In this article, we describe the notion of dialogue move intended as the minimal unit for the analysis of dialogues. We propose an approach to discourse analysis based on the pragmatic idea that the joint dialogical intentions are also co-constructed through the individual moves and the higher-order communicative intentions that the interlocutors pursue. In this view, our goal is to bring to light the pragmatic structure of a dialogue as a complex net of dialogical goals, which represent the communicative purposes (...) that the interlocutors intend to achieve through their utterances. Dialogue moves are shown to represent the necessary interpretive link between the general description of the dialogical context or type and the syntactical analysis of the sentences expressed by the individual utterances. In the concluding part of this article, we show how this method can be used and further developed for analyzing various types of real-life dialogues, outlining possible uses and lines of empirical research based thereon. (shrink)

Pragmatic presupposition is analyzed in this paper as grounded on an implicit reasoning process based on a set of presumptions, which can define cultural differences. The basic condition for making a presupposition can be represented as a reasoning criterion, namely reasonableness. Presuppositions, on this view, need to be reasonable, namely as the conclusion of an underlying presumptive reasoning that does not or may not contain contradictions with other presumptions, including the ordering of the hierarchy of presumptions. Presumptions are in turn (...) analyzed considering their nature and their hierarchy, namely their object and their possible contextual backing, which eliminates some of their possible defaults. This analysis of presupposition brings to light the relationship between communicative infelicities or misunderstandings deriving from presuppositional failures and the underlying system of presumptions and presumptive reasoning. This approach can be applied to the investigation of communicative problems within the medical context, and more precisely the communication in diabetes cases. (shrink)

The purpose of this chapter is twofold. On the one hand, our goal is theoretical, as we aim at providing an instrument for detecting, analyzing, and solving ambiguities based on the reasoning mechanism underlying interpretation. To this purpose, combining the insights from pragmatics and argumentation theory, we represent the background assumptions driving an interpretation as presumptions. Presumptions are then investigated as the backbone of the argumentative reasoning that is used to assess and solve ambiguities and drive (theoretically) interpretive mechanisms. On (...) the other hand, our goal is practical. By analyzing ambiguities as stemming from different presumptions concerning language or, more importantly, expected communicative roles and goals, we can use communicative misunderstandings as the signal of deeper disagreements concerning mutual expectations or cultural differences. This argumentation-based interpretive mechanism will be applied to the analysis of medical interviews in the area of diabetes care, and will be used to bring to light the sources of misunderstanding and the different presumptions that define distinct cultures. We will consequently illustrate the analytical tools by identifying and distinguishing the various types of ambiguity underlying misunderstandings, and we will address them by describing the communicative intentions ascribed to the ambiguous utterances. (shrink)

In the domain of medical science, factual evidence is usually considered as the criterion on which to base decisions and construct hypotheses. Evidence-based medicine is the translation of this approach into the field of patient care, and it means providing only the type of care that is based on evidence that proves its effectiveness and appropriateness. However, while the literature has focused on the types and force of evidence used to establish the recommendation and treatment guidelines, the problem of how (...) evidence is used in doctor–patient interactions to motivate, or refuse, treatment or habit change has been almost completely neglected. In this specific context, characterized by the epistemic unbalance between the interlocutors and a specific conversational goal, the scientific categories of evidence are often irrelevant. The goal of this paper is to address this challenge by analyzing the role evidence plays in doctor–patient interactions in diabetes care. After introducing an analytical distinction between the epistemic and the pragmatic aspect of evidence, we will propose a classification of the types and functions of evidence in chronic care communication, and illustrate its possible uses through its application to our corpus of diabetes-care consultations. From our qualitative analyses, it is possible to observe how in this communicative context a crucial role is played by the conflicts of evidence, in which providers correct patients’ uses of evidence leading them to using less defeasible levels of evidence. (shrink)

The relevance of context has been acknowledged also recently as a fundamental element for the correct evaluation of argumentative moves within institutional fields of interaction. Indeed, not considering the larger culture-specific and social features of the context within which the interactions take place poses problems of interpretation of the data and comparability of results. Starting from these considerations, the paper aims at discussing a model for the description of the social context of interaction that may allow for a better interpretation (...) and evaluation of argumentative moves within medical consultations. The efficacy of the model is shown by applying it to the description and analysis of examples of real-life consultations recorded in the Italian region of Lombardy. In the first section, the model for the description of the social context of interaction is presented and discussed. In the second section, examples of argumentative passages from a selection of consultations are presented and commented on by relying on the model. Some concluding remarks and further developments of the research are proposed in the final section Keywords: communication context, argumentation in context, situated discourse, medical consultation. (shrink)

This volume focuses on the role language plays at all levels of the argumentation process. It explores the effects that specific linguistic choices may have in the production and the reception of arguments and in doing so, it moves beyond the first, necessary, descriptive stance provided by current literature on the topic. Each chapter provides an original take illuminating one or more of the following three issues: the range of linguistic resources language users draw on as they argue; how cognitive (...) processes of meaning construction may influence argumentative practices; and which discursive devices can be used to fulfil a number of argumentative goals. The volume includes theoretical and empirical or applied stances, providing the reader both with state-of-the-art reflections on the relationship between argumentation and language, and with concrete examples of how this relationship plays out in naturally occurring argumentative practices, such as classroom interaction, and political, parliamentary or journalistic discourse. This is a very original, timely and welcome contribution to the study of argumentation conducted with the tools of the language sciences. The collection of papers relevantly tackles key linguistic, discursive and cognitive aspects of argumentative practices whose treatment is underrepresented in mainstream argumentation studies by offering new and exciting linguistically-grounded theoretical accounts. As such, the volume testifies both to the vigour of the linguistic current within the discipline and to the high standards of scholarly commitment and quality that the younger generation is pushing forward. Without question, this book marks an important milestone in the relationships between linguistics and argumentation theory. Christian Plantin, Professor Emeritus. (shrink)

Amyloid fibril formation plays a central role in the pathogenesis of a number of neurodegenerative diseases, including Alzheimer and Parkinson diseases. Transient prefibrillar oligomers forming during the aggregation process, exhibiting a small size and a large hydrophobic surface, can aberrantly interact with a number of molecular targets on neurons, including the lipid bilayer of plasma membranes, resulting in a fatal outcome for the cells. By contrast, the mature fibrils, despite presenting generally a high hydrophobic surface, are endowed with a low (...) diffusion rate and poorly penetrate the interior of the lipid bilayer. However, increasing evidence shows that both intracellular α‐synuclein fibrils, as well and as extracellular amyloid‐β and β2‐microglobulin fibrils, can release oligomers over time that quickly diffuse to reach the membrane of the neighboring cells. The persistent leakage of harmful oligomers from fibrils triggers an ongoing cascade of events resulting in a sustained injury to neurons and glia and also provides aggregates with the ability to cross biological membranes and diffuse between cells or cellular compartments. (shrink)

ObjectiveThe objective of this study was to validate the computerized Symbol Digit Modalities Test in a Swiss pediatric cohort, in comparing the Swiss sample to the Canadian norms. Secondly, we evaluated sex effects, age-effects, and test–retest reliability of the c-SDMT in comparison to values obtained for the paper and pencil version of the Symbol Digit Modalities Test.MethodsThis longitudinal observational study was conducted in a single-center setting at the University Children’s Hospital of Bern. Our cohort consisted of 86 children aged from (...) 8 to 16 years. The cohort included both healthy participants and patients hospitalized for a non-neurological disease. Forty eight participants were assessed during two testing sessions with the SDMT and the c-SDMT.ResultsTest–retest reliability was high in both tests. A reliable change index was calculated for the SDMT and the c-SDMT corrected for practice effects. While a significant age effect on information processing speed was observed, no such effect was found for sex. When data on the c-SDMT performance of the Swiss cohort was compared with that from a Canadian cohort, no significant difference was found for the mean time per trial in any age group. Norm values for age groups between 8 and 16 years in the Swiss cohort were established.ConclusionNorms for the c-SDMT between the Swiss and the Canadian cohort were comparable. The c-SDMT is a valid alternative to the SDMT. It is a feasible and easy to administer bedside tool due to high reliability and the lack of motor demands. (shrink)

BackgroundInformation processing speed is a marker for cognitive function. It is associated with neural maturation and increases during development. Traditionally, IPS is measured using paper and pencil tasks requiring fine motor skills. Such skills are often impaired in patients with neurological conditions. Therefore, an alternative that does not need motor dexterity is desirable. One option is the computerized symbol digit modalities test, which requires the patient to verbally associate numbers with symbols.MethodsEighty-six participants were examined, 38 healthy and 48 hospitalized for (...) a non-neurological disease. All participants performed the written SDMT, c-SDMT, and the Test of Non-verbal Intelligence Fourth Edition. Statistical analyses included a multivariate analysis of covariance for the effects of intelligence and hospitalization on the performance of the SDMT and c-SDMT. A repeated measures analysis of variance was used to compare performance across c-SDMT trials between inpatients and outpatients.ResultsThe MANCOVA showed that hospitalization had a significant effect on IPS when measured with the SDMT but not with the c-SDMT, while IQ had no effect on IPS. Age was the best predictor of performance of both tests. The repeated measures ANOVA revealed no significant difference in within-test performance between outpatient and inpatient participants in the c-SDMT.ConclusionPerformance of the c-SDMT is not confounded by hospitalization and gives within-test information. As a valid and reliable measure of IPS for children and adolescents, it is suitable for use in both inpatient and outpatient populations. (shrink)