Self-administered Research Articles

FEASIBILITY OF AN AUTOMATED SELF-ADMINISTERED 24 HOUR (ASA-24) DIETARY ASSESSMENT TOOL IN OLDER ADULTS

Abstract Background Certain dietary patterns impact trajectories of healthy aging. However, dietary assessment tools can be challenging to use. With the increased technology use in older adults, we aimed to explore the feasibility of completing an online, Automated Self-Administered 24-hour (ASA-24) dietary assessment tool. Methods We conducted a randomized, crossover study of n=20 community-dwelling older adults’ (>65 years) preference for self-administered (SA) versus research assistant-administered (RAA) ASA-24. Participants were recruited via ResearchMatch.com and randomly allocated 1:1 to each group and completed either an SA or RAA ASA-24. One week later, the alternative sequence was completed. After each session, participants completed an online 11-item feasibility survey (Likert-scale;1-5, strongly disagree to strongly agree). Mean and standard deviations were reported for each question. Results Mean age was 69±3.5 years (90% females), and no differences were observed for sex, age, race, ethnicity, education, or income. Neither group felt a need for RA assistance (p=0.34). However, both groups felt the system was easier to follow with a research assistant (RAA 4.4±1.3 vs. SA 4.6±0.5, p=0.65), particularly when self-administered first (p=0.04). When conducting an SA ASA-24 first, there was less confidence the system could be learned quickly (SA 4.5±0.5 vs RAA 3.4 ±1.0, p=0.001). Conclusion Older adults can complete dietary recall using a self-administered online assessment; however, use of a research assistant led to better accessibility. Order of administration method may impact perceived ease of use. Next steps include increasing sample diversity and using an RAA ASA-24 platform to identify dietary patterns that impact aging.

S3346 TNF-alpha Inhibitor Adherence Review: Healthcare Practitioner Administration Compared to Self-Administration

Introduction: Adherence is the extent to which a person’s behavior coincides with health related advice. Poor medication adherence leads to poorer clinical outcomes. TNF-alpha inhibitors (TNF inhibitors) have a significant relationship between clinical outcome and rate of medication adherence. TNF inhibitors are either self-administered (SA) or administered by a healthcare practitioner (HC P-administered), such as a Registered Nurse (RN). To better understand medication adherence in SA and HCP-administered TNF inhibitor populations, an analysis was conducted to measure medication adherence to the HCP-administered product, infliximab, through an alternate site infusion pharmacy. These results were then compared to SA medication adherence rates according to previously published analyses. The comparative results show that administration of infliximab by an RN results in higher medication adherence rates than those reported for SA TNF inhibitor patients. Methods: The analysis was conducted using data extracted from a CPR+ dispensing system, targeting infliximab dispenses with a start of service date (SVC START DT) between 1/1/20 and 8/31/20. Unique patients with at least two SVC START DT values were included. The eligibility of each patient was considered to end as of their final SVC START DT. Adherence was calculated using the industry-standard metric “Proportion of Days Covered” (PDC) methodology. Medication coverage of each treatment was calculated as: Medication Coverage = SVC START DT + Days Supply -1 Adherence was reported as a percentage of analyzed patients with a PDC value of 80% and as the average PDC value of the analyzed population. Results: A 92% average PDC was observed in the overall infliximab RN administered population, with 89% of patients at or above the 80% PDC threshold required to be considered “adherent”. No statistically significant difference in average PDC across age band, sex, or disease state was observed. Conclusion: In this study, patients receiving infliximab administered by an RN (HCP-administered) have a very high adherence rate, as measured by PDC. As it has been reported that patients utilizing SA TNF inhibitors have an average adherence rate of only 37%, these data represent a substantial improvement over SA treatment as it relates to adherence. Additional patient factors not related to the method of administration that could affect adherence including treatment outcomes were not evaluated.Table 1.: Overall Patient Adherence.

Emergence of negative affect as motivation for drug taking in rats chronically self-administering cocaine.

The role of negative affect as a motivational factor in animal models of drug addiction has been underexplored in the context of cocaine self-administration. The present investigation studied the relationship between magnitude of affective response and quantity of cocaine consumed in order to clarify the affective components that drive drug use in a preclinical model. Rats self-administered (SA) cocaine 6h/day for 14 consecutive days while their ultrasonic vocalizations (USVs) were recorded. Animals displayed an increase in 50-kHz call rates (indicating positive affect) when their drug levels were rapidly rising and an increase in 22-kHz call rates (indicating negative affect) when forced to abstain. The rate of 50-kHz calls predicted drug consumption during the 1st week of SA, but not week two. Contrarily, there was a strongly predictive positive association between rate of 22-kHz calls and amount of drug consumed during the 2nd week of SA. Experimental results indicate that after chronic cocaine self-administration, negative affect emerges when animals are deprived of expected drug during withdrawal. Moreover, the increase in USVs indicating negative affect when deprived of drug was directly related to drug intake, concurrent with a decay in the direct relationship between USVs indicating positive affect and drug intake. The present preclinical support for the widely hypothesized shift from positive to negative affect as a salient motivational factor in human drug abuse adds to growing evidence of the unique value of rat USVs for understanding the role of emotion in drug addiction.

Cost-effectiveness of outpatient parenteral antibiotic therapy: a simulation modelling approach.

In the UK, patients who require intravenous antimicrobial (IVA) treatment may receive this in the community through outpatient parenteral antimicrobial therapy (OPAT) services. Services include: IVA administration at a hospital outpatient clinic (HO); IVA administration at home by a general nurse (GN) or a specialist nurse (SN); or patient self-administered (SA) IVA administration following training. There is uncertainty regarding which OPAT services represent value for money; this study aimed to estimate their cost-effectiveness. A cost-effectiveness decision-analytic model was developed using a simulation technique utilizing data from hospital records and a systematic review of the literature. The model estimates cost per QALY gained from the National Health Service (NHS) perspective for short- and long-term treatment of infections and service combinations across these. In short-term treatments, HO was estimated as the most effective (0.7239 QALYs), but at the highest cost (£973). SN was the least costly (£710), producing 0.7228 QALYs. The combination between SN and HO was estimated to produce 0.7235 QALYs at a cost of £841. For long-term treatments, SN was the most effective (0.677 QALYs), costing £2379, while SA was the least costly at £1883, producing 0.666 QALYs. A combination of SA and SN was estimated to produce 0.672 QALYs at a cost of £2128. SN and SA are cost-effective for short- and long-term treatment of infections, while combining services may represent the second-best alternative for OPAT in the UK.

Validation of an Arabic Questionnaire for Symptom Assessment.

Impeccable assessment of symptoms is central to palliative care (PC) practice. The study objectives are (1) to test the validity of the Arabic Questionnaire for Symptom Assessment (AQSA) as a self-administered (SA) tool for assessing the severity of the listed symptoms among PC patients and (2) to test the validity of AQSA when completed by a proxy. The AQSA is a tool for assessing the severity of 11 symptoms in addition to the overall suffering experience on a 0 to 10 numeric scale. Symptom scores on the SA AQSA were compared to scores obtained through interviews with patients. The same procedure was repeated with patients' sitters to explore the validity of using the tool for symptom assessment by proxy. The study involved 107 pairs (a patient and a sitter, each) with a mean age of 46.3 years (females 59.8%) for patients and 35.9 years (females 65.7%) for sitters. The correlation coefficient ( r) for agreement between SA and interview-based (IB) scores for patients ranged from .65 ( P < .0001) for drowsiness to .86 ( P < .0001) for pain. The SA AQSA showed positive correlation between sitters' and patients' scores, with r ranging from .28 ( P = .004) for depression to .62 ( P ≤ .0001) for vomiting. The strong positive correlation between SA and IB AQSA indicates that the former is a valid tool. When the SA AQSA is used by proxy, it showed moderate to strong positive correlation with patients' actual scores for most of the symptoms.

Gender effects on zolpidem efficacy and safety

Gender effects on zolpidem efficacy and safety

Early mortality after entering a methadone treatment program in Badalona, Spain

Early mortality after entering a methadone treatment program in Badalona, Spain

Self-administration of intranasal influenza vaccine: Immunogenicity and volunteer acceptance

BackgroundIn outbreak settings, mass vaccination strategies could maximize health protection of military personnel. Self-administration of live attenuated influenza vaccine (LAIV) may be a means to vaccinate large numbers of people and achieve deployment readiness while sparing the use of human resources. MethodsA phase IV, open-label, randomized controlled trial evaluating the immunogenicity and acceptance of self-administered (SA) LAIV was conducted from 2012 to 2014. SA subjects were randomized to either individual self-administration or self-administration in a group setting. Control randomized subjects received healthcare worker-administered (HCWA) LAIV. Anti-hemagglutinin (HAI) antibody concentrations were measured pre- and post-vaccination. The primary endpoint was immunogenicity non-inferiority between SA and HCWA groups. Subjects were surveyed on preferred administration method. ResultsA total of 1077 subjects consented and were randomized (529 SA, 548 HCWA). Subject characteristics were very similar between groups, though SA subjects were younger, more likely to be white and on active duty. The per-protocol analysis included 1024 subjects (501 SA, 523 HCWA). Post-vaccination geometric mean titers by vaccine strain and by study group (HCWA vs. SA) were: A/H1N1 (45.8 vs. 48.7, respectively; p=0.43), A/H3N2 (45.5 vs. 46.4; p=0.80), B/Yamagata (17.2 vs. 17.8; p=0.55). Seroresponses to A components were high (∼67%), while seroresponses to B components were lower (∼25%). Seroresponse did not differ by administration method. Baseline preference for administration method was similar between groups, with the majority in each group expressing no preference. At follow-up, the majority (64%) of SA subjects preferred SA vaccine. ConclusionsLAIV immunogenicity was similar for HCWA and SA vaccines. SA was well-tolerated and preferred to HCWA among those who performed SA.

Endocannabinoid 2-Arachidonoylglycerol Self-Administration by Sprague-Dawley Rats and Stimulation of in vivo Dopamine Transmission in the Nucleus Accumbens Shell.

2-Arachidonoylglycerol (2-AG) is the most potent endogenous ligand of brain cannabinoid CB1 receptors and is synthesized on demand from 2-arachidonate-containing phosphoinositides by the action of diacylglycerol lipase in response to increased intracellular calcium. Several studies indicate that the endocannabinoid (eCB) system is involved in the mechanism of reward and that diverse drugs of abuse increase brain eCB levels. In addition, eCB are self-administered (SA) by squirrel monkeys, and anandamide increases nucleus accumbens (NAc) shell dopamine (DA) in rats. To date, there is no evidence on the reinforcing effects of 2-AG and its effects on DA transmission in rodents. In order to fill this gap, we studied intravenous 2-AG SA and monitored the effect of 2-AG on extracellular DA in the NAc shell and core via microdialysis in male Sprague-Dawley rats. Rats were implanted with jugular catheters and trained to self-administer 2-AG [25 mg/kg/inf intravenously (iv)] in single daily 1 h sessions for 5 weeks under initial fixed ratio (FR) 1 schedule. The ratio was subsequently increased to FR2. Active nose poking increased from the 6th SA session (acquisition phase) but no significant increase of nose pokes was observed after FR2. When 2-AG was substituted for vehicle (25th SA session, extinction phase), rate responding as well as number of injections slowly decreased. When vehicle was replaced with 2-AG, SA behavior immediately recovered (reacquisition phase). The reinforcing effects of 2-AG in SA behavior were fully blocked by the CB1 receptor inverse agonist/antagonist rimonabant (1 mg/kg intraperitoneally, 30 min before SA session). In the microdialysis studies, we observed that 2-AG (0.1–1.0 mg/kg iv) preferentially stimulates NAc shell as compared to the NAc core. NAc shell DA increased by about 25% over basal value at the highest doses tested (0.5 and 1.0 mg/kg iv). The results obtained suggest that the eCB system, via 2-AG, plays an important role in reward.

Do non-users value coral reefs?: Economic valuation of conserving Tubbataha Reefs, Philippines

The main purpose of the study is to determine whether non-use values exist among residents of Quezon City, hundreds of kilometers away from Tubbataha Reefs. The dichotomous choice contingent valuation method (CVM) was employed across 800 randomly selected respondents, 400 of which were personally interviewed (PI) and 400 were asked to accomplish self-administered (SA) questionnaires, 198 of the latter were found useable for the study. Results showed that 46% of all respondents were willing to pay for conservation of the reefs, with bequest motive or concern for future generations as their main reason. The mean WTP ranged from 437 pesos for PI respondents to 233 pesos for SA respondents. These substantial non-use values justify the need for regular government appropriation for conserving Tubbataha Reefs.

Lack of patient-clinician concordance (LOC) across disease and treatment status in cancer.

e20520 Background: The number and severity of cancer patients’ concerns is associated with their distress. Discrepancies between patient (pt) and clinician reporting of cancer pts’ symptoms and concerns have been reported during treatment. However, information on LOC across the disease and treatment status is lacking. This study explored LOC between pts and clinicians about pts’ bother related to disease and treatment status in those who needed assistance with questionnaires (NA) or self-administered (SA). Methods: Cancer pts and their clinicians in the Symptom Outcomes and Practice Patterns study rated pts’ bother (scale:0=Not at all, 4=Extremely) due to difficulties related to cancer, its treatment, side effects (SE), and comorbidity (COMORB), recoded to LOC ( 0=no difference between pts and clinicians, 1=any difference). Comparison of LOC proportions was conducted based on the disease status (4 groups: no evidence of disease [NED], local/regional [LR], metastases [mets], and mets+ LR) and current treatment (yes/no) using Chi square test. Results: The majority of pts (N=3013) were Caucasian (86%) females (70%) and had ECOG PS= 0 (87%). Mean age was 61.2 years (SD=12.4). 86.7% did not need help with the questionnaires/SA. Eight subgroups defined by disease status and current treatment showed statistically significant differences in LOC proportions re: bother due to treatment, SE, and COMORB in both the SA (range: 52.8%-86.7%, 41.6%-80.0%, 52.3%-81.3%, respectively, p&lt;.001) and NA groups (range: 40.7%-82.4%, 29.6%-70.6%, 48.1%-72.8%, respectively, p&lt;.05). Differences in the proportions of pts with LOC re: bother due to cancer were statistically significant for SA group only (range: 55.6%-81.3%, p=.01). In both SA and NA groups, pts with mets or mets+ LR had higher proportion of LOC re: bother due to treatment, SE, and COMORB than pts with NED or LR (p&lt;.05). Conclusions: This study provides evidence of LOC in patient-clinician reporting of cancer pts’ bother re: disease and treatment status. Greater proportion of pts with advanced disease showed LOC. Further study of LOC in reporting bother related to various aspects of cancer experience is needed to confirm these results and to understand how they relate to outcomes of care. Clinical trial information: NCT00303914.

Psychometric assessment of a self-administered version of the Significant Other Survey.

While there are a number of general measures that assess interpersonal and psychological distress experienced by individuals who are in a close relationship with a substance abusing adult, until recently the field has lacked a psychometrically sound, self-administered multidimensional measure explicitly designed to measure the problems of non-substance-abusing adults who are concerned about a substance using loved one. This study examined the psychometric properties of a 54-item, self-administered (SA) version of the Significant Other Survey (SOS), a measure designed to address this gap. The SOS-SA assesses problems across seven problem domains (emotional, relationship, family, financial, physical violence, legal, health). Coefficient alpha estimates (N = 168) were good to excellent for five of the domains, the test-retest reliability (N = 83) across a 7-day time frame was fair to excellent for all seven domains. Similar reliability coefficients were identified regardless of whether the item queried about the problem frequency or perceived severity. There was preliminary support for the construct and discriminant validity of the SOS-SA. The SOS-SA appears to be a promising instrument given that it is brief, requires no specialized training to administer, and has good psychometric properties.

Cocaine potentiates excitatory drive in the perifornical/lateral hypothalamus

The hypothalamus is a critical controller of homeostatic responses and plays a fundamental role in reward-seeking behaviour. Recently, hypothalamic neurones in the perifornical/lateral hypothalamic area (PF/LHA) have also been implicated in drug-seeking behaviour through projections to extra-hypothalamic sites such as the ventral tegmental area. For example, a population of neurones that expresses the peptide orexin has been strongly implicated in addiction-relevant behaviours. To date, the effect of addictive drugs on synaptic properties in the hypothalamus remains largely unexplored. Previous studies focusing on the PF/LHA neurones, however, have shown that the orexin system exhibits significant plasticity in response to food or sleep restriction. This neuroadaptive ability suggests that PF/LHA neurones could be highly susceptible to modifications by drug exposure. Here, we sought to determine whether cocaine produces synaptic plasticity in PF/LHA neurones. Whole-cell patch-clamp techniques were used to examine the effects of experimenter-administered (passive) or self-administered (SA) cocaine on glutamatergic synaptic transmission in PF/LHA neurones. These experiments demonstrate that both passive and SA cocaine exposure increases miniature excitatory postsynaptic current (mEPSC) frequency in PF/LHA neurones. In addition, SA cocaine reduced the paired-pulse ratio but the AMPA/NMDA ratio of evoked excitatory inputs was unchanged, indicative of a presynaptic locus for synaptic plasticity. Dual-labelling for orexin and excitatory inputs using the vesicular glutamate transporter (VGLUT2), showed that passive cocaine exposure increased VGLUT2-positive appositions onto orexin neurones. Further, a population of recorded neurones that were filled with neurobiotin and immunolabelled for orexin confirmed that increased excitatory drive occurs in this PF/LHA population. Given the importance of the PF/LHA and the orexin system in modulating drug addiction, we suggest that these cocaine-induced excitatory synapse-remodelling events within the hypothalamus may contribute to persistence in drug-seeking behaviour and relapse.

The effects of social hierarchy on cocaine reinforcement and brain interactions in male and female monkeys

Male and female cynomolgus monkeys living in same‐sex social groups form linear hierarchies based on outcomes of fights. Earlier work from our laboratory found that males who became dominant (DOM) had significant increases in dopamine (DA) D2 receptor availability, as measured with PET imaging. There appeared to be behavioral consequences to the increase in D2 signal – DOM monkeys self‐administered (SA) cocaine at lower rates and intakes compared to subordinates (SUB) and the effect of high‐dose cocaine on reinstatement was blunted in DOM compared to SUBs. The present study extended this work to female monkeys. After 3 months of social housing, DOM females also showed a significant (&gt;20%) increase in D2 receptor availability. However, unlike males, DOM females were more sensitive to the reinforcing effects of cocaine, acquiring reinforcement at lower doses than SUBs. In contrast, preliminary data suggest that cocaine pretreatments elicit substantially greater reinstatement in SUB compared to DOM females. There appear to be additional sex differences as a function of social rank related to stress responsiveness and CSF metabolite levels for DA and serotonin. The present findings indicate (1) profound sex differences in the relationship between D2 availability and cocaine reinforcement and (2) a dissociation, in females, between sensitivity to cocaine SA and cocaine‐induced reinstatement. DA17763, DA10584.

A pilot of audio computer-assisted self-interview for youth reproductive health research in Vietnam

Purpose Several recent adolescent health studies in Vietnam have shown low levels of premarital sex among youth compared to neighboring countries and other regions of the world. One possible explanation for these findings is that adolescents in Vietnam are less willing to reveal their true behaviors. This study aims to assess the level of reporting of sensitive behaviors/events using three methods of survey data collection: face-to-face interviewer-administered (IA), paper-and-pencil self-administered (SA) and AudioComputerAssisted Self Interview (ACASI). Methods A randomized experiment was undertaken in Gialam, a suburb of Hanoi, among a sample of 2,394 youth ages 15 to 24 years. Respondents were randomly assigned to one of three interviewing methods, with females and males evaluated separately. Results ACASI showed certain advantages with regard to respondent attitudes and perceptions of sensitive topics. ACAI also revealed higher prevalence rates for sensitive and stigmatized behaviors. Among those in the pencil and paper survey group it is estimated that 12.9% of unmarried males and 3.4% of unmarried females have had premarital sex. The rate found by using ACASI is higher at 17.1% in males (95% CI: 13.5-21.4) and 4.5% in females (95% CI: 2.7-7.3). Using ACASI, unmarried males also reported higher levels of risky sexual relations. For example, 7.8% confirmed visiting sex workers compared with only 1.2% in SA group and 3.9% in IA group. Additionally, ACASI respondents reported having had more sex partners by age group, gender and marital status. Conclusions When coupled with the emerging data from around the world, the present findings suggest that researchers should consider using ACASI for future studies dealing with sensitive and stigmatized topics.

Instruction in Reliability and Magnitude of Evaluation Parameters at Each Phase of a Sit-to-Stand Movement

The sit-to-stand movement strategy of each subject is different depending on whether the subjects perform voluntary movements or have concrete instructions (i.e., stand quickly), which is strongly reflected in the performance of each sit-to-stand movement phase. Thirty young-adult male subjects participated in this study (M age=20.7 yr; SD=2.6). Subjects performed the two movements from a chair height adjusted to the subject's lower thigh length. In the self-administered (SA) condition, subjects voluntarily stood up from the chair without instruction, and in the assigned-ordered (AO) condition subjects stood up from the chair as fast as possible. Vertical floor reaction force and electromyograms of the rectus femoris and tibialis anterior muscles were measured, and 15 parameters were selected. The parameters in the phase between the peak value of the floor reaction force and completion of the movement was highly reliable regardless of instruction. However, other parameters had different reliabilities between the instruction conditions. In particular, the parameters in the phase between starting the movement and the peak value of the floor reaction force under the assigned-order were higher than those of the self-administered condition. Moreover, the sit-to-stand movement was conducted faster in the assigned-order condition during the phase between starting the movement and buttocks-syneresis, and the peak value of the floor reaction force and completion of the movement. From the above, in the assigned-order condition "as fast as possible," the anteflexion bending movement and extension of knee and trunk joints were faster, and anteflexion movement was repeated more similarly under a concrete instruction such as moving as fast as possible.

A randomised trial to evaluate the self-administered standardised chronic respiratory questionnaire

The original chronic respiratory questionnaire (CRQ), one of the most widely used measures of health-related quality of life (HRQL) in chronic respiratory disease (CRD), is traditionally interviewer administered (IA) and includes an individualised dyspnoea domain. The present authors studied the impact of self-administered (SA) and standardised dyspnoea questions on CRQ measurement properties. In a factorial design multicentre trial, 177 patients with CRD (mean age 67.7 yrs; mean forced expiratory volume in one second per cent predicted 44.6%) were randomised to CRQ-IA (n = 86) or CRQ-SA (n = 91), and to initially complete the standardised or individualised items before and after respiratory rehabilitation. While maintaining validity, the CRQ-SA proved more responsive to changes in HRQL than the CRQ-IA in all domains. Compared with the standardised dyspnoea domain, the individualised dyspnoea domain indicated greater responsiveness. The correlations of baseline scores and change scores with other HRQL instruments indicated good validity of the CRQ-SA. In conclusion, self-administration and standardisation of the chronic respiratory questionnaire maintains validity and responsiveness relative to the interviewer-administered chronic respiratory questionnaire. These results challenge the assumption that interviewer-administered questionnaires are superior to self-administered questionnaires in older patients with chronic respiratory disease.

Self-administered ethanol as a discriminative stimulus in rats

The neurochemical and behavioral effects produced by drugs can differ based on whether self-administered or experimenter-administered. In addition, self-administered drugs, particularly those taken orally or by inhalation, have peripheral stimulus effects that are not present following experimenter administration. One drug with highly prominent peripheral stimulus effects when taken orally is ethanol. The purpose of the present experiment was to examine whether orally self-administered (SA) ethanol would serve as a discriminative stimulus and to determine if the peripheral effects of ethanol play a major role in the discriminative stimulus of orally SA ethanol. Twelve Long-Evans rats were trained to orally self-administer 750 mg/kg of 10% (w/v) ethanol and then discriminate that dose of ethanol from SA water. Six of twelve rats were successfully trained to discriminate oral SA ethanol from water. Intraperitoneal experimenter-administered and orally SA ethanol doses of 100–1320 mg/kg were tested for substitution. SA and i.p. ethanol doses of 750, 1000, and 1320 mg/kg fully substituted for the SA training dose. SA doses of 100, 320 and 560 mg/kg partially substituted for the SA ethanol training dose, whereas the 100 and 320 mg/kg i.p. ethanol doses did not substitute for SA ethanol. The ED 50 values for SA and i.p. ethanol were not significantly different from one another. The results indicate that SA ethanol can serve as a discriminative stimulus in rats and that i.p. ethanol can substitute for SA ethanol. In addition, the results also show that the discriminative stimulus effects of SA ethanol are primarily mediated by CNS drug effects.

Self-administration cues as signals: Drug self-administration and tolerance.

There is evidence that drug-associated exteroceptive cues elicit compensatory conditional responses (CCRs) that contribute to tolerance. The authors evaluated whether interoceptive, self-administration cues (SACs) similarly contribute to tolerance. In Experiments 1 and 2, the ataxic effect of ethanol was measured in rats that self-administered (SA) ethanol--by either oral consumption or intragastric infusion--and in rats that were yoked (Y) to these self-administrators. In both experiments, the ataxic effect of ethanol was more pronounced in Y than in SA rats. In addition, SA rats failed to display usual levels of tolerance when ethanol was administered in the absence of SACs and displayed a CCR of hypertaxia in response to SACs not followed by ethanol. The results of Experiment 3 indicate that the ataxic effect of intravenous heroin also was greater in Y than in SA rats. The findings suggest that SACs contribute to drug tolerance.

PALPATED vs ELECTRONICALLY MONITORED HEART RATES IN PREDICTING VO2max WITH SUBMAXIMAL EXERCISE TESTS 275

The purpose of this study was to compare self palpated exercise pulse rates to simultaneously electronically monitored heart rates and their subsequent use in predicting aerobic capacity from two sub-maximal exercise tests. Both the palpated (PHR) and electronically monitored (EHR) exercise heart rates were used to estimate self-administered (SA) and tester-administered (TA) aerobic capacity, respectively, from the 1-mile track walk (TW) and 1-mile track jog (TJ) tests. Eighty-eight males and 86 females ranging in age between 18-40 years randomly performed the TW and TJ tests. All subjects were instructed on heart rate palpation and practiced resting heart rate palpations. Upon completing the 1-mile distance, time to completion and PHR were recorded by the subject while an administrator simultaneously recorded time to completion and EHR. Time to completion recorded by subjects and administrator were not significantly different for either the 1-mile walk or jog. PHR was on the average 13 bpm less than EHR following the 1-mile walk and 17 bpm less following the 1-mile jog (P<0.0001). Subsequent prediction of aerobic capacity resulted in SA predictions (50.0±5.9, 48.3±7.3 ml·kg-1·min-1) significantly overestimating(p<0.05) TA predictions (48.2± 5.9, 44.9±6.0 ml·kg-1·min-1) of aerobic capacity using the TW and TJ equations respectively. Results of this study suggest that prior to administering sub-maximal exercise tests, users must be competent in palpating exercise heart rate. In addition, incorrect palpation of exercise heart rate results in erroneous predictions of aerobic capacity.