Vaccine hesitancy in primary care: Building bridges by understanding barriers.

Adult vaccination is an accepted part of health care and diabetes care. In spite of evidence regarding the efficacy and utility of vaccination in preventing disease, we continue to encounter vaccine hesitancy and vaccine skepticism. As physicians, it is our duty to encourage the public to get vaccinated. In this article, we create a simple framework which helps assess the barriers to vaccine acceptance, and create bridges to overcome vaccine hesitancy and skepticism. We use an interesting mnemonic, NARCO, to remind ourselves, and our readers, of the appropriate hierarchy of interviewing related to vaccine acceptance.

Face masks are less effective than sunglasses in masking face identity.

The effect of covering faces on face identification is recently garnering interest amid the COVID-19 pandemic. Here, we investigated how face identification performance was affected by two types of face disguise: sunglasses and face masks. Observers studied a series of faces; then judged whether a series of test faces, comprising studied and novel faces, had been studied before or not. Face stimuli were presented either without coverings (full faces), wearing sunglasses covering the upper region (eyes, eyebrows), or wearing surgical masks covering the lower region (nose, mouth, chin). We found that sunglasses led to larger reductions in sensitivity (d') to face identity than face masks did, while both disguises increased the tendency to report faces as studied before, a bias that was absent for full faces. In addition, faces disguised during either study or test only (i.e. study disguised faces, test with full faces; and vice versa) led to further reductions in sensitivity from both studying and testing with disguised faces, suggesting that congruence between study and test is crucial for memory retrieval. These findings implied that the upper region of the face, including the eye-region features, is more diagnostic for holistic face-identity processing than the lower face region.

Debriefing works: Successful retraction of misinformation following a fake news study.

In recent years there has been an explosion of research on misinformation, often involving experiments where participants are presented with fake news stories and subsequently debriefed. In order to avoid potential harm to participants or society, it is imperative that we establish whether debriefing procedures remove any lasting influence of misinformation. In the current study, we followed up with 1547 participants one week after they had been exposed to fake news stories about COVID-19 and then provided with a detailed debriefing. False memories and beliefs for previously-seen fake stories declined from the original study, suggesting that the debrief was effective. Moreover, the debriefing resulted in reduced false memories and beliefs for novel fake stories, suggesting a broader impact on participants' willingness to accept misinformation. Small effects of misinformation on planned health behaviours observed in the original study were also eliminated at follow-up. Our findings suggest that when a careful and thorough debriefing procedure is followed, researchers can safely and ethically conduct misinformation research on sensitive topics.

Even affective changes induced by the global health crisis are insufficient to perturb the hyper-stability of visual long-term memory.

Past studies of emotion and mood on memory have mostly focused on the learning of emotional material in the laboratory or on the consequences of a punctate catastrophic event. However, the influence of a long-lasting global condition on memory and learning has not been studied. The COVID-19 pandemic unfortunately offered a unique situation to observe the effects of prolonged, negative events on human memory for visual information. One thousand online subjects were asked to remember the details of real-world photographs of objects to enable fine-grained visual discriminations from novel within-category foils. Visual memory performance was invariant across time, regardless of the infection rate in the local or national population, or the subjects' self-reported affective state using the Positive and Negative Affect Schedule (PANAS). Thus, visual memory provides the human brain with storage that is particularly resilient to changes in emotional state, even when those changes are experienced for months longer than any imaginable laboratory procedure.

COVID-19-related distress is associated with analogue PTSD symptoms after exposure to an analogue stressor.

Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.

Antecedentes: El brote de COVID-19 a principios de 2020 se asoció con un aumento inmediato de problemas de salud mental en un porcentaje significativo de la población general. Por lo tanto, es crucial investigar cómo la pandemia de COVID-19, como estresor psicosocial, afectó los procesos etiológicos de los trastornos mentales. Investigaciones anteriores han demostrado que el estrés potencia el aprendizaje asociativo (miedo) y los síntomas análogos del trastorno de estrés postraumático (TEPT) y que los síntomas análogos del TEPT pueden surgir en respuesta al aprendizaje asociativo.Objetivo: Investigamos si el malestar psicológico en respuesta al brote de COVID-19 contribuye al desarrollo de intrusiones y rumiación después de la exposición a un trauma análogo no relacionado con COVID-19. Además, examinamos si estos efectos están mediados por la fuerza del aprendizaje asociativo durante el trauma analógico.Método: 122 estudiantes universitarios de pregrado participaron en un experimento en línea entre marzo y julio de 2020. Completaron cuestionarios que midieron el malestar psicológico y la rumiación relacionados con el brote de COVID-19. Al día siguiente, realizaron una tarea de aprendizaje asociativo, en la que se emparejaron estímulos neutrales con la exposición a un clip de película altamente aversivo. Las calificaciones subjetivas se evaluaron como indicadores de aprendizaje asociativo. Al día siguiente, los participantes documentaron intrusiones y rumiaciones relacionadas con la película.Resultados: El malestar psicológico relacionado con COVID-19, pero no la rumiación, se asoció con la intrusión posterior a la película y la carga de rumiación. Estos efectos fueron mediados por el aprendizaje asociativo.Conclusiones: Los hallazgos actuales están en línea con las suposiciones de que el estrés potenció tanto el aprendizaje asociativo como los síntomas del TEPT. Específicamente, indican que el estrés psicosocial prolongado, como el ocurrido durante el brote de COVID-19, está relacionado con diferencias individuales en el procesamiento de la memoria de eventos aversivos. Se necesita más investigación confirmatoria para replicar estos resultados.

Non-linear susceptibility to interferences in declarative memory formation.

After encoding, memories go through a labile state followed by a stabilization process known as consolidation. Once consolidated they can enter a new labile state after the presentation of a reminder of the original memory, followed by a period of re-stabilization (reconsolidation). During these periods of lability the memory traces can be modified. Currently, some studies show a rapid stabilization after 30 min, while others show that stabilization occurs after longer periods (e.g. > 6 h). Here we investigate the effect of an interference treatment on declarative memory consolidation, comparing distinct time intervals after acquisition. On day 1, participants learned a list of non- syllable pairs (List 1). 5 min, 30 min, 3 h or 8 h later, they received an interference list (List 2) that acted as an amnesic agent. On day 2 (48 h after training) participants had to recall List 1 first, followed by List 2. We found that the List 1 memory was susceptible to interference when List 2 was administered 5 min or 3 h after learning but not when it was administered 30 min or 8 h after. We propose the possibility that this rapid memory protection could be induced by a fast and transient neocortical integration. Our results open a discussion about the contribution of molecular and systemic aspects to memory consolidation.

Qualitative analysis of hotspots and intrusive memories after viewing an aversive film highlights their sensory and spatial features.

Intrusive memories of trauma are recurrent distressing sensory-perceptual impressions of the traumatic event that enter consciousness spontaneously and unwanted. They often contain the worst moment/s ('hotspots') of the trauma memory and have primarily been studied in clinical populations after real trauma. Intrusive memories can also be studied using analogue trauma as an 'experimental psychology model'. Little is known about the features of analogue trauma hotspots. Here we report an ancillary analysis of data from a randomized controlled trial. Seventy non-clinical participants viewed a trauma film containing COVID-19 related footage. Features of hotspots/intrusive memories of the film were explored using linguistic analysis and qualitative content coding. Participants reported on average five hotspots (M = 9.5 words/hotspot). Akin to hotspots soon after real trauma, analogue hotspots/intrusions primarily contained words related to space. Most contained sensory features, yet few cognitions and emotions. Results indicate that features of analogue trauma hotspots mirror those of hotspots soon after real trauma, speaking to the clinical validity of this 'experimental psychology model'.ClinicalTrials.gov ID: NCT04608097, registered on 29/10/2020.

Realistic context doesn't amplify the survival processing effect: Lessons learned from Covid-19 scenarios.

Imagining being stranded in the grasslands of an unknown territory without basic survival materials and subsequently rating the relevance of words for this situation leads to exceptionally good memory for these words. This survival processing effect has received much attention, primarily because it has been argued to disclose the evolutionary foundations of human memory. So far, only fictitious scenarios were used to demonstrate this effect. To provide a fairer test of emotional response against richness-of-encoding explanations of the effect, we aimed at increasing everyday relevance and realism of the survival scenarios. For this purpose, we created two new Covid-19 scenarios, one focusing on emotional response (Covid-19-emotion) and the other on survival strategy (Covid-19-strategy). Both new scenarios were compared to the classical grassland and moving scenarios typically used to investigate the survival processing effect. In Experiment 1, we observed better memory for the grassland and Covid-19-strategy scenarios compared to the other two, but no significant difference between the former. A descriptively similar result pattern emerged in Experiment 2 for the number of ideas generated on how to use objects in the four scenarios. Theoretical implications are discussed.

Staying informed without a cost: No effect of positive news media on stress reactivity, memory and affect in young adults.

INTRODUCTION: We read, see and hear news from various media sources every day. A large majority of the news is negative. A previous study from our laboratory showed that reading negative news is associated with both increased stress reactivity (measured via the stress hormone cortisol) and recall of the negative news segments in women. OBJECTIVES: The present study investigated the effects of positive news on cortisol stress reactivity, memory and affect using a methodology highly similar to the study on negative news that was previously used by our team. METHODS: Sixty-two healthy participants aged between 18 and 35 years (81% women) were randomly exposed to either positive or neutral news segments, followed by a laboratory stressor. We assessed participants' affect three times during the procedure and measured cortisol in saliva eight times (at 10-minute intervals). Twenty-four hours later, participants were contacted by phone to assess their recall of the news segments. RESULTS: Results showed that exposure to positive news, relative to neutral news, did not modulate participants' cortisol levels in response to the laboratory stressor. Positive news had no impact on memory recall of the news and did not change participants' positive or negative affect. Bayes factors suggested that these nonsignificant results are not attributable to low statistical power. CONCLUSION: Contrary to negative news, positive and neutral news do not modulate stress reactivity, memory and affect. These results suggest that people can stay informed without physiological and psychological costs when the news to which they are exposed adopt a positive or neutral approach.

Verbal memory is associated with adherence to COVID-19 protective behaviors in community dwelling older adults.

BACKGROUND: Adherence to protective behaviors is central to limiting the spread of COVID-19 and associated risk of serious illness and mortality in older populations. Whether cognition predicts adherence to protective behaviors has not been examined in older adults. AIMS: To examine whether specific cognitive abilities predict adherence to COVID-19 protective behaviors in older adults, independent of other relevant factors. METHODS: Data from 431 older adults (i.e., ≥ 65 years) who took part in the COVID-19 module of the Health and Retirement Study were included in the present study. Separate binary logistic regression models were used to examine whether performance on measures of immediate and delayed recall and working memory predicted adherence to COVID-19 protective behaviors, controlling for demographics, level of COVID-19 concern, depressive symptoms, and medical conditions. RESULTS: For every unit increase in immediate and delayed recall, the probability of adhering to COVID-19 protective behaviors increased by 47% and 69%, respectively. There was no association between the measure of working memory and adherence. DISCUSSION: It is of public interest to understand the factors that reduce adherence to protective behaviors so that we can better protect those most vulnerable and limit community spread. Our findings demonstrate that reduced memory predicts non-adherence to COVID-19 protective behaviors, independent of virus concern, and other relevant demographic and health factors. CONCLUSIONS: Public health strategies aimed at increasing adherence to COVID-19 protective behaviors in community dwelling older adults, should account for the role of reduced cognitive function in limiting adherence.

Remembering.

This reflection heightens the value of the role of chaplain during the time of the pandemic.

Microbiome Yarns: bacterial predators, tissue tropism and molecular decoys.

This Crystal Ball speculates on the potential of molecular decoys for prevention and therapy in infectious diseases. It is dedicated to the memory of Singh Chhatwal, who pioneered research on disguises and decoys produced by Streptococcus, and so much more.

Transient prenatal ruxolitinib treatment suppresses astrogenesis during development and improves learning and memory in adult mice.

Ruxolitinib is the first janus kinase 1 (JAK1) and JAK2 inhibitor that was approved by the United States Food and Drug Administration (FDA) agency for the treatment of myeloproliferative neoplasms. The drug targets the JAK/STAT signalling pathway, which is critical in regulating the gliogenesis process during nervous system development. In the study, we assessed the effect of non-maternal toxic dosages of ruxolitinib (0-30 mg/kg/day between E7.5-E20.5) on the brain of the developing mouse embryos. While the pregnant mice did not show any apparent adverse effects, the Gfap protein marker for glial cells and S100ß mRNA marker for astrocytes were reduced in the postnatal day (P) 1.5 pups' brains. Gfap expression and Gfap+ cells were also suppressed in the differentiating neurospheres culture treated with ruxolitinib. Compared to the control group, adult mice treated with ruxolitinib prenatally showed no changes in motor coordination, locomotor function, and recognition memory. However, increased explorative behaviour within an open field and improved spatial learning and long-term memory retention were observed in the treated group. We demonstrated transplacental effects of ruxolitinib on astrogenesis, suggesting the potential use of ruxolitinib to revert pathological conditions caused by gliogenic-shift in early brain development such as Down and Noonan syndromes.

Contact Tracing: A Memory Task With Consequences for Public Health.

In the battle for control of coronavirus disease-19 (COVID-19), we have few weapons. Yet contact tracing is among the most powerful. Contact tracing is the process by which public-health officials identify people, or contacts, who have been exposed to a person infected with a pathogen or another hazard. For all its power, though, contact tracing yields a variable level of success. One reason is that contact tracing's ability to break the chain of transmission is only as effective as the proportion of contacts who are actually traced. In part, this proportion turns on the quality of the information that infected people provide, which makes human memory a crucial part of the efficacy of contact tracing. Yet the fallibilities of memory, and the challenges associated with gathering reliable information from memory, have been grossly underestimated by those charged with gathering it. We review the research on witnesses and investigative interviewing, identifying interrelated challenges that parallel those in contact tracing, as well as approaches for addressing those challenges.

In loving memory of 'us': facing grief during the time of COVID-19 through redirecting perception of life's realities.

Recent correspondence highlighted the complicated process of grief in the time of COVID-19 where some family members and the dying person too are undergoing distress. New rituals can lighten the process of coping with grief or death, one may find it difficult to hurdle such situation and move on without first redirecting one's perception on the different realities of life. There are things that we can control but at the same time, things that are beyond our reach. With these realities, acceptance plays a key role to handle the situation. Acceptance is a person's assent to life's realities. Creativity in accepting grief or death is finding ways to lighten the heavy emotion of the 'ones left and the one leaving' through a preservation of memory. This is done through safeguarding and reliving the memories of the dead with various programs and advocacies.