Ovarian and cervical cancer awareness: development of two validated measurement tools.

The aim of the study was to develop and validate measures of awareness of symptoms and risk factors for ovarian and cervical cancer (Ovarian and Cervical Cancer Awareness Measures)

Acute Phase Proteins in Response to Dictyocaulus viviparus Infection in Calves

Three experiments were carried out to examine the acute phase response, as measured by the acute phase proteins (APP) haptoglobin, serum amyloid A (SAA) and fibrinogen, in calves infected with lungworm, Dictyocaulus vivparus. In addition, eosinophil counts were analysed. Three different dose models were used in 3 separate experiments: I) 250 D. viviparus infective third stage larvae (L3) once daily for 2 consecutive days, II) 100 D. viviparus L3 once daily for 5 consecutive days, and III) 2000 L3 once. All 3 dose regimes induced elevated levels of haptoglobin, SAA and fibrinogen, although there was considerable variation both between and within experiments. A significant increase was observed in all 3 APP at one or several time points in experiment I and III, whereas in experiment II, the only significant elevation was observed for fibrinogen at one occasion. The eosinophil numbers were significantly elevated in all 3 experiments. The results show that lungworm infection can induce an acute phase response, which can be monitored by the selected APP. Elevated APP levels in combination with high numbers of eosinophils in an animal with respiratory disease may be used as an indicator of lung worm infection, and help the clinician to decide on treatment. However, high numbers of eosinophils and low levels of APP do not exclude a diagnosis of lungworm. Thus, lungworm infection may not be detected if measurements of APP are used to assess calf health in herds or individual animals

UK Women's Views of the Concepts of Personalised Breast Cancer Risk Assessment and Risk-Stratified Breast Screening: A Qualitative Interview Study.

Any introduction of risk-stratification within the NHS Breast Screening Programme needs to be considered acceptable by women. We conducted interviews to explore women's attitudes to personalised risk assessment and risk-stratified breast screening. Twenty-five UK women were purposively sampled by screening experience and socioeconomic background. Interview transcripts were qualitatively analysed using Framework Analysis. Women expressed positive intentions for personal risk assessment and willingness to receive risk feedback to provide reassurance and certainty. Women responded to risk-stratified screening scenarios in three ways: 'Overall acceptors' considered both high- and low-risk options acceptable as a reasonable allocation of resources to clinical need, yet acceptability was subject to specified conditions including accuracy of risk estimates and availability of support throughout the screening pathway. Others who thought 'more is better' only supported high-risk scenarios where increased screening was proposed. 'Screening sceptics' found low-risk scenarios more aligned to their screening values than high-risk screening options. Consideration of screening recommendations for other risk groups had more influence on women's responses than screening-related harms. These findings demonstrate high, but not universal, acceptability. Support and guidance, tailored to screening values and preferences, may be required by women at all levels of risk

Self-Reported And Objectively Recorded Colorectal Cancer Screening Participation In England

Objective To compare self-reported with objectively recorded participation in Faecal Occult Blood testing (FOBt) colorectal cancer (CRC) screening in a national programme. Methods Survey respondents living in England who were eligible for screening were asked in face-to-face interviews if they had ever been invited to do a CRC screening test, how many times they had been invited, and how many times they had participated. National Health Service (NHS) Bowel Cancer Screening Programme (BCSP) records were consulted for respondents who had consented to a record check. The outcome measures were ‘ever uptake’ (responded to ≥1 invitation), ‘repeat uptake’ (responded to ≥2 invitations), and ‘consistent uptake’ (responded to all invitations). Results In the verified group, self-reported ever uptake was highly consistent with recorded ever uptake (87.0% vs. 87.8%). Among those who indicated that they had been invited more than once, self-reported repeat uptake was 89.8% compared with 84.8% recorded repeat uptake. Among those with more than one recorded invitation, self-reported repeat uptake was 72.7% compared with 77.2% recorded repeat uptake, and self-reported consistent uptake was 81.6% compared with 65.6% recorded consistent uptake. Conclusion Our results suggest that people can accurately report whether they have ever taken part in CRC screening. The vast majority of those whose records were verified could also accurately report whether they had taken part in screening at least twice. They were somewhat less accurate in reporting whether they had responded to all screening invitations

Comparing perceived clarity of information on overdiagnosis used for breast and prostate cancer screening in England: an experimental survey.

OBJECTIVES: 'Overdiagnosis', detection of disease that would never have caused symptoms or death, is a public health concern due to possible psychological and physical harm but little is known about how best to explain it. This study evaluated public perceptions of widely used information on the concept to identify scope for improving communication methods. DESIGN: Experimental survey carried out by a market research company via face-to-face computer-assisted interviews. SETTING: Interviews took place in participants' homes. PARTICIPANTS: 2111 members of the general public in England aged 18-70 years began the survey; 1616 were eligible for analysis. National representativeness was sought via demographic quota sampling. INTERVENTIONS: Participants were allocated at random to receive a brief description of overdiagnosis derived from written information used by either the NHS Breast Screening Programme or the prostate cancer screening equivalent. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was how clear the information was perceived to be (extremely/very clear vs less clear). Other measures included previous exposure to screening information, decision-making styles and demographic characteristics (eg, education). Binary logistic regression was used to assess predictors of perceived clarity. RESULTS: Overdiagnosis information from the BSP was more likely to be rated as more clear compared with the prostate screening equivalent (adjusted OR: 1.43, 95% CI 1.17 to 1.75; p=0.001). Participants were more likely to perceive the information as more clear if they had previously encountered similar information (OR: 1.77, 1.40 to 2.23; p<0.0005) or a screening leaflet (OR: 1.35, 1.04 to 1.74; p=0.024) or had a more 'rational' decision-making style (OR: 1.06, 1.02 to 1.11; p=0.009). CONCLUSIONS: Overdiagnosis information from breast screening may be a useful template for communicating the concept more generally (eg, via organised campaigns). However, this information may be less well-suited to individuals who are less inclined to consider risks and benefits during decision-making

Survey of public definitions of the term 'overdiagnosis' in the UK

Objectives: To determine how ‘overdiagnosis’ is currently conceptualised among adults in the United Kingdom (UK) in light of previous research, which has found that the term is difficult for the public to understand and awareness is low. This study aims to add to current debates on healthcare in which overdiagnosis is a prominent issue. Design: An observational, web-based survey was administered by a survey company. Setting: Participants completed the survey at a time and location of their choosing. Participants: 390 consenting UK adults aged 50-70 years. Quota sampling was used to achieve approximately equal numbers in three categories of education. Primary outcome measures: Participants were asked whether they had seen or heard the term ‘overdiagnosis’. If they had, they were then invited to explain in a free text field what they understood it to mean. If they had not previously encountered it, they were invited to say what they thought it meant. Responses were coded and interpreted using content analysis and descriptive statistics. Results: Data from 390 participants were analysed. Almost a third (30.0%) of participants reported having previously encountered the term. However, their responses often indicated that they had no knowledge of its meaning. The most prevalent theme consisted of responses related to the diagnosis itself. Subthemes indicated common misconceptions, including an ‘overly negative or complicated diagnosis’, ‘false positive diagnosis’ or ‘misdiagnosis’. Other recurring themes consisted of responses related to testing (i.e. ‘too many tests’), treatment (e.g. ‘overtreatment’), and patient psychology (e.g. ’overthinking’). Responses categorised as consistent with ‘overdiagnosis’ (defined as detection of a disease that would not cause symptoms or death) were notably rare (n=10; 2.6%). Conclusions: Consistent with previous research, public awareness of ‘overdiagnosis’ in the UK is low and its meaning is often misunderstood or misinterpreted

Reduce Tall Fescue Toxicosis in \u3cem\u3eFestuca arundinacea\u3c/em\u3e Forage Systems with Legumes

Tall fescue (Lolium arundinaceum = Festuca arundinacea) is an important cool-season grass because of persistence and spring and autumn productivity. Most existing tall fescue pastures in Tennessee are Kentucky-31 (KY-31) and are infested with the endophytic fungus Neotyphodium coenophialum that causes tall fescue toxicosis. Symptoms in beef cattle include reduced rates of gain, poor conception rates, decreased dry matter intake, a long rough haircoat in summer, and very low serum prolactin. Earlier studies indicated that the performance of cattle grazing endophyte-free (EF) tall fescue is superior to that of cattle grazing endophyte-infected (EI) tall fescue (Fribourg et al., 1995). However, EF tall fescue is not as persistent as EI. Addition of clovers to tall fescue pastures is a recommended practice. Our objective was to compare forage quality, in vitro dry matter disappearance, dry matter intake, and animal performance of EI and EF KY-31 pastures, and inclusion of legumes

Thermodynamic and dynamic anomalies for a three dimensional isotropic core-softened potential

Using molecular dynamics simulations and integral equations (Rogers-Young, Percus-Yevick and hypernetted chain closures) we investigate the thermodynamic of particles interacting with continuous core-softened intermolecular potential. Dynamic properties are also analyzed by the simulations. We show that, for a chosen shape of the potential, the density, at constant pressure, has a maximum for a certain temperature. The line of temperatures of maximum density (TMD) was determined in the pressure-temperature phase diagram. Similarly the diffusion constant at a constant temperature, $D$, has a maximum at a density $\rho_{max}$ and a minimum at a density $\rho_{min}<\rho_{max}$. In the pressure-temperature phase-diagram the line of extrema in diffusivity is outside of TMD line. Although in this interparticle potential lacks directionality, this is the same behavior observed in SPC/E water.Comment: 16 page