Meat consumption after disaggregation of meat dishes in a cohort of British adults in 1989 and 1999 in relation to diet quality

Objectives—The aim of the study was to quantify more precisely the meat intake of a cohort of adults in the UK by disaggregating composite meat dishes. Subjects/Methods—Subjects were members of the MRC National Survey of Health and Development, 1946 birth cohort. Five-day diaries were collected from 2256 men and women in 1989 and 1772 men and women in 1999. From the details provided, composite meat dishes were broken down into their constituent parts and the meat fraction added to meat only portions. Meat intake was classified as red meat, processed meat and poultry. Results—Meat consumption without disaggregation of meat dishes resulted in a mean overestimation of 50% in men and 33% in women. Red meat consumption fell between 1989 and 1999 from 51.7 to 41.5g/day in men and 35.7 to 30.1g/day in women. Poultry consumption rose from 21.6 to 32.2g./day in men and 18.2 to 29.4 g/day in women. Re-calculating red meat intakes resulted in the percentage of subjects in 1999 consuming more the recommendation of the World Cancer Research Fund falling from 30% to 12 %. Increasing consumption of red and processed meat was associated with increased intakes of energy, fat, haem iron, zinc and vitamin B12 and lower intake of fibre. Increased sodium intake was associated with increased consumption of processed meat. Conclusions—Disaggregation of meat dishes provided a more precise estimate of meat consumption. The quantity of red or processed meat in the diet was reflected in the nutrient content of the entire diet

Consumption of red or processed meat does not predict risk factors for coronary heart disease; results from a cohort of British adults in 1989 and 1999

Objectives—To investigate whether a high consumption of red or processed meat is associated with increased risk of coronary heart disease. Subjects/Methods—The subjects were 517 men and 635 women who were members of the Medical Research Council National Survey of Health and Development, 1946 birth cohort. Assessment of diet was carried out at two time-points 1989 and 1999 with outcome measures collected in 1999. Food intake data were recorded in 5 -day diaries. Meat consumption was estimated by adding individual meat portions to the meat fractions of composite dishes. Results—There was no significant association between red or processed meat consumption in 1989 and 1999 and serum cholesterol concentrations and blood pressure measured in 1999. The combined intake of red and processed meat in 1999 had a significant positive association with blood pressure in men only. Red and processed meat intakes in 1989 separately and combined had a significant positive association with waist circumference in 1999: a 10g increase in red meat consumption accounted for a 0.3cm increase in waist circumference; p=0.04 (men), 0.05 (women). Conclusions—Consumption of red or processed meat assessed separately was not related to the major risk factors for CHD but did contribute to increased waist circumference that has also been identified as a risk factor

Insights from the supplementary motor area syndrome in balancing movement initiation and inhibition

The supplementary motor area syndrome is a characteristic neurosurgical syndrome that can occur after unilateral resection of the supplementary motor area. Clinical symptoms may vary from none to a global akinesia, predominantly on the contralateral side, with preserved muscle strength, and mutism. A remarkable feature is that these symptoms completely resolve within weeks to months, leaving only a disturbance in alternating bimanual movements. In this review we give an overview of the old and new insights from the supplementary motor area syndrome and extrapolate these findings to seemingly unrelated diseases and symptoms such as Parkinson’s disease and tics. Furthermore, we integrate findings from lesion, stimulation and functional imaging studies to provide insight in the motor function of the supplementary motor area

Emotion Recognition in Patients with Low-Grade Glioma before and after Surgery

Research on patients with low-grade gliomas (LGGs) showed neurocognitive impairments in various domains. However, social cognition has barely been investigated. Facial emotion recognition is a vital aspect of social cognition, but whether emotion recognition is affected in LGG patients is unclear. Therefore, we aimed to investigate the effect of LGG and resection by examining emotion recognition pre- and postoperatively. Additionally, the relationships among emotion recognition and general cognition and tumor location were investigated. Thirty patients with LGG who underwent resective surgery were included and matched with 63 healthy control participants (HCs). Emotion recognition was measured with the Facial Expressions of Emotion–Stimuli and Tests (FEEST) and general cognition with neuropsychological tests. Correlations and within-group and between-group comparisons were calculated. Before surgery, patients performed significantly worse than the HCs on FEEST-Total and FEEST-Anger. Paired comparisons showed no significant differences between FEEST scores before and post-surgery. No significant correlations with general cognition and tumor location were found. To conclude, the results of this study indicate that the tumor itself contributes significantly to social cognitive dysfunction and that surgery causes no additional deficit. Impairments were not related to general cognitive deficits or tumor location. Consequently, incorporating tests for emotion recognition into the neuropsychological assessment of patients with LGG is important

Understanding communication pathways to foster community engagement for health improvement in North West Pakistan

Background: This paper describes the community engagement process undertaken to ascertain the focus, development and implementation of an intervention to improve iodised salt consumption in rural communities in North West Pakistan. The Jirga is a traditional informal structure, which gathers men respected within their community and acts in a governing and decision making capacity in the Pukhtoon culture. The Jirga system had a dual purpose for the study; to access men from the community to discuss the importance of iodised salt, and as an engagement process for the intervention. Methods: A number of qualitative data collection activities were undertaken, with Jirga members and their wives, male and female outreach workers and two groups of women, under and over forty years old. The aim of these were to highlight the communication channels and levers of influence on health behaviour, which were multiple and complex and all needed to be taken into consideration in order to ensure successful and locally sensitive community engagement. Results: Communication channels are described within local families and the communities around them. The key influential role of the Jirga is highlighted as linked both to the standing of its members and the community cohesion ethos that it embodies. Engaging Jirga members in discussions about iodised salt was key in designing an intervention that would activate the most influential levers to decision making in the community. Gendered decision making-processes within the household have been highlighted as restricting women’s autonomy. Whilst in one respect our data confirm this, a more complex hierarchy of decisional power has been highlighted, whereby the concept of ‘wisdom’, an amalgamation of age, experience and education, presents important possibilities. Community members with the least autonomy are the youngest uneducated females, who rely on a web of socially and culturally determined ways to influence decision-making. Conclusions: The major lines of communication and influence in the local community described are placed within the wider literature on community engagement in health improvement. The process of maximisation of local cultural knowledge as part of a community engagement effort is one that has application well beyond the particular setting of this study

Evaluation Design for Community-Based Physical Activity Programs for Socially Disadvantaged Groups: Communities on the Move

Background: As interventions are not yet successful in substantially improving physical activity levels of low socioeconomic status groups in the Netherlands, it is a challenge to undertake more effective interventions. Participatory community-based physical activity interventions such as Communities on the Move (CoM) seem promising. Evaluating their effectiveness, however, calls for appropriate evaluation approaches. Objective: This paper provides the conceptual model for the development of a context-sensitive monitoring and evaluation approach in order to (1) measure the effectiveness and cost-effectiveness of CoM, and (2) develop an evaluation design enabling the identification of underlying mechanisms which explain what works and why in community-based physical activity programs. Methods: A cohort design is proposed, based on multiple cases, measuring impact, processes, and changes at each of the distinguished levels. The methods described in this paper will evaluate both short- and long-term effects, costs, and benefits of CoM. Results: Testing of the proposed model began in October 2012 and is on-going. Conclusions: The design offers a valid research strategy for evaluating the effectiveness of community-based physical activity programs. Internal validity is guaranteed by the use of several verification techniques such as triangulation. The multiple case studies at the program and community levels enhance external validit

Gezonde snacks:De kunst van het verleiden

In de jaren tachtig en negentig van de vorige eeuw zijn de fysieke en sociale determinanten van gezondheid door de Canadese Minister Marc Lalonde en de WHO op de kaart gezet [1, 2]. Sindsdien is de aandacht voor de fysieke en sociale omgeving als belangrijke determinant van gezondheid sterk toegenomen door het groeiende inzicht dat alleen aandacht voor individuele leefstijl en gedrag niet tot de gewenste verandering in gezondheid leidt. Een omgeving die de keuze voor gezond gedrag makkelijker maakt – making the healthy choice, the easy choice – is een belangrijke voorwaarde voor gezond gedrag. Andere voordelen die samengaan met het veranderen van de omgeving zijn onder meer dat het een positief effect kan hebben op gedragsverandering zonder dat er sprake is van blaming the victim, dat er mogelijk groepen bereikt worden die anders niet of moeilijk te bereiken zijn en dat de veranderingen in de omgeving van lange duur zijn, en daardoor mogelijk (kosten)effectiever [3]

Between-hospital variation in mortality and survival after glioblastoma surgery in the Dutch Quality Registry for Neuro Surgery

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The SAFE-trial:Safe surgery for glioblastoma multiforme: Awake craniotomy versus surgery under general anesthesia. Study. protocol for a multicenter prospective randomized controlled trial

Background: Surgery of GBM nowadays is usually performed under general anesthesia (GA) and resections are often not as aggressive as possible, due to the chance of seriously damaging the patient with a rather low life expectancy. A surgical technique optimizing resection of the tumor in eloquent areas but preventing neurological deficits is necessary to improve survival and quality of life in these patients. Awake craniotomy (AC) with the use of cortical and subcortical stimulation has been widely implemented for low-grade glioma resections (LGG), but not yet for GBM. AC has shown to increase resection percentage and preserve quality of life in LGG and could thus be of important value in GBM surgery. Methods/design: This study is a prospective, multicenter, randomized controlled trial (RCT). Consecutive patients with a glioblastoma in or near eloquent areas (Sawaya grading II/III) will be 1:1 randomized to awake craniotomy or craniotomy under general anesthesia. 246 patients will be included in neurosurgical centers in the Netherlands and Belgium. Primary end-points are: 1) Postoperative neurological morbidity and 2) Proportion of patients with gross-total resections. Secondary end-points are: 1) Health-related quality of life; 2) Progression-free survival (PFS); 3) Overall survival (OS) and 4) Frequency and severity of Serious Adverse Effects in each group. Also, a cost-benefit analysis will be performed. All patients will receive standard adjuvant treatment with concomitant chemoradiotherapy. Discussion: This RCT should demonstrate whether AC is superior to craniotomy under GA on neurological morbidity, extent of resection and survival for glioblastoma resections in or near eloquent areas. Trial registration: Clinicaltrials.gov: NCT03861299 Netherlands Trial Register (NTR): NL758