The Master's Thesis deals with the usage of various software tools in emergency management and in environmental protection. Nowadays, on every step we make, we can face emergency situations which can cause great harm to the environment as well as to human life and property. The theoretical part provides an overview of software tools. Different software tools, their basic parameters, development and usage are described. There are also explained terms like geographic information system, etc. The practical part is focused on the instruments used in selected countries, including Czech Republic, Slovak Republic, Hungary, USA, Canada and the United Kingdom. In the conclusion is the comparison of the effectiveness of software tools in emergency management and in environmental protection.

Aujourd’hui, les zones côtières concentrent souvent des villes densément peuplées où le développement économique est associé à une rapide urbanisation. Dans de nombreux endroits, les cours d’eau sont intégrés en zone urbaine présentant à la fois des ressources et des risques potentiels. La concurrence croissante entre les activités économiques et l'espace essentiel aux rivières et aux milieux naturels nécessite une gestion intégrée basée sur des outils fiables capables de fournir des informations hydrologiques. La basse vallée du Var, dans le sud de la France, est spécifiquement exposée à une augmentation de l’activité humaine, et les impacts sociaux sur l’environnement deviennent de plus en plus intenses. Par conséquent, le cycle de l’eau est déséquilibré et induit des problèmes liés à l’eau. Pour traiter ces problèmes, les collectivités territoriales ont besoin d’outils d’aide à la décision qui simulent le comportement du bassin versant. Tel est l’objectif du projet AquaVar qui repose sur trois modèles numériques : Mike SHE pour le bassin versant du Var, Mike 21FM pour la rivière, et Feflow pour l’aquifère. Ces travaux de recherches se concentrent sur le modèle des écoulements à surface libre et son intégration au sein de l’outil d’aide à la décision.Les modèles hydrauliques 2D sont fréquemment utilisés car ils fournissent une vision précise des phénomènes physiques en rivière et de l’hydrodynamique durant des événements extrêmes (inondation, sécheresse et pollution accidentelle). Le modèle des écoulements à surface libre 2D est conçu avec le logiciel Mike 21FM en utilisant la méthodologie classique. Il est calibré et validé pour des conditions spécifiques de la basse vallée du Var : hautes eaux au mois de novembre, hautes eaux au printemps dues à la fonte des neiges et basses eaux en été. Le modèle hydraulique peut non seulement être utilisé pour simuler des scénarios d’événements extrêmes, mais il est également capable d’interagir avec le modèle des écoulements souterrains développé avec Feflow. Une interface spécifique est développée pour connecter le Var et son aquifère dans la basse vallée. Elle nécessite cependant une phase de validation afin de précisément simuler les échanges nappe-rivière.De toute évidence, le modèle Mike 21FM est le cœur de l’outil d’aide à la décision. L'hydrodynamique du fleuve dépend de la transformation des précipitations en débit (modélisée par Mike SHE) et du volume d'eau échangé avec l'aquifère (modélisé par Feflow). La dernière partie est consacrée à la construction de l'outil d’aide à la décision avec l'intégration du modèle hydraulique 2D. Ce système de modèles est implémenté dans une interface web et accessible par différents utilisateurs. Cet outil peut être facilement mis à jour en partageant les données de chaque partenaire. Dans le futur, cet outil pourrait intégrer le petit cycle de l'eau (réseaux d’assainissement et d’alimentation en eau potable). Les autorités locales pourraient donc prévoir et contrôler leurs ressources en eau et les risques potentiels. / Nowadays, the coastal areas concentrate frequently densely populated cities where economic development is associated to a fast urbanization. In many locations rivers are integrated within the urban areas and present both resources and potential risks. The growing competition between the economic activities and the essential space for the rivers requests an efficient management based on reliable tools able to provide hydrological information. Typically, the Lower Var valley, in south of France, faces to an increase of human activities, and the social impacts on the natural environment have become more and more intensive. Therefore, the water cycle is unbalanced implying water problems. To deal with this issue, local authorities needs a Decision Support System (DSS) tool to simulate the behaviour of water system. This is the objective of the AquaVar research which includes three numerical models: Mike SHE for the Var catchment, Mike 21FM for the Lower Var River, and Feflow for the aquifer. Here, the research is focused on the 2D free surface flow model and its integration in the DSS tool.The 2D hydraulic models represent a meaningful approach that can provide an accurate view on the physical processes within the river and on the hydrodynamics during the extreme events (inundation, drought and accidental pollution). The 2D free surface flow model is designed with Mike 21FM software using common methodology. It is calibrated and validated for the three specific weather conditions in the Lower Var valley: floods which occur in November, spring floods due to snow melting and droughts in summer. Not only the 2D hydraulic model allows to simulate scenarios of inundation and accidental pollutions, but it is also able to exchange water volume with the groundwater model developed with Feflow. A specific interface is developed to connect river and aquifer in the Lower Var valley. It required validation cases to accurately simulate the river-aquifer exchanges.Obviously, Mike 21FM is finally the core of the DSS tool because it is the centre of the modelling system. The hydrodynamics of the river depends on precipitations converted in flow by Mike SHE model, and exchanges water volume with the aquifer modelled by Feflow. The last part of this research is dedicated to the construction of the DSS tool and the integration of the 2D hydraulic model. The modelling system is implemented in a web interface adapted for different types of users. This DSS tool can be easily updated by sharing data from all the stakeholders. In the future, this tool could integrate sewage network and drinking water supply system to consider all the water cycle. Hence, local authorities could forecast and control the water resources and the potential risks.

Intresset av att uppföra byggnader i trä har ökat i kombination med att kunskapen inom ämnet har vuxit. KL-T är träskivor som kan formas efter behov, balkar, pelare, bjälklag samt väggar kan samtliga utföras som KL-T element. Ration mellan hållfasthet och vikt är en aspekt som har bidragit till att entreprenörer och konstruktörer ser fördelar med att bygga i just trä. KL-T är en produkt som begränsar träets svagheter i olika fiberriktningar eftersom lamellerna limmas korsvis. Den snabbt ökande användningen av KL-T har lämnat kunskapsluckor inom vissa områden och en av dessa kunskapsluckor är hur robustheten i en byggnad kan ökas för att hantera olyckslaster. Fortskridande ras uppstår när ett lokalt brott skapar ras i omkringliggande bärverk för att sedan fortplanta sig från element till element, vilket leder till kollaps av hela eller en del av byggnaden. För att motverka detta ska en viss nivå av robusthet i byggnaden uppnås. Det finns olika metoder att skapa robusthet i en byggnad, ett av dessa sätt är att sammanbinda bärverk med bjälklag och väggar med dragband enligt bilaga A i SS-EN-1991-1-7. Metoden benämns Indirekt Metod och är frekvent använd i branschen för alla typer av konstruktioner, men för betongkonstruktioner är den betydligt mer välutvecklad med generella metoder för sammanfogning. Hur vertikala och horisontella dragband bör utformas i en KL-T konstruktion är ett område som är i behov av tydliga metoder som uppfyller kapacitetskraven som regelverken ställer. Syftet med studien är att skapa förståelse för det nu gällande regelverket samt ge konkreta exempel på hur dragband kan utföras för att möta de nya kraven som EKS 11 medförde. Syftet är även att visa vad den Indirekta Metoden är och hur kraven uppfylls med hjälp av den. Studien visar kapaciteten för tre olika förbandstyper satta i scenarion där de nyttjas som vertikala samt horisontella dragband, både i och längsmed upplagslinje. Beräkningar visar att de olika förbandstyperna beter sig olika beroende av vilket dragband de sammanfogar med övrigt bärverk sam vilken placering i byggnaden de har. Vidare diskuteras kapacitetskrav och formlers anpassning för KL-T konstruktioner. För att skapa förutsättningar som branschen kan ta till sig behöver reducering av minimikraven för dragbandskapacitet utföras på ett mer tydligt sätt när dimensionering mot olyckslaster ska genomföras med den Indirekta Metoden för konstruktioner med låg egentyngd. / The interest to build in wood has increased in combination with grown knowledge in the subject. CL-T are wooden board that can be shaped in many different form, beams, pillars, wall and floor elements can all be made as CL-T elements. Ration between strength and weight is one aspect that has contributed entrepreneurs and designers to see the benefits of building in wood. CL-T is a product that reduce the weaknesses of the wood in different fiber directions since the slats are glued together crosswise. The rapidly increasing use of CL-T has left knowledge gaps, one of these knowledge gaps is how the robustness of a building can be increased to handle accident loads. Progressive collapse occurs when a local failure creates a collapse in surrounding structural elements and then propagate from element to element, leading to collapse of whole or part of the building. To counteract this a certain level of robustness must be achieved. There are various methods to create robustness in a building, one of these methods are to tie the walls to the floor with tension ties as described in Appendix A of SS-EN-1991-1-7. This method is called indirect method and is frequently used today for all types of structures. But for concrete structures it is considerably more well developed with general methods of how to tie the structure together. How vertical and horizontal ties should be designed in a CL-T construction need distinct methods that meets meet the capacity requirement set by the regulations. The purpose of the thesis is to create and understanding of the current regulations and to provide concrete examples of how tension ties can be carried out to meet the new requirements in EKS 11. It should also show what the indirect method is and how the requirements are met using it. The thesis shows the capacity of three different types and tension ties set in scenarios where they are used as both vertical and horizontal ties. Calculations show that the different types of ties behave differently depending on if they act a vertical or horizontal tie and which location in the building they have. Furthermore, the capacity requirements and the formulas adaption to CL-T designs are discussed. To create conditions that the industry can take on, reduction of the minimum requirements for tie capacity in constructions with a lightweight structural system needs to be made clearer when dimensioning against accidental loads with the indirect method.

The Master's Thesis deals with the usage of various software tools in emergency management and in environmental protection. Nowadays, on every step we make, we can face emergency situations which can cause great harm to the environment as well as to human life and property. The theoretical part provides an overview of software tools. Different software tools, their basic parameters, development and usage are described. There are also explained terms like geographic information system, etc. The practical part is focused on the instruments used in selected countries, including Czech Republic, Slovak Republic, Hungary, USA, Canada and the United Kingdom. In the conclusion is the comparison of the effectiveness of software tools in emergency management and in environmental protection.

Although axillary artery injury occurs frequently with dislocations of the shoulder and fractures of the clavicle, it is rarely associated with fractures of the proximal humerus. If the axillary artery is damaged, prompt recognition and treatment are necessary to salvage the involved extremity.

No / When descending stairs bodyweight becomes supported on a single limb while the forwards-reaching contralateral limb is lowered in order to make contact with the step below. This is associated with lowering of the centre of mass (CoM), which in order to occur in a controlled manner, requires increased ankle and knee joint torque production relative to that in overground walking. We have previously shown that when descending steps or stairs older people operate at a higher proportion of their maximum eccentric capacity and at, or in excess of the maximum passive reference joint range of motion. This suggests they have reduced and/or altered control over their CoM and we hypothesised that this would be associated with alterations in muscle activity patterns and in the CoM vertical acceleration and velocity profiles during both the lowering and landing phases of stair descent. 15 older (mean age 75 years) and 17 young (mean age 25 years) healthy adults descended a 4-step staircase, leading with the right limb on each stair, during which CoM dynamics and electromyographic activity patterns for key lower-limb muscles were assessed. Maximum voluntary eccentric torque generation ability at the knee and ankle was also assessed. Older participants compared to young participants increased muscle co-contraction relative duration at the knee and ankle of the trailing limb so that the limb was stiffened for longer during descent. As a result older participants contacted the step below with a reduced downwards CoM velocity when compared to young participants. Peak downwards and peak upwards CoM acceleration during the descent and landing phases respectively, were also reduced in older adults compared to those in young participants. In contrast, young participants descended quickly onto the step below but arrested their downward CoM velocity sooner following landing; a strategy that was associated with longer relative duration lead-limb plantar flexor activity, increased peak upwards CoM acceleration, and a reduced landing duration. These results suggest that a reduced ability to generate high eccentric torque at the ankle in the forward reaching limb is a major factor for older participants adopting a cautious movement control strategy when descending stairs. The implications of this CoM control strategy on the incidences of falling on stairs are discussed.

Bakgrund: Patienter som riskerar att drabbas av/har drabbats av accidentell hypotermi förekommer i all akutsjukvård. Accidentell hypotermi innebär oavsiktlig nedkylning till följd av skada eller sjukdom. Akutsjuksköterskor utgör en viktig funktion i att identifiera denna patientgrupp tidigt, såväl pre-, som intrahospitalt men även för att påbörja behandling. Tillståndet innebär obehandlat en hög risk för mortalitet. Det saknas tillräcklig kunskap som beskriver vårdåtgärder och påverkande faktorer vid accidentell hypotermi. Genom en sådan sammanställning kan akutsjuksköterskor få stöd i vårdandet av denna patientgrupp. Syfte: Syftet med litteraturstudien var att sammanställa faktorer och vårdåtgärder i det akuta omhändertagandet vid behandling eller förebyggande av accidentell hypotermi. Metod: En integrativ litteraturstudie genomfördes enligt Whittemore och Knafls femstegsprocess. Artiklar söktes fram i databaserna PubMed och Cinahl på ett systematiskt sätt genomsök block utvecklade enligt PEO-struktur. Tolv artiklar svarade till studiens syfte och kvalitetsgranskades för att sedan användas i resultatet. Dataanalysen genomfördes utifrån Braun och Clarkes tematiska analys. Resultat: Två huvudteman identifierades; De vårdande åtgärderna med subtema Passiv uppvärmning och Aktiv uppvärmning samt De påverkande faktorerna med subtema Behovet av kunskap, Omgivningens temperatur, Akutsjuksköterskans vårdande attityd samt Frysa och bli varm. Slutsats: Ur resultatet framkom att det fanns flertalet sätt att behandla och förebygga accidentell hypotermi samt att kombinationer av olika metoder förekom. Viktiga faktorer var kunskap och attityder hos akutsjuksköterskor för att få en struktur idet akuta omhändertagandet av accidentell hypotermi samt en ökad patientsäkerhet. Känslan av att frysa är en obehaglig upplevelse för patienter där värme upplevs som tryggt och avslappnande. / Background: Patients at risk of/suffering from accidental hypothermia due to injury or illness occur in all emergency settings. Emergency nurses have a key role in identifying these patients early, pre-, or intrahospital, and in initiating treatment. The condition carries a high risk of mortality if left untreated. There is currently a lack of knowledge regarding care measures and influencing factors for this condition. Such a review may assist emergency nurses in the management of these patients. Aim: The aim of this literature review was to compile factors and care measures in the acute management of treatment or prevention of accidental hypothermia. Method: An integrative literature review was conducted according to Whittmore and Knafls five step process. Articles were searched in the PubMed and Cinahl databases in a systematic manner using the PEO-structure. Twelve articles were quality reviewed for use in the results. Data analysis was performed following Braun and Clarke’s thematic analysis. Result: Two main themes were identified; The caring measures with subthemes Passive warming and Active warming as well as The influencing factors with subthemes The need for knowledge, The temperature of the environment, The caring attitude of the emergency nurse and Freezing and getting warm. Conclusion: There were several ways to treat and prevent accidental hypothermia and combinations of different methods were used. Important factors were knowledge and attitude of emergency nurses to manage structure and to provide patient safe care. The feeling of freezing is unpleasant for patients where warmth is perceived as safe and relaxing.

Les chutes chez les personnes âgées représentent un problème majeur. Il n’est donc pas étonnant que l’identification des facteurs qui en accroissent le risque ait mobilisé autant d’attention. Les aînés plus fragiles ayant besoin de soutien pour vivre dans la communauté sont néanmoins demeurés le parent pauvre de la recherche, bien que, plus récemment, les autorités québécoises en aient fait une cible d’intervention prioritaire. Les études d’observation prospectives sont particulièrement indiquées pour étudier les facteurs de risque de chutes chez les personnes âgées. Leur identification optimale est cependant compliquée par le fait que l’exposition aux facteurs de risque peut varier au cours du suivi et qu’un même individu peut subir plus d’un événement. Il y a 20 ans, des chercheurs ont tenté de sensibiliser leurs homologues à cet égard, mais leurs efforts sont demeurés vains. On continue aujourd’hui à faire peu de cas de ces considérations, se concentrant sur la proportion des personnes ayant fait une chute ou sur le temps écoulé jusqu’à la première chute. On écarte du coup une quantité importante d’information pertinente. Dans cette thèse, nous examinons les méthodes en usage et nous proposons une extension du modèle de risques de Cox. Nous illustrons cette méthode par une étude des facteurs de risque susceptibles d’être associés à des chutes parmi un groupe de 959 personnes âgées ayant eu recours aux services publics de soutien à domicile. Nous comparons les résultats obtenus avec la méthode de Wei, Lin et Weissfeld à ceux obtenus avec d’autres méthodes, dont la régression logistique conventionnelle, la régression logistique groupée, la régression binomiale négative et la régression d’Andersen et Gill. L’investigation est caractérisée par des prises de mesures répétées des facteurs de risque au domicile des participants et par des relances téléphoniques mensuelles visant à documenter la survenue des chutes. Les facteurs d’exposition étudiés, qu’ils soient fixes ou variables dans le temps, comprennent les caractéristiques sociodémographiques, l’indice de masse corporelle, le risque nutritionnel, la consommation d’alcool, les dangers de l’environnement domiciliaire, la démarche et l’équilibre, et la consommation de médicaments. La quasi-totalité (99,6 %) des usagers présentaient au moins un facteur à haut risque. L’exposition à des risques multiples était répandue, avec une moyenne de 2,7 facteurs à haut risque distincts par participant. Les facteurs statistiquement associés au risque de chutes incluent le sexe masculin, les tranches d’âge inférieures, l’histoire de chutes antérieures, un bas score à l’échelle d’équilibre de Berg, un faible indice de masse corporelle, la consommation de médicaments de type benzodiazépine, le nombre de dangers présents au domicile et le fait de vivre dans une résidence privée pour personnes âgées. Nos résultats révèlent cependant que les méthodes courantes d’analyse des facteurs de risque de chutes – et, dans certains cas, de chutes nécessitant un recours médical – créent des biais appréciables. Les biais pour les mesures d’association considérées proviennent de la manière dont l’exposition et le résultat sont mesurés et définis de même que de la manière dont les méthodes statistiques d’analyse en tiennent compte. Une dernière partie, tout aussi innovante que distincte de par la nature des outils statistiques utilisés, complète l’ouvrage. Nous y identifions des profils d’aînés à risque de devenir des chuteurs récurrents, soit ceux chez qui au moins deux chutes sont survenues dans les six mois suivant leur évaluation initiale. Une analyse par arbre de régression et de classification couplée à une analyse de survie a révélé l’existence de cinq profils distinctifs, dont le risque relatif varie de 0,7 à 5,1. Vivre dans une résidence pour aînés, avoir des antécédents de chutes multiples ou des troubles de l’équilibre et consommer de l’alcool sont les principaux facteurs associés à une probabilité accrue de chuter précocement et de devenir un chuteur récurrent. Qu’il s’agisse d’activité de dépistage des facteurs de risque de chutes ou de la population ciblée, cette thèse s’inscrit dans une perspective de gain de connaissances sur un thème hautement d’actualité en santé publique. Nous encourageons les chercheurs intéressés par l’identification des facteurs de risque de chutes chez les personnes âgées à recourir à la méthode statistique de Wei, Lin et Weissfeld car elle tient compte des expositions variables dans le temps et des événements récurrents. Davantage de recherches seront par ailleurs nécessaires pour déterminer le choix du meilleur test de dépistage pour un facteur de risque donné chez cette clientèle. / Falls in the elderly represent a major problem. It is therefore not surprising that the identification of factors that may increase the risk of falls has received much attention. Frailer seniors who need support to live in the community remained nonetheless poorly documented, although more recently, the Québec authorities have given high priority to interventions that target this population. Risk factors for falls are usually identified by observational prospective studies. Their optimal identification is however complicated by the fact that exposure may vary during the follow-up, and that an individual may experience more than one event. Twenty years ago, some researchers attempted to sensitize their peers in this respect, but their efforts were vain. Researchers continue today to neglect these considerations and to use improper statistical techniques, focusing on the proportion of fallers or the time to first fall. In doing so, we discard a significant amount of relevant information. In this thesis, we review the existing methods and propose a Cox hazards extension. We apply it in the study of potential fall-risk factors associated with 959 community-dwelling seniors using home-care services. Finally, we compare the results of the proposed Wei, Lin, & Weissfeld (WLW) method with those of several other techniques, notably the conventional logistic regression, the pooled logistic regression, the negative binomial regression and the Andersen & Gill regression. At baseline and every six months thereafter, participants were visited at home in order to ascertain information about potential risk factors. Falls were monitored by use of a calendar and monthly phone calls. Baseline exposure variables and updated time-varying exposures include socio-demographic characteristics, BMI, nutritional risk, gait and balance, alcohol consumption, home hazards, and medications. Almost all (99.6%) of participants showed at least one high risk factor. Exposure to multiple risks was frequent, with an average of 2.7 different high-risk factors per participant. The risk factors significantly associated to the risk of falling include male sex, age, history of falling, Berg balance score, BMI, use of benzodiazepines, number of home hazards and residential facility for seniors. Results demonstrate that the usual methods of analyzing risk factors for falling (any sort of fall as well as those leading to medical consultations) are inappropriate, as they produce considerable biases relative to the WLW model using time-dependent covariates. Bias for the considered effect measures comes from the manner in which the observed data (both measured exposures and health outcomes) was measured and defined as well as the way in which the statistical analysis took into account this information. An additional part of the thesis was undertaken to identify risk profiles of subjects regarding the recurrence of falling, defined as participants who reported at least two falls within six months of initial assessment at entry in the study. A classification and regression tree analysis classified the population into five groups differing in risk of recurrent falling, based on history of falls in the three months prior to the initial interview, Berg balance score, type of housing, and usual alcohol consumption in the six months preceding study entry. The relative risks varied from 0.7 to 5.1. A subsequent survival analysis showed that the length of time before becoming a recurrent faller varies among risk profiles. This thesis discusses highly topical subjects about a target population and a fall-risk screening activity which are priorities in the public health sector in Québec. We encourage researchers interested in the identification of risk of falls among the elderly to use the statistical method of Wei, Lin and Weissfeld because it takes into account updated time-varying exposures and multiple events. More research will be necessary to determine the best screening test for a given risk-factor in this setting and population.

The argument advanced is this thesis is that the entities that make up the environment are those that do not owe their origin to any willful creative activity but have evolved through accidental natural processes. This fact of not being willfully created makes the environment ontologically independent and confers on it intrinsic value as opposed to instrumental value. This intrinsic value is one that all the entities that make up the environment share. It is further argued that this intrinsic value is aesthetic rather than moral. Only beings that are specially endowed with certain capacities, like reflection and understanding, could be said, in the context of this work, to have intrinsic moral value in the sense of being moral agents. But as moral agents, we need to give moral considerability to all the natural entities in the environment since they share the same natural right with us, based on our common origin. So, even though the nonhuman, natural entities in the environment do not have moral rights, they have natural rights. It is further argued that this natural right could be best safeguarded in a legal framework.

The argument advanced is this thesis is that the entities that make up the environment are those that do not owe their origin to any willful creative activity but have evolved through accidental natural processes. This fact of not being willfully created makes the environment ontologically independent and confers on it intrinsic value as opposed to instrumental value. This intrinsic value is one that all the entities that make up the environment share. It is further argued that this intrinsic value is aesthetic rather than moral. Only beings that are specially endowed with certain capacities, like reflection and understanding, could be said, in the context of this work, to have intrinsic moral value in the sense of being moral agents. But as moral agents, we need to give moral considerability to all the natural entities in the environment since they share the same natural right with us, based on our common origin. So, even though the nonhuman, natural entities in the environment do not have moral rights, they have natural rights. It is further argued that this natural right could be best safeguarded in a legal framework.