1987-1991. Joint Archaeological Project of the National Museum of Malta and the Universities of Bristol, Cambridge and Malta.

Malone, C.A.T. and S.K.F. Stoddart, Five Year Statement.1991: Cambridge University.

Management of Hyperphosphataemia in Chronic Kidney Disease:Summary of National Institute for Health and Clinical Excellence (NICE) Guideline

Bone disease and ectopic calcification are the two main consequences of hyperphosphataemia of chronic kidney disease (CKD). Observational studies have demonstrated that hyperphosphataemia in CKD is associated with increased mortality. Furthermore, the use of phosphate binders in dialysis patients is associated with significantly lower mortality. The UK Renal Registry data show significant underachievement of phosphate targets in dialysis patients. It is believed to be due to wide variation in how management interventions are used. The National Institute for Health and Clinical Excellence (NICE) has developed a guideline on the management of hyperphosphataemia in CKD. This is based on the evidence currently available using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. This review outlines the recommendations including research recommendations and discusses methodology, rationale and challenges faced in developing this guideline and the health economic model used to assess the cost-effectiveness of different phosphate binders. © 2013 S. Karger AG, Basel.

Obesity and kidney disease in type 1 and 2 diabetes: an analysis of the National Diabetes Audit

Background: Obesity is increasingly prevalent in many countries. Obesity is a major risk factor for the development of type 2 diabetes but its relationship with diabetic kidney disease (DKD) remains unclear. Some studies have suggested that the metabolic syndrome (including obesity) may be associated with DKD in type 1 diabetes. Aim: To investigate the association between obesity and DKD. Design: Retrospective cross-sectional study. Methods: National Diabetes Audit data were available for the 2007–08 cycle. Type 1 and 2 diabetes patients with both a valid serum creatinine and urinary albumin:creatinine ratio were included. DKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, albuminuria or both. Logistic regression was used to analyse associations of obesity (body mass index ≥30 kg/m2) and other variables including year of birth, year of diagnosis, ethnicity and stage of kidney disease. Results: A total of 58 791 type 1 and 733 769 type 2 diabetes patients were included in the analysis. After adjustment, when compared with type 1 diabetes patients with normal renal function those with DKD were up to twice as likely to be obese. Type 2 DKD patients were also more likely to be obese. For example, type 2 diabetes patients with an eGFR <15 ml/min/1.73 m2 and normoalbuminuria, microalbuminuria or macroalbuminuria were all more likely to be obese; odds ratios (95% CI) 1.65 (1.3–2.1), 1.56 (1.28–1.92) and 1.27 (1.05–1.54), respectively. Conclusions: This study has highlighted a strong association between obesity and kidney disease in type 1 diabetes and confirmed their association in type 2 diabetes.

''We are an island”: Geographical Imagery in Accounts of Citizenship, Civil Society, and National Identity in Scotland and in England

In this article we question recent psychological approaches that equate the constructs of citizenship and social identity and which overlook the capacity for units of governance to be represented in terms of place rather than in terms of people. Analysis of interviews conducted in England and Scotland explores how respondents invoked images of Britain as “an island” to avoid social identity constructions of nationality, citizenship, or civil society. Respondents in Scotland used island imagery to distinguish their political commitment to British citizenship from questions relating to their subjective identity. Respondents in England used island imagery to distinguish the United Kingdom as a distinctive political entity whilst avoiding allusions to a common or distinctive identity or character on the part of the citizenry. People who had moved from England to Scotland used island imagery to manage the delicate task of negotiating rights to social inclusion in Scottish civil society whilst displaying recognition of the indigenous population’s claims to distinctive national culture and identity.

Right-Wing Violence in Germany: Assessing the Objectives, Personalities and Terror Trail of the National Socialist Underground and the State's Response to It

In the last five years the forces of organised right-wing extremism have made electoral advances across many states in contemporary Europe. Germany has not been immune and the extreme right party, the National Democratic Party of Germany won its first seat in the European Parliament since 1989. The recent successes of the extreme right pose issues for European society about tolerance and immigration policy, but this scene has also been associated with an upsurge in racially motivated political violence and acts of right-wing terrorism. Much of this violence is perpetrated by small neo-Nazi styled groups. This paper looks at the most notorious and recent of such groups to emerge in Germany, the National Socialist Underground. The paper explores the origins and personalities behind this terror cell, provides derails of its criminal activities and murder spree, and questions why it took so long for the authorities to identify the NSU.

British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus

These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.

Evolving national park models: The emergence of an economic imperative and its effect on the contested nature of the 'national' park concept in Northern Ireland.

National park models have evolved in tandem with the emergence of a multifunctional countryside. Sustainable development has been added to the traditional twin aims of conservation and recreation. This is typified by recent national park designations, such as the Cairngorms National Park in Scotland. A proposed Mournes national park in Northern Ireland has evolved a stage further with a model of national park to deliver national economic goals envisaged by government. This seeks to commodify the natural landscape. This paper compares Cairngorm and Mourne stakeholders’ views on the principal features of both models: park aims, management structures and planning functions. While Cairngorm stakeholders were largely positive from the outset, the model of national park introduced is not without criticism. Conversely, Mourne stakeholders have adopted an anti-national park stance. Nevertheless, the model of national park proposed possessing a strong economic imperative, an absence of the Sandford Principle as a means to manage likely conflicts, and lacking any planning powers in its own right, may still be insufficient to bring about widespread support for a Mourne national park. Such a model is also likely to accelerate the degradation of the Mourne landscape. Competing national identities (British and Irish) provide an additional dimension to the national park debate in Northern Ireland. Deep ideological cleavages are capable of derailing the introduction of a national park irrespective of the model proposed. In Northern Ireland the national park debate is not only about reconciling environmental and economic interests but also political and ethno-national differences.

The stability of alcohol consumption between age 16 and 26: Evidence from a National Birth Cohort Study

This study examined the association between moderate drinking at age 16 (adolescence) and alcohol consumption at age 26 (young adulthood), whilst controlling for possible confounding effects at the individual and family level (assessed at birth and age 10). Using the British Cohort Study (BCS70), 6515 respondents provided data on their adolescent alcohol consumption and other behaviours. Of these, 4392 also completed the survey at age 26. Consumption patterns established in adolescence persisted, to a large degree, into early adulthood. Those adolescents who drank moderately in adolescence drank significantly less in adulthood than those adolescents who drank to heavy or hazardous levels. Implications for health promotion strategies and guidance are discussed.