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The aim of this study was to formatively evaluate a health communication campaign on body image targeting undergraduate female students.A total of 331 students at a large public Midwestern university participated in the study.Researchers used central intercept procedures to recruit students from residence halls. After viewing the campaign materials, students completed an online survey assessing their message endorsement and level of eating disorder symptomology and provided open-ended comments.Students appreciated the message and thought it was effective, though students with greater body image concerns were less receptive to the message. Thematic analysis indicated students perceive body image to be a relevant issue, yet they want the university to provide more attention to, and information on, the topic.Overall, students understood the message and found it helpful. Nevertheless, students with body image issues responded less favorably, warranting the need for secondary and tertiary prevention.

Background Fatigue in axSpA is described as a complex, multidimensional symptom that involve disease-specific, cognitive/behavioural and personal factors. However, current assessment guidance in axSpA recommends using a single-item visual analogue scale on fatigue severity. This type of provides a limited assessment and may fail to adequately capture the multiplicity of fatigue experience. Despite the high prevalence and significant impact of fatigue, there is currently no axSpA-specific patient-derived multi-item questionnaire for fatigue. In our previous qualitative research, we identified energy as a related but distinct component of fatigue experience in axSpA. In response, and in collaboration with our patient and public involvement (PPI) group, we have co-produced a 30-item patient-reported outcome measure (PROM) specific to axSpA-fatigue and energy: the Warwick Axial Spondyloarthritis faTigue and Energy measure (WASTEd). The aim of this study was to evaluate the quality of the WASTEd and make statistically informed item refinement decisions following completion by a UK-wide patient cohort. Methods A UK-based postal survey of 580 axSpA patients provided necessary data supporting both classic (Classic Test Theory; CTT) and modern (Rasch Measurement Theory; RMT) psychometric evaluation. CTT analysis included evaluating structural validity using exploratory factor analysis (EFA), internal consistency using Cronbach’s alpha and assessing item-total correlations. RMT analysis included evaluating evidence of local dependency between items, item fit and category characteristic curves. Results The survey response rate was 64.13% (n = 372). EFA identified four factors: energy, fatigue, symptoms and control. Five items were removed due to narrow cross-loadings. Final item-total correlations ranged from 0.61 to 0.83. Cronbach’s alpha was estimated to be 0.97. Rasch analysis highlighted one item as under discriminating. Numerous items showed evidence of respondents opting for a middle-option answer following visual inspection of the category characteristic curves. Findings were discussed with the study PRP group and co-refinement (item removal, modification or introduction) decisions were made during the meeting. A further seven items were removed to produce a final 18-item short-form version of the WASTEd. Conclusion The WASTEd has good evidence of data quality, structural validity and content validity. Psychometric evidence supports qualitative findings that energy is a distinct but related component in fatigue experience. Following a final stage of testing, the WASTEd will be ready for incorporation into both research and clinical practice settings, providing an essential patient-derived assessment of fatigue and energy with which to inform shared decision-making. Disclosures N.A. Pearson None. H. Parsons None. E. Tutton None. J. Martindale Honoraria; JM has received speaker fees and/or honoraia from Abbvie Ltd, Novartis, Pfizer and UCB. Grants/research support; JM has received a research grant from Pfizer. G. Strickland None. J. Thompson None. J. Packham None. K.L. Haywood None.

Background The last decade has witnessed significant growth in the active involvement of patients as research partners (PRPs) in health and social care research to facilitate a stronger patient-focus in research endeavours and outputs. Whilst general guidance is available - e.g. INVOLVE - there is limited guidance pertaining to how one should collaborate with patients as partners in the development of patient-reported outcome measures (PROMs). Here, we describe our active collaboration with patients as research partners in the co-production of a new PROM: the Warwick Axial Spondyloarthritis measure of faTigue and Energy (WASTEd). Methods An established PRP group contributed to the development of the initial funding application, whom received training and support from the PRP group facilitator (JM). The key stages for PRP collaboration throughout the PROM development process were jointly agreed and included: developing qualitative research topic guides and supporting data analysis; supporting development and refinement of the measurement framework to underpin the new PROM, and; supporting question (item) generation and refinement following both qualitative and quantitative explorations. All key decisions were made following face-to-face meetings between the lead research and the PRP group. Results Six face-to-face meetings were held over 2.5 years (average meeting duration 2 hours; range 1.5 to 3 hours) with between three and eight PRP members attended each meeting. Additional e-mail correspondence and summary reports were shared between meetings. The group contributed across all project stages including: developing ethics applications which included assessing the acceptability of the study to patients; generating interview topic guides and verbal probes for key issues identified by the PRP group; interpreting qualitative data with the lead researcher; co-designing and editing the draft PROM and refining the long form version of the PROM using both qualitative and statistical data. PRP collaboration was particularly integral to the appropriate use of relevant language and, most substantively, in providing a clearer understanding of the distinction between fatigue and energy. Conclusion The active collaboration with PRPs has supported the co-production of a relevant and acceptable PROM, driven by the needs and perspectives of patients. Additionally, the PRP groups were able to ensure all refinement decisions made to the PROM did not undermine the content validity of the measure. Finally, their involvement has sought to act as a check, support and challenge on inferences drawn by the researchers, enriching the process and study outcomes. Disclosures N.A. Pearson None. G. Strickland None. J. Thompson None. J. Martindale Honoraria; JM has received speaker fees and/or honoraria from Abbvie Ltd, Novartis, Pfizer and UCB. Grants/research support; JM has received a research grant from Pfizer. E. Tutton None. H. Parsons None. J. Packham None. K. Haywood None.

Ontario’s rural youth drink more frequently and in greater quantities than their urban counterparts (Boak et al., 2015). While this puts them at greater risk of sexual violence, injury, academic disruptions, and the harms associated with drinking and driving as a result of alcohol use than their counterparts, it also increases the population’s likelihood of experiencing alcohol related use or abuse issues later in life as research has demonstrated that the age of first use of alcohol has such implications (Chou & Pickering, 1992; Skidmore et al., 2011). Considering the risks associated with excessive alcohol use, determining the motivations and context for the choice to use alcohol to intoxication is very important. This presentation intends to discuss the literature related to rural youth and alcohol use, the available data, and the researcher’s plans to address the need for qualitative research on the subject.

Evidence from the longitudinal Competent Children project is provided which shows the continuing contribution of early childhood education to children's competencies at age 10. Among the New Zealand sample, children had higher average scores if they had 3 or more years of early childhood education in general. The quality of their final early childhood education centre, particularly related to teacher-child interaction, also continued to show enduring associations with children's performance. The socio-economic mix of the children's final early childhood education centre also had a bearing on their competency levels 5 years later. L'e´vidence du projet longitudinal 'Enfants Compe´tents' ici fournis montre la contribution continue de la e´ducation de la premie ¤ re enfance aux compe´tences des enfants a ¤ l'aˆge 10. Parmi l'e´chantillon de la Nouvelle-Ze´lande, les enfants avaient des points moyens plus hauts s'ils avaient trois anne´es ou plus d'e´ducation de premie ¤ re enfance en ge´ne´ral. La qualite´ d...

In a report by UNICEF (2006), it was estimated that two million children have been killed by armed conflicts, six million were injured and ­disabled, more than one million were displaced or separated from their parents and twenty million were left homeless. Three years later, the International Committee of the Red Cross (ICRC) reported that in 2008, eighteen million children were forced to leave their homes either as refugees or as internally displaced persons (2009, p. 1).

The University of the Third Age (U3A) is a highly successful adult education movement that is providing opportunities for older adults to enjoy a range of activities associated with well‐being in later life. Two substantially different approaches—the original French approach and the British approach that evolved a few years later — have become the dominant U3A models adopted by different countries. In many countries, communication between U3As is limited; there is even less communication between U3As in different countries. Thus little that is readily accessible has been written about U3A developments internationally. We provide an overview of the U3As in many countries that is based on information obtained from colleagues in a number of countries on U3As in their region.

Background. Familial melanoma has been associated with “clinically atypical moles” or “dysplastic nevi,” (DN) which are markers for increased melanoma risk. In addition, melanomas in these kindreds present at a younger age, and tend to be multiple. Methods. Melanoma incidence rates were determined for 710 members of 311 melanoma families, defined as kindreds in which melanoma had occurred in two or more blood relatives. Patients were classified either clinically or histologically as expressing DN. Melanomas that occurred before the first examination were recorded, and patients were followed prospectively for new melanomas. Results. In prospective follow-up, the age-adjusted melanoma incidence rate was 1710/100,000 patient-years in family members with DN. In contrast, the rate was zero (no melanomas occurred) in family members without DN. For family members with DN, but without a history of melanoma, the age-adjusted incidence rate of melanoma was 413/100,000 patient-years, whereas the rate was 2779/100,000 patient-years in family members with DN and a history of melanoma. Conclusions. Dysplastic nevi and a history of melanoma are strong risk factors for subsequent melanoma. Prognostic factors are greatly improved for patients with melanomas diagnosed in follow-up compared with the first two melanomas in each kindred. These findings warrant surveillance of individuals with DN who are members of familial melanoma kindreds.

Carbon dioxide levels in the core of ‘Cox's Orange Pippin’ and ‘Braeburn’ apples, stored in air at 1°C in 1984 and 1985, were higher than in surrounding air. The CO 2 gradient between core and air for both cultivars over the two years averaged 1.1% at 1°C and 3.5% after transfer to ambient temperatures. Vacuum infiltration of apples with calcium solutions increased internal CO 2 and decreased O 2 levels, and increased gradients between core and outside air, in fruit stored in either air or in modified atmospheres, compared with untreated fruit. Drenching of fruit with calcium did not influence internal gas levels or gradients. Highest internal CO 2 and lowest O 2 levels were generated in vacuum-infiltrated fruit subsequently stored in microperforated polymeric film bags at both 1°C and after transfer to ambient temperatures, although gradients were less than in air stored fruit. The results suggest that vacuum infiltration of apple fruit with calcium solutions filled the intercellular spaces of the outer cortical tissue forming a barrier to gas diffusion thus reducing exchange of CO 2 and O 2 between the fruit tissue and the surrounding atmosphere.

Screening, surveillance, and educational programs have been recommended for members of hereditary melanoma kindreds with dysplastic nevi, who are at very high risk for melanoma. For melanomas detected in a surveillance program offered to 555 such persons, the average thickness was 0.52 mm for 28 surveillance incident melanomas, 0.55 mm for 64 nonsurveillance incident melanomas, and 1.44 mm for 48 index lesions (p less than 0.001). The proportion of cases with level I or II invasion was 60.8%, 58.3%, and 36.2% respectively (p = 0.002). The nonsurveillance incident melanomas were diagnosed before entry into the surveillance program, but these patients were presumably aware of the earlier occurrence of two index melanomas in their families. These findings are consistent with a favorable effect of surveillance and education in a high-risk population and suggest that patient factors as well as physician factors may contribute to early diagnosis.

Jane Cooper, Roy Jones and Jean Thompson explain how self-management training for patients with long-term illnesses can make clinicians' work easier.

Trustees for public community colleges have become subjects of research interest during the last 15 years. Whereas previous studies resulted in profiles of trustee characteristics, the study reported here sought answers to whether beliefs held by trustees about selected issues are associated with various trustee characteristics and the method by which persons had become trustees. The examination of these relationships differienti‐ates this study from others. Public community colleges were identified whose trustees were either all gubernatorially appointed or all locally elected. A random selection was made of 50 colleges in each group, and a 71% response was obtained from 646 trustees contacted. Statistically significant differences were found between beliefs about selected issues and both trustee characteristics and methods by which trustees gained board membership.

Modified atmospheres (MA) generated within cartons of ‘Cox's Orange Pippin’ apples containing 25 µm thick polybags with 50 microperforations, effectively reduced bitter pit and maintained quality in fiuit from a range of growers after storage at 1 ± °C for 6 weeks and 1 week at ambient temperatures. A pilot-scale trial transported to the United Kingdom indicated that the polybag system could be utilised commercially for export of apples in MA conditions. Large scale evaluation of the system on fruit from a number of growers confirmed the effectiveness of the system but suggested that, where background levels of bitter pit exceed 20–30%, neither MA nor commercial postharvest calcium treatments can reduce bitter pit levels to less than 5%. A disorder similar to brown-heart developed in fruit that had been vacuum-infiltrated with CaCl2 followed by storage in microperforated polybags, indicating that this combined treatment would not be commercially viable.

The alarming increase in the incidence of cutaneous malignant melanoma in the United States emphasizes the importance of its early detection and treatment. Early detection requires accurate clinical recognition of both malignant and precancerous skin lesions (dysplastic nevi). This study presents data on dermatologists' and nondermatologists' ability to diagnose skin lesions. A total of 105 nondermatologist physicians, from first-year residents to practicing physicians, and forty-eight dermatologists were asked to identify color slides or photographs of eleven cutaneous lesions, including malignant melanomas, dysplastic nevi, and innocuous lesions such as seborrheic keratoses and common moles. Diagnosis of cutaneous lesions was generally inaccurate among nondermatologists. Only 38% correctly identified four or more of the six melanomas as melanoma of any type, and 58% were unable to diagnose dysplastic nevi. Only 17% categorized their relevant training as excellent or good. Improved training in the diagnosis of skin lesions for practicing physicians and house staff is required if mortality from malignant melanoma is to be decreased in the United States.

Incidence of the physiological disorder bitter pit was reduced by storage of cultivar ‘Cox's Orange Pippin’ apples at 1°C in 25-μm thickness polyethylene bags (polybags) in which there were a number of 1-mm microperforations. Concentrations of CO 2 increased and O 2 decreased as the number of microperforations per bag was reduced. These changes were associated with reduced levels of bitter pit. It is suggested that 50–70 microperforations per polybag, of sufficient size to fit inside an 18.5-kg carton, could be used commercially to reduce bitter pit and maintain quality of fruit stored for 6 weeks at 1°C, and then kept at ambient temperatures within the polybags for an additional 7 days. The effectiveness of microperforated polybags and vacuum infiltration with CaCl 2 in reducing bitter pit was compared over 3 seasons. The results were variable, with polybags being more effective than vacuum treatment in 2 of the 3 seasons, and vacuum treatment better than polybags in 1 season. Neither method reduced bitter pit to commercially acceptable levels when the non-treated fruit had levels of bitter pit exceeding 20–30%. When apples were placed in microperforated polybags after vacuum infiltration, up to 20% developed a brown-heart-like disorder.

THE incidence of cutaneous malignant melanoma is rising rapidly throughout the world.1 The most current data from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) sy...