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41.
42.

Background

Dry age-related macular degeneration (AMD) is a leading cause of untreatable, progressive central vision loss, social isolation, and disability in older people. Evidence suggests that diet (eg, the Mediterranean dietary pattern or increased oral carotenoid intake) might protect against dry AMD progression. The aim of this pilot study was to test the feasibility of a participant-informed community kitchens intervention (Eating for Eye Health project) to implement dietary behaviour change, to benefit macular health of older adults.

Methods

Adults (≥50 years) with documented visual impairment due to dry AMD were invited, with a partner, carer, or friend for support, via a National Institute of Health Research mailing list, to participate in a focus group and pilot intervention in London, UK. The intervention was an ice-breaker session and a cookery activity with integrated health promotion information; it was participant codesigned to increase capability and opportunity for implementing dietary change for macular health. For the cookery activity, participants were divided into small groups, with different groups preparing different courses of a three-course meal containing carotenoid-rich foods, which they ate together. The primary outcome was participants' self-reported capability in cooking skills for eye health, evaluated before and after the intervention, using a ten-point confidence score (10=most confident). Secondary outcomes were participant-rated taste acceptability of the food, evaluated by a two-point (a physical thumbs-up or thumbs-down motion) scale for each course, and subjective experience of the intervention (thematic analysis of written qualitative feedback consisting of unstructured feedback using post-it notes immediately after the event and a standardised email questionnaire 1 week later).

Findings

12 adults (ten with dry AMD and two partners or friends) participated. All participants reported increased confidence scores, with improvement in scores ranging from 2 to 6 points, with all giving a score of 7 points or higher after the intervention, and rated food as acceptable in taste. Thematic analysis of qualitative written feedback, immediately and 1 week after the intervention, identified positive subjective experiences of “social participation” and “peer support”.

Interpretation

This pilot study provides evidence to support the feasibility of National Health Service social prescribing of community cookery programmes for older people with dry AMD to increase their capability and social opportunity to implement dietary behaviour change for eye health.

Funding

University College London Beacon Bursary (for RG to support Eating for Eye Health public engagement work).  相似文献   
43.
Two patients with anomalous origin of the left main coronary artery from the pulmonary artery had an associated defect (one, critical pulmonary stenosis; the other, ventricular septal defect). They presented with signs and symptoms of the associated defect and the coronary anomaly was unrecognized. Both cases at autopsy lacked the usual large right coronary artery seen with this anomaly. The pathophysiologic features of the combined defects are described, their differences from the isolated anomaly are noted and their relation to surgery is discussed.  相似文献   
44.
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绿茶提取物清除单线态氧的作用及抗脂质过氧化效应   总被引:1,自引:0,他引:1  
光敏化剂玫瑰红光照后产生单线态氧(~1O_2),以N,N-二甲基-4-亚硝基苯胺(DM-NA)被漂白作用测定~1O_2的产生及清除。绿茶提取物(GTE)可以清除光敏氧化反应系统产生的~1O_2,在起始阶段作用更显著,随GTE浓度增加清除作用加强。新配制的GTE溶液清除~1O_2的效果较陈旧溶液为佳。GTE可以防护单线态氧造成的红细胞膜及微粒体脂质过氧化作用,达到一定浓度时可以完全抑制丙二醛的产生。  相似文献   
46.
This report summarizes our successful management of 6 patients who underwent repair of mycotic aneurysms of the ascending aorta within a four-year period. Repairs have been successful despite involvement of as much as two-thirds of the circumference of the aortic valve annulus, involvement of the origin of the right coronary artery, and development of heart block. Three patients required surgical intervention because of hemodynamic decompensation before they had completed antibiotic therapy for endocarditis.In 3 patients, the aneurysm was buttressed with the valve skirt so that aneurysm repair and valve replacement were accomplished in continuity. In 2 patients, the aneurysm was repaired separately and the valve seated on the repair. In 1 patient, a large defect between the left and right coronary arteries was repaired with a woven Dacron patch secured to the valve skirt. The valve was seated to the left ventricle and the graft to the aorta. There were no operative or postoperative deaths. Our data suggest that mycotic aneurysms of the aortic annulus can be successfully repaired despite extensive damage.  相似文献   
47.
48.
Estimates of body surface area were made based on measurement of 81 subjects, ranging from premature infants to adults. SA was calculated geometrically for each subject from 34 body measurements, and the values obtained compared with those based on previously published formulas and graphs. The most widely used formula, that of Du Bois and Du Bois, increasingly underestimated SA as values fell below 0.7 m2; the disparity was greatest in the newborn infant (7.96%). Closer agreement was obtained with the equations and nomograms of Body, Brody, Faber and Melcher, and Sendroy and Cecchini, although minor deviations were noted in some age ranges. The formula SA (m2) = weight (kg)0.5378 X height (cm)0.3964 X 0.024265, derived from the measured data by multiple regression analysis, gave a good fit for all values of SA from less than 0.2 m2 to greater than 2.0 m2 (r = 0.998). This formula was used to construct nomograms for estimation of SA in infants, children, and adults from height (length) and weight.  相似文献   
49.
Two patients with Addison's disease related to urogenital tuberculosis had enlargement of one or both adrenal glands detected with computed tomographic scanning. Review of reports of adrenal size on computed tomographic examination suggests that adrenal enlargement in the presence of Addison's disease demands further investigation about the cause of the adrenal insufficiency.  相似文献   
50.
Fifty-three patients with carcinoma of the esophagus treated since 1972 are reviewed. Eighteen unresectable patients with distant metastases or pulmonary insufficiency were treated with irradiation or with esophageal or gastrostomy tubes plus irradiation. There were 5 early deaths, and only 3 patients survived more than three months. Six patients underwent bypass. Three died in the hospital, and 1 lived three months. None compled a course of irradiation or gained weight. The remaining 29 patients, who did not differ clinically from the bypass group, underwent resection for palliation or cure. There were 5 hospital deaths. Twenty patients lived more than three months and 7 of these more than one year. Two of them apparently were cured. These data indicate that the only effective means of increasing the duration of survival for esophageal carcinoma is resection with immediate reconstruction.  相似文献   
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