Introduction: Ankle injuries are among the most prevalent acute musculoskeletal injuries, and are a significant burden on any health system. The interaction of the physiotherapist with the patient and their mutual understanding of impairments, function and recovery are important to achieving a satisfactory return to work and leisure activities. To date, little attention has focused on this interaction. There is a need for further exploration of differences and associations between outcome questionnaires that investigate similar domains of pain and function, and whether scores from such outcome measures are related to the patient’s perception of function and recovery. Of further interest is whether there are relationships between impairment measures and perceived function, and how actual performance of tasks might influence the patients understanding of their capabilities. To provide a more complete picture of these relationships, a ‘mixed methods’ approach using qualitative research methods within a quantitative study was thought to be most appropriate. The overall aim of this thesis was to utilise this research approach to investigate patients’ perceptions of their recovery and elucidate factors important to both therapists and patients that ultimately might enhance their understanding of recovery from an ankle injury. Literature reviews: Three literature reviews were undertaken. Firstly a review of systematic reviews investigating ankle sprains identified a wide variety of management strategies. There was a lack of strong evidence to support any particular management strategy. Hence clinicians are likely to have difficulty setting appropriate rehabilitation plans. Secondly a critical review identified a number of different outcome questionnaires that were utilised to gauge recovery level; however, justification for their selection was often lacking. This review also identified that little emphasis was placed on understanding the patients’ perception of their injury and the rehabilitation process. A final critical review investigated impairment and performance measures and identified four specific areas that were focused upon by clinicians during the treatment of ankle sprains: joint position sense, postural control, strength and performance during function. However, only weak evidence was found for there being a deficit in joint position sense, postural control and strength in the injured limb following an ankle sprain, and inconclusive evidence of deficits in physical performance of tasks related to function. Methods: Forty participants with an acute sprained ankle were recruited along with their treating physiotherapist. The participants completed a Global questionnaire, the Lower Limb Task Questionnaire (LLTQ) and the Short Form -36 (SF-36) Questionnaire at the initial visit, at discharge and at a six week follow up visit where they also undertook impairment testing involving, joint position sense, postural control and strength along with a functional performance test and selected functional activities. Ten participants were purposefully selected to undertake semi-structured interviews. The treating physiotherapists completed global questionnaires at the initial visit and at time of discharge. An interpretive hermeneutic approach was undertaken to examine the participants’ perceptions. Results: There were equal numbers of males and female participants and the average age of participants was 30.5 years. The relationship between questionnaires for the domains of pain and function varied between low and high degrees of association. The global limitations scores between the participants and physiotherapists were similar at the initial visit, whereas on discharge the participants had a significantly lower score (p<0.05) compared to the physiotherapists. With respect to impairment testing, there was a significant difference (p<0.05) between the uninjured limb compared to the injured limb for the joint position sense and performance agility hop test. All other comparisons of impairments were not significant (p>0.05). There was no association between questionnaire scores and impairment measures (p>0.05). Additionally there were no significant associations between previous injury and questionnaire scores and impairment measures. Finally in relation to the performance of specific functional tests there was a significant difference (p<0.05) between the six week follow up LLTQ score and the score following actual performance of the test. The findings of the participants’ interviews identified three key concerns. Firstly, that participants have a limited understanding of questionnaires, and secondly, that there is a difference in understanding of ‘recovery’ between the therapist and the patient at time of discharge. Thirdly, there was dissociation between outcome measures and the patient’s perception of their own recovery. Conclusions: This study revealed a lack of understanding and effective communication concerning physiotherapy practice in relation to ankle sprains. It was apparent that questionnaires purporting to measure similar constructs are at times dissimilar in scores and are not related strongly. Care needs to be taken in selecting and interpreting outcome measures particularly in relation to questionnaires. It was also apparent that caution should be exercised when considering the influence of impairment measures upon function. Physiotherapists should be aware that patients may perceive a lack of confidence in their level of function at the time of discharge. As a result physiotherapists need to incorporate strategies to improve patient confidence in their management plan.

Cette recherche vise à construire un cadre théorique correspondant aux différentes formes de tests et de questionnaires dont on a acquis l'expérience (en psychologie appliquée, puis par la pratique des enquêtes sociologiques). Dans une première partie, on présente la polymorphie syntaxique de l'interrogation en français (en l'illustrant d'exemples tirés de tests ou de questionnaires), pour chercher ensuite à réduire les multiples formes de questions à une forme canonique, dont toutes les autres formes sont dérivables par transformations paraphrastiques (on s'inspire principalement des travaux de Chomsky, Tesnière, et Harris). Dans la seconde partie, on décrit les relations sémantiques qui lient questions, réponses, et présuppositions ; on expose ensuite les principaux systèmes de logique érotétique (Belnap, Åqvist, Kubinski), pour aboutir à la description de la syntaxe et de la sémantique formelles des questions et des réponses. La troisième partie porte sur la structure du questionnaire et sa réduction à une forme canonique utilisable pour l'analyse des données recueillies. La conclusion indique les applications possibles, et signale les recherches nécessaires pour qu'il soit possible d'élaborer une théorie générale du questionnaire.

<p>Learning styles have been the subject of educational discussion since 1967. The Dunn and Dunn model has been world leading ever since. The Dunn and Dunn theory states that each individual learns differently and that school can help the students’ results by adapting the teaching to each student’s learning style and perceptual preference. This study focuses on learning styles and especially its connection to reading. When, where and why a student chooses to read is of importance and can affect the reading outcome. To get insight into how students read, this study looks at what type of setting students choose to read in when they do not read in school. It also examines students’ attitudes. The study also discusses how learning style-based learning can help teachers in their work.</p>

<p>Open access to scientific literature on Internet is a concept which is supposed to change librarians' work. The aim of the thesis was to examine librarians' perception of Open access. A questionnaire survey was conducted among librarians at libraries with specialisation in technique, natural sciences, medicine and pharmacy in Sweden. Even though Open access can be regarded as an alarming for librarians' work, the results of the survey showed that the future of the librarians' profession can be positive if they flexibly adopt their work routines according to changes in publication forms and library users' needs.</p>

<p>The general aim of the present thesis is to investigate needs of support and service in clients with long-term mental disabilities living in the community. A further aim is to study changes in these client needs during a 3.5-year follow-up. </p><p>A questionnaire, The Need of Support and Service Questionnaire (NSSQ), was developed to provide staffs in psychiatric care and social services with a brief instrument to assess how their clients live in the community and to identify their needs. </p><p>The results are based on 1,759 clients. The prevalence of clients in urban and rural areas was 6.4/1,000 and 4.5/1,000 inhabitants, respectively. The clients living in the urban setting were more frequently male, older, with a diagnosis of schizophrenia and needed more support in activities of daily living than rural clients. </p><p>Clients identified by staff in psychiatric care only were more often living with a partner, with children living at home and more often had a rehabilitation allowance than clients identified by social services staff. In clients assessed by both organizations similar needs at a group level were identified. However, agreements were lower at the individual level. </p><p>Although clients reported fewer needs than staff in psychiatric care, the reported needs were in the same areas.</p><p>A majority of the clients with unmet needs of service at baseline had their needs met at the 3.5-year follow-up. New unmet needs were also identified at the follow-up, however. The results demonstrate less improvement in clients with schizophrenia as compared with non-schizophrenic clients.</p><p>In conclusion, needs of support and service present a dynamic process and both psychiatric care and social services should critically evaluate assessments of these needs.</p>

<p>This thesis deals with idioms taken from contemporary newspapers. The purpose is to find out which idioms are known and used by native speakers of different ages and also to what extent the entries in the dictionaries offer accurate descriptions to the meaning of these idioms. We already know that idioms which have been modified, as often is the case in newspapers, are often more difficult to understand than others.</p><p>The study has been conducted by means of questionnaires answered by native speakers in Germany. In order to assess the ability that German native speakers have to understand and use these idioms, I have chosen informants from three age groups; the first two groups of informants are grammar school students at a German Gymnasium, in the 7 and the 10 form respectively and the last group consists of adult speakers in Germany with university education. This last group conforms to the final phase of language acquisition.</p><p>The results clearly show that younger generations - and to a certain extent older students and indeed educated adults - are less likely to understand idioms which have complex explanations in the dictionaries and/or whose meanings have been modified. Similarly, all age groups are more likely to understand idioms with simple explanations, those which appear frequently on the Internet and those whose meanings have not been modified, though there is a higher degree of “tolerance” when it comes to complex idioms among the adults.</p><p>It is also clear that the meaning of an idiom cannot always be fully explained out of context. In most cases dictionaries offer an explanation that functions in most contexts, yet it is not uncommon for the meaning of an idiom to be complex and to vary more or less depending on the context. As a way to find out how frequent the idioms are, I have compared their frequency in www.Google.de and found that there is a clear correlation between high frequency in Google and the knowledge displayed by the informants.</p>

The general aim of the present thesis is to investigate needs of support and service in clients with long-term mental disabilities living in the community. A further aim is to study changes in these client needs during a 3.5-year follow-up. A questionnaire, The Need of Support and Service Questionnaire (NSSQ), was developed to provide staffs in psychiatric care and social services with a brief instrument to assess how their clients live in the community and to identify their needs. The results are based on 1,759 clients. The prevalence of clients in urban and rural areas was 6.4/1,000 and 4.5/1,000 inhabitants, respectively. The clients living in the urban setting were more frequently male, older, with a diagnosis of schizophrenia and needed more support in activities of daily living than rural clients. Clients identified by staff in psychiatric care only were more often living with a partner, with children living at home and more often had a rehabilitation allowance than clients identified by social services staff. In clients assessed by both organizations similar needs at a group level were identified. However, agreements were lower at the individual level. Although clients reported fewer needs than staff in psychiatric care, the reported needs were in the same areas. A majority of the clients with unmet needs of service at baseline had their needs met at the 3.5-year follow-up. New unmet needs were also identified at the follow-up, however. The results demonstrate less improvement in clients with schizophrenia as compared with non-schizophrenic clients. In conclusion, needs of support and service present a dynamic process and both psychiatric care and social services should critically evaluate assessments of these needs.

This thesis deals with idioms taken from contemporary newspapers. The purpose is to find out which idioms are known and used by native speakers of different ages and also to what extent the entries in the dictionaries offer accurate descriptions to the meaning of these idioms. We already know that idioms which have been modified, as often is the case in newspapers, are often more difficult to understand than others. The study has been conducted by means of questionnaires answered by native speakers in Germany. In order to assess the ability that German native speakers have to understand and use these idioms, I have chosen informants from three age groups; the first two groups of informants are grammar school students at a German Gymnasium, in the 7 and the 10 form respectively and the last group consists of adult speakers in Germany with university education. This last group conforms to the final phase of language acquisition. The results clearly show that younger generations - and to a certain extent older students and indeed educated adults - are less likely to understand idioms which have complex explanations in the dictionaries and/or whose meanings have been modified. Similarly, all age groups are more likely to understand idioms with simple explanations, those which appear frequently on the Internet and those whose meanings have not been modified, though there is a higher degree of “tolerance” when it comes to complex idioms among the adults. It is also clear that the meaning of an idiom cannot always be fully explained out of context. In most cases dictionaries offer an explanation that functions in most contexts, yet it is not uncommon for the meaning of an idiom to be complex and to vary more or less depending on the context. As a way to find out how frequent the idioms are, I have compared their frequency in www.Google.de and found that there is a clear correlation between high frequency in Google and the knowledge displayed by the informants.

Learning styles have been the subject of educational discussion since 1967. The Dunn and Dunn model has been world leading ever since. The Dunn and Dunn theory states that each individual learns differently and that school can help the students’ results by adapting the teaching to each student’s learning style and perceptual preference. This study focuses on learning styles and especially its connection to reading. When, where and why a student chooses to read is of importance and can affect the reading outcome. To get insight into how students read, this study looks at what type of setting students choose to read in when they do not read in school. It also examines students’ attitudes. The study also discusses how learning style-based learning can help teachers in their work.

Localized prostate cancer (LPC) is predominantly a tumor among older men, and few patients will get symptoms from the disease. All methods to treat LPC with a curative intent have different types and degrees of side effects. It is therefore very important to evaluate the side effects thoroughly to make sure that treatment complications will not decrease the quality of life more than the disease would have done. In search for new and better treatments, complications has to be registered and evaluated in relation to quality of life (QOL) for the patients. Few validated self-assessment questionnaires for evaluation of external radiotherapy (EBRT) induced side effects has yet been developed. The present project focus on the development of the PC-specific questionnaire, QUFW94, and evaluation of symptoms in patients treated with EBRT and un-treated (watchful waiting) patients with a LPC. In the newly developed LPC-specific questionnaire a reliability and responsiveness test was performed. Both the inter-rater test and the test-retest show high correlation coefficients (ICC), above 0.60 for all scales. The internal reliability exceeded the lower acceptable limit (Cronbach a &gt;0.70). The questionnaire was proven to be valid for the evaluations of EBRT side effects in LPC patients. Late side effects were evaluated 4 years after treatment in 181 LPC patients, treated with conventional large field EBRT, and compared with 141 age-matched PC disease free men. The most prominent urinary side effects were urgency and leakage which were doubled in the patient group. A ten fold increase was seen in comparison to controls at the most prominent intestinal problems, blood, mucus and leakage. The results support the use 3-D conformai therapy to decrease irradiation dose to the rectum and the bladder and thereby decreased side effects. A prospective additional evaluation 8 years after EBRT did not show any changes in urinary problems between 4 and 8-yr follow-up in the patients or the controls. EBRT of LPC is also accompanied by disturbances in sexual function. These problems were therefore evaluated, 4 years after EBRT, in relation to the function in PC free men. Patients treated with EBRT indicated higher levels of sexual dysfunction than age-matched controls. No erection was reported from 12% of the control subjects, 56% of the patients who had only received radiotherapy (RT) and 87% of the RT+castration (RT+A) patients. The extended evaluation 8 years after EBRT show similar sexual function in all groups. QOL and late side effects/symptoms were evaluated in the first and only randomized trial between RT and deferred treatment (DT) and compared to age-matched controls. QOL was evaluated with the general QOL formula, EORTC's QLQ-C30 (+3), and LPC specific side effects with QUFW94 in 108 randomized patients with LPC 3 years after diagnosis. Social functioning was the only QOL scale where a significant difference was found between the two patient groups and in comparison with the control group. Multivariate regression analysis showed that hematuria, incontinence, mucus, and planning of the daily activities due to intestinal problems caused this decrease in QOL in the RT group. In conclusion, the LPC specific QUFW94 questionnaire was proven to be valid for evaluation of side effects and showed increased intestinal problems in the patients treated with conventional large field EBRT in comparison to untreated LPC patients. No difference in urinary and intestinal late side effects or sexual function was seen between a 4 year vs. 8 year follow-up. / digitalisering@umu