Gender differences in survival and the use of primary care prior to diagnosis of three cancers:an analysis of routinely collected UK general practice data

Objective To explore whether there are gender differences in the number of GP recorded cases, the probability of survival and consulting pattern prior to diagnosis amongst patients with three non-sex-specific cancers. Design Cross sectional study. Setting UK primary care. Subjects 12,189 patients aged 16 years or over diagnosed with colorectal cancer (CRC), 11,081 patients with lung cancer and 4,352 patients with malignant melanoma, with first record of cancer diagnosis during 1997–2006. Main outcome measures Cancer cases recorded in primary care; probability of survival following diagnosis; and number of GP contacts within the 24 months preceding diagnosis. Results From 1997–2006, overall rates of GP recorded CRC and lung cancer cases recorded were higher in men than in women, but rates of malignant melanoma were higher in women than in men. Gender differences in survival were small; 49% of men and 53% of women survived at least 5 years following CRC diagnosis; 9% of men and 12% of women with lung cancer, and 77% of men and 86% of women with malignant melanoma. The adjusted male to female relative hazard ratio of death in all patients was 1.20 (95%CI 1.13–1.30), 1.24 (95%CI 1.16–1.33) and 1.73 (95%CI 1.51–2.00) for CRC, lung cancer and malignant melanoma respectively. However, gender differences in the relative risk were much smaller amongst those who died during follow-up. For each cancer, there was little evidence of gender difference in the percentage who consulted and the number of GP contacts made within 24 months prior to diagnosis. Conclusions This study found that patterns of consulting prior to cancer diagnosis differed little between two genders, providing no support for the hypothesis that gender differences in survival are explained by gender differences in consultation for more serious illness, and suggests the need for a more critical view of gender and consultation

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer.

Childhood maltreatment is associated with elevated risk for depression across the human lifespan. Identifying the pathways through which childhood maltreatment relates to depressive symptoms may elucidate intervention targets that have the potential to reduce the lifelong negative health sequelae of maltreatment exposure. In this cross-sectional study, 271 women with early-stage breast cancer were assessed after their diagnosis but before the start of adjuvant treatment (chemotherapy, radiation, endocrine therapy). Participants completed measures of childhood maltreatment exposure, psychological resources (optimism, mastery, self-esteem, mindfulness), and depressive symptoms. Using multiple mediation analyses, we examined which psychological resources uniquely mediated the relationship between childhood maltreatment and depressive symptoms. Exposure to maltreatment during childhood was robustly associated with lower psychological resources and elevated depressive symptoms. Further, lower optimism and mindfulness mediated the association between childhood maltreatment and elevated depressive symptoms. These results support existing theory that childhood maltreatment is associated with lower psychological resources, which partially explains elevated depressive symptoms in a sample of women facing breast cancer diagnosis and treatment. These findings warrant replication in populations facing other major life events and highlight the need for additional studies examining childhood maltreatment as a moderator of treatment outcomes

Industrial constructions of publics and public knowledge: a qualitative investigation of practice in the UK chemicals industry

This is a post print version of the article. The official published version can be obtained from the link below - © 2007 by SAGE PublicationsWhile the rhetoric of public engagement is increasingly commonplace within industry, there has been little research that examines how lay knowledge is conceptualized and whether it is really used within companies. Using the chemicals sector as an example, this paper explores how companies conceive of publics and "public knowledge," and how this relates to modes of engagement/communication with them. Drawing on qualitative empirical research in four companies, we demonstrate that the public for industry are primarily conceived as "consumers" and "neighbours," having concerns that should be allayed rather than as groups with knowledge meriting engagement. We conclude by highlighting the dissonance between current advocacy of engagement and the discourses and practices prevalent within industry, and highlight the need for more realistic strategies for industry/public engagement.Funding was received from the ESRC Science in Society Programme

The SCUBA Bright Quasar Survey (SBQS): 850micron observations of the z>4 sample

We present initial results of a new, systematic search for massive star-formation in the host galaxies of the most luminous and probably most massive z>=4 radio-quiet quasars (M(B) 10^13Lsun). A total of 38 z>=4 radio-quiet quasars have been observed at the JCMT using SCUBA at 850microns: 8 were detected (>3sigma) with S(850microns)>~ 10mJy (submillimetre-loud). The new detections almost triple the number of optically selected, submillimetre-loud z>~4 radio-quiet quasars known to date. We include a detailed description of how our quasar sample is defined in terms of radio and optical properties. There is no strong evidence for trends in either detectability or 850microns flux with absolute magnitude, M(B). We find that the weighted mean flux of the undetected sources is 2.0 +/- 0.6mJy, consistent with an earlier estimate of \~3mJy based on more sensitive observations of a sample z>~4 radio-quiet quasars (McMahon et al., 1999). This corresponds to an inferred starformation rate of \~1000Msun/yr, similar to Arp220. The typical starformation timescale for the submillimetre-bright sources is ~1Gyr, 10 times longer than the typical accretion-driven e-folding timescale of ~5x10^7 years. Our 850micron detection of the z=4.4 quasar PSS J1048+4407 when analysed in conjunction with 1.2mm single-dish and interferometric observations suggests that this source is resolved on angular scales of 1-2" (6-12 kpc). In addition, we present a new optical spectrum of this source, identifying it as a broad absorption line (BAL) quasar. The new redshift is outside that covered in a recent CO line search by Guilloteau et al., (1999), highlighting the need for accurate redshifts for the obervation and interpretation of high-redshift line studies.Comment: 16 pages, 11 figures. Accepted by Monthly Notices of the Royal Astronomical Societ

The influence of socio-demographic characteristics on consultation for back pain—a review of the literature

Background. There are several assumptions within clinical practice about who is more or less likely to consult a health care practitioner for particular symptoms, most commonly these focus around socio-demographic characteristics. We aimed to assess the evidence for the impact of socio-demographic characteristics on consultation for back pain