The present study examines sociolinguistic features of a particular speech act, paying compliments, by comparing and contrasting native Chinese and native American speakers' performances. By focusing on a relatively understudied speaker group such as the Chinese, typically regarded as having rules of speaking and social norms very different from those of Westerners, this paper aims at illuminating the fact that, in cross-cultural communication, foreign language speakers have to pay close attention to sociolinguistic rules of the target language in addition to structure and discourse rules to meet the needs of linguistic accuracy and fluency. This is due to the fact that such rules play an indispensable role in appropriating the proper use of linguistic forms. The data for this study were collected using ethnographic observation pioneered in this field by Wolfson and Manes (1980). The analysis will first explore both the features of distribution of paying compliments, and the functions they may serve in spoken exchanges for native Chinese and American English speakers. To present a fuller picture of the socio-cultural features this speech act may represent in Chinese and American societies, the analysis will further focus on the issues of topics, the addresser-addressee relationship, and culture-specificity versus universality.

OBJECTIVE

Widely used MRI methods show brain morphology both in vivo and ex vivo at very high resolution. Many of these methods (e.g., T2*-weighted imaging, phase-sensitive imaging, or susceptibility-weighted imaging) are sensitive to local magnetic susceptibility gradients produced by subtle variations in tissue composition. However, the spectral resolution of commonly used methods is limited to maintain reasonable run-time combined with very high spatial resolution. Here, the authors report on data acquisition at increased spectral resolution, with 3-dimensional high spectral and spatial resolution MRI, in order to analyze subtle variations in water proton resonance frequency and lineshape that reflect local anatomy. The resulting information compliments previous studies based on T2* and resonance frequency.

METHODS

The proton free induction decay was sampled at high resolution and Fourier transformed to produce a high-resolution water spectrum for each image voxel in a 3D volume. Data were acquired using a multigradient echo pulse sequence (i.e., echo-planar spectroscopic imaging) with a spatial resolution of 50 × 50 × 70 μm(3) and spectral resolution of 3.5 Hz. Data were analyzed in the spectral domain, and images were produced from the various Fourier components of the water resonance. This allowed precise measurement of local variations in water resonance frequency and lineshape, at the expense of significantly increased run time (16-24 h).

RESULTS

High contrast T2*-weighted images were produced from the peak of the water resonance (peak height image), revealing a high degree of anatomical detail, specifically in the hippocampus and cerebellum. In images produced from Fourier components of the water resonance at -7.0 Hz from the peak, the contrast between deep white matter tracts and the surrounding tissue is the reverse of the contrast in water peak height images. This indicates the presence of a shoulder in the water resonance that is not present at +7.0 Hz and may be specific to white matter anatomy. Moreover, a frequency shift of 6.76 ± 0.55 Hz was measured between the molecular and granular layers of the cerebellum. This shift is demonstrated in corresponding spectra; water peaks from voxels in the molecular and granular layers are consistently 2 bins apart (7.0 Hz, as dictated by the spectral resolution) from one another.

CONCLUSIONS

High spectral and spatial resolution MR imaging has the potential to accurately measure the changes in the water resonance in small voxels. This information can guide optimization and interpretation of more commonly used, more rapid imaging methods that depend on image contrast produced by local susceptibility gradients. In addition, with improved sampling methods, high spectral and spatial resolution data could be acquired in reasonable run times, and used for in vivo scans to increase sensitivity to variations in local susceptibility.

An estimated 3% of US pregnancies are affected by maternal thyroid dysfunction, with between one and three of every 1000 pregnancies being complicated by overactive maternal thyroid levels. Excess thyroid hormones are linked to neurological impairment and excessive craniofacial variation, affecting both endochondral and intramembranous bone. Using a geometric morphometric approach, this study evaluates the role of in utero thyroxine overexposure on the growth of offspring mandibles in a sample of 241 mice. Canonical variate analysis utilized 16 unilateral mandibular landmarks obtained from 3D micro-computed tomography to assess shape changes between unexposed controls (n = 63) and exposed mice (n = 178). By evaluating shape changes in the mandible among three age groups (15, 20 and 25 days postnatal) and different dosage levels (low, medium and high), this study found that excess maternal thyroxine alters offspring mandibular shape in both age- and dosage-dependent manners. Group differences in overall shape were significant (P < 0.001), and showed major changes in regions of the mandible associated with muscle attachment (coronoid process, gonial angle) and regions of growth largely governed by articulation with the cranial base (condyle) and occlusion (alveolus). These results compliment recent studies demonstrating that maternal thyroxine levels can alter the cranial base and cranial vault of offspring, contributing to a better understanding of both normal and abnormal mandibular development, as well as the medical implications of craniofacial growth and development.

In post-amputation rehabilitation, a common goal is to return to ambulation using a prosthetic limb, suspended by a customised socket. Prosthetic socket design aims to optimise load transfer between the residual limb and mechanical limb, by customisation to the user. This is a time-consuming process, and with the increase in people requiring these prosthetics, it is vital that these personalised devices can be produced rapidly while maintaining excellent fit, to maximise function and comfort. Prosthetic sockets are designed by capturing the residual limb's shape and applying a series of geometrical modifications, called rectifications. Expert knowledge is required to achieve a comfortable fit in this iterative process. A variety of rectifications can be made, grouped into established strategies [e.g. in transtibial sockets: patellar tendon bearing (PTB) and total surface bearing (TSB)], creating a complex design space. To date, adoption of advanced engineering solutions to support fitting has been limited. One method is numerical optimisation, which allows the designer a number of likely candidate solutions to start the design process. Numerical optimisation is commonly used in many industries but not prevalent in the design of prosthetic sockets. This paper therefore presents candidate shape optimisation methods which might benefit the prosthetist and the limb user, by blending the state of the art from prosthetic mechanical design, surrogate modelling and evolutionary computation. The result of the analysis is a series of prosthetic socket designs that preferentially load and unload the pressure tolerant and intolerant regions of the residual limb. This spectrum is bounded by the general forms of the PTB and TSB designs, with a series of variations in between that represent a compromise between these accepted approaches. This results in a difference in pressure of up to 31 kPa over the fibula head and 14 kPa over the residuum tip. The presented methods would allow a trained prosthetist to rapidly assess these likely candidates and then to make final detailed modifications and fine-tuning. Importantly, insights gained about the design should be seen as a compliment, not a replacement, for the prosthetist's skill and experience. We propose instead that this method might reduce the time spent on the early stages of socket design and allow prosthetists to focus on the most skilled and creative tasks of fine-tuning the design, in face-to-face consultation with their client.

OBJECTIVE

To maximise involvement of the multidisciplinary team using a model of sexual health management for spinal cord-injured persons.

BACKGROUND

Regaining sexual function is a priority following spinal cord injury, with the majority of people remaining sexually active with a satisfying sex life. Nevertheless, rehabilitation programmes often focus on activities related to mobility and elimination, with sexual health relegated to a secondary under-resourced position.

METHODS

Model creation and audit of current and desired status to identify required education.

METHODS

A four-tier model for sexual health management identified phases of management, increasing in complexity, from tier 1 to tier 4. The model was used to audit the current and desired status of the multidisciplinary team on a spinal injuries unit, identifying knowledge levels, barriers to involvement and education requirements.

RESULTS

Fifty-nine questionnaires were completed (85%) by nurses and allied health professionals. Knowledge deficits and discomfort with the topic were the primary reasons prohibiting involvement with sexual health rehabilitation. Two thirds were willing to be involved with sexual health activities, mainly at an introductory level rather than providing education or problem-solving. However, following relevant education, the level of involvement changed: 90% (n = 53) desired involvement at more complex levels, and 10% (n = 6) were unwilling to be involved.

CONCLUSIONS

Developing the necessary skills and knowledge creates potential to increase the resources available to participate in sexual health rehabilitation following a spinal cord injury and ensure that it is a core rehabilitation activity.

CONCLUSIONS

The progressive model portrayed discrete phases of sexual health management, which collectively portray the whole. Team members identified a level of involvement to compliment their skills and knowledge. The audit demonstrated that the primary barriers to involvement were not culture, language or attitude as hypothesised, but inadequate knowledge, addressable through education.

A vital role for Clinical and Translational Science Award (CTSA) evaluators is to first identify and then articulate the necessary change processes that support the research infrastructures and achieve synergies needed to improve health through research. The use of qualitative evaluation strategies to compliment quantitative tracking measures (e.g., number of grants/publications) is an essential but under-utilized approach in CTSA evaluations. The Clinical and Translational Science Institute of Southeast Wisconsin implemented a qualitative evaluation approach using appreciative inquiry (AI) that has revealed three critical features associated with CTSA infrastructure transformation success: developing open communication, creating opportunities for proactive collaboration, and ongoing attainment of milestones at the key function group level. These findings are consistent with Bolman & Deal's four interacting hallmarks of successful organizations: structural (infrastructure), political (power distribution; organizational politics), human resource (facilitating change among humans necessary for continued success), and symbolic (visions and aspirations). Data gathered through this longitudinal AI approach illuminates how these change features progress over time as CTSA funded organizations successfully create the multiinstitutional infrastructures to connect laboratory discoveries with the diagnosis and treatment of human disease.

The purpose of this study was to explore LGBTQ women's experiences with unwritten or formal dress codes at work. I asked: What are LGBTQ women's experiences in the workplace with appearance management, and what are LGBTQ women's experiences navigating the written and unwritten dress codes in the workplace? To answer the research question, interviews were conducted with 24 self-identifying LGBTQ women. Six key themes emerged from the data. Themes included (1) expressed sexual identity in appearance, (2) unwritten dress codes in work environments did not always allow for expression of sexual identity in appearance, (3) motivations for pressure or desire to conceal expression of sexual identity in appearance at work, (4) negotiations of revealing or concealing sexual identity in appearance in the workplace impacted levels of comfort and confidence, (5) verbal and nonverbal negative experiences related to appearance at work, and (6) received compliments about appearance at work.

Cooperation is widespread across the tree of life, with examples ranging from vertebrates to lichens to multispecies biofilms. The initial evolution of such cooperation is likely to involve interactions that produce non-additive fitness effects among small groups of individuals in local populations. However, most models for the evolution of cooperation have focused on genealogically related individuals, assume that the factors influencing individual fitness are deterministic, that populations are very large, and that the benefits of cooperation increase linearly with the number of cooperative interactions. Here we show that stochasticity and non-additive interactions can facilitate the evolution of cooperation in small local groups. We derive a generalized model for the evolution of cooperation and show that if cooperation reduces the variance in individual fitness (separate from its effect on average fitness), this can aid in the evolution of cooperation through directional stochastic effects. In addition, we show that the potential for the evolution of cooperation is influenced by non-additivity in benefits with cooperation being more likely to evolve when the marginal benefit of a cooperative act increases with the number of such acts. Our model compliments traditional cooperation models (kin selection, reciprocal cooperation, green beard effect, etc.) and applies to a broad range of cooperative interactions seen in nature.

BACKGROUND

This paper describes an assessment approach of clinical competencies which widens the number of problems and tasks evaluated using videos and images.

METHODS

Clinical Image and Video Assessment (CIVA) was used to assess clinical reasoning and decision making of final year medical students. Forty to fifty clinical videos and images supported by rich text vignette and reviewed by subject matter experts were selected based on examination blueprints for analysis. CIVA scores were correlated with OSCE, Direct Observation Clinical Encounter Exam (DOCEE) and written exam scores, using the 2-sided Pearson correlation analysis, and their reliability was analyzed using Cronbach's Alpha Coefficient. Furthermore, students personally evaluated the CIVA using a 5- point Likert scale.

RESULTS

CIVA and OSCE scores showed a high correlation (r = 0.83) in contrast with the correlation scores of the written examination (r = .36) and the DOCEE (r = 0.35). Cronbach's Alpha for the OSCE and CIVA for the first batch was 0.71 and 0.78. As for the second batch it was 0.91 and 0.91 respectively. Eighty-two percent of students were very satisfied or satisfied with the CIVA process, contents and quality.

CONCLUSIONS

A well constructed CIVA type assessment with a rich authentic vignette and good quality videos and images could be used to assess clinical reasoning and decision making of final year medical students. CIVA is an assessment tool which correlates well with OSCE, compliments the written and DOCEE and is easier to conduct at a possibly reduced cost.

In the laboratories staffs, there is potential for adverse health effects in exposure to chemicals. Therefore, risk assessment is one of the main issues to prevent these effects. The purpose of this study was to assess the health risk of laboratory staffs and compare the two methods, including 'Chemical Health Risk Assessment' (CHRA) and 'Regional Screening Levels' (RSLs), that developed by the Department of Occupational Safety and Health of Malaysia and the Environmental Protection Agency respectively. Using these two methods, the places with the highest risk were identified. Comparisons showed that RSLs is a precise method without personal judgment. The CHRA is a simple method for wider chemicals that categorize risk. But CHRA includes fewer parameters compared to RSLs, as well as personal judgment. The results of the present study showed that two methods did not compatible. According to the characteristics of these two methods, it is recommended to use them as a compliment each other to obtain accurate results.

Deposits of fibrous sediment, which include fiberbanks and fiber-rich sediments, are known to exist on the Swedish seafloor adjacent to coastally located former pulp and paper industries. These deposits contain concentrations of hazardous substances that exceed national background levels and contravene national environmental quality objectives (EQOs). In this study of metal fluxes from fibrous sediments using benthic flux chamber measurements (BFC) in situ we obtained detected fluxes of Co, Mo, Ni and Zn, but no fluxes of Pb, Hg and Cr. The absence of fluxes of some of the analyzed metals indicates particle bound transport of Pb, Cr and Hg from fiberbanks even though Hg might become methylated under anoxic conditions and, in that case, may enter the food chain. We found less metal fluxes than expected and thus emphasize the importance of in-situ flux measurements as a compliment to sediment metal concentrations within risk assessments of contaminated sediments.

The Chikungunya virus (CHIKV) is an arthropod borne virus. In the last 50 years, it has been the cause of numerous outbreaks in tropical and temperate regions, worldwide. There is limited understanding regarding the underlying molecular mechanisms involved in CHIKV replication and how the virus interacts with its host. In the present study, comparative proteomics was used to identify secreted host proteins that changed in abundance in response to early CHIKV infection. Two-dimensional gel electrophoresis was used to analyse and compare the secretome profiles of WRL-68 cells infected with CHIKV against mock control WRL-68 cells. The analysis identified 25 regulated proteins in CHIKV infected cells. STRING network analysis was then used to predict biological processes that may be affected by these proteins. The processes predicted to be affected include signal transduction, cellular component and extracellular matrix (ECM) organization, regulation of cytokine stimulus and immune response. These results provide an initial view of CHIKV may affect the secretome of infected cells during early infection. The results presented here will compliment earlier results from the study of late host response. However, functional characterization will be necessary to further enhance our understanding of the roles played by these proteins in the early stages of CHIKV infection in humans.

This investigation was motivated by physician reports that patient compliments often raise 'red flags' for them, raising questions about whether compliments are being used in the service of achieving some kind of advantage. Our goal was to understand physician discomfort with patient compliments through analyses of audiotaped surgeon-patient encounters. Using conversation analysis, we demonstrate that both the placement and design of compliments are consequential for how surgeons hear and respond to them. The compliments offered after treatment recommendations are neither designed nor positioned to pursue institutional agendas and are responded to in ways that are largely consistent with compliment responses in everyday interaction, but include modifications that preserve surgeons' expertise. In contrast, some compliments offered before treatment recommendations pursue specific treatments and engender surgeons' resistance. Other compliments offered before treatment recommendations do not overtly pursue institutionally-relevant agendas-for example, compliments offered in the opening phase of the visit. We show how these compliments may but need not foreshadow a patient's upcoming agenda. This work extends our understanding of the interactional functions of compliments, and of the resources patients use to pursue desired outcomes in encounters with healthcare professionals.

It is well documented that thyroid hormone (TH) action is critical for normal brain development, which is mediated by both nuclear and extranuclear pathways. Given this dependence, the impact of environmental endocrine disrupting chemicals that interfere with thyroid signaling is a major concern with direct children's health implications. However, identification of thyroid disrupting chemicals in vivo is primarily reliant on serum T4 measurements within greater developmental and reproductive toxicity assessments. These studies do not often measure known TH-dependent neurodevelopmental phenotypes in parallel, which complicates chemical assessment. Additionally, there exist no recommendations regarding what degree of serum T4 dysfunction is adverse, and little consideration is given to quantifying TH action within the developing brain. This review summarizes current chemical testing strategies in rodent models and discusses new approaches for evaluating developmental neurotoxicity of thyroid disrupting chemicals. This includes assays for identifying adverse cellular effects of the brain by both immunohistochemistry and gene expression to compliment standard measures of serum T4. While additional experiments are needed to test the full utility of these approaches, incorporation of such complimentary cellular and molecular assays could enhance chemical evaluation within the regulatory arena.

A review of the concept of ideology in a nursing context is presented. The meaning of a nursing ideology is explored and that meaning compared to the proposals for the future of nursing contained in the 1996 report on The Future Healthcare Workforce published by the University of Manchester, England. The paper suggests a number of core beliefs and values that are generally supported in nursing and their implications for the future development of the profession. These include a commitment to the role of science in nursing, the concept of caring in nursing practice and the continued pursuit of the professional project. The paper will demonstrate the extent to which the proposals contained within the report for a 'generic career' compliment or conflict with the suggested ideology of nursing. It concludes with a reference to the policy-making process at local and national levels and the opportunities available to nurses to influence the direction of change. The paper reflects the volatility of the current political climate in health care and the extent to which nurses operating in that climate feel empowered or disenfranchised.

The purpose of this article is to illustrate types of diagnostic errors and feedback given to radiologists, using cases to support and clarify these categories. A comment-enhanced peer review system may be leveraged to generate a comprehensive feedback categorization scheme. These include errors of observation, errors of interpretation, inadequate patient data gathering, errors of communication, interobserver variability, informational feedback, and compliments. Much of this feedback is captured through comments associated with interpretative agreements.

Limited research exists which aids in structuring health IT contracts in an era of performance-based payments. We provide an assessment of common approaches to contracting and measuring of performance in practice. We conducted a review of existing literature and compliment this approach with a survey of healthcare professionals directly involved with health IT systems to further understand and classify current approaches. We identified architypes for structuring healthcare IT performance contracts to include: (1) internal operations, (2) external evaluation and (3) joint agreement for the delivery of value-based care.

Two experiments were conducted to investigate whether sexual objectification increases retaliatory aggression serially through increased vulnerability and hostile intent attributions. Female participants were first exposed to the sexual objectification manipulation by receiving compliments from an online male partner (Experiment 1) or imagining a workplace objectification experience (Experiment 2). Afterward, their vulnerability and hostile intent attributions were assessed. Finally, they were given an opportunity to behave aggressively toward the source of objectification. The results of both experiments indicated that, compared with their counterparts in the control conditions, participants in the sexual objectification condition reported higher levels of vulnerability, hostile intent attributions, and aggression. Moreover, vulnerability and hostile intent attributions serially mediated the effect of sexual objectification on aggression. These findings highlight the critical influence of vulnerability and hostile intent attributions in understanding how sexual objectification increases aggression.