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PubMed2003

Transvaginal ultrasound in pregnancy: its acceptability to women and maternal psychological morbidity.

OBJECTIVES: To assess the acceptability to women of antenatal transvaginal ultrasound scans; to compare the characteristics of women who accept the offer of a transvaginal scan with those who decline; to establish the prevalence of any psychological morbidity associated with the scan. METHODS: The study was a cross-sectional questionnaire survey. Women were recruited from two hospitals in South London. The sample consisted of 755 pregnant women who had a transvaginal scan at 23 weeks' gestation to assess the risk of preterm delivery and 167 women who were offered the transvaginal scan but declined. Women completed a questionnaire at home. Those who reported finding the scan a difficult experience were sent a questionnaire 4 weeks post-scan to assess its longer term impact. The main outcomes were acceptability (assessed by individual questionnaire items); anxiety before and during the scan (Spielberger State-trait Anxiety Inventory); pain during the scan (Present Pain Intensity Scale of the McGill Pain Questionnaire); psychological trauma (Impact of Event Scale). RESULTS: Over half (55.2%) of women accepted the offer of a transvaginal scan, according to hospital records. The majority of study participants who had transvaginal ultrasound reported finding the experience acceptable. Women experienced some anxiety before and during the scan and over a third experienced some (usually mild) pain during the procedure. Twelve women (1.6%) reported clinically significant levels of psychological trauma in relation to the scan. CONCLUSIONS: Antenatal transvaginal ultrasound for assessing the risk of preterm delivery is an acceptable procedure for the majority of women. A significant minority decline the scan. The procedure has some psychological sequelae for some women.

Adult↗
PubMed2000

Impact of beverage acceptability on fluid intake during exercise.

These two studies investigated the impact of beverage acceptability on voluntary fluid intake during exercise and the subsequent impact of exercise on the perception and liking of beverages. In Experiment 1, 49 triathletes and runners first tasted an array of 10 commercially available flavors of a 6% carbohydrate-electrolyte drink (CE) and water (W) to determine the most-acceptable flavor (M) and least-acceptable flavor (L) for each subject. Subjects were subsequently given M, L, or W ad libitum during 180 min of exercise. Drink acceptability was again measured after 90 and 180 min of exercise. Drink intake was measured at 15-min intervals. Intake of M was significantly greater than L and W throughout the first 75 min and significantly greater than W throughout the entire exercise period. In Experiment 2, subjects were given M+W, or L+W, in a two-bottle procedure. Voluntary intake of M and L exceeded W by 318% and 233%, respectively. An unexpected finding was a strong interaction between drink acceptability and exercise state. The acceptability of L increased substantially from sedentary to exercise conditions. These data demonstrated that the flavored, sweetened beverages used in this study, substantially increased voluntary fluid intake over W.

Adult↗
PubMed1981

Peer acceptance: the correspondence between children's sociometric scores and teachers' ratings of peer interactions.

In view of the current interest in children's peer relationships and social skills, and the need for valid assessment procedures for children's peer problems, the intent of the present study was to examine the correspondence between peer ratings of acceptance and teacher ratings of a child's social behavior and likability. The 92 children were males and females from the third, fourth, and fifth grades. Classroom teachers rated each of the children on withdrawal, aggressive, and likable behavior using the Pupil Evaluation Inventory. Peer ratings of the child's acceptance in play and work situations were obtained from same-sex classmates. The teacher rating of likability was the best predictor of peer acceptance scores for males; withdrawn behavior was the best predictor of peer acceptance scores for females. Ratings of withdrawn and aggressive behavior contributed to the prediction of peer acceptance scores for males; for females, only withdrawn behavior contributed to the prediction of peer acceptance. In terms of the clinical utility of teacher ratings for assessing children with peer problems, the use of the withdrawn and/or aggressive ratings scales appeared to offer promise as a means of identifying such children. Implications for the area of children's social skills and directions for future research were discussed.

Aggression↗
PubMed1994

Consumer acceptability of stiff porridge based on various composite flour proportions of sorghum, maize and cassava.

A study was conducted to determine consumer acceptable proportions of flours in sorghum (var. serena) and maize or sorghum, maize and cassava composite flours. Breeder's serena flour extracted at 75 percent was mixed at various proportions with maize or with maize and cassava to constitute composite flours. The various composite flours were made into stiff porridge and presented to a group of panellists for sensory evaluation. The evaluation was conducted by scoring on a hedonic scale of 0-5 for poor to excellent, respectively, for the parameters colour, texture, flavour, taste and overall acceptability. The responses were analysed statistically. Alternatively the panellists were allowed to eat ad-lib any of the presented samples which appealed to them. The results demonstrated that slight incorporation (< 10%) of sorghum (var. serena) to maize flour leads to reduction in consumer acceptability. However, increased incorporation of sorghum in excess of 10 percent leads to no significant decrease in consumer acceptability until a level of 30 percent incorporation is exceeded. In sorghum, maize, cassava composite flours the formulation of 30:40:30, respectively, was found to be most acceptable. It is suggested that at this combination of flours desirable textural characteristics of the porridge overrides other factors in contributing to its acceptability.

Consumer Behavior↗
PubMed1995

Health insurance does not guarantee access to primary care: a national study of physicians' acceptance of publicly insured patients.

The roles of reimbursement and other predictors that affect physicians' willingness to accept publicly insured continuing care patients were examined in a national survey. The response rate was 47%. Eighty-eight percent of the respondents were accepting new patients. Forty-two percent of these physicians were willing to accept new continuing care patients insured by Medicaid, 70% reported accepting those paying by Medicare assignment, and 85% said they accept patients covered by Medicare plus balance-billing payments. Low reimbursement was the strongest predictor for lack of acceptance. The results suggest that systems of multitiered reimbursement are associated with diminished access for patients insured in the lower tiers.

Adult↗
PubMed2003

HLAMatchmaker-based strategy to identify acceptable HLA class I mismatches for highly sensitized kidney transplant candidates.

HLAMatchmaker determines HLA compatibility at the level of polymorphic amino acid triplets in antibody-accessible sequence positions. Recent studies have shown that among HLA-DR-matched kidney transplants, the HLA-A,B antigen mismatches which are compatible at the triplet level have almost identical graft survival rates as the zero-HLA-A,B antigen mismatches. This finding provides the basis of a new strategy to identify HLA-mismatched organs that have similar success rates as the zero-HLA-antigen mismatches. This report describes how in conjunction with the Acceptable Mismatch program in Eurotransplant, HLAMatchmaker can expand the pool of potential donors for highly sensitized patients, for whom it is very difficult to find a compatible transplant. Sera from 35 highly sensitized kidney transplant candidates with an average PRA of 96% were screened by lymphocytotoxicity with HLA-typed panels that included cells that were selectively mismatched for one or two HLA antigens for each patient. Acceptable and unacceptable HLA-A,B antigen mismatches were determined from the serum reactivity with the cell panel. HLAMatchmaker analysis was applied to identify additional HLA class I antigens that were matched at the triplet level. For each patient, we calculated the probability of finding a donor (PFD) in the different match categories from HLA gene frequencies in the kidney donor population. The median PFD for a zero-antigen mismatch was 0.025%. Matching at the triplet level increased the median PFD to 0.037% ( P = 0.008). The median PFD was 0.058% for a 0-1-triplet mismatch and 0.226% for a 0-2-triplet mismatch. Serum screening identified acceptable antigen mismatches for 28 of 35 highly sensitized patients, and the median PFD increased to 0.307% for a zero/acceptable antigen mismatch. The application of HLAMatchmaker permitted for 33 patients (or 92%) the identification of additional antigens that were acceptable at the triplet level, and the median PFD for a zero/acceptable triplet mismatch went up to 0.425%. Inclusion of one-triplet mismatches increased the median PFD to 1.112%. Validation studies have shown that patient sera reacted with none of the zero-triplet-mismatched antigens, 8-13% of the one-triplet mismatches, and 12-19% of the two-triplet mismatches. Although most antigens with one or two mismatched triplets appear acceptable to highly sensitized patients, a serum analysis must ascertain that the patient's antibodies do not recognize such mismatched triplets. HLAMatchmaker offers a useful strategy of identifying more donors with acceptable HLA mismatches and could alleviate the problem of accumulation of highly sensitized patients on the transplant waiting list.

Algorithms↗
PubMed1990

Stairway risers and treads: acceptable and preferred dimensions.

Stairway preference and acceptability were investigated with psychophysical techniques. A series of six experiments was conducted where subjects ascended and descended 19 sets of stairways with different riser and tread (run) dimensions. Subjects were instructed to identify stairways that they considered acceptable, and the one stairway they most preferred. The optimum riser was 7.2 in (183 mm), and the optimum tread (run) was 11 or 12 in (279 or 300 mm). These dimensions were acceptable to both males and females, young and old, and subjects of greater or lesser stature. Larger dimensions were not as acceptable to shorter subjects, and smaller dimensions were not as acceptable to taller subjects. The 4-in (102 mm) riser was almost totally unacceptable, and never preferred. The 5.14 and 9-in (131 and 229 mm) risers were acceptable to less than one-third of the subjects, and rarely or never preferred. These results are compared with existing practices and recommendations.

Journal Article↗
PubMed1989

The television, school, and family project. V. The impact of curriculum delivery format on program acceptance.

Social psychological interventions have been successful in preventing drug and tobacco use in adolescents, but target audience involvement has not been well documented. Examination of program acceptance is necessary to avoid ambiguity when interpreting findings within and across studies. This report presents results from a program acceptance study of a seventh-grade smoking/drug-use prevention and cessation field trial. The research design is an assessment of two experimentally manipulated variations in program delivery on the program acceptance of all provider and target groups involved. Experimental manipulations included classroom and mass broadcast television demonstrations of social resistance skills against pressures to smoke and use drugs. Three aspects of target audience program acceptance were assessed: participation, satisfaction, and perceived program efficacy. Respondents included the target audience (seventh-grade students and parents), instructors, classroom observers, and school administrative staff. Strong main effects of television delivery on student and parent participation were observed. The findings suggest the usefulness of student homework assignment to view television segments with parents at home as a strategy to achieve family involvement in school-based programs. Both television and classroom delivery separately demonstrated significant positive effects on overall program acceptance with moderate interactive effects on perceived program efficacy. While classroom teacher/observers and school administrators reported strong preferences for the experimental (social resistance) classroom curriculum, acceptance of experimental and comparison (information-based) curricula by the student/parent target audience was equivalent.

Curriculum↗
PubMed1992

Uncertainty in risk assessment: exceedence frequencies, acceptable risk, and risk-based decision making.

The use of "exceedence frequencies" is proposed as a means of evaluating the acceptability of uncertain environmental risks. A survey was conducted of U.S. Environmental Protection Agency personnel. When respondents were requested to identify preferred "acceptable" exceedence frequencies at four different regulatory risk thresholds (10(-3) to 10(-6), three general response patterns were found: "absolutist" responses in which no level of exceedence was deemed acceptable; "fixed" responses in which respondents felt that the level of exceedence should remain constant at all risk levels; and "outcome sensitive" responses in which preferred exceedence frequencies were inversely related to the risk level. This last group's responses were based on the rationale that the "marginal cost" of risk (in terms of expected mortalities) increases as the risk threshold increases. Although the majority of respondents accepted the concept of an acceptable risk exceedence frequency, the low exceedence frequencies selected as being "acceptable" by survey respondents (generally 5% or less) appear to be overly conservative given the degree of uncertainty inherent in risk assessments. Finally, two regulatory uses of exceedence frequencies are proposed as a tool for streamlined risk ranking.

Attitude of Health Personnel↗
PubMed2005

A comparison of thought suppression to an acceptance-based technique in the management of personal intrusive thoughts: a controlled evaluation.

Research suggests that suppressing unwanted thoughts is not possible, leads to a subsequent increase in frequency of the suppressed thoughts, and results in higher levels of distress. Because thought suppression may have negative effects, an alternative, acceptance-based approach has been proposed. The current paper reports the outcomes of two studies. Study I examined the relationships between two naturally occurring strategies of thought management (thought suppression and acceptance), symptoms of psychopathology, and experiences with personally relevant intrusive thoughts. Results showed that those who naturally suppress personally relevant intrusive thoughts have more, are more distressed by, and have a greater "urge to do something" about the thoughts, while those who are naturally more accepting of their intrusive thoughts are less obsessional, have lower levels of depression, and are less anxious. Study II compared three groups (thought suppression, acceptance, and monitor-only groups) on the frequency and distress associated with experiencing personally relevant intrusive thoughts. Results revealed that those instructed to suppress their personal intrusive thoughts were unable to do so and experienced an increased level of distress after suppression, whereas those instructed to use an acceptance-based strategy experienced a decrease in discomfort level (but not thought frequency) after having used such a strategy. These data offer initial evidence that acceptance may be a useful alternative to the suppression of personally relevant intrusive thoughts.

Adolescent↗
PubMed2006

Effects of suppression, acceptance and spontaneous coping on pain tolerance, pain intensity and distress.

Wegner's Theory of Ironic Processes has been applied to study the effects of cognitive strategies to control pain. Research suggests that suppression contributes to a more distressing pain experience. Recently, the acceptance-based approach has been proposed as an alternative to cognitive control. This study assessed the tolerance time, the distress and the perceived pain intensity in three groups (suppression, acceptance and spontaneous coping groups) when the participants were exposed to a cold pressor procedure. Two hundred and nineteen undergraduates volunteered to participate. The suppression group showed the shortest tolerance time and the acceptance group showed the longest tolerance time. The acceptance group showed pain and distress immersion ratings that were significantly lower than in the other two groups, between which the differences were not significant. In the first recovery period, the suppression group showed pain and distress ratings that were higher than in the other two groups. In the second recovery period, although the acceptance group showed pain and distress ratings that were significantly lower than in the other two groups, the suppression and the spontaneous coping groups did not differ. The presence of a 'rebound' of physical discomfort and the effects of suppression on behavioural avoidance are discussed. These results support the acceptance approach in the management of pain.

Adaptation, Psychological↗
PubMed2006

A comparison of the relative utility of coping and acceptance-based measures in a sample of chronic pain sufferers.

Previous research suggests that to define the problem of chronic pain as a problem of coping may not be as useful as framing it as a problem of acceptance for some patients. The coping approach may encourage, or at least permit, a somewhat inflexible agenda of pain reduction or control while the acceptance approach may allow a more flexible agenda of willingness to have pain in some circumstances where that serves the goal of better life functioning. The purpose of this study was to continue to examine the relative utility of concepts of coping and acceptance of pain. Two hundred and thirty consecutive patients seeking assessment from a pain management service were the participants in the study. Patients completed the Coping Strategies Questionnaire (CSQ) and the Chronic Pain Acceptance Questionnaire (CPAQ). A revised scoring method was used for the CSQ (to correct for technical limitations noted in the past) and recently developed subscales of the CPAQ were examined. Correlation results showed that the acceptance variables were reliably stronger predictors of distress and disability compared with coping variables. Regression analyses confirmed that, compared with coping variables, acceptance accounted larger unique increments in variance in measures of patient functioning regardless of whether the coping variables were given priority in the regression equations. Increasing data support the view that the pain management field may benefit from evolving toward incorporating a less control-oriented and more accommodating view of aversive private experiences in some circumstances.

Adaptation, Psychological↗
PubMed2006

ICT and OTs: a model of information and communication technology acceptance and utilisation by occupational therapists.

There is evidence to suggest that health professionals are reluctant to accept and utilise information and communication technologies (ICT) and concern is growing within health informatics research that this is contributing to the lag in adoption and utilisation of ICT across the health sector. Technology acceptance research within the field of information systems has been limited in its application to health and there is a concurrent need to develop and gain empirical support for models of technology acceptance within health and to examine acceptance and utilisation issues amongst health professionals to improve the success of information system implementation in this arena. This paper outlines a project that examines ICT acceptance and utilisation by Australian occupational therapists. It describes the theoretical basis behind the development of a research model and the methodology being employed to empirically validate the model using substantial quantitative, qualitative and longitudinal data. Preliminary results from Phase II of the study are presented. The theoretical significance of this work is that it uses a thoroughly constructed research model, with potentially the largest sample size ever tested, to extend technology acceptance research into the health sector.

Adult↗
PubMed2006

Well-being in patients with chronic fatigue syndrome: the role of acceptance.

OBJECTIVE: Research in chronic pain patients has shown that accepting the chronic nature of their illness is positively related to quality of life. The aim of this study was to investigate whether acceptance is also associated with better well-being in patients suffering from chronic fatigue syndrome (CFS). METHODS: Ninety-seven patients completed a battery of questionnaires measuring fatigue, functional impairment, psychological distress, and acceptance. RESULTS: Results indicated that acceptance has a positive effect upon fatigue and psychological aspects of well-being. More specifically, acceptance was related to more emotional stability and less psychological distress, beyond the effects of demographic variables, and fatigue severity. CONCLUSION: We suggest that promoting acceptance in patients with CFS may often be more beneficial than trying to control largely uncontrollable symptoms.

Activities of Daily Living↗
PubMed2006

Impact on outcomes after listing and transplantation, of a strategy to accept ABO blood group-incompatible donor hearts for neonates and infants.

BACKGROUND: Recent data suggest that ABO blood group-incompatible donor hearts are immunologically well tolerated in infants undergoing transplantation. METHODS: Competing-risks methodology was used to assess outcomes after listing and the impact of a strategy to accept heart grafts from any blood group donor for infants less than 18 months of age. RESULTS: From 1992 to 2002, there were 91 listing episodes in 84 patients (including 20 fetuses; 50% were male and 63% had congenital heart disease). Beginning in 1995, a strategy to accept ABO-incompatible organs was adopted. Competing-risks analysis showed that after 20 months 60% underwent transplantation, 18% died, and less than 1% were still listed; the remaining 21% were de-listed because of a change of surgical strategy (9%), improved clinical condition (8%), and deterioration to ineligibility (4%). Risk factors for transplantation included only a strategy to accept ABO-incompatible organs (P <.001). Risk factors for death included failure to accept ABO-incompatible organs (P =.002) and Canadian listing status 3 (P =.085) or 4 (P <.001). Multivariable parametric models were used to create competing risk predictions for outcomes specific to status and ABO-incompatible strategy. Higher status resulted in greater mortality regardless of strategy, although for any status, more patients underwent transplantation and fewer died using a strategy to accept ABO-incompatible organs. Parametric modeling of time-related freedom from death or retransplantation demonstrated no significant difference at 4 years posttransplantation (P =.78) for ABO-incompatible (74%) versus ABO-compatible transplants (72%). CONCLUSIONS: A strategy to accept ABO-incompatible donor hearts for infant transplantation significantly improves the likelihood of transplantation and reduces waiting list mortality while not adversely altering outcomes after transplantation.

ABO Blood-Group System↗
PubMed2005

A prospective study of acceptance of pain and patient functioning with chronic pain.

Acceptance of chronic pain is emerging as an important concept in understanding ways that chronic pain sufferers can remain engaged with valued aspects of life. Recent studies have relied heavily on cross-sectional investigations at a single time point. The present study sought to prospectively investigate relations between acceptance of chronic pain and patient functioning. A sample of adults referred for interdisciplinary treatment of severe and disabling chronic pain was assessed twice, an average of 3.9 months apart. Results showed that pain and acceptance were largely unrelated. Pain at Time 2 was weakly related to measures of functioning at Time 2. On the other hand, acceptance at Time 1 was consistently related to patient functioning at Time 2. Those patients who reported greater acceptance at Time 1 reported better emotional, social, and physical functioning, less medication consumption, and better work status at Time 2. These data suggest that willingness to have pain, and to engage in activity regardless of pain, can lead to healthy functioning for patients with chronic pain. Treatment outcome and process studies may demonstrate the potential for acceptance-based clinical methods for chronic pain management.

Activities of Daily Living↗
PubMed2005

The persistence of regulatory cells developing after rat spontaneous liver acceptance.

BACKGROUND: We have previously reported that the spontaneous acceptance of Lewis (LEW, RT1(l)) to Dark Agouti (DA, RT1(a)) rat orthotopic liver transplant (OLT) is eliminated by donor gamma-irradiation. The acceptance of the irradiated LEW liver is also reestablished in a naïve rat after the adoptive transfer of T regulatory (T-reg) cells from a LEW to a DA liver-tolerant long-term (>60 days) survivor (LTS) into a naïve DA rat. However, little is known about the growth conditions required to maintain T-reg function. In this study, we examined the need for continued donor-specific alloantigen stimulation for the maintenance and function of T-reg cells. METHODS: Splenocytes (SCs; 1.5 x 10(8) cells) from a LEW liver allograft-tolerant LTS DA recipient were adoptively transferred fresh or after in vitro stimulation into another naive DA rat on day 1, 4, or 7 before an irradiated (1000R) LEW liver transplant. For in vitro alloantigen stimulation, SCs from LEW to DA LTS were co-cultured with mitomycin-C (MMC)-treated naïve LEW (donor alloantigen-specific) or Brown Norway (BN) (RT1(n); third party) SCs for 72 hours. Graft rejection, as defined by death of the recipient, was confirmed histologically. RESULTS: All LEW liver grafts were accepted spontaneously by DA recipients for more than 60 days (n=32), while all irradiated LEW livers were acutely rejected (n=9; mean survival time [MST]=12.8 +/- 4.0 days). When LTS DA SCs were adoptively transferred into a naive DA rat 1 day before OLT, all irradiated LEW grafts were accepted greater than 60 days (n=9). However, when fresh LTS DA SCs were transferred to a new naïve DA rat on 4 or 7 days before OLT, all irradiated LEW liver grafts were acutely rejected (MST=10.2 +/- 0.5 days [n=4] and MST=13.5 +/- 5.0 days [n=4], respectively). When LTS DA SCs were stimulated in vitro before adoptive transfer, irradiated LEW liver grafts after 4 days (n=5) were then accepted. In vitro culture of LTS DA SCs with MMC-treated BN SCs (third-party) for 72 hours before adoptive transfer resulted in 3 of 5 irradiated LEW livers at day 4 being accepted (n=5). CONCLUSIONS: The maintenance of T-reg function requires continuous LEW donor-specific alloantigen stimulation.

Adoptive Transfer↗
PubMed1995

Consumer acceptance of foods lower in sodium.

OBJECTIVE: To assess the magnitude of sodium reduction that can be made without significantly changing the perception of saltiness and acceptability of a broad range of common food items. DESIGN: The investigation was carried out in two phases. Military and civilian volunteers (N = 190 in study 1; N = 380 in study 2) from the US Army Natick Research, Development and Engineering Center rated the saltiness and acceptability of foods containing differing sodium concentrations. SETTING: Consumers rated food items in the sensory testing laboratory. INTERVENTION: "Regular" and "low-sodium" entrees were rated for saltiness and acceptability in study 1. Prepared food, commercially prepared food, and beverages containing various concentrations of sodium were rated for saltiness and acceptability in study 2. STATISTICAL ANALYSES PERFORMED: Results were analyzed using Pearson correlation coefficients, Student's t test, and analysis of variance. RESULTS: The perception of saltiness increased as the concentration of sodium increased. Acceptance ratings varied considerably over a broad range of sodium concentrations, which indicates that the relationship was product specific. Results suggest that a reduction of one third or more in added sodium can be made to some foods without significantly affecting consumer acceptance. APPLICATIONS: The sodium content of food can be reduced by consumer-guided food engineering and food preparation. Alterations in food preparation and product formulation, in conjunction with alterations in diet, can be effective methods for reducing sodium consumption.

Adolescent↗