German and English comparison of fluency development and stuttering.

The thesis explored disfluencies in stuttering through linguistic contrasts between English and German. Part one focused on the analysis of speech samples of German speaking adults and children who stutter. Part two analysed bilingual German-English language development aiming to examine whether increased cognitive load of two languages is related to language errors. Since people who stutter do not speak disfluently all the time, but have stretches where speech is fluent, research has investigated whether there is a consistent pattern predicting fluency breakdown (Brown, 1937, 1938a, 1938b, 1938c, 1945; Johnson and Brown, 1939). Inconsistencies across different languages would weaken purely motoric accounts of stuttering. This was analysed with spontaneous speech samples of German speaking people who stutter, from a wide age range (2 years to adult). Previously, mainly in English, an exchange pattern of function and content word disfluencies with age was reported (see Au-Yeung, Howell and Pilgrim, 1998, and Rommel, 2000, for increased function word disfluencies in German children). This pattern was more prominent in German speakers changing from more function words in children to predominantly content word disfluencies in adults. Larger amounts of content word disfluencies in German adults were related to their higher phonetic complexity in comparison to English. Part two of the thesis dealt with factors affecting language development in bilingual infants (language onset to school age) based on the link, identified in the literature, between bilingualism and onset of disfluencies. This part aimed to explore differences in lexical and syntax development (both are influential in the onset of disfluencies in infants who stutter - Bernstein Ratner, 1997), naming errors, and lexical access. The results showed differences concerning the lexicon (i.e. compound nouns - complex content words) and syntax (i.e. word order).The last chapter highlighted aspects of findings that differentiate current models / theories of fluency failure

Und täglich grüßt das Murmeltier…: die neue Justizreform der PiS in Polen

Kaum ist die Diskussion rund um das polnische Verfassungstribunal abgeebbt, hat die Partei PiS (deutsch: Recht und Gerechtigkeit) mit ihrem Vorsitzenden Jarosław Kaczyński das nächste „Projekt“ angestoßen: das Gerichtswesen in Polen soll „reformiert“ werden. Am 12.7.2017 hat der Sejm, das Unterhaus des Parlaments, zu diesem Zweck zwei Gesetze verabschiedet, die den sog. „Landesjustizrat“ (polnisch: Krajowa Rada Sądownictwa) und die ordentliche Gerichtsbarkeit neuorganisieren. Wenige Tage später folgte ein Gesetzentwurf, mit dem das Oberste Gericht reformiert werden soll. Ist die Gewaltenteilung in Gefahr

Strong genetic influences on the stability of autistic traits in childhood

Objective: Disorders on the autism spectrum, as well as autistic traits in the general population, have been found to be both highly stable across age and highly heritable at individual ages. However, little is known about the overlap in genetic and environmental influences on autistic traits across age and the contribution of such influences to trait stability itself. The present study investigated these questions in a general population sample of twins. Method: More than 6,000 twin pairs were rated on an established scale of autistic traits by their parents at 8, 9, and 12 years of age and by their teachers at 9 and 12 years of age. Data were analyzed using structural equation modeling. Results: The results indicated that, consistently across raters, not only were autistic traits stable, and moderately to highly heritable at individual ages, there was also a high degree of overlap in genetic influences across age. Furthermore, autistic trait stability could largely be accounted for by genetic factors, with the environment unique to each twin playing a minor role. The environment shared by twins had virtually no effect on the longitudinal stability in autistic traits. Conclusions: Autistic traits are highly stable across middle childhood and this stability is caused primarily by genetic factors

Cost-effectiveness of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris

Background. Acne vulgaris is a common skin condition that may cause psychoso-cial distress. There is evidence that topical treatment combinations, chemical peels and photochemical therapy (combined blue/red light) are effective for mild-to-moderate acne, while topical treatment combinations, oral antibiotics combined with topical treatments, oral isotretinoin and photodynamic therapy are most effective for moderate-to-severe acne. Effective treatments have varying costs. The National Institute for Health and Care Excellence (NICE) in England considers cost-effectiveness when producing national clinical, public health and social care guidance.Aim: To assess the cost-effectiveness of treatments for mild-to-moderate and moderate-to-severe acne to inform relevant NICE guidance.Methods: A decision–analytical model compared costs and quality-adjusted life-years (QALYs) of effective topical pharmacological, oral pharmacological, physical and combined treatments for mild-to-moderate and moderate-to-severe acne, from the perspective of the National Health Service in England. Effectiveness data were derived from a network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.Results: All of the assessed treatments were more cost-effective than treatment with placebo (general practitioner visits without active treatment). For mild-to-moderate acne, topical treatment combinations and photochemical therapy (com-bined blue/red light) were most cost-effective. For moderate-to-severe acne, topical treatment combinations, oral antibiotics combined with topical treatments, and oral isotretinoin were the most cost-effective. Results showed uncertainty, as reflected in the wide confidence intervals around mean treatment rankings.Conclusion: A range of treatments are cost-effective for the management of acne. Well-conducted studies are needed to examine the long-term clinical efficacy and cost-effectiveness of the full range of acne treatments

Detail-oriented cognitive style and social communicative deficits, within and beyond the autism spectrum: independent traits that grow into developmental interdependence

At the heart of debates over underlying causes of autism is the "Kanner hypothesis" that autistic deficits in social reciprocity, and a cognitive/perceptual 'style' favouring detail-oriented cognition, co-vary in autistic individuals. A separate line of work indicates these two domains are normally distributed throughout the population, with autism representing an extremity. This realisation brings the Kanner debate into the realm of normative co-variation, providing more ways to test the hypothesis, and insights into typical development; for instance, in the context of normative functioning, the Kanner hypothesis implies social costs to spatial/numerical prowess

Cost-Effectiveness of Gene-Specific Prevention Strategies for Ovarian and Breast Cancer.

IMPORTANCE: Pathogenic variants (PVs) in BRCA1, BRCA2, PALB2, RAD51C, RAD51D, and BRIP1 cancer susceptibility genes (CSGs) confer an increased ovarian cancer (OC) risk, with BRCA1, BRCA2, PALB2, RAD51C, and RAD51D PVs also conferring an elevated breast cancer (BC) risk. Risk-reducing surgery, medical prevention, and BC surveillance offer the opportunity to prevent cancers and deaths, but their cost-effectiveness for individual CSGs remains poorly addressed. OBJECTIVE: To estimate the cost-effectiveness of prevention strategies for OC and BC among individuals carrying PVs in the previously listed CSGs. DESIGN, SETTING, AND PARTICIPANTS: In this economic evaluation, a decision-analytic Markov model evaluated the cost-effectiveness of risk-reducing salpingo-oophorectomy (RRSO) and, where relevant, risk-reducing mastectomy (RRM) compared with nonsurgical interventions (including BC surveillance and medical prevention for increased BC risk) from December 1, 2022, to August 31, 2023. The analysis took a UK payer perspective with a lifetime horizon. The simulated cohort consisted of women aged 30 years who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. Appropriate sensitivity and scenario analyses were performed. EXPOSURES: CSG-specific interventions, including RRSO at age 35 to 50 years with or without BC surveillance and medical prevention (ie, tamoxifen or anastrozole) from age 30 or 40 years, RRM at age 30 to 40 years, both RRSO and RRM, BC surveillance and medical prevention, or no intervention. MAIN OUTCOMES AND MEASURES: The incremental cost-effectiveness ratio (ICER) was calculated as incremental cost per quality-adjusted life-year (QALY) gained. OC and BC cases and deaths were estimated. RESULTS: In the simulated cohort of women aged 30 years with no cancer, undergoing both RRSO and RRM was most cost-effective for individuals carrying BRCA1 (RRM at age 30 years; RRSO at age 35 years), BRCA2 (RRM at age 35 years; RRSO at age 40 years), and PALB2 (RRM at age 40 years; RRSO at age 45 years) PVs. The corresponding ICERs were -£1942/QALY (-$2680/QALY), -£89/QALY (-$123/QALY), and £2381/QALY ($3286/QALY), respectively. RRSO at age 45 years was cost-effective for RAD51C, RAD51D, and BRIP1 PV carriers compared with nonsurgical strategies. The corresponding ICERs were £962/QALY ($1328/QALY), £771/QALY ($1064/QALY), and £2355/QALY ($3250/QALY), respectively. The most cost-effective preventive strategy per 1000 PV carriers could prevent 923 OC and BC cases and 302 deaths among those carrying BRCA1; 686 OC and BC cases and 170 deaths for BRCA2; 464 OC and BC cases and 130 deaths for PALB2; 102 OC cases and 64 deaths for RAD51C; 118 OC cases and 76 deaths for RAD51D; and 55 OC cases and 37 deaths for BRIP1. Probabilistic sensitivity analysis indicated both RRSO and RRM were most cost-effective in 96.5%, 89.2%, and 84.8% of simulations for BRCA1, BRCA2, and PALB2 PVs, respectively, while RRSO was cost-effective in approximately 100% of simulations for RAD51C, RAD51D, and BRIP1 PVs. CONCLUSIONS AND RELEVANCE: In this cost-effectiveness study, RRSO with or without RRM at varying optimal ages was cost-effective compared with nonsurgical strategies for individuals who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. These findings support personalizing risk-reducing surgery and guideline recommendations for individual CSG-specific OC and BC risk management

Looking behind the mask: social coping strategies of girls on the autistic spectrum

The socio-communication deficits of individuals on the autistic spectrum are well documented. However, this has largely been based on the male population and less is known about how females with autism manage social relationships across the developmental period. Ten adolescent female participants with a diagnosis of autism were interviewed and Interpretative Phenomenological Analysis used to explore their experiences of managing their social relationships. The results showed that participants were motivated to develop and maintain friendships, but during adolescence this became increasingly difficult. Consequently, they developed explicit strategies to manage these relationships, including masking and imitation. The use of such strategies was both advantageous and disadvantageous, and such findings should be considered in developing gender sensitive assessment and developmentally appropriate support