Effects of an AAC feature on decoding and encoding skills of adults with Down syndrome

Literacy skills can assist in the navigation and enjoyment of adult life. For individuals who have reached adulthood without strong literacy skills, opportunities for continued literacy learning are few. Redesigning AAC technologies to support literacy skill development could extend literacy learning opportunities for adults with developmental disabilities who have limited speech. The current preliminary study evaluated an AAC technology feature designed to support literacy development. The study used a multiple probe across participants design. Three adults with Down syndrome who had limited speech and only basic decoding skills participated. Results suggest the participants made modest gains in decoding accuracy after interacting using the AAC app with the literacy supportive feature, though performance was highly variable. Results also offer emerging evidence that, for two participants, some generalization to encoding performance may have also been achieved. Results showed that, for all the participants, interacting using the literacy supportive feature increased their reading confidence. Altogether, the study's results show preliminary evidence that the feature can support adults with Down syndrome in their ongoing literacy learning, though access to formal instruction is still critical. Future research is needed to continue to explore this and other AAC technology redesigns to increase learning opportunities for the people who use the technology every day to communicate.

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

OBJECTIVES

This study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance.

METHODS

Data was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year.

RESULTS

The results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy.

CONCLUSION

The findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior.

PRACTICE IMPLICATIONS

The potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

Effectiveness of a media literacy-based smoking prevention program in female adolescents

OBJECTIVES

To examine the effectiveness of a media literacy-based smoking prevention program based on Ajzen's theory of planned behavior in female adolescents.

METHODS

This quasi-experimental study was conducted with female high school students aged 16-17 years in Seoul, Republic of Korea. The program provided eight sessions over 4 weeks. Quantitative data were collected before and after online surveys in an intervention (n = 21) and control (n = 21) groups, and analyzed using mixed analysis of variance. Qualitative data on participation experiences was collected by requesting the participants to answer open-ended questions once a week during the intervention and performing co-occurrence analysis of specific terms in the responses was conducted through text mining.

RESULTS

Although the program decreased smoking intention and increased smoking media literacy in the intervention group, there were no significant differences between the groups. Qualitative results obtained from the intervention group showed cognitive and behavioral changes in the perception of the harmfulness of e-cigarettes in the media and the expression of a willingness to overcome the temptation to smoke.

CONCLUSIONS

Our findings show that the enhancement of smoking media literacy, specifically by correcting misconceptions regarding e-cigarettes promoted by the new media, contributes smoking prevention in female adolescents. It supports calls for an expanded role of public health professionals in health education at the school level.

A remotely-delivered pilot and feasibility program to promote physical and food literacy in adolescents with intellectual disabilities

BACKGROUND

Youth with intellectual disabilities experience disparities in physical activity and diet quality. Physical and food literacy are hypothesised to support adoption of healthy lifestyles; however, few such interventions have been developed for this population.

METHOD

Participants with intellectual disabilities ages 12-16 years were recruited for a 12-week online sports skills and nutrition education intervention. Feasibility, acceptability, and preliminary efficacy were assessed by attendance, satisfaction, and pre-post measures of motor skills, perceived competence and motivation for physical activity, classifying foods, making healthy choices, and food consumption.

RESULTS

Six teens participated in the program and attended 87.5% of the sessions. Satisfaction data suggested that the program was well-received by both teens and parents. Trends toward improvements on physical activity and nutrition outcome measures were observed.

CONCLUSIONS

Preliminary data from this pilot study suggest that physical and food literacy in youth with intellectual disabilities can be improved, which in turn may contribute to the adoption of healthy lifestyles.

Do STEM women feel ethically and emotionally better prepared for their careers than men?

Despite a growing imperative for graduates to possess STEM skills, both to boost their employability prospects and their perceived economic value, it is critical to also consider the professional or 'soft skills' that will enable these graduates to thrive in their careers. Ironically, gender differences in personality and occupational choice are larger, not smaller, in more gender-equal countries. This is known as the gender equality paradox and in STEM it highlights the importance of purposeful initiatives throughout the educational trajectory, even in countries with higher levels of gender equality. This study employed an online self-assessment of perceived employability (PE) using a validated instrument and analyzed the data from 2493 STEM students studying at multiple Australian universities. The findings, underpinned by Social Cognitive Careers Theory, indicate that female report greater confidence than their male peers in ethical literacy and in some emotional literacy skills; these are understood to be critical soft skills for STEM graduates. This distinction is more pronounced in the natural and physical sciences and within information technology fields. Theoretical contributions and practical implications are discussed.

Genome-Wide Analyses of Vocabulary Size in Infancy and Toddlerhood: Associations With Attention-Deficit/Hyperactivity Disorder, Literacy, and Cognition-Related Traits

BACKGROUND

The number of words children produce (expressive vocabulary) and understand (receptive vocabulary) changes rapidly during early development, partially due to genetic factors. Here, we performed a meta-genome-wide association study of vocabulary acquisition and investigated polygenic overlap with literacy, cognition, developmental phenotypes, and neurodevelopmental conditions, including attention-deficit/hyperactivity disorder (ADHD).

METHODS

We studied 37,913 parent-reported vocabulary size measures (English, Dutch, Danish) for 17,298 children of European descent. Meta-analyses were performed for early-phase expressive (infancy, 15-18 months), late-phase expressive (toddlerhood, 24-38 months), and late-phase receptive (toddlerhood, 24-38 months) vocabulary. Subsequently, we estimated single nucleotide polymorphism-based heritability (SNP-h2) and genetic correlations (rg) and modeled underlying factor structures with multivariate models.

RESULTS

Early-life vocabulary size was modestly heritable (SNP-h2 = 0.08-0.24). Genetic overlap between infant expressive and toddler receptive vocabulary was negligible (rg = 0.07), although each measure was moderately related to toddler expressive vocabulary (rg = 0.69 and rg = 0.67, respectively), suggesting a multifactorial genetic architecture. Both infant and toddler expressive vocabulary were genetically linked to literacy (e.g., spelling: rg = 0.58 and rg = 0.79, respectively), underlining genetic similarity. However, a genetic association of early-life vocabulary with educational attainment and intelligence emerged only during toddlerhood (e.g., receptive vocabulary and intelligence: rg = 0.36). Increased ADHD risk was genetically associated with larger infant expressive vocabulary (rg = 0.23). Multivariate genetic models in the ALSPAC (Avon Longitudinal Study of Parents and Children) cohort confirmed this finding for ADHD symptoms (e.g., at age 13; rg = 0.54) but showed that the association effect reversed for toddler receptive vocabulary (rg = -0.74), highlighting developmental heterogeneity.

CONCLUSIONS

The genetic architecture of early-life vocabulary changes during development, shaping polygenic association patterns with later-life ADHD, literacy, and cognition-related traits.

Self-perceived food literacy in relation to the quality of overall diet and main meals: A cross-sectional study in Japanese adults

This cross-sectional study aimed to assess the relationship between self-perceived food literacy (SPFL) and quality of overall diet and main meals in Japanese adults. In total, 5998 adults aged 20-79 years were included in this analysis. The SPFL was assessed using the Japanese version of the 29-item Dutch SPFL scale (score range 1-5). Using validated dietary information, the Healthy Eating Index-2015 (HEI-2015) was calculated (score range 0-100). The mean SPFL was 3.18; the internal consistency of the overall scale was considered good (Cronbach's alpha: 0.80). The mean HEI-2015 for overall diet was 50.4. The SPFL was significantly and positively associated with the HEI-2015. Using multiple linear regression, one point increase of SPFL corresponded to an increase in HEI-2015 by a point of 4.8 for overall diet, 6.2 for breakfast, 4.6 for lunch, and 3.6 for dinner (all P < 0.0001). Six of the eight domains of SPFL (i.e., food preparation skills, resilience and resistance, healthy snack styles, examining food labels, healthy budgeting, and healthy food stockpiling) were significantly associated with the HEI-2015 for overall diet. When the HEI-2015 for each meal was examined, the domains showing significant associations with all three meals included food preparation skills, healthy snack styles, and healthy budgeting. The healthy food stockpiling was associated with the HEI-2015 for breakfast and lunch, but not dinner. The social and conscious eating and daily food planning were associated with the breakfast HEI-2015 only, with the resilience and resistance associated with the dinner HEI-2015 only. In conclusion, the SPFL was cross-sectionally associated with the quality of overall diet and main meals in Japanese adults. Further observation and intervention studies are needed to confirm the associations observed here.

A Model of the Home Literacy Environment and Family Risk of Reading Difficulty in Relation to Children's Preschool Emergent Literacy

This study extends the research on the preschool home literacy environment (HLE) in the context of the family risk (FR) of reading disability (RD) by examining a multiple-deficit model of RD. A total of 1,171 six-year-old Norwegian children were assessed at school entry, the onset of formal reading instruction in Norway. Their parents completed a questionnaire regarding their own RD, education, and the HLE. The final sample after applying the inclusion criteria was 794 children and their parents. The findings suggest, first, that two HLE factors (access to print and reading-related activities) should be distinguished rather than treated as a single factor ("exposure to print") as the majority of previous studies have done. This finding suggests a three-factor HLE model that includes parents' reading interests and habits, reading-related activities, and access to print. Second, family risk of RD is related to some extent to the HLE, even after controlling for parents' education. Third, children's experiences in their home environments and their emergent literacy may not be independent of their family risk of RD. More importantly, this study highlights the potential protective role of the HLE, especially when there is a history of RD within the family. The reason is that the positive association between the HLE and children's code-related emergent literacy remains significant when controlling for family risk of RD (access to print → emergent literacy: 0.39 [0.01, 0.68], p < 0.01; reading-related activities → emergent literacy: 0.37 [0.02, 0.35], p < 0.01; parents' reading interests and habits → emergent literacy: 0.26 [0.001, 0.15], p < 0.01). This finding supports that children's emergent literacy can be improved via a modifiable, dynamic factor such as the HLE.

ChatGPT: Literate or intelligent about UN sustainable development goals?

Generative AI tools, such as ChatGPT, are progressively transforming numerous sectors, demonstrating a capacity to impact human life dramatically. This research seeks to evaluate the UN Sustainable Development Goals (SDGs) literacy of ChatGPT, which is crucial for diverse stakeholders involved in SDG-related policies. Experimental outcomes from two widely used Sustainability Assessment tests-the UN SDG Fitness Test and Sustainability Literacy Test (SULITEST) - suggest that ChatGPT exhibits high SDG literacy, yet its comprehensive SDG intelligence needs further exploration. The Fitness Test gauges eight vital competencies across introductory, intermediate, and advanced levels. Accurate mapping of these to the test questions is essential for partial evaluation of SDG intelligence. To assess SDG intelligence, the questions from both tests were mapped to 17 SDGs and eight cross-cutting SDG core competencies, but both test questionnaires were found to be insufficient. SULITEST could satisfactorily map only 5 out of 8 competencies, whereas the Fitness Test managed to map 6 out of 8. Regarding the coverage of the Fitness Test and SULITEST, their mapping to the 17 SDGs, both tests fell short. Most SDGs were underrepresented in both instruments, with certain SDGs not represented at all. Consequently, both tools proved ineffective in assessing SDG intelligence through SDG coverage. The study recommends future versions of ChatGPT to enhance competencies such as collaboration, critical thinking, systems thinking, and others to achieve the SDGs. It concludes that while AI models like ChatGPT hold considerable potential in sustainable development, their usage must be approached carefully, considering current limitations and ethical implications.

Literacy overrides effects of animacy: A picture-naming study with pre-literate German children and adult speakers of German and Arabic

Animacy plays a key role for human cognition, which is also reflected in the way humans process language. However, while experiments on sentence processing show reliable effects of animacy on word order and grammatical function assignment, effects of animacy on conjoined noun phrases (e.g., fish and shoe vs. shoe and fish) have yielded inconsistent results. In the present study, we tested the possibility that effects of animacy are outranked by reading and writing habits. We examined adult speakers of German (left-to-right script) and speakers of Arabic (right-to-left script), as well as German preschool children who do not yet know how to read and write. Participants were tested in a picture naming task that presented an animate and an inanimate entity next to one another. On half of the trials, the animate entity was located on the left and, on the other half, it was located on the right side of the screen. We found that adult German and Arabic speakers differed in their order of naming. Whereas German speakers were much more likely to mention the animate entity first when it was presented on the left than on the right, a reverse tendency was observed for speakers of Arabic. Thus, in literate adults, the ordering of conjoined noun phrases was influenced by reading and writing habits rather than by the animacy status of an entity. By contrast, pre-literate children preferred to start their utterances with the animate entity regardless of position, suggesting that effects of animacy in adults have been overwritten by effects of literacy.

Impact of tobacco habits on poor oral health status among bone-factory workers in a low literacy city in India: A cross-sectional study

Oral health is a vital indicator of well-being that is influenced by various habits and lifestyles of individuals. Oral diseases are the bottleneck in the effective control of non-communicable diseases (NCDs) due to chronic in nature and reciprocal relationship as sharing the common risk factors and habits such as sugar, tobacco, and alcohol consumption that increase the risk of developing various inevitable diseases. However, there is a lack of literature highlighting the relationship between risk factors for oral diseases and general health among individuals. This cross-sectional study was carried out among 500 study participants aged 20 to 64 years who gave written informed consent and were recruited by Multistage Stratified Cluster Sampling technique among workers in five bone factories, working for at least one year since January 2001 to March 2022 in Sambhal city, Uttar Pradesh. WHO-Basic Oral Health Survey-1997 was used to record the data regarding sociodemographic and oral health status variables. We used the modified WHO-STEPWISE pre-structured questionnaire to record tobacco consumption habits and oral health-seeking behavior. We scheduled a clinical intra-oral examination to record the Decayed Missing Filled Teeth (DMFT) index and the interview on the premises of five bone factories. Among the 500 bone-factory workers, the total number of males was 342 (68.40%) and 158 (31.60%) were females. The mean age (Standard Deviation) was 33.18 (10), and the mean DMFT score of factory workers was 2.84 (3.12). Production workers had the highest mean DMFT score of 4.60 (3.25). More than half of the factory workers (53.2%) were tobacco users. Tobacco users were 3.52 times more likely to have a severe DMFT index. Most common pre-cancerous lesions were oral submucous fibrosis and leukoplakia. Compared to non-tobacco users, mild tobacco users have 6.80 folds higher odds of oral lesions. Tobacco consumption is not only harmful for oral health but also leads to several non-communicable and systemic diseases. NCDs and dental caries are chronic and preventable conditions with a bidirectional relationship implicated by modifiable major risk factors such as tobacco consumption. Decreasing the consumption of tobacco use may improve oral health and reduce the risk of the development of NCDs. Also, regular dental visits should be scheduled to monitor the oral health status of factory workers. Additionally, tailored intervention for tobacco cessation should be implicated to maintain the general and oral health of industrial workers.

Population ageing, incarceration and the growing digital divide: Understanding the effects of digital literacy inequity experienced by older people leaving prison

BACKGROUND

Digital inequity refers to the inequality and exclusion experienced by those who lack the same opportunities or circumstances to support the development of digital skills as the rest of modern society. One rapidly growing and highly vulnerable group to digital inequity is older people attempting to reintegrate into society after release from prison, where technology access is limited. Inadequate support for digital skills in this population entails widespread consequences for public health, human rights, social welfare and recidivism. This qualitative study is the first to: examine digital inequity experienced by older people who have been incarcerated, understand the effects of this on reintegration to society, and begin informing appropriate solutions.

METHOD

Semi-structured interviews were conducted with N = 15 older people (mean age = 57) who had been released from an Australian prison in the last two years, regarding their experiences of digital literacy since leaving prison. Reflexive thematic analysis was conducted under a critical realist lens.

RESULTS

The analysis resulted in six themes that illustrated the extent of digital inequity experienced by this population, and key challenges for improving digital literacy: 'surviving in a digital world', 'stranger in a foreign world', 'questioning the digital divide', 'overcoming your "old" self', 'don't like what you don't know', and 'seeking versus finding help'.

CONCLUSIONS

The digital inequity that older people experience during and after incarceration creates additional challenges for a growing group who are already medically and socially marginalised. Prioritisation of this group for digital literacy initiatives both during incarceration and in the community will have benefits for their health, social and financial reintegration. Their unique life experiences should be considered in designing and delivering these programs. Simultaneously, prisons should be cognizant of the potential detrimental effects of technology restriction on reintegration and criminogenic outcomes.

The Impact of Morphological Intervention on Literacy Knowledge and Reading Motivation: A Cluster-Randomized Comparison Trial in Diverse Socioeconomic Status Kindergartens

PURPOSE

This study investigated the effectiveness of a storytelling-based morphological intervention program on the language and literacy knowledge and reading motivation of kindergarten children from low and mid socioeconomic status (SES) backgrounds. It also explored how these groups compared in change scores against a non-intervened high SES group.

METHOD

Employing a cluster randomization approach, this study included 158 kindergarten children, comprising intervention and comparison groups from low and mid SES backgrounds, as well as a non-intervened high SES group. Assessments were conducted on morphological awareness (MA), print concepts, vocabulary, and reading motivation.

RESULTS

Children in the intervention groups showed better performance in MA and print concept scores than those in their respective comparison groups. The mid SES intervention group also displayed significant improvement in vocabulary and motivation scores compared to its counterpart. When examining the effects of SES on change scores, the low SES intervention group achieved superior results in vocabulary and print concept scores compared to both the mid SES intervention and the non-intervened high SES groups. For reading motivation, the mid SES group outperformed the low SES group.

CONCLUSIONS

The morphological intervention program using storytelling positively impacts both the literacy skills and reading motivation of kindergarten children, especially those from low and mid SES backgrounds. This study emphasizes the significance of designing interventions that cater to the distinct educational needs of children from different SES backgrounds.

Development of an index system for the scientific literacy of medical staff: a modified Delphi study in China

BACKGROUND

Scientific research activity in hospitals is important for promoting the development of clinical medicine, and the scientific literacy of medical staff plays an important role in improving the quality and competitiveness of hospital research. To date, no index system applicable to the scientific literacy of medical staff in China has been developed that can effectively evaluate and guide scientific literacy. This study aimed to establish an index system for the scientific literacy of medical staff in China and provide a reference for improving the evaluation of this system.

METHODS

In this study, a preliminary indicator pool for the scientific literacy of medical staff was constructed through the nominal group technique (n = 16) with medical staff. Then, two rounds of Delphi expert consultation surveys (n = 20) were conducted with clinicians, and the indicators were screened, revised and supplemented using the boundary value method and expert opinions. Next, the hierarchical analysis method was utilized to determine the weights of the indicators and ultimately establish a scientific literacy indicator system for medical staff.

RESULTS

Following expert opinion, the index system for the scientific literacy of medical staff featuring 2 first-level indicators, 9 second-level indicators, and 38 third-level indicators was ultimately established, and the weights of the indicators were calculated. The two first-level indicators were research literacy and research ability, and the second-level indicators were research attitude (0.375), ability to identify problems (0.2038), basic literacy (0.1250), ability to implement projects (0.0843), research output capacity (0.0747), professional capacity (0.0735), data-processing capacity (0.0239), thesis-writing skills (0.0217), and ability to use literature (0.0181).

CONCLUSIONS

This study constructed a comprehensive scientific literacy index system that can assess medical staff's scientific literacy and serve as a reference for evaluating and improving their scientific literacy.

Medical students' AI literacy and attitudes towards AI: a cross-sectional two-center study using pre-validated assessment instruments

BACKGROUND

Artificial intelligence (AI) is becoming increasingly important in healthcare. It is therefore crucial that today's medical students have certain basic AI skills that enable them to use AI applications successfully. These basic skills are often referred to as "AI literacy". Previous research projects that aimed to investigate medical students' AI literacy and attitudes towards AI have not used reliable and validated assessment instruments.

METHODS

We used two validated self-assessment scales to measure AI literacy (31 Likert-type items) and attitudes towards AI (5 Likert-type items) at two German medical schools. The scales were distributed to the medical students through an online questionnaire. The final sample consisted of a total of 377 medical students. We conducted a confirmatory factor analysis and calculated the internal consistency of the scales to check whether the scales were sufficiently reliable to be used in our sample. In addition, we calculated t-tests to determine group differences and Pearson's and Kendall's correlation coefficients to examine associations between individual variables.

RESULTS

The model fit and internal consistency of the scales were satisfactory. Within the concept of AI literacy, we found that medical students at both medical schools rated their technical understanding of AI significantly lower (MMS1 = 2.85 and MMS2 = 2.50) than their ability to critically appraise (MMS1 = 4.99 and MMS2 = 4.83) or practically use AI (MMS1 = 4.52 and MMS2 = 4.32), which reveals a discrepancy of skills. In addition, female medical students rated their overall AI literacy significantly lower than male medical students, t(217.96) = -3.65, p <.001. Students in both samples seemed to be more accepting of AI than fearful of the technology, t(745.42) = 11.72, p <.001. Furthermore, we discovered a strong positive correlation between AI literacy and positive attitudes towards AI and a weak negative correlation between AI literacy and negative attitudes. Finally, we found that prior AI education and interest in AI is positively correlated with medical students' AI literacy.

CONCLUSIONS

Courses to increase the AI literacy of medical students should focus more on technical aspects. There also appears to be a correlation between AI literacy and attitudes towards AI, which should be considered when planning AI courses.

Understanding the processes, practices and influences of calibration on feedback literacy in higher education marking: A qualitative study

BACKGROUND

In the University setting, striving for consistency and reliability of assessment evaluation is essential to reducing the impact of marking variations. Marking processes such as consensus calibration have the potential to reduce issues which arise from the influence of markers professional knowledge and experience, as well as fixed and acquired marking habits. Furthermore, the influence of marker feedback which supports learning development is associated with the feedback literacy of both the teacher and the student. A gap is currently present in the literature as these practices are not discussed together.

OBJECTIVES

To explore how nursing academics perceive and understand calibration practices and associated feedback literacy.

DESIGN

Theoretical underpinnings in participatory and person-centred research methodology supported the critical ontological perspective of this study where the intent of the research was to explore the reality that exists within the context where the research was conducted.

SETTING

A single School of Nursing in an Australian University with six campuses spanning metropolitan, regional and rural sites.

PARTICIPANTS

Nursing academics and casual tutors with various levels of experience in assessment marking and feedback.

METHODS

Semi-structured group interviews that were analysed using reflexive thematic analysis.

RESULTS

Four overarching themes were identified; rubrics, calibration, feedback and justice.

CONCLUSION

Calibration improves staff cohesion, fosters better practices and consistency, and permits nuanced interpretation of assessments while maintaining uniformity. Enhanced feedback literacy that integrates principles of equity, justice, and learner-centeredness is required. Fundamentally calibration guides educators toward holistic approaches that foster consistency, equity, and thorough feedback practices.

PERSIST: a pre-post study to assess an educational methodology to enhance youth climate literacy and systems thinking ability

BACKGROUND

Education has a pivotal role in preparing society to address the forthcoming health impacts of the climate crisis. Education provides the tools necessary to instil both individual and collective attitudes for mitigating climate change, fosters the development of adaptive skills and mindsets, and promotes a critical understanding of climate change. The aim of the PERSIST project was to assess the effectiveness of a school educational intervention to strengthen literacy on the climate crisis, pro-environmental behaviours, and systems thinking in high school students (aged 14-18 years).

METHODS

Three meetings were carried out in a scientific high school in the suburbs of Rome (Italy) between March 21, and April 12, 2023, using complex systems models, group activities, and collective discussions. Pre-intervention and post-intervention questionnaires were administered to students to record knowledge, climate-related emotions, and pro-environmental behaviours. Questionnaires that were complete were considered valid. The anonymously collected data were processed using descriptive statistics and t test.

FINDINGS

A total of 273 students in ten different classes attending between grades 1 and 4 took part in the project. 78 (36%) participants were female, 133 (62%) were male, and four (2%) did not disclose their gender. The mean age was 15 years. We received 211 pairs of valid pre-intervention and post-intervention questionnaires. The preliminary analysis showed an average increase of 19% in correct responses to knowledge questions, a 21·2% increase in pro-environmental behaviours, and no discernible differences in climate-related emotions between pre-intervention and post-intervention questionnaires.

INTERPRETATION

An interactive approach and the use of complex systems might improve students' literacy and attitudes towards the climate crisis, without increasing negative ecological emotions. This pilot project can guide similar, repeatable programmes in other schools and countries and it represents the first measure of climate-related emotions after school intervention.

FUNDING

None.

Are children with early literacy difficulties at risk for anxiety disorders in late childhood?

The present study examined whether literacy difficulties in both grades 2 and 3 are associated with social and generalized anxiety within the school environment in grade 5 and if children with different literacy difficulties differ in anxiety levels compared to typically developing children in grade 5 after controlling for inattention. Sixty-nine Greek children with literacy difficulties and fifty-two children with typical literacy development were assessed at the beginning of grade 2 and at the end of grade 3 on standardized literacy measures (reading accuracy, text-reading fluency, reading comprehension, and spelling). In grade 5, teachers were asked to rate their children's social and generalized anxiety levels and inattentive behavior in the school context. Results of one-way ANCOVAs showed that children with literacy difficulties were experiencing more social anxiety than typically developing children. Furthermore, children with both reading and spelling difficulties, but not those with single reading or spelling difficulties, had more social anxiety. These findings suggest that there is a close connection between early literacy difficulties and social anxiety in upper elementary grades and particularly among children with both reading and spelling difficulties. Implications for both teachers and other professionals who support children's socioemotional development will be discussed.

The impact of school-based cooking classes on vegetable intake, cooking skills and food literacy of children aged 4-12 years: A systematic review of the evidence 2001-2021

BACKGROUND

Many children consume a poor quality diet with only a third of children aged 6-9 years eating vegetables daily. A high quality diet is important for good health in childhood; however, the prevalence of children living with obesity has doubled from 10% to 23% during primary school in the UK. Cooking lessons have the potential to improve diet quality and reduce obesity prevalence in childhood, both of which are associated with improved cardiometabolic outcomes in adulthood. The aim of this systematic review is to investigate the impact of school-based cooking classes on cooking skills, food literacy and vegetable intake of children aged 4-12 years.

METHODS

We conducted a systematic review of OVID Medline, OVID Embase, EBSCO CINHAL and EBSCO ERIC for comparative studies that evaluated outcomes of children receiving cooking classes compared to a control group. Interventions included contained food preparation or a cooking activities and took place on school premises. Risk of bias was assessed using ROB2 and Robins-I. Outcomes were pooled in a meta-analysis using a random-effects model using standardised mean differences or reviewed using narrative synthesis. Certainty of evidence was assessed using GRADE.

RESULTS

We included 21 studies, (6 randomised). Meta-analysis showed a small positive effect on cooking self-efficacy of 0.39 units (95% CI 0.05 to 0.54), and a small positive effect on vegetable intake of 0.25 units (95% CI 0.05 to 0.45). Programmes with more than 6 h of cooking showed the greatest effects.

CONCLUSIONS

Children's cooking programmes result in small improvements in cooking efficacy and vegetable intake, particularly those with more than 6 h of classes. It is recommended that future interventions use consistent measurement for children's food literacy and cooking confidence.

Effectiveness of Serious Games in Improving Genetic Literacy and Genetic Risk Awareness in the General Public: A Pilot Study

Background: Genomics is an integral part of medical science; however, European citizens' literacy on basic genetic concepts is still poor. The aim of this study was to evaluate the effectiveness of Serious Games (SGs) in increasing genetic literacy in laypeople and to assess the impact of SGs on participants' perceived self-efficacy (SE) in managing genetic risk implications. Materials and Methods: Two minigames and an adventure game were created, together with leaflets reporting the same information as the SGs. Sixty participants enrolled at baseline and completed a brief sociodemographic questionnaire and an ad hoc questionnaire assessing their genetic knowledge. They were assigned to the SGs group (30 subjects) or to the Leaflets group (30 subjects) by matching age and sex. Both groups had about 40 minutes to play the SGs or to read the leaflets. In the postlearning session, participants completed the same genetic knowledge questionnaires administered at baseline and five items from the Self-Efficacy Scale, whereas the SGs group also filled in the In-Game Experience Questionnaire. Results and Conclusion: Results showed that learning genetic concepts through SGs was comparable to learning through leaflets. Playing SGs was also associated with poor feelings of frustration or annoyance, good engagement in the game challenges and contents, and positive feelings, particularly in subjects under 30 years. Participants perceiving SE increased significantly in both Leaflets and SGs groups, but the effect was higher for SGs players. SGs have the potential to increase genetic literacy in the public by making the learning process more engaging, pleasant and by enhancing SE.

Evaluation of depression symptoms and depression literacy among medical students: a cross-sectional study

OBJECTIVE

Mental health plays an important role in educational performance. The present study aimed to determine the relationship between depression symptoms, depression literacy, and quality of life in undergraduate and postgraduate medical students in the Kingdom of Saudi Arabia.

SUBJECTS AND METHODS

This cross-sectional survey was conducted in 2023 in Riyadh with 263 medical students. Data were obtained using three different sets of questionnaires (a demographic section, the Depression Literacy Scale, and a quality-of-life questionnaire).

RESULTS

In total, 134 men (51%) and 129 women (49%) participated in the study; out of these, 142 participants reported depression, while 109 individuals reported family-related depression. Only 25% of the participants attended depression seminars and workshops in the last year, while 83% felt that depression was an illness. Students with a family history of depression also reported higher levels of depression. Depression was lowest among students who attended depression management seminars or workshops. Marital status did not affect depression among medical students.

CONCLUSIONS

These findings reveal that depression is widespread among medical students and that counseling and frequent depression assessments are required. There is a need for greater awareness of different aspects of depression among medical students, parents, and medical educators. Health education programs and interventions targeting mental health care can be implemented at the individual, family, and community levels.

Effectiveness of a food literacy and positive feeding practices program for parents of 0 to 5 years olds in Western Australia

ISSUE ADDRESSED

Lifelong eating behaviours are established in childhood. Improving parents' food literacy skills is essential, as parents play a fundamental role in establishing their children's healthy eating behaviours and preferences for nutritious food. This paper describes the development and evaluation of an innovative program that combines food literacy with positive parent feeding practices, targeting parents in disadvantaged areas of Western Australia.

METHODS

The Food Sensations® for Parents five-week program was delivered to participants from community-based parenting organisations during 2020 and 2021. Formative research and a pre-post evaluation design were adopted.

RESULTS

Pre- and post-evaluation data were collected from 224 participants (96% female). There was a statistically significant improvement in the mean score for 13 food literacy behaviours, 10 positive parenting feeding practices and a mean increase in parents' daily vegetable intake of 1/3 serve. Participants reported significantly greater net improvements in food literacy behaviours than feeding practices, the largest being the Use a nutrition information panel to make food choices (33.1%). Multivariate logistic regression analyses found English as a first language, being older than 35, and from a higher Socio-Economic Index for Areas resulted in a higher likelihood of positive changes in behaviours and practices.

CONCLUSIONS

The findings indicate that the program is effective in improving the frequency of use of food literacy behaviours, positive parenting feeding practices and increasing vegetable consumption. SO WHAT?: Analysing improvements in food literacy behaviours and feeding practices provides clarity on what change can be expected with a five-week parent program.

Heat literacy and adaptation among semi-rural community in Malaysia

BACKGROUND

Heatwaves present health risks globally but there is limited evidence on how temperature perceptions affect activities. This study aimed to examine community perceptions of heat as a potential health hazard and ascertain the current heat protection measures of the residents of the South East Asia Community Observatory (SEACO) in Malaysia.

METHODS

In this longitudinal study, we randomly selected community members aged between 18 and 70 years who resided in Segamat district of Johor state, Malaysia. Over 21 days, we conducted three home visits to each participant. During each visit, participants completed a questionnaire consisting of Likert scale, multiple choice, and free text questions and we collected quantitative and qualitative data. These inquiries assessed the participants' perception of heat as health threat, whether or not they took heat preventive measures, and the specific protective measures they routinely employed. Descriptive data analyses were conducted and patterns of protective measures were investigated.

FINDINGS

Between March 29 and July 31, 2023, 120 participants (72 women and 48 men) completed 360 questionnaires over three home visits. Initially, 58% participants recognised heat hazards to daily activities, decreasing to 42% and 35% by visits 2 and 3. Participants took preventive measures throughout the day, which was consistently high between 1200 h and 1400 h, with 77% of participants taking preventive measures on visit 1, 82% on visit 2, and 82% on visit 3. Use of preventive measures was also high between 1400 h and 1730 h, with 77% using preventive measure on visit 1, 81% on visit 2, and 79% on visit 3. The most common protective measures were fans (used by 68-88% of participants), drinking more water (70-78% of participants), and resting (44-72% of participants). The least common were relocating to cooler places, removing clothes, and using wet towels (0-2·5%). Despite high temperatures, perceptions of heat risks decreased over time. Participants took basic protections, especially at midday, but improved literacy and affordable cooling options are needed to protect vulnerable rural populations.

INTERPRETATION

Our findings underline the need to improve heat literacy and adaptation as only half of the population assessed perceived heat as a potential health hazard and practised limited heat protective measures. Addressing climate change and health necessitates fundamental behavioural changes on the part of individuals and communities, to protect them against the adverse effects of heat.

FUNDING

Monash University Malaysia and Heidelberg Institute of Global Health, Heidelberg University.

Parents on the Concept of Physical Literacy: What Do They Know, What Do They Do, and What Do They Want?

Physical literacy development in early childhood, viewed by many as the foundation for lifelong physical activity engagement, is significantly influenced by parents. Our aim was to explore parents' understanding of physical literacy and gain insight into their perspectives on physical literacy promotion. We recruited 18 parents of children between 5 and 8 years old in Australia. Using semistructured interviews and thematic analysis, we identified several key issues regarding parents' understanding and implementation of physical literacy. Parents expressed interest in improving their implementation of physical literacy practices and had (often unintentionally) provided support for physical literacy subcomponents in the past. However, they described difficulties prioritizing physical literacy above other parental demands and expressed conflicting perceptions regarding where the responsibility should lie for developing their child's physical literacy (e.g., at home or at school). To ensure that the physical literacy "message" reaches parents, we encourage physical literacy promoters to consider the target (e.g., responsibility, priorities, and awareness) of their promotional strategies. Further investigation into the influence of sociocultural and economic factors on parents' understanding and application of physical literacy is warranted.

Youth Perspectives on the Effects of a Family-centered Media Literacy Intervention to Encourage Healthier Eating

A pretest-posttest field test with control group (N = 189 parent-child dyads) tested a structural model representing youths' (ages 9-14) perspectives to examine the efficacy of a family-centered, media literacy-oriented intervention promoting fruit and vegetable consumption. The intervention facilitated critical discussion about nutrition and media, mentored by the parent. Results showed that youths' increases in fruit and vegetable consumption flowed from parent-child discussion of nutrition labels, which was predicted by child-initiated discussion, critical thinking about media sources, and critical thinking about media content. Multivariate analyses revealed that the intervention was productive for all participating age groups and for all dependent variables. The results suggest that a developmental progression from critical thinking about source to critical thinking about content affects behavior change and can be catalyzed through media literacy education and encouragement to discuss media messages (i.e. practice) with parents.

A systematic review of the impact of childhood vision impairment on reading and literacy in education

PURPOSE

This systematic review evaluates current literature on the impact vision impairment has on reading and literacy levels within education.

METHODS

Six databases were searched with inclusion criteria of trials or studies involving children who are blind or vision impaired, and impact on academic or school performance - including reading and literacy. 1262 articles were identified, with 61 papers undergoing full screening. Quality appraisal was performed using Critical Appraisal Skills Program (CASP) and seven articles deemed eligible for inclusion.

RESULTS

Included articles achieved a quality score of over 70 % using the CASP checklists. Direct comparison of articles was not possible due to methodological differences in assessing reading and literacy levels. All seven studies investigated aspects of reading speed, with additional measures of reading performance, such as reading reserve, comprehension, and reading accuracy.

DISCUSSION

Underlying trends highlighted students with a vision impairment do not perform at same level as their normally sighted peers with respect to reading performance - in terms of speed, but not ability. Additionally, early intervention to enhance literacy skills may help improve educational outcomes. Future direction should be aimed at identifying specific obstacles to learning these students face and providing interventions to improve academic outcomes.

The Contribution of Perceptual Reasoning Skills to Phonological Awareness for School Age Autistic Children

This study aimed to investigate the phonological awareness (PA) skills of school age autistic children (age range = 6-12) in two parts: (1) comparing their performance on a PA task to non-autistic children with groups matched on chronological age, verbal and non-verbal cognitive skills, and (2) exploring the role of cognitive skills and autism characteristics on PA skills. Results revealed that the groups did not differ in their PA skills (study 1) and that perceptual reasoning skills are associated with the PA skills of autistic participants (study 2). Results highlight the role of non-verbal cognitive skills in literacy development for autistic children and suggest that their perceptual reasoning abilities likely contribute a great deal when learning to read.

Validation of the Portuguese Version of the Perceived Physical Literacy Instrument

BACKGROUND

The Perceived Physical Literacy Instrument (PPLI) has been the most adopted physical literacy instrument designed for adults to date, having been already translated to 5 languages. Still, despite its popularity, there is limited evidence of its psychometric properties. The aim of this study was to translate and adapt cross-culturally the PPLI to the Portuguese language and to analyze the psychometric properties of the Portuguese version in a sample of Portuguese-speaking adults.

METHODS

The study sample was composed of 434 participants (70% females) with a median age of 25 (18-39) years. Confirmatory factor analysis was used to assess psychometric properties of the scale. In addition, instrument assumptions between sexes through invariance testing were examined. Finally, concurrent validity, test-retest reliability, and test-retest agreement analyses were performed to gather additional evidence.

RESULTS

The results of the present study generally supported the measurement model. The 9-item, 3-factor model presented a good fit to the data and adequate construct validity (χ2 = 82.859 [24], P < .001, comparative-fit index = .948, Tucker-Lewis index = .922, standardized root mean square residual = .049, root mean square error of approximation = .075). In addition, the scale presented concurrent validity. Some issues arose with measurement invariance and overtime consistency.

CONCLUSIONS

Considering the lack of validated instruments, we suggest a fair use of Portuguese version of PPLI to access physical literacy in adults. This study contributes to the validation of the PPLI by providing evidence of its psychometric properties in the Portuguese-speaking adult population and facilitates comparative analysis with previous and future studies utilizing the PPLI instrument.

The validity of the Physical Literacy in Children Questionnaire in children aged 4 to 12

BACKGROUND

Given the growing evidence on the health benefits associated with physical literacy (PL), it is necessary to develop sound measures to assess the levels of PL in children. The Physical Literacy in Children Questionnaire (PL-C Quest) is the first self-report pictorial-based scale to assess children's perceived PL. It has good validity and reliability in Australian children aged 7 to 12 years, but little is known in younger children and in other cultural contexts. The aim of this study was to examine the validity and reliability in an expanded age range.

METHODS

A total of 1,870 Chinese children (girls, n = 871; 46.6%), aged 4 to 12 years (M = 8.07 ± 2.42) participated in validity testing. Structural equation modeling with the Weighted Least Squares with Mean and Variance approach was used to assess construct validity. The hypothesized theoretical model used the 30 items and four hypothesized factors: physical, psychological, social and cognitive capabilities. Multigroup confirmatory factor analysis was used to assess sex and age group (4-6 years, 7-9 years and 10-12 years) measurement invariance. Internal consistency analyses were conducted using polychoric alpha. A random subsample (n = 262) was selected to determine test-retest reliability using Intra-Class Correlations (ICC).

RESULTS

All items except one (moving with equipment-skateboarding) loaded on sub-domains with λ > 0.45. The hypothesized model had a good fit (CFI = 0.954, TLI = 0.950, RMSEA = 0.042), with measurement equivalence across sex and age groups separately. Internal consistency values were good to excellent (overall: α = 0.94; physical: α = 0.86; psychological: α = 0.83; social: α = 0.81; cognitive: α = 0.86). Test-retest reliability was adequate to excellent (overall: ICC = 0.90, physical: ICC = 0.86, psychological: ICC = 0.75, social: ICC = 0.71, cognitive: ICC = 0.72).

CONCLUSION

The Chinese version of the PL-C Quest is valid and reliable for testing the self-reported PL of Chinese children aged 4 to 12. This study provides the first evidence of validity for this tool in children aged 4-6 years and also evidence that the PL-C Quest would be a meaningful instrument to assess PL in Chinese children.

Reaching the unheard: overcoming challenges in health research with hard-to-reach populations

PURPOSE

Addressing obstacles such as logistical complexities, social stigma, and the impact of historical traumas is essential for the successful inclusion of underrepresented groups in health research.

METHODS

This article reviews engagement and interview techniques used to ethically engage recently settled Afghan refugees in Oklahoma and rural Mexican-born women in Illinois in research. The paper concludes with a reflective discussion on the challenges and lessons learned.

RESULTS

Creative strategies to engage hard-to-reach populations in research included considering the participants' socioeconomic and cultural contexts in their interactions and developing community partnerships to establish trust and obtain reliable data. Other engagement strategies were communicating in the participants' preferred language, providing assistance with reading and responding to study questions for those with low literacy, employing research staff from the population of interest, and recruiting in specific locations where the populations of interest live.

CONCLUSIONS

Community engagement is essential at all stages of research for building trust in hard-to-reach populations, achieving inclusivity in health research, and ensuring that interventions are culturally sensitive and effective.

I feel blue- teacher, can you help me? A study on the effect of digital literacies on language learners' technostress, on-line engagement, autonomy, and academic success

This phenomenological study explored the experiences of language learners in the digital age, specifically investigating the intersection of digital literacy, technostress, online engagement, autonomy, and academic success. Twenty participants, selected through purposive sampling, shared Chinese as their native language and were between 18 and 20 years old, with five participants being female. Employing interviews and document analysis, the study aimed to understand the subjective meanings, emotions, and perceptions associated with these phenomena. The findings revealed the multifaceted nature of technostress, the crucial role of digital literacy in shaping online engagement and autonomy, and the nuanced impact on academic success. These qualitative insights contribute to a deeper understanding of the complex relationships in the digital language learning landscape. The study has implications for educators, materials developers, syllabus designers, and policy-makers, providing practical insights to enhance language learning experiences in the digital era. Future research may further explore specific dimensions uncovered in this study to adapt educational practices to the evolving digital terrain.

Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets

Food literacy has emerged as a key individual trait to promote the transformation of food systems toward healthy and sustainable diets. Childhood and adolescence are key periods for establishing the foundations of eating habits. Different food literacy competencies are acquired as children develop different cognitive abilities, skills, and experiences, contributing to the development of critical tools that allow them to navigate a complex food system. Thus, the design and implementation of programs to support the development of food literacy from early childhood can contribute to healthier and more sustainable eating habits. In this context, the aim of the present narrative review is to provide an in-depth description of how different food literacy competencies are developed in childhood and adolescence, integrating the extensive body of evidence on cognitive, social, and food-related development. Implications for the development of multisectoral strategies to target the multidimensional nature of food literacy and promote the development of the 3 types of competencies (relational, functional, and critical) are discussed.

Dark Data in Real-World Evidence: Challenges, Implications, and the Imperative of Data Literacy in Medical Research

Randomized controlled trials (RCTs) and real-world evidence (RWE) studies are crucial and complementary in generating clinical evidence. RCTs provide controlled settings to validate the clinical effect of specific drugs or medical devices, while RWE integrates extrinsic factors, encompassing external influences affecting real-world scenarios, thus challenging RCT results in practical applications. In this study, we explore the impact of extrinsic factors on RWE outcomes, focusing on "dark data," which refers to data collected but not used or excluded from the analyses. Dark data can arise in many ways during research process, from selecting study samples to data collection and analysis. However, even unused or unanalyzed dark data hold potential insights, providing a comprehensive view of clinical contexts. Extrinsic factors lead to divergent RWE outcomes that could differ from RCTs beyond statistical correction's scope. Two main types of dark data exist: "known-unknown" and "unknown-unknown." The distinction between these dark data types highlights RWE's complexity. The transformation of unknown into known depends on data literacy-powerful utilization capabilities that can be interpreted based on medical expertise. Shifting the focus to excluded subjects or unused data in real-world contexts reveals unexplored potential. Understanding the significance of dark data is vital in reflecting the complexity of clinical settings. Connecting RCTs and RWEs requires medical data literacy, enabling clinicians to decipher meaningful insights. In the big data and artificial intelligence era, medical staff must navigate data complexities while promoting the core role of medicine. Prepared clinicians will lead this transformative journey, ensuring data value shapes the medical landscape.

Literacy and attitude of Asian youths on dengue and its prevention in an endemic developed community

Background

Over the past few decades, the incidence of dengue fever has considerably increased. Effective vector control strategies and specific protection using dengue vaccine are thought to be the key elements to combat dengue. The dengue incidence among the Singapore youths (15-24 years) was second only to that of adults (25-44 years). This study evaluated the knowledge and attitude of Singapore youths on dengue and its preventive measures.

Methods

A cross-sectional study using online-based questionnaire survey was conducted among Singapore youths from September to November 2022. Data were analyzed for descriptive statistics whereas Chi-squared test, linear regression analysis and Pearson correlation were used to determine the association between demographic factors and youth's attitude on dengue prevention using Rstudio.

Results

A total of 624 respondents completed the survey out of 1822 surveys distributed nation-wide, with a response rate of 34.2% (mean age 17.4 years ± 1.84; 59.3% female; 89.9% Chinese). The mean dengue knowledge scores of participants were 14.1 ± 2.8. Univariate analysis showed that teenagers (15-19 years) had significantly higher knowledge score than the young adults (20-24 years) (β =0.82,95%CI = 0.13-1.51, p = 0.021). Majority of them were aware of the Mozzie Wipeout campaign (90.2%) followed by the release of Wolbachia mosquitos (69.1%). Two-thirds of the youths who were aware of Wolbachia and Gravitrap considered that it was effective in reducing dengue infection rates. Participants suggested information about the current dengue infection rate (71.9%) as the most effective of the five proposed strategies to improve uptake of dengue preventive measures. In comparison to young adults, teenagers were more likely to uptake dengue preventive measures if widespread mosquito control practices were implemented (69.1% vs. 42.3%).

Conclusion

The overall knowledge of the youths on dengue and its prevention was satisfactory. Future health promotion campaigns targeting the youths should focus on transforming the knowledge into practice.

School-based promotion of physical literacy: a scoping review

Introduction

The role of physical activity in children's healthy development is undisputed, with school-based interventions being seen as a priority. The promotion of physical literacy (PL) seems to be promising due to its holistic approach, combining physical, cognitive, and affective domains. To develop recommendations for possible measures, we compiled existing literature on existing school-based PL interventions.

Methods

Five databases (MEDLINE, Web of Science, SPORTDiscus, ERIC, and PsycInfo) were searched between July 6 and July 10, 2023, by combining the terms "physical literacy," "school," "program," "workshop," "intervention," and "curriculum" as well as a manual search. Records were screened in a two-stage process by two independent authors using a priori criteria. Eligible studies concerned PL interventions in the school context. The included records were sorted according to school type/population, structure, content, PL domains addressed, and evaluation.

Results

In total, 706 articles were found through the database search and an additional 28 articles through the manual search. After removing duplicates, 502 publications remained, which were screened by title and abstract, leaving 82 full texts. These were cut down to 37 articles describing 31 different programs (19 in primary schools, eight in secondary schools, one in both primary and secondary schools, and three unspecified). Most interventions were conducted during physical education classes (n = 12). All three PL domains were addressed by five interventions, while 11 interventions solely concerned the physical domain. In addition, 21 interventions evaluated their effects on PL. Most evaluations showed small to moderate but inconsistent effects on several PL-related constructs (e.g., self-efficacy, motivation, movement skills). Interventions incorporating all three domains reported positive effects on physical competence and enjoyment.

Discussion

Although there is a growing body of data related to school-based PL promotion, their effects and practical application remains relatively underdeveloped: study designs, study quality, PL assessments, and results are heterogeneous. Corresponding research adhering to the holistic approach of PL will be crucial in clarifying the potential lifelong role of PL in promoting physical activity, increasing health and well-being and to actually enable development of recommendations for action.

Associations of sleep time, quality of life, and obesity indicators on physical literacy components: a structural equation model

AIM

To verify the association between ideal sleep time and physical literacy components while also considering multiple mediators, such as quality of life and obesity, using a sample of adolescents.

METHODS

This cross-sectional study consisted of 470 adolescents aged 11-17 years from southern Brazil. Sleep time, health-related quality of life, and physical literacy components (i.e., physical education enjoyment, sports participation, sedentary behavior, moderate to vigorous physical activity, sex, and age) were evaluated through self-reported questionnaires. In addition, body mass index (BMI), and waist circumference were determined. The theoretical/statistical support of the structural equation model was evaluated according to fit parameters and strength of association.

RESULTS

A direct association was observed between more sleep time and lower levels of obesity. The obesity indicators also had a negative association with HqOL, and HqOL had a positive association with physical literacy. The indirect associations indicated that the ideal sleep time was positively associated with HqOL and physical literacy components, considering the negative mediation effect of obesity. The model explains physical literacy in 31% of the variance (R = 0.31).

CONCLUSION

There was an indirect association between ideal sleep duration and quality of life and between both variables with physical literacy. These relationships occur even considering the negative influence of obesity. Therefore, a child who sleeps adequately has a higher likelihood of being physically active, regardless of obesity, potentially enhancing overall quality of life across various domains.

An Exploration of the Nature of Vocabulary Change Following Language and Literacy Together Intervention

PURPOSE

This exploratory study evaluates how bilingual first graders' vocabulary use in narrative changed after a Spanish-language intervention that focuses on connection between language and literacy.

METHOD

Ten Spanish-English bilingual first graders produced three English and three Spanish narratives based on the Test of Narrative Language protocol pre- and postintervention. All samples were transcribed. Based on comprehensive word inventories, all words produced by the children were identified as being core words; Tiers 1, 2, and 3 words; and/or cognates in both languages. We also coded all utterances for use of internal state terms (ISTs). We evaluated total and unique production of these kinds of words.

RESULTS

Postintervention children increased their total number of cognates and ISTs across languages. They also increased the unique core words, Tier 1 words, and cognates postintervention. They also used more of each of these kinds of words in Spanish-the language of intervention-than in English.

CONCLUSIONS

Children make qualitative changes to their vocabulary postintervention. There is greater change in the use of core words and Tier 1 words in Spanish. These increases in productivity and variability were indicated by the number of unique words added to the children's repertoires in ways that supported narrative production.

Determining the Diagnostic Accuracy of the Test of Integrated Language and Literacy Skills for College Students

PURPOSE

This study sought to determine whether the Test of Integrated Language and Literacy Skills (TILLS; Nelson et al., 2016) can accurately identify language disorders in college-aged adults.

METHOD

Fifty-nine college students between the ages of 18 and 23 years were administered the test battery validated by Fidler et al. (2011) for the diagnosis of language disorders as well as the Identification Core (ID Core) subtests of the TILLS validated for ages 12-18 years. Sensitivity and specificity information was calculated for the TILLS at various cut-scores to determine the diagnostic accuracy of the ID Core for this population. Discriminant function analysis was also performed to determine if sensitivity and specificity could be improved using empirically derived discriminant scores.

RESULTS

The recommended cut-score of 42 for ages 12-18 years underidentified individuals with language disorders in this sample. An adjusted cut-score of 51 maximized sensitivity and specificity to acceptable levels. Discriminant function analysis also yielded acceptable sensitivity and specificity (> 80%).

CONCLUSION

Using either an adjusted cut-score for the ID Core or weighted discriminant scores, the TILLS can be used to accurately differentiate between college-aged adults with and without language disorders.

Association of filial attitude, filial behavior and death literacy: implications for development of death system in Guangdong-Hong Kong-Macao Greater Bay Area of China

BACKGROUND

Filial piety, as a major traditional norm in Chinese culture and in Chinese families, affects the attitudes and behaviors of adult children toward their parents and impacts their end-of-life decision-making and the quality of death of their parents. Death literacy is a novel concept aimed at promoting palliative care in the context of public health.

AIMS

To understand attitudes and behaviors related to filial piety and to examine the role of death literacy in filial behaviors toward dying parents among residents in the Guangdong-Hong Kong-Macao Greater Bay Area of China.

METHODS

A cross-sectional online survey that employed the convenient and snowball sampling methods was adopted. Filial Piety Representations at Parents' End of Life Scale and Death Literacy Index were used.

RESULTS

This study identified a significant gap between the filial piety attitudes and behaviors of Chinese adult children. Gender, caregiving experience and death literacy were predictors of filial behaviors in an end-of-life context.

CONCLUSION

Providing truth disclosure support, offering guidance to young adult children and caregivers of terminally ill fathers, and strengthening factual and community knowledge of death are necessary to enhance the reciprocal comfort of both adult children and dying parents in the context of Chinese filiality.

Digital Literacy and Associated Factors in Older Adults Living in Urban South Korea: A Qualitative Study

This study aimed to explore digital literacy among community-dwelling older adults in urban South Korea. A semistructured interview guide was developed using the Digital Competence ( 2.0 framework, which emphasizes the competencies for full digital participation in five categories: information and data literacy, communication and collaboration, content creation, safety, and problem-solving. The data were analyzed using combined inductive and deductive content analysis. Inductive analysis identified three main categories: perceived ability to use digital technology, responses to digital technology, and contextual factors. In the results of deductive analysis, participants reported varying abilities in using digital technologies for information and data literacy, communication or collaboration, and problem-solving. However, their abilities were limited in handling the safety or security of digital technology and lacked in creating digital content. Responses to digital technology contain subcategories of perception (positive or negative) and behavior (trying or avoidance). Regarding contextual factors, aging-related physical and cognitive changes were identified as barriers to digital literacy. The influence of families or peers was viewed as both a facilitator and a barrier. Our participants recognized the importance of using digital devices to keep up with the trend of digitalization, but their digital literacy was mostly limited to relatively simple levels.

Financial Literacy in Plastic Surgery Training: Importance and Current Status

BACKGROUND

Medical training is known to impose financial burden on trainees, which has been shown to contribute to burnout, even possibly compromising patient care. Financial literacy allows for management of financial situations affecting professional and personal life. The authors aimed to evaluate the financial status and knowledge among plastic surgery residents.

METHODS

A survey regarding finances and financial literacy of plastic surgery residents was sent to all the current accredited U.S. residency programs. The same survey was distributed internally. A descriptive analysis was performed, and multiple Fisher exact tests and a t test evaluated comparisons.

RESULTS

Eighty-six residents were included. Most trainees had a student loan (59.3%), with 22.1% having loans more than $300,000. A majority had at least one personal loan debt other than educational (51.1%). Residents with more debt were significantly less likely to pay off their balances monthly. A total of 17.4% of trainees had no plan for how to invest their retirement savings, whereas 55.8% reported not knowing how much they need to save to retire. One in five trainees did not feel prepared to manage personal finances/retirement planning after graduation, a majority had no formal personal finance education in their curriculum, and 89.5% agreed that financial literacy education would be beneficial. Our institutional data largely mirrored national data.

CONCLUSIONS

Many residents are lacking in financial knowledge, despite most having significant debt. Additional financial literacy education is needed in plastic surgery training. Curricula development at an institutional or national society level are possible paths toward a coordinated response to this need.

Contrasting Direct Instruction in Morphological Decoding and Morphological Inquiry-Analysis Interventions in Grade 3 Children With Poor Morphological Awareness

We report on a school-based randomized control trial study comparing two morphological interventions with untaught controls: one focusing on direct instruction targeting print morphological decoding (direct decoding condition) and the other on inquiry-focused pedagogy using oral morphological analysis (inquiry-analysis condition). We identified 63 Grade 3 children with below-average morphological awareness following screening (from N = 163). This sub-sample showed average pseudoword decoding but poor language and word reading abilities. Following a 13-week supplemental intervention randomized within the 63 children, results showed a statistically significant main effect of intervention on standardized reading vocabulary measures at immediate post-test in the direct decoding condition. Pre-test morphological awareness moderated reading vocabulary effects for the untaught control group. Statistically significant moderation of growth in sentence comprehension at post- by pre-test morphological awareness was also evident in the inquiry-analysis condition. Universal screening for below-average morphological awareness followed by inquiry-based or direct instruction interventions focusing on the meaning dimensions of morphemes may be modestly efficacious for supporting reading vocabulary and sentence comprehension in such at risk learners, potentially aiding school-wide literacy improvement.

Media Literacy Practices to Prevent Obesity and Eating Disorders in Youth

PURPOSE OF REVIEW

Obesity and eating disorders share common issues related to media use and effects, especially in the USA. Current research increasingly demonstrates that media literacy can address this problem. This narrative review highlights current media literacy-based research for obesity and eating disorder prevention among youth.

RECENT FINDINGS

Current research using media literacy techniques to prevent obesity indicates that these interventions improve nutrition outcomes, improve family communication about food, improve critical thinking about food advertisements, reduce sugar and fat intake, and reduce screen use for parents and youth. In addition, eating disorder research reveals that media literacy techniques lead to higher scores of body satisfaction and self-esteem, with lower scores of perfectionism, thinness, and ideal masculinity. There is a need for media literacy-based interventions to focus on family communication to prevent obesity and eating disorders. Furthermore, there should be more focus on identified levels of prevention and specific clinical outcomes.

The Relationship of Food Literacy and Sustainable Consumption Behaviors with Anthropometric Measurements during the Covid-19 Pandemic Period: A Sample from Turkey

AIM

This study aimed to evaluate the impact of food literacy and sustainable consumption behaviors on nutritional status during the pandemic in Turkey.

METHODS

The study was conducted between May and July 2021 with a questionnaire delivered in a digital environment (social media, Twitter/Facebook/Instagram) to 200 volunteer adults aged 20-65. With this questionnaire form, sociodemographic characteristics, general information, and consumer behaviors of the individuals were obtained. Anthropometric measurements (height, body weight, body mass index (BMI), waist circumference, hip circumference, waist/hip ratio, and waist/height ratio) of the individuals were recorded online as self-report. The Self Perceived Food Literacy (SPFL) Scale was administered to measure nutritional literacy levels. To measure the sustainable consumption behaviors of the individuals, the Sustainable Consumption Behavior (SCB) Scale was administered.

RESULTS

We found that 87.2% of women and 40% of men had heard of sustainable nutrition before (p < 0.001). The mean total score of SCB was statistically significantly higher in women than in men (3.1 ± 0.48 in women, 2.9 ± 0.69 in men, p < 0.05). The mean score of SPFL was 3.31 ± 0.275 in women, while it was 3.05 ± 0.395 in men. There was a statistically significant relationship between SPFL mean scores and gender (p < 0.05).

CONCLUSION

There was a statistically significant negative relationship between SPFL score and BMI, body weight, and waist/hip ratio. There was a statistically significant negative relationship between the SCB and waist/hip ratio. Food literacy and sustainable consumption behaviors are associated with anthropometric measurements. Sustainable nutrition, sustainable consumption behaviors, and food literacy should be considered as a whole. Trainings should be increased to raise awareness of individuals about food literacy.

Colorectal cancer literacy and related factors in northeast of Iran: A cross-sectional study

BACKGROUND

Colorectal cancer (CRC) is a health challenge and the second most common cancer worldwide. Increasing colorectal cancer literacy (CRCL) is one of the most effective factors in CRC prevention.

AIM

The aim of this study was to determine and evaluate CRCL and its related factors in Torbat Heydarieh, northeastern Iran.

METHODS AND RESULTS

This study was a cross-sectional survey conducted in 2021 in Torbat Heydarieh, a city in northeastern Iran, on 200 clients presenting to a comprehensive health service centers. In addition to collecting sociodemographic characteristics, participants were administered the Knowledge and Attitude Questionnaire and the Colorectal Cancer Literacy Questionnaire (CRCLQ). Data were analyzed with SPSS software version 25 using independent samples t-tests, one-way analysis, chi-square, and Pearson correlation coefficients. The statistical significance level was set at p < .05. The results showed that the mean age of the participants was 51.12 ± 8.45 years. The majority of participants (84%) stated that their friends and relatives had no history of CRC. Pearson correlation coefficient results showed a significant correlation between knowledge and attitude toward CRC (r = .15, p = .041). A significant correlation was also found between knowledge and CRCL (r = .4, p ≤ .001).

CONCLUSION

We found low CRCL among clients of comprehensive health service centers. More targeted educational interventions are needed to promote CRCL among Iranian adults.

Variability in the age of schooling contributes to the link between literacy and numeracy in Côte d'Ivoire

Literacy and numeracy are correlated throughout development, however, our understanding of this relation is limited. We explored the predictors of literacy and numeracy covariance (i.e., shared fluency between literacy and numeracy) in children (N = 1167, girls = 563) in rural Côte d'Ivoire, with specific focus on how developmental timing of instruction may relate to covariance. Many Ivorian children experience late enrollment and grade repetition, leading to variation in age-for-grade; participants were between grades 1 to 6, but their ages ranged from 5 to 15 (M = 9.19, SD = 2.07). Phonological awareness, numerical magnitude, ordinality, working memory, and inhibitory control were cognitive predictors of covariance. Age-for-grade was negatively related to covariance suggesting that covariance is related to timing of instruction.

Guardians' food literacy and breakfast skipping among Japanese school children

Children and adolescents who regularly skip breakfast are at a greater risk of obesity than those who regularly eat breakfast. Guardian's food literacy, defined in this study as a collection of a guardian's knowledge, skill, and attitude towards healthy food practices, may directly influence their child's dietary habits. Thus, this study utilized a food literacy scale to assess the relationship between guardians' food literacy and breakfast skipping among school-attending Japanese children and adolescents and the most commonly reported reasons for skipping breakfast. This was a cross-sectional study using survey data collected from a nationally representative sample of households in Japan (n = 1520). Our results show that 13.0% of children self-reported skipping breakfast at least once a week. Children in households where guardians reported higher knowledge and attitude scores had significantly lower odds of skipping breakfast (odds ratios = 0.90 [95% confidence interval: 0.83-0.98] and 0.81 [0.74-0.90], respectively). These findings suggest that a guardian's attitude and knowledge towards healthy food practices influence the frequency at which their child eats breakfast. Moreover, lower parental attitude scores were associated with children skipping due to not having enough time for breakfast in the morning. Improving guardians' food literacy may provide an avenue by which to decrease the rate of breakfast skipping among children and adolescents, thereby decreasing the risk of obesity and other adverse health outcomes.