Communicating the effectiveness and ineffectiveness of government policies and their impact on public support: a systematic review with meta-analysis

Low public support for government interventions in health, environment and other policy domains can be a barrier to implementation. Communicating evidence of policy effectiveness has been used to influence attitudes towards policies, with mixed results. This review provides the first systematic synthesis of such studies. Eligible studies were randomized controlled experiments that included an intervention group that provided evidence of a policy's effectiveness or ineffectiveness at achieving a salient outcome, and measured policy support. From 6498 abstracts examined, there were 45 effect sizes from 36 eligible studies. In total, 35 (N = 30 858) communicated evidence of effectiveness, and 10 (N = 5078) communicated evidence of ineffectiveness. Random effects meta-analysis revealed that communicating evidence of a policy's effectiveness increased support for the policy (SMD = 0.11, 95% CI [0.07, 0.15], p < 0.0001), equivalent to support increasing from 50% to 54% (95% CI [53%, 56%]). Communicating evidence of ineffectiveness decreased policy support (SMD = -0.14, 95% CI [-0.22, -0.06], p < 0.001), equivalent to support decreasing from 50% to 44% (95% CI [41%, 47%]). These findings suggest that public support for policies in a range of domains is sensitive to evidence of their effectiveness, as well as their ineffectiveness.

Public acceptability of nudging and taxing to reduce consumption of alcohol, tobacco, and food: A population-based survey experiment

There is growing evidence for the effectiveness of choice architecture or 'nudge' interventions to change a range of behaviours including the consumption of alcohol, tobacco and food. Public acceptability is key to implementing these and other interventions. However, few studies have assessed public acceptability of these interventions, including the extent to which acceptability varies with the type of intervention, the target behaviour and with evidence of intervention effectiveness. These were assessed in an online study using a between-participants full factorial design with three factors: Policy (availability vs size vs labelling vs tax) x Behaviour (alcohol consumption vs tobacco use vs high-calorie snack food consumption) x Evidence communication (no message vs assertion of policy effectiveness vs assertion and quantification of policy effectiveness [e.g., a 10% change in behaviour]). Participants (N = 7058) were randomly allocated to one of the 36 groups. The primary outcome was acceptability of the policy. Acceptability differed across policy, behaviour and evidence communication (all ps < .001). Labelling was the most acceptable policy (supported by 78%) and Availability the least (47%). Tobacco use was the most acceptable behaviour to be targeted by policies (73%) compared with policies targeting Alcohol (55%) and Food (54%). Relative to the control group (60%), asserting evidence of effectiveness increased acceptability (63%); adding a quantification to this assertion did not significantly increase this further (65%). Public acceptability for nudges and taxes to improve population health varies with the behaviour targeted and the type of intervention but is generally favourable. Communicating that these policies are effective can increase support by a small but significant amount, suggesting that highlighting effectiveness could contribute to mobilising public demand for policies. While uncertainty remains about the strength of public support needed, this may help overcome political inertia and enable action on behaviours that damage population and planetary health.

Perceptual Errors Support the Notion of Masking by Object Substitution

Two experiments examined the effect of object substitution masking (OSM) on the perceptual errors in reporting the orientation of a target. In Experiment 1, a four-dot trailing mask was compared with a simultaneous-noise mask. In Experiment 2, the four-dot and noise masks were factorially varied. Responses were modelled using a mixture regression model and Bayesian inference to deduce whether the relative impacts of OSM on guessing and precision were the same as those of a noise mask, and thus whether the mechanism underpinning OSM is based on increasing noise rather than a substitution process. Across both experiments, OSM was associated with an increased guessing rate when the mask trailed target offset and a reduction in the precision of the target representation (although the latter was less reliable across the two experiments). Importantly, the noise mask also influenced both guessing and precision, but in a different manner, suggesting that OSM is not simply caused by increasing noise. In Experiment 2, the effects of OSM and simultaneous-noise interacted, suggesting the two manipulations involve common mechanisms. Overall results suggest that OSM is often a consequence of a substitution process, but there is evidence that the mask increases noise levels on trials where substitution does not occur.

Impact of proximity of healthier versus less healthy foods on intake: A lab-based experiment

BACKGROUND

Placing food further away from people decreases likelihood of consumption ("Proximity Effect"). However, it is unclear how proximity affects consumption when both healthier and less healthy foods are available and cognitive resource for self-control is limited.

AIMS

To test the hypothesis that when both healthier (raisins) and less healthy (chocolate M&Ms) foods are available, placing less healthy food far, rather than near, increases the likelihood that healthier food is consumed.

METHODS

General population participants (N = 248) were all put under cognitive load and randomised to one of four groups: 1. Raisins near (20 cm), M&Ms far (70 cm); 2. Both foods near; 3. M&Ms near, raisins far; 4. Both far.

PRIMARY OUTCOME

proportions of participants consuming raisins and M&Ms, respectively.

RESULTS

The results did not support the primary hypothesis: when healthier and less healthy foods were both available, placing M&Ms far, rather than near, did not increase likelihood of consuming raisins (OR = 1.54, p = .432). Regardless of the M&Ms proximity, likelihood of consuming raisins was unaffected by the raisins' proximity (62.9%(near) vs. 56.5%(far) OR = 0.61, p = .211). Likelihood of consuming M&Ms non-significantly decreased when they were far and raisins were near, and when both foods were far (OR = 2.83, p = .057). Likelihood of consuming M&Ms was affected by M&Ms proximity, being higher when near (68.3%) than far (55.6%), OR = 0.39, p = .015. Indices of cognitive load impact (higher vs lower) were unrelated to consumption of either food.

CONCLUSIONS

Likelihood of consuming a healthier food was unaffected by its proximity and that of a less healthy food. By contrast, likelihood of consuming a less healthy food was influenced by its proximity and possibly by that of a healthier food. These effects need replication in studies designed to detect smaller effect sizes.

TRIAL REGISTRATION

This study was registered online with ISRCTN (ISRCTN11740813).

Process Design and Optimization in the Pharmaceutical Industry: A Suzuki-Miyaura Procedure for the Synthesis of Savolitinib

A multidisciplinary approach covering synthetic, physical, and analytical chemistry, high-throughput experimentation and experimental design, process engineering, and solid-state chemistry is used to develop a large-scale (kilomole) Suzuki-Miyaura process. Working against clear criteria and targets, a full process investigation and optimization package is described highlighting how and why key decisions are made in the development of large-scale pharmaceutical processes.

Change perception and change interference within and across feature dimensions

The ability to perceive a change in a visual object is reduced when that change is presented in competition with other changes which are task-irrelevant. We performed two experiments which investigate the basis of this change interference effect. We tested whether change interference occurs as a consequence of some form of attentional capture, or whether the interference occurs at a stage prior to attentional selection of the task-relevant change. A modified probe-detection task was used to explore this issue. Observers were required to report the presence/absence of a specified change-type (colour, shape) in the probe, in a context in which - on certain trials - irrelevant changes occur in non-probe items. There were two key variables in these experiments: the attentional state of the observer, and the dimensional congruence of changes in the probe and non-probe items. Change interference was strongest when the irrelevant changes were the same as those on the report dimension. However the interference pattern persisted even when observers did not know the report dimension at the time the changes occurred. These results seem to rule out attention as a factor. Our results fit best with an interpretation in which change interference produces feature-specific sensory noise which degrades the signal quality of the target change.

Exploiting CELLULOSE SYNTHASE (CESA) Class Specificity to Probe Cellulose Microfibril Biosynthesis

Cellulose microfibrils are the basic units of cellulose in plants. The structure of these microfibrils is at least partly determined by the structure of the cellulose synthase complex. In higher plants, this complex is composed of 18 to 24 catalytic subunits known as CELLULOSE SYNTHASE A (CESA) proteins. Three different classes of CESA proteins are required for cellulose synthesis and for secondary cell wall cellulose biosynthesis these classes are represented by CESA4, CESA7, and CESA8. To probe the relationship between CESA proteins and microfibril structure, we created mutant cesa proteins that lack catalytic activity but retain sufficient structural integrity to allow assembly of the cellulose synthase complex. Using a series of Arabidopsis (Arabidopsis thaliana) mutants and genetic backgrounds, we found consistent differences in the ability of these mutant cesa proteins to complement the cellulose-deficient phenotype of the cesa null mutants. The best complementation was observed with catalytically inactive cesa4, while the equivalent mutation in cesa8 exhibited significantly lower levels of complementation. Using a variety of biophysical techniques, including solid-state nuclear magnetic resonance and Fourier transform infrared microscopy, to study these mutant plants, we found evidence for changes in cellulose microfibril structure, but these changes largely correlated with cellulose content and reflected differences in the relative proportions of primary and secondary cell walls. Our results suggest that individual CESA classes have similar roles in determining cellulose microfibril structure, and it is likely that the different effects of mutating members of different CESA classes are the consequence of their different catalytic activity and their influence on the overall rate of cellulose synthesis.

Chemotherapeutic response to cisplatin-like drugs in human breast cancer cells probed by vibrational microspectroscopy

Studies of drug-cell interactions in cancer model systems are essential in the preclinical stage of rational drug design, which relies on a thorough understanding of the mechanisms underlying cytotoxic activity and biological effects, at a molecular level. This study aimed at applying complementary vibrational spectroscopy methods to evaluate the cellular impact of two Pt(ii) and Pd(ii) dinuclear chelates with spermine (Pt2Spm and Pd2Spm), using cisplatin (cis-Pt(NH3)2Cl2) as a reference compound. Their effects on cellular metabolism were monitored in a human triple-negative metastatic breast cancer cell line (MDA-MB-231) by Raman and synchrotron-radiation infrared microspectroscopies, for different drug concentrations (2-8 μM) at 48 h exposure. Multivariate data analysis was applied (unsupervised PCA), unveiling drug- and concentration-dependent effects: apart from discrimination between control and drug-treated cells, a clear separation was obtained for the different agents studied - mononuclear vs. polynuclear, and Pt(ii) vs. Pd(ii). Spectral biomarkers of drug action were identified, as well as the cellular response to the chemotherapeutic insult. The main effect of the tested compounds was found to be on DNA, lipids and proteins, the Pd(ii) agent having a more significant impact on proteins while its Pt(ii) homologue affected the cellular lipid content at lower concentrations, which suggests the occurrence of distinct and unconventional pathways of cytotoxicity for these dinuclear polyamine complexes. Raman and FTIR microspectroscopies were confirmed as powerful non-invasive techniques to obtain unique spectral signatures of the biochemical impact and physiological reaction of cells to anticancer agents.

Abstract P3-13-02: Impact of primary surgery on short-term survival of older breast cancer patients in the UK

Introduction

Lack of surgery for older breast cancer patients may reduce cancer survival. Previous studies did not adjust for comorbidity and tumour characteristics which affect survival.

Methods

In a prospective cohort study investigating older patients' treatment, survival analyses (mean 3.8 years, 95% CI: 3.69-3.83) was undertaken for 910 breast cancer patients aged ≥65 years diagnosed at 22 English hospitals from 1/7/10 to 31/12/12. Primary outcome was breast cancer specific survival. Independent variables included surgery, comorbidity, functional status and tumour characteristics recorded from patient interview (at diagnosis) and case note review. Data analyses included Cox's multiple regression.

Results

Adjusting for tumour stage, comorbidity and functional status, women undergoing primary surgery (n=772) had a third of the hazard of breast cancer death compared to those who did not (n=138) (HR 0.36, 95% CI: 0.20-0.66, p=0.001). The number of observed breast cancer deaths exceeded those expected for participants who did not have primary surgery, were aged ≥85 years, steroid receptor negative or had a higher grade or stage tumour. In univariate analysis women aged ≥85 years had an increased hazard of breast cancer death compared to 65-69 year olds (HR 4.02, 95% CI: 1.61-10.01, p=0.003). Patients' role in the treatment decisions did not alter whether they received surgery or not; those who were active/collaborative were as likely to get surgery as those who were passive (i.e. left the decision up to the Surgeon).

Conclusions

Surgery for older breast cancer patients reduces the hazard of cancer death by a third, independent of age, comorbidity and tumour characteristics. Surgeons must actively advise surgery for all elderly patients.

Cox's proportional hazards regression of breast cancer specific survival (unadjusted n=906)VariableCategoryUnadjusted HRUnivariable 95% CIP ValueAdjusted HR#Multivariable 95% CIP ValuePrimary surgeryNo(ref)  (ref)   Yes0.320.19-0.53&lt;0.0010.360.20-0.660.001Age group (years)65-69(ref)  (ref)   70-741.530.61-3.860.3641.310.52-3.340.565 75-791.350.51-3.540.5481.040.39-2.770.933 80-842.390.92-6.220.0741.720.65-4.560.272 85+4.021.61-10.010.0032.610.99-6.910.053Grade1(ref)  (ref)   21.370.60-3.140.4531.180.51-2.710.704 34.552.01-10.31&lt;0.0013.231.36-7.650.008ER or PR positiveYes(ref)  (ref)   No3.502.02-6.08&lt;0.0012.751.49-5.090.001Tumour StageI(ref)  (ref)   II and IIIa2.251.33-3.810.0021.480.85-2.570.164Co-morbidity (Charlson)0(ref)  (ref)   11.020.60-1.740.9350.970.56-1.670.917 2+0.960.50-1.840.9020.800.41-1.570.518Functional status*Independent (1-2)(ref)  (ref)   Dependent (3-4)1.690.97-2.950.0641.000.53-1.880.995# Adjusted for all other variables in table

(Funded by NIHR Programme Grant).

Citation Format: Bundred N, Lavelle K, Sowerbutts AM, Pilling M, Todd C. Impact of primary surgery on short-term survival of older breast cancer patients in the UK [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-13-02.

FTIR imaging of the molecular burden around Aβ deposits in an early-stage 3-Tg-APP-PSP1-TAU mouse model of Alzheimer's disease

High spatial resolution FTIR imaging of early-stage 3-Tg-APP-PSP1-TAU mouse brain identifies molecular burden around Aβ deposits.

Fundamental developments in infrared spectroscopic imaging for biomedical applications

Infrared chemical imaging is a rapidly emerging field with new advances in instrumentation, data acquisition and data analysis. These developments have had significant impact in biomedical applications and numerous studies have now shown that this technology offers great promise for the improved diagnosis of the diseased state. Relying on purely biochemical signatures rather than contrast from exogenous dyes and stains, infrared chemical imaging has the potential to revolutionise histopathology for improved disease diagnosis. In this review we discuss the recent advances in infrared spectroscopic imaging specifically related to spectral histopathology (SHP) and consider the current state of the field. Finally we consider the practical application of SHP for disease diagnosis and consider potential barriers to clinical translation highlighting current directions and the future outlook.

The role of distractors in object substitution masking

In object substitution masking (OSM) a surrounding mask (typically comprising of 4 dots) onsets with a target but lingers after offset; under such conditions, the ability to perceive the target can be significantly reduced. OSM was originally claimed to occur only when a target was not the focus of attention, for instance, when embedded in an array of distractors (Di Lollo, Enns, & Rensink, 2000). It was argued that the distractors influenced the time taken for focal attention to reach the target. Some recent work, however, failed to find any such distractor influence; the effect of mask duration was found to be independent of set size when steps were taken to avoid ceiling effects in the smallest set size condition (Argyropoulos, Gellatly, Pilling, & Carter, 2013; Filmer, Mattingley, & Dux, 2014). In 3 experiments, we repeatedly found that set size manipulations can interact with mask duration (in which neither ceiling nor floor effects are evident), with the effect of the mask on target perceptibility being amplified according to the number of distractor items. However, a further experiment (Experiment 4) showed that crowding by nearby distractors was actually responsible for this "set size" effect. When decoupled from crowding, set size alone did not interact with masking, though it did influence overall accuracy. Thus, the presence of distractors does influence OSM, but not in the way originally assumed by Di Lollo and colleagues in their model. The Crowding × OSM interaction suggests that the 2 phenomena involve partly overlapping mechanisms.

Pretreatment health measures and complications after surgical management of elderly women with breast cancer

BACKGROUND

Elderly patients with breast cancer are less likely to be offered surgery, partly owing to co-morbidities and reduced functional ability. However, there is little consensus on how best to assess surgical risk in this patient group.

METHODS

The ability of pretreatment health measures to predict complications was investigated in a prospective cohort study of a consecutive series of women aged at least 70 years undergoing surgery for operable (stage I-IIIa) breast cancer at 22 English breast units between 2010 and 2013. Data on treatment, surgical complications, health measures and tumour characteristics were collected by case-note review and/or patient interview. Outcome measures were all complications and serious complications within 30 days of surgery.

RESULTS

The study included 664 women. One or more complications were experienced by 41·0 per cent of the patients, predominantly seroma or primary/minor infections. Complications were serious in 6·5 per cent. More extensive surgery predicted a higher number of complications, but not serious complications. Older age did not predict complications. Several health measures were associated with complications in univariable analysis, and were included in multivariable analyses, adjusting for type/extent of surgery and tumour characteristics. In the final models, pain predicted a higher count of complications (incidence rate ratio 1·01, 95 per cent c.i. 1·00 to 1·01; P = 0·004). Fatigue (odds ratio (OR) 1·02, 95 per cent c.i. 1·01 to 1·03; P = 0·004), low platelet count (OR 4·19, 1·03 to 17·12: P = 0·046) and pulse rate (OR 0·96, 0·93 to 0·99; P = 0·010) predicted serious complications.

CONCLUSION

The risk of serious complications from breast surgery is low for older patients. Surgical decisions should be based on patient fitness rather than age. Health measures that predict surgical risk were identified in multivariable models, but the effects were weak, with 95 per cent c.i. close to unity.

Is lack of surgery for older breast cancer patients in the UK explained by patient choice or poor health? A prospective cohort study

BACKGROUND

Older women have lower breast cancer surgery rates than younger women. UK policy states that differences in cancer treatment by age can only be justified by patient choice or poor health.

METHODS

We investigate whether lack of surgery for older patients is explained by patient choice/poor health in a prospective cohort study of 800 women aged ≥70 years diagnosed with operable (stage 1-3a) breast cancer at 22 English breast cancer units in 2010-2013.

DATA COLLECTION

interviews and case note review.

OUTCOME MEASURE

surgery for operable (stage 1-3a) breast cancer <90 days of diagnosis. Logistic regression adjusts for age, health measures, tumour characteristics, socio-demographics and patient's/surgeon's perceived responsibility for treatment decisions.

RESULTS

In the univariable analyses, increasing age predicts not undergoing surgery from the age of 75 years, compared with 70-74-year-olds. Adjusting for health measures and choice, only women aged ≥85 years have reduced odds of surgery (OR 0.18, 95% CI: 0.07-0.44). Each point increase in Activities of Daily Living score (worsening functional status) reduced the odds of surgery by over a fifth (OR 0.23, 95% CI: 0.15-0.35). Patient's role in the treatment decisions made no difference to whether they received surgery or not; those who were active/collaborative were as likely to get surgery as those who were passive, that is, left the decision up to the surgeon.

CONCLUSION

Lower surgery rates, among older women with breast cancer, are unlikely to be due to patients actively opting out of having this treatment. However, poorer health explains the difference in surgery between 75-84-year-olds and younger women. Lack of surgery for women aged ≥85 years persists even when health and patient choice are adjusted for.

Translation and psychometric assessment of the Persian version of the Rhodes Index of Nausea, Vomiting and Retching (INVR) scale for the assessment of chemotherapy-induced nausea and vomiting

No tools are available to assess or measure the experience of chemotherapy-induced nausea and vomiting (CINV) for Persian/Farsi speakers. The purpose of this study is to translate the Rhodes Index of Nausea, Vomiting and Retching (INVR) scale for use with Persian-speaking cancer patients. A sample of 94 cancer patients were recruited from a cancer research centre in Mashhad-Iran. A standard two phase process of scale translation and validation was conducted. In phase I, standard 'forward-backward' translation procedure was used to translate the original version of the INVR questionnaire into Persian. The translated questionnaire was reviewed and revised and a Persian version of the scale was produced. In the second phase, a multiphase instrumentation study describing the internal consistency and test-retest reliability of the translated version was conducted. The inter-item correlation measured by Cronbach's alpha was 0.88. Test/re-test reliability was measured by the weighted kappa and was between 0.63 and 0.79, indicating 'substantial agreement' and stability between the initial and subsequent administrations for each item. These results demonstrate that the Persian version of the INVR is acceptable for use among Iranian cancer patients. Researchers could use this study as a model for future translation and application of psychometric instrumentation.

Looming motion primes the visuomotor system

A wealth of evidence now shows that human and animal observers display greater sensitivity to objects that move toward them than to objects that remain static or move away. Increased sensitivity in humans is often evidenced by reaction times that increase in rank order from looming, to receding, to static targets. However, it is not clear whether the processing advantage enjoyed by looming motion is mediated by the attention system or the motor system. The present study investigated this by first examining whether sensitivity is to looming motion per se or to certain monocular or binocular cues that constitute stereoscopic motion in depth. None of the cues accounted for the looming advantage. A perceptual measure was then used to examine performance with minimal involvement of the motor system. Results showed that looming and receding motion were equivalent in attracting attention, suggesting that the looming advantage is indeed mediated by the motor system. These findings suggest that although motion itself is sufficient for attentional capture, motion direction can prime motor responses.

Task probability and report of feature information: what you know about what you 'see' depends on what you expect to need

We investigated the influence of dimensional set on report of object feature information using an immediate memory probe task. Participants viewed displays containing up to 36 coloured geometric shapes which were presented for several hundred milliseconds before one item was abruptly occluded by a probe. A cue presented simultaneously with the probe instructed participants to report either about the colour or shape of the probe item. A dimensional set towards the colour or shape of the presented items was induced by manipulating task probability - the relative probability with which the two feature dimensions required report. This was done across two participant groups: One group was given trials where there was a higher report probability of colour, the other a higher report probability of shape. Two experiments showed that features were reported most accurately when they were of high task probability, though in both cases the effect was largely driven by the colour dimension. Importantly the task probability effect did not interact with display set size. This is interpreted as tentative evidence that this manipulation influences feature processing in a global manner and at a stage prior to visual short term memory.

Set size and mask duration do not interact in object-substitution masking

Object-substitution masking (OSM) occurs when a mask, such as four dots that surround a brief target item, onsets simultaneously with the target and offsets a short time after the target, rather than simultaneously with it. OSM is a reduction in accuracy of reporting the target with the temporally trailing mask, compared with the simultaneously offsetting mask. It has been thought that OSM occurs only if attention cannot be rapidly focused, or prefocused, on the target location. One line of evidence for this is a reported interaction between target display set size and the duration of the trailing mask. We analyze the evidence for this interaction and suggest it occurs only as an artifact of data being compressed by a ceiling effect. We report six experiments that support this interpretation by showing that the interaction is always absent unless a ceiling effect is induced. We go on to analyze other evidence to support the notion that attention modulates OSM, and argue that in each case, the data either reflect a ceiling effect or can be explained in another way. Our data and our analyses of the existing literature have strong implications for how OSM should be conceptualized.

Audiovisual cues and perceptual learning of spectrally distorted speech

Two experiments investigate the effectiveness of audiovisual (AV) speech cues (cues derived from both seeing and hearing a talker speak) in facilitating perceptual learning of spectrally distorted speech. Speech was distorted through an eight channel noise-vocoder which shifted the spectral envelope of the speech signal to simulate the properties of a cochlear implant with a 6 mm place mismatch: Experiment I found that participants showed significantly greater improvement in perceiving noise-vocoded speech when training gave AV cues than when it gave auditory cues alone. Experiment 2 compared training with AV cues with training which gave written feedback. These two methods did not significantly differ in the pattern of training they produced. Suggestions are made about the types of circumstances in which the two training methods might be found to differ in facilitating auditory perceptual learning of speech.

Auditory event-related potentials (ERPs) in audiovisual speech perception

PURPOSE

It has recently been reported (e.g., V. van Wassenhove, K. W. Grant, & D. Poeppel, 2005) that audiovisual (AV) presented speech is associated with an N1/P2 auditory event-related potential (ERP) response that is lower in peak amplitude compared with the responses associated with auditory only (AO) speech. This effect was replicated. Further comparisons were made between ERP responses to AV speech in which the visual and auditory components were in or out of synchrony, to test whether the effect is associated with the operation of integration mechanisms, as has been claimed, or occurs because of other factors such as attention.

METHOD

ERPs were recorded from participants presented with recordings of unimodal or AV speech syllables in a detection task.

RESULTS

Comparisons were made between AO and AV speech and between synchronous and asynchronous AV speech. Synchronous AV speech produced an N1/P2 with lower peak amplitudes than with AO speech, unaccounted for by linear superposition of visually evoked responses onto auditory-evoked responses. Asynchronous AV speech produced no amplitude reduction.

CONCLUSION

The dependence of N1/P2 amplitude reduction on AV synchrony validates it as an electrophysiological marker of AV integration.

Target Visibility in the Standing Wave Illusion: Is Mask—Target Shape Similarity Important?

The perceptibility of a flickering central bar can be dramatically reduced by the presence of two flanking bars presented in counterphase. This phenomenon, known as the ‘standing wave illusion’, has been suggested to involve local edge interactions (Macknik et al, 2000 Proceedings of the National Academy of Sciences of the USA97 7556–7560). High-level re-entrant mechanisms have also been implicated. Enns (2002, Psychonomic Bulletin & Review9 489–496) reports an association between the reported viability of the centre bar and its similarity in shape with the flanking bars. We find that this relationship between shape similarity and reported visibility seems to be contingent on the degree of experienced apparent motion. When target duration is shortened, so reducing apparent motion, reports of visibility reflect the amount of abutting contour. In a further experiment we find that luminance discriminations of the centre bar are related to the amount of abutting contour not to shape similarity. This is despite experiment 3 being conducted at stimulus durations for which experiment 2 visibility ratings indicated that shape similarity is important and contour is not. We suggest that this perceived motion may be the factor mediating shape ‘effects’ in the reported visibility task. We propose that the absence of such shape effects in the discrimination task may be because the task provides an objective measure of visibility that is immune to bias from perceived motion. We also speculate that while target luminance information may be immune to masking resulting from perceived motion, it may be subject to masking due to lateral inhibition.

What is being masked in object substitution masking?

Object substitution masking (OSM) is said to occur when a perceptual object is hypothesized that is mismatched by subsequent sensory evidence, leading to a new hypothesized object being substituted for the first. For example, when a brief target is accompanied by a longer lasting display of nonoverlapping mask elements, reporting of target features may be impaired. J. T. Enns and V. Di Lollo (2000) considered it an outstanding question whether OSM masks some or all aspects of a target. The authors report three experiments demonstrating that OSM can selectively affect target features. Participants may be able to detect a target while being unable to report other aspects of it or to report the color but not the orientation of a target (or vice versa). We discuss these findings in relation to two other visual phenomena.

The nature of infant color categorization: Evidence from eye movements on a target detection task

Infants respond categorically to color. However, the nature of infants' categorical responding to color is unclear. The current study investigated two issues. First, is infants' categorical responding more absolute than adults' categorical responding? That is, can infants discriminate two stimuli from the same color category? Second, is color categorization in infants truly perceptual? Color categorization was tested by recording adults' and infants' eye movements on a target detection task. In Experiment 1, adults were faster at fixating a colored target when it was presented on a colored background from a different color category (between-category) than when it was presented on a colored background from the same color category (within-category), even when within- and between-category chromatic differences were equated in CIE (Committee International d'Eclairage) color space. This category effect was found for two chromatic separation sizes. In Experiment 2, 4-month-olds also responded categorically on the task. Infants were able to fixate the target when the background color was from the same category. However, as with adults, infants were faster at fixating the target when the target background chromatic difference was between-category than when it was within-category. This implies that infant color categorization, like adult color categorization, is truly perceptual.

Linguistic relativism and colour cognition

Native speakers of two languages (English and Ndonga) were compared on three colour cognition tasks (sorting, triads and visual search) in a test of the linguistic relativity hypothesis (Whorf, 1956). The colour lexicons of these two languages differ because Ndonga has no basic terms for ORANGE, PINK and PURPLE, and stimuli were chosen to exploit this difference. On the sorting task (sorting into similarity-groups) for each language, nominally similar colours were grouped together more often than nominally dissimilar colours. On the triads task (choosing the most different of three colours), when the most nominally isolated colour differed for the two language-groups, each group tended to choose their nominal isolate. On the search task (scanning for target colours among distractors), targets were either in a different English category than distractors (cross-category), or some distractors were in the same English category as distractors (within-category). The 'cost' in speed of having within-category distractors was much greater for the English than for the Ndonga. Overall, these data suggest that a core universal component is modulated by a small relativist influence. The differences in the visual search task are consistent with language affecting pre-attentive processes (an indirect language effect) as well as exerting on-line influences (a direct effect).

Is color "categorical perception" really perceptual?

Roberson and Davidoff (2000) found that color categorical perception (CP; better cross-category than within-category discrimination) was eliminated by verbal, but not by visual, interference presented during the interstimulus interval (ISI) of a discrimination task. On the basis of this finding, Roberson and Davidoff concluded that CP was mediated by verbal labels, and not by perceptual mechanisms, as is generally assumed. Experiment 1 replicated their results. However, it was found that if the interference type was uncertain on each trial (Experiment 2), CP then survived verbal interference. Moreover, it was found that the target color name could be retained across the ISI even with verbal interference (Experiment 3). We therefore conclude that color CP may indeed involve verbal labeling but that verbal interference does not necessarily prevent it.

Contracting for high-tech health care for patients at home: a survey of purchaser responses

Points out that the Department of Health's Executive Letter: EL(95)5 moved the finance of high technology treatment provided at home for chronically ill patients from the NHS prescribing budget onto a defined and consistent framework. The aim was to obtain better value for money by encouraging competition between potential homecare providers. Reports on a survey of prescribing advisers of purchasing health authorities, which focused on their response to these developments, and discusses the issues identified by purchasers in their implementation of EL(95)5. Notes that, although most purchasers chose to contract directly with a single commercial homecare organization in 1995-1996, there was no consensus about where contracts should be placed in the future, and that the purchasers identified inefficiencies in contracting for such care. Discusses methods of improving the purchasers' response to contracting.

Effective contracting of high-tech health care for patients at home

High-technology treatments such as total parenteral nutrition or intravenous antibiotics may increasingly be provided to patients at home. In the past, these services have been funded by the NHS prescribing budget. The aim of the Department of Health's Executive letter EL(95)5, Purchasing High Tech Healthcare for Patients at Home was to ensure that contracts placed by health authority purchasers maintain effective patient services and obtain better value for money by encouraging competition between potential homecare providers. Examines contracting for high-tech health care for patients at home and suggests that efficiency could be improved when contracting with commercial home-care organizations by lead purchasing arrangements. In the long-term, contracting with NHS tertiary centres is most likely to ensure continuity of care and appropriate clinical monitoring of patients.

A note on the recovery of micro-organisms from an oil-in-water cream

The isolation of micro-organisms from the oil-in-water Aqueous Cream BP, has been examined using a variety of solvent systems to disperse the cream prior to membrane filtration or direct inoculation. Pour-plate methods which utilize combinations of either peptone-water (containing 5% w/v polysorbate 80) or nutrient broth (containing 4% w/v Lubrol W) provided the most efficient recovery of Pseudomonas aeruginosa but still allowed less than 20% recovery. White spirit and isopropyl myristate allowed no recovery when used as dispersants. Recoveries of P. aeruginosa varied according to the source of the cream. A combination of 1% w/v polysorbate 80 in 0.1% w/v peptone-water and membrane filtration allowed 63.2% w/v and 67.0% w/v recoveries respectively of Aspergillus niger and Candida albicans from unpreserved aqueous cream, but gave unreproducible results for Escherichia coli and P. aeruginosa. Chlorocresol 0.1% w/v) did not meet the British Pharmacopoeial requirements for efficacy of antimicrobial preservatives when tested against C. albicans using membrane filtration to isolate the micro-organism.

The dissolution and oral bioavailability of mexiletine capsules modified for clinical trial. A preliminary report

The dissolution and bioavailability of two preparations of mexiletine hydrochloride (200 mg), one available commercially as Mexitil and one modified by the Hospital Pharmacy for a clinical trial, were investigated in a cross-over study with healthy volunteer subjects. The evaluation of bioavailability was based on comparisons of the mean residence time (MRTp.o.) and mean absorption time (MATp.o.), areas under the plasma mexiletine concentration time-curve (AUC) and urinary recovery of unchanged mexiletine under controlled condition of acidic urinary pH after oral administration of single doses of either 400 mg or 200 mg as mexiletine hydrochloride. Three different methods of calculation were used to account for possible changes in clearance of the drug in between treatments. Bioavailability data were available from 3 cross-over studies as the investigation was terminated because one subject experienced idiosyncratic reactions to mexiletine. The mean-transit-time, T DISSOLVED-IN VITRO, for the hospital-modified capsules (2.8 min) was longer than that of the Mexitil capsule (2.0 min) in 0.1 HCl. This delay in dissolution was complemented by an increase in MATp.o. (0.43 and 0.58 hr respectively for Mexitil and hospital-modified capsules) obtained in one subject. The bioavailabilities of the two preparations were comparable from AUC between 0 to 6 hr, but the plasma curves from 6 to 48 hr were not followed. The mean times in vivo, T MEAN-IN VIVO (determined from urinary elimination curves in a cross-over study of 3 subjects) were consistently shorter after ingestion of Mexitil capsules though the significance was difficult to obtain due to small sample size.(ABSTRACT TRUNCATED AT 250 WORDS)