Public awareness of cancer in Britain: a population-based survey of adults

*_Objective:_* To assess public awareness of cancer warning signs, anticipated delay, and perceived barriers to seeking medical advice in the British population. 
Methods: We carried out a population-based survey using face-to-face, computer-assisted interviews to administer the Cancer Awareness Measure (CAM), a newly-developed, validated measure of cancer awareness. The sample included 2216 adults (970 male and 1246 female) recruited as part of the Office for National Statistics Opinions Survey using stratified probability sampling.

*_Results:_* Awareness of cancer warning signs was low when open-ended (recall) questions were used and higher with closed (recognition) questions; but on either measure, awareness was lower in those who were male, younger, and from lower socioeconomic status (SES) groups or ethnic minorities. The most commonly endorsed barriers to help-seeking were difficulty making an appointment, worry about wasting the doctor’s time and worry about what would be found. Emotional barriers were more prominent in lower SES groups and practical barriers (e.g. too busy) more prominent in higher SES groups. Anticipated delay was lower in ethnic minority and lower SES groups. In multivariate analysis, higher symptom awareness was associated with lower anticipated delay, and more barriers with greater anticipated delay.

*_Conclusions:_* A combination of public education about symptoms and empowerment to seek medical advice, as well as support at primary care level, could enhance early presentation and improve cancer outcomes

Primary ciliary dyskinesia (Siewert's / Kartagener's Syndrome): Respiratory symptoms and psycho-social impact

BACKGROUND: Although the pathophysiological defect in primary ciliary dyskinesia (PCD; Siewert's / Kartagener's syndrome) is now well characterised, there are few studies of the impact of the condition upon health function, particularly in later life. This study assesses the health impact of the condition in a large group of patients. In addition, it assesses the similarity in age of diagnosis, symptoms and problems of those with situs inversus (PCD-SI) and those with situs solitus (PCD-SS). METHODS: Postal questionnaire sent to members of the UK Primary Ciliary Dyskinesia Family Support Group. The questionnaire contained the St. George's Respiratory Questionnaire (SGRQ) and the SF-36 questionnaire for assessing health status. RESULTS: 93 questionnaires were returned, representing a 66% response rate. Replies were received from similar numbers of PCD-SI and PCD-SS. Individuals with PCD-SI did not show a significant tendency to be diagnosed earlier, and neither did they show any difference in their symptoms, or the relationship of symptoms to age. Respiratory symptoms were fairly constant up until the age of about 25, after which there was a slow increase in symptoms, and a decline in health status, patients over the age of 40 being about one and a half standard deviations below the mean on the physical component score of the PCS. Patients diagnosed earlier in life, and hence who had received more treatment for their condition, had better scores on the SGRQ Impact and Activity scores. CONCLUSIONS: PCD is a chronic condition which has a progressively greater impact on health in the second half of life, producing significant morbidity and restriction of life style. Early diagnosis, and hence earlier treatment, may improve symptoms and the impact of the condition

X-Ray Observations of V4641 SGR (= SAX J1819.3-2525) During the Brief and Violent Outburst of 2003

We present the results of detailed analysis of pointed X-ray observations by RXTE PCA/HEXTE of the black hole X-ray binary (BHXRB) system V4641 Sgr (= SAX J1819.3-2525) during its outburst of August 2003. Soft X-ray (3-20 keV) flux variations by factors of 10 or more on timescales of minutes or shorter were seen. The rapid and strong variability of this source sets it apart from typical XRBs. In spite of large luminosity fluctuations, the spectral state of the source did not change significantly during the dwells which suggests that the physical emission processes did not change much during the observations. The energy spectra during the dwells were dominated by a hard Comptonized powerlaw component, indicative of the canonical low/hard state observed in other BHXRBs. No soft thermal component was found in three out of the four RXTE pointings. However spectral deconvolution of the observation with largest average luminosity suggests an obscured, hot accretion disk. During one of the observations we detected a short term (about 100s) soft X-ray dropout which is apparently due to variability in the observed column density. Strong Fe K$\alpha$ fluorescent emisssion line near 6.5 keV was detected with large equivalent widths in the range of 700 - 1000eV. In the temporal domain, the Fourier power spectra were dominated by red noise below a few Hz. Poisson noise dominated at higher frequencies and no high frequency features were detected. The strong Comptonized spectra, broad iron emission line, absence of disk component in the spectra, absence of any timing variability above few Hz and occasional large changes in the column density along the line-of-sight, all support an enshrouded black hole with occasional outflow and a very dynamic environment.Comment: 27 pages, 10 figures (1 color figure), accepted for publication in the Astrophysical Journal. It is tentatively scheduled for the ApJ 01 February 2006, v637, 2 issu

Shepard avocado maturity consumer sensory research

Dry matter content (DM) of avocados represents the amount of carbohydrates and nutrients that have been transported from the tree into the fruit. The longer the avocado remains on the tree, the higher the dry matter, and consequently, %DM is used by growers to decide when avocados are ready to harvest. In the current study, 112 consumers tasted ‘Shepard’, a variety of avocado that can be harvested early in the season. The avocados were collected from a range of locations in Northern Queensland in order to ensure that fruit of varying maturity (%DM) were available for tasting at the same time. Consumers’ liking of flavour increased progressively as the DM content of avocados increased from 18% to 23% but then reached a plateau, where further increases in DM did not result in corresponding increases in liking. The immature (lower DM) avocados were frequently described as having ‘bland/tasteless’ or ‘watery’ flavour as well as being less liked than other avocados. Following tasting, consumers were asked about their experience with avocados and the extent that a quality guarantee offering to refund or replace damaged fruit might increase purchasing. Consumers continued to report a high incidence and severity of damage in the avocados they purchased for consumption at home. The study indicated that consumers’ willingness to buy avocados increased as a consequence of the quality guarantee

Two X-Ray Bright Cataclysmic Variables with Unusual Activities: GZ Cnc and NSV 10934

We report on a discovery of unexpected activities in two X-ray bright dwarf novae. GZ Cnc showed an anomalous clustering of outbursts in 2002, in contrast to a low outburst frequency in the past record. The activity resembles an increased activity seen in some intermediate polars or candidates. We identified NSV 10934, X-ray selected high-amplitude variable star, as a dwarf nova with unusually rapid decline. The outburst characteristics make NSV 10934 a twin of recently discovered intermediate polar (HT Cam) with dwarf nova-type outbursts. We propose that these activities in X-ray strong dwarf novae may be a previously overlooked manifestation of outburst activities in magnetic cataclysmic variables

Outbursts of EX Hydrae: mass-transfer events or disc instabilities?

We present the 45-yr record of EX Hya's lightcurve and discuss the characteristics of its 15 observed outbursts. We then concentrate on the 1998 outburst, reporting the first outburst X-ray observations. We discover an X-ray beat-cycle modulation, indicating that an enhanced accretion stream couples directly with the magnetosphere in outburst, confirming our previous prediction. Optical eclipse profiles late in outburst show that the visible light is dominated by an enhanced mass-transfer stream overflowing the accretion disc. We are uncertain whether the enhanced mass transfer is triggered by a disc instability, or by some other cause. While in outburst, EX Hya shows some of the characteristics of SW Sex stars.Comment: To appear in MNRAS (8 pages; 9 figs

Individualized Ranibizumab Regimen Driven by Stabilization Criteria for Central Retinal Vein Occlusion: Twelve-Month Results of the CRYSTAL Study

Purpose To assess the 12-month efficacy and safety profile of an individualized regimen of ranibizumab 0.5 mg driven by stabilization criteria in patients with macular edema secondary to central retinal vein occlusion (CRVO). Design A 24-month, prospective, open-label, single-arm, multicenter study. Participants Three hundred fifty-seven patients. Methods Patients were treated with monthly ranibizumab 0.5-mg injections (minimum of 3 injections) until stable visual acuity (VA) was maintained for 3 consecutive months. Thereafter, ranibizumab 0.5 mg was dosed as needed if monthly monitoring indicated a loss of VA resulting from disease activity. Main Outcome Measures Mean change from baseline at month 12 in best-corrected VA (BCVA; primary end point) and safety over 12 months. The efficacy of this regimen in subgroups categorized by baseline BCVA score, CRVO duration, or presence of macular ischemia (exploratory analysis). Results At baseline, the mean BCVA was 53.0 letters and mean CRVO duration was 8.9 months (median, 2.4 months). Ranibizumab 0.5-mg treatment resulted in a statistically significant mean gain in BCVA from baseline at month 12 of 12.3 letters (standard deviation [SD], 16.72 letters; P < 0.0001). The mean number of ranibizumab injections up to month 12 was 8.1 (SD, 2.77). At month 12, mean BCVA gains were similar with or without macular ischemia at baseline (11.6 vs. 12.1 letters); the mean BCVA gain was higher with baseline CRVO duration of less than 3 months (13.4 letters) than with a longer duration (≥3-<9 months, 11.1 letters; ≥9 months, 10.9 letters). Patients with lower baseline BCVA had larger mean BCVA gains at month 12 than those with higher baseline BCVA (≤39/40-59/≥60 and 18.0/12.7/8.9 letters, respectively), although the absolute BCVA at month 12 was higher with higher baseline BCVA. No new ocular or nonocular safety events were observed. Conclusions An individualized dosing regimen of ranibizumab 0.5 mg driven by stabilization criteria for up to 12 months resulted in significant BCVA gain in a broad population of patients with macular edema secondary to CRVO, including those with macular ischemia at baseline. The safety findings were consistent with those reported in previous ranibizumab studies in patients with CRVO