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Diet composition alters the acceptance of fat by rats.

The acceptance of dietary fat by rats is influenced by changes in fat digestion and metabolism. In these experiments, rats were fed diets that differed in fat, carbohydrate and fiber content, and the acceptance of fat was measured. Rats fed a high fat (HF) diet ate more corn oil in 30-min or 6-h tests than did rats fed an isocaloric high carbohydrate (HC) diet. This effect was seen after the diets were switched and rats retested. Differences in dietary fiber between the isocaloric HF and HC diets did not account for this effect because rats fed HF diets, either high or low in fiber content, drank more oil than rats fed the HC diet. Rats fed the HF diet with added carbohydrate drank less oil than rats fed the HF diet, and the same amount of oil as rats fed the HC diet. Compared with rats fed the HC diet, rats fed the HF diet drank more oil in a two-bottle preference test with sucrose or when mixed with sucrose in a single-bottle test. Rats offered a variety of fats, sugars or other test foods, ate more nutritive liquid fats and some solid fats, but did not eat more sugar or other items if they were fed the HF diet rather than the HC diet. These studies taken together strongly suggest that rats fed a high fat diet show a greater acceptance of fat compared with rats fed a high carbohydrate diet.

Animals↗

Handwashing in a neonatal intensive care nursery: product acceptability and effectiveness of chlorhexidine gluconate 4% and triclosan 1%.

The effectiveness of triclosan 1% w/v against methicillin-resistant Staphylococcus aureus (MRSA) and its effect on skin were compared with chlorhexidine gluconate 4% w/v ('Hibiclens') in a 7-week trial. Clinical information of MRSA rates obtained during the previous 10 months and results from earlier user acceptability trials were included. The average number of new cases of MRSA per week was reduced from 3.4 to 0.14 (P less than 0.0001) in the experimental ward whilst no significant changes occurred in the control ward. Staff reported less skin damage and a higher rate of acceptance with the experimental product. Based on results of the trial, a proposal to introduce triclosan for a 12-month study period has been accepted.

Aerosols↗

Acceptability and skin reactions to transdermal estrogen replacement therapy in relation to climate.

The acceptability and skin reaction of Estraderm Transdermal Therapeutic Systems as a function of climatic variability were examined in various zones which alter considerably in their temperature and humidity. An open, noncomparative prospective study was carried out in four institutional out-patient menopausal clinics in varying climatic areas. Eighty symptomatic postmenopausal patients without previous estrogen replacement were examined. Estraderm T.T.S. 50 was applied twice weekly in four weekly cycles. Norethisterone-acetate tablets (1 mg), were taken orally for 12 consecutive days. Using a questionnaire, the subjects were asked about the efficacy of the treatment on postmenopausal symptoms, the adhesiveness and tolerability. The results were matched with the meteorological conditions. The duration of the study was 6 months. Acceptability of Estraderm T.T.S. is high (78.7%). Discontinuation of treatment was found in 21.3% of the study group. The main reason for discontinuation is due to skin reactions which occurred in 14 of the 80 patients (17.5%). Meteorological conditions in this study did not influence the rate of skin reactions. No difference in acceptability of the treatment was found in relation to the mean temperature and mean humidity as registered in the dry desert and the humid coastal areas.

Administration, Cutaneous↗

Evaluation of criteria for the acceptance of bioanalytical data.

Results from bioanalytical analyses for registration of a new drug entity are used to define its pharmacokinetics and bioavailability/bioequivalence. Whilst analytical data may be derived from the application of a validated method, it is essential to apply mathematical criteria to its acceptance, in order that the analyst can be assured that the assay is performing within defined limits and to its validated specification. Parameters evaluated for acceptability are the batch calibration curve, the minimum quantifiable concentration and the quality control (QC) sample acceptability. Specifically, six QC samples per analytical batch are used, two samples at each of three concentrations. The rationale for the definition of these criteria is evaluated together with a consideration of their applications and limitations. The relevance and use of Shewhart and Cusum plots to monitor assay performance is illustrated.

Biological Availability↗

Preference history prevents schedule-induced preferential ethanol acceptance.

Two groups of rats were given differential schedule-induced polydipsia histories. One had a history of choosing between 5% ethanol and 0.7% glucose solution (dilute, mildly acceptable), in daily, 3-hr, fixed-time 1-min schedules of food-pellet delivery, while the other similarly treated group chose between 5% ethanol and 5% glucose (highly acceptable). A 30-day period, wherein only 5% ethanol was available during daily sessions, intervened before session-fluid preferences were evaluated by pitting a series of glucose solutions of increasing concentration (0.7-5.0%) against 5% ethanol. The group which had a remote history of having chosen 5% glucose solution in preference to 5% ethanol imbibed less 5% ethanol during the series of glucose-ethanol acceptability preference tests. Hence, they were less vulnerable to a continuance of their ethanol overindulgence than the group with the remote history of having chosen 5% ethanol over the dilute glucose solution.

Alcohol Drinking↗

Triage nurse perceptions of the use, reliability and acceptability of the Toowoomba Adult Triage Trauma Tool (TATTT).

OBJECTIVE: The 'Toowoomba Adult Triage Trauma Tool' (TATTT) is a computerised clinical decision support tool developed to provide an evidence-based, valid and consistent method of triage assessment and categorisation. The objective of this study was to determine the most appropriate training and testing strategy for implementing the TATTT and to evaluate its acceptability for assisting in the triage prioritization process. METHODS: Triage nurses (15) from two hospitals underwent training in the TATTT and were tested on its application. Semi-structured interviews gathered their perceptions of the training, the methods for testing and the acceptability of the TATTT for assisting in triage. RESULTS: The TATTT was viewed positively by all but one of the nurses. Participants believed that it provided clear direction in the triage assessment process, increased their confidence in reaching a decision and would be comfortable in adopting the TATTT in clinical practice. CONCLUSIONS: The study has shown that the TATTT is acceptable to users and is viewed as a viable alternative to current triage practice.

Adult↗

The acceptability to older drivers of different types of licensing restriction.

The primary objective of this study was to determine the acceptability of various driving restrictions to older drivers. Licensed drivers aged 65 years or more living in the community in the Ottawa, Ontario area were recruited by means of posters and advertisements in regional and local newspapers. We recruited 86 subjects, 56 men and 30 women with a mean age of 75 years (50 urban and 36 rural residents). The subjects completed a one-hour interview with one of two trained study nurses during which their driving restriction preferences (utilities) were determined using a modified standard gamble technique. Highly endorsed restrictions included regular assessment by the Ministry of Transportation (mean utility 0.94), driving with vehicle adaptations (0.94) and daytime driving only (0.93). Less acceptable restrictions included avoidance of roads with a speed limit greater than 60 km/h (0.50), limitation of destinations (0.45), driving only within a 10-km radius of home (0.45) and requirement of another licensed driver in the vehicle (0.42). Our subjects' preferences appeared to be inversely related to the impact on autonomy and the ability to access the community. These findings may be useful to motor transport administrators in designing effective restricted licensing programs that are acceptable to older drivers.

Age Factors↗

Physiological and psychophysical responses in handling maximum acceptable weights under different footwear--floor friction conditions.

A study on combined manual materials-handling tasks performed on floors under three friction levels was conducted. Eight male subjects participated in the study. The maximum acceptable weight of handling, including lifting, carrying for 3m, lowering, and walking 3m back at twice per minute was determined. The subject then performed the same tasks for 10 min. Heart rate, Vo2, energy efficiency, perceived sense of slip, and rating of perceived exertion for whole body strain were measured. The results showed that the effects of friction level on the maximum acceptable weights of handling, perceived sense of slip, Vo2, and energy efficiency were statistically significant (p<or=0.0006). As the friction level increased from low to high, the maximum acceptable weights of handling increased from 8.15 to 9.34 kg. The energy efficiency on the low friction condition (12.58 kg/L/min) was significantly lower than those of the medium (15.73 kg/L/min) and high (15.38 kg/L/min) friction conditions. The perceived sense of slip was the highest (5.44) on the low-friction condition, followed by the medium-friction condition (3.58), and last the high-friction condition (1.84). The implication of this study was that friction level should be regarded as one of the major environmental factors in designing MMH tasks as it affected both physiological and psychophysical responses of the subjects. Low-friction footwear-floor interface should be avoided as it resulted in not only high scores of perceived sense of slip but also in low-energy efficiency utilized in the body.

Adult↗

Perceived naturalness and acceptance of genetically modified food.

This study examines people's acceptance of genetically modified (GM) food. Results suggest that GM acceptance depends most on how natural the genetically modified product is perceived and not directly on how natural the non-GM product is seen. A GM product that is perceived as more natural is more likely to be accepted than a GM product that is perceived as less natural. The extent to which GM affects the perceived naturalness of a product partly depends on the kind of product.

Adolescent↗

Food deprivation enhances the expression but not acquisition of flavor acceptance conditioning in rats.

The postingestive actions of nutrients condition strong flavor preferences in rats and may also enhance flavor acceptance (increase total intake) in some situations. This study determined the impact of food deprivation on flavor preference and acceptance conditioned by intragastric (i.g.) infusions of glucose. Rats fitted with gastric catheters were trained (20 h/day) to associate a CS+ solution (bitter or sour) with i.g. 16% glucose and a CS- solution with water infusions. One group (FR) was food-restricted during the training sessions, while a second group (AL) was given food ad libitum. All rats were given 2-h access to food prior to the daily sessions. During one-bottle training, the FR rats consumed substantially more CS+ than CS- whereas AL rats drank only slightly more CS+ than CS-. In additional one-bottle acceptance tests, the FR and AL rats consumed substantially more CS+ than CS- when both groups were food-restricted, but only slightly more CS+ than CS- when both groups had food ad libitum. Throughout the experiment, the FR and AL rats displayed equally strong CS+ preferences in two-bottle choice tests irrespective of their deprivation state during the test. The findings indicate that food restriction stimulates the intake of a CS+ flavor that is (or was previously) paired with i.g. glucose infusions but does not fundamentally alter the learned association between the CS+ flavor and the post-oral nutrient stimulus.

Animals↗

Cost-effectiveness of alternative cascade screening strategies for familial hypercholesterolemia with realistic cascade screening acceptance rates and use of novel treatment.

BACKGROUND AND AIMS: Cascade screening (CS) for familial hypercholesterolemia (FH) has been found to be cost-effective in many published studies. However, most existing studies (i) ignored or overstated first-degree relative (FDR) participation rate (as 60-100&#xa0;%), (ii) did not consider novel and expensive therapies, e.g. PCSK9 inhibitors (PCSK9i), and (iii) were conducted outside of Asia. This study, conducted in Singapore, where FDR participation rate is about 25&#xa0;% among probands who have known pathogenic variants, aims to identify drivers of cost-effectiveness of CS protocols for FH. METHODS: Four CS protocols, which vary in the application of genetic tests, were examined using a hybrid decision tree-Markov model. Sensitivity analyses were conducted to identify drivers of cost-effectiveness. RESULTS: Cascade acceptance rates are key drivers of cost-effectiveness. Other drivers include age of proband, prevalence of FH among probands, health-related quality of life loss with cardiovascular disease, timeliness of starting treatment post-screening, treatment effectiveness, cost of PCSK9i and discount rate for cost and QALY. With cascade acceptance rates observed in Singapore, among various screening protocols examined, probabilities of being cost-effective ranged from 86&#xa0;% to 95&#xa0;% when no access to PCSK9i and ranged from 75&#xa0;% to 98&#xa0;% when PCSK9i are provided. The most cost-effective protocol differs depending on cascade acceptance rates and whether PCSK9i is provided. CONCLUSION: For better cost-effectiveness of CS for FH, health systems need to look for ways to improve proband's willingness to share contact of their relatives and relatives' willingness to be screened and to lower the cost of novel treatment. Other ways to improve cost-effectiveness include to select age groups for proband screening, improve screening detection rate among probands, and start timely treatment post-screening.

Humans↗

Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase.

The concept of acceptance is receiving increased attention as an alternate approach to the suffering that is often associated with persistent and disabling pain. This approach differs from established treatments in that it does not principally focus on reducing pain, but on reducing the distressing and disabling influences of pain as they concern important areas in patients' lives. The present analyses represent a preliminary evaluation of an acceptance-based approach to chronic pain within an interdisciplinary treatment program. One hundred and eight patients with complex chronic pain conditions completed treatment and provided data for the current study. Treatment was conducted in a 3- or 4-week residential or hospital-based format. It included a number of exposure-based, experiential, and other behavior change methods focused on increasing (a) engagement in daily activity regardless of pain and (b) willingness to have pain present without responding to it. Significant improvements in emotional, social, and physical functioning, and healthcare use were demonstrated following treatment. The majority of improvements continued at 3-months post-treatment. Improvements in most outcomes during treatment were correlated with increases in acceptance, supporting the proposed process of treatment.

Activities of Daily Living↗

Acceptance, motivators, and barriers in attending breast cancer genetic counseling in Asians.

AIM: Cancer genetic risk assessment clinics represent the primary prevention arm in oncology in identifying high-risk patients for screening and prevention, but deals with the taboo subject of cancer risk prediction. Low knowledge level and traditional beliefs may pose significant barriers to its acceptance in Asia. METHODS: We conducted a questionnaire survey to evaluate the acceptance of breast cancer genetic counseling. RESULTS: More than 70% of the 438 respondents indicated interest and perceived potential benefits. Higher education level and use of English were associated with greater acceptance. Learning about cancer risk and cancer detection, helping the family, and the doctor's recommendation, were important motivators, while misperception that cancer patients could not gain personally, concerns of not understanding the information, cost issues, and fears of bad news, were important barriers. CONCLUSIONS: Singaporean women were receptive to cancer genetics counseling. Education to correct misperceptions may optimize utilization of a cancer genetics service.

Adult↗

PCB contaminated dust on indoor surfaces--health risks and acceptable surface concentrations in residential and occupational settings.

Polychlorinated biphenyls (PCBs) have been used in diverse purposes such as indoor paints. Removal of these paints with dust creating techniques, like sandblasting, will result in contamination of building surfaces with PCB-containing dust. Objectives of this study was to analyze the PCB concentrations on surfaces after sandblasting with silica using wipe samples and estimate the resulting health risks and further calculate the risk based acceptable PCB surface concentrations that do not cause incremental lifetime cancer risk higher that 10(-5) or does not cause immunosupression effects in residential use or in occupational settings. Both deterministic and probabilistic approaches were used. The total PCB concentrations on surfaces ranged from 10 to 1100 microg/m(2). Estimated cancer risk was 1.2 x 10(-4) for childhood exposure, 1.3 x 10(-5) for adult residents and 1.5 x 10(-5) for occupational exposure. Probabilistic risk assessment revealed that point estimates were quite reasonable and located between 45th and 79th percentiles on probabilistic distribution of risk. The noncancer risks were calculated as hazard quotients (HQ) which ranged from 3.3 to 35 depending on the exposure scenario. Acceptable surface concentrations based on noncancer effects that are protective for 95% of exposed population were 7 microg/m(2) for residential use, 65 microg/m(2) for residential use if only adults will be exposed and 140 microg/m(2) for occupational use. Preliminary cleanup experiment revealed that when contaminated dust was carefully removed with industrial vacuum cleaner and further washed with terpene containing liquid the surface concentration dropped below the acceptable levels calculated in this study.

Air Pollutants↗

Vegetable acceptance by infants: effects of formula flavors.

Individual differences in acceptance patterns are evident as early as the child's first experiences with a particular food. To test hypothesis that the flavor of formula fed to infants modifies their acceptance of some foods, we conducted a within- and between-subjects design study in which two groups of 6- to 11-month-old infants were tested on two separate days. One group was currently feeding a milk-based formula whereas the other was feeding a protein hydrolysate formula, a particularly unpleasant tasting formula to adults that contains similar flavor notes (e.g., sulfur volatiles) with Brassica vegetables such as broccoli. In counterbalanced order, acceptance of pureed broccoli/cauliflower was determined during one test session and pureed carrots on the other. Although there were no group differences in the amount of carrots consumed, hydrolysate infants consumed significantly less broccoli/cauliflower relative to carrots when compared to those who were currently fed milk based formulas (F(1,72 df)=4.43; p=0.04). The mothers of hydrolysate infants were significantly more likely to report that their infants did not enjoy feeding the broccoli/cauliflower (54.2%) when compared to mothers of infants being fed milk-based formulas (28.0%; Chi-Square (1 df)=4.79; p=0.03). Such findings are consistent with prior research that demonstrated a sensory specific satiety following repeated exposure to a particular flavor in milk. We hypothesize that when infants are experiencing a flavor in milk or formula, in the short term, the preference that develops is specific to the context it is experienced in (e.g., milk). Over the longer term, the preference may generalize to other contexts such as solid foods. Hydrolysate infants were also significantly more likely to be judged by their mothers as being more active (F(1,69 df)=3.95; p=0.05) and hesitant (F(1,69 df)=6.55; p=0.01) when compared to those infants who were feeding milk-based formulas, a finding that further supports the hypothesis that mother-child dynamics surrounding early feeding impacts upon mothers' perception of their children's temperament.

Adult↗

MINI International Neuropsychiatric Schedule: clinical utility and patient acceptance.

OBJECTIVE: Clinical diagnosis has been shown to be unreliable compared to structured diagnostic schedules. However, clinicians rarely use structured diagnostic schedules due to concerns about the feasibility in clinical practice and about patient acceptance. Mini International Neuropsychiatric Schedule is a short diagnostic instrument validated against SCID and CIDI but its feasibility and patient acceptance has not been studied. SUBJECTS AND METHODS: One hundred and eleven patients admitted to a partial program were administered Mini International Neuropsychiatric Schedule and the interview was timed. A short questionnaire was administered to assess patients' views about the interview. For a subgroup of patients, diagnoses by both open interviews and Mini International Neuropsychiatric Interview (MINI) were available. These were compared to look for agreement in primary diagnoses and co-morbid conditions. RESULTS: MINI took an average of 16.4 min to administer. Patients' views of MINI were positive. It was considered comprehensive enough to cover all patient symptoms and at the same time not unduly lengthy. Patients were not bothered by the interview format. There was disagreement between MINI primary diagnosis and open diagnosis in 42% cases. In 33% the disagreement was of substantial clinical significance. MINI diagnosed more co-morbid conditions (average 2.05 compared to 0.5 in open interview). CONCLUSIONS: MINI is a short diagnostic interview schedule that can be easily incorporated into routine clinical interviews. It has good acceptance by patients.

Adolescent↗

Why do not all hip- and knee patients facing long waiting times accept re-referral to hospitals with short waiting time? Questionnaire study.

Patients' preferences are often assumed to be homogeneous and to favour hospitals with a short waiting time and high quality. Due to long waiting times (6 months) for artificial hip or knee implantation a Danish county in 1999-2000 offered patients on a waiting list a choice between remaining on the local hospital's waiting list with the long waiting time, or re-referral to a hospital outside the county with a shorter waiting time. Fewer patients than expected took advantage of the offer of re-referral ("accepters"): 89 of 149 patients (60%). In 2003, we asked patients about the reasons for their choice: 87% of patients responded. Respondents and non-respondents were similar by decision, choice of hospital, diagnosis and age; men were significantly more likely to respond than women. Accepters and decliners were similar by age, sex, diagnosis and the presence of a car in the household. Short distance, short transport time and previous experience with the nearby hospital were the most important reasons for choosing that hospital. Some patients appeared to be willing to accept a long waiting time, if they were told exactly when they would undergo surgery. The results of this study question the validity of the conventional wisdom, that patients are willing to travel long distances in order to receive treatment with short waiting time.

Arthroplasty, Replacement, Hip↗

Acceptability of community and health facility-based directly observed treatment of tuberculosis in Tanzanian urban setting.

SETTING: An urban district in Dar es Salaam, Tanzania. OBJECTIVE: To assess the acceptability of community and health facility-based direct observation of treatment (DOT) of tuberculosis (TB) patients in Temeke district. DESIGN: Both quantitative and qualitative study methodologies were used. Eight focus group discussions were carried out with TB patients, treatment supporters, health workers and community members. Quantitative study was also carried out among TB patients and treatment supporters. RESULTS: A total of 268 patients and 103 treatment supporters were enrolled in the study. The majority of the patients (75%) were satisfied with the DOT options they received. Males were more satisfied with community-based DOT (84%) than females (67%) (OR 4.96, 95% CI 1.38-17.86). The majority (81%) were willing to supervise another TB patient. The results of the qualitative study demonstrated that community-based DOT was preferred because it was found to be convenient, reduced costs, saved time of the patients and reduced workload in health services. The main challenge of community-based DOT was to ensure effective supervision and monitoring of patients and treatment supporters in the community. CONCLUSION: The results from the quantitative and qualitative studies indicate that both DOT options were acceptable. The study has also identified key challenges and opportunities for effective implementation of community-based DOT interventions that are relevant, sensitive and acceptable to the population. Community-based DOT is a viable option and can complement and strengthen the existing health facility-based DOT, especially in countries like Tanzania where the health system is overwhelmed with increasing number of TB and HIV/AIDS patients.

Adult↗