To investigate the latent factor structure and construct validity of the Verbal Series Attention Test (VSAT) across clinical patient populations.

Participants included a consecutive series of clinical patients presenting with a primary memory complaint. Each patient underwent a comprehensive neuropsychological assessment and provided informed consent to allow their clinical data to be used for research. Groups formed included 1) No Neurocognitive Disorder [NoND, N=262, mean age=68.8, mean education=16.2, mean MMSE=28.3], 2) Mild Neurocognitive Disorder [MildND, N=337, mean age=72.3, mean education=15.4, mean MMSE=28.7], and 3)

Major Neurocognitive Disorder [MajorND, N=524, mean age=76.5, mean education=14.5, mean MMSE=19.0] with etiologies including suspected Alzheimer’s disease and/or vascular pathology. Latent factors were investigated using exploratory factor analysis (EFA).

EFA was conducted using SAS 9.4 software and the promax (oblique) rotation to reveal the latent factors of the eight timed items of the VSAT in each of the three clinical groups. The structure was essentially identical in all three groups with two primary factors consistently emerging identified as 1-Complex Attention and 2-Simple Attention. Each factor had four items loading with a correlation range of > 0.37 x < 0.92. The internal consistency (Cronbach’s alpha) for the VSAT total score in each group was excellent (NoND a=0.83, MildND a=0.81, and MajorND a=0.84). To investigate construct validity, the VSAT items were entered into factor analysis with measures of attention and executive function (i.e., Digit Span [forward, backward, sequence], Trail Making Test A & B, semantic fluency (animals), Controlled Oral Word Association Test [COWAT, FAS]). All three patient groups were combined (N=950) given the VSAT’s consistent factor structure. Using the same EFA procedure as before, two main factors emerged with the VSAT Complex Attention variables loading on a general complex attention/working memory factor including Trails B, semantic fluency, and Digit Span subtests. The VSAT Simple Attention items loaded on a general attention factor with the VSAT Simple Attention variables and Trails A. COWAT did not load significantly on either factor.

The latent factor structure of the VSAT was consistent across patient populations with excellent internal consistency in each clinical group. The Complex and Simple Attention factors of the VSAT loaded on factors with similar variables identifying the anticipated latent factor structure demonstrating the construct validity of the VSAT across a wide spectrum of cognitive impairment in patients with primary memory complaints ranging from NoND to MajorND. This supports the use of the VSAT in patients across neurocognitive severity. Future studies will further explore additional psychometric properties of this instrument.

Child and adolescent mental health (CAMHS) wards treat patients with variable presentations. During diagnosis and treatment, psychiatric professionals use structured criteria, but also honed awareness of countertransference. Unacknowledged emotional responses can produce powerful dynamics and impact patient care.

Limited information exists on possible emotional responses and team dynamics when working with catatonia.

This project aimed to establish common themes relating to staff felt-experience of working with a specific case of catatonia on a Child and Adolescent Mental Health (CAMHS) ward. A secondary aim was to establish potential areas for future training and service improvement.

Trust Research and Development department approved this work. Inpatient professionals working with the specified patient during admission were eligible. Participants were invited via email and face-face discussion with one of the authors. Participants, patient and mother provided written consent.

A questionnaire was created and disseminated via email to eligible staff (n = 33). 27 questions asked individuals to rate responses on Likert scales, plus space for further comments. Questions involved emotional responses to different catatonic states, feelings towards self, patient, colleagues and plans. Descriptive analysis was completed on this anonymised data.

Qualitative data were gathered via 1-hour recorded focus group, led by a systemic psychotherapist and psychologist. The session was transcribed anonymously. Two clinicians, using Thematic Analysis, reviewed the transcript independently.

16 (48.5%) questionnaires were completed. Participants felt negatively about themselves and colleagues more frequently than about the patient. Participants felt positively about themselves less frequently than about colleagues and the patient. Participants identified with more feelings during immobile patient states than lucid states. During immobile states, participants identified with abusive, guilt, hopeless and neglectful responses; during lucid states, with helpful, caring, happy responses

Eight (50%) participants felt they sometimes did not understand their feelings towards colleagues/plans. Nine (57%) participants felt they sometimes did not understand their feelings towards themselves. Ten (66%) participants felt they sometimes did not understand their feelings towards the patient.

Ten (62.5%) participants felt confused by their emotions at least some of the time. Two (12.5%) frequently felt confused by their emotions.

Four participants attended the focus group. Themes included confusion, internal and team conflict.

Working with catatonia involved confusion and team splitting. Staff conflict between plans and morals resulted in painful emotions. Prompt psycho-education within teams working with uncommon presentations was identified as a focus for improvement. The authors plan to explore possible avenues for future teaching, learning and team support.

Traditional dietary assessment methods in research can be challenging, with participant burden to complete an interview, diary, 24 h recall or questionnaire and researcher burden to code the food record to obtain a nutrient breakdown. Self-reported assessment methods are subject to recall and social desirability biases, in addition to selection bias from the nature of volunteering to take part in a research study. Supermarket loyalty card transaction records, linked to back of pack nutrient information, present a novel opportunity to use objective records of food purchases to assess diet at a household level. With a large sample size and multiple transactions, it is possible to review variation in food purchases over time and across different geographical areas.

This study uses supermarket loyalty card transactions for one retailer's customers in Leeds, for 12 months during 2016. Fruit and vegetable purchases for customers who appear to shop regularly for a ‘complete’ shop, buying from at least 7 of 11 Living Cost and Food Survey categories, were calculated. Using total weight of fruits and vegetables purchased over one year, average portions (80g) per day, per household were generated. Descriptive statistics of fruit and vegetable purchases by age, gender and Index of Multiple Deprivation of the loyalty card holder were generated. Using Geographical Information Systems, maps of neighbourhood purchases per month of the year were created to visualise variations.

The loyalty card holder transaction records represent 6.4% of the total Leeds population. On average, households in Leeds purchase 3.5 portions of fruit and vegetables per day, per household. Affluent and rural areas purchase more fruit and vegetables than average with 22% purchasing more than 5 portions/day. Conversely poor urban areas purchase less, with 18% purchasing less than 1 portion/day. Highest purchases are in the winter months, with lowest in the summer holidays. Loyalty cards registered to females purchased 0.4 portions per day more than male counterparts. The over 65 years purchased 1.5 portions per day more than the 17–24 year olds. A clear deprivation gradient is observed, with the most deprived purchasing 1.5 portions less per day than the least deprived.

Loyalty card transaction data offer an exciting opportunity for measuring variation in fruit and vegetable purchases. Variation is observed by age, gender, deprivation, geographically across a city and throughout the seasons. These insights can inform both policymakers and retailers regarding areas for fruit and vegetable promotion.

Supermarket transaction data, generated from loyalty cards, offers a novel source of food purchase information. Data are available for large sample sizes, over sustained periods of time, allowing for habitual purchasing patterns to be generated. In the UK, recommended dietary patterns to achieve a healthy diet are pictorially illustrated using the Eatwell Guide. Foods include: Fruit and vegetables; starchy products including potatoes, bread, pasta, rice; dairy or dairy alternatives; proteins such as beans, pulses, fish, eggs and meat; oils and spreads; and advice to limit foods high in salt, fat and sugar. Through mapping of foods purchased to the categories of the Eatwell Guide it is possible to review population performance against these national recommendations.

All loyalty card transaction records for purchases made in a UK supermarket chain, by residents of Yorkshire and the Humber during 2016 were included in this research. Customers who purchased foods from 7 or 11 Living Cost and Food Survey (LCFS) categories on ten or more occasions throughout the year were included in the sample, as these customers were considered to be purchasing the majority of their foods from the supermarket. All foods purchased were mapped to the Eatwell Guide food groups via the LCFS categories.

Households purchased: 25% of their total spend on fruits and vegetables, compared with 39% recommended; 13% on starchy products compared to 37% recommended; 23% of protein rich foods compared with 12% recommended; 12% dairy and alternatives compared to 8%; oils and spreads 2% compared to 1% recommended; and 25% foods that should be limited compared to 3% (recommended, but not pictorially illustrated on the plate).

Supermarket transaction data is a novel source of food purchase information which can be used to illustrate dietary behaviours in the UK population. However, it represents foods purchased, not consumed and is at a household level, not individual. Food purchases outside the home are not included. That said, it is arguably an objective measure for dietary assessment. From this study, it is clear to see that food purchases do not match the recommendations. Purchases of high sugar, high fat and high salt snacks constitute a significant proportion of spending, when they should in fact be limited. Protein rich products are also over-represented. Fruit and vegetables and starchy products are under-represented. This insight can benefit both retailers and policy makers for understanding the food purchase behaviours of our society.

To assess potential transmission of antibiotic-resistant organisms (AROs) using surrogate markers and bacterial cultures.

Pilot study.

A 1,260-bed tertiary-care academic medical center.

The study included 25 patients (17 of whom were on contact precautions for AROs) and 77 healthcare personnel (HCP).

Fluorescent powder (FP) and MS2 bacteriophage were applied in patient rooms. HCP visits to each room were observed for 2–4 hours; hand hygiene (HH) compliance was recorded. Surfaces inside and outside the room and HCP skin and clothing were assessed for fluorescence, and swabs were collected for MS2 detection by polymerase chain reaction (PCR) and selective bacterial cultures.

Transfer of FP was observed for 20 rooms (80%) and 26 HCP (34%). Transfer of MS2 was detected for 10 rooms (40%) and 15 HCP (19%). Bacterial cultures were positive for 1 room and 8 HCP (10%). Interactions with patients on contact precautions resulted in fewer FP detections than interactions with patients not on precautions (P < .001); MS2 detections did not differ by patient isolation status. Fluorescent powder detections did not differ by HCP type, but MS2 was recovered more frequently from physicians than from nurses (P = .03). Overall, HH compliance was better among HCP caring for patients on contact precautions than among HCP caring for patients not on precautions (P = .003), among nurses than among other nonphysician HCP at room entry (P = .002), and among nurses than among physicians at room exit (P = .03). Moreover, HCP who performed HH prior to assessment had fewer fluorescence detections (P = .008).

Contact precautions were associated with greater HCP HH compliance and reduced detection of FP and MS2.

Basic symptoms, defined as subjectively perceived disturbances in thought, perception and other essential mental processes, have been established as a predictor of psychotic disorders. However, the relationship between basic symptoms and family history of a transdiagnostic range of severe mental illness, including major depressive disorder, bipolar disorder and schizophrenia, has not been examined.

We sought to test whether non-severe mood disorders and severe mood and psychotic disorders in parents is associated with increased basic symptoms in their biological offspring.

We measured basic symptoms using the Schizophrenia Proneness Instrument – Child and Youth Version in 332 youth aged 8–26 years, including 93 offspring of control parents, 92 offspring of a parent with non-severe mood disorders, and 147 offspring of a parent with severe mood and psychotic disorders. We tested the relationships between parent mental illness and offspring basic symptoms in mixed-effects linear regression models.

Offspring of a parent with severe mood and psychotic disorders (B = 0.69, 95% CI 0.22–1.16, P = 0.004) or illness with psychotic features (B = 0.68, 95% CI 0.09–1.27, P = 0.023) had significantly higher basic symptom scores than control offspring. Offspring of a parent with non-severe mood disorders reported intermediate levels of basic symptoms, that did not significantly differ from control offspring.

Basic symptoms during childhood are a marker of familial risk of psychopathology that is related to severity and is not specific to psychotic illness.

None.