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Society for the Study of Human Biology Proffered Papers Meeting, Thursday 10 October, 2013 Oxford Brookes University, Headington Campus, The Buckley Building, Room BG10

10.00 Arrivals, coffee and poster set-up

PODIUM PRESENTATIONS - Morning

10.20 A. Garnish, et al., University of Leeds. What aspects of sleep influence executive cognitive ability in the short- and longer-term?

10.40 S. Scheepers, et al., University of Leeds. Are we losing sleep over information technology?

11.00 Georgina Blakey, et al., University of Leeds. Do differences in treatment for gestational diabetes reflect/produce differences in perinatal outcome? An audit of antenatal care involving: dietary advice alone, insulin and/or metformin.

11.20 Coffee and poster viewing

11.40 Mairi Dent, University of the West of Scotland. Use of BMI and WaHtR in an intervention programme for overweight and obese Scottish children.

12.00 Alize Lacoste Jeanson, University of Bordeaux, France. Dental Mineralization as a possible indicator of menarche.

12.20 Annual General Meeting/ Lunch

1.15 Poster viewing

PODIUM PRESENTATIONS – Afternoon

1.30 Julia Beaumont & Janet Montgomery, University of Bradford; Durham University. Stable isotope analysis of incremental dentine collagen as a method of investigating perinatal health and nutrition.

1.50 Amy Sutton, University of Sheffield. Molar crown morphology in Pan and Gorilla.

2.10 Becky Haywood, University of Sheffield. Attitudes toward teaching ID and Evolution in British Schools: results of a survey questionnaire.

2.30 Keynote address: Humans, food and feeding from a biocultural perspective. Professor Stanley Ulijaszek, Director of the Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford

3.00 Tea break & Poster viewing

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3.30 Sophie Brookes, University of Sheffield. An investigation into the ancestry of Homo floresiensis through intraspecific scaling and proportional grade shifts in brain size reduction.

3.50 James Kendrick, University of Sheffield. Using a morphometric craniodental analysis of Homo habilis to reappraise issues regarding the genus Homo.

4.10 Stephen Oppenheimer, University of Oxford. The ‘diving reflex’, birth asphyxia, obstructed labour, pelvic dimorphism and Upper Palaeolithic decline in human size.

4.45 Award of Student Prize and tea.

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Society for the Study of Human Biology Proffered Papers Meeting, Thursday 10 October 2013 Oxford Brookes University, Headington Campus, The Buckley Building, Room BG10

ALPHABETICAL LIST OF POSTER PRESENTATIONS

Name Title

Al Afif N, Law GR, Scott EM, Al Naji A, Ellison GTH, University of Leeds.

The sensitivity of sleep-related research filters based on the search terms used by contemporary systematic reviews.

Andre, AL; Marques, VMR; Varela-Silva, MI, Loughborough University.

Obesity and Environmental factors in Cape Verdean Migrants living in Portugal.

Assasie, E.Y. and Varela-Silva, MI, Loughborough University.

Physical Activity, lifestyle choices, nutrition transition and the onset of Hypertension and Type 2 diabetes in Ghanaian young adults.

William Bolton, Alex Hodgson, Conor Vincent, Jessica Sinclair, Kieran Purchase, Ben Marriott, Saadiysh Khan, Jessica Hayward, Philippa Gaunt, Amber Garnish, Mathew Duke, Fiona Campbell, and Robina Anwar, University of Leeds.

Acute modification of bedtime has no apparent effect on blood pressure in healthy young subjects.

Yena Cho, Davies C, Dewhurst J, Duke M., University of Leeds.

How long do the British sleep? Individual-, household- and socioeconomic correlates of sleep duration amongst participants in the nationally-representative ‘Understanding Society’ cohort study.

Veronique Delort, University of Westminster.

Optimal cholesterol levels in the elderly – A rapid assessment of the evidence for the need to amend UK public Health recommendations.

George Ellison, et al., University of Leeds. Are text-based bed-time reminders an effective intervention for extending sleep duration?

Chloe Firmstone, Mohd Hamzah M Nasir, and Srabasti J Chakravorty, Keele University.

Characterization of transformed human brain endothelial cells as a model for investigation of the effect of Plasmodium falciparum infected red blood cells on the blood brain barrier in cerebral malaria.

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Jason Gellis, University of Sheffield. Testing spatial hypotheses of mandibular shape and form: relationships of tooth crown and tooth root dimensions to jaw size in P. troglodytes and G. gorilla.

Parveen Herar, Durham University. Practical Applications of Evolutionary Medicine: Physicians’ Perspective.

Ellen Kendall, Durham University. Breastfeeding as an adaptive strategy to environmental pressures in early Anglo-Saxon England.

Ross Kendall, Durham University. Histological Preservation: Implications for Protein Extraction from Archaeological Bone.

Manica, S., FSL Wong, HM Liversidge, Queen Mary University of London.

A study of cervical vertebral and dental maturation.

McNaughton T, Vaiyani O, Campbell F and Tharmakulasingam M., University of Leeds.

What is the relationship between sleep quality, sleep duration and heart disease? Evidence from the Understanding Society cohort study.

Norris, T., Tuffnell, D.J., Wright, J. & Cameron, N., Loughborough University.

Risk of SGA and LGA when using an internally derived ethnic specific birth weight chart, compared to UK-WHO. Results from the Born in Bradford study.

O’Kane M, Idisi A and Haresceugh N., University of Leeds.

The effect of early/late bedtimes on sleep duration, sleep onset latency and sleep efficiency: a randomised crossover trial.

Purchase K, Samin S, Al-Robeye A and Begum N., University of Leeds.

The relative importance of sleep quality and sleep duration as predictors of subsequent stroke: a longitudinal analysis of the Understanding Society cohort.

Emily Rankin, Durham University. The application of evolutionary biology in medical education: benefits, barriers and future implications.

Sophie C. Warner & Katherine Brooke-Wavell, Loughborough University.

Evaluation of a portable ultrasound device for assessing body fat content in women.

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PODIUM ABSTRACTS (Presentation order)

What aspects of sleep influence executive cognitive ability in the short- and longer-term?

Garnish A,* Marriott B, Poyser E, Roscamp J on behalf of the Understanding Society Sleep Project (USocSP)1 - Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics; Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

* Presenting author: um10ag@leeds.ac.uk

¹The USocSP comprised: Arwa Al-Robeye, Samin Amin, Natasha Begum, Fiona Campbell, Yena Cho, Camilla Davies, Jennifer Day, Jake Dewhurst, Mathew Duke, Nicholas Fincham, Misha Gaur, Nicola Haresceugh, Andrea Idisi, Katherine Lloyd Jones, Tom McNaughton, Emily Moore, Arish Noshirwani, Ricky Page, Kieran Purchase, Clare Richards, Salomon Scheepers, Mena Tharmakulasingam, Omair Vaiyani, Harriet Wilson, Georgina Blakey, Laura Brooke, Christina Hitchen, Hannah Panayiotou, Anna R Weighall, Ian Kellar, Graham R Law, Eleanor M Scott and George TH Ellison

Background: Inconsistencies in the observed relationship between sleep and executive cognitive ability appear to be the result of the type of sleep measure used (Horne 2012). The aim of the present study was to explore this possibility using six different self-reported measures of sleep (sleep quality; waking in the night; daytime sleepiness; sleep disruption due to coughing/snoring; >30 minute sleep onset latency; and use of sleep medication).

Method: Data from the first two waves (A: 2008; B: 2009) of the Understanding Society (USoc) nationally representative cohort study were used to explore the cross-sectional and longitudinal relationships between self-reported sleep, concentration and decision-making. Nineteen covariates were examined as potential confounders, mediators or competing exposures in these relationships, using a directed cyclic graph constructed using the freeware programme DAGitty (www.dagitty.net) to identify the minimally sufficient set of confounders required to generate an unbiased estimate of any causal relationships. This set included: body mass index; age; highest educational qualification; limiting long-standing illness/disability; underlying cognitive impairment; alcohol consumption; smoking status; depression; work-limiting pain; and income – variables for which complete data were available for 19,662 of the 50,993 participants.

Results: Multiple regression analyses of the cross-sectional data (Wave A) indicated strong, direct and statistically significant relationships between a range of sleep measures, concentration and decision-making, although some sleep measures (such as sleep quality) had a stronger relationship with these cognitive outcomes than others (in particular sleep duration). However, none of the sleep measures at Wave A were statistically significant predictors of subsequent concentration or decision-making at Wave B, suggesting that the cross-sectional relationship observed in the analysis of Wave A data was not causal or that the causal relationship is immediate and does not persist over the time interval between Waves A and B (c18mo).

Discussion: The results of these analyses are consistent with previous research indicating that sleep deprivation has a detrimental effect on cognitive ability and decision making (Horne 2012), and confirm that: sleep quality may be more important/relevant than sleep duration (or deprivation) per se; and the impact of sleep quality on concentration and decision-making is primarily an acute phenomenon in this nationally representative cohort.

Reference: Horne J. Working throughout the night: beyond ‘sleepiness’ – impairments to critical decision-making. Neuroscience and Biobehavioral Reviews 2012; 36: 2226–2231.

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Are we losing sleep over information technology?

Scheepers S,* Richards C, Noshirwani A, and Day J on behalf of the Understanding Society Sleep Project (USocSP)1 - Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics; Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

* Presenting author: um10sjs@leeds.ac.uk

¹The USocSP comprised: Arwa Al-Robeye, Samin Amin, Natasha Begum, Fiona Campbell, Yena Cho, Camilla Davies, Jake Dewhurst, Mathew Duke, Nicholas Fincham, Amber Garnish, Misha Gaur, Nicola Haresceugh, Andrea Idisi, Katherine Lloyd Jones, Ben Marriott, Tom McNaughton, Emily Moore, Ricky Page, Emily Poyser, Kieran Purchase, Joe Roscamp, Mena Tharmakulasingam, Omair Vaiyani, Harriet Wilson, Georgina Blakey, Laura Brooke, Christina Hitchen, Hannah Panayiotou, Anna R Weighall, Ian Kellar, Graham R Law, Eleanor M Scott and George TH Ellison

Background: There is substantial concern that information technology might have a deleterious effect on sleep, either by increasing the time spent awake or reducing sleep quality. The aim of the present study was to examine whether these concerns might be supported empirically, using data from a new, nationally-representative cohort of UK adults (‘Understanding Society’; USoc).

Methods: The first wave of USoc generated data on three relevant sleep-related variables (sleep duration; sleep quality; and the frequency with which respondents reported ‘waking up in the middle of the night’); and discrete markers of television, mobile phone and internet access/use. The relationships between these two sets of variables were explored after adjustment for a minimally sufficient dataset of measured confounders and competing exposures (including age, sex and markers of socioeconomic status), identified using a directed acyclic graph and www.dagitty.net.

Results: After excluding participants with missing data on any of the exposure, outcome and/or confounding/competing exposure covariates, the final dataset comprised n=28703 participants (n=12524 males; n=16179 females) who were broadly comparable to the original USoc cohort. Participants who had access to cable/satellite television, mobile phones and the internet were all significantly more likely to report more frequent ‘waking up in the middle of the night’; for example, those with mobile phones were 37% more likely to report waking up ‘more than once most nights’ (RRR:1.37; 95%CI:1.20,1.57). However, access to/usage of cable/satellite television, mobile phones and the internet had very different relationships with sleep duration and sleep quality. There was no significant association between access to cable/satellite television and sleep duration, but it was associated with a significantly lower risk of ‘very good’ and a significantly higher risk of ‘fairly/very bad’ sleep quality. Participants with mobile phones were significantly less likely to sleep for more than 10 hours (RRR=0.52; 95%CI:0.37,0.75), but were not at elevated risk of poor self-reported sleep quality. And while participants with access to the internet were significantly less likely to sleep for <6 or >10 hours, they were also significantly less likely to report ‘very bad’ sleep quality (RRR=0.65; 95%CI:0.54,0.76).

Discussion: These results indicate that the relationship between sleep and information technology depends upon the specific type of technology involved. Although access to satellite/cable television, mobile phones and the internet were all associated with an increased risk of frequently disturbed sleep, none were associated with an increased risk of abnormally short or long sleep duration, and only cable/satellite television was associated with an increased risk of poor sleep quality. Indeed, participants with mobile phones and access to the internet tended to report more normative sleep durations and better sleep quality. While these differences may reflect the differential impact of these three technologies (and their associated impact on activity levels and wakefulness) on sleep duration and sleep quality, they may also partly/simply reflect incomplete adjustment for socioeconomic variation in access to/uptake thereof.

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Do differences in treatment for gestational diabetes reflect/produce differences in perinatal outcome? An audit of antenatal care involving: dietary advice alone, insulin and/or metformin.

Georgina Blakey, Laura Brooke, Daniel Ashmore, Hannah Panayiotou (on behalf of PADAP: the Pregnancy and Diabetes Audit Project)1

Pregnancy and Diabetes Audit Project, Leeds Institute of Genetics, Health & Therapeutics, University of Leeds Medical School 1PADAP members: D Abdul-Rahman, L Albazi, J Conville, J Davies, S Henderson, C Hitchen, Z Hussain, J Meacock, Zava Ngonidzashe, S Twaij, E Ciantar, V Brown, J Brewster, GR Law, W Harrison, EM Scott and GTH Ellison)

Objective

Pharmacological management of diabetic pregnancy aims to balance the benefits of maternal glycaemic control with any risks to foetus. We explored variation in perinatal outcomes amongst women receiving different treatments for gestational diabetes: dietary advice alone, with or without metformin and/or insulin.

Methods

Routine audit data on socio-demographic, anthropometric, clinical and perinatal variables were available for 440 consecutive women referred to Leeds antenatal endocrinology clinics between 2008-10. 305 of these had gestational diabetes, 249 of whom had complete data. Directed acyclic graphs were used to identify confounders requiring adjustment in multiple regression analyses of the relationship between treatment and perinatal outcomes.

Results

Compared to those receiving dietary advice alone, women receiving metformin delivered babies with a significantly higher risk of neonatal complications (OR:3.06; 95%CI:1.18, 7.94; p=0.022.), as did those receiving insulin (OR:6.71; 95%CI:2.75, 16.39; p<0.001). The latter had a higher risk of intensive/transitional care (OR:14.27; 95%CI:3.69, 55.14; p<0.001) and were, on average, 243g (95%CI:96.29, 388.79; p=0.001) heavier. Women receiving both insulin and metformin had babies 283g (95%CI:44.54, 521.12; p=0.020) heavier and had an increased risk of instrumental delivery (RRR:5.05; 95%CI:1.06, 24.13; p=0.042).

Summary

The results are open to two interpretations, neither of which are mutually exclusive: antenatal treatment decisions accurately identified women with low/high risks of adverse neonatal outcomes; and/or the different treatments influenced the risk of adverse neonatal outcomes. While the former interpretation seems most plausible, further research is warranted to address the risk that the latter might (also) be the case.

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Use of BMI and WaHtR in an intervention programme for overweight and obese Scottish children, Mairi S. Dent1, Lesley Fowler2 and Moira S. Lewitt1

1Institute for Maternal, Child and Family Health, University of the West of Scotland, Paisley, UK 2Leisure Development, East Ayrshire Council, Ayrshire, UK

Background: Family-based intervention programmes are effective for overweight children. Most programmes follow the weight/height2 (BMI). We have previously shown, in a group of Welsh schoolchildren, that BMI does not fully adjust for the effect of height during puberty and that waist-to-height ratio (WaHtR) is more reliable (Lewitt et al., Ann Hum Biol 39:440, 2012).

Aim: To determine the relationship between height and weight, and height and waist circumference in overweight children participating in a family-based intervention programme (MEND) in Scotland.

Subjects: Girls (n=32) and boys (n=30) aged 7-13 years and > 91st centile for BMI, adjusted for age and sex. MEND tracks waist as well as BMI. Log-log regression analysis was used to estimate the power with which to raise height to control for the effect on weight and waist circumference.

Results: BMI correlated with height in girls (r=0.513, p=0.003) and boys (r=0.402, p=0.027). Log-log regression analysis indicated that height needed to be raised to the power 2.9 and 2.7, respectively, to control for its effect on weight. Waist also correlated with height in girls (r=0.615, p<0.001) and boys (r=0.557, p=0.001). There was no relationship between WaHtR and height in girls (r=-0.087, p=0.635) or boys (r=-0.005, p=0.977). During the 10 week MEND intervention WaHtR decreased by 3.6% in girls and 3.5% in boys while BMI changed 2.9 and 2.5%, respectively (both p<0.001).

Conclusion: WaHtR is a more reliable than BMI in overweight children aged 7-13 years, and should be used to track responses to lifestyle interventions in this age group.

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Dental Mineralization as a possible indicator of menarche.

Alizé LACOSTE JEANSON1, Vanessa URZEL1, 2, Frédéric SANTOS1, Jaroslav BRUZEK1, 3, 4 1 UMR 5199 PACEA « Anthropology of Past and Present Populations », CNRS, University of Bordeaux, France.

2 Faculty of Odontology, University of Bordeaux, France.

3 Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czech Republic.

4 Department of Social and Cultural Anthropology, Faculty of Humanities, University of West Bohemia, Plzeň, Czech Republic.

Age at menarche is a frequently used indicator to study growth and development. The development of hand and wrist indicates the peak height velocity which appears about two years before menarche. Bone development is linked with dental mineralization but the relationship between tooth maturation and sexual maturity has not been demonstrated yet (Lewis & Garn 1960, Garn et al. 1965, Demirjian 1985). Proving that a link exists between these indicators would be interesting to study trends of development rhythm from menarche: easy to collect and to encode, panoramic radiographs could be a new way to know menarche status in large samples.

Our sample consists in 176 panoramic radiographs of French girls from 7 to 17 years old, with known menarche status. Dental mineralization was encoded with Demirjian et al. 1973 and Moorrees et al. 1963 methods.

Despite previous studies results, statistical tools (correlation ratios, regression and classification trees, Bayes’ theorem) show that premolars mineralization is correlated with menarche. We have created computer programs based on the implementation bayesian inference results with premolars: (1) to estimate mean age of menarche in a population sample; (2) to assign menarche status (ante or post). Mean age of menarche estimation is based on seven mandibular tooth stages: program calculates mean dental age of girls selected to be peri-menarche thanks to their premolars tooth stages. Menarche status assignation requires premolars tooth stages only.

Further studies are planned to get the accuracy needed in clinical studies and to test our computer programs in a meta-population sample.

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Stable isotope analysis of incremental dentine collagen as a method of investigating perinatal health and nutrition.

Julia Beaumont1 and Janet Montgomery2. 1. Archaeological Sciences, University of Bradford; 2. Archaeology Department, Durham University.

Stable isotope analysis of sequential increments of human dentine allows reconstruction of juvenile diet and physiology. These isotope profiles constitute a new approach to the study of maternal health and infant feeding in the past and enable comparison of surviving infants with those who died. Nutrition in utero and during the perinatal period has a huge impact on the morbidity and mortality of infants and the adults they become. In the absence of documentary evidence, the analysis and comparison of the light stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) in the skeletal tissues of adult females and juveniles has been used to infer the prevalence and duration of breastfeeding within cemetery populations. These interpretations rely on the assumption, based on modern studies using tissues with a fast turnover such as hair and fingernail, that the isotope values in the bone collagen of a mother and her newborn child are the same. This model has been challenged by recent research demonstrating that mothers can have bone collagen δ15N and δ13C which differs significantly from their deceased infants. As archaeological bone samples are by definition taken from neonates and infants who have died, their isotope values may be affected by changes in the nitrogen balance as the result of ante-mortem stress or pathology. This study compares diachronic isotope profiles from the teeth of juveniles who died with those from survivors to investigate normal and abnormal, survivable and non-survivable, responses.

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Molar crown morphology in Pan and Gorilla.

Amy Sutton, University of Sheffield.

Molar crown morphology is a highly useful tool in the field of palaeontology, as it is relatively stable and largely unaffected by environmental stresses. However, the number and distribution of crown cusps is a particularly variable molar crown feature. The mandibular molars of both Pan and Gorilla have at least five cusps, the maxillary at least four, and different numbers of accessory cusps are common on each.

The aim of this study is to document intra- and interspecific patterns of molar crown size, cusp number and spatial relationships in Pan and Gorilla, and to evaluate the observed patterns in the context of different theories of tooth morphogenesis. Does variation in molar cusp number and distribution follow a mesial-distal gradient within teeth or along the tooth row (morphogenetic field theory), or do accessory cusps occur in relation to molar crown size and spacing of the primary cusps across the tooth crown surface (patterning cascade model)? One way to examine these potential relationships is to analyse variation in cusp number and proportional size with respect to crown size and molar tooth position (M1, M2, M3).

Molar crown base areas and individual cusp areas were measured from high resolution digital photographs of mandibular and maxillary molar teeth of Pan and Gorilla specimens at the Powell-Cotton Museum. Statistical analysis using descriptive measures, t-tests, and PCA confirmed that a) accessory cusps in these species are more common on the distal aspect of the molar crown; b) larger molars are more likely (but not exclusively) to possess accessory cusps; and that c) the occurrence of accessory cusps increases from M1 to M3. These results suggest that variation in cusp number on the molar teeth is influenced by a number of factors, and that neither the gradient or cascade models appear to account fully for their occurrence.

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Attitudes toward teaching ID and Evolution in British Schools: results of a survey questionnaire.

Rebecca Haywood & Kevin Kuykendall, University of Sheffield.

Exposure to the Creation-Evolution debate in Britain, has until recently, been relatively minimal. However, Britain is now faced with increasing pressure from lobbying groups such as Truth in Science, to incorporate the teaching of Intelligent Design (I.D.) into the school science curriculum, thereby following the lead of similar movements in the US. Consequently, a questionnaire was distributed to two museums and a University in the UK, to investigate the general and academic public’s knowledge, understanding and beliefs about the debate, and what should be included in the school science curriculum.

The results indicate that the majority of respondents generally favour evolutionary theory over I.D. or religious viewpoints. For example, 70% rejected Creationist explanations; in contrast, 77% agreed that evolution explains the origins of life. Overall, the majority of the sample does not believe I.D. should be taught alongside evolution in the science curriculum (68.1%). However, approximately 20% of respondents agreed that ID should be taught in the school Science Curriculum, and about 12% were neutral. In general, response frequencies for different statements on similar topics varied by as much as 10% between categories (Agree, Neutral, Disagree), which may indicate that not all respondents have a fully consistent or coherent understanding of evolution. Other factors such as participant’s level of education, and their age also appeared to influence beliefs about evolutionary theory and creationism.

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An investigation into the ancestry of Homo floresiensis through intraspecific scaling and proportional grade shifts in brain size reduction.

Sophie Brookes, University of Sheffield.

The ancestry and origin of Homo floresiensis has remained ambiguous because of the mix of derived and primitive anatomical features; especially its small stature (of around 106cm), and small brain (380-430cc) and the fact it has not been associated with any other known hominin species. One explanation is to explain H. floresiensis in terms of insular dwarfism; a pattern of evolutionary change in which large bodied mammals decrease in size under insular settings. It can be observed in other insular mammal species that there is a larger than expected (proportional grade shift) reduction in the size of the brain. When intraspecific scaling factors were applied to several endocranial volumes (ECV) for a number of ancestral candidates, predicted ECV for Australopithecus africanus and Homo habilis fell into the range of the ECV estimates for H.floresiensis and both geographical variants of Homo erectus studied (African and Indonesian), and the Dmanisi Homo specimens when a 25% proportional grade shift reduction in brain size (as seen in other insular mammal dwarf species) was applied. Although the degree of size reduction in the brain is currently unknown for this species, this study concludes that the most likely ancestor is an as yet undiscovered small-bodied, smaller-brained pre-erectus type hominin. This conclusion is reached due to the mixture of primitive and derived features making it likely to be an earlier species than H. erectus whilst maintaining advanced cognitive abilities that are beyond that which has been noted in H. habilis and earlier hominin species.

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Using a morphometric craniodental analysis of Homo habilis to reappraise issues regarding the genus Homo.

James Kendrick, University of Sheffield.

The credibility of Homo habilis has been the subject of much debate since the species was first described in 1964. In the ensuing half century, definitions of the genus Homo have faced multiple alterations to accommodate a growing range of morphological variation. Acting on suggestion that the boundaries had been overstretched, Wood and Collard (1999a) used cladistic and evolutionary systematic reasoning to propose the reallocation of H. habilis and Homo rudolfensis to the genus Australopithecus. Here, using morphometric statistical analyses on cranial and dental datasets, H. habilis sensu lato is shown to be australopithecine in grade. Discriminant functions analysis (DFA), principal components analysis (PCA) and cluster analysis are utilised to demonstrate how particular specimens such as KNM-ER 1813 and OH24 consistently group with Australopithecus africanus material. Whilst H. habilis will group with Homo erectus to the exclusion of Australopithecus in limited samples, the reverse is true when ‘later Homo’ species such as Homo sapiens are included in the analysis. Coupled with the phylogenetic insights afforded by Wood and Collard (1999b), the retention of H. habilis in the genus Homo is tenuous. Addressing other topics, the distinct craniomorph of KNM-ER 1470 diverges from other H. habilis material in nearly all analyses. Hence it is most probable that H. rudolfensis is a valid hominin species represented by megadont dental specimens such as KNM-ER 1482 and KNM-ER 1590. Evidence found to suggest KNM-ER 1805 belongs in an alternative genus to Homo is mixed and ambiguous.

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The ‘diving reflex’, birth asphyxia, obstructed labour, pelvic dimorphism and Upper Palaeolithic decline in human size.

Stephen Oppenheimer, Institute of Cognitive and Evolutionary Anthropology, School of Anthropology and Museum Ethnography, University of Oxford.

The vertebrate reflex cardio-vascular response to extreme hypoxia, originally called the ‘master switch of life’, later re-labelled the ‘diving reflex’ by some, has long been acknowledged as useful, even essential, protection against terrestrial vertebrate perinatal asphyxia. In spite of this role, 2M deaths (28% of annual worldwide human perinatal mortality) still result from perinatal asphyxia. In spite of obstetric intervention, obstructed labour is still responsible for 11% of all maternal deaths (case fatality rate 0.67%). Translated to the pre-obstetric-intervention era, such figures would have been a more potent cause of size selection, if not a bottleneck. Modern humans (AMH) have more difficult deliveries than other living anthropoid primates (LAPs). Hominin brains have grown over 3 times in size over 2.5 Mya resulting in dangerous cephalo-pelvic disproportion (CPD). AMH fœtal adaptations include altriciality, slowed brain growth in late 3rd trimester and possibly the so-called ‘exaggerated diving reflex’. On the maternal side, adaptations include hormonal softening of pelvic ligaments and exaggerated pelvic sexual dimorphism compared with other LAPs. A pertinent question is how the post-Early-Upper-Palaeolithic decline in AMH stature has affected CPD? For other LAPs, CPD would have increased with decreasing stature. In spite of obstetric perception, that may not be the overall case for AMH, offering a possible evolutionary explanation for Upper Palaeolithic AMH body size reduction, whilst keeping Encephalisation Quotient constant.

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Poster Abstracts

The sensitivity of sleep-related research filters based on the search terms used by contemporary systematic reviews

Al Afif N,* Law GR, Scott EM, Al Naji A, Ellison GTH

Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics; Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

*Corresponding author: ml11noa@leeds.ac.uk

Background: The aim of the present study was to establish the desirability of developing a generic search strategy for sleep-related studies based on search strategies used by contemporary systematic reviews of sleep research.

Methods: Search I searched Ovid-Medline for the expanded term "sleep*" between "2012 to present" with no language limits applied, filtered for studies on "human subjects" and "reviews (maximizes sensitivity)". Full text copies of all search results were obtained and close-read to identify any that reported the search terms used. Search II combined these search terms, while Search III used “sleep*” alone, to search Ovid-Medline for “human subjects” studies between “1946 to 2012” with no language limits and no filters for study method/type. Random (www.random.org) samples of 50 consecutive articles found by Search II and III were close-read to establish the sensitivity of each search technique.

Results: Search I located n=359 contemporary review articles, but only n=54 of these reported the search terms used. Of these, only n=26 contained search terms relevant to sleep. By combining these search terms, Search II located n=104,147 all method/type articles between 1946-2012; compared to n=100,104 articles located by “sleep*” alone (Search III). The percentage of additional articles found by Search II increased over time while close-reading of randomly sampled articles indicated that the sensitivity of Search III was greater than that for Search II.

Conclusion: The results of the present study confirm that sleep-related research has increased in terminological complexity over time. While a combination of search terms may be required to access research on the full range of sleep-related topics, the increase in search results is offset by a decrease in sensitivity. Further research is warranted to improve the efficiency of systematic search strategies for sleep research.

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Obesity and Environmental factors in Cape Verdean Migrants living in Portugal.

Andre, AL1; Marques, VMR2,3; Varela-Silva, MI1

1Centre for Global Health and Human Development, SSEHS, Loughborough University, Leicestershire, UK ;

2 Departamento de Ciências Humanas, Instituto de Investigação Científica Tropical Lisboa, Portugal

3Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal

Obesity is a worldwide epidemic and Portugal is one of the European countries with the highest rates of overweight and obesity (OW/OB) [1,2]. Furthermore there is plenty of evidence that this epidemic disproportionately affects ethnic minorities. Therefore, it is important to understand how low educational levels, materials and social deprivation and overall lower quality of life contribute for this epidemic [1,2]. The Cape Verdean community in Portugal represents one of those deprived ethnic minority groups [3] and so it would be expected that the OW/OB prevalence to be higher than the Portuguese population. Pilot studies from 1993 and 2010 show, however, that Cape Verdean children (4-12 years old) living in very deprived areas of Lisbon show lower prevalence of OW/OB with the Cape Verdeans following a different path than the Portuguese. This fact calls for a deep ethnographic characterization of the Cape Verdean community. It is important to first characterize the Cape Verdean community in a migrant environment by measuring the energy expenditure, living conditions and intergenerational effects and from that determine the strategies to diminish the escalating values of OW/OB on the Portuguese children. This project aims to determine the growth and nutritional status of the Cape Verdean migrants living in Lisbon in what regards to the length of the exposure to different physical, social, and economic ecologies that shape child’s growth and risk for OW/OB and identify metabolic and intergenerational factors working on this group.

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Physical Activity, lifestyle choices, nutrition transition and the onset of Hypertension and Type 2 diabetes in Ghanaian young adults.

Assasie, E.Y. and Varela-Silva, MI

Centre for Global Health and Human Development, SSEHS, Loughborough University, Leicestershire, UK

Hypertension and diabetes are becoming major causes of morbidity and mortality in Ghana (Addo, Smeeth, & Leon, 2009; Quaye, Ababio, & Amoah, 2006). This is believed to be directly linked to the effects of globalization and urbanization. Also, the rapid progress in nutrition transition, lifestyle choices and reduced physical activity levels are also linked to the increases in the prevalence of chronic diseases in both developed and developing countries. The aims of this research are: i) To investigate aspects of the behavioural transition (from physical activity to physical inactivity patterns) and the nutrition transition (from traditional to globalized foods) in young adults from urban settings in Ghana and ii) To put these aspects in the biocultural context of the epidemic of diabetes II and hypertension that is rampant in Ghana. A summary of a systematic review of the literature focusing on these variables will be presented and a summarised plan of the fieldwork will be highlighted.

19

Acute modification of bedtime has no apparent effect on blood pressure in healthy young subjects.

William Bolton,1 Alex Hodgson, Conor Vincent, Jessica Sinclair, Kieran Purchase, Ben Marriott, Saadiysh Khan, Jessica Hayward, Philippa Gaunt, Amber Garnish, Mathew Duke, Fiona Campbell, and Robina Anwar on behalf of the Sleep Duration Project (SDP)** - Temporal Influences on Metabolic Events (TIME) Research Group, Leeds Institute of Genetics, Health and Therapeutics (LIGHT), School of Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

*Presenting author; um10wsb@leeds.ac.uk 1The SDP comprised: Harriet Wilson, Omair Vaiyani, Catherine Turner, Sreeharshan Thampy, Salomon Scheepers, Mark O'Kane, Arish Noshirwani, Emily Moore, Sam Mitchell, Katherine Lloyd Jones, Duncan Littlechild, Gillian Lever, Andrea Idisi, Emily Holt, Nicola Haresceugh, Alison Hallett, Ben Green, Vidushi Golash, Jai Gohil, Darren French, Nicholas Fincham, Jake Dewhurst, Jennifer Day, Camilla Davies, Rachael Campbell, Marika Blackham, Thomas James Bewick, Natasha Begum, Samin Amin, Hannah Panayiotou, James Meacock, Christina Hitchen, Laura Brooke, Wendy Harrison, Benjamin Morris, Andrew J Prestwich, Ian Kellar, Anna R Weighall, Eleanor M Scott, Graham R Law, and George TH Ellison.

Aim: Compared to other professions engaging in shift and on-call work, doctors are at particular risk of work pattern-related sleep disruption/deprivation. This is because the onset of sleep disruption/deprivation precedes formal employment in the medical profession, as a result of the intensive academic and extramural lifestyle of medical students and trainee doctors. Given that sleep appears essential to good cardiovascular health, the aim of the present study was to assess whether the earlier onset of sleep disruption/deprivation might initiate earlier cardiovascular effects in medical students using a randomised cross-over trial of a 10pm vs. 2am bedtime intervention. Methods: 40 healthy undergraduate medical students completed a two-day randomised crossover control trial in which participants were randomly allocated to bed times of 10pm/2am vs. 2am/10pm on consecutive nights (see Figure 1), stratified according to pre-existing, self-reported sleep patterns and chronotypes (see Table 1). Participants fasted from 10pm on both nights and got up at 7am on the mornings of both days. On each morning participants recorded their own blood pressure (systolic and diastolic) and heart rates immediately before, and two hours after, an oral glucose tolerance test (OGTT). These measurements were conducted using a validated wrist blood pressure monitor (Boots Intellisense) placed on the wrist of their left hand. Data were analysed using STATA version 12. Ethical clearance for this research project was granted by the University of Leeds LHIS/LIGHT/LIMM Joint Research Ethics Committee (Ref: HSLTLM12075). Results: After adjustment for participant sex and bedtime sequence, there were no significant differences in blood pressure, pulse pressure, mean arterial blood pressure or heart rate between a 10pm vs. 2am, either prior to or following the OGTT (see Table 2). Conclusion: This study found little evidence that earlier/later bed times (and associated differences in sleep duration and quality) had any acute cardiovascular effects on medical undergraduates the following morning. These findings appear to run contrary to previous observational studies but are likely to reflect: the short duration of the intervention; the young age and good health of the study participants; and the experimental (as opposed to natural/observational) nature of the study design. The last of these deserves additional attention in more prolonged, field-based interventions of older participants. In the absence of these studies it nonetheless seems reasonable to conclude that the earlier onset of sleep disruption/deprivation in the medical profession might not predispose doctors to a greater risk of cardiovascular disease than other shift/on-call workers.

20

How long do the British sleep? Individual-, household- and socioeconomic correlates of sleep duration amongst participants in the nationally-representative ‘Understanding Society’ cohort study

Yena Cho,* Davies C, Dewhurst J, Duke M on behalf of the Understanding Society Sleep Project (USocSP)1 - Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics; Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

* Presenting author: um11yc@leeds.ac.uk

¹The USocSP comprised: Arwa Al-Robeye, Samin Amin, Natasha Begum, Fiona Campbell, Camilla Davies, Jennifer Day, Jake Dewhurst, Mathew Duke, Nicholas Fincham, Amber Garnish, Misha Gaur, Nicola Haresceugh, Andrea Idisi, Katherine Lloyd Jones, Ben Marriott, Tom McNaughton, Emily Moore, Arish Noshirwani, Ricky Page, Emily Poyser, Kieran Purchase, Clare Richards, Joe Roscamp, Salomon Scheepers, Mena Tharmakulasingam, Omair Vaiyani, Harriet Wilson, Georgina Blakey, Laura Brooke, Christina Hitchen, Hannah Panayiotou, Anna R Weighall, Ian Kellar, Graham R Law, Eleanor M Scott and George TH Ellison

Aim: The aim of the present study was to explore the extent and nature of variation in sleep duration amongst adults in the UK, drawing on data from the nationally-representative cohort study – Understanding Society (USoc: www.understandingsociety.ac.uk).

Methods: Data on self-reported sociodemographic variables and sleep measures were extracted from the first wave (Wave A) of the Understanding Society cohort (www.understandingsociety.ac.uk). A directed acyclic graph was used to summarise the likely causal relationships between covariates, and thereby identify minimally sufficient datasets of confounders and competing exposures that required adjustment in subsequent multivariate analyses of the relationships between each sociodemographic variable and sleep.

Results: Complete data were available for 43,591 of the 50,993 USoc participants who completed Wave A. At an individual level, short sleep duration was found to be significantly more common among specific sociodemographic groups, including female respondents (RRR:1.19; 95%CI:1.09,1.31); older respondents (RRR per additional year:1.01; 95%CI:1.00,1.01); respondents with an elevated BMI (RRR:1.02; 95%CI:1.01,1.02); and respondents from minority ethnic groups (compared to ‘White’ – ‘Black’ RRR:2.69; 95%CI:2.29,3.17; ‘Asian’ RRR:1.84; 95%CI:1.55,2.19; ‘Mixed’ RRR:1.45; 95%CI:1.18,1.77). At a familial level, both marital status and the presence of children in the household were associated with sleep duration, such that married participants reported longer sleep durations, while separated, divorced or widowed participants or participants with children reported shorter sleep durations than single participants or those without children. Finally, at a socioeconomic level, the present analyses indicated that sleep duration also varied with employment status, such that employed participants were less likely to sleep for short or longer periods.

Conclusion: These analyses confirm that there is substantial variation in sleep duration at individual, household and sociodemographic levels, and offer an insight into the extent and nature of variation in sleep duration across the UK. Alongside well-established demographic and anthropometric variation in sleep duration (particularly amongst older and overweight/obese individuals, and those with children), the more normative sleep durations of advantaged groups (particularly men, those from ‘White’ ethnic groups, and the employed) suggests that poor sleep duration may be a sensitive behavioural marker of disadvantage and/or a contributor to inequalities in health.

21

Optimal cholesterol levels in the elderly – A rapid assessment of the evidence for the need to amend UK public Health recommendations.

Veronique Delort, University of Westminster.

Aim: To determine whether or not the optimal serum total cholesterol (TC) value in elders above 80 years differs from that of younger age groups with regard to all-cause mortality.

Background: Risk profiles for cardiovascular disease (CVD) and all-cause mortality show a change at 80 years of age potentially favourable to a TC higher than the UK threshold of 5 mmol/L. Despite this, above 75 years old, British elders are systematically recommended lipid lowering medication.

Methods: A search (database & manual) selected prospective cohort studies of healthy 75+ year olds, and RCTs for CVD prevention in 70+ year olds. Data were analysed with a meta-analysis when results formats were compatible.

Results: Of six cohort studies of 4402 healthy Caucasian subjects (mean age 81.5), four displayed with 3055 Europeans a negative association between TC and all-cause mortality (hazard ratio (HR)=0.87(0.82-0.93), p=0.0001 for 2450 subjects) around the median value of 5.9 mmol/L. Two with US citizens displayed no association.

A meta-analysis of four RCTs with a total of 15,316 Caucasians (mainly) aged 70-97, did not display a significant difference between statin treatment and lacebo (risk ratio (RR)=0.98 (95% CI 0.91-1.05,p=0.32), nor did a further division into primary and secondary prevention.

Conclusion: A TC above 5.9 mmol/L predicts longevity for European Caucasian elders. Until further RCT studies establish with significant numbers whether lowering lipids decreases or increases all-cause mortality above 75 years of age, UK Public Health recommendations should not advocate the systematic use of statins for these British elders.

22

Are text-based bed-time reminders an effective intervention for extending sleep duration?

The 2013 SSRP Sleep Project (SSRPSP)1 - Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics; Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

*Corresponding author: g.t.h.ellison@leeds.ac.uk

¹The SSRPSP comprised: Eleanor Bates, Danielle Bucke, Francine Cheese, Sophie Danby, Rachael Dunnill, Benjamin Edgar, Victoria Farmery, Alice Fellbaum, Rebecca Haddow, Luke Hampshire, Cameron Hunter, Larissa Jones, Andzhela Kabia, Gopal Krishan, Daniel Lloyd, Mason McGlynn, Kiran Morjaria, Rosalind Revans, Sumaiya Salehin, Anna Todd, Alia Al Naji, Eleanor M Scott, Graham R Law, Nora Al Afif, George TH Ellison

Aim: Few interventions have succeeded in extending sleep duration through earlier bed-times, and the impact of these on sleep quality remains equivocal. The aim of the present study was to explore this issue amongst first year medical students – a population known to display short and variable sleep duration.

Methods: Twenty first year medical students (13 female; 7 male) completed a week-specific version of the Pittsburgh Sleep Quality Index. This permitted stratified randomisation by sex and self-reported bed-time to one of two interventions over a period of four consecutive weekdays. These involved a text message at 6pm on Monday requesting that participant go to bed "at/before11" or as "normal". Further ‘reminder’ text messages were sent the following four evenings at 9pm to ensure that participants remembered when they had been requested to go to bed. Data on sleep duration and quality were collected by self-report every morning and from actigraphic measurements recorded using an Actiwatch 2 (Phillips Respironics).

Results: A blinded intention to treat analysis demonstrated substantial variation in self-reported bed-times, getting-up times and sleep duration during both interventions. Average self-reported "at/before11" bed-times were significantly earlier and less variable than "normal" bed-times, although "at/before11" bed-times increased from Monday through Friday. Complete actigraphic data were only available for 17 of the 20 participants due to equipment failure. These data displayed a similar but attenuated pattern of sleep timing and duration to self-reports, and revealed that “normal” bed-times resulted in lower sleep latency and higher average sleep efficiency.

Conclusions: This population struggle to respond to a short term earlier bed-time intervention, and experience lower sleep quality than recorded following “normal” bed-times. Further work is required on the intervention used and the period of exposure and measurement to establish the effectiveness of earlier bed-time recommendations in this population.

23

Characterization of transformed human brain endothelial cells as a model for investigation of the effect of Plasmodium falciparum infected red blood cells on the blood brain barrier in cerebral malaria.

Chloe Firmstone, Mohd Hamzah M Nasir, and Srabasti J Chakravorty.

School of Life Sciences, Institute for Science and Technology in Medicine, Keele University, Keele, ST5 5BG, UK.

Malaria kills over 660,000 people each year and is caused by the parasite Plasmodium falciparum, transmitted by mosquito. Cerebral malaria (CM), a severe form of Malaria, causes neurological dysfunction and often death, if untreated. Connected by tight junctions (TJ’s), cerebral endothelial cells make up the blood brain barrier (BBB) which during CM can become leaky. Presence of the parasite induces immune responses including upregulation of the inflammatory cytokines TNF-α and IL-1β; and intercellular cell adhesion molecule-1 (ICAM-1), which correlated with parasite sequestration.

Transformed human brain microvascular endothelial cells (tHBEC) were used in these studies as a model for the endothelium of the blood brain barrier. Immunofluorescence staining for von Willebrand factor, PECAM-1/CD31, ICAM-1 and Dil-acetylated LDL was used to phenotypically characterize the tHBEC. For functional characterization, the effect of inflammatory cytokines on ICAM-1 expression in tHBEC was investigated using cell based ELISA. Overall, TNF-α and IL-1β treated cells produced significantly more ICAM-1 than controls, conforming to established observations about endothelial cells.

Expression of TJ proteins vinculin, claudin-5 and ZO-1 in tHBEC was measured using ELISA following treatment with supernatants harvested from co-cultures of PRBC and tHBEC. Expression of Vinculin and Claudin-5 was higher in tHBEC treated with tHBEC-PRBC coculture supernatant, compared to controls. This may be a survival response of the tHBEC inducing an over production of Vinculin and Claudin-5 was observed. Thus, the effect of PRBC on TJ proteins on tHBEC remains inconclusive and needs further investigation to better understand the mechanisms that lead to the endothelium becoming leaky in CM.

24

Testing spatial hypotheses of mandibular shape and form: relationships of tooth crown and tooth root dimensions to jaw size in P. troglodytes and G. gorilla.

Jason Gellis, University of Sheffield.

The association of mandibular robusticity to diet and masticatory stress constitute what is known as a biomechanical model of adaptation. However, there are inconsistent results reported in the literature regarding such a model. Alternatively, it is possible that non-dietary factors either contribute to, or are responsible for mandibular robusticity. A spatial model posits that corpus depth, breadth, and robusticity are secondary effects of functional support for large teeth and tooth roots.

There have been few investigations into the relationship between tooth size and jaw size from the view of a spatial model. Furthermore, an assumption shared by previous studies is that tooth crown and tooth root length are correlated with one another. Measures of canine tooth crowns, molar tooth crowns, corpus breadth, depth, and corpus robusticity indices (calculated as breadth/depth), along with radiographs of canine and molar tooth roots were taken for P. troglodytes (n=37) and G. gorilla (n=38). Intraspecific analyses reveal no correlation between tooth crown size and root length. Canine root length is strongly correlated with corpus depth in males, while molar root length is strongly correlated to corpus depth in females. While corpus depth is found to scale with canine dimensions, robusticity indices (measured as breadth/height) do not correlate to tooth dimensions. Results indicate that while tooth size variation does play a part in mandible size variation, there is no specific pattern shared between taxa.

25

Practical Applications of Evolutionary Medicine: Physicians’ Perspective

Parveen Herar, MSc Candidate – Evolutionary Medicine | Anthropology Durham University

This study will investigate physicians’ current knowledge and understanding of evolutionary medicine and how it is integrated into daily medical care practice in the UK. Evolutionary medicine is an emerging field that has gained speed in the past twenty years and is regarded by some as being able to offer a deeper understanding of bodily systems and potentially lead to a higher quality of life for patients. Understanding, holistically, aetiology of disease through evolution is beneficial to the patient.

The practical care that medicine offers may be usefully understood from an evolutionary perspective; knowing how and why an organism evolved can be very helpful in various medical practices such as when designing and prescribing pharmaceuticals, managing virulent diseases, vaccine distribution, treating chronic conditions, and many other treatments.

Evolutionary medicine has an expanding evidence based literature that has the potential be integrated more in the field of medicine. Physicians are increasingly using evidence based medicine and evidence based decision making but seem to be severely lacking in the realm of evolutionary medicine.

This study will employ 'think aloud' exercises to evaluate and assess physician decision making as well as semi-structured interviews. The script collected will be used as primary data and coded with an original coding scheme for statistical analysis.

This information will hopefully be able to provide insight on integrating evolutionary medicine practices through various education avenues by gaining an understanding of the current spread of knowledge on the topic of evolutionary medicine amongst current physicians in the UK.

26

Breastfeeding as an Adaptive Strategy to Environmental Pressures in Early Anglo-Saxon England

Ellen Kendall (e.j.kendall@durham.ac.uk), Department of Archaeology, Durham University.

Early childhood diet is known to have importance in both child morbidity and long-term health. Many studies have attempted to characterize the pattern and duration of infant feeding practices in the past, while acknowledging the complex array of factors which determine these: cultural tradition, familial structure, fertility, and environment. The last of these has rarely been deconstructed, despite having a significant effect on all other factors, heavily influencing disease ecology and life expectancy. This study presents pilot data examining the role of environment in breastfeeding and weaning patterns at two early Anglo-Saxon (5th-6th century AD) cemetery sites in Cambridgeshire. Littleport was a Fen island community which would have faced significant threats to health from waterborne diseases inherent to living in a marshy environment, as well as “ague” (malaria), which was known to be endemic to the Fens during the pre-drainage era. The second site, Edix Hill (Barrington A), was a non-Fen upland site. Comparison of skeletal “indicators of stress” supports the identification of these sites as differing in states of health and environmental pressure. First permanent molar dentine from four adult females was sequentially sectioned for high-resolution analysis of carbon and nitrogen stable isotope analysis. Results tentatively suggest that decline in δ15N values at Littleport occurred later in childhood than at Edix Hill, although a larger study will clarify this picture. This will contribute to our understanding of early childhood diet during the early Anglo-Saxon period, a timespan for which there is currently a paucity of data.

27

Histological Preservation: Implications for Protein Extraction from Archaeological Bone

Ross Kendall, PhD student, Department of Archaeology, Durham University.

A major challenge in the characterisation of endogenous archaeological bone proteins is the successful extraction of target proteins from the bone matrix. The intimate association of biomineralised collagen and, in particular, non-collagenous proteins (NCPs) with bone hydroxyapatite affords protection from diagenetic factors following death. Extraction of these tightly bound proteins, while maintaining their structure and integrity, presents a considerable challenge. Conflicting research on collagen diagenesis demonstrates a lack of correlation between bone structure and surviving collagen content. Even less is known about the survival of non-collagenous proteins, although their high affinity to hydroxyapatite may offer preferential protection. Histological analysis can characterise bone preservation and provides a relatively simple method of controlling for contamination by exogenous, diagenetically-introduced materials which may confound downstream protein analyses.

This study, as part of a larger doctoral project, has investigated the correlation between histological preservation and bulk protein yield. Romano British and Anglo-Saxon bone samples (n=14) were thick sectioned and scored using the Oxford Histological Index prior to exhaustive protein extraction in the form of demineralisation, denaturing, and chelation. Results demonstrate that poorly preserved bone releases protein far more readily, and in higher concentrations, than well preserved bone. This indicates the need for varied extraction protocols dependent upon bone preservation. This data confirms the importance of histological analysis as a precursory sample selection step, and suggests that histological preservation should help to dictate the choice of subsequent protein extraction methods.

28

A study of Cervical Vertebral and Dental Maturation.

Scheila Manica, FSL Wong, HM Liversidge, Queen Mary University of London, Institute of Dentistry, London.

Teeth are frequently used to estimate age but few reference data exist of cervical vertebrae stages for age. Maturation of the cervical vertebrae, seen from cephalometric radiographs are used by orthodontists to predict the pubertal growth spurt to target the timing of treatment, however, the relationship between cervical vertebrae and dental maturation is not well understood. The aim of this study was to assess cervical vertebrae maturation (CVM) in terms of dental maturity and age and explore if CVM might be applied to estimating age. The sample was archived lateral cephalograms and panoramic dental radiographs of 40 boys and 40 girls (aged 8.60 to 19.31 year) taken on the same day. CVM (using Hassel and Farman, 1995) and dental maturity (using Demirjian et al., 1973) was assessed by the first author. Intra-observer reliability of bone staging and tooth stage was calculated using Kappa. The mean age of each cervical maturation stage was compared between boys and girls using a t-test. Kappa was 0.65 for bone (60 bone stages) and 0.85 for teeth (420 tooth stages). Results show that mean ages for each CVM stage were not significantly different between boys and girls. Stage III was most variable for both dental and chronological age. Chronological age for CVM stages II and VI did not overlap. These results suggest that CVM might be applicable to estimate age in children who are dentally immature (up to the calcification of M2), but there is scope for a new quantitative method of CVM.

29

What is the relationship between sleep quality, sleep duration and heart disease? Evidence from the Understanding Society cohort study.

McNaughton T, Vaiyani O, Campbell F and Tharmakulasingam M on behalf of the Understanding Society Sleep Project (USocSP)1 - Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics, Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

*Presenting author; um11mov@leeds.ac.uk 1The USocSP comprised: Arwa Al-Robeye, Samin Amin, Natasha Begum, Yena Cho, Camilla Davies, Jennifer Day, Jake Dewhurst, Mathew Duke, Nicholas Fincham, Amber Garnish, Misha Gaur, Nicola Haresceugh, Andrea Idisi, Katherine Lloyd Jones, Ben Marriott, Emily Moore, Arish Noshirwani, Ricky Page, Emily Poyser, Kieran Purchase, Clare Richards, Joe Roscamp, Salomon Scheepers, Harriet Wilson, Georgina Blakey, Laura Brooke, Christina Hitchen, Hannah Panayiotou, Anna R Weighall, Ian Kellar, Graham R Law, Eleanor M Scott and George TH Ellison.

Background: The role of sleep in the aetiology of heart disease has been the focus of many studies over the past two decades, with increasing interest in the potential impact of poor quality, disturbed and/or short sleep on heart disease. There has also been a diversification in the measurement of sleep with a growing range of reliable self-reported sleep measures.

Objective: The aim of the present study was to conduct a cross-sectional analysis of a nationally representative United Kingdom (UK) cohort (Understanding Society; USoc) examining associations between a range of sleep measures and a range of heart conditions.

Methods: Data from the first wave (Wave A) of USoc were analysed using multivariate logistic regression to explore the relationship between four separate self-reported sleep measures (sleep duration; sleep quality; sleep disturbance due to coughing/snoring; and trouble falling asleep within 30 minutes) and self-reported diagnoses of four heart conditions (angina; congestive heart failure, CHF; coronary heart disease, CHD; and myocardial infarction, MI; see Table 1). Using a directed acyclic graph (see Figure 1), four covariates (namely: age; socioeconomic status; body mass index; and psychological wellbeing) were identified as the minimally sufficient set of variables required to adjust for confounding. Subsequent analyses were conducted in age-specific subsamples (aged: 16-30; 31-50; 51-65 and 65+ years).

Results: There were statistically significant associations between all four sleep measures and all four heart conditions. After adjustment for potential confounding, these associations remained statistically significant for all but one of the sleep measures (sleep duration; see Table 2). Sleep disturbance due to coughing or snoring was the measure most strongly associated with heart disease, with statistically significant associations in all but the youngest (16-30) age group (see Figure 2). Poor sleep quality and trouble falling asleep within 30 minutes were strongly associated with angina, CHF and CHD, but not MI; while sleep duration was only associated with CHD and MI in the 51-65 age group.

Conclusion: This study suggests that sleep quality/disturbance might be stronger and more consistent correlates of angina, CHF, CHD and MI than sleep duration per se. While the cross-sectional design of these analyses cannot determine whether poor quality, disturbed and (to some extent) shorter sleep were causes or consequences of heart disease, it is plausible that they were both. In particular, the reason disturbed sleep due to coughing or snoring was the sleep measure most strongly associated with heart disease, probably reflects the established causal relationship between sleep apnoea and heart disease. For this reason, sleep quality and (to some extent) sleep duration warrant further consideration in the development of preventive and therapeutic cardiac services.

30

Risk of SGA and LGA when using an internally derived ethnic specific birth weight chart, compared to UK-WHO. Results from the Born in Bradford study.

Norris, T., Tuffnell, D.J., Wright, J. & Cameron, N., University of Loughborough.

Background & aim: Studies have shown that UK born South Asians are 200g to 300g lighter at birth compared to White British infants. These apparently ethnic specific growth patterns will have implications for the assessment of health in these sub-groups when using a population derived growth chart. Interpretation is also dependent upon whether the population chart is a reference; describing growth ‘as is’, or a standard; describing growth as it ‘ought to be’. The aim therefore was to produce an ethnic specific birth weight chart and compare risk of SGA/LGA. Methods: Ethnic and sex specific birth weight charts were produced on a sample of 9 092 White British and Pakistani newborns enrolled in the Born in Bradford study. Internally derived L, M, S values and those used to produce the UK-WHO standards were used to generate gestational age adjusted Z scores. Rates of SGA and LGA were generated for each chart and relative risk calculated. Results: Risk of classifying SGA was significantly higher when using the UK-WHO standard compared to internally derived charts. This was more evident in Pakistani neonates, but increased risks were also observed for White neonates. The opposite pattern was observed for LGA, with a reduced risk of classifying as LGA using UK-WHO. Conclusions: The recently adopted UK-WHO charts may be an inappropriate tool for classification of SGA and LGA in this ethnically diverse population. Future work will look to identify which chart better predicts neonatal outcomes in this group.

31

The effect of early/late bedtimes on sleep duration, sleep onset latency and sleep efficiency: a randomised crossover trial

O’Kane M, Idisi A and Haresceugh N on behalf of the Sleep Duration Project (SDP)1 - Temporal Influences on Metabolic Events (TIME) Research Group, Leeds Institute of Genetics, Health and Therapeutics (LIGHT), School of Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time 1The SDP comprised: Harriet Wilson, Conor Vincent, Omair Vaiyani, Catherine Turner, Sreeharshan Thampy, Jessica Sinclair, Salomon Scheepers, Kieran Purchase, Arish Noshirwani, Emily Moore, Sam Mitchell, Ben Marriott, Katherine Lloyd Jones, Duncan Littlechild, Gillian Lever, Saadiysh Khan, Emily Holt, Alex Hodgson, Jessica Hayward, Alison Hallett, Ben Green, Vidushi Golash, Jai Gohil, Philippa Gaunt, Amber Garnish, Darren French, Nicholas Fincham, Mathew Duke, Jake Dewhurst, Jennifer Day, Camilla Davies, Rachael Campbell, Fiona Campbell, William Bolton, Marika Blackham, Thomas James Bewick, Natasha Begum, Robina Anwar, Samin Amin, Hannah Panayiotou, James Meacock, Christina Hitchen, Laura Brooke, Wendy Harrison, Benjamin Morris, Andrew J Prestwich, Ian Kellar, Anna R Weighall, Eleanor M Scott, Graham R Law, and George TH Ellison.*

*Presenting authors: um09m2o@leeds.ac.uk, ed11a2i@leeds.ac.uk; um11njh@leeds.ac.uk

Aim: The aim of the present study was to examine the effect of radically different bedtimes (2am vs. 10pm) on standardised sleep measures (sleep duration, onset latency and efficiency) using a new, objective actigraphic technique (a mobile phone accelerometry application) and an extensively used and comprehensively validated subjective psychometric tool (the Pittsburgh Sleep Quality Index; PSQI). Methods: 40 healthy undergraduate medical students completed a two-day randomised crossover control trial in which participants were randomly allocated to bed times of 10pm/2am vs. 2am/10pm on consecutive nights, stratified according to pre-existing, self-reported sleep patterns and chronotypes assessed using the PSQI and Morningness-Eveningness questionnaires. Participants fasted from 10pm on both nights and got up at 7am on the mornings of both days. Objective and subjective sleep data were recorded using the ‘SleepMeister’ application on an iPhone4 and an adapted ‘previous night’ version of the PSQI, respectively. Data were analysed using STATA version 12. Ethical clearance for this research project was granted by the University of Leeds LHIS/LIGHT/LIMM Joint Research Ethics Committee (Ref: HSLTLM12075). Results: After adjustment for participant sex and bedtime sequence, both the SleepMeister application and the PSQI recorded significantly later bedtimes (SleepMeister:-19.9; 95%CI:-20.1,19.7; PSQI:-19.9; 95%CI:-20.1,19.7) and shorter sleep durations (SleepMeister decimal hours:-3.8; 95%CI:-4.3,-3.4; PSQI:-3.4; 95%CI:-3.9,-2.9) following a 2am (vs. 10pm) bedtime. While neither recorded a significant difference in sleep efficiency (SleepMeister percentage:-0.419; 95%CI:-4.9,4.0; PSQI:3.6; 95%CI:-2.4,9.7), there was a significant decrease in sleep onset latency (i.e. time to fall asleep) following a 2am (vs. 10pm) bedtime (SleepMeister decimal minutes:-18.9; 95%CI:-22.4,-15.5; PSQI:-20.6; 95%CI:-34.6,-6.6). Discussion: This study obtained very similar results using both objective (SleepMeister app) and subjective (PSQI) sleep measures, and there was no indication that the former generated consistently less variable estimates than the latter (compare, for example, the 95%CI of the sleep onset latency and sleep efficiency variables for each measure). This suggests that both capture similar sleep-related parameters with a similar level of bias. Nonetheless, despite a substantial and significant effect of 2am vs. 10pm bedtime on app-recorded and self-reported bedtimes, sleep durations and sleep onset latency, there was no significant difference in sleep efficiency (the proportion of time spent in bed asleep). These findings call into question the sensitivity of sleep efficiency as a marker of sleep quality given that it depends not only on sleep onset latency but also on sleep duration and is therefore likely to underestimate sleep efficiency as sleep duration declines.

32

The relative importance of sleep quality and sleep duration as predictors of subsequent stroke: a longitudinal analysis of the Understanding Society cohort

Purchase K,* Samin S, Al-Robeye A and Begum N on behalf of the Understanding Society Sleep Project (USocSP)1 - Temporal Influences on Metabolic Events (TIME) Research Group; Leeds Institute of Genetics; Health and Therapeutics (LIGHT); School of Medicine; University of Leeds; Clarendon Way; Leeds LS2 9JT; www.medhealth.leeds.ac.uk/homepage/136/time

*Presenting author: um11s2a@leeds.ac.uk 1The USocSP comprised: Fiona Campbell, Yena Cho, Camilla Davies, Jennifer Day, Jake Dewhurst, Mathew Duke, Nicholas Fincham, Amber Garnish, Misha Gaur, Nicola Haresceugh, Andrea Idisi, Katherine Lloyd Jones, Ben Marriott, Tom McNaughton, Emily Moore, Arish Noshirwani, Ricky Page, Emily Poyser, Clare Richards, Joe Roscamp, Salomon Scheepers, Mena Tharmakulasingam, Omair Vaiyani, Harriet Wilson, Georgina Blakey, Laura Brooke, Christina Hitchen, Hannah Panayiotou, Anna R Weighall, Ian Kellar, Graham R Law, Eleanor M Scott and George TH Ellison.

Background: There is some evidence that sleep duration is a predictor of both metabolic and cardiovascular disease. However, this evidence remains somewhat equivocal with, some recent studies identifying a U-shaped association between sleep duration and stroke. At the same time, few studies have yet examined the role of sleep quality (as opposed to sleep duration) as a predictor of stroke.

Methods: To further explore the prognostic value of sleep quality and sleep duration as a predictor of stroke, data from the Understanding Society (USoc) study (originally comprising around 50,000 participants), were filtered to generate a subsample of n=24,094 participants with complete data in both of the first waves of data collection (Wave A and B), none of whom had had a stroke at Wave A (see Table 1). The role of self-reported sleep measures as predictors of stroke 18 months later (at Wave B) were examined after adjusting for: age; sex; body mass index; smoking and other chronic illnesses (all of which were identified as potential confounders using a directed acyclic graph; see Figure 1).

Results: There were strong, statistically significant associations between all self-reported sleep measures and subsequent stroke, both before and after adjustment for confounders (see Table 2). However, for sleep duration this relationship was no longer statistically significant when examined separately in the two oldest age groups (aged 40-64 years and 65+; see Figure 2). In contrast, poor sleep quality was a stronger predictor of stroke among 40-64 year olds (OR:17.96, 95%CI:1.89-170.38) while frequent sleep medication use was a stronger predictor of stroke amongst those aged 65+ years (OR:9.38, 95%CI:3.25-27.05).

Conclusion: The present study confirms that self-reported sleep measures are powerful predictors of stroke and that their predictive ability remained statistically significant even after adjustment for potential confounders. However, the predictive value of self-reported sleep was greatest for older age groups; and sleep quality measures (including the frequency of sleep medication use) were stronger predictors of stroke than sleep duration per se. Nonetheless, it remains to be seen whether: (i) the relationship between poor sleep quality and an enhanced risk of stroke reflects a direct causal role for some component(s) of sleep quality (and/or duration); or (ii) whether this reflects other factors which themselves affect sleep, and for which sleep acted as a proxy in these analyses.

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The application of evolutionary biology in medical education: benefits, barriers and future implications

Emily Rankin, MSc Evolutionary Medicine Postgraduate Student (Supervised by Dr Sarah Elton), Durham University, Department of Anthropology

Background

Evolutionary theory is widely seen as a fundamental component of the biomedical sciences. Despite research into the application of evolutionary biology in medicine becoming increasingly significant, and its relevance becoming ever more apparent, evolutionary biology is thought to receive relatively little attention in the medical curriculum (Nesse 2012).

Aims

• Discover whether/how evolutionary concepts are addressed in UK medical curricula.

• Gain insight into medical students’ views and knowledge of evolution and its relevance to medicine.

Methods

Participating medical school curricula and Tomorrow’s Doctors (2009) were analysed for evolutionary content. An electronic questionnaire was distributed to all years of four UK medical schools (n=425) and analysed using SPSS. Focus groups were carried out at three of the four medical schools (n= 7/5/7); these were analysed and coded using NVivo.

Results

• 18% of respondents studied evolution in their medical degree

• Topics students selected as being taught were variable within medical schools and do not correlate with topics mentioned in the curriculum

• 64% of participants felt evolutionary theory was relevant to medicine; 29% were unsure of the relevance.

• 77% of students would like to learn more about evolution.

Conclusions

Evolutionary biology is largely not addressed in UK medical curricula. Medical teaching and students’ knowledge of evolutionary concepts are variable. Many students are unable to identify evolutionary topics and there is uncertainty concerning the relevance of evolution to medicine and its application to clinical practice. To encourage the application of evolutionary biology in medicine its relevance and value needs to be highlighted at medical school. Considering the current lack of expertise within the medical field, creating an effective and useful component in the medical curriculum will require involvement and guidance from evolutionary biologists

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Evaluation of a portable ultrasound device for assessing body fat content in women.

Sophie C. Warner & Katherine Brooke-Wavell, School of Sport, Exercise and Health Sciences, Loughborough University, UK

Background: This study evaluated a new portable ultrasound device for measurement of body fat content. The device’s portability makes it convenient for research in field settings.Aim: The aim was to compare the accuracy of ultrasound (US), bioelectrical impedance (BIA) and skinfold (SF) techniques to dual energy X-ray absorptiometry (DXA).

Participants and Methods: 18 healthy women aged 18-40 years had their body fat estimated from: tissue interface depths by US (BodyMetrix); SF (Jackson and Pollock); BIA (Tanita BC-418 hand-to-foot scales) and DXA scans (GE Lunar Prodigy). Descriptive statistics were calculated and techniques compared by repeated measurements ANOVA, regression, and Bland-Altman analysis.

Results: The participants’ mean+SD age was 29.1 ± 4.4 years; height 1.652 ± 0.067m; weight 62.9 ± 11.1kg. Mean (SE) %fat by DXA, US, SF and BIA was 30.1 (2.4), 27.5 (0.7), 25.3 (1.4) and 26.9 (2.0) respectively. This differed significantly between techniques, with estimates for SKF and BIA being significantly lower than DXA (p=0.04 and 0.01 respectively). The standard error of estimate was greatest for ultrasound (US 6.5, SF 6.1 and BIA 3.5 %fat). Examination of Bland-Altman plots revealed that bias varied with measurement range for US and SKF, with overestimation at lower, and underestimation at higher, levels of fatness.

Conclusion: This study provides preliminary indication that the portable ultrasound device provided group mean %fat estimates that were more consistent with those from DXA than were those from other techniques, but there was larger individual variation for US, specially at the extremes of body composition.