Attention to quality outcomes, cost reduction, value-based purchasing, and improved initiatives for hospital-acquired conditions (HACs), as well as labor utilization savings, provide a foundation for hospitals to achieve safety and quality outcomes. Falls resulting in fractures, joint dislocation, or other physical injuries are considered HACs and can produce unexpected consequences such as an increase in costs related to an increased length of stay. The CareView Communications system, a fall prevention management program that uses video surveillance technology, offers a strategy to prevent patient falls by customizing patient rounding, conducting fall risk assessments, and generating reports. Guided by Donabedian's framework, this project evaluated the effectiveness of implementation of CareView video monitoring to decrease falls, avoid falls with injury, and reduce use of the patient safety technician on the hospital's telemetry and neurological unit. One year of preimplementation fall data were compared to 1 year of postimplementation data to measure the video monitoring (VM) system effectiveness in fall reduction. Although there was a reduction in the number of falls on the neurological (4.08 to 3.24/1,000 patient days) and the telemetry (2.92 to 1.96.1,000 patient days) units, the results were not statistically significant. The results of this project could contribute to positive social change by helping to determine the effectiveness of the CareView system in reducing falls and identifying strategies for implementing the use of the VM system to reduce patient falls and enhance patient safety.

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Cette thèse constitue une analyse de la dynamique du bois mort en rivière par une approche de bilan ligneux multi-scalaire dans une rivière semi-alluviale de région froide: la rivière Saint-Jean, Gaspé. L’étude de la variabilité spatiale et temporelle de la dynamique du bois mort a été réalisée grâce à une approche méthodologique combinant quatre années de terrain et par l’analyse de documents historiques. Les rivières de la péninsule gaspésienne produisent et transportent annuellement de grandes quantités de bois mort. Cette production provient à la fois de la puissance spécifique élevée des cours d’eau et de berges composées de sédiments peu cohésifs et comportant une ripisylve arborescente généralement dense. Jusqu’en 2015, le delta de la rivière Saint-Jean comportait plusieurs embâcles de bois de très grandes tailles. Ces embâcles se mettent en place depuis les années 1960, ils représentent une opportunité unique de quantifier et d’appliquer un budget ligneux pour cerner les variables clefs liées à la dynamique du bois mort à multiples échelles spatiales et temporelles.Nos résultats montrent que la quasi-totalité des bois morts en rivière est produite par la migration latérale et par l’influence de la morphologie. Au niveau des accumulations dans le corridor fluvial, deux zones accumulent la majorité des bois et ces premiers résultats montrent une mobilité importante qui peut varier fortement d'une année à l'autre. Au niveau de la mobilité, l’analyse d’imagerie vidéo de trois évènements différents ont montré que l’intensité (nombre de bois par minute) du transport de bois pouvait être jusqu’à dix fois supérieures durant un évènement avec débâcle mécanique glacielle, comparativement à un évènement hydroclimatique en eau libre.Finalement, nous avons réalisé une analyse par bilans ligneux et une analyse de la trajectoire éco-hydrophormologique sur une période de plus de 50 ans. Nous avons quantifié chaque composante (intrant, accumulée et sortie) d'un budget ligneux à multiples échelles spatio-temporelles. Autant à l’échelle interannuelle, qu’à l’échelle décennale, la dynamique du bois mort comporte des périodes où l’entrée de bois, le stockage et la mobilité diffèrent selon les contextes éco-hydromorphologiques. La trajectoire éco-hydromorphologiques suggère une augmentation de la dynamique fluviale en raison d'un changement significatif dans l'hydrologie conduisant à une plus grande production et mobilité des bois morts et par l'augmentation des volumes accumulés dans le corridor de la RSJ depuis 2004. / This thesis is an analysis of the dynamics of large wood in river by a multi-scale large wood budget approach in a semi-alluvial river of cold regions: the Saint-Jean River, Gaspé. The study of the spatial and temporal variability of the dynamics of large wood was carried out through a methodological approach combining four years of field and by analyzing historical documents. The rivers of the Gaspé Peninsula produce annually and carry large amounts of large wood. This production comes from the high specific power of rivers and by banks composed of noncohesive sediment and having a generally dense riparian forest tree. Until 2015, the Delta of the Saint-Jean River had several very large jams. These jams are put in place since the 1960s, they represent a unique opportunity to quantify and apply a wood budget and to identify key variables related to the dynamics of large wood at multiple spatial and temporal scales.Our results show that almost all large wood in river is produced by lateral migration and by the influence of the morphology. For the accumulations in the river corridor, two areas accumulate the majority of wood and these first results show a significant mobility, which can fluctuate substantially from year to year. In terms of mobility, video analysis of three different events showed that the intensity of the transport (number of large wood per minute) can be higher to ten times during an event with mechanical ice-breakup, compared to an open water.hydroclimatic event.Finally, we conducted an analysis by large wood budget and analysis of eco-hydromorphological trajectory over more than 50 years. We quantified each component (input, output and accumulated) of a large wood budget at multiple spatial and temporal scales. At the interannual scale or decadal, scale, the dynamics of large wood have periods when the input, storage and mobility of large wood differ according to eco-hydromorphological contexts. The eco-hydromorphological trajectory suggests an increase in river dynamics due to a significant change in the hydrology, resulting in higher production and mobility of large wood and increased in volumes accumulated in the corridor of the Saint-Jean River since the last decade.

Quality of Experience (QoE) is the degree of delight or annoyance of the user of an application or service [1]. To ensure a proper level of QoE for end users, networks and service providers have to continuously monitor their systems in terms of technical parameters, which can then be used to estimate QoE. Especially for video streaming services, which consume a large amount of traffic, network problems such as bandwidth fluctuations quickly develop into annoying artefacts visible to the users, which may lead to abandonment of services. Internet Service Providers (ISPs) are therefore continuously monitoring video network streams in order to provide the better QoE. In this regard to conduct the user behavioral studies, the ISPs spend a large amount of money and energy every time. To avoid this, we are using existing user behavioral studies and simulating the user behavior in an automated set-up and try to measure the impact of network conditions. In our current studies based on the user-behavioral model used [5], we can conclude that low upload speeds don’t affect on simulated user behavior unless they are in high download speed networks. Simulated users with the mid-range download and upload bandwidth tend to face more stalling and quality switches compared to both low and high-bandwidth users. Key quality indicators(KQIs) of video QoE also depends on the number of videos we measure in a single session. Reloading of player helps to reduce stalling for mid and high bandwidths. Reloading worsens the situation in low bandwidth scenarios. / Kvalitet av erfarenhet (QoE) definieras som: "Graden av fröjd eller förargelse av användaren av en applikation eller en service. Den resulterar från uppfyllelsen av hans eller hennes förväntningar med hänsyn till hjälpmedlet, och/eller njutning av applikationen eller servicen i ljuset av användarens personlighet och aktuella tillstånd" [1]. Att att se till en riktig nivå av QoE för slut användare, nätverk och tjänstefamiljeförsörjare måste övervakar fortlöpande deras system när det gäller tekniska parametrar, som kan därefter vara den van vid bedömningen QoE. Speciellt för videoen som strömmar service, som konsumerar ett stort belopp av trafik, framkallar nätverksproblem liksom bandbreddväxlingar snabbt in i förargliga artefacts som är synliga till användarena, som kan leda till övergivande av service. Internetleverantörer (ISPs) är därför fortlöpande videopp nätverksströmmar för övervakning för att att ge den bättre QoEen. I detta avseende att föra de beteendestudierna för användaren, spenderar ISPsna en stor mängd pengar och energi varje gång. Att undvika denna, använder simulerar vi beteendestudier för existerande användare och användareuppförandet i en automatiserat aktivering och försök för att mäta inverkan av nätverksvillkor. I våra aktuella studier som baseras på den använda användare-beteendemodellen [5], oss kan avsluta som laddar upp lågt hastigheter inte påverkar på simulerat användareuppförande, om inte de är i höga nedladdninghastighetsnätverk. Simulerade användare med mitt–området nedladdar och laddar upp bandbredd ansar för att vända mot mer avbrottsoch kvalitetsströmbrytare som jämförs till både låga och höga bandbreddanvändare. Nyckelkvalitetsindikatorer (KQIs) av video QoE beror också på numret av video som vi mäter i en enkel period. Tillbakaläggande av spelaren hjälper att förminska avbrott för mittoch höga bandbredder. Tillbakaläggande försämrar läget i scenarion för låg bandbredd.