To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Robust development of behavior change interventions is based on a sound understanding of the target group, the target behaviors that need to change, the context in which change will occur, the hypothesized mechanisms of change, and the behavior change techniques. Intervention development frameworks advocate a systematic approach to behavior change intervention development. Key tasks include (1) identify and analyze the problem addressed in behavioral terms; (2) identify intervention mechanisms, content, and delivery mode(s) and design a logic model or program theory; (3) develop materials or prototypes (e.g., interface); and (4) test the intervention iteratively through empirical optimization. The tasks apply to both developing new interventions and optimizing existing interventions. The tasks may differ somewhat for digital behavior change interventions (e.g., iterative testing and refinement of early prototypes during development). Depending on time and resources, the tasks can be completed relatively quickly or take considerable time. The current chapter presents key challenges in intervention development and describes potential solutions. Fidelity, feasibility, and acceptability should be considered during all development tasks. The chapter also provides recommendations for advancing the methodology of intervention development and the use of intervention development frameworks and approaches in practice and policy settings.
Many people are unable or unwilling to participate in face-to-face interventions for functional behavior change, and existing services often have poor fidelity to evidence-based approaches. Pervasive ownership of digital devices may offer ways to supplement and increase the reach and impact of face-to-face care. Digital approaches to support behavioral change range from informational resources, through self-guided programs or apps, to digitally-delivered or guided human interventions. Online information is well accepted, and digital interventions are increasing in acceptability and use. Digital interventions also have strong research support. For example, coached web programs for some mental health conditions have equivalent effects to face-to-face treatment. However, many digital tools have no quality or efficacy data, and more agile ways to obtain data are needed. Threats to acceptance and use of digital interventions include concerns about data security, and difficulties deciding which resources and interventions to choose. What is promising is that sound assessment tools and initiatives to provide advice are emerging. Digital tools and resources have the potential to increase the reach, impact, and cost-effectiveness of existing behavior change initiatives, although they have yet to fully impact the way services are funded and delivered. That picture is likely to change rapidly in the coming decade.
Previous research has supported the importance of the interaction between family and school contexts for student adjustment to school. This study aimed to investigate the mediating role of school engagement and academic self-concept in relation to family adaptability/cohesion, social acceptability and school adjustment. A sample of 268 5th- and 6th-grade students aged 11–13 years (131 males, 137 females) from elementary schools in Iran participated in this study. Results showed that school adjustment was positively related to family adaptability/cohesion, social acceptability, school engagement, and academic self-concept. Family adaptability/cohesion and social acceptability also positively correlated with school engagement and academic self-concept. In addition, the data provided a good fit for the hypothesised model of the mediating role of school engagement and academic self-concept in relation to family adaptability/cohesion, social acceptability, and school adjustment. The results showed that coherent and adaptable family systems and high social acceptability of students can affect school adjustment both directly and indirectly through school engagement and academic self-concept.
To investigate the level of public acceptability of a sugar-sweetened beverage (SSB) tax and its associated factors.
Participants completed an online self-administered questionnaire. Acceptability of an SSB tax was measured on a seven-point Likert scale (strongly disagree to strongly agree). Associations between acceptability and sociodemographic factors, weight status, SSB consumption and beliefs about effectiveness (e.g., ‘An SSB tax would reduce people’s SSB consumption’), appropriateness, socioeconomic and economic benefit, implementation and trust were assessed using multivariable linear regression analyses.
Dutch adults aged ≥18 years representative of the Dutch population for age, sex, education level and location (n 500).
Of the participants, 40 % supported and 43 % opposed an SSB tax in general. Moreover, 42 % supported (43 % opposed) an SSB tax as a strategy to reduce overweight, and 55 % supported (32 % opposed) an SSB tax if revenue is used for health initiatives. Participants with a low education level (B = –0·82, 95 % CI –1·31, –0·32), overweight (B = –0·49, 95 % CI –0·89, –0·09), moderate or high SSB consumption (B = –0·86, 95 % CI –1·30, –0·43 and B = –1·01, 95 % CI –1·47, –0·56, respectively) and households with adolescents (B = –0·57, 95 % CI –1·09, –0·05) reported a lower acceptability of an SSB tax than their counterparts. Beliefs about effectiveness, appropriateness, socioeconomic and economic benefit, implementation and trust were associated with acceptability (P < 0·001).
Public acceptability of an SSB tax tends to be higher if revenue is used for health initiatives. The factors associated with acceptability should be taken into consideration.
Because personality disorders are seen as highly complex there is a natural tendency to describe them in convoluted and multifaceted language. Novelists and playwrights have done this for hundreds of years; it is not the task of nosologists to repeat it. Instead we need a simpler classification of a very common disorder, as even if we lose some of the subtlety of the condition this is more than compensated by greater use and understanding. We also need to pay more attention to science rather than to clinical intuition in our terminology. Both the DSM-5 alternative model and the new ICD-11 classification have moved towards a dimensional system of classification that should help in selecting treatment and diluting the pervasive and unhelpful spread of the grossly heterogeneous condition, horderline. This has hindered progress and made us forget the many parts of personality disorder that are not in any way connected to the borderline spectrum and yet which are highly relevant pathologies.
To assess the feasibility, patient and clinician acceptability and test-retest reliability of the Mini-International Neuropsychiatric Interview (MINI) used by non-psychiatrists in an acute psychiatric ward.
Of 268 consecutive patients included in a cross-sectional study, 176 (66%) completed MINI, and were compared to patients not interviewed. Patients and clinicians were questioned about the interview, using Visual Analogue Scales (VAS). For 38 patients, test-retest reliability was assessed with Cohen's kappa and observed agreement.
MINI was not feasible for all patients. Among factors associated with not being interviewed were early discharge, psychosis, substance use and involuntary admissions. Although evaluations by patients and clinicians completing the postinterview questionnaire varied, MINI was generally perceived as being useful and feasible. Psychotic symptoms were associated with a less positive experience with MINI for both patients and clinicians. In the test-retest analyses, kappa values indicated excellent agreement for six diagnoses, fair to good for six and poor for seven, whereas observed agreement was 75% or above for all disorders.
Among patients admitted to an acute psychiatric ward willing and able to complete the interview, MINI was well accepted by patients and clinicians, and has moderately good test-retest reliability.
The acceptability and efficacy of tianeptine were evaluated in three open trials in a total of 549 elderly patients, 426 of whom were treated for 3 months and 188 for 1 year. The therapeutic effect was that expected from an effective antidepressant, with a marked response after treatment for one month. In the geriatric trial, where patients were primarily dysthymic, continuation of treatment after 6 months consolidated the improvement already observed. Tianeptine also had a favorable long-term effect in chronic refractory depression. Drop-outs due to side-effects were few (4.4%), despite the high risk population. All pre-treatment complaints improved on tianeptine. The high frequency of somatic complaints expressed before treatment confirmed the extent to which depression is somatised in the elderly. Concomitant physical disease present in 87% of patients did not restrict the use of tianeptine. The fact that tianeptine has a low incidence of anticholinergic effects and no affinity for either H1 or α1 receptors makes it a particularly easy drug to use in elderly subjects who are sensitive to the side-effects of psychotropic agents.
We argue that the interpretation of transitive aspectual-verb sentences like “Sue finishes the book” results from an evaluation of the degree of asymmetry in control power between the participants in the sentence. Control asymmetry is proposed as one conceptual constraint on sentence meaning precisification. An evaluation of ‘high control asymmetry’ for the relation between “Sue” and “book” yields an agentive/actor-undergoer interpretation (Sue is doing something involving the book). An evaluation of ‘low control asymmetry’ yields a constitutive/part–whole interpretation (Sue’s story is the last one in the book). Which reading emerges depends on the comprehender’s control-asymmetry evaluation based on contextual cues or, in the absence of explicit context, based on conventionalized control asymmetry expectations given the participants’ denotations. Results show that semantically under-specified aspectual-verb sentences such as “Sue finishes/begins/continues the book” (i) receive multiple readings in a control-asymmetry neutral context, (ii) are judged as less acceptable than their control asymmetry-biased counterparts, and (iii) clearly evidence the constitutive reading as part of their core reading. These findings are consistent with a real-time linguistic meaning composition system that systematically draws from context guided by lexically driven semantic demands and that presents the structure of these demands as a cognitively viable metric of complexity.
Reassurance seeking (RS) in obsessive compulsive disorder (OCD) is commonly addressed in cognitive behavioural therapy (CBT) using a technique called reducing accommodation. Reducing accommodation is a behaviourally based CBT intervention that may be effective; however, there is a lack of controlled research on its use and acceptability to clients/patients, and case studies suggest that it can be associated with negative emotional/behavioural consequences. Providing support to encourage coping with distress is a cognitively based CBT intervention that may be an effective alternative, but lacks evidence regarding its acceptability.
This study aimed to determine whether support provision may be a more acceptable/endorsed CBT intervention for RS than a strict reducing accommodation approach.
Participants and familiar partners (N = 179) read vignette descriptions of accommodation reduction and support interventions, and responded to measures of perceived intervention acceptability/adhereability and endorsement, before completing a forced-choice preference task.
Overall, findings suggested that participants and partners gave significantly higher ratings for the support than the accommodation reduction intervention (partial η2 = .049 to .321). Participants and partners also both selected the support intervention more often than the traditional reducing accommodation intervention when given the choice.
Support provision is perceived as an acceptable CBT intervention for RS by participants and their familiar partners. These results have implications for cognitive behavioural theory and practice related to RS.
During the 2014–2016 Ebola epidemic in West Africa, some communities reacted hostilely to the implementation of quarantine measures. This study's aim was to examine the views of lay people in Guinea on the acceptability of community quarantine. From June to August 2016, 302 adults indicated the acceptability of quarantine in 36 scenarios varying as a function of four factors: the infectious disease's level of contagiousness, its level of lethality, the number of cases in the community and whether persons in quarantine are provided with support services. Five clusters were identified: (1) for 18% of the participants, quarantine is never acceptable; (2) 16% considered, in contrast, that quarantine is always acceptable; (3) for 14%, it depends on the disease's level of contagiousness and lethality; (4) 36% based their judgement not only on the levels of contagiousness and lethality, but also on whether those in quarantine are provided with support services; and (5) 16% had no opinion. Interventions to increase voluntary compliance with community quarantine in Guinea must not be ‘one size fits all’, but must be multifaceted and tailored in design and implementation to match the diversity of people's concerns and needs.
Respite services have traditionally been viewed as services for carers mainly. Perhaps as a result, the perspectives of people with dementia have been largely ignored. In this study, we consider these perspectives in relation to day and respite services, and contextualise them in light of Kitwood's prediction that person-centred care would be adopted only superficially by such services. Convenience sampling was employed and semi-structured interviews were conducted with six community-dwelling people with dementia. A thematic analysis was conducted and four themes were identified: ‘acceptability of service characteristics’, ‘meaningful engagement’, ‘personhood’ and ‘narrative citizenship’. The findings suggest that day services were more acceptable than residential respite, though some people would prefer home-based models, if available. ‘Meaningful’ engagement must be individually defined; however purposeful and reciprocal activity was commonly invoked as meaningful. ‘Personhood’ and ‘narrative citizenship’ were quintessential markers of quality care; while some people experienced personhood being bestowed upon them, others reported distinct instances of malignant social psychology, discrimination and stigma. In conclusion, an implementation gap may still persist regarding person-centred care in some respite services, based on the perspectives of people with dementia. Delivering the vision for care outlined here would require greater flexibility in service provision, more resources and more one-on-one staff–client time. The fundamental shift in thinking required by some staff relies on us supporting them to develop a greater self- and shared cultural-awareness around dementia.
Introduction: It is recommended that seniors consulting to the Emergency Department (ED) undergo a comprehensive geriatric screening, which is difficult for most EDs. Patient self-assessment using electronic tablet could be an interesting solution to this issue. However, the acceptability of self-assessment by older ED patients remains unknown. Assessing acceptability is a fundamental step in evaluating new interventions. The main objective of this project is to compare the acceptability of older patient self-assessment in the ED to that of a standard assessment made by a professional, according to seniors and their caregivers. Methods: Design: This randomized crossover design cohort study took place between May and July 2018. Participants: 1) Patients aged ≥65 years consulting to the ED, 2) their caregiver, when present. Measurements: Patients performed self-assessment of their frailty, cognitive and functional status using an electronic tablet. Acceptability was measured using the Treatment Acceptability and Preferences (TAP) questionnaires. Analyses: Descriptive analyses were performed for sociodemographic variables. Scores were adjusted for confounding variables using multivariate linear regression. Thematic content analysis was performed by two independent analysts for qualitative data collected in the TAP's open-ended question. Results: A total of 67 patients were included in this study. Mean age was 75.5 ± 8.0 and 55.2% of participants were women. Adjusted mean TAP scores for RA evaluation and patient self-assessment were 2.36 and 2.20, respectively. We found no difference between the two types of evaluations (p = 0.0831). When patients are stratified by age groups, patients aged 85 and over (n = 11) showed a difference between the TAPs scores, 2.27 for RA evaluation and 1.72 for patient self-assessment (p = 0.0053). Our qualitative data shows that this might be attributed to the use of technology, rather than to the self-assessment itself. Data from 9 caregivers showed a 2.42 mean TAP score for RA evaluation and 2.44 for self-assessment. However, this relatively small sample size prevented us to perform statistical tests. Conclusion: Our results show that older patients find self-assessment in the ED using an electronic tablet just as acceptable as a standard evaluation by a professional.
This article examines the performance of heritage speakers (HSs) on two types of acceptability judgment tasks (AJTs) as well as their corresponding confidence ratings. Data were collected from 75 native speakers of Spanish who were subsequently divided into three groups: Spanish monolinguals, Spanish-dominant HSs, and English-dominant HSs. An AJT targeting morphosyntax (Task 1) showed that all groups were affected by task stimulus, that is, they were significantly less accurate on the ungrammatical items. A lexically focused AJT (Task 2) revealed the tendency of HSs to accept complex words that are possible yet not attested. Confidence ratings on both tasks were very high overall, and there was a significant relationship between accuracy and confidence. Thus, the data question the assumption made in a number of previous studies that HSs suffer from a lack of certainty in their linguistic intuitions. Finally, between-group effects show that the Spanish-dominant HS group was not different from the monolingual group on Task 1, yet there were significant differences between all three groups on Task 2. By comparing morphosyntactic and lexical phenomena on two tasks administered in the same modality, this research contributes to the discussion of vulnerable domains in heritage language bilingualism.
Test anxiety is experienced by 10–40% of students. The physical symptoms associated with test anxiety may be more likely to be exhibited by elementary students. Progressive muscle relaxation (PMR) has been demonstrated to reduce physical symptoms of anxiety and could be used in the classroom, but teacher acceptability of PMR for test anxiety has not been assessed. This study used a vignette format to survey 404 first through fifth grade teachers on their acceptability of classroom-based PMR as an intervention for test anxiety. Good levels of acceptability were found for implementation with a school psychologist or counsellor, CD player, or digital music player. Special education teachers reported slightly lower levels of acceptability for using PMR in the digital music player scenario. With good levels of teacher acceptability of PMR to address test anxiety, school psychologists and counsellors may be more likely to recommend the use of PMR in classrooms. Implications for implementation of PMR to reduce test anxiety, study limitations, and suggestions for future research are discussed.
Smoking is the largest single contributor to poor physical health and increased mortality in people with serious mental illnesses. The aim of the study was to investigate the utility of electronic cigarettes (e-cigarettes) as a harm reduction intervention in this population.
Fifty tobacco smokers with a psychotic disorder were enrolled onto a 24-week pilot study (ClinicalTrials.gov: NCT02212041) investigating the efficacy of a 6-week free e-cigarette intervention to reduce smoking. Cigarette and e-cigarette use was self-reported at weekly visits, and verified using carbon monoxide tests. Psychopathology, e-cigarette acceptability and adverse effects were assessed using standardised scales.
There was a significant (⩾50%) reduction in cigarettes consumed per day between baseline and week 6 [F(2.596,116.800) = 25.878, p < 0.001], and e-cigarette use was stable during this period [F(2.932,46.504) = 2.023, p = 0.115]. These changes were verified by significant carbon monoxide reductions between these time points [F(3.335,126.633) = 5.063, p = 0.002].
The provision of e-cigarettes is a potentially useful harm reduction intervention in smokers with a psychotic disorder.
English outweighs other languages as a source for linguistic borrowing in present-day Norwegian. Most of the research on this topic has considered direct lexical loans, yet observations indicate that English is increasingly burrowing its way below the lexical surface of Norwegian – evident in the rising number of calques. This study investigates how a selection of recently observed multiword calques from English are evaluated by native Norwegian speakers. This is examined through acceptability judgements among young bilingual Norwegians (n = 83, mean age 18), and among two control groups comprising 10 bilingual adults (mean age 55) and 16 minimally bilingual seniors (mean age 75), respectively. A translation test was included to compare the judgements against production data. Based on our overall findings, we suggest that increased calquing is a sign of heightened proficiency in and exposure to the English language.
To assess the compatibility between reduction of diet-related greenhouse gas emissions (GHGE) and nutritional adequacy, acceptability and affordability dimensions of diet sustainability.
Dietary intake, nutritional composition, GHGE and prices were combined for 402 foods selected among those most consumed by participants of the Individual National Study on Food Consumption. Linear programming was used to model diets with stepwise GHGE reductions, minimized departure from observed diet and three scenarios of nutritional constraints: none (FREE), on macronutrients (MACRO) and for all nutrient recommendations (ADEQ). Nutritional quality was assessed using the mean adequacy ratio (MAR) and solid energy density (SED).
Adults (n 1899).
In FREE and MACRO scenarios, imposing up to 30 % GHGE reduction did not affect the MAR, SED and food group pattern of the observed diet, but required substitutions within food groups; higher GHGE reductions decreased diet cost, but also nutritional quality, even with constraints on macronutrients. Imposing all nutritional recommendations (ADEQ) increased the fruits and vegetables quantity, reduced SED and slightly increased diet cost without additional modifications induced by the GHGE constraint up to 30 % reduction; higher GHGE reductions decreased diet cost but required non-trivial dietary shifts from the observed diet. Not all the nutritional recommendations could be met for GHGE reductions ≥70 %.
Moderate GHGE reductions (≤30 %) were compatible with nutritional adequacy and affordability without adding major food group shifts to those induced by nutritional recommendations. Higher GHGE reductions either impaired nutritional quality, even when macronutrient recommendations were imposed, or required non-trivial dietary shifts compromising acceptability to reach nutritional adequacy.
To assess the acceptability and adherence to daily doses of lipid-based nutrient supplement (LNS) among children and micronutrient powder (MNP) among children and pregnant and lactating women.
Household interviews and sachet counting were conducted to measure acceptability and adherence, 15 and 30 d after product distribution. Qualitative information on product acceptability was collected using focus group discussions.
LNS was distributed to 123 children aged 6–35 months (LNS-C), and MNP to 112 children aged 36–59 months (MNP-C) and 119 pregnant or lactating women (MNP-W).
At the end of the test 98·4 % of LNS-C, 90·4 % of MNP-C and 75·5 % of MNP-W participants reported that they liked the product (P<0·05). Other measures of acceptability did not differ. Median consumption of sachets was highest in the LNS-C group (P<0·001). ‘Good’ adherence to the daily regimen (consumption of 75–125 % of recommended dose) was 89·1 % in the LNS-C, compared with 57·0 % in the MNP-C and 65·8 % in the MNP-W groups (P<0·001). Qualitative findings supported the quantitative measures and guided selection of local product names, packaging designs, distribution mechanisms, and the design of the information campaign in the subsequent programme scale-up.
Acceptability, consumption and adherence were higher in participants receiving LNS compared with MNP. However, both products were found to be suitable when compared with predefined acceptability criteria. Acceptability studies are feasible and important in emergency nutrition programmes when the use of novel special nutritional products is considered.
We assessed the host stage preference and performance of the aphid parasitoid Diaeretiella rapae (McIntosh) on two aphid species, Brevicoryne brassicae (L.) and Lipaphis pseudobrassicae (Davis). Although the parasitoid parasitized all nymphal instars of both aphid species, it showed a higher oviposition preference for 2nd (48.2 ± 7.74%) and 3rd (41.0 ± 7.82%) instars of L. pseudobrassicae, and for the 3rd (40.0 ± 4.59%) instar of B. brassicae. Across the host species, there was no significant difference in parasitoid preference between the 3rd and 4th instars, while 1st and 2nd instars of L. pseudobrassicae were significantly more preferred than their counterparts (B. brassicae). Days to mummification among different instars of the same host was not significantly different when the parasitoid was reared on B. brassicae, whereas this was highest on the 2nd, 3rd and 4th instars of L. pseudobrassicae. Number of mummies was also significantly different among the nymphal instars of both host species and between the two host species for the 1st and 2nd instars. In terms of body size, female D. rapae reared on L. pseudobrassicae were significantly larger than those reared on B. brassicae. We discuss the findings in the context of laboratory mass rearing of D. rapae and its potential as a biological control agent for both aphid pest species.
To explore the experiences of people with HIV (PWHIV) using general practitioner (GP) services in order to identify barriers to use.
Traditionally, GPs have little involvement in the care of PWHIV. However, as HIV becomes a chronic condition and the population of PWHIV ages, there is a need to increase this involvement. Despite high levels of GP registration, the majority of PWHIV in London report that their GP is not involved in their HIV care.
This paper presents qualitative findings from a mixed method study of PWHIV’s experiences of clinical services. Survey respondents were purposively sampled to recruit 51 PWHIV who took part in eight focus groups. Participants were asked about their experience of using GP services.
Three factors emerged which mediated experiences of GP care. Competence: respondents were concerned about the potential for misdiagnosis of symptoms, lack of awareness of the health needs of PWHIV and experiences of prescribing, which could lead to drug interactions. Continuity: not being able to get appointments quickly enough, not being able to see the same doctor twice and not being able to keep the same GP when one changed address were experienced as impediments to use. Communication: lack of communication between GPs and HIV specialists led to what participants called ‘patient ping-pong’ where they found themselves acting as a go-between for different clinical specialists trying to make sense of their care.
Meaningful contact between HIV specialists and GPs is likely to allay concerns about competency as treatment and care decisions can be taken collaboratively between the GP, HIV specialist and patient. A key component of acceptable GP care for PWHIV is likely to be the application of long-term condition management approaches, which includes empowered patient self-management.