Aspectos pragmalingüisticos de la interrogación en español con atención especial a las secuencias de preguntas

Haverkate proposes the empirical analysis of an area of pragmatics seldom looked into, the interactional nature of chains of questions in the Spanish language. The combination of speech act theory and the three interactional categories of empathy, antagonism and discursive insistence illustrate the various ways in which the emergence of implicature may relate to strategies of positive / negative politeness.Haverkate propone el estudio de un fenómeno escasamente estudiado en el ámbito de la pragmalingüística, como es el carácter interaccional de las secuencias de preguntas en el idioma español, que combina con la teoría de los actos de habla. Mediante un análisis empírico centrado en las categorías de la empatía, el antagonismo y la insistencia discursiva, se ilustra cómo los diversos grados de implicatura resultantes afectan y reflejan las estrategias de la cortesía positiva / negativa

Voicethread: A Technology Tool Worth Your Time

I have worked at the Applied English Center since 1991 and over that time the kinds of technology I have had access to have changed dramatically. The technology we now have access to makes teaching spoken English much easier. In the following article, I address three key questions about Voicethread and why I think it is worth learning about and using with your students. Caveats are also discussed but the drawbacks do not outweigh the benefits. In the following discussion Voicethread with a capital V refers to the program and voicethread with a small v refers to an individual voicethread that the user has created

Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments

<p>Abstract</p> <p>Background</p> <p>The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals.</p> <p>Methods</p> <p>A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level.</p> <p>Results</p> <p>The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals.</p> <p>Conclusions</p> <p>Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care providers about these policies is not always provided, and quality assessment tools are used in less than half of the hospitals.</p

Insider perspectives of ‘outsiders’. A phenomenological study on migrant care workers in Italy.

Objectives: This study aims to gain more insight in the perspectives of migrant elderly home care workers in Italy. In scrutinizing the experiences of these caregivers this research seeks to understand what these experiences mean in terms of good caring, to deliver a contribution to the care ethical field of inquiry. Background: As a consequence of an aging population and limited social services in Italy, the demand and supply of elderly care are out of balance. An increasing phenomenon is to hire a family assistant; these mainly immigrant women give daily home care and often live-in with the elderly. The family assistants are hired on an enormous scale, but their perspective is barely represented in public and political debates. How do they experience being a family assistant in Italy? Method: The data is collected by conducting in-depth interviews and participative observations. An Interpretative Phenomenological Analysis is used to analyse the data. Findings: Family assistants have dynamic positions towards their care recipient, they feel both dependent and in control. Within the caring relationship they try to build, they seem to constantly balance between proximity and distance. The family assistants fully commit themselves to the needs of the care recipient, and experience their own limits in doing so. Conclusion: It is not always taken into account the family assistants are dependent and vulnerable too. They are attuned with the care recipient but they do not always attune with themselves or receive care themselves. Therefore it is questioned whether this is good care, seen from a care ethical perspective

‘The ordinary magic’. Een narratief onderzoek naar veerkracht en trauma bij drie generaties Joodse Nederlanders.

In onderzoek naar de Holocaust wordt sinds een aantal decennia gesproken over de mogelijkheid van intergenerationele traumaoverdracht. Dit betekent dat de (potentieel) traumatische gebeurtenissen die de Holocaust overlevenden hebben meegemaakt ook doorwerken in de levens van hun kinderen, en mogelijk kleinkinderen. Recentelijk is de mogelijkheid van intergenerationele overdracht van veerkracht eveneens een actueel onderwerp geworden. Tot op heden bestaat er nog geen consensus over. Veerkracht wordt ook wel omschreven als ‘the ordinary magic’. Veelal vertrekken de onderzoeken vanuit een dominant psychologisch perspectief – zijnde een individueel perspectief - in plaats van een meer sociale, culturele dimensie in ogenschouw te nemen. Daarnaast blijft onderzoek naar de beleving en vertelwijze van de betrokkenen achter. Dit onderzoek vertrekt vanuit een narratief perspectief, aansluitend op cultural memory studies en tracht zo meer inzicht te verwerven in de wijze waarop de eerste, tweede en derde generatie Joodse Nederlanders betekenis geven aan hun leven in het licht van de Holocaust. Op deze manier wordt gepoogd de processen van veerkracht, zingeving en trauma te beschrijven en tot begrip ervan te komen. De ‘Dialogical Self Theory’ vormt de theoretische fundering en de analysemethode van dit onderzoek. Door de meerstemmige posities van de respondenten te onderzoeken wordt getracht inzicht te krijgen in hoe een veerkrachtige of kwetsbare omgang met moeilijkheden gerelateerd is aan de familiare context. Er zijn zes Joodse Nederlandse families onderzocht, bestaande uit drie opeenvolgende generaties waarvan de eerste generatie tot de Holocaust overlevenden behoren. Opvallend is de grote rijkheid aan posities die ieder individu heeft en hoe zeer deze met elkaar in tegenspraak én dialoog zijn. De verwevenheid tussen het ‘ik’ en ‘collectief’ wordt onderstreept, waarbij intergenerationele overdracht plaatsvindt via herinneringen en verhalen. Veerkracht wordt vooral zichtbaar als relationeel proces en als situationeel van aard. Trauma wordt zichtbaar in de bestaansonzekerheid die veel respondenten ervaren en in de ervaring geen zeggenschap over het leven te hebben. Vooralsnog wordt er in het wetenschappelijk en maatschappelijk discours vooral gedacht in dichotomieën betreffende trauma (kwetsbaarheid) en veerkracht. Dit onderzoek laat zien dat er voorbij deze tegenstelling gekeken moet worden omdat mensen zowel veerkrachtig als kwetsbaar kunnen zijn

Relation of C-reactive protein to body fat distribution and features of the metabolic syndrome in Europeans and South Asians.

OBJECTIVE: To investigate the association between circulating C-reactive protein (CRP) concentrations and indices of body fat distribution and the insulin resistance syndrome in South Asians and Europeans. DESIGN: : Cross-sectional study. SUBJECTS: A total of 113 healthy South Asian and European men and women in West London (age 40-55 y, body mass index (BMI) 17-34 kg/m(2)). MEASUREMENTS: Fatness and fat distribution parameters (by anthropometry, dual-energy X-ray absorptiometry and abdominal CT scan); oral glucose tolerance test with insulin response; modified fat tolerance test; and CRP concentration by sensitive ELISA. RESULTS: Median CRP level in South Asian women was nearly double that in European women (1.35 vs 0.70 mg/1, P=0.05). Measures of obesity and CRP concentration were significantly associated in both ethnic groups. The correlation to CRP was especially strong among South Asians (P0.15). CONCLUSION: We suggest that adiposity and in particular visceral adipose tissue is a key promoter of low-grade chronic inflammation. This observation may in part account for the association of CRP with markers of the metabolic syndrome. Future studies should confirm whether CRP concentrations are elevated in South Asians and whether losing weight by exercise or diet, or reduction in visceral fat mass, is associated with reduction in plasma CRP concentrations

GATA2 haploinsufficient patients lack innate lymphoid cells that arise after hematopoietic cell transplantation.

Innate lymphoid cells (ILC) are important barrier tissue immune regulators. They play a pivotal role in early non-specific protection against infiltrating pathogens, regulation of epithelial integrity, suppression of pro-inflammatory immune responses and shaping the intestinal microbiota. GATA2 haploinsufficiency causes an immune disorder that is characterized by bone marrow failure and (near) absence of monocytes, dendritic cells, B cells and natural killer (NK) cells. T cells develop normally, albeit at lower numbers. Here, we describe the absence of ILCs and their progenitors in blood and bone marrow of two patients with GATA2 haploinsufficiency and show that all subsets of ILCs appear after allogeneic hematopoietic stem cell transplantation, irrespective of the preparative conditioning regimen. Our data indicate that GATA2 is involved in the development of hematopoietic precursor cells (HPC) towards the ILC lineage