Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK.

Delay in help seeking for cancer 'alarm' symptoms has been identified as a contributor to delayed diagnosis

On the existence of dyons and dyonic black holes in Einstein-Yang-Mills theory

We study dyonic soliton and black hole solutions of the ${\mathfrak {su}}(2)$ Einstein-Yang-Mills equations in asymptotically anti-de Sitter space. We prove the existence of non-trivial dyonic soliton and black hole solutions in a neighbourhood of the trivial solution. For these solutions the magnetic gauge field function has no zeros and we conjecture that at least some of these non-trivial solutions will be stable. The global existence proof uses local existence results and a non-linear perturbation argument based on the (Banach space) implicit function theorem.Comment: 23 pages, 2 figures. Minor revisions; references adde

Different populations of RNA polymerase II in living mammalian cells

RNA polymerase II is responsible for transcription of most eukaryotic genes, but, despite exhaustive analysis, little is known about how it transcribes natural templates in vivo. We studied polymerase dynamics in living Chinese hamster ovary cells using an established line that expresses the largest (catalytic) subunit of the polymerase (RPB1) tagged with the green fluorescent protein (GFP). Genetic complementation has shown this tagged polymerase to be fully functional. Fluorescence loss in photobleaching (FLIP) reveals the existence of at least three kinetic populations of tagged polymerase: a large rapidly-exchanging population, a small fraction resistant to 5,6-dichloro-1-β-D-ribofuranosylbenzimidazole (DRB) but sensitive to a different inhibitor of transcription (i.e. heat shock), and a third fraction sensitive to both inhibitors. Quantitative immunoblotting shows the largest fraction to be the inactive hypophosphorylated form of the polymerase (i.e. IIA). Results are consistent with the second (DRB-insensitive but heat-shock-sensitive) fraction being bound but not engaged, while the third (sensitive to both DRB and heat shock) is the elongating hyperphosphorylated form (i.e. IIO)

Higher-dimensional solitons and black holes with a non-minimally coupled scalar field

We study higher-dimensional soliton and hairy black hole solutions of the Einstein equations non-minimally coupled to a scalar field. The scalar field has no self-interaction potential but a cosmological constant is included. Non-trivial solutions exist only when the cosmological constant is negative and the constant governing the coupling of the scalar field to the Ricci scalar curvature is positive. At least some of these solutions are stable when this coupling constant is not too large.Comment: 17 pages, revtex4, 21 figures, minor changes to match published versio

Disability in intergalactic environments : the representation of disability issues in Star Trek

The science fiction series Star Trek is peopled with various humanoid species living and working together, reflecting the philosophy of its creator, Gene Rodenderry, that diversity is a strength to be celebrated. This is reflected in the Vulcan philosophy of 'Infinite Diversity in Infinite Combinations'. Among the issues of diversity that feature in many episodes there are those related to disabled people. On the whole, the representation of disability in Star Trek encourages the viewer to challenge stereotypes about people with disability and to see them not simply in terms of their impairments, but as people who go about their work in ways which are sometimes different from the norm; simply beings with ”differing abilities“. This is especially the case for people with sensory or mobility impairments. They may see in a different way, communicate in a different way or move around in a different way, but they still give a valid contribution, and in some episodes it is their very difference that saves the day. When it comes to intellectual disability, however, the representation takes on a more negative turn. This paper considers these different representations of disability in four episodes of Star Trek: The Masterpiece Society, Melora, Loud as a Whisper and Samaritan Snare.peer-reviewe

Socioeconomic inequalities in attitudes towards cancer: an international cancer benchmarking partnership study.

Socioeconomic status (SES) differences in attitudes towards cancer have been implicated in the differential screening uptake and the timeliness of symptomatic presentation. However, the predominant emphasis of this work has been on cancer fatalism, and many studies focus on specific community subgroups. This study aimed to assess SES differences in positive and negative attitudes towards cancer in UK adults. A population-based sample of UK adults (n=6965, age≥50 years) completed the Awareness and Beliefs about Cancer scale, including six belief items: three positively framed (e.g. 'Cancer can often be cured') and three negatively framed (e.g. 'A cancer diagnosis is a death sentence'). SES was indexed by education. Analyses controlled for sex, ethnicity, marital status, age, self-rated health, and cancer experience. There were few education-level differences for the positive statements, and overall agreement was high (all>90%). In contrast, there were strong differences for negative statements (all Ps<0.001). Among respondents with lower education levels, 57% agreed that 'treatment is worse than cancer', 27% that cancer is 'a death sentence' and 16% 'would not want to know if I have cancer'. Among those with university education, the respective proportions were 34, 17 and 6%. Differences were not explained by cancer experience or health status. In conclusion, positive statements about cancer outcomes attract near-universal agreement. However, this optimistic perspective coexists alongside widespread fears about survival and treatment, especially among less-educated groups. Health education campaigns targeting socioeconomically disadvantaged groups might benefit from a focus on reducing negative attitudes, which is not necessarily achieved by promoting positive attitudes

Improvement of Energy Efficiency for Wastewater Treatment

Wastewater treatment requires the elimination of pathogens and reduction of organic matter in the treated sludge to acceptable levels. One process used to achieve this is Autothermal Thermophylic Aerobic Digestion (ATAD), which relies on promoting non-pathogenic thermophilic bacteria to digest organic matter and kill pathogens through metabolic heat generation. This process requires continuous aeration that may be energy consuming, and the final aim of the study is to identify how the process design can minimize the energy input per mass of treated sludge. Appropriate modeling of the reactor process is an essential ingredient, so we explore properties of an existing model and propose a simplified alternative model

Smokers are less likely than non-smokers to seek help for a lung cancer 'alarm' symptom

BACKGROUND: The majority (>85%) of lung cancer cases are linked with smoking, and prognosis is poor because it is often diagnosed at a late stage. One contributor to late-stage diagnosis could be patient delay in help-seeking. We investigated the help-seeking behaviour of smokers and non-smokers for a recent lung cancer alarm symptom. METHODS: A health survey was sent to 4913 men and women aged >50 years through through General Practice. It included questions on symptoms experienced in the past 3 months (from a checklist), help-seeking (Yes/No) for each symptom and demographic characteristics including smoking status. Univariable and multivariable binary logistic regression analyses were used to assess the association between smoking status and help-seeking for a cough or hoarseness. RESULTS: Among 2042 participants (42% response rate), 280 (14%) reported 'cough or hoarseness' in the past 3 months; of whom 22% were current smokers. Being a smoker was associated with reduced likelihood of help-seeking (OR 0.44; 95% CI 0.23 to 0.83), even after adjusting for demographic factors (OR 0.46; 95% CI 0.21 to 1.00). CONCLUSIONS: Delay in help-seeking in smokers for a symptom that is potentially indicative of lung cancer is a cause for concern. Future research could usefully address the psychological mechanisms through which help-seeking in smokers is hindered

The impact of body vigilance on help-seeking for cancer 'alarm' symptoms: a community-based survey.

BACKGROUND: The act of detecting bodily changes is a pre-requisite for subsequent responses to symptoms, such as seeking medical help. This is the first study to explore associations between self-reported body vigilance and help-seeking in a community sample currently experiencing cancer 'alarm' symptoms. METHODS: Using a cross-sectional study design, a 'health survey' was mailed through primary care practices to 4913 UK adults (age ≥50 years, no cancer diagnosis), asking about symptom experiences and medical help-seeking over the previous three months. Body vigilance, cancer worry and current illness were assessed with a small number of self-report items derived from existing measures. RESULTS: The response rate was 42% (N = 2042). Almost half the respondents (936/2042; 46%) experienced at least one cancer alarm symptom. Results from logistic regression analysis revealed that paying more attention to bodily changes was significantly associated with help-seeking for cancer symptoms (OR = 1.44; 1.06-1.97), after controlling for socio-demographics, current illness and cancer worry. Being more sensitive to bodily changes was not significantly associated with help-seeking. CONCLUSIONS: Respondents who paid attention to their bodily changes were more likely to seek help for their symptoms. Although the use of a cross-sectional study design and the limited assessment of key variables preclude any firm conclusions, encouraging people to be body vigilant may contribute towards earlier cancer diagnosis. More needs to be understood about the impact this might have on cancer-related anxiety

Worrying about wasting GP time as a barrier to help-seeking: a community-based, qualitative study

Background Worrying about wasting GP time is frequently cited as a barrier to help-seeking for cancer symptoms. Aim To explore the circumstances under which individuals feel that they are wasting GP time. Design and setting Community-based, qualitative interview studies that took place in London, the South East and the North West of England. Method Interviewees (n = 62) were recruited from a sample (n = 2042) of adults aged ≥50 years, who completed a ‘health survey’ that included a list of cancer ‘alarm’ symptoms. Individuals who reported symptoms at baseline that were still present at the 3-month follow-up (n = 271), and who had also consented to be contacted (n = 215), constituted the pool of people invited for interview. Analyses focused on accounts of worrying about wasting GP time. Results Participants were worried about wasting GP time when time constraints were visible, while dismissive interactions with their GP induced a worry of unnecessary help-seeking. Many felt that symptoms that were not persistent, worsening, or life-threatening did not warrant GP attention. Additionally, patients considered it time-wasting when they perceived attention from nurses or pharmacists to be sufficient, or when appointment structures (for example, ‘one issue per visit’) were not adhered to. Close relationships with GPs eased worries about time-wasting, while some patients saw GPs as fulfilling a service financed by taxpayers