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Showing papers by "University College Cork published in 2003"


Journal ArticleDOI
TL;DR: The protocols in this unit discuss how to use ClustalX and ClUSTalW to construct an alignment, and create profile alignments by merging existing alignments.
Abstract: The Clustal programs are widely used for carrying out automatic multiple alignment of nucleotide or amino acid sequences. The most familiar version is ClustalW, which uses a simple text menu system that is portable to more or less all computer systems. ClustalX features a graphical user interface and some powerful graphical utilities for aiding the interpretation of alignments and is the preferred version for interactive usage. Users may run Clustal remotely from several sites using the Web or the programs may be downloaded and run locally on PCs, Macintosh, or Unix computers. The protocols in this unit discuss how to use ClustalX and ClustalW to construct an alignment, and create profile alignments by merging existing alignments.

2,318 citations


Journal ArticleDOI
TL;DR: The most common mechanisms that help Gram-positive bacteria overcome the challenge posed by different acidic environments are described, i.e., the use of proton pumps, the protection or repair of macromolecules, cell membrane changes, production of alkali, induction of pathways by transcriptional regulators, alteration of metabolism, and the role of cell density and cell signaling.
Abstract: Gram-positive bacteria possess a myriad of acid resistance systems that can help them to overcome the challenge posed by different acidic environments. In this review the most common mechanisms are described: i.e., the use of proton pumps, the protection or repair of macromolecules, cell membrane changes, production of alkali, induction of pathways by transcriptional regulators, alteration of metabolism, and the role of cell density and cell signaling. We also discuss the reponses of Listeria monocytogenes, Rhodococcus, Mycobacterium, Clostridium perfringens, Staphylococcus aureus, Bacillus cereus, oral streptococci, and lactic acid bacteria to acidic environments and outline ways in which this knowledge has been or may be used to either aid or prevent bacterial survival in low-pH environments.

1,114 citations


Journal ArticleDOI
TL;DR: In this article, the progress of lipolysis and its effect on flavour development during cheese ripening is reviewed and the current methods for quantification of free fatty acids in cheese are compared and compared.

634 citations


Journal ArticleDOI
TL;DR: In this paper, the authors use the notion of relations of regard to illustrate the benefits to both parties arising from their interaction that go well beyond narrowly financial evaluations, and the source of strong moral values that permeates the network is considered in relation to an important food personality.

543 citations


Journal ArticleDOI
TL;DR: Relationships among milk production, body condition score (BCS), body weight (BW), and reproduction were studied using logistic regression on data from spring-calving Holstein-Friesian dairy cows to identify cows at risk of poor reproduction.

378 citations


Journal Article
TL;DR: Probiotic milk‐based formulations were spray‐dried with various combinations of prebiotic substances in an effort to generate synbiotic powder products.
Abstract: AIMS Probiotic milk-based formulations were spray-dried with various combinations of prebiotic substances in an effort to generate synbiotic powder products. METHODS AND RESULTS To examine the effect of growth phase and inclusion of a prebiotic substance in the feed media on probiotic viability during spray-drying, Lactobacillus rhamnosus GG was spray-dried in lag, early log and stationary phases of growth in reconstituted skim milk (RSM) (20% w/v) or RSM (10% w/v), polydextrose (PD) (10% w/v) mixture at an outlet temperature of 85-90 degrees C. Stationary phase cultures survived best (31-50%) in both feed media and were the most stable during powder storage at 4-37 degrees C over 8 weeks, with 30-140-fold reductions in cell viability at 37 degrees C in RSM and PD/RSM powders, respectively. Stationary phase Lact. rhamnosus GG was subsequently spray-dried in the presence of the prebiotic inulin in the feed media, composed of RSM (10% w/v) and inulin (10% w/v), and survival following spray-drying was of the order 7.1-43%, while viability losses of 20,000-90,000-fold occurred in these powders after 8 weeks' storage at 37 degrees C. Survival of the Lactobacillus culture after spray-drying in powders produced using PD (20% w/v) or inulin (20% w/v) as the feed media was only 0.011-0.45%. To compare different probiotic lactobacilli during spray-drying, stationary phase Lact. rhamnosus E800 and Lact. salivarius UCC 500 were spray-dried using the same parameters as for Lact. rhamnosus GG in either RSM (20% w/v) or RSM (10% w/v) and PD (10% w/v). Lact. rhamnosus E800 experienced approx. 25-41% survival, yielding powders containing approximately 10(9) CFU g(-1), while Lact. salivarius UCC 500 performed poorly, experiencing over 99% loss in viability during spray-drying in both feed media. In addition to the superior survival of Lact. rhamnosus GG after spray-drying, both strains experienced higher viability losses (570-700-fold) during storage at 37 degrees C over 8 weeks compared with Lact. rhamnosus GG. CONCLUSIONS Stationary phase cultures were most suitable for the spray-drying process, while lag phase was most susceptible. The presence of the prebiotics PD and inulin did not enhance viability during spray-drying or powder storage. SIGNIFICANCE AND IMPACT OF THE STUDY High viability (approximately 10(9) CFU g(-1)) powders containing probiotic lactobacilli in combination with prebiotics were developed, which may be useful as functional food ingredients for the manufacture of probiotic foods.

348 citations


Journal ArticleDOI
TL;DR: To assess strains of Lactobacillus, Lactococcus, Pediococcus and Bifidobacterium for their ability to produce the health‐promoting fatty acid conjugated linoleic acid (CLA) from free linolesic acid.
Abstract: Aims: To assess strains of Lactobacillus, Lactococcus, Pediococcus and Bifidobacterium for their ability to produce the health-promoting fatty acid conjugated linoleic acid (CLA) from free linoleic acid. Methods and Results: In this study, strains of Lactobacillus, Lactococcus, Pediococcus and Bifidobacterium were grown in medium containing free linoleic acid. Growth of the bacteria in linoleic acid and conversion of the linoleic acid to CLA was assessed. Of the bacteria assessed, nine strains of Bifidobacterium produced the c9, t11 CLA isomer from free linoleic acid. The t9, t11 CLA isomer was also produced by some strains, but at much lower concentrations. Conclusions: The production of CLA by bifidobacteria exhibited considerable interspecies variation. Bifidobacterium breve and B. dentium were the most efficient CLA producers among the range of strains tested, with B. breve converting up to 65% linoleic acid to c9, t11 CLA when grown in 0·55 mg ml−1 linoleic acid. Strains also varied considerably with respect to their sensitivity to linoleic acid. Significance and Impact of the Study: The production of CLA by probiotic bifidobacteria offers a possible mechanism for some health-enhancing properties of bifidobacteria and provides novel opportunities for the development of functional foods.

295 citations


Journal ArticleDOI
TL;DR: In this paper, the phytase activity of 12 species of sourdough lactic acid bacteria was screened and the results showed that Lactobacillus sanfranciscensis CB1 exhibited the highest hydrolysing activity on Na-phytate after reaching the stationary phase of growth.

280 citations


Journal ArticleDOI
TL;DR: An antibacterial peptide corresponding to β-CN f184-210 was identified in human sodium caseinate hydrolysate, which showed a very large spectrum of inhibition against gram-positive and -negative bacteria, including species of potential clinical interest, such as Enterococcus faecium, Bacillus megaterium, Escherichia coli, Listeria innocua, Salmonella spp.
Abstract: Sodium caseinates prepared from bovine, sheep, goat, pig, buffalo or human milk were hydrolyzed by a partially purified proteinase of Lactobacillus helveticus PR4 Peptides in each hydrolysate were fractionated by reversed-phase fast-protein liquid chromatography The fractions which showed the highest angiotensin I-converting-enzyme (ACE)-inhibitory or antibacterial activity were sequenced by mass spectrum and Edman degradation analyses Various ACE-inhibitory peptides were found in the hydrolysates: the bovine alpha(S1)-casein (alpha(S1)-CN) 24-47 fragment (f24-47), f169-193, and beta-CN f58-76; ovine alpha(S1)-CN f1-6 and alpha(S2)-CN f182-185 and f186-188; caprine beta-CN f58-65 and alpha(S2)-CN f182-187; buffalo beta-CN f58-66; and a mixture of three tripeptides originating from human beta-CN A mixture of peptides with a C-terminal sequence, Pro-Gly-Pro, was found in the most active fraction of the pig sodium caseinate hydrolysate The highest ACE-inhibitory activity of some peptides corresponded to the concentration of the ACE inhibitor (S)-N-(1-[ethoxycarbonyl]-3-phenylpropyl)-ala-pro maleate (enalapril) of 49253 micro g/ml (100 micro mol/liter) Several of the above sequences had features in common with other ACE-inhibitory peptides reported in the literature The 50% inhibitory concentration (IC(50)) of some of the crude peptide fractions was very low (16 to 100 micro g/ml) Some identified peptides were chemically synthesized, and the ACE-inhibitory activity and IC(50)s were confirmed An antibacterial peptide corresponding to beta-CN f184-210 was identified in human sodium caseinate hydrolysate It showed a very large spectrum of inhibition against gram-positive and -negative bacteria, including species of potential clinical interest, such as Enterococcus faecium, Bacillus megaterium, Escherichia coli, Listeria innocua, Salmonella spp, Yersinia enterocolitica, and Staphylococcus aureus The MIC for E coli F19 was ca 50 micro g/ml Once generated, the bioactive peptides were resistant to further degradation by proteinase of L helveticus PR4 or by trypsin and chymotrypsin

266 citations


Journal ArticleDOI
TL;DR: It is shown that HepG2 cells can absorb and turnover quercetin glucuronides and that human endogenous beta-glucuronidase activity could modulate the intracellular biological activities of dietary antioxidant flavonoids.

259 citations


Journal ArticleDOI
TL;DR: Fat globule size decreased as HPH pressure increased and, under certain conditions of temperature and pressure, HPH yielded significantly smaller fat globules than conventional homogenisation.
Abstract: Although widely adopted by the chemical and pharmaceutical industries in recent years, little published data is available regarding possible applications of high pressure homogenisation for dairy products. The objective of this work was to compare the effects of conventional (18 MPa, two-stage) and single or two-stage high pressure homogenisation (HPH) at 50-200 MPa on some properties of raw whole bovine milk (approximately 4% fat). Fat globule size decreased as HPH pressure increased and, under certain conditions of temperature and pressure, HPH yielded significantly smaller fat globules than conventional homogenisation. Fat globule size was also affected by milk inlet temperature. The pH of all homogenised milk samples decreased during 24 h refrigerated storage. Total bacterial counts of milk were decreased significantly (P < 0.05) for milk samples HPH-treated at 150 or 200 MPa. Whiteness and rennet coagulation properties of milk were unaffected or enhanced, respectively, as homogenisation pressure was increased. Average casein micelle size decreased slightly when skim milk was homogenised at 200 MPa. Thus, HPH treatment has several, potentially significant, effects on milk properties.

Journal ArticleDOI
TL;DR: This review aims to identify and discuss the various mechanisms employed by cells to alter their sensitivity to Fas-mediated apoptosis by regulating DISC formation.

Journal ArticleDOI
TL;DR: Data from the COPINE project has been used to generate a model of such offending behavior that emphasizes the role of cognitions in both the etiology, engagement with and problematic use of the Internet for those with a sexual interest in children.
Abstract: Agencies working with sex offenders are starting to see the emergence of people with a sexual interest in children who meet some of their needs through the use of child pornography, or the seduction of children, through the Internet. While CBT models dominate our understanding of sex offenders, there has been little research into the role that such new technologies may play in offending behavior. Data from the COPINE project has been used to generate a model of such offending behavior that emphasizes the role of cognitions in both the etiology, engagement with and problematic use of the Internet for those with a sexual interest in children. Such a model seeks to incorporate contemporary thinking about the role of cognitions in Pathological Internet Use, but applies this from a nonpathological perspective. This model is a first step towards providing a conceptual framework for such offending that will help inform both assessment and therapy.

Journal ArticleDOI
TL;DR: The findings of this study suggest that VR and GR may have a useful role in the treatment of driving phobia post-accident even when co-morbid conditions such as post-traumatic stress disorder and depression are present.
Abstract: Specific phobia, situational type-driving, induced by accident (accident phobia) occurs in 18-38% of those involved in a vehicular accident of sufficient severity to warrant referral to the emergency departments of a general hospital. The objective is to investigate, in an open study, the effectiveness of the combined use of computer generated environments involving driving games (game reality [GR]) and a virtual reality (VR) driving environment in exposure therapy for the treatment of driving phobia following a motor vehicle accident (MVA) program. Fourteen subjects who met DSM-IV criteria for Simple Phobia/Accident Phobia and were referred from the emergency department of a general hospital were exposed to a Virtual Driving Environment (Hanyang University Driving Phobia Environment) and computer driving games (London Racer/Midtown Madness/Rally Championship). Patients who experienced "immersion" (i.e., a sense of presence with heightened anxiety) in one of the driving simulations (defined as an increase in SUD ratings of 3 and/or an increase of heart rate > 15 BPM in a 1-h trial session of computer simulation driving) were exposed to a cognitive behavioral program of up to 12 1-h sessions involving graded driving simulation tasks with self-monitoring, physiological feedback, diaphragmatic breathing and cognitive reappraisal. Subjects were assessed at the beginning and end of therapy with measurements of: physiological responsivity (heart rate), subjective ratings of distress (SUD), rating scales for severity of fear of driving (FDI), Posttraumatic Stress Disorder (CAPS) and depression (HAM-D) and achievement of target behaviors. Of all patients 7/14 (50%) became immersed in the driving environments. This immersed group (n = 7) completed the exposure program. Pre- and post-treatment comparisons showed significant post treatment reductions on all measures SUDS (p = 0.008), FDI (p = 0.008), CAPS (p = 0.008), HR (p = 0.008), CAPS (p = 0.008), HAM-D (p = 0.031). Further analysis of the FDI showed significant reductions in all three subscales: travel distress (p = 0.008), travel avoidance (p = 0.008), and maladaptive driving strategies (p = 0.016). The findings of this study suggest that VR and GR may have a useful role in the treatment of driving phobia post-accident even when co-morbid conditions such as post-traumatic stress disorder and depression are present.

Journal ArticleDOI
TL;DR: In this paper, it was shown that there are giant carbonate mounds (bioherms) in the Rockall Trough, with a variety of shapes and sizes up to 350 m high and 2 km wide at the base.

Journal ArticleDOI
01 Nov 2003
TL;DR: Evidence indicates that dietary Ca intake is inadequate for maintenance of bone health in a substantial proportion of some population groups, particularly adolescent girls and older women.
Abstract: Approximately 99% of body Ca is found in bone, where it serves a key structural role as a component of hydroxyapatite. Dietary requirements for Ca are determined by the needs for bone development and maintenance, which vary throughout the life stage, with greater needs during the periods of rapid growth in childhood and adolescence, during pregnancy and lactation, and in later life. There is considerable disagreement between expert groups on the daily Ca intake levels that should be recommended, reflecting the uncertainty in the data for establishing Ca requirements. Inadequate dietary Ca in early life impairs bone development, and Ca supplementation of the usual diet for periods of < or = 3 years has been shown to enhance bone mineral status in children and adolescents. However, it is unclear whether this benefit is long term, leading to the optimisation of peak bone mass in early adulthood. In later years inadequate dietary Ca accelerates bone loss and may contribute to osteoporosis. Ca supplementation of the usual diet in post-menopausal women and older men has been shown to reduce the rate of loss of bone mineral density at a number of sites over periods of 1-2 years. However, the extent to which this outcome reduces fracture risk needs to be determined. Even allowing for disagreements on recommended intakes, evidence indicates that dietary Ca intake is inadequate for maintenance of bone health in a substantial proportion of some population groups, particularly adolescent girls and older women.

Journal ArticleDOI
TL;DR: A review of copper(II) stereochemistry involving structural pathways is presented in this paper in an attempt to describe and rationalise these variable stereochemistries, and new interpretations linking the Jahn-Teller effect (JTE), vibronic coupling, structure correlation analysis, structural pathways and comparative X-ray crystallography are reported.

Journal ArticleDOI
TL;DR: A characteristic feature of the intracellular food-borne pathogen Listeria monocytogenes is its ability to survive and even proliferate under a variety of hostile environmental conditions, particularly elevated osmolarity and reduced temperature.
Abstract: A characteristic feature of the intracellular food-borne pathogen Listeria monocytogenes is its ability to survive and even proliferate under a variety of hostile environmental conditions, particularly elevated osmolarity (10% NaCl) ([47][1]) and reduced temperature (−0.1°C) ([75][2]). Early

Journal ArticleDOI
TL;DR: The power of CIA is illustrated by using it to identify the main common relationships in expression profiles on a panel of 60 tumour cell lines from the National Cancer Institute which have been subjected to microarray studies using both Affymetrix and spotted cDNA array technology.
Abstract: Rapid development of DNA microarray technology has resulted in different laboratories adopting numerous different protocols and technological platforms, which has severely impacted on the comparability of array data. Current cross-platform comparison of microarray gene expression data are usually based on cross-referencing the annotation of each gene transcript represented on the arrays, extracting a list of genes common to all arrays and comparing expression data of this gene subset. Unfortunately, filtering of genes to a subset represented across all arrays often excludes many thousands of genes, because different subsets of genes from the genome are represented on different arrays. We wish to describe the application of a powerful yet simple method for cross-platform comparison of gene expression data. Co-inertia analysis (CIA) is a multivariate method that identifies trends or co-relationships in multiple datasets which contain the same samples. CIA simultaneously finds ordinations (dimension reduction diagrams) from the datasets that are most similar. It does this by finding successive axes from the two datasets with maximum covariance. CIA can be applied to datasets where the number of variables (genes) far exceeds the number of samples (arrays) such is the case with microarray analyses.

Journal ArticleDOI
04 Jul 2003-Talanta
TL;DR: A microwave digestion technique was developed to determine the content of nine heavy metals in sediments and soils and demonstrated that the proposed method is precise and accurate.

Journal ArticleDOI
TL;DR: In this paper, a distinction is drawn between e•government and e•public service, and it is proposed that there is a continuum of public sector organisations based on complexity of task, while profit motivation has little relevance in the public sector, homogeneity of consumers, definability of tasks and finite and measureable outcomes can serve as likely conditions of success in e‐public service.
Abstract: Definitions of e‐service and e‐government are considered in seeking to contextualise the discussion, and a distinction is drawn between e‐government and e‐public service. Current theoretical and empirical work is considered in conjunction with the contribution of the usability school and the commercial literature related to outcome measurement. While profit motivation has little relevance in the public sector, homogeneity of consumers, definability of tasks and finite and measureable outcomes can serve as likely conditions of success in e‐public service. The public sector is then considered in light of this knowledge. It is proposed that there is a continuum of public sector organisations based on complexity of task. Initial evidence suggests that e‐service delivery has greater potential for success in public sector tasks that have low or limited levels of complexity. Finally, the paper concludes that any discussion of e‐public service must take cognisance of the context, both internal and external, in which e‐service is delivered.

Journal ArticleDOI
TL;DR: It is found that cytochrome c-dependent proteolysis and activation of caspase-9 could not be restored in an adult cell-free system because of an age-related decrease in the expression of Apaf-1 in the normal developing mouse retina.
Abstract: Apoptosis is the mode of cell death in retinitis pigmentosa, a group of retinal degenerative disorders primarily affecting rod photoreceptors. Although caspases have been demonstrated to play a central role in many incidences of apoptosis, accumulating evidence suggests that they may not be required for all forms of apoptotic cell death. The present study examined the mechanism of cell death in two in vivo models of photoreceptor apoptosis: the retinal degeneration (rd) mouse, a naturally occurring mutant model, and N-methyl-N-nitrosourea-induced retinal degeneration. Specifically, we examined the activation status of caspase-9, -8, -7, -3, and -2 and determined the caspase requirements for cytochrome c release, DNA fragmentation, and apoptosis-associated proteolysis of specific caspase substrates. We show that apoptosis in both in vivo models is independent of caspase-9, -8, -7, -3, and -2 activation. DNA fragmentation occurs in the absence of caspase-mediated ICAD (inhibitor of caspase-activated DNase) proteolysis, suggesting that an alternative endonuclease is responsible for DNA cleavage in these models. Importantly, we show that apoptosome activation is prevented because of an absence of mitochondrial cytochrome c release. Experiments performed using a cell-free system indicate that cytochrome c-dependent proteolysis and activation of caspase-9 can be restored in a neonatal cell-free system. However, we found that cytochrome c-dependent proteolysis and activation of caspase-9 could not be restored in an adult cell-free system because of an age-related decrease in the expression of Apaf-1 in the normal developing mouse retina. In the rd mouse, however, this age-related downregulation of apoptotic proteins was not observed, highlighting a critical feature of this model and the prevention of cytochrome c release as an apical event in caspase-independent apoptosis in this system.

Journal ArticleDOI
TL;DR: In this paper, it has been shown that xanthan solutions have gel-like properties, including the ability to hold particles in suspension, but the network structure breaks down readily, allowing the solutions to flow freely.

Journal ArticleDOI
TL;DR: This article examined a group of small, coral-topped mounds (the Darwin mounds) which occur at 1000 m water depth in the northern Rockall Trough, northwest of the UK.

Journal ArticleDOI
TL;DR: In this article, the authors present a comprehensive theoretical and experimental analysis of 1.3/spl mu/m InGaAsN/GaAs laser devices and show that the threshold current is dominated by nonradiative, defect-related recombination.
Abstract: We present a comprehensive theoretical and experimental analysis of 1.3-/spl mu/m InGaAsN/GaAs lasers. After introducing the 10-band k /spl middot/ p Hamiltonian which predicts transition energies observed experimentally, we employ it to investigate laser properties of ideal and real InGaAsN/GaAs laser devices. Our calculations show that the addition of N reduces the peak gain and differential gain at fixed carrier density, although the gain saturation value and the peak gain as a function of radiative current density are largely unchanged due to the incorporation of N. The gain characteristics are optimized by including the minimum amount of nitrogen necessary to prevent strain relaxation at the given well thickness. The measured spontaneous emission and gain characteristics of real devices are well described by the theoretical model. Our analysis shows that the threshold current is dominated by nonradiative, defect-related recombination. Elimination of these losses would enable laser characteristics comparable with the best InGaAsP/InP-based lasers with the added advantages provided by the GaAs system that are important for vertical integration.

Journal ArticleDOI
TL;DR: The results (including a subgroup analysis of soya product consumers) showed that such levels are difficult to achieve with the European diets studied here.
Abstract: The aim of this study was to identify the level of isoflavone intake (total isoflavones, daidzein and genistein) in four European countries: Ireland, Italy, The Netherlands and the UK. For this purpose national food composition databases of isoflavone content were created in a comparable way, using the Vegetal Estrogens in Nutrition and the Skeleton (VENUS) analytical database as a common basis, and appropriate food consumption data were selected. The isoflavone intake in Ireland, Italy, The Netherlands and the UK is on average less than 1 mg/d. Small groups of consumers of soya foods could be identified in Ireland, The Netherlands and the UK. The estimated intake levels are low compared with those found in typical Asian diets (∼20-100 mg/d) and also low compared with levels where physiological effects are expected (60-100 mg/d). The results (including a subgroup analysis of soya product consumers) showed that such levels are difficult to achieve with the European diets studied here. Chemicals/CAS: daidzein, 486-66-8; genistein, 446-72-0; isoflavone, 574-12-9; daidzein, 486-66-8; Genistein, 446-72-0; Isoflavones

Journal ArticleDOI
TL;DR: In this paper, the relationship between glass transition, water plasticization and relaxation times can be shown in state diagrams, which are useful as stability or quality maps and in the control of rates of changes in food processing and storage.
Abstract: Thermal properties of food systems are important in understanding relationships between food properties and changes in food quality. Concentrated food systems (low-moisture and frozen foods) are seldom in an equilibrium state and they tend to form amorphous, non-crystalline structures. Several glass transition-related changes in such foods affect stability, e.g., stickiness and caking of powders, crispness of snack foods and breakfast cereals, crystallisation of amorphous sugars, recrystallisation of gelatinised starch, ice formation and recrystallisation in frozen foods and rates of non-enzymatic browning and enzymatic reactions. Relationships between glass transition, water plasticisation and relaxation times can be shown in state diagrams. State diagrams are useful as stability or quality maps and in the control of rates of changes in food processing and storage.

Journal ArticleDOI
TL;DR: In this article, the performance of different fat replacers at various levels (Inulin powder, Inulin gel and Simplesse) in wheat bread and dough compared to a control containing block fat was examined.

Journal ArticleDOI
TL;DR: In this article, three batches of three Italian ewes' milk cheeses (Canestrato Pugliese, Fiore Sardo and Pecorino Romano), which were manufactured under the Protected Denomination of Origin (PDO), were compared for microbiological, compositional, biochemical, volatile profile and sensory characteristics.

Journal ArticleDOI
TL;DR: It is argued that despite the availability of a range of treatment options and policy changes advocating greater use of self-treatment, patients are inhibited from disclosing prior self- treatment, and disclosure is affected by patients' perceptions of the legitimacy ofSelf-treatment.