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PubMed2003

IFN-gamma is an absolute requirement for spontaneous acceptance of liver allografts.

Experimental liver allografts undergo spontaneous acceptance despite undergoing rejection during the first few weeks post transplant. We explored the role of interferon-gamma (IFN-gamma) in the spontaneous acceptance of mouse liver allografts. Strain of mouse (CBA) liver allografts transplanted into normal BALB/c mice developed histologic changes typical of rejection that spontaneously regressed, permitting long-term survival of these allografts similar to that of syngeneic grafts. In contrast, CBA liver allografts in IFN-gamma-deficient hosts manifested not only infiltration but also hemorrhage and necrosis, with no survival beyond 14 days. Despite differences in survival, local expression of cytotoxic T-cell genes in the transplant was not increased in IFN-gamma-deficient hosts, but livers in interferon-gamma-deficient mice (GKO) hosts displayed much less induction of major histocompatibility complex (MHC) class I and II expression. To determine whether the difference in survival was secondary to the direct effects of IFN-gamma on the liver, we transplanted livers from IFN-gamma-receptor-deficient mice into normal hosts. Liver allografts lacking IFN-gamma receptors also developed hemorrhage and necrosis with minimal induction of MHC expression. Thus IFN-gamma mediates a direct effect on rejecting liver allografts that reduces hemorrhage and necrosis, induces MHC expression, and is absolutely required for spontaneous acceptance.

Animals↗
PubMed1994

Admission requirements, acceptance rates, and financial assistance in clinical psychology programs. Diversity across the practice-research continuum.

129 directors (80% response) of APA-accredited clinical psychology programs provided information pertaining to admission requirements, acceptance rates, financial assistance, and theoretical orientations. Summary data are presented and comparisons are made among 4 types of clinical programs: PsyD programs, practice-oriented PhD programs, equal-emphasis PhD programs, and research-oriented PhD programs. Clinical doctoral programs held similar expectations for undergraduate preparation in psychology, but robust differences emerged on preferred Graduate Record Examination scores, acceptance rates, and financial assistance. In the most extreme comparison (PsyD vs. research-oriented PhD programs), students were 4 times more likely to gain acceptance but 6 times less likely to receive full financial assistance in PsyD programs. Implications of these results for potential graduate students and for the future of applied psychology programs are briefly discussed.

Curriculum↗
PubMed2002

The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial.

The present study examined the impact of a brief version of an acceptance-based treatment (acceptance and commitment therapy; ACT) that teaches patients to accept unavoidable private events; to identify and focus on actions directed toward valued goals; and to defuse from odd cognition, just noticing thoughts rather than treating them as either true or false. Eighty inpatient participants with positive psychotic symptoms were randomly assigned to treatment as usual (TAU) or to 4 sessions of ACT plus TAU. ACT participants showed significantly higher symptom reporting and lower symptom believability and a rate of rehospitalization half that of TAU participants over a 4-month follow-up period. The same basic pattern of results was seen with all participant subgroups except delusional participants who denied symptoms.

Adaptation, Psychological↗
PubMed1996

Self-esteem and "if . . . then" contingencies of interpersonal acceptance.

The degree to which an individual perceives interpersonal acceptance as being contingent on successes and failures, versus relatively unconditional, is an important factor in the social construction of self-esteem. The authors used a lexical-decision task to examine people's "if. . . then" expectancies. On each trial, participants were shown a success or failure context word and then they made a word-nonword judgment on a second letter string, which sometimes was a target word relating to interpersonal outcomes. For low-self-esteem participants, success and failure contexts facilitated the processing of acceptance and rejection target words, respectively, revealing associations between performance and social outcomes. Study 2 ruled out a simple valence-congruency explanation. Study 3 demonstrated that the reaction-time pattern was stronger for people who had recently been primed with a highly contingent relationship, as opposed to one based more on unconditional acceptance. These results contribute to a social-cognitive formulation of the role of relational schemas in the social construction of self-esteem.

Adult↗
PubMed2003

Parental acceptance, postpartum depression, and maternal sensitivity: mediating and moderating processes.

Mothers (n = 92), fathers (n = 84), and their infants (60% male) participated in a longitudinal study of postpartum depression and maternal sensitivity. Mothers completed questionnaire measures of remembered parental acceptance, depressive symptoms, and infant distress to novelty and limits. Mothers and partners reported on marital aggression and avoidance. Maternal sensitivity was observed in the laboratory at 6 months. Characteristics of mothers, partners, and infants combined to predict postpartum depression and maternal sensitivity. Remembered parental rejection predicted postpartum depressive symptoms with prenatal depression controlled; self-esteem mediated this effect. Paternal acceptance buffered against postpartum depression when infants were highly reactive and when partners were aggressive. Paternal acceptance reduced the impact of postpartum depression on maternal sensitivity; having an aggressive marital partner exacerbated the effect.

Adult↗
PubMed2006

Popularity, social acceptance, and aggression in adolescent peer groups: links with academic performance and school attendance.

This article reports a short-term longitudinal study focusing on popularity and social acceptance as predictors of academic engagement for a sample of 342 adolescents (approximate average age of 14). These youths were followed for 4 consecutive semesters. Popularity, social acceptance, and aggression were assessed with a peer nomination inventory, and data on academic engagement were obtained from school records. For adolescents who were highly aggressive, increases in popularity were associated with increases in unexplained absences and decreases in grade point average. Conversely, changes in social acceptance were not predictive of changes in grade point average or unexplained absences. These results highlight the importance of multidimensional conceptualizations of social standing for research on school adjustment during adolescence and emphasize the potential risks associated with popularity.

Achievement↗
PubMed2003

Acceptability and availability of harm-reduction interventions for drug abuse in American substance abuse treatment agencies.

This study assessed acceptability, availability, and reasons for nonavailability of interventions designed to prevent drug use related harm by substituting pharmaceuticals for illicit drugs; facilitating detoxification; and reducing the occurrence of HIV transmission, relapse, and opiate overdose. A survey was mailed to a sample of 500 randomly selected American substance abuse treatment agencies. Of 435 potentially eligible respondents, 222 (51%) returned usable data. A subset of interventions--including harm reduction education, cue exposure therapy, needle exchange, substitute opiate prescribing, various detoxification regimes, and complementary therapies--were rated as somewhat or completely acceptable by 50% or more of the respondents. Regardless of their acceptability, listed interventions were generally not available from responding agencies; respondents typically attributed unavailability to lack of resources and inconsistency of an intervention with agency philosophy.

Attitude of Health Personnel↗
PubMed1998

Perceived parental acceptance and early adolescent self-competence.

Relationships between perceived parental acceptance and adolescent self-competence were examined in 214 sixth- and seventh-grade students by both adolescent and parental gender. Results indicated that for boys, paternal but not maternal, acceptance significantly predicted self-competence, while the opposite pattern was found for girls. In addition, self-worth significantly predicted maternal and paternal acceptance for both boys and girls. The consistency of these findings with current models of human development is discussed, along with their implications for research.

Adolescent↗
PubMed2004

Conditions for the acceptance of deontic conditionals.

Recent psychological research has investigated how people assess the probability of an indicative conditional. Most people give the conditional probability of q given p as the probability of if p then q. Asking about the probability of an indicative conditional, one is in effect asking about its acceptability. But on what basis are deontic conditionals judged to be acceptable or unacceptable? Using a decision theoretic analysis, we argue that a deontic conditional, of the form if p then must q or if p then may q, will be judged acceptable to the extent that the p & q possibility is preferred to the p & not-q possibility. Two experiments are reported in which this prediction was upheld. There was also evidence that the pragmatic suitability of permission rules is partly determined by evaluations of the not-p & q possibility. Implications of these results for theories of deontic reasoning are discussed.

Adolescent↗
PubMed2002

Crucial Fas-Fas ligand interaction in spontaneous acceptance of hepatic allografts in mice.

The Fas/Fas ligand (FasL) system plays important roles in the immune system, including host immunoregulation and cytotoxicity. In this study, we investigated the involvement of Fas-FasL interactions in spontaneous acceptance of hepatic allografts in murine orthotopic liver transplantation. Liver transplantation between the C57BL/6 (B6, H-2b) donor and the MRL/Mp (MRL, H-2k) recipient was performed in various combinations of donor and recipient mice with wild type (+/+), Fas-mutant (lpr) or FasL-mutant (gld) genotypes. The prolongation and spontaneous acceptance of the fully allogeneic grafts in recipients was not observed in either MRL-lpr recipients with B6+/+ livers or MRL+/+ recipients with B6-gld livers. Moreover, the serum alanine aminotransferase (ALT) levels and the degree of cell infiltration into hepatic allografts on day 7 after transplantation were inversely correlated with the recipient survival time (in days). The donor-specific cytotoxic T-lymphocyte (CTL) activities of the graft-infiltrating cells (GICs) from MRL-gld recipients with B6+/+ livers were much lower than those from MRL+/+ or -lpr recipients on days 5 and 10 after transplantation. However, the CTL activities of the GICs from MRL+/+ and -gld recipients predominantly disappeared by day 15 after transplantation. Furthermore, the anti-donor CTL activities induced in MRL+/+ recipients were ascribed to CD8+ cells, and were not mediated by Fas-FasL interactions. These results strongly suggest that the Fas/FasL system plays a critical role for recipient immunoregulation, enabling recipients in accepting hepatic allografts by deletion of the donor-specific T cells, but not for CTL/target cell interaction in MRL+/+ recipients.

Alanine Transaminase↗
PubMed1998

Cooperative learning and social acceptance of children with mild intellectual disability.

The effects of the participation of non-disabled children in a cooperative learning programme on their social acceptance of classmates with mild intellectual disability was examined. A sample of 24 children with mild intellectual disability in the 9-11-year-old age-range was identified from educational psychologists' case records. All of the children were receiving mainstreaming special education programmes at the time of the study. Twelve of the children had previously attended special education classes, while the remainder had always attended regular classes. Half of the children's regular classes were randomly assigned to either receive an experimental cooperative learning programme or to serve as control classrooms. The non-disabled children in the experimental classes showed significant increases in their social acceptance (sociometric ratings) of the children with mild intellectual disability, both immediately following the programme and 5 weeks later, but no such increases were evident in the children in the control classrooms. This pattern held for both the former special class pupils and the children with mild intellectual disability who had never attended special classes. The results confirm the usefulness of cooperative learning strategies for enhancing the social acceptance of children with mild intellectual disability in mainstreaming special educational programmes, regardless of the nature of their previous special educational provisions.

Child↗
PubMed2002

Towards an acceptance of performance assessment.

The utility of any assessment tool critically depends on its level of acceptance by those on whom the assessment impacts. Performance assessment impacts on three distinct groups: patients/consumers, doctors and employers. While these groups may have conflicting beliefs and expectations of performance assessment, the process must be made acceptable to all. This can happen through an exploration of the beliefs and wishes of the key stakeholders in relation to performance assessment, together with the potential rewards and costs. This paper draws on the psychology literature in describing an effective model for change management. It outlines some strategies for each of the three key elements of any successful strategy for change, i.e. getting started, facilitating the transition and ensuring consolidation. Such a practical approach will foster the acceptance of performance assessment structures among all stakeholders.

Clinical Competence↗
PubMed2000

Acceptable levels of digital image compression in chest radiology.

The introduction of picture archival and communications systems (PACS) and teleradiology has prompted an examination of techniques that optimize the storage capacity and speed of digital storage and distribution networks. The general acceptance of the move to replace conventional screen-film capture with computed radiography (CR) is an indication that clinicians within the radiology community are willing to accept images that have been 'compressed'. The question to be answered, therefore, is what level of compression is acceptable. The purpose of the present study is to provide an assessment of the ability of a group of imaging professionals to determine whether an image has been compressed. To undertake this study a single mobile chest image, selected for the presence of some subtle pathology in the form of a number of septal lines in both costphrenic angles, was compressed to levels of 10:1, 20:1 and 30:1. These images were randomly ordered and shown to the observers for interpretation. Analysis of the responses indicates that in general it was not possible to distinguish the original image from its compressed counterparts. Furthermore, a preference appeared to be shown for images that have undergone low levels of compression. This preference can most likely be attributed to the 'de-noising' effect of the compression algorithm at low levels.

Humans↗
PubMed2002

Spontaneous acceptance of liver transplants in rodents: evidence that liver leucocytes induce recipient T-cell death by neglect.

In many animal models transplanted livers are not rejected, even when there is a complete MHC mismatch between the donor and recipient and the recipient is not immunosuppressed. This distinguishes liver transplants from other organs, such as kidneys and hearts, which are rapidly rejected in mismatched individuals. Acceptance of transplanted livers in a rat model is not due to the absence of an immune response to the liver and there is a rapid, abortive response that is ultimately exhausted. Donor leucocytes transferred with the liver appear to be responsible for both liver acceptance and the abortive activation of the recipient's T cells. The immune mechanism of liver transplant acceptance appears to be due to 'death by neglect' in which T cells are activated to express IL-2 and IFN-gamma mRNA in the recipient lymphoid tissues, but not at adequate levels within the graft. Subsequently the activated T cells die leading to specific clonal deletion of liver donor-reactive T cells. These findings have important implications for liver transplant patients as immunosuppressive drugs that are given to prevent rejection can also interfere with this form of tolerance. In addition, it might be possible to modify the immunosuppressive drug treatment of transplant patients to promote the process of death by neglect of recipient alloreactive T cells.

Animals↗
PubMed2001

The effect of under and over refractive correction on visual performance and spectacle lens acceptance.

As a follow-on from a previous study by Miller, Kris and Griffiths (1997, Optom. Vis. Sci. 84, 521-526), we investigated the effect of small prescription errors on spatial visual performance and spectacle lens acceptability. We included both negative and positive errors and binocular and monocular errors. Data were collected on 15 young adult subjects. Clinical measures were taken of pupil size, ocular dominance, binocular visual acuity, negative and positive relative accommodation, distance and near heterophorias, and stereopsis. Visual performance was measured with the best correction and for +/-0.50 D spherical binocular and monocular errors. Subjects wore spectacles, each containing a different error in turn, for 2 days and compared them with a reference pair. Following the wearing period subjects assessed the performance of the spectacles by completing a short questionnaire. The only ocular tests for which these small prescription errors had significant effects were binocular visual acuity and negative relative accommodation. No significant relationship was observed between any of the clinical test results and overall lens acceptance. Despite this, the reference pair was generally perceived as better than the test pairs containing errors, and a considerable proportion of subjects reported pairs with errors as being unacceptable. In conclusion, the questionnaire findings support the need for both accurate monocular and binocular refractions. Subjects differed in their criteria for judging lens acceptability.

Accommodation, Ocular↗
PubMed1989

Establishment of a system to standardize acceptability criteria for alanine aminotransferase activity in donated blood.

A multilaboratory study was conducted to develop a system for standardizing alanine aminotransferase (ALT) acceptability criteria ("cutoffs") for donated blood. Without standardized cutoffs, each laboratory must develop its own cutoff, and this may not make optimal use of ALT testing to reduce transmission of non-A, non-B hepatitis (NANB). Defining an ALT acceptability criterion in absolute terms is necessary because relative cutoffs based on local donor populations may be affected by the prevalence of NANB in each community. This study involved 16 laboratories using 23 different analytic systems. The ALT results of the analysis of a plasma reference sample could be used to translate mathematically a single, absolute cutoff to units applicable to each analytic system. The distribution of ALT results in 1.4 million donations from across the country was established; basing the cutoff on this sample avoids the problems inherent in using a local donor base to establish a cutoff. We propose the implementation of a system to standardize ALT acceptability criteria to an activity level defined by analysis of a nationwide donor sample.

Alanine Transaminase↗
PubMed2003

The risks and benefits of accepting men who have had sex with men as blood donors.

BACKGROUND: It has been suggested that men who have had sex with men (MSM) should become eligible to donate blood if they recently abstained from male-to-male sex. STUDY DESIGN AND METHODS: The impact of a 12-month deferral policy for MSM on the risk of introducing contaminated units in the blood supply and the benefit of obtaining additional donations were estimated. Considered were the prevalence of HIV among MSM, the window period of infection, the rate of laboratory testing errors, and the occurrence of other system failures. This was compared with the risk and benefit that currently results from accepting female donors who have had sex with MSM. RESULTS: The revised policy for MSM would potentially result in one HIV-contaminated unit for every 136,000 additional donations (95% CI, 1 in 69,000 to 1 in 268,000), for an overall increase in HIV risk estimated at 8 percent. The number of donations would increase by 1.3 percent (95% CI, 0.9%-1.7%). The risk-benefit ratio of currently accepting female partners of MSM is approximately five times lower. CONCLUSION: The risk increment of accepting 12-month abstinent MSM would be very small but not zero. From a risk-benefit perspective, the current deferral policy for MSM is more efficient compared to an analogous hypothetical criterion for female partners of MSM.

Blood Donors↗
PubMed1998

Cellular basis of long-term organ transplant acceptance: pivotal role of intrathymic clonal deletion and thymic dependence of bone marrow microchimerism-associated tolerance.

Long-term acceptance of MHC-incompatible organ allografts without chronic immunosuppressive therapy has been achieved in experimental animals. There are also reports, mainly in liver transplant, of patients who after complete withdrawal of immunosuppressants still have a functioning graft. It has been proposed that organ transplant implies a migratory flux of donor "passenger" leukocytes out of the graft into the recipient tissues or organs, serving to establish a persistent condition of "microchimerism," and being a tolerogenic precursor of chimeric cells. Although there is evidence that the same migratory mechanisms apply to all organ grafts, migration of passenger leukocytes is less in organs other than the liver, such as the kidney and heart. To enhance the acceptance of organs less tolerogenic than the liver, perioperative infusion of donor bone marrow has been attempted to increase the migration of donor leukocytes of bone marrow origin. It has been suggested that such peripheral donor microchimerism is not only associated with long-term acceptance of the organ graft but that it plays an active role in induction and maintenance of unresponsiveness. However, the intimate mechanisms(s) responsible for prolonged organ survival in this setting remains speculative. Experimental evidence that the thymus plays the major role in the development of self-tolerance and is also critical in the induction of acquired tolerance to exogenous antigens has focussed the attention on the intrathymic events that lead to donor-specific unresponsiveness to allograft. Data are available showing that after direct intrathymic injection of donor cells, clonal deletion of maturing host thymocytes occurs and is the major mechanism in the induction of donor-specific tolerance. The central role of the thymus in transplant tolerance is also supported by more recent findings that in mixed allogeneic bone marrow chimeras in mice with a nonmyeloablative conditioning regimen, migration of donor bone marrow-derived dendritic cells to the thymus serves to negatively select newly developing host T cells. Therefore, the peripheral T-cell component would be devoid of alloreactive population. Thus, lifelong intrathymic clonal deletion is the only significant mechanism involved in the maintenance of donor-specific T-cell tolerance that would allow the subsequent vascularized organ from the same donor to survive indefinitely.

Animals↗