88 results
Degree of adherence to plant-based diet and total and cause-specific mortality: prospective cohort study in the Million Veteran Program
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- Dong D Wang, Yanping Li, Xuan-Mai T Nguyen, Rebecca J Song, Yuk-Lam Ho, Frank B Hu, Walter C Willett, Peter Wilson, Kelly Cho, J Michael Gaziano, Luc Djoussé
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 2 / February 2023
- Published online by Cambridge University Press:
- 21 March 2022, pp. 381-392
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Objective:
To examine the association between adherence to plant-based diets and mortality.
Design:Prospective study. We calculated a plant-based diet index (PDI) by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful PDI (hPDI) and an unhealthful PDI (uPDI) by further separating the healthy plant foods from less-healthy plant foods.
Setting:The VA Million Veteran Program.
Participants:315 919 men and women aged 19–104 years who completed a FFQ at the baseline.
Results:We documented 31 136 deaths during the follow-up. A higher PDI was significantly associated with lower total mortality (hazard ratio (HR) comparing extreme deciles = 0·75, 95 % CI: 0·71, 0·79, Ptrend < 0·001]. We observed an inverse association between hPDI and total mortality (HR comparing extreme deciles = 0·64, 95 % CI: 0·61, 0·68, Ptrend < 0·001), whereas uPDI was positively associated with total mortality (HR comparing extreme deciles = 1·41, 95 % CI: 1·33, 1·49, Ptrend < 0·001). Similar significant associations of PDI, hPDI and uPDI were also observed for CVD and cancer mortality. The associations between the PDI and total mortality were consistent among African and European American participants, and participants free from CVD and cancer and those who were diagnosed with major chronic disease at baseline.
Conclusions:A greater adherence to a plant-based diet was associated with substantially lower total mortality in this large population of veterans. These findings support recommending plant-rich dietary patterns for the prevention of major chronic diseases.
Excess dietary fructose does not alter gut microbiota or permeability in humans: A pilot randomized controlled study
- José O. Alemán, Wendy A. Henderson, Jeanne M. Walker, Andrea Ronning, Drew R. Jones, Peter J. Walter, Scott G. Daniel, Kyle Bittinger, Roger Vaughan, Robert MacArthur, Kun Chen, Jan L. Breslow, Peter R. Holt
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- Journal:
- Journal of Clinical and Translational Science / Volume 5 / Issue 1 / 2021
- Published online by Cambridge University Press:
- 14 June 2021, e143
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Introduction:
Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of chronic liver disease that accompanies obesity and the metabolic syndrome. Excess fructose consumption can initiate or exacerbate NAFLD in part due to a consequence of impaired hepatic fructose metabolism. Preclinical data emphasized that fructose-induced altered gut microbiome, increased gut permeability, and endotoxemia play an important role in NAFLD, but human studies are sparse. The present study aimed to determine if two weeks of excess fructose consumption significantly alters gut microbiota or permeability in humans.
Methods:We performed a pilot double-blind, cross-over, metabolic unit study in 10 subjects with obesity (body mass index [BMI] 30–40 mg/kg/m2). Each arm provided 75 grams of either fructose or glucose added to subjects’ individual diets for 14 days, substituted isocalorically for complex carbohydrates, with a 19-day wash-out period between arms. Total fructose intake provided in the fructose arm of the study totaled a mean of 20.1% of calories. Outcome measures included fecal microbiota distribution, fecal metabolites, intestinal permeability, markers of endotoxemia, and plasma metabolites.
Results:Routine blood, uric acid, liver function, and lipid measurements were unaffected by the fructose intervention. The fecal microbiome (including Akkermansia muciniphilia), fecal metabolites, gut permeability, indices of endotoxemia, gut damage or inflammation, and plasma metabolites were essentially unchanged by either intervention.
Conclusions:In contrast to rodent preclinical findings, excess fructose did not cause changes in the gut microbiome, metabolome, and permeability as well as endotoxemia in humans with obesity fed fructose for 14 days in amounts known to enhance NAFLD.
Between the city and the farm: food environments in artisanal mining communities in Upper Guinea
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- Stella Nordhagen, Mohamed L Fofana, Alpha O Barry, Sadio Diallo, Joseph L Songbono, Ronald Stokes-Walters, Laetitia X Zhang, Rolf Klemm, Peter J Winch
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- Journal:
- Public Health Nutrition / Volume 25 / Issue 2 / February 2022
- Published online by Cambridge University Press:
- 12 May 2021, pp. 368-380
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Objective:
Artisanal and small-scale mining (ASM) is a widespread livelihood in low- and middle-income countries; however, many in ASM communities face high levels of poverty and malnutrition. The food environments in ASM communities have non-agricultural rural characteristics that differ from those in urban and agricultural rural areas examined in much existing food environment literature.
Design:We examine these complex external and personal food environments in ASM communities via a study using qualitative and quantitative methods. Market surveys and a cross-sectional household survey, plus qualitative mining site non-participant observations and in-depth structured interviews, were conducted in three waves.
Setting:Eighteen study sites in ASM communities in northern Guinea.
Participants:Surveys covered mothers in mining households with young children (n 613); in-depth interviews engaged caregivers of young children (n 45), food vendors (n 40) and young single miners (n 15); observations focused on mothers of young children (n 25).
Results:The external food environment in these ASM communities combines widespread availability of commercially processed and staple-heavy foods with lower availability and higher prices for more nutritious, non-staple foods. Within the personal food environment, miners are constrained in their food choices by considerable variability in daily cash income and limited time for acquisition and preparation.
Conclusions:We demonstrate that ASM communities have characteristics of both urban and rural populations and argue for greater nuance and appreciation of complexity in food environment research and resultant policy and programming.
Sustaining University Operations During the COVID-19 Pandemic
- Benjamin J. Ryan, Michael P. Muehlenbein, Jon Allen, Joshua Been, Kenneth Boyd, Mark Brickhouse, Bryan W. Brooks, Matthew Burchett, C. Kevin Chambliss, Jason D. Cook, Adam Ecklund, Lori Fogleman, Peter Granick, Sharra Hynes, Tonya Hudson, Michelle Huse, Micah Lamb, Tiffany Lowe, Jim Marsh, Niesha Nixon, Dennis Nolan, George Nuñez, Walter “Sparky” Matthews, Sharon Stern, Meaghann Wheelis, Nancy Brickhouse
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 16 / Issue 5 / October 2022
- Published online by Cambridge University Press:
- 08 March 2021, pp. 1901-1909
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Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.
Examining pathways between genetic liability for schizophrenia and patterns of tobacco and cannabis use in adolescence
- Hannah J. Jones, Gemma Hammerton, Tayla McCloud, Lindsey A. Hines, Caroline Wright, Suzanne H. Gage, Peter Holmans, Peter B Jones, George Davey Smith, David E. J. Linden, Michael C. O'Donovan, Michael J. Owen, James T. Walters, Marcus R. Munafò, Jon Heron, Stanley Zammit
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- Journal:
- Psychological Medicine / Volume 52 / Issue 1 / January 2022
- Published online by Cambridge University Press:
- 09 June 2020, pp. 132-139
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Background
It is not clear to what extent associations between schizophrenia, cannabis use and cigarette use are due to a shared genetic etiology. We, therefore, examined whether schizophrenia genetic risk associates with longitudinal patterns of cigarette and cannabis use in adolescence and mediating pathways for any association to inform potential reduction strategies.
MethodsAssociations between schizophrenia polygenic scores and longitudinal latent classes of cigarette and cannabis use from ages 14 to 19 years were investigated in up to 3925 individuals in the Avon Longitudinal Study of Parents and Children. Mediation models were estimated to assess the potential mediating effects of a range of cognitive, emotional, and behavioral phenotypes.
ResultsThe schizophrenia polygenic score, based on single nucleotide polymorphisms meeting a training-set p threshold of 0.05, was associated with late-onset cannabis use (OR = 1.23; 95% CI = 1.08,1.41), but not with cigarette or early-onset cannabis use classes. This association was not mediated through lower IQ, victimization, emotional difficulties, antisocial behavior, impulsivity, or poorer social relationships during childhood. Sensitivity analyses adjusting for genetic liability to cannabis or cigarette use, using polygenic scores excluding the CHRNA5-A3-B4 gene cluster, or basing scores on a 0.5 training-set p threshold, provided results consistent with our main analyses.
ConclusionsOur study provides evidence that genetic risk for schizophrenia is associated with patterns of cannabis use during adolescence. Investigation of pathways other than the cognitive, emotional, and behavioral phenotypes examined here is required to identify modifiable targets to reduce the public health burden of cannabis use in the population.
The temperature- and density-dependent acoustic emission response of snow in monoaxial compression tests
- Carlo Scapozza, Felix Bucher, Peter Amann, Walter J. Ammann, Perry Bartelt
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- Journal:
- Annals of Glaciology / Volume 38 / 2004
- Published online by Cambridge University Press:
- 14 September 2017, pp. 291-298
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Results of acoustic emission tests on cylindrical specimens under compression are reported. Deformation-rate-controlled tests with strain rates ranging from 1.1 × 10-6 s-1 to 2.6 × 10-3 s-1 at temperatures between T = -11.2°Cand T = -1.7°C were performed. The investigated snow was fine-grained, with a density varying between 220 and 380 kgm-3. The acoustic emission was measured with two distinct piezoelectric sensors: a wide-band sensor (frequency 100–1000 kHz) and a resonant sensor (frequency 35–100 kHz). The relationship between the applied strain rate and the measured maximum acoustic-emission rate as a function of temperature and density was found to obey a power law, which is valid for the ductile behaviour range. The quantitative and qualitative effects produced on the acoustic emissions during the transition from ductile to brittle behaviour, occurring at strain rates of approximately 1 × 10-3 s-1, are reported. Finally, the influence of the load history on the acoustic emissions of snow is discussed on the basis of a cyclic test, including deformation-controlled loading steps and relaxation steps, performed at different strain rates and different relaxation times.
18 - The use of ECT in people with intellectual disability
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- By Peter Cutajar, Nottinghamshire Healthcare NHS Trust, Jo Jones, Nottinghamshire Healthcare NHS Trust, Walter J. Muir, University of Edinburgh
- Edited by Jonathan Waite, Andrew Easton
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- The ECT Handbook
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 166-183
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Summary
Intellectual disability is a descriptive term not a condition in itself and although the number of identifiable disorders that alter neurodevelopment and create an associated intellectual disability is steadily increasing, we are only beginning to understand the many ways in which the altered neural substrate modifies the course and presentation of coexisting psychiatric disorders. Save in the case of relatively common conditions, such as Down syndrome or fragile-X syndrome, studies in intellectual disability usually involve patients with ill-defined, heterogeneous aetiologies grouped on the basis of their degree of intellectual impairment rather than aetiology. It is clear, however, that adults with intellectual disability are susceptible to the whole range of psychiatric disorders seen in the general population. In addition, our understanding of behaviour phenotypes has developed over recent years; this concept has helped us understand some of the links between genetics and behaviour (O'Brien & Yule, 1995).
The term intellectual disability is used throughout this chapter because it has been adopted by the Royal College of Psychiatrists and is used internationally.
The evidence base in this area of ECT use is composed almost entirely of case reports. The limited nature of this evidence, compounded with specific issues regarding diagnosis and consent, partially explains why ECT seems to be used rarely in people with intellectual disability.
Diagnostic issues
Principles of psychiatric assessment in this population are similar to those in general adult and child psychiatry; particular attention is given to the person's level of communication and understanding, developmental history, direct observation and information from informants, as well as the exploration of associated disabilities.
The predominant view is that psychiatric disorder can be reliably diagnosed using standard diagnostic classifications in people with mild intellectual disability (Meins, 1995; Hurley, 2006). However, diagnosis is more difficult in those with a more severe level of intellectual disability. Diagnostic criteria are very much language-based, so they are less relevant to people with significant communication difficulties. It is then much more difficult, if not impossible, to assess cardinal features of psychiatric disorder such as low self-esteem, guilt (Hemmings, 2007), delusions or hallucinations. The presence of intellectual disability will alter the way that signs of psychiatric disorder manifest themselves. Psychiatric diagnosis can be difficult because of the frequent assumption that symptoms could be part of the presentation of the intellectual disability because of ‘diagnostic overshadowing’ (Santosh & Baird, 1999).
Intraventricular Alpha Interferon Therapy for Rasmussen’s Syndrome
- L. Maria Bernard, M. Ringdahl Debbie, J. Parker Mickle, J. Smith Linda, D. Reuman Peter, L. Gilmore Robin, E. Drane Walter, G. Quisling Ronald
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 20 / Issue 4 / November 1993
- Published online by Cambridge University Press:
- 18 September 2015, pp. 333-336
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A 4-year-old boy developed Rasmussen’s syndrome and was treated with alpha interferon intraventricularly. An improvement in the epileptic and neurologic syndrome was noted for several weeks following interferon. No adverse side effects were encountered. Since hemispherectomy is the only established therapy in Rasmussen’s Syndrome, further studies are needed to establish if intraventricular alpha interferon may halt the clinical progression of the syndrome.
The Occurrence of Multiple Sclerosis in the Hutterites of North America
- Walter J. Hader, T. Peter Seland, Mary B. Hader, Colleen J. Harris, Dennis W. Dietrich
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 23 / Issue 4 / November 1996
- Published online by Cambridge University Press:
- 18 September 2015, pp. 291-295
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Objective: To report the occurrence, clinical characteristics and genealogical analysis of multiple sclerosis in the Hutterites of North-Western United States and Western Canada. Background: The incidence of multiple sclerosis is reported to be lower or rare in certain ethnic groups and genetic isolates and was previously observed to be absent in the Hutterite population. Methods: After long-term surveillance, six patients were identified and clinical examinations and laboratory investigations including VER and MRI were completed. Results: The six cases included two brothers, two first cousins, male and female, another male and female, all representing two of the three endogamous groups of Hutterites, are linked to two common ancestors through lines of descent dating to 1723. The individual pedigrees were analyzed from extensive genealogical records covering eight generations. Conclusion: The incidence of multiple sclerosis in Hutterites is low in a high risk area of North America. A specific mode of inheritance pattern has not been established and a common founder effect may play a role in the development of multiple sclerosis. The genetic contribution of the Hutterites seems greater than previously recognized.
Notes on contributors
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- By Margaret Bent, Anna Maria Busse Berger, Lawrence F. Bernstein, Bonnie J. Blackburn, M. Jennifer Bloxam, Philippe Canguilhem, Julie E. Cumming, Anthony M. Cummings, David Fallows, David Fiala, Alison K. Frazier, James Hankins, Leofranc Holford-Strevens, Deborah Howard, Andrew Kirkman, Michael Long, Laurenz Lütteken, Evan A. MacCarthy, Patrick Macey, Honey Meconi, John Milsom, Klaus Pietschmann, Alejandro Enrique Planchart, Yolanda Plumley, Keith Polk, Anne Walters Robertson, Jesse Rodin, David J. Rothenberg, Thomas Schmidt-Beste, Peter Schubert, Nicole Schwindt, Richard Sherr, Pamela F. Starr, Anne Stone, Reinhard Strohm, Richard Taruskin, Blake Wilson, Emily Zazulia
- Edited by Anna Maria Busse Berger, University of California, Davis, Jesse Rodin, Stanford University, California
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- Book:
- The Cambridge History of Fifteenth-Century Music
- Published online:
- 05 July 2015
- Print publication:
- 16 July 2015, pp xix-xxvi
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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- By Rony A. Adam, Gloria Bachmann, Nichole M. Barker, Randall B. Barnes, John Bennett, Inbar Ben-Shachar, Jonathan S. Berek, Sarah L. Berga, Monica W. Best, Eric J. Bieber, Frank M. Biro, Shan Biscette, Anita K. Blanchard, Candace Brown, Ronald T. Burkman, Joseph Buscema, John E. Buster, Michael Byas-Smith, Sandra Ann Carson, Judy C. Chang, Annie N. Y. Cheung, Mindy S. Christianson, Karishma Circelli, Daniel L. Clarke-Pearson, Larry J. Copeland, Bryan D. Cowan, Navneet Dhillon, Michael P. Diamond, Conception Diaz-Arrastia, Nicole M. Donnellan, Michael L. Eisenberg, Eric Eisenhauer, Sebastian Faro, J. Stuart Ferriss, Lisa C. Flowers, Susan J. Freeman, Leda Gattoc, Claudine Marie Gayle, Timothy M. Geiger, Jennifer S. Gell, Alan N. Gordon, Victoria L. Green, Jon K. Hathaway, Enrique Hernandez, S. Paige Hertweck, Randall S. Hines, Ira R. Horowitz, Fred M. Howard, William W. Hurd, Fidan Israfilbayli, Denise J. Jamieson, Carolyn R. Jaslow, Erika B. Johnston-MacAnanny, Rohna M. Kearney, Namita Khanna, Caroline C. King, Jeremy A. King, Ira J. Kodner, Tamara Kolev, Athena P. Kourtis, S. Robert Kovac, Ertug Kovanci, William H. Kutteh, Eduardo Lara-Torre, Pallavi Latthe, Herschel W. Lawson, Ronald L. Levine, Frank W. Ling, Larry I. Lipshultz, Steven D. McCarus, Robert McLellan, Shruti Malik, Suketu M. Mansuria, Mohamed K. Mehasseb, Pamela J. Murray, Saloney Nazeer, Farr R. Nezhat, Hextan Y. S. Ngan, Gina M. Northington, Peggy A. Norton, Ruth M. O'Regan, Kristiina Parviainen, Resad P. Pasic, Tanja Pejovic, K. Ulrich Petry, Nancy A. Phillips, Ashish Pradhan, Elizabeth E. Puscheck, Suneetha Rachaneni, Devon M. Ramaeker, David B. Redwine, Robert L. Reid, Carla P. Roberts, Walter Romano, Peter G. Rose, Robert L. Rosenfield, Shon P. Rowan, Mack T. Ruffin, Janice M. Rymer, Evis Sala, Ritu Salani, Joseph S. Sanfilippo, Mahmood I. Shafi, Roger P. Smith, Meredith L. Snook, Thomas E. Snyder, Mary D. Stephenson, Thomas G. Stovall, Richard L. Sweet, Philip M. Toozs-Hobson, Togas Tulandi, Elizabeth R. Unger, Denise S. Uyar, Marion S. Verp, Rahi Victory, Tamara J. Vokes, Michelle J. Washington, Katharine O'Connell White, Paul E. Wise, Frank M. Wittmaack, Miya P. Yamamoto, Christine Yu, Howard A. Zacur
- Edited by Eric J. Bieber, Joseph S. Sanfilippo, University of Pittsburgh, Ira R. Horowitz, Emory University, Atlanta, Mahmood I. Shafi
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- Book:
- Clinical Gynecology
- Published online:
- 05 April 2015
- Print publication:
- 23 April 2015, pp viii-xiv
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Postprandial plasma betaine and other methyl donor-related responses after consumption of minimally processed wheat bran or wheat aleurone, or wheat aleurone incorporated into bread
- Edel M. Keaveney, Ruth K. Price, Lesley L. Hamill, Julie M. W. Wallace, Helene McNulty, Mary Ward, J. J. Strain, Per M. Ueland, Anne M. Molloy, Vieno Piironen, Walter von Reding, Peter R. Shewry, Jane L. Ward, Robert W. Welch
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- Journal:
- British Journal of Nutrition / Volume 113 / Issue 3 / 14 February 2015
- Published online by Cambridge University Press:
- 13 January 2015, pp. 445-453
- Print publication:
- 14 February 2015
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The bran and particularly the aleurone fraction of wheat are high in betaine and other physiological methyl donors, which may exert beneficial physiological effects. We conducted two randomised, controlled, cross-over postprandial studies to assess and compare plasma betaine and other methyl donor-related responses following the consumption of minimally processed bran and aleurone fractions (study A) and aleurone bread (study B). For both studies, standard pharmacokinetic parameters were derived for betaine, choline, folate, dimethylglycine (DMG), total homocysteine and methionine from plasma samples taken at 0, 0·5, 1, 2 and 3 h. In study A (n 14), plasma betaine concentrations were significantly and substantially elevated from 0·5 to 3 h following the consumption of both bran and aleurone compared with the control; however, aleurone gave significantly higher responses than bran. Small, but significant, increases were also observed in DMG measures; however, no significant responses were observed in other analytes. In study B (n 13), plasma betaine concentrations were significantly and substantially higher following consumption of the aleurone bread compared with the control bread; small, but significant, increases were also observed in DMG and folate measures in response to consumption of the aleurone bread; however, no significant responses were observed in other analytes. Peak plasma betaine concentrations, which were 1·7–1·8 times the baseline levels, were attained earlier following the consumption of minimally processed aleurone compared with the aleurone bread (time taken to reach peak concentration 1·2 v. 2·1 h). These results showed that the consumption of minimally processed wheat bran, and particularly the aleurone fraction, yielded substantial postprandial increases in plasma betaine concentrations. Furthermore, these effects appear to be maintained when aleurone was incorporated into bread.
Contributors
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- By Ra‘anan Boustan, Jonathan P. Conant, Brian Croke, Susanna Elm, Hugh Elton, Geoffrey Greatrex, Peter J. Heather, Kenneth G. Holum, Caroline Humfress, Scott F. Johnson, Christopher Kelly, Étienne De La Vaissière, Noel Lenski, Michael Maas, Maya Maskarinec, Andy Merrills, Richard Payne, Walter Pohl, Michele Renee Salzman, Joseph E. Sanzo, Peter Sarris, Raymond Van Dam, Edward Watts, Susan Wessel
- Edited by Michael Maas, Rice University, Houston
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- Book:
- The Cambridge Companion to the Age of Attila
- Published online:
- 05 October 2014
- Print publication:
- 29 September 2014, pp xiii-xiv
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Contributors
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- By Federica Agosta, Alberto Albanese, Timothy J. Amrhein, A. M. Barrett, Walter S. Bartynski, Felix Benninger, Thomas Brandt, Andrew G. Burke, Michelle Cameron, Elisa Canu, Louis R. Caplan, Christine M. Carr, Daniel J. A. Connolly, Firouz Daneshgari, John DeLuca, Marianne de Visser, Marianne Dieterich, Antonio E. Elia, Joseph H. Feinberg, Massimo Filippi, Lauren C. Frey, Gaëtan Garraux, Andrea Ginestroni, Peter J. Goadsby, Bronwyn E. Hamilton, Simon J. Hickman, Holly E. Hinson, Jon P. Jennings, Jan Kassubek, Horacio Kaufmann, David M. Kaylie, Joanna Kitley, Vladimir S. Kostic, C. T. Paul Krediet, Megan C. Leary, Farooq H. Maniyar, Ken R. Maravilla, Mario Mascalchi, Rajarshi Mazumder, Priyesh Mehta, Jacqueline A. Palace, Raj M. Paspulati, Christopher A. Potter, Angelo Quattrini, Louis P. Riccelli, Nilo Riva, Maria A. Rocca, Mirabelle B. Sajisevi, Richard Salazar-Montero, Nicholas D. Schiff, Jack H. Simon, Israel Steiner, Carl D. Stevens, Bart P. van de Warrenburg, Judith van Gaalen, William J. Weiner, Jane L. Weissman, Jay Yao, G. Bryan Young
- Edited by Massimo Filippi, Jack H. Simon
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- Book:
- Imaging Acute Neurologic Disease
- Published online:
- 05 October 2014
- Print publication:
- 11 September 2014, pp vi-viii
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Contributors
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- By Britta L. Anderson, Jillian Berkman, Priscila G. Brust-Renck, Kerri L. Cavanaugh, Edward T. Cokely, Stephanie Dukhovny, Angela Fagerlin, Wolfgang Gaissmaier, Rocio Garcia-Retamero, Saima Ghazal, Gillian Mayman, Jan Multmeier, Ronald Paulus, Ellen Peters, Valerie F. Reyna, Jay Schulkin, Peter H. Schwartz, Walter F. Stewart, Odette Wegwarth, Louise Wilkins-Haug, Brian J. Zikmund-Fisher
- Edited by Britta L. Anderson, American College of Obstetricians and Gynecologists, Washington, DC, Jay Schulkin, American College of Obstetricians and Gynecologists, Washington, DC
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- Book:
- Numerical Reasoning in Judgments and Decision Making about Health
- Published online:
- 05 July 2014
- Print publication:
- 12 June 2014, pp xiv-xv
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Contributors
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- By Ioannis P. Androulakis, Djillali Annane, Gérard Audibert, Lisa L. Barnes, Paolo Bartolomeo, Walter S. Bartynski, David A. Bennett, Nicolas Bruder, Nathan E. Brummel, Steve E. Calvano, Alain Cariou, F. Chretien, Jan Claassen, Colm Cunningham, Souhayl Dahmani, Robert Dantzer, Dimitry S. Davydow, Sanjay V. Desai, E. Wesley Ely, Frédéric Faugeras, Karen J. Ferguson, Brandon Foreman, Sadanand M. Gaikwad, Rebecca F. Gottesman, Maura A. Grega, Richard D. Griffiths, Marion Griton, Stefan D. Gurney, Hebah M. Hefzy, Michael T. Heneka, Dustin M. Hipp, Ramona O. Hopkins, Christopher G. Hughes, James C. Jackson, Christina Jones, Peter W. Kaplan, Keith W. Kelley, Raymond C. Koehler, Matthew A. Koenig, Jan Pieter Konsman, Felix Kork, John P. Kress, Stephen F. Lowry, Alawi Luetz, David Luis, Alasdair M. J. MacLullich, Guy M. McKhann, Jean Mantz, Panteleimon D. Mavroudis, Mervyn Maze, Bruno Mégarbane, Lionel Naccache, Dale M. Needham, Pratik P. Pandharipande, Jean-Francois Payen, V. Hugh Perry, Margaret Pisani, C. Rauturier, Benjamin Rohaut, Jennifer Ryan, Robert D. Sanders, Jeremy D. Scheff, Frederic Sedel, Ola A. Selnes, Tarek Sharshar, Martin Siegemund, Yoanna Skrobik, Jamie W. Sleigh, Romain Sonneville, Claudia D. Spies, Luzius A. Steiner, Robert D. Stevens, Raoul Sutter, Fabio Silvio Taccone, Richard E. Temes, Willem A. van Gool, Christel C. Vanbesien, F. Verdonk, Odile Viltart, Julia Wendon, Catherine N. Widmann, Robert S. Wilson
- Edited by Robert D. Stevens, Tarek Sharshar, E. Wesley Ely, Vanderbilt University, Tennessee
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- Book:
- Brain Disorders in Critical Illness
- Published online:
- 05 October 2013
- Print publication:
- 19 September 2013, pp viii-xii
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Contributors
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- By Victoria M. Allen, Frederic Amant, Sarah Armstrong, Thomas F. Baskett, Michael A. Belfort, Meredith Birsner, Renee D. Boss, Leanne Bricker, Josaphat K. Byamugisha, Giorgio Capogna, Michael P. Casaer, Frank A. Chervenak, Vicki Clark, Filip Claus, Malachy O. Columb, Charles Cox, Jean T. Cox, Vegard Dahl, John Davison, Jan Deprest, Clifford S. Deutschman, Roland Devlieger, Karim Djekidel, Steven Dymarkowski, Roshan Fernando, Clare Fitzpatrick, Sreedhar Gaddipati, Thierry Girard, Emily Gordon, Ian A. Greer, David Grooms, Sina Haeri, Katy Harrison, Edward J. Hayes, Michelle Hladunewich, Andra H. James, Tracey Johnston, Bellal Joseph, Erin Keely, Ruth Landau, Stephen E. Lapinsky, Susanna I. Lee, Larry Leeman, Hennie Lombaard, Stephen Lu, Alison MacArthur, Laura A. Magee, Paul E. Marik, Laurence B. McCullough, Alexandre Mignon, Carlo Missant, Jack Moodley, Lisa E. Moore, Kate Morse, Warwick D. Ngan Kee, Catherine Nelson-Piercy, Clemens M. Ortner, Geraldine O’Sullivan, Luis D. Pacheco, Fathima Paruk, Melina Pectasides, Nigel Pereira, Patricia Peticca, Sharon T. Phelan, Felicity Plaat, Lauren A. Plante, Michael P. Plevyak, Dianne Plews, Wendy Pollock, Laura C. Price, Peter Rhee, Leiv Arne Rosseland, Kathryn M. Rowan, Helen Ryan, Helen Scholefield, Neil S. Seligman, Nadir Sharawi, Alex Sia, Bob Silver, Mieke Soens, Ulrich J. Spreng, Silvia Stirparo, Nova Szoka, Andrew Tang, Kha M. Tran, Els Troost, Lawrence C. Tsen, Derek Tuffnell, Kristel Van Calsteren, Marc Van de Velde, Marcel Vercauteren, Chris Verslype, Peter von Dadelszen, Carl Waldman, Michelle Walters, Linda Watkins, Paul Westhead, Cynthia A. Wong, Gerda G. Zeeman, Joost J. Zwart
- Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
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- Book:
- Maternal Critical Care
- Published online:
- 05 July 2013
- Print publication:
- 04 July 2013, pp ix-xiv
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- Edited by Neil Fraistat, University of Maryland, College Park, Julia Flanders, Brown University, Rhode Island
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- Book:
- The Cambridge Companion to Textual Scholarship
- Published online:
- 05 May 2013
- Print publication:
- 09 May 2013, pp x-x
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18 - The use of ECT in people with intellectual disability
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- By Peter Cutajar, Consultant Psychiatrist, Learning Disabilities, Nottinghamshire Healthcare NHS Trust, Jo Jones, Consultant Psychiatrist, Learning Disabilities, Nottinghamshire Healthcare NHS Trust, Walter J. Muir, formerly Reader in the Psychiatry of Learning Disability, Division of Psychiatry, University of Edinburgh
- Edited by Jonathan Waite, Andrew Easton
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- Book:
- The ECT Handbook
- Published online:
- 02 January 2018
- Print publication:
- 01 May 2013, pp 166-183
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Summary
Intellectual disability is a descriptive term not a condition in itself and although the number of identifiable disorders that alter neurodevelopment and create an associated intellectual disability is steadily increasing, we are only beginning to understand the many ways in which the altered neural substrate modifies the course and presentation of coexisting psychiatric disorders. Save in the case of relatively common conditions, such as Down syndrome or fragile-X syndrome, studies in intellectual disability usually involve patients with ill-defined, heterogeneous aetiologies grouped on the basis of their degree of intellectual impairment rather than aetiology. It is clear, however, that adults with intellectual disability are susceptible to the whole range of psychiatric disorders seen in the general population. In addition, our understanding of behaviour phenotypes has developed over recent years; this concept has helped us understand some of the links between genetics and behaviour (O'Brien & Yule, 1995).
The term intellectual disability is used throughout this chapter because it has been adopted by the Royal College of Psychiatrists and is used internationally.
The evidence base in this area of ECT use is composed almost entirely of case reports. The limited nature of this evidence, compounded with specific issues regarding diagnosis and consent, partially explains why ECT seems to be used rarely in people with intellectual disability.
Diagnostic issues
Principles of psychiatric assessment in this population are similar to those in general adult and child psychiatry; particular attention is given to the person's level of communication and understanding, developmental history, direct observation and information from informants, as well as the exploration of associated disabilities.
The predominant view is that psychiatric disorder can be reliably diagnosed using standard diagnostic classifications in people with mild intellectual disability (Meins, 1995; Hurley, 2006). However, diagnosis is more difficult in those with a more severe level of intellectual disability. Diagnostic criteria are very much language-based, so they are less relevant to people with significant communication difficulties. It is then much more difficult, if not impossible, to assess cardinal features of psychiatric disorder such as low self-esteem, guilt (Hemmings, 2007), delusions or hallucinations. The presence of intellectual disability will alter the way that signs of psychiatric disorder manifest themselves. Psychiatric diagnosis can be difficult because of the frequent assumption that symptoms could be part of the presentation of the intellectual disability because of ‘diagnostic overshadowing’ (Santosh & Baird, 1999).