The Rhetoric of an Architectural Presentation to a Client

In a small observational study in two Canadian architectural firms, the authors tracked the interactions (person-to-person, person with non-human sources such as documents) that took place during specific parts of the design process. This pilot study helped us to secure a grant which is currently allowing us to investigate the relationship between designing (in schools of architecture and architectural practice) and semiotic activity (processes of representation and communication). In one firm the development of a preliminary elevation design for a proposed corporate laboratory facility was followed over three continuous days to the point at which it was ready to be presented at an internal team meeting. Some months later, a senior designer, in frequent interaction with other members of the firm, spent a day preparing a Powerpoint presentation in which the elevation would be presented and justified to a committee of the client organisation. We recorded the day's transactions–the main subject of our paper--with fieldnotes, audio recording and the collection of documents. In making the transition from being a concept that circulated amongst the designers to one for external presentation, the design remained unchanged. However–and this is the point of the paper–the invisible ‘semiotic envelope' within which it had its meaning and was readable in a certain way had to undergo radical and arduous reconstruction. The design process had been as much a matter of the collaborative building of an ‘envelope' of relevance criteria, intentions, values and associations as of the conceptual configuration of materials in space. It was in reference to this envelope that the design had a clear logic and meaning for the designers. But, unlike the drawings, sketches and models, the semiotic envelope could not be directly transmitted to the client participants, who would bring their own envelope of expectations and meanings to the meeting. Specific rhetorical strategies had to be devised, therefore, to ensure that the design would be ‘read' correctly. This involved, for instance, a sort of fictional retrospective reconstruction of the design process in terms of choices between alternatives most of which were never actually entertained, and the conjuring up of ‘bad', ‘rejected' solutions for the sake of presenting the design as a desirable solution. It also involved the post-hoc identification of passages from the client's brief which could be cited as if they had directly governed the design process: ‘Look, we're simply following your requirements here.' The construction of a new justificatory envelope was partly informed by knowledge of the values, assumptions and perspectives (Aristotle's pathos) that framed the client committee's perceptions, as revealed at a previous meeting. In the paper we will briefly summarise our findings about the ‘semiotic envelope' that evolved during the earlier design stage, and then deal more fully with the preparation of the presentation, particularly as it addressed issues of glazing and massing. We will draw on transcripts of our audio-recordings and on the slides and other artefacts produced during the day

Clinical presentation of childhood leukaemia : a systematic review and meta-analysis

OBJECTIVE: Leukaemia is the most common cancer of childhood, accounting for a third of cases. In order to assist clinicians in its early detection, we systematically reviewed all existing data on its clinical presentation and estimated the frequency of signs and symptoms presenting at or prior to diagnosis. DESIGN: We searched MEDLINE and EMBASE for all studies describing presenting features of leukaemia in children (0-18 years) without date or language restriction, and, when appropriate, meta-analysed data from the included studies. RESULTS: We screened 12 303 abstracts for eligibility and included 33 studies (n=3084) in the analysis. All were cohort studies without control groups. 95 presenting signs and symptoms were identified and ranked according to frequency. Five features were present in >50% of children: hepatomegaly (64%), splenomegaly (61%), pallor (54%), fever (53%) and bruising (52%). An additional eight features were present in a third to a half of children: recurrent infections (49%), fatigue (46%), limb pain (43%), hepatosplenomegaly (42%), bruising/petechiae (42%), lymphadenopathy (41%), bleeding tendency (38%) and rash (35%). 6% of children were asymptomatic on diagnosis. CONCLUSIONS: Over 50% of children with leukaemia have palpable livers, palpable spleens, pallor, fever or bruising on diagnosis. Abdominal symptoms such as anorexia, weight loss, abdominal pain and abdominal distension are common. Musculoskeletal symptoms such as limp and joint pain also feature prominently. Children with unexplained illness require a thorough history and focused clinical examination, which should include abdominal palpation, palpation for lymphadenopathy and careful scrutiny of the skin. Occurrence of multiple symptoms and signs should alert clinicians to possible leukaemia

The problems of offenders with mental disorders: A plurality of perspectives within a single mental health care organisation

Managers, doctors, nurses, occupational therapists, social workers, psychologists, unqualified staff and service users were interviewed for a qualitative study of risk management and rehabilitation in an inner city medium secure forensic mental health care unit. Different professional orientations to service user problems were identified. Doctors focused primarily on the diagnosis of mental disorder, which they managed mainly through pharmaceutical interventions. Psychologists were principally concerned with personal factors, for example service user insight into their biographical history. Occupational therapists concentrated mainly on daily living skills, and social workers on post-discharge living arrangements. Some front line nurses, held accountable for security lapses, adopted a criminogenic approach. Service users were more likely than professionals to understand their needs in terms of their wider life circumstances. These differences are explored qualitatively in relation to four models of crossdisciplinary relationships: monoprofessional self-organisation combined with restricted communication; hermeneutic reaching out to other perspectives; the establishment of interdisciplinary sub-systems; and transdisciplinary merger. Relationships between professions working in this unit, as portrayed in qualitative interviews, corresponded mainly to the first model of monoprofessional self-organisation. Reasons for restricted crossdisciplinary understanding, particularly the wide power/status differences between the medical and other professions, and between staff and patients, are discussed

Ameliorating Patient Stigma Amongst Staff Working With Personality Disorder: Randomized Controlled Trial of Self-Management Versus Skills Training.

Background: Patients diagnosed with a personality disorder (PD) are often stigmatized by the healthcare staff who treat them. Aims: This study aimed to compare the impact on front-line staff of a self-management Acceptance and Commitment Therapy-based training intervention (ACTr) with a knowledge- and skills-based Dialectical Behaviour Training intervention (DBTr). Method: A service-based randomized controlled trial was conducted comparing the effects of 2-day ACTr (N = 53) and DBTr (N = 47) staff workshops over 6 months. Primary outcome measures were staff attitudes towards patients and staff-patient relationships. Results: For both interventions, staff attitudes, therapeutic relationship, and social distancing all improved pre- to postintervention, and these changes were maintained at 6-month follow-up. Conclusions: Although offering different resources to staff, both ACTr and DBTr were associated with an improved disposition towards PD patients. Future research could evaluate a combined approach, both for staff working with PD patients and those working with other stigmatized groups

No evidence that the widespread environmental contaminant caffeine alters energy balance or stress responses in fish

Anthropogenic sources of environmental pollution are ever-increasing as urban areas expand and more chemical compounds are used in daily life. The stimulant caffeine is one of the most consumed chemical compounds worldwide, and as a result, has been detected as an environmental contaminant in all types of major water sources on all continents. Exposure of wildlife to environmental pollutants can disrupt the energy balance of these organisms, as restoration of homeostasis is prioritised. In turn, energy allocated to other key biological processes such as growth or reproduction may be affected, consequently reducing the overall fitness of an individual. Therefore, we aimed to investigate if long-term exposure to environmentally relevant concentrations of caffeine had any energetic consequences on wildlife. Specifically, we exposed wild eastern mosquitofish (Gambusia holbrooki) to one of three nominal concentrations of caffeine (0, 100 and 10,000 ng/L) and assayed individuals for metabolic rate, general activity, antipredator and foraging behaviour and body size as measures of energy expenditure or energy intake. We found no differences in any measured traits between any of the given exposure treatments, indicating that exposure to caffeine at current environmental levels may not adversely affect the energy balance and fitness of vulnerable freshwater fish

Design and performance of a stable first crystal mount for a cryogenically cooled Si monochromator at the Advanced Photon Source

We present a new design for mounting a cryogenically cooled Si crystal which gives greatly improved beam stability. The design has been successfully implemented at the University of Michigan, Howard University, Bell Laboratories-Lucent Technologies Collaborative Access Team (MHATT-CAT) 7ID Beamline of the Advanced Photon Source. Before the installation of the new crystal mount, our Si (lll) cryogenically cooled monochromator was sensitive to the pressure fluctuations of the liquid nitrogen coolant, such that the angle of incidence on the first crystal varied linearly with the applied pressure in the cooling lines, causing beam motion of about 250 μm, 60 m250μm,60m from the source. The key element of the design is a symmetrically positioned cooling manifold which balances the forces caused by pressure fluctuations. With this new mount, the typical beam stability is now about 10 μm, comparable to the source stability. © 2002 American Institute of Physics.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69891/2/RSINAK-73-3-1511-1.pd

Aquilegia, Vol. 22 No. 1-2, January-April 1998: Newsletter of the Colorado Native Plant Society

https://epublications.regis.edu/aquilegia/1084/thumbnail.jp

Measuring the well-being of people with dementia : a conceptual scoping review

Background: Enabling people with dementia to ‘live well’ is a policy and research priority in many countries. However, instruments for measuring outcomes of psychosocial interventions designed to promote well-being in dementia are often derived from a symptom-focused, loss/deficit approach, or from broad quality of life concepts. A pan-European dementia working group called for research on the development of an alternative asset/strengths-based conceptual framework of well-being in dementia. This paper takes forward this recommendation by developing such a framework and using this to map relevant self-report outcome measures.Methods: Three scoping reviews of published studies were conducted iteratively. First, we examined the literature on lived experiences of well-being and quality of life in people with dementia and then the wider dementia literature for application of well-being constructs. The synthesised findings generated conceptual domains of well-being in people with dementia. Corresponding self-report instruments used in dementia research were scoped, categorised within the conceptual framework and their potential value in measuring outcomes for people with dementia was then examined.Findings: Six conceptual domains for the measurement of well-being and 35 self-report instruments that have been used with people with dementia were identified. Six instruments were developed specifically for people with dementia, five were derived from the gerontological literature and 24 from the well-being literature. Fifteen instruments and one sub-scale have been examined for psychometric properties. To date, twenty have been used as outcome measures, with seven showing change over time. A number of identified instruments utilise traditional retrospective Likert-scaling formats, limiting their potential for use with some groups of people with dementia.Conclusion: An assets/strengths-based framework is presented, outlining structural domains for selecting self-report measures of well-being in people with dementia. It provides a foundation for enhancing research on processes and outcomes of psychosocial interventions, including instrument development, more precise matching of intervention aims with outcome measurement, and newer technology-based ‘in-the-moment’ measurement. Key words: dementia; outcome measurement; well-being; quality of life; positive psychology; successful aging; lived experienc