Biomedical subjects

Jane Wardle

Publications and source records attributed to Jane Wardle.

At least 55 records · Page 3Linked to original sources

PubMed2004

Public interest in genetic testing for susceptibility to heart disease and cancer: a population-based survey in the UK.

BACKGROUND: Given the current concerns about the clinical validity of commercially marketed genetic tests for multifactorial diseases, there is a surprising dearth of information about what public demand might be for genetic tests for any complex diseases other than cancer. The aim of this study was to examine interest in genetic testing for the most common multifactorial disease, heart disease, and to compare it with interest in testing for cancer in a general population sample that had not received detailed information about genetic tests. METHODS: Interest in genetic testing for heart disease susceptibility was surveyed and compared to interest in genetic testing for cancer susceptibility among a nationally representative sample of 1,960 British adults as part of the Office for National Statistics Omnibus survey. RESULTS: Sixty-nine percent of respondents expressed interest in being tested for genetic susceptibility to heart disease. Men, people aged 45-60 years, those with less education, and those with a family history were most interested in genetic testing for heart disease. Sixty-four percent of respondents expressed interest in genetic testing for susceptibility to cancer, and gender, age, and education, but not family history, were associated with interest. CONCLUSIONS: Interest in genetic testing for susceptibility to both heart disease and cancer was high, with the most educated individuals being the least interested in testing. Although the shift toward the 'expert patient' is actively encouraged and consistent with today's health policies, there is considerable and justifiable concern about some of the genetic tests for multifactorial diseases that are currently being marketed directly to the public. The high level of initial interest in the general public found in this study supports the need for a public education program around genetic testing for multifactorial diseases.

Adolescent↗

PubMed2004

Mild acute inflammatory stimulation induces transient negative mood.

OBJECTIVE: This study aims to assess the mood changes induced by mild acute inflammatory stimulation (typhoid vaccination). METHODS: Using a double blind study design, 26 healthy volunteers underwent baseline assessments of mood, financial strain and work stress and were randomised to injection of Salmonella typhi vaccine or placebo injection. Mood, symptoms and body temperature was assessed by a modified version of the Profile of Mood States at 1, 2, 3, 4, 6 and 8 h post injection. RESULTS: Typhoid vaccination induces no increases in physical symptoms or temperature. Mood improved over the day in the placebo but not in the vaccine condition. Negative changes in mood following injection were correlated with chronic stress (financial strain) in the vaccination condition (r=-.65, P<.025). CONCLUSION: A mild acute inflammatory stimulus induces transient negative mood, and responses were modulated by chronic stress. Implications for depressed mood in physical illness are discussed.

Acute Disease↗

PubMed2004

Subjective and objective risk of colorectal cancer (UK).

OBJECTIVE: The aim of this study was to see whether individuals who perceive their risk for developing colorectal cancer (CRC) as lower than average are found to be at lower risk as determined by findings at flexible sigmoidoscopy (FS) screening. METHODS: Participants (n = 10,551) were men and women aged 55-64 years from a subset of participants in the UK FS Trial. Self-report questionnaires assessed perceived comparative risk of developing bowel cancer prior to participants being invited to attend FS screening. Objective risk was judged from polyp status during the FS test. RESULTS: A very modest relationship was found between risk judgments and actual risk with 77% of 'optimists' having negative findings compared to 71% of 'pessimists'. More pessimists (14%) had an adenoma compared to optimists (11%). Compared to pessimists the odds of optimists actually being at lower risk of CRC equaled 0.70 (0.57, 0.86). CONCLUSIONS: The results suggest that people may have a limited ability to assess their risk of developing CRC. Health professionals should not assume that individuals have an accurate perception of their risk for cancer. Increasing people's ability to accurately perceive their risk may encourage more appropriate cancer preventive behavior.

Colorectal Neoplasms↗

PubMed2004

Socioeconomic variation in attitudes to eating and weight in female adolescents.

This study was stimulated by J. Sobal and A. J. Stunkard's (1989) theory that differences in deliberate weight control could underlie the socioeconomic gradient in adult weight. Female adolescents (N=1,248) completed measures of socioeconomic status, social norms for weight, weight ideals, attitudes to weight, and weight control behaviors. Higher socioeconomic status adolescents had greater awareness of the social ideals of slimness and had more family and friends who were trying to lose weight. They also defined a lower body mass index as "fat" and were more likely to have used healthy weight control methods. The results support the idea that socioeconomic differences in weight-related attitudes and behaviors may mediate the development of a gradient in weight.

Adolescent↗

PubMed2004

Wide variation in adenoma detection rates at screening flexible sigmoidoscopy.

BACKGROUND & AIMS: Wide between-center variation in adenoma detection rates (ADRs) was observed in the U.K. Flexible Sigmoidoscopy Screening Trial (overall, 12.1%; range, 8.6%-15.9%; P < 0.0001). The aim of this study was to determine whether the observed differences could be attributed to varying performance by endoscopists, to examine the effect of experience on performance, and to identify an attainable, standard ADR to which endoscopists could aspire. METHODS: Thirteen medical endoscopists, one per trial center, each performed about 3000 examinations (200 per month) using the same equipment and protocol. Overall and monthly ADRs were compared using multivariable logistic regression. RESULTS: Differences in ADRs were not explained by patient characteristics, incidence of colorectal cancer in the local population, or the endoscopists' medical specialty or previous experience. Average ADRs increased significantly with screening experience (up to 400 examinations). Endoscopists were classified as higher, intermediate, or lower adenoma detectors, and performance levels were maintained over time. Higher detectors had ADRs of 15% overall (men, 20%; women, 10%) and also detected more adenomas per case (higher/lower detectors, 21.7/10.4 adenomas per 100 examinations). CONCLUSIONS: The differences in ADRs were due to variation in performance of the endoscopists. Long-term follow-up will determine whether this variation is clinically important. We suggest that the standards in higher detecting centers should be achievable by all endoscopists screening unscreened populations aged older than 55 years. Endoscopists should aim to stay above the lower 95% confidence interval band for 200 examinations (10% overall; 5% in women, 15% in men).

Adenoma↗

PubMed2004

Testing positive for human papillomavirus in routine cervical screening: examination of psychosocial impact.

OBJECTIVE: To examine the psychosocial impact of testing positive for high risk human papillomavirus (HPV) among women attending primary cervical screening. DESIGN: Cross sectional survey. Measures were taken at baseline and one week after the receipt of HPV and cytology screening results. SETTING: Well women's clinic in London, UK. Population or Sample Four hundred and twenty-eight women aged 20-64 years. METHODS: Postal questionnaire survey. MAIN OUTCOME MEASURES: Psychosocial and psychosexual outcomes were anxiety, distress and feelings about current, past and future sexual relationships. RESULTS: Women with normal cytology who tested positive for HPV (HPV+) were significantly more anxious and distressed than women who were negative (HPV-) using both a state anxiety measure [F(1,267) = 29, P < 0.0001] and a screening specific measure of psychological distress [F(1,267) = 69, P < 0.0001]. Women with an abnormal or unsatisfactory smear result, who tested HPV+, were significantly more distressed than HPV- women with the same smear result [F(1,267) = 8.8, P = 0.002], but there was no significant difference in state anxiety. Irrespective of cytology result, HPV+ women reported feeling significantly worse about their sexual relationships. Approximately one-third of women who tested positive reported feeling worse about past and future sexual relationships compared with less than 2% of HPV- women. CONCLUSION: The findings suggest that testing positive for HPV may have an adverse psychosocial impact, with increased anxiety, distress and concern about sexual relationships. Psychosocial outcomes of HPV testing need further investigation and must be considered alongside clinical and economic decisions to include HPV testing in routine cervical screening.

Adult↗

PubMed2004

Human papillomavirus and cervical cancer: issues for biobehavioral and psychosocial research.

There is now overwhelming evidence that high-risk, sexually transmitted types of human papillomavirus (HPV) are the main causal agent in cervical cancer. Biobehavioral and psychosocial research is uniquely capable of addressing many of the issues raised by HPV and its link with cervical cancer. In this article we review current findings in this area and identify issues for future research. The first of the three sections explores issues associated with the introduction of HPV testing for the detection and management of cervical abnormalities and the impact of growing public awareness of the sexually transmitted nature of cervical cancer. The implications for public understanding of cervical cancer, psychosocial issues associated with screening, and the potential impact on screening uptake are discussed. The second section addresses the role of biobehavioral factors in the persistence and progression of HPV infection as well as possible interventions to minimize the risk of persistence. Finally, primary prevention of HPV is discussed.

Cervix Uteri↗

PubMed2004

Gender differences in food choice: the contribution of health beliefs and dieting.

BACKGROUND: Gender differences in health behaviors have been reported in many studies but casual mechanisms have been neglected. PURPOSE AND METHODS: This study examines 4 food choice behaviors in a large sample of young adults from 23 countries and tests 2 possible explanatory mechanisms for the gender differences-women's greater likelihood of dieting and women's greater beliefs in the importance of healthy diets. RESULTS: Women were more likely than men to report avoiding high-fat foods, eating fruit and fiber, and limiting salt (to a lesser extent) in almost all of the 23 countries. They were also more likely to be dieting and attached greater importance to healthy eating. Dieting status explained around 22% of fiber choices, and 7% of fruit, but none of the gender difference in salt. Health beliefs explained around 40% of the differences in each of the dietary behaviors and together they explained almost 50%. Gender differences in food choices therefore appear to be partly attributable to women's greater weight control involvement and partly to their stronger beliefs in healthy eating. CONCLUSION: Further research is needed to understand the additional factors that could promote men's participation in simple healthy eating practices.

Adult↗

PubMed2004

Depression, perceived control, and life satisfaction in university students from Central-Eastern and Western Europe.

The poor health and psychological well-being of people in the former socialist states of Centeral-Eastern Europe are of serious concern and may be related to low perceived control. We compared depressive symptoms, life satisfaction, and self-rated health in 3,571 male and female university students from 5 Western European countries and 4,793 students from 5 Central-Eastern European countries. Depression scores (short Beck Depression Inventory; Beck & Beck, 1972) were higher in Central-Eastern than Western European samples. The prevalence of low life satisfaction was also greater in Central-Eastern Europeans, but ratings of self-rated health did not differ. Ratings of perceived control were diminished, but sense of mastery and internal health locus of control were higher in Central-Eastern Europe. Depression and low life satisfaction were associated with low perceived control and mastery and with strong beliefs in the influence of chance over health. However, taking these factors into account did not explain the East-West difference in depressive symptoms and low life satisfaction.

Adolescent↗

PubMed2004

Measuring cancer knowledge: comparing prompted and unprompted recall.

Studies evaluating public knowledge of the warning signs and risk factors associated with cancer have varied in the question format used. Those using a prompted (recognition) format have tended to find higher levels of knowledge than those using an unprompted, recall format. The aim of this study was to quantify the effect of prompting on knowledge of the seven warning signs of cancer, and risk factors for breast and bowel cancer, using data from large representative samples of the UK population. We also tested for demographic differences in the effect of prompting, hypothesizing that prompting would have the greatest impact on groups with least knowledge, specifically men, older and younger people, and those with least education. Analysis of data from four ONS surveys (total n = 5,863) demonstrated significantly higher knowledge of all signs and risk factors in the prompted compared with the unprompted condition. Contrary to our hypothesis, the pattern of interaction of prompting with gender and level of education was inconsistent, and the effect of prompting decreased with increasing age. Implications for future research on cancer knowledge and the most appropriate question format are discussed.

Adolescent↗

PubMed2004

Demographic and psychosocial factors associated with perceived risk for colorectal cancer.

OBJECTIVES: The objective of this study was to investigate demographic and psychosocial predictors of perceptions of risk for colorectal cancer (CRC) in a population-based sample. METHODS: The study was a cross-sectional survey of 18,447 men and women aged 55-64 years. A mailed questionnaire assessed perceived comparative risk for CRC along with demographic characteristics (age, gender, ethnicity, marital status, and socioeconomic status), health-related factors (family history, subjective health and bowel symptoms, and health behaviors), and emotional state (anxiety). RESULTS: Being male and older were associated with lower perceived risk. Having a family history of CRC, poorer subjective health, more symptoms, and higher levels of anxiety were all associated with increased perceived risk of CRC. Smokers and nonexercisers perceived their risk as higher. CONCLUSIONS: Misperceptions surrounding the effects of age and gender on CRC risk, as well as the genetic link and pathogenesis of CRC, need to be addressed in risk communications.

Age Factors↗

PubMed2003

Prevalence of hardcore smoking in England, and associated attitudes and beliefs: cross sectional study.

OBJECTIVE: To quantify the prevalence and characteristics of hardcore smokers in England. DESIGN: Cross sectional survey. SETTING: Interview in respondents' household. PARTICIPANTS: 7766 adult cigarette smokers. MAIN OUTCOME MEASURES: Hardcore smoking defined by four criteria (less than a day without cigarettes in the past five years; no attempt to quit in the past year; no desire to quit; no intention to quit), all of which had to be satisfied. RESULTS: Some 16% of all smokers were categorised as hardcore. Hardcore smoking was associated with nicotine dependence, socioeconomic deprivation, and age, rising from 5% in young adults aged 16-24 to 30% in those aged >or= 65 years. Hardcore smokers displayed distinctive attitudes towards and beliefs about smoking. In particular they were likely to deny that smoking affected their health or would do so in the future. Prevalence of hardcore smoking was almost four times higher than in California. CONCLUSION: Hardcore smoking presents a serious challenge to public health efforts to reduce the prevalence of smoking, but the proportion of hardcore smokers does not necessarily increase as overall prevalence in a population declines. More hardcore smokers could be persuaded to quit, but this will require interventions that are targeted to the particular needs and perceptions of both socially disadvantaged and older smokers.

Adolescent↗

PubMed2003

Internalization of ideal body shapes in 9-12-year-old girls.

OBJECTIVE: Body dissatisfaction is reported in girls as young as 9 years old in Western countries. In the current study, internalization of the "thin ideal" was predicted to be a critical influence on the development of body dissatisfaction. METHOD: Participants (n = 356) were weighed and completed measures of body dissatisfaction, awareness and internalization of the thin ideal, and peer and maternal attitudes and behavior. Exposure to relevant print media was also assessed. RESULTS: Body dissatisfaction was associated with a higher body mass index, although it was not restricted to overweight girls. Internalization mediated the relationship between awareness of the sociocultural standard of appearance and body dissatisfaction. Media exposure and peer and maternal weight-related attitudes and behavior were, in turn, related to awareness, supporting the hypothesized sociocultural processes. DISCUSSION: Internalization operates as a central component in the development of body dissatisfaction, occurring at a young age in some girls. Internalization may be a suitable target for preventive strategies.

Body Image↗

PubMed2003

Receiving a screen-detected diagnosis of cancer: the experience of participants in the UK flexible sigmoidoscopy trial.

The experience of receiving a screen-detected diagnosis of colorectal cancer was explored using open-ended interviews. Twenty four people who had been diagnosed with cancer at flexible sigmoidoscopy screening were interviewed at their homes over the telephone. Thematic analysis of the transcripts showed that the experience of gaining a diagnosis of cancer through screening was characterised by a lack of prior expectation that cancer would be detected and feelings of shock. This was largely because of the absence of symptoms and current feelings of well-being. Some interviewees expressed feelings of relief and gratitude at having cancer diagnosed at an early enough stage that 'something could be done about it'. The experience of receiving a screen-detected diagnosis could be summarised as one of 'moderated shock' whereby the shock of the unexpected diagnosis was often moderated by the news that the cancer had been caught early. Whilst these screen-detected cancers were diagnosed relatively rapidly, a significant number of interviewees had a period in which they were effectively 'symptomatic' (e.g. knew they had an adenoma but did not know whether it was malignant or benign). However, they did not use this period to prepare themselves for a possible cancer diagnosis. Raising awareness of the adenoma-carcinoma sequence may help reduce the shock of a screen-detected diagnosis. However, any interventions aimed at reducing the distress of a screen-detected cancer would need to consider the overall benefit to screening attenders, most of whom will have benign polyps detected.

Adenoma↗

PubMed2003

Psychophysiologic effects of applied tension on the emotional fainting response to blood and injury.

OBJECTIVE: The present study was designed to investigate the psychophysiologic effects of "Applied Tension" (AT) on the emotional fainting response to blood and injury in a controlled experiment. METHOD: Twenty-two persons reporting to generally feel faint or to have fainted at the sight of blood or injury and 22 participants classified as Non-Fainters were randomly allocated to a treatment or control condition. Psychophysiologic responses were continuously monitored while individuals watched a video depicting open-heart surgery and a control film. Prior to the surgery film, participants in the treatment condition were instructed in the use of AT. RESULTS: All participants classified as Fainters showed a diphasic response pattern while watching the surgery film. This response, however, was significantly attenuated in Fainters in the treatment condition. CONCLUSIONS: These results suggest that AT provides an effective treatment strategy for the prevention of fainting responses in persons with a fear of blood and injury.

Adult↗

PubMed2003

Knowledge, attitudes, and behavioral intentions in relation to the early detection of colorectal cancer in the United Kingdom.

BACKGROUND: Colorectal cancer (CRC) mortality is high. Understanding the social, psychological, and cognitive predictors of early detection practices such as screening may help improve CRC outcomes. This study examined knowledge of CRC and the relationship between knowledge, attitudes to cancer, and intentions to engage in early detection behaviors for CRC in a national representative population sample. METHOD: An interview-based survey was carried out in a British population sample of adults ages 16 to 74 years (n = 1637), assessing knowledge, attitudes, and intention with regard to colorectal cancer. RESULTS: Knowledge levels were very low; 58% (n = 995) of respondents could not list any colorectal cancer risk factors and 24% (n = 393) were unable to identify any warning signs for cancer. Knowledge was lower among men (chi(2)[2] = 52.8, P < 0.0001), younger respondents (chi(2)[10] = 79.9, P <.0001), and those with less education (chi(2)[4] = 73.9, P < 0.0001). Attitudes to cancer were more negative among women (chi(2) [2] = 7.4, P = 0.025), younger participants (chi(2)[10] = 22.4, P = 0.013), and those with less education (chi(2) [4] = 75.0, P < 0.0001). Low knowledge was associated with negative attitudes (P < 0.0001) and both factors were associated with lower intentions to participate in colorectal cancer screening (P < 0.0001). Multivariate analysis indicated that attitudes partially mediated the effect of knowledge on screening intentions. CONCLUSIONS: Increasing knowledge may reduce negative public perceptions of cancer which may impact positively on intentions to participate in screening.

Adolescent↗

PubMed2003

Increasing children's acceptance of vegetables; a randomized trial of parent-led exposure.

Despite considerable epidemiological evidence of the health benefits of a diet high in fruit and vegetables, consumption in pre-school children remains well below recommended levels. This study evaluated the effectiveness of an exposure-based intervention, carried out by parents in the home, in increasing children's liking for a previously disliked vegetable. 156 parents of 2-6 year old children were randomly assigned to Exposure, Information or Control groups after a pre-intervention taste test at which a 'target' vegetable was selected. Parents in the Exposure group gave their child a taste of this vegetable daily for 14 days, parents in the Information group were given nutritional advice and a leaflet, and parents in the Control group received no further intervention. All participants took part in a post-intervention taste test. Greater increases in liking, ranking and consumption of the 'target' vegetable from pre- to post-intervention occurred in the Exposure group than in either of the other two groups. Only the Exposure group showed significant increases across all three outcomes. It can be concluded that a parent-led, exposure-based intervention involving daily tasting of a vegetable holds promise for improving children's acceptance of vegetables. These findings suggest a parental advice strategy which could be disseminated directly to parents or by health professionals.

Adult↗

PubMed2003

Sex differences in fruit and vegetable intake in older adults.

Fruits and vegetables are important components of a healthy diet, but intakes in most Western countries are well below the recommended five servings a day. Men in particular are eating too little. The aim of this study is to understand the processes underlying this gender difference. Fruit and vegetable intake, nutrition knowledge, taste preferences, attitudes to fruit and vegetable intake, and dieting status, were assessed in a simple questionnaire in 1,024 older adults attending population-based cancer screening across the UK. The results confirmed the pattern of men consuming fewer servings of fruit and vegetables daily than women (2.52 vs 3.47; p<0.01). Fewer men than women knew the current recommendations for fruit and vegetable intake, and fewer were aware of the links between fruit and vegetable consumption and disease prevention. Women rated their liking for vegetables but not fruit higher, and there were no differences in attitudes. Men were less likely to be dieting to lose weight. Multivariate analysis showed that the gender difference in intake was substantially attenuated by controlling for nutrition knowledge. There were no significant attenuating effects of preferences, attitudes or dieting status. These results indicate that men's poorer nutrition knowledge explains a significant part of their lower intake of fruit and vegetables.

Diet↗