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

Paternity analysis reveals wide pollen dispersal and high multiple paternity in a small 1 isolated population of Eucalyptus caesia (Myrtaceae)

Optimal foraging behaviour by nectavores is expected to result in a leptokurtic pollen dispersal distribution and predominantly near-neighbour mating. However, complex social interactions among nectarivorous birds may result in different mating patterns to those typically observed in insect-pollinated plants. Mating system, realised pollen dispersal and spatial genetic structure were examined in the bird-pollinated Eucalyptus caesia, a species characterised by small, geographically disjunct populations. Nine microsatellite markers were used to genotype an entire adult stand and 181 seeds from 28 capsules collected from 6 trees. Mating system analysis using MLTR revealed moderate to high outcrossing (tm =0.479–0.806) and low estimates of correlated paternity (rp=0.136± s.e. 0.048). Paternity analysis revealed high outcrossing rates (mean = 0.72) and high multiple paternity, with 64 different sires identified for 181 seeds. There was a significant negative relationship between the frequency of outcross mating and distance between mating pairs. Realised mating events were more frequent than expected with random mating for plants o40 m apart. The overall distribution of pollen dispersal distances was platykurtic. Despite extensive pollen dispersal within the stand, three genetic clusters were detected by STRUCTURE analysis. These genetic clusters were strongly differentiated yet geographically interspersed, hypothesised to be a consequence of rare recruitment events coupled with extreme longevity. We suggest that extensive polyandry and pollen dispersal is a consequence of pollination by highly mobile honeyeaters and may buffer E. caesia against the loss of genetic diversity predicted for small and genetically isolated populations.The project was funded by an Australian Research Council Grant to SDH, SLK and RDP (DP140103357) for work on the evolution and conservation consequences of promiscuity in plants pollinated by vertebrates. SDH was also supported by a Discovery Outstanding Researcher Award attached to this grant, and by grants from the Great Southern Development Commission and the Jack Family Trust

Primary pollinator exclusion has divergent consequences for pollen dispersal and mating in different populations of a bird-pollinated tree

Pollination by nectarivorous birds is predicted to result in different patterns of pollen dispersal and plant mating compared to pollination by insects. We tested the prediction that paternal genetic diversity, outcrossing rate and realized pollen dispersal will be reduced when the primary pollinator group is excluded from bird-pollinated plants. Pollinator exclusion experiments in conjunction with paternity analysis of progeny were applied to Eucalyptus caesia Benth. (Myrtaceae), a predominantly honeyeater-pollinated tree that is visited by native insects and the introduced Apis mellifera (Apidae). Microsatellite genotyping at 14 loci of all adult E. caesia at two populations (n = 580 and 315), followed by paternity analysis of 705 progeny, revealed contrasting results between populations. Honeyeater exclusion did not significantly impact pollen dispersal or plant mating at Mount Caroline. In contrast, at the Chiddarcooping site, the exclusion of honeyeaters led to lower outcrossing rates, a threefold reduction in the average number of sires per fruit, a decrease in intermediate-distance mating and an increase in near-neighbour mating. The results from Chiddarcooping suggest that bird pollination may increase paternal genetic diversity, potentially leading to higher fitness of progeny and favouring the evolution of this strategy. However, further experimentation involving additional trees and study sites is required to test this hypothesis. Alternatively, insects may be effective pollinators in some populations of bird-adapted plants, but ineffective in others.Jack family trust; Australian Research Council, Grant/Award Number: DP140103357; University of Western Australia; Great Southern Development Commission; Holsworth Wildlife Research Endowment—Equity Trustees Charitable Foundation; Wiley Fundamental Ecology Award, Ecological Society of Australia Student Research Awar

'Use of antipsychotics in children and adolescents: a picture from the ARITMO population-based European cohort study'

Aims. Prevalence of the use of antipsychotics (APs) in the paediatric population is globally increasing. The aim of this study was to describe multinational trends and patterns in AP use in children and adolescents in Europe. Methods. This was a dynamic retrospective cohort study comprising all children and adolescents (⩽18 years of age). Data were extracted from five population-based electronic healthcare databases in Europe (Denmark, Germany, Italy, the Netherlands and United Kingdom) from 2000 to 2010. Yearly prevalence and incidence of AP use was expressed per 1000 person-years (PYs). Results. Prevalence increased from 1.44 to 3.41/1000 PYs (2008) in Denmark and from 2.07 to 4.35/1000 PYs in the NL (2009), moderately increased from 2.8 to 3.24/1000 in UK (2009) and from 1.53 to 1.74/1000 PYs in Germany (2008) and remained low from 0.61 to 0.34/1000 PYs in Italy (2010). Similarly, incidence rates increased from 0.69 to 1.52/1000 PYs in Denmark and from 0.86 to 1.49/1000 PYs in the NL, stabilised from 2.29 to 2.37/1000 PYs in the UK and from 0.79 to 0.80/1000 PYs in Germany and remained low from 0.32 to 0.2/1000 PYs in Italy. AP use was highest in 15–18 year olds and in boys compared to girls. Yet, the use observed in the 5–9 year olds was found to be comparatively high in the NL. Prescriptions of second generation APs, especially risperidone, were privileged but the first generation APs were still prescribed in the youngest. Conclusions. A steady increase in AP use in children and adolescents was observed essentially in the NL and Denmark. The use in Germany and Italy was lowest among countries. The use of APs under 9 years of age underlines their off-label use and should be carefully monitored as the risk/benefit ratio of these medications remains unclear in young children. AP use was altogether lower in Europe as compared to that reported in North America

Innocent Frauds Meet Goodhart’s Law in Monetary Policy

This paper discusses recent UK monetary policies as instances of Galbraith’s ‘innocent frauds’, including the idea that money is a thing rather than a relationship, the fallacy of composition that what is possible for one bank is possible for all banks, and the belief that the money supply can be controlled by reserves management. The origins of the idea of QE, and its defense when it was applied in Britain, are analysed through this lens. An empirical analysis of the effect of reserves on lending is conducted; we do not find evidence that QE ‘worked’ either by a direct effect on money spending, or through an equity market effect. These findings are placed in a historical context in a comparison with earlier money control experiments in the UK

The way forward in biochar research: targeting trade-offs between the potential wins.

Plant science

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand.

OBJECTIVE: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. DESIGN: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. METHODS: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. RESULTS: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. CONCLUSION: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Peddling a semiotics of fear: a critical examination of scare tactics and commercial strategies in public health promotion

This study critically examines the ways in which the nationwide Diabetes UK/Tesco public health promotion campaign (2013-2014) sought to raise awareness of Type 2 diabetes. Conducting a multimodal critical discourse analysis of six campaign images, we identify the presence of fear-inducing, stigmatising and commercial strategies, through which the campaign emphasises the dangers of diabetes and advocates personal responsibility for assessing both individual and others’ risk of the disease. Specifically, three discursive techniques are deployed in this campaign to achieve these ends: (1) the depiction of grief and amplification of diabetes-related danger, (2) the promotion of diabetes risk and responsibilization of individuals for their health, and (3) the commercial branding and framing of the Diabetes UK/Tesco partnership as providing tools for diabetes prevention and management. Our findings raise concerns about the moral legitimacy of using fear-inducing and commercial strategies in public health campaigns, strategies which do little to address the environmental factors which are associated with increasing rates of the disease