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A large proportion of older adults are affected by impaired glucose metabolism. Previous studies with fish protein have reported improved glucose regulation in healthy adults, but the evidence in older adults is limited. Therefore, we wanted to assess the effect of increasing doses of a cod protein hydrolysate (CPH) on postprandial glucose metabolism in older adults. The study was a double-blind cross-over trial. Participants received four different doses (10, 20, 30 or 40 mg/kg body weight (BW)) of CPH daily for 1 week with 1-week washout periods in between. The primary outcome was postprandial response in glucose metabolism, measured by samples of serum glucose and insulin in 20 min intervals for 120 min. The secondary outcome was postprandial response in plasma glucagon-like peptide 1 (GLP-1). Thirty-one subjects aged 60–78 years were included in the study. In a mixed-model statistical analysis, no differences in estimated maximum value of glucose, insulin or GLP-1 were observed when comparing the lowest dose of CPH (10 mg/kg BW) with the higher doses (20, 30 or 40 mg/kg BW). The estimated maximum value of glucose was on average 0·28 mmol/l lower when the participants were given 40 mg/kg BW CPH compared with 10 mg/kg BW (P = 0·13). The estimated maximum value of insulin was on average 5·14 mIU/l lower with 40 mg/kg BW of CPH compared with 10 mg/kg BW (P = 0·20). Our findings suggest that serum glucose and insulin levels tend to decrease with increasing amounts of CPH. Due to preliminary findings, the results require further investigation.
The Salkovskis (1999) model of obsessive compulsive disorder (OCD), which emphasizes the role of inflated responsibility, has proven highly influential in both the understanding and treatment of OCD.
This study aimed to empirically test several core processes of this model.
The individual components of the model were measured using multiple indicators in a sample of undergraduate students (n = 170), and confirmatory factor analyses were used to ascertain the most reliable, valid and theoretically consistent latent variables. Structural equation modelling was used to test proposed relations between latent constructs in the model.
The inflated responsibility model was a good fit for the data in the present sample. As predicted by the model, misinterpretations of intrusive thoughts as indicating personal responsibility fully mediated the relationships between responsibility beliefs and counterproductive safety strategies, neutralizing actions and mood changes.
The Salkovksis (1999) inflated responsibility model of OCD is empirically supported in the present sample of undergraduate students, lending support to the proposed mechanisms in the model and supporting prior evidence.
Stictococcus vayssierei is a major pest of root and tuber crops in central Africa. However, data on its ecology are lacking. Here we provide an updated estimate of its distribution with the aim of facilitating the sustainable control of its populations. Surveys conducted in nine countries encompassing 13 ecological regions around the Congo basin showed that African root and tuber scale was present in Cameroon, Central African Republic, Congo, Democratic Republic of Congo, Equatorial Guinea, Gabon and Uganda. It was not found on the sites surveyed in Chad and Nigeria. The pest occurred in the forest and the forest-savannah mosaic as well as in the savannah where it was never recorded before. However, prevalence was higher in the forest (43.1%) where cassava was the most infested crop, compared to the savannah (9.2%) where aroids (cocoyam and taro) were the most infested crops. In the forest habitat, the pest was prevalent in all but two ecological regions: the Congolian swamp forests and the Southern Congolian forest-savanna mosaic. In the savannah habitat, it was restricted to the moist savannah highlands and absent from dry savannahs. The scale was not observed below 277 m asl. Where present, the scale was frequently (87.1% of the sites) attended by the ant Anoplolepis tenella. High densities (>1000 scales per plant) were recorded along the Cameroon–Gabon border. Good regulatory measures within and between countries are required to control the exchange of plant materials and limit its spread. The study provides information for niche modeling and risk mapping.
The Foodborne Diseases Active Surveillance Network (FoodNet) conducts population-based surveillance for Campylobacter infection. For 2010 through 2015, we compared patients with Campylobacter jejuni with patients with infections caused by other Campylobacter species. Campylobacter coli patients were more often >40 years of age (OR = 1·4), Asian (OR = 2·3), or Black (OR = 1·7), and more likely to live in an urban area (OR = 1·2), report international travel (OR = 1·5), and have infection in autumn or winter (OR = 1·2). Campylobacter upsaliensis patients were more likely female (OR = 1·6), Hispanic (OR = 1·6), have a blood isolate (OR = 2·8), and have an infection in autumn or winter (OR = 1·7). Campylobacter lari patients were more likely to be >40 years of age (OR = 2·9) and have an infection in autumn or winter (OR = 1·7). Campylobacter fetus patients were more likely male (OR = 3·1), hospitalized (OR = 3·5), and have a blood isolate (OR = 44·1). International travel was associated with antimicrobial-resistant C. jejuni (OR = 12·5) and C. coli (OR = 12) infections. Species-level data are useful in understanding epidemiology, sources, and resistance of infections.
The World Health Organization (WHO)’s Mental Health Atlas series has established itself as the single most comprehensive and most widely used source of information on the global mental health situation. The data derived from the latest Mental Health Atlas survey carried out in 2014 describes the availability and delivery of mental health services in the WHO's Member States, focussing on differences by country's income level.
The data contained in this paper are mainly derived from questions relating to mental health service availability and uptake, as well as on financial and human resources for mental health. Results are presented as median values and analysed by World Bank income group. Interquartile ranges are also provided as measures of statistical dispersion.
In total, 171 out of WHO's 194 Member States were able to at least partially complete the Atlas questionnaire. The results highlight a wide gap between high and low-medium income countries in a number of areas: for example, high-income countries have 20 times more beds in community-based inpatient units and 30 times more admissions; the rate of patients cared by outpatient facilities is 40 times higher; and there are 66 times more community outpatient contacts and 15 times more mental health staff at outpatient level. Overall resources for mental health are not distributed efficiently: globally about 60% of financial resources and over two-thirds of all available mental health staff are concentrated in mental hospitals, which serve only a small proportion of patients. Results indicate that outpatient care is the only effective means of increasing the coverage for mental disorders and is expanding, but it is strongly influenced by country income level. Two elements of the network of mental health facilities are particularly scarce in low- and middle-income countries: day treatment facilities and community residential facilities.
The WHO Mental Health Atlas 2014 survey provides basic mental health information at the level of WHO's Member States, concerning mental health resources and activities. Atlas promotes the use of information, usually underestimated not only in low- and middle-income countries but also in high-income countries. Information is needed not only for monitoring the scaling up of the mental health system at country level, but also for improving transparency and accountability for users, families and the public.
A wide range of Arthurian material is discussed here, reflecting its diversity, and enduring vitality. Geoffrey of Monmouth's best-selling Historia regum Britannie is discussed in the context of Geoffrey's reception in Wales and the relationship between Latin and Welsh literary culture. Two essays deal with the Middle English Ywain and Gawain: the first offers a comparative study of the Middle English poem alongside Chrétien's Yvain and the Welsh Owein, while the second considers Ywain and Gawain with the Alliterative Morte Arthure in their northern English cultural and political context, the world of the Percys and the Nevilles. It is followed by a discussion of Edward III's recuperation of his abandoned Order of the Round Table, which offers an intriguing explanation for this reversal in the context of Edward's victory over the French at Poitiers. The final essay is a comparison of fifteenth- and twentieth-century portrayals of Camelot in Malory and T.H. White, as both idea and locale, and a centre of hearsay and gossip. The volume is completed with a unique and little-known medieval Greek Arthurian poem, presented in facing-page edition and modern English translation.
Elizabeth Archibald is Professor of English Studies at Durham University, and Principal of St Cuthbert's Society; David F. Johnson is Professor of English at Florida State University, Tallahassee.
Contributors: Christopher Berard, Louis J. Boyle, Thomas H. Crofts, Ralph Hanna, Georgia Lynn Henley, Erich Poppe
This volume of Arthurian Literature ranges from the reception of Geoffrey of Monmouth in Wales to the Camelot of T. H. White. Georgia Henley discusses Latin literary culture in medieval Wales, evaluating the intellectual and literary context in which Geoffrey of Monmouth's seminal Historia regum Britanniae was received. She makes the case for discarding the binary distinction of ‘Welsh vs Latin’ in favour of a view of medieval Wales as a multilingual culture in which Latin and Welsh existed side-by-side and the classical tradition had a significant influence on Welsh literature.
We are pleased to be able to publish a revised version of Prof. Erich Poppe's 2016 O'Donnell Lecture in Celtic Studies, in which he shines a bright comparative light (in terms of both plot and lexis) on Chrétien's Ivain, the Middle English Ywain and Gawain and the Middle Welsh Owein, otherwise known as Chwedyl Iarlles y Ffynnawn (The Tale of the Lady of the Well / Countess of the Spring). In his reading of these poems, Poppe effectively demonstrates Peter Clemoes’ axiom that to read ‘Medieval Welsh literature alongside that of Middle English’ is to recognize how great a debt English literature owes to the Celtic tradition for its Arthurian inspirations.
Christopher Berard returns to the subject of Edward III's abandoned Order of the Round Table to argue that, while Edward's ‘un-Arthurian’ tactics at Crécy made his association with the legendary king problematic, his victory at Poitiers and the capture of the flower of French knighthood – and of Jean II of France himself – rendered that association apt once more. Portraying himself as an Arthurian ‘King of Kings’ enabled Edward to negotiate a treaty with, and seek ransom for, the French king without undermining his own claim to that throne.
Ralph Hanna considers Ywain and Gawain and the Alliterative Morte Arthure in the cultural and political context of the turbulent history of the borders and of two great northern families, the Percys and the Nevilles. In spite of the popular image of the ‘uncouth / violent North’, he argues that northern romances diverge from the popular insular pattern of usurpation, exile and return, focusing instead on more domestic themes and on ‘the failure of mere martial prowess to offer meaningful achievement’. He sees Ywain and Gawain as a response to criticism of romance in texts such as Cursor mundi, stressing the importance of both time and ‘trowth’.
Amazonian white-sand vegetation has unique tree communities tolerant to nutrient-poor soils of interest for interpreting processes of adaptation in neotropical forests. Part of this phytophysionomy is confined to Late Quaternary megafan palaeo-landforms, thus we posit that sedimentary disturbance is the main ecological factor controlling tree distribution and structuring in this environment. In this study, we characterize the topographic trend of one megafan palaeo-landform using a digital elevation model and verify its relationship to the forest by modelling the canopy height with remote sensing data. We also compare the composition and structure (i.e. canopy height and diameter at breast height) of tree groups from the outer and inner megafan environments based on the integration of remote sensing and floristic data. The latter consist of field inventories of trees ≥ 10 cm dbh using six (500 × 20 m) plots in várzea, terra firme and igapó from the outer megafan and 20 (50 × 20 m) plots in woodlands and forests from the inner megafan. The unweighted pair group method with arithmetic mean (UPGMA) and the non-metric multidimensional scaling (NMDS) were applied for clustering and dissimilarity analyses, respectively. The megafan is a sand-dominated triangular wetland with a topographic gradient of < 15 cm km−1, being more elevated along its axis. The outer megafan has a higher number of tree species (367), taller canopy height (mean of 14.1 m) and higher diameter at breast height (mean of 18.2 cm) than the white-sand forest. The latter records 89 tree species, mean canopy height of 8.4 cm and mean diameter at breast height of 15.3 cm. Trees increase in frequency closer to channels and toward the megafan's axis. The flooded and nutrient-poor sandy megafan substrate favoured the establishment of white-sand vegetation according to the overall megafan topography and morphological heterogeneities inherent to megafan sub-environments.
Cognitive dysfunction is common in major depressive disorder (MDD) and a critical determinant of health outcome. Anhedonia is a criterion item toward the diagnosis of a major depressive episode (MDE) and a well-characterized domain in MDD. We sought to determine the extent to which variability in self-reported cognitive function correlates with anhedonia.
A post hoc analysis was conducted using data from (N=369) participants with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR)-defined diagnosis of MDD who were enrolled in the International Mood Disorders Collaborative Project (IMDCP) between January 2008 and July 2013. The IMDCP is a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, Canada, and the Cleveland Clinic, Cleveland, Ohio. Measures of cognitive function, anhedonia, and depression severity were analyzed using linear regression equations.
A total of 369 adults with DSM-IV-TR–defined MDD were included in this analysis. Self-rated cognitive impairment [ie, as measured by the Adult ADHD Self-Report Scale (ASRS)] was significantly correlated with a proxy measure of anhedonia (r=0.131, p=0.012). Moreover, total depression symptom severity, as measured by the total Montgomery–Åsberg Depression Rating Scale (MADRS) score, was also significantly correlated with self-rated measures of cognitive dysfunction (r=0.147, p=0.005). The association between anhedonia and self-rated cognitive dysfunction remained significant after adjusting for illness severity (r=0.162, p=0.007).
These preliminary results provide empirical data for the testable hypothesis that anhedonia and self-reported cognitive function in MDD are correlated yet dissociable domains. The foregoing observation supports the hypothesis of overlapping yet discrete neurobiological substrates for these domains.