Decision making processes underlying avoidance of mandatory child vaccination in Croatia - a qualitative study.

Despite extensive research evidencing child vaccination is safe and effective, we are witnessing a trend of increasing vaccine hesitancy which is listed among the top ten global health threats. Although some countries incorporate mandatory vaccination programs, no particularly efficient strategies for addressing vaccine avoidance have so far been identified. Within this study we investigated perceptions and reasoning of vaccine hesitant parents from Croatia where child vaccination is mandatory. The aims were to reveal different strategies by which they avoid mandatory vaccination schedules and hypothetical situations in which they would reconsider vaccinating, as well as to identify features of related decision-making. We conducted 25 semi-structured interviews with vaccine hesitant parents and analyzed the data using the framework of thematic analyses. The identified themes were related to the parents' decision-making process, reflection as well as justification of their decision, avoidance behavior of mandatory vaccination schedules and related consequences, dealing with outcomes of the decision and reconsidering vaccinating. The results support and extend previous findings regarding vaccine reasoning, linking hesitancy with the experientially intuitive thinking style and social intuitionist model of moral reasoning. The findings provide important insights into vaccination avoidance and potential for reconsideration, as well as dealing with related risks. Furthermore, we offer a general framework as well as practical guidelines that may help the development of strategies aimed at increasing vaccination rates.

Peritraumatic Distress and Posttraumatic Stress Symptoms During the COVID-19 Pandemic: The Contributions of Psychosocial Factors and Pandemic-Related Stressors.

The present study aimed to identify the contributions of sociodemographic factors, psychological hardiness, and pandemic-related stressors to the development of peritraumatic distress and posttraumatic stress symptoms (PTSS) during the peak of the COVID-19 pandemic. We also examined the mediating contribution of peritraumatic distress with respect to the associations between PTSS and (a) individual characteristics and (b) pandemic-related stressors. A total of 1,238 participants (82.1% women, 17.9% men) aged 18-75 years were included in the study. Participants completed the Dispositional Resilience Scale, Peritraumatic Distress Inventory, and Posttraumatic Stress Disorder (PTSD) Checklist. The results showed that 11.5% of participants scored above the clinical cutoff for peritraumatic distress, and 12.8% of participants scored above the clinical cutoff for PTSS. Regression models showed that higher levels of peritraumatic distress were statistically predicted by female gender, ß = -.12, p < .001; exposure to more than one stressor, ß = .21, p < .001; lower levels of commitment to people and activities, ß = -.12, p = .002; and resistance to challenges, ß = -.17, p < .001. Additionally, male gender, ß = .05, p = .007; younger age, ß = -.05, p = .005; lower levels of commitment to people and activities, ß = -.11, p < .001; lower ratings of hardiness with regard to challenge, ß = -.04, p = .043; and more severe peritraumatic distress, ß = .75, p < .001, predicted more severe PTSS during the pandemic. Peritraumatic distress mediated the associations between PTSS and both the number of experienced stressors and psychological hardiness.

Emotional and behavioral outcomes and quality of life in school-age children born as late preterm: retrospective cohort study.

Aim To determine the effect of late preterm birth and treatment at the intensive care unit (ICU) on school-age children's emotional and behavioral problems and quality of life (QoL). METHODS: Emotional and behavioral problems and QoL were investigated in 6-12-year-olds who were born late preterm at the University Hospital Center Split in the period from January 2002 to March 2008. The study included 126 late preterm children treated in ICU (LP-ICU group), 127 late preterm children not treated in ICU (LP-non-ICU group), and 131 full-term children treated in ICU (FT-ICU group). Emotional and behavioral difficulties were assessed using the Child Behavior Checklist. QoL was evaluated with the Royal Alexandra Hospital for Children Measure of Function questionnaire. The data was collected via telephone interview with mothers during 2014. RESULTS: Late preterm children had a nearly 5-fold risk for internalizing problems in comparison with FT-ICU children (OR 4.76, 95% confidence interval [CI] 2.37-9.56 and OR 4.82, 95% CI 2.25-10.37 in LP-ICU and LP-non-ICU children, respectively). They also had a greater risk for externalizing problems (OR 3.08, 95% CI 1.44-6.61 and OR 2.68, 95% CI 1.14-6.28, respectively) and total problems (OR 6.29, 95% CI 2.86-13.83 and OR 7.38, 95% CI 3.08-17.69, respectively) and a considerably increased risk for lower QoL (OR 12.79, 95% CI 5.56-29.41 and OR 5.05, 95% CI 2.04-12.48, respectively). CONCLUSION: Children born late preterm had a greater risk for emotional and behavioral problems and lower QoL during childhood than their full-term born peers and they experienced serious health problems upon birth.

Late preterm birth is a strong predictor of maternal stress later in life: Retrospective cohort study in school-aged children.

AIM: The aim of this study was to compare the level of stress in mothers of school-aged children born late preterm and admitted to the intensive care unit (ICU) with the level of maternal stress if a child was born late preterm and not admitted to the ICU as well as if a full-term child was admitted to the ICU. METHODS: In this retrospective cohort study the data were gathered via telephone interview with mothers. The Parenting Stress Index/Short Form was used to determine the level of stress in mothers. Background demographic characteristics, medically relevant variables, and the level of stress were tested using the chi-square test and Kruskal-Wallis test. Logistic regression was used in order to identify predictors of significant level of stress. RESULTS: Mothers of late preterm born children who were admitted to the ICU, as well as mothers of late preterm children who were not admitted had higher level of stress compared to mothers of full-term children. Namely, mothers of late preterm born children admitted to the ICU had 18-fold increase in risk for significant level of total stress (OR = 18.09; 95% CI 8.55 to 38.26) while 24-fold greater risk was observed in mothers of late preterm children who were not admitted to the ICU (OR = 24.05; 95% CI 10.66 to 54.26) in comparison to mothers of full-term born children. CONCLUSION: Results indicate that preterm birth and its complications are associated with a higher level of stress in mothers, that persists to school age.

Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study.

Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.

Contribution of rationality to vaccine attitudes: Testing two hypotheses.

Although previous studies have demonstrated an association between vaccine attitudes and cognitive biases, often resulting in vaccination hesitancy, the exact contribution of rationality has not been fully clarified. We tested two hypotheses regarding the impact of rationality on vaccine attitudes stemming from bounded and expressive rationality. We focused on parental vaccine attitudes operationalized by the affective, behavioral, and cognitive attitude components and investigated how these are influenced by disillusionment toward authorities and ability to engage in rational thinking operationalized using cognitive reflection and heuristics and biases tasks. The study was of a cross-sectional correlational design with a non-probabilistic sample of 823 volunteer participants surveyed online in April and May 2018 in Croatia. The results identified disillusionment toward authorities as a predictor of all components. Furthermore, performance on heuristics and biases tasks also predicted the affective and cognitive, but not the behavioral component, whereas cognitive reflection had no impact on vaccine attitudes. Next, a moderation effect of disillusionment toward authorities on the association between the omission bias task and all attitude components was identified. Parents with low disillusionment demonstrated positive vaccine attitudes regardless of their rationality, whereas for parents with high disillusionment a significant positive correlation between performance on the omission bias task as assessed with a vaccination vignette and attitudes was identified. This suggests that the ability to resist vaccine specific omission bias, that is, higher rationality, can decrease the negative effects of disillusionment, which supports the bounded rationality hypothesis.

Exploring the detection of associatively novel events using fMRI.

Identifying and evaluating events which are novel in a particular environment is crucially important for adaptive behavior. These events are often not just novel, as they typically violate expectations which may be formulated based on numerous features of our surroundings, one of which includes the ordinal structure (temporal order) of relevant stimuli. Events which violate such expectations, namely sequential deviants, constitute one category of associatively novel stimuli. The present event-related fMRI study investigated the detection of sequential deviants presented within three types of equivalently organized, attended visual sequences which differed in stimulus dimensions relevant for defining the sequential structure (position, rhythm, and object identity). Presenting deviants within perceptual sequences defined by position and rhythm stimulus properties triggered comparable patterns of activations within the lateral parietal, premotor, and prefrontal regions. However, the activations identified in the context of position sequences showed a more dorsal distribution when compared to those in rhythm sequences. In contrast, detection of deviants within object sequences was supported by right-lateralized parietal and temporal cortices. Thus, although the obtained results indicate similarities and partial overlap in activations triggered by specific pairs of deviants, differences in their processing were also revealed. This suggests that the general task context and specific stimulus features which define the deviant itself influence which brain regions within a widespread network incorporating lateral prefrontal, anterior premotor, and posterior (mainly lateral parietal) areas will become engaged in its processing.

It just doesn't feel right - the relevance of emotions and intuition for parental vaccine conspiracy beliefs and vaccination uptake.

Objective: Vaccine hesitancy has been identified as one of the major contributors to child under-vaccination. Research indicates that some hesitant parents' mistrust extends to specific conspiracy ideation, but research on vaccine conspiracy beliefs is still scarce. Our objective was to explore factors contributing to parental vaccine conspiracy beliefs and actual vaccine uptake in children.Design: A cross-sectional correlational design with a non-probabilistic sample of 823 volunteer participants surveyed online.Main outcome measures: We focussed on the contributions of the analytically rational and experientially intuitive thinking styles, as well as measures of emotional functioning, namely optimism and emotions towards vaccination, to vaccine conspiracy beliefs and vaccine uptake as outcomes.Results: The obtained results showed that greater vaccine conspiracy beliefs were associated with stronger unpleasant emotions towards vaccination and greater experientially intuitive thinking, as well as lower levels of education. Furthermore, unpleasant emotions towards vaccination and intuitive thinking were associated with vaccine refusal.Conclusion: These findings confirm the primary importance of emotions, along with the propensity towards intuitive thinking, in the context of vaccine conspiracy beliefs and refusal, supporting the notion that parents' avoidance is guided by their affect. These results have direct implications for addressing vaccine hesitancy within public campaigns and policies.

Motor foundations of higher cognition: similarities and differences in processing regular and violated perceptual sequences of different specificity.

Processing perceptual sequences relies on the motor system, which is able to simulate the dynamics of the environment by developing internal representations of external events and using them to predict the incoming stimuli. Although it has previously been demonstrated that such models may incorporate predictions based on exact stimulus properties and single stimulus dimensions, it is not known whether they can also support abstract predictions pertaining to the level of stimulus categories. This issue was investigated within the present event-related functional magnetic resonance imaging study, which compared the processing of perceptual sequences of different specificity, namely those in which the sequential structure was based on the order of presentation of individual stimuli (token), and those in which such structure was defined by stimulus categories (type). The results obtained indicate a comparable engagement of the basic premotor-parietal network in processing both specific and categorical perceptual sequences. However, type sequences additionally elicited activations within the lateral prefrontal, occipital and posterior temporal regions that supported categorization in this task context. Introducing sequential deviants into token sequences activated parietotemporal and ventrolateral frontal cortices, whereas a less pronounced overall response, dominated by lateral prefrontal activation, was elicited by violations introduced into type sequences. Overall, the findings obtained suggest that, although forward models in perception may be able to incorporate expectations of lower specificity when compared to the motor domain, such processing is crucially dependent on additional contributions from lateral prefrontal as well as inferior occipital and temporal cortices that support categorization occurring in such a dynamic context.

"Dysrationalia" Among University Students: The Role of Cognitive Abilities, Different Aspects of Rational Thought and Self-Control in Explaining Epistemically Suspect Beliefs.

The aim of the study was to investigate the role that cognitive abilities, rational thinking abilities, cognitive styles and self-control play in explaining the endorsement of epistemically suspect beliefs among university students. A total of 159 students participated in the study. We found that different aspects of rational thought (i.e. rational thinking abilities and cognitive styles) and self-control, but not intelligence, significantly predicted the endorsement of epistemically suspect beliefs. Based on these findings, it may be suggested that intelligence and rational thinking, although related, represent two fundamentally different constructs. Thus, deviations from rational thinking could be well described by the term "dysrationalia", meaning the inability to think rationally despite having adequate intelligence. We discuss the implications of the results, as well as some drawbacks of the study.

Keeping our eyes on the eyes: the case of Arcimboldo.

While contemporaries often viewed his reversible composite heads as scherzi (jokes) and modem art connoisseurs as creative masterpieces, Giuseppe Arcimboldo's ingenious paintings served as inspiring stimuli for the present eye-tracking experiment. One group of participants viewed three chosen paintings in an upright, and another in an upside-down, orientation. We compared how participants viewed three selected areas of interest (AOIs) within the painting when these could, and could not, be identified as a face or distinct facial element (eyes and mouth). The obtained results indicate that the participants fixated the parts of the painting which represent faces more in the upright than in the inverted orientation. Furthermore, in the upright orientation the participants focused more on the upper AOls (eyes) than the lower AOIs (mouth). This was not the case for the inverted orientation of two paintings. In conclusion, the face inversion effect occurs even in this artistic context, and the gaze often goes where the eyes are.

Development of abstract mathematical reasoning: the case of algebra.

Algebra typically represents the students' first encounter with abstract mathematical reasoning and it therefore causes significant difficulties for students who still reason concretely. The aim of the present study was to investigate the developmental trajectory of the students' ability to solve simple algebraic equations. 311 participants between the ages of 13 and 17 were given a computerized test of equation rearrangement. Equations consisted of an unknown and two other elements (numbers or letters), and the operations of multiplication/division. The obtained results showed that younger participants are less accurate and slower in solving equations with letters (symbols) than those with numbers. This difference disappeared for older participants (16-17 years), suggesting that they had reached an abstract reasoning level, at least for this simple task. A corresponding conclusion arises from the analysis of their strategies which suggests that younger participants mostly used concrete strategies such as inserting numbers, while older participants typically used more abstract, rule-based strategies. These results indicate that the development of algebraic thinking is a process which unfolds over a long period of time. In agreement with previous research, we can conclude that, on average, children at the age of 15-16 transition from using concrete to abstract strategies while solving the algebra problems addressed within the present study. A better understanding of the timing and speed of students' transition from concrete arithmetic reasoning to abstract algebraic reasoning might help in designing better curricula and teaching materials that would ease that transition.

Prediction, cognition and the brain.

The term "predictive brain" depicts one of the most relevant concepts in cognitive neuroscience which emphasizes the importance of "looking into the future", namely prediction, preparation, anticipation, prospection or expectations in various cognitive domains. Analogously, it has been suggested that predictive processing represents one of the fundamental principles of neural computations and that errors of prediction may be crucial for driving neural and cognitive processes as well as behavior. This review discusses research areas which have recognized the importance of prediction and introduces the relevant terminology and leading theories in the field in an attempt to abstract some generative mechanisms of predictive processing. Furthermore, we discuss the process of testing the validity of postulated expectations by matching these to the realized events and compare the subsequent processing of events which confirm to those which violate the initial predictions. We conclude by suggesting that, although a lot is known about this type of processing, there are still many open issues which need to be resolved before a unified theory of predictive processing can be postulated with regard to both cognitive and neural functioning.

Differences in processing violations of sequential and feature regularities as revealed by visual event-related brain potentials.

Identifying novel or unexpected events which violate predictions based on the regularities extracted from our environment is crucially important for adaptive behavior. However, the exact dynamics of processing such events is not well understood. Furthermore, it is not known in which degree the process of deviant detection differs across contexts and how much it depends on the characteristics of deviant events. This issue was addressed by the present study which used event-related potentials (ERPs) in order to investigate the dynamics of identifying two types of deviants presented within the same visual setting. These events violated expectations based on two different types of information contained within each trial, either temporal order of stimulus presentation (sequential deviant) or physical attributes shared by the majority of individual stimuli (feature deviant). The obtained results indicate a certain degree of similarity in detecting two deviant types which, when task-relevant, both elicited N2 and P3b event-related potential components. However, significant differences across different stages of their processing were also identified. First, only feature, but not sequential deviants elicited an N1 enhancement. Furthermore, N2 and P3b responses elicited by sequential and feature deviants differed in their latency and topography and, in case of P3b, amplitude. Taken together, these results suggest that the dynamics of detecting different types of deviants strongly depends on the specific characteristics of such events. Furthermore, the identified differences in the topography of N2 and P3b indicate distinct mechanisms underlying several stages of their processing.

Violation of expectation: neural correlates reflect bases of prediction.

Setting perceptual expectations can be based on different sources of information that determine which functional networks will be involved in implementing preparatory top-down influences and dealing with situations in which expectations are violated. The goal of the present study was to investigate and directly compare brain activations triggered by violating expectations within two different task contexts. In the serial prediction task, participants monitored ordered perceptual sequences for predefined sequential deviants. In contrast, the target detection task entailed a presentation of stimuli which had to be monitored for predefined nonsequential deviants. Detection of sequential deviants triggered an increase of activity in premotor and cerebellar components of the "standard" sequencing network and activations in additional frontal areas initially not involved in sequencing. This pattern of activity reflects the detection of a mismatch between the expected and presented stimuli, updating of the underlying sequence representation (i.e., forward model), and elaboration of the violation. In contrast, target detection elicited activations in posterior temporal and parietal areas, reflecting an increase in perceptual processing evoked by the nonsequential deviant. The obtained results suggest that distinct functional networks involved in detecting deviants in different contexts reflect the origin and the nature of expectations being violated.