The Scale of Quantitative Assessment Adherence to Treatment «QAA-25»: Updating of Formulations, Constructive and Factor Validity and a Measure of Consent

Aim: To update the definitions of selected questions of the "QAA-25" (quantitative adherence assessment) scale and evaluate it according to the criteria of validity and measure of agreement.Materials and Methods. In a descriptive cross-sectional study including 200 patients with coronary heart disease, adherence was determined using traditional and alternative versions of selected questions of the QAA-25 scale, followed by assessment of construct validity, factor validity, and measure of agreement.Results. Alternative question versions did not significantly affect test results, with 81% of respondents in the outpatient sample and 69% in the inpatient sample rating them as "more acceptable." The QAA-25 scale has good construct and internal validity (α – 0.818, αst – 0.832), with moderate agreement (κ – 0.562) and demonstrates high reliability of internal validity – when scale items are consistently excluded, α values remain in the 0.801-0.839 range.Conclusion. The QAA-25 scale with modified question definitions should be used instead of the previous version of the scale. Good construct validity and factor validity, sufficient measure of agreement and specificity, high sensitivity and reliability of the QAA-25 scale allow to recommend it as a tool for assessing adherence to drug therapy, medical support, lifestyle modification and integral adherence to treatment in scientific and clinical practice.

Reported communication challenges for adult witnesses with intellectual disabilities giving evidence in court

Communication plays a key role in a witness's ability to give evidence and participate in the court process. Adults with intellectual disabilities (ID) can be negatively impacted by communication difficulties such as: limitations in recall abilities; suggestibility to leading questions; difficult question styles used by advocates; and unfamiliar language used within the court setting. Most research carried out on communication challenges for adults with ID, when giving evidence, has involved participants in psychology-based experimental methodology. In this study 19 court reports assessing actual witnesses (complainants and defendants) with ID, written by Registered Intermediaries in Northern Ireland, were analysed. A wide range of communication difficulties were identified for the adult witnesses. Difficulties resulting from communication used by their communication partner (typically the advocate in a court setting) were also described. A rich model of the challenges for both partners, in giving evidence and in cross-examination, is presented, extending previous research. This study highlights the need for research within UK courts to assess: how witnesses with ID are being questioned; the effectiveness of changes made to the court process to enhance communication; the impact of the court process and environment on communication and alternative question styles for advocates to use.

On the nature of AA question1 in Yi2 and related problems

This paper aims to study a kind of interrogative in Yi which surfaces as an AA form commonly viewed as AA/Reduplicative Question. It explores the interrogative motivation, question type, generative mechanism and syntactic derivation of AA Question. We first assume that (i) AA question in Yi is a kind of alternative question, which is reduced successively from A-or-not-A and A-not-A question and (ii) the [+Q] feature of AA question does not result from reduplication but from other reasons. To justify these two assumptions, we use tests including adverb tests, modal tests, tag question tests, SFP tests, Q & A tests, and cross-language investigation and sociolinguistic survey. The findings include (i) the [+Q] feature of AA question results from the existence of an abstract interrogative morpheme, (ii) the phenomenon of reduplication is just a kind of byproduct with the syntactic derivation of AA question and (iii) AA question, diachronically speaking, is essentially a kind of alternative question, which is reduced successively from A-or-not-A and A-not-A question to meet the economic principle of language.

QUESTION PATTERNS AND CONVERSATION IMPLICATURE ON TRADITIONAL MARKET IN LAMPUNG-INDONESIA

The purpose of this study was to describe the patterns and functions of questions expressed in conversational implicature found in market transactions. A descriptive qualitative method was used in this research. And conversation analysis was applied to determine question patterns, while conversational implicature was to examine question functions. The research data was collected in the form of recorded and transcripted conversations along with the corresponding situations or contexts. The data of this research was primarily obtained from both sellers and buyers in Way Halim Market, Lampung, Indonesia, and it was gathered by listening and taking notes. This study showed that there were six types of question patterns found in such transactions that contained conversational implicature, namely (1) yes/no question for asking, (2) tag question for rejecting and ordering (3) declarative question for ordering, (4) alternative question for asking, (5) wh-question for asking and sugesting, and (6) rhetorical question for rejecting. The results also indicated that the sellers used persuasive implied questions more often than the buyers. These questions functioned to persuade buyers politely to make purchase.Keywords: question patterns, implicature, market transactionsPOLA PERTANYAAN DAN IMPLIKATUR PERCAKAPANDI PASAR TRADISIONAL LAMPUNG-INDONESIAAbstrakTujuan penelitian ini untuk mendeskripsikan pola dan fungsi tuturan pertanyaan yang disampaikan dalam implikatur percakapan ketika melakukan transaksi jual beli. Pendekatan penelitian ini adalah kualitatif deskriptif. Adapun jenis penelitian dalam menganalisis data menggunakan analisis percakapan untuk menentukan pola pertanyaan dan implikatur percakapan untuk menentukan fungsi tuturan pertanyaan. Data penelitian berupa tuturan percakapan hasil rekaman yang telah ditranskrip serta situasi atau konteks percakapan yang melatarbelakangi peristiwa tersebut. Sumber data penelitian ini diperoleh dari para pedagang dan pembeli di Pasar Way Halim, Provinsi Lampung, Indonesia. Pengumpulan data menggunakan metode simak dan metode catat. Hasil penelitian ini ditemukan enam bentuk pola pertanyaan dalam transaksi jual beli yang mengandung implikatur percakapan, yaitu (1) yes/no question fungsi meminta, (2) tag question fungsi menolak dan menyuruh (3) declarative question fungsi menyuruh, (4) alternative question fungsi meminta, (5) wh-question fungsi meminta dan menyarankan, dan (6) rhetorical question fungsi menolak. Dari data yang ditemukan, penjual lebih sering menggunakan tuturan pertanyaan bersifat persuasif dengan makna yang disampaikan secara tidak langsung kepada pembeli. Fungsi penggunaan tuturan persuasif tersebut yakni penjual terlihat memiliki kesantunan sehingga mempengaruhi pembeli dengan harapan akan terjadi transaksi jual beli.Kata kunci: pola pertanyaan, implikatur, transaksi jual-beli

‘Primary care sensitive’ situations that result in an ambulance attendance: a conversation analytic study of UK emergency ‘999’ call recordings

ObjectivesTo explore common features of conversations occurring in a sample of emergency calls that result in an ambulance dispatch for a ‘primary care sensitive’ situation, and better understand the challenges of triaging this cohort.DesignA qualitative study, applying conversation analytic methods to routinely recorded telephone calls made through the ‘999’ system for an emergency ambulance. Cases were identified by a primary care clinician, observing front-line UK ambulance service shifts. A sample of 48 ‘999’ recordings were analysed, corresponding to situations potentially amenable to primary care management.ResultsThe analysis focuses on four recurring ways that speakers use talk in these calls. Progress can be impeded when call-taker’s questions appear to require callers to have access to knowledge that is not available to them. Accordingly, callers often provide personal accounts of observed events, which may be troublesome for call-takers to ‘code’ and triage. Certain question formats—notably ‘alternative question’ formats—appear particularly problematic. Callers deploy specific lexical, grammatical and prosodic resources to legitimise the contact as ‘urgent’, and ensure that their perception of risk is conveyed. Difficulties encountered in the triage exchange may be evidence of misalignment between organisational and caller perceptions of the ‘purpose’ of the questions.ConclusionsPrevious work has focused on exploring the presentation and triage of life-threatening medical emergencies. Meaningful insights into the challenges of EMS triage can also be gained by exploring calls for ‘primary care sensitive’ situations. The highly scripted triage process requires precise, ‘codeable’ responses to questions, which can create challenges when the exact urgency of the problem is unclear to both caller and call-taker. Calling on behalf of someone else may compound this complexity. The aetiology of some common interactional challenges may offer a useful frame for future comparison between calls for ‘primary care sensitive’ situations and life-threatening emergencies.

Interview Testing: An Exploratory Study into the Use of Method Adjustment Strategy to Compensate for a Less Structured Interview Test

An exploratory study was formulated to see whether instruction in strategic competence would better help students manage a less structured version of the pre-existing bi-semester interview test (B-test). Furthermore, the author hoped to determine whether the structured nature of the test was actually detrimental to the students’ communicative ability. A study group of four higher-level English classes from two departments (two classes from each department), as determined by TOEIC bridge placement tests, was formed. One class each from both departments was designated a control group, and the other a strategy group that was instructed in method adjustment strategies. All four groups were given a supplementary interview test (S-test) made up of two each of five types of question variations of the original B-test questions. Students were then interviewed by the author and another teacher, and their scores and the strategies employed were recorded. Analysis revealed that while overall both strategy groups managed the S-Test better than their corresponding control group, the most revealing difference was that both the strategy and control group from one department scored significantly worse in the S-test than those in the other department (although they achieved higher scores in the B-test), despite that strategy group employing a wide variety of message adjustment strategies. It was therefore concluded that the message adjustment strategies taught should be mostly limited to utterances and shadowing, and the structured nature of the B-test be adjusted to accommodate alternative question types. 既存のあまり体系的ではないインタビュー式試験（B試験）に、2学期にわたって学生が対処する際、戦略的能力をつけることが彼らの助けになるかどうかを調査するため、探査的研究を行った。さらに、試験の体系的性質が実際には学生のコミュニケーション能力に有害かどうかを検討した。研究の対象として、TOEIC Bridgeのプレイスメントテストから判断した2つの 学科の学生から、比較的レベルの高い4 つの英語クラス（各学科から2 クラスずつ）のグループを作った。各学科で1 つのクラスを基準グループとし、もう1 つのクラスは戦略グループとして調整戦略法を教えた。全4 グループは補足のインタビュー式試験（S試験）を受けた。S試験は、元のB試験の設問のうち2 つに、それぞれ5タイプの設問のバリエーションを設けたものである。その際学生は、筆者と他1 名の教員によるインタビューを受け、得点と用いられた戦略が記録された。分析の結果、両戦略グループは全体として、比較対象となる基準グループよりS試験にうまく対処できたことが明らかになった。さらに最も顕著な違いは、1 つの学科の戦略グループと基準グループが共に、S試験においては他学科のグループより明らかに低得点であったことだ。（彼らはB試験においてはより高得点を達成していたし）、戦略グループは多様なメッセージ調整法を用いたにもかかわらず、である。ゆえに結論付けられたことは、メッセージ調整法の教授は発話と復唱にほぼ限るべきであり、B試験の体系的性質は、別の設問タイプに対応するために調整されるべきであるということである。

“Common Sense Geography” and the Elected Official: Technical Evidence and Conceptions of ‘Trust’ in Toronto’s Gardiner Expressway Decision

In fields such as Sociology and Political Science, there have been, over the course of three decades, attempts to engage elected officials in “Evidence-Based Decision-Making”. Evidence is generally conceived as “expert” advice provided to politicians. A question that has gained more centrality in recent years is “why do elected officials not trust expert opinion or technical evidence?” and the answer to this question has been sought in historical or general terms (e.g. Irwin 2006; Weiss et al. 2008; Kraft et al. 2015). Here I will propose an alternative question: “when politicians exhibit a lack of trust in expert advice, how is such skepticism publicly accounted for?” I will examine this question by utilizing a case study ethnographic approach to the City of Toronto’s controversial decision to endorse the Hybrid alternative for the Gardiner expressway. By doing so, I intend to show that knowledge controversies are not inherently a form of deficiency on the part of the elected official – that they are ignorant to the implications of evidence – but rather the standard by which elected officials and appointed experts review and understand evidence can lead to very different (although both reasonably ‘correct’) conclusions.

Aligning caller and call-taker

This paper reports on conversation analytic research for the Dutch national emergency call-centre. In a corpus study of 120 emergency calls we show that callers’ orientations to their communicative tasks are not aligned to the institutional communicative tasks of the call-takers. In a subsequent workplace experiment involving over 2000 calls, it appeared that the use of an alternative question rather than a wh-question, significantly altered callers’ emergency deliveries and adapted them to call-takers’ communicative needs. The analysis shows two aspects of callers’ responses to the different question formats: (i) The alternative questions produced significantly more type-conforming answers than the wh-questions, and also (ii) callers treated their non-conforming answer to alternative question more often as dispreferred than their non-conforming answers to wh-questions. Callers thus treated the preference for type-conformity to be stronger for alternative questions than for wh-questions.