Why do people believe health misinformation and who is at risk? A systematic review of individual differences in susceptibility to health misinformation

RATIONALE

Health misinformation poses a significant threat to public health. Understanding why people believe health misinformation and who is at risk is crucial for developing effective interventions to reduce the harmful impact of misinformation.

APPROACH

We conducted a systematic review of published empirical research that examined individual differences in susceptibility to health misinformation, focusing on the psychological, demographic, and behavioral correlates of health misinformation susceptibility. To guide our review on psychological correlates, we developed an integrative psychological model of susceptibility to health misinformation based on one's ability and motivation to reason.

RESULTS

We identified 47 publications (61 empirical studies) that met our criteria. Our review suggests that subject knowledge, literacy and numeracy, analytical thinking (vs. intuitive thinking), and trust in science confer strong resistance to health misinformation, whereas conspiracy thinking, religiosity, conservative ideology, and conservative party identification are associated with more susceptibility to health misinformation. Demographically, older age and higher educational attainment predict less susceptibility to health misinformation, whereas racial minority status is associated with greater susceptibility. Behaviorally, relying on health professionals or scientists as information sources predicts less susceptibility to health misinformation, whereas social media use is associated with greater susceptibility.

CONCLUSIONS

Susceptibility to health misinformation is driven by multiple psychological processes. Interventions for reducing the spread and impact of health misinformation should be tailored to the psychological mechanism underlying susceptibility to health misinformation. Limited resources should be used to support interventions targeted at individuals at risk.

Do weak readers in rural India automatically read same language subtitles on Bollywood films? An eye gaze analysis

Same Language Subtitling (SLS) of audio-visual content on mainstream TV entertainment to improve mass reading literacy was first conceived and piloted in India. SLS is now being scaled up nationally to ensure that the reading skills of one billion TV viewers, including 600 million weak readers, remain on a lifelong pathway to practice, progress, and proficiency. Will weak readers ignore or try to read along with SLS? Our eye-tracking study investigates this question with 136 weak readers drawn from a remote village in Rajasthan state by showing them popular Hindi film clips of dialog and songs, with and without SLS. We developed an interactive web-based visual analytics tool for exploring eye-tracking data. Based on an analysis of fixations, saccades, and time spent in the subtitle and non-subtitle areas, our main finding is that 70 percent of weak readers engaged in unprompted reading while watching film clips with SLS. We observed that saccadic eye movement is a good indicator to quantify the amount of reading with SLS, and saccadic regression can further differentiate weak readers. Eye-tracking studies of weak readers watching subtitles are rare, and ours may be the first with subjects from rural India.

Home language and literacy environment and its relationship to socioeconomic status and white matter structure in infancy

The home language and literacy environment (HLLE) in infancy has been associated with subsequent pre-literacy skill development and HLLE at preschool-age has been shown to correlate with white matter organization in tracts that subserve pre-reading and reading skills. Furthermore, childhood socioeconomic status (SES) has been linked with both HLLE and white matter organization. It is important to understand whether the relationships between environmental factors such as HLLE and SES and white matter organization can be detected as early as infancy, as this period is characterized by rapid brain development that may make white matter pathways particularly susceptible to these early experiences. Here, we hypothesized that HLLE (1) relates to white matter organization in pre-reading and reading-related tracts in infants, and (2) mediates a link between SES and white matter organization. To test these hypotheses, infants (mean age: 8.6 ± 2.3 months, N = 38) underwent diffusion-weighted imaging MRI during natural sleep. Image processing was performed with an infant-specific pipeline and fractional anisotropy (FA) was estimated from the arcuate fasciculus (AF) and superior longitudinal fasciculus (SLF) bilaterally using the baby automated fiber quantification method. HLLE was measured with the Reading subscale of the StimQ (StimQ-Reading) and SES was measured with years of maternal education. Self-reported maternal reading ability was also quantified and applied to our statistical models as a proxy for confounding genetic effects. StimQ-Reading positively correlated with FA in left AF and to maternal education, but did not mediate the relationship between them. Taken together, these findings underscore the importance of considering HLLE from the start of life and may inform novel prevention and intervention strategies to support developing infants during a period of heightened brain plasticity.

Enhanced numeracy skills following team-based learning in United States pharmacy students: a longitudinal cohort study

PURPOSE

The literature suggests that the ability to numerate cannot be fully understood without accounting for the social context in which mathematical activity is represented. Team-based learning (TBL) is an andragogical approach with theoretical links to sociocultural and community-of-practice learning. This study aimed to quantitatively explore the impact of TBL instruction on numeracy development in 2 cohorts of pharmacy students and identify the impact of TBL instruction on numeracy development from a social perspective for healthcare education.

METHODS

Two cohorts of students were administered the Health Science Reasoning Test-Numeracy (HSRT-N) before beginning pharmacy school. Two years after using TBL as the primary method of instruction, both comprehensive and domain data from the HSRT-N were analyzed.

RESULTS

In total, 163 pharmacy student scores met the inclusion criteria. The students’ numeracy skills measured by HSRT-N improved after 2 years of TBL instruction.

CONCLUSION

Numeracy was the most significantly improved HSRT-N domain in pharmacy students following two years of TBL instruction. Although a closer examination of numeracy development in TBL is warranted, initial data suggest that TBL instruction may be an adequate proxy for advancing numeracy in a cohort of pharmacy students. TBL may encourage a social practice of mathematics to improve pharmacy students’ ability to numerate critically.

Supporting Young Readers: A Mixed-Methods Study of Their Literacy, Behaviour, and Perceptions When Reading Aloud to Dogs or Adults

Animal-assisted interventions (AAI) have been found to benefit human emotional state and cognitive performance. Recent applications of AAI have extended to classrooms with a range of intentions including to improve literacy. This Canadian study sought to examine differences in reading performance and behaviour in early readers identified as requiring extra supports following exposure to a canine-assisted and adult-assisted reading support. Twenty-four 7- to 8-year-olds experienced both supports in random order. At the start of the study and after completion of either support learners' oral reading, reading comprehension, social functioning, and reading affect were assessed. Parents, teachers, and children were also asked a range of closed- and open-ended questions. Findings showed evidence of improvement in reading performance, particularly after reading to a dog. There was also evidence of improved social competence overall and decreased problematic behaviour, although this was dependent on order of exposure. Teacher and parent reports showed they believed both supports to improve learner skills and affect for reading, and that teachers made more distinctions here. Implications for the practical application and relevance of methodological detail for future work are discussed.

Predictors of Literacy and Attitudes Toward Reading Among Syrian Refugee Children in Jordan

Refugee children often face disruptions to their education before and during displacement. However, little is known about either levels or predictors of refugee children's literacy or about their attitudes toward reading in low- or middle-income countries. To address this, we conducted in-home literacy assessments using the Holistic Assessment of Learning and Development Outcomes with 322 Syrian refugee mother-child dyads who lived in Jordan (child age range 4-8 years, M = 6.32 years, 50% female). Overall, the children had quite low levels of literacy, although they indicated a strong enthusiasm for reading. Child age, maternal education, and maternal ability to read all predicted child literacy, although maternal literacy predicted it only among children enrolled in school. Among those enrolled in school (64.9% of the total sample, 88.7% of those aged ≥ 6), students attending hybrid classes had better literacy than those attending either solely in-person or solely online, although the frequency of school attendance did not predict literacy. A less consistent pattern emerged for predicting children's attitudes toward reading. Our results suggest an urgent need to improve literacy skills among refugee children in Jordan, as well as a need for validated measures of attitudes toward reading for use with Arabic-speaking youth.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13158-022-00334-x.

Associations between executive function and early math and literacy skills in preschool children

The current study directly compared the magnitude of associations between executive function (EF) and math versus literacy and investigated whether they differed by age within the preschool years. Participants were 92 typically developing, preschool children in the United States (M _age=58.53 months; 47.8% Female; 58.7% White; 29.3% Non-White). Children completed a developmentally sensitive battery of direct EF assessments, math and literacy achievement tests, and IQ tests. Results showed an EF Composite was associated with math, but not literacy, after controlling for age, verbal and nonverbal IQ, and socioeconomic status. Extending prior work to a younger age, we examined whether the association between EF and academic achievement was moderated by age but found no significant interactions. These findings support the link between EF and math before kindergarten and indicate a similar magnitude of associations in younger and older preschoolers.

"It's about sharing a moment": Parents' views and experiences of home reading with their autistic children with moderate-to-severe intellectual disabilities

BACKGROUND

The home literacy environment plays a critical role in the development of children's literacy and language development. Little is known, however, about the home literacy environment of autistic children, especially those with moderate-to-severe intellectual disabilities.

AIMS

The current study used a sequential mixed-methods design to understand how parents attempt to engage their autistic children in reading activities and support them in learning to read.

METHODS AND PROCEDURE

First, 63 parents (53 mothers) whose autistic children attended an autism-specific special school completed a bespoke questionnaire about the home literacy environments for their children (n = 69, age range = 3-11 years, 61 boys, 8 girls). Second, a subsample of parents (n = 19, 15 mothers) participated in focus groups to understand in-depth their views and experiences of home reading with their children (n = 20, age range = 3-11 years, 19 boys, 1 girl). We used reflexive thematic analysis to analyse the focus group data.

OUTCOMES AND RESULTS

Across questionnaire and focus group methods, parents were united in considering reading to be an important life skill, a sentiment that was reflected both by their often literacy-rich homes and the ingenuity in their efforts to engage their children in shared home-reading activities - even when such engagement could be challenging. They also emphasised, however, the importance of valuing these activities as an opportunity to "catch a moment" with their child.

CONCLUSIONS AND IMPLICATIONS

Parents and teachers should work together to identify ways to enhance autistic children's engagement in shared home-reading activities, listening to and learning from each other's experiences and expertise, and to show what is possible within each learning context.

Social Insurance Literacy of Dutch Workers Receiving Disability Benefits and its Associations with Socio-Economic Characteristics

Purpose This study explores the concept social insurance literacy (SIL) and corresponding questionnaire (SILQ) among workers receiving disability benefits and the comprehensibility of the social security institute (SSI), and examines associations with socio-economic characteristics. Methods 1753 panel members of the Dutch SSI were approached to complete the SILQ-NL37. This measure was based on the original SILQ. The SILQ-NL37 contains domains for obtaining, understanding and acting upon information for both individual SIL and system comprehensibility. A higher score means better SIL or comprehensibility. Data on age, gender, education, living situation, Dutch skills and time receiving disability benefits were also collected. With k-means clustering, groups with adequate and limited SIL were created. Associations with socio-economic characteristics were examined with independent t-tests and linear regression analyses for both the total scores and within domain scores. Cronbach α and Spearman rho's indicated measurement properties were good to acceptable for the SILQ-NL37. Results Thirty-five percent of the 567 participants were in the group with limited SIL. Higher individual SILQ-NL37 scores were associated with having a partner (p = 0.018) and northeastern living region (p = 0.031). Higher scores for obtaining (p = 0.041) and understanding (p = 0.049) information were associated with female sex, and for acting on information with younger age (p = 0.020). People with limited Dutch skills (p = 0.063) and a partner (p = 0.085) rated system comprehensibility higher. Conclusions According to the SILQ-NL37 scores, about 35% of the panel members have limited ability to obtain, understand and act upon social insurance systems information. Limited SIL is associated with several socio-economic factors. Future researches should study the concept in a more representative sample, and in different countries and social insurance contexts.

Speech, language, and literacy outcomes for children with mild to moderate hearing loss: A systematic review

PURPOSE

To systematically review the current literature to describe the speech, language, and literacy skills of children with mild to moderate hearing loss (MMHL).

METHOD

Systematic searching of seven online databases identified 13 eligible studies examining speech, language, and literacy outcomes for children with MMHL. Studies were rated for quality. Findings were reported via narrative synthesis.

RESULTS

Many studies reported no significant differences between children with MMHL and hearing peers on speech, language, and literacy measures. Studies that did report significant differences reported that children with MMHL performed significantly more poorly than hearing peers in speech production, receptive morphology, following directions, recalling sentences, expressive morphology, and word and non-word reading.

CONCLUSIONS

Due to the heterogeneity in participant characteristics, moderating factors reported, and measures used, clear patterns in the outcomes were difficult to find. Further research into speech, language and literacy outcomes for children with MMHL from early childhood to adolescence (longitudinal studies) are required to describe possible trajectories for children with MMHL including how moderating factors (such as age of hearing aid fitting, duration of use, and access to early intervention) may be contributing to these trajectories.

Interventions for Increasing Digital Equity and Access (IDEA) among rural patients who smoke: Study protocol for a pragmatic randomized pilot trial

BACKGROUND

Cigarette smoking prevalence is higher among rural compared with urban adults, yet access to cessation programming is reduced. The Increasing Digital Equity and Access (IDEA) study aims to evaluate three digital access and literacy interventions for promoting engagement with an online evidence-based smoking cessation treatment (EBCT) program among rural adults.

METHODS

The pilot trial will use a pragmatic, three-arm, randomized, parallel-group design with participants recruited from a Midwest community-based health system in Minnesota, Wisconsin, and Iowa. All participants will receive an online, 12-week, EBCT program, and written materials on digital access resources. Participants will be stratified based on state of residence and randomly assigned with 1:1:1 allocation to one of three study groups: (1) Control Condition-no additional study intervention (n = 30); (2) Loaner Digital Device-Bluetooth enabled iPad with data plan coverage loaned for the study duration (n = 30); (3) Loaner Digital Device + Coaching Support-loaner device plus up to six, 15-20 min motivational interviewing-based coaching calls to enhance participants' digital access and literacy (n = 30). All participants will complete study assessments at baseline and 4- and 12-weeks post-randomization. Outcomes are cessation program and trial engagement, biochemically confirmed smoking abstinence, and patient experience.

RESULTS

A rural community advisory committee was formed that fostered co-design of the study protocol for relevance to rural populations, including the trial design and interventions.

CONCLUSION

Study findings, processes, and resources may have relevance to other health systems aiming to foster digital inclusion in smoking cessation and chronic disease management programs and clinical trials in rural communities.

Behavioral and neurobiological evidence for the effects of reading interventions on autistic children: A systematic review

This study systematically reviewed the literature on reading interventions for autistic children. Peer-reviewed articles that reported behavioral and/or neurobiological effects of reading intervention were identified in five online databases. After screening, 15 studies met the inclusion criteria for this review. These studies focus on interventions targeted towards improving specific reading skills: comprehension, vocabulary, fluency, and phonological awareness. Studied interventions included interactive and shared reading, visualization strategies, vocabulary and main idea instruction, video modeling, and interventions supported by tablet-based technology. Overall, the studies identified in this review reported improvements to each of the targeted reading skills and changes to neural activation and connectivity. In addition, changes at the brain level were associated with improvements in reading. Specifically, frontal, temporal, and occipital regions associated with visual and language processing showed increased activation and functional connectivity following intervention. This review provides important insights into the landscape of reading intervention studies in autism and into the neurobiological underpinnings of reading skills and how interventions affect those processes.

Breast Cancer Awareness Based on Health Information Literacy and Influential Factors among Female Nursing Students in China

This investigation aimed to study breast cancer awareness based on health information literacy and influential factors of breast cancer awareness among female nursing students in Changchun city in China. A four-part self-report questionnaire including the participants' general demographic characteristics, the participants' specialized characteristics concerning breast cancer screening, the Chinese version of the Breast Cancer Awareness Measurement (C-BCAM), and the Chinese version of the Health Information Literacy Self-rating Scale (HILSS) was designed to investigate breast cancer awareness and health information literacy and influential factors of breast cancer awareness among 205 female nursing students in Year 1-Year 3 using convenience sampling. The data were analyzed with SPSS 26.0 using descriptive statistics, nonparametric tests, and multiple regression analysis. The nursing students had an average level of HIL (median = 101.00, (93.00, 107.00)) and a good level of breast cancer awareness (median = 82.00, (76.00, 88.00)). A significant positive correlation was found between the HILSS and total C-BCAM score (r = 0.439, P < 0.01). Multivariate logistic regression analysis demonstrated that grades (P < 0.001), training in BSE (P = 0.025), and intention of undergoing breast cancer screening (P = 0.028) were three predictive factors for breast cancer awareness among female nursing students. The female nursing students' HIL was at an average level, and breast cancer awareness was at a good level. Health information literacy and breast cancer awareness among female nursing students in Changchun were significantly positively correlation, as demonstrated by this survey. Therefore, nursing education has the responsibility to improve female nursing students' awareness of breast cancer at different grades and to cultivate health information literacy. More training in BSE is needed. Greater efforts may be needed to develop targeted nursing education to strengthen female nursing students' awareness of breast cancer and HIL.

[Influence of Learning Presence of Non-Face-to-Face Class Experience in Nursing Students on Academic Achievement: Mediating Effect of Learning Flow and Moderated Mediation of Digital Literacy]

PURPOSE

This study aimed to identify the mediating effect of learning flow and the moderated mediation effect of digital literacy on the effect of the learning presence of non-face-to-face class experience in nursing students on academic achievement.

METHODS

Participants were 272 nursing students from six universities in two different cities. A self-report questionnaire was used to measure learning presence, learning flow, digital literacy, and academic achievement. Analysis was performed using SPSS 26.0 and SPSS PROCESS Macro (4.0).

RESULTS

The mediating effect of learning flow on the effect of learning presence on academic achievement was 0.42, and the moderated mediation index of digital literacy was 0.17. Learning flow showed a mediating effect on the relationship between learning presence and academic achievement. Digital literacy had a moderated mediation effect on the relationship between learning presence and academic achievement that was mediated by learning flow.

CONCLUSION

The intensity of the mediating effect of nursing students' learning presence on academic achievement through learning flow increases as the level of digital literacy increases. These results suggest that educational programs considering the level of learning presence, learning flow, and digital literacy are required to promote the academic achievement of nursing college students.

A trial of online ABRACADABRA literacy instruction with supplementary parent-led shared book reading for children with autism

BACKGROUND/AIMS

The COVID-19 pandemic has highlighted the need for accessible support for children with developmental disabilities. This study explored online literacy instruction with supplementary parent-led shared book reading (SBR) for children with autism.

METHODS

Twenty-one children with autism (5-12 years) completed a battery of assessments (T1) before being assigned to ability matched Instruction (n = 10) and Control groups (n = 11). Instruction group participants completed 16 h of ABRACADABRA instruction working with a researcher 1:1 online and SBR activities at home with a parent over 8 weeks. All participants were reassessed after the instruction period (T2) and parents of children in the Instruction group were interviewed regarding their views and experiences.

RESULTS

Quantitative analyses showed no significant improvements in reading for Instruction group children relative to Control group children. However, each child successfully participated in 16 online instruction sessions and qualitative data revealed that parents were generally positive about the program, with some observing improvements in their child's literacy skills and reading confidence.

CONCLUSIONS AND IMPLICATIONS

While it appears children with autism can participate in online literacy instruction, sixteen hours of online ABRACADABRA instruction with parent-led SBR may not be effective in improving their reading skills. Further research is required to explore whether more intensive and/or extended online instruction may be feasible and effective, and to improve uptake of parent-led book reading activities at home.

Factors affecting family planning literacy among women of childbearing age in the rural Lake zone, Tanzania

BACKGROUND

Low uptake of various recommended modern family planning methods is associated with inadequate family planning literacy among potential beneficiaries of the methods. As such, understanding factors affecting family planning literacy is key to addressing this problem. This study, therefore, explored factors affecting family planning literacy among women of childbearing age in the rural Lake Zone of Tanzania.

METHODS

The study utilized an exploratory descriptive qualitative research approach using focus group discussions to collect data. A total of eight focus group discussion sessions were held to solicit information from childbearing age women involved in the study. Thematic analysis was used to analyze the data collected from the study participants.

RESULTS

Several factors were found to negatively affect the family planning literacy of women of childbearing age in the communities under review. These factors were low levels of education, religious affiliation, and low family income. Other factors that were also found to negatively affect women's family planning literacy include fertility preference, negative perceptions of family planning, preference of unproven family planning methods, limited access to reliable sources of family planning information, household responsibilities, and poor male partner support on family planning matters.

CONCLUSION

This study has identified a multitude of factors affecting the family planning literacy of women of childbearing age. These factors can limit the women's capacity to make informed decisions on the utilization of modern family planning methods. Thus, addressing these factors is pivotal in increasing the women's overall uptake of various recommended family planning methods and enhancing their reproductive health outcomes.

Characterizing the knowledge of educators across the tiers of instructional support

Translating the research base on effective reading instruction to the classroom has been a challenge. The delivery of these instructional methods requires practical skills coupled with an understanding of the aspects of language being taught. The purpose of this study was to explore the level of literacy knowledge of the English language held by educators who provide instruction to students in the primary grades. Data from 1369 classroom teachers, 74 reading interventionists, and 131 special educators comprising the analytic sample were collected as part of a training initiative in a US state. Participating educators completed a 50-item test of phonological sensitivity, phonemic awareness, decoding, encoding, and morphology. Multiple regression analyses confirmed differences in the levels of knowledge observed between the groups of educators. Reading interventionists demonstrated greater knowledge than classroom teachers and special educators in the total proportion of correct responses and across each domain. Classroom teachers demonstrated greater knowledge than special educators in phonological sensitivity and decoding but did not differ from each other in phonemic awareness, encoding, or morphology knowledge. Special educators provide intervention to students with the most severe forms of reading disabilities, yet they had the lowest level of knowledge. In contrast, reading interventionists, who provide intervention within general education, had the highest levels of knowledge. These findings suggest a need to elevate the knowledge of special educators and consider reading interventionists' role in supporting students identified with a specific learning disability in reading.

Literacy improves the comprehension of object relatives

While there is a considerable body of research indicating that the acquisition of literacy has profound effects on many aspects of language and cognition, to our knowledge, very little is known about its effects on morphosyntax. In this paper, we explore the effects of literacy on the comprehension of Spanish object relative clauses, a structure which is typically acquired by literate children about the age of 10, i.e., after a considerable amount of exposure to written language. We tested three groups of native Spanish speakers (semi-literates, late-literates and high-literates) using a picture selection task. Subject relatives were used as a control condition. All three groups performed at ceiling on subject relatives (group means of 95% or above). In contrast, we observed very large differences in performance on object relatives, with the semi-literate group performing at chance (51% correct) and the late-literate group slightly above chance (65% correct). Performance in the high-literate group was much better, although not quite at ceiling (82% correct). The results appear to support the hypothesis that literacy helps in the acquisition of some aspects of grammar. This could be partly due to differences in IQ, metalinguistic awareness, working memory and/or executive functioning. The results are also consistent with the 'training wheels' hypothesis (Dąbrowska, 2020), according to which the availability of written representations facilitates the acquisition of difficult structures by easing memory load and enabling speakers to process sentences at their own pace.

Feasibility study of an intervention program to enhance self-confidence of kindergarten teachers who deal with radiation-related health concerns from parents with young children

Background

Following the Fukushima Daiichi Nuclear Power Station accident in March 2011, radiation anxiety was high among residents in affected areas. Enhancing radiation-related health literacy is effective in reducing radiation anxiety. This feasibility study aimed to examine a novel intervention program to enhance the self-confidence of kindergarten teachers who deal with radiation-related health concerns from parents in order to determine the feasibility of conducting a future randomized controlled trial.

Methods

Teachers and administrative staff of two private kindergartens in Fukushima City and members of Media Doctor Japan (a research group for enhancing the quality of health news reporting in Japan) were recruited for study participation. Participants were randomly assigned to intervention and control groups. The intervention group participated in the intervention program, comprised of lectures, group discussions, and presentations. The control group received the same written materials used in the intervention program. The primary outcome of this study was feasibility, assessed via four questions concerning program acceptability and described without quantitative analysis. Secondary outcomes were self-confidence concerning parent consultation (1 question, 4-point Likert scale), radiation-related health knowledge (5 question quiz, 1 point for each correct answer, score: 0–5), and health literacy (assessment developed by Ishilawa, et al., score: 1–5) assessed numerically before and after the intervention. Means and standard deviations of outcomes before and after the intervention and their changes in both groups were reported with groups of participants (kindergartens and the Media Doctor Research Japan) reported separately. No quantitative analyses were performed for secondary outcomes.

Results

Five and six kindergarten workers and seven and seven Media Doctor Japan members participated in the intervention and control groups, respectively. Reported acceptability was generally positive, and only one participant gave a negative response regarding program usefulness. Improved self-confidence was found in kindergarten employee participants. Radiation-related health knowledge was higher after the intervention in both kindergarten teachers and Media Doctor Japan members. The amount of change was higher in the intervention group than in the control group.

Conclusions

The intervention program enhanced self-confidence in kindergarten employees. The feasibility of the intervention program for a larger randomized controlled trial was ascertained. Time to conduct lectures and group discussions should be increased to further enhance health literacy.

Trial registrations

UMIN000042527 [University Hospital Medical Information Network (UMIN) Center] registered on November 25, 2020.

Tailoring nutrition and cancer education materials for breast cancer patients

OBJECTIVE

Many breast cancer patients are vulnerable to poor nutritional status and may benefit from nutrition education, but existing materials are not generally tailored to the needs of low-literacy immigrant and minority patients.

METHODS

With nutritionist guidance, we developed a nutrition presentation for breast cancer patients. English- (n = 29) and Spanish-speaking (n = 19) patients were recruited from 5 safety-net hospitals, an academic cancer center, and a Latina cancer support organization. Materials were tested using multiple rounds of cognitive interviewing (with an adapted USDA interview guide), followed by study team reviews and modifications, until saturation.

RESULTS

Seven rounds of interviews per language were needed. Approximately 25% of interviewees had less than a high school education. Changes included adapting to regional lexicons and resolving vague/confusing phrasing. Specific food examples needed cultural tailoring. Text color coding (red/bad, green/good) was requested. Labeled images enhanced participants' understanding of concepts. Spanish speakers expressed a desire to understand nutrition labeling, and this was emphasized in the Spanish slides.

CONCLUSION

Cognitive interviews were an important tool for creating a nutrition curriculum tailored to the needs of low-literacy, mostly immigrant patients.

PRACTICE IMPLICATIONS

Cultural and linguistic factors should be considered for nutritional education materials in diverse patient populations.

Sharing research results with Latina breast cancer survivors who participated in a community-engaged behavioral RCT study: a descriptive cross-sectional survey study

BACKGROUND

An often heard and justifiable concern of ethnic minorities is related to researchers' lack of attention to sharing the results of a study with participants after the study has concluded. Few studies have examined the effects of returning overall study results on participants' attitudes, especially among populations underrepresented in research. Among Latina research participants, providing a summary of study results could enhance participation in research. We assess Latina breast cancer survivors' reactions to receiving study results and their attitudes about participating in future studies.

METHODS

For this cross-sectional survey study, all women who had participated in two behavioral randomized controlled trials (RCTs) were mailed a letter summarizing the study results (using written and graphic formats) and a questionnaire assessing problems and understanding the results, importance of sharing results, willingness to participate in future studies, and format preferences for receiving the results. A postage-paid envelope for returning the completed questionnaire was included. Logistic regression examined the associations of age, education, and rural/urban residence on format preferences and willingness to participate. The survey sample consisted of 304 low-income, predominantly Spanish-speaking Latina breast cancer survivors (151 from urban and 153 from rural communities) who had participated in two RCTs testing a stress management program designed for Latina breast cancer survivors.

RESULTS

Ninety-two women returned the questionnaires (30.3%). Most of the women (91.1%) indicated that they had no trouble understanding the results of the study, and 97% agreed that it is very/extremely important for researchers to share the study result with the participants. The majority (60.2%) reported that receiving the results increased their willingness to participate in future studies. About half (51.7%) did not have a format preference, 37.4% preferred written summaries, and 10.9% preferred graphs.

CONCLUSIONS

This study is an important first step to understanding the impact of returning study results among a population that is underrepresented in research. Returning the results of studies and understanding the impact of doing so is consistent with maintaining community involvement in all phases of research. The findings suggest that sharing aggregate research results in simple language yields few problems in participants' understanding of the results and is viewed as important by participants.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02931552 Date registered: October 13, 2016 and NCT01383174 Date registered: June 28, 2011.

Clusters of Dementia Literacy: Implications from a Survey of Older Adults

Clinicians and scientists suggest that up to 40% of dementia cases are potentially preventable. Data on awareness of dementia risk and protective factor among older adults can inform and facilitate designing educational interventions to prevent dementia. We aimed to quantify awareness of dementia risk and protective factors using a telephone survey. The modified Lifestyle for Brain Health scale was used to assess dementia risk and prevention knowledge. A representative sample of 1,005 older adults, mean age 64.02 (standard deviation + 1.4; range: 50-74 years) completed the survey (77% response rate). Under representation of non-European ethnicities was noted. Participants Respondents were all New Zealanders, more women (n=518, 51.5%), mostly European (n=921, 91.6%) and well educated (n=347, 34.5%, university or post-graduate degree). Only 6/14 modifiable risk or protective factors for dementia were adequately identified. Three clusters of dementia literacy were identified: psychosocial, medical and activities. These findings support personalizing dementia prevention efforts via targeted educational packages.

Acquired dyslexias following temporal lesions

The acquisition of reading by children is supported by deep changes in the brain systems devoted to vision and language. The left temporal lobe contributes critically to both systems, and lesions affecting it may therefore cause both peripheral vision-related and central language-related reading impairments. The diversity of peripheral dyslexias reflects the anatomical and functional division of the visual cortex into early visual regions, whose lesions have a limited impact on reading; ventral regions, whose lesions are mostly associated to Pure Alexia; and dorsal regions, whose lesions may yield spatial, neglect-related, and attentional dyslexias. Similarly, central alexias reflect the broad distinction, within language processes, between phonological and lexico-semantic components. Phonological and surface dyslexias roughly result from impairment of the former and the latter processes, respectively, while deep dyslexia may be seen as the association of both. In this chapter, we review such types of acquired dyslexias, their clinical features, pathophysiology, and anatomical correlates.

The effects of language preference and home resources on foundational literacy retention during school holiday closures in Ghana: Lessons from the Complementary Basic Education Programme

This article assesses the extent to which children’s language preference and their home environment matter for literacy retention. Using data from the Complementary Basic Education (CBE) program in Ghana, the authors found that large numbers of disadvantaged students reverted to not even being able to read a single word following school closures over a four-month holiday period. Widening literacy gaps were found for girls who reported they did not receive instruction in a language that they understood or did not have the resources, support, or activities at home to enable them to continue to learn while schools were closed. For boys, widening literacy gaps were only influenced by resources, support, or activities at home, but not by language preferences. The article findings suggest that schools and teachers must pay closer attention to language preference, particularly for girls, in order to ensure that language of instruction is not a barrier to literacy retention. The article also provides further evidence to support the growing claims that home supports are essential for reducing inequities in learning outcomes during school closures.

Heterogeneous Impacts of Interventions Aiming to Delay Girls' Marriage and Pregnancy Across Girls' Backgrounds and Social Contexts

PURPOSE

Despite many programs aiming to delay girls' marriage and pregnancy over the last 2 decades, there is no consensus yet concerning the effectiveness of different approaches and the contexts in which they are implemented. We focus on different social contexts within Bangladesh and Zambia and investigate how literacy, poverty, and community characteristics impact the effectiveness of interventions.

METHODS

We utilize data sets from two randomized controlled trials conducted by the Population Council in Bangladesh and Zambia. Within each respective country, we estimate the impacts of the interventions on marriage and pregnancy among adolescent girls using the analysis of covariance estimator by different social contexts based on community-level variables.

RESULTS

In Bangladesh, providing academic skill training had a significant impact on discouraging child marriage in the villages where girls' paid-work participation rate was relatively high, whereas in low paid-work participation villages, providing gender-awareness skill training had an impact. In Zambia, providing empowerment intervention and safe spaces had a significant impact on delaying pregnancy especially for illiterate girls in the communities where premarital sex was relatively common.

CONCLUSIONS

In Bangladesh, where girls' paid-work participation is limited, premarital sex is uncommon, and marriage is subject to collective decision-making; the effectiveness of a program may depend on girls' agency and the availability of acceptable working opportunities. In Zambia where premarital sex is common, pregnancy may precede marriage, and marriage entails the nature of individual decision-making; empowering the most vulnerable girls seems to be more effective in delaying marriage/pregnancy.

Knowledge of Jordanian nurses and attitudes toward patients with suicidal attempt

Nurses' attitudes toward attempted suicide may affect the quality of care provided to those patients. There is a significant relationship between suicide literacy level and stigmatizing attitudes toward suicide. This study aimed to examine nurses' knowledge and attitudes toward patients with suicidal attempts. A cross-sectional correlational design was used to guide this study, and data were collected using an online survey. The Stigma of Suicide Scale-short form (SOSS-SF) was used to measure stigmatizing attitudes toward suicide, while the Literacy of Suicide Scale (LOSS) was used to measure suicide literacy level. The sample consisted of 343 Jordanian nurses, and their mean age was approximately 31 years old. Only 58 (16.9%) nurses reported having suicide training. Nurses had low stigmatizing attitudes toward suicidal patients. Nurses showed low suicide literacy levels. Only 46% of nurses had scores equal to or higher than the passing score of the LOSS. Linear multiple regression was used to predict nurses' level of stigma toward suicidal patients. Among the four predictors entered in this analysis, only LOSS showed a significant and negative effect. This study highlighted the importance of suicide training and education for nurses because it may improve their attitudes, self-confidence, and professional practices when providing care for patients.

Cultural adaptation and psychometric evaluation of the Yoruba version of the Health Literacy Questionnaire

Background

Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire.

Methods

A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach's alpha, intra class correlation) and association with sociodemographic variables.

Results

A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was 'Actively managing my health' and hardest was 'Ability to find good health information' and 'Navigating the healthcare system'. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach's α of ≥ 0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76.

Conclusion

The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare.

Why do early mathematics skills predict later mathematics and reading achievement? The role of executive function

A robust association between young children's early mathematical proficiency and later academic achievement is well established. Less is known about the mechanisms through which early mathematics skills may contribute to later mathematics and especially reading achievement. Using a parallel multiple mediator model, the current study investigated whether executive function (integration of working memory, inhibition, and cognitive flexibility) can explain the relations between early mathematics skills and elementary school mathematics and reading achievement. Data in this longitudinal study were collected from 243 children during the last year of early childhood education and care (kindergarten ages 5 and 6 years), 1 year later in first grade, and 5 years later when the children were in fifth grade. Background variables (maternal education, age, sex, and immigrant status), kindergarten baseline skills, and mediating effects of first-grade mathematics, phonological awareness, vocabulary, and possible omitted variables were controlled. Results showed that first-grade executive function mediated the effects of kindergarten mathematics on fifth-grade mathematics and on reading achievement. These findings suggest that executive function may work as a mechanism that may help to explain the frequently found strong association between children's early mathematics skills and later mathematics and reading achievement.

Development of the pharmacogenomics and genomics literacy framework for pharmacists

BACKGROUND

Pharmacists play a unique role in integrating genomic medicine and pharmacogenomics into the clinical practice and to translate pharmacogenomics from bench to bedside. However, the literature suggests that the knowledge gap in pharmacogenomics is a major challenge; therefore, developing pharmacists' skills and literacy to achieve this anticipated role is highly important. We aim to conceptualize a personalized literacy framework for the adoption of genomic medicine and pharmacogenomics by pharmacists in the United Arab Emirates with possible regional and global relevance.

RESULTS

A qualitative approach using focus groups was used to design and to guide the development of a pharmacogenomics literacy framework. The Health Literacy Skills framework was used as a guide to conceptualize the pharmacogenomics literacy for pharmacists. The framework included six major components with specific suggested factors to improve pharmacists' pharmacogenomics literacy. Major components include individual inputs, demand, skills, knowledge, attitude and sociocultural factors.

CONCLUSION

This framework confirms a holistic bottom-up approach toward the implementation of pharmacogenomics. Personalized medicine entails personalized efforts and frameworks. Similar framework can be created for other healthcare providers, patients and stakeholders.

Equity and inclusivity in research: co-creation of a digital platform with representatives of marginalized populations to enhance the involvement in research of people with limited literacy skills

To improve health equity, as well as equity in research, community-engaged research and participatory research needs to be inclusive. Equity in health research refers to the principle that anyone affected by research or who can benefit from its outcomes should have equal opportunities to contribute to it. Many researchers advocate the importance of promoting equity in research and engage in processes that foster the research involvement of lay persons, patients, and community members who are otherwise "absent" or "silent". Still, people with limited literacy skills who experience unwarranted structural barriers to healthcare access have little involvement in research. Low literacy is a major barrier to equity in health research. Yet there exist approaches and methods that promote the engagement in research of people with literacy challenges. Building on our previous research projects conducted with community members using participatory visual and sound methods (participatory mapping, photovoice, digital storytelling, etc.), we embarked on the co-creation of a digital platform in 2017. Our aim in this commentary is to report on this co-creation experience that was based on a social justice-oriented partnership. The development of the online platform was overseen by a steering committee made up of workers from community organizations involved with people with limited literacy skills, students, and researchers. In the development process, the co-creation steps included a literature review, informal interviews with key informants, and discussion and writing sessions about format and content. After numerous challenges raised and addressed during co-creation, the Engage digital platform for engagement in research went live in the winter of 2020. This platform presents, on an equal footing, approaches and methods from academic research as well as from the literacy education community engaged with people with limited literacy skills.

Effective investment in women's futures: Schooling with learning

Women's schooling has long been regarded as one of the best investments in development. Yet countries vary widely in the extent to which a year of schooling conveys useful skills and knowledge and hence schooling and education cannot be treated as synonyms. Using two different cross-nationally comparable data sets which contain measures of schooling, assessments of literacy, and life outcomes for more than 50 countries we show the association of women's education, defined as schooling and the acquisition of literacy, with four life outcomes (fertility, child mortality, empowerment, and financial practices) is much larger than the standard estimates of the gains from schooling alone. In our preferred instrumental variables (IV) estimates, that correct for the attenuation bias induced by measurement error, the gain from education is more than 3 times larger than the standard OLS estimates of gains from schooling alone. While our results are not causal estimates, if anything like our results are true in the causal pathways whereby schooling and learning lead to improvements in women's well-being this implies the estimates of the costs and benefits of expansions in grade attainment versus improving learning need to be adjusted accordingly.

Oral and Written Language Abilities of School-Age Internationally Adopted Children from Eastern Europe

PURPOSE

Children adopted from Eastern Europe were assessed at ages 6 to 7 years and results were compared to the same children when they were 8 years. Patterns of relative strengths and weaknesses in language, verbal memory and literacy were analyzed. Variables that predicted reading and writing were determined.

METHOD

Children adopted from Eastern Europe between 1;0 and 4;11 years of age were assessed at ages 6 to 7 years and age 8 years on a variety of tests that measured language, verbal memory and literacy. Results were compared across ages, and language, verbal memory and literacy domains.

RESULTS

Group means for all measures fell within the average range at both ages. The children's scores were not significantly different from test norms except for measures of rapid naming and number repetition. However, a larger than expected percentage of children scored -1SD below the mean on decontextualized measures of verbal working memory and reading fluency. At age 8 years 24% of children received speech language therapy services and 26% had repeated a grade level. Vocabulary, expressive syntax, verbal short-term memory and writing were areas of relative strength. Higher level vocabulary knowledge was strongly correlated with all literacy measures.

CONCLUSION

As a group, Eastern European adoptees scored average on measures of language and literacy at 6 or 7 years and again at age 8 years. However, 26% of the children had repeated a grade and 24% were still receiving speech and language services. Vocabulary was an area of strength reflecting the children's enriched adopted home environments. In-depth knowledge of vocabulary was the best predictor of reading and writing. Some aspects of working memory were a strength but others were not. Rapid naming was also a weakness.

Drawing a New Picture: Children with Developmental Dyslexia Exhibit Superior Nonverbal Creativity

BACKGROUND

Creativity and literacy are essential skills that today's children are expected to develop. However, the question of whether children with developmental dyslexia, a severe difficulty in reading and writing, exhibit any intact creativity strengths remains controversial. This study examined creativity strengths across verbal, figural, and nonverbal modalities, and the relations among creativity, nonverbal intelligence, and literacy skills, in younger and older Chinese children with and without developmental dyslexia.

METHODS

Two age groups of Chinese children with developmental dyslexia (Grade 2: N = 62; Grades 4-5: N = 62) and their age matched controls (Grade 2: N = 61; Grades 4-5: N = 61) were assessed on fluency and originality of verbal, figural, and nonverbal creativity, as well as on nonverbal intelligence, vocabulary, working memory, Chinese word reading accuracy and fluency, and word dictation.

RESULTS

Multifactorial analysis of variance demonstrated that regardless of grade level, children with developmental dyslexia exhibited higher nonverbal creativity than, and comparable figural creativity to, their typically developing peers. Moreover, the partial correlation analysis revealed creativity was not significantly correlated with nonverbal intelligence and literacy skills.

CONCLUSIONS

These findings suggest that children with dyslexia possess strengths and even advantages in nonverbal creativity and that the relationship between intelligence and/or literacy and creativity is negligible.

Story hour at a family homeless center: contribution to graduate students' preparation and confidence in preliteracy skills

PURPOSE

This study evaluated the potential benefit to graduate students' of participating in a service-learning program conducting a storybook reading program for children in a family homeless shelter.

METHOD

Ten graduate students in the second year of a two-year master's degree program in communication science and disorders participated in the storybook reading program. The graduate students engaged in reflective writing about their experiences and completed self-ratings of confidence in preliteracy skills before and after program participation. Twenty graduate students in two comparison groups (10 students in a pre-program comparison group, and 10 in a post-program comparison group) also completed questionnaires. The mixed-methods study used quantitative analyses to analyze questionnaire ratings and qualitative methods to analyze reflective writings.

RESULTS

Together, the quantitative and qualitative results indicated positive outcomes from the service-learning experience with regard to graduate students' perceived confidence in preliteracy skills and preparation for careers as speech-language pathologists. The results provide empirical data showing that service-learning experiences with at-risk populations can contribute to graduate students' clinical education and preparation as speech-language pathologists.

CONCLUSION

The results support the value of service-learning experiences in communication sciences and disorders. Clinical preparation in preliteracy development also supports the American Speech-Language-Hearing Association statement on the roles and responsibilities of speech-language pathologists in relation to reading and writing in children.

Integrated functional adult education program and its contributions for livelihoods in Ethiopia

While adult literacy programs are considered as a potentially important vehicle to improve literacy and numeracy skills, their impact on the livelihoods of the rural poor in an integrated approach is less focused. Thus, this research examined the contributions of adult literacy in the Integrated Functional Adult Education (IFAE) program for the enhancement of livelihoods. Embedded mixed method design was used where data were obtained from structured interviews conducted with 235 participants and semi-structured interviews performed with 24 respondents. The results revealed that the program had positive roles in the family life, economic issues, and social issues of the participants' livelihoods. Therefore, setting up a directive approach for better contributions of the program is imperative.

Literacy-related skills among children after left or right hemispherectomy

OBJECTIVE

Following hemispherectomy surgery, children's educational outcomes are of great importance but are understudied. The study goal was to investigate reading, language, and nonverbal cognitive skills in children obligatorily relying on a left versus right hemisphere using a cross-sectional design.

METHODS

Participants (ages 6-18) who had undergone left hemispherectomy (LH; n = 10) or right hemispherectomy (RH; n = 14) completed standardized measures of reading, language, and nonverbal cognition.

RESULTS

LH and RH groups were balanced for socioeconomic status, sex, and age. Both groups scored below the population mean across standardized measures (RH: -0.79 to -1.95 SDs; LH: -0.97 to -2.32 SDs). Compared to the LH group, the group retaining a functional left hemisphere (RH group) learned to read sooner (p = .011) despite no significant differences for surgery age, and scored higher on untimed real word and pseudoword reading measures (p < .05). Effect sizes were medium (r = 0.34-0.46) for the LH and RH comparison on measures of phonological awareness and both untimed and timed word and pseudoword reading. In examining the association between clinical variables and reading-related outcomes, younger age of post-hemispherectomy reading acquisition and shorter duration between seizure onset and hemispherectomy surgery were associated with higher standardized reading and language test scores (p < .05).

SIGNIFICANCE

Investigations of psychoeducational skills in reading, language, and nonverbal cognition among children who have undergone hemispherectomy can offer important insights into compensatory potential for left and right hemispheres as well as inform educational programming for children following medical stabilization.

Long-term written language experience affects grammaticality judgements and usage but not priming of spoken sentences

"Book language" offers a richer linguistic experience than typical conversational speech in terms of its syntactic properties. Here, we investigated the role of long-term syntactic experience on syntactic knowledge and processing. In a preregistered study with 161 adult native Dutch speakers with varying levels of literacy, we assessed the contribution of individual differences in written language experience to offline and online syntactic processes. Offline syntactic knowledge was assessed as accuracy in an auditory grammaticality judgement task in which we tested violations of four Dutch grammatical norms. Online syntactic processing was indexed by syntactic priming of the Dutch dative alternation, using a comprehension-to-production priming paradigm with auditory presentation. Controlling for the contribution of nonverbal intelligence quotient (IQ), verbal working memory, and processing speed, we observed a robust effect of literacy experience on the detection of grammatical norm violations in spoken sentences, suggesting that exposure to the syntactic complexity and diversity of written language has specific benefits for general (modality-independent) syntactic knowledge. We replicated previous results by finding robust comprehension-to-production structural priming, both with and without lexical overlap between prime and target. Although literacy experience affected the usage of syntactic alternates in our large sample, it did not modulate their priming. We conclude that amount of experience with written language increases explicit awareness of grammatical norm violations and changes the usage of (prepositional-object [PO] vs. double-object [DO]) dative spoken sentences but has no detectable effect on their implicit syntactic priming in proficient language users. These findings constrain theories about the effect of long-term experience on syntactic processing.

Prevalence and Predictors of Limited Literacy in Public Mental Health Care

Literacy is an important predictor of health care utilization and outcomes. We examine literacy among people seeking care in a state funded mental health clinic (Site 1) and a safety-net hospital clinic (Site 2). Limited literacy was defined as literacy at or below the 8th grade level. At Site 1, 53% of participants had limited reading literacy and 78% had limited aural literacy. At Site 2, 72% had limited reading and 90% had limited aural literacy. Regression analyses examined associations among limited literacy and psychiatric, neurocognitive and sociodemographic characteristics. Few associations among psychiatric and neurocognitive factors, and literacy were found. At Site 2, black and "other" race participants had higher odds for limited literacy compared to white participants suggesting that limited literacy may be an under-examined mechanism in understanding racial disparities in mental health. Work is needed to understand the relationships among literacy, mental health and mental health care.

Literacy-supporting skills in college students with specific reading comprehension deficit and developmental language disorder

Specific reading comprehension deficit (S-RCD) and developmental language disorder (DLD) are both commonly occurring developmental disorders of language. The ways in which these disorders do and do not overlap during childhood are a matter of debate (Nation & Norbury, 2005). Moreover, in both populations, the challenges faced by individuals in adulthood are understudied. Here, we combined data across cohorts of college students, and classified individuals with only S-RCD (n = 20), only DLD (n = 55), and co-occurring S-RCD and DLD (n = 13). Individuals with good language and reading skills, who matched those with S-RCD on decoding, comprised our typical language and reading group (TD; n = 20). Beyond the measures used for classification, group-level differences were identified in sentence-level reading fluency, phonological processing, verbal working memory, and rapid automatized naming. We found that skill profiles differed across groups; however, we found no evidence of weaknesses beyond the core deficit in reading comprehension observed in those with only S-RCD. In contrast, when S-RCD co-occurs with DLD, weaknesses are observed in phonological processing, as well as reading fluency and verbal working memory. These findings suggest that some adults with S-RCD have co-occurring DLD as a core weakness. These findings, as well as differences between individuals with S-RCD and DLD, are further discussed.

Read, speak, sing: Promoting early literacy in the health care setting

This statement will help health care providers assess and advise on early literacy with families in almost any practice setting. It defines emergent literacy skills, including early language learning and storytelling, and explores the benefits of reading, speaking, and singing with infants and toddlers for both children and caregivers. Book sharing at bedtime and other language-related routines positively affect family, relational, and social-emotional health. Early exposure to any language, when spoken at home, can benefit literacy learning in other languages children may encounter. Specific recommendations for clinicians counselling families on early literacy are included.

Head to head randomized trial of two decision aids for prostate cancer

Background

While many studies have tested the impact of a decision aid (DA) compared to not receiving any DA, far fewer have tested how different types of DAs affect key outcomes such as treatment choice, patient–provider communication, or decision process/satisfaction. This study tested the impact of a complex medical oriented DA compared to a more simplistic decision aid designed to encourage shared decision making in men with clinically localized prostate cancer.

Methods

1028 men at 4 VA hospitals were recruited after a scheduled prostate biopsy. Participants completed baseline measures and were randomized to receive either a simple or complex DA. Participants were men with clinically localized cancer (N = 285) by biopsy and who completed a baseline survey. Survey measures: baseline (biopsy); immediately prior to seeing the physician for biopsy results (pre- encounter); one week following the physician visit (post-encounter). Outcome measures included treatment preference and treatment received, knowledge, preference for shared decision making, decision making process, and patients’ use and satisfaction with the DA.

Results

Participants who received the simple DA had greater interest in shared decision making after reading the DA (p = 0.03), found the DA more helpful (p’s < 0.01) and were more likely to be considering watchful waiting (p = 0.03) compared to those receiving the complex DA at Time 2. While these differences were present before patients saw their urologists, there was no difference between groups in the treatment patients received.

Conclusions

The simple DA led to increased desire for shared decision making and for less aggressive treatment. However, these differences disappeared following the physician visit, which appeared to change patients’ treatment preferences.

Trial registration This trial was pre-registered prior to recruitment of participants.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-021-01505-x.

Profiling the Word Reading Abilities of School-Age Children with Neurofibromatosis Type 1

OBJECTIVE

Reading difficulties are one of the most significant challenges for children with neurofibromatosis type 1 (NF1). The aims of this study were to identify and categorize the types of reading impairments experienced by children with NF1 and to establish predictors of poor reading in this population.

METHOD

Children aged 7-12 years with NF1 (n = 60) were compared with typically developing children (n = 36). Poor word readers with NF1 were classified according to impairment type (i.e., phonological, surface, mixed), and their reading subskills were compared. A hierarchical multiple regression was conducted to identify predictors of word reading.

RESULTS

Compared to controls, children with NF1 demonstrated significantly poorer literacy abilities. Of the 49 children with NF1 classified as poor readers, 20 (41%) were classified with phonological dyslexia, 24 (49%) with mixed dyslexia, and 5 (10%) fell outside classification categories. Children with mixed dyslexia displayed the most severe reading impairments. Stronger working memory, better receptive language, and fewer inattentive behaviors predicted better word reading skills.

CONCLUSIONS

The majority of children with NF1 experience deficits in key reading skills which are essential for them to become successful readers. Weaknesses in working memory, receptive language, and attention are associated with reading difficulties in children with NF1.

Knowledge of mental health symptoms and help seeking attitude in a population-based sample in Hong Kong

Background

Mental health symptoms can be subtle, resulting in delaying treatment. A prompt identification of mental signs and symptoms is important for preventing mental disorders in the public. This study examined whether local public have adequate knowledge to identify mental health symptoms and the need to get timely professional help.

Methods

The population-based telephone surveys were conducted in 2015 and 2018. It involved a random sample of 4033 respondents aged 12–75 years. Mental health knowledge and help seeking attitude were assessed using six vignettes depicting subtle and obvious symptoms of anxiety disorders, mixed anxiety and depressive disorders, and dementia. Logistic regression models were performed to examine association between mental health knowledge and help-seeking attitude.

Results

Individuals with poor knowledge in subtle symptoms were more likely to be males (t =  − 5.0, p < .001), younger (F = 15.0, p < .001), have tertiary education (F = 15.0, p < .001), and employed (t =  − 2.1, p = .037). The knowledge scores of subtle and obvious symptoms were 1.5 and 2.3 respectively. Binary logistic regression found that poor knowledge of subtle symptoms was associated with reluctance to professional help seeking.

Conclusions

Poorly identified subtle mental health symptoms is a major barrier to early professional help in highly educated working males. Future research should explore specific interventions to increase knowledge and professional help seeking in this group.

Is the author recognition test a useful metric for native and non-native English speakers? An item response theory analysis

Studies of reading have shown the “Matthew effect” of exposure to print on reading skill: poor readers avoid reading, and ability develops more slowly compared to peers, while good readers improve more quickly through increased exposure. Yet it is difficult to determine just how much an individual reads. The Author Recognition Test (ART, Stanovich & West Reading Research Quarterly, 24(4), 402-433, 1989) and its multilingual adaptations are often used for quantifying exposure to print and have shown high validity and reliability in proficient readers in their dominant language (L1). When studying bilingualism and second language acquisition, it is ideal to have a single test which is equally reliable for all cohorts for comparison, but it is unclear whether ART is effective for speakers of English as a foreign language (L2). This study assesses the reliability of ART in English-medium university and college students with different language backgrounds. Following Moore and Gordon (Behavior Research Methods, 47(4), 1095-1109, 2015), we use item response theory (IRT) to determine how informative the test and its items are. Results showed an expected gradient in ART performance, with L1 speakers showing higher scores than L2 speakers of English, university students showing higher scores than college students, and both cohorts performing better than students in an English as a second language (ESL) university pre-admission program. IRT analyses further revealed that ART is not an informative measure for L2 speakers of English, as most L2 participants show a floor effect. Reasons for this unreliability are discussed, as are alternative measures of print exposure.

Using educational transitions to estimate learning loss due to COVID-19 school closures: The case of Complementary Basic Education in Ghana

Learning loss is expected for millions of children who have been out of school as a result of the current COVID-19 pandemic. Unfortunately, it is uncertain how much learning will be lost and how wide the gaps may be for disadvantaged children. This paper uses a unique longitudinal dataset to estimate learning loss during a three-month transition from Complementary Basic Education to government schools in Ghana. Our results show an average learning loss of 66 % of previous learning gains in foundational numeracy during this transition period. More importantly, we estimate widening gaps in learning loss according to lack of home learning support, as well as lack of home learning resources. Our results have implications for the provision of learning activities and support at home, not just during current school closures due to COVID-19, but also during transitions between academic years.

The oral and written narrative language skills of adolescent students in youth detention and the impact of language disorder

BACKGROUND

Unmet language and literacy needs are common among young people who are involved with youth justice systems. However, there is limited research regarding the functional text-level language skills of this population with regard to narrative macrostructure (story grammar) and microstructure (semantics and syntax) elements.

METHODS

In this study, we examined macrostructure and microstructure elements in the oral and written narrative texts of 24 adolescent students of a youth detention centre. The students, who were aged 14- to 17- years, were all speakers of Standard Australian English, and 11 (46%) students met criteria for language disorder (LD).

FINDINGS

When we compared the narratives according to modality of language, the students demonstrated stronger narrative language skills in the written modality compared to the oral. However, when we compared the narratives according to language ability, we found that the impact of LD on inclusion of macrostructure elements was greater in the oral modality, and for microstructure elements, was greater in the written modality. Errors in written conventions were common among both students with and without LD.

CONCLUSIONS

Our results indicate that both the modality of language as well as the presence of LD should be considered when young people are required to participate in forensic contexts including programs that address educational and rehabilitation needs. Our results indicate a need for consistent text-level language assessment to better identify and respond to functional difficulties within language and literacy. There is potential for speech-language pathology services to enhance comprehensive assessment as well as inform educational and rehabilitation programs for young people who are involved with youth justice systems.

Comorbidity and cognitive overlap between developmental dyslexia and congenital amusia in children

Developmental dyslexia and congenital amusia are two specific neurodevelopmental disorders that affect reading and music perception, respectively. Similarities at perceptual, cognitive, and anatomical levels raise the possibility that a common factor is at play in their emergence, albeit in different domains. However, little consideration has been given to what extent they can co-occur. A first adult study suggested a 30% amusia rate in dyslexia and a 25% dyslexia rate in amusia (Couvignou et al., Cognitive Neuropsychology 2019). We present newly acquired data from 38 dyslexic and 38 typically developing children. These were assessed with literacy and phonological tests, as well as with three musical tests: the Montreal Battery of Evaluation of Musical Abilities, a pitch and time change detection task, and a singing task. Overall, about 34% of the dyslexic children were musically impaired, a proportion that is significantly higher than both the estimated 1.5-4% prevalence of congenital amusia in the general population and the rate of 5% observed within the control group. They were mostly affected in the pitch dimension, both in terms of perception and production. Correlations and prediction links were found between pitch processing skills and language measures after partialing out confounding factors. These findings are discussed with regard to cognitive and neural explanatory hypotheses of a comorbidity between dyslexia and amusia.

On the Gymnastics of Memory: Stiegler, Positive Pharmacology, and Illiteracy

Here I shall write about the late Bernard Stiegler (1952-2020) and contextualize this important philosopher's work with respect to the concrete, everyday pedagogical issue of language learning. To demonstrate Stiegler's applicability to education studies, I shall address the issue of character amnesia (, tibiwangzi in Chinese, literally "pick up pen, forget the character"), a relatively recent phenomenon experienced in China and Japan, which is concerned with the loss of the ability to write and remember Chinese ideograms. I shall use tibiwangzi as a striking and heuristic example to explain the growing crisis in literacy, that is the crisis in the ability to read and write. Tibiwangzi is a Stieglerian issue of vital importance. In this light, my focus will be on language learning and literacy and I shall couch my analysis regarding this in terms of both Stiegler's thoughts on tertiary, exteriorized memory and the neuroscientist Maryanne Wolf's concern with the neurological and cognitive effects of reading. I intend to focus on the apparent rupture or disruption between traditional writing systems (alphabetic writing) and digital technologies and argue that a pharmacological understanding of technology and therefore a consideration of Stiegler's work in the light of neuroscience, memory and digital technologies, is necessary as it can spark timely and critical research into the perceived crisis of literacy. I am making the case for what I am naming a gymnastics of memory.

Disparity in Educational Attainment Partially Explains Cognitive Gender Differences in Older Rural South Africans

OBJECTIVES

Direction and magnitude of gender differences in late-life cognitive function are inextricably tied to sociocultural context. Our study evaluates education and literacy as primary drivers of gender equality in cognitive performance among middle-aged and older adults in rural South Africa.

METHOD

Data were collected on 1,938 participants aged 40-79 from Agincourt, South Africa. Cognitive function was measured via the Oxford Cognitive Screen-Plus, a tablet-based assessment with low literacy demands. Four cognitive domains were derived through confirmatory factor analysis: episodic memory, executive function, visual spatial, and language. Structural equation models tested domain-specific gender effects, incrementally controlling for demographic, education, health, and socioeconomic variables.

RESULTS

In the model adjusting only for demographic factors, men outperformed women on executive function and visual-spatial domains. Adding education and literacy to the model revealed a robust female advantage in episodic memory, and reduced the magnitude of male advantage in executive function and visual and spatial by 47% and 42%, respectively. Health and socioeconomic factors did not alter patterns of gender associations in subsequent models.

DISCUSSION

In this older South African cohort, gender inequality in cognitive performance was partially attributable to educational differences. Understanding biopsychosocial mechanisms that promote cognitive resilience in older women is critically important given the predominantly female composition of aging populations worldwide.

Tracking second language immersion across time: Evidence from a bi-directional longitudinal cross-linguistic fMRI study

Parallel cohorts of Hebrew speakers learning English in the U.S., and American-English speakers learning Hebrew in Israel were tracked over the course of two years of immersion in their L2. We utilised a functional MRI semantic judgement task with print and speech tokens, as well as a battery of linguistic and cognitive behavioural measures prior to and after immersion, to track changes in both L1 and L2 processing. fMRI activation for print tokens produced a similar network of activation in both English and Hebrew, irrespective of L1 or L2 status. Significant convergence of print and speech processing was also observed in both languages across a network of left-hemisphere regions joint for both L1 and L2. Despite significant increases in behavioural measures of L2 proficiency, only a few signs of longitudinal change in L2 brain activation were found. In contrast, L1 showed widespread differences in processing across time, suggesting that the neurobiological footprint of reading is dynamic and plastic even in adults, with L2 immersion impacting L1 processing. Print/speech convergence showed little longitudinal change, suggesting that it is a stable marker of the differences in L1 and L2 processing across L2 proficiency.