The impact of Degraded distractors on (Nondegraded) target identification

In this series of experiments, based on Biederman's Recognition by Components theory, we postulate that corners (vertices) of objects are crucial in programming and execution of goal-directed action. We used a distractor interference paradigm to present line drawings of letters (M and W) with distractors (also M and W), which were either nondegraded or degraded (that is, corners or line segments missing). Degraded distractors caused less interference overall (reduced response times and errors) than Nondegraded distractors, when these were presented peripherally or at fixation (Experiments 1 and 2). When presented at fixation, however, distractors with corners missing caused greater interference than distractors with line segments missing. This pattern was not replicated with non-identical, non-mirror reversed stimuli (H and E: Experiment 3). We speculate that corners are critical in determining the extent of distractor interference. When missing from view, and given sufficient attentional resources and structural similarity, they may be reconstructed by the visuomotor system to aid performance to the target.     

Reforming the Swiss nurse education system: a policy review

BACKGROUND: Western Europe has been swept in the last three decades by ongoing reforms within the nurse education systems. Within the Western European region, Switzerland is one of the last countries initiating the integration of nursing programs into higher education institutions. OBJECTIVES: This article examines the nurse education reforms recently enacted in Switzerland. The specific aims of the analysis were to: (a) examine modes of reform implementation and the current status of the Swiss nurse education system; (b) compare between two new Swiss nurse education models developed in the various linguistic regions. METHOD: A documentary search for policy documents, reports and studies related to the implementation processes of reforms was conducted through websites of various legal institutions and the Swiss university library system. FINDINGS: The analysis indicated that although a fit between environmental pressures and the reform agenda exists, the implementation of the nursing reform varied considerably between the various Swiss linguistic regions. This variation resulted in two newly created models of nurse education programs revealing a high level of variability and inconsistency. As such, the development of a unified system of nurse education, which was set as the primary goal of the reformed system, was not achieved. CONCLUSIONS: Overall, Switzerland is contributing to the widening heterogeneity rather than to the aspired homogeneity across Western European countries.     

Taking care of terminally-ill patients at home - the economic perspective revisited

End-of-life care can be delivered in a variety of settings, whereby the majority of terminally-ill cancer patients prefer to die at home. The aim of our study is to evaluate health services utilisation during the last year of life, and to compare terminally ill patients who have received home-specialised palliative care services (HSPCS) with patients who died receiving home non-specialised palliative care services. The study included 120 and 515 patients, respectively, who died between 1999-2000. Age and gender distribution were similar in both groups. During the last year of life, mean health services cost per person among the HSPCS group was lower by more then 30% (P < 0.005). The median cost per patient was as low as one-fifth in the last month. Men and the older age group of 65 and above, cost significantly less compared with women and younger patients, respectively, regardless of provider setting. The main differences in health services utilisation were in hospitalisations and oncology treatments (P < 0.01 and P < 0.05, respectively).     

Surveillance of drug abuse in Hong Kong by hair analysis using LC‐MS/MS

The aim of this study is to reveal the habits of drug abusers in hair samples from drug rehabilitation units in Hong Kong. With the application of liquid chromatography–tandem mass spectrometry (LC–MS/MS) technology, a total of 1771 hair samples were analyzed during the period of hair testing service (January 2012 to March 2016) provided to 14 drug rehabilitation units including non‐governmental organizations (NGOs), rehabilitation centers, and medical clinics. Hair samples were analyzed for abused drugs and their metabolites simultaneously, including ketamine, norketamine, cocaine, benzoylecgonine, cocaethylene, norcocaine, codeine, MDMA, MDA, MDEA, amphetamine, methamphetamine, morphine, 6‐acetylmorphine, phencyclidine, and methadone. The results showed that ketamine (77.2%), cocaine (21.3%), and methamphetamine (16.5%) were the frequently detected drugs among those drug abusers, which is consistent with the reported data. In addition, the usage of multiple drugs was also observed in the hair samples. About 29% of drug‐positive samples were detected with multiple drug use. Our studies prove that our locally developed hair drug‐testing method and service can be a valid tool to monitor the use of abused drugs, and which could facilitate rehabilitation program management.     

Surgical site abscess caused by Lactobacillus fermentum identified by 16S ribosomal RNA gene sequencing

We report the first case of surgical site abscess caused by Lactobacillus fermentum from a 53-year-old woman with squamous cell carcinoma of the esophagus after transthoracic esophagectomy and neoadjuvant chemoirradiation. 16S rRNA gene sequencing is a useful tool to better characterize the epidemiology and clinical significance of L. fermentum.     

Best practices to optimize utilization of the National Living Donor Assistance Center for the financial assistance of living organ donors

Living organ donors face direct costs when donating an organ, including transportation, lodging, meals, and lost wages. For those most in need, the National Living Donor Assistance Center (NLDAC) provides reimbursement to defray travel and subsistence costs associated with living donor evaluation, surgery, and follow‐up. While this program currently supports 9% of all US living donors, there is tremendous variability in its utilization across US transplant centers, which may limit patient access to living donor transplantation. Based on feedback from the transplant community, NLDAC convened a Best Practices Workshop on August 2, 2018, in Arlington, VA, to identify strategies to optimize transplant program utilization of this valuable resource. Attendees included team members from transplant centers that are high NLDAC users; the NLDAC program team; and Advisory Group members. After a robust review of NLDAC data and engagement in group discussions, the workgroup identified concrete best practices for administrative and transplant center leadership involvement; for individuals filing NLDAC applications at transplant centers; and to improve patient education about potential financial barriers to living organ donation. Multiple opportunities were identified for intervention to increase transplant programs’ NLDAC utilization and reduce financial burdens inhibiting expansion of living donor transplantation in the United States.     

Custom designed radial forearm free flap for reconstruction of nasomaxillary defects: Report of two cases

Nasal amputation and nasomaxillary defects, need to reconstruct the internal lining, osteochondral structure, and external coating of the nose. Authors report a 70-year-old male and a 65-year-old female treated for nasomaxillary defects (Brown JS, Shaw RJ. The Lancet Oncology 2010;11:1001–1008) due to squamous cell carcinoma (SCC) where the tip of the nose was preserved. A new custom design of the radial forearm free flap (RFFF) consisting on a subcutaneous tissue (SCT) component, a skin paddle for the internal nasal vault lining, and a skin paddle for the external nasal skin coating was raised to treat both total thickness nasal defects. The dimension of each skin paddle corresponds to the defect measurements. The skin incisions of the custom design correspond to those of a conventional RFFF. The SCT component was harvested in a subcutaneous plane continuously with the skin island for the internal nasal lining which is drawn on the ulnar skin of the forearm. The component for the external nasal coating was drawn on the radial skin area of the flap. No postoperative complications and a satisfactory outcome was reported after 1 year of follow-up. This new custom design of the RFFF is described for reconstruction of nasomaxillary defects when the tip of the nose is preserved.