Study Design: A blinded, prospective diagnostic test study was conducted.<p>Objectives: To assess the inter-tester reliability of clinical examination items for carpal tunnel syndrome (CTS), to assess the validity of individual clinical test items and self-report measures for the diagnosis of CTS and to assess the accuracy of an optimum test item cluster for the diagnosis of CTS.<p>Study Rational: Examination of the diagnostic validity of various clinical tests for the diagnosis of CTS has shown mixed results and the reliability of many of these tests has not been determined. The majority of the diagnostic validity research for CTS has examined tests individually which is in contrast to clinical practice where the results of multiple tests are combined as part of the clinical reasoning process in order to formulate a differential diagnosis: the test item cluster, derived through logistic regression, is proposed as a means to integrate the validity of multiple tests. Methods: 37 subjects (74 hands) were recruited from a convenience sample of consecutive patients referred to for electrodiagnostic (EDX) testing due to upper extremity symptomatic complaints. Subjects underwent EDX testing followed by completion of self-report questionnaires and a standardized clinical examination by examiners blinded to EDX results. Diagnostic validity was determined for both general and restricted CTS classification groupings. <p>Results: Out of 18 clinical test items, 12 had reliability coefficients (i.e. ICC or Kappa) of .40 or greater. There were 10 clinical exam and self-report items that were found to have likelihood point estimates above 2 or below 0.50 for the general diagnostic classification and 6 items had acceptable validity for the restricted classification. The test item cluster (TIC) derived for the general classification included hand numbness and symptom reproduction with the upper limb neurodynamic test 1. The TIC derived for the restricted classification included hand numbness and the overall score of the symptom component of the Bringham Carpal Tunnel Questionnaire. The 95% confidence intervals for most likelihood ratio point estimates were wide. <p>Conclusions: The TICs for both classification groupings did not yield improved diagnostic validity beyond that found with the single best test item (hand numbness). The value of the single best test item hand numbness was in a negative response. Further investigation is required to validate the TIC and the single best test item and to improve the point estimate precision.

Sammanfattning Att undersöka en befolknings fysiska aktivitet ger beskrivande data utav dagsläget samt att resultatet fungerar som mätinstrument för hur en framtida intervention ska utformas. Syftet med denna studie var att se om något samband förelåg mellan tre olika undersökningsinstrument för fysisk aktivitet, som används för med barn med övervikt. Metod: Deltagarna mättes, vägdes, skattade sin fysiska aktivitetsnivå (frågeformulär), testade sin fysiska prestationsförmåga (sex minuters gångtest) och deras fysiska aktivitet mättes (accelerometer). Resultat: Åtta flickor, 7-13 år, med ett Body Mass Index (BMI) på 26 ± 3,7 kg/m2deltog. Majoriteten skattade sig vara fysiskt aktiva 30-60 min/dag under vardag och helg, men som grupp var skattningen signifikant lägre på helgen. Deltagarnas fysiska prestationsförmåga var signifikant lägre än det beräknade normalvärde. Barnen utförde i snitt 67 ±24 min/dag aktivitet under vardagarna och signifikant mindre aktivitet (31 ± 29,7min/dag) på helgerna. Ett signifikant samband förelåg mellan undersökningsinstrumenten för utförd fysisk aktivet under vardagarna och prestationsförmågan, där även en formel för hur sambandet kunde kalkyleras framtogs. Slutsats: Trots litet deltagarantal skulle studiens resultat tyda på att 6MGT kan användas inte bara för att bedöma prestationsförmåga utan även för beräknad utförd fysisk aktivitet under vardagarna. / Abstract Investigation physical activity in a population gives descriptive data and the result serves as a measuring instrument for how future interventions ought to be designed. The purpose of this study was to see whether any associations existed between three examination instruments for physical activity that are used with children with overweight. Method: The participants were measured, weighed, estimated their physical activity (questionnaire), testing their physical performance (six-minute walking test) and their physical activity was measured (accelerometer). Results: Eight girls, aged 7-13, body mass index of 26 ± 3.7, participated. The majority of the children estimated to be physically active for 30-60 min/day, during weekdays and weekends, but seen as a group the estimation was significantly lower on the weekend. Their physical performance showed a significantly lower value than the predicted value. The children performed on average for 67 ± 24 min / day during the week and significantly less (31 ± 29.7 min / day) on weekends. A significant association existed between performed physical activity during weekdays and the performance test. A formula for how this relationship could be calculated was designed. Conclusion: Despite low numbers of participants the result of the study could indicate that 6MWT can be used not only for assessing the performance but also to calculate the executed amount of activity during weekdays.

Syfte: Att undersöka hur läkare och sjuksköterskor arbetar med livsstilsfrågor och livsstilsfor-muläret vid lasarettet i Enköping. Dessutom undersöka vad personalen har för åsikt omlivsstilsformuläret samt om de behöver mer kunskap om livsstilsfrågorna och motiverandesamtal. Metod: En enkät skickades ut till 79 sjuksköterskor och läkare, svarsfrekvens 52 %.Huvudresultat: Alla deltagare tyckte att det var mycket viktigt eller ganska viktigt att frågapatienter om livsstilsfrågor och de områden man frågade mest om var tobak och alkohol.Bland svaren framkom det att de flesta samtalade med en patient som hade ett riskbeteende.De områden deltagarna ville ha mest kunskap i var motiverande samtal och stress. Positivaåsikter som framkom om livsstilsformuläret var att personalen fick en bra överblick av patien-tens levnadsvanor och hade ett bra underlag att samtala om vid mötet med patienten. De nega-tiva aspekterna som framkom var formulärets utformning och svarsalternativ som ansågs varaför komplicerat. Slutsats: Det hälsofrämjande arbetet anses viktigt och det behövs kontin-uerlig utbildning till personalen för att kunna arbeta med dessa frågor med patienterna. Detbehövs även klarare riktlinjer i uppföljningen av patienter med riskbeteende. Livsstilsfor-muläret är ett bra verktyg men det behöver förbättras. / Aim: To study how physicians and nurses work with health promotion at the hospital inEnköping, Sweden. And investigate the staffs’ opinion about the lifestyle questionnaire and ifthey need more education in health promotion or motivational interviewing. Method: Aninquiry was sent to 79 nurses and doctors, with a response rate of 52 %. Primary results:Everyone thought it was important or very important to ask about lifestyle questions werealcohol and tobacco was the most frequently asked questions. Among the answers most ofthem had a conversation with patients who had a risk behavior. The subjects that the staffwanted more knowledge of was motivational interviewing and stress. The positive aspects ofthe questionnaire were that the employees got an overview of the patient ́s health and couldhave a conversation around it. The negative aspect of the questionnaire was the formattingand the complicated answers to choose from. Conclusion: The work with health promotion isimportant and the employees need a continuously updated education to work in a professionalway with the patients. There is also a need to have stricter routines to evaluate the patientswith a risk behavior. The questionnaire is a good tool to work with but it needs improvement.Keywords: Health promoting hospitals (HPH), employees, lifestyle questions, questionnaireof lifestyle.

The mental-health consequences of childlessness have been well documented and the perception is that women are more likely than men to experience lower mental well-being, including emotional distress, as a result of childlessness; despite the fact that very few studies have focused on the implications for men. Thus, employing OLS multiple regression we seek to examine: (1) the association between childlessness and emotional distress and whether the risk was greater among men or women. (2) Whether there is significant variation in emotional distress among childless individuals after controlling for socio-demographic factors. The data was derived from the Estonian Health Interview Survey, collected in 2006 and 2007. The survey was a multi-stage random sample of the Estonian Population aged 15-85. Under study was men and women aged 40 and above (N=4294).The outcome variable- emotional distress is based on the emotional state questionnaire (EST-Q), a self-rated health measure. The simple regression and multivariate OLS regressions indicated higher predicted levels of emotional distress symptoms for childless men when compared to childless women. In comparison, the interactions revealed more distress among childless women. Overall, the results garnered indicate that educational attainment and personal income ameliorates the negative mental health consequences of childlessness. However, the degree and manner in which childlessness matter differ by gender, ethnicity and relationship status, but was inconclusive for age. An unexpected finding from the interaction models was the high level of distress among women that were parents. In general, the outcomes point to other reasons for the higher levels of distress among women. The mental-health consequences of childlessness have been well documented and the perception is that women are more likely than men to experience lower mental well-being, including emotional distress, as a result of childlessness; despite the fact that very few studies have focused on the implications for men. Thus, employing OLS multiple regression we seek to examine: (1) the association between childlessness and emotional distress and whether the risk was greater among men or women. (2) Whether there is significant variation in emotional distress among childless individuals after controlling for socio-demographic factors. The data was derived from the Estonian Health Interview Survey, collected in 2006 and 2007. The survey was a multi-stage random sample of the Estonian Population aged 15-85. Under study was men and women aged 40 and above (N=4294).The outcome variable- emotional distress is based on the emotional state questionnaire (EST-Q), a self-rated health measure. The simple regression and multivariate OLS regressions indicated higher predicted levels of emotional distress symptoms for childless men when compared to childless women. In comparison, the interactions revealed more distress among childless women. Overall, the results garnered indicate that educational attainment and personal income ameliorates the negative mental health consequences of childlessness. However, the degree and manner in which childlessness matter differ by gender, ethnicity and relationship status, but was inconclusive for age. An unexpected finding from the interaction models was the high level of distress among women that were parents. In general, the outcomes point to other reasons for the higher levels of distress among women.

Background and aims: The population of older people in our society is increasing. Agerelated changes in the skin results in a diminished perception of pain and pressure and a decreased microcirculation in the skin affects its ability to adapt to injury. Occurrence of pressure sore on geriatrikal clinics are 5-10%, witch means that between five and ten thousand patients gets daily treat for pressure sores. When the patient gets a pressure sore the need for help increases. A common apprehension is that if the patient’s affects with pressure sores it’s because of deficiency in care. According to the law, all nursing interventions should be performed according to scientific and evidence and the nurse’s assistants are responsible for how they perform. The aim of this study was to examine how much knowledge the nurses assistants in community care services has about preventing, predicting and locate riskfactors for pressure sores and if they get the right education. Methods: A questionnaire based on 20 questions was maid and used for this purpose. Out of 99 persons the questionnaires was answered bye 65 nurses assistants working in community care service in a small town in Sweden. Results: The results shown that the nurses assistants don’t use risk assessment scales in attempt to identify patients vulnerable to pressure sores and they are not well associated with the riskfactors. The study even shows that they have little knowledge in how to prevent pressure sores from appearing. The nursing model are some times out of date and the nurses assistants personal view attends to decide witch care they will perform instead of scientific and evidenced based nursing.

Syftet med denna studie var att reliabilitetstesta Alberta Context Tool (ACT) i svensk hälso- och sjukvård och beskriva ortopedsjuksköterskors skattning av kontextuella faktorer såsom ledarskap, arbetskultur, återkoppling, utvecklingsmöjligheter och forskningsanvändning, som kan påverka möjligheten att omsätta forskningsresultat i vårdarbetet. Urvalet bestod av 119 sjuksköterskor som arbetade på ortopediska vårdavdelningar på sex olika sjukhus i mellersta Sverige. ACT är ett frågeformulär framtaget utifrån de senaste årens forskning om vilka faktorer i kontexten som har betydelse för sjuksköterskors forskningsanvändning. Reliabilitetstest gjordes enligt analys med Chronbach`s Alpa och innehållsvaliditet. Resultatet visade att ACT var relevant att användas för sjuksköterskor som arbetar på ortopedisk vårdavdelning i Sverige. Reliabilitetstesten med Chronbach´s Alpa gav värden nära 0,7 för de åtta frågeområden som behandlar kontexten.Sjuksköterskorna rapporterade att det fanns brister i många av de delar av kontexten som enligt forskning visat sig ha betydelse för möjligheten att implementera evidensbaserad vård. Sjuksköterskorna trivdes med sitt arbete och kände att deras kunskaper värderades högt i vårdteamet. Resultatet visade dock att det inte fanns tillräckligt stöd från ledningen för att utveckla vården. De rapporterade att de nästan inte alls fick återkoppling i vårdarbetet. Det saknades stödfunktioner och strategier för att implementering av forskningsresultat skulle vara möjligt att implementera i vårdarbetet. Majoriteten av sjuksköterskorna såg positivt på forskningsanvändning.

Im Rahmen der vorliegenden Arbeit wurden von Juli bis Oktober 2008 alle auf allgemeinpädiatrischen Stationen der Krankenhäuser Wurzen, Borna und Torgau behandelten Kinder und Jugendliche im Alter von 3 bis 16 Jahren mittels Strengths and Difficulties Questionnaire (SDQ, Goodman 1997) untersucht. Anhand der Elternfrage-bögen (n=414) wurden insgesamt 11,8% (95%KI: 8,7-14,9) der beurteilten Patientinnen und Patienten als psychisch auffällig und weitere 10,4% (95%KI: 7,5-13,3) als grenz-wertig eingestuft. Somit lag der Gesamtanteil psychischer Auffälligkeiten in der pädiatrischen Inanspruchnahmepopulation signifikant über dem der Allgemein-bevölkerung (gemessen im Kinder- und Jugendgesundheitssurvey, Robert- Koch-Institut, KiGGS-Studie 2003-2006). Durch den zusätzlichen Einsatz eines fallbezogenen standardisierten Personalfragebogens konnte erfasst werden, dass das Pflegepersonal bei 31,6%, die behandelnden Ärztinnen und Ärzte bei 15,6% aller Patientinnen und Patienten psychische Symptome wahrnahmen. Der konkrete Bedarf an kinder- und jugendpsychiatrischen Konsilen lag bei 12,4%. Die Expertenangaben aus den ergänzend durchgeführten strukturierten Interviews verdeutlichten die Notwendigkeit einer Intensivierung der Kooperation zwischen Pädiatrie und Kinder- und Jugendpsychiatrie und belegten gemeinsam mit den Fragebogenergebnissen den Bedarf frühzeitiger kinder- und jugendpsychiatrischer Interventionen.

Abstract The purpose of this research is to investigate the different types of tutorial education and training implementation profiles and impact. And to understand tutorial teachers through the regularization of education and training, whether it can be operational concept to convey to the teachers and thereby affecting their professional growth and educational philosophy and attitude, and finally implement the business service concept. The main purposes of this research are as follows¡G 1. To understand and compare the overview of different types of tutorial education and training of the implementation. 2. The effectiveness of cram educational training, and to identify the factors of limiting different tutorial training. 3. Optimal principle and mode of tutorial education and training, to put forward a set of tutorial education and training principles and models for further reference. The information collection methods are expert interviews and questionnaires. The research interviews the manager of training for cram, and has the employees fill out a questionnaire survey. According to the interviews and survey,the main findings of this research are as follows: A¡BDifferent types of cram education and training of implementation has variations, but all of them would make plans on educational training based on different types of motivations and purpose ,training implementation patterns and training implementation plans ,such as part to plan education and train. B¡BThe staff and training manager both agree that education and training have effective outcome , it should be combined with the primary consideration: "payroll system" and "reward system". Different types of cram schools could vary the measures and methods of training programs based on their scale of organizations. Moreover, the cram school dean believes that training programs are merely utilized to help teachers upgrade their professional ability and they could not connected to any system inside the crams. C¡BThe tutorial class staff generally believes that for the most effective and favorite training way are ¡ugroup discussion¡v,and ¡uteaching demonstration and observation ¡v¡C D¡BThe rank by the staff toward training programs in terms of the satisfactions of needs assessment,implementation and effectiveness are between satisfied and very satisfied. E¡BAccording to the research on the tutorial staff, it can be found that the biggest difficulty in planning conducting training programs are ¡§raining incentives¡¨ ¡§and¡¨ teacher¡¦s lack of interest. Key words: cram school, questionnaire survey, educational, training program, payroll system, group discussion

In recent years, engineering education has witnessed a sharp increase in research aimed at the outcomes of academic success and persistence within engineering programs. However, research surrounding the key forces shaping student persistence remains unknown. This study explores enhancements and broader perspectives of learning; the relationship among dimensions of resilience theory and learning styles in engineering students to identify elements of both that contribute towards academic persistence and to determine which components of both contribute towards strengthening students’ academic persistence in engineering. The study was conducted using two quantitative self-reporting instruments to measure resilience and learning style preference, the Personal Resilience Questionnaire (PQR) and the Index of Learning Styles (ILS). Retention was measured as the continuous enrollment of a student into the second semester of the first-year engineering program. Results indicate that the following have a statistically significant effect on student persistence in engineering programs at Texas A&M University: learning style construct sequential; resilience constructs positive (self) and focus; with both tools combined, positive (self), organized, positive (world), flexibility (self) and focus; and a newly combined construct, Walton’s self-efficacy.

Always, researchers are trying to use different ways to describe the concept ¡§Motivation¡¨. Different definition of motivation will develop different theory. However, there are two points under below at least: First is the fitness of the culture, the concept of the Western would have the specific background, will not fit in the individual person with other culture. Second, to ease the verifying of the science, most of the researches only discuss the relationship of immediate variables but neglect the influence of individual personality in different points of time. This study will combine the concepts of motivation and creativity through integrating work motivation theories and following up Teresa M. Amabile¡¦s research to build up the ¡§Personal Creative Process Model¡¨. The research model includes: the environment of organization, the process of perception, motivation, behavior and outcome. Especially, process of perception includes personality, criterion and response. ¡§Criterion¡¨ refers to personal need and value which are influenced by social environment and culture in country. Addition, ¡§Response¡¨ refers to attitude and emotion which are influenced by time. In this study, I use the concepts, ¡§Criterion¡¨ and ¡§Response¡¨, to compensate the loss of old motivation theories. Supposing the variable, ¡§Criterion¡¨, is determined, this study¡¦s purpose will find out the relationship of other variables and how these variables influence creativity. Next, using questionnaire to capture responses of college student and work adult will help us to understand the relationship of these responses. The questionnaire, this study uses, includes: ¡§Cognitive Style Instrument¡¨, ¡§What Is Happening in This Class? Questionnaire¡¨, ¡§KEYS¡¨ and ¡§The Work Preference Inventory¡¨. In addition, this study uses the grade of students to represent personal creativity and analyze the relationship between creativity and other constructs. The conclusion shows cognitive style indeed affects creativity, but the relations are different from theory. Furthermore, cognitive style and response/motivation are almost independent. To infer, the response and motivation are intervening variables between personality and creativity. Finally, regression analysis by students, this study got the result: ¡§Close by the factor is the key element of the creativity performance¡¨.