Conspiratorial Exceptionality: A Case study of Mushunguli

Cross-linguistically, there are a variety of attested non-phonological conditions onphonotactics and alternations. The extreme end of this are exceptions, whose idiosyncraticbehaviors are unattributable to any morphological, morphosyntactic, or semanticclass. Studying exceptions is challenging because they require a substantive languagedescription to even be identified, and because their identification can appear to subvertdescriptive and analytical generalizations about the grammar. As a result, exceptionalityresearch often focuses on major world languages, and there is considerable contention surroundingwhether exceptions are wholly phonological, extragrammatical, or somethingin between.This dissertation addresses these gaps via an in-depth case study of segmental phonologyin Mushunguli (Somali Chizigula, Kizigua; Narrow Bantu, G.31), an endangered,under-described language spoken by members of the Somali Bantu diaspora. This casestudy, drawn from original fieldwork conducted in 2011-2012, includes a description andanalysis of the hiatus resolution and onset structure conspiracies of Mushunguli, the formerof which exhibits what appear to be four operations (asymmetric coalescence, glideformation, secondary articulation, and elision) in identical morphosyntactic contexts.Situated within this discussion are three exceptional patterns, each representing aseparate typological instantiation of exceptional blocking: a set of high vowel-initial stemsthat exclusively block coalescence, but not other applicable repairs (simple blocking); a prefixand a verb root which unexpectedly undergo otherwise unattested palatalization inlieu of elision (walljumping); and a set of roots that exceptionally block all forms of hiatusresolution (total non-participation). Adopting lexically-indexed constraints in Stratal OptimalityTheory as a means of capturing these patterns reveals complex interdependenciesbetween exceptions and regular forms in Mushunguli, with the form and behavior of oneexception crucially determining the forms and behaviors of other exceptional and regularpatterns. This suggests that exceptions are lexical but not extragrammatical, insteadplaying an important role in the grammar as reifying and reinforcing agents.The study concludes by examining alternative representational analyses of theMushunguli exceptions, including whole-segment absolute neutralization and underspecification.While these approaches are sometimes capable of capturing the exceptionalpatterns, they ultimately struggle to unify or situate them with respect to the grammar asa whole

The Vocalic Phonology of Mushunguli

Mushunguli, spoken along the lower Jubba river in Somalia, is an undescribed, endangered Bantu language related to Tanzanian Zigua. This study aims to describe and analyze the phonological processes affecting vowel sequences in Mushunguli, in an effort to contribute to understanding the grammar of the language. Mushunguli’s status as an endangered and undescribed language makes documenting these processes critically important for the furthering of linguistic knowledge. Working with a native speaker in regular elicitation sessions, data was gathered that established the grammatical patterns of the language. Multiple phonological processes were uncovered, and rules were formulated using the Incremental Constriction Model (Parkinson: 1996). These rules include fusion, glide formation, post-consonantal y-deletion, palatalization, o-conditioned glide deletion, homorganic glide deletion, and nasal syllabification. Analysis and data of both lexical and post-lexical rules is given, where applicable. The most theoretically interesting rules discovered were fusion and palatalization. In fusion, the non-high vowel /a/ fuses with a following vowel, becoming a single, long, non-high vowel with the second vowel’s place of articulation (front, back, or placeless). For example, the underlying form /ka-iva/ ‘he heard’ is realized in speech as [keeva]. This rule necessitated the use of Parkinson’s Incremental Constriction Model to represent height, and requires that the vowel a be unspecified for place of articulation, breaking with the traditional rule formalization. In palatalization, glide formation first changes the grammatical prefix /di/ to dy, and this output is further changed to the palatal stop [j]. This process is unusual in that it is sensitive to the syntactic context of the utterance—the rule only applies when the first phrasal node dominating the prefix is NP. For example, in /yonda di-edi/ → [yonda jeedi] ‘good baboon,’ the prefix on the adjective contracts, but in /yonda di-ambiza/ → [yonda daambiiza] ‘a baboon helped,’ the same prefix on the verb does not. Syntactically-conditioned phonological rules exist, but are usually related to prosody, not segmental phonology.OSU Department of LinguisticsOSU College of Arts and SciencesOSU Undergraduate Research OfficeNo embarg

The disambiguating effects of phonological exceptions in grammar

This paper explores the analytical and typological consequences of lexically-indexed constraints in Optimality Theory; namely, that the introduction of an indexed constraint by an exception can force the determination of otherwise unspecified rankings in the grammar. This "disambiguating" effect makes two important predictions. First, the typology of exceptional blocking is more complex than has been traditionally assumed: in addition to typical non-undergoing (=faithfulness-obeying) exceptions, exceptions that block a regular repair but undergo an alternative instead (referred to here as "walljumping" exceptions) are also predicted to exist. Second, the forced determination effect means that the existence of an exception determines the possibility or impossibility of other exceptional and regular patterns in the grammar. Using two exceptions to the hiatus resolution conspiracy in Mushunguli (Somali Chizigula, ISO [xma]) as a test case, I show that these predictions hold true, and demonstrate that indexed constraints allow for a unified analysis of hiatus resolution in the language. This result builds upon and strengthens prior observations made by Ito & Mester (1995) regarding the behavior of stratal faithfulness constraints, and supports a view of exceptions as clarifying and reifying agents within the grammar

Editors' Note

A summary of the conference and proceedings volumes.

Comparing palliative care in care homes across Europe (PACE) : protocol of a cross-sectional study of deceased residents in 6 EU countries

Objectives: Although a growing number of older people are dying in care homes, palliative care has developed in these settings only recently. Cross-country representative comparative research hardly exists in this area. As part of a large EU-funded project, we aim to undertake representative comparative research in care homes in Europe, to describe and compare 6 countries in terms of (1) resident outcomes, quality and costs of palliative and end-of-life care; and (2) palliative care structures and staff knowledge and attitudes toward palliative care. We also aim to explore country, facility, staff, patient, and care characteristics related to better outcomes at resident level. Design and Methods: To obtain a representative nationwide sample, we will conduct a large-scale cross-sectional study of deceased residents in care homes in Belgium, Finland, Italy, the Netherlands, Poland, and the United Kingdom, using proportional stratified random sampling (taking into account region, facility type and bed capacity). In each country, all participating care homes retrospectively report all deaths of residents in and outside the facilities over the previous 3-month period. For each case, structured questionnaires, including validated instruments, are sent to (1) the administrator/manager, (2) staff member most involved in care, (3) treating physician (general practitioner or elderly care physician), and (4) a closely involved relative. It is estimated that, per country, 50 care homes are needed on average to obtain a minimum of 200 deceased residents. Collected data include clinical and socio-demographic characteristics, quality of dying, quality and costs of palliative care and end-of-life care, and palliative care structures at the facility level and country level. To obtain a representative view of staff knowledge and attitudes regarding palliative care, PACE will conduct a cross-sectional study of staff working in the participating care homes. Conclusion: Considering the growing challenges associated with aging in all European countries, there is an urgent need to build a robust international comparative evidence base that can inform the development of policies to target improved palliative care in care homes. By describing this research protocol, we hope to inform international research in care homes on how to perform representative end-of-life care research in these settings and better understand which systems are associated with better outcomes

Using a discrete choice experiment involving cost to value a classification system measuring the quality of life impact of self-management for diabetes

Objective: This paper describes the use of a novel approach in health valuation of a discrete choice experiment (DCE) including a cost attribute to value a recently developed classification system for measuring the quality of life impact (both health and treatment experience) of self-management for diabetes. Methods: A large online survey was conducted using DCE with cost on UK respondents from the general population (n=1,497) and individuals with diabetes (n=405). The data was modelled using a conditional logit model with robust standard errors. The marginal rate of substitution (MRS) was used to generate willingness to pay estimates for every state defined by the classification system. Robustness of results was assessed by including interaction effects for household income. Results: There were some logical inconsistencies and insignificant coefficients for the milder levels of some attributes. There were some differences in the rank ordering of different attributes for the general population and diabetes patients. The willingness to pay to avoid the most severe state was £1,118.53 per month for the general population and £2,356.02 per month for the diabetes patient population. The results were largely robust. Conclusion: Health and self-management can be valued in a single classification system using DCE with cost. The MRS for key attributes can be used to inform cost-benefit analysis of self-management interventions in diabetes using results from clinical studies where this new classification system has been applied. The method shows promise, but found large willingness to pay estimates exceeding the cost levels used in the survey

Palliative care implementation in long-term care facilities : European Association for Palliative Care white paper

Objectives: The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions in LTCFs. The PACE study mapped palliative care in LTCFs in Europe, evaluated quality of end-of-life care and quality of dying in a cross-sectional study of deceased residents of LTCFs in 6 countries, and undertook a cluster-randomized control trial that evaluated the impact of the PACE Steps to Success intervention in 7 countries. Working with the European Association for Palliative Care, a white paper was written that outlined recommendations for the implementation of interventions to improve palliative and end-of-life care for all older adults with serious illness, regardless of diagnosis, living in LTCFs. The goal of the article is to present these key domains and recommendations. Design: Transparent expert consultation. Setting: International experts in LTCFs. Participants: Eighteen (of 20 invited) international experts from 15 countries participated in a 1-day face-to-face Transparent Expert Consultation (TEC) workshop in Bern, Switzerland, and 21 (of 28 invited) completed a follow-up online survey. Methods: The TEC study used (1) a face-to-face workshop to discuss a scoping review and initial recommendations and (2) an online survey. Results: Thirty recommendations about implementing palliative care for older people in LTCFs were refined during the TEC workshop and, of these, 20 were selected following the survey. These 20 recommendations cover domains at micro (within organizations), meso (across organizations), and macro (at national or regional) levels addressed in 3 phases: establishing conditions for action, embedding in everyday practice, and sustaining ongoing change. Conclusions and implications: We developed a framework of 20 recommendations to guide implementation of improvements in palliative care in LTCFs. (C) 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine

Identification of a BRCA2-Specific modifier locus at 6p24 related to breast cancer risk

Common genetic variants contribute to the observed variation in breast cancer risk for BRCA2 mutation carriers; those known to date have all been found through population-based genome-wide association studies (GWAS). To comprehensively identify breast cancer risk modifying loci for BRCA2 mutation carriers, we conducted a deep replication of an ongoing GWAS discovery study. Using the ranked P-values of the breast cancer associations with the imputed genotype of 1.4 M SNPs, 19,029 SNPs were selected and designed for inclusion on a custom Illumina array that included a total of 211,155 SNPs as part of a multi-consortial project. DNA samples from 3,881 breast cancer affected and 4,330 unaffected BRCA2 mutation carriers from 47 studies belonging to the Consortium of Investigators of Modifiers of BRCA1/2 were genotyped and available for analysis. We replicated previously reported breast cancer susceptibility alleles in these BRCA2 mutation carriers and for several regions (including FGFR2, MAP3K1, CDKN2A/B, and PTHLH) identified SNPs that have stronger evidence of association than those previously published. We also identified a novel susceptibility allele at 6p24 that was inversely associated with risk in BRCA2 mutation carriers (rs9348512; per allele HR = 0.85, 95% CI 0.80-0.90, P = 3.9×10−8). This SNP was not associated with breast cancer risk either in the general population or in BRCA1 mutation carriers. The locus lies within a region containing TFAP2A, which encodes a transcriptional activation protein that interacts with several tumor suppressor genes. This report identifies the first breast cancer risk locus specific to a BRCA2 mutation background. This comprehensive update of novel and previously reported breast cancer susceptibility loci contributes to the establishment of a panel of SNPs that modify breast cancer risk in BRCA2 mutation carriers. This panel may have clinical utility for women with BRCA2 mutations weighing options for medical prevention of breast cancer

Associations of common breast cancer susceptibility alleles with risk of breast cancer subtypes in BRCA1 and BRCA2 mutation carriers

Introduction: More than 70 common alleles are known to be involved in breast cancer (BC) susceptibility, and several exhibit significant heterogeneity in their associations with different BC subtypes. Although there are differences in the association patterns between BRCA1 and BRCA2 mutation carriers and the general population for several loci, no study has comprehensively evaluated the associations of all known BC susceptibility alleles with risk of BC subtypes in BRCA1 and BRCA2 carriers. Methods: We used data from 15,252 BRCA1 and 8,211 BRCA2 carriers to analyze the associations between approximately 200,000 genetic variants on the iCOGS array and risk of BC subtypes defined by estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and triple-negative- (TN) status; morphologic subtypes; histological grade; and nodal involvement. Results: The estimated BC hazard ratios (HRs) for the 74 known BC alleles in BRCA1 carriers exhibited moderate correlations with the corresponding odds ratios from the general population. However, their associations with ER-positive BC in BRCA1 carriers were more consistent with the ER-positive as