No abstract

PTAMs may be an effective way to control early prescribing of new drugs in general practice. For PTAMs to be effective, it is vital that GPs and pharmacists set common goals on how to optimize pharmacotherapy. This concordance should be reflected in PTAMs that result in concrete decisions with auditing of GP prescribing behavior. Pharmacists should play an active role in organizing PTAMs to increase their influence on drug prescribing.

Theorists have increasingly suggested that both speech-motor and linguistic factors are involved in the etiology of stuttering. This contention has been supported by findings that tend to indicate that youngsters who stutter have a slower speech rate and are less linguistically skilled than nonstutterers. However, no inferences can be drawn from these findings as to the nature or the causation of this disorder. This is because the aforementioned findings might be a result rather than a cause of the disorder. In order to clarify the directionality issue, a multi-year prospective study was undertaken that involved 93 preschool children with a parental history of stuttering.At the initial session, none of the high-risk children sampled was regarded as having a stuttering problem. One year later, 26 children were classified as stutterers. Statistical analyses revealed that prior to the onset of stuttering these children did not differ from the other youngsters studied with respect to either their receptive or expressive language abilities. However, their rate of articulation was significantly faster. The latter finding is taken to mean that the children who developed stuttering were not limited in speechmotor ability. Rather, their fluency failures are seen as a result of a relatively high articulation rate. It is noteworthy, in this regard, that the rate of the high-risk children who continued to be viewed as nonstutterers was slower than that previously reported for youngsters of their age. This suggests that the slower rate served as a buffer against fluency breakdown.