Using multiple data sets

This chapter highlights the benefits of using multiple data sets and data triangulation in corpus-assisted discourse study (CADS) research. It discusses the nitty-gritty of methodological decision-making involved in selecting appropriate data sources and analytical tools for meaningful comparisons of discourse across corpora, and outlines a hands-on framework for doing CADS with multiple data sets. This chapter is a must read for students and researchers who are interested in using corpus tools and methods to examine how discourse behaves across contexts and explore aspects of recontextualisation and intertextuality

A corpus-assisted study of the discourses of infertility in UK blogs, news articles and clinic websites

Infertility, the inability to have children when this is desirable, is reported to affect 1in 6 couples in the UK. The experience of infertility has become increasingly ‘medicalised’ (Conrad, 2004) in the context of rapid developments in assisted reproductive technologies, leading Greil et al., (2010) to posit that “the social construction of health and illness is perhaps even more striking in the case of infertility than it is for other conditions”. While there is considerable work into the social aspects of infertilty, as yet there is almost no research into the linguistic or discursive representations of infertility, an absence addressed by this thesis, in the research question what are the discourses of infertility? The combination of corpus linguistics and discourse analysis (CADS) has been fruitfully employed previously in the study of a range of social phenomena (Partington et al., 2013; Baker et al., 2008), including health issues such as depression (Hunt, 2013) and is the approach adopted in this study. Crucial to CADS is the use of comparison, this requirement is met in this thesis by using three text types on the topic of infertility; 1) weblogs written by people experiencing infertility, 2) news reports on the topic of infertility, and 3) fertility clinic websites, all collected in the UK context. I apply a combination of corpus linguistic methods to identify salient linguistic features, and close reading of these features in context to identify traces of discourses (Sunderland, 2004) around the topic of infertility in the three text types. Unique to the methodology of the thesis is the use of the Patterns tool in the Wordsmith suite to identify repeated collocate patterns around a word of interest and identify features for close analysis. Through this process of linguistic analysis and contextual reading, four overarching discourses of infertility were identified; 1) the transformative effect of infertility, 2) medicalised (in)fertility, 3) the marketization of reproduction, and 4) parenthood as privilege and imperative. These discourses encompass multiple, intersecting subdiscourses which operate interdiscursively within and across the three text types studied. The increased awareness of these discourses has the potential to improve understanding of practitioners in the field of infertility, especially frontline staff and thus improve the experience of those accessing services. On a societal level, to critically appraise dominate discourses around a condition can be a conduit to challenging those discourses which are problematic

Using a comparative corpus-assisted approach to study health and illness discourses across domains: the case of postnatal depression (PND) in lay, medical and media texts

In this chapter we highlight the benefits of a comparative corpus-assisted discourse approach to health communication (Jaworska and Kinloch 2018) by examining discursive representations of postnatal depression (PND) in lay, medical and media accounts. PND is an important case to study; it is a highly stigmatised condition which in the UK affects 10-15 in every 100 women and is the leading cause of maternal death (Oates 2003; NHS 2016). Our study endeavours to contribute to a better understanding of the lived experience of PND through a comparative analysis of discourses about the condition produced by mothers in an online discussion forum, the medical profession and the UK print media. We focus specifically on the ways in which the condition – PND – is discursively constructed across different types of texts and the extent to which medical and media discourses around PND are re-contextualised by mothers and how mothers position themselves vis-à-vis the social stigma. To this end, we examine the use of the acronym PND (as opposed to the term postnatal depression) in three large data sets (corpora) including: 1) lay narratives sourced from Mumsnet, 2) information by clinicians for lay people and 3) articles about PND from British newspapers. Analysis of a large dataset of language on a particular topic has clear potential benefits for the study of health language, particularly in gathering evidence of discursive practices around a particular user group or condition

‘Your mind is part of your body’: negotiating the maternal body in online stories of postnatal depression on Mumsnet

This paper looks at the intersection between motherhood and online illness narratives, examining the ways in which women conceptualise their maternal bodies in the context of postnatal depression. Specifically, we examine how discourses of motherhood in distress are positioned in relation to societal norms and expectations, and the othering of the ‘imbalanced’ maternal body. To do so, we apply corpus assisted discourse analysis to posts made in the Mumsnet Talk forum, which specifically discuss postnatal depression. Our findings highlight the discursive strategies employed to represent embodied experiences of a stigmatised condition in an online forum. We focus particularly on the use of embodied explanatory models for mental ill health in mothers to mitigate the stigma attached to the condition. Our study also shows how the embodied lived experience continually interacts with states of mind when making sense of PND and in doing so, transgresses the boundaries set by the body/mind dualism, which prevails in modern medicine

Impact of a decade of successful antiretroviral therapy initiated at HIV-1 seroconversion on blood and mucosal reservoirs

Persistent reservoirs remain the major obstacles to achieve an HIV-1 cure. Prolonged early antiretroviral therapy (ART) may reduce the extent of reservoirs and allow for virological control after ART discontinuation. We compared HIV-1 reservoirs in a cross-sectional study using polymerase chain reaction-based techniques in blood and tissue of early-treated seroconverters, late-treated patients, ART-naïve seroconverters, and long-term non-progressors (LTNPs) who have spontaneous virological control without treatment. A decade of early ART reduced the total and integrated HIV-1 DNA levels compared with later treatment initiation, but not reaching the low levels found in LTNPs. Total HIV-1 DNA in rectal biopsies did not differ between cohorts. Importantly, lower viral transcription (HIV-1 unspliced RNA) and enhanced immune preservation (CD4/CD8), reminiscent of LTNPs, were found in early compared to late-treated patients. This suggests that early treatment is associated with some immunovirological features of LTNPs that may improve the outcome of future interventions aimed at a functional cure

Early treated HIV-1 positive individuals demonstrate similar restriction factor expression profile as long-term non-progressors

Background: A wide range of host restriction factors (RF) become upregulated upon HIV-1 infection to suppress viral infectivity and may aid viremic control in vivo. This cross-sectional study evaluated HIV-1 RFs and dependency factors in HIV infected individuals with progressive or non-progressive infection, as well as in early and late treated cohorts that exhibit different viro-immunological profiles due to differences in timing of treatment-initiation. Methods: The expression profile of IFIT1, MX1, APOBEC3G, SAMHD1, BST2 (encoding TETHERIN), TRIM5, MX2, SLFN11, PAF1, PSIP1 (encoding LEDGF/p75), and NLRX1 was measured by qPCR in 104 HIV-1 positive individuals: seroconverters (SRCV; n =19), long term non-progressors (LTNP; n =17), viremic progressors (VP; n =12), patients treated during seroconversion (Early treated; n =24) or chronic infection (Late treated; n =32), and non-infected controls. Findings: Expression levels of early treated HIV-1 positive individuals were significantly upregulated in comparison to late treated patients (IFIT1: p=0.0003; MX1: p=0.008; APOBEC3G: p=0.002; SAMHD1: p=0.0008; SLFN11: p<0.0001; BST2: p<0.0001). Similarly, SLFN11, BST2, and SAMHD1 were highly expressed in LTNPs at comparable levels as in early treated HIV-1 positive individuals. Furthermore, SLFN11 and SAMHD1 expression negatively correlated with total and integrated HIV-1 DNA levels. Interpretation: Early treatment initiation maintains initial RF elevation even after a decade of ART. Elevated expression of SLFN11, BST2, and SAMHD1 in LTNP and early treated subjects implies that these RFs may be associated with spontaneous virological control

Clinical Applications of Autoimmunity to Citrullinated Proteins in Rheumatoid Arthritis, from Improving Diagnostics to Future Therapies

Rheumatoid arthritis (RA), although widely considered to be the most commonly occurring autoimmune disease, has only truly been substantiated as a distinct autoimmune disease very recently. The lack of understanding of the specific autoimmune system/s at work in rheumatoid patients resulted in an absence of robust diagnostic tools and had meant that the rational choice for use and design of therapy was based on broad-spectrum immunosuppression. The revelation that the autoimmune response specific for patients with RA is to particular protein antigens bearing the posttranslational modification ‘citrulline’ has therefore revolutionized diagnostics and has helped explain why patients carrying particular MHC alleles are predisposed to the disease. The last two decades have seen the characterization of citrullinated antigens targeted by both antibodies and T cells in rheumatoid patients. In more recent years, we have also witnessed the success of biological therapies in the treatment of RA that specifically target T cells and B cells. Ongoing mapping of antibody targets is increasing the percentage of patients who can be definitively diagnosed with, and prognosed to develop, RA. These advances have led to a great number of patents for citrullinated peptides that have been and may be, in the coming years, used in diagnostic test kits. More recently, characterization of T cell targets (citrullinated peptides) has resulted in the patenting of peptides that could be used in antigen specific therapy. This review focuses on the characterization of the autoimmune response to citrullinated protein targets in RA and how the community is translating this knowledge to improve diagnostics, prognostics and therapy