Flemish Women Research Articles

The future burden of type 2 diabetes in Belgium: a microsimulation model

ObjectiveTo forecast the annual burden of type 2 diabetes and related socio-demographic disparities in Belgium until 2030.MethodsThis study utilized a discrete-event transition microsimulation model. A synthetic population was created using 2018 national register data of the Belgian population aged 0–80 years, along with the national representative prevalence of diabetes risk factors obtained from the latest (2018) Belgian Health Interview and Examination Surveys using Multiple Imputation by Chained Equations (MICE) as inputs to the Simulation of Synthetic Complex Data (simPop) model. Mortality information was obtained from the Belgian vital statistics and used to calculate annual death probabilities. From 2018 to 2030, synthetic individuals transitioned annually from health to death, with or without developing type 2 diabetes, as predicted by the Finnish Diabetes Risk Score, and risk factors were updated via strata-specific transition probabilities.ResultsA total of 6722 [95% UI 3421, 11,583] new cases of type 2 diabetes per 100,000 inhabitants are expected between 2018 and 2030 in Belgium, representing a 32.8% and 19.3% increase in T2D prevalence rate and DALYs rate, respectively. While T2D burden remained highest for lower-education subgroups across all three Belgian regions, the highest increases in incidence and prevalence rates by 2030 are observed for women in general, and particularly among Flemish women reporting higher-education levels with a 114.5% and 44.6% increase in prevalence and DALYs rates, respectively. Existing age- and education-related inequalities will remain apparent in 2030 across all three regions.ConclusionsThe projected increase in the burden of T2D in Belgium highlights the urgent need for primary and secondary preventive strategies. While emphasis should be placed on the lower-education groups, it is also crucial to reinforce strategies for people of higher socioeconomic status as the burden of T2D is expected to increase significantly in this population segment.

How follow-up rates in cervical cancer screening depend on organizational factors: A comparison of two population-based organized screening programmes.

This study compares the follow-up rates of non-normal cervical screening samples between Denmark and Flanders (Belgium) to illuminate whether organizational differences between the health systems might affect the follow-up rates, e.g. sending of reminders in Denmark since 2012 compared to Flanders with no such system in place. The study population included 48,082 Danish women and 22,271 Flemish women who received abnormal or inadequate primary screening results from 2014 to 2016. The participants were followed for 24 months, and the timeliness and appropriateness of the recommended follow-up, according to national guidelines, were evaluated. After 18 months over 90% of the Danish women had received some form of follow-up, while in Flanders, this level is achieved only for those who test positive for human papillomavirus. The analysis also revealed that 10-28% of follow-ups were performed too early, with Danish women showing the highest proportions. In both regions, general practitioners (GPs) exhibited better follow-up rates compared to gynaecologists, with gynaecologists displaying a tendency towards earlier re-testing than recommended. An important factor influencing the follow-up rate may be the sending of reminders in Denmark since 2012, as the follow-up rates in general were higher in this period. It is noteworthy that a reminder system is currently being implemented in Flanders and further studies on the potential effects should be studied. Additionally, the organization of the health system might influence the follow-up rate, as engaging the GP for screening in Denmark may have had a positive effect.

What influences women's experiences of childbirth in Flanders? – A quantitative cross-sectional analysis of the Babies Born Better survey

ObjectiveLabour and birth experiences are of great importance since these can have positive, but also negative effects on women's health and wellbeing. This is the first study, which investigated the factors that influence women's experiences of childbirth in Flanders, Belgium. DesignA cross-sectional quantitative analysis was used to examine primary data obtained by the Babies Born Better project. Data collection took place via an online survey from April 2018 until August 2018 in Flanders. Participants1414 women that gave birth across all birth settings between 2013 and 2018, who speak Flemish/Dutch were included. Participants were self-selected by filling out the Babies Born Better survey in 2018. FindingsThe majority of the Flemish women included in this study reported a positive labour and birth experience. Analysis of the demographic variables showed that women who were single or not co-habiting reported a worse experience of labour and birth (P = 0.012). All obstetric factors included showed significant differences (P<0.01). Lastly, women were more likely to report a better experience when birth took place at home or in a midwifery unit and when the main care provider was a midwife (P<0.01). When controlled for significant variables from the univariate analysis, an impact on the birth experience was only found with the obstetric factors. A preterm (OR 0.544, 95%CI 0.362–0.817) and post term birth (OR 0.664, 95% CI 0.462–0.953) were found to reduce the chance of a good experience compared to a birth at term. In case of complications during pregnancy, women were less likely to report having had a good experience (OR 0.632, 95% CI 0.470 – 0.849). Medical interventions such as induction- (OR 0.346, 95% CI 0.241 – 0.497) and augmentation of labour (OR 0.318, 95% CI 0.218–0.463), an instrumental birth (OR 0.318, 95% CI 0.218–0.463) or a planned- (OR 0.349, 95% CI 0.205–0.596) or emergency caesarean section (OR 0.190, 95% CI 0.109–0.329) reduced the chances of women reporting to have had a good experience with care around labour and birth. Key conclusionsThe majority of women included in this study reported a good experience of care during labour and at birth. Certain obstetric factors such as having a straightforward pregnancy without complications, a physiological onset of labour at term without the need for augmentation and to give birth vaginally (without instrument) have shown a positive impact on women's reported birth experiences. Implications for practiceWomen's involvement in decision-making, especially when medical interventions are wanted or needed can improve positive birth experiences. More research is needed on how to support women and empower them, even more so in case of complications to ensure a sense of control and achievement.

Pregnancy-Related Anxiety and Associated Coping Styles and Strategies: A Cross-Sectional Study

BACKGROUND:Pregnancy-related anxiety is a distinct psychological construct during pregnancy, requiring adequate coping behavior.METHOD:A cross-sectional survey was performed among 420 pregnant Dutch-speaking women in Belgium to establish the prevalence rate of pregnancy-related anxiety and to explore its associated coping styles and strategies. Pregnancy-related anxiety was measured with the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R2) and coping was measured with the Brief Coping Orientation to Problems Experienced.FINDINGS:Based on PRAQ-R2 score ≥90th percentile, the pregnancy-related anxiety prevalence rate was 13.3%. Women with heightened scores significantly more often had a (family) history of psychological problems (p= .027,p= .013), were significantly more often nulliparous women (p&lt; .000), had a fear of birth (p= .041), felt ill-prepared for birth and parenthood (p&lt; .000), and significantly more often reported to have received insufficient emotional (p= .002) and practical support (p&lt; .000) during pregnancy. The coping style “avoidance” showed a significant positive association with pregnancy-related anxiety (p&lt; .000), while “positive thinking” showed a significant negative association (p= .054). The coping strategies “self-blame,” “substance use,” and “self-distraction” showed a significant positive association with pregnancy-related anxiety (p&lt; .001,p= .011,p= .003).CONCLUSION:Flemish women show overall maladaptive styles and strategies in coping with pregnancy-related anxiety, of which self-blame seems to be a newfound strategy, requiring attention. Health care practitioners might benefit when being aware of the predisposing factors of pregnancy-related anxiety and women’s (mal)adaptive coping styles and strategies to better understand and adequately support these women.

P-557 Validating the Dutch polycystic ovary syndrome questionnaire (PCOSQ) and the polycystic ovary syndrome quality of life tool (PCOSQOL) in Dutch and Flemish women with PCOS

Abstract Study question What are the test-retest reliability and the domain structures of the Dutch version of the PCOSQ and PCOSQOL in Dutch and Flemish women with PCOS? Summary answer The Dutch version of the PCOSQ and the PCOSQOL are reliable and can both be used to measure health-related quality of life (HRQoL) in PCOS. What is known already The polycystic ovary syndrome questionnaire (PCOSQ) is recommended to measure the quality of life in women with PCOS. The PCOSQ was developed in 1998 to complement generic health-related QoL instruments. The PCOSQ has been validated in Arabic, German, Chinese, and Swedish. Recent research suggested that the PCOSQ focuses on the physical impact of PCOS and that psychological, social, or environmental aspects are less represented. Therefore, the Polycystic Ovary Syndrome Quality Of Life Scale (PCOSQOL) was developed in 2018. Both questionnaires have not been validated in Dutch yet. Study design, size, duration A forward and backward translation was performed on the original English PCOSQ and PCOSQOL by two independent translators. PCOS patients were contacted with a request to complete both questionnaires (and some additional demographic questions) online in their home environment (T0). A test-retest design was applied to demonstrate stability over time by having all women complete the same questionnaires a second time (T1). Approval of the clinic’s Ethics Committee was obtained in both participating centres. Participants/materials, setting, methods Women of at least 18 years old, who were able to speak and write Dutch, and who were diagnosed with PCOS according to the Rotterdam criteria (ESHRE/ASRM, 2003) or according to the international evidence-based guideline for the assessment and management of PCOS (ESHRE, 2018) were eligible for the study. Women who were pregnant at T0 or T1 were excluded from the study. Participants were included between January and December 2021. Main results and the role of chance In total, 245 women were included in this study. The median age was 31 (19-54) years. For the PCOSQ, the Cronbach alpha statistic for the five domains ranged from 0.88 to 0.96 demonstrating good to excellent internal consistency. The Intra-class Correlation Coefficient (ICC) for the five domains was high to excellent ranging from 0.88 to 0.96. For the PCOSQOL, the Cronbach alpha ranged from 0.91 to 0.96 demonstrating excellent internal consistency. The ICC ranged from 0.91 to 0.96 for the four domains indicating excellent reliability. The factor analysis presented five domains of the PCOSQ and the original domain structure was partly confirmed. An extra domain for acne was included based on previous studies. Therefore, the Dutch version of the PCOSQ contained six domains: Weight, Body hair, Emotions, Infertility, Menstrual problems, and Acne. Based on the factor analysis, an extra domain was added to the original four domains of the PCOSQOL, which included items related to dealing with PCOS. Most women (70.6%) needed approximately 15 minutes to complete both questionnaires and had no preference for one of the two questionnaires (55.9%). Limitations, reasons for caution A limitation of our study could be that women with more PCOS complaints were more motivated to participate in this study. Therefore, potential selection bias should be taken into account. Wider implications of the findings The PCOSQ and PCOSQOL are disease-specific QoL measures for women with PCOS. The Dutch versions can be used in studies and in clinical settings (e.g. by nurses and midwives, counsellors, psychologists) to examine the impact of PCOS on QoL in Dutch and Flemish women. Trial registration number NA

Translation of the Modified Polycystic Ovary Syndrome Questionnaire (mPCOSQ) and the Polycystic Ovary Syndrome Quality of Life Tool (PCOSQOL) in Dutch and Flemish Women with PCOS.

This study aims to determine the test-retest reliability and to confirm the domain structures of the Dutch version of the modified polycystic ovary syndrome questionnaire (mPCOSQ) and the Polycystic Ovary Syndrome Quality of Life Scale (PCOSQOL) in Dutch and Flemish women with Polycystic Ovary Syndrome (PCOS). PCOS patients were contacted with a request to complete both questionnaires (including additional demographic questions) online in their home environment on T0 and on T1. The study was approved by the Ethics Committee of Erasmus Medical Centre and of Ghent University Hospital. In this study, 245 participants were included between January and December 2021. The mPCOSQ has excellent internal consistency (α: 0.95) and a high to excellent Intraclass Correlation Coefficient (ICC) for all six domains (ICC: 0.88-0.96). The PCOSQOL demonstrates excellent internal consistency (α: 0.96) and ICC (ICC: 0.91-0.96) for all four domains. The original six-factor structure of the mPCOSQ is partly confirmed. An extra domain is added to the PCOSQOL which included coping items. Most women have no preference for one of the two questionnaires (55.9%). In conclusion, The Dutch mPCOSQ and PCOSQOL are reliable and disease-specific QoL measures for women with PCOS. Both questionnaires are recommended for clinical practice.

Women’s view on shared decision making and autonomy in childbirth: cohort study of Belgian women

BackgroundHealth care providers have an important role to share evidence based information and empower patients to make informed choices. Previous studies indicate that shared decision making in pregnancy and childbirth may have an important impact on a woman’s birth experience. In Flemish social media, a large number of women expressed their concern about their birth experience, where they felt loss of control and limited possibilities to make their own choices. The aim of this study is to explore autonomy and shared decision making in the Flemish population.MethodsThis is a cross-sectional, non-interventional study to explore the birth experience of Flemish women. A self-assembled questionnaire was used to collect data, including the Pregnancy and Childbirth Questionnaire (PCQ), the Labor Agentry Scale (LAS), the Mothers Autonomy Decision Making Scale (MADM), the 9-item Shared Decision Making Questionnaire (SDM–Q9) and four questions on preparation for childbirth. Women who gave birth two to 12 months ago were recruited by means of social media in the Flemish area (Northern part of Belgium).Linear mixed-effect modelling with backwards variable selection was applied to examine relations with autonomy in decision making.ResultsIn total, 1029 mothers participated in this study of which 617 filled out the survey completely. In general, mothers experienced moderate autonomy in decision-making, both with an obstetrician and with a midwife with an average on the MADM score of respectively 18.5 (± 7.2) and 29.4 (±10.4) out of 42. The linear mixed-effects model showed a relationship between autonomy in decision-making (MADM) for the type of healthcare provider (p < 0.001), the level of self-control during labour and birth (LAS) (p = 0.003), the level of perceived quality of care (PCQ) (p < 0.001), having epidural analgesia during childbirth (p = 0.026) and feeling to have received sufficient information about the normal course of childbirth (p < 0.001).ConclusionsChildbearing women in Flanders experience moderate levels of autonomy in decision- making with their health care providers, where lower autonomy was observed for obstetricians compared to midwives. Future research should focus more on why differences occur between obstetrics and midwives in terms of autonomy and shared decision-making as perceived by the mother.

Evolution of human papilloma virus prevalence in a highly vaccinated region in Belgium: a retrospective cohort study in Flemish women (2010-2019).

In order to lower the incidence of cervical cancer, vaccines against high-risk types of the human papilloma virus (hrHPV) were approved and brought on the market in 2007, with a partial reimbursement for Belgian citizens younger than 18 years old. Since 2010, a school-based vaccination program ensures a high vaccination coverage in young women. In this study, the impact of the Belgian vaccination program on the prevalence of HPV 16/18 is studied, together with the evolution of the prevalence of other hrHPV types and precancerous lesions. Results of HPV typing and cytology in papanicolaou-smears from women aged 20-23 years taken between 2010 and 2019 were used. An older, nonvaccinated group of women of 40-45 years old served as a control group. A significant decrease in prevalence of HPV types 16 and 18 was found in the 20-23-years-old women, whereas no decrease was found in the age group 40-45. Alongside this decrease, a significant decrease in prevalence of subtypes 6, 11 and 31 was observed, whereas type 31 is not included in the administered vaccines. Remarkably, there was no decrease in prevalence of cytological abnormalities in the study group during this study. There was even an increase in prevalence of high-risk types 53, 58 and 67. These findings emphasise the need to maintain the screening programs, even in areas with high vaccination coverage.

Vom Nutzen soziolektometrischer Methoden zur Erfassung sprachlicher Repertoires

In this paper, we will discuss the importance of (socio)lectometric research in attempts to empirically map the range and internal structure of language repertoires, on both the level of the individual and the level of the speech community. Spoken data from 10 East Flemish women (city of Ghent) in 5 speech settings are analysed using 3 multivariate statistical techniques: correspondence regression, multidimensional scaling, and cluster analysis. These analyses show that on a community level, the language repertoire in Ghent can be called - following Auer (2005) - “diaglossic”, with a continuum stretching from dialect to standard language with intermediate variations in between. In this continuum, focal points or prototypes can be identified, such as dialect, tussentaal and Standard Dutch. On the level of the individual language user, however, the repertoires are not necessarily diaglossic. Methodologically, we will argue that different multivariate techniques are ideally combined and complemented, as each technique has both advantages and drawbacks, and only structures emerging in multiple analyses can be considered robust. The Flemish case-study will moreover demonstrate that the techniques can only be usefully implemented in repertoire structure studies when stylistically stratified datasets are available and a diverse set of language features is observed.

Female Labour Force Participation After Divorce: How Employment Histories Matter

This article focuses on the labour market decisions of divorced women, surrounding the time of the factual separation. We build on earlier research, but explicitly distinguish between homemakers and unemployed women. Using retrospective data gathered from a sample of 1251 Flemish women from the Divorce in Flanders project (DiF 2009–2010), we performed anticipation-controlled event-history analysis to estimate the probability of an employment increase around the time of separation. We find that: (a) women were twice as likely to increase their employment for a short period of time after the separation, (b) there was an increasingly negative relationship between employment intensity at the time of separation and the probability of increasing employment immediately afterwards, and (c) observed differences between homemakers and unemployed women were likely due to compositional differences at the time of separation.

The Effect of Personal Characteristics, Perceived Threat, Efficacy and Breast Cancer Anxiety on Breast Cancer Screening Activation.

In order to activate women to participate in breast cancer screening programs, a good understanding is needed of the personal characteristics that influence how women can be activated to search for more information, consult friends and doctors, and participate in breast cancer screening programs. In the current study, we investigate the effect of six personal characteristics that have in previous research been identified as important triggers of health behavior on breast cancer screening activation: Health awareness, Need for Cognition, Affect Intensity, Breast cancer knowledge, Topic involvement, and the Perceived breast cancer risk. We test the effect of these factors on four activation variables: intention of future information seeking, forwarding the message to a friend, talking to a doctor, and actual breast cancer screening attendance. Additionally, we try to unravel the process by means of which the antecedents (the six personal characteristics) lead to activation. To that end, we test the mediating role of perceived breast cancer threat, perceived efficacy of screening, and the evoked breast cancer anxiety as mediators in this process. The data were collected by means of a cross-sectional survey in a sample of 700 Flemish (Belgium) women who were invited to the free-of-charge breast cancer population screening. Screening attendance of this sample was provided by the government agency in charge of the organisation of the screening. Health awareness, affects intensity, topic involvement, and perceived risk have the strongest influence on activation. Breast cancer anxiety and perceived breast cancer threat have a substantial mediation effect on these effects. Efficacy perceptions are less important in the activation process. Increased health awareness and a higher level of perceived risk lead to less participation in the free of charge population based breast screening program. Implications for theory and practice are offered. The limitation of the study is that only a standard invitation message was used. In future research, other types of awareness and activation messages should be tested. Additionally, the analysis could be refined by investigating the potentially different activation process in different subgroups of women.

The decision to have an abortion from both partners’ perspectives: a dyadic analysis

Objectives: Male partners are often involved in induced abortion although they have no legal rights. It is, however, unknown how women’s thoughts and feelings regarding the decision for abortion are associated with the decisional experiences of the involved male partners and vice versa.Methods: Flemish women and their involved male partners (IMP) filled out a questionnaire on abortion motives and feelings of decisiveness in the abortion centre waiting room (N = 106 couples). Actor Partner Interdependence Models investigated whether the decisiveness of one partner was associated with a subjective feeling of autonomy (high internal, low external abortion motivation) and decisiveness of the other partner, above and beyond the own feeling of autonomy and personal vulnerabilities for being uncertain.Results: Partner congruence in motivation and decisiveness was substantial (r= 0.23 to 0.42), especially for cohabiting partners. The IMPs were less internally motivated for the abortion than the women but both partners reported more internal than external motives, and they both tended to feel certain. In contrast to the women, a higher subjective feeling of autonomy in the IMPs was not associated with feeling more certain. When accounting for partners’ living situation, levels of uncertainty were not only associated with personal vulnerabilities for being uncertain, but were also related to the degree of uncertainty and subjective level of autonomy of the other partner.Conclusions: Partners’ thoughts and feelings regarding the decision for abortion partially have an interpersonal basis and mostly run parallel despite an inherent gender difference in level and importance of decision autonomy.

Breast cancer screening: how well-informed are Flemish women?

Breast cancer screening: how well-informed are Flemish women?

Predictors of Sexual Distress in Women With Desire and Arousal Difficulties: Distinguishing Between Personal, Partner, and Interpersonal Distress

IntroductionAlthough impaired sexual function is relatively common, not all sexual impairments are associated with distress. To date, most studies on protective and risk factors for sexual distress have asked about distress in a more general manner and have failed to distinguish different dimensions of sexual distress. AimTo examine the association of several intra- and interpersonal factors with personal, perceived partner, and interpersonal distress due to an impairment in sexual functioning in women. MethodsThis study is a cross-sectional representative population-based survey with a two-level random selection of Flemish women 14 to 80 years old from the Belgian National Register. The data of 520 sexually active heterosexual women with a partner (weighted N) and impairment in sexual desire (n = 291) and/or sexual arousal (n = 273) were used for analysis. Main Outcome MeasuresDemographic information was obtained, and the five-item Mental Health Inventory, the Marital Adjustment subscale of the Maudsley Marital Questionnaire, and the four-item Dyadic Sexual Communication Questionnaire were used. Presence and severity of sexual impairments and associated sexual distress were assessed using the Sexual Functioning Scale. ResultsSeverity and number of sexual impairments were predictive of all types of sexual distress. Also, for desire and arousal impairments, lower mental well-being predicted personal distress, and lower relationship satisfaction predicted perceived partner distress. For desire impairments, lower relationship satisfaction and less communication about sexual needs were predictive of interpersonal distress. For impairments in sexual arousal, lower mental well-being and lower relationship satisfaction were predictive of interpersonal distress. ConclusionPersonal, perceived partner, and interpersonal distress due to sexual impairments have different types of predictors. Clinical assessment and treatment could benefit from differentiating between different types of distress and the intra- and interpersonal factors that are associated with them.

Wives and widows in medieval Flanders

ABSTRACTWidowhood has long been regarded as the most emancipated condition that women might enjoy, affording them a freedom, agency and access to the public sphere denied their single or married counterparts. A corollary of this assumption is that most women documented as active participants in public life should be identified as widows. Based on a large corpus of references to female activity in bailiffs’ accounts and in town records and ordinances, however, this article argues that in pre-Burgundian Flanders widowhood in no way constituted a privileged status, either morally, socially, legally or economically. Flemish women were educated in order that they might achieve gainful employment; they married late and maintained control of property in marriage. Married women functioned as legal persons; they participated publicly, independently and routinely in Flemish urban life to such a degree that their subsequent activities as widows can only be understood as being in fundamental continuity with their prior behaviour as wives. This, in conjunction with the ambiguity and instability of terms for ‘women whose spouses are deceased’, destabilized the very concept of ‘widow’ itself.

Systematic development of an evidence-based website on preconception care

Introduction: In February 2015, the Flemish Minister of Welfare, Public Health and Family launched a website on preconception care: ‘gezondzwangerworden.be’. The website was developed in response to the lack of comprehensive communication on preconception care and the inadequate intake of folic acid among Flemish women. Despite the international recommendation to take 400 μg folic acid on a daily basis one month before conception until 12 weeks of pregnancy, studies show a lack of compliance in women wanting to become pregnant.Procedure: A compilation of evidence was made through reviewing well-established guidelines on preconception and prenatal care. The quality of guidelines was assessed by means of AGREE II. The topics included in the website were selected by an internal committee of 5 experts and an external committee of 16 experts. Content validation was carried out by 40 experts in preconception care or related topics.Results: The above-described procedure resulted in an evidence-based website with a selection of relevant, validated information for both women and men who plan a pregnancy and professionals who are consulted by these people.Evaluation and recommendation: The website is currently attracting a constant number of 100 to 200 visitors a day. The information on folic acid is among the most requested, which is an important finding with regard to the policy objectives on preconception care. More research is needed in order to evaluate the use and effect of the website more thoroughly.

The Food Industries of Europe in the Nineteenth and Twentieth Centuries

Contents: Preface Introduction, Derek J. Oddy Part I The Origins and Growth of Industrial Organization: Pioneering spadework in the history of the German food industry during the 19th and early 20th centuries: beet sugar, wheat starch and health foods, Karl-Peter Ellerbrock and Hans-JA rgen Teuteberg Vinegar and sugar: the early history of factory-made jams, pickles and sauces in Britain, Peter J. Atkins Rural capitalism: the Societe des Caves de Roquefort, from c. 1840 to1914, Sylvie Vabre Modernizing the Mediterranean olive-oil industry, 1850s-1930s, Ramon Ramon-MuA+-oz. Part II Creating New Foods: 'The biggest chocolate factory in the world': the Menier chocolate factory in Noisiel, Alain Drouard 'Czech chocolate is the best!' Nationalism in the food industry in the Czech lands around the year 1900, Martin Franc Margarine in competition with butter in Germany (1872-1933): the example of Van den Bergh's margarine factory in Kleve, Sabine Merta The nutritional transformation of Danish pork, 1887-1960, Tenna Jensen The rise of the frozen-fish industry in Iceland and Norway: the case of fish fingers, Gudmundur JA^3nsson and A-rn JA^3nsson. Part III The Effect of Food Technology on Consumption Patterns: Food labelling and packaging in the Dutch food industry: persuading and informing consumers, 1870s-1950s, Adel P. den Hartog Promoting packaging and selling self-service: the rapid modernization of the Swedish food retail trade, Jenny Lee and Ulrike Torell Food preservation in Flemish women's magazines, 1945-1960, Anneke Geyzen The growth of bread consumption among Romanian peasants, 1950-1980, Lucian Scrob From roast beef to chicken nuggets: how technology changed meat consumption in Britain in the 20th century, Derek J. Oddy The European food industries in perspective, Derek J. Oddy Index.

Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study

Objectivewe examined the prevalence of Post-Traumatic Stress Disorder (PTSD) and the role of personal and obstetric risk factors, as well as the role of midwifery team care factors in a cohort of Flemish women. Designprospective cohort study. Data collection was performed at two times post partum: During the first week, socio-demographic and obstetric data as well as information related to midwifery team care factors were assessed using self-report measures. To asses PTSD symptomatology, the Impact of Event Scale-Revised (IES-R) and the Traumatic Event Scale (TES) were used. At six weeks post partum, PTSD symptoms were reassessed either by telephone interviews or e-mail. Results were calculated in frequencies, means and standard deviations. Differences between week one and six were analysed using parametrical and non-parametrical statistics. Multiple and logistic regression was performed to determine risk factors for PTSD symptomatology. P-value was set at 0.05. Settingmaternity wards in Flanders, Belgium. Participantsthe first (week 1) and follow-up (week 6) sample of the data collection consisted of 340 and 229 women respectively. Resultsthe prevalence of PTSD symptoms after childbirth ranged from 22% to 24% in the first week and from 13% to 20% at six weeks follow-up. Multiple regression analysis showed that Islamic belief, a traumatic childbirth experience, family income <€2500, a history of psychological or psychiatric consults and labour/birth with complications significantly predicted PTSD symptomatology at six weeks post-birth. Midwifery team care and the opportunity to ask questions, as well as experiencing a normal physiological birth were significantly associated with less postnatal PTSD symptoms. Key conclusions and implications for practisethe results of this study suggest that contextual factors such as religion, socio-economic status, and childbirth experience might be important factors to address by the midwifery team. Midwifery team care factors such as ‘providing the opportunity to the mother to ask questions’ and the ‘perception of the midwife being in control’ proved to be potential protective factors for postnatal PTSD symptoms. Despite its prevalence, PTSD symptoms after birth are not yet well understood by health care workers. Further research concerning the influence of midwifery team care factors on developing childbirth related PTSD is required.

Reproducibility and validity of an FFQ to assess usual intake of methyl-group donors.

To develop and validate a novel FFQ to assess the daily intake of four methyl-group donors (methionine, choline, betaine and folate). The relative validity of the FFQ was assessed by comparison with 7 d estimated diet records (n 80) and its reproducibility was evaluated by repeated administrations 6 weeks apart (n 92). Paired Student t tests were used to compare group means and de-attenuated intra-class correlations to investigate the ability of the FFQ to rank individuals according to their methyl-group donor intake. De-attenuated intra-class correlation coefficients were calculated between the test and reference method for methionine, choline, betaine, folate and the sum of methyl-group donors. The weighted kappa (κ w) was calculated as a measure of tertile agreement. Flanders, Belgium. The FFQ was validated among Flemish women of reproductive age (18-35 years). The questionnaire had an acceptable ranking ability (r=0·32-0·68; κ w=0·10-0·35), but overestimated the daily intake of folate (280·6 μg v. 212·0 μg) and betaine (179·1 mg v. 147·0 mg) compared with the 7 d estimated diet record. Cross-classification analysis indicated that 20 % (choline) of the participants were grossly misclassified in the validation study. The correlation between repeated administrations was good (r=0·62-0·83) with a maximal misclassification of 7 % for betaine (κ w=0·44-0·66). These results indicate that this newly developed FFQ is a reliable instrument with acceptable validity for ranking individuals according to methyl-group donor intake (except for a poor agreement for choline (κ w=0·10) and a fair ranking ability for betaine (r=0·32)) in Flemish women of reproductive age.

Validation of a food-frequency questionnaire assessment of methyl-group donors using estimated diet records and plasma biomarkers: the method of triads

In this study, the intake of methyl-group donors (methionine, folate, betaine, and choline) among Flemish women of reproductive age (n = 30) assessed by a 7-d estimated diet record (7 d EDR) and food-frequency questionnaire (FFQ) was compared with plasma S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), and SAH:SAM ratio. Pearson correlation coefficients were calculated between each of the dietary methods and the validity coefficient was calculated using the method of triads. Correlations were higher between intake assessed by the FFQ and biomarkers than between 7 d EDR and biomarkers. The validity coefficients of the FFQ, when using SAH as a biomarker, were high (0.86 for methionine to 0.94 for folate), when the SAH:SAM ratio was used as a biomarker the validity coefficients ranged from 0.63 to 1.00. These data indicate that the FFQ is a reliable tool to estimate the intake of the methyl-group donors in women of reproductive age.