Code-switching and identity on the blogs: an analysis of Taglish in computer mediated communication

This study analyses the code-switching variety Taglish (Tagalog-English) in personal weblogs written by Filipino bloggers.The main research questions are set forth in chapter one: why do writers of weblogs code-switch in contexts where there is no specific addressee and hence no turn taking, and why is 'this' particular language chosen at 'this' juncture in the weblog narrative?Chapter two gives an overview of relevant code-switching theory and research, and focuses especially on the sociolinguistic dimensions. In particular, the markedness model of Myers-Scotton is reviewed with respect to the notion of code-switching itself as an unmarked choice. This sets the stage for introducing Taglish as a normal and unmarked phenomenon for many Filipinos.Chapter three presents the socio-political and linguistic background in the Philippines. This give a backdrop for a focus on the evolution and status of Taglish.The problems associated with the presentation of self in Computer Mediated Communication (CMC) are examined in Chapter four and then the unique characteristics of weblogs are explored with respect to their purpose and genre.Chapter five looks at the design and methodology employed and emphasises the qualitative nature of the research and the sampling method as purposive. The main corpus of 25 extracts were analysed using frameworks which bring important perspectives to bear on the use of code-switching in the construction and negotiation of identity. These frameworks are: the referee design dimension of Bell's audience design model with its emphasis on initiative style shifts to project different identities; discursive psychology which highlights the use of language to position self and others; and narrative psychology with its stress on people's use of narrative to seek coherence of self and life-experience. These frameworks are combined with Bakhtinian notions of polyphony, dialogism and heteroglossia.Chapter six gives the detailed results of the analysis of seven weblogs which typify the findings of the corpus. Code-switching on these weblogs highlights the creative end of language use. However, it is a creativity tempered by the realities of Bakhtinian heteroglossia. The heteroglossic nature of the code-switching, in seemingly monological texts, is implicated in how the bloggers negotiate and construct social identities by positioning themselves and others in the ongoing narrative flow. In that the code-switching is extremely plentiful in this non-oral environment, it poses a serious challenge to the attempts by some conversational analysts (e.g., Li, 2005) to claim that code-switching can only really be explicated in terms of the systematics of an interaction taking place. The research seeks to stay within the spirit of CA by suggesting that even in a seemingly monologic form, interaction may be reconceived as heteroglossia covertly present in all language and overtly manifest in switching. Thus switching is not merely a product of how speakers attend to the orderly production of conversation, but also a product of how they attend to the inherent heteroglossic nature of language and exploit their linguistic repertoire maximally to make their communication as effective as possible, and to construct and negotiate multiple identities

Stakeholders? Perspectives Of Accounting Faculty Time Allocations

This study provides evidence on how various stakeholder groups perceive faculty time is and should be allocated across teaching, research and service. To ascertain the priorities of various stakeholders, a questionnaire was administered to accounting professionals, accounting students, and taxpayers. Assistant professors were also surveyed to establish a benchmark for comparisons. Overall, the findings indicate a disparity between the perceptions of accounting professors and their stakeholders regarding time allocations. Suggestions on ways to mitigate these differences are offered

Access to Health Care and Religion among Young American Men

In order to elucidate cultural correlates of utilization of primary health services by young adult men, we investigated religion in which one was raised and service utilization. Using data from a national survey we tested the hypothesis that religion raised predicts access to and utilization of a regular medical care provider, examinations, HIV and other STD testing and counseling at ages 18–44 years in men born between 1958 and 1984. We also hypothesized that religion raised would be more predictive of utilization for Hispanic Americans and non-Hispanic Black Americans than for non-Hispanic White Americans. The study included a national sample of 4276 men aged 18–44 years. Descriptive and multivariate statistics were used to assess the hypotheses using data on religion raised and responses to 14 items assessing health care access and utilization. Compared to those raised in no religion, those raised mainline Protestant were more likely (p < 0.01) to report a usual source of care (67% vs. 79%), health insurance coverage (66% vs. 80%) and physical examination (43% vs. 48%). Religion raised was not associated with testicular exams, STD counseling or HIV testing. In multivariate analyses controlling for confounders, significant associations of religion raised with insurance coverage, a physician as usual source of care and physical examination remained which varied by race/ethnicity. In conclusion, although religion is a core aspect of culture that deserves further study as a possible determinant of health care utilization, we were not able to document any consistent pattern of significant association even in a population with high rates of religious participation

Small cell carcinoma of the anus: a case report

Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60-year old lady with small cell carcinoma of the anus. She had no metastatic disease on presentation. She had chemotherapy and radiotherapy but developed distant metastasis after completion of treatment. Immunohistochemistry is required to make a diagnosis. Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease. Radiotherapy is for local control and relief of symptoms

How a universal health system reduces inequalities: lessons from England

Background: Provision of universal coverage is essential for achieving equity in healthcare, but inequalities still exist in universal healthcare systems. Between 2004/5 and 2011/12 the English NHS, which has provided universal coverage since 1948, made sustained efforts to reduce health inequalities by strengthening primary care. We provide the first comprehensive assessment of trends in socioeconomic inequalities of primary care access, quality and outcomes during this period. Methods: Whole-population small area longitudinal study, based on 32,482 neighbourhoods of approximately 1,500 people in England from 2004/5 to 2011/12. We measured slope indices of inequality in four indicators: (i) patients per family doctor (ii) primary care quality (iii) preventable emergency hospital admissions and (iv) mortality from conditions considered amenable to healthcare. Results: Between 2004/5 and 2011/12 there were larger absolute improvements on all indicators in more deprived neighbourhoods. The modelled gap between the most and least deprived neighbourhoods in England decreased by: 193 patients per family doctor (95% confidence interval 173 to 213), 3.29 percentage points of primary care quality (3.13 to 3.45), 0.42 preventable hospitalisations per 1,000 people (0.29 to 0.55) and 0.23 amenable deaths per 1,000 people (0.15 to 0.31). By 2011/12 inequalities in primary care supply and quality were almost eliminated but socio-economic inequality was still associated with 158,396 preventable hospitalisations and 37,983 deaths amenable to healthcare. Conclusions: Between 2004/5 and 2011/12 the NHS succeeded in substantially reducing socioeconomic inequalities in primary care access and quality but made only modest reductions in healthcare outcome inequalities

Mental illness related disparities in diabetes prevalence, quality of care and outcomes: a population-based longitudinal study

<p>Abstract</p> <p>Background</p> <p>Health care disparity is a public health challenge. We compared the prevalence of diabetes, quality of care and outcomes between mental health clients (MHCs) and non-MHCs.</p> <p>Methods</p> <p>This was a population-based longitudinal study of 139,208 MHCs and 294,180 matched non-MHCs in Western Australia (WA) from 1990 to 2006, using linked data of mental health registry, electoral roll registrations, hospital admissions, emergency department attendances, deaths, and Medicare and pharmaceutical benefits claims. Diabetes was identified from hospital diagnoses, prescriptions and diabetes-specific primary care claims (17,045 MHCs, 26,626 non-MHCs). Both univariate and multivariate analyses adjusted for socio-demographic factors and case mix were performed to compare the outcome measures among MHCs, category of mental disorders and non-MHCs.</p> <p>Results</p> <p>The prevalence of diabetes was significantly higher in MHCs than in non-MHCs (crude age-sex-standardised point-prevalence of diabetes on 30 June 2006 in those aged ≥20 years, 9.3% vs 6.1%, respectively, <it>P </it>< 0.001; adjusted odds ratio (OR) 1.40, 95% CI 1.36 to 1.43). Receipt of recommended pathology tests (HbA_1c, microalbuminuria, blood lipids) was suboptimal in both groups, but was lower in MHCs (for all tests combined; adjusted OR 0.81, 95% CI 0.78 to 0.85, at one year; and adjusted rate ratio (RR) 0.86, 95% CI 0.84 to 0.88, during the study period). MHCs also had increased risks of hospitalisation for diabetes complications (adjusted RR 1.20, 95% CI 1.17 to 1.24), diabetes-related mortality (1.43, 1.35 to 1.52) and all-cause mortality (1.47, 1.42 to 1.53). The disparities were most marked for alcohol/drug disorders, schizophrenia, affective disorders, other psychoses and personality disorders.</p> <p>Conclusions</p> <p>MHCs warrant special attention for primary and secondary prevention of diabetes, especially at the primary care level.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study

<p>Abstract</p> <p>Background</p> <p>Emerging evidence indicates an association between mental illness and poor quality of physical health care. To test this, we compared mental health clients (MHCs) with non-MHCs on potentially preventable hospitalisations (PPHs) as an indicator of the quality of primary care received.</p> <p>Methods</p> <p>Population-based retrospective cohort study of 139,208 MHCs and 294,180 matched non-MHCs in Western Australia from 1990 to 2006, using linked data from electoral roll registrations, mental health registry (MHR) records, hospital inpatient discharges and deaths. We used the electoral roll data as the sampling frame for both cohorts to enhance internal validity of the study, and the MHR to separate MHCs from non-MHCs. Rates of PPHs (overall and by PPH category and medical condition) were compared between MHCs, category of mental disorders and non-MHCs. Multivariate negative binomial regression analyses adjusted for socio-demographic factors, case mix and the year at the start of follow up due to dynamic nature of study cohorts.</p> <p>Results</p> <p>PPHs accounted for more than 10% of all hospital admissions in MHCs, with diabetes and its complications, adverse drug events (ADEs), chronic obstructive pulmonary disease (COPD), convulsions and epilepsy, and congestive heart failure being the most common causes. Compared with non-MHCs, MHCs with any mental disorders were more likely to experience a PPH than non-MHCs (overall adjusted rate ratio (ARR) 2.06, 95% confidence interval (CI) 2.03-2.09). ARRs of PPHs were highest for convulsions and epilepsy, nutritional deficiencies, COPD and ADEs. The ARR of a PPH was highest in MHCs with alcohol/drug disorders, affective psychoses, other psychoses and schizophrenia.</p> <p>Conclusions</p> <p>MHCs have a significantly higher rate of PPHs than non-MHCs. Improving primary and secondary prevention is warranted in MHCs, especially at the primary care level, despite there may be different thresholds for admission in people with established physical disease that is influenced by whether or not they have comorbid mental illness.</p