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Unilateral spatial neglect, a debilitating condition affecting awareness of one side of space, is commonly assessed using cancellation tasks in which patients cross out targets distributed over a sheet. Standard scores emphasize the left-right distribution of omissions. Here, the additional value of extracting temporal as well as spatial aspects of performance from video recordings was examined. Videos from 18 patients with left neglect and 19 healthy age-matched control participants were obtained. Interrater reliability of the video analysis was high. In addition to overall differences in target detection and bias, patients significantly differed from the control group in terms of the location of first cancellation, overall slowness, greater variability in speed, systematic slowing with time on task and as a function of target location, less coherent search organization, and a sharply increased tendency to recancel targets. Considering a subset of patients whose scores, by standard criteria, were at or near the normal range indicated that these additional variables indeed increased the sensitivity of the task as well as allowed the simultaneous assessment of spatial and nonspatial aspects of the disorder.

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Background: The aim of this case study was to examine the impact of Schwartz Rounds on staff wellbeing and patient care. Methods: A series of interviews were conducted with staff, regarding stress. The key themes, which were extracted using Grounded Theory, were used to inform the development of a new measure, 'The Organizational Response to Emotions Scale'. This was administered at the beginning and end of Schwartz Rounds.Results: Analysis of the results revealed a significant reduction in attendees' appraisal of emotional labour and an increase in reflection. This was associated with a reported upsurge in feelings of interconnectivity and compassion towards colleagues. More traditional forms of individualised staff support were in contrast, viewed as unhelpful. In particular, the offer of counselling sessions was resented by many staff because it carried the implicit message that the problem arose from a deficiency or weakness within them. New performance management policies compounded this problem and left many feeling blamed and punished for their stress. A referral to Occupational Health was widely seen as an index of failure; a sign that they could not cope.Discussion: Attendance at the Schwartz Rounds helped staff to recognise that their feelings were normal in the context of a highly-pressured healthcare system. Eradicating the stigma associated with emotional responses should help to improve organizational culture. It may also help to address an emerging phenomenon that was identified within this study, namely that staff had begun to hide their feelings from their managers. In the longer term, this could serve to mask the true extent of stress and burnout within the NHS. Conclusions: The findings suggest that Schwartz Rounds may indirectly improve the quality of patient care by addressing the stress-induced cognitive narrowing and decline in empathy that precedes withdrawal; the process that is a likely forerunner of dehumanization. An additional finding was that the line manager played an important mediating role of containment. This, in turn, appeared to influence the level of support that staff provided to each other.

In adults and older children, evidence consistent with relative separation between selective and sustained attention, superimposed upon generally positive inter-test correlations, has been reported. Here we examine whether this pattern is detectable in 5-year-old children from the healthy population. A new test battery (TEA-ChJ) was adapted from measures previously used with adults and older children and administered to 172 5-year-olds. Test-retest reliability was assessed in 60 children. Ninety-eight percent of the children managed to complete all measures. Discrimination of visual and auditory stimuli were good. In a factor analysis, the two TEA-ChJ selective attention tasks (one visual, one auditory) loaded onto a common factor and diverged from the two sustained attention tasks (one auditory, one motor), which shared a common loading on the second factor. This pattern, which suggests that the tests are indeed sensitive to underlying attentional capacities, was supported by the relationships between the TEA-ChJ factors and Test of Everyday Attention for Children subtests in the older children in the sample. It is possible to gain convincing performance-based estimates of attention at the age of 5 with the results reflecting a similar factor structure to that obtained in older children and adults. The results are discussed in light of contemporary models of attention function. Given the potential advantages of early intervention for attention difficulties, the findings are of clinical as well as theoretical interest.