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Healthcare workers are under increasing pressure to use limited resources more efficiently and improve patient outcomes. Healthcare redesign, a quality improvement methodology derived from the automotive industry, is a proven means of achieving these goals. Continuing Professional Development (CPD) opportunities for nurses seeking to build their capacity for healthcare redesign often come in the form of university courses, which can be costly and prohibitively time-consuming. We developed a Massive Open Online Course (MOOC) with a view to increasing the number of healthcare workers undertaking CPD in healthcare redesign and subsequently using these principles in their workplaces. The aim of the current study is to describe the development of our MOOC and its initial feedback from users. Materials and Methods: The theoretical and practical components of an existing postgraduate award course unit were made fit for purpose by being arranged into six weekly modules, before being transposed to an established learning management platform for MOOCs. Related quizzes, videos and interactive activities were then developed and included in each of these modules. Peer review of this content was completed by subject matter and teaching and learning experts prior to the MOOC being launched. Results: After running for nine months, 578 participants had enrolled in the MOOC, of whom 118 (20%) had followed through to completion. Participants were overwhelmingly from Australia (89%) and identified as female (78%). Preliminary feedback obtained from participants was positive, with 81% of respondents agreeing that they were satisfied with their experience, and 82% intending to apply their knowledge in practice. Conclusions: The MOOC has addressed a learning need by providing a brief and free form of education; learning from its development will help others seeking similar educational solutions. Initial feedback suggests the MOOC has been well-received and is likely to be translated into practice.

The Australian state of Tasmania has seen a spike in Emergency Department presentations in recent years, particularly among the elderly. A novel extended scope occupational therapy (ESOT) service was implemented by the Tasmanian Health Service, aimed at supporting hospital avoidance. Clients were referred to the ESOT service by other services after being assessed as having a high risk of imminent hospital presentation. Occupational Therapists provided short-term interventions related to falls, mobility, nutrition, and initiated onward referrals to other services. A convergent parallel mixed methods design was used to evaluate the ESOT service. Quantitative data from routinely collected administrative records and a purpose-built survey of referring clinicians were used alongside qualitative data from semi-structured interviews with clients/carers, to enable the triangulation of data. Quantitative data were analysed using descriptive statistics, while qualitative data collected in interviews were thematically analysed. A total of 104 extended scope interventions were provided to 100 clients. Most clients were able to stay at home. Qualitative data revealed that mobility, support, and facilitating access to support services were factors which added value to the client and carer experience. In conclusion, the ESOT program contributed to potentially avoiding hospital admissions and to improving the quality of life of participating clients.

Objective To compare the processes and outcomes of care in patients who had a stroke treated in urban versus rural hospitals in Australia.Design Observational study using data from a multicentre national registry.Setting Data from 50 acute care hospitals in Australia (25 urban, 25 rural) which participated in the Australian Stroke Clinical Registry during the period 2010–2015.Participants Patients were divided into two groups (urban, rural) according to the Australian Standard Geographical Classification Remoteness Area classification. Data pertaining to 28 115 patients who had a stroke were analysed, of whom 8159 (29%) were admitted to hospitals located within rural areas.Primary and secondary outcome measures Regional differences in processes of care (admission to a stroke unit, thrombolysis for ischaemic stroke, discharge on antihypertensive medication and provision of a care plan), and survival analyses up to 180 days and health-related quality of life at 90–180 days.Results Compared with those admitted to urban hospitals, patients in rural hospitals less often received thrombolysis (urban 12.7% vs rural 7.5%, p

Objectives: Individuals living in rural areas have comparatively less access to acute stroke care than their urban counterparts. Understanding the local barriers and facilitators to the use of current best practice for acute stroke may inform efforts to reduce this disparity. Methods: A qualitative study featuring semi-structured interviews and focus groups was conducted in the Australian state of Tasmania. Clinical staff from a range of disciplines involved in acute stroke care were recruited from three of the state’s four major public hospitals (one urban and two rural). A semi-structured interview guide based on the findings of an earlier quantitative study was used to elicit discussion about the barriers and facilitators associated with providing acute stroke care. An inductive process of thematic analysis was then used to identify themes and subthemes across the data set. Results: Two focus groups and five individual interviews were conducted. Four major themes were identified from analysis of the data: systemic issues, clinician factors, additional support and patient-related factors. Acute stroke care within the study’s urban hospital was structured and comprehensive, aided by the hospital’s acute stroke unit and specialist nursing support. In contrast, care provided in the study’s rural hospitals was somewhat less comprehensive, and often constrained by an absence of infrastructure or poor access to existing resources. Conclusion: The identified factors help to characterise acute stroke care within urban and rural hospitals and will assist quality improvement efforts in Tasmania’s hospitals.

Abstract Background With the increasing burden of mental illness globally, it is becoming common for hospitalised patients with chronic medical conditions to have a comorbidity of mental illness. This combination could prolong length of stay (LOS) of this patient cohort. We conducted an investigation in Tasmania, Australian hospitals to characterise this cohort and assess if co-morbidity of mental illness is a distinguishing factor that generates LOS variation across different chronic medical conditions. Methods The retrospective study analysed 16,898 admissions of patients with a primary diagnosis of one of five chronic medical conditions: lung or colorectal cancer, chronic obstructive pulmonary disease (COPD), type II diabetes, ischaemic heart disease (IHD) and stroke. Data were from July 2010 to June 2015, across four hospitals that collectively cover 95% of public hospital admissions in Tasmania, Australia. Descriptive statistics were used to compare characteristics of patients between the scenarios of with and without co-morbidity of mental illness. We used negative binomial regression models to assess whether co-morbidity of mental illness, along with its sub-types, after adjustment for potential confounding variables, associated with LOS variation in patients of each medical condition. Based on the adjusted LOS variation, we estimated differences in bed days’ use between patients with and without comorbidity of mental illness. Results Patients with co-morbidity of mental illness were significantly younger in comparison to patients without mental illness. With each medical condition, patients with comorbidity of mental illness had incurred higher bed days’ use than for those without mental illness. In cancer and stroke cohorts, co-morbidity of mental illness unfavourably affected the LOS variation by as high as 97% (CI: 49.9%–159%) and 109% (78%–146%), respectively. Though mental and behavioural disorders due to psychoactive substances was a dominant sub-type of mental illness across the medical conditions, it contributed significant unfavourable LOS variation only in the stroke patients i.e. 36.3% (CI: 16.2%–59.9%). Conclusions Mental illness consistently produced unfavourable LOS variation. Upskilling of healthcare teams and greater reporting and analysis of LOS variation for this patient cohort, and the sub-cohorts within it, are necessary to provide improved medical care and achieve system efficiencies.

Background: Long QT syndrome is a lethal arrhythmia syndrome, frequently caused by rare loss-of-function variants in the potassium channel encoded by KCNH2 . Variant classification is difficult, often because of lack of functional data. Moreover, variant-based risk stratification is also complicated by heterogenous clinical data and incomplete penetrance. Here we sought to test whether variant-specific information, primarily from high-throughput functional assays, could improve both classification and cardiac event risk stratification in a large, harmonized cohort of KCNH2 missense variant heterozygotes., Methods: We quantified cell-surface trafficking of 18 796 variants in KCNH2 using a multiplexed assay of variant effect (MAVE). We recorded KCNH2 current density for 533 variants by automated patch clamping. We calibrated the strength of evidence of MAVE data according to ClinGen guidelines. We deeply phenotyped 1458 patients with KCNH2 missense variants, including QTc, cardiac event history, and mortality. We correlated variant functional data and Bayesian long QT syndrome penetrance estimates with cohort phenotypes and assessed hazard ratios for cardiac events., Results: Variant MAVE trafficking scores and automated patch clamping peak tail currents were highly correlated (Spearman rank-order ρ=0.69; n=433). The MAVE data were found to provide up to pathogenic very strong evidence for severe loss-of-function variants. In the cohort, both functional assays and Bayesian long QT syndrome penetrance estimates were significantly predictive of cardiac events when independently modeled with patient sex and adjusted QT interval (QTc); however, MAVE data became nonsignificant when peak tail current and penetrance estimates were also available. The area under the receiver operator characteristic curve for 20-year event outcomes based on patient-specific sex and QTc (area under the curve, 0.80 [0.76-0.83]) was improved with prospectively available penetrance scores conditioned on MAVE (area under the curve, 0.86 [0.83-0.89]) or attainable automated patch clamping peak tail current data (area under the curve, 0.84 [0.81-0.88])., Conclusions: High-throughput KCNH2 variant MAVE data meaningfully contribute to variant classification at scale, whereas long QT syndrome penetrance estimates and automated patch clamping peak tail current measurements meaningfully contribute to risk stratification of cardiac events in patients with heterozygous KCNH2 missense variants.

Background: Long QT syndrome (LQTS) is a lethal arrhythmia syndrome, frequently caused by rare loss-of-function variants in the potassium channel encoded by KCNH2 . Variant classification is difficult, often owing to lack of functional data. Moreover, variant-based risk stratification is also complicated by heterogenous clinical data and incomplete penetrance. Here, we sought to test whether variant-specific information, primarily from high-throughput functional assays, could improve both classification and cardiac event risk stratification in a large, harmonized cohort of KCNH2 missense variant heterozygotes., Methods: We quantified cell-surface trafficking of 18,796 variants in KCNH2 using a Multiplexed Assay of Variant Effect (MAVE). We recorded KCNH2 current density for 533 variants by automated patch clamping (APC). We calibrated the strength of evidence of MAVE data according to ClinGen guidelines. We deeply phenotyped 1,458 patients with KCNH2 missense variants, including QTc, cardiac event history, and mortality. We correlated variant functional data and Bayesian LQTS penetrance estimates with cohort phenotypes and assessed hazard ratios for cardiac events., Results: Variant MAVE trafficking scores and APC peak tail currents were highly correlated (Spearman Rank-order ρ = 0.69). The MAVE data were found to provide up to pathogenic very strong evidence for severe loss-of-function variants. In the cohort, both functional assays and Bayesian LQTS penetrance estimates were significantly predictive of cardiac events when independently modeled with patient sex and adjusted QT interval (QTc); however, MAVE data became non-significant when peak-tail current and penetrance estimates were also available. The area under the ROC for 20-year event outcomes based on patient-specific sex and QTc (AUC 0.80 [0.76-0.83]) was improved with prospectively available penetrance scores conditioned on MAVE (AUC 0.86 [0.83-0.89]) or attainable APC peak tail current data (AUC 0.84 [0.81-0.88])., Conclusion: High throughput KCNH2 variant MAVE data meaningfully contribute to variant classification at scale while LQTS penetrance estimates and APC peak tail current measurements meaningfully contribute to risk stratification of cardiac events in patients with heterozygous KCNH2 missense variants.

Background: Truncating variants in filamin C (FLNC) can cause arrhythmogenic cardiomyopathy (ACM) through haploinsufficiency. Noncanonical splice-altering variants may contribute to this phenotype., Objective: The purpose of this study was to investigate the clinical and functional consequences of a recurrent FLNC intronic variant of uncertain significance (VUS), c.970-4A>G., Methods: Clinical data in 9 variant heterozygotes from 4 kindreds were obtained from 5 tertiary health care centers. We used in silico predictors and functional studies with peripheral blood and patient-specific induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). Isolated RNA was studied by reverse transcription polymerase chain reaction. iPSC-CMs were further characterized at baseline and after nonsense-mediated decay (NMD) inhibition, using quantitative polymerase chain reaction (qPCR), RNA-sequencing, and cellular electrophysiology. American College of Medical Genetics and Genomics (ACMG) criteria were used to adjudicate variant pathogenicity., Results: Variant heterozygotes displayed a spectrum of disease phenotypes, spanning from mild ventricular dysfunction with palpitations to severe ventricular arrhythmias requiring device shocks or progressive cardiomyopathy requiring heart transplantation. Consistent with in silico predictors, the c.970-4A>G FLNC variant activated a cryptic splice acceptor site, introducing a 3-bp insertion containing a premature termination codon. NMD inhibition upregulated aberrantly spliced transcripts by qPCR and RNA-sequencing. Patch clamp studies revealed irregular spontaneous action potentials, increased action potential duration, and increased sodium late current in proband-derived iPSC-CMs. These findings fulfilled multiple ACMG criteria for pathogenicity., Conclusion: Clinical, in silico, and functional evidence support the prediction that the intronic c.970-4A>G VUS disrupts splicing and drives ACM, enabling reclassification from VUS to pathogenic., (Copyright © 2023. Published by Elsevier Inc.)

Background: Rare protein-altering variants in SCN5A , KCNQ1 , and KCNH2 are major causes of Brugada syndrome and the congenital long QT syndrome. While splice-altering variants lying outside 2-bp canonical splice sites can cause these diseases, their role remains poorly described. We implemented 2 functional assays to assess 12 recently reported putative splice-altering variants of uncertain significance and 1 likely pathogenic variant without functional data observed in Brugada syndrome and long QT syndrome probands., Methods: We deployed minigene assays to assess the splicing consequences of 10 variants. Three variants incompatible with the minigene approach were introduced into control induced pluripotent stem cells by CRISPR genome editing. We differentiated cells into induced pluripotent stem cell-derived cardiomyocytes and studied splicing outcomes by reverse transcription-polymerase chain reaction. We used the American College of Medical Genetics and Genomics functional assay criteria (PS3/BS3) to reclassify variants., Results: We identified aberrant splicing, with presumed disruption of protein sequence, in 8/10 variants studied using the minigene assay and 1/3 studied in induced pluripotent stem cell-derived cardiomyocytes. We reclassified 8 variants of uncertain significance to likely pathogenic, 1 variant of uncertain significance to likely benign, and 1 likely pathogenic variant to pathogenic., Conclusions: Functional assays reclassified splice-altering variants outside canonical splice sites in Brugada Syndrome- and long QT syndrome-associated genes.

Many genes, including KCNH2, contain "hotspot" domains associated with a high density of variants associated with disease. This has led to the suggestion that variant location can be used as evidence supporting classification of clinical variants. However, it is not known what proportion of all potential variants in hotspot domains cause loss of function. Here, we have used a massively parallel trafficking assay to characterize all single-nucleotide variants in exon 2 of KCNH2, a known hotspot for variants that cause long QT syndrome type 2 and an increased risk of sudden cardiac death. Forty-two percent of KCNH2 exon 2 variants caused at least 50% reduction in protein trafficking, and 65% of these trafficking-defective variants exerted a dominant-negative effect when co-expressed with a WT KCNH2 allele as assessed using a calibrated patch-clamp electrophysiology assay. The massively parallel trafficking assay was more accurate (AUC of 0.94) than bioinformatic prediction tools (REVEL and CardioBoost, AUC of 0.81) in discriminating between functionally normal and abnormal variants. Interestingly, over half of variants in exon 2 were found to be functionally normal, suggesting a nuanced interpretation of variants in this "hotspot" domain is necessary. Our massively parallel trafficking assay can provide this information prospectively., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.)

Background: Sequencing Mendelian arrhythmia genes in individuals without an indication for arrhythmia genetic testing can identify carriers of pathogenic or likely pathogenic (P/LP) variants. However, the extent to which these variants are associated with clinically meaningful phenotypes before or after return of variant results is unclear. In addition, the majority of discovered variants are currently classified as variants of uncertain significance, limiting clinical actionability., Methods: The eMERGE-III study (Electronic Medical Records and Genomics Phase III) is a multicenter prospective cohort that included 21 846 participants without previous indication for cardiac genetic testing. Participants were sequenced for 109 Mendelian disease genes, including 10 linked to arrhythmia syndromes. Variant carriers were assessed with electronic health record-derived phenotypes and follow-up clinical examination. Selected variants of uncertain significance (n=50) were characterized in vitro with automated electrophysiology experiments in HEK293 cells., Results: As previously reported, 3.0% of participants had P/LP variants in the 109 genes. Herein, we report 120 participants (0.6%) with P/LP arrhythmia variants. Compared with noncarriers, arrhythmia P/LP carriers had a significantly higher burden of arrhythmia phenotypes in their electronic health records. Fifty-four participants had variant results returned. Nineteen of these 54 participants had inherited arrhythmia syndrome diagnoses (primarily long-QT syndrome), and 12 of these 19 diagnoses were made only after variant results were returned (0.05%). After in vitro functional evaluation of 50 variants of uncertain significance, we reclassified 11 variants: 3 to likely benign and 8 to P/LP., Conclusions: Genome sequencing in a large population without indication for arrhythmia genetic testing identified phenotype-positive carriers of variants in congenital arrhythmia syndrome disease genes. As the genomes of large numbers of people are sequenced, the disease risk from rare variants in arrhythmia genes can be assessed by integrating genomic screening, electronic health record phenotypes, and in vitro functional studies., Registration: URL: https://www., Clinicaltrials: gov; Unique identifier; NCT03394859.

Based on morphological investigations and a phylogeny constructed with partial sequences of the SSU rDNA gene, we revalidate the genus Alwisia and propose the combination Alwisia bombarda Berk. & Broome to be used against Tubifera bombarda (Berk. & Broome) G.W. Martin. Two new species, Alwisia morula and A. repens, are described based on material collected respectively in Costa Rica and Australia. Both new species lack a capillitium and possess individually stalked subspherical sporothecae. Alwisia repens differs from A. morula by its procumbent stalks and iridescent peridium. A comparison of 83 sequences of species in the genera Lycogala, Reticularia and Tubifera with a recent two-gene phylogeny of the bright-spored myxomycetes resulted in a similar topology of both Bayesian and maximum likelihood trees and placed A. bombarda, A. morula and A. repens in one well delimited clade within Reticulariaceae., (© 2014 by The Mycological Society of America.)

The use of visual habituation in the study of infant cognition and learning is reviewed. This article traces the history of the technique, underlying theory, and procedural variation in its measurement. In addition, we review empirical findings with respect to the cognitive processes that presumably contribute to habituation, studies of developmental course and long-term prediction, as well as recent attempts to address or explain the phenomenon of visual habituation through the use of mathematical or quantitative models. The review ends with an appeal for a return to the study of habituation per se as a valid measure of infant learning, rather than relegating the phenomenon to its use as a technique for familiarizing infants in procedures testing for discrimination or recognition.

Gifted children often display sensitivities to their environment that vary from those of the general population. Data were gathered on 6- to 11-year-old gifted children attending a public elementary school gifted program. Parents completed Dunn's (1999) Sensory Profile questionnaire regarding their child. Two primary analyses were conducted: (1) a comparison of the gifted children's sensory sensitivity with Sensory Profile norms and (2) an examination of the internal consistency of the Sensory Profile for the gifted sample. Gifted children were more sensitive to their environment and reacted with heightened emotional and behavioral responses than did children of average intelligence. Internal consistencies for the 14 Sensory Profile sections and the Sensory Profile factors for the gifted sample were found to be equal to the reported norms of the Sensory Profile. These findings further support that gifted children may have important sensory modulation differences and add to our understanding of gifted children.

We studied the mean hemoglobin (Hb) concentration in elite male and female long track junior and senior speed skaters from 2000 to 2005. In addition, the number of abnormal hematological findings observed over this period of time was investigated. We also studied whether there were differences in Hb concentration between top ranked and lower ranked skaters, and whether a relationship between Hb concentration and competitive results could be observed. The present study shows that the mean Hb level in male and female junior and senior long track speed skaters remained fairly stable and did not change from 2000 through 2005. The number and percentage of abnormal hematological findings were found to vary between 0 and 2 %, and failed to show a clear pattern or trend over the years. There was no difference in mean Hb levels between top ranked and lower ranked skaters, and no meaningful relationship between Hb concentration and ranking could be found.

This study evaluated a porous tantalum biomaterial (Hedrocel) designed to function as a scaffold for osseous ingrowth. Samples were characterized for structure, Vickers microhardness, compressive cantilever bending, and tensile properties, as well as compressive and cantilever bending fatigue. The structure consisted of regularly arranged cells having struts with a vitreous carbon core with layers of CVI deposited crystalline tantalum. Microhardness values ranged from 240-393, compressive strength was 60 +/- 18 MPa, tensile strength was 63 +/- 6 MPa, and bending strength was 110 +/- 14 MPa. The compressive fatigue endurance limit was 23 MPa at 5 x 10(6) cycles with samples exhibiting significant plastic deformation. SEM examination showed cracking at strut junctions 45 degrees to the axis of the applied load. The cantilever bending fatigue endurance limit was 35 MPa at 5 x 10(6) cycles, and SEM examination showed failure due to cracking of the struts on the tension side of the sample. While properties were variable due to morphology, results indicate that the material provides structural support while bone ingrowth is occurring. These findings, coupled with the superior biocompatibility of tantalum, makes the material a candidate for a number of clinical applications and warrants further and continued laboratory and clinical investigation., (Copyright 2001 John Wiley & Sons, Inc.)

A new in-magnetic field electrospray ionization (ESI) and Fourier transform ion cyclotron resonance mass spectrometer has been constructed and evaluated. This system is characterized by the use of multiple concentric cryopanels to achieve ultrahigh vacuum in the ion cyclotron resonance cell region, a probe-mounted internal ESI source, and a novel in-field shutter. Initial experiments demonstrate high resolution mass measurement capability at a field strength of 1 T. Mass resolution of 700,000 has been obtained for the 3+ charge state of Met-Lys-bradykinin (at m/z 440) generated by electrospray ionization. When electron impact ionization was employed, resolution in excess of 9,200,000 was achieved for nitrogen molecular ions (N 2 (+) ). Isotopic resolution for molecular ions of bovine ubiquitin (MW=8565 µ) also was achieved by using small ion populations.

Background: Spontaneous regression of non-Hodgkin's lymphoma, occasionally reported in low grade groups, is a rare phenomenon in high grade groups. Clonal proliferation has not been confirmed in the majority of reported cases. In this woman, age 58 years, who had been diagnosed as having high grade immunoblastic lymphoma after excision of a single cervical lymph node, the remaining bilateral cervical, inguinal, and axillary adenopathy regressed completely without any cytotoxic treatments 22 days after biopsy. At the time of this writing, the patient has been free of disease for 24 months., Methods: Clonality of the lymphoproliferation in the case was examined by immunohistochemistry and polymerase chain reaction (PCR) amplification using paraffin embedded biopsy material. Possible implications of Epstein-Barr virus in the pathogenesis of this process was examined also by PCR amplification and in situ hybridization., Results: The proliferating lymphoid cells showed restricted expression of immunoglobulin (Ig) light chain and amplification of clonally rearranged V-D-J regions of Ig heavy chain gene. Epstein-Barr virus did not appear to be involved in the process., Conclusion: The present study shows that spontaneous complete regression of clonal lymphoproliferation that is morphologically a high grade lymphoma can occur.

To investigate the issue of clonality in Richter's syndrome, phenotypic, molecular genetic, and cytogenetic studies were performed on tumor tissue from a patient with concurrent chronic lymphocytic leukemia and diffuse large cell lymphoma in a single lymph node specimen. The tumor was biphenotypic for immunoglobulin (Ig) expression with surface Ig lambda-positive chronic lymphocytic leukemia and surface and cytoplasmic Ig kappa-positive diffuse large cell lymphoma. DNA samples prepared from areas of the lymph node rich in chronic lymphocytic leukemia cells and diffuse large cell lymphoma cells were examined in parallel. Identical Ig heavy chain gene rearrangements were detected in the BamHI and EcoRI digests of the two samples, but the patterns of rearrangement were different in the HindIII and PstI digests. Because it is very unlikely that multiple rearranged Ig heavy chain gene fragments of identical size would be found in more than one enzyme digest from two independently derived B-cell clones, it is probable that the two processes originated from a single clone. Modifications after rearrangement probably accounted for the differing band sizes seen in the HindIII and PstI digests. These conclusions are supported by cytogenetic analysis, which revealed two clones with a common primary abnormality (trisomy 12), one of which also exhibited secondary abnormalities. Therefore, Richter's syndrome may represent a composite tumor of common clonal origin, even when differences in light chain expression are identified.

Individual differences in the duration of infants' visual fixations are reliable and stable and have been linked to differential cognitive performance; short-looking infants typically perform better than long-looking infants. 4 experiments tested the possibility of whether short lookers' superiority on perceptual-cognitive tasks is attributable to attention to the featural details of visual stimuli, or simply to differences in the speed or efficiency of visual processing. To do this, the performance of long- and short-looking 4-month-olds was examined on separate discrimination tasks that could be solved only by processing either featural or global information. The global task was easier than the featural task, but as the amount of time allotted for infants to solve either type of task was decreased, short lookers' performance was superior to that of long lookers. These results thus lend support to a speed or efficiency of stimulus processing interpretation of infant fixation duration.

In five experiments, 10-month-olds were habituated to exemplars of a form category and tested for categorization in paired-comparison trials involving in-category versus out-of-category stimuli. Across these experiments, color was systematically manipulated during habituation and/or test trials. Infants categorized form when color was either held constant or varied during habituation, but failed to categorize form when exposed to color-constant stimuli during habituation and tested for categorization with novel-color form exemplars. Two subsequent experiments traced this failure to the narrow experience of exposure to color-constant exemplars during habituation. These results suggest that (a) infants' internal representation for a category will not include a stimulus dimension not varied in the exemplars from which the category was derived, but (b) if variation in that dimension is experienced, exemplars constructed of novel instances of that dimension will still be regarded as belonging to the category.

In four studies, 3-, 6-, and 9-month-old human infants were tested in a discrimination learning task in which visual fixation to a particular stimulus or lateral position was reinforced with an auditory stimulus. In Experiment 1, all age groups exhibited acquisition, extinction, and reinstatement of fixation to the reinforced target or position. Experiment 2 revealed that 3-month-olds retained the positional discrimination but not the stimulus discrimination after a 5-min delay between acquisition and extinction; older infants retained both types of discriminations. In Experiments 3 and 4 we investigated a possible developmental shift in the dominance of positional versus stimulus cues by training infants on displays in which stimulus and position were confounded and then by dissociating the cues on test trials. Results from both experiments indicated positional cue dominance for young infants and stimulus cue dominance for older infants. The findings are discussed in terms of differences in the attentional demands elicited by proprioceptive versus exteroceptive cues.

The duration of intraocular pressure reduction by Ocusert Pilocarpine was found to be 10 days for P20 and 12 days for P40. Ocusert Pilocarpine reduced visual acuity and anterior chamber depth less than the aqueous pilocarpine drops.

The short-term reliability and long-term stability of visual habituation and dishabituation in infancy were assessed in a sample of 186 infants from 4 age groups (3-, 4-, 7-, and 9-month-olds) seen for 2 within-age sessions and in a sample of 69 infants seen longitudinally at 3, 4, 7, and 9 months of age. Moderate week-to-week reliability (r's = .30-.50) was observed for duration-based and magnitude of habituation variables at all ages, although better reliability was evident at 4 and 9 months than at 3 and 7 months. In most cases, the reliability of habituation magnitude measures was attributable to the reliability of the peak fixation alone. Data from the longitudinal sample suggested that only the duration of peak fixation was consistently stable across the ages tested, although stability for several measures emerged across the 7-9-month testing. No consistent reliability or stability emerged for the presence or magnitude of dishabituation in either sample.

A study of the duration of intraocular pressure reduction of Ocusert P 20 and P 40 revealed that both agents were active in this regard at the end of a week. The side effects of this new mode of medication were less than with conventional Pilocarpine drops.

The visual behavior of infants in the paired-comparison paradigm was assessed with multiple discrimination tasks week-to-week at 4 and 7 months and longitudinally from 4 to 7 months. Results indicated that although task-to-task reliability was extremely variable and typically low, most measures of infants' attention averaged across multiple tasks were reliable from 1 week to the next as well as relatively stable over the longer longitudinal period. Across all groups, infants who had shorter fixations (i.e., more fixations per fixed-exposure period) during the familiarization phase showed higher novelty preferences. While infants' shift rate during test phases was a reliable individual characteristic at 7 months, it was not at 4 months; rather, data suggested that the difficulty of the stimulus discrimination may be related to young infants' shift rate.

A study of the Dioptron automatic refraction machine reveals a good reproducibility of the results obtained by the machine. In a comparison with retinoscopy and subjective refraction, the spherical components were well correlated while the cylindrical power was less well related. The rejection rate of the machine was high and its usefulness in refraction is discussed.

In 2 studies, the Range of State cluster derived from infants' scores on the Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K) was found to correlate significantly with visual discrimination performance at 3 months of age. Contrary to the expectation that NBAS-K orientation scores would predict visual discrimination at 3 months, it was neonatal behavioral state organization that related to later cognitive functioning in infancy.

Forty untrained mildly mentally retarded and 32 untrained nonretarded junior high school students were given eight trails of practice on a self-paced memory problem with lists of letters or words. For each trail a new list was presented, requiring ordered recall of terminal list items followed by ordered recall of initial items. Subgroups of solvers and nonsolvers were identified at each IQ level by a criterion of strict recall accuracy. Direct measures of mnemonic activity showed that over trails, solvers at both IQ levels increasingly fit a theoretically ideal memorization method. At neither IQ level did nonsolvers show similar inventions. On early trials, for both IQ levels, fit to the ideal method was uncorrelated with recall accuracy. On late trials fit and recall were highly correlated at each IQ level and across levels. The results support a problem-solving theory of individual differences in retarded and nonretarded children's memory performances.