There are research questions whose answers require record linkage of multiple databases that may be characterized by limited options for full data sharing. For this purpose, the Open Data Infrastructure for Social Science and Economic Innovations (ODISSEI) consortium has supported the development of the ODISSEI Secure Supercomputer (OSSC) platform that allows researchers to link cohort data to data from Statistics Netherlands and run large-scale analyses in a high-performance computing (HPC) environment. Here, we report a successful record linkage genomewide association (GWA) study on expenditure for total health, mental health, primary and hospital care, and medication. Record linkage for genotype data from 16,726 participants from the Netherlands Twin Register (NTR) with data from Statistics Netherlands was accomplished in the secure OSSC platform, followed by gene-based tests and estimation of total and single nucleotide polymorphism (SNP)-based heritability. The total heritability of expenditure ranged between 29.4% (SE 0.8) and 37.5% (SE 0.8), but GWA analyses did not identify SNPs or genes that were genomewide significantly associated with health care expenditure. SNP-based heritability was between 0.0% (SE 3.5) and 5.4% (SE 4.0) and was different from zero for mental health care and primary care expenditure. We conclude that successfully linking genotype data to administrative health care expenditure data from Statistics Netherlands is feasible and demonstrates a series of analyses on health care expenditure. The OSSC platform offers secure possibilities for analyzing linked data in large scale and realizing sample sizes required for GWA studies, providing invaluable opportunities to answer many new research questions.

The University of Tasmania balloon-borne large area X-ray telescope was flown from Alice Springs on 20 November 1978. A number of known X-ray sources were observed and a transient increase believed to be a gamma ray burst was detected.

The initial flight of the University of Tasmania balloon-borne X-ray telescope was made from Parkes on Dec. 2, 1976. During the flight, enhanced X-ray emission was observed from the directions of 3U0900-40 (Vela XR-1), GX301-2 and the Galactic Centre. In this paper we report on the performance of the payload during the 11 hour flight and describe the preliminary results thus far obtained.

The binary X-ray source GX 1 + 4 was observed during a balloon flight in 1986, November. The source was in a relatively high intensity state. Time analysis of the data shows that the pulsation period was 111.8 ± 1.0 s indicating that one or more episodes of spin-down occurred between 1980 and 1986. Folded pulse profiles are very broad with an indication of a notch at the peak. Evidence has been found for a correlation between hard X-ray intensity and phase of the proposed 304 day orbital period. The time averaged intensity since 1980 is an order of magnitude lower than during the 1970’s. A survey of the post 1980 data shows that several reversals of the period derivative have occurred. Spin-up at the rates typical of the 1970’s has been followed by a dramatic spin-down episode with dP/dt>2.4 × 10−7 s/s.

The aim of this review paper is to consider how the principles of clinical audit could be applied to the development of an audit of nutritional care in hospitals and care homes, based on criteria derived from the Essence of Care: Food and Drink. A literature review identified fifteen key papers that included guidance or standards for nutritional care in hospitals or care homes. These were used to supplement the ten factors suggested by the Essence of Care to develop a set of potential audit criteria covering all aspects of the nutritional care pathway including the identification of risk of malnutrition, implementation of nutritional care plans, referral to healthcare professionals for further nutritional assessment and nutritional support strategies. A series of audit tools have been developed, including an organisational level audit tool, a staff questionnaire, a patients' and residents' records audit tool and a patients' and residents' experiences questionnaire. Further issues to consider in designing a national nutritional audit include the potential role of direct observation of care, the use of trained auditors and the scope for including the results of pre-existing local audits. In conclusion, a national audit would need to encompass a very large number of health and care organisations of widely varying sizes and types and a diverse range of people.

Archaeological and engineering work that took place in Westminster Hall in 2005–6 led to the discovery of further remains of the King's High Table, to add to those discovered in 1960. The Purbeck marble table stood at the south end of the hall from the thirteenth century to the seventeenth century and was the focus and symbol of English monarchy, serving particular roles in coronation feasts and in the development of the law courts. This paper suggests a reconstruction of the original table and its later extensions from the recovered fragments, and reviews the evidence for the construction, usage and destruction of the table in the context of the evolution of the hall and the palace, tracing its history through to its recent rediscovery and exhibition.

Prospective cohort and case-control studies suggest an association between low folate intake and increased risk of colo-rectal adenoma and cancer. Some, but not all, animal studies indicate that folate supplementation protects against the development of colo-rectal neoplasms, although supraphysiological folate doses have been shown to enhance tumour growth. Folate is a methyl donor for nucleotide synthesis and biological methylation reactions, including DNA methylation. A low dietary folate intake may increase the risk of colo-rectal neoplasia by inducing genomic DNA hypomethylation, which can affect the expression of proto-oncogenes and tumour suppressor genes associated with the development of cancer. Common polymorphisms in genes involved in the methylation pathway, such as methylenetetrahydrofolate reductase and methionine synthase, have been shown to influence risk of colo-rectal neoplasia, with interactions dependent on folate status and/or alcohol intake, which is known to antagonise methyl group availability. There is some evidence to show that DNA from normal-appearing colo-rectal mucosa in individuals with colo-rectal cancer is hypomethylated. In a case-control study DNA methylation in normal-appearing colo-rectal mucosa has been shown to be lower in individuals with colo-rectal cancer (P=0.08) and colo-rectal adenoma (P=0.009) than in controls free of colo-rectal abnormalities. Human intervention trials to date suggest that supraphysiological doses of folate can reverse DNA hypomethylation in colo-rectal mucosa of individuals with colo-rectal neoplasia. In a double-blind randomised placebo-controlled study folate supplementation at physiological doses has been shown to increase DNA methylation in leucocytes (P=0.05) and colonic mucosa (P=0.09). Further studies are required to confirm these findings in larger populations and to define abnormal ranges of DNA methylation.

A short quantitative food frequency questionnaire (FFQ) to assess folate intake was developed and validated against a 7-d weighed food intake record (7d-WR) and biochemical indices of folate status. Thirty-six men and women completed the self-administered FFQ on two occasions a month apart, kept a 7d-WR and gave two fasting blood samples at the beginning and end of the study for measuring serum and erythrocyte folate, respectively. Mean folate intakes were similar by repeat FFQ and correlated strongly (r 0·77 and r 0·72, P<0·001, for men and women, respectively). All other comparisons were done using the results of the FFQ administered on the first occasion. Men reported similar folate intakes on the FFQ and 7d-WR, but women reported greater intakes on the FFQ compared with the 7d-WR (P<0·05). There was a statistically significant correlation (partial, controlling for gender) between folate intakes reported by FFQ and 7d-WR (r 0·53, P<0·01). Folate intakes estimated by FFQ correlated significantly with serum (r 0·47, P<0·01), but not erythrocyte folate (r 0·25, P>0·05); the strength of the association was greater in men than in women. Validity coefficients estimated using the method of triads were higher for the FFQ than for the 7d-WR when serum folate was used as the biomarker. Overall, these results suggest that this short FFQ is a useful method for assessing folate intake, particularly in men.