Sleep restriction alters the integration of multiple information sources in probabilistic decision-making.

The detrimental effects of sleep loss on overall decision-making have been well described. Due to the complex nature of decisions, there remains a need for studies to identify specific mechanisms of decision-making vulnerable to sleep loss. Bayesian perspectives of decision-making posit judgement formation during decision-making occurs via a process of integrating knowledge gleaned from past experiences (priors) with new information from current observations (likelihoods). We investigated the effects of sleep loss on the ability to integrate multiple sources of information during decision-making by reporting results from two experiments: the first implementing both sleep restriction (SR) and total sleep deprivation (TSD) protocols, and the second implementing an SR protocol. In both experiments, participants were administered the Bayes Decisions Task on which optimal performance requires the integration of Bayesian prior and likelihood information. Participants in Experiment 1 showed reduced reliance on both information sources after SR, while no significant change was observed after TSD. Participants in Experiment 2 showed reduced reliance on likelihood after SR, especially during morning testing sessions. No accuracy-related impairments resulting from SR and TSD were observed in both experiments. Our findings show SR affects decision-making through altering the way individuals integrate available sources of information. Additionally, the ability to integrate information during SR may be influenced by time of day. Broadly, our findings carry implications for working professionals who are required to make high-stakes decisions on the job, yet consistently receive insufficient sleep due to work schedule demands.

Gambling habits and Probability Judgements in a Bayesian Task Environment.

Little is known about how gamblers form probability assessments. This paper reports on a preregistered study that administered an incentivized Bayesian choice task to n = 465 self-reported gamblers and non-gamblers. The task elicits subjective probability assessments and allows one to estimate the degree to which distinct information sources are weighted in forming probability assessments. Our data failed to support our main hypotheses that experienced online gamblers would be more accurate than non-gamblers in estimating probabilities, that gamblers experienced in games of skill (e.g., poker) would be more accurate than gamblers experienced only in non-skill games (e.g., slots), that accuracy would differ by sex, or that information sources would be weighted differently across different participant groups. Exploratory analysis, however, revealed that gambling frequency predicted lower Bayesian accuracy, while cognitive reflection predicted higher accuracy. The decline in accuracy linked to self-reported gambling frequency was stronger for female participants. Decision modeling estimated a decreased weight place on new evidence (over base rate odds) for those participant groups who showed decreased accuracy, which suggests that a proper incorporation of new information is important for probability assessments. Our results link online gambling frequency to worse performance in the critical probability assessment skills that should benefit gambling success (i.e., in skill-based games). Additional research is needed to better understand the mechanism linking reported gambling frequency to probability assessment accuracy.

For preschoolers, word knowledge falls on a continuum: A novel framework for capturing the incremental process of word learning.

In gaining word knowledge, children's semantic representations are initially imprecise before becoming gradually refined. We developed and tested a framework for a digital receptive vocabulary assessment that captured varied levels of representation as children learn words. At pre-test and post-test, children selected one of four images to match a word's meaning: a correct target, a conceptually-related foil, a thematically-related foil, and a phonologically-similar foil. We expected that selecting a conceptually related foil would indicate that the word is understood at a deeper level than selecting a phonologically similar foil. Indeed, selection of phonological foils decreased from pre- to post-test, while selection of more advanced thematic and conceptual foils increased. These results demonstrate that this assessment tool probed semantic knowledge that might be characterized as intermediate word knowledge. The current paper presents a novel and sensitive way to capture the incremental process of word learning. Applications for vocabulary interventions are discussed.

Preliminary evidence that misalignment between sleep and circadian timing alters risk-taking preferences.

Decision-making has been shown to suffer when circadian preference is misaligned with time of assessment; however, little is known about how misalignment between sleep timing and the central circadian clock impacts decision-making. This study captured naturally occurring variation in circadian alignment (i.e., alignment of sleep-wake timing with the central circadian clock) to examine if greater misalignment predicts worse decision-making. Over the course of 2 weeks, 32 late adolescent drinkers (aged 18-22 years; 61% female; 69% White) continuously wore actigraphs and completed two overnight in-laboratory visits (Thursday and Sunday) in which both dim-light melatonin onset (DLMO) and behavioural decision-making (risk taking, framing, and strategic reasoning tasks) were assessed. Sleep-wake timing was assessed by actigraphic midsleep from the 2 nights prior to each in-laboratory visit. Alignment was operationalised as the phase angle (interval) between average DLMO and average midsleep. Multilevel modelling was used to predict performance on decision-making tasks from circadian alignment during each in-laboratory visit; non-linear associations were also examined. Shorter DLMO-midsleep phase angle predicted greater risk-taking under conditions of potential loss (B = -0.11, p = 0.06), but less risk-taking under conditions of potential reward (B = 0.14, p = 0.03) in a curvilinear fashion. Misalignment did not predict outcomes in the framing and strategic reasoning tasks. Findings suggest that shorter alignment in timing of sleep with the central circadian clock (e.g., phase-delayed misalignment) may impact risky decision-making, further extending accumulating evidence that sleep/circadian factors are tied to risk-taking. Future studies will need to replicate findings and experimentally probe whether manipulating alignment influences decision-making.

The impact of self-selected short sleep on monetary risk taking.

Risky choice has been widely studied in experimental settings, but there is a paucity of research examining the effects of self-selected sleep schedules on risky choices. The current study examined incentivised risky choices of 100 young, healthy adults whose self-selected (at-home) sleep schedules were tracked via actigraphy for 1 week prior to decision making. Average nightly sleep was 6.43 h/night. On each trial of the decision task, individuals chose between two monetary gambles, with separate blocks of trials presenting amounts to gain versus amounts to lose for each paired gamble choice. In general, participants were risk-averse when trying to maximise gains (GAINS) and risk-seeking when trying to minimise losses (LOSSES). These tendencies were amplified in trials where gambles differed more (vs less) in their riskiness. Response times were longer for real choices (vs. dummy trials of random choice), LOSS versus GAINS trials, and when gambles were more similar versus different in risk. Gamble choices were not impacted by actigraphy measured average sleep levels, which suggests self-selected moderate sleep deprivation does not affect risky monetary choices, as has been found in studies of experimentally induced sleep deprivation. However, our data showed that sleep variability increased risk-taking behaviour in the LOSS condition. Thus, risky decision-making may relate more to variability in sleep efficiency than to overall sleep duration or quality in naturalistic settings. The current study gives insight into how decision making in experimental sleep settings may or may not translate to more ecologically valid settings of self-directed sleep.

Mealtimes in Head Start pre-k classrooms: examining language-promoting opportunities in a hybrid space.

In this study we sought to identify profiles of talk during Head Start preschool mealtime conversations involving teachers and students. Videos of 44 Head Start classrooms' lunch interactions were analyzed for the ratio of teacher-child talk and amount of academic vocabulary, and then coded for instances of academic/food, social/personal, and management talk to highlight the degree of hybridity of talk within this unique setting. Cluster analysis revealed four distinct patterns of teacher-child mealtime interactions in 44 Head Start preschool classrooms: classroom discourse, home discourse, hybrid-low, and hybrid-high. Multilevel models further demonstrated a relationship among these clusters of teacher-child interactions and children's end-of-year expressive vocabulary scores controlling for ratio of teacher-child talk and pre-test scores. Children in classrooms displaying a hybrid style of mealtime discourse made the greatest gains on measures of expressive vocabulary in contrast to their peers in classrooms displaying other discourse styles.

Thinking about complex decisions: How sleep and time-of-day influence complex choices.

In this study, we systematically manipulate a person's state of sleep; Sleep-deprived and Well-rested along with Matching or Mismatching the decision time-of-day to their circadian preferred time-of-day. We assessed how these conditions influenced performance on an incentivized complex decision task. In the overall analysis of these variables no differences emerged. However, a comparison of the more cognitively depleting Sleep-deprivation/Circadian-mismatch condition to the cognitively enhancing Well-rested/Circadian-match condition showed improved performance in the Well-rested/Circadian matched group for one complex decision task but not for the other. These findings build upon the existing literature on sleep and circadian rhythm effects while uniquely observing the combined effects of these variables on complex decision making.

Cues for word-learning during shared book-reading and guided play in preschool.

The present study examines the perceptual, linguistic, and social cues that were associated with preschoolers' (4;11) growth in word-learning during shared book-reading and guided play activities. Small groups of three preschoolers (n = 30) and one adult were video-recorded during an intervention study in which new vocabulary words were explicitly taught. Adult use of taught words was coded for perceptual and linguistic cues and type of social interaction. Hearing taught words used in the book text and learning information about words' meanings during play was positively associated with growth in word-learning. Adult use of words in responsive, or child-initiated, interactions was positively associated with word-learning growth in both book-reading and play, while adult-initiated use of words was negatively associated with word-learning growth in both settings.

Return on investment for financial assistance for living kidney donors in the United States.

BACKGROUND: The National Living Donor Assistance Center (NLDAC) enables living donor kidney transplants through financial assistance of living donors, but its return on investment (ROI) through savings on dialysis costs remains unknown. METHODS: We retrospectively reviewed 2012-2015 data from NLDAC, the United States Renal Data System, and the Scientific Registry of Transplant Recipients to construct 1-, 3-, and 5-year ROI models based on NLDAC applications and national dialysis and transplant cost data. ROI was defined as state-specific federal dialysis cost minus (NLDAC program costs plus state-specific transplant cost), adjusted for median waiting time (WT). RESULTS: A total of 2425 NLDAC applications were approved, and NLDAC costs were USD $6.76 million. Median donor age was 41 years, 66.1% were female, and median income was $33 759; 43.6% were evaluated at centers with WT >72 months. Median dialysis cost/patient-year was $81 485 (IQR $74 489-$89 802). Median kidney transplant cost/patient-year was $30 101 (IQR $26 832-$33 916). Overall, ROI varied from 5.1-fold (1-year) to 28.2-fold (5-year), resulting in $256 million in savings. Higher ROI was significantly associated with high WT, larger dialysis and transplant costs differences, and more NLDAC applicants completing the donation process. CONCLUSIONS: Financial support for donor out-of-pocket expenses produces dramatic federal savings through incremental living donor kidney transplants.

Personal sleep debt and daytime sleepiness mediate the relationship between sleep and mental health outcomes in young adults.

BACKGROUND: Sleep duration and chronotype (i.e., morningness-eveningness) are associated with increased depression and anxiety risk, but differences in individual sleep need and lifestyle may mean these sleep parameters do not present the same risk across all individuals. This study explored the mediating role of sleep debt and daytime sleepiness in the relationship between sleep and mental health symptoms in young adults, a particularly vulnerable population. METHODS: Young adult university students (n = 2,218) and young adults from the general population in the United States (n = 992) provided estimates of actual and optimal sleep duration, and completed validated measures of sleepiness, chronotype, and depression and anxiety risk. Mediation models examining sleepiness and sleep debt (i.e., difference between optimal and actual sleep) as parallel mediators were tested. RESULTS: Sleepiness and sleep debt mediated the relationship between short sleep and depression and anxiety risk in the university sample, while sleepiness mediated these relationships in the general population sample. Sleepiness and sleep debt also mediated the impact of evening-type preferences on depression and anxiety risk in university students, but no mediation of this effect was found in young adults from the general population. CONCLUSIONS: This study reports potential mediating mechanisms related to the increased mental health risk conferred by short sleep and evening chronotype. These results have implications for how primary care physicians assess psychopathology risk, arguing for a focus on the assessment of daytime sleepiness and sleep debt in university populations, while for young adults in the general population, these factors may be less important.

Primary Care Patient Records in the United Kingdom: Past, Present, and Future Research Priorities.

This paper briefly outlines the history of the medical record and the factors contributing to the adoption of computerized records in primary care in the United Kingdom. It discusses how both paper-based and electronic health records have traditionally been used in the past and goes on to examine how enabling patients to access their own primary care record online is changing the form and function of the patient record. In addition, it looks at the evidence for the benefits of Web-based access and discusses some of the challenges faced in this transition. Finally, some suggestions are made regarding the future of the patient record and research questions that need to be addressed to help deepen our understanding of how they can be used more beneficially by both patients and clinicians.

Voluntary Sleep Choice and Its Effects on Bayesian Decisions.

This study examines whether voluntary sleep restriction at commonly experienced levels impacts decision making in a Bayesian choice task. Participants recruited were largely traditional age college students from a regional state university (n = 100) and a federal military academy (n = 99; n = 56 and 43, respectively, used in final analysis). Sleep was measured by actigraphy over a one-week period, followed by performance of a decision task. The task involved two sources of information, base rate odds and sample evidence, with subjects asked to make a probability judgment. Results found that subjects with nightly sleep < 6 hr (sleep deprived = SD), relative to those with > 7 hr, placed less decision weight on new evidence, relative to base rate information, in making difficult choices. This result is strongest among female subjects. For easier choices, voluntary SD did not affect relative decision weights placed on the two sources of available information.

The impact of restricting sleep duration on physical activity: Secondary analysis of a randomized crossover study.

OBJECTIVES: This study investigated the causal impact of sleep durations on participants' physical activity (PA) in real-world conditions. METHOD: We performed a secondary analysis of PA data from 146 young adults using a randomized crossover design: both restricted (5-6 hr/night) and well-rested (8-9 hr/night) sleep weeks were assessed, with a washout week in between. Sleep and activity were tracked via research-grade actigraphy. Data analysis of PA involved repeated-measures analysis of variance (ANOVA) and regression techniques. RESULTS: Analysis plans and hypothesis were preregistered before data analysis. The exogenously assigned sleep restriction (SR) treatment reduced nightly sleep an average of 92.65 min (± 40.44 min) compared to one's well-rested sleep treatment. The impact of SR on PA was substantial, leading to a 7% reduction in average hourly PA: 18,081.2 (well-rested) versus 16,818.2 (restricted sleep). Significant findings were revealed in daily, F(1, 6) = 84.37, p < .001, ηp² = 0.934, and hourly comparisons, F(1, 166) = 30.47, p < .001, ηp² = 0.155. Further, sensitivity analysis using a variety of regression specifications also found that exogenously assigned SR decreased average wake-hour activity counts by approximately 4.4%-4.7% (p < .01 in all cases) when controlling for other factors. Exploratory analysis showed the PA effects of SR manifested via reductions in PA intensity with concurrent increases in the proportion of time considered as sedentary. CONCLUSIONS: SR significantly lowered PA by around 7%, characterized by reduced intensity and elevated sedentary behavior in a naturalistic setting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Myths or theories? Alternative beliefs about HIV and AIDS in South African working class communities.

Despite three decades of public health promotion based on the scientific explanation of HIV/AIDS, alternative explanations of the disease continue to circulate. While these are seen as counter-productive to health education efforts, what is rarely analysed is their plurality and their tenacity. This article analyses the 'AIDS myths' collected by African HIV/AIDS workplace peer educators during an action research project. These beliefs about HIV/AIDS are organised, in this article, around core ideas that form the basis of 'folk' and 'lay theories' of HIV/AIDS. These constitute non-scientific explanations of HIV/AIDS, with folk theories drawing on bodies of knowledge that are independent of HIV/AIDS while lay theories are generated in response to the disease. A categorisation of alternative beliefs about HIV/AIDS is presented which comprises three folk theories - African traditional beliefs, Christian theology, and racial conspiracy - and three lay theories, all focused on avoiding HIV infection. Using this schema, the article describes how the plausibility of these alternative theories of HIV/AIDS lies not in their scientific validity, but in the robustness of the core idea at the heart of each folk or lay theory. Folk and lay theories of HIV/AIDS are also often highly palatable in that they provide hope and comfort in terms of prevention, cure, and the allocation of blame. This study argue that there is coherence and value to these alternative HIV/AIDS beliefs which should not be dismissed as ignorance, idle speculation or simple misunderstandings. A serious engagement with folk and lay theories of HIV/AIDS helps explain the continued circulation of alternative beliefs of HIV/AIDS and the slow uptake of behavioural change messages around the disease.

Just jokes! Icebreakers, innuendo, teasing and talking: The role of humour in HIV/AIDS peer education among university students.

Peer conversation provides an important platform for people to explore and disseminate sexual health knowledge. Humour forms part of conversations held between peers including those where sexual health and sexual decisions are discussed. The central argument of this article links conversation, humour and peer education. Drawing on interviews and diaries kept by 12 student peer educators over a two-month period in a South African university, the article explores the forms and functions of humour in instigating and encouraging informal peer education between young people in a university setting. The evidence shows that humour can foster intimacy, familiarity and camaraderie in peer interactions; keeps conversation moving; and acts as a gateway to discussion of taboo, personal and private subjects that lie at the core of effective peer education. Components of humour (joking, teasing, innuendo, provocation) and the transformation of the serious (and boring) into the enjoyable (and accessible) are found in these peer interactions. However, humour can also limit communication by keeping conversations light and superficial or, in the case of inappropriate humour, close conversation altogether. Acknowledging the nuances of humour within conversation and peer education allows for a clearer understanding of the ways in which humour contributes to effective health promotion efforts and how it can be used within peer educator practice. The effect of the personality traits of peer educators on effective use of humour in conversation is an area that could benefit from further insight and research.

Sex moderates the effects of total sleep deprivation and sleep restriction on risk preference.

Sleep loss has been shown to alter risk preference during decision-making. However, research in this area has largely focussed on the effects of total sleep deprivation (TSD), while evidence on the effects of sleep restriction (SR) or the potentially moderating role of sex on risk preference remains scarce and unclear. The present study investigated risky decision-making in 47 healthy young adults who were assigned to either of two counterbalanced protocols: well-rested (WR) and TSD, or WR and SR. Participants were assessed on the Lottery Choice Task (LCT), which requires a series of choices between two risky gambles with varying risk levels. Analyses on the pooled dataset indicated across all sleep conditions, participants were generally more risk-seeking when trying to minimise financial loss (LOSSES) than while trying to maximise financial gain (GAINS). On GAINS trials, female participants were more risk-averse during TSD and SR, whereas male participants remained unchanged. On LOSSES trials, female participants remained unchanged during TSD and SR, whereas male participants became more risk-seeking during TSD. Our findings suggest the relationship between sleep loss and risk preference is moderated by sex, whereby changes in risk preference after TSD or SR differ in men and women depending on whether the decision is framed in terms of gains or losses.

Relation between language experiences in preschool classrooms and children's kindergarten and fourth-grade language and reading abilities.

Indirect effects of preschool classroom indexes of teacher talk were tested on fourth-grade outcomes for 57 students from low-income families in a longitudinal study of classroom and home influences on reading. Detailed observations and audiotaped teacher and child language data were coded to measure content and quantity of verbal interactions in preschool classrooms. Preschool teachers' use of sophisticated vocabulary during free play predicted fourth-grade reading comprehension and word recognition (mean age=9; 7), with effects mediated by kindergarten child language measures (mean age=5; 6). In large group preschool settings, teachers' attention-getting utterances were directly related to later comprehension. Preschool teachers' correcting utterances and analytic talk about books, and early support in the home for literacy predicted fourth-grade vocabulary, as mediated by kindergarten receptive vocabulary.

Preliminary results of combining low frequency low intensity ultrasound and liposomal drug delivery to treat tumors in rats.

Ultrasound is a convenient trigger for site-specific drug delivery in cancer therapy. Nano-sized liposomes formulated from soy phosphatidyl choline, cholesterol, 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[carboxy(polyethylene glycol)-2000] and alpha-tocopherol were loaded with Doxorubicin (Dox) using a pH gradient. The liposomal suspension was infused through the tail vein of BDIX rats possessing bilateral intradermal DHD/K12 tumors on their hind legs. Then 20-kHz ultrasound was applied to only one of the tumors for 15 minutes. This therapy was repeated weekly for 4 weeks. The results showed that in five of six rats, the tumors regressed to non-measurable size within 4 weeks. A paired comparison of the normalized size of the insonated and non-insonated tumors in the same rat indicated that the insonated tumors were smaller (p < 0.0001, n = 6 rats, 21 pairs). This observation has significant potential for non-invasive site-specific therapy of solid tumors.

The influence of dietary patterns on outcomes in a Bayesian choice task.

BACKGROUND AND AIMS: Previous research has investigated the impact of diet on cognition, but the focus has often been on general cognition. This paper reports on a preregistered cross-sectional study aimed at testing for specific executive function differences across individuals who self-reported one of four distinct dietary patterns: No Diet, No Sugar, Vegetarian, or Mediterranean Diet pattern. Our hypotheses were aimed at testing whether adherence to a specialty diet improved decision making relative to those who reported following No Diet. METHODS: We administered an incentivized Bayesian choice task to all participants. The task involved multiple components of information-existing information (base rate odds) as well as new information (sample draw evidence)-to allow a test of how these information components were used in making probability assessments, and how this may differ by self-reported dietary pattern. Sample size, hypotheses, and analysis plans were all determined ex ante and registered on the Open Science Framework. Multi-variate linear and non-linear estimation methods were used to analyze the data. RESULTS: Our data failed to support our pre-registered hypotheses. In fact, we found some evidence that self-reported adherence to a specialty No Sugar Diet was associated with a reduced decision accuracy and was connected to an increased imbalance in how the participant weighted the two available sources of information when making choices. CONCLUSION: Our results suggest that decision making is nuanced among dietary groups, but that short-term incentivized decisions in an ecologically valid field setting are likely not improved solely by following promoted dietary patterns such as the Mediterranean or Vegetarian diets.

Bargaining and trust: the effects of 36-h total sleep deprivation on socially interactive decisions.

Although it is well known that sleep loss results in poor judgement and decisions, little is known about the influence of social context in these processes. Sixteen healthy young adults underwent three games involving bargaining ('Ultimatum' and 'Dictator') and trust, following total sleep deprivation (TSD) and during rested wakefulness (RW), in a repeated-measures, counterbalanced design. To control for repeatability, a second group (n = 16) was tested twice under RW conditions. Paired anonymously with another individual, participants made their simple social interaction decisions facing real monetary incentives. For bargaining, following TSD participants were more likely to reject unequal-split offers made by their partner, despite the rejection resulting in a zero monetary payoff for both participants. For the trust game, participants were less likely to place full trust in their anonymous partner. Overall, we provide novel evidence that following TSD, the conflict between personal financial gain and payoff equality is focused upon avoidance of unfavourable inequality (i.e. unfairness). This results in the rejection of unfair offers at personal monetary cost, and the lack of full trust which would expose one to being exploited in the interaction. As such, we suggest that within a social domain decisions may be more influenced by emotion following TSD, which has fundamental consequences for real-world decision-making involving social exchange.