Search

This paper analyses disfluencies and ungrammatical expressions in the speech of 11-13-year-old Finnish-speaking boys with ASD (N = 5) and with neurotypical development (N = 6). The ASD data were from authentic group therapy sessions and neurotypical data from teacher-led group discussions. The proportion of disfluencies and ungrammatical expressions was greater in the speech of participants with ASD (26.4%) than in the control group (15.5%). Furthermore, a qualitative difference was noted: The ASD group produced long, complex disfluent turns with word searches, self-repairs, false starts, fillers, prolongations, inconsistent syntactic structures and grammatical errors, whereas in the control group, the disfluencies were mainly fillers and sound prolongations. The disfluencies and ungrammatical expressions occurring in the ASD participants' interactions also caused comprehension problems.

The testing effect, defined as the positive effect of "retrieval practice" (i.e., self-testing) on long-term memory retention relative to other ways to support learning, is a robust empirical phenomenon. Despite substantial scientific evidence for the testing effect, less is known about its effectiveness in relation to individual differences in cognitive ability. In the present study, we examine whether the effect of retrieval practice is beneficial independent of cognitive ability using behavioral and brain imaging data. In a within-subject design, upper-secondary students learned Swahili-Swedish word pairs through retrieval practice and study. The testing effects were assessed at a direct test and for a subsample after 1- and 4-weeks retention intervals, respectively. Another subsample performed the 1-week retention test during functional MRI (fMRI). Memory retention was analyzed in relation to an educationally relevant composite score dividing participants into low, intermediate, and high cognitive-ability groups. We provide behavioral evidence that the testing effect is independent of cognitive ability. The fMRI findings confirmed a general effectiveness of retrieval practice by showing that brain regions associated with successful retrieval of conceptual representations and semantic processing were more strongly engaged after retrieval practice in all cognitive-ability groups. It is argued that the advantages of retrieval practice should be conveyed to all teachers and students.

Retrieval practice is a learning technique that is known to produce enhanced long-term memory retention when compared to several other techniques. This difference in learning outcome is commonly called "the testing effect". Yet there is little research on how individual differences in personality traits and working memory capacity moderate the size of the retrieval-practice benefits. The current study is a conceptual replication of a previous study, further investigating whether the testing effect is sensitive to individual differences in the personality traits Grit and Need for Cognition, and working memory capacity. Using a within-subjects design (N = 151), participants practiced 60 Swahili-Swedish word pairs (e.g., adhama-honor) through retrieval practice and re-studying. Learning was assessed at three time points: five minutes, one week, and four weeks after practice. The results revealed a significant testing effect at all three time points. Further, the results showed no association between the testing effect and the personality traits, or between the testing effect and working memory, at any time point. To conclude, retrieval practice seems to be a learning technique that is not moderated by individual differences in these specific personality traits or with working memory capacity, thus possibly beneficial for all students.

Although many studies have investigated teaching in one-to-one computing classrooms, not many have considered the material dimension as equally important to the human dimension. Thus, by using a sociomaterial perspective, we aim to broaden the discussion about emergent teaching practices in Nordic classrooms where students use tablets as personal devices. We therefore provide three vignettes from ethnographic classroom studies in Sweden, Finland and Denmark. These illustrate how tablets were used in specific classrooms. In our qualitative analysis of the vignettes, we draw on the concept of patterns of relations to describe the dynamic entanglements of the emergent teaching and learning practices. These are patterns of 1) interrogation, 2) spacemaking and 3) materialisation. Our findings show that tablets do not enter empty learning spaces but are woven into and participate in forming ways of teaching in one-to-one classrooms. Teachers must therefore learn to engage with and manage complex relationships rather than learn how to use an iPad.

Practitioners designing for mobile learning (mLearning) and scholars exploring the same are faced with the challenge of planning for and understanding a variety of ways and places of learning. This study focuses on one crucial distinction concerning this; that of formal and informal learning. Through the analysis of contemporary research literature, we found that informal learning is represented as more enriching than formal learning. We also identified that some representations of informal learning, such as subconscious and tacit, actually gainsay the idea of designing the learning process. Based on these results we propose a number of implications to enhance pedagogical sustainability in mLearning design. We argue that in order to fuse informal and formal learning, mLearning designers need to offer more clear definitions of the concepts "formal" and "informal"; they need to omit some design aspects to the learners themselves, or to offer a design in form of a learning path that students themselves can customise according to their learning habits, routines, and preferences.

The original version of this Article contained an error in the spelling of the author Manuela Gago-Dominguez, which was incorrectly given as Manuela G. Dominguez. This has now been corrected in both the PDF and HTML versions of the Article.

AimsTo objectively appraise evidence for possible adverse effects of long-term statin therapy on glucose homeostasis, cognitive, renal and hepatic function, and risk for haemorrhagic stroke or cataract.Methods and resultsA literature search covering 2000-2017 was performed. The Panel critically appraised the data and agreed by consensus on the categorization of reported adverse effects. Randomized controlled trials (RCTs) and genetic studies show that statin therapy is associated with a modest increase in the risk of new-onset diabetes mellitus (about one per thousand patient-years), generally defined by laboratory findings (glycated haemoglobin ≥6.5); this risk is significantly higher in the metabolic syndrome or prediabetes. Statin treatment does not adversely affect cognitive function, even at very low levels of low-density lipoprotein cholesterol and is not associated with clinically significant deterioration of renal function, or development of cataract. Transient increases in liver enzymes occur in 0.5-2% of patients taking statins but are not clinically relevant; idiosyncratic liver injury due to statins is very rare and causality difficult to prove. The evidence base does not support an increased risk of haemorrhagic stroke in individuals without cerebrovascular disease; a small increase in risk was suggested by the Stroke Prevention by Aggressive Reduction of Cholesterol Levels study in subjects with prior stroke but has not been confirmed in the substantive evidence base of RCTs, cohort studies and case-control studies.ConclusionLong-term statin treatment is remarkably safe with a low risk of clinically relevant adverse effects as defined above; statin-associated muscle symptoms were discussed in a previous Consensus Statement. Importantly, the established cardiovascular benefits of statin therapy far outweigh the risk of adverse effects.

ContextRadical cystectomy continues to be associated with a significant risk of morbidity and all-cause mortality (ACM). Practice pattern data demonstrating underuse of surgery for patients with muscle-invasive and high-risk non-muscle invasive bladder cancer (BC) have been linked to the advanced age and higher comorbidity status of such patients, which suggests that rates of ACM as well as cancer-specific mortality should be incorporated into patient counseling and guideline recommendations.ObjectiveTo review the literature on risk assessment tools for preoperative comorbidity in BC that may aid in treatment decision-making.Evidence acquisitionA systematic search was conducted using Ovid and Medline according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies between 1970 and 2017 reporting on comorbidity risk assessment (CRA) tools for BC. Prospective and retrospective studies were included.Evidence synthesisThere are no published randomized control trials comparing CRA tools for BC. Patients undergoing radical cystectomy with combined high-risk comorbidity and performance scores may face up to a sevenfold greater risk of other-cause mortality compared to those with low scores. The Charlson Comorbidity Index is one of the most widely studied indices for 90-d perioperative mortality and overall and cancer-specific survival, with an area under the receiver operating characteristic curve of up to 0.810. Prospective studies of CRA tools for BC have consistently shown that patients with higher comorbidity have worse outcomes. While not specific for BC, comorbidity indices provide useful assessment of competing risks. Competing-risks assessment tools are lacking, with limited studies assessing the impact of these tools on treatment decision-making by patients and providers. We provide the impetus for incorporation of comorbidity risks into practice guidelines when discussing treatment options with patients.ConclusionsCRA tools should be incorporated into preoperative treatment counseling and the assessment of postoperative outcomes. While retrospective evidence supports the use of CRA tools for BC, further comparative studies evaluating the effectiveness of these tools and identifying the patients most likely to benefit from a treatment according to competing-risks assessment are needed.Patient summaryIn this review we explored the clinical evidence for comorbidity risk assessment tools in bladder cancer. We found evidence to support incorporation of comorbidity risks into practice guidelines when discussing treatment options with patients.

Given previous findings on test enhanced learning, the present study examined the implementation of this practice in terms of quizzing, during the progress of a course. After completing the university course, 88 Swedish teacher students were asked to answer an adapted Retrieval Practice and Test Anxiety Survey. The results showed that students perceived quizzing to improve learning, and reduce test anxiety. Nonetheless, based on students' misconceptions regarding why quizzing actually enhances learning, it is suggested that implications of test enhanced learning was not fully conveyed. It is for educational purpose imperative to not forget this application.

ObjectivesTo develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (PCa) and to guide decisions of who to screen and at what age.DesignAnalysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis. These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10 ng/L, nodal metastasis, distant metastasis). The resulting polygenic hazard score is an assessment of individual genetic risk. The final model was applied to an independent dataset containing genotype and PSA screening data. The hazard score was calculated for these men to test prediction of survival free from PCa.SettingMultiple institutions that were members of international PRACTICAL consortium.ParticipantsAll consortium participants of European ancestry with known age, PCa status, and quality assured custom (iCOGS) array genotype data. The development dataset comprised 31 747 men; the validation dataset comprised 6411 men.Main outcome measuresPrediction with hazard score of age of onset of aggressive cancer in validation set.ResultsIn the independent validation set, the hazard score calculated from 54 single nucleotide polymorphisms was a highly significant predictor of age at diagnosis of aggressive cancer (z=11.2, P98th centile) were compared with those with average scores (30th-70th centile), the hazard ratio for aggressive cancer was 2.9 (95% confidence interval 2.4 to 3.4). Inclusion of family history in a combined model did not improve prediction of onset of aggressive PCa (P=0.59), and polygenic hazard score performance remained high when family history was accounted for. Additionally, the positive predictive value of PSA screening for aggressive PCa was increased with increasing polygenic hazard score.ConclusionsPolygenic hazard scores can be used for personalised genetic risk estimates that can predict for age at onset of aggressive PCa.

AimsTo appraise the clinical and genetic evidence that low-density lipoproteins (LDLs) cause atherosclerotic cardiovascular disease (ASCVD).Methods and resultsWe assessed whether the association between LDL and ASCVD fulfils the criteria for causality by evaluating the totality of evidence from genetic studies, prospective epidemiologic cohort studies, Mendelian randomization studies, and randomized trials of LDL-lowering therapies. In clinical studies, plasma LDL burden is usually estimated by determination of plasma LDL cholesterol level (LDL-C). Rare genetic mutations that cause reduced LDL receptor function lead to markedly higher LDL-C and a dose-dependent increase in the risk of ASCVD, whereas rare variants leading to lower LDL-C are associated with a correspondingly lower risk of ASCVD. Separate meta-analyses of over 200 prospective cohort studies, Mendelian randomization studies, and randomized trials including more than 2 million participants with over 20 million person-years of follow-up and over 150 000 cardiovascular events demonstrate a remarkably consistent dose-dependent log-linear association between the absolute magnitude of exposure of the vasculature to LDL-C and the risk of ASCVD; and this effect appears to increase with increasing duration of exposure to LDL-C. Both the naturally randomized genetic studies and the randomized intervention trials consistently demonstrate that any mechanism of lowering plasma LDL particle concentration should reduce the risk of ASCVD events proportional to the absolute reduction in LDL-C and the cumulative duration of exposure to lower LDL-C, provided that the achieved reduction in LDL-C is concordant with the reduction in LDL particle number and that there are no competing deleterious off-target effects.ConclusionConsistent evidence from numerous and multiple different types of clinical and genetic studies unequivocally establishes that LDL causes ASCVD.

Background and aimsAlthough much has been written about the conventional cardiovascular risk factor correlates of the extent of coronary artery calcification (CAC), few studies have been carried out on symptomatic patients. This paper assesses the potential ability of risk factors to associate with an increasing CAC score.MethodsFrom the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62% male, from Denmark, France, Germany, Italy, Spain and the USA. All had conventional cardiovascular risk factor assessment and CT scanning for CAC scoring.ResultsAmong all patients, male sex (OR = 4.85, p

An increased interest in health, diet, and physical activity exist among young people, in this study termed 'fitness hype'. Viewing the body and health as commodities can be understood as part of a healthism discourse. In this study, we explored how Swedish high school students perceive and negotiate the trend regarding exercise, diet and body ideals. Semi-structured interviews were conducted with ten high school students, aged 16-18 years, from various educational programs and with varying levels of physical activity. Using qualitative content analysis, we developed one overarching theme "navigating life satisfaction in the face of an 'unhealthy fitness hype'". Four additional, interrelated categories showed how the young people negotiated this developing trend through: (1) the quest for social recognition and value, (2) social media sets the standards, (3) the paradox of strong and skinny as the new standard, and (4) the need for new safety nets. Our results highlight the young people's perceptions of an excessive and influential focus on health and exercise in contemporary society. They described a fitness hype as exorbitant and unhealthy ideals of body and exercise, and understood this as problematic. Social media was seen as contributing to this hype as a powerful arena for 'the quest for social recognition and value'. While not all the young people felt negatively affected by the fitness hype, they perceived its influence on their lives. Further, body and fitness ideals were gendered. Teenage girls faced the paradox of shaping themselves as 'strong "and" skinny'. Social ties were recognized as an important safety net, particularly classmates, sports mates, and coaches. Knowledge of these problems from the perspective of young people is crucially needed among health professionals and educators. Further research should explore additional support strategies, and young people's experiences of fitness hype among additional youth groups.