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This study uses data from a shoe-repair shop, supplemented by data from medical and mundane contexts, to analyze three progressively minimal grammatical formats used to implement offers and requests in interaction (i.e. do you want…?, you want…?, and want…?). We argue that this cline of minimality reflects a cline of the action-initiator's stance, from relatively weak to strong (respectively), regarding their expectation that the action will be accepted or complied with. In doing so, we illustrate that, as part of the design of requests and offers, participants rely on more granular distinctions than a simple binary between interrogative and declarative morphosyntax. We conclude with a discussion of the interactional logic that undergirds the normative use of these grammatical formats, and of our findings’ implications for action formation and preference organization. (Conversation analysis, interactional linguistics, offer, request, stance, grammar, morphosyntax)*
Antimicrobial susceptibility patterns across US pediatric healthcare institutions are unknown. A national pooled pediatric antibiogram (1) identifies nationwide trends in antimicrobial resistance, (2) allows across-hospital benchmarking, and (3) provides guidance for empirical antimicrobial regimens for institutions unable to generate pediatric antibiograms.
In January 2012, a request for submission of pediatric antibiograms between 2005 and 2011 was sent to 233 US hospitals. A summary antibiogram was compiled from participating institutions to generate proportions of antimicrobial susceptibility. Temporal and regional comparisons were evaluated using χ² tests and logistic regression, respectively.
Of 200 institutions (85%) responding to our survey, 78 (39%) reported generating pediatric antibiograms, and 55 (71%) submitted antibiograms. Carbapenems had the highest activity against the majority of gram-negative organisms tested, but no antibiotic had more than 90% activity against Pseudomonas aeruginosa. Approximately 50% of all Staphylococcus aureus isolates were methicillin resistant. Western hospitals had significantly lower proportions of S. aureus that were methicillin resistant compared with all other regions tested. Overall, 21% of S. aureus isolates had resistance to clindamycin. Among Enterococcus faecium isolates, the prevalence of susceptibility to ampicillin (25%) and vancomycin (45%) was low but improved over time (P < .01), and 8% of E. faecium isolates were resistant to linezolid. Southern hospitals reported significantly higher prevalence of E. faecium with susceptibilities to ampicillin, vancomycin, and linezolid compared with the other 3 regions (P < .01).
A pooled, pediatric antibiogram can identify nationwide antimicrobial resistance patterns for common pathogens and might serve as a useful tool for benchmarking resistance and informing national prescribing guidelines for children.
Introduction
Languages provide speakers with resources for both referencing and repairing. While referencing is crucial for sustaining intersubjectivity, repairing is crucial for re-establishing intersubjectivity (Auer 1984; Schegloff 1992a; Schegloff et al. 1977). This chapter describes a repair-initiation action that claims that a particular aspect of the prior turn presents “trouble” for its speaker (e.g., understanding the prior turn; for a review of “repair” and its associated terminology, see Schegloff 1992a). The trouble source is treated as being a pro-term/indexical expression (e.g., “it”, “this”, “that”). The repair operation – that is, the interactional move that is performed by the speaker of the trouble source in response to the repair-initiation action being investigated, and that is designed to deal with/resolve the trouble – involves producing a full-reference form/full noun phrase (NP) (e.g., “the folder”, “the token”, “the ticket”) that is relevantly associated with the trouble-source indexical expression. Given that the trouble-source speaker orients to the trouble source as being an indexical expression, and given that the trouble-source speaker resolves the trouble by producing a recipient-designed full-reference form, the repair-related trouble can be characterized as a referent that is (claimed to be) underspecified for the person initiating repair. Languages provide for different types of referents, such as people, places, times, and things. This chapter focuses on a comparative analysis of one repair-initiation action in English and German that always (in our data) is taken by trouble-source speakers as targeting underspecified “thing”-referents. The repair-initiation action being examined is implemented by “Was denn” or “Was.”
This review discusses the historical aspects, current state of the art, and potential future advances in the areas of nomenclature and databases for the analysis of outcomes of treatments for patients with congenitally malformed hearts. We will consider the current state of analysis of outcomes, lay out some principles which might make it possible to achieve life-long monitoring and follow-up using our databases, and describe the next steps those involved in the care of these patients need to take in order to achieve these objectives. In order to perform meaningful multi-institutional analyses, we suggest that any database must incorporate the following six essential elements: use of a common language and nomenclature, use of an established uniform core dataset for collection of information, incorporation of a mechanism of evaluating case complexity, availability of a mechanism to assure and verify the completeness and accuracy of the data collected, collaboration between medical and surgical subspecialties, and standardised protocols for life-long follow-up.
During the 1990s, both The European Association for Cardio-Thoracic Surgery and The Society of Thoracic Surgeons created databases to assess the outcomes of congenital cardiac surgery. Beginning in 1998, these two organizations collaborated to create the International Congenital Heart Surgery Nomenclature and Database Project. By 2000, a common nomenclature, along with a common core minimal dataset, were adopted by The European Association for Cardio-Thoracic Surgery and The Society of Thoracic Surgeons, and published in the Annals of Thoracic Surgery. In 2000, The International Nomenclature Committee for Pediatric and Congenital Heart Disease was established. This committee eventually evolved into the International Society for Nomenclature of Paediatric and Congenital Heart Disease. The working component of this international nomenclature society has been The International Working Group for Mapping and Coding of Nomenclatures for Paediatric and Congenital Heart Disease, also known as the Nomenclature Working Group. By 2005, the Nomenclature Working Group crossmapped the nomenclature of the International Congenital Heart Surgery Nomenclature and Database Project of The European Association for Cardio-Thoracic Surgery and The Society of Thoracic Surgeons with the European Paediatric Cardiac Code of the Association for European Paediatric Cardiology, and therefore created the International Paediatric and Congenital Cardiac Code, which is available for free download from the internet at [http://www.IPCCC.NET].
This common nomenclature, the International Paediatric and Congenital Cardiac Code, and the common minimum database data set created by the International Congenital Heart Surgery Nomenclature and Database Project, are now utilized by both The European Association for Cardio-Thoracic Surgery and The Society of Thoracic Surgeons. Between 1998 and 2007 inclusive, this nomenclature and database was used by both of these two organizations to analyze outcomes of over 150,000 operations involving patients undergoing surgical treatment for congenital cardiac disease.
Two major multi-institutional efforts that have attempted to measure the complexity of congenital heart surgery are the Risk Adjustment in Congenital Heart Surgery-1 system, and the Aristotle Complexity Score. Current efforts to unify the Risk Adjustment in Congenital Heart Surgery-1 system and the Aristotle Complexity Score are in their early stages, but encouraging. Collaborative efforts involving The European Association for Cardio-Thoracic Surgery and The Society of Thoracic Surgeons are under way to develop mechanisms to verify the completeness and accuracy of the data in the databases. Under the leadership of The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease, further collaborative efforts are ongoing between congenital and paediatric cardiac surgeons and other subspecialties, including paediatric cardiac anaesthesiologists, via The Congenital Cardiac Anesthesia Society, paediatric cardiac intensivists, via The Pediatric Cardiac Intensive Care Society, and paediatric cardiologists, via the Joint Council on Congenital Heart Disease and The Association for European Paediatric Cardiology.
In finalising our review, we emphasise that analysis of outcomes must move beyond mortality, and encompass longer term follow-up, including cardiac and non cardiac morbidities, and importantly, those morbidities impacting health related quality of life. Methodologies must be implemented in these databases to allow uniform, protocol driven, and meaningful, long term follow-up.
This article investigates two types of preference organization in
interaction: in response to a question that selects a next speaker in
multi-party interaction, the preference for answers over non-answer
responses as a category of a response; and the preference for selected
next speakers to respond. It is asserted that the turn allocation rule
specified by Sacks, Schegloff & Jefferson (1974) which states that a response is relevant by the
selected next speaker at the transition relevance place is affected by
these two preferences once beyond a normal transition space. It is argued
that a “second-order” organization is present such that
interactants prioritize a preference for answers over a preference for a
response by the selected next speaker. This analysis reveals an observable
preference for progressivity in interaction.
Introduction
This chapter describes how to specify, solve, and draw policy lessons from small, two-sector, general equilibrium models of open, developing economies. In the last two decades, changes in the external environment and economic policies have been instrumental in determining the performance of these economies. The relationship between external shocks and policy responses is complex; this chapter provides a starting point for its analysis.
Two-sector models provide a good starting point because of the nature of the external shocks faced by these countries and the policy responses they elicit. These models capture the essential mechanisms by which external shocks and economic policies ripple through the economy. By and large, the shocks have involved the external sector: terms-of-trade shocks, such as the fourfold increase in the price of oil in 1973–74 or the decline in primary commodity prices in the mid-1980s; or cutbacks in foreign capital inflows. The policy responses most commonly proposed (usually by international agencies) have also been targeted at the external sector: (1) depreciating the real exchange rate to adjust to an adverse terms-of-trade shock or to a cutback in foreign borrowing and (2) reducing distortionary taxes (some of which are trade taxes) to enhance economic efficiency and make the economy more competitive in world markets.
A “minimalist” model that captures the shocks and policies mentioned should therefore emphasize the external sector of the economy. Moreover, many of the problems – and solutions – are related to the relationship between the external sector and the rest of the economy.