Learning under stress impairs memory formation

Neural underpinnings of fine motor skills under stress and anxiety: A review

This review offers a comprehensive examination of how stress and anxiety affect motor behavior, particularly focusing on fine motor skills and gait adaptability. We explore the role of several neurochemicals, including brain-derived neurotrophic factor (BDNF) and dopamine, in modulating neural plasticity and motor control under these affective states. The review highlights the importance of developing therapeutic strategies that enhance motor performance by leveraging the interactions between key neurochemicals. Additionally, we investigate the complex interplay between emotional-cognitive states and sensorimotor behaviors, showing how stress and anxiety disrupt neural integration, leading to impairments in skilled movements and negatively impacting quality of life. Synthesizing evidence from human and rodent studies, we provide a detailed understanding of the relationships among stress, anxiety, and motor behavior. Our findings reveal neurophysiological pathways, behavioral outcomes, and potential therapeutic targets, emphasizing the intricate connections between neurobiological mechanisms, environmental factors, and motor performance.

Diversity and limitations of electroencephalogram and event-related potential applications in nursing research: A scoping review

AIMS

This scoping review was conducted to provide a comprehensive summary of how electroencephalogram (EEG) and event-related potentials (ERPs) have been used in nursing research, with the goal of mapping the themes and methods of nursing research involving EEGs or ERPs as a measurement tool.

METHODS

The eligibility criteria were determined according to the Population, Concept, and Context principle. A systematic electronic search of articles in the PubMed, Web of Science, Embase, CINAHL, APA PsycInfo, and Scopus databases was carried out for the period from database establishment to November 21, 2022. The included studies were analyzed using descriptive statistics and content analysis.

RESULTS

The review process culminated in 45 articles, evidencing an increasing trend and dispersion characteristics of EEG in nursing research and reflecting five thematic domains of inquiry related to nursing. There was a deficiency of detailed reports of EEG recording and data analysis parameters in nursing research. The common EEG bands in nursing research were Delta, Theta, Alpha, Beta, Gamma. The ERP components used frequently were P3, P2, N1, N2, P1, N170, and feedback-related negativity.

CONCLUSIONS

The wide variety of EEG components used show broad potential for studying nursing questions. In the future, it will be necessary to increase the depth of the research content, the repeatability of the experiment and the standardization of the report. Nursing researchers should give full play to the characteristics of nursing and establish a systematic and complete EEG research system for nursing.

Memory under stress: from adaptation to disorder

Stressful events are ubiquitous in everyday life. The exposure to these stressors initiates the temporally orchestrated release of a multitude of hormones, peptides, and neurotransmitters that target brain areas critically implicated in learning and memory. This review summarizes recent insights on the profound impact of stress on four fundamental processes of memory: memory formation, memory contextualization, memory retrieval, and memory flexibility. Stress mediators instigate dynamic alterations in these processes, facilitating efficient responding under stress and the creation of a decontextualized memory representation that can effectively aid coping with novel future threats. While being generally adaptive, the same stress-related changes may contribute to rigid behaviors, uncontrollable intrusions, or generalized fear responding seen in anxiety disorders or posttraumatic stress disorder (PTSD). Drawing on recent discoveries in cognitive neuroscience and psychiatry, this review discusses how stress-induced alterations in memory processes can simultaneously foster adaptation to stressors and fuel psychopathology. The transition from adaptive to maladaptive changes in the impact of stress on memory hinges on the nuanced interplay of stressor characteristics and individual predispositions. Thus, taking individual differences in the cognitive response to stressors into account is essential for any successful treatment of stress-related mental disorders.

A novel model for curriculum design: Preparation, planning, prototyping, and piloting

Dental education continuously strives to provide students with positive and meaningful learning experiences. Developing or improving a curriculum usually encompasses three main phases: design, implementation, and evaluation. Most research on curriculum development in dental education has focused on the last two phases. Our commentary addresses this gap by describing a new model for curriculum design that effectively guided the design phase of the complete overhaul of the four-year Doctor of Dental Surgery curriculum at the School of Dentistry, University of Alberta. Built on the strengths of pre-existing curriculum design models, the new model provided enough structure and rigour to support the complexity required during a complete curriculum redesign whilst still allowing sufficient consultation and flexibility to encourage stakeholder engagement. The steps of the new 4P's model (preparation, planning, prototyping, and piloting) and main actions within each step are described. Challenges observed in each step and strategies to address them are reported. Other institutions embarking on renewing or redesigning a curriculum at a program level may benefit from using a curriculum design process similar to the 4P's model. Recommendations are discussed including the inclusion of educational consultants in the curriculum renewal committee, the importance of a leadership that effectively supports curriculum reform, purposeful engagement of stakeholders during each step of the design phase and ensuring that project and change management occur concurrently.

Falling NAPLEX pass rates are cause for concern

INTRODUCTION

First-time pass rates of the North American Pharmacist Licensure Examination (NAPLEX) have declined 7% from 2019 to 2022 with more than a third of schools experiencing a decline of ≥10%.

COMMENTARY

The cause of the decline is likely multifactorial and extends beyond the impact of the COVID-19 pandemic. Changes to the NAPLEX blueprint in 2021, curricular revisions in response to the implementation of Accreditation Council for Pharmacy Education Standards 2016, and changes to prerequisite course requirements in response to declining enrollment must also be evaluated as potential causes.

IMPLICATIONS

The academy must respond to this decline by scrutinizing admissions, curriculum, and assessment processes. We urge the National Association of Boards of Pharmacy to provide access to student-level data on NAPLEX performance and increase transparency in passing standard practices to inform this process.

Strong but Fragmented Memory of a Stressful Episode

While it is commonly assumed that stressful events are vividly remembered, it remains largely unknown whether all aspects of memory for a stressful episode are enhanced. In this preregistered study, we tested whether stress enhances later remembering of individual elements of a stressful episode at the cost of impaired processing of the association between these elements. Therefore, male and female participants (N = 122) underwent a stressful (or control) episode during which they encoded a series of stimuli. To investigate stress effects on the memory for individual events and the links between these, we used temporal sequence effects in recognition memory tested 24 h after encoding. Specifically, we tested whether stress would affect the memory enhancement for a target item if this is preceded by another item that also preceded the target during encoding (recognition priming). Our results showed that participants recalled single events encoded under stress better than those encoded under nonstressful conditions, but were less able to leverage the temporal sequence of events encoded under stress to cue memory at delayed recall, reflected in reduced memory for items preceded by the item that preceded them also during encoding. Functional near-infrared spectroscopy further revealed that encoding under stress was accompanied by opposite changes in inferotemporal and dorsolateral prefrontal areas. Together, our data suggest that acute stress induces a mode of memory formation that results in strong but less integrated memories.

Enhanced memory for central visual and auditory elements experienced during a stressful episode

Acute psychosocial stress has been shown to benefit memory for central visual elements of a stressful episode. Here, we aimed at investigating whether this effect is accompanied by improved visual memory for the committee members in a modified version of the Trier Social Stress Test (TSST). Specifically, we tested participants´ recognition memory for accessories located on the bodies of the committee members, as well as their faces. Moreover, we investigated how stress influences memories for the content of the verbal interactions. That is, we studied how well participants remembered factual information associated with the main stress source, like name, age, and position of the committee members, as well as how accurately they could recite the exact wording of phrases used by them. In a counterbalanced 2 × 2 design, 77 men and women took part either in a stressful or non-stressful version of the TSST. While stressed participants better remembered personal information about the committee members than non-stressed participants, no differences in memory for the correct wording of phrases could be observed. Furthermore, in line with our hypothesis, stressed participants better remembered central, but not peripheral visual stimuli, compared to non-stressed participants, while, contrary to our expectations, stress did neither affect memory for objects located on the bodies of the committee members nor their faces. Our results are in line with the theory of enhanced memory binding under stress and extend previous results regarding improved memory for central visual elements encoded under stress to auditory learning material associated with the stressor.

Competitive Neurocognitive Processes Following Bereavement

Bereavement is a common human experience that often involves significant impacts on psychological, emotional and even cognitive functioning. Though various psychological theories have been proposed to conceptualize the grief process, our current understanding of the underlying neurocognitive mechanisms of grief is limited. The present paper proposes a neurocognitive model to understand phenomena in typical grief, which links loss-related reactions to underlying learning and executive processes. We posit that the competitive relationship between the basal ganglia (BG) and circuitry involving the medial temporal lobe (MTL) underlies common cognitive experiences in grief such as a sense of "brain fog." Due to the intense stressor of bereavement, we suggest that these two systems' usually flexible interactive relationship become imbalanced. The resulting temporary dominance of either the BG or the MTL system is then manifested in perceived cognitive changes. Understanding the underlying neurocognitive mechanism in grief could inform ways to best support bereaved individuals.

Good versus bad news consultations in advanced breast cancer: the role of empathy in information recall - an observational study

OBJECTIVE

We explored, in advanced breast cancer, whether: (1) patients recall less information following bad versus good news consultations; (2) empathy has a greater effect on recalled information following bad versus good news consultations.

METHODS

Observational study using audio-recorded consultations. Participants' recall of provided information about treatment options, aims/positive effects and side-effects was assessed. Clinician-expressed empathy and consultation type were determined. Regression analyses assessed associations between consultation type and recall, exploring moderating influences of clinician-expressed empathy.

RESULTS

For 41 consultations (18 bad news, 23 good news), recall data were completed; total recall (47% vs 73%, p=0.03) and recall about treatment options (67% vs 85%, p=0.08, trend) were significantly worse following bad news compared with good news consultations. Recall about treatment aims/positive effects (53% vs 70%, p=0.30) and side-effects (28% vs 49%, p=0.20) was not significantly worse following bad news. Empathy moderated the relationship between consultation type and total recall (p<0.01), recall about treatment options (p=0.03) and about aims/positive effects (p<0.01) but not about side-effects (p=0.10). Only following good news consultations empathy influenced recall favourably.

CONCLUSIONS

This explorative study suggests that in advanced cancer, information recall is especially impaired following bad news consultations, for which empathy does not improve remembered information.

Cognitive Load Management: An Invaluable Tool for Safe and Effective Surgical Training

This article highlights the importance of considering Cognitive Load (CL) and Cognitive Load Theory (CLT) during surgical training, focusing on the acquisition of intra-operative skills. It describes the basis of CLT with the overarching aim of describing CLT-based techniques to enhance current training strategies and surgical performance, many of which are instinctively already employed in surgical practice. Currently, methods of feedback and assessment are imperfect - typically subjective, unsystematic, opportunistic, or retrospective, and at risk of human bias. Surgical Sabermetrics, the advanced analytics of surgical and audio-visual data, aims to enhance this feedback by providing objective, real-time, digital-based feedback. This article introduces the benefit of real-time measurement of CL to enhance feedback and its applications to surgical performance that follow the ethos of Surgical Sabermetrics.¹ The 2022 theme for ICOSET was "Making it Better." Cognitive Load and Surgical Sabermetrics principles provide tools to make Surgical training better, with the goal of higher quality care for patients.

Memory and processing speed impairments in first-episode drug-naïve patients with major depressive disorder

BACKGROUND

Cognitive impairment, an intrinsic feature of major depressive disorder (MDD), affects daily and social functioning in depression patients. However, the cognitive impairment profile in MDD remains ambiguous because of the high heterogeneity of previous studies.

METHODS

Four cognitive domains, including memory, processing speed, executive function (EF), and attention, were assessed in 184 first-episode drug-naïve (FEDN) MDD patients and matched 71 healthy controls (HCs). The effects of demographic and depressive factors on cognitive performance were analyzed using various statistical methods, including multi-factor analysis of variance, Mann-Whitney U test, and Spearman's rank correlation. In addition, the impact of depression severity on cognitive function was further assessed using subgroup analyses and partial correlation analyses.

RESULTS

Age and education significantly impacted most cognitive performances, and depression severity appeared to influence processing speed. Moreover, cognitive scores in memory and processing speed, rather than in EF and attention, were significantly different between FEDN MDD patients and HCs after controlling for sex, age, educational attainment, household income, and body mass index.

LIMITATIONS

The number of HCs was relatively small, which may have slightly reduced the study's statistical power.

CONCLUSIONS

Age and educational attainment have confirmative confounding effects greater than those of depression in most cognitive functions. More importantly, memory and processing speed were impaired in MDD after strictly controlling for confounders. These findings provide new information for understanding the pattern of cognitive impairment and offer clues for further exploring the pathogenesis of cognitive abnormalities in MDD.

Use of a Digital Cognitive Aid Improves Memorization of Military Caregivers After High-Fidelity Simulations of Combat Casualty Care

INTRODUCTION

High-fidelity simulation is widely used in the ongoing education of caregivers. However, the complex high-stakes simulated crisis environment affects memorization. This study investigated whether participants would remember more key training messages 3 months after a simulated complex emergency situation if they had used a digital cognitive aid (CA) during the simulations.

MATERIALS AND METHODS

This randomized controlled trial was performed during a combat casualty training course for military physicians and nurses. Each pair of care providers completed two scenarios randomized to be undertaken either with or without a digital CA. At the end of each debriefing, instructors gave five scenario-specific key messages aloud. Three months later, learners were asked to recall the messages from their two scenarios and were scored for each scenario. The primary endpoint was the number of key messages recalled. The secondary endpoints were the influence on the results of the profession and the scenario block and age of the leader.

RESULTS

Thirty-six pairs of participants were included. Due to operational constraints, only 34 completed the study. The use of the digital CA was associated with a positive effect on memorization at 3 months (F = 82.2, P < .001), unrelated to the leader's profession, age, or the scenario block. The median of the memorization scores was 2/5 [1-3] with the digital CA and 1/5 [1-1] without it, which represents a difference of one memorized element (95% CI, 1-2; η2 = 0.39).

CONCLUSIONS

The digital CA allowed learners to remember twice as many key elements 3 months after simulated training of medical care for military combat casualties. A dedicated digital CA might be an asset for better care in a combat environment and for learning and memorizing critical care procedures following complex emergency situations.

Identifying best practices for disclosure of amyloid imaging results: A randomized controlled trial

INTRODUCTION

Empirical studies on effective communication for amyloid disclosure in mild cognitive impairment (MCI) are lacking. We aimed to study the impact of six communication strategies.

METHOD

We performed a randomized controlled trial with seven randomly assigned, video-vignette conditions: six emphasizing a communication strategy and one basic condition. All showed a scripted consultation of a neurologist disclosing positive amyloid positron emission tomography (PET) scan results to an MCI patient. Healthy individuals (N = 1017; mean age ± SD 64 ± 8, 808 (79%) female) were instructed to imagine themselves in the video, answered questionnaires assessing information recall, emotional state, and behavioral intentions, and evaluate the physician/information.

RESULTS

"Risk best practice" resulted in highest free recall compared to other strategies (P < .05), except "emotional support". Recall in "emotional support" was better compared to "basic-' and elaborate information"(P < .05). "Risk best practice" resulted in the highest uncertainty (P < .001). "Teach-back" and "emotional support" contributed to the highest evaluations (P -values < .01).

CONCLUSION

Risk communication best practices, attending to emotions, and teach-back techniques enhance information recall of amyloid-PET results, and could contribute to positive care evaluations.

Advances in the understanding and enhancement of the human cognitive functions of learning and memory

Learning and memory are among the key cognitive functions that drive the human experience. As such, any defective condition associated with these cognitive domains could affect our navigation through everyday life. For years, researchers have been working toward having a clear understanding of how learning and memory work, as well as ways to improve them. Many advances have been made, as well as some challenges that have also been faced in the process. That notwithstanding, there are prospects with regards to the frontier of the enhancement of learning and memory in humans. This review article selectively highlights four broad areas of focus in research into the understanding and enhancement of learning and memory. Brain stimulation, effects of sleep, effects of stress and emotion, and synaptic plasticity are the main focal areas of this review, in terms of some pivotal research works, findings and theories.

Sound stimulus effects on dusky damselfish behavior and cognition

Anthropogenic noises are widespread and affect marine wildlife. Despite the growing knowledge on noise pollution in the marine environment, its effects on fish cognition are scarce. Here, we investigated the effects of sound exposure on anxiety-like behavior and memory retention on dusky damselfish Stegastes fuscus. The animals were trained in a conditioned place aversion task, and exposed to two daily sessions of music at intensities of 60-70 dBA or 90-100 dBA, while the control group was kept at 42-46 dBA (no music) for five days. After that, fish were tested in the novel tank paradigm and tested for the memory of the aversive task. In the novel tank, animals exposed to sound spent more time still and decreased the distance from the bottom of the tank. Animals also spent more time on the aversive side of the conditioning tank. These results suggest that anthropogenic noise applied through high-intensity music can increase anxiety and decrease memory retention in S. fuscus, suggesting the deleterious potential of noise for reef species.

Habit Formation and the Effect of Repeated Stress Exposures on Cognitive Flexibility Learning in Horses

Horse training exposes horses to an array of cognitive and ethological challenges. Horses are routinely required to perform behaviours that are not aligned to aspects of their ethology, which may delay learning. While horses readily form habits during training, not all of these responses are considered desirable, resulting in the horse being subject to retraining. This is a form of cognitive flexibility and is critical to the extinction of habits and the learning of new responses. It is underpinned by complex neural processes which can be impaired by chronic or repeated stress. Domestic horses may be repeatedly exposed to multiples stressors. The potential contribution of stress impairments of cognitive flexibility to apparent training failures is not well understood, however research from neuroscience can be used to understand horses’ responses to training. We trained horses to acquire habit-like responses in one of two industry-style aversive instrumental learning scenarios (moving away from the stimulus-instinctual or moving towards the stimulus-non-instinctual) and evaluated the effect of repeated stress exposures on their cognitive flexibility in a reversal task. We measured heart rate as a proxy for noradrenaline release, salivary cortisol and serum Brain Derived Neurotrophic Factor (BDNF) to infer possible neural correlates of the learning outcomes. The instinctual task which aligned with innate equine escape responses to aversive stimuli was acquired significantly faster than the non-instinctual task during both learning phases, however contrary to expectations, the repeated stress exposure did not impair the reversal learning. We report a preliminary finding that serum BDNF and salivary cortisol concentrations in horses are positively correlated. The ethological salience of training tasks and cognitive flexibility learning can significantly affect learning in horses and trainers should adapt their practices where such tasks challenge innate equine behaviour.

Psychometric properties and factorial invariance of the Farsi version of the Stress Mindset Measure

The Stress Mindset Measure consists of eight items to assess whether individuals hold a stress-is-enhancing or a stress-is-debilitating mindset. The current research is a cross-sectional study and aimed to investigate the factor structure, internal consistency reliability, and construct and convergent validity of the Farsi version of the Stress Mindset Measure (SMM). Prior to conducting the study, forward and backward translations of the SMM were performed. Using the convenience sampling method, we recruited 400 none-clinical sample (161 men and 239 women; aged 18 to 69). We utilized SPSS version 24, Amos, and Mplus 7.1 software to analyze the data. Results revealed satisfactory reliability and validity indexes for the Farsi version of the Stress Mindset Measure. The internal consistency of the Farsi version of the Stress Mindset Measure was in the excellent range (α = 0.87). The results of the confirmatory factorial analysis revealed two factors of the Stress Mindset Measure instead of the single factor suggested by the previous studies (fitness indices for the two-factor model were RMSEA = 0.78, CFI = 0.96, and TLI = 0.94). Moreover, we found that the stress-is-debilitating mindset is positively associated with stress (r = 0.233), depression (r = 0.163), and anxiety (r = 0.197). However, this mindset has been found to have no significant relationship with cognitive strategies of emotion regulation and life satisfaction. Also, findings showed no significant correlation between the stress-is-enhancing mindsets and the other variables. The results of this study suggest that the Farsi SMM has proper psychometric properties to assess stress mindsets.

Toward a basic science of communication in serious illness

High-quality communication can mitigate suffering during serious illness. Innovations in theory and technology present the opportunity to advance serious illness communication research, moving beyond inquiry that links broad communication constructs to health outcomes toward operationalizing and understanding the impact of discrete communication functions on human experience. Given the high stakes of communication during serious illness, we see a critical need to develop a basic science approach to serious illness communication research. Such an approach seeks to link "what actually happens during a conversation" - the lexical and non-lexical communication content elements, as well as contextual factors - with the emotional and cognitive experiences of patients, caregivers, and clinicians. This paper defines and justifies a basic science approach to serious illness communication research and outlines investigative and methodological opportunities in this area. A systematic understanding of the building blocks of serious illness communication can help identify evidence-informed communication strategies that promote positive patient outcomes, shape more targeted communication skills training for clinicians, and lead to more tailored and meaningful serious illness care.

Stress-induced HPA activation in virtual navigation and spatial attention performance

Background

Previous research has shown that spatial performance (e.g. navigation, visuospatial memory, attention) can be influenced by acute stress; however, studies have produced mixed findings sometimes showing an improvement after stress, other times showing impairment or no overall effect. Some of these discrepancies may be related to: the type of stress system activated by the stressor (sympathetic adrenal medulla [SAM] or hypothalamic-pituitary-adrenocortical [HPA]); whether cortisol responders vs. nonresponders are analyzed subsequent to main effects; and sex differences in stress responses. In the present study, we examine the influence of HPA activation from an acute laboratory stressor (Socially Evaluated Cold Pressor test [SECPT]) on performance during two spatial tasks: Useful Field of View (UFOV; a measure of spatial attention) and virtual reality (VR) navigation. We assigned 31 males and 30 females to either the SECPT or a Non-Stress condition prior to the two spatial tasks. Cardiovascular measures including heart rate and blood pressure, and salivary cortisol biosamples were obtained at specific time points.

Results

Participants in the Stress condition showed increases in heart rate, systolic and diastolic blood pressure indicating sympathetic adrenal medulla (SAM) axis activation. Stress also led to increases in salivary cortisol, suggesting hypothalamic-pituitary-adrenocortical (HPA) activation. Stress did not influence overall performance in the spatial attention UFOV or the VR navigation task. However, a sex difference in spatial attention was detected when participants were divided into Stress-cortisol responders and non-responders in the UFOV task. Male Stress-cortisol responders (n = 9) showed better UFOV accuracy than female Stress-cortisol responders (n = 6); no sex differences were found among the Non-Stress control group. Furthermore, for females in the stress condition (n = 14), higher cortisol responses were associated with lower spatial attention performance.

Conclusions

Socially Evaluated Cold Pressor stress resulted in no change in speed or accuracy in a VR navigation task. For the spatial attention task, the SECPT led to a sex difference among Stress-cortisol responders with males showing improved accuracy over females. The relationship between HPA activation and prefrontal cortex activity may be necessary to understand sex differences in spatial attention performance.

Fostering emotional self-regulation in female teachers at the public teaching network: A mindfulness-based intervention improving psychological measures and inflammatory biomarkers

OBJECTIVE

To examine the effect of a mindfulness-based program specifically designed for teachers in reducing perceived stress and improving the quality of experienced emotion in female active working teachers. A second outcome evaluated is the associated change in cellular inflammatory activity, measured by peripheral blood levels of cytokines.

METHOD

Eighty-eight female active teachers from public schools from São Paulo Municipality were recruited, and randomly allocated to an eight-week Mindfulness-Based Health Program for Educators (MBHP-Educa) or to Neuroscience for Education Program (Neuro-Educa: active control group). The venue of both programs were several public school facilities, where many of the teachers actually worked. Both groups received activities during eight weeks in a 2 ​h/week regimen, totalizing 16 ​h. Sixty-five participants completed the program and pre- and post-interventions measures were taken from the following scales: Interpersonal Multidimensional Reactivity Scale (IRI), Positive-and-Negative Affects Scale (PANAS), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC), and a primary outcome in Ryff's Psychological Well-Being Scale (PBWS). At pre-and post-intervention, blood samples were collected for the measurement of several important inflammatory biomarkers, Tumor Necrosis Factor - α (TNF-α), Interleukin 1β (IL-1β), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) and Interleukin 12p70 (IL-12P70) through flow cytometry assay. Intervention effects were analyzed via Generalized mixed models (GLMM).

RESULTS

According to the GLMM, MBHP-Educa significantly reduced the scores of perceived stress (p ​< ​0.0001), and negative affect (p ​< ​0.0001) compared to active control group (Neuro-Educa). Conversely, an increase was observed on Psychological Well Being Scale in dimensions of Self-acceptance (p ​< ​0.0001), and Autonomy (p ​= ​0.001), as well as improvements in Resilience (p ​< ​0.0001), and Positive Affect (p ​< ​0.0001). MBHP-Educa also promoted a reduction in the levels of IL-6 (p ​= ​0.003), IL-8 (p ​= ​0.036), and increase in the levels of IL-10 (p ​< ​0.0001) and IL-12p70 (p ​< ​0.044). TNF-α, IL-1β, and IL-10p70 showed results below theoretical limit of detection accepted for CBA kit.

CONCLUSIONS

Our data suggest that mindfulness-based interventions introduced as a strategy for reducing stress, promoting well-being and improve immune function can be a useful asset in promoting psychological health among teachers in Basic Education.

Mechanisms of memory under stress

It is well established that stress has a major impact on memory, driven by the concerted action of various stress mediators on the brain. Recent years, however, have seen considerable advances in our understanding of the cellular, neural network, and cognitive mechanisms through which stress alters memory. These novel insights highlight the intricate interplay of multiple stress mediators, including-beyond corticosteroids, catecholamines, and peptides-for instance, endocannabinoids, which results in time-dependent shifts in large-scale neural networks. Such stress-induced network shifts enable highly specific memories of the stressful experience in the long run at the cost of transient impairments in mnemonic flexibility during and shortly after a stressful event. Based on these recent discoveries, we provide a new integrative framework that links the cellular, systems, and cognitive mechanisms underlying acute stress effects on memory processes and points to potential targets for treating aberrant memory in stress-related mental disorders.

Non-genomic steroid signaling through the mineralocorticoid receptor: Involvement of a membrane-associated receptor?

Corticosteroid receptors in the mammalian brain mediate genomic as well as non-genomic actions. Although receptors mediating genomic actions were already cloned 35 years ago, it remains unclear whether the same molecules are responsible for the non-genomic actions or that the latter involve a separate class of receptors. Here we focus on one type of corticosteroid receptors, i.e. the mineralocorticoid receptor (MR). We summarize some of the known properties and the current insight in the localization of the MR in peripheral cells and neurons, especially in relation to non-genomic signaling. Previous studies from our own and other labs provided evidence that MRs mediating non-genomic actions are identical to the ones involved in genomic signaling, but may be translocated to the plasma cell membrane instead of the nucleus. With fixed cell imaging and live cell imaging techniques we tried to visualize these presumed membrane-associated MRs, using antibodies or overexpression of MR-GFP in COS7 and hippocampal cultured neurons. Despite the physiological evidence for MR location in or close to the cell membrane, we could not convincingly visualize membrane localization of endogenous MRs or GFP-MR molecules. However, we did find punctae of labeled antibodies intracellularly, which might indicate transactivating spots of MR near the membrane. We also found some evidence for trafficking of MR via beta-arrestins. In beta-arrestin knockout mice, we didn't observe metaplasticity in the basolateral amygdala anymore, indicating that internalization of MRs could play a role during corticosterone activation. Furthermore, we speculate that membrane-associated MRs could act indirectly via activating other membrane located structures like e.g. GPER and/or receptor tyrosine kinases.

The effect of stress and exercise on the learning performance of horses

Domestic horses are widely used for physically demanding activities but the effect of exercise on their learning abilities has not been explored. Horses are also frequently exposed to stressors that may affect their learning. Stress and exercise result in the release of glucocorticoids, noradrenaline and other neurotransmitters that can influence learning. It is not currently possible to directly measure concentrations of neurotransmitters in the brains of behaving horses, however the inference of neurobiological processes from peripheral markers have been widely used in studies of human cognition. We assigned 41 horses to either ridden exercise, uncontrollable stress or inactivity and evaluated their acquisition of an industry-style aversive instrumental learning task. Exercised horses achieved the learning criterion in the fewest number of trials compared to the stressed and inactive horses whose performance did not differ. The exercised horses’ salivary cortisol concentrations decreased during learning whereas the concentrations of the other groups increased. Spearman’s correlations revealed that horses with the highest cortisol concentrations required the most trials to reach the criterion. We present novel data that exercise prior to learning may enhance the acquisition of learning in horses. Conversely, activities that expose horses to uncontrollable stressors causing strong cortisol release may impair learning. It is proposed that these effects may be due to the influence of neurotransmitters such as cortisol and noradrenaline on brain regions responsible for learning.

Stress and memory encoding: What are the roles of the stress-encoding delay and stress relevance?

The effects of acute stress on memory encoding are complex. Recent work has suggested that both the delay between stress and encoding and the relevance of the information learned to the stressor may modulate the effects of stress on memory encoding, but the relative contribution of each of these two factors is unclear. Therefore, in the present study, we manipulated (1) acute stress, (2) the delay between stress and encoding, and (3) the relevance of the information learned to the stressor. The results indicated that stress during encoding led to better memory for study materials that were related to the stressor relative to memory for study materials that were unrelated to the stressor. This effect was numerically reduced for materials that were encoded 40 min after stressor onset (23 min after the stressor had ended) compared with items encoded at the time of the stressor, but this difference was not significant. These results suggest that the relevance of the information learned to the stressor may play a particularly important role in the effects of stress on memory encoding, which has important implications for theories of stress and memory.

The Relative Contributions of Live and Recorded Online Mindfulness Training Programs to Lower Stress in the Workplace: Longitudinal Observational Study

Background

Despite numerous gaps in the literature, mindfulness training in the workplace is rapidly proliferating. Many “online” or “digital mindfulness” programs do not distinguish between live teaching and recorded or asynchronous sessions, yet differences in delivery mode (eg, face-to-face, online live, online self-guided, other) may explain outcomes.

Objective

The aim of this study was to use existing data from an online mindfulness solutions company to assess the relative contribution of live and recorded mindfulness training to lower perceived stress in employees.

Methods

Perceived stress and the amount of live and recorded online mindfulness training accessed by employees were assessed during eMindful’s One-Percent Challenge (OPC). The OPC is a 30-day program wherein participants are encouraged to spend 1% of their day (14 minutes) practicing mindfulness meditation on the platform. We used linear mixed-effects models to assess the relationship between stress reduction and usage of components of the eMindful platform (live teaching and recorded options) while controlling for potential reporting bias (completion) and sampling bias.

Results

A total of 8341 participants from 44 companies registered for the OPC, with 7757 (93.00%) completing stress assessments prior to the OPC and 2360 (28.29%) completing the postassessment. Approximately one-quarter of the participants (28.86%, 2407/8341) completed both assessments. Most of the completers (2161/2407, 89.78%) engaged in the platform at least once. Among all participants (N=8341), 8.78% (n=707) accessed only recorded sessions and 33.78% (n=2818) participated only in the live programs. Most participants engaged in both live and recorded options, with those who used any recordings (2686/8341, 32.20%) tending to use them 3-4 times. Controlling for completer status, any participation with the eMindful OPC reduced stress (B=–0.32, 95% CI –0.35 to –0.30, SE=0.01, t_2393.25=–24.99, P<.001, Cohen d=–1.02). Participation in live programs drove the decrease in stress (B=–0.03, SE=0.01, t_3258.61=–3.03, P=.002, d=–0.11), whereas participation in recorded classes alone did not. Regular practice across the month led to a greater reduction in stress.

Conclusions

Our findings are in stark contrast to the rapid evolution of online mindfulness training for the workplace. While the market is reproducing apps and recorded teaching at an unprecedented pace, our results demonstrate that live mindfulness programs with recorded or on-demand programs used to supplement live practices confer the strongest likelihood of achieving a significant decrease in stress levels.

The key to superior memory encoding under stress: the relationship between cortisol response and mnemonic discrimination

Some previous studies have shown that increased stress hormone levels have beneficial effects on memory encoding; however, there is no clear consensus on which encoding-related processes are affected by stress hormones. In the present study, we investigated the relationship between interindividual differences in neuroendocrine response to acute stress and interference resolution (i.e., mnemonic discrimination). Participants were healthy young adults who were exposed to physical and psychological stressors (Socially Evaluated Cold Pressor Test). Then participants completed the modified version of the Mnemonic Similarity Task. Specifically, they were presented with photographs of emotionally arousing (negative and positive) and nonarousing (neutral) scenes followed by a recognition memory test where they saw a mixture of old and new stimuli. Crucially, participants were also presented with critical lure items, that is, visually similar stimuli to ones presented at encoding. We found that participants who had higher cortisol response to the stressors were better in discriminating between the studied items and their visually similar lures. This effect was present for the arousing and nonarousing materials as well. These findings suggest that increased hormonal response to acute stress has a beneficial impact on the formation of distinct, nonoverlapping, unique memory representations, and consequently, on episodic memory encoding processes.

Alpha lipoic acid ameliorates scopolamine induced memory deficit and neurodegeneration in the cerebello-hippocampal cortex

Scopolamine- induced memory loss is used to study new drug discovery in Alzheimer's disease (AD) pathogenesis. This study was aimed at evaluating the role of an antioxidant supplement alpha-lipoic acid (AHA), in ameliorating the oxidative damaging effects of scopolamine on cognition, memory, and the neurohistology of the cerebello-hippocampal cortex. Twenty adult male Wistar rats used were categorized into four (4) groups (n = 5): Group A- Control, Group B- 200 mg/kg of AHA, Group C- Scopolamine (memory-impaired model), and Group D- Neurodegenerative repair model (Scopolamine + AHA). The treatment lasted for fourteen (14) days. Y-maze and hang-wire (limb use test) were used as behavioural index to assess memory and motor function while brain tissues were processed for histology (H and E stain), histochemistry using Cresyl Fast violet stain for Nissl bodies, and immunohistochemistry of astrocytes using glial fibrillary acidic protein (GFAP). Results showed that scopolamine led to a decline in brain weight, impaired memory and motor function, induced oxidative tissue damage cumulating in loss of neuronal cells, chromatolysis, the proliferation of reactive astrocytes (neuroinflammation biomarker) in the cerebello-hippocampal cortex; but upon administration of AHA these neuropathological characterizations were inhibited and reversed by AHA demonstrating its antioxidant and neuro- repair potential. In conclusion, AHA is a useful therapeutic agent against scopolamine-induced cognitive and memory deficit because it has the ability to ameliorate oxidative tissue damage by attenuating reactive astrocytes proliferation and neuron chromatolysis thereby improving memory and motor function.

Facing stress: No effect of acute stress at encoding or retrieval on face recognition memory

Eyewitnesses may experience stress during a crime and when attempting to identify the perpetrator subsequently. Laboratory studies can provide insight into how acute stress at encoding and retrieval affects memory performance. However, previous findings exploring this issue have been mixed. Across two preregistered experiments, we examined the effects of stress during encoding and retrieval on face and word recognition performance. We used the Maastricht Acute Stress Test (MAST) to induce stress and verified the success of the stress manipulation with blood pressure measures, salivary cortisol levels, and negative affect scores. To examine differences in stressor timing, participants encoded target faces or words both when confronted with the stressor and during the subsequent cortisol peak and retrieved these stimuli 24 h later. We found neither effects of acute stress on face recognition memory during encoding or retrieval (Experiments 1 and 2), nor effects of encoding stress on word recognition memory (Experiment 2). Bayesian analyses largely provided substantial or strong evidence for the null hypotheses. We emphasize the need for well-powered experiments using contemporary methodology for a more complete understanding of the effect of acute stress on face recognition memory.

The effects of acute stress on eyewitness memory: an integrative review for eyewitness researchers

The eyewitness and fundamental memory research fields have investigated the effects of acute stress at encoding on memory performance for decades yet results often demonstrate contrasting conclusions. In this review, we first summarise findings on the effects of acute encoding stress on memory performance and discuss how these research fields often come to these diverging findings regarding the effects of encoding stress on memory performance. Next, we critically evaluate methodological choices that underpin these discrepancies, emphasising the strengths and limitations of different stress-memory experiments. Specifically, we elaborate on choice of stressors and stimuli, stress manipulation checks, stressor timing, and the interval between encoding and retrieval and discuss how methodological shortcomings in both the eyewitness and fundamental memory fields have limited our understanding of how encoding stress may affect eyewitness memory performance. Finally, we propose several recommendations for researchers interested in this topic, such as confirming stress inductions with physiological measures, implementing sufficient retrieval intervals to isolate the memory phase of interest and using ecologically valid memory paradigms. We conclude that the best progress can be made if researchers are responsive to the methodologies and findings reported in other research fields and encourage collaborations between the different disciplines.

The power of clinician-expressed empathy to increase information recall in advanced breast cancer care: an observational study in clinical care, exploring the mediating role of anxiety

OBJECTIVE

Experimental studies have found that clinician-expressed empathy improves patients' information recall in (advanced) cancer consultations. It remains unclear, however, whether these results are generalizable to clinical care and, if so, what the underlying mechanism is. We aimed to i) determine the relationship between clinician-expressed empathy and patients' information recall in clinical advanced breast cancer consultations; and ii) test whether the relationship between clinician-expressed empathy and recall is mediated by a decrease in patients' anxiety.

METHODS

Forty-one consultations between oncologists and female patients with advanced breast cancer were audio recorded. Patients' post-consultation information recall and pre- and post-consultation anxiety (0-100) were assessed. Recall was scored according to a self-created questionnaire. Clinician-expressed empathy (0-100) was assessed by observers. Structural Equation Modelling was used for all analyses.

RESULTS

Participants remembered 61% of the information discussed. Clinician-expressed empathy significantly increased patients' total information recall (p = .041) and recall of treatment aims/positive effects (p = .028). The mediating role of anxiety could not be established.

CONCLUSION

Although the underlying mechanism remains unclear, clinicians have a powerful tool to improve seriously ill breast cancer patients' recall of information: empathy.

PRACTICE IMPLICATIONS

These insights should encourage clinicians to express empathy; practical communication training might prove helpful.

In the great pond snail (Lymnaea stagnalis), two stressors that individually enhance memory in combination block memory formation

Stress plays an important role in memory formation in the great pond snail (Lymnaea stagnalis (Linnaeus, 1758)). Individual stressors have been shown to enhance or to perturb long-term memory (LTM) formation. However, when snails perceive a combination of two stressors, it is unclear the outcome with regards to LTM formation. Here we first show that when L. stagnalis are exposed individually to either a predator stressor (crayfish effluent (CE), which is a kairomone) or a thermal stressor (30 °C), LTM formation is enhanced. In their natural environment, L. stagnalis may experience temperatures approaching 30 °C and they may encounter crayfish at the same time. How such a combination of stressors alters adaptive behaviour is unknown. Here we show that when these two stressors are combined, LTM formation is blocked. Since boiling CE inactivates the kairomone, we used previously boiled CE that we combined with the thermal stressor and found that LTM formation is again enhanced. These data show that (i) it cannot accurately be predicted how a combination of stressors when combined interact to alter LTM formation and (ii) there is a difference between hot CE and room temperature CE.

How to improve eyewitness testimony research: theoretical and methodological concerns about experiments on the impact of emotions on memory performance

The purpose of this paper is to present crucial shortcomings of research into eyewitness testimony. It presents the state-of-the-art of research on the relationship between emotions and memory performance. In addition, it addresses contradictions and concerns about previous studies. Despite the declarations of consensus on the role of emotions in memory coding and retrieving, there are as many studies suggesting that emotional events are better remembered than neutral ones, as there are reports that show the opposite. Therefore, by indicating the theoretical and methodological limitations of previous studies, this paper advocates a more rigorous approach to the investigation of emotions and their impact on the quality and quantity of testimony. It also provides a framework for inquiry that allows better comparisons between studies and results, and may help to build a more comprehensive theory of the effects of emotion on memory.

Student-Centered Learning in the Anatomy Laboratory: Medical Students' Perspective

The teaching of anatomy has for long been delivered through lectures and supplemented with laboratory sessions that are predominantly delivered by faculty members. In this study, we aimed to assess the benefits of medical students' student-centered learning (SCL) approach in the anatomy laboratory. First-year medical students were invited to participate in this study. Information about the study was provided to the students and informed consent was obtained. In one laboratory session, students were divided into groups and were provided with a list of structures that they need to identify on prosections using the available resources. This was followed by a faculty-led learning session (FLL) to identify the same list of structures. Students were then asked to complete a questionnaire at the end of the laboratory session evaluating the benefits of incorporating SCL into their learning. Anonymized data was collected and analyzed using Statistical Package for Social Scientist (SPSS). From the 86 registered students, 65 took part in this study. Medical students preferred FLL session when it comes to consolidating anatomical knowledge, remembering new anatomical knowledge, and developing in-depth understanding of anatomy and their ability to ask questions regarding challenging topics. Meanwhile, students' preferred SCL session when it comes to helping them stay focused, providing a more relaxed learning environment, enhancing communication with peers, and developing independent learning skills. In this study, we highlight the benefits of incorporating SCL in the anatomy laboratory complemented by FLL. With the clear benefits of SCL, further research is required to investigate the best way to integrate similar sessions in an anatomy laboratory and its impact on student performance.

Evaluating heart rate variability as a predictor of the influence of lying on memory

Previous research suggests self-provided misinformation (lying) impairs memory for the truth, whereby more incorrect details are remembered compared to being truthful. The cognitive control processes evoked by inhibiting retrieval of truthful information may come at the expense of retaining that information in memory. Because lying requires quick adaptability to the situation, heart rate variability (HRV), reflecting cognitive control processes, is a useful metric of these cognitive demands. The present experiment extends previous research (Paige et al., 2019) and had participants complete a questionnaire orally in front of a panel while electrocardiography (ECG) data was collected. Participants were instructed to tell the truth for half of the questions and lie for the other half. For a subset of the questions, participants were instructed to elaborate on their response. After a delay, participants completed the same questionnaire on the computer, responding truthfully to all items. Results revealed that correct memory was lower for items participants previously lied about compared to truthful items. Although prior work suggests increased HRV is associated with increased cognitive control, HRV did not predict memory for truth or lie items. These findings are consistent with past literature showing that lying impairs memory for veridical information compared to truth-telling.

Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury

Study design

Prospective pre–post study.

Objectives

International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) represents the most frequently used assessment to determine the level and severity of a spinal cord injury (SCI). The guidelines for ISNCSCI are complex and challenging. Knowledge of its correct execution needs to be imparted precisely. The aim of this study was to investigate whether hands-on instructional courses can increase the knowledge of the ISNCSCI examination guidelines.

Setting

European Multicenter Study about SCI.

Methods

Before and after the instructional courses, participants were asked to complete questionnaires. The set of questions covered the most important aspects of the examination guidelines. Attendees were asked to self-rate their occupation and experience in ISNCSCI.

Results

The comparison of pretest and posttest results of 164 attendees from 2014 to 2018 revealed an improvement of knowledge reflected by an increase of correct answers from 66 ± 17% before to 89 ± 11% after the course (p < 0.01). The improvement was not associated with occupation (p > 0.1). However, the correctness of pretest results differed concerning both the period of experience with ISNCSCI (p < 0.05) and the course language (p < 0.01), while the frequency of execution resulted in differences in the posttest (p = 0.01).

Conclusions

Instructional courses substantially improve knowledge of the ISNCSCI examination guidelines. Differences in knowledge present before the course leveled off after the course. Comprehensive theoretical training is strongly recommended to ensure reliability and validity of ISNCSCI examinations in clinical routine and research. Albeit being practiced in the instructional courses, the benefit of hands-on training still needs to be systematically evaluated in future studies.

Acute stress enhances tolerance of uncertainty during decision-making

Acute stress has been shown to influence reward sensitivity, feedback learning, and risk-taking during decision-making, primarily through activation of the hypothalamic pituitary axis (HPA). However, it is unclear how acute stress affects decision-making among choices that vary in their degree of uncertainty. To address this question, we conducted two experiments in which participants repeatedly chose between two options-a high-uncertainty option that offered highly variable rewards but was advantageous in the long-term, and a low-uncertainty option that offered smaller yet more consistent rewards. The Socially Evaluated Cold Pressor Task (SECPT) was utilized to induce acute stress. Participants in Experiment 1 (N = 114) were exposed to either the SECPT or a warm-water control condition and then completed the decision-making under uncertainty task. Compared to the control condition, those exposed to the acute stress manipulation chose the high-uncertainty option that provided highly variable but larger rewards over the option that provided stable, smaller rewards. Experiment 2 (N = 95) incorporated a salivary cortisol measure. Results replicated the behavioral findings in Experiment 1 and demonstrated that the acute stress manipulation increased salivary cortisol. This work suggests that moderate acute stress is associated with tolerance of outcome variability in contexts that depend on learning to maximize rewards.

Improving the patient experience in the Emergency Department Short Stay Unit

BACKGROUND

To explore whether giving patients admitted to the Short Stay Unit (SSU) in the Emergency Department (ED) their medical notes improved patient understanding of key information.

METHODS

A two armed non-blinded randomised controlled trial was performed, with patients enrolled on admission to the SSU from the ED. The intervention was provision of a copy of the patient's medical notes both on admission to SSU and on discharge, together with a plain English statement about their medical condition and a detailed care plan. Control patients were provided with standard care (verbal information). Patients were surveyed in SSU and followed up two weeks post discharge via telephone interview. Treating clinicians, in both the ED and SSU, were surveyed to establish acceptability of the intervention.

RESULTS

Two hundred patients were enrolled, with 176 completing the study. The intervention group found the information provided more helpful (p=0.048) and understood their condition and treatment plan better than the control group (p=0.034). All other data points, despite a positive trend towards the intervention, were statistically insignificant.

CONCLUSIONS

This study suggests that this simple intervention may positively contribute to the patient experience, with no discernible negative effect on the overall delivery of safe and efficient healthcare.

A six-step brief intervention to reduce distress and increase treatment readiness in problem gamblers

OBJECTIVE

The majority of people with gambling problems contact helplines when they are in crisis, hampering their capacity to explore suitable treatment options. To date, there has been limited research identifying the best way to support individuals to reduce distress and maximise further treatment-seeking. In this paper, we describe the development and piloting of the resulting six-step brief intervention.

METHOD

A six-step brief intervention was developed based on a literature review of existing interventions for crisis management, semi-structured interviews with 19 participants comprising gambling and crisis support counsellors and consumers, as well as experts in the addiction field.

RESULTS

The resulting six-step brief-intervention focusses on (1) acknowledging and measuring distress; (2) normalising and reducing distress; (3) optimising motivation for change; (4) providing a sense of hope; (5) re-measuring distress and, if reduced; (6) exploring options for treatment and support.

CONCLUSION

Whilst developed primarily for helpline counsellors, the intervention has potential application for health practitioners working across telephone, online and face-to-face services. Further research is required to determine its effectiveness in improving treatment engagement amongst people with gambling problems.

Incivility and the clinical learner

The impact of incivility in terms of individual and team performance in clinical environments is increasingly acknowledged and supported by a growing evidence base. However, clinical environments are not just areas where patient care is delivered, they are also rich, key learning arenas for healthcare professionals. To date, the potential impact of incivility in clinical environments on healthcare professional learning and development has not been comprehensively explored. This article provides an overview of the physiological mechanisms that inhibit learning and memory recall in individuals experiencing or observing incivility and social stress. It establishes a clear need for focus on the impact of incivility on clinical learners and educators and further evidence for the need for clinical environments in which civility is firmly rooted into the pervading culture.

Aha! Taking on the myth that simulation-derived surprise enhances learning

OBJECTIVES

This paper aims to discuss the recurring education-related issue of the high-fidelity simulation myth. In the current instantiation, educators erroneously believe that trainees benefit from authentic uncertainty and surprise in simulation-based training.

METHODS

We explore the origins of this myth within the experiential learning and social constructivism theories and propose an evidence-based solution of transparent and guided instruction in simulation.

RESULTS

Constructivist theories highlight meaning making as the benefit of inquiry and discovery learning strategies. Inappropriate translation of this epistemology into an element of curriculum design creates unfortunate unintended consequences.

CONCLUSIONS

We propose that the translation of constructivist theories of learning within simulation-based education has resulted in a pervasive myth, which decrees that scenarios must introduce realistic tension or surprises to encourage exploration and insightful problem solving. We argue that this myth is masquerading as experiential learning. In this narrative review, we interpret our experiences and observations of simulation-based education through our expertise in education science and curriculum design. We offer anecdotal evidence along with a review of selected literature to establish the presence of this previously undetected myth.

Improving the Efficiency and Effectiveness of Parent Education in the Neonatal Intensive Care Unit

Background:

March of Dimes partners with hospitals across the country to implement NICU Family Support (NFS) Core Curriculum, a program providing education to parents in neonatal intensive care units (NICUs) across the country.

Purpose:

This NFS project's goal was to increase the efficiency and effectiveness of NICU parent education by establishing consistency, improving quality, and identifying best practices.

Methods/Search Strategy:

A 5 topic curriculum was developed and implemented across NFS program sites. The project studied 4 main outcomes of interest related to efficiency and effectiveness: increase in parenting confidence, parent learning, knowledge change, and satisfaction. Data were collected from speakers and attendees immediately following educational sessions. Analytical approaches included descriptive statistics such as frequency, percentage, and response rate, and inferential approaches such as t test, χ², and analysis of variance.

Findings/Results:

Findings suggest that the NFS Core Curriculum improved both program efficiency and effectiveness. Sessions fully implemented according to recommended strategies had better outcomes than sessions not fully implemented according to recommended strategies (P < .0001). Across the 3648 attendees at 41 sites, 77% of parents reported learning “a lot” at the session they attended and 85% of attendees reported increased confidence. Attendees also reported positive knowledge change and high satisfaction.

Implications for Practice:

Parent education best practices identified through this initiative can be utilized for future NFS Core Curriculum topics and potentially generalized to all NICU parent education and family education in other hospital intensive care units.

Implications for Research:

Content and best practices identified through this project will require regular review to ensure medical accuracy and appropriateness of best practices as the physical design of NICUs evolves.

Striatal reactivity to reward under threat-of-shock and working memory load in adults at increased familial risk for major depression: A preliminary study

INTRODUCTION

Anhedonia, a core symptom of Major Depressive Disorder (MDD), manifests as a lack or loss of motivation as reflected by decreased reward responsiveness, at both behavioral and neural (i.e., striatum) levels. Exposure to stressful life events is another important risk factor for MDD. However, the mechanisms linking reward-deficit and stress to MDD remain poorly understood. Here, we explore whether the effects of stress exposure on reward processing might differentiate between Healthy Vulnerable adults (HVul, i.e., positive familial MDD) from Healthy Controls (HCon). Furthermore, the well-described reduction in cognitive resources in MDD might facilitate the stress-induced decrease in reward responsiveness in HVul individuals. Accordingly, this study includes a manipulation of cognitive resources to address the latter possibility.

METHODS

16 HVul (12 females) and 16 gender- and age-matched HCon completed an fMRI study, during which they performed a working memory reward task. Three factors were manipulated: reward (reward, no-reward), cognitive resources (working memory at low and high load), and stress level (no-shock, unpredictable threat-of-shock). Only the reward anticipation phase was analyzed. Imaging analyses focused on striatal function.

RESULTS

Compared to HCon, HVul showed lower activation in the caudate nucleus across all conditions. The HVul group also exhibited lower stress-related activation in the nucleus accumbens, but only in the low working memory (WM) load condition. Moreover, while stress potentiated putamen reactivity to reward cues in HVul when the task was more demanding (high WM load), stress blunted putamen reactivity in both groups when no reward was at stake.

CONCLUSION

Findings suggest that HVul might be at increased risk of developing anhedonic symptoms due to weaker encoding of reward value, higher difficulty to engage in goal-oriented behaviors and increased sensitivity to negative feedback, particularly in stressful contexts. These findings open new avenues for a better understanding of the mechanisms underlying how the complex interaction between the systems of stress and reward responsiveness contribute to the vulnerability to MDD, and how cognitive resources might modulate this interaction.

Constitutive differences in glucocorticoid responsiveness are related to divergent spatial information processing abilities

The stress response facilitates survival through adaptation and is intimately related to cognitive processes. The Morris water maze task probes spatial learning and memory in rodents and glucocorticoids (i.e. corticosterone (CORT) in rats) have been suggested to elicit a facilitating action on memory formation. Moreover, the early aging period (around 16-18 months of age) is susceptible to stress- and glucocorticoid-mediated acceleration of cognitive decline. In this study, we tested three lines of rats selectively bred according to their individual differences in CORT responsiveness to repeated stress exposure during juvenility. We investigated whether endogenous differences in glucocorticoid responses influenced spatial learning, long-term memory, and reversal learning abilities in a Morris water maze task at early aging. Additionally, we assessed the quality of the different swimming strategies of the rats. Our results indicate that rats with differential CORT responsiveness exhibit similar spatial learning abilities but different long-term memory retention and reversal learning. Specifically, the high CORT responding line had a better long-term spatial memory, while the low CORT responding line was impaired for both long-term retention and reversal learning. Our modeling analysis of performance strategies revealed further important line-related differences. Therefore, our findings support the view that individuals with high CORT responsiveness would form stronger long-term memories to navigate in stressful environments. Conversely, individuals with low CORT responsiveness would be impaired at different phases of spatial learning and memory.