Search

This study traces the relationship between two erstwhile separate linguistic elements, just and so, within the framework of Functional Discourse Grammar (FDG). In keeping with FDG’s form-oriented function-to-form approach, the study proceeds semasiologically by, first, examining the uses of relatively independent forms (i.e. the focus particle just modifying so as a degree word and a manner proform), then turning to more tightly-knit structures (i.e. just so as a subordinator of purpose and condition), and finally, looking at the fixed expression just so used as a part of a pragmatic marker. Using data from the Corpus of Contemporary American English and the Corpus of Historical American English, we argue that the different meanings of just so raise a number of issues related to the analysis of modification in FDG, namely the status and function of the modifier just in the constructions under discussion and the concomitant representation of so. Furthermore, the analysis shows that FDG can model very precisely the interplay of semantic and pragmatic information in the stages when just so is still compositional, with just providing interpersonal (i.e. pragmatic) and so representational (i.e. semantic) information, as well as its development into the non-compositional and purely pragmatic discourse marker just so you know.

Elements of Peirce's and Greimas' semiotics can be related to each other within one coherent semiotic theory, as we have demonstrated earlier. 1 This theory is focused upon the generation of texts and is reflected in an explanatory model. Based on this semiotic theory of a text we will formulate an analytical model for narrative texts. On the one hand the explanatory model indicates how texts come into being, on the other hand the analytical model expresses how we can arrive at a reliable analysis of a narrative text. The first part of this article is a description of the semiotic explanatory model for texts. Although this model is proceeding from the theories of Peirce and Greimas, these will not be described separately nor in detail.2 The second part of this article will deal with the consequences of this semiotic explanation with reference to the practical analysis of narrative texts. [ABSTRACT FROM AUTHOR]

The article focuses on literary works of Algirdas Julien Greimas. It states that Greimas semiotics is concerned with semantic and narrative structures of language and culture, and mentions that his book "Du Sens II" consists of a collection of papers from the period 1973-1983. It notes that according to Greimas, the articulation or production of meaning cannot be explained in terms of a genetic process with meaning more or less automatically evolving as time goes on.

Aim: In a previous study we detected 1 axillary recurrence in 292 breast cancer patients with negative sentinel node biopsy (SNB) and no axillary lymph node dissection (ALND) during a mean of 27.2 months follow-up period. The aim of our present study is to investigate the rate of axillary recurrence in a longer follow-up period. Material and methods: Between October 2000 and Augustus 2005 selective ALND was performed in 517 consecutive patients with a T1 or T2 breast cancer and clinically negative axillary nodes, i.e. ALND was omitted in patients with negative sentinel node (SN) biopsy. SN(s) were identified using a combined labelling method: Tc99m -labelled nanocolloid was injected peritumorally on the day before the operation and vital blue dye was injected above the tumor just before the operation. Only hot and/or blue lymph node(s) were declared as SN(s) during surgery. ALND was omitted in 323/517 patients on the basis of a negative intraoperative imprint cytology and postoperative hematoxylin-eosin (HE) and cytokeratin immunohistochemistry stained sections of SN(s). 300/317 patients were followed-up: the mean of follow-up time was 36.45 months (range 9–73 months). In 140/300 patients (46.6%) the follow-up time was 37–73 months. Results: Axillary recurrence was found in 2/300 patients (0.66%) 11 and 23 months after the operation. In 3/300 patients (1%) local recurrence, and in 12 patients (4%) distant metastases occured in a mean of 23 months after the primary treatment. Conclusions: During a longer follow-up period only 1 further axillary recurrence was detected in the same patient group. The rate of axillary recurrence (< 1%) is similar or lower as compared to the data published by experienced authors (Veronesi [2005]: 0.3%, Roumen [2001]: 1%, Krokke [2005]: 0.88%). Our results confirm that 1. using strict patient enrollment, 2. using combined radiocolloid and blue dye labelling technique 3. and a collaboration of a properly trained team (nuclear medicine, surgery, pathology) SN biopsy without ALND in SN-negative patients is a reliable staging procedure with a low axillary recurrence rate. [ABSTRACT FROM AUTHOR]

Purpose: Patients with advanced cancer can experience their disease as a contingent life event. The sudden interruption of their life stories can obscure life goals and disrupt meaning making. In the context of the research project "In search of stories," we aim to investigate the reading and discussion of selected stories which present ways of dealing with a contingent life event. In addition, we examine the use of a newly developed guide for reading these exemplary texts together with advanced cancer patients., Methods: This qualitative study describes the experiences of five patients with advanced cancer who participated in a guided reading and discussion about selected literary texts. The intervention consisted of reading a selected story, after which each patient was interviewed, using the reading guide as a conversation template. The interviews were then thematically analyzed for their conceptual content using a template analysis., Results: All five conversations showed some form of recognition in reaction to the chosen text, which led to personal identification of experiences of contingency, such as loss of life goals, impending death, or feelings of uncertainty. Besides the important role of identification, revealed by the responses to the questions in the reading guide, the discussion of the text helped them articulate their own experience and sources of meaning. Diverse worldviews came to the fore and concepts of meaning such as fate, life goals, quality of life, and death., Conclusions: First experiences with our newly developed reading guide designed to support a structured reading of stories containing experiences of contingency suggest that it may help patients to express their own experiences of contingency and to reflect on these experiences., Implications for Cancer Survivors: The intervention tested in this study may contribute to supportive care for survivors with advanced cancer, but further research is needed to evaluate its effect on quality of life., (© 2021. The Author(s).)

Background: The combination of verbal and visual tools may help unravel the experiences of advanced cancer patients. However, most previous studies have focused on a specific symptom, at only one moment in time. We recently found that a specific visual tool, originating from systems thinking, that is, rich pictures (RPs), could provide a more comprehensive view of the experiences of patients with advanced cancer., Aims: To examine whether the repeated use of RPs can make changes in subjective experiences of patients living with advanced cancer visible over time., Methods and Results: We performed a prospective study with a generic qualitative approach that was mostly informed by the process of grounded theory. We invited patients to make an RP twice, at the start of the study, and again after 2 months. Both RP drawing sessions were directly followed by a semi-structured interview. Patients with all types of solid tumors, above the age of 18, and with a diagnosis of advanced, incurable cancer, were eligible. Eighteen patients participated and 15 patients were able to draw an RP twice. In eight RP-sets, considerable differences between the first and second RP were noticeable. Two patterns were distinguished: (1) a change (decline or improvement) in physical health (five patients), and/or (2) a change in the way patients related to cancer (three patients)., Conclusion: RPs are a valuable qualitative research method that can be used to explore the experiences of patients with advanced cancer, not only at a single point in time but also over time., (© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

Background: To provide holistic care to patients with advanced cancer, health care professionals need to gain insight in patients' experiences across the different domains of health. However, describing such complex experiences verbally may be difficult for patients. The use of a visual tool, such as Rich Pictures (RPs) could be helpful. We explore the use of RPs to gain insight in the experiences of patients with advanced cancer., Methods: Eighteen patients with advanced cancer were asked to draw a RP expressing how they experienced living with cancer, followed by a semi-structured interview. Qualitative content analysis, including the examination of all elements in the drawings and their interrelationships, was used to analyze the RPs, which was further informed by the interviews., Results: The RPs clearly showed what was most important to an individual patient and made relations between elements visible at a glance. Themes identified included: medical aspects, the experience of loss, feelings related to loss, support from others and meaningful activities, and integration of cancer in one's life. The added value of RPs lies in the ability to represent these themes in one single snapshot., Conclusions: RPs allow for a complementary view on the experiences of advanced cancer patients, as they show and relate different aspects of patients' lives. A RP can provide health care professionals a visual summary of the experiences of a patient. For patients, telling their story to health care professionals might be facilitated when using RPs., (© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background: Ethiopia houses the second largest population of female adolescents in Africa. Adolescent childbearing can have detrimental effect to the health and wellbeing of women and their offspring. This study examined trends, sub-national variations and determinants of early childbearing (i.e. childbearing before age 20) in Ethiopia., Methods: Data from the 2000-2011 Ethiopia Demographic and Health Surveys and from the 2014-2016 Performance Monitoring and Accountability surveys were pooled for this analysis. Based on the year the women reached puberty, five different cohorts were reconstructed that date back to the early 1970s. Kaplan-Meier methodology was used to estimate the cumulative probability of early childbearing and a Cox proportional hazard regression model to examine the associated factors., Results: The cumulative probability of early childbearing declined by approximately two-fifth in the past four decades, from 57.6 to 35.3%. The occurrence of early childbearing varies substantially by region. In the most recent period, it ranged from 9.6% in Addis Ababa to 59% in Benishangul-Gumuz. Early childbearing risk was reduced by 95% for women who did not marry before the age of 20 years compared to those who married before the age of 18 years. For adolescents who married at the age of 18 and 19 years, early childbearing risk decreased by 60 and 78%, respectively. During the same period, there was a parallel decline in the cumulative probability of early marriage (i.e., before the legal age of 18 years) from 55.3 to 28.7%. Compared with adolescents with no education, those with elementary and secondary or higher education had a 50 and 82% lower risk of early childbearing, respectively., Conclusions: Early childbearing declined in Ethiopia, largely driven by a parallel reduction in early marriage. However, a large portion of adolescents are still facing early childbearing, and the situation is more dismal in some regions than others. A further reduction in early childbearing is warranted by enforcing the law on the minimum marriage age and expanding secondary and higher education for females. These efforts should give greater emphasis to regions where early childbearing is markedly high.

Small breast cancers often require different treatment than larger ones. The frequency and predictability of further nodal involvement was evaluated in patients with positive sentinel lymph nodes and breast cancers < or =15 mm by means of 8 different predictive tools. Of 506 patients with such small tumors 138 with positive sentinel nodes underwent axillary dissection and 39 of these had non-sentinel node involvement too. The Stanford nomogram and the micrometastatic nomogram were the predictive tools identifying a small group of patients with low probability of further axillary involvement that might not require completion axillary lymph node dissection. Our data also suggest that the Tenon score can separate subsets of patients with a low and a higher risk of non-sentinel node metastasis. Predictive tools based on multivariate models can help in omitting completion axillary dissection in patients with low risk of non-sentinel lymph node metastasis based on their small tumor size.