Studies on lexical inferencing and inter comprehension of Italian as a foreign language in a Swedish setting

This dissertation is a collection of three studies in which the main focus is on the role of Swedish L1 speakers’ background languages for the comprehension of written Italian at a lexical level. Italian is one of the foreign languages that Swedish pupils in upper secondary school can choose to study. Previous research on third language acquisition and the role of the background languages in the Swedish context has mainly concerned oral production. With the studies in this thesis we intend to contribute to research on third language acquisition regarding comprehension of Italian both as an L3 and an unknown language. The first study, written in Italian, is a licenciate thesis. It examines the lexical inferencing procedures of 12 upper secondary school pupils studying Italian as a beginner’s language when they are trying to translate as much as possible of an Italian text into Swedish by means of think-aloud protocols. The second study is an intercomprehension study, which means that the three participants did not have any knowledge of Italian. The role of the participants’ background languages when translating Italian text into Swedish was examined, with focus on which language(s) were mainly activated and used and the use of which language(s) led to the highest success rate. As in the first study, the method used was think-aloud protocols. The third study had 60 participants divided into three groups. Neither of the participants had any knowledge of Italian. One group translated, in writing, a short Italian text into L2 English, the second group into L3 Spanish and the third into L3 French. The results of the three studies indicate that all the languages that the participants know are to some extent activated and used for the comprehension of Italian. Furthermore, it appears that the language into which the participants were asked to translate had an impact on the activation of the background languages. If they were asked to translate into another foreign language instead of Swedish, Swedish was not activated and used to the same extent

Characteristics of Everyday Leisure Trips by Car in Sweden – Implications for Sustainability Measures

In search for measures to reduce greenhouse gas emissions from transport, insights into the characteristics of all sorts of trips and specifically trips by car are needed. This paper focuses on everyday leisure trips for social and recreational purposes. Travel behaviour for these purposes is analysed considering individual and household factors as well as properties of the trip, based on Swedish national travel survey data. The analysis reveals that everyday leisure trips are often of joint character and that the average distance travelled per person and day increases with, for example, income, cohabitation, children in the household and residence in rural areas. The result also shows that the studied characteristics vary between studied trip purposes, influencing the sustainability potential of a reduction in car use and suggested measures. For instance, the largest share of passenger mileage comes from social trips, whereas trips for exercise and outdoor life have the largest share of car trips below 5 km. Several characteristics indicate difficulties in transferring trips by car to, for example, bicycle or public transport due to convenience, economy, start times, company etc. The study indicates that there is a need to take a broader view of the effective potential

Low Progesterone and Low Estradiol Levels Associate with Abdominal Aortic Aneurysms in Men

Context Male sex is a major risk factor for abdominal aortic aneurysms (AAA) but few studies have addressed associations between sex hormone levels and AAA.ObjectiveTo describe the associations between serum sex steroids and early, screening-detected AAA in men.MethodsWe validated a high-sensitivity liquid chromatography-tandem mass spectrometry assay for comprehensive serum sex hormone profiling. This assay was then employed in a case-control study including 147 men with AAA (infrarenal aorta ≥30 mm) and 251 AAA-free controls recruited at the general population-based ultrasound screening for AAA in 65-year-old Swedish men.Outcomes includedAssociations between dehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and AAA presence.ResultsDehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, testosterone, and estradiol, but not the other hormones, were lower in men with AAA. In models with adjustments for known AAA risk factors and comorbidity, only progesterone (odds ratio per SD decrease 1.62 [95% CI 1.18-2.22]) and estradiol (1.40 [95% CI 1.04-1.87]) remained inversely associated with the presence of AAA. Progesterone and estradiol contributed with independent additive information for prediction of AAA presence; compared with men with high (above median) levels, men with low (below median) levels of both hormones had a 4-fold increased odds ratio for AAA (4.06 [95% CI 2.25-7.31]).​​​​​​​ConclusionMeasured by a high-performance sex steroid assay, progesterone and estradiol are inversely associated with AAA in men, independently of known risk factors. Future studies should explore whether progesterone and estradiol, which are important reproductive hormones in women, are protective in human AAA.</p

Interventions for hyperhidrosis in secondary care : a systematic review and value-of-information analysis

Background: Hyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable. Objective: To establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care. Methods: A systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only. Results and conclusions: Fifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life. Limitations: The evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla. Future work: Based on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses

Abdominal Aortic Aneurysm, aspects on diagnosis and treatment

Background An abdominal aortic aneurysm (AAA) is an abnormal widening of the aorta with a risk of rupture if it grows to a large diameter. Rupture is associated with massive bleeding and a poor prognosis for survival. Aims The aim of this thesis was to evaluate the results of surgical intervention in patients with AAAs detected by population-based screening, including comparisons with the results in patients with aneurysms that were not detected by screening. A further aim was to investigate how common misdiagnosis is in the emergency department in patients seeking care for a ruptured AAA (rAAA), and how misdiagnosis affects the prognosis. A third aim was to investigate whether it is beneficial to treat patients with a primary open abdomen with delayed closure after open repair for rAAA. Methods Patients with AAA were identified in the Swedish Vascular Registry (Studies 1‒4) and the Swedish Cause of Death Registry (Study 4). Additional information was obtained through review of medical charts (Studies 2‒4). In Study 1, mortality, complications, and method of surgical intervention were compared in patients with AAAs detected by screening and in age-matched controls with AAAs that were not detected by screening. In Study 2 and Study 4, the outcome in patients with a ruptured abdominal aortic aneurysm (rAAA) who were misdiagnosed at the first assessment in the emergency department was compared to the outcome in patients who were correctly diagnosed initially. Study 2 included patients who reached surgery and Study 4 included all patients with rAAA, whether or not they reached surgery. In Study 3, mortality and complications in patients treated with a primary open abdomen after open repair for rAAA were compared to a propensity score-matched control group in which the majority of patients had the abdomen closed at the end of the procedure. Results Study 1: A higher proportion of the screening-detected patients were treated with open repair (56% vs. 45% in those with AAAs not detected by screening). The mortality 30 days, 90 days, and 1 year after open repair was similar in patients with screening detected and non screeningdetected aneurysms. Mortality at 30 days and 1 year after Endovascular Aortic Repair (EVAR) was similar in both groups. Mortality at 90 days after EVAR was lower in the screening-detected compared to the non screening-detected patients (0% vs. 3.1%; p = 0.04). The overall 30-day mortality (including patients treated with either open repair or EVAR) was 0.6% in screening-detected patients and 1.4% in non screeningdetected patients. (p = 0.45). The adjusted odds ratio for the primary endpoint (mortality or major complication at 30 days) was 1.64 (95% CI 0.82‒3.25) in non screening-detected patients. Studies 2 and 4: Misdiagnosis was common and occurred in more than one-third of the patients with rAAA. Overall, the mortality was 74.6% in misdiagnosed patients and 62.9% in correctly diagnosed patients (p = 0.01). The adjusted odds ratio for mortality in the whole cohort of misdiagnosed patients was 1.83 (1.13‒2.96). In patients who reached surgery, there was no significant difference in mortality between misdiagnosed patients and correctly diagnosed patients. Study 3: There were no significant differences in mortality or major complications between patients treated with a primary open abdomen with delayed closure and patients treated with primary closure of the abdomen. Conclusion The contemporary mortality after AAA surgery in Sweden was low irrespective of whether or not screening was used for detection. Patients with AAAs detected by screening had the same comorbidities and outcome as those with non screening-detected aneurysms, except for 90- day mortality after EVAR, which was lower in the screening group. Misdiagnosis is common in patients who seek care for a rAAA, and misdiagnosis is associated with a substantially higher risk of dying from the ruptured aneurysm. No survival advantage and no lower frequency of complications was observed in patients treated with a primary open abdomen and delayed closure after open repair for rAAA as compared to a propensity score-matched control group where the majority of patients were treated with primary closure of the abdomen

Lexical inferencing procedures in L3 Italian

This study is aimed at investigating and describing the different procedures of foreign language learners of Italian when they infer the meaning of unknown words in a written authentic text. Vocabulary is a crucial component in the learning process of a foreign language and many studies show that lexical inferencing is one of the most important strategies when foreign language learners encounter unknown words in a context. Think-aloud protocols in combination with stimulated recalls were used to examine the lexical inferencing procedures of upper secondary school students of Italian as L3. The combination of the two methods is widely used in this line of research (Fraser, 1999; Bengeleil & Paribakht 2004). The informants, of varying proficiency levels of the target language, were interviewed about their language background and use. Their use of interlingual inferencing (the use of the learner's L1 or other previously studied languages), intralingual inferencing (the use of the target language itself such as word classes or morphology) and contextual inferencing (the use of the immediate context or world knowledge) was examined (Haastrup 1999; Wesche & Paribakht 2010). The informants' use of additional strategies, as well as individual differences, was also explored. Interlingual inferencing proved to be the most employed strategy among all the informants, independently of proficiency level of the target language. The use of Italian outside of the school context proved to be a decisive factor for the number of intralingual and contextual strategies utilized. The general finding of this study suggests that even at low proficiency levels students manage to make use of varying inferencing strategies, but the most employed strategy is interlingual inferencing across all proficiency levels

Avgasemissioner och bränsleförbrukning i gatunät med olika egenskaper

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An intercomprehension study of multilingual Swedish L1 speakers reading and decoding words in text in Italian, an unknown language

The purpose of the present study was to investigate the intercomprehension processes of multilingual Swedish L1 speakers while reading and decoding text in Italian, an unknown language. The three Swedish L1 participants in the present case study had English as L2 and respectively French, Spanish and German as L3. The participants read two texts in Italian, a language unknown to them, and using think-aloud protocols in combination with stimulated recalls, they verbalized their thoughts while decoding the texts. The results of both qualitative and quantitative analysis indicate that all the previously acquired languages involved in the study (Swedish, English, German, French and Spanish) were activated and used to infer the meaning of the words in the texts. The findings also suggest that, regarding the success rate of the inferences, French, Spanish, English and Swedish were nearly equally helpful for comprehension. Thus, the results seem to indicate that comprehension of written Italian, a Romance language, can be aided not only by other Romance languages, but also Germanic languages. Further, the results support the view of non-selective access to the mental lexicon of multilinguals

Il processo delle inferenze lessicali in italiano L3 : il ruolo delle lingue apprese in precedenza e altre strategie di comprensione

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