427 research outputs found

    Partner Bereavement and Detection of Dementia: A UK-Based Cohort Study Using Routine Health Data

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    BACKGROUND: In the UK, an estimated one third of people with dementia have not received a diagnosis. Good evidence suggests that dementia risk is increased among widowed individuals; however, it is not clear if they are being diagnosed in routine primary care. // OBJECTIVE: This study aimed to investigate if bereavement influenced the probability of having received a dementia diagnosis. // METHODS: A population-based cohort study using UK electronic health records, between 1997 and 2017, among 247,586 opposite-sex partners. Those experiencing partner bereavement were matched (age, sex, and date of bereavement) to a non-bereaved person living in a partnership. Multivariate cox regression was performed. // RESULTS: Partner bereavement was associated with an increased risk of receiving a diagnosis of dementia in the first three months (hazard ratio (HR) 1.43, 95% CI 1.20-1.71) and first six months (HR 1.24, 95% CI 1.09-1.41), while there was a small reduced risk of getting a dementia diagnosis over all follow-up (HR 0.94, 95% CI 0.89-0.98). // CONCLUSIONS: Partner bereavement appears to lead to a short-term increased risk of the surviving partner receiving a diagnosis of dementia, suggesting that bereavement unmasks existing undiagnosed dementia. Over the longer term, however, bereaved individuals are less likely to have a diagnosis of dementia in their health records than non-bereaved individuals

    Incidence of acute complications of herpes zoster among immunocompetent adults in England:a matched cohort study using routine health data

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    BACKGROUND: Herpes zoster can cause rare but serious complications; the frequency of these complications has not been well described. OBJECTIVES: To quantify the risks of acute non-postherpetic neuralgia (PHN) zoster complications, to inform vaccination policy. METHODS: We conducted a cohort study among unvaccinated immunocompetent adults with incident zoster, and age-, sex- and practice-matched control adults without zoster, using routinely collected health data from the UK Clinical Practice Research Datalink (years 2001 to 2018). Crude attributable risks of complications were estimated as the difference between Kaplan-Meier-estimated 3-month cumulative incidences in patients with zoster vs. controls. We used Cox models to obtain hazard ratios for our primary outcomes in patients with and without zoster. Primary outcomes were ocular, neurological, cutaneous, visceral and zoster-specific complications. We also assessed whether antivirals during acute zoster protected against the complications. RESULTS: In total 178 964 incident cases of zoster and 1 799 380 controls were included. The absolute risks of zoster-specific complications within 3 months of zoster diagnosis were 0·37% [95% confidence interval (CI) 0·34-0·39] for Ramsay Hunt syndrome, 0·01% (95% CI 0·0-0·01) for disseminated zoster, 0·04% (95% CI 0·03-0·05) for zoster death and 0·97% (95% CI 0·92-1·00) for zoster hospitalization. For other complications, attributable risks were 0·48% (95% CI 0·44-0·51) for neurological complications, 1·33% (95% CI 1·28-1·39) for ocular complications, 0·29% (95% CI 0·26-0·32) for cutaneous complications and 0·78% (95% CI 0·73-0·84) for visceral complications. Attributable risks were higher among patients > 50 years old. Patients with zoster had raised risks of all primary outcomes relative to controls. Antiviral prescription was associated with reduced risk of neurological complications (hazard ratio 0·61, 95% CI 0·53-0·70). CONCLUSIONS: Non-PHN complications of zoster were relatively common, which may affect cost-effectiveness calculations for zoster vaccination. Clinicians should be aware that zoster can lead to various complications, besides PHN

    Derivation of the aerodynamic roughness parameters for a Sahelian savannah site using the eddy correlation technique

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    Vertical exchange of heat, moisture and momentum above the earth's surface depends strongly on the turbulence generated by surface roughness. This roughness is best specified through the roughness length and the zero plane displacement. The ratio of windspeed to friction velocity was measured at four heights using the eddy correlation technique at a fallow savannah site in the Sahel. The change in this ratio with height was used to derive the zero plane displacement and the roughness length of the surface, together with an estimate of the error in each parameter. These were estimated as 0.93 ± 0.35 m and 0.17 ± 0.01 m, respectively. The method appears to be a more robust alternative to wind profile derivation

    Three-dimensionally Ordered Macroporous Structure Enabled Nanothermite Membrane of Mn2O3/Al

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    Mn2O3 has been selected to realize nanothermite membrane for the first time in the literature. Mn2O3/Al nanothermite has been synthesized by magnetron sputtering a layer of Al film onto three-dimensionally ordered macroporous (3DOM) Mn2O3 skeleton. The energy release is significantly enhanced owing to the unusual 3DOM structure, which ensures Al and Mn2O3 to integrate compactly in nanoscale and greatly increase effective contact area. The morphology and DSC curve of the nanothermite membrane have been investigated at various aluminizing times. At the optimized aluminizing time of 30 min, energy release reaches a maximum of 2.09 kJ∙g−1, where the Al layer thickness plays a decisive role in the total energy release. This method possesses advantages of high compatibility with MEMS and can be applied to other nanothermite systems easily, which will make great contribution to little-known nanothermite research

    Youth Savings Groups in Africa: They’re a Family Affair

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    Based on fieldwork in Tanzania, Zambia, Uganda, and Ghana, in the paper we provide new evidence that young people’s engagement with savings groups in Africa is deeply embedded in networks of family and social relations. Savings group members rely on money that is given to them by partners and family members to make savings contributions to the groups, while they also transfer some of their share-outs and loans to family members and friends. This is particularly true for younger members. As such we argue that the socially embedded nature of young people's engagement with savings group needs to be taken into account. The tension between the primary focus on the individual within youth saving programming, and the socially embedded nature of their engagement, has important implications for programme design, implementation and evaluation

    Preliminary measurements of net radiation and evaporation over bare soil and fallow bushland in the Sahel

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    Net radiation and evaporation are compared over two contrasting land surfaces, fallow bushland and bare soil, in Niger, West Africa. Data are presented for 6 days, before and after a large rainstorm (39 mm), which illustrate how evaporation from the bush vegetation changed little in comparison with the larger change in evaporation observed over the bare soil. Net radiation over the bush vegetation was 20 per cent greater than that over the dry bare soil, but only 12 per cent greater than that over wet bare soil. These differences are consistent with the expected difference in albedo and surface temperature of the two surface

    Cirrhosis and liver transplantation in patients co-infected with HIV and hepatitis B or C: an observational cohort study

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    This study assessed the likelihood of referral for liver transplantation assessment in a prospective cohort of patients co-infected with HIV and hepatitis B or C with complications of cirrhosis. There were 141 co-infected patients from 11 UK centres with at least one complication of cirrhosis recorded (either decompensation or hepatocellular carcinoma) out of 772 identified with cirrhosis and/or HCC. Only 23 of these 141 (16.3%) were referred for liver transplantation assessment, even though referral is recommended for co-infected patients after the first decompensation episode

    Measurements of albedo variation over natural vegetation in the sahel

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    This paper reports ground-based measurements of albedo at two different sites in south-western Niger: agricultural fallow at the ICRISAT Sahelian Center (ISC), Sadoré, and a type of open natural forest (tiger-bush), 6 km south-west of ISC. The vegetative cover at each site consisted of two clearly defined components, for which separate measurements were made. The four different component surfaces spanned the entire range of plant cover density normally occurring in the southern Sahel, ranging from zero (bare soil) to a dense, closed canopy of woody shrubs. Continuous automated observations of albedo were made over a period of 15 months, from July 1989 to September 1990, including both wet and dry seasons. The data are analysed on hourly, monthly, and annual time-scales in order to demonstrate how albedo varies in response to the density of plant cover, soil-surface moisture content, solar zenith angle, and the proportion of diffuse light in the incoming solar radiation. Large annual variation in monthly mean albedo was observed at both sites (increases from the wet to dry season of 0.065 and 0.057 for the fallow and tiger-bush, respectively). At the fallow site the annual variation in albedo resulted mainly from the wet to dry season cycle of leaf growth and loss. At the tiger-bush site the primary cause of annual variation in albedo was the frequent wetting of the extensive bare soil component that occurred during the rainy season. The significance of these results for global climate modelling is assessed briefly
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