- Remarks on deixis (1992)
- The prevailing conception of deixis is oriented to the idea of 'concrete' physical and perceptual characteristics of the situation of speech. Signs standardly adduced as typical deictics are I, you, here, now, this, that. I and you are defined as meaning "the person producing the utterance in question" and "the person spoken to", here and now as meaning "where the speaker is at utterance time" and "at the moment the utterance is made" (also, "at the place/time of the speech exchange"); similarly, the meanings of this and that are as a rule defined via proximity to speaker's physical location. The elements used in such definitions form the conceptual framework of most of the general characterisations of deixis in the literature. [...] There is much in the literature, of course, that goes far beyond this framework . A great variety of elements, mostly with very abstract meanings, have been found to share deictic characteristics although they do not fit into the personnel-place-time-of-utterance schema. The adequacy of that schema is also called into question by many observations to the effect that the use of such standard deictics as here, now, this, that cannot really be accounted for on its basis, and by the far-reaching possibilities of orienting deictics to reference points in situations other than the situation of speech, to 'deictic centers' other than the speaker. [...] Analyses along the lines of the standard conception regularly acknowledge the existence of deviations from the assumed basic meanings. One traditional solution attributes them to speaker's "subjectivity", or to differences between "physical" and "psychological" space or time; in a similar vein, metaphorical extensions may be said to be at play, or a distinction between prototypical and non-prototypical meanings invoked. Quite apart from the question of the relative merits of these explanatory principles, which I do not wish to discuss here, the problem with all such accounts is that the definitions of the assumed basic meanings themselves are founded on axiom rather than analysis of situated use. The logical alternative, of course, is to set out for more abstract and comprehensive meaning definitions from the start. In fact, a number of recent, discourse-oriented, treatments of the demonstratives proceed this way; they view those elements as processing instructions rather than signs with inherently spatial denotation (Isard 1975, Hawkins 1978, Kirsner 1979, Linde 1979 , Ehlich 1982.)
- Self-rated health in multimorbid older general practice patients: a cross-sectional study in Germany (2014)
- BACKGROUND: With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients. METHODS: Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses. RESULTS: Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson's disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors. CONCLUSION: In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH.