Despite a myriad of studies on fall prevention, patient falls continue to be a longterm problem experienced by health care organisations world-wide. Falls impose a heavy burden in terms of social, medical, and financial outcomes, and continue to pose a threat to patient safety. Because the potential for a fall is a constant clinical safety issue in every health care organisation, protecting the patient from falls and subsequent injuries, and ensuring that the patient care environment facilitates, are fundamental aspects in providing quality care. Moreover, the current international focus on creating a culture of quality care and patient safety requires the implementation of fall prevention programs that decrease the risk of falls. As with other international health care organisations, the National University Hospital (where the principal investigator is working), has been challenged with the issue of how to prioritise and implement quality initiatives across all disciplines. Faced with persistent patient falls that affect care outcomes, fall prevention has been a priority initiative at the hospital since 2003. In response, a nursing task force was established in an attempt to resolve this problem. A root cause analysis undertaken by this task force revealed that the hospital protocol on fall prevention was outdated and not evidence-based. Furthermore, many nurses did not understand the importance of fall prevention, while the administration of the fall prevention program was instituted on an ad hoc basis rather than as a standard of care for all patients. The challenge for this task force, as with other health care professionals, was not only in finding an intervention that was effective, but also identifying who would benefit from its implementation. Although the need to apply current best practices to reduce patient falls is clear from the task force results, evidence of the effectiveness of fall prevention interventions in acute care hospitals is lacking in literature. In addition, there are no published studies on fall prevention in Singapore to support changes in nursing practices. Thus, it becomes apparent that research on fall prevention is greatly needed in Singapore so that an evidence-based fall prevention program can be developed. This topic coincides with the Doctor of Nursing course, which requires the student to gain knowledge through scholarly research on contemporary issues in nursing by undertaking two separate projects related to a single area of interest. Undertaking the two research projects on fall prevention in an acute care inpatient hospital as part of the doctoral studies provided an opportunity to address this deficit in a way that could raise awareness of the importance of fall prevention in Singapore hospitals. This research also provides a platform for the first body of research into fall prevention to be conducted within the Singapore health care environment, which is essential, as international studies are not always necessarily applicable to the Singapore context due to differences in educational preparation, skills-mix, organisational culture and nursing practices. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1321300 / Thesis (D.Nurs.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008

This thesis proposes a fresh engagement with the idea of the archaic as a means to recover and replenish some of the lost vitality suffered during what William Barrett characterized the modern period as “the gigantic externalization of life.” An introductory essay examines how the related ideas of the archaic, the primal, and the prehistoric have at key moments provided a source of creative energy for the arts of the last century. Collections of found material, and several photographic studies document the city of Niagara Falls—icon of American pop culture and faded relic of romanticism. The photographs present an alternative to the world of the touristic snapshot, and address the questions: In the age of simulation how do we know what is real anymore? Can we learn to see with archaic eyes?

This thesis proposes a fresh engagement with the idea of the archaic as a means to recover and replenish some of the lost vitality suffered during what William Barrett characterized the modern period as “the gigantic externalization of life.” An introductory essay examines how the related ideas of the archaic, the primal, and the prehistoric have at key moments provided a source of creative energy for the arts of the last century. Collections of found material, and several photographic studies document the city of Niagara Falls—icon of American pop culture and faded relic of romanticism. The photographs present an alternative to the world of the touristic snapshot, and address the questions: In the age of simulation how do we know what is real anymore? Can we learn to see with archaic eyes?

Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people. Falls have been found to be a leading cause of disability, distress, admission to supervised care and death among older persons that pose a serious problem to public health. The purpose of this study was to determine the prevalence of and risk factors for falls in the community-dwelling elderly persons in the Umutara province of Rwanda.

Orientador: Silvana Andrea Molina Lima / Resumo: Introdução: Os serviços de Saúde devem promover meios para prestar uma assistência segura e livre de danos, buscando otimizar resultados relacionados a segurança do paciente e a assistência prestada. A confiança transmitida por meio do cuidado seguro torna-se o desejo de todos os envolvidos no processo, seja o paciente, familiares ou profissionais de saúde. As práticas de assistências à saúde aumentam as chances para uma possível ocorrência de um incidente. Dentre os incidentes que podem ocorrer em uma instituição hospitalar, destaca-se o evento adverso relacionado à queda do paciente, que pode causar diversos tipos de danos como leve, moderado e grave, incluindo a morte. A ocorrência destes eventos pode aumentar o tempo de internação e a necessidade de intervenções diagnósticas e terapêuticas, as quais não estavam no planejamento do cuidado inicial, além de acarretar consequências significativas para o sistema de saúde. Além disso, devem ser contabilizados os custos sociais, emocionais e econômicos decorrentes do evento. Objetivo: O presente trabalho teve como objetivo analisar as notificações de eventos adversos relacionados às quedas dos pacientes hospitalizados em hospital universitário do Estado de São Paulo. Método: Trata-se de um estudo transversal, retrospectivo e descritivo, realizado com dados de relatórios gerenciais do Núcleo de Segurança do Paciente de um hospital escola do interior de São Paulo. Foram incluídas as notificações espontâneas da área de Segurança do... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Health services must provide means to supply safe and harmless assistance, seeking to optimize results related to patient safety and care. Confidence from safe care is desirable for everyone involved in the process, patient, family, or healthcare professionals. Health care practices increase the chances of a possible occurrence of an incident. Among the incidents that may occur in a hospital, the adverse event related to patient fall is highlighted, which can cause several types of damage such as mild, moderate and severe, including death. The occurrence of these events may increase hospitalization time and the need for diagnostic and therapeutic interventions, which were not part of the initial care planning, and would have significant consequences for the health system. In addition, social, emotional and economic costs of such events must be accounted for. The present study aimed to analyze reports of adverse events related to falls of hospitalized patients in a university hospital in São Paulo State. This is a cross-sectional, retrospective and descriptive study, carried out with data from management reports from Patient Safety Center of a school hospital in the interior of São Paulo State. We included spontaneous reports from Patient Safety area related to falls, which occurred between January 1, 2016 and December 2016. The sample consists of 121 notifications. Data analysis allowed us to identify that about one third of the falls (29.8%) occurred among the elderly, ages ... (Complete abstract click electronic access below) / Mestre

Habitat selection may be considered a behavioural consequence of an individual actively selecting where it lives or passively persisting in a certain habitat. There are a variety of approaches to assessing habitat selection, including relating densities to predefined habitats and the characteristics of these habitats, measuring the behaviour of animals within predefined habitats in order to assess the relative benefits to the animal and comparing these between habitats, and using optimality theory to allow the animal to provide measures of its preference for particular habitats or patches. Each approach provides different perspectives on an animal’s choice and use of habitat, with some approaches working more effectively with certain species or habitats than others. There have, however, been no attempts to apply all these approaches to a single species at a single site. The objective of this study was therefore to apply the three above-mentioned approaches to assess habitat use and quality to a single species, the springbok (Antidorcas marsupialis) at the Augrabies Falls National Park (AFNP), on the northern bank of the Orange River, in order to provide the basis for further work on comparing and integrating these approaches. The relative abundance of springbok in Augrabies Falls National park was used to develop a habitat suitability model for the park, and thus determine the habitat variables that influenced habitat suitability. Isodar analysis revealed information on the mechanisms underlying habitat preference. Behavioural models were developed to improve our understanding of how springbok behaviour changes in relation to the habitat, and incorporated the variables identified in the habitat suitability model. The different spatial and temporal scales influencing springbok habitat selection were determined using optimal foraging theory and giving-up densities. Springbok preferred open habitats providing high food quality. Springbok behaviour was related to the foraging and predation risk characteristics of the habitat, and springbok varied their temporal and spatial utilisation so as to minimise their risk of predation and maximise their food intake. The habitat suitability model, behaviour models and giving-up densities were compared for ease of use and applicability. Using giving-up densities to reveal habitat suitability had greater applicability and was both efficient and objective.

Rotational falls, or somersault falls, have led to serious and fatal injuries during the cross-country phase of Eventing competitions. Research to improve the safety of the sport began in 2000 after five fatal injuries occurred in the 1999 Eventing season. These efforts led to safety devices such as air jackets, improved helmets, and frangible/deformable fences. The focus of this thesis is to develop a more complete understanding of the horse-fence interaction as the approach motion transitions to a rotational fall. To achieve this, a large distribution of inertial properties was compiled through the development of a cylinder-based inertia approximation and a citizen science effort to gather equine geometrical measurements through a survey distributed by the United States Eventing Association (USEA). Furthermore, fundamental kinematic properties of the horse and rider were gathered from the literature. These distributions were used to conduct a Monte Carlo analysis to examine if the approach conditions of the horse and rider would result in a transition to a rotational fall upon horse-fence contact. Through the analysis the sensitivity of the main control parameters was explored to determine the dominant variables in the transition.

Children who learn best are physically, mentally, and emotionally adequate. In conjunction with this fact, this study attempts to show the relation that exists between the children from uncomfortable, unsatisfactory environments and those with comfortable, satisfactory environments.

The problem of this thesis consists primarily of a bacteriological survey of the eating utensils of Hardin College Cafeteria and twenty-five other eating establishments in the city of Wichita Falls, Texas. This investigation was made primarily with reference to a determination of the possible presence of typhoid and related organisms, and secondarily to an investigation of the actual presence of those bacterial organisms associated with the more common outbreaks of food poisoning.

Thesis (M Sport Sc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Falling is a common occurrence and one of the most serious problems in the elderly population (65 years and older). Falls account for 70% of accidental deaths in persons aged 75 years and older. Falls can be markers/indicators of poor health and declining function, and are often associated with significant morbidity. More than 90% of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age (Fuller, 2000). About one third of people aged 65 years and older fall each year, resulting in a substantial decrease in quality of life in addition to placing a huge burden on current health care systems. The purpose of this study was to determine whether a 12-week exercise intervention programme, consisting of two 30 minute exercise sessions a week, could lower the risk of falling in a group of elderly women. Female subjects (n=22) with an average age of 79.5 years were selected from three retirement homes situated in Stellenbosch, Western Cape, South Africa, according to specific inclusion and exclusion criteria. The subjects included presented no major cardiovascular and pulmonary disease signs and symptoms as recognised by the American College of Sports Medicine (2011); had no serious illnesses or co-morbidities; were mobile with no significant musculoskeletal disorders; had no uncorrected visual or vestibular problems as well as no significant cognitive impairments or major psychological disturbances; were not taking any psychotropic medications or Benzodiazepines that could affect their progress. Subjects also had to be willing to follow the 12-week exercise intervention programme and sign an informed consent document. The selected subjects then underwent a pre- and post-intervention assessment consisting of a subjective rating of their fear of falling, the Fall Risk Assessment: Biodex Balance system, Balance Evaluations Systems Test (BESTest) and the 30-Second Chair Stand Test. Statistica 10 was used to analyse the data. Data was analysed to assess any significant improvements that the exercise intervention had on each fall risk variable tested. The main fall risk variables consisted of: fear of falling, muscular strength, balance, gait and getting up strategies. Statistically significant improvements (p<0.001) were seen in: Fear of falling, muscular strength, balance, gait and getting up strategies after the 12-week exercise intervention programme. This study suggests that exercise intervention has the potential to decrease the risk of falling among elderly women and should play an extremely important role in the prevention of falling amongst this population group. / AFRIKAANSE OPSOMMING: Om te val is ‘n alledaagse gebeurtenis en een van die mees ernstige probleme vir ons bejaarde bevolking (65 jaar en ouer). Insidente van val verklaar tot 70% van toevallige sterftes met betrekking tot persone van 75 jarige ouderdom en ouer. Om te val kan ‘n teken van swak gesondheid en/of ‘n afname in funksionele kapasiteit wees, en is gewoonlik met morbiditeitspatrone gekoppel. Meer as 90% van heupfrakture kom as gevolg van valle voor, waar die meeste van die frakture in persone bo 70 jarige ouderdom voorkom (Fuller, 2000). Minstens een derde van persone bo 65 jaar en ouer val elke jaar, so ‘n val het ‘n noemenswaardige afname in lewenskwaliteit tot gevolg asook ‘n enorme druk wat op huidige gesondheidsorg sisteme geplaas word. Die doel van die studie was om te bepaal of ‘n 12 week oefenintervensieprogram, wat uit twee oefen sessies van 30 minute elk bestaan, die risiko van val vir n groep bejaarde vroue kan verlaag. Vroulike individue (n=22) met ‘n gemiddelde ouderdom van 79.5 jaar uit drie ouetehuise/aftree oorde in Stellenbosch, Wes-Kaap, Suid-Afrika geleë; is volgens bepaalde insluitings- en uitsluitingskriteria geselekteer. Individue wie ingesluit is het geen tekens of simptome van grootskaalse kardiovaskulêre of pulmonêre siekte getoon nie, soos herken deur die “American College of Sports Medicine (2011) ; het aan geen ernstige siektes of ko-morbiditeite gely nie; kon stap met geen merkwaardige muskulo-skeletale afwykings nie; het geen nie-gekorrigeerde visie of vestibulêre probleme asook geen beduidende kognitiewe gestremdhede of ernstige sielkundige steurnisse gehad nie; het nie enige psigotropiese medikasie of Benzodiazepines geneem wat hul kon beinvloed nie. Individue moes bereid gewees het om die 12 week oefenintervensieprogram te volg en moes ook ‘n ingeligte toestemmingsvorm onderteken. Die geselekteerde individue het ‘n pre- en post-intervensie assessering ondergaan wat uit ‘n subjektiewe bepaling van hul vrees vir val bestaan het, die Val Risiko Assessering asook “Biodex Balans System Test, Balance Evaluations Systems Test (BESTest)” asook die 30 Sekonde Stoel-staan Toets. Statistica 10 is gebruik om die data te analiseer. Data was geanaliseer om enige merkwaardige verandering wat die oefenintervensie op elke val risiko veranderlike wat getoets was gehad het, te bepaal. Die belangrikste val risiko veranderlikes het uit: die vrees vir val, spier sterkte, balans, stappatroon en opstaan tegnieke bestaan. Betekenisvolle statistiese veranderinge (p<0.001) is gerapporteer in: die vrees vir val, spiersterkte, balans, stappatroon en opstaan tegnieke na die 12 week oefenintervensieprogram. Die studie bevind dat die intervensieprogram die potensiaal het om die risiko van val onder bejaarde vroue te verminder en behoort ‘n uiters belangrike rol in die voorkoming van val onder die bevolkingsgroep te speel.