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Background Late diagnosis is a considered to be a major factor contributing to poorer cancer survival rates in the UK. Interventions have focussed on the promotion of earlier diagnosis in patients with potential cancer symptoms. However, to assess the effectiveness of these interventions, the time from symptom onset to presentation needs to be reliably and accurately measured. This qualitative study explored the use of calendar landmarking instruments in cancer symptom research. Methods We performed a secondary analysis of transcripts of interviews using the calendar landmarking instrument, undertaken with patients who had either been diagnosed with cancer (n = 40, IRCO study, Western Australia), or who had symptoms suggestive of cancer (n = 38, SYMPTOM study, North East and Eastern England). We used constant comparison methods to identify use of the calendar landmarking instruments and the impact of their application. Results The calendar landmarking instrument appeared to help many patients, either by acting as a prompt or helping to refine recall of events. A combination of personal (e.g. birthday) and national (e.g. Christmas) landmarks seemed to be the most effective. Calendar landmarking instruments appeared more useful where the time period between onset of symptoms and date of first consultation was less than three months. The interviewee's age, gender and cancer type did not appear to influence whether or not the instrument facilitated recall, and there were no instances where the use of the instrument resulted in the disclosure of a new first symptom. Symptoms of similar chronic conditions could create difficulties when applying the instrument; it was difficult for these participants to characterise and disentangle their symptoms which prompted their decisions to seek help. Some participants tended to prefer to use their own, already personalised, diaries to assist in their recall of events. Conclusions This study is the first to describe the potential role of calendar landmarking instruments to support research interviews which explore symptoms and events along the cancer diagnostic pathway. The major challenge remains as to whether they actually improve accuracy of recall. [ABSTRACT FROM AUTHOR]

The frequency effect in short-term serial recall is influenced by the composition of lists. In pure lists, a robust advantage in the recall of high-frequency (HF) words is observed, yet in alternating mixed lists, HF and low-frequency (LF) words are recalled equally well. It has been argued that the preexisting associations between all list items determine a single, global level of supportive activation that assists item recall. Preexisting associations between items are assumed to be a function of language co-occurrence; HF-HF associations are high, LF-LF associations are low, and mixed associations are intermediate in activation strength. This account, however, is based on results when alternating lists with equal numbers of HF and LF words were used. It is possible that directional association between adjacent list items is responsible for the recall patterns reported. In the present experiment, the recall of three forms of mixed lists-those with equal numbers of HF and LF items and pure lists-was examined to test the extent to which item-to-item associations are present in serial recall. Furthermore, conditional probabilities were used to examine more closely the evidence for a contribution, since correct-in-position scoring may mask recall that is dependent on the recall of prior items. The results suggest that an item-to-item effect is clearly present for early but not late list items, and they implicate an additional factor, perhaps the availability of resources at output, in the recall of late list items. [ABSTRACT FROM AUTHOR]