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Institution

University of Exeter

EducationExeter, United Kingdom
About: University of Exeter is a education organization based out in Exeter, United Kingdom. It is known for research contribution in the topics: Population & Climate change. The organization has 15820 authors who have published 50650 publications receiving 1793046 citations. The organization is also known as: Exeter University & University of the South West of England.


Papers
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Journal ArticleDOI
TL;DR: In this article, the authors synthesize the findings from 14 studies that investigated trends in dementia prevalence (nine studies) and incidence (five studies) from Sweden, Spain, the UK, the Netherlands, France, the USA, Japan and Nigeria.
Abstract: Dementia is an increasing focus for policymakers, civil organizations and multidisciplinary researchers. The most recent descriptive epidemiological research into dementia is enabling investigation into how the prevalence and incidence are changing over time. To establish clear trends, such comparisons need to be founded on population-based studies that use similar diagnostic and research methods consistently over time. This narrative Review synthesizes the findings from 14 studies that investigated trends in dementia prevalence (nine studies) and incidence (five studies) from Sweden, Spain, the UK, the Netherlands, France, the USA, Japan and Nigeria. Besides the Japanese study, these studies indicate stable or declining prevalence and incidence of dementia, and some provide evidence of sex-specific changes. No single risk or protective factor has been identified that fully explains the observed trends, but major societal changes and improvements in living conditions, education and healthcare might have favourably influenced physical, mental and cognitive health throughout an individual's life course, and could be responsible for a reduced risk of dementia in later life. Analytical epidemiological approaches combined with translational neuroscientific research could provide a unique opportunity to explore the neuropathology that underlies changing occurrence of dementia in the general population.

454 citations

Journal ArticleDOI
TL;DR: Evidence suggests that pragmatic diabetes prevention programs are effective and can be improved by maximizing guideline adherence, but more research is needed to establish optimal strategies for maximizing both cost-effectiveness and longer-term maintenance of weight loss and diabetes prevention effects.
Abstract: OBJECTIVE To summarize the evidence on effectiveness of translational diabetes prevention programs, based on promoting lifestyle change to prevent type 2 diabetes in real-world settings and to examine whether adherence to international guideline recommendations is associated with effectiveness. RESEARCH DESIGN AND METHODS Bibliographic databases were searched up to July 2012. Included studies had a follow-up of ≥12 months and outcomes comparing change in body composition, glycemic control, or progression to diabetes. Lifestyle interventions aimed to translate evidence from previous efficacy trials of diabetes prevention into real-world intervention programs. Data were combined using random-effects meta-analysis and meta-regression considering the relationship between intervention effectiveness and adherence to guidelines. RESULTS Twenty-five studies met the inclusion criteria. The primary meta-analysis included 22 studies (24 study groups) with outcome data for weight loss at 12 months. The pooled result of the direct pairwise meta-analysis shows that lifestyle interventions resulted in a mean weight loss of 2.12 kg (95% CI -2.61 to -1.63; I(2) = 91.4%). Adherence to guidelines was significantly associated with a greater weight loss (an increase of 0.3 kg per point increase on a 12-point guideline-adherence scale). CONCLUSIONS Evidence suggests that pragmatic diabetes prevention programs are effective. Effectiveness varies substantially between programs but can be improved by maximizing guideline adherence. However, more research is needed to establish optimal strategies for maximizing both cost-effectiveness and longer-term maintenance of weight loss and diabetes prevention effects.

453 citations

Journal ArticleDOI
TL;DR: To assess the effectiveness of psychological interventions compared with usual care for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress, a Cochrane systematic review is published.
Abstract: BACKGROUND: Psychological interventions can form part of comprehensive cardiac rehabilitation programmes (CCR). These interventions may include stress management interventions, which aim to reduce stress, either as an end in itself or to reduce risk for further cardiac events in patients with heart disease. OBJECTIVES: To determine the effectiveness of psychological interventions, in particular stress management interventions, on mortality and morbidity, psychological measures, quality of life, and modifiable cardiac risk factors, in patients with coronary heart disease (CHD). SEARCH STRATEGY: We searched CCTR to December 2001 (Issue 4, 2001), MEDLINE 1999 to December 2001 and EMBASE 1998 to the end of 2001, PsychINFO and CINAHL to December 2001. In addition, searches of reference lists of papers were made and expert advice was sought. SELECTION CRITERIA: RCTs of non-pharmacological psychological interventions, administered by trained staff, either single modality interventions or a part of CCR with minimum follow up of 6 months. Adults of all ages with CHD (prior myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty, angina pectoris or coronary artery disease defined by angiography). Stress management (SM) trials were identified and reported in combination with other psychological interventions and separately. DATA COLLECTION AND ANALYSIS: Studies were selected, and data were abstracted, independently by two reviewers. Authors were contacted where possible to obtain missing information. MAIN RESULTS: Thirty six trials with 12,841 patients were included. Of these, 18 (5242 patients) were SM trials. Quality of many trials was poor with the majority not reporting adequate concealment of allocation, and only 6 blinded outcome assessors. Combining the results of all trials showed no strong evidence of effect on total or cardiac mortality, or revascularisation. There was a reduction in the number of non-fatal reinfarctions in the intervention group (OR 0.78 (0.67, 0.90), but the two largest trials (with 4809 patients randomized) were null for this outcome, and there was statistical evidence of publication bias. Similar results were seen for the SM subgroup of trials. Provision of any psychological intervention or SM intervention caused small reductions in anxiety and depression. Few trials reported modifiable cardiac risk factors or quality of life. REVIEWERS' CONCLUSIONS: Overall psychological interventions showed no evidence of effect on total or cardiac mortality, but did show small reductions in anxiety and depression in patients with CHD. Similar results were seen for SM interventions when considered separately. However, the poor quality of trials, considerable heterogeneity observed between trials and evidence of significant publication bias make the pooled finding of a reduction in non-fatal myocardial infarction insecure.

453 citations

Journal ArticleDOI
TL;DR: Bifrost as mentioned in this paper is a massively parallel numerical code for simulating stellar convection and photospheres from the convection zone to the corona, which can be used to simulate the whole atmosphere.
Abstract: Context. Numerical simulations of stellar convection and photospheres have been developed to the point where detailed shapes of observed spectral lines can be explained. Stellar atmospheres are very complex, and very di erent physical regimes are present in the convection zone, photosphere, chromosphere, transition region and corona. To understand the details of the atmosphere it is necessary to simulate the whole atmosphere since the di erent layers interact strongly. These physical regimes are very diverse and it takes a highly e cient massively parallel numerical code to solve the associated equations. Aims. The design, implementation and validation of the massively parallel numerical code Bifrost for simulating stellar atmospheres from the convection zone to the corona. Methods. The code is subjected to a number of validation tests, among them the Sod shock tube test, the Orzag-Tang colliding shock test, boundary condition tests and tests of how the code treats magnetic field advection, chromospheric radiation, radiative transfer in an isothermal scattering atmosphere, hydrogen ionization and thermal conduction. Results. Bifrost completes the tests with good results and shows near linear e ciency scaling to thousands of computing cores.

453 citations

Journal ArticleDOI
TL;DR: This is the first evidence documenting a relationship between the morphological effects of endocrine disruption and the reproductive capabilities of any wild vertebrate, and the results suggest that mixtures ofendocrine-disrupting substances discharged into the aquatic environment could pose a threat to male reproductive health.
Abstract: Endocrine-disrupting chemicals, known to be present in the environment, have great potential for interfering with reproductive health in wildlife and humans. There is, however, little direct evidence that endocrine disruption has adversely affected fertility in any organism. In freshwater and estuarine fish species, for example, although a widespread incidence of intersex has been reported, it is not yet known if intersexuality influences reproductive success. The purpose of this study was, therefore, to determine gamete quality in wild intersex roach (Rutilus rutilus) by assessing sperm characteristics, fertilization success, and ability to produce viable offspring. The results clearly demonstrate that gamete production is reduced in intersex roach. A significantly lower proportion of moderately or severely feminized fish (17.4% and 33.3%, respectively) were able to release milt compared with normal male fish from contaminated rivers (in which 97.6% of the males were able to release milt), reference male fish (97.7%), or less severely feminized intersex fish (experiment 1: 85.8%, experiment 2: 97%). Intersex fish that did produce milt produced up to 50% less (in terms of volume per gram of testis weight) than did histologically normal male fish. Moreover, sperm motility (percentage of motile sperm and curvilinear velocity) and the ability of sperm to successfully fertilize eggs and produce viable offspring were all reduced in intersex fish compared with normal male fish. Male gamete quality (assessed using sperm motility, sperm density, and fertilization success) was negatively correlated with the degree of feminization in intersex fish (r = -0.603; P < 0.001) and was markedly reduced in severely feminized intersex fish by as much as 50% in terms of motility and 75% in terms of fertilization success when compared with either less severely feminized intersex fish or unaffected male fish. This is the first evidence documenting a relationship between the morphological effects (e.g., intersex) of endocrine disruption and the reproductive capabilities of any wild vertebrate. The results suggest that mixtures of endocrine-disrupting substances discharged into the aquatic environment could pose a threat to male reproductive health.

452 citations


Authors

Showing all 16338 results

NameH-indexPapersCitations
Frank B. Hu2501675253464
John C. Morris1831441168413
David W. Johnson1602714140778
Kevin J. Gaston15075085635
Andrew T. Hattersley146768106949
Timothy M. Frayling133500100344
Joel N. Hirschhorn133431101061
Jonathan D. G. Jones12941780908
Graeme I. Bell12753161011
Mark D. Griffiths124123861335
Tao Zhang123277283866
Brinick Simmons12269169350
Edzard Ernst120132655266
Michael Stumvoll11965569891
Peter McGuffin11762462968
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
2023295
2022782
20214,412
20204,192
20193,721
20183,385