A fragile effect: The influence of episodic memory on delay discounting.

Delay discounting occurs when a reward loses value as a function of delay. Episodic future thinking (EFT) reliably decreases delay discounting. EFT may share cognitive features with recalling episodic memories such as constructive episodic simulation. We therefore explored whether recalling episodic memories also reduces delay discounting. In Experiment 1, participants wrote about episodic memories and recalled those memories before completing a delay discounting task. Episodic memories reduced delay discounting according to one commonly used delay discounting measure (area under the curve) but not another (using the hyperbolic model). Experiment 2 compared the effects of general and episodic memories. Neither general nor episodic memories significantly decreased delay discounting compared with a control "counting" condition, but episodic memories reduced delay discounting compared with general memories under some conditions. In Experiment 3, episodic memories did not decrease delay discounting compared with three other control conditions while EFT did. Experiment 3 therefore found that thinking must be both episodic and future orientated to reduce delay discounting. Together, these results suggest that episodic thinking is not sufficient to reliably decrease delay discounting, rather, features unique to episodic future thinking are required. Episodic memory might reduce delay discounting in some contexts, but this effect is small and fragile.

Developing and validating a novel staff questionnaire to identify barriers and enablers to nutrition and mealtime care on hospital wards.

AIMS: Improving hospital nutrition and mealtime care is complex and often requires multifaceted interventions and implementation strategies to change how staff, wards and systems operate. This study aimed to develop and validate a staff questionnaire to identify multilevel barriers and enablers to optimal nutrition and mealtime care on hospital wards, to inform and evaluate local quality improvement. METHODS: Literature review, multidisciplinary focus groups and end-user testing informed questionnaire development and establishment of content and face validity. To determine the construct validity, the questionnaire was administered to ward staff working in five wards across two facilities (acute hospital, rehabilitation unit). Exploratory factor analysis was used to estimate the number of factors and to guide decisions about whether to retain or reject individual items. Scale reliability was assessed using Cronbach's alpha. RESULTS: The questionnaire was completed by 138 staff, with most respondents being nurses (57%) and working in the acute care facility (76%). Exploratory factor analysis supported construct validity of four of the original seven subscales. The final questionnaire consisted of 17 items and 4 sub sub-scales related to (1) Personal Staff Role; (2) Food Service; (3) Organisational Support, and (4) Family Involvement; each sub-scale demonstrated good reliability with Cronbach's alpha values all >0.70. CONCLUSION: This novel and brief questionnaire shows good reliability and preliminary evidence of construct validity in this small sample. It provides a potentially useful instrument to identify barriers and enablers to nutrition and mealtime care from the staff perspective and inform where improvement efforts should be focused.