Dual energy X-ray absorptiometry positioning protocols in assessing body composition: A systematic review of the literature:A systematic review of the literature

OBJECTIVES: To systematically identify and assess methods and protocols used to reduce technical and biological errors in published studies that have investigated reliability of dual energy X-ray absorptiometry (DXA) for assessing body composition. DESIGN: Systematic review. METHODS: Systematic searches of five databases were used to identify studies of DXA reliability. Two independent reviewers used a modified critical appraisal tool to assess their methodological quality. Data was extracted and synthesised using a level of evidence approach. Further analysis was then undertaken of methods used to decrease DXA errors (technical and biological) and so enhance DXA reliability. RESULTS: Twelve studies met eligibility criteria. Four of the articles were deemed high quality. Quality articles considered biological and technical errors when preparing participants for DXA scanning. The Nana positioning protocol was assessed to have a strong level of evidence. The studies providing this evidence indicated very high test–retest reliability (ICC 0.90–1.00 or less than 1% change in mean) of the Nana positioning protocol. The National Health and Nutrition Examination Survey (NHANES) positioning protocol was deemed to have a moderate level of evidence due to lack of high quality studies. However, the available studies found the NHANES positioning protocol had very high test–retest reliability. Evidence is limited and reported reliability has varied in papers where no specific positioning protocol was used or reported. CONCLUSIONS: Due to the strong level of evidence of excellent test–retest reliability that supports use of the Nana positioning protocol, it is recommended as the first choice for clinicians when using DXA to assess body composition

A Mesolithic settlement site at Howick, Northumberland: a preliminary report

Excavations at a coastal site at Howick during 2000 and 2002 have revealed evidence for a substantial Mesolithic settlement and a Bronze Age cist cemetery. Twenty one radiocarbon determinations of the earlier eighth millennium BP (Cal.) indicate that the Mesolithic site is one of the earliest known in northern Britain. An 8m core of sediment was recovered from stream deposits adjacent to the archaeological site which provides information on local environmental conditions. Howick offers a unique opportunity to understand aspects of hunter-gatherer colonisation and settlement during a period of rapid palaeogeographical change around the margins of the North Sea basin, at a time when it was being progressively inundated by the final stages of the postglacial marine transgression. The cist cemetery will add to the picture of Bronze Age occupation of the coastal strip and again reveals a correlation between the location of Bronze Age and Mesolithic sites which has been observed elsewhere in the region

Investment in sensory structures, testis size, and wing coloration in males of a diurnal moth species: trade-offs or correlated growth?

For dioecious animals, reproductive success typically involves an exchange between the sexes of signals that provide information about mate location and quality. Typically, the elaborate, secondary sexual ornaments of males signal their quality, while females may signal their location and receptivity. In theory, the receptor structures that receive the latter signals may also become elaborate or enlarged in a way that ultimately functions to enhance mating success through improved mate location. The large, elaborate antennae of many male moths are one such sensory structure, and eye size may also be important in diurnal moths. Investment in these traits may be costly, resulting in trade-offs among different traits associated with mate location. For polyandrous species, such trade-offs may also include traits associated with paternity success, such as larger testes. Conversely, we would not expect this to be the case for monandrous species, where sperm competition is unlikely. We investigated these ideas by evaluating the relationship between investment in sensory structures (antennae, eye), testis, and a putative warning signal (orange hindwing patch) in field-caught males of the monandrous diurnal painted apple moth Teia anartoides (Lepidoptera: Lymantriidae) in southeastern Australia. As predicted for a monandrous species, we found no evidence that male moths with larger sensory structures had reduced investment in testis size. However, contrary to expectation, investment in sensory structures was correlated: males with relatively larger antennae also had relatively larger eyes. Intriguingly, also, the size of male orange hindwing patches was positively correlated with testis size

Marketing a tourism industry in late stage decline: The case of the Isle of Man

Qualitative interviews in the Isle of Man uncovered local perceptions of a tourism industry in late stage decline. Social impacts of decline are pronounced including facilities loss, cultural changes and a heightening of perceived peripherality: which taken together undermine local identity. Tourists are welcomed as they help to affirm the pride residents have in their island in creating a more active atmosphere, provide social interaction opportunities and to combat negative stereotyping. Thus findings emphasise the diverse, unique and persistent benefits of tourism in the Isle of Man, despite its decline. Destination marketing recommendations are therefore made to better address the experiences and desires of communities experiencing decline

Introduction : screen Londons

Our aim, in editing the ‘London Issue’ of this journal, is to contribute to a conversation between scholars of British cinema and television, London historians and scholars of the cinematic city. In 2007, introducing the themed issue on ‘Space and Place in British Cinema and Television’, Steve Chibnall and Julian Petley observed that it would have been possible to fill the whole journal with essays about the representation of London. This issue does just that, responding to the increased interest in cinematic and, to a lesser extent, televisual, Londons, while also demonstrating the continuing fertility of the paradigms of ‘space and place’ for scholars of the moving image1. It includes a wide range of approaches to the topic of London on screen, with varying attention to British institutions of the moving image – such as Channel Four or the British Board of Film Classification – as well as to concepts such as genre, narration and memory. As a whole, the issue, through its juxtapositions of method and approach, shows something of the complexity of encounters between the terms ‘London’, ‘cinema’ and ‘television’ within British film and television studies

Exploring Attitudes towards Genetically Modified Foods: Is there a Connection between People who are Concerned About the Environment and their Attitudes towards GM Foods

Genetically modified (GM) foods provide many advantages to modern agriculture, such as increased yields due to insect and pathogen resistance, productivity improvements, and offer a potential solution to address world hunger. However, GM foods have the potential to cause serious environmental harm, triggering public attitudes towards them to be divided. People are often suspicious of genetic modification, which may inhibit future development and adoption. This study considers GM foods, and aims to explore attitudes towards them, testing the hypotheses that people who are concerned about the environment are less likely to favour GM foods. Data collected through an online questionnaire, yielding 214 responses, is used to correlate environmental concern with attitudes towards GM foods, represented by a GM score. The data shows that total green score correlated against GM score showed a significant, but weak correlation. However, there were clear signs of heteroscedasticity in the data, showing that more environmentally concerned individuals show a greater variation in their attitude towards GM foods. Age also affected attitudes towards GM foods, with individuals between 46 and 60 being more likely to be against GM foods. The data shows that respondents’ main hesitations towards GM foods resulted from insufficient knowledge on the subject, concern over corporations using them for personal gain, and the uncertainty of the long-term effects on human and environmental health. If GM is to be used as part of the solution to sustainable food production, more emphasis is required on educating individuals on GM foods, their uses and future impacts

Managing tourism decline: insights from the Isle of Man

Qualitative interviews conducted in the Isle of Man investigate local perceptions of a tourism industry in long-term decline: a development stage typically overlooked. Negative impacts of decline are revealed; including facilities loss, landscape erosion, and a heightened sense of peripherality. Together such impacts undermine local identity and attractiveness of place. Tourists are welcomed as they help to affirm the pride residents have in their island, create atmosphere, provide social interaction opportunities, stimulate positive emotions and combat negative stereotyping. Emphasised is the on-going importance of tourism impacts in a peripheral location. Practioner recommendations are therefore made calling attention to the need to more carefully manage the process of decline. Potential strategies for achieving this are signposted

Sustainable Development Policies as Indicators and Pre-Conditions for Sustainability Efforts at Universities: fact or fiction?

Purpose - There is a widely held belief that Sustainable Development (SD) policies are essential for universities to successfully engage in matters related to sustainability, and are an indicator of the extent to which they are active in this field. This paper examines the evidence which currently exists to support this assumption. It surveys a sample of universities in Brazil, Germany, Greece, Portugal, South Africa, United Kingdom (UK) and United States of America (USA) to ascertain the extent to which universities that are active in the field of sustainable development have formal policies on sustainable development, and whether such policies are a pre-condition for successful sustainability efforts. Design/methodology/approach –The study involved 35 universities in these seven countries (five universities respectively). A mixed-methods approach has been used, ranging from document analysis, website analysis, questionnaires and interviewing. Findings – Although only 60% of the sampled universities had a policy that specifically addressed SD, this cannot be regarded as an indicator that the remaining 40% are not engaged with substantial actions that address SD. Indeed, all of the universities in the sample, regardless of the existence of a SD formal policy, demonstrated engagement with environmental sustainability policies or procedures in some form or another. This research has been limited by the availability and ability to procure information from the sampled universities. Despite this, it is one of the largest research efforts of this kind ever performed. Originality/value – Our findings provide some valuable insights about the connections between SD policies on the one hand, and the practice of SD in higher education institutions on the other

An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: protocol for a cluster randomized controlled trial

Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification. Methods: Following a systematic development process, the intervention will be evaluated in a pragmatic cluster randomized controlled trial including 70 general practices for a median period of 18 months. The 35 general practices in the intervention group will work with a nominated partner pharmacy, whereas those in the control group will provide usual care without access to the intervention tools. The primary outcome is the proportion of patients at high CVD risk who were inadequately treated at baseline who achieve target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels at the study end. The outcomes will be analyzed using data from electronic medical records, utilizing a validated extraction tool. Detailed process and economic evaluations will also be performed. Discussion: The study intends to establish evidence about an intervention that combines technological innovation with team collaboration between patients, pharmacists, and general practitioners (GPs) for CVD prevention. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN1261600023342