. Sensory specific satiety in man. PHYSIOL. BEHAV. 27(1) [137][138][139][140][141][142] 1981.--To investigate the specificity of satiety in man, subjects (n=32) rated the pleasantness of the taste of eight foods, were then given one of the foods to eat for lunch, and re-rated the pleasantness of the taste of the eight foods 2 and 20 rain after the end of the meal. The pleasantness of the food eaten decreased more than that of the foods not eaten (p<0.001). In a second experiment it was shown that this relative specificity of satiety influenced subsequent food intake. Before a first course, subjects (n =24) rated their liking for the taste of eight foods, were then given one of the foods to eat for lunch, and 2 min after finishing eating re-rated their liking for the taste of the eight foods. Again liking decreased more for the food eaten than for foods not eaten. These changes in liking for the foods eaten and not eaten were highly correlated (p <0.001) with the amounts of those foods eaten in an unexpected second course. Thus in man satiety can be partly specific to foods eaten and this specificity may be an important determinant of the foods selected for consumption. Specificity of satietyTaste Food intake WHILE recording from lateral hypothalamic neurons which responded to the sight and/or taste of food in the alert behaving monkey, E. Rolls and his colleagues observed that the responses of these neurons became attenuated to the sight and/or taste of the food on which the animal was satiated, but continued to respond to other foods which had not been used to produce satiety [2,17,18,19]. It was also observed that the monkeys continued to accept these other foods while rejecting the food on which they had satiated. This finding suggests that satiety may not be completely general, but rather may be at least partly specific to the particular food consumed. This led to the present investigation of satiety and its specificity in man. In relation to satiety in man it has been shown that the pleasantness of the taste or smell of food-related test stimuli was decreased by a 50 g load of glucose which was either swallowed or delivered intragastrically [3,4,6,7]. Cabanac and his colleagues I6,8] showed that the glucose load decreased the pleasantness of sucrose solutions but not of salt solutions, and that eating a meal decreased the pleasantness of food-related odors but not of non-food-related odors. They have argued from these findings that there is modulation of the hedonic responses to food produced by the internal nutritional state which could be important in controlling feeding, and have called the phenomenon "alliesthesia" (literally, changing sensation) [3].On the basis of these findings in the monkey and man, we performed the experiments described here, to investigate whether in man there is a satiety mechanism specific for foods eaten. In Experiment 1, the possibility that the pleasantness of the taste of food might decline more for a food eaten than for other foods not eaten was investigated. It was found ...

Objectives To explore the reasons why general practitioners do not always implement best evidence. Design Qualitative study using Balint-style groups. Setting Primary care. Participants 19 general practitioners. Main outcome measures Identifiable themes that indicate barriers to implementation.Results Six main themes were identified that affected the implementation process: the personal and professional experiences of the general practitioners; the patient-doctor relationship; a perceived tension between primary and secondary care; general practitioners' feelings about their patients and the evidence; and logistical problems. Doctors are aware that their choice of words with patients can affect patients' decisions and whether evidence is implemented. Conclusions General practitioner participants seem to act as a conduit within the consultation and regard clinical evidence as a square peg to fit in the round hole of the patient's life. The process of implementation is complex, fluid, and adaptive.

Understanding the factors that influence patient's choices may help professionals guide them to the most appropriate CR method and hence improve uptake.

Dee Mangin, Kieran Sweeney, and Iona Heath argue that, rather than prolonging life, preventive treatments in elderly people simply change the cause of death—the manner of our dying

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