Social Semiotics: Theorising Meaning Making

This chapter outlines a theoretical framework to account for practices of meaning making in health care and sets out an agenda for clinical educational research. It shows how meaning making pervades all aspects of clinical work and how it can be explored and made explicit within a framework derived from social semiotics. The chapter illustrates how the framework produces accounts of the ways in which clinicians make sense of and interact with the world, in situations where they give, review, and imagine care. It explores how clinicians interpret, and communicate through, human bodies, tools, and technologies, giving meaning to, and expressing meaning through, distinct material forms. In so doing, the chapter begins to render visible the semiotic skills that clinicians develop to prepare for, provide, and evaluate clinical care

Multimodality: A Guide for Linguists

This chapter provides a rationale for a multimodal perspective on meaning, communication and discourse. It draws attention to the range of different modes that people use beyond speech and writing and explores the theoretical and methodological implications of multimodality. The chapter addresses two key questions. First, what is multimodality? Why and how is it relevant to linguistics? Second, how has multimodality been taken up? What questions are addressed, what materials are collected, and what methods are used to analyze these materials? Taking one approach – Social Semiotics – and one area of research – online text making – as an example, the chapter defines and illustrates key concepts and steps in multimodal inquiry. It concludes with consideration of future directions

Resurgence of HIV infection among men who have sex with men in Switzerland : mathematical modelling study

New HIV infections in men who have sex with men (MSM) have increased in Switzerland since 2000 despite combination antiretroviral therapy (cART). The objectives of this mathematical modelling study were: to describe the dynamics of the HIV epidemic in MSM in Switzerland using national data; to explore the effects of hypothetical prevention scenarios; and to conduct a multivariate sensitivity analysis. METHODOLOGY/PRINCIPAL FINDINGS: The model describes HIV transmission, progression and the effects of cART using differential equations. The model was fitted to Swiss HIV and AIDS surveillance data and twelve unknown parameters were estimated. Predicted numbers of diagnosed HIV infections and AIDS cases fitted the observed data well. By the end of 2010, an estimated 13.5% (95% CI 12.5, 14.6%) of all HIV-infected MSM were undiagnosed and accounted for 81.8% (95% CI 81.1, 82.4%) of new HIV infections. The transmission rate was at its lowest from 1995-1999, with a nadir of 46 incident HIV infections in 1999, but increased from 2000. The estimated number of new infections continued to increase to more than 250 in 2010, although the reproduction number was still below the epidemic threshold. Prevention scenarios included temporary reductions in risk behaviour, annual test and treat, and reduction in risk behaviour to levels observed earlier in the epidemic. These led to predicted reductions in new infections from 2 to 26% by 2020. Parameters related to disease progression and relative infectiousness at different HIV stages had the greatest influence on estimates of the net transmission rate. CONCLUSIONS/SIGNIFICANCE: The model outputs suggest that the increase in HIV transmission amongst MSM in Switzerland is the result of continuing risky sexual behaviour, particularly by those unaware of their infection status. Long term reductions in the incidence of HIV infection in MSM in Switzerland will require increased and sustained uptake of effective interventions