Objective numeracy exacerbates framing effects from decision-making under political risk

While Prospect Theory helps to explain decision-making under risk, studies often base frames on hypothetical events and fail to acknowledge that many individuals lack the ability and motivation to engage in complex thinking. We use an original survey of US adults (N = 2813) to test Prospect Theory in the context of the May 2023 debt ceiling negotiations in the US Congress and assess whether objective numeracy moderates framing effects. We hypothesize and find evidence to suggest that most respondents are risk-averse to potential gains and risk-accepting to potential losses; however, high numerates are more risk-averse and risk-accepting to gains and losses, respectively, than low numerates. We also find that need for cognition interacts with numeracy to moderate framing effects for prospective losses, such that higher need for cognition attenuates risk-acceptance among low numerates and exacerbates risk-acceptance among high numerates. Our results are robust to a range of other covariates and in models accounting for the interaction between political knowledge and need for cognition, indicating joint moderating effects from two knowledge domains similarly conditioned by the desire to engage in effortful thinking. Our findings demonstrate that those who can understand and use objective information may remain subjectively persuaded by certain policy frames.

Collective overclaiming is related to collective narcissism and numeracy

When asked to estimate how much their state or nation has contributed to history, people typically provide unreasonably large estimates, claiming that their group has contributed much more to history than nongroup members would estimate, demonstrating collective overclaiming. Why does such overclaiming occur? In the current study we examined factors that might predict collective overclaiming. Participants from 12 U.S. states estimated how much their home state contributed to U.S. history, completed measures of collective narcissism and numeracy, and rated the importance of 60 specific historical events. There was a positive relationship between collective overclaiming and collective narcissism, a negative relationship between collective overclaiming and numeracy, and a positive relationship between collective overclaiming and the importance ratings of the specific events. Together, these results indicate that overclaiming is partially and positively related to collective narcissism and negatively related to people's ability to work with numbers. We conclude that collective overclaiming is likely determined by several factors, including the availability heuristic and ego protection mechanisms, in addition to collective narcissism and relative innumeracy.

"R" you getting this? Factors contributing to the public's understanding, evaluation, and use of basic reproduction numbers for infectious diseases

BACKGROUND

We (1) examined the effects of evaluative labels and visual aids on people's understanding, evaluation, and use of the COVID-19 reproduction number (or "r-number"), (2) examined whether people's perceived susceptibility and (intended) adherence to preventive measures changed after being exposed to the r-number, and (3) explored whether these effects and changes depended on people's numeracy skills.

METHODS

In an online experiment, participants from a large Dutch representative sample (N = 1,168) received information about the COVID-19 r-number displayed on the corona dashboard of the Dutch Ministry of Health, Welfare and Sport. The r-number was either presented with or without a categorical line display (i.e., evaluative label) and with or without an icon-based tree diagram (i.e., visual aid) explaining how the number works. Regarding people's use of the statistic, we measured perceived susceptibility to COVID-19 and adherence (intention) to five preventive measures before and after exposure to the r-number. After exposure, we also measured participants' understanding, perceived usefulness, affective and cognitive evaluation, and objective numeracy.

RESULTS

About 56% of participants correctly interpreted the r-number, with highly numerate people having better understanding than less numerate people. Information about the r-number was perceived as more useful when presented with a visual aid. There were no differences across experimental conditions in people's understanding, affective, and cognitive evaluations. Finally, independent of experimental conditions, intention to adhere to preventive measures was higher after seeing the r-number, but only among highly numerate people.

CONCLUSIONS

Although evaluative labels and visual aids did not facilitate people's understanding and evaluation of the r-number, our results show that the statistic is perceived as useful and may be used to stimulate adherence to preventive measures. Policy makers and public health communicators are advised to clearly explain why they are giving these numbers to - especially - the less numerate people, but also how people could use them for behavior change to combat the spread of virus during a pandemic.

Are numerical abilities determined at early age? A brain morphology study in children and adolescents with and without developmental dyscalculia

The intraparietal sulcus (IPS) has been associated with numerical processing. A recent study reported that the IPS sulcal pattern was associated with arithmetic and symbolic number abilities in children and adults. In the present study, we evaluated the link between numerical abilities and the IPS sulcal pattern in children with Developmental Dyscalculia (DD) and typically developing children (TD), extending previous analyses considering other sulcal features and the postcentral sulcus (PoCS). First, we confirm the longitudinal sulcal pattern stability of the IPS and the PoCS. Second, we found a lower proportion of left sectioned IPS and a higher proportion of a double-horizontal IPS shape bilaterally in DD compared to TD. Third, our analyses revealed that arithmetic is the only aspect of numerical processing that is significantly related to the IPS sulcal pattern (sectioned vs not sectioned), and that this relationship is specific to the left hemisphere. And last, correlation analyses of age and arithmetic in children without a sectioned left IPS indicate that although they may have an inherent disadvantage in numerical abilities, these may improve with age. Thus, our results indicate that only the left IPS sulcal pattern is related to numerical abilities and that other factors co-determine numerical abilities.

Do adolescent girls' education and friendships have independent effects on early pregnancy? Results of a mediation analysis from a longitudinal cohort study in Nairobi, Kenya

Background

Few studies have examined whether the effect of education on pregnancy and childbearing is due to the academic skills acquired or the social environment that schooling provides. This paper explores whether adolescent girls' learning skills, school enrollment, grade attainment, and friendships affect risk of pregnancy, and whether friendships mediate the relationship between education and pregnancy.

Methods

We draw on three waves of longitudinal data on adolescent girls aged 11-15 in Kibera, an informal settlement in Nairobi, Kenya between years 2015-2019. We use fixed effects regression models to estimate effects of girls' learning skills, school attendance, grade attainment, and friendships on their probability of experiencing a pregnancy. We conduct mediation analyses to assess whether friendships mediate the relationship between education and pregnancy.

Results

By round one (2015), 0.1 % of girls reported having experienced a pregnancy; by round three (2019), 6.3 %. Even after adjusting for friendships, we find that attending school decreases probability of pregnancy by nine percentage points; an additional year of schooling decreases probability of pregnancy by three percentage points; and a one standard deviation increase in numeracy decreases probability of pregnancy by one percentage point. Having any male friends who do not attend school increases girls' probability of experiencing a pregnancy by four percentage points; this association remains after adjusting for girls' education. However, out-of-school girls are far more likely to report out-of-school male friends. We find no evidence that other types of friendships affect girls' probability of becoming pregnant.

Conclusion

We find significant protective effects of school attendance, higher grade attainment and numeracy skills on girls' pregnancy, and that having close friendships with out-of-school males increases girls' probability of pregnancy. We did not find evidence of meaningful mediation, suggesting that the protective effects of school attendance and learning remain regardless of any risk they may face from their friendships.

Successful Aging is Associated with Better Health Literacy in Older Adults with HIV Disease

People with HIV (PWH) are susceptible to neurocognitive, physical, and mental health problems that may decrease their likelihood of experiencing successful aging. This cross-sectional, retrospective study estimated the extent to which health literacy is associated with successful aging among 116 older PWH and 60 persons without HIV. Successful aging was defined using indicators of biological health, cognitive efficiency, mental health, and productivity. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine, Newest Vital Sign, Brief Health Literacy Screening, and Beliefs Related to Medication Adherence. A series of logistic regressions covarying for education showed that better health literacy was associated with a higher frequency of successful aging among older PWH. Older PWH were approximately three times less likely to experience successful aging as compared to older adults without HIV. Future studies may examine whether improving health literacy among younger PWH increases the likelihood of successful aging.

Talk outside the box: Parents' decontextualized language during preschool years relates to child numeracy and literacy skills in middle childhood

Children's literacy and numeracy skills are fundamental for early academic performance and later academic success, mental health, and employment prospects in adulthood. Given that parents play a key role in promoting child development, identifying early parenting behaviors that predict literacy and numeracy skills is a research imperative. Emerging evidence suggests that parental use of decontextualized language (DL)-talk that requires cognitive abstraction and transcends the here and now-predicts children's literacy skills. However, its relation to numeracy remains underexplored. Accordingly, the current study examined how DL during interaction with children in infancy (T1) and preschool years (T2) relates to child literacy and numeracy in middle childhood (T3). Participants were 26 Irish mother-father-child triads (16 female children). At T1 and T2, participants engaged in 5-min interactions that were coded for DL. At T3, child literacy and numeracy were assessed using the Wechsler Intelligence Scale for Children-Fourth Edition and teacher report of child scores on national standardized tests. Controlling for child age and contextualized utterances, child reading in middle childhood was negatively related to maternal and child DL in infancy but was positively related to DL during preschool years, suggesting that the benefits of DL may become apparent later in development. Mothers', fathers', and children's DL during preschool years was also positively linked with child numeracy in middle childhood. Thus, embedding DL in conversation with children may have positive domain-specific and cross-domain effects on children's literacy and numeracy performance. Findings provide incentive for future research to examine relations between DL and children's school performance across a wider range of developmental domains.

Nurse education leaders' perspectives on the teaching of numeracy to undergraduate nursing students: A qualitative research study

AIM

The aim of this study was to explore the perspectives of nurse education leaders of Australian undergraduate nursing degrees on the teaching of nursing numeracy and how the Australian Nursing & Midwifery Accreditation Standards influence curriculum development.

BACKGROUND

Nurses' numeracy skills are reportedly deficient worldwide, posing a significant threat to patient safety. This is an issue for the education of undergraduate nurses and thus for the nursing profession. The international literature reveals a heterogeneous blend of learning approaches, but it is unclear which approaches are best suited to improve the numerical calculation ability of nurses. In the Australian context, there are no accreditation standards referring to numeracy, therefore, it is important to discover how nurse education leaders' design and implement the teaching of numeracy.

DESIGN

A qualitative approach using thematic analysis was employed. The setting was Australian universities that delivered an accredited undergraduate nursing degree leading to nursing registration.

METHODS

Purposive sampling was used to recruit 17 nurse education leaders of Australian undergraduate nursing degrees. Individual, semi-structured virtual interviews were conducted between November 2022 and January 2023. Interview data were analysed using Braun and Clarke's (2006) six phases of thematic analysis.

FINDINGS

Five themes emerged from the analysis: (i) indistinct accreditation standards, (ii) teaching basic maths for clinical applications, (iii) a range of bespoke teaching approaches (iv) we're nurses, not numeracy educators and (v) assumptions about an unprepared cohort.

CONCLUSION

The leaders of undergraduate nursing degrees assumed that nursing students would have proficiency in numeracy skills on entering university. However, this was not the case, hence numeracy was an essential skill that needed to be taught to the undergraduate nursing students. Lack of direction from the accreditation council led to the existence of various curricula and an array of approaches to teaching numeracy and medication calculations, which challenged nursing academics who did not consider themselves numeracy educators. This study makes a novel contribution to knowledge, teaching and practice in undergraduate nursing numeracy curricula.

An Exploratory Study on the Impacts of Individual Skills and Health Information Exposure on Perceptions of Cancer Control and Expert Competence

People's perceptions of control over their risk of cancer, and their perceptions of health experts' abilities to manage cancer risks, shape their beliefs about the effectiveness of expert-recommended cancer-preventive behaviors and actions. The aims of this exploratory study were to investigate the impact of individual skills and sources of health information on (i) internal locus of cancer control (ILOC) and (ii) perceived expert competence. Using a cross-sectional survey (n = 172), we collected data on individual health expertise, numeracy, health literacy, amounts of health information received from various sources, ILOC for cancer prevention and perceived expert competence (i.e., believing that health experts have the knowledge to correctly estimate cancer risks). Significant associations between health expertise and ILOC, and between health literacy and ILOC, were not observed in this study (OR = 2.15, 95%CI = 0.96-5.98; OR = 1.78, 95%CI = 0.97-3.63, respectively). Participants who received more health information from the news were more likely to perceive experts as competent (OR = 1.86, 95%CI = 1.06-3.57). Logistic regression analyses suggested that higher levels of health literacy among individuals with lower numeracy may promote ILOC but discourage expert competence beliefs. Analyses by gender suggested females with low educational attainment and lower numeracy may especially benefit from educational interventions to improve health literacy and promote ILOC. Our findings build off existing literature that point to a possible interaction between numeracy and health literacy. This research, with follow up work, may have practical implications for health educators aiming to promote specific cancer beliefs that lead to the uptake of expert-recommended cancer-preventive behaviors.

Differences in decisions affected by cognitive biases: examining human values, need for cognition, and numeracy

A better understanding of factors that can affect preferences and choices may contribute to more accurate decision-making. Several studies have investigated the effects of cognitive biases on decision-making and their relationship with cognitive abilities and thinking dispositions. While studies on behaviour, attitude, personality, and health worries have examined their relationship with human values, research on cognitive bias has not investigated its relationship to individual differences in human values. The purpose of this study was to explore individual differences in biased choices, examining the relationships of the human values self-direction, conformity, power, and universalism with the anchoring effect, the framing effect, the certainty effect, and the outcome bias, as well as the mediation of need for cognition and the moderation of numeracy in these relationships. We measured individual differences and within-participant effects with an online questionnaire completed by 409 Brazilian participants, with an age range from 18 to 80 years, 56.7% female, and 43.3% male. The cognitive biases studied consistently influenced choices and preferences. However, the biases showed distinct relationships with the individual differences investigated, indicating the involvement of diverse psychological mechanisms. For example, people who value more self-direction were less affected only by anchoring. Hence, people more susceptible to one bias were not similarly susceptible to another. This can help in research on how to weaken or strengthen cognitive biases and heuristics.

Characterizing exact arithmetic abilities before formal schooling

Children appear to have some arithmetic abilities before formal instruction in school, but the extent of these abilities as well as the mechanisms underlying them are poorly understood. Over two studies, an initial exploratory study of preschool children in the U.S. (N = 207; Age = 2.89-4.30 years) and a pre-registered replication of preschool children in Italy (N = 130; Age = 3-6.33 years), we documented some basic behavioral signatures of exact arithmetic using a non-symbolic subtraction task. Furthermore, we investigated the underlying mechanisms by analyzing the relationship between individual differences in exact subtraction and assessments of other numerical and non-numerical abilities. Across both studies, children performed above chance on the exact non-symbolic arithmetic task, generally showing better performance on problems involving smaller quantities compared to those involving larger quantities. Furthermore, individual differences in non-verbal approximate numerical abilities and exact cardinal number knowledge were related to different aspects of subtraction performance. Specifically, non-verbal approximate numerical abilities were related to subtraction performance in older but not younger children. Across both studies we found evidence that cardinal number knowledge was related to performance on subtraction problems where the answer was zero (i.e., subtractive negation problems). Moreover, subtractive negation problems were only solved above chance by children who had a basic understanding of cardinality. Together these finding suggest that core non-verbal numerical abilities, as well as emerging knowledge of symbolic numbers provide a basis for some, albeit limited, exact arithmetic abilities before formal schooling.

Association between breakthrough labor pain, patient-controlled epidural analgesia use, and numeracy: A pilot observational study

OBJECTIVE

Labor analgesia can be maintained with a continuous epidural infusion, supplemented by patient-controlled epidural boluses. patient-controlled epidural boluses use and timing require numeric understanding, as patients need to understand when they can administer supplemental boluses, lockout intervals, and total doses. We hypothesized that women with lower numeric literacy have a higher rate of provider-administered supplemental boluses for breakthrough pain because they do not understand the concept behind patient-controlled epidural boluses.

DESIGN

Pilot observational study SETTING: Labor and Delivery Suite PARTICIPANTS: Nulliparous, English-speaking patients with singleton, vertex pregnancies admitted for postdates (gestational age ≥ 41 weeks) induction of labor requesting neuraxial labor analgesia.

INTERVENTIONS

Combined spinal-epidural labor analgesia was initiated with intrathecal fentanyl and epidural analgesia was maintained using continuous epidural infusion with patient-controlled epidural boluses.

MEASUREMENTS AND FINDINGS

Numeric literacy was assessed using the Lipkus 7-item expanded numeracy test. Patients were stratified by whether or not they required supplemental provider-administered analgesia and patient-controlled epidural boluses use patterns were evaluated. A total of 89 patients completed the study. There were no demographic differences between patients who required supplemental analgesia compared with those who did not. Patients that required supplemental analgesia were more likely to request and receive patient-controlled epidural boluses (P<0.001). Hourly bupivacaine requirement was higher in women with breakthrough pain. There were no differences in numeric literacy between the two groups.

KEY CONCLUSIONS

Patients who required treatment of breakthrough pain had higher patient-controlled epidural boluses demands-to-delivery ratio. Numeric literacy was not correlated with the need for provider-administered supplemental boluses.

IMPLICATIONS FOR PRACTICE

Easy to understand scripts on how to use patient-controlled epidural boluses allows for understanding of patient-controlled epidural boluses use.

Accelerated epigenetic aging in older adults with HIV disease: associations with serostatus, HIV clinical factors, and health literacy

The prevalence of older persons with HIV (PWH) disease has increased considerably in the last 20 years, but our understanding of biological factors of aging and their clinical correlates among PWH remains limited. Study participants were 149 persons aged 50 and older, including 107 PWH and 42 seronegatives. All participants completed a blood draw, research medical evaluation, structured psychiatric interview, neurocognitive assessment, questionnaires, and measures of health literacy. Four epigenetic clocks were generated from stored blood samples using standardized laboratory methods. In regression models adjusting for sex and smoking status, PWH had significantly higher epigenetic aging acceleration values than seronegatives on all four indicators. Within the PWH sample, higher levels of epigenetic aging acceleration were moderately associated with lower current CD4 count, AIDS diagnoses, higher scores on the Veterans Aging Cohort Study Index, and lower telomere values. Higher epigenetic aging acceleration indices were also associated with lower health literacy among PWH. PWH experience accelerated aging as measured by a series of epigenetic clocks, which may be linked to immune compromise and risk of all-cause mortality. Health literacy may be a modifiable target for mitigating the risk of accelerated aging among older PWH.

Mathematics Skills in Epilepsy: A Systematic Review and Meta-Analysis

Mathematics incorporates a broad range of skills, which includes basic early numeracy skills, such as subitizing and basic counting to more advanced secondary skills including mathematics calculation and reasoning. The aim of this review was to undertake a detailed investigation of the severity and pattern of early numeracy and secondary mathematics skills in people with epilepsy. Searches were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Twenty adult studies and 67 child studies were included in this review. Overall, meta-analyses revealed significant moderate impairments across all mathematics outcomes in both adults (g= -0.676), and children (g= -0.593) with epilepsy. Deficits were also observed for specific mathematics outcomes. For adults, impairments were found for mathematics reasoning (g= -0.736). However, two studies found that mathematics calculation was not significantly impaired, and an insufficient number of studies examined early numeracy skills in adults. In children with epilepsy, significant impairments were observed for each mathematics outcome: early numeracy (g= -0.383), calculation (g= -0.762), and reasoning (g= -0.572). The gravity of impairments also differed according to the site of seizure focus for children and adults, suggesting that mathematics outcomes were differentially vulnerable to the location of seizure focus.

Task-independent neural bases of peer presence effect on cognition in children and adults

There is ample behavioral evidence that others' mere presence can affect any behavior in human and non-human animals, generally facilitating the expression of mastered responses while impairing the acquisition of novel ones. Much less is known about i) how the brain orchestrates the modulation of such a wide array of behaviors by others' presence and ii) when these neural underpinnings mature during development. To address these issues, fMRI data were collected in children and adults alternately observed and unobserved by a familiar peer. Subjects performed a numerosity comparison task and a phonological comparison task. While the former involves number-processing brain areas, the latter involves language-processing areas. Consistent with previous behavioral findings, adults' and children's performance improved in both tasks when observed by a peer. Across all participants, task-specific brain regions showed no reliable change in activity under peer observation. Rather, we found task-independent changes in domain-general brain regions typically involved in mentalizing, reward, and attention. Bayesian analyses singled out the attention network as the exception to the close child-adult resemblance of peer observation neural substrates. These findings suggest that i) social facilitation of some human education-related skills is primarily orchestrated by domain-general brain networks, rather than by task-selective substrates, and ii) apart from attention, peer presence neural processing is largely mature in children.

An investigation of Head Start preschool children's executive function, early literacy, and numeracy learning in the midst of the COVID-19 pandemic

The COVID-19 pandemic's impact on preschool children's school readiness skills remains understudied. This research investigates Head Start preschool children's early numeracy, literacy, and executive function outcomes during a pandemic-affected school year. Study children (N = 336 assessed at fall baseline; N = 237-250 assessed in spring depending on outcome; fall baseline sample: mean age = 51 months; 46% Hispanic; 36% Black Non-Hispanic; 52% female) in a network of Head Start centers in four states (Nevada, New Jersey, Pennsylvania, and Wisconsin) experienced low in-person preschool exposure compared to national pre-pandemic norms. Children experienced fall to spring score gains during the pandemic-affected year of 0.05 SD in executive function, 0.27 SD in print knowledge, and 0.45-0.71 SD in early numeracy skills. Descriptively, for two of the three early numeracy domains measured, spring test score outcomes were stronger among children who attended more in-person preschool. We discuss implications for future research and policy.

Relationship Between Numeracy and Vocabulary Skills in Indonesian Preschool Children and the Impacts of Learning Environments

Although many studies on early childhood have been conducted, there is still a need for further research on numeracy and vocabulary skills, particularly in Indonesia. This research aims to confirm the correlation between numeracy and vocabulary skills in preschool children and to disentangle the effects of environmental factors on both numeracy and vocabulary skills. This research was conducted at Early Childhood Education and Care (ECEC) in the Jatinangor district and followed the principle of simple random sampling. Children were given numeracy and vocabulary tests, parents were asked to fill out a questionnaire about sociodemographic aspects and the learning environment in their homes, and teachers were asked to fill out a questionnaire about preschool activities concerning numeracy and vocabulary. Data were analyzed using a structural equation model with numeracy and vocabulary as outcome variables. Covariates such as age, gender and social status were also included in the model. The results of this study show that numeracy is closely linked to vocabulary skills and that only a specific preschool activity can explain the variance of numeracy. On the other hand, both home numeracy activities and a specific preschool literacy activity are significant predictors of vocabulary skills.

Executive function and mathematics in preschool children: Training and transfer effects

Identifying the underpinnings of mathematics proficiency is relevant for all societies. A growing literature supports a relation between executive function (EF) and mathematics across a wide age range, but causal links are not well understood. In the current study, typically developing preschool children (N = 104) were randomly assigned to one of four training conditions: EF, Number, EF + Number, or an active Control. They participated in three brief training sessions and pretest and posttest sessions measuring EF and mathematics skills. EF training improved EF skills on a task similar to the training but did not extend to an untrained EF task. In addition, the EF training improved number skills but not general mathematics skills. The EF + Number training improved number and general mathematics skills but not EF skills. The EF + Number training did not yield significantly greater benefits for EF and mathematics beyond other training conditions. Finally, differential training effects emerged, such that children with lower pretest EF skills had greater EF benefits on only the trained EF skill. In addition, children from lower versus higher socioeconomic households had greater gains in numerical skills following EF training. No training condition improved verbal knowledge, suggesting that results were specific to the targeted skills. These results extend prior findings on the effectiveness of improving EF and mathematical skills through short-term trainings during early childhood.

Are accuracy discernment and sharing of COVID-19 misinformation associated with older age and lower neurocognitive functioning?

The online proliferation of COVID-19 misinformation led to adverse health and societal consequences. This study investigated possible differences in COVID-19 headline accuracy discernment and online sharing of COVID-19 misinformation between older and younger adults, as well as the role of individual differences in global cognition, health literacy and verbal IQ. Fifty-two younger (18-35 years old) and fifty older adults (age 50 and older) completed a neurocognitive battery, health literacy and numeracy measures, and self-report questionnaires via telephone. Participants also completed a social media headline-sharing experiment (Pennycook et al., Psychological science, 31(7), 770-780, 2020) in which they were presented with true and false COVID-19 headlines about which they indicated: 1) the likelihood that they would share the story on social media; and 2) the factual accuracy of the story. A repeated measures multivariate analysis of variance controlling for gender and race/ethnicity showed no effects of age (p = .099) but a significant interaction between actual COVID-19 headline accuracy and the likelihood of sharing (p < .001), such that accuracy was more strongly related to sharing false headlines (r = -.64) versus true headlines (r = -.43). Moreover, a higher likelihood of sharing false COVID-19 headlines was associated with lower verbal IQ and numeracy skills in older adults (rs = -.51--.40) and with lower verbal IQ, numeracy, and global cognition in younger adults (rs = -.66--.60). Findings indicate that headline accuracy judgements, numeracy, and verbal IQ are important contributors to sharing COVID-19 misinformation in both older and younger adults. Future work might examine the benefits of psychoeducation for improving health and science literacy for COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04464-w.

The home numeracy environment and children's math skills: The moderating role of parents' math anxiety

Evidence suggests that parents' math anxiety moderates the association between parents' help in mathematics homework and first graders' mathematics skills. Understanding whether similar associations are evident in younger children, in regard to the home numeracy environment (HNE) is essential, given that early math skills are strong predictors of later academic outcomes, and children's skills prior to kindergarten are fostered principally by their parents. Thus, the purpose of this study was to examine the association and interaction between the HNE and parents' math anxiety related to preschool children's numeracy performance. Participants were 121 parent-child dyads. Results from hierarchical multiple regression models demonstrated that parents' math anxiety and the HNE, included as separate predictors of children's math skills, were not statistically significant. However, the interaction between HNE and parents' math anxiety was statistically significant, such that the positive association between HNE and children's numeracy skills emerged when parents felt less anxious about math. These findings highlight the importance of accounting for parents' math anxiety when exploring the home influences on children's numeracy skills.

Numeracy levels influence shared decision-making and surgical outcomes: A scoping review of the literature

BACKGROUND

Health literacy has been widely studied with regard to medical decision-making and health care access, however research regarding numeracy - the ability to comprehend and attach meaning to numbers - is more limited.

METHODS

A scoping review following PRISMA guidelines was conducted. We screened 132 abstracts and 12 studies were included in the analysis.

RESULTS

Surgical population numeracy ranged from 47 to 86.1%. We found heterogeneity in the scales used to measure numeracy and the cutoff values used to define adequate numeracy. Low numeracy was shown to influence the accuracy of patients' responses to quality of life measures used to determine surgical outcomes and was associated with patient overestimation of pre-operative risk. Adequate numeracy was correlated with improved outcomes 2-4 years after bariatric surgery.

CONCLUSIONS

Patient numeracy is generally poor and has important implications for pre-operative risk understanding, accuracy of health measurement tools and long-term surgical outcomes.

Difficulties with mathematics experienced by adults with epilepsy in daily life: An online study

OBJECTIVE

Mathematics encompass a variety of skills, broadly grouped into basic numeracy to complex secondary mathematical skills. In children with epilepsy difficulties with mathematics are common and related to a multicomponent working memory capacity. Little is known about mathematical skills of adults with epilepsy in daily life. Hence, we aimed to compare basic and secondary mathematical skills of adults with epilepsy to controls, examine relations between mathematical skills and working memory, and explored relationships between mathematical skills and epilepsy variables (age of onset, seizure frequency, and anti-seizure medication).

METHODS

Eighty four people with epilepsy and 86 healthy controls completed questionnaires on their subjective experience of using mathematics and working memory skills in daily life: The Dyscalculia Checklist (DC) and Working Memory Questionnaire (WMQ; including attention, storage, and executive scales), respectively. Questionnaires also collected demographic and epilepsy variables.

RESULTS

Adults with epilepsy reported greater difficulties in basic and secondary mathematical skills on the DC compared with controls. Only one epilepsy variable, a younger age of epilepsy onset, related to higher DC scores (greater mathematical difficulties), but was not significantly related in regression analyses. Instead, the WMQ explained 33% of the variance on the DC; the poorer storage and attention (but not executive) on the WMQ were associated with the higher DC score, when demographic and epilepsy variables were accounted for.

SIGNIFICANCE

Adults with epilepsy reported significant difficulties with mathematics in daily life, which were not explained by epilepsy variables but by poor working memory. While our findings suggest that daily difficulties with mathematics may be comorbid with epilepsy rather than epilepsy related, it is important to be cognizant of mathematical difficulties experienced by patients with epilepsy as they have potential to impact understanding of numerical information provided in patient care, such as risks associated with different epilepsy treatments.

Gender differences in reading and numeracy achievement across the school years

Developing students' reading and numeracy skills remain key goals of contemporary schooling. In Australia, the National Assessment Program - Literacy and Numeracy (NAPLAN) tests have assessed these skills since 2008. Previous research found a significant gender gap in favour of females for the NAPLAN writing test, yet no study has examined whether gender gaps exist for reading and numeracy or their developmental pattern across the school years. Given the educational and public interest in NAPLAN and its considerable costs, it is important to understand what these tests reveal about student outcomes. The paper presents the first investigation of patterns of male and female student achievement on the NAPLAN reading and numeracy tests from 2008 to 2021. It applies the equivalent year level technique to explain the pedagogical significance of NAPLAN achievement and compares the findings with the writing gender gap to present a fuller picture of male and female achievement.

Analysing mathematical modelling tasks in light of citizenship education using the COVID-19 pandemic as a case study

In this paper, we discuss the theoretical background of mathematical modelling and its connection to citizenship education. Citizenship education in this context means that young people are equipped with competencies to respond as responsible citizens in situations relevant for society. To outline the connection between mathematical modelling and citizenship education in theory, we discuss the aims of mathematical modelling, modelling competences and the connection between numeracy and modelling. Based on these reflections we present an extended modelling cycle that specifically highlights modelling steps relevant to citizenship education. To show how the theoretical connection between mathematical modelling and citizenship education can be used in teaching practice, we describe three different examples of modelling tasks and analyse them with the help of the extended modelling cycle. We argue that the three tasks support different learning aims in relation to citizenship education and require modellers to carry out different steps of the extended modelling cycle. As an example of context, we used the pandemic caused by COVID-19, as it affected the quality of human life greatly, as all students in the Western world experienced.

Health Literacy in Neurosurgery: A Scoping Review

OBJECTIVE

Low health literacy is prevalent and associated with suboptimal health outcomes. In neurosurgery, social determinants of health are increasingly recognized as factors underpinning outcomes, as well as access to and use of care. We conducted a scoping review to delineate the scope of existing literature regarding health literacy in the field and facilitate future research.

METHODS

A scoping review was conducted using the PubMed, Embase, and Scopus databases. Titles and abstracts were screened for relevance. Studies meeting prespecified inclusion criteria underwent full text review. Relevant data were extracted.

RESULTS

Of 5056 resultant articles, 57 manuscripts were included. Thirty-seven studies (64.9%) investigated personal health literacy, while the remaining 20 (35.1%) investigated organizational health literacy. Domains of health literacy investigated were science (36, 63.2%), fundamental (20, 35.1%), and civic (1, 1.7%). No studies investigated numeracy. Recall among patients after discussions with neurosurgeons is low. Patient perspectives are often erroneous. Patient informational needs are often unmet. Written patient educational materials are written at a level too complex for the average patients. Videos are mostly of poor quality. Multimodal audiovisual interventions, eBooks, models, and virtual reality are shown to be effective methods for promoting recall.

CONCLUSIONS

Studies examining health literacy in neurosurgery primarily focus on the topic indirectly, most often via written educational materials and recall after educational interventions. Increasing awareness of health literacy among neurosurgeons, assessing health literacy, and incorporating health literacy-informed counseling approaches are warranted to improve patient care.

Excluding numeric side-effect information produces lower vaccine intentions

Encouraging vaccine uptake is important to reducing the impact of infectious disease. However, negative attitudes and vaccine hesitancy, due in part to worry about side effects, are obstacles to achieving high vaccination rates. Provided vaccine information sheets typically include a list of side effects without numeric information about their likelihoods, but providing such numbers may yield benefits. We investigated the effect of providing numeric information about side-effect likelihood (e.g., "1%") and verbal labels (e.g., "uncommon") on intentions to get a hypothetical vaccine, reasons for the vaccination decision, and risk overestimation. In a diverse, online, convenience sample (N = 595), providing numeric information increased vaccine intentions-70% of those who received numeric information were predicted to be moderately or extremely likely to vaccinate compared to only 54% of those who did not receive numeric information (p<.001), controlling for age, gender, race, education, and political ideology. Participants receiving numeric information also were less likely to overestimate side-effect likelihood. Verbal labels had additional benefits when included with numeric information, particularly among the vaccine hesitant. For these participants, verbal labels increased vaccine intentions when included with numeric information (but not in its absence). Among the vaccine-hesitant, 43% of those provided numeric information and verbal labels were predicted to be moderately or extremely likely to get vaccinated vs. only 24% of those given a list of side effects (p<.001). We conclude that the standard practice of not providing numeric information about side-effect likelihood leads to a less-informed public who is less likely to vaccinate.

Conducting a representative national randomized control trial of tailored clinical decision support for nurses remotely: Methods and implications

Clinical Decision Support (CDS) systems, patient specific evidence delivered to clinicians via the electronic health record (EHR) at the right time and in the right format, has the potential to improve patient outcomes. Unfortunately, outcomes of CDS research are mixed. A potential cause lies in its testing. Many CDS are implemented in practice without sufficient testing, potentially leading to patient harm. When testing is conducted, most research has focused on "what" evidence to provide with little attention to the impact of the CDS display format (e.g., textual, graphical) on the user. In an adequately powered randomized control trial with 220 hospital based registered nurses, we will compare 4 randomly assigned CDS format groups (text, text table, text graphs, tailored to subject's graph literacy score) for effects on decision time and simulated patient outcomes. We recruit using state based professional registries, which allows access to participants from multiple institutions across the nation. We use online survey software (REDCap) for efficient study workflow including screening, informed consent documentation, pre-experiment demographic data collection including a graph literacy questionnaire used in randomization. The CDS prototype is accessed via a web app and the simulation-based experiment is conducted remotely at a subject's local computer using video-conferencing software. Also included are 6 post intervention surveys to assess cognitive workload, usability, numeracy, format preference, CDS utilization rationale, and CDS interpretation. Our methods are replicable and scalable for testing of health information technologies and have the potential to improve the safety and effectiveness of these technologies across disciplines.

Education, Child Marriage, and Work Outcomes Among Young People in Rural Malawi

PURPOSE

School attainment has increased and gender gaps narrowed in many settings without commensurate declines in child marriage and with persistent gender gaps in work. This paper investigates whether child marriage changes young people's ability to translate education into paid work in rural Malawi.

METHODS

Using data from a longitudinal study of adolescents in rural Malawi followed through young adulthood, individual-level fixed-effects regressions that account for time-invariant factors were used to investigate differences in child marriage status on the extent to which grade attainment, reading, and numeracy skills lead to higher participation in paid work and reduce participation in unpaid work. Gender differences in these relationships were explored.

RESULTS

Prevalence of child marriage is high for young women (53% vs. 6% for men), and participation in paid work low (7% vs. 42% for men). Attainment of six grades among young married women and nine grades among young married men was associated with paid work irrespective of child marriage. Reading with comprehension in two languages was associated with paid work for young men married as adults (coefficient = .27, p ≤ .01). Numeracy was associated with paid work among unmarried young women (coefficient = .04, p ≤ .01). Negative associations between grade attainment and unpaid work were found for young women married at ages 16-17 and unmarried, while positive associations were found for young unmarried men.

CONCLUSIONS

The relationship between education and work among young people in Malawi is compromised by related challenges of poor learning and continued high levels of child and young adult marriage.

Inequality, low-intensity immigration and human capital formation in the regions of Chile, 1820-1939

This article traces inequality and numeracy development in the regions of Chile during the 19th and early 20th century. Inequality, measured with anthropometric methods, was associated with a lower speed of human capital formation. Not all talents received the necessary education to make full use of their talent for the regional economy, especially in the south in the early period. However, Chile became slightly less unequal over time and more numerate during the late 19th century. In addition, we study the correlates of low-intensity immigration in Chile. Regions with a relatively high share of North European migrants developed faster in terms of numeracy.

Intuition and exponential growth: bias and the roles of parameterization and complexity

Exponential growth bias is the phenomenon that humans intuitively underestimate exponential growth. This article reports on an experiment where treatments differ in the parameterization of growth: Exponential growth is communicated to one group in terms of growth rates, and in terms of doubling times to the other. Exponential growth bias is much smaller when doubling times are employed. Considering that in many applications, individuals face a choice between different growth rates, rather than between exponential growth and zero growth, we ask a question where growth is reduced from high to low. Subjects vastly underestimate the effect of this reduction, though less so in the parameterization using doubling times. The answers to this question are more severely biased than one would expect from the answers to the exponential growth questions. These biases emerge despite the sample being highly educated and exhibiting awareness of exponential growth bias. Implications for teaching, the usefulness of heuristics, and policy are discussed.

Revisiting the Open Sampling format: Improving risky choices through a novel graphical representation

When making risky choices, people often fall short of the norm of expected value (EV) maximization. Previous research has shown that presenting options in the Open Sampling (OSa) format, a 10-by-10 matrix of randomly arranged outcomes, can improve choices and reduce decision times. First, the current research aims to replicate and extend the findings on the OSa format. To this end, we compare OSa to the common description-based format as well as further graphical representations, and investigate the resulting accordance with EV maximization and decision time. Second, we study whether people lower (vs. higher) in numeracy, the ability to use probabilistic and mathematical concepts, particularly benefit from a graphical representation of options. We conducted five high-powered studies (total N = 1,575) in which participants chose repeatedly between two risky gambles, using different populations and gamble-problem sets. Overall, we could not find a benefit of the OSa format in terms of EV accordance in any of the five studies. However, three studies also tested a novel variant of the OSa format with grouped outcomes and found that it consistently improved EV accordance compared with all other formats. All graphical formats led to faster decisions without harming decision quality. The effects of presentation format were not moderated by numeracy in three of the four studies that assessed numeracy. In conclusion, our research introduces a new presentation format which consistently improves risky choices and can also be used to communicate risks in applied contexts such as medical decision making.

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.

Parents' math anxiety and mathematics performance of pre-kindergarten children

Prior research demonstrates that individuals' math anxiety may be negatively related to their mathematics performance. However, little research has examined how caregivers' math anxiety is associated with children's mathematics performance prior to kindergarten. The purpose of this study was to investigate the relation between parents' math anxiety and the change in children's mathematics performance during the preschool year. Participants were 310 preschool-age children (155 female; 4.12-5.78 years of age, M = 5.20 years, SD = 0.29). Structural equation modeling results demonstrated that parents' math anxiety was significantly negatively related to change in children's mathematics performance during the pre-kindergarten year when controlling for fall mathematics performance and demographics. Moreover, multigroup path analyses revealed that this association did not differ for male versus female children.

The association of health insurance literacy and numeracy with financial toxicity and hardships among colorectal cancer survivors

PURPOSE

In this study, we examined the association of financial hardship measured by material financial burden and financial toxicity with health insurance literacy and numeracy among colorectal cancer survivors. The lack of evidence on the impact of cost-related health literacy, specifically health insurance literacy and numeracy, on financial toxicity among cancer survivors warrants further research.

METHODS

Between January and November 2019, we used a cross-sectional research design to collect surveys from 104 colorectal cancer survivors (diagnosed within last 5 years) from the Kentucky Cancer Registry. Survey items assessed health insurance literacy (measured by confidence and behaviors in choosing and using health insurance), numeracy, material financial burden, and financial toxicity, in addition to socio-demographic variables. Survey data were subsequently linked to the participant's cancer registry record. Data were analyzed using descriptive, bivariate, and multiple linear regression analyses.

RESULTS

The mean financial toxicity score was 24.5, with scores ranging from 3 to 43 (higher scores indicating greater financial toxicity). Eighty percent of participants indicated they had experienced one or more material burdens related to their cancer. The majority had adequate health insurance (79%); however, the majority also had low numeracy (84%). After controlling for socio-demographic covariates, significant predictors of greater financial toxicity were high material burden scores, low health insurance literacy, and low numeracy.

CONCLUSIONS

Findings indicate the need to develop programs and interventions aimed at improving health insurance literacy and numeracy as a strategy for reducing financial toxicity and hardships among colorectal cancer survivors.

Ability-related political polarization in the COVID-19 pandemic

In two large-scale longitudinal datasets (combined N = 5761), we investigated ability-related political polarization in responses to the COVID-19 pandemic. We observed more polarization with greater ability in emotional responses, risk perceptions, and product-purchase intentions across five waves of data collection with a diverse, convenience sample from February 2020 through July 2020 (Study 1, N = 1267). Specifically, more liberal participants had more negative emotional responses and greater risk perceptions of COVID-19 than conservative participants. Compared to conservatives, liberal participants also interpreted quantitative information as indicating higher COVID-19 risk and sought COVID-related news more from liberal than conservative news media. Of key importance, we also compared verbal and numeric cognitive abilities for their independent capacity to predict greater polarization. Although measures of numeric ability, such as objective numeracy, are often used to index ability-related polarization, ideological differences were more pronounced among those higher in verbal ability specifically. Similar results emerged in secondary analysis of risk perceptions in a nationally representative longitudinal dataset (Study 2, N = 4494; emotions and purchase intentions were not included in this dataset). We further confirmed verbal-ability-related polarization findings on non-COVID policy attitudes (i.e., weapons bans and Medicare-for-all) measured cross-sectionally. The present Study 2 documented ability-related polarization emerging over time for the first time (rather than simply measuring polarization in existing beliefs). Both studies demonstrated verbal ability measures as the most robust predictors of ability-related polarization. Together, these results suggest that polarization may be a function of the amount and/or application of verbal knowledge rather than selective application of quantitative reasoning skills.

Lower objectively and subjectively assessed numeracy are both associated with poorer self-rated health

Objective

To compare an objective with a subjective numeracy assessment for association with self-reported health status, where numeracy refers to “the degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistical, and probabilistic health information needed to make effective health decisions”

Results

We completed a secondary analysis of two population-based surveys, the Empire State Poll (n = 763) and the Program for the International Assessment of Adult Competencies (PIAAC; n = 2609). The first survey assessed numeracy with a 3-item subjective instrument. The second assessed numeracy with more than 20 math problems. Both used the same measure for self-reported health status. Lower numeracy, whether subjectively or objectively assessed, was associated with worse self-reported health, even after controlling for education and other sociodemographic confounders. The odds ratios for the association were very similar (0.91 and 0.90 respectively). A lengthy objective numeracy assessment and a brief self-report assessment had similar associations with health status. A brief self-report measure of numeracy has similar properties to a lengthy objective assessment and is likely to be more feasible to use to screen patients in practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05737-y.

The effects of numeracy and presentation format on judgments of contingency

Covariation information can be used to infer whether a causal link plausibly exists between two dichotomous variables, and such judgments of contingency are central to many critical and everyday decisions. However, individuals do not always interpret and integrate covariation information effectively, an issue that may be compounded by limited numeracy skills, and they often resort to the use of heuristics, which can result in inaccurate judgments. This experiment investigated whether presenting covariation information in a composite bar chart increased accuracy of contingency judgments, and whether it can mitigate errors driven by low numeracy skills. Participants completed an online questionnaire, which consisted of an 11-item numeracy scale and three covariation problems that varied in level of difficulty, involving a fictitious fertilizer and its impact on whether a plant bloomed or not. Half received summary covariation information in a composite bar chart, and half in a 2 × 2 matrix that summarized event frequencies. Viewing the composite bar charts increased accuracy of individuals both high and low in numeracy, regardless of problem difficulty, resulted in more consistent judgments that were closer to the normatively correct value, and increased the likelihood of detecting the correct direction of association. Findings are consistent with prior work, suggesting that composite bar charts are an effective way to improve covariation judgment and have potential for use in the domain of health risk communication.

Relations among spatial skills, number line estimation, and exact and approximate calculation in young children

Decades of research have established that spatial skills correlate with numerical skills. However, because both spatial and numerical skills are multidimensional, we sought to determine how specific spatial skills relate to specific numeracy skills. We used a cohort-sequential design, assessing a large diverse sample of students (N = 612, initially in pre-kindergarten [pre-K]-3rd grade, 4-9 years of age) at four time points spanning 2 years. We examined how initial levels of five spatial skills (visuospatial working memory [VSWM], mental transformation, mental rotation, proportional reasoning, and analog magnitude system [AMS] acuity) related to initial levels and growth rates in exact and approximate calculation skills, and we further investigated number line estimation as a potential mediator. We found unique patterns of relations between spatial skills and numeracy. Initial levels of mental rotation, proportional reasoning, and AMS acuity related to initial levels of exact calculation skill; initial levels of AMS acuity related to initial levels of approximate calculation; and initial levels of proportional reasoning related to initial levels of number line estimation. VSWM and mental transformation did not relate to numeracy skills after controlling for other spatial skills. Initial levels of number line estimation related to both exact and approximate calculation after controlling for spatial skills. Notably, neither spatial skills nor number line estimation predicted growth in exact or approximate calculation skills. These results indicate that there is specificity in the time-invariant relations between spatial skills and numeracy, and they suggest that researchers and educators should treat spatial skills and numeracy as multidimensional constructs with complex and unique interrelations.

Parental Risk Literacy is Related to Quality of Life in Spanish Families of Children with Autism Spectrum Disorder

Families of children with autism spectrum disorder (ASD) often experience much more negative perceptions of their family quality of life (FQoL). To investigate key factors that may shape these experiences, we conducted a case-control study of sixty-one Spanish families (29 with a child with ASD) using a broad psychosocial assessment (e.g., ASD severity, social support, demographics), including the first direct test of the relationship between FQoL and parental risk literacy (i.e., the ability to evaluate and understand risk, as measured by numeracy). Results revealed that numeracy was associated with differences in perceived FQoL among families of children with ASD (R² = .10), a finding that held across several models statistically controlling for the influence of other variables. Findings suggest that parental risk literacy skills may generally be associated with differences in decision making vulnerabilities (e.g., risk evaluation and interpretation) that influence family outcomes including FQoL.

Your health vs. my liberty: Philosophical beliefs dominated reflection and identifiable victim effects when predicting public health recommendation compliance during the COVID-19 pandemic

In response to crises, people sometimes prioritize fewer specific identifiable victims over many unspecified statistical victims. How other factors can explain this bias remains unclear. So two experiments investigated how complying with public health recommendations during the COVID19 pandemic depended on victim portrayal, reflection, and philosophical beliefs (Total N = 998). Only one experiment found that messaging about individual victims increased compliance compared to messaging about statistical victims-i.e., "flatten the curve" graphs-an effect that was undetected after controlling for other factors. However, messaging about flu (vs. COVID19) indirectly reduced compliance by reducing perceived threat of the pandemic. Nevertheless, moral beliefs predicted compliance better than messaging and reflection in both experiments. The second experiment's additional measures revealed that religiosity, political preferences, and beliefs about science also predicted compliance. This suggests that flouting public health recommendations may be less about ineffective messaging or reasoning than philosophical differences.

Can a brief peer-led group training intervention improve health literacy in persons living with HIV? Results from a randomized controlled trial

OBJECTIVE

The goal of this study was to determine if a 6-week, peer-led intervention improves health literacy and numeracy among people living with HIV (PLWH).

METHODS

We used a randomized controlled trial with repeated measurements, which included six, 90-minute, group-based training sessions. We recruited PLWH participants (n = 359) from safety-net practices in the New York City Metropolitan area and Rochester, NY. Participants were randomly assigned (1:1) to an intervention group (n = 180) or a control group (n = 179). Outcome measures were collected at baseline, eight weeks post-baseline, and at six months using the Brief Estimate of Health Knowledge and Action-HIV (BEHKA-HIV), the Electronic Health Literacy Scale (eHEALS), the Rapid Estimate of Adult Literacy (REALM), and the Newest Vital Sign (NVS).

RESULTS

The intervention group had statistically significant improvements in eHealth literacy and BEHKA-HIV compared to the control group. There were no statistically significant changes in general health literacy or numeracy in either group. The intervention had the greatest impact on participants with the lowest levels of eHealth literacy at baseline.

CONCLUSION

The intervention had a positive impact on participants' HIV health literacy and eHealth literacy.

PRACTICE IMPLICATIONS

Our findings have implications for broadening the function of peer-workers in the health care continuum.

The role of cognitive reserve as mediator for addition and multiplication skills in late adulthood

BACKGROUND

The role played by cognitive reserve for the maintenance of numeracy skills in late adulthood is still not sufficiently explored.

AIMS

This study mainly investigated whether cognitive reserve (i.e., vocabulary) mediates on the relationship between non-verbal reasoning and addition and multiplication skills of older individuals. Moreover, the impact of schooling and gender on written calculation was examined, controlling for the effect of cognitive decline.

METHODS

One hundred and six 68-94-year-old participants completed a battery of tests assessing numeracy, executive functions, and cognitive reserve skills.

RESULTS

Significant correlations were found between age, cognitive reserve, numeracy, and executive functions measures. Besides, mediation analyses indicated that cognitive reserve and non-verbal reasoning explain 23% and 29% of the variance in written addition and multiplication conditions, respectively. Finally, more educated individuals performed better numeracy tasks, whereas the solution of additions and multiplications was not impact by gender.

CONCLUSIONS

Cognitive reserve impacts numeracy in late adulthood.

Testing a best practices risk result format to communicate genetic risks

OBJECTIVE

To investigate the effect of a genetic report format using risk communication "best-practices" on risk perceptions, in part to reduce risk overestimates.

METHODS

Adults (N = 470) from the Coriell Personalized Medicine Collaborative (CPMC) were randomized to a 2 × 2 experimental design to receive a hypothetical "personalized" genetic risk result for leukemia (relative risk = 1.5 or 2.5) through either the standard CPMC report (N = 232) or an enriched report informed by best practices (N = 238). A one-time, online survey assessed numeracy and risk perceptions including "feelings of risk" and a numerical estimate.

RESULTS

Regardless of numeracy, participants who received the enriched report had fewer overestimates of their lifetime risk estimate (LRE; odds ratio = 0.19, p < .001) and lower feelings of risk on two of three measures (p < .001). Participants with higher numeracy scores had fewer overestimates of LRE (OR = 0.66, p < .001) and lower feelings of risk on two out of three measures (p ≤ .01); the interaction between numeracy and report format was non-significant.

CONCLUSION

The enriched report produced more accurate LRE and lower risk perceptions regardless of numeracy level, suggesting the enriched format was helpful to individuals irrespective of numeracy ability.

PRACTICE IMPLICATIONS

Best practice elements in risk reports may help individuals form more accurate risk perceptions.

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.

Approximate multiplication in young children prior to multiplication instruction

Prior work indicates that children have an untrained ability to approximately calculate using their approximate number system (ANS). For example, children can mentally double or halve a large array of discrete objects. Here, we asked whether children can perform a true multiplication operation, flexibly attending to both the multiplier and multiplicand, prior to formal multiplication instruction. We presented 5- to 8-year-olds with nonsymbolic multiplicands (dot arrays) or symbolic multiplicands (Arabic numerals) ranging from 2 to 12 and with nonsymbolic multipliers ranging from 2 to 8. Children compared each imagined product with a visible comparison quantity. Children performed with above-chance accuracy on both nonsymbolic and symbolic approximate multiplication, and their performance was dependent on the ratio between the imagined product and the comparison target. Children who could not solve any single-digit symbolic multiplication equations (e.g., 2 × 3) on a basic math test were nevertheless successful on both our approximate multiplication tasks, indicating that children have an intuitive sense of multiplication that emerges independent of formal instruction about symbolic multiplication. Nonsymbolic multiplication performance mediated the relation between children's Weber fraction and symbolic math abilities, suggesting a pathway by which the ANS contributes to children's emerging symbolic math competence. These findings may inform future educational interventions that allow children to use their basic arithmetic intuition as a scaffold to facilitate symbolic math learning.

Impact of numeracy preferences on information needs for genome sequencing results

OBJECTIVE

This study investigated how self-reported numeracy ability and preferences predict preferences for the amount and types of information provided about genome sequencing results among 1080 women diagnosed with breast cancer at age 40 or younger.

METHODS

Participants reported their level of interest in 14 topics related to genome sequencing results on a survey. We calculated a Participant Information Needs (PIN) value based on the number of topics for which a participant wanted "a lot" of information. Numeracy was assessed using the Subjective Numeracy Scale. Analyses examined associations between the numeracy ability and preferences subscales, information needs for individual content topics, and PIN.

RESULTS

Higher preference for numeric data was correlated with increased PIN (β = 0.60, p < 0.01), while numeric ability was not correlated (β=0.16, p = 0.22). Family composition and knowledge about sequencing benefits were also significant covariates. Patients most preferred information on topics related to disease risk and health implications.

CONCLUSION

There may be utility in separating numeracy ability and preferences into two components in future research in order to investigate how numeracy impacts the return of genetic testing results.

PRACTICE IMPLICATIONS

These data suggest that numeracy preferences may be important to inform strategies for the return of genetic results.

Emergent academic skills growth in New Zealand pre-school children undergoing treatment for sleep disordered breathing: a case-control pilot study

OBJECTIVES

The main objective of this study was to explore the feasibility and treatment sensitivity of measures of preschool oral language and emergent literacy and numeracy for assessing developing skills of preschool children with sleep disordered breathing (SDB) in New Zealand following adenotonsillectomy.

METHODS

Eight preschool children aged 3 years 1 month-4 years 5 months were recruited from a surgical waiting list and matched to controls for age (±3 months) and sex. Tasks designed to be sensitive to growth in oral language and emergent literacy and numeracy were reviewed for contextual fit, adapted as necessary for the New Zealand context, and administered before surgery (baseline), three months post-surgery, and at a seven-month follow-up alongside other measures.

RESULTS

Growth in oral language and emergent literacy was greater for case children than matched controls, suggesting that the tasks were sensitive to treatment effects. No such effect was observed for early numeracy tasks. Case children had more symptoms of SDB and behavioral and emotional difficulties than matched controls prior to surgery, and improvements were reported in these domains following surgery.

CONCLUSIONS

Oral language and emergent literacy measures trialled in the present research showed potential for evaluating treatment outcomes in pre-schoolers with SDB, and provided preliminary evidence that early treatment of SDB could have positive effects on learning in these domains.

Impact of Previous Genetic Counseling and Objective Numeracy on Accurate Interpretation of a Pharmacogenetics Test Report

INTRODUCTION

Pharmacogenetic (PGx) testing can be useful for providing information about a patient's drug response by increasing drug efficacy and decreasing the incidence of adverse drug events. While PGx tests were previously only offered to patients under healthcare provider supervision, they are now available as direct to consumer (DTC) tests. This study aimed to assess how accurately individuals from the general population were able to interpret a sample PGx test report and if accuracy differed based on individuals' numeracy or prior genetic counseling (GC).

METHODS

We surveyed 293 individuals from the general population, ascertained through ResearchMatch. The survey included questions about PGx test interpretation, numeracy, and genetic literacy.

RESULTS

In our cohort, numeracy level impacted PGx result interpretation, with those of high numeracy performing statistically significantly better on both the table format and graphical format (p value = 0.002 and p value <0.001, respectively) and genetic knowledge questions (p value <0.001) than those with low/average numeracy. In addition, previous GC did not impact test interpretation or genetic knowledge, but the number of individuals with prior GC was small (n = 26).

DISCUSSION/CONCLUSION

We found that numeracy had a significant impact on correct interpretation of PGx test reports. Because many individuals in the USA have low numeracy levels, it is extremely important that patients do not make their own medication management decision based on the test results and that they consult with their physicians about their PGx testing. The importance of consultation and discussion with providers about results should be emphasized on the test report.

The role of age, health literacy, numeracy and graph literacy

OBJECTIVE

To investigate 1) younger (< 65) and older (> 65) adults' preference for and understanding of graph formats presenting risk information, and 2) the contribution of age, health literacy, numeracy and graph literacy in understanding information.

MATERIALS AND METHODS

To assess preferences, participants (n = 219 < 65 and n = 227>65) were exposed to a storyboard presenting six types of graphs. Understanding (verbatim and gist knowledge) was assessed in an experiment using a 6 (graphs: clock, bar, sparkplug, table, pie vs pictograph) by 2 (age: younger [<65] vs older [>65]) between-subjects design.

RESULTS

Most participants preferred clock, pie or bar chart. Pie was not well understood by both younger and older people, and clock not by older people. Bar was fairly well understood in both groups. Table yielded high knowledge scores, particularly in the older group. Lower age, higher numeracy and higher graph literacy contributed to higher verbatim knowledge scores. Higher health literacy and graph literacy were associated with higher gist knowledge.

DISCUSSION AND CONCLUSION

Although not the preferred format, tables are best understood by older adults.

PRACTICE IMPLICATIONS

Graph literacy skills are essential for both verbatim and gist understanding, and are important to take into account when developing risk information.

Integrating nutrition into the mathematics curriculum in Australian primary schools: protocol for a randomised controlled trial

Background

Nutrition education programs in schools have been effective in improving children’s knowledge and behaviours related to food and nutrition. However, teachers find it challenging to implement such programs due to overcrowded curricula. Integrating nutrition with core subjects such as mathematics could potentially address time constraints and improve the learning of both. The primary aim of this randomized controlled trial (RCT) is to evaluate the impact of a cross-curricular nutrition and mathematics program on primary school students’ portion size estimation skills. Secondary aims include impact on their nutrition knowledge, attitudes towards mathematics and evaluating the quality of the lessons.

Methods

Twelve Year 3–4 classes from Catholic schools in New South Wales, Australia will be randomised to intervention (n = 6) or control (n = 6) groups. Teachers in the intervention group will receive a professional development workshop and resources to teach 4–5 lessons on portion size and measurements across 1–4 weeks. Outcome measures include portion size estimation skills, nutrition knowledge and attitudes towards mathematics, with data collected during three school visits (pre-intervention, immediately post-intervention, 4 weeks post-intervention). Additionally, teaching quality will be assessed in both intervention and control groups and process evaluation undertaken using teacher interviews and student focus groups.

Discussion

This RCT uses an innovative approach to improve both nutrition and mathematics related learning outcomes among primary school children. It has the potential to impact teaching practices regarding integration of nutrition into curricula and enhance the implementation of nutrition education interventions.

Trial registration

Australian and New Zealand Clinical Trials Register ACTRN12619001071112 31/07/2019.