Cat and dog owners' expectations and attitudes towards advanced veterinary care (AVC) in the UK, Austria and Denmark

Modern veterinary medicine offers a level of care to cats and dogs similar to that available to their owners, including blood transfusions, chemotherapy and MRI scans. The potential benefits to the animals of owners who can afford such care are obvious, but there can also be negative consequences if owners with strong emotional attachments to their pets pursue treatments that significantly reduce the quality of the animal's life while attempting to prolong it. Moreover, caring for a chronically or seriously ill animal can lead to emotional distress and financial and practical challenges for the pet owner. A questionnaire was used to survey cat and dog owners from representative samples of citizens in the UK, Austria and Denmark, to investigate owners' expectations and attitudes towards advanced veterinary care, and the factors that might influence those views. Overall, 58.4% of the pet owners surveyed believed that their pets should have access to the same treatment options as humans, while 51.5% believed that they should have access to the same diagnostic tests as humans. Owners were most likely to be neutral on the question of whether advanced veterinary care has 'gone too far' (45.3%), and to disagree with the statement that advanced care is 'unnecessary' (40.1%). In all three countries, the level of attachment owners had to their pets was most strongly associated with attitudes towards advanced care, with owners scoring higher on Lexington Attachment to Pets Scale (LAPS) being more likely to expect advanced care to be available. Other factors such as owner age, living situation (alone or not), income or possession of pet insurance were less consistently with owner attitudes. Our findings will help inform veterinarians and other health care providers about pet owner expectations and attitudes towards advanced veterinary care, and contribute to the debate on increasing specialisation within the profession.

Seeing the benefits, but not taking advantage of them: Dog and cat owners' beliefs about veterinary telemedicine

BACKGROUND

Telemedicine offers benefits to clients and their animals, but potential disadvantages are also being debated.

METHODS

Using a questionnaire, we investigated dog and cat owners' (N = 2117) use of and beliefs about telemedicine and whether beliefs impact past and expected future use.

RESULTS

Although the majority of owners are aware that telemedicine can lead to the risk of something being missed, they see great potential in remote consultation in terms of usefulness for follow-up appointments or improving access to a specialist. However, only 12% of dog owners and 6% of cat owners have used telemedicine, and around 25% of owners who have never used it would be willing to use it in the future. Owners with a larger number of recent veterinary visits were more likely to have used telemedicine.

LIMITATIONS

Although a definition of 'telemedicine' was provided, respondents may have had different perceptions of what this meant.

CONCLUSION

Owners of dogs and cats recognise the potential benefits of telemedicine, but there is a mismatch with the actual uptake. This not only raises questions about the current availability of telemedicine but also should increase veterinary professionals' understanding of its potential benefits in veterinary practice.

Do people really care less about their cats than about their dogs? A comparative study in three European countries

Previous studies have shown that cat owners seem to care less about their cats than dog owners care about their dogs - both in terms of their emotional state of attachment and in their willingness to pay for services that potentially benefit the animals. One study speculated that this difference is "driven by the behavior of the pet" - that the behavior of dogs encourages care more than the behavior of cats - and therefore is a universal phenomenon. However, previous studies mostly relied on convenience sampling of owners and were undertaken in single countries. Based on responses to a questionnaire from cat and dog owners drawn from representative samples of citizens (18 to 89 years of age) in three different European countries, Denmark, Austria and the United Kingdom, we tested the degree to which owners care about their cats and dogs. We used four different measures: Lexington attachment to pets scale (LAPS), possession of pet health insurance, willingness to pay for life-saving treatment, and expectation of veterinary diagnostic and treatment options. Dog owners had higher LAPS scores in all countries. However, the difference between dog and cat owners was greater in Denmark than in Austria and the United Kingdom. More dogs than cats were insured in all three countries, but the ratio was much less skewed in favor of dogs in the United Kingdom compared to Denmark. In terms of expensive life-saving treatment, in every country, more dog owners than cat owners were willing to spend over a certain amount, but the differences were much more pronounced in Denmark compared to the United Kingdom. In Denmark and Austria, dog owners expected more veterinary treatment options to be available, but species made no difference to the expectations of UK owners. People care more about their dogs than their cats in all countries, but with a clear cross-country variation and a very modest difference in the United Kingdom. Therefore, it does not seem to be a universal phenomenon that people care much less about their cats than their dogs. This finding has practical implications for future efforts to expand the level of veterinary services provided for cat owners.

Perceptions of the rabbit as a low investment 'starter pet' lead to negative impacts on its welfare: Results of two Danish surveys

Concerns over compromised companion rabbit (Oryctolagus cuniculus domesticus) welfare are widespread. The welfare problems have been linked to the perception of rabbits as low investment 'children's pets.' To test this hypothesis and investigate the current conditions for rabbits, data were gathered from two surveys in 2021: a nationally representative survey of Danish companion animal owners (Survey I) and a detailed social media-based survey of Danish rabbit owners (Survey II). Using logistic regression, three owner-related variables (whether a child/adult was responsible for care of the rabbit, owner-opinion on rabbits' suitability as 'starter pets' and willingness-to-pay [WTP] for veterinary treatment) were employed to investigate the effect of rabbit status on owner-provision of selected husbandry conditions. The 76 (Survey I) and 4,335 (Survey II) responses suggested that most rabbits are acquired for children and are solitarily housed, and that many are kept in cages of an unsuitable size and not checked daily. Owners who perceived rabbits as 'starter pets' and with lower WTP were more likely to house rabbits in restricted space and to not provide continuous gnawing opportunities, ad libitum hay or routine healthcare. A child fulfilling the role of the rabbit's main caretaker was also associated with inadequate housing type and fewer gnawing opportunities. Thus, many rabbits live in unsuitable conditions, and owners who perceive rabbits as low investment 'children's pets' are more likely to not provide recommended resources. Changing owners' perceptions of rabbits and promoting suitable husbandry through official education programmes and minimum requirements is important if there are to be improvements made to rabbit welfare.

Exploring everyday life dynamics in meat reduction - A cluster analysis of flexitarians in Denmark

Exploring everyday life dynamics in meat reduction - a cluster analysis of flexitarians in Denmark. Flexitarians are attracting increasing attention in the research on meat reduction. But there has been limited focus on comprehensive understandings of a broader range of dynamics that can work as barriers and facilitators for meat reduction. In this article, we use social practice theory (SPT) as a comprehensive approach to barriers and facilitators in meat reduction in everyday life. We present an analysis of data from a representative Danish cross-sectional survey. We show, first, that Danish flexitarians can be divided into four distinct clusters (what we will refer to as classes) in accordance with combinations of everyday facilitators and barriers. Second, we show that the prevalence of these classes varies considerably depending on how long people have been flexitarians. We argue that the patterns in this variation indicate that over time people transition to other classes where barriers to plant-rich eating become less significant, and routinization emerges in different ways. Finally, third, we show that flexitarians do report eating less meat than consumers who label themselves as eating meat with no restrictions. But we also highlight that the difference is relatively modest. Indeed, meat intake is still quite common even in classes where routinization is highest. Throughout the paper, we discuss similarities and differences between the SPT framework and another recent framework, the COM-B model, that also provides a comprehensive approach to the understanding of behavioural change.

Danish milk consumers are critical of advanced breeding methods in dairy production, but only 1 in 5 is unwilling to drink milk from dairy cows bred with semen derived from such methods

Assisted reproductive technologies and genetic technologies can accelerate progress in breeding programs in dairy farming, but it is unclear how consumers will react to the use of these technologies. Using representative questionnaire data on Danish citizens (n = 2,036) this cross-sectional study examined consumer attitudes to the application of advanced technologies in dairy cattle breeding. Attitudes were examined in 2 ways. First, we prompted about general attitudes to assisted reproductive technologies and genetic technologies in dairy cow breeding. Here we found that most of the participants were critical of cow impregnation involving hormone therapy and the insertion of cloned fetuses. Second, we used a vignette experiment to study whether acceptance of and willingness to drink milk varies with the type of technique that farmers use for their breeding work, as well as the traits being bred for. We included 5 breeding methods with differing degrees of technological complexity. Participants were randomly assigned to receive tailored information about 1 of the 5 breeding methods. The information specified that dairy farmers' own use of advanced technologies is limited to using semen in artificial insemination on the farm. The potentially concerning technologies are here not applied at farm level but are represented in the semen used in artificial insemination because they were used by breeders on earlier generations of cows and bulls to develop semen with higher genetic merit. There was much less concern about this indirect use of the technologies. Only 1 in 5 participants thought the most advanced method we prompted about (use of semen from breeding methods involving genetic engineering and cloning) was unacceptable. Unwillingness to drink milk from cows produced through such a breeding method was also modest (18%) and not much higher than the unwillingness to drink milk from a cow produced by natural fertilization (10%). A likely reason for the unexpectedly low level of unwillingness to drink milk is that people regard the genetic engineering as distant from the final product. We also found that high-frequency organic milk consumers were more critical of advanced breeding methods. Thus, 28% within this group were unwilling to drink milk from cows impregnated with semen derived from earlier generations of cows and bulls bred using gene editing and cloning. Further, this share rose if the high-frequency organic consumers were very averse to the manipulation of nature. The organic sector may need to cater to this subgroup (e.g., by ensuring the traceability of the semen that organic farmers use to artificially inseminate their cows).

"I am very critical of my body, but I am not a worthless person": A qualitative investigation of internalized weight stigma in Denmark

Aim

The aim of this study was to explore how two of the main dimensions of internalized weight stigma (IWS), namely weight-related self-devaluation and distress, play out in the lives of people with excess weight (EW), and to study whether there are further dimensions of IWS.

Method

Ten informants with EW were included in this study. The sample size was determined prior to data collection based on available resources at the time of data collection. All informants both participated in in-depth interviews and responded to the questionnaire WBIS-2F consisting of the two subscales: weight-related self-devaluation and distress. The interview accounts were thematically coded and compared with the informants' scoring on WBIS-2F.

Findings

Seven themes were identified from the in-depth interviews: (1) devaluation of competencies, (2) self-blame, (3) bodily devaluation, (4) ambivalence, (5) anticipated stigma, (6) coping strategies, and (7) mental well-being. Overall, the informants scored low on the WBIS-2F subscale weight-related self-devaluation and high on the subscale weight-related distress. The qualitative findings echo the informants' scoring on WBIS-2F. However, novel aspects of IWS not covered by WBIS-2F were also identified. In particular, bodily devaluation presented itself as an integral part of IWS.

Conclusion

The two current dimensions of WBIS-2F were retrieved, but important additional aspects of IWS were also identified. Future research is needed to evaluate and test both qualitatively and quantitatively whether the additional aspects of IWS identified in this exploratory examination are separate constructs of IWS.

"The person in power told me to"-European PhD students' perspectives on guest authorship and good authorship practice

Questionable authorship practices in scientific publishing are detrimental to research quality and management. The existing literature dealing with the prevalence, and perceptions, of such practices has focused on the medical sciences, and on experienced researchers. In contrast, this study investigated how younger researchers (PhD students) from across the faculties view fair authorship attribution, their experience with granting guest authorships to more powerful researchers and their reasons for doing so. Data for the study were collected in a survey of European PhD students. The final dataset included 1,336 participants from five European countries (Denmark, Hungary, Ireland, Portugal, and Switzerland) representing all major disciplines. Approximately three in ten reported that they had granted at least one guest authorship to "a person in power". Half of these indicated that they had done so because they had been told to do so by the person in power. Participants from the medical, natural and technical sciences were much more likely to state that they had granted a guest authorship than those from other faculties. We identified four general views about what is sufficient for co-authorship. There were two dominant views. The first (inclusive view) considered a broad range of contributions to merit co-authorship. The second (strongly writing-oriented) emphasised that co-authors must have written a piece of the manuscript text. The inclusive view dominated in the natural, technical, and medical sciences. Participants from other faculties were more evenly distributed between the inclusive and writing oriented view. Those with an inclusive view were most likely to indicate that they have granted a guest authorship. According to the experiences of our participants, questionable authorship practices are prevalent among early-career researchers, and they appear to be reinforced through a combination of coercive power relations and dominant norms in some research cultures, particularly in the natural, technical, and medical sciences.

Compete or Cooperate with ‘Dr. Google’? Small Animal Veterinarians’ Attitudes towards Clients’ Use of Internet Resources—A Comparative Study across Austria, Denmark and the UK

Simple Summary

Owners of dogs, cats, and other companion animals increasingly make use of the internet to find out how to best care for their animals. This may affect owners’ relations with veterinarians in both positive and negative ways. A positive consequence could be that owners are better informed when they approach a veterinarian. However, there can also be challenging situations in which the owners may question veterinarians’ professional advice based on online information. Using a questionnaire, we found that a majority of Austrian, Danish, and UK veterinarians (n = 641) surveyed were occasionally confronted with clients who question their medical advice based on information obtained from the internet. In addition, the veterinarians were concerned about the potential for clients to misunderstand information found on the internet, or to develop unrealistic expectations of what is possible in small animal practices. As internet use becomes ever more widespread, we suggest that the types of resources that are available and used by animal owners should be further explored.

Abstract

Veterinary medicine is increasingly affected by animal owners having the opportunity to become better informed on pet health issues by using various internet resources. Using an online questionnaire including a section on clients’ use of internet resources to obtain medical information, this study aimed to investigate veterinarians’ estimates of the percentage of clients using internet resources, how often clients question veterinarians’ professional medical advice based on online information, and veterinarians’ attitudes towards clients’ use of internet resources, across Austrian, Danish, and UK veterinarians (n = 641). The results show that 48.8% of respondents estimated that 40–79% of their clients use internet resources to find medical information. Further, 70–80% of respondents stated that they are occasionally challenged by clients questioning their advice based on online information. Although veterinarians recognized the potential advantages related to clients’ use of internet resources, such as an increased acceptance of advanced diagnostics and treatments, they also highlighted clients’ increased expectations or false impressions of small animal practices as potentially negative aspects in this context. As internet use increases, it seems likely that these issues will become increasingly important in the future.

Digital opportunities to connect and complain – the use of Facebook in small animal practice

Background

Material/methods

Results

Conclusions

Comparing veterinarians' attitudes to and the potential influence of pet health insurance in Austria, Denmark and the UK

BACKGROUND

Health insurance offers many benefits to clients and veterinarians, such as the ability to perform necessary and possibly cost-intensive medical interventions without financial constraints, or to potentially prevent euthanasia based on financial challenges. However, concerns about negative consequences, such as the overuse of diagnostic tests or overtreatment, have also been raised.

METHODS

Using an online questionnaire distributed via e-mail, which included a section on health insurance, we investigated the relative number of insured dogs and cats treated by Austrian, Danish and UK veterinarians (N = 636) and the attitudes of those veterinarians toward health insurance. Further, using a case vignette, we examined whether coverage by health insurance may influence treatment suggestions.

RESULTS

Even though veterinarians in all three countries believe that health insurance reduces stress since clients' financial resources will be less important, we found that Austrian veterinarians are more likely to agree that health insurance is unnecessary compared to Danish and UK veterinarians. Further, many raised the concern that insurance policies influence clinical decisions; and less than half supported the idea of making insurance mandatory. A majority of veterinarians in Austria and the UK thought that insurance can lead to the overuse of diagnostic tests, and in the UK a majority also thought that it can lead to overtreatment. Using case vignettes, we found that veterinarians were significantly more likely to suggest a CT scan to a client with an insured animal, in contrast to a client with stated financial limitations. Further, UK veterinarians were more likely to suggest a CT scan to a client with an insured animal, in contrast to a client without insurance.

CONCLUSION

In conclusion, we found that veterinarians, in general, were in favour of health insurance, and that greater coverage may increase more cost-intensive veterinary care. Our findings also raise a potential ethical challenge of health insurance causing differential access to clinical care for patients.

Is there a potential international market for Danish welfare pork? - A consumer survey from Denmark, Sweden, and Germany

This cross-country study investigates the potential to improve pig welfare by exploiting consumer demand, domestically and in export markets, for welfare pork produced in indoor production systems. The analysis is based on questionnaire data collected in 2019 focusing on demand for Danish welfare pork both in Denmark and in two nearby export markets, Sweden and Germany. To reduce hypothetical bias, a willingness-to-pay indicator is combined with an indicator of positive interest in buying a fictive Danish welfare labelled pork. We find that the market potential is relatively weak. Our findings indicate that there is some, albeit limited, potential in Denmark and Germany while demand is practically non-existing in Sweden, probably because the pig welfare guaranteed by Swedish legislation is similar to what is provided by the fictive welfare label employed in the study. Hence, consumer demand alone cannot secure enhanced pig welfare. Moreover, we found national differences in the characteristics of consumers who are interested in Danish welfare pork.

Managing conflicting ethical concerns in modern small animal practice-A comparative study of veterinarian's decision ethics in Austria, Denmark and the UK

Small animal veterinarians frequently have to manage conflicting interests. Beside the key consideration of the patient’s interests, small animal veterinarians are often challenged to consider not only client’s emotional needs, but also their own personal aspirations to provide quality patient care and to make a good living as a professional. Further, veterinarians have an interest in continuous professional development and the use of the newest treatments, which may influence their decision-making process. Based on published work, we hypothesize the existence of four decision ethics orientations that veterinarians can use to manage potentially conflicting concerns. These are: the patient-focused, the client-empathetic, the client-devolved and the development-oriented decision ethics orientations. We surveyed small animal veterinarians in Austria, Denmark, and the UK using a questionnaire (N = 648), and successfully identified the four decision ethics orientations in all three countries. The patient-focused and client-empathetic decision ethics orientations are salient in all countries, whereas Danish and UK veterinarians are slightly more client-empathetic and client-devolved compared to their Austrian colleagues. Across countries our findings show that experienced and older veterinarians tend to be more client-empathetic. Younger and less experienced professionals are more development-oriented compared to their older and more experienced colleagues. In contrast to other studies investigating ethical issues in small animal practice, we found no evidence that gender plays a decisive role in the tendency towards any decision ethics orientation. We also show that veterinarians with a higher client-empathetic orientation and development-orientation more often discuss the possibility of health insurance with clients who do not have it. The present study provides a first empirical insight into how veterinarians manage challenging expectations and ethical concerns as part of decision making in modern small animal practice.

Danish dairy farmers' acceptance of and willingness to use semen from bulls produced by means of in vitro embryo production and genomic selection

A novel technology combining in vitro production and genomic embryo selection is currently under development in dairy cattle breeding. Adoption of this technology will probably accelerate genetic progress toward the main breeding goals of economic interest, as well as allow selection for traits of societal concern such as decreased methane emissions and improved animal welfare. However, dairy farmers, and especially organic farmers, could find the technology morally questionable and reject its use. This cross-sectional study surveyed Danish dairy farmers' general acceptance of the combined technology and their reported likelihood of using semen produced with it. Drawing on diffusion theory, a questionnaire was developed to examine the way farmers discover and communicate about new technological breeding options, and to measure the factors which predict acceptance and likelihood of adopting the technology. The questionnaire was sent to a randomly selected sample of organic and conventional dairy farmers in Denmark, and 85 organic and 71 conventional farmers (41% response rate) completed it. Seventy-six percent of farmers reported that they would be likely to use semen from bulls derived from the technology. A majority (61%) also found the technology acceptable, but many (33%) were unsure or undecided. Most farmers saw the technology as beneficial, but ethical reservations were aired by around a fifth of the farmers. There were no differences between organic and conventional farmers in likelihood of using, perceived utility, and ethical reservations about the technology. Self-reported idealistic organic farmers showed lower acceptance of the technology, but reported similar likelihood of using semen produced by it. Young farmers (20-39 yr) exhibited higher acceptance of the technology. Larger producers (in terms of number of cows) were more likely to report that they will use and accept the technology. We conclude that it is likely that semen from the technology combining in vitro production and genomic selection would be widely used by both organic and conventional farmers provided that costs can be kept low, and that there are advantages in terms of achieving breeding goals. Structural developments, growth in size of dairy farms, acceptance by young farmers, and the fact that economic incentives (and even ethical arguments) seem to favor the technology all point to this conclusion.

Good friend or good student? An interview study of perceived conflicts between personal and academic integrity among students in three European countries

Students are often reluctant to report the academic dishonesty of their peers. Loyalty to friends and classmates has previously been identified as an important reason for this. This paper explores loyalty conflicts among students from upper secondary school, through bachelor's, to Ph.D. level. Drawing on semi-structured qualitative interviews (N = 72) conducted in Denmark, Ireland and Hungary, we show that loyalty considerations among students can be complex and draw on a range of norms including responsibility. The study demonstrates how students are often willing to assume substantial personal responsibility for dealing with the academic dishonesty of a peer, often preferring this to reporting. However, when deciding on the right course of action, they also perceive tensions between the norms of the good researcher and student and their own norms of being a good friend and person. The loyalty considerations and tension were identified in all three countries and across the educational levels, which suggests that this is a cross-cultural challenge. We argue that institutions should formally decide whether they want students to take some degree of responsibility themselves for addressing less serious cases of academic dishonesty and communicate their decision to their students.

Neutering increases the risk of obesity in male dogs but not in bitches - A cross-sectional study of dog- and owner-related risk factors for obesity in Danish companion dogs

Knowledge of risk factors for canine obesity is an important pre-requisite of effective preventative strategies. This study aimed to investigate risk factors for canine obesity in adult companion dogs across Zealand, Denmark. Client-owned dogs (>2 years of age and without chronic illness) were recruited and examined at eight companion animal veterinary practices in areas with varying socio-economic characteristics. The body condition score (BCS) of the dogs was examined by two investigators based on a 9-point scoring scheme. Dog owners answered a questionnaire that had prompts regarding: 1) dog characteristics, including neuter status, 2) owner characteristics, 3) feeding and exercise practices and 4) the owners' attachment to the dog. The effect of these factors on BCS and the risk of being heavy/obese (BCS scores 7-9) were analysed in two separate analyses. A total of 268 dogs were included in the analysis, of which 20.5% were found to be heavy/obese. The average BCS was 5.46. In terms of dog characteristics, neutering dramatically increased both BCS and the risk of being heavy/obese in male dogs but not in bitches. BCS and the risk of being heavy/obese increased in senior bitches and decreased in senior male dogs. The risk of being heavy/obese was higher in dogs with overweight and obese owners. Regarding feeding and exercise practices, providing only one meal per day increased BCS and risk of being heavy/obese. Treats during relaxation increased the risk of dogs being heavy/obese. It also increased the dogs' BCS, but only if the owners were overweight or obese. An increased duration of daily walking increased the risk of the dog being heavy/obese, but only if the owner was overweight or obese. Allowing the dog to run free in the garden/property decreased the risk of the dog being heavy/obese. The owners' attachment to the dog was not associated with the dogs' BCS or dogs' being heavy/obese. An important and novel finding was that neutering increased the risk of being overweight or obese for male dogs while bitches were at risk irrespective of neuter status. Furthermore, a complex interaction between owners' weight status, feeding practices and the risk of dogs being overweight or obese was found, which stresses the need to consider companion animal obesity from a One Health perspective in future prospective studies. Finally, this study was unable to confirm that canine obesity is a product of owners being too attached to their dogs.

A multidimensional measure of animal ethics orientation - Developed and applied to a representative sample of the Danish public

We present a questionnaire-based measure of four animal ethics orientations. The orientations, which were developed in light of existing empirical studies of attitudes to animal use and ethical theory, are: animal rights, anthropocentrism, lay utilitarianism, and animal protection. The two latter orientations can be viewed as variants of animal welfarism. Three studies were conducted in Denmark in order to identify the hypothesised orientations, evaluate their concurrent validity, and report their prevalence and relevance in animal-related opinion formation and behaviour. Explorative factor analysis (Study 1) and confirmative factor analysis (Study 2) successfully identified the four orientations. Study 2 revealed good measurement invariance, as there was none or very modest differential item functioning across age, gender, living area, and contrasting population segments. Evaluation of concurrent validity in Study 2 found that the orientations are associated with different kinds of behaviour and opinion when the human use of animals is involved in the hypothesised directions. In Study 3, a representative population study, the animal protection orientation proved to be most prevalent in the Danish population, and as in study 2 the four orientations were associated with different behaviours and opinions. Remarkably, the animal protection orientation does not lead to increased animal welfare-friendly meat consumption, the main reason for this being non-concern about the current welfare status of farm animals. We argue that the developed measure covers a wide range of diversity in animal ethics orientations that is likely to exist in a modern society such as Denmark and can be used in future studies to track changes in the orientations and to understand and test hypotheses about the sources and justifications of people’s animal-related opinions and behaviours.

A Study of Anti-Fat Bias among Danish General Practitioners and Whether This Bias and General Practitioners' Lifestyle Can Affect Treatment of Tension Headache in Patients with Obesity

OBJECTIVES

The study investigated whether treatment options for episodic tension-type headache vary among general practitioners (GPs) in Denmark depending on the patients' weight status and gender, and whether these decisions can be explained by the GPs' own anti-fat bias and lifestyle.

METHODS

A cross-sectional questionnaire study with responses from 240 GPs on measures of anti-fat bias, healthiness of GPs' lifestyles, and reported patient treatment decisions.

RESULTS

GPs tended to exhibit negative explicit and implicit anti-fat bias. There were no differences in choice of medical treatment for patients with obesity and those of a normal weight. GPs were more likely to advise a general health check to a patient with obesity (p < 0.001). GPs treating a male patient with obesity were less likely to believe that their patient would comply with the advised treatment compared to those with a male patient of normal weight. Compared with other patient types (4.4-7.7%), GPs who treated a male patient with obesity (27.9%) were more likely to advise a general health check only and no diary-keeping or follow-up consultation (p < 0.001). This was explained by the healthiness of the GPs' lifestyles (Spearman's ρ = 0.367; p < 0.01).

CONCLUSION

Despite the presence of clear anti-fat bias, there were no differences in medical treatment, and GPs managed the general health of patients with obesity proactively. The fact that the GPs' own lifestyle influenced the likelihood that they would recommend diary-keeping and follow-up consultations for male patients with obesity is remarkable and requires further investigation.

Eating out in four Nordic countries: National patterns and social stratification

Using a survey conducted in four Nordic countries (Denmark, Finland, Norway and Sweden) in 2012, we investigated whether eating out in cafés and restaurants in these countries is best characterized as a workday pattern activity or a leisure activity; and, whether frequent eating at cafés and restaurants is related to socio-demographic factors and factors relevant to the organization of daily life. We found that eating out is not a fundamental part of everyday eating. It is something which takes place occasionally. This may be taken to suggest that eating out in the Nordic countries is primarily a leisure activity. However, while this is an accurate portrayal of Denmark and Norway, eating out in Finland and Sweden is somewhat more common and linked to work-life. This difference probably reflects contrasting historical-institutional paths: in Finland and Sweden a food culture emphasizing cooked lunches and dedicated public policies supporting the provisioning of lunches outside the home may have promoted eating out. Multivariate analysis revealed that eating out declines with age. An urbanization effect exists, as residence in a capital city increases the propensity to eat out. There were socio-economic differences in all countries. We hypothesized that education and status would not significantly explain eating out activity after people's gastronomic interest had been controlled for. However, education was statistically significant in Sweden and Norway, and surprisingly status was negatively associated with eating out in Sweden. As expected, eating out was positively associated with income, and it was more frequent among the higher salariat and the self-employed (although not in Norway).

Veterinarian's dilemma: a study of how Danish small animal practitioners handle financially limited clients

This study examined the extent to which Danish veterinary practices encounter financially limited clients and how different factors relating to the animal, the client and the veterinarian affect decisions to provide treatment for these clients. 300 small animal practices were invited to participate in an online survey. 195 participated, giving a response rate of 65 per cent. The results show that Danish small animal veterinary practices encounter clients with limited finances regularly: 33.8 per cent of them 3-4 times, 24.6 per cent 5-10 times and 19.5 per cent 1-2 times a month. Only around 9 per cent reported having a written practice policy on handling financially limited clients. Factors affecting decisions to treat include the severity and type of the animal's condition, the medical care needed and the client's expressed emotions. The propensity to treat is significantly higher in female veterinarians and in situations involving unborn animals. The overall conclusion is that small animal veterinary practices often provide treatment to clients who are not able to pay-far beyond what is legally required. This can be considered a major economic and psychological challenge for the practising veterinarians.

Painful dilemmas: A study of the way the public's assessment of animal research balances costs to animals against human benefits

The conflict between animal costs and human benefits has dominated public as well as academic debates about animal research. However, surveys of public perceptions of animal research rarely focus on this part of attitude formation. This paper traces the prevalence of different attitudes to animal research in the public when people are asked to take benefit and cost considerations into account concurrently. Results from the examination of two representative samples of the Danish public identify three reproducible attitude stances. Approximately 30-35% of people questioned approved of animal research quite strongly, and 15-20% opposed animal research. The remaining 50% were reserved in their views. Further studies will ideally use the measure developed here to make possible relatively fine-grained comparisons and understandings of differences between populations and changes in attitudes over time.

Is it acceptable to use animals to model obese humans? A critical discussion of two arguments against the use of animals in obesity research

Animal use in medical research is widely accepted on the basis that it may help to save human lives and improve their quality of life. Recently, however, objections have been made specifically to the use of animals in scientific investigation of human obesity. This paper discusses two arguments for the view that this form of animal use, unlike some other forms of animal-based medical research, cannot be defended. The first argument leans heavily on the notion that people themselves are responsible for developing obesity and so-called 'lifestyle' diseases; the second involves the claim that animal studies of obesity's causes and therapies distract attention from preventive efforts. Drawing on both empirical data and moral reasoning, we argue that the relevant attributions of responsibility and claims about distraction are not plausible, and that, therefore, there is no reason to single out the use of animals in obesity research as especially problematic.

Transgene expression in human epidermal keratinocytes: cell cycle arrest of productively transfected cells

We have analysed the consequences of liposome mediated gene transfer into human primary epidermal keratinocytes and compared non-Epstein-Barr Virus (EBV) and EBV based expression vectors that carry the genes encoding human Growth Hormone (hGH) or Enhanced Green Fluorescent Protein (EGFP). Different kinetics between the non-EBV and EBV based vectors were revealed upon subcultivation of hGH transfected keratinocytes. The keratinocytes transfected with non-EBV based vector showed a rapid reduction in hGH production. Although the EBV based vector resulted in more stable expression, this was also reduced over time. Chromatin inactivation by deacetylation was investigated by treatment with sodium butyrate and found not to be the reason for the decreasing expression. Keratinocytes divided into subpopulations enriched for either stem cells or transit amplifying cells, based on beta1-integrin expression and function, do not differ significantly with respect to susceptibility to productive transfection. However, when the keratinocytes were transfected with the EGFP gene and sorted live by FACS into EGFP negative and positive populations, only the negative cells were capable of forming significant numbers of colonies. This is consistent with the observation that the ability to incorporate BrdU was dramatically reduced in the EGFP expressing population within 24-48 h post transfection indicating an almost complete cell cycle arrest. p53 levels were unaffected by the procedures, and the keratinocyte cell line HaCat, mutated in both p53 alleles, also shows a marked reduction in clonogenic potency upon transfection. There was a slight increase of TUNEL positive apoptotic nuclei in the positive population at early time points. However, the apoptotic index was still very low. When we measured the frequency of involucrin expressing cells, we found an increase in the productively transfected population over time indicating an initiation of terminal differentiation. In contrast to the transfected cultures, keratinocytes that were transduced using a retroviral vector showed no decrease in colony forming efficiency. In conclusion we find that transgene expressing cells from transfected cultures of epidermal keratinocytes undergo cell cycle arrest and initiate terminal differentiation by mechanisms which are independent of p53 levels.

Long-chain acyl-CoA esters and acyl-CoA binding protein are present in the nucleus of rat liver cells

A detailed analysis of the subcellular distribution of acyl-CoA esters in rat liver revealed that significant amounts of long-chain acyl-CoA esters are present in highly purified nuclei. No contamination of microsomal or mitochondrial marker enzymes was detectable in the nuclear fraction. C16:1 and C18:3-CoA esters were the most abundant species, and thus, the composition of acyl-CoA esters in the nuclear fraction deviates notably from the overall composition of acyl-CoA esters in the cell. After intravenous administration of the non-beta-oxidizable [(14)C]tetradecylthioacetic acid (TTA), the TTA-CoA ester could be recovered from the nuclear fraction. Acyl-CoA esters bind with high affinity to the ubiquitously expressed acyl-CoA binding protein (ACBP), and several lines of evidence suggest that ACBP functions as a pool former and transporter of acyl-CoA esters in the cytoplasm. By using immunohistochemistry, immunofluorescence microscopy, and immunoelectron microscopy we demonstrate that ACBP localizes to the nucleus as well as the cytoplasm of rat liver cell and rat hepatoma cells, suggesting that ACBP may also be involved in regulation of acyl-CoA-dependent processes in the nucleus.

Rapid degradation of short-chain acyl-CoA dehydrogenase variants with temperature-sensitive folding defects occurs after import into mitochondria

Most disease-causing missense mutations in short-chain acyl-CoA dehydrogenase (SCAD) and medium-chain acyl-CoA dehydrogenase are thought to compromise the mitochondrial folding and/or stability of the mutant proteins. To address this question, we studied the biogenesis of SCAD proteins in COS-7 cells transfected with cDNA corresponding to two SCAD missense mutations, R22W (identified in a patient with SCAD deficiency) or R22C (homologous to a disease-associated R28C mutation in medium-chain acyl-CoA dehydrogenase deficiency). After cultivation at 37 degreesC the steady-state amounts of SCAD antigen and activity in extracts from cells transfected with mutant SCAD cDNAs were negligible compared with those of cells transfected with SCAD wild type cDNA, documenting the deleterious effect of the two mutations. Analysis of metabolically labeled and immunoprecipitated SCAD wild type and mutant proteins showed that the two mutant proteins were synthesized as the 44-kDa precursor form, imported into mitochondria and processed to the mature 41.7-kDa form in a normal fashion. However, the intramitochondrial level of matured mutant SCAD proteins decreased rapidly to very low levels, indicating a rapid degradation of the mutant proteins at 37 degreesC. A rapid initial elimination phase was also observed following cultivation at 26 degreesC; however, significantly higher amounts of metabolically labeled and immunoprecipitated mature mutant SCAD proteins remained detectable. This corresponds well with the appreciable steady-state levels of SCAD mutant enzyme activity observed at 26 degreesC. In addition, confocal laser scanning microscopy of immunostained cells showed that the SCAD mutant proteins were localized intramitochondrially. Together, these results show that newly synthesized SCAD R22W and R22C mutant proteins are imported and processed in the mitochondrial matrix, but that a fraction of the proteins is rapidly eliminated by a temperature-dependent degradation mechanism. Thermal stability profiles of wild type and mutant enzymes revealed no difference between the two mutants and the wild type protein. Furthermore, the turnover of the SCAD mutant enzymes in intact cells was comparable to that of the wild type, indicating that the rapid degradation of the mutant SCAD proteins is not due to lability of the correctly folded tetrameric structure but rather to elimination of partly folded or misfolded proteins along the folding pathway.

Rapid characterization of disease-causing mutations in the low density lipoprotein receptor (LDL-R) gene by overexpression in COS cells

To characterize disease-causing mutations in the low density lipoprotein receptor (LDL-R) gene, COS cells are transfected with the mutant gene in an EBV-based expression vector and characterized by flow cytometry. Using antibodies against the LDL-receptor the amount of receptor protein on the cell surface is quantitated. The receptor activity is measured by incubating the cells with fluorescence labeled LDL (Dil-labelled LDL) at 37 degrees C and 4 degrees C. The transfected cells stained with anti-LDL-R antibodies can also be analysed by immunofluorescence microscopy allowing the study of the intracellular location of variants of the receptor. To evaluate these methods, we are analyzing four previously well-characterized LDL-R mutations, belonging to each of the classes 2 to 5. Preliminary data show that mutant genes belonging to class 3 and 4A give rise to receptor protein on the cell surface, but impaired LDL uptake, while mutant receptors belonging to class 2A and 5 can only be detected intracellularly. Expression of the class 2A mutation results in an ER staining pattern, whereas the class 5 mutation gives rise to an intracellular staining compatible with localization in the endosomal/lysosomal compartments. We conclude that this system is useful for a rapid functional analysis of newly discovered mutations in the LDL-R gene.

Comparison between medium-chain acyl-CoA dehydrogenase mutant proteins overexpressed in bacterial and mammalian cells

Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is a potentially lethal inherited defect in the beta-oxidation of fatty acids. By comparing the behaviour of five missense MCAD mutant proteins expressed in COS cells and in Escherichia coli, we can define some of these as "pure folding mutants." Upon expression in E. coli, these mutant proteins produce activity levels in the range of the wild-type enzyme only if the chaperonins GroESL are co-overproduced. When overexpressed in COS cells, the pure folding mutants display enzyme activities comparable to the wild-type enzyme. The results suggest that the MCAD mutations can be modulated by chaperones, a phenomenon that may influence the manifestation of the MCAD disease.

Simultaneous detection of centromere-specific probes and chromosome painting libraries by a combination of primed in situ labelling and chromosome painting (PRINS-painting)

In situ techniques for the detection of specific chromosomes using centromeric probes and the decoration of entire chromosomes using chromosome painting are well established. However, in the deciphering of complex chromosomal aberrations it is valuable to be able to detect the centromere and the entire DNA of a specific chromosome in different colours simultaneously on the same metaphase. In this report we describe a combination of the primed in situ labelling (PRINS) technique and chromosome painting for simultaneous visualization of centromere-specific oligonucleotides and chromosome painting libraries. A key feature is that the denaturation step in the PRINS reaction is sufficient to keep the chromosomes denatured for chromosome painting. This means that PRINS and consecutive chromosome painting can be performed as a single procedure (PRINS-painting).