Are there independent effects of constraint and predictability on eye movements during reading?

Evidence of processing costs for unexpected words presented in place of a more expected completion remains elusive in the eye-movement literature. The current study investigated whether such prediction error costs depend on the source of constraint violation provided by the prior context. Participants' eye movements were recorded as they read predictable words and unpredictable alternatives that were either semantically related or unrelated in three-sentence passages. The passages differed in whether the source of constraint originated solely from the global context provided by the first two semantically rich sentences of the passage, from the local context provided by the final sentence of the passage, from both the global and local context, or from none of the three sentences of the passage. The results revealed the expected processing advantage for predictable completions in any constraining context, although the relative contributions of the different sources of constraint varied across the time course of word processing. Unpredictable completions, however, did not yield any processing costs when the context constrained toward a different word, instead producing immediate processing benefits in the presence of any constraining context. Moreover, the initial processing of related unpredictable completions was enhanced further by the provision of a supportive global context. Predictability effects therefore do not appear to be determined by cloze probability alone but also by the nature of the prior contextual constraint especially when they encourage the construction of higher-level discourse representations. The implications of these findings for understanding existing theoretical models of predictive processing are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Looking for immediate and downstream evidence of lexical prediction in eye movements during reading

Previous investigations of whether readers make predictions about the full identity of upcoming words have focused on the extent to which there are processing consequences when readers encounter linguistic input that is incompatible with their expectations. To date, eye-movement studies have revealed inconsistent evidence of the processing costs that would be expected to accompany lexical prediction. This study investigated whether readers' lexical predictions were observable during or downstream from their initial point of activation. Three experiments assessed readers' eye movements to predictable and unpredictable words, and then to subsequent downstream words, which probed the lingering activation of previously expected words. The results showed novel evidence of processing costs for unexpected input but only when supported by a plausible linguistic environment, suggesting that readers could strategically modulate their predictive processing. However, there was limited evidence that their lexical predictions affected downstream processing. The implications of these findings for understanding the role of prediction in language processing are discussed.

Flexible tape-drive target system for secondary high-intensity laser-driven sources

We present the development of a flexible tape-drive target system to generate and control secondary high-intensity laser-plasma sources. Its adjustable design permits the generation of relativistic MeV particles and x rays at high-intensity (i.e., ≥1 × 1018 W cm-2) laser facilities, at high repetition rates (>1 Hz). The compact and robust structure shows good mechanical stability and a high target placement accuracy (<4 μm RMS). Its compact and flexible design allows for mounting in both the horizontal and vertical planes, which makes it practical for use in cluttered laser-plasma experimental setups. The design permits ∼170° of access on the laser-driver side and 120° of diagnostic access at the rear. A range of adapted apertures have been designed and tested to be easily implemented to the targetry system. The design and performance testing of the tape-drive system in the context of two experiments performed at the COMET laser facility at the Lawrence Livermore National Laboratory and at the Advanced Lasers and Extreme Photonics (ALEPH) facility at Colorado State University are discussed. Experimental data showing that the designed prototype is also able to both generate and focus high-intensity laser-driven protons at high repetition rates are also presented.

Lexical processing across the visual field

This article reports six experiments in which participants made speeded binary decisions about letter strings that were displayed for 100 versus 300 ms at different retinal eccentricities in the left versus right visual field to examine how these variables and task demands influence word-identification accuracy and latency. Across the experiments, lexical-processing performance decreased with eccentricity, but to a lesser degree for words displayed in the right visual field, replicating previous reports. However, the effect of eccentricity was attenuated for the two tasks that required "deep" semantic judgments (e.g., discriminating words that referenced animals vs. objects) relative to the tasks that required "shallow" letter and/or lexical processing (e.g., detecting words containing a pre-specified target letter, discriminating words from nonwords). These results suggest that lexical and supra-lexical knowledge play a significant role in supporting lexical processing, especially at greater eccentricities, thereby allowing readers to extend the visual span, or region of effective letter processing, into the perceptual span, or region of useful information extraction. The broader theoretical implications of these findings are discussed in relation to existing and future models of reading. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How do task demands and aging affect lexical prediction during online reading of natural texts?

Facilitated identification of predictable words during online reading has been attributed to the generation of predictions about upcoming words. But highly predictable words are relatively infrequent in natural texts, raising questions about the utility and ubiquity of anticipatory prediction strategies. This study investigated the contribution of task demands and aging to predictability effects for short natural texts from the Provo corpus. The eye movements of 49 undergraduate students (mean age 21.2) and 46 healthy older adults (mean age 70.8) were recorded while they read these passages in two conditions: (a) reading for meaning to answer occasional comprehension questions; (b) proofreading to detect "transposed letter" lexical errors (e.g., clam instead of calm) in intermixed filler passages. The results suggested that the young adults, but not the older adults, engaged anticipatory prediction strategies to detect semantic errors in the proofreading condition, but neither age group showed any evidence of costs of prediction failures. Rather, both groups showed facilitated reading times for unexpected words that appeared in a high constraint within-sentence position. These findings suggest that predictability effects for natural texts reflect partial, probabilistic expectancies rather than anticipatory prediction of specific words. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A multitask comparison of word- and character-frequency effects in Chinese reading

In this study, we examined the effects of word and character frequency across three commonly used word-identification tasks (lexical decision, naming, and sentence reading) using the same set of two-character target words (N = 60) and participants (N = 82). Facilitatory effects of word frequency were observed across all three tasks. The character-frequency effects, however, were facilitatory for naming but inhibitory for both lexical decision and reading. Further correlational analyses indicated that participants' performance (as measured using overall response latencies and the sizes of the frequency effects) was not consistent across tasks but was relatively reliable within the lexical-decision and reading tasks. These findings are discussed in relation to what is known about the reading of Chinese versus alphabetic scripts, word-identification tasks, and models of word identification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

P-031 AN UNUSUAL CASE OF AN INCARCERATED 5MM PORT SITE HERNIA FOLLOWING LAPAROSCOPIC FUNDOPLICATION

Aim

Port site hernias are a rare, but recognised risk of laparoscopic surgery. Literature supports fascial closure at port sites of 10mm or greater. However, there are few reported cases of herniation through 5mm port sites.

Methods

This case report focuses on a 67-year-old female who underwent an uncomplicated primary laparoscopic Toupet's fundoplication. 11 days post procedure she presented with an incarcerated port site hernia. CT scan demonstrated high grade small bowel obstruction with a transition point at the site of the 5mm right sided port. A laparotomy was performed, the hernia reduced, small bowel was viable, and the port site hernia was closed internally using vicryl sutures.

Results

The incidence of 5mm trocar-site hernias is rare. A recent literature review found only 10 such cases related to general surgery (cholecystectomy:6; appendicectomy: 2; right hemicolectomy: 1; paraesophageal hernia:1). Risk factors for port-site hernias include: high BMI, midline position, size, number and type of trocar tip. The limited current literature identifies excessive trocar manipulation as the major risk factor for developing 5mm port-site hernias, yet routine fascial closure is not supported.

Conclusion

Herniation at 5mm port sites is rare but attention should be paid when patients present with symptoms suggesting its occurrence.

Assessing cognitive flexibility in anorexia nervosa using eye tracking: A registered report

OBJECTIVE

Cognitive flexibility research in anorexia nervosa (AN) has primarily focused on group differences between clinical and control participants, but research in the general population utilizing the mixed pro- anti-saccade flexibility task has demonstrated individual differences in trait anxiety are a determinant of switching performance, and switching impairments are more pronounced for keypress than saccadic (eye-movement) responses. The aim of the current research is to explore trait anxiety and differences in saccadic and keypress responding as potential determinants of performance on flexibility tasks in AN.

METHOD

We will compare performance on the mixed pro- anti-saccade paradigm between female adult participants with a current diagnosis of AN and matched control participants, observing both saccadic and keypress responses while controlling for trait anxiety (State - Trait Anxiety Inventory) and spatial working memory (Corsi Block Tapping Test). Associations with eating disorder-related symptoms (Eating Disorder Examination Questionnaire), flexibility in everyday life (Eating Disorder Flexibility Index), and the Clinical Perfectionism Questionnaire will also be assessed.

RESULTS

Data which controls for individual differences in trait anxiety and assesses flexibility at both the task- and response-set level may be used to more accurately understand differences in performance on cognitive flexibility tasks by participants with AN.

DISCUSSION

Clarifying the effects of trait anxiety on flexibility, and differences between task- and response-set switching may advance our understanding of how cognitive flexibility relates to flexibility in everyday life and improve translation to therapeutic approaches.

PUBLIC SIGNIFICANCE STATEMENT

This research will compare performance on a flexibility task between participants with anorexia nervosa (AN) and controls while observing their eye-movements to examine whether trait anxiety and type of response (eye-movement and keypress) are associated with performance. This data may improve our understanding of why participants with AN perform more poorly on cognitive flexibility tasks, and how poor cognitive flexibility relates to eating disorder-related issues with flexibility in everyday life.

Understanding the visual constraints on lexical processing: New empirical and simulation results

Word identification is slower and less accurate outside central vision, but the precise relationship between retinal eccentricity and lexical processing is not well specified by models of either word identification or reading. In a seminal eye-movement study, Rayner and Morrison (1981) found that participants made remarkably accurate naming and lexical-decision responses to words displayed more than 3 degrees from the center of vision-even under conditions requiring fixed gaze. However, the validity of these findings is challenged by a range of methodological limitations. We report a series of gaze-contingent lexical-decision and naming experiments that replicate and extend Rayner and Morrison's study to provide a more accurate estimate of how visual constraints delimit lexical processing. Simulations were conducted using the E-Z Reader model (Reichle et al., 2012) to assess the implications for understanding eye-movement control during reading. Augmenting the model's assumptions about the impact of both eccentricity and visual crowding on the rate of lexical processing provided good fits to the observed data without impairing the model's ability to simulate benchmark eye-movement effects. The findings are discussed with a view toward the development of a complete model of reading. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

969 ACUTE FRAILTY MODEL: A DISTRICT GENERAL HOSPITAL EXPERIENCE OF DELIVERING COMPREHENSIVE GERIATRIC ASSESSMENT

Introduction

Under the NHS Long Term Plan1, every hospital with a Type 1 Emergency Department (ED) has been asked to provide Acute Frailty Services for at least 70 hours a week. We have adopted a liaison model to ensure Comprehensive Geriatric Assessment at the front door. The Frailty Team now includes two Frailty Practitioners, a Specialist Registrar based in ED and the Acute Medical Unit (AMU) with Consultant Physician of the Week support.

Method

The team attend multi-disciplinary meetings in ED and AMU on a daily basis. Frail patients are reviewed and Comprehensive Geriatric Assessments are undertaken together with appropriate signposting. The aim being, to enhance the care of frail patients at the earliest opportunity.

Results

High bed utilisation comes at a cost and a longer length of stay (LOS) is associated with an increased risk of deconditioning. Since introducing incremental changes to our working model, the average LOS of patients on AMU has been reduced from a mean of 1.33 days to 0.82 days. This represents a 38.3% reduction from September 2020 to August 2021. This reduction has been sustained, while 30-day readmission rates have not increased. Feedback has been very positive from all the other teams involved.

Conclusion

Our service has established a more positive working culture to efficiently manage frail patients. The AMU team now feel empowered to make patient-centric decisions regarding patient flow and discharges. Since this data was analysed we have implemented a further change to help enhance the care of frail patients. A list of appropriate patients is emailed to the hospital site team every afternoon to aid getting the right patients into the right beds. The impact of LOS on the frailty wards will then be reviewed following this introduction.

Reference

1. nhs-long-term-plan-june-2019.pdf (longtermplan.nhs.uk).

Small-molecule inhibitors of P-Rex guanine-nucleotide exchange factors

P-Rex1 and P-Rex2 are guanine-nucleotide exchange factors (GEFs) that activate Rac small GTPases in response to the stimulation of G protein-coupled receptors and phosphoinositide 3-kinase. P-Rex Rac-GEFs regulate the morphology, adhesion and migration of various cell types, as well as reactive oxygen species production and cell cycle progression. P-Rex Rac-GEFs also have pathogenic roles in the initiation, progression or metastasis of several types of cancer. With one exception, all P-Rex functions are known or assumed to be mediated through their catalytic Rac-GEF activity. Thus, inhibitors of P-Rex Rac-GEF activity would be valuable research tools. We have generated a panel of small-molecule P-Rex inhibitors that target the interface between the catalytic DH domain of P-Rex Rac-GEFs and Rac. Our best-characterized compound, P-Rex inhibitor 1 (PREX-in1), blocks the Rac-GEF activity of full-length P-Rex1 and P-Rex2, and of their isolated catalytic domains, in vitro at low-micromolar concentration, without affecting the activities of several other Rho-GEFs. PREX-in1 blocks the P-Rex1 dependent spreading of PDGF-stimulated endothelial cells and the production of reactive oxygen species in fMLP-stimulated mouse neutrophils. Structure-function analysis revealed critical structural elements of PREX-in1, allowing us to develop derivatives with increased efficacy, the best with an IC₅₀ of 2 µM. In summary, we have developed PREX-in1 and derivative small-molecule compounds that will be useful laboratory research tools for the study of P-Rex function. These compounds may also be a good starting point for the future development of more sophisticated drug-like inhibitors aimed at targeting P-Rex Rac-GEFs in cancer.

Predictability effects and parafoveal processing in older readers

Normative aging is accompanied by visual and cognitive changes that impact the systems that are critical for fluent reading. The patterns of eye movements during reading displayed by older adults have been characterized as demonstrating a trade-off between longer forward saccades and more word skipping versus higher rates of regressions back to previously read text. This pattern is assumed to reflect older readers' reliance on top-down contextual information to compensate for reduced uptake of parafoveal information from yet-to-be fixated words. However, the empirical evidence for these assumptions is equivocal. This study investigated the depth of older readers' parafoveal processing as indexed by sensitivity to the contextual plausibility of parafoveal words in both neutral and highly constraining sentence contexts. The eye movements of 65 cognitively intact older adults (61-87 years) were compared with data previously collected from young adults in two sentence reading experiments in which critical target words were replaced by valid, plausible, related, or implausible previews until the reader fixated on the target word location. Older and younger adults showed equivalent plausibility preview benefits on first-pass reading measures of both predictable and unpredictable words. However, older readers did not show the benefit of preview orthographic relatedness that was observed in young adults and showed significantly attenuated preview validity effects. Taken together, the data suggest that older readers are specifically impaired in the integration of parafoveal and foveal information but do not show deficits in the depth of parafoveal processing. The implications for understanding the effects of aging on reading are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Morphological preview effects in English are restricted to suffixed words

Much of the evidence for morphological decomposition accounts of complex word identification has relied on the masked-priming paradigm. However, morphologically complex words are typically encountered in sentence contexts and processing begins before a word is fixated, when it is in the parafovea. To evaluate whether the single word-identification data generalize to natural reading, Experiment 1 investigated the contribution of morphological structure to the very earliest stages of lexical processing indexed by preview effects during sentence reading in the gaze-contingent boundary paradigm. Preview conditions systematically assessed the impact of prefixed and suffixed nonword previews that manipulated stem and affix overlap, and affix status, against an orthographically legal control baseline. Initial fixations on suffixed target words showed a preview benefit from nonwords that combined the target stem with a legitimate affix, but not with a nonaffix, whereas prefixed targets only benefited from an identical preview. When presented in a masked prime lexical-decision task in Experiment 2, the same stimuli yielded equivalent stem priming from suffixed and prefixed primes regardless of affix status, consistent with previous masked priming studies using similar nonword primes. The early effects of morphological structure selectively observed on parafoveal processing of suffixed words are inconsistent with recent nonmorphological, position-invariant accounts of embedded stem activation. These results provide the first evidence of morphological parafoveal processing in English and contribute to recent evidence that readers extract a higher level of information from the parafovea during natural reading than was previously assumed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Performance of typical and superior face recognizers on a novel interactive face matching procedure

Unfamiliar simultaneous face matching is error prone. Reducing incorrect identification decisions will positively benefit forensic and security contexts. The absence of view-independent information in static images likely contributes to the difficulty of unfamiliar face matching. We tested whether a novel interactive viewing procedure that provides the user with 3D structural information as they rotate a facial image to different orientations would improve face matching accuracy. We tested the performance of 'typical' (Experiment 1) and 'superior' (Experiment 2) face recognizers, comparing their performance using high-quality (Experiment 3) and pixelated (Experiment 4) Facebook profile images. In each trial, participants responded whether two images featured the same person with one of these images being either a static face, a video providing orientation information, or an interactive image. Taken together, the results show that fluid orientation information and interactivity prompt shifts in criterion and support matching performance. Because typical and superior face recognizers both benefited from the structural information provided by the novel viewing procedures, our results point to qualitatively similar reliance on pictorial encoding in these groups. This also suggests that interactive viewing tools can be valuable in assisting face matching in high-performing practitioner groups.

Electron acceleration at oblique angles via stimulated Raman scattering at laser irradiance >10^{16}Wcm^{-2}μm^{2}

The generation of hot, directional electrons via laser-driven stimulated Raman scattering (SRS) is a topic of great importance in inertial confinement fusion (ICF) schemes. Little recent research has been dedicated to this process at high laser intensity, in which back, side, and forward scatter simultaneously occur in high energy density plasmas, of relevance to, for example, shock ignition ICF. We present an experimental and particle-in-cell (PIC) investigation of hot electron production from SRS in the forward and near-forward directions from a single speckle laser of wavelength λ_{0}=1.053μm, peak laser intensities in the range I_{0}=0.2-1.0×10^{17}Wcm^{-2} and target electron densities between n_{e}=0.3-1.6%n_{c}, where n_{c} is the plasma critical density. As the intensity and density are increased, the hot electron spectrum changes from a sharp cutoff to an extended spectrum with a slope temperature T=34±1keV and maximum measured energy of 350 keV experimentally. Multidimensional PIC simulations indicate that the high energy electrons are primarily generated from SRS-driven electron plasma wave phase fronts with k vectors angled ∼50^{∘} with respect to the laser axis. These results are consistent with analytical arguments that the spatial gain is maximized at an angle which balances the tendency for the growth rate to be larger for larger scattered light wave angles until the kinetic damping of the plasma wave becomes important. The efficiency of generated high energy electrons drops significantly with a reduction in either laser intensity or target electron density, which is a result of the rapid drop in growth rate of Raman scattering at angles in the forward direction.

A pilot study evaluating GSK1070806 inhibition of interleukin-18 in renal transplant delayed graft function

INTRODUCTION

Delayed graft function (DGF) following renal transplantation is a manifestation of acute kidney injury (AKI) leading to poor long-term outcome. Current treatments have limited effectiveness in preventing DGF. Interleukin-18 (IL18), a biomarker of AKI, induces interferon-γ expression and immune activation. GSK1070806, an anti-IL18 monoclonal antibody, neutralizes activated (mature) IL18 released from damaged cells following inflammasome activation. This phase IIa, single-arm trial assessed the effect of a single dose of GSK1070806 on DGF occurrence post donation after circulatory death (DCD) kidney transplantation.

METHODS

The 3 mg/kg intravenous dose was selected based on prior studies and physiologically based pharmacokinetic (PBPK) modeling, indicating the high likelihood of a rapid and high level of IL18 target engagement when administered prior to kidney allograft reperfusion. Utilization of a Bayesian sequential design with a background standard-of-care DGF rate of 50% based on literature, and confirmed via extensive registry data analyses, enabled a statistical efficacy assessment with a minimal sample size. The primary endpoint was DGF frequency, defined as dialysis requirement ≤7 days post transplantation (except for hyperkalemia). Secondary endpoints included safety, pharmacokinetics and pharmacodynamic biomarkers.

RESULTS

GSK1070806 administration was associated with IL18-GSK1070806 complex detection and increased total serum IL18 levels due to IL18 half-life prolongation induced by GSK1070806 binding. Interferon-γ-induced chemokine levels declined or remained unchanged in most patients. Although the study was concluded prior to the Bayesian-defined stopping point, 4/7 enrolled patients (57%) had DGF, exceeding the 50% standard-of-care rate, and an additional two patients, although not reaching the protocol-defined DGF definition, demonstrated poor graft function. Six of seven patients experienced serious adverse events (SAEs), including two treatment-related SAEs.

CONCLUSION

Overall, using a Bayesian design and extensive PBPK dose modeling with only a small sample size, it was deemed unlikely that GSK1070806 would be efficacious in preventing DGF in the enrolled DCD transplant population.

TRIAL REGISTRATION

NCT02723786.

Cost effectiveness of intraoperative laparoscopic ultrasound for suspected choledocholithiasis; outcomes from a specialist benign upper gastrointestinal unit

INTRODUCTION

Common bile duct stones are present in 10% of patients with symptomatic gallstones. One-third of UK patients undergoing cholecystectomy will have preoperative ductal imaging, commonly with magnetic resonance cholangiopancreatography. Intraoperative laparoscopic ultrasound is a valid alternative but is not widely used. The primary aim of this study was to assess cost effectiveness of laparoscopic ultrasound compared with magnetic resonance cholangiopancreatography.

MATERIALS AND METHODS

A prospective database of all patients undergoing laparoscopic cholecystectomy between 2015 and 2018 at a district general hospital was assessed. Inclusion criteria were all patients, emergency and elective, with symptomatic gallstones and suspicion of common bile duct stones (derangement of liver function tests with or without dilated common bile duct on preoperative ultrasound, or history of pancreatitis). Patients with known common bile duct stones (magnetic resonance cholangiopancreatography or failed endoscopic retrograde cholangiogram) were excluded. Ninety-day morbidity data were also collected.

RESULTS

A total of 420 (334 elective and 86 emergency) patients were suspected to have common bile duct stones and were included in the study. The cost of a laparoscopic ultrasound was £183 per use. The cost of using the magnetic resonance cholangiopancreatography unit was £365 per use. Ten postoperative magnetic resonance cholangiopancreatographies were performed for inconclusive intraoperative imaging. The estimated cost saving was £74,650. Some 128 patients had common bile duct stones detected intraoperatively and treated. There was a false positive rate of 4.7%, and the false negative rate at 90 days was 0.7%. laparoscopic ultrasound use saved 129 bed days for emergency patients and 240 magnetic resonance cholangiopancreatography hours of magnetic resonance imaging.

CONCLUSION

The use of laparoscopic ultrasound during laparoscopic cholecystectomy for the detection of common bile duct stone is safe, accurate and cost effective. Equipment and maintenance costs are quickly offset and hospital bed days can be saved with its use.

A rare late complication of traumatic diaphragmatic hernia repair

We report a case of sudden cardiovascular collapse several weeks following surgical repair of a traumatic diaphragmatic hernia. The patient presented with features of circulatory shock without a clear diagnosis, therefore an urgent computed tomography scan of the chest and abdomen was undertaken, which revealed a pericardial effusion with evidence of cardiac tamponade. Ultrasound-guided needle pericardiocentesis with aspiration of blood from the pericardial sac in the Emergency Department provided an immediate response and her cardiac output improved. On review of the imaging, it is likely a surgically-placed permanent metallic fixation device, sitting near the pericardium, caused bleeding into the pericardial sac due to local trauma as a delayed postoperative complication.

DNA methylation and mRNA expression of imprinted genes in blastocysts derived from an improved in vitro maturation method for oocytes from small antral follicles in polycystic ovary syndrome patients

STUDY QUESTION

Does imprinted DNA methylation or imprinted gene expression differ between human blastocysts from conventional ovarian stimulation (COS) and an optimized two-step IVM method (CAPA-IVM) in age-matched polycystic ovary syndrome (PCOS) patients?

SUMMARY ANSWER

No significant differences in imprinted DNA methylation and gene expression were detected between COS and CAPA-IVM blastocysts.

WHAT IS KNOWN ALREADY

Animal models have revealed alterations in DNA methylation maintenance at imprinted germline differentially methylated regions (gDMRs) after use of ARTs. This effect increases as more ART interventions are applied to oocytes or embryos. IVM is a minimal-stimulation ART with reduced hormone-related side effects and risks for patients. CAPA-IVM is an improved IVM system that includes a pre-maturation step (CAPA), followed by an IVM step, both in the presence of physiological compounds that promote oocyte developmental capacity.

STUDY DESIGN, SIZE, DURATION

For DNA methylation analysis 20 CAPA-IVM blastocysts were compared to 12 COS blastocysts. For RNA-Seq analysis a separate set of 15 CAPA-IVM blastocysts were compared to 5 COS blastocysts.

PARTICIPANTS/MATERIALS, SETTING, METHODS

COS embryos originated from 12 patients with PCOS (according to Rotterdam criteria) who underwent conventional ovarian stimulation. For CAPA-IVM 23 women were treated for 3-5 days with highly purified hMG (HP-hMG) and no hCG trigger was given before oocyte retrieval. Oocytes were first cultured in pre-maturation medium (CAPA for 24 h containing C-type natriuretic peptide), followed by an IVM step (30 h) in medium containing FSH and Amphiregulin. After ICSI, Day 5 or 6 embryos in both groups were vitrified and used for post-bisulphite adaptor tagging (PBAT) DNA methylation analysis or RNA-seq gene expression analysis of individual embryos. Data from specific genes and gDMRs were extracted from the PABT and RNA-seq datasets.

MAIN RESULTS AND THE ROLE OF CHANCE

CAPA-IVM blastocysts showed similar rates of methylation and gene expression at gDMRs compared to COS embryos. In addition, expression of major epigenetic regulators was similar between the groups.

LIMITATIONS, REASONS FOR CAUTION

The embryos from the COS group were generated in a range of culture media. The CAPA-IVM embryos were all generated using the same sperm donor. The DNA methylation level of gDMRs in purely in vivo-derived human blastocysts is not known.

WIDER IMPLICATIONS OF THE FINDINGS

A follow-up of children born after CAPA-IVM is important as it is for other new ARTs, which are generally introduced into clinical practice without prior epigenetic safety studies on human blastocysts. CAPA-IVM opens new perspectives for patient-friendly ART in PCOS.

STUDY FUNDING/COMPETING INTEREST(S)

IVM research at the Vrije Universiteit Brussel has been supported by grants from the Institute for the Promotion of Innovation by Science and Technology in Flanders (Agentschap voor Innovatie door Wetenschap en Technologie-IWT, project 110680), the Fund for Research Flanders (Fonds voor Wetenschappelijk Onderzoek-Vlaanderen-FWO-AL 679 project, project G.0343.13), the Belgian Foundation Against Cancer (HOPE project, Dossier C69Ref Nr 2016-119) and the Vrije Universiteit Brussel (IOF Project 4R-ART Nr 2042). Work in G.K.'s laboratory is supported by the UK Biotechnology and Biological Sciences Research Council and Medical Research Council. The authors have no conflicts of interest.

ANTI-DIABETIC EFFECT OF ETHANOL EXTRACT OF Costus spicatus JACQ. IN RHIZOME EXTRACT IN STREPTOZOTOCIN-INDUCED DIABETIC RATS –HISTOLOGICAL STUDY

Objective: The rats were randomly divided into 5 groups and each group consisted of 6 rats and the duration of treatment was 45 days. Body weight, fasting plasma glucose levels, SGOT, SGPT and ALP levels were measured. Methods: Albino Wistar male rats; 10- weeks old with a bodyweight ranged between 180-250 g were used. Anti-diabetic effect of plant Costus spicatus. In rhizome extract of ethanol extract. Result: The present study clearly indicates in the form of administration of C. spicatus rhizome extract towards glucose fed mice normalizes blood glucose level. Recent studies have revealed induced diabetic rats caused anti-diabetic effects. Histopathological studies of Pancreasin diabetic and treated groups are determined to show the protective action of the ECS. The administration of STZ resulted in a significant increase in plasma glucose level, SGOT, SGPT and ALP along with a reduction in body weight. Conclusion: All these effects were observed on 45th day. ECS and Glibenclamide of STZ induced diabetic animals restored the normal plasma glucose levels and SGOT, SGPT and ALP levels without damaging the pancreas. Keywords:Anti-hypolipidemic, diabetes mellitus, peripheral insulin resistance, pancreatic, STZ.

Understanding patient access patterns for primary health-care services for Aboriginal and Islander people in Queensland: a geospatial mapping approach

This paperexplores the patterns ofpatients'accessingsix Aboriginal and Islander CommunityControlled Health Services (AICCHSs) in Queensland. Between August 2011 and February 2014, 26199 patients made at least one visit over a 2-year period prior to at least one of six Queensland AICCHS - one urban service (RA 1) in south-east Queensland, and five services in regional towns (RA 3) in Far North Queensland. Geospatial mapping of addresses for these registered patients was undertaken. The outcomes analysed included travel times to, the proportion of catchment populations using each AICCHS and an assessment of alternative mainstream general practice availability to these patients was made. In brief, the use of AICCHS was higher than Australian Bureau of Statistics census data would suggest. Approximately 20% of clients travel more than 30min to seek Aboriginal Health services, but only 8% of patients travelled longer than 60min. In the major city site, many other general practitioner (GP) services were bypassed. The data suggest Aboriginal and Islander patients in Queensland appear to value community-controlled primary care services. The number of Indigenous clients in regional locations in the Far North Queensland registered with services is often higher than the estimated resident population numbers.

Selective RET kinase inhibition for patients with RET-altered cancers

Background

Alterations involving the RET kinase are implicated in the pathogenesis of lung, thyroid and other cancers. However, the clinical activity of multikinase inhibitors (MKIs) with anti-RET activity in RET-altered patients appears limited, calling into question the therapeutic potential of targeting RET. LOXO-292 is a selective RET inhibitor designed to inhibit diverse RET fusions, activating mutations and acquired resistance mutations.

Patients and methods

Potent anti-RET activity, high selectivity, and central nervous system coverage were confirmed preclinically using a variety of in vitro and in vivo RET-dependent tumor models. Due to clinical urgency, two patients with RET-altered, MKI-resistant cancers were treated with LOXO-292, utilizing rapid dose-titration guided by real-time pharmacokinetic assessments to achieve meaningful clinical exposures safely and rapidly.

Results

LOXO-292 demonstrated potent and selective anti-RET activity preclinically against human cancer cell lines harboring endogenous RET gene alterations; cells engineered to express a KIF5B-RET fusion protein -/+ the RET V804M gatekeeper resistance mutation or the common RET activating mutation M918T; and RET-altered human cancer cell line and patient-derived xenografts, including a patient-derived RET fusion-positive xenograft injected orthotopically into the brain. A patient with RET M918T-mutant medullary thyroid cancer metastatic to the liver and an acquired RET V804M gatekeeper resistance mutation, previously treated with six MKI regimens, experienced rapid reductions in tumor calcitonin, CEA and cell-free DNA, resolution of painful hepatomegaly and tumor-related diarrhea and a confirmed tumor response. A second patient with KIF5B-RET fusion-positive lung cancer, acquired resistance to alectinib and symptomatic brain metastases experienced a dramatic response in the brain, and her symptoms resolved.

Conclusions

These results provide proof-of-concept of the clinical actionability of RET alterations, and identify selective RET inhibition by LOXO-292 as a promising treatment in heavily pretreated, multikinase inhibitor-experienced patients with diverse RET-altered tumors.

Laparoscopic common bile duct exploration; a preferential pathway for elderly patients

Background

Laparoscopic common bile duct exploration (LCBDE) has emerged as a recommended alternative to endoscopic retrograde cholangiopancreatography (ERCP) for the management of choledocholithiasis. However, its use in the elderly has been limited, and evidence of its safety and efficacy in these patients is yet to be established. This study describes our experience of LCBDE in elderly patients, analysing the safety and efficacy of this technique in comparison to younger patients.

Methods

All patients undergoing laparoscopic cholecystectomy (LC) with LCBDE for choledocholithiasis in our unit between January 2015 and January 2017 were included. Data pertaining to patient demographics, comorbidities, investigations, operative technique and outcomes were analysed. Patients were divided into 2 groups based on age (Group A:<65 years vs Group B: >/ = 65 years) for comparative analysis.

Results

124 patients (Group A: 65, Group B: 59) were included. Group B were more co-morbid and had a higher ASA grade than Group A. However, there was no significant difference between groups in rates of conversion to open or complications, including bile leak (3.1% vs 5.1%, p = 0.67), retained stone (4.6% vs 1.7%, p = 0.62), or complications according to Clavien-Dindo classification (p = 0.78). Re-intervention rates were also similar between groups (7.7% vs 3.4%, p = 0.44 and 3.1% vs 3.4%, p = 1.0 respectively), as was length of stay.

Conclusion

Despite higher frequency of comorbidities and ASA grade, LCBDE in elderly patients is safe and effective, and has similar outcomes to younger patients. Therefore elderly patients with choledocholithiasis should be offered LCBDE as an alternative to ERCP.

Event-related potentials reveal the development of stable face representations from natural variability

Natural variability between instances of unfamiliar faces can make it difficult to reconcile two images as the same person. Yet for familiar faces, effortless recognition occurs even with considerable variability between images. To explore how stable face representations develop, we employed incidental learning in the form of a face sorting task. In each trial, multiple images of two facial identities were sorted into two corresponding piles. Following the sort, participants showed evidence of having learnt the faces performing more accurately on a matching task with seen than with unseen identities. Furthermore, ventral temporal event-related potentials were more negative in the N250 time range for previously seen than for previously unseen identities. These effects appear to demonstrate some degree of abstraction, rather than simple picture learning, as the neurophysiological and behavioural effects were observed with novel images of the previously seen identities. The results provide evidence of the development of facial representations, allowing a window onto natural mechanisms of face learning.

Spelling ability selectively predicts the magnitude of disruption in unspaced text reading

We examined the effect of individual differences in written language proficiency on unspaced text reading in a large sample of skilled adult readers who were assessed on reading comprehension and spelling ability. Participants' eye movements were recorded as they read sentences containing a low or high frequency target word, presented with standard interword spacing, or in one of three unsegmented text conditions that either preserved or eliminated word boundary information. The average data replicated previous studies: unspaced text reading was associated with increased fixation durations, a higher number of fixations, more regressions, reduced saccade length, and an inflation of the word frequency effect. The individual differences results provided insight into the mechanisms contributing to these effects. Higher reading ability was associated with greater overall reading speed and fluency in all conditions. In contrast, spelling ability selectively modulated the effect of interword spacing with poorer spelling ability predicting greater difficulty across the majority of sentence- and word-level measures. These results suggest that high quality lexical representations allowed better spellers to extract lexical units from unfamiliar text forms, inoculating them against the disruptive effects of being deprived of spacing information. (PsycINFO Database Record

Individual differences in automatic semantic priming

This research investigated whether masked semantic priming in a semantic categorization task that required classification of words as animals or nonanimals was modulated by individual differences in lexical proficiency. A sample of 89 skilled readers, assessed on reading comprehension, vocabulary and spelling ability, classified target words preceded by brief (50 ms) masked primes that were either congruent or incongruent with the category of the target. Congruent primes were also selected to be either high (e.g., hawk EAGLE, pistol RIFLE) or low (e.g., mole EAGLE, boots RIFLE) in semantic feature overlap with the target. "Overall proficiency," indexed by high performance on both a "semantic composite" measure of reading comprehension and vocabulary and a "spelling composite," was associated with stronger congruence priming from both high and low feature overlap primes for animal exemplars, but only predicted priming from low overlap primes for nonexemplars. Classification of high frequency nonexemplars was also significantly modulated by an independent "spelling-meaning" factor, indexed by the discrepancy between the semantic and spelling composites, because relatively higher scores on the semantic than the spelling composite were associated with stronger semantic priming. These findings show that higher lexical proficiency is associated with stronger evidence of automatic semantic priming and suggest that individual differences in lexical quality modulate the division of labor between orthographic and semantic processing in early lexical retrieval. (PsycINFO Database Record

152 SPECIES-SPECIFIC DIFFERENCES IN THE METHYLATION REPROGRAMMING DURING EARLY PRE-IMPLANTATION DEVELOPMENT

Studies in mouse and human have shown extensive DNA methylation reprogramming in pre-implantation development followed by remethylation from implantation. However, the extent to which such reprogramming is conserved in mammals and the timing of demethylation and remethylation are unknown. As part of a major objective to characterise methylation dynamics in the bovine and porcine species from the oocyte to the blastocyst stage, we aimed here to compare the distribution of methylation at single-base resolution in both species at Day 7.5 of development. The DNA methylation profiles were obtained from individual blastocysts at Day 7.5 [pig: 3 in vivo, 3 in vitro; cow: 3 in vivo, 3 in vitro, 3 inner cell mass (ICM) and 3 trophoectoderm (TE) dissected from in vitro blastocysts] using the post-bisulphite adaptor tagging method and Illumina sequencing. For oocytes, data (GEO: GSE63330) from Schroeder et al. 2015 were analysed. Raw sequences were mapped, methylation calls made using Bismark and data analysis and visualisation was done within the SeqMonk platform. Gene expression profiles from individual blastocysts (3 pig, 3 cow) were obtained by RNA-seq. Annotated mRNA features were quantitated in SeqMonk and these were fed into DESeq2 for differential expression analysis (P < 0.05) as previously reported (Love et al. 2014 Genome Biol. 15, 550). Global methylation levels in whole blastocysts differed substantially between porcine and bovine embryos (in vivo: 12.33 ± 3.6 v. 28.33 ± 3.5%; in vitro: 15.02 ± 3.3 v. 24.41 ± 4.1%). In addition, the distribution of methylation differed: the pattern of cytosine methylated seemed random in the porcine genome, but was highly structured in the bovine genome, with methylation predominantly over gene bodies, resembling the profile previously reported in oocytes (Schroeder et al. 2015 PLoS Genet. 11, e1005442). Regarding correlation analysis, gene expression versus methylation were plotted. It suggested that gene body methylation reflected gene expression pattern in oocytes as well as in bovine blastocysts. Pair-wise comparison of isolated ICM and TE was filtered to require 5% change, and replicate set statistics were applied. This revealed very similar total and regional methylation levels in the 2 compartments, indicating that remethylation does not initiate preferentially in one compartment in bovine pre-implantation embryos. This confirms, from a viewpoint of the genome-wide DNA methylation, what has been observed in mouse for specific genes: the trophoblast-specific DNA methylation occurs after the segregation of the TE and ICM (Nakanishi et al. 2012 Epigenetics 7, 173–183). Our study is the first to provide whole genome methylation profiles from single blastocysts of economically important livestock species. Our data demonstrate that methylation reprogramming in early pre-implantation development is species specific. Knowledge of these specific patterns may have high importance when decisions are taken regarding the use of assisted reproductive technologies, cloning, or generation of transgenic animals. This work was funded by AGL2015–66341-R (MINECO-FEDER), PRX14/00348 (MECD), 19595/EE/14 (F. Séneca).

Stress Detection Using Wearable Physiological and Sociometric Sensors

Stress remains a significant social problem for individuals in modern societies. This paper presents a machine learning approach for the automatic detection of stress of people in a social situation by combining two sensor systems that capture physiological and social responses. We compare the performance using different classifiers including support vector machine, AdaBoost, and [Formula: see text]-nearest neighbor. Our experimental results show that by combining the measurements from both sensor systems, we could accurately discriminate between stressful and neutral situations during a controlled Trier social stress test (TSST). Moreover, this paper assesses the discriminative ability of each sensor modality individually and considers their suitability for real-time stress detection. Finally, we present an study of the most discriminative features for stress detection.

Parafoveal preview effects depend on both preview plausibility and target predictability

Recent studies using the boundary paradigm have shown that readers benefit from a parafoveal preview of a plausible continuation of the sentence. This plausibility preview effect occurs irrespective of the semantic or orthographic relatedness of the preview and target word, suggesting that it depends on the degree to which a preview word fits the preceding context. The present study tested this hypothesis by examining the impact of contextual constraint on processing a plausible word in the parafovea. Participants' eye movements were recorded as they read sentences in which a target word was either highly predictable or unpredictable. The boundary paradigm was used to compare predictable, unpredictable, and implausible previews. The results showed that target predictability significantly modulated the effects of identical and plausible previews. Identical previews yielded significantly more benefit than plausible previews for highly predictable targets, but for unpredictable targets a plausible preview was as beneficial as an identical preview. The results shed light on the role of contextual predictability in early lexical processing. Furthermore, these data support the view that readers activate a set of appropriate words from the preceding sentence context, prior to the presentation of the target word.

The Rise of Consumer Health Wearables: Promises and Barriers

Lukasz Piwek and colleagues consider whether wearable technology can become a valuable asset for health care.

Is semantic preview benefit due to relatedness or plausibility?

There is increasing evidence that skilled readers of English benefit from processing a parafoveal preview of a semantically related word. However, in previous investigations of semantic preview benefit using the gaze-contingent boundary paradigm the semantic relatedness between the preview and target has been confounded with the plausibility of the preview word in the sentence. In the present study, preview relatedness and plausibility were independently manipulated in neutral sentences read by a large sample of skilled adult readers. Participants were assessed on measures of reading and spelling ability to identify possible sources of individual differences in preview effects. The results showed that readers benefited from a preview of a plausible word, regardless of the semantic relatedness of the preview and the target. However, there was limited evidence of a semantic relatedness benefit when the plausibility of the preview was controlled. The plausibility preview benefit was strongest for low proficiency readers, suggesting that poorer readers were more likely to program a forward saccade based on information extracted from the preview. High proficiency readers showed equivalent disruption from all nonidentical previews suggesting that they were more likely to suffer interference from the orthographic mismatch between preview and target. (PsycINFO Database Record

Semantic preview benefit in English: Individual differences in the extraction and use of parafoveal semantic information

Although there is robust evidence that skilled readers of English extract and use orthographic and phonological information from the parafovea to facilitate word identification, semantic preview benefits have been elusive. We sought to establish whether individual differences in the extraction and/or use of parafoveal semantic information could account for this discrepancy. Ninety-nine adult readers who were assessed on measures of reading and spelling ability read sentences while their eye movements were recorded. The gaze-contingent boundary paradigm was used to manipulate the availability of relevant semantic and orthographic information in the parafovea. On average, readers showed a benefit from previews high in semantic feature overlap with the target. However, reading and spelling ability yielded opposite effects on semantic preview benefit. High reading ability was associated with a semantic preview benefit that was equivalent to an identical preview on first-pass reading. High spelling ability was associated with a reduced semantic preview benefit despite an overall higher rate of skipping. These results suggest that differences in the magnitude of semantic preview benefits in English reflect constraints on extracting semantic information from the parafovea and competition between the orthographic features of the preview and the target. (PsycINFO Database Record

Beyond Self-Report: Tools to Compare Estimated and Real-World Smartphone Use

Psychologists typically rely on self-report data when quantifying mobile phone usage, despite little evidence of its validity. In this paper we explore the accuracy of using self-reported estimates when compared with actual smartphone use. We also include source code to process and visualise these data. We compared 23 participants’ actual smartphone use over a two-week period with self-reported estimates and the Mobile Phone Problem Use Scale. Our results indicate that estimated time spent using a smartphone may be an adequate measure of use, unless a greater resolution of data are required. Estimates concerning the number of times an individual used their phone across a typical day did not correlate with actual smartphone use. Neither estimated duration nor number of uses correlated with the Mobile Phone Problem Use Scale. We conclude that estimated smartphone use should be interpreted with caution in psychological research.

Gene Clustering Using Metaheuristic Optimization Algorithms

Gene clustering is a familiar step in the exploratory analysis of high dimensional biological data. It is the process of grouping genes of similar patterns in the same cluster and aims at analyzing the functions of gene that leads to the development of drugs and early diagnosis of diseases. In the recent years, much research has been proposed using nature inspired meta-heuristic algorithms. Cuckoo Search is one such optimization algorithm inspired from nature by breeding strategy of parasitic bird, the cuckoo. This paper proposes cuckoo search clustering and clustering using levy flight cuckoo search for grouping brain tumor gene expression dataset. A comparative study is made with genetic algorithm, PSO clustering, cuckoo search clustering and clustering using levy flight cuckoo search. Levy flight is an important property of levy distribution which covers the entire search space. Breeding pattern of cuckoo is associated with the genes that cause tumor to grow and affect other organs gradually. Clusters generated by these algorithms are validated to find the closeness among the genes in a cluster and separation of genes between clusters. Experimental results carried out in this paper show that cuckoo search clustering outperforms other clustering methods used for experimentation.

Visual field asymmetries in object individuation

Repetition blindness (RB) is a failure to detect both instances of two identical stimuli presented in close temporal proximity. It is due to an inability to form separate episodic tokens for a repeated stimulus, resulting in a single conscious representation. In three experiments, participants identified two targets presented simultaneously in different spatial locations. These stimuli were either the same or different. In two experiments the targets occurred on either side of fixation, and in a third experiment both were in the same hemifield. In all experiments, RB was more pronounced for stimuli in the right hemifield. In addition, there was a left hemifield advantage for both repeated and non-repeated stimuli when the two stimuli occurred in opposite visual fields and, thus, were processed by different hemispheres. These findings suggest that the right hemisphere plays a dominant role in attentional selection and in creating conscious representations of visual events.

To transform or not to transform: using generalized linear mixed models to analyse reaction time data

Linear mixed-effect models (LMMs) are being increasingly widely used in psychology to analyse multi-level research designs. This feature allows LMMs to address some of the problems identified by Speelman and McGann (2013) about the use of mean data, because they do not average across individual responses. However, recent guidelines for using LMM to analyse skewed reaction time (RT) data collected in many cognitive psychological studies recommend the application of non-linear transformations to satisfy assumptions of normality. Uncritical adoption of this recommendation has important theoretical implications which can yield misleading conclusions. For example, Balota et al. (2013) showed that analyses of raw RT produced additive effects of word frequency and stimulus quality on word identification, which conflicted with the interactive effects observed in analyses of transformed RT. Generalized linear mixed-effect models (GLMM) provide a solution to this problem by satisfying normality assumptions without the need for transformation. This allows differences between individuals to be properly assessed, using the metric most appropriate to the researcher's theoretical context. We outline the major theoretical decisions involved in specifying a GLMM, and illustrate them by reanalysing Balota et al.'s datasets. We then consider the broader benefits of using GLMM to investigate individual differences.

Telling faces together: Learning new faces through exposure to multiple instances

We are usually able to recognize novel instances of familiar faces with little difficulty, yet recognition of unfamiliar faces can be dramatically impaired by natural within-person variability in appearance. In a card-sorting task for facial identity, different photos of the same unfamiliar face are often seen as different people. Here we report two card-sorting experiments in which we manipulate whether participants know the number of identities present. Without constraints, participants sort faces into many identities. However, when told the number of identities present, they are highly accurate. This minimal contextual information appears to support viewers in "telling faces together". In Experiment 2 we show that exposure to within-person variability in the sorting task improves performance in a subsequent face-matching task. This appears to offer a fast route to learning generalizable representations of new faces.

Masked translation priming asymmetry in Chinese-English bilinguals: Making sense of the Sense Model

Masked translation priming asymmetry is the robust finding that priming from a bilingual's first language (L1) to their second language (L2) is stronger than priming from L2 to L1. This asymmetry has been claimed to be task dependent. The Sense Model proposed by Finkbeiner, Forster, Nicol, and Nakamura (2004) claims that the asymmetry is reduced in semantic categorization relative to lexical decision due to a category filtering mechanism that limits the features considered in categorization decisions to dominant, category-relevant features. This paper reports two pairs of semantic categorization and lexical decision tasks designed to test the Sense Model's predictions. The experiments replicated the finding of Finkbeiner et al. that L2-L1 priming is somewhat stronger in semantic categorization than lexical decision, selectively for exemplars of the category. However, the direct comparison of L2-L1 and L1-L2 translation priming across tasks failed to confirm the Sense Model's central prediction that translation priming asymmetry is significantly reduced in semantic categorization. The data therefore fail to support the category filtering account of translation priming asymmetry. Rather, they suggest that pre-activation of conceptual features of the target category provides feedback to lexical forms that compensates for the weak connections between the lexical and conceptual representations of L2 words.

Improving student nurses' aged care understandings through a supported placement

AIM

The study aimed to identify the potential for aged care placements to deliver benefits for second year nursing students when conducted within a supportive framework with debriefing and critical reflection opportunities.

BACKGROUND

Given the ageing population and complex care needs of aged care facility residents, exacerbated by the high prevalence of dementia, the healthcare workforce's ability to meet older people's care needs is paramount. Yet research shows that nursing students are disengaged from aged care.

METHODS

Using a quasi-experimental mixed method design within an action research framework, 40 students were allocated a 3-week supported placement in 2011-2012 at one of the two intervention residential aged care facilities in Tasmania, Australia. Staff formed mentor action research groups in each facility and participated in a pre-placement capacity-building programme. Thirty-nine students were placed across 14 control facilities. Data were collected via meetings with students and pre-post placement questionnaires on placement experiences, attitudes and dementia knowledge.

RESULTS

The intervention facility placement programme led to mentors and students being well prepared for the placement and to students experiencing enhanced teaching and learning derived from high levels of mentor support and increased autonomy. Students' knowledge, understanding and attitudes around aged care and dementia improved.

DISCUSSION

Mentors working together within an action research framework can provide a supported residential aged care placement for nursing students that improves students' aged care attitudes and understandings.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

Provision of quality, supported aged care student placements is vital to prepare a new generation of nurses who will have to deal with the complex chronic healthcare needs associated with an ageing population.