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Therefore generic 200mg avana erectile dysfunction 34, the specificity of the expert-to-expert discourse is eschewed in favour of a less gate- keeping rhetorical representation of the content − characterized by the frequent resorting to explanations cheap generic avana canada erectile dysfunction doctors tucson az, definitions order cheap avana on line erectile dysfunction virgin, and reformulations − which “does not alter the disciplinary content […] as much as its language” (Gotti 2014: 19) purchase 250 mcg fluticasone free shipping. From a pragmatic standpoint cheap malegra dxt plus 160mg fast delivery, the different representations of medical discourse are used to convey meanings in the most effective and contextually appropriate way viagra soft 100 mg, thus adjusting the linguistic repre- sentation of the content to the competence, needs and expectations of the receiver. From a Critical Discourse perspective, besides having an informative function, medical language also serves to stigmatize certain behaviours by pathologizing them, that is, by cognitively framing them into symptoms-diagnosis-treatment paradigms, or to either sanction or proscribe given therapies and practices (Conrad/ Barker 2010). Besides contextual factors, language use in medical settings is also markedly affected by the code and the channel of its communica- tion, that is, on the one hand, the genres and text-types which are typically associated with the transmission of given contents, and, on the other, the medium employed for such communicative events. Focus on medical discourse This volume investigates how context- and medium-based factors may influence medical communication, both in synchronic and diachronic terms. Death, plagues, diseases have always been a cause of major concern, panic and terror, as is witnessed by many literary works from the past cen- turies (Virgil, Boccaccio, Chaucer, Shakespeare and many others wrote about epidemics), which were directly inspired by such power- ful feelings. These works evidence the fascination such collective apprehension generates and, at the same time, they contribute to the establishment of given views within a specific culture. Based on the assumption that language can contribute to raising fears, the chapter examines the rhetorical techniques and processes used to construct the expression of fear, first by designing a model which diachronically illustrates the evolution of the interpretation of pandemics over time and the type of fear they generate (accounting for such parameters as ‘what is to be feared? Another diachronic investigation into the ways language was used in the medical domain in order to shape up notions and frame them into cognitive terms so as to either justify or stigmatize, or 16 Michele Sala / Stefania M. With a special focus placed on the use of given expressions, metaphors and concepts by authors promoting competing views of the nature and significance of epidemics (either aligning with the Church of England’s official view or with the Puritan interpretation of the phenomenon), this chapter investigates some crucial dynamics of the ethics of medical communication about plague. The analysis illustrates how different authors − when con- fronted with devastating epidemics in both economic, demographic and social terms − exploited and manipulated discursive resources to promote either resistance to or compliance with medical treatments and public orders. The corpus-based investigation involves the analysis of two English subcorpora: on the one hand an expert-to-expert communication corpus; on the other hand, an expert- semiexpert/non-expert communication corpus. The analysis reveals that the amount and type of biomedical variants employed in each biomedical register is not only dependent upon situational factors, but also upon the writers’ intention of the recipients’ level of knowledge in each situational context. By examining variants in the two sub- corpora, the author identifies regular semantico-syntactic patterns in variant formation corresponding to each register. For instance, in the expert-to-expert register, the type of variants preferred are acronyms, whereas in the expert-semiexpert/non-expert type of communication, there is greater exploitation of terminological variants implying a re- formulation of terms composed of Greek and Latin roots than bio- medical denominations. Since new media, especially Internet-based, have an increasingly significant impact on science communication and in the dissemination of medical Introduction 17 issues to lay audiences, it is worthwhile to see how such resources are employed to communicate and recontextualize medical concepts in health and medicine news in electronic science magazines. The cross-linguistic nature of the corpus makes it possible to highlight similarities and differences in the use of pictures and captions in the three languages. Given the increasing importance − for the purpose of de- tecting and identifying language disorders − acquired by such testing methods, designed to assess the ability on the part of English speaking children to recognize and understand linguistic stimuli (presented in the written form) and elaborate in turn a response which is con- textually appropriate and pragmatically effective, this analysis hypo- thesizes the translation of such texts into Italian, anticipating possible translation problems due to either culture- or language-specific fac- tors, and offering workable solutions. The results suggest that variations do exist and that they do not merely mirror different national contexts, but rather occur within specific national contexts. Indeed, a profound contrast has been identified between institutionalised discourse, where altruism and en- lightened self-interest tend to emerge, and media reports, where self- interest clearly predominates, despite the universal positive quality, in medical term, of the giving blood procedure. In particular, they focus on the texts – the first source of information on this condition – uploaded on Italian, German and Dutch hospital websites and other similar centres, with the purpose of identifying the communicative style employed to deal with such sensitive issues and to detect, if any, cultural differences. Findings indicate variation in style: while the Italian corpus seems monologic and doctor-centred, the German and Dutch ones appear more patient-centred and reader-friendly.

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Emergency department management of the airway in Extrication from the scene of an accident or even from the obese adults safe avana 50mg erectile dysfunction ring. To be most effective there should be seamless transition between care in the prehospital buy generic avana causes of erectile dysfunction in late 30s, transport and hospital environments order avana 200mg with amex erectile dysfunction definition. The usual operating paradigm in patient transport has been to ‘bring the patient to care’ and enable access to higher levels of care large centres usually for subspecialty services are sometimes called or definitive management discount 100 mg suhagra free shipping. Highly trained retrieval teams Primary retrievals may be further categorized as ‘land on’ or can optimize patient outcomes by earlier introduction of critical ‘winch’ order avana on line amex, depending on whether site access is possible cheap 100 mg sildigra overnight delivery. The characteristics of primary and secondary retrievals are at least equal care at the referral point and also prepare the patient described in Table 32. The risk of transport should (transport frame, equipment, staff ), and helps define retrieval not exceed any potential benefit the patient may obtain from the services roles. Some are purely pre- hospital, some offer neonatal services, while others are mixed (all Definitions and terminology ages, ‘medical’ and trauma). Distances may range from inner-city responses, to decentralized rural populations where long fixed-wing Patient retrieval can be defined as the use of clinicians (medical, flight times may be needed (Figure 32. Casemix and geogra- nursing, paramedic, other) to facilitate clinical management and phy are integral in determining the structure of retrieval services safe transport of a patient(s) from one location to another. Secondary Crewmix retrievals are from one health facility to another and are also referred to as interfacility transfers. Patient movement between Physicians, paramedics, nurses and other personnel are all used as transport and retrieval crew. System variances are determined mainly by historical difference in prehospital care models. Regardless of discipline, crew should be adequately trained and Edited by Tim Nutbeam and Matthew Boylan. Computer-assisted dispatch systems offer consistency and data integrity while clinician-based systems offer clinical acumen and local knowledge. While the outcomes of tasking decisions may be different for an injuredswimmerandasickchildonaremoteproperty(Figures32. While safety and patient outcomes are the primary considerations these are not mutually exclusive. Tasking and coordination Effects of transport Tasking and coordination of patient retrieval is summarized by the adage ‘getting the right patient to the right place in the right Patient transport is not without risk even in perfect weather. The transport environment has its own unique characteristics that Increasingly in health care we need to add ‘at the right cost’. Clinical coordination serves to align the response (urgency, The range of transport effects are detailed in Table 32. Under-triage may are common to both road and airframes such as noise, vibration, result in delayed transport with possible adverse patient outcomes. These Over-triage may increase resource utilization with associated costs, affect both patient care and crew wellbeing. Fatigue management is exposure of transport risks for crew and patients and risk that important as anyone who has spent time in the back of a transport services are not available for others in need.