Protocol for a pilot randomised controlled trial of an intervention to increase the use of traffic light food labelling in UK shoppers (the FLICC trial)

Background: Traffic light labelling of foods—a system that incorporates a colour-coded assessment of the level of total fat, saturated fat, sugar and salt on the front of packaged foods—has been recommended by the UK Government and is currently in use or being phased in by many UK manufacturers and retailers. This paper describes a protocol for a pilot randomised controlled trial of an intervention designed to increase the use of traffic light labelling during real-life food purchase decisions.

Methods/design: The objectives of this two-arm randomised controlled pilot trial are to assess recruitment, retention and data completion rates, to generate potential effect size estimates to inform sample size calculations for the main trial and to assess the feasibility of conducting such a trial. Participants will be recruited by email from a loyalty card database of a UK supermarket chain. Eligible participants will be over 18 and regular shoppers who frequently purchase ready meals or pizzas. The intervention is informed by a review of previous interventions encouraging the use of nutrition labelling and the broader behaviour change literature. It is designed to impact on mechanisms affecting belief and behavioural intention formation as well as those associated with planning and goal setting and the adoption and maintenance of the behaviour of interest, namely traffic light label use during purchases of ready meals and pizzas. Data will be collected using electronic sales data via supermarket loyalty cards and web-based questionnaires and will be used to estimate the effect of the intervention on the nutrition profile of purchased ready meals and pizzas and the behavioural mechanisms associated with label use. Data collection will take place over 48 weeks. A process evaluation including semi-structured interviews and web analytics will be conducted to assess feasibility of a full trial.

Discussion: The design of the pilot trial allows for efficient recruitment and data collection. The intervention could be generalised to a wider population if shown to be feasible in the main trial.

Implications of aligning full registration of doctors with medical school graduation:a qualitative study of stakeholder perspectives

OBJECTIVES: The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders' views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis.

SETTING: Four UK study sites, one in each country.Save

PARTICIPANTS: 185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25).

RESULTS: We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and 'sign off' to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a 'radical review' of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal.

CONCLUSIONS: A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers' decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical practice and professionalism domains need development, and good practice in postgraduate supervision and support must be shared.

The Value of Full Scale Prototype Data - Testing Oyster 800 at EMEC, Orkney

This paper demonstrates the unparalleled value of full scale data which has been acquired from ocean trials of Aquamarine Power’s Oyster 800 Wave Energy Converter (WEC) at the European Marine Energy Centre (EMEC), Orkney, Scotland.
High quality prototype and wave data were simultaneously recorded in over 750 distinct sea states (comprising different wave height, wave period and tidal height combinations) and include periods of operation where the hydraulic Power Take-Off (PTO) system was both pressurised (damped operation) and de-pressurised (undamped operation).
A detailed model-prototype correlation procedure is presented where the full scale prototype behaviour is compared to predictions from both experimental and numerical modelling techniques via a high temporal resolution wave-by-wave reconstruction. This unquestionably provides the definitive verification of the capabilities of such research techniques and facilitates a robust and meaningful uncertainty analysis to be performed on their outputs.
The importance of a good data capture methodology, both in terms of handling and accuracy is also presented. The techniques and procedures implemented by Aquamarine Power for real-time data management are discussed, including lessons learned on the instrumentation and infrastructure required to collect high-value data.

Full-Scale Shaking Table Tests on a Substandard RC Building Repaired and Strengthened with Post-Tensioned Metal Straps

The effectiveness of a novel Post-Tensioned Metal Strapping (PTMS) technique at enhancing the seismic behaviour of a substandard RC building was investigated through full-scale shake-table tests during the EU-funded project BANDIT. The building had inadequate reinforcement detailing in columns and joints to replicate old construction practices. After the bare building was initially damaged significantly, it was repaired and strengthened with PTMS to perform additional seismic tests. The PTMS technique improved considerably the seismic performance of the tested building. Whilst the bare building experienced critical damage at an earthquake of PGA=0.15g, the PTMS-strengthened building sustained a PGA=0.35g earthquake without compromising stability.

The impact of body fat on three dimensional motion of the paediatric foot during walking

Childhood obesity is commonly associated with a pes planus foot type and altered lower limb joint function during walking. However, limited information has been reported on dynamic intersegment foot motion with the level of obesity in children. The aim of this study was to explore the relationships between intersegment foot motion during gait and body fat in boys age 7 to 11 years. Fat mass was measured in fifty-five boys using air displacement plethysmography. Three-dimensional gait analysis was conducted on the right foot of each participant using the 3DFoot model to capture angular motion of the shank, calcaneus, midfoot and metatarsals. Two multivariate statistical techniques were employed; principle component analysis reduced the multidimensional nature of gait analysis, and multiple linear regression analysis accounted for potential confounding factors. Higher fat mass predicted greater plantarflexion of the calcaneus during the first half and end of stance phase and at the end of swing phase. Greater abduction of the calcaneus throughout stance and swing was predicted by greater fat mass. At the midfoot, higher fat mass predicted greater dorsiflexion and eversion throughout the gait cycle. The findings present novel information on the relationships between intersegment angular motion of the foot and body fat in young boys. The data indicates a more pronated foot type in boys with greater body fat. These findings have clinical implications for pes planus and a predisposition for pain and discomfort during weight bearing activities potentially reducing motivation in obese children to be physically active.

Cloning and expression in Escherichia coli of full-length complementary DNA coding for human α1-antitrypsin

A cDNA library prepared from human liver was screened for α₁-antitrypsin, a major constituent of plasma which functions as inhibitor of proteolytic enzyms. The library was screened using a 12-base-long synthetic oligodeoxyribonucleotide corresponding to a known DNA fragment of human α₁-antitrypsin and by hybrid-selection of α₁-antitrypsin mRNA.

Molecular cloning, full-length sequence and preliminary characterization of a 56-kDa protein induced by human interferons

Among the various proteins which are induced when human cells are are treatened with interferon, a predominant protein of unknown function, with molecular mass 56 kDa, has been observed. With the aim of exploring the molecular basis of the regulation of this protein and of its mRNA, in order to understand its biological functionand its possible contribution to the various antiviral and non-antiviral actions exerted by interferons.

Pope as media star: a long career full of reinvention

On the whole, a man who is elected as Pope is well on in years. Some, despite this, have managed to reign for a long time, Leo XIII for instance who came to the throne when he was already seventy in 1878, reigned for twenty five years. Wojtyla was elected when he was only fifty eight, in 1978. In the last century or so, the papacy has become visible worldwide through the mass media. On his accession, Wojtyla was presented as a man's man, a sportsman - according to Professor Eamon Duffy of Cambridge University - as a Bishop with balls. Like other media stars who have stayed the test of time, e.g. Madonna, David Bowie, it seems that he has been able to reinvent his media image to some extent; from the active sportsman to the benevolent grandfather to the ailing figure we see today. He has taken on the aspect of a media star, a world traveller, a spiritual leader, a politician, a mediator and a peace leader. He has been described as the most-photographed person on the planet. This paper will attempt to trace these changes and to ascertain, using Vatican and media sources to discover how much of this continual change is driven by the personality of John Paul himself and how much is a deliberate policy on the part of the Vatican.

Big and beautiful: attractiveness and health ratings of the female body by male "fat admirers"

This study examined the body weight and waist-to-hip ratio (WHR) preferences of “fat admirers” (FAs), that is, individuals who are sexually attracted to heavier partners. Fifty-six heterosexual men involved in the FA community rated a series of line drawings that varied in three levels of body weight and six of WHR for physical attractiveness and health. The results showed significant main effects of body weight and WHR, as well as a significant body weight × WHR interaction for both health ratings. In general, there was a preference for heavyweight figures and high WHRs for ratings of attractiveness and normal-weight figures and mid-ranging WHRs for ratings of health. Limitations of the study and explanations for fat admiration are discussed.

Circulating pancreatic polypeptide concentrations predict visceral and liver fat content

CONTEXT AND OBJECTIVE: No current biomarker can reliably predict visceral and liver fat content, both of which are risk factors for cardiovascular disease. Vagal tone has been suggested to influence regional fat deposition. Pancreatic polypeptide (PP) is secreted from the endocrine pancreas under vagal control. We investigated the utility of PP in predicting visceral and liver fat. PATIENTS AND METHODS: Fasting plasma PP concentrations were measured in 104 overweight and obese subjects (46 men and 58 women). In the same subjects, total and regional adipose tissue, including total visceral adipose tissue (VAT) and total subcutaneous adipose tissue (TSAT), were measured using whole-body magnetic resonance imaging. Intrahepatocellular lipid content (IHCL) was quantified by proton magnetic resonance spectroscopy. RESULTS: Fasting plasma PP concentrations positively and significantly correlated with both VAT (r = 0.57, P < .001) and IHCL (r = 0.51, P < .001), but not with TSAT (r = 0.02, P = .88). Fasting PP concentrations independently predicted VAT after controlling for age and sex. Fasting PP concentrations independently predicted IHCL after controlling for age, sex, body mass index (BMI), waist-to-hip ratio, homeostatic model assessment 2-insulin resistance, (HOMA2-IR) and serum concentrations of triglyceride (TG), total cholesterol (TC), and alanine aminotransferase (ALT). Fasting PP concentrations were associated with serum ALT, TG, TC, low- and high-density lipoprotein cholesterol, and blood pressure (P < .05). These associations were mediated by IHCL and/or VAT. Fasting PP and HOMA2-IR were independently significantly associated with hepatic steatosis (P < .01). CONCLUSIONS: Pancreatic polypeptide is a novel predictor of visceral and liver fat content, and thus a potential biomarker for cardiovascular risk stratification and targeted treatment of patients with ectopic fat deposition.

Body fat MRS

The increasing levels of obesity, and its associated comorbidities, have prompted a reassessment of the techniques used for assessing body fat, including content, distribution, and composition. Magnetic resonance spectroscopy (MRS) is one among the many invaluable in vivo tools available today to evaluate the role of body fat in health and disease. However, although MRS has become a powerful technique for assessing ectopic fat in vivo, it has had limited use in other areas of research associated with body fat. MRS has found some success as a fast method to determine whole body adiposity in rodent models of disease, as well as a noninvasive method of obtaining an index of the overall composition of body fat in human subjects. Its more significant use has been in the understanding of bone marrow fat content, where important advances have been made, especially in longitudinal studies. In conclusion, in the area of body fat, MRS continues to be an adjunct technique to more precise and versatile MRI methods.