University of Lincoln

About: University of Lincoln is a education organization based out in Lincoln, Lincolnshire, United Kingdom. It is known for research contribution in the topics: Population & Context (language use). The organization has 2341 authors who have published 7025 publications receiving 124797 citations.

General practitioners’ experiences and perceptions of benzodiazepine prescribing: systematic review and meta-synthesis

Abstract: Benzodiazepines are often prescribed long-term inappropriately. We aimed to systematically review and meta-synthesise qualitative studies exploring clinicians’ experiences and perceptions of benzodiazepine prescribing to build an explanatory model of processes underlying current prescribing practices. We searched seven electronic databases for qualitative studies in Western primary care settings published in a European language between January 1990 and August 2011 analysing GP or practice nurse experiences of benzodiazepine prescribing. We assessed study quality using the Critical Appraisal Skills Programme Checklist. We analysed findings using thematic synthesis. We included eight studies from seven countries published between 1993 and 2010. Benzodiazepine prescribing decisions are complex, uncomfortable, and demanding, taken within the constraints of daily general practice. Different GPs varied in the extent to which they were willing to prescribe benzodiazepines, and individual GPs’ approaches also varied. GPs were ambivalent in their attitude towards prescribing benzodiazepines and inconsistently applied management strategies for their use. This was due to the changing context of prescribing, differing perceptions of the role and responsibility of the GP, variation in GPs’ attitudes to benzodiazepines, perceived lack of alternative treatment options, GPs’ perception of patient expectations and the doctor-patient relationship. GPs faced different challenges in managing initiation, continuation and withdrawal of benzodiazepines. We have developed a model which could be used to inform future interventions to improve adherence to benzodiazepine prescribing guidance and improve prescribing through education and training of professionals on benzodiazepine use and withdrawal, greater provision of alternatives to drugs, reflective practice, and better communication with patients.

Stress detection using wearable physiological sensors

Abstract: As the population increases in the world, the ratio of health carers is rapidly decreasing. Therefore, there is an urgent need to create new technologies to monitor the physical and mental health of people during their daily life. In particular, negative mental states like depression and anxiety are big problems in modern societies, usually due to stressful situations during everyday activities including work. This paper presents a machine learning approach for stress detection on people using wearable physiological sensors with the final aim of improving their quality of life. The presented technique can monitor the state of the subject continuously and classify it into ”stressful” or ”non-stressful” situations. Our classification results show that this method is a good starting point towards real-time stress detection.

Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case–control study

Abstract: Background: Previous studies have shown an association between acute myocardial infarction and preceding respiratory infection. Contradictory evidence exists on the influence of influenza vaccination and pneumococcal vaccination in preventing cardiovascular disease. We aimed to investigate the possible association of influenza vaccination and pneumococcal vaccination with acute myocardial infarction. Methods: We used a matched case–control design with data from the United Kingdom General Practice Research Database. Cases were patients who were at least 40 years of age at diagnosis of first acute myocardial infarction recorded from Nov.1, 2001, to May 31, 2007, and were matched for sex, general practice, age and calendar time (i.e., month corresponding to index date of acute myocardial infarction), with up to four controls each. Data were analyzed using conditional logistic regression, adjusted for vaccination target groups, cardiovascular risk factors, treatment medications and attendances at a general practice. Results: We included 78 706 patients, of whom 16 012 were cases and 62 694 were matched controls. Influenza vaccination had been received in the previous year by 8472 cases (52.9%) and 32 081 controls (51.2%) and was associated with a 19% reduction in the rate of acute myocardial infarction (adjusted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.77–0.85). Early seasonal influenza vaccination was associated with a lower rate of acute myocardial infarction (adjusted OR 0.79, 95% CI 0.75–0.83) than vaccination after mid-November (adjusted OR 0.88, 95% CI 0.79–0.97). Pneumococcal vaccination was not associated with a reduction in the rate of acute myocardial infarction (adjusted OR 0.96, 95% CI 0.91–1.02). Interpretation: Influenza vaccination but not pneumococcal vaccination is associated with a reduced rate of first acute myocardial infarction. This association and the potential benefit of early seasonal vaccination need to be considered in future experimental studies.

An egg-adult association, gender, and reproduction in pterosaurs.

Abstract: A sexually mature individual of Darwinopterus preserved together with an egg from the Jurassic of China provides direct evidence of gender in pterosaurs and insights into the reproductive biology of these extinct fliers. This new find and several other examples of Darwinopterus demonstrate that males of this pterosaur had a relatively small pelvis and a large cranial crest, whereas females had a relatively large pelvis and no crest. The ratio of egg mass to adult mass is relatively low, as in extant reptiles, and is comparable to values for squamates. A parchment-like eggshell points to burial and significant uptake of water after oviposition. This evidence for low parental investment contradicts the widespread assumption that reproduction in pterosaurs was like that of birds and shows that it was essentially like that of reptiles.

The plastic waste problem in Malaysia: management, recycling and disposal of local and global plastic waste

Abstract: Plastic waste is one of the world’s most pressing human health and environmental concerns. Plastic constitutes the third highest waste source globally, with the total volume of plastic waste growing in-line with increases in the global population and per capita consumption. Malaysia is tracking global trends in both the overall generation of plastic waste and the consumption of single-use plastics and since 2017 has been the world’s largest importer of plastic waste. These elements create a number of major challenges for the country’s waste management system. This review outlines the current state of plastic waste production and management in Malaysia, including options for landfill, recycling and incineration. It presents information on the scale and both the human and ecological risks of plastic waste in the country (i.e. microplastics, landfill, incineration), outlines key plastic waste management policy initiatives (including plastics alternatives such as biodegradable plastics) and highlights key constraints on the success of these. Significant internal constraints stem from the inconsistent application of policy initiatives by state governments, in addition to the lack of public awareness and interest in household recycling. The paper closes by discussing options for and constraints on the switch to biodegradable alternatives and proposes a model of plastic management based on a circular economy approach and solid waste management hierarchy. Success in reducing the problems posed by plastic in Malaysia will require sustained effort at many levels, but positive experiences in other countries give some cause for optimism.