Are parents' willing to vaccinate their children against COVID-19? A qualitative study based on the Health Belief Model

In response to the COVID-19 pandemic, several countries have started implementing voluntary or involuntary mass vaccination programs. Although vaccine acceptance is high among adults, uncertainty about whether to vaccinate children against COVID-19 remains a controversial theme. To date, few qualitative studies have explored parents' views on this topic. A qualitative descriptive study design was used to collect data and individual in-depth interviews were conducted with 50 parents in the Makkah region of Saudi Arabia. The Health Belief Model (HBM) was used as a guide in developing the interview guide. Each question was related to a construct of the HBM. The data were then analyzed using thematic content analysis and interpreted using NVivo software. Two major themes emerged: motivation to vaccinate children, which was influenced by perceived benefits, perceived severity, perceived suitability, collective responsibilities, confidence, and cues to action; and barriers to vaccination in children, which included complacency, rapid vaccine development, and uncertainty about the long-term side effects of the vaccine. The findings of this study revealed that the public is not sufficiently informed about the efficacy or side effects of the COVID-19 vaccine, increasing the awareness of which will help parents make informed decisions regarding vaccinating their children and potentially increase vaccine acceptance.

Framing of national HPV vaccine recommendations and willingness to recommend at ages 9-10

Proactive HPV vaccination at age 9 better prevents infection and improves vaccine series completion. Because national organizations recommend starting the vaccine at different ages, we sought to understand the impact of these recommendation frames. In 2022, we surveyed 2,527 US clinical staff (45% physicians) who provide HPV vaccine for children. We randomized respondents to one of three frames based on HPV vaccine recommendations of national organizations or a no-recommendation control, and assessed willingness to recommend HPV vaccine for children ages 9-10. Respondents also reported perceived benefits of HPV vaccination at ages 9 or 12. Recommending HPV vaccination "at ages 11-12" led to lower willingness to vaccinate at ages 9-10 than control (37% vs. 54%, p < .05). Recommending vaccination "at ages 9-12" led to similar willingness as control. However, "starting at age 9" led to higher willingness than control (63% vs. 54%, p < .05). Results were similar across respondents' training, specialty, or years in practice, or their clinic's rurality or healthcare system membership. More common benefits of recommending at age 9 than 12 were avoiding the topic of sex (24% vs. 10%, OR = 2.78, 95%CI: 2.23, 3.48) and completing the vaccine series before age 13 (56% vs. 47%, OR = 1.44, 95%CI: 1.23, 1.68). Less common benefits for age 9 were having parents ready to talk about HPV vaccine and agreeing to vaccination (both p < .05). An effective way to encourage proactive HPV vaccination is to say that it starts at age 9. Aligning national recommendations to start at age 9 can promote timely vaccination.

Anticipated fear and anxiety of Automated Driving Systems: Estimating the prevalence in a national representative survey

Background

Automated Driving Systems (ADS) may reshape mobility. Yet, related fear and anxiety are largely unknown. We estimated the prevalence and risk factors of anticipated anxiety towards ADS.

Method

In a nationally representative face-to-face household survey, we assessed anticipated levels of anxiety towards ADS based on DSM-5 specific phobia criteria, using structured diagnostic interviews. We estimated weighted prevalences and conducted adjusted logistic regression models.

Results

Of N = 2076 respondents, 40.82% (95%-confidence interval (CI) 37.73-43.98) anticipated experiencing some symptoms of phobia of ADS, 15.22% (CI 13.19-17.51) anticipated subthreshold phobia, and 3.39% (CI 2.42-4.75) anticipated full-blown phobia of ADS. Of subjects anticipating subthreshold phobia, 74.02% showed no strong, enduring fears of driving non-automated cars and 65.07% presented no other specific phobias (full-blown anticipated phobia: 50.37% and 50.03%, respectively). Anticipated phobia highly overlapped with anticipating marked or strong fears of passively encountering ADS in traffic (odds ratio 312.4-1982.2).

Conclusion

About 20% of subjects anticipated at least subthreshold and 4% of subjects anticipated full-blown phobia of ADS. It appears to be distinct from fears related to non-automated driving and other specific phobias. Our findings call for prevention and treatment of phobia of ADS as they become increasingly ubiquitous.

Situating Higher-Order, Critical, and Critical-Analytic Thinking in Problem- and Project-Based Learning Environments: A Systematic Review

Critical thinking (CT) is widely regarded as an important competence to obtain in education. Students’ exposure to problems and collaboration have been proven helpful in promoting CT processes. These elements are present in student-centered instructional environments such as problem-based and project-based learning (P(j)BL). Next to CT, also higher-order thinking (HOT) and critical-analytic thinking (CAT) contain elements that are present in and fostered by P(j)BL. However, HOT, CT, and CAT definitions are often ill-defined and overlap. The present systematic review, therefore, investigated how HOT, CT, and CAT were conceptualized in P(j)BL environments. Another aim of this study was to review the evidence on the effectiveness of P(j)BL environments in fostering HOT, CT, or CAT. Results demonstrated an absence of CAT in P(j)BL research and a stronger focus on CT processes than CT dispositions (i.e., trait-like tendency or willingness to engage in CT). Further, while we found positive effects of P(j)BL on HOT and CT, there was a lack of clarity and consistency in how researchers conceptualized and measured these forms of thinking. Also, essential components of P(j)BL were often overlooked. Finally, we identified various design issues in effect studies, such as the lack of control groups, that bring the reported outcomes of those investigations into question.

COVID-19 vaccination acceptance among older adults: A qualitative study in New South Wales, Australia

Objectives

The COVID-19 pandemic has had a severe impact on people across the world, particularly older adults who have a higher risk of death and health complications. We aimed to explore older adults’ intention towards COVID-19 vaccination and factors that influenced their motivation to get vaccinated.

Study design

A qualitative study was conducted in New South Wales, Australia (April 2021), involving interviews with older adults (aged 70 years and older).

Methods

In-depth interviews were carried out with 14 older adults on their perceptions around COVID-19 vaccination. The COVID-19 vaccination program had just commenced at the time of data collection. We thematically analysed interviews and organised the themes within the Behavioural and Social Drivers of Vaccination (BeSD) Framework.

Results

We found that most participants were accepting of COVID-19 vaccination. Participants’ motivation to get vaccinated was influenced by the way they thought and felt about COVID-19 disease and vaccination (including perceptions of vaccine safety, effectiveness, benefits, COVID-19 disease risk, and vaccine brand preferences) and social influences (including healthcare provider recommendation, and influential others). The uptake of COVID-19 vaccination was also mediated by practical issues such as access and affordability.

Conclusions

Efforts to increase COVID-19 vaccination acceptance in this population should focus on highlighting the benefits of vaccination. Support should be given to immunisation providers to enhance efforts to discuss and recommend vaccination to this high-risk group.

Overconfidence effects and learning motivation refreshing BLS: An observational questionnaire study

Aim of the study

Regular refresher skill courses are necessary to maintain competence in basic life support. The utilization of these training programs strongly depends on the motivation to learn. Learning motivation may be affected by overconfidence and clinical tribalism, as they both imply a higher competence compared to others, and therefore, a lower demand for training. This study aimed to assess how overconfidence in basic life support competencies affects learning motivation.

Methods

We conducted a cross-sectional, observational, multicenter, anonymous online questionnaire survey using validated psychometric tests for healthcare professionals in Germany. Further, we tested participants' knowledge and attitude regarding international basic life support guidelines. The study was conducted between March and April 2022, and healthcare providers from 22 German emergency medical services and hospitals at all levels were assessed.

Results

Of 2,000 healthcare professionals assessed, 407 completed the assessment (response rate, 20.4%). We confirmed the presence of overconfidence and clinical tribalism (identity differentiation between social groups) among the 407 physicians, nurses, and emergency medical service providers who completed the survey. Three different learning-motivation groups emerged from cluster analysis: "experts" (confident and motivated), "recruitables" (overconfident and motivated), and "unawares" (overconfident and unmotivated). The three groups were present in all professional groups, independent of the frequency of exposure to cardiac arrest and educational level.

Conclusions

These findings showed the presence of overconfidence effects and different learning motivation types in individuals learning basic life support, even in instructors.

The social scar of the pandemic: Impacts of COVID-19 exposure on interpersonal trust

This paper employs a difference-in-differences strategy to examine the causal effect of exposure to the COVID-19 pandemic on interpersonal trust amidst zero-COVID policies in China. Using a nationally representative panel survey, we find that COVID-19 exposure leads to a decrease in the levels of generalized trust. We also show that the change in interpersonal trust varies across domains. Specifically, COVID-19 exposure significantly decreases trust in parents, neighbors, and local government officials, but has small and insignificant effects on trust in doctors, strangers, and Americans. Empirical tests suggest that changes in income and physical health status are not likely to be potential channels. We provide some evidence for the mechanism of deteriorated mental health status and pessimistic expectations.

Configurational patterns for COVID-19 related social media rumor refutation effectiveness enhancement based on machine learning and fsQCA

Infodemics are intertwined with the COVID-19 pandemic, affecting people's perception and social order. To curb the spread of COVID-19 related false rumors, fuzzy-set qualitative comparative analysis (fsQCA) is used to find configurational pathways to enhance rumor refutation effectiveness. In this paper, a total of 1,903 COVID-19 related false rumor refutation microblogs on Sina Weibo are collected by a web crawler from January 1, 2022 to April 20, 2022, and 10 main conditions affecting rumor refutation effectiveness index (REI) are identified based on "three rules of epidemics". To reduce data redundancy, five ensemble machine learning models are established and tuned, among which Light Gradient Boosting Machine (LGBM) regression model has the best performance. Then five core conditions are extracted by feature importance ranking of LGBM. Based on fsQCA with the five core conditions, REI enhancement can be achieved through three different pathway elements configurations solutions: "Highly influential microblogger * high followers' stickiness microblogger", "high followers' stickiness microblogger * highly active microblogger * concise information description" and "high followers' stickiness microblogger * the sentiment tendency of the topic * concise information description". Finally, decision-making suggestions for false rumor refutation platforms and new ideas for improving false rumor refutation effectiveness are proposed. The innovation of this paper reflects in exploring the REI enhancement strategy from the perspective of configuration for the first time.

A systems model for the design of occupational health and safety management systems inclusive of work-from-home arrangements

The study addressed an important knowledge gap in the literature by co-designing a model for OHS management systems inclusive of workers who work-from-home, with a focus on psychosocial risks. This qualitative research study utilised a series of co-design focus groups involving Australian regulators, health and safety managers and practitioners, senior managers, middle managers and workers who work-from-home, to better understand the types of measures that organisations can apply to improve their health and safety management systems. Using a systems approach, consideration was given to the organisation of the remote working system, the home-work interface for remote workers, the competencies of managers and employees in regard to their occupation health and safety (OHS) responsibilities, and the complexity of identifying, reporting and monitoring psychosocial hazards for employees working from home. The study identified a need for tools designed to support both managers and workers in promoting psychologically safe working from home.

Trace elements in Foodstuffs from the Mediterranean Basin-Occurrence, Risk Assessment, Regulations, and Prevention strategies: A review

Trace elements (TEs) are chemical compounds that naturally occur in the earth's crust and in living organisms at low concentrations. Anthropogenic activities can significantly increase the level of TEs in the environment and finally enter the food chain. Toxic TEs like cadmium, lead, arsenic, and mercury have no positive role in a biological system and can cause harmful effects on human health. Ingestion of contaminated food is a typical route of TEs intake by humans. Recent data about the occurrence of TEs in food available in the Mediterranean countries are considered in this review. Analytical methods are also discussed. Furthermore, a discussion of existing international agency regulations will be given. The risk associated with the dietary intake of TEs was estimated by considering consumer exposure and threshold values such as Benchmark dose lower confidence limit and provisional tolerable weekly intake established by the European Food Safety Authority and the Joint FAO/WHO Expert Committee on Food Additives, respectively. Finally, several remediation approaches to minimize TE contamination in foodstuffs were discussed including chemical, biological, biotechnological, and nanotechnological methods. The results of this study proved the occurrence of TEs contamination at high levels in vegetables and fish from some Mediterranean countries. Lead and cadmium are more abundant in foodstuffs than other toxic trace elements. Geographical variations in TE contamination of food crops clearly appear, with a greater risk in developing countries. There is still a need for the regular monitoring of these toxic element levels in food items to ensure consumer protection.

The promise and peril of interactive embodied agents for studying non-verbal communication: a machine learning perspective

In face-to-face interactions, parties rapidly react and adapt to each other's words, movements and expressions. Any science of face-to-face interaction must develop approaches to hypothesize and rigorously test mechanisms that explain such interdependent behaviour. Yet conventional experimental designs often sacrifice interactivity to establish experimental control. Interactive virtual and robotic agents have been offered as a way to study true interactivity while enforcing a measure of experimental control by allowing participants to interact with realistic but carefully controlled partners. But as researchers increasingly turn to machine learning to add realism to such agents, they may unintentionally distort the very interactivity they seek to illuminate, particularly when investigating the role of non-verbal signals such as emotion or active-listening behaviours. Here I discuss some of the methodological challenges that may arise when machine learning is used to model the behaviour of interaction partners. By articulating and explicitly considering these commitments, researchers can transform 'unintentional distortions' into valuable methodological tools that yield new insights and better contextualize existing experimental findings that rely on learning technology. This article is part of a discussion meeting issue 'Face2face: advancing the science of social interaction'.

One Size Does Not Fit All: Methodological Considerations for Brain-Based Predictive Modeling in Psychiatry

Psychiatric illnesses are heterogeneous in nature. No illness manifests in the same way across individuals, and no two patients with a shared diagnosis exhibit identical symptom profiles. Over the last several decades, group-level analyses of in vivo neuroimaging data have led to fundamental advances in our understanding of the neurobiology of psychiatric illnesses. More recently, access to computational resources and large, publicly available datasets alongside the rise of predictive modeling and precision medicine approaches have facilitated the study of psychiatric illnesses at an individual level. Data-driven machine learning analyses can be applied to identify disease-relevant biological subtypes, predict individual symptom profiles, and recommend personalized therapeutic interventions. However, when developing these predictive models, methodological choices must be carefully considered to ensure accurate, robust, and interpretable results. Choices pertaining to algorithms, neuroimaging modalities and states, data transformation, phenotypes, parcellations, sample sizes, and populations we are specifically studying can influence model performance. Here, we review applications of neuroimaging-based machine learning models to study psychiatric illnesses and discuss the effects of different methodological choices on model performance. An understanding of these effects is crucial for the proper implementation of predictive models in psychiatry and will facilitate more accurate diagnoses, prognoses, and therapeutics.

Counseling Gifted Black Students

Gifted students are often regarded as the privileged recipients of the best a school district has to offer. On the one hand, gifted students have access to the best teachers, the most rigorous curriculum, and the best postsecondary options. However, gifted Black students also face unique academic, social/emotional, and college/career challenges, and a lot of brilliant Black students are overlooked. A major thrust of this chapter is to identify some conditions or barriers that cause the underrepresentation of Black students in gifted education and offer recommendations to support student achievement.

I Will Get Myself Vaccinated for Others: The Interplay of Message Frame, Reference Point, and Perceived Risk on Intention for COVID-19 Vaccine

The purpose of this study is to seek an effective strategy to promote COVID-19 vaccination among young adults. Given that COVID-19 is less deadly for young adults, this study explores whether highlighting potential benefits or disadvantages that others may experience as a result of one's vaccination increases young adults' intention to get vaccinated, particularly for those who have low perceived risk of COVID-19. To test this idea, we conducted an experiment and analyzed the effect of interaction between message frame (gain vs. loss) and reference point (self vs. others) on intention for vaccination by one's perceived risk (low vs. high). The results show that for those with low perceived risk of COVID-19, messages about potential negative consequences to others (e.g., family, friends, community members) from one's failure to get vaccinated led to message elaboration and favorable attitude toward vaccination, which in turn promoted one's intention to get vaccinated. We discuss practical implications of the findings for message strategies that target populations experiencing COVID-19 disparities.

Neurorehabilitation of Offenders, Consent and Consequentialist Ethics

The new biotechnology raises expectations for modifying human behaviour through its use. This article focuses on the ethical analysis of the not so remote possibility of rehabilitating criminals by means of neurotechnological techniques. The analysis is carried out from a synthetic position of, on the one hand, the consequentialist conception of what is right and, on the other hand, the emphasis on individual liberties. As a result, firstly, the ethical appropriateness of adopting a general predisposition for allowing the neurorehabilitation of prisoners only if it is safe and if they give their consent will be defended. But, at the same time, reasons will be given for requiring, in certain circumstances, the exceptional use of neurotechnology to rehabilitate severely psychopathic prisoners, even against their will, from the same ethical perspective.

Students' Perspectives on Basic and Clinical Science Integration When Step 1 is Administered After the Core Clerkships

Phenomenon: According to adult learning theories, effective cognitive integration of basic and clinical science may promote the transfer of knowledge to patient care. The placement of the U.S. Medical Licensing Examination (USMLE) Step 1 after the core clerkships is one strategy intended to facilitate cognitive integration, though learner experiences with this model are unexplored. The purpose of this study is to understand students' perspectives on basic and clinical science integration in a post-clerkship Step 1 curriculum. Approach: Focus groups were conducted between August and September 2020 with senior medical students from the University of California, San Francisco School of Medicine and University of Michigan Medical School. Data were analyzed using a constructivist approach to thematic analysis. Findings: Thirty-three students participated in six focus groups. Participants described multiple barriers to cognitive integration in the clerkship learning environment, though they also identified examples of teaching and learning that facilitated integration. Early in their clerkships, students struggled to integrate because of their tenuous basic science foundation, cognitive overload, and difficulty perceiving the relevance of basic science to patient care. They felt that educators primarily focused on clinical science, and many basic science teaching sessions during clerkships felt irrelevant to patient care. However, students also described experiences that made the connection between basic and clinical science more explicit, including modeling by educators and clerkship learning activities that more overtly encouraged the application of basic science to clinical care. In addition, the return to basic science studying during the post-clerkship dedicated Step 1 study period offered powerful integration opportunities. These facilitators of cognitive integration helped students recognize the value of integration for enduring learning. Insights: There are myriad barriers to cognitive integration of basic and clinical science during clerkships in a post-clerkship Step 1 curriculum. The relevance of basic science to patient care needs to be made more explicit to students through modeling by clinician educators to augment the potential benefits of curricular change. The post-clerkship Step 1 study period appears to offer a unique opportunity for cognitive integration later in a learner's trajectory that may be related to curricular design. When learners recognize the applicability of basic science to patient care, they may more intentionally transfer basic science knowledge to clinical practice.

Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan

INTRODUCTION

Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan.

METHODS

DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500 cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology.

RESULTS AND DISCUSSION

Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings.

CONCLUSION

DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research.

Infant negative affectivity and patterns of affect-biased attention

Biased attention toward affective cues often cooccurs with the emergence and maintenance of internalizing disorders. However, few studies have assessed whether affect-biased attention in infancy relates to early indicators of psychopathological risk, such as negative affectivity. The current study evaluates whether negative affectivity relates to affect-biased attention in 6-month-old infants. Affect-biased attention was assessed via a free-viewing eye-tracking task in which infants were presented with a series of face pairs (comprised of a happy, angry, or sad face and a neutral face). Attention was quantified with metrics of both attention orienting and attention holding. Overall, infants showed no differences in attention orienting (i.e., speed of looking) or attention holding (i.e., duration of looking) toward emotional faces in comparison to the neutral face pairs. Negative affectivity, assessed via parent report, did not relate to attention orienting but was associated with biased attention toward positive, happy faces and away from threat-cueing, angry faces in comparison to the neutral faces they were paired with. These findings suggest that negative affectivity is associated with differences in attention holding, but not initial orienting toward emotional faces; biases which have important implications for the trajectory of socioemotional development.

Factors associated with contact tracing compliance among communities of color in the first year of the COVID-19 pandemic

RATIONALE

The disproportionate impact of COVID-19 on communities of color has raised questions about the unique experiences within these communities not only in terms of becoming infected with COVID-19 but also mitigating its spread. The utility of contact tracing for managing community spread and supporting economic reopening is contingent upon, in part, compliance with contact tracer requests.

OBJECTIVE

We investigated how trust in and knowledge of contact tracers influence intentions to comply with tracing requests and whether or not these relationships and associated antecedent factors differ between communities of color.

METHOD

Data were collected from a U.S. sample of 533 survey respondents from Fall (2020) to Spring 2021. Multi-group SEM tested quantitative study hypotheses separately for Black, AAPI, Latinx, and White sub-samples. Qualitative data were collected via open-ended questions to inform the roles of trust and knowledge in contact tracing compliance.

RESULTS

Trust in contact tracers was associated with increased intentions to comply with tracing requests and significantly mediated the positive relationship between trust in healthcare professionals and government health officials with compliance intentions. Yet, the indirect effects of trust in government health officials on compliance intentions were significantly weaker for the Black, Latinx, and AAPI samples compared to Whites, suggesting this strategy for increasing compliance may not be as effective among communities of color. Health literacy and contact tracing knowledge played a more limited role in predicting compliance intentions directly or indirectly, and one that was inconsistent across racial groups. Qualitative results reinforce the importance of trust relative to knowledge for increasing tracing compliance intentions.

CONCLUSIONS

Building trust in contact tracers, more so than increasing knowledge, may be key to encouraging contact tracing compliance. Differences among communities of color and between these communities and Whites inform the policy recommendations provided for improving contact tracing success.

Methods for think-aloud interviews in health-related resource-use research: the PECUNIA RUM instrument

BACKGROUND

The think-aloud (TA) approach is a qualitative research method that allows for gaining insight into thoughts and cognitive processes. It can be used to incorporate a respondent's perspective when developing resource-use measurement (RUM) instruments. Currently, the application of TA methods in RUM research is limited, and so is the guidance on how to use them. Transparent publication of TA methods for RUM in health economics studies, which is the aim of this paper, can contribute to reducing the aforementioned gap.

METHODS

Methods for conducting TA interviews were iteratively developed by a multi-national working group of health economists and additional qualitative research expertise was sought. TA interviews were conducted in four countries to support this process. A ten-step process was outlined in three parts: Part A 'before the interview' (including translation, recruitment, training), Part B 'during the interview' (including setting, opening, completing the instrument, open-ended questions, closing), and part C 'after the interview' (including transcription and data analysis, trustworthiness).

CONCLUSIONS

This manuscript describes the step-by-step approach for conducting multi-national TA interviews with potential respondents of the PECUNIA RUM instrument. It increases the methodological transparency in RUM development and reduces the knowledge gap of using qualitative research methods in health economics.

Does the Integration of Migrants in the Host Society Raise COVID-19 Vaccine Acceptance? Evidence From a Nationwide Survey in Japan

Research indicates that integration contributes to maintaining health among migrants, yet little is known about the association between integration and vaccination acceptance. This study aimed to explore COVID-19 vaccine intention and acceptance, and the association between integration and vaccine hesitancy among migrants in Japan. We conducted an internet survey among migrants in Japan from October 5 to October 14, 2021. Among 1,455 participants, 11.6% reported hesitancy toward COVID-19 vaccination. We found that the overall integration and social integration were associated with the vaccination intention. Some commonly identified barriers (e.g., financial difficulties, language) were not related to COVID-19 vaccination acceptance among migrants in Japan. Highly integrated migrants were less likely to report vaccine hesitancy against COVID-19. To promote COVID-19 acceptance among migrants, customized intervention policies should focus on the migrants with a lower level of integration, especially those with little social connection with the locals.

Conceptual Framework for Integrating Family Caregivers Into the Health Care Team: A Scoping Review

More than 80% of family care partners of older adults are responsible for coordinating care between and among providers; yet, their inclusion in the health care delivery process lacks recognition, coordination, and standardization. Despite efforts to include care partners (e.g., through informal or formal proxy access to their care recipient's patient portal), policies and procedures around care partner inclusion are complex and inconsistently implemented. We conducted a scoping review of peer-reviewed articles published from 2015 to 2021 and reviewed a final sample of 45 U.S.-based studies. Few articles specifically examine the inclusion of care partners in health care teams; those that do, do not define or measure care partner inclusion in a standardized way. Efforts to consider care partners as "partners" rather than "visitors" require further consideration of how to build health care teams inclusive of care partners. Incentives for health care organizations and providers to practice inclusive team-building may be required.

The role of social and intellectual activity participation in older adults' cognitive function

THEORETICAL BACKGROUND

A challenge of the ageing of the population is cognitive performance, given its association to optimal ageing. Documented predictors of cognition have included socio-demographics, education or physical factors. However, the association of social and intellectual activity participation to cognition has been less studied.

AIM

This study presents a predictive model of cognitive functioning including these alternative factors as well as more seminal ones to explain cognition in old age.

MATERIALS AND METHODS

The sample was composed by 45475 older adult participants in the 8th Wave of the Survey of Health, Aging and Retirement in Europe, that took place between 2019 and 2020. A correlational design was specified to test the effects of age, gender, years of education, physical inactivity, number of chronic diseases, social activity participation and intellectual activity participation on temporal orientation, numeracy, verbal fluency and memory. A completely a priori Structural Equation Model with latent variables was tested.

RESULTS

The sample had an average of 70 years of age, was well-educated and physically active and engaged in reading. There was a higher proportion of females. The model showed an optimal fit to the data, explaining 8.7%-36.0% of the different cognitive components' variance. Age, years of education and intellectual activity displayed the largest effects across the cognitive domains.

CONCLUSIONS

Findings suggest that social and intellectual activity participation are of relative importance to predict cognition in old age, even when considering other well-documented factors affecting older adults' cognitive functioning.

Examining heterogeneity in mentoring: Associations between mentoring discussion topics and youth outcomes

The current study aims to apply a staged approach to document heterogeneity in discussions in mentoring relationships, chiefly, discussion topics from weekly mentoring sessions with undergraduate women mentors (n = 40), then link each of the eight topics (relationships with friends, family, teachers, and romantic relationships, as well as goals, academic skills, academic problems, and hopes for the future) to developmental outcomes for middle school girls (n = 41) who participated in a school-based mentoring program. In doing so, the authors hope to better understand the mechanisms that influence variability in mentoring treatment effects. Mentoring dyads engaged in unstructured one-on-one sessions and structured group meetings across the 2018-2019 academic year. The primary predictors for this study are weekly mentor-reported discussion topics and activities addressed during unstructured one-on-one mentoring sessions, with 11 social-emotional, academic, and behavioral outcomes measured via pre- and postsurveys administered by research assistants to mentees during the fall and spring. A series of 11 path analyses indicate small to moderate associations, both beneficial and negative, between key discussion topics, such as hopes for the future, family relationships, and goals, and several mentee-reported outcomes of interest at the end of the intervention, including extrinsic motivation, life satisfaction, and self-esteem. Study findings provide information about heterogeneity in mentoring practices to inform how various mechanisms of mentoring (e.g., discussions focused on relationships, goals and skills, and strengths) influence developmentally-relevant effects for youth.

Are adults influenced by the experience of mentoring youth? A scoping review

AIMS

A relatively large body of research exists on the effectiveness of mentoring programs directed at youth and numerous syntheses of this literature have proven useful for advancing both research and practice. Less studied, but also important is the potential for adults serving in the role of mentor to young persons to be influenced by this experience. A scoping review was conducted with the aim of identifying and critically assessing major trends in the methods and findings in this literature.

METHODS

Included sources were empirical studies reporting findings that address potential influences on adults (18+) serving as mentors to youth (<18) in formal programs designed for this purpose. The initial search resulted in 3155 records and 96 were included in the review.

RESULTS

Approximately half of the studies (58%) focused on younger adults (ages 18-22 years old, e.g., college students) serving as mentors; only a small minority of studies focused on adults over 35 years old (10%). Most studies were qualitative (n = 54). Studies with a quantitative component (n = 18 quantitative only; n = 24 mixed methods) exhibited a significant risk of bias for inferring effects on mentors due to limitations in study design (e.g., lack of comparison group). Studies most often addressed potential outcomes for mentors in academic/career (55%) and social (45%) domains, when findings suggested possible effects on mentors, they were nearly universally in a positive direction.

CONCLUSION

Existing research, although consistent with the potential for adults to benefit from the experience of mentoring youth, has insufficient rigor and representativeness to adequately address this question. Future research should utilize more rigorous quantitative designs and samples with greater representativeness of the different stages of adult development.

Clinician Communication to Address Vaccine Hesitancy

There are several factors that influence childhood vaccine uptake. Pediatric clinicians play a particularly influential role in parent vaccine decision-making. It is critical therefore that pediatric clinicians have a "communication toolbox"--a set of effective, evidence-based communication strategies to facilitate uptake of childhood vaccines--that they can use in conversations with parents about vaccines. In this article, recent advances in our understanding of what constitutes effective clinician vaccine communication with parents are discussed.

Modelling the Cost-Effectiveness of Diagnostic Tests

Diagnostic tests are used to determine whether a disease or condition is present or absent in a patient, who will typically be suspected of having the disease or condition due to symptoms or clinical signs. Economic evaluations of diagnostic tests (e.g. cost-effectiveness analyses) can be used to determine whether a test produces sufficient benefit to justify its cost. Evidence on the benefits conferred by a test is often restricted to its accuracy, which means mathematical models are required to estimate the impact of a test on outcomes that matter to patients and health payers. It is important to realise the case for introducing a new test may not be restricted to its accuracy, but extend to factors such as time to diagnosis and acceptability for patients. These and other considerations may mean the common modelling approach, the decision tree, is inappropriate for underpinning an economic evaluation. There are no consensus guidelines on how economic evaluations of diagnostic tests should be conducted-this article attempts to explore the common challenges encountered in economic evaluations, suggests solutions to those challenges, and identifies some areas where further methodological work may be necessary.

Memory Monitoring and Control in Japanese and German Preschoolers

Prior studies explored the early development of memory monitoring and control. However, little work has examined cross-cultural similarities and differences in metacognitive development in early childhood. In the present research, we investigated a total of 100 Japanese and German preschool-aged children's memory monitoring and control in a visual perception task. After seeing picture items, some of which were repeated, children were presented with picture pairs, one of which had been presented earlier and the other was a novel item. They then were asked to identify the previously presented picture. Children were also asked to evaluate their confidence about their selection, and to sort the responses to be used for being awarded with a prize at the end of the test. Both groups similarly expressed more confidence in the accurately remembered items than in the inaccurately remembered items, and their sorting decision was based on their subjective confidence. Japanese children's sorting more closely corresponded to memory accuracy than German children's sorting, however. These findings were further confirmed by a hierarchical Bayesian estimation of metacognitive efficiency. The present findings therefore suggest that early memory monitoring and control have both culturally similar and diverse aspects. The findings are discussed in light of broader sociocultural influences on metacognition.

Heroin use and neuropsychological impairments: comparison of intravenous and inhalational use

BACKGROUND AND OBJECTIVES

Injection and inhalational heroin use are associated with different levels of brain exposure to heroin and its metabolites and differences in the severity of dependence, which might lead to differential impacts on neuropsychological functions. We examined the difference and the magnitude of difference in the neuropsychological functions between inhalational and injection heroin-dependent subjects and also compared them with healthy controls.

METHODS

The study sample comprised three groups: 73 subjects with injection heroin dependence, 74 with inhalational heroin dependence, and 75 healthy controls (HC). We excluded patients with HIV, head injury, epilepsy, and severe mental illness. Neuropsychological assessments were done by Standard Progressive Matrices, Wisconsin Card Sorting Test (WCST), Iowa Gambling Task, Trail-Making Tests A and B (TMT), and Verbal and Visual Memory 1 and 2 Backtests (NBT). We estimated independent effects of the groups on various neuropsychological test parameters, adjusted for age and duration of dependence.

RESULTS

In the WCST, the inhalational heroin-dependent group took more trials to complete the first category and had higher scores in the failure to maintain set than controls. The intravenous group had higher total errors than controls in verbal working memory tests and Visual Working Memory 2 Backtest. This group scored higher commission errors in the Verbal 2 Backtest than the controls. The two groups of heroin users differed in failure to maintain set and Verbal Working Memory 2 Backtests. The effect sizes of the group differences were modest.

CONCLUSION AND SCIENTIFIC SIGNIFICANCE

Either route of heroin use is associated with cognitive impairments; inhalational and injection use involve different cognitive domains.

Post-traumatic stress disorder among civilians 6 and 18 months after the January 2015 terrorist attacks in the Paris region

In the literature, the association between medium and long-term PTSD (post-traumatic stress disorder) after terrorist attack has rarely been described. The objective of our study was to identify the factors associated with PTSD in the medium and longer term among people exposed to a terrorist attack in France. We used data from a longitudinal survey of 123 terror-exposed people interviewed 6-10 (medium term) and 18-22 (long term) months after. Mental health was assessed by the Mini Neuropsychiatric Interview. PTSD in the medium term was associated with history of traumatic events, low levels of social support and severe peri-traumatic reactions, which were in turn associated with high levels of terror exposure. PTSD in the medium term was linked in turn to the presence of anxiety and depressive disorders, which was also linked to PTSD in the longer term. The factors leading to PTSD are different in the medium and long term. In order to improve future support for people exposed to distressing events, it is important to follow up people with intense peri-traumatic reactions, high levels of anxiety and depression and to measure reactions.

Monitoring and control processes in mock witnesses in under-represented non-WEIRD samples with high or low educational level

A popular model proposes that metamemory is based on two processes, monitoring and control. The first examines memories and evaluates their quality and the second uses that information to decide on the most appropriate course of action. Monitoring and control processes have been studied mostly with university students, which raises the question of how well do they work in groups of people from under-represented samples such as people with a low educational level. In this research, we tested the monitoring and control processes of three groups of participants from a non-WEIRD (Western, Educated, Industrialized, Rich and Democratic) country (Colombia). Two groups of adults (aged 30-55 years) living in urban or rural areas and with a low educational level and a group of Colombian university students watched a bank robbery video and answered cued recall questions. To measure monitoring ability, participants rated their confidence that they had produced the correct answer, and to measure control they indicated whether they preferred to report or withhold the response were they in a trial. Results showed that the three groups had a functional ability to monitor their memories and control their behaviour, and that university students had better memory and metamemory than the two low education groups. The results support the concept that the basic metamemory processes of monitoring and control are functional in different groups of individuals, but the differences between groups highlight the need to test the generalizability of cognitive processes and phenomena across individuals.