RESUMEN
A central tenet of theories of meaning in the Gricean tradition-such as Relevance Theory-is that others will come to believe certain things simply by recognizing our intentions to communicate. In this article I demonstrate that this is not equally the case for all interlocutors; some bear additional burdens. In particular, I argue that this can happen in two ways. First, I demonstrate how a response to persistent testimonial injustice can be understood in terms of Sperber and Wilson's distinction between meaning-that and showing-that; a speaker who experiences repeated testimonial injustice will often move down the meaning vs. showing continuum. This is a result of a speaker learning that recognition of her intention has not in her experience been sufficient to induce the intended response in the hearer. Secondly, in consideration of social science research around perception of accent prestige and other status cues, I detail further costs borne by those who change their physical appearance and voice to be perceived as more credible. The costs of communication are not equal for all: they are greater for those who face a credibility deficit based in identity prejudice. Overall, by bringing Fricker's notion of testimonial injustice to bear on Relevance Theory, this article shows how social factors affect the reality of how interlocutors communicate.
RESUMEN
BACKGROUND: The prevalence of diabetes in pregnant women has increased in the USA over recent decades. The primary aim of this study was to assess the association between diabetes in pregnancy and maternal near-miss incident, maternal mortality and selected adverse foetal outcomes. METHODS: We conducted a retrospective, cross-sectional analysis among pregnancy-related hospitalizations in USA between 2002 and 2014. We examined the association between DM and GDM as exposures and maternal in-hospital mortality, maternal cardiac arrest, early onset of delivery, poor foetal growth and stillbirth as the outcome variables. RESULTS: Among the 57.3 million pregnant women in the study population, the prevalence of GDM and DM was 5.4 and 1.3%, respectively. We found that pregnant women with DM were three times more likely to experience cardiac arrest (OR = 3.21; 95% CI = 2.57-4.01) and in-hospital maternal death (OR = 3.05; 95% CI = 2.45-3.79), as compared to those without DM. Among pregnant women with GDM and DM, the risk for early onset of delivery was higher, compared to women without GDM or DM. CONCLUSION: A diagnosis of diabetes prior to pregnancy contributes significantly to the risk of maternal cardiac arrest, maternal mortality and adverse foetal outcomes.