Explore the vast range of titles available.

It has been widely observed that adult men of all ages are at higher risk of developing serious complications from COVID-19 when compared with women. This study aimed to investigate the association of COVID-19 positivity and severity with estrogen exposure in women, in a population based matched cohort study of female users of the COVID Symptom Study application in the UK. Analyses included 152,637 women for menopausal status, 295,689 women for exogenous estrogen intake in the form of the combined oral contraceptive pill (COCP), and 151,193 menopausal women for hormone replacement therapy (HRT). Data were collected using the COVID Symptom Study in May-June 2020. Analyses investigated associations between predicted or tested COVID-19 status and menopausal status, COCP use, and HRT use, adjusting for age, smoking and BMI, with follow-up age sensitivity analysis, and validation in a subset of participants from the TwinsUK cohort. Menopausal women had higher rates of predicted COVID-19 (P = 0.003). COCP-users had lower rates of predicted COVID-19 (P = 8.03E-05), with reduction in hospital attendance (P = 0.023). Menopausal women using HRT or hormonal therapies did not exhibit consistent associations, including increased rates of predicted COVID-19 (P = 2.22E-05) for HRT users alone. The findings support a protective effect of estrogen exposure on COVID-19, based on positive association between predicted COVID-19 with menopausal status, and negative association with COCP use. HRT use was positively associated with COVID-19, but the results should be considered with caution due to lack of data on HRT type, route of administration, duration of treatment, and potential unaccounted for confounders and comorbidities.

Measurement of language atypicalities in Autism Spectrum Disorder (ASD) is cumbersome and costly. Better language outcome measures are needed. Using language transcripts, we generated Automated Language Measures (ALMs) and tested their validity. 169 participants (96 ASD, 28 TD, 45 ADHD) ages 7 to 17 were evaluated with the Autism Diagnostic Observation Schedule. Transcripts of one task were analyzed to generate seven ALMs: mean length of utterance in morphemes, number of different word roots (NDWR), um proportion, content maze proportion, unintelligible proportion, c-units per minute, and repetition proportion. With the exception of repetition proportion (p = . 07 ), nonparametric ANOVAs showed significant group differences (p < 0.01 ). The TD and ADHD groups did not differ from each other in post-hoc analyses. With the exception of NDWR, the ASD group showed significantly (p < 0.01 ) lower scores than both comparison groups. The ALMs were correlated with standardized clinical and language evaluations of ASD. In age- and IQ-adjusted logistic regression analyses, four ALMs significantly predicted ASD status with satisfactory accuracy (67.9–75.5%). When ALMs were combined together, accuracy improved to 82.4%. These ALMs offer a promising approach for generating novel outcome measures.

Deficits in social communication, particularly pragmatic language, are characteristic of individuals with autism spectrum disorder (ASD). Speech disfluencies may serve pragmatic functions such as cueing speaking problems. Previous studies have found that speakers with ASD differ from typically developing (TD) speakers in the types and patterns of disfluencies they produce, but fail to provide sufficiently detailed characterizations of the methods used to categorize and quantify disfluency, making cross-study comparison difficult. In this study we propose a simple schema for classifying major disfluency types, and use this schema in an exploratory analysis of differences in disfluency rates and patterns among children with ASD compared to TD and language impaired (SLI) groups. 115 children ages 4-8 participated in the study (ASD = 51; SLI = 20; TD = 44), completing a battery of experimental tasks and assessments. Measures of morphological and syntactic complexity, as well as word and disfluency counts, were derived from transcripts of the Autism Diagnostic Observation Schedule (ADOS). High inter-annotator agreement was obtained with the use of the proposed schema. Analyses showed ASD children produced a higher ratio of content to filler disfluencies than TD children. Relative frequencies of repetitions, revisions, and false starts did not differ significantly between groups. TD children also produced more cued disfluencies than ASD children.

Recent worldwide epidemiological surveys of autism conducted in 37 countries are reviewed; the median prevalence of autism is .97% in 26 high-income countries. Methodological advances and remaining challenges in designing and executing surveys are discussed, including the effects on prevalence of variable case definitions and nosography, of reliance on parental reports only, case ascertainment through mainstream school surveys, innovative approaches to screen school samples more efficiently, and consideration of age in interpreting surveys. Directions for the future of autism epidemiology are discussed, including the need to systematically examine cross-cultural variation in phenotypic expression and developing surveillance programs.

According to King, the concert had the desired effect of moving the audience; whether it had the power to make people act is another question altogether since, as King states, it was pain that was the dominant theme of the show. [...]it is Maracle's voice more than Chanie's that is audible throughout the story, most significantly in its use of irony, as in the following example: The word \"practiced\" belies the intelligence of the children, who manage to deceive the teachers with little effort. [...]not only Chanie but all the children are \"practiced\" in deceiving the teachers, demonstrating the same collective resistance that allowed so many groups of children to plan their escapes from residential school together. \"First Nations Troubadour Sings Truth to Power.\"

Pragmatic language difficulties, including unusual filler usage, are common among children with Autism Spectrum Disorder (ASD). This study investigated “um” and “uh” usage in children with ASD and typically developing (TD) controls. We analyzed transcribed Autism Diagnostic Observation Schedule (ADOS) sessions for 182 children (117 ASD, 65 TD), aged 4 to 15. Although the groups did not differ in “uh” usage, the ASD group used fewer “ums” than the TD group. This held true after controlling for age, sex, and IQ. Within ASD, social affect and pragmatic language scores did not predict filler usage; however, structural language scores predicted “um” usage. Lower “um” rates among children with ASD may reflect problems with planning or production rather than pragmatic language.

BackgroundIn 2013 the Junior Doctor Service Improvement Board (JDSIB) was created to support multi-disciplinary staff in Quality Improvement Projects (QIP) across Dartford and Gravesham NHS Trust. In 2018–2019 the JDSIB introduced four co-chair roles from varying specialities. This unique advantage provides valuable perspectives and crucial trust-wide links.AimsIdentifying and supporting opportunities for meaningful, sustainable improvement.MethodsJDSIB’s rebranding using distinct logos and colour scheme improved visibility and recognisability and thus engagement. Despite staff identifying areas for improvement across the Trust, there was a perceived notion that the culture was not receptive to change. To tackle this, JDSIB held regular events to showcase QIP ideas in the presence of senior key leaders such as the medical director, CEO, and the audit team. These forums discussed solutions to roadblocks and provided a dedicated space to listen to, and inspire new projects. Cross-team collaboration with the audit team proved crucial in combining resources, expertise and preventing duplicated effort.ResultsJDSIB was deemed ‘inspirational’ by management and ‘very useful’ by colleagues. JDSIB linked motivated individuals and supported colleagues in implementing QIPs, but most importantly emphasised that investigating roadblocks can lead to sustainable solutions. Challenges ranged from co-ordinating rota commitments with events, to influencing senior staff involvement.ConclusionEmploying a senior solely dedicated to QI and leadership would be a useful resource. The strong emphasis on junior doctors to become more engaged, provides opportunities for organisations to nurture their trainees for future leadership roles. Trust wide engagement is by no means an easy feat, yet slowly changing micro-cultures is the start to embracing wider change. The JDSIB are dedicated to encourage improvement and support healthcare professionals to create meaningful change.

The Canadian family-adventure series Adventures in Rainbow Country followed in the wake of the deeply optimistic 1967 Centennial celebrations and reflects the country’s long tradition of nation building. Given the rise of the Separatist and Red Power movements in Canada, the program’s depiction of the harmonious co-existence of anglophone, francophone, and Indigenous populations is hardly an accurate representation of the era. Its strength lies in both its truths and its untruths, however. While postmodernism has taught us to question dangerous fictions, unmasking injustice, it can also stifle change, since it offers no alternatives to reality. This essay examines the contradictions behind the program’s creation and reception in an attempt to explain its lasting impact.