This article investigates the claim that tongue protrusion ('th') acts as a nonmanual adverbial morpheme in British Sign Language (BSL) (Brennan 1992; SuttonSpence & Woll 1999) drawing on narrative data produced by two deaf native signers as part of the European Cultural Heritage Online (ECHO) corpus. Data from ten BSL narratives have been analysed to observe the frequency and form of tongue protrusion. The results from this preliminary investigation indicate tongue protrusion occurs as part of the phonological formation of lexical signs (i.e., 'echo phonology' , see Woll 2001), as well as a separate meaningful unit that co-occurs (sometimes as part of constructed action) with classifier constructions and lexical verb signs. In the latter cases, the results suggest 'th' sometimes appears to function as an adverbial morpheme in BSL, but with a greater variety of meanings than previously suggested in the BSL literature. One use of the adverbial appears similar to a nonmanual signal in American Sign Language described by Liddell (1980), although the form of the mouth gesture in our BSL data differs from what is reported in Liddell's work. Thus, these findings suggest the mouth gesture 'th' in BSL has a broad range of functions. Some uses of tongue protrusion, however, remain difficult to categorise and further research with a larger dataset is needed.

Both palliative care (PC) and integrative medicine (IM) focus on the whole person to optimize wellbeing. Integrative palliative care combines the best of both approaches in relieving the distressing symptoms of serious illness and its treatment by combining evidence informed, pharmacological and nonpharmacological modalities that are aligned with the person’s goals, values and preferences. Healing is valued, as well as symptom relief, shared decisionmaking, person empowerment, compassionate care, and nurturing of hope. Increasingly, symptom clusters in serious illness are being recognized and addressed in both PC and IM. Symptom clusters arise from the complexity of the physical, psychological, social and spiritual aspects of a person interacting with serious illness. Many complementary and integrative health (CIH) modalities address symptom clusters effectively, and may allow for reduced doses of medication and their resulting side effects, or help alleviate the need for medication altogether, and increase health, healing and well being. Research reveals that the public desires more access to CIH including palliative care settings although actual delivery of these services in health care settings remains limited. This review explores the evidence for a combined palliative care and integrative medicine approach to symptom clusters experienced by people with serious illness through increased access and funding of these services in the community and health care settings with quality practitioners.

This article investigates the claim that tongue protrusion (‘th’) acts as a nonmanual adverbial morpheme in British Sign Language (BSL) (Brennan 1992; Sutton-Spence & Woll 1999) drawing on narrative data produced by two deaf native signers as part of the European Cultural Heritage Online (ECHO) corpus. Data from ten BSL narratives have been analysed to observe the frequency and form of tongue protrusion. The results from this preliminary investigation indicate tongue protrusion occurs as part of the phonological formation of lexical signs (i.e., ‘echo phonology’, see Woll 2001), as well as a separate meaningful unit that co-occurs (sometimes as part of constructed action) with classifier constructions and lexical verb signs. In the latter cases, the results suggest ‘th’ sometimes appears to function as an adverbial morpheme in BSL, but with a greater variety of meanings than previously suggested in the BSL literature. One use of the adverbial appears similar to a nonmanual signal in American Sign Language described by Liddell (1980), although the form of the mouth gesture in our BSL data differs from what is reported in Liddell’s work. Thus, these findings suggest the mouth gesture ‘th’ in BSL has a broad range of functions. Some uses of tongue protrusion, however, remain difficult to categorise and further research with a larger dataset is needed.