Maintaining attention underlies many aspects of cognition and becomes compromised early in neurodegenerative diseases like Alzheimer’s disease (AD). The consistency of maintaining attention can be measured with reaction time (RT) variability. Previous work has focused on measuring such fluctuations during in-clinic testing, but recent developments in remote, smartphone-based cognitive assessments can allow one to test if these fluctuations in attention are evident in naturalistic settings and if they are sensitive to traditional clinical and cognitive markers of AD.

Three hundred and seventy older adults (aged 75.8 +/− 5.8 years) completed a week of remote daily testing on the Ambulatory Research in Cognition (ARC) smartphone platform and also completed clinical, genetic, and conventional in-clinic cognitive assessments. RT variability was assessed in a brief (20-40 seconds) processing speed task using two different measures of variability, the Coefficient of Variation (CoV) and the Root Mean Squared Successive Difference (RMSSD) of RTs on correct trials.

Symptomatic participants showed greater variability compared to cognitively normal participants. When restricted to cognitively normal participants, APOE ε4 carriers exhibited greater variability than noncarriers. Both CoV and RMSSD showed significant, and similar, correlations with several in-clinic cognitive composites. Finally, both RT variability measures significantly mediated the relationship between APOE ε4 status and several in-clinic cognition composites.

Attentional fluctuations over 20–40 seconds assessed in daily life, are sensitive to clinical status and genetic risk for AD. RT variability appears to be an important predictor of cognitive deficits during the preclinical disease stage.

Youth with attention-deficit/hyperactivity disorder (ADHD), characterized by symptoms of inattention and hyperactivity, often experience challenges with emotion regulation (ER) and/or emotional lability/negativity (ELN).1-3 Prior work has shown that difficulties with ER and ELN among young children contribute to lower academic achievement.4-6 To date, research examining associations between ADHD and academic achievement have primarily focused on the roles of inattentive symptoms and executive functioning.7-8 However, preliminary work among youth with ADHD suggests significant associations between disruptions in emotional functioning and poor academic outcomes.9-10 The current study will examine associations between ER, ELN, and specific subdomains of academic achievement (i.e., reading, spelling, math) among youth with and without ADHD.

Forty-six youth (52% male; Mage=9.52 years; 76.1% Hispanic/Latino; 21 with ADHD) and their parents were recruited as part of an ongoing study. Parents completed the Disruptive Behavior Disorders Rating Scale11 and Emotion Regulation Checklist12 about their child. Youth completed the Wechsler Abbreviated Scale of Intelligence-II13 and three subtests [Spelling (SP), Numerical Operations (NO), Word Reading (WR)] of the Wechsler Individual Achievement Test-III.14 Univariate analysis of variance assessed differences in emotional functioning and academic achievement among youth with and without ADHD. Correlation and regression analyses were conducted to examine the association between emotional factors and the three subtests of academic achievement.

Youth with ADHD exhibited significantly higher ELN (M=30.7, SD=8.7) compared to their peers (M=23.2, SD=5.8), when controlling for child age, sex, and diagnoses of conduct disorder and/or oppositional defiant disorder [F(1,41)=8.96, p<.01, ŋp2=.18]. With respect to ER, youth with (M=24.8, SD=4.2) and without ADHD (M=25.8, SD=4.3) did not differ [F(1,41)=.51, p=.48]. Surprisingly, within this sample, ADHD diagnostic status was not significantly associated with performance on any of the academic achievement subtests [WR: F(1,41)=.29, p=.59; NO: F(1,41)=.91, p=.35; SP: F(1,41)=2.14, p=.15]. Among all youth, ER was significantly associated with WR (r=.31, p=.04) and SP (r=.35, p=.02), whereas ELN was associated with performance on NO (r=-.30, p=.04). When controlling for child age, sex, IQ, and ER within the full sample, higher ELN was associated with lower scores on the NO subtest (b=-.56, SE=.26, p=.04). The associations between higher ER and WR scores (b=1.12, SE=.51, p=.03), as well as higher ER and SP scores (b=1.47, SE=.56, p=.01), were significant when controlling for child age and sex, but not ELN and IQ (p=.73 and p=.64, respectively).

As expected, youth with ADHD had higher ELN, although they did not differ from their peers in terms of ER. Results identified distinct associations between ER and higher reading/spelling performance, as well as ELN and lower math performance across all youth. Thus, findings suggest that appropriate emotional coping skills may be most important for reading and spelling, while emotional reactivity appears most salient to math performance outcomes. In particular, ELN may be a beneficial target for intervention, especially with respect to improvement in math problem-solving skills. Future work should account for executive functioning skills, expand the academic achievement domains to include fluency and more complex academic skills, and assess longitudinal pathways within a larger sample.

There is emerging evidence of heterogeneity within treatment-resistance schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and a smaller group becoming treatment-resistant after an initial response period. It has been suggested that these groups have different aetiologies. Few studies have investigated socio-demographic and clinical differences between early and late onset of TRS.

This study aims to investigate socio-demographic and clinical correlates of late-onset of TRS.

Using data from the electronic health records of the South London and Maudsley, we identified a cohort of people with TRS. Regression analyses were conducted to identify correlates of the length of treatment to TRS. Analysed predictors include gender, age, ethnicity, positive symptoms severity, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics.

We observed a continuum of the length of treatment until TRS presentation. Having severe hallucinations and delusions at treatment start was associated shorter duration of treatment until the presentation of TRS.

Our findings do not support a clear cut categorisation between early and late TRS, based on length of treatment until treatment resistance onset. More severe positive symptoms predict earlier onset of treatment resistance.

DFdF, GKS, EF and IR have received research funding from Janssen and H. Lundbeck A/S. RDH and HS have received research funding from Roche, Pfizer, Janssen and Lundbeck. SES is employed on a grant held by Cardiff University from Takeda Pharmaceutical Comp

To identify characteristics of US health systems and end users that report antimicrobial use and resistance (AUR) data, to determine how NHSN AUR data are used by hospitals and health systems and end users, and to identify barriers to AUR reporting.

An anonymous survey was sent to Society of Infectious Diseases Pharmacists (SIDP) and Society for Healthcare Epidemiology of America (SHEA) Research Network members.

Data were collected via Survey Monkey from January 21 to February 21, 2020. Respondent and hospital data were analyzed using descriptive statistics.

We received responses from 238 individuals across 43 US states. Respondents were primarily pharmacists (84%), from urban areas, (44%), from nonprofit medical centers (81%), and from hospitals with >250 beds (72%). Also, 62% reported data to the AU module and 19% reported data to the AR module. Use of software for local AU or AR tracking was associated with increased reporting to the AU module (19% vs 64%) and the AR module (2% vs 30%) (P < .001 each). Only 36% of those reporting data to the AU module used NHSN AUR data analysis tools regularly and only 9% reported data to the AR module regularly. Technical challenges and time and/or salary support were the most common barriers to AUR participation cited by all respondents. Among those not reporting AUR data, increased local expectations to report and better software solutions were the most commonly identified solutions to increase AUR reporting.

Efforts to increase AUR reporting should focus on software solutions and salary support for data-entry activities. Increasing expectations to report may incentivize local resource allocation to improve AUR reporting rates.

Globally, the corona virus disease 2019 (COVID-19) pandemic has created an interpersonally threatening context within which other people have become a source of possible threat. This study reports on the development and validation of a self-report measure of pandemic paranoia; that is, heightened levels of suspicion and mistrust towards others due to the COVID-19 pandemic.

An international consortium developed an initial set of 28 items for the Pandemic Paranoia Scale (PPS), which were completed by participants from the UK (n = 512), USA (n = 535), Germany (n = 516), Hong Kong (n = 454) and Australia (n = 502) using stratified quota sampling (for age, sex and educational attainment) through Qualtrics and translated for Germany and Hong Kong.

Exploratory factor analysis in the UK sample suggested a 25-item, three-factor solution (persecutory threat; paranoid conspiracy and interpersonal mistrust). Confirmatory factor analysis (CFA) on the remaining combined sample showed sufficient model fit in this independent set of data. Measurement invariance analyses suggested configural and metric invariance, but no scalar invariance across cultures/languages. A second-order factor CFA on the whole sample indicated that the three factors showed large loadings on a common second-order pandemic paranoia factor. Analyses also supported the test–retest reliability and internal and convergent validity.

The PPS offers an internationally validated and reliable method for assessing paranoia in the context of a pandemic. The PPS has the potential to enhance our understanding of the impact of the pandemic, the nature of paranoia and to assist in identifying and supporting people affected by pandemic-specific paranoia.