces. This resulted in a high LA/LNA ratio. The intake of all long-chain PUFA was far below the recommended levels. Meat and meat products were the most important sources of arachidonic acid. Consumption of fish and other seafood was very low, though these were the most important sources of long-chain n-3 PUFA. In conclusion, Flemish pre-school children should consume more n-3-rich products in order to increase their LNA intake and decrease their LA/LNA ratio. Furthermore, the replacement of meat products rich in SFA by poultry would increase the arachidonic acid intake. As well, fatty fish consumption needs to be increased, as it is a rich source of long-chain n-3 PUFA.
Theological Reflections on the Place of the Sacred in Society
- John Inge
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- Journal:
- Ecclesiastical Law Journal / Volume 7 / Issue 35 / July 2004
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- 31 July 2008, pp. 380-404
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- July 2004
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This paper attempts an overview of currents of theological thinking on the place of the sacred in society. It considers the long tradition of active engagement between Church and State, which derives its authority from the New Testament and can be traced through St Augustine and Anglican Divines to the present day. Having examined contemporary arguments of those who question the propriety of such an arrangement it concludes that it remains theologically justifiable. The paper then turns to the particular question of the Establishment of the Church of England and engages both with those who support it and those who are in favour of disestablishment. It observes that Establishment functions at various levels in English society and, whilst acknowledging and welcoming the fact that its form will continue to change, argues that it offers distinct advantages to both Church and State. In a country where seventy-one per cent of the population professes itself to be Christian it gives the state legitimacy by reminding the latter that all authority derives from God and ensures that Christian influence for the maintenance of a just and peaceful society remains strong. Establishment reminds the Church that it has a responsibility to the whole nation, not just those who regularly attend its churches, and protects the mission and ministry of the Church throughout the parishes of the land.
Looking Backward, Looking Forward: MLA Members Speak
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 115 / Issue 7 / December 2000
- Published online by Cambridge University Press:
- 23 October 2020, pp. 1986-2078
- Print publication:
- December 2000
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