Developmental divergence: motor trajectories in children with fragile X syndrome with and without co-occurring autism.

BackgroundAutism spectrum disorder (ASD) is highly prevalent in fragile X syndrome (FXS), affecting 50-70% of males. Motor impairments are a shared feature across autism and FXS that may help to better characterize autism in FXS. As motor skills provide a critical foundation for various language, cognitive, and social outcomes, they may serve an important mechanistic role for autism in FXS. As such, this study aimed to identify differences in motor trajectories across direct assessment and parent-report measures of fine and gross motor development between FXS with and without autism, and typical development, while controlling for cognitive functioning.MethodsThis prospective longitudinal study included 42 children with FXS, 24 of whom also had ASD (FXS + ASD), as well as 40 typically developing children. The Mullen Scales of Early Learning provided a direct measure of fine and gross motor skills, and the Vineland Adaptive Behavior Scales provided a measure of parent-reported fine and gross motor skills. Random slopes and random intercepts multilevel models were tested to determine divergence in developmental motor trajectories between groups when controlling for cognitive level.ResultsModel results indicated the children with FXS + ASD diverged from TD children by 9-months on all measures of gross and fine motor skills, even when controlling for cognitive level. Results also indicated an early divergence in motor trajectories of fine and gross motor skills between the FXS + ASD and FXS groups when controlling for cognitive level. This divergence was statistically significant by 18 months, with the FXS + ASD showing decelerated growth in motor skills across direct observation and parent-report measures.ConclusionsThis study is the first to examine longitudinal trends in motor development in children with FXS with and without comorbid ASD using both direct assessment and parent-report measures of fine and gross motor. Furthermore, it is among the first to account for nonverbal cognitive delays, a step towards elucidating the isolated role of motor impairments in FXS with and without ASD. Findings underscore the role of motor impairments as a possible signal representing greater underlying genetic liability, or as a potential catalyst or consequence, of co-occurring autism in FXS

Foundations of early planning in Down syndrome

2017 Spring.Includes bibliographical references.Goal-directed behavior, or planning is critical for academic and daily outcomes, and an area of distinct challenge in Down syndrome. This study examined early foundations of object-related planning in toddlers (N=38) with Down syndrome. Motor abilities, visual attention, and motor cognition were tested as predictors of two planning outcomes in DS: object-related problem solving and functional object use. In addition, a potential developmental cascade from motor abilities to object-related problem solving was also tested. Results revealed that motor abilities are an important developmental foundation for both types of object-related planning outcomes. Results also revealed differences in the contribution of visual attention and motor cognition to object-related planning outcomes. Findings also provided support for a potential developmental cascade between motor abilities and planning outcomes. Collective results from this study contribute to the understanding of early development within Down syndrome, and therefore provide implications for the development of early, targeted intervention

Rough Cilicia Archaeological Survey Project: Analysis of Amphora Finds Season 2000 Summer

Elizabeth L. Will analyzed the Study Collection of amphora fragments amassed since 1996, as well as 49 bags of additional fragments, seven of them collected during the surveys of the year 2000. She also visited three areas that had been identified as the sites of possible kilns, at Biçkici, Syedra, and Antiocheia ad Cragum. In addition, Elizabeth L. Will also examined and photographed the amphoras on display in the museums at Alanya and Antalya. The amphora fragments collected during the 1996-1999 seasons have been noted in the reports for those years and described by Nicholas Rauh and Kathleen Slane in the article, “Possible amphora kiln sites in W. Rough Cilicia.” This report contains additional observations regarding the found fragments of amphoras

Using investment appraisal models in strategic negotiation: the cultural political economy of electricity generation

Although accepting that the Discounted Cash Flow model of investment appraisal has well known technical limitations, researchers have begun to explore its performative properties. This paper demonstrates how the Discounted Cash Flow model frames negotiations between actors around narratives of economization, marketization and financialization in a regulated industry. Reconnecting economics and politics, the theory of Cultural Political Economy is used to interpret and evaluate an empirical study of Great Britain's electricity generating industry. Although alternative imaginaries, based on political and employment goals, have historically influenced investment decision making in the industry, the current narrative of investment appraisal is dominated by Discounted Cash Flow models. These models have allowed industry players to construct imaginaries of an investment hiatus, leading to the possibility of future power cuts and blackouts, and a need for guaranteed prices

Alternative Large-Scale Conservation Visions for Northern Maine: Interviews with Decision Leaders in Maine

Based on confidential interviews with 21 decision leaders in Maine, Elizabeth Baldwin, Laura Kenefic, and Will LaPage examine the complexity of the conflicts over alternate visions for large-scale conservation in Maine. Exploring models that may be useful for policymakers grappling with competing values for Maine’s forests, they present four alternatives: national forests, new U.S. forest service models, forest heritage areas, and the British national park model. The authors found that the leaders interviewed agreed about the need for some level of conservation, but did not completely agree on how this might happen and where the decision-making power should lie

Framework for better living with HIV in England

1 Introduction and overview 1.1 The goal, purpose and scope of the framework This framework is the first of its kind in the UK. It describes the shared aspirations of a group of agencies for the lives of people diagnosed with HIV in England. The overarching goal of the framework is: All people with HIV are enabled to have the maximum level of health, well-being, quality of life and social integration. This is no less than the majority of people in the country expect for themselves. However, numerous obstacles prevent people with HIV from achieving this goal. These obstacles are not about having the virus but about how people with the virus are treated. This overarching goal is the situation we want to bring about. We detail this goal in seventeen subsidiary goals (what we want to happen). Each of these has a number of related aims and target groups (what we want individuals and groups to do to bring about the goal). The framework starts with the individual and seeks to bring about the conditions most favourable to individual self-determination and self-empowerment. The purpose of the framework is to: • Promote and protect the rights and well-being of all people with HIV in England. • Maximise the capacity of individuals and groups of people with HIV to care for, advocate and represent themselves effectively. • Improve and protect access to appropriate, effective and sufficient information, social support and social care services. • Minimise social, economic, governmental and judicial change detrimental to the rights and well-being of people with HIV. • Build consensus among those with a responsibility for promoting the well-being and rights of people with HIV. • Provide benchmarks against which the activities of a range of key stakeholders can be assessed, critiqued and coordinated. The framework does not describe all the activities of the organisations represented in the Framework Development Group (see section 1.4). Nor can these organisations undertake all the interventions necessary within the framework. Rather, the framework seeks to mobilise and coordinate the actions of a broad range of individuals and groups, from people with HIV themselves to government ministers. The framework primarily seeks to benefit people with diagnosed HIV infection. It is concerned with the health and well-being of those diagnosed with HIV and not those with undiagnosed HIV or those who might become infected (HIV prevention).As we are concerned with the lives of people with HIV after diagnosis, this framework is not focused on increasing HIV testing or HIV diagnosis nor does it attend to the needs of the broader population affected by HIV except where they relate to people with diagnosed HIV

Designing community-based health programs to address the needs of marginalised and disadvantaged communities

The focus of the visit by Dr Julie Will was to explore evidence based approaches for improving access and equity in primary health care, with a particular emphasis on preventing and managing chronic conditions and health problems of people who are unemployed. Dr Will is a senior epidemiologist in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention. For the past 13 years, she served as the WISEWOMAN Team Leader, Acting Team Lead for the Applied Research and Translation Team, and Senior Epidemiologist for Health Services Research and Registry Team.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and

Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis

OBJECTIVE: To evaluate how varicocele repair (VR) impacts pregnancy (PRs) and live birth rates in infertile couples undergoing assisted reproduction wherein the male partner has oligospermia or azoospermia and a history of varicocele. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Azoospermic and oligospermic males with varicoceles and in couples undergoing assisted reproductive technology (ART) with IUI, IVF, or testicular sperm extraction (TESE) with IVF and intracytoplasmic sperm injection (ICSI). INTERVENTION(S): Measurement of PRs, live birth, and sperm extraction rates. MAIN OUTCOME MEASURE(S): Odds ratios for the impact of VR on PRs, live birth, and sperm extraction rates for couples undergoing ART. RESULT(S): Seven articles involving a total of 1,241 patients were included. Meta-analysis showed that VR improved live birth rates for the oligospermic (odds ratio [OR] = 1.699) and combined oligospermic/azoospermic groups (OR = 1.761). Pregnancy rates were higher in the azoospermic group (OR = 2.336) and combined oligospermic/azoospermic groups (OR = 1.760). Live birth rates were higher for patients undergoing IUI after VR (OR = 8.360). Sperm retrieval rates were higher in persistently azoospermic men after VR (OR = 2.509). CONCLUSION(S): Oligospermic and azoospermic patients with clinical varicocele who undergo VR experience improved live birth rates and PRs with IVF or IVF/ICSI. For persistently azoospermic men after VR requiring TESE for IVF/ICSI, VR improves sperm retrieval rates. Therefore, VR should be considered to have substantial benefits for couples with a clinical varicocele even if oligospermia or azoospermia persists after repair and ART is required