Trends in coronary risk factors in the WHO MONICA Project

Background. The World Health Organization (WHO) MONICA Project was established to determine how trends in event rates for coronary heart disease (CHD) and, optionally, stroke were related to trends in classic coronary risk factors. Risk factors were therefore monitored over ten years across 38 populations from 21 countries in four continents (overall period covered: 1979-1996). Methods. A standard protocol was applied across participating centres, in at least two, and usually three, independent surveys conducted on random samples of the study populations, well separated within the 10-year study period. Results. Smoking rates decreased in most male populations (35-64 years) but in females the majority showed increases. Systolic blood pressure showed decreasing trends in the majority of centres in both sexes. Mean levels of cholesterol generally showed downward trends, which, although the changes were small, had large effects on risk. There was a trend of increasing body mass index (BMI) with half the female populations and two-thirds of the male populations showing a significant increase. Conclusions. It is feasible to monitor the classic CHD risk factors in diverse populations through repeated surveys over a decade. In general, the risk factor trends are downwards in most populations but in particular, an increase in smoking in women in many populations and increasing BMI, especially in men, are worrying findings with significant public health implications.

Nuclear magnetic resonance-determined lipoprotein subclass profile in the DCCT/EDIC cohort:associations with carotid intima-media thickness

To relate nuclear magnetic resonance lipoprotein subclass profiles (NMR-LSP) and other lipoprotein-related factors with carotid intima-media thickness (IMT) in Type 1 diabetes.

Patrick Moore, Arthur C. Clarke and ‘British Outer Space’ in the mid 20th century

This article seeks to explore a notion of 'British outer space' in the mid 20th century with reference to the British Interplanetary Society and the works of Patrick Moore and Arthur C. Clarke. Geographies of outer space have been examined following early work by Denis Cosgrove on the Apollo space photographs. Cosgrove's work has encouraged a growing body of work that seeks to examine both the 'Earth from space' perspective as well as its reciprocal, 'space from Earth'. This article aligns itself with the latter viewpoint, in attempting to define a national culture of 'British outer space'. This is found to have an important connection with the British Interplanetary Society, founded in 1933 near Liverpool, which went on to influence the works of Patrick Moore, who edited the magazine Spaceflight and presented the television programme The Sky at Night, and Arthur C. Clarke, who became known as a science fiction writer through his early novels in the 1950s. The themes of audience participation and human destiny in outer space are examined in a close reading of these two case studies, and further engagement with cultures of outer space in geography is encouraged. © The Author(s) 2012.

A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study

Objective: The incidence of oesophageal adenocarcinoma (EAC) has increased rapidly over the past 40 years and accumulating evidence suggests that obesity, as measured by body mass index (BMI), is a major risk factor. It remains unclear whether abdominal obesity is associated with EAC and gastric adenocarcinoma.

Design: Cox proportional hazards regression was used to examine associations between overall and abdominal obesity with EAC and gastric adenocarcinoma among 218 854 participants in the prospective NIHeAARP cohort.

Results: 253 incident EAC, 191 gastric cardia adenocarcinomas and 125 gastric non-cardia adenocarcinomas accrued to the cohort. Overall obesity (BMI) was positively associated with EAC and gastric
cardia adenocarcinoma risk (highest ($35 kg/m2) vs referent (18.5e<25 kg/m2); HR 2.11, 95% CI 1.09 to 4.09 and HR 3.67, 95% CI 2.00 to 6.71, respectively). Waist circumference was also positively associated with EAC and gastric cardia adenocarcinoma risk (highest vs referent; HR 2.01, 95% CI 1.35 to 3.00 and HR 2.22, 95% CI 1.43 to 3.47, respectively), whereas waist-to-hip ratio (WHR) was positively associated with EAC risk only (highest vs referent; HR 1.81, 95% CI 1.24 to 2.64) and persisted in patients with normal BMI (18.5e<25 kg/m2). Mutual adjustment of WHR and BMI attenuated
both, but did not eliminate the positive associations for either with risk of EAC. In contrast, the majority of the anthropometric variables were not associated with adenocarcinomas of the gastric non-cardia.

Conclusion Overall obesity was associated with a higher risk of EAC and gastric cardia adenocarcinoma, whereas abdominal obesity was found to be associated with increased EAC risk; even in people with normal BMI

Incubation or Induction? Gendered Identity Work in the Context of Technology Business Incubation

While there is a substantial body of literature exploring the influence of business incubation upon early stage firms, this debate remains almost entirely gender blind. This article challenges this assumption by adopting a feminist perspective to reveal business incubation as a gendered process shaping the identity work undertaken by women seeking legitimacy as technology venturers. In so doing, we critically evaluate prevailing normative analyses of the business incubation process and entrepreneurial legitimation. To illustrate this argument, we draw upon empirical evidence which reveals technology incubation as a legitimating induction process encouraging women to reproduce masculinized representations of the normative technology entrepreneur.

Tri-axial accelerometers tease apart discrete behaviours in the common cuttlefish Sepia officinalis

Acceleration data loggers can be used to construct time-energy budgets or identify specific behaviours in free living animals. Within a marine context such devices have been largely deployed on vertebrates with comparatively little attention paid to commercially important invertebrates such as cephalopod molluscs. Here we tested the utility of tri-axial accelerometers to tease apart six discrete behaviours in the common cuttlefish Sepia officinalis. By considering depth profiles in conjunction with body pitch and roll and overall dynamic body acceleration we were able to make distinctions between resting at the seabed, active swimming, mating, post-coital panting and active manoeuvring along the seabed. © 2012 Marine Biological Association of the United Kingdom.

Polemic and apocalyptic in the Cromwellian invasion of Scotland

This article describes the culture of print and polemic associated with the Cromwellian invasion of Scotland and the resistance of the Church of Scotland. It argues that print solidified Parliamentary ideas during the invasion but that it did not continue to do so after English dominance had been established. These texts illustrate the divisions between the mentalité of the Cromwellian rank-and-file and that of the rather small and probably unrepresentative body of opinion formers who sought to control and represent it.

Evaluation of Corrosion Fatigue Behaviour of Laser-welded NiTi Alloys using Bending Rotation Fatigue Test in Simulated Body Fluid

Shape memory NiTi alloys have been used extensively for medical device applications such as orthopedic, dental, vascular and cardiovascular devices on account of their unique shape memory effect (SME) and super-elasticity (SE). Laser welding is found to be the most suitable method used to fabricate NiTi-based medical components. However, the performance of laser-welded NiTi alloys under corrosive environments is not fully understood and a specific focus on understanding the corrosion fatigue behaviour is not evident in the literature. This study reveals a comparison of corrosion fatigue behaviour of laser-welded and bare NiTi alloys using bending rotation fatigue (BRF) test which was integrated with a specifically designed corrosion cell. The testing environment was Hanks’ solution (simulated body fluid) at 37.5oC. Electrochemical impedance spectroscopic (EIS) measurement was carried out to monitor the change of corrosion resistance at different periods during the BRF test. Experiments indicate that the laser-welded NiTi alloy would be more susceptible to the corrosion fatigue attack than the bare NiTi alloy. This finding can serve as a benchmark for the product designers and engineers to determine the factor of safety of NiTi medical devices fabricated using laser welding.

Microabrasion-corrosion of cast CoCrMo alloy in simulated body fluids

Wear and corrosion of metal-on-metal hip replacements results in wear debris and metal-ion release in vivo, which may subsequently cause pain and hypersensitivity for patients. Retrieved metal-on-metal hip replacements have revealed that two-body sliding wear and three-body abrasive wear are the predominant wear mechanisms. However, there is a lack of understanding of the combined effects of wear/corrosion, especially the effect of abrasion-corrosion.

This study investigates the sliding-corrosion and abrasion-corrosion performance of a cast CoCrMo alloy in simulated hip joint environments using a microabrasion rig integrated with an electrochemical cell. Tests have been conducted in 0.9% NaCl, phosphate buffered saline solution, 25% and 50% bovine serum solutions with 0 or 1 g cm(-3) SiC at 37 degrees C. Experimental results reveal that under abrasion-corrosion test conditions, the presence of proteins increased the total specific wear rate. Conversely, electrochemical noise measurements indicated that the average anodic current levels were appreciably lower for the proteinaceous solutions when compared with the inorganic solutions. A severely deformed nanocrystalline layer was identified immediately below the worn surface for both proteinaceous and inorganic solutions. The layer is formed by a recrystallisation process and/or a strain-induced phase transformation that occurs during microabrasion-corrosion. (C) 2008 Elsevier Ltd. All rights reserved.

Micro-abrasion mechanisms of cast CoCrMo in simulated body fluids

The abrasion seen on some of the retrieved CoCrMo hip joints has been reported to be caused by entrained hard particles in vivo. However, little work has been reported on the abrasion mechanisms of CoCrMo alloy in simulated body environments. Therefore. this study covers the mapping of micro-abrasion wear mechanisms of cast CoCrMo induced by third body hard particles under a wide range of abrasive test conditions. This study has a specific focus on covering the possible in vivo wear modes seen on metal-on-metal (MoM) surfaces. Nano-indentation and nano-scratch tests were also employed to further investigate the secondary wear mechanisms-nano-scale material deformation that involved in micro-abrasion processes. This work addresses the potential detrimental effects of third body hard particles in vivo such as increased wear rates (debris generation) and corrosion (metal-ion release). The abrasive wear mechanisms of cast CoCrMo have been investigated under various wear-corrosion conditions employing two abrasives, SiC (similar to 4 mu m) and Al(2)O(3) (similar to 1 mu m), in two test solutions, 0.9% NaCl and 25% bovine serum. The specific wear rates, wear mechanisms and transitions between mechanisms are discussed in terms of the abrasive size, volume fraction and the test solutions deployed. The work shows that at high abrasive volume fractions, the presence of protein enhanced the wear loss due to the enhanced particle entrainment, whereas at much lower abrasive volume fractions, protein reduced the wear loss by acting as a boundary lubricant or rolling elements which reduced the abrasivity (load per particle) of the abrasive particles. The abrasive wear rate and wear mechanisms of the CoCrMo are dependent on the nature of the third body abrasives, their entrainment into the contact and the presence of the proteins. (C) 2009 Elsevier B.V. All rights reserved.

Living in The Matrix: Virtual Reality Systems and Hyperspatial Representation in Architecture

In the digital age, the hyperspace of virtual reality systems stands out as a new spatial concept creating a parallel realm to "real" space. Virtual reality influences one’s experience of and interaction with architectural space. This "otherworld" brings up the criticism of the existing conception of space, time and body. Hyperspaces are relatively new to designers but not to filmmakers. Their cinematic representations help the comprehension of the outcomes of these new spaces. Visualisation of futuristic ideas on the big screen turns film into a medium for spatial experimentation. Creating a possible future, The Matrix (Andy and Larry Wachowski, 1999) takes the concept of hyperspace to a level not-yet-realised but imagined. With a critical gaze at the existing norms of architecture, the film creates new horizons in terms of space. In this context, this study introduces science fiction cinema as a discussion medium to understand the potentials of virtual reality systems for the architecture of the twenty first century. As a "role model" cinema helps to better understand technological and spatial shifts. It acts as a vehicle for going beyond the spatial theories and designs of the twentieth century, and defining the conception of space in contemporary architecture.

Sediment changes upstream and downstream of the Altnahinch Dam in the River Bush in Northern Ireland: A preliminary study

The River Bush must reach a standard of good ecological potential (GEP) by 2015 due to the requirements of the water framework directive. The role of sediments within a water body is extremely important to all aspects of a river's regime. The aim of this research is to investigate the effects of Altnahinch Dam on sediment distribution in the River Bush (a heavily modified water body) with comparison made against the Glendun River (an unmodified water body). Samples collected from the rivers were analysed by physical (pebble count, sieve analysis) and statistical methods (ANOVA, GRADISTAT). An increase in fine sediments upstream of the dam provides evidence that the dam is impacting sediment distribution. Downstream effects are not shown to be significant. The output of this study also implies similar impacts at other drinking water storage impoundments. This research recommends that a sediment management plan be put in place for Altnahinch Dam and that further studies be carried-out concentrating on fine sediment distribution upstream of the dam. 

The Changing Context for Planning Education in the UK and the Prospects for Research-Led, Practice-Engaged Teaching

The UK’s Royal Town Planning Institute (RTPI) celebrates its centenary in 2014, marking 100 years of close relationships between university-based Planning Schools and a professional body focussed on planning practice. During this period, the context for university education and the very idea of planning has changed dramatically contributing to a continual renegotiation of the relationships between the planning profession and the educational institutions it accredits. These changes have been particularly acute in the last ten years where a number of factors have forced a rapid change in the nature of planning education in the UK. This has included a boom and then slump in the number of planning students linked to the national economic situation, a reorganisation of many planning schools and their merger with cognate disciplines such as geography and an increased focus of research output, rather than professional engagement the key institutional indicator of success. This last factor adds a particularly new dimension to the profession-university relationship, which could potentially lead to either a straining of tensions or a synergy through research-led teaching that could significantly benefit both.

This paper will briefly review the evolution of UK planning schools and the co-evolution of the main ideas informing planning education. It will then describe the current profile of UK planning schools, based on an extensive national survey conducted on behalf of the Royal Town Planning Institute. The paper will then critically review the main challenges and opportunities facing UK Planning Schools in the context of changes in both planning practice and higher education. It will then move on to the concept of research-led teaching, drawing on current practice in the UK and review how well this concept serves students and the idea of developing reflective planning practitioners. Finally, the paper will seek to draw broad lessons from the experience of the UK and reflect on the type of planning education that can best serve planning professions in a variety of international contexts in the future.

Accuracy of LightCycler SeptiFast for the detection and identification of pathogens in the blood of patients with suspected sepsis: a systematic review and meta-analysis

Purpose: There is an urgent need to develop diagnostic tests to improve the detection of pathogens causing life-threatening infection (sepsis). SeptiFast is a CE-marked multi-pathogen real-time PCR system capable of detecting DNA sequences of bacteria and fungi present in blood samples within a few hours. We report here a systematic review and meta-analysis of diagnostic accuracy studies of SeptiFast in the setting of suspected sepsis.

Methods: A comprehensive search strategy was developed to identify studies that compared SeptiFast with blood culture in suspected sepsis. Methodological quality was assessed using QUADAS. Heterogeneity of studies was investigated using a coupled forest plot of sensitivity and specificity and a scatter plot in receiver operator characteristic space. Bivariate model method was used to estimate summary sensitivity and specificity.

Results: From 41 phase III diagnostic accuracy studies, summary sensitivity and specificity for SeptiFast compared with blood culture were 0.68 (95 % CI 0.63–0.73) and 0.86 (95 % CI 0.84–0.89) respectively. Study quality was judged to be variable with important deficiencies overall in design and reporting that could impact on derived diagnostic accuracy metrics.

Conclusions: SeptiFast appears to have higher specificity than sensitivity, but deficiencies in study quality are likely to render this body of work unreliable. Based on the evidence presented here, it remains difficult to make firm recommendations about the likely clinical utility of SeptiFast in the setting of suspected sepsis.

Promoting normality in the management of the perineum during the second stage of labour

The management of the perineum during birth has multiple long-term effects on women and their families. The midwife has a key role to play and often the techniques they employ vary significantly, as does their justification of these practices. This article seeks to examine current evidence to explore what is known to contribute to lower perineal trauma rates and what practices should be avoided to protect childbearing women. The conclusions drawn show that the updating of
practice and antenatal education may be required so that woman are given the information they need to make an informed choice as to what they want for their own body, child and experience.