We are what we (think we) eat: The effect of expected satiety on subsequent calorie consumption.

Varying expected satiety (ES) for equi-calorie portions of different foods can affect subsequent feelings of hunger and fullness and alter consumption. To our knowledge, no study has manipulated ES for an equal portion of the same solid food, subsequent appetite has not been measured >3 h and studies have not consistently measured later consumption. Further, it is not clear whether any changes in hunger, fullness or later consumption that stem from differing ES are the result of a psychological or physiological response. The aims of this study were to manipulate ES for the same solid food on two occasions in order to compare participants' appetitive responses over a 4-h inter-meal period, to measure later consumption, and to assess whether any effect of ES on these measures was related to a physiological (i.e. total ghrelin) response. Using a within-subjects design, 26 healthy participants had their ES for omelettes manipulated experimentally, believing that a 3-egg omelette contained either 2 (small condition) or 4 (large condition) eggs. When ES was higher (large condition) participants ate significantly fewer calories at a lunchtime test meal (mean difference = 69 kcal [± 95% CI 4-136]) and consumed significantly fewer calories throughout the day (mean difference = 167 kcal [± 95% CI 26-309]). The results show that there was a significant main effect of time on hunger and fullness, but no main effect of 'portion size' (p > .05). There was also a significant interaction between time and portion size for hunger. There was no evidence for any significant differences in appetite or consumtpion resulting from changes in total ghrelin. Overall, the data suggest that ES for a solid food can be manipulated and that, when given at breakfast, having a higher ES for a meal significantly reduces lunchtime and whole day caloric consumption.

An obesogenic bias in women's spatial memory for high calorie snack food.

To help maintain a positive energy balance in ancestral human habitats, evolution appears to have designed a functional bias in spatial memory that enhances our ability to remember the location of high-calorie foodstuffs. Here, we investigated whether this functional bias has obesogenic consequences for individuals living in a modern urban environment. Spatial memory, dietary intentions, and perceived desirability, for high-calorie snacks and lower-calorie fruits and vegetables were measured using a computer-based task in 41 women (age: 18-35, body mass index: 18.5-30.0). Using multiple linear regression, we analyzed whether enhanced spatial memory for high-calorie snacks versus fruits and vegetables predicted BMI, controlling for dietary intention strength and perceived food desirability. We observed that enhanced spatial memory for high-calorie snacks (both independently, and relative to that for fruits and vegetables), significantly predicted higher BMI. The evolved function of high-calorie bias in human spatial memory, to promote positive energy balance, would therefore appear to be intact. But our data reveal that this function may contribute to higher, less healthy BMI in individuals in whom the memory bias is most marked. Our findings reveal a novel cognitive marker of vulnerability to weight gain that, once the proximal mechanisms are understood, may offer new possibilities for weight control interventions.

Achieving Self-Directed Integrated Cancer Aftercare (ASICA) in melanoma: protocol for a randomised patient-focused pilot trial of delivering the ASICA intervention as a means to earlier detection of recurrent and second primary melanoma.

BACKGROUND: Melanoma is common; 15,906 people in the UK were diagnosed with melanoma in 2015 and incidence has increased fivefold in 30 years. Melanoma affects old and young people, with poor prognosis once metastatic. UK guidelines recommend people treated for cutaneous melanoma receive extended outpatient, hospital follow up to detect recurrence or new primaries. Such follow up of the growing population of melanoma survivors is burdensome for both individuals and health services. Follow up is important since approximately 20% of patients with early-stage melanoma experience a recurrence and 4-8% develop a new primary; the risk of either is highest in the first 5 years. Achieving Self-directed Integrated Cancer Aftercare (ASICA) is a digital intervention to increase total-skin-self-examination (TSSE) by people treated for melanoma, with usual follow up. METHODS: We aim to recruit 240 adults with a previous first-stage 0-2C primary cutaneous melanoma, from secondary care in North-East Scotland and the East of England. Participants will be randomised to receive the ASICA intervention (a tablet-based digital intervention to prompt and support TSSE) or control group (treatment as usual). Patient-reported and clinical data will be collected at baseline, including the modified Melanoma Worry Scale (MWS), the Hospital Anxiety and Depression Scale (HADs), the EuroQoL 5-dimension 5-level questionnaire (EQ-5D-5 L), and questions about TSSE practice, intentions, self-efficacy and planning. Participants will be followed up by postal questionnaire at 3, 6 and 12 months following randomization, along with a 12-month review of clinical data. The primary timepoint for outcome analyses will be12 months after randomisation. DISCUSSION: If the ASICA intervention improves the practice of TSSE in those affected by melanoma, this may lead to improved psychological well-being and earlier detection of recurrent and new primary melanoma. This could impact both patients and National Health Service (NHS) resources. This study will determine if a full-scale randomised controlled trial can be undertaken in the UK NHS to provide the high-quality evidence needed to determine the effectiveness of the intervention. ASICA is a pilot study evaluating the effectiveness of the practice of digitally supported TSSE in those affected by melanoma. TRIAL REGISTRATION: Clinical Trials.gov, NCT03328247 . Registered on 1 November 2017.

Cystic fibrosis: survival to adult life: ability to live with disability.

One hundred and twenty-eight patients managed by, or in association with, the Cystic Fibrosis Clinic, Royal Children's Hospital, Melbourne, have reached the age of 16 years; and 83 patients were alive on December 31, 1978, the oldest being 65 years of age. Survival data analysis on this group of patients showed a cumulative survival of 49% to 28 years. Despite the presence of substantial lung disease, most patients continued in full-time employment or education, and enjoyed a normal range of social activities. A review of these adults justifies a positive approach to the management of all patients with cystic fibrosis. With an increasing proportion of patients reaching adult life with minimal lung disease, the outlook can be expected to improve further over the next decade.

Incidence of cystic fibrosis in ethnic Italians and Greeks and in Australians of predominantly British origin.

The incidence of cystic fibrosis among the Australian born children of parents born in Italy was 1:3 625 live births and among Australian born children of parents born in Greece 1:3 726. These incidences were significantly lower than the incidence for cystic fibrosis of 1:2 021 in children born to Australian born parents, about 90% of whom have ancestors born in the British Isles. The figures suggest there are significant variations in the incidence of cystic fibrosis in different European populations.

Improved survival of patients with cystic fibrosis.

The survival of 320 patients, who were born in and after 1958 with cystic fibrosis and managed by the Departments of Thoracic Medicine and Gastroenterology, Royal Children's Hospital, Melbourne, is reviewed. Eighty per cent of patients survived to 11 years of age, and 64% to 18 years. Of patients managed between 1973 and 1977, 91% survived to 12 years of age, and 80% to 17 years of age. In the same period, 79% of patients survived for 16 years after diagnosis. Forty-four per cent of the 240 patients currently being managed have no significant permanent lung disease, and only 9% have advanced disease.

Familial occurrence of meconium ileus.

A recurrence rate for meconium ileus of 39% was found among C.F. affected siblings in a study of 488 families with at least one C.F. child born over a 24 year period. The recurrence rate was highly significant and indicated a familial trend for the occurrence of meconium ileus. The findings of the study support the existence of genetic heterogeneity in cystic fibrosis.