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.

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.

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.

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).

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.

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.

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.

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.

The effect of sleep on public good contributions and punishment: Experimental evidence.

We investigate the effect of a full week of sleep restriction (SR) vs. well-restedness (WR) on contributions in a common public good experiment, the voluntary contributions mechanism (VCM). We examine the effect of sleep manipulation on decisions regarding both contributions and punishment of non-contributors. Actigraphy devices are used to confirm that our random assignment to sleep condition generates significant differences in objective nightly sleep duration and sleepiness. We find that when punishment is unavailable public good contributions do not differ by SR/WR assignment. When punishment is available, we find evidence that SR subjects contribute more than WR subjects, respond more to the availability of punishment than do WR subjects, and that the availability of punishment significantly increases the contributions of SR but not WR subjects. Yet SR subjects do not punish others more or less than WR subjects. Our main findings are robust when considering compliance and sample selection. However, some findings are not robust to an alternative but less objective sleep control measure that is based partly on participants' self-identified optimal sleep levels.

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.

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.

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.

Author Correction: Insufficient sleep reduces voting and other prosocial behaviours.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Insufficient sleep reduces voting and other prosocial behaviours.

Insufficient sleep is a growing public health concern in industrial societies. Although a lack of sleep is known to negatively affect private behaviours-such as working or going to school-comparatively little is known about its consequences for the social behaviours that hold society and democracy together. Using three complementary methods, we show how insufficient sleep affects various measures of civic participation. With survey data from two countries, we show that insufficient sleep predicts lower voter turnout. Next, with a geographical regression discontinuity design, we demonstrate that individuals from the United States who tend to sleep less due to circadian impacts of time-zone boundaries are also less likely to vote. Finally, we experimentally manipulate short-term sleep over a two-stage study. We observe that the treatment decreases the levels of civic engagement, as shown by their willingness to vote, sign petitions and donate to charities. These results highlight the strong negative consequences that current levels of insufficient sleep have on vitally important measures of social capital.

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.

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.

The viability of an ecologically valid chronic sleep restriction and circadian timing protocol: An examination of sample attrition, compliance, and effectiveness at impacting sleepiness and mood.

Chronic sleep restriction (SR) increases sleepiness, negatively impacts mood, and impairs a variety of cognitive performance measures. The vast majority of work establishing these effects are tightly controlled in-lab experimental studies. Examining commonly-experienced levels of SR in naturalistic settings is more difficult and generally involves observational methods, rather than active manipulations of sleep. The same is true for analyzing behavioral and cognitive outcomes at circadian unfavorable times. The current study tested the ability of an at-home protocol to manipulate sleep schedules (i.e., impose SR), as well as create a mismatch between a subject's circadian preference and time of testing. Viability of the protocol was assessed via completion, compliance with the SR, and success at manipulating sleepiness and mood. An online survey was completed by 3630 individuals to assess initial eligibility, 256 agreed via email response to participate in the 3-week study, 221 showed for the initial in-person session, and 184 completed the protocol (175 with complete data). The protocol consisted of 1 week at-home SR (5-6 hours in bed/night), 1 week wash-out, and 1 week well-rested (WR: 8-9 hours in bed/night). Sleep was monitored with actigraphy, diary, and call-ins. Risk management strategies were implemented for subject safety. At the end of each experimental week, subjects reported sleepiness and mood ratings. Protocol completion was 83%, with lower depression scores, higher anxiety scores, and morning session assignment predicting completion. Compliance with the sleep schedule was also very good. Subjects spent approximately 2 hours less time in bed/night and obtained an average of 1.5 hours less nightly sleep during SR, relative to WR, with 82% of subjects obtaining at least 60 minutes less average nightly sleep. Sleepiness and mood were impacted as expected by SR. These findings show the viability of studying experimental chronic sleep restriction outside the laboratory, assuming appropriate safety precautions are taken, thus allowing investigators to significantly increase ecological validity over strictly controlled in-lab studies.

Neural correlates of decision-making during a Bayesian choice task.

Many critical decisions require evaluation of accumulated previous information and/or newly acquired evidence. Although neural correlates of belief updating have been investigated, how these neural processes guide decisions involving Bayesian choice is less clear. Here, we used functional MRI to investigate neural activity during a Bayesian choice task involving two sources of information: base rate odds ('odds') and sample evidence ('evidence'). Thirty-seven healthy control individuals performed the Bayesian choice task in which they had to make probability judgements. Average functional MRI activity during the trials where choice was consistent with use of Odds, use of Evidence, and use of Both was compared. Decision-making consistent with odds, evidence and both each strongly activated the bilateral executive network encompassing the bilateral frontal, cingulate, posterior parietal and occipital cortices. The Evidence consistent, compared with Odds consistent, decisions showed greater activity in the bilateral middle and inferior frontal and right lateral occipital cortices. Decisions consistent with the use of Both strategies were associated with increased activity in the bilateral middle frontal and superior frontal cortices. These findings support the conclusion that both overlapping and distinct brain regions within the frontoparietal network underlie the incorporation of different types of information into a Bayesian decision.

A practical validation study of a commercial accelerometer using good and poor sleepers.

We validated a Fitbit sleep tracking device against typical research-use actigraphy across four nights on 38 young adults. Fitbit devices overestimated sleep and were less sensitive to differences compared to the Actiwatch, but nevertheless captured 88 (poor sleepers) to 98 percent (good sleepers) of Actiwatch estimated sleep time changes. Bland-Altman analysis shows that the average difference between device measurements can be sizable. We therefore do not recommend the Fitbit device when accurate point estimates are important. However, when qualitative impacts are of interest (e.g. the effect of an intervention), then the Fitbit device should at least correctly identify the effect's sign.