Hälso- och sjukvårdens utveckling har lett fram till ett marknadsstyrt system. För att kunna jämföra olika vårdgivare och utveckla kvalitén har ett flertal kvalitetsindikatorer och uppföljningsområden införts. Fallrisk är ett av dessa uppföljningsområden. I Sverige är Downton Fall Risk Index förstahandsval som fallriskbedömningsinstrument. Hälso- och sjukvård ska utformas och genomföras i samråd med patienterna. Den traditionella rollfördelningen mellan patienterna och sjuksköterskorna håller på att förändras till att patienternas rätt till delaktighet uppmärksammas. Syftet med denna uppsats var att belysa sjuksköterskornas erfarenhet av och syn på patienternas delaktighet i fallriskbedömningen. Det här är en intervjustudie med kvalitativ ansats. Åtta sjuksköterskor som arbetar på ett akutsjukhus i mellersta Sverige och använder sig av Downton Fall Risk Index vid fallriskbedömningen har intervjuats. Kvalitativ innehållsanalys som inspirerats av Graneheim och Lundman har använts. Den teoretiska utgångspunkten är Peplaus syn på relationen mellan sjuksköterskorna och patienterna som en av de viktigaste grundstenarna inom omvårdnaden. Studien kom fram till följande fem teman: fallrisk är sjuksköterskornas bedömning, standardmall har ett eget liv, fallrisk - skrämselpropaganda eller verklighet, sjuksköterskornas svårigheter med att involvera patienterna och sjuksköterskornas syn på patienternas delaktighet. Det standardiserade arbetssättet uppmuntrar inte till utvecklingen av reflektionsförmågan och kliniska blicken bland nyutbildade sjuksköterskor därför behövs det en kompetensstege för sjuksköterskor. Sjuksköterskor hittar inte plats varken för sin egen eller för patienternas delaktighet i Downton Fall Risk Index. Frågan som kan ställas är om rätt instrument har valts för fallriskbedömningen i akutsjukvården.

The number of people suffering from natural disasters, and the economic impact of those disasters, continue to increase as the years go by. Better preparation and risk management strategies can help lessen the impacts of these disasters. One important aspect of risk management is risk assessment, which can be accomplished with a hazard map. One application of hazard maps is to forecast volcanic ashfall following an eruption to help people and organisations prepare themselves for, and mitigate the detrimental impacts of, volcanic ashfall. This research evaluated the key elements of a hazard map and how to make a hazard map most effective through the study of short-term ashfall forecast maps in New Zealand. A mixed-methods approach was taken for this research. Interviews were conducted with scientists at GNS and stakeholders who use the ashfall forecast maps. After the data from the interviews was analysed, an internet-based survey was created and sent out to anyone interested in participating. The survey served as a low-resolution verification of the high-resolution data gathered in the interviews. After each stage of information gathering, the ashfall forecast map design was updated. This research found that there are seven basic elements which should be considered when creating a hazard map. These elements are: simplicity of the map, base map, map scale, the use of colour, geographical information, the inclusion of uncertainty, and time. This research also found key lessons which can be applied to any hazard map creation process. These lessons are: established practices should be revaluated periodically, communication between the information provider and the enduser is critical, the information provider must decide between satisfying the individual or the group, education and outreach are important, audience feedback is necessary for an effective map, and that hazard maps are just one step in the risk mitigation process.

As aging occurs, safely maintaining an active lifestyle is critical for health and independence. Independent mobility is influenced by one???s ability to perform three essential tasks of daily living: transitioning from a seated to standing posture, maintaining upright stance and walking. In spite of the apparent similarities in the predictive utility of these different tasks, there are few studies that have explored the specific relationship between these tasks that define independent mobility within individuals to determine if they reflect unique challenges to control. The thesis focused on two studies to advance understanding of the determinants of independent mobility in older adults. Study 1 explored the association between measures of standing, transitions and walking in 28 older adults. An important element was the assessment using portable low-cost measurement technology (Wii force boards and wearable accelerometers) so that testing could be done in the community. The results of this study revealed the potential importance of sit-to-stand performance as an independent measure of function in older adults. One important outcome was the need for a more detailed measurement of the sit-to-stand task, which is characterized by different phases that have unique control challenges. As a result, Study 2 was designed to evaluate different measurements of the sit-to-stand phases in order to provide a measurement tool that could be used in community and clinical testing. Ground reaction forces were found capable of identifying the different sit-to-stand phases and therefore afford the ability to quantify this behavior using portable technology. Identifying the underlying control mechanisms and relationships between these mechanisms allows clinicians to prescribe targeted and potentially more effective interventions focused on behavior specific control challenges.

Fallolyckor är ett stort patientsäkerhets- och samhällsekonomiskt problem. I Sverigedrabbas varje år cirka 18 000 personer av höftfraktur som leder till lidande för patientenoch stora kostnader för samhället. Syftet med litteraturöversikten var att beskrivautfallet av att använda höftskydd som prevention. Studien genomfördes som en litteraturöversikt där tolv vetenskapliga artiklar utgjorde underlaget för resultatet.Resultatet som redovisas i tre kategorier är: effekter av höftskydd, följsamhet till att bära höftskydd och upplevelser av höftskydd. Risken för höftfraktur minskas vid fall om höftskydd används. Följsamheten till att använda höftskydd minskar över tid. Resultatetvisar även att både personal och patienter är överens om att en stor anledning till varförinte höftskydd används är att de anses vara obekväma. Sjuksköterskor bör genomutbildning få en ökad medvetenhet om höftskyddens effekt för att därmed kunna minskaantalet höftfrakturer. Forskning inom området för att öka följsamheten och görahöftskydden bekvämare är önskvärt för att kunna minska antalet höftfrakturer, ochdärigenom reducera lidandet och minska stora samhällskostnader för vård ochrehabilitering som en höftfraktur medför. / Falls is a major patient safety and socio- economic concern. In Sweden approximately 18 000 persons every year suffer a hip fracture which causes the person major suffering and cost forthe society. The aim of this literature study was to describe the outcome of using hipprotectors as prevention. A literature overview was carried out were twelve scientific articleswere the basis of the result. The result is presented in three categories: effect of hip protectors, compliance to the use of hip protectors and the experiences of hip protectors. The risk of contacting a hip fracture is reducing if the fall occurs when using hip protectors. Compliance to the use of hip protector decreases over time. The result showed that patient and staff both agreed that a large reason for not using hip protectors is that they are uncomfortable. Through education nurses need to increase their awareness about the effect of hip protectors and thereby decrease the amount of hip fractures. Further research to increase compliance and to make the hip protector more comfortable would be desirable to reduce the amount of hip fractures. This will not only reduce suffering for those who contract a hip fracture but also reduce society´s major cost for the care and rehabilitation of a hip fracture.

A two-year field study and two incubation studies were conducted to evaluate incorporating urea with a urease and nitrification inhibitor to reduce N2O and N losses from fall banded fertilizer. In each year of the field experiment, five fertilizer treatments (fall banded NBPT-DCD urea, conventional urea, calcium nitrate, spring banded conventional urea and control) were applied at three sites. The effect of incorporating urease and nitrification inhibitors with urea was not consistent in our studies. The application of fall banded NBPT and DCD did not result in greater agronomic performance. Moreover, the addition of inhibitors to urea did not reduce nitrous oxide emissions in the field. The addition of inhibitors resulted in significantly less cumulative nitrous oxide emissions compared to conventional urea in only one of two laboratory experiments. In conditions where fertilizer was not generally susceptible to large losses, the effects of urease and nitrification inhibitors may not be evident.

This thesis was inspired by the project funded by Bureau of Safety and Environment Enforcement (BSEE) to study the use of epoxy (or any cement alternative) to plug offshore wells damaged by hurricanes. The project focuses on non-cement materials to plug wells that are either destroyed or damaged to an extent where vertical intervention from the original wellhead is no longer possible. The proposed solution to this problem was to drill an offset well and intersect the original borehole at the very top and spot epoxy (or any suitable non-cement plugging material) in the original well. The spotted epoxy then would fall by gravitational force all the way down to the packer and then settle on top of the packer to plug the annulus of the damaged well permanently. This thesis mainly concentrates on the factors affecting the fall rates and how to correlate them in order to derive an applicable test that can be conducted on the field or lab to calculate the terminal velocity of the known epoxy composition. Determining the settling velocity of the epoxy is crucial due to the fact that epoxy should not set prematurely for a better seal and isolation. The terminal velocity and the recovery for epoxy based plugging fluids were tested by using an experimental setup that was developed for this purpose. The results were also validated by using an alternative experiment setup designed for this purpose. Factors affecting the terminal velocity and recovery of epoxy were studied in this research since the settling velocity of the epoxy is crucial because epoxy should not set prematurely for a better seal and isolation. The study was conducted by using an experiment setup that was specially developed for terminal velocity and recovery calculations for plugging fluids. Results obtained from the experiment setup were successfully correlated to epoxy's composition for estimating the terminal velocity of the mixture.

Thesis (Th. M.)--St. Vladimir's Orthodox Theological Seminary, Crestwood, N.Y., 1995. / Includes bibliographical references (leaves 165-170).

Thesis (M.A.)--University of Canterbury, 2008. / Typescript (photocopy). Includes bibliographical references (leaves [144-145]). Also available via the World Wide Web.

Thesis--Stockholm. / Summary in German. Bibliography: p. 514-517.

Thesis (Th. M.)--Calvin Theological Seminary, 2004. / Abstract. Includes bibliographical references (leaves 91-96).