Pastoral Modes in the Poetry and Prose Fiction of WG Sebald

In this thesis I extend the discussion of the works of W.G. Sebald beyond the more commonly discussed themes of melancholy, trauma, loss and memory. To this end I examine his long prose poem After Nature and his four books of prose fiction Vertigo, The Emigrants, The Rings of Saturn and Austerlitz to expose underlying pastoral modes and structural forms in these texts. In After Nature I make the case for this poem to be read as an anti-pastoral text which runs true to the elegiac form but exhibits a subtext of pastoral and anti-pastoral tension. The first published work of prose fiction, Vertigo, I argue demonstrates the pastoral structural device, integral to pastoral form, of the double-plot and in so doing, extend William Empson’s original thesis. In The Emigrants, I examine the parallels between Heimat and Pastoral by exposing the characters’ difficult relationships with displacement both physically and psychologically and argue for an anti-Heimat mode expressed largely in anti-pastoral imagery. The Rings of Saturn demonstrates the impossibility of utopia by constantly deferring a potential pastoral both spatially and temporally during the narrator’s “pilgrimage” across the Suffolk countryside. And finally in Austerlitz, we have a coalescence of pastoral modes structured as a discourse of retreat and return which, I argue, qualifies this work as a truly pastoral novel. In the final chapter I discuss the four short pieces of prose fiction in Campo Santo, which, although too brief to exhibit a pastoral form, demonstrate pastoral tropes commensurate with those discussed in the previous works

Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS)

Background and purpose A questionnaire was introduced by the New Zealand Arthroplasty Registry for use when evaluating the outcome of total ankle replacement surgery. We evaluated the reliability, validity, and responsiveness of the modified Swedish version of the questionnaire (SEFAS) in patients with osteoarthritis or inflammatory arthritis before and/or after their ankle was replaced or fused. Patients and methods The questionnaire was translated into Swedish and cross-culturally adapted according to a standardized procedure. It was sent to 135 patients with ankle arthritis who were scheduled for or had undergone surgery, together with the foot and ankle outcome score (FAOS), the short form 36 (SF-36) score, and the EuroQol (EQ-5D) score. Construct validity was evaluated with Spearman's correlation coefficient when comparing SEFAS with FAOS, SF-36, and EQ-5D, content validity by calculating floor and ceiling effects, test-retest reliability with intraclass correlation coefficient (ICC), internal consistency with Cronbach's alpha (n = 62), agreement by Bland-Altman plot, and responsiveness by effect size and standardized response mean (n = 37). Results For construct validity, we correlated SEFAS with the other scores and 70% or more of our predefined hypotheses concerning correlations could be confirmed. There were no floor or ceiling effects. ICC was 0.92 (CI 95%: 0.88-0.95), Cronbach's alpha 0.96, effect size was 1.44, and the standardized response mean was 1.00. Interpretation SEFAS is a self-reported foot and ankle score with good validity, reliability and responsiveness, indicating that the score can be used to evaluate patients with osteoarthritis or inflammatory arthritis of the ankle and outcome of surgery

The prevalence of foot problems in older women: a cause for concern.

BACKGROUND: Painful feet are an extremely common problem amongst older women. Such problems increase the risk of falls and hamper mobility. The aetiology of painful and deformed feet is poorly understood. METHODS: Data were obtained during a pilot case-control study about past high heel usage in women, in relation to osteoarthritis of the knee. A total of 127 women aged 50-70 were interviewed (31 cases, 96 controls); case-control sets were matched for age. The following information was obtained about footwear: (1) age when first wore shoes with heels 1, 2 and 3 inches high; (2) height of heels worn for work; (3) maximum height of heels worn regularly for work, going out socially and for dancing, in 10-year age bands. Information about work-related activities and lifetime occupational history was gathered using a Life-Grid. The interview included a foot inspection. RESULTS: Foot problems, particularly foot arthritis, affected considerably more cases than controls (45 per cent versus 16 per cent, p = 0.001) and was considered a confounder. Cases were therefore excluded from subsequent analyses. Amongst controls, the prevalence of any foot problems was very high (83 per cent). All women had regularly worn one inch heels and few (8 per cent) had never worn 2 inch heels. Foot problems were significantly associated with a history of wearing relatively lower heels. Few work activities were related to foot problems; regular lifting was associated with foot pain (p = 0.03). CONCLUSION: Most women in this age-group have been exposed to high-heeled shoes over many years, making aetiological research difficult in this area. Foot pain and deformities are widespread. The relationship between footwear, occupational activities and foot problems is a complex one that deserves considerably more research

A patient-based questionnaire to assess outcomes of foot surgery: Validation in the context of surgery for hallux valgus

BACKGROUND: A patient-based outcome measure with good measurement properties is urgently needed for use in clinical trials of foot surgery. METHODS: We evaluated an existing foot pain and disability questionnaire (the Manchester Foot Pain and Disability Questionnaire) for its suitability as an outcome measure in the context of hallux valgus corrective surgery. Interviews with patients led to initial changes, resulting in 20 candidate questionnaire items with five response categories each. These were tested in a prospective study of 100 patients (representing 138 foot operations) undergoing hallux valgus corrective surgery. Analysis of underlying factor structure, dimensionality, internal reliability, construct validity and responsiveness of the questionnaire items in relation to (i) SF-36 general health survey and (ii) American Orthopaedic Foot and Ankle Society (AOFAS) hallux clinical scale resulted in a final 16 item questionnaire (the 'Manchester-Oxford Foot Questionnaire' (MOXFQ)), consisting of three domains/scales: 'Walking/standing' (seven items), 'Pain' (five items) and 'Social interaction' (four items) each having good measurement properties. All three domains were unidimensional. CONCLUSIONS: The new 16-item MOXFQ has good measurement properties in the context of outcomes assessment of surgery for hallux valgus. Future studies should assess the MOXFQ in the context of surgery for other foot and ankle conditions