382 research outputs found

    Eating Is Not Political Action

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    Food and environment are cultural stalwarts. Picture the red barn and solitary farmer toiling over fruited plains; or purple mountains majesty reflected in pristine waters. Agriculture and environment are core, distinct, American mythologies that we know are more intertwined than our stories reveal. To create policy at the interface of such centrally important and overlapping American ideals, there are two options. Passive governance fosters markets in which participants make individual choices that aggregate into inadvertent collective action. In contrast, assertive governance allows the public, mediated through elected officials, to enact intentional, goal oriented policy. American mythologies of food and environment arise because each is important culturally and physically. Given their essentiality, we must demand more intentionality, must demand policies not only because they are possible, but because they are thoughtful, effective, goal oriented, and intentional. Food and the environment are both too important to do otherwise. In today’s political climate, finding shared goals will be hard and accidental policy may be the best we can hope for in the short term. Progressive food advocates may settle for passive policies because these policies make fewer normative commitments. For three decades this has been exactly the strategy of environmental advocates. It is the wrong strategy. Without boldly speaking about our goals, even when we know we will fall short, we cannot imagine the big picture that we intend to paint, the new integrated mythology we intend to write

    Dementia and osteoporosis in a geriatric population: Is there a common link?

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    AIM To determine the existence of a common pathological link between dementia and osteoporosis through reviewing the current evidence base. METHODS This paper reviews the current literature on osteoporosis and dementia in order to ascertain evidence of a common predisposing aetiology. A literature search of Ovid MEDLINE (1950 to June 2016) was conducted. The keywords “osteoporosis”, “osteoporotic fracture”, “dementia” and “Alzheimer’s disease” (AD) were used to determine the theoretical links with the most significant evidence base behind them. The key links were found to be vitamins D and K, calcium, thyroid disease, statins, alcohol and sex steroids. These subjects were then searched in combination with the previous terms and the resulting papers manually examined. Theoretical, in vitro and in vivo research were all used to inform this review which focuses on the most well developed theoretical common causes for dementia (predominantly Alzheimer’s type) and osteoporosis. RESULTS Dementia and osteoporosis are multifaceted disease processes with similar epidemiology and a marked increase in prevalence in elderly populations. The existence of a common link between the two has been suggested despite a lack of clear pathological overlap in our current understanding. Research to date has tended to be fragmented and relatively weak in nature with multiple confounding factors reflecting the difficulties of in vivo experimentation in the population of interest. Despite exploration of various possible mechanisms in search for a link between the two pathologies, this paper found that it is possible that these associations are coincidental due to the nature of the evidence available. One finding in this review is that prior investigation into common aetiologies has found raised amyloid beta peptide levels in osteoporotic bone tissue, with a hypothesis that amyloid beta disorders are systemic disorders resulting in differing tissue manifestations. However, our findings were that the most compelling evidence of a common yet independent aetiology lies in the APOE4 allele, which is a well-established risk for AD but also carries an independent association with fracture risk. The mechanism behind this is thought to be the reduced plasma vitamin K levels in individuals exhibiting the APOE4 allele which may be amplified by the nutritional deficiencies associated with dementia, which are known to include vitamins K and D. The vitamin theory postulates that malnutrition and reduced exposure to sunlight in patients with AD leads to vitamin deficiencies. CONCLUSION Robust evidence remains to be produced regarding potential links and regarding the exact aetiology of these diseases and remains relevant given the burden of dementia and osteoporosis in our ageing population. Future research into amyloid beta, APOE4 and vitamins K and D as the most promising aetiological links should be welcomed

    The effects of inspiratory muscle training in older adults

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    Purpose: Declining inspiratory muscle function and structure and systemic low-level inflammation and oxidative stress may contribute to morbidity and mortality during normal ageing. Therefore, we examined the effects of inspiratory muscle training (IMT) in older adults on inspiratory muscle function and structure and systemic inflammation and oxidative stress, and re-examined the reported positive effects of IMT on respiratory muscle strength, inspiratory muscle endurance, spirometry, exercise performance, physical activity levels (PAL) and quality of life (QoL). Methods: Thirty-four healthy older adults (68 ± 3 years) with normal spirometry, respiratory muscle strength and physical fitness were divided equally into a pressure-threshold IMT or sham-hypoxic placebo group. Before and after an 8 week intervention, measurements were taken for dynamic inspiratory muscle function and inspiratory muscle endurance using a weighted plunger pressure-threshold loading device, diaphragm thickness using B-mode ultrasonography, plasma cytokine concentrations using immunoassays, DNA damage levels in peripheral blood mononuclear cells (PBMC) using Comet Assays, spirometry, maximal mouth pressures, exercise performance using a six minute walk test, PAL using a questionnaire and accelerometry, and QoL using a questionnaire

    Inspiratory muscle training reduces blood lactate concentration during volitional hyperpnoea

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    Although reduced blood lactate concentrations ([lac−]B) have been observed during whole-body exercise following inspiratory muscle training (IMT), it remains unknown whether the inspiratory muscles are the source of at least part of this reduction. To investigate this, we tested the hypothesis that IMT would attenuate the increase in [lac−]B caused by mimicking, at rest, the breathing pattern observed during high-intensity exercise. Twenty-two physically active males were matched for 85% maximal exercise minute ventilation (V˙Emax) and divided equally into an IMT or a control group. Prior to and following a 6 week intervention, participants performed 10 min of volitional hyperpnoea at the breathing pattern commensurate with 85% V˙Emax

    Diagnostic Accuracy of Monitoring Tests of Fellow Eyes in Patients with Unilateral Neovascular Age-Related Macular Degeneration : Early Detection of Neovascular Age-Related Macular Degeneration Study

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    Funding Information: The author(s) have made the following disclosure(s): R.G.: Personal fees ? Heidelberg Engineering.S.S.: Grants and personal fees ? Bayer, during the conduct of the study; Grants and personal fees ? Novartis, Boehringer Ingleheim; Grants ? Allergan, Roche; Personal fees ? Apellis, Oxurion, Heidelberg Engineering, Optos, outside the submitted work; Funded by the Moorfields Biomedical Research Centre and Clinical Research Facility.The project was funded by the National Institute for Health Research Health Technology Assessment Programme (Project Number: 12/142/07) and will be published in full in Health Technology Assessment. The Health Services Research Unit and the Health Economics Research Unit are core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate. F.G.: Grants ? NIHR, during the conduct of the study; Grants and personal fees ? Novartis, Roche, Bayer; Personal fees ? Allergan, Alimera; Grants ? Chengdu Pharma; Grants and nonfinancial support ? NIHR, outside the submitted work. J.A.C.: Study grant ? NIHR. K.B.: Grants ? NIHR HTA Programme, during the conduct of the study. Obtained funding: Chakravarthy, Ramsay, Sivaprasad, Scotland, Azuara-Blanco, Heiman and Cook Publisher Copyright: © 2021Peer reviewedPublisher PD

    Doing research in peoples’ homes: fieldwork, ethics and safety – on the practical challenges of researching and representing life on the margins

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    Drawing on the author’s experiences and reflections of researching vulnerable people for a housing research project, this article explores the ethical dilemmas, and the health and safety challenges, of conducting in-depth, qualitative interviews with ‘vulnerable’ research participants in their own homes. Vulnerability, in a housing research context, takes account of: living in poverty; insecure housing/employment situations; poor health and/or mental ill health; alcohol and /or drug dependency, etc. Diary notes are used to illustrate the challenging situations that can unfold when working alone in the field in disadvantaged areas, with vulnerable people, which can present physical and emotional risk. Concern with risk and the potential impact on individuals is two-fold: that on the participant; and that on the researcher. Through reflexivity and revisiting of experiences in the field, this paper explains the difficulties and negotiations, and it provides some suggestions for better research practice
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