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Constructing simultaneous communication: the contributions of natural sign language.

This article examines simultaneous communication (SC) by analyzing the changes in productions of teachers who underwent a program specifically designed to address improvements in the signed modality by working with both English-based signing and American Sign Language (ASL). Based on theoretical concepts found in bilingualism, language contact situations, and conversational analysis, we focus on the process of constructing utterances by examining the teachers' spontaneous repair sequences as evidence of an active productive system. Two teachers received special instruction in SC that included both ASL and English-based signing systems as separate but equal systems. Videotapes of their use of SC, collected over four years, were analyzed for sign/speech ratio and repair sequences. Repairs were classified as repetitions, replacements, or synchronization. We found that the sign/speech ratio of both teachers increased over time. Examination of repair sequences showed that repetitions tended to occur in speech with the sign channel more completely encoded in the repair. Changes in speech tended to be accompanied by changes in sign. Errors in synchrony were relatively rare. We conclude that the simultaneous communication of both teachers was speech-driven, but error detection was largely sign-driven. The greater the automaticity of both languages, the more attention could be devoted to monitoring the coordination of the two modalities. The amount and quality of monitoring that actually occurred, however, were subject to individual differences.

Journal Article↗

Mediation of skin allograft rejection in scid mice by CD4+ and CD8+ T cells.

We analyzed the role of CD4+ and CD8+ T cells in H-2-disparate skin allograft rejection in the mutant mouse strain C.B-17/Icr scid with severe combined immunodeficiency. On the day of skin allografting, scid mice were adoptively transferred with negatively selected CD4+ or CD8+ splenocytes from normal unsensitized C.B-17/Icr mice. These populations were obtained using a double-mAb--plus--complement elimination protocol using anti-CD4 or anti-CD8 mAb that resulted in no detectable CD4+ or CD8+ cells by FACS and negligible numbers of cytolytic T lymphocytes by limiting dilution analysis in anti-CD8 treated populations. Spleen cells were removed from grafted mice at the time of rejection and were tested in vitro for antidonor reactivity in several assays: mixed lymphocyte culture, cell-mediated lympholysis, and LDA for CTL and for IL-2-producing HTL. The presence of Thy 1.2+, CD4+, or CD8+ cells was determined by FACS. All control C.B-17 mice and scid mice adoptively transferred with nondepleted CD4+, and CD8+ cells rejected skin allografts with similar mean survival times (15.6 +/- 1.5, 18.8 +/- 3.4, 18.0 +/- 5.4, respectively), whereas control scid mice retain skin allografts indefinitely (all greater than 100 days). C.B-17 syngeneic grafts survived indefinitely in all groups. At the time of rejection, splenocytes from scid mice receiving CD4+ cells had negligible donor-specific cytotoxicity in CML and negligible numbers of CTL by LDA, but demonstrated a good proliferative response in MLC and IL-2-producing cells by LDA (frequency = 1/1764). There were no detectable CD8+ cells present by FACS analysis. Conversely, splenocytes from scid mice adoptively transferred with CD8+ cells had strong donor-specific cytotoxicity in CML (58.8% +/- 16.1%) and CTL by LDA (frequency = 1/3448), but no significant proliferation was detected in MLC. There were no detectable CD4+ cells by FACS, but there were small numbers of IL-2-producing cells by LDA (frequency = 1/10,204). These data demonstrate that CD4+ cells adoptively transferred into scid mice are capable of mediating skin allograft rejection in the absence of any detectable CD8+ cells or significant functional cytolytic activity. The adoptive transfer of CD8+ cells also results in skin allograft rejection in the absence of detectable CD4+ cells. The detection of small numbers of IL-2 secreting cells in these mice may indicate that CD(8+)-mediated allograft rejection in this model is dependent on IL-2-secreting CD8+ cells.

Animals↗

Astigmatism and LASIK.

Although laser in situ keratomileusis (LASIK) enjoys a high success rate, postoperative residual or induced astigmatism may limit uncorrected visual acuity and cause starbursts and glare at night. Irregular astigmatism can also cause loss of best-corrected visual acuity, monocular diplopia, and ghosting of images. Astigmatism may be measured by keratometry and refraction, while corneal topographic techniques help to define irregular astigmatism, in particular. Further information may be obtained regarding induced higher-order aberrations with aberrometry. Because astigmatism has both direction and magnitude, its analysis is more complex than that of the spherical component of the treatment. There are multiple approaches to the analysis of surgically induced astigmatism, including vector analysis, conversion to a Cartesian coordinate system, matrix formalism, and linear optics. Both excimer laser and incisional techniques may be used to correct astigmatism after LASIK, but the treatment of irregular astigmatism requires selective zonal ablation techniques or customized corneal ablations, using topographic or wavefront derived data.

Astigmatism↗

Explanations in consultations: the combined effectiveness of doctors' and nurses' communication with patients.

BACKGROUND: Multidisciplinary and interprofessional working is currently a priority in health care policy, in caring for patients and in health professional education. Realising multidisciplinary approaches presents challenges in the context of changes in doctors' and nurses' roles and the increased emphasis placed on communication with patients. In communication in consultations, explanations are employed in the service of numerous activities, including decision making, diagnosis and physical examination, but they have been little studied. SETTING: This paper presents findings from a comparative study of doctors' and nurses' communication with patients in multidisciplinary health care, focusing on diabetes in primary care. METHODS: Video- and audio-recorded consultations were subjected to conversation analysis. Output from discussion groups with patient representatives and health professionals underwent qualitative analysis. FINDINGS: Distinctive features of explanations in nurses' and doctors' consultations with patients were identified. These can be understood by reference to patterns of communication. Nurses' communication was mediated by patients' contributions; doctors' communication gave an overarching direction to the consultation as a whole. While nurses' explanations began from the viewpoint of a patient's responsibility and behaviour, doctors' explanations began from the viewpoint of biomedical intervention. Their consultations lent different opportunities for patients' involvement. CONCLUSION: Nurses' and doctors' communications each exhibit their own distinct features. Specification of these features, when considered in the context of a particular consultation activity such as explanations, allows both recognition of the distinct contributions each profession can offer and identification of ways of combining these to maximum effect. This has implications for policy, for practice and for interprofessional education.

Blood Glucose↗

Are your minimal pairs too neat? The dangers of phonemicisation in phonology therapy.

Using Conversation Analysis (CA) to look at the interactional dynamics of therapy repair sequences, this paper shows exactly what happens for children when idealised misrepresentations of their phonology are used in therapy. The primary video extract involves a 4-year-old phonologically disordered boy and his therapist. It is not new to warn of the dangers of overlooking any subtle phonetic distinctions that the phonologically disordered child may have but this paper adds something new to the debate. The child's interpretation of the adult's prior turn in the sequence is made explicit and the likelihood of the child producing phonetic revision following an error is seen to be affected by the way the therapist chooses to initiate repair. This is especially true where a 'redoing' of the error is incorporated into such an initiation, when the child's phonetic output is 'tidied up' so that it fits in with the neat minimal pair which forms part of the therapy programme. This is one factor that can be seen to militate against appropriate phonetic repair by the child, especially when used in certain turn structures that are routinely associated with lexical rather than phonetic matters. When the adult 'redoing' more accurately reflects the child's output phonetic revision is more likely to occur. Implications for assessment and therapy are drawn from this evidence, with accurate phonological assessment and continuing interactional error analysis being recommended.

Child, Preschool↗

Information, understanding and the benign order of everyday life in genetic counselling.

Genetic counselling as a medical encounter is characterised by the centrality of the provision of information. Much of the counselling session is filled by information delivery about the symptoms, the prognosis and the transmission of the disease, the risks involved and the possibilities for genetic testing. The present paper is a study of how information is delivered in actual genetic counselling sessions. The data consist of 10 video-recorded sessions from a genetics clinic in Finland, and the methodology is based on conversation analysis. The paper focuses on the doctor's talk in a specific interactional context, the slot after a candidate understanding by a client. The analysis shows that the doctors have two basic orientations: they work towards securing correct understanding and they display being attuned to what the information means to the clients, particularly to whether it is positive or negative to them. The latter orientation is related to what has been called 'the benign order of everyday life' (Maynard 2003). The findings in the paper offer a possibility for a discussion about the principles and practices of genetic counselling.

Communication↗

"You'll feel me touching you, sweetie": vaginal examinations during the second stage of labor.

Videotapes of women during the second stage of labor and their caregivers were examined in this descriptive study to determine how caregivers performed sterile vaginal examinations. Conversational analysis techniques were used to analyze the data. Results showed that the examinations were performed in a ritualistic manner by all caregivers, and the way the ritual was enacted repeatedly demonstrated the power of the caregivers over the women. The most common reason for performing the procedure, to help the woman push better, seems to be specific to the second stage of labor and is not described in the literature. The authors offer suggestions for better use of the examination, and recommend that it be performed far less frequently than is common.

Adolescent↗

Notes for a cultural history of family therapy.

The official history of family therapy describes its beginnings as a daring technical and philosophical departure from traditional individual treatment in the 1960s, inspired especially by the "system thinking" of Gregory Bateson. This celebrated origin story needs to be supplemented with a longer and larger history of both practice and thought about the family, and that is the subject of this article. The longer history goes back to the founding of social work by Mary Richmond, of pragmatism by William James, and of the organic view of social systems intervention by John Dewey. Seen against this background, family therapy is, among other things, a consequence of the development of persistent elements of American professional culture, experience, and philosophy. The taking of this historical-anthropological view discloses also the origins of two other histories that have made their contribution to the development of family therapy: a science of observing communication processes that starts with Edward Sapir and leads to contemporary conversation analysis, and a history of mesmerism in the United States that culminates in Milton Erickson and his followers.

Family Therapy↗

Long-lasting transneuronal changes in rat dentate granule cell dendrites after entorhinal cortex lesion. A combined intracellular injection and electron microscopy study.

Following entorhinal cortex lesion, inhibitory hippocampal neurons show a persistent rarefication of those dendrites formally receiving entorhinal input. Physiological data indicate a long lasting disequilibrium of inhibition and excitation in the de-entorhinated hippocampus. We analyzed the intracellularly-stained dendritic tree of de-entorhinated excitatory rat granule cells. Granule cells of controls and animals surviving 2, 8, 60 and 270 days after unilateral entorhinal cortex lesion were impaled. Dendrites of control cells were of typical shape, traced to the hippocampal fissure and a complete dye filling of dendrites was ascertained by EM-analysis. Conversely, 60 and 270 days following lesioning, dendrites were only rarely seen to extend into the outer portions of the molecular layer and the dendritic architecture became significantly rarefied. Sixty days post-lesion, intracellularly filled dendrites extending to the middle molecular layer were surrounded by cell clusters resembling glia. Some of these contained the neuronally applied dye, suggesting a close association of the cytosolic compartments with the altered dendrites. These observed alterations exceed the process of sprouting and de novo synaptogenesis of remaining afference for long periods of time. The dendritic morphology of both inhibitory and excitatory neurons seems to require specific input from the entorhinal cortex. Moreover, sprouting of remaining afferents is apparently not sufficient to compensate for this loss of input.

Animals↗

Functional characterization of the beta-adrenergic receptor subtypes expressed by CA1 pyramidal cells in the rat hippocampus.

Recent studies have demonstrated that activation of the beta-adrenergic receptor (AR) using the selective beta-AR agonist isoproterenol (ISO) facilitates pyramidal cell long-term potentiation in the cornu ammonis 1 (CA1) region of the rat hippocampus. We have previously analyzed beta-AR genomic expression patterns of 17 CA1 pyramidal cells using single cell reverse transcription-polymerase chain reaction, demonstrating that all samples expressed the beta2-AR transcript, with four of the 17 cells additionally expressing mRNA for the beta1-AR subtype. However, it has not been determined which beta-AR subtypes are functionally expressed in CA1 for these same pyramidal neurons. Using cell-attached recordings, we tested the ability of ISO to increase pyramidal cell action potential (AP) frequency in the presence of subtype-selective beta-AR antagonists. ICI-118,551 [(+/-)-1-[2,3-(dihydro-7-methyl-1H-inden-4-yl)oxy]-3-[(1-methylethyl)amino]-2-butanol] and butoxamine [alpha-[1-(t-butylamino)ethyl]-2,5-dimethoxybenzyl alcohol) hydrochloride], agents that selectively block the beta2-AR, produced significant parallel rightward shifts in the concentration-response curves for ISO. From these curves, apparent equilibrium dissociation constant (K(b)) values of 0.3 nM for ICI-118,551 and 355 nM for butoxamine were calculated using Schild regression analysis. Conversely, effective concentrations of the selective beta1-AR antagonists CGP 20712A [(+/-)-2-hydroxy-5-[2-([2-hydroxy-3-(4-[1-methyl-4-(trifluoromethyl)-1H-imidazol-2-yl]phenoxy)propyl]amino)ethoxy]-benzamide methanesulfonate] and atenolol [4-[2'-hydroxy-3'-(isopropyl-amino)propoxy]phenylacetamide] did not significantly affect the pyramidal cell response to ISO. However, at higher concentrations, atenolol significantly decreased the potency for ISO-mediated AP frequencies. From these curves, an apparent atenolol K(b) value of 3162 nM was calculated. This pharmacological profile for subtype-selective beta-AR antagonists indicates that beta2-AR activation is mediating the increased AP frequency. Knowledge of functional AR expression in CA1 pyramidal neurons will aid future long-term potentiation studies by allowing selective manipulation of specific beta-AR subtypes.

Action Potentials↗

Genetic recombination between two genotypes of genogroup III bovine noroviruses (BoNVs) and capsid sequence diversity among BoNVs and Nebraska-like bovine enteric caliciviruses.

To determine the genogroups and genotypes of bovine enteric caliciviruses (BECVs) circulating in calves, we determined the complete capsid gene sequences of 21 BECVs. The nucleotide and predicted amino acid sequences were compared phylogenetically with those of known human and animal enteric caliciviruses. Based on these analyses, 15 BECVs belonged to Norovirus genogroup III and genotype 2 (GIII/2) and were genetically distinct from human Norovirus GI and GII. Six BECVs had capsid gene sequences similar to that of the unclassified Nebraska (NB)-like BECV. The 15 bovine noroviruses (BoNVs) were more closely related to Bo/NLV/Newbury-2/76/UK (GIII/2) and other known genotype 2 BoNVs than to genotype 1 Bo/NLV/Jena/80/DE. The BoNV Bo/CV521-OH/02/US showed high nucleotide and amino acid identities (84 and 94%, respectively) with the capsid gene of Bo/NLV/Newbury-2/76/UK, whereas the nucleotide and amino acid sequences of the RNA polymerase gene were more closely related to those of Bo/NLV/Jena/80/DE (77 and 87% identities, respectively) than to those of Bo/NLV/Newbury-2/76/UK (69 and 69% identities, respectively), suggesting that Bo/CV521-OH/02/US is a genotype 1-2 recombinant. Gene conversion analysis by the recombinant identification program and SimPlot also predicted that Bo/CV521-OH/02/US was a recombinant. Six NB-like BECVs shared 88 to 92% nucleotide and 94 to 99.5% amino acid identities with the NB BECV in the capsid gene. The results of this study demonstrate genetic diversity in the capsid genes of BECVs circulating in Ohio veal calves, provide new data for coinfections with distinct BECV genotypes or genogroups, and describe the first natural BoNV genotype 1-2 recombinant, analogous to the previously reported human norovirus recombinants.

Animals↗

Engagement of patients with psychosis in the consultation: conversation analytic study.

OBJECTIVE: To investigate how doctors engage with patients with psychotic illness in routine consultations. DESIGN: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder. SETTING: Two psychiatric outpatient clinics in east London and south west London. PARTICIPANTS: 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder. MAIN OUTCOME MEASURE: Mutual engagement in communication during the consultation. RESULTS: Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients' concerns about their psychotic symptoms. CONCLUSIONS: Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients' concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.

Adult↗

Evidence for a basal release of a cytochrome-related endothelium-derived hyperpolarizing factor in the radial artery in humans.

Whether a cytochrome P-450 (CYP)-related endothelium-derived hyperpolarizing factor (EDHF), acting through calcium-activated potassium (K(Ca)) channels, interacts with nitric oxide (NO) to regulate the basal diameter of human peripheral conduit arteries is unexplored in vivo. Radial artery diameter (echo tracking) and blood flow (Doppler) were measured, after oral aspirin (500 mg), in eight healthy volunteers during local infusion for 8 min of tetraethylammonium chloride (TEA; 9 micromol/min), as K(Ca) channel inhibitor, and fluconazole (0.4 micromol/min), as CYP inhibitor, alone and in combination with N(G)-monomethyl-L-arginine (L-NMMA; 8 micromol/min), as endothelial NO synthase inhibitor. Endothelium-independent dilatation was assessed by using sodium nitroprusside (SNP). Radial diameter was unaffected by L-NMMA (0.4 +/- 0.9%) and fluconazole (-1.6 +/- 0.8%) but was decreased by TEA (-5.0 +/- 1.0%), L-NMMA + fluconazole (-5.3 +/- 0.5%), and L-NMMA + TEA (-9.9 +/- 1.3%). These effects are still significant even when the concomitant decreases in blood flow induced by L-NMMA (-24 +/- 4%), TEA (-21 +/- 3%), L-NMMA + fluconazole (-26 +/- 5%), and L-NMMA + TEA (-35 +/- 4%) were taken as covariate into analysis. Conversely, fluconazole alone slightly but not significantly increased radial flow (13 +/- 6%). L-NMMA alone or with TEA and with fluconazole enhanced radial artery dilatation to SNP, whereas TEA and fluconazole alone did not modify this response. These results confirm in humans the involvement of NO and K(Ca) channels in the regulation of basal conduit artery diameter. Moreover, the synergistic effect of combined inhibition of NO synthesis and CYP on the decrease in radial diameter in the absence of such effect after L-NMMA and fluconazole alone unmasks the role of CYP in this regulation and shows the presence of an interaction between NO and a CYP-related EDHF to maintain peripheral conduit artery diameter in vivo. Furthermore, the higher vasoconstrictor effect of TEA compared with fluconazole suggests that different K(Ca) channel-dependent hyperpolarizing mechanisms could exist in conduit arteries.

Adult↗

Articulatory planning is continuous and sensitive to informational redundancy.

This study investigates the relationship between word repetition, predictability from neighbouring words, and articulatory reduction in Dutch. For the seven most frequent words ending in the adjectival suffix -lijk, 40 occurrences were randomly selected from a large database of face-to-face conversations. Analysis of the selected tokens showed that the degree of articulatory reduction (as measured by duration and number of realized segments) was affected by repetition, predictability from the previous word and predictability from the following word. Interestingly, not all of these effects were significant across morphemes and tar-get words. Repetition effects were limited to suffixes, while effects of predictability from the previous word were restricted to the stems of two of the seven target words. Predictability from the following word affected the stems of all target words equally, but not all suffixes. The implications of these findings for models of speech production are discussed.

Humans↗

The communicative functions of final rises in Finnish intonation.

This paper considers the communicative function of final rises in Finnish conversational talk between pairs of teenage girls. Final rises are fairly common, occurring approximately twice a minute, predominantly on declaratives and in narrative sequences. We briefly consider the interplay between voice quality (known to be a marker of transition relevance) and rising intonation in Finnish. We argue that in narrative sequences, rising terminals manage two main interactional tasks: they provide a place for a coparticipant to mark recipiency, and they project more talk by the current speaker. Using a methodology which combines phonetic observation with conversation analysis, we demonstrate participants' orientation to these functions.

Adolescent↗

Chronic blockade of endothelin receptors improves ischemia-induced angiogenesis in rat hindlimbs through activation of vascular endothelial growth factor-no pathway.

This study investigated in vivo the putative angiogenic role of endothelin (ET)-1 in a model of ischemia-induced angiogenesis. Ischemia was produced by unilateral femoral artery occlusion in Wistar rats submitted to either chronic ET-1 infusion (2 nmol. kg(-1). min(-1)) or to a dual ET(A)/ET(B) receptor antagonist (bosentan, 100 mg. kg(-1). d(-1)) for 3 and 28 days. Arterial density was evaluated by microangiography and measurement of capillary and arteriolar density in hindlimb muscles. ET-1 infusion had no effect on ischemia-induced angiogenesis and was associated with a slight decrease in vascular endothelial growth factor (VEGF) content measured by Western blot analysis. Conversely, bosentan induced a marked increase in vessel density at 3 and 28 days (1.4-fold and 1.7-fold, respectively, compared with no treatment; P<0.05), which was associated with an increase in VEGF and endothelial NO synthase levels in ischemic legs (by 31+/-8% and 45+/-23%, respectively, at 3 days and by 65+/-13% and 55+/-15%, respectively, at 28 days; P<0.05 versus nontreated rats). At day 28, the proangiogenic effect of bosentan was abolished when NO synthesis inhibitor N(G)-nitro-L-arginine methyl ester (10 mg. kg(-1). d(-1)) or VEGF-neutralizing antibody (2.5 micro/kg twice a week) were coadministered with bosentan. Those results provide the first evidence of an early and sustained proangiogenic effect of endothelin antagonism associated with an upregulation of VEGF and endothelial NO synthase in vivo.

Animals↗

Taciturn patients in health counseling at a hospital: passive recipients or active participators?

This study explored patients' taciturnity as observed on videotape during hospital health counseling situations with a nurse. Health counseling sessions, 38 in number, were videotaped, transcribed verbatim, and analyzed by using an adaptation of conversation analysis. The data analysis included information on 18 selected patients who spoke little and did not introduce new topics, but rather supported the discussion on the theme chosen by the nurse. When we examined nurses' and patients' speech word by word, we discovered four participation frames that produced taciturnity: in the hands of professionals, compliant, guilty, and polite. These could fluctuate during interaction. The findings indicate that there is a need for a more extensive description of taciturn, or silent, patients. What has been interpreted as passivity in the literature can be interpreted more constructively. This insight can be useful for developing health counseling practice in hospitals.

Adolescent↗

Negotiation in type 2 diabetes counseling: from problem recognition to mutual acceptance during lifestyle counseling.

Negotiation, an essential communication activity in lifestyle counseling, has rarely been studied at the micro level of interaction. Furthermore, the evidence for interpersonal negotiation to occur in counseling practice is inconclusive. In this study, the authors describe how negotiation focused on lifestyle changes was produced in nurse-patient interaction. The research data, 73 videotaped diabetes counseling situations, were analyzed using conversation analysis. The process of negotiation consisted of recognizing the problems in the patients' health behavior, offering proposals as solutions to the problems, and reaching an agreement on them. Negotiation had characteristics similar to those mentioned in the literature, but there were also prominent inadequacies. The authors suggest that nurses might need to become more aware of their counseling practices in routine situations through conscious effort for self-evaluation. In addition, further research would be required to demonstrate the effectiveness of negotiation for facilitating changes in patients' health behavior.

Aged↗