Magister Educationis (Adult Learning and Global Change) - MEd(AL) / This study examines student activism and student protests that occurred at South African higher education institutions (HEIs) during the academic years 2015 and 2016. These protests were inspired by multiple grievances experienced by students at HEIs, which included protesting against the maintenance and celebration of imperial symbols at universities as well as the unaffordability of academic and residence fees. These protests were different to previous student protests in that student discontentment and protests were popularised and advocated through social media under Twitter hashtags such as #RhodesMustFall (RMF) and #FeesMustFall (FMF).

Bakgrund: Distriktssköterskan möter i sitt arbete ofta en åldrande befolkning i deras hem, och ska arbeta för att främja deras trygghet och välbefinnande. Fall hos äldre personer är ett stort folkhälsoproblem då skadorna ofta blir stora och rehabiliteringen omfattande. Distriktssköterskan är en nyckelperson i fallpreventionsarbetet och ska arbeta med en helhetssyn kring den äldre personen, när omvårdnadsåtgärder sätts in för att förebygga fall. Syfte: Syftet med denna studie var att beskriva distriktssköterskans fallpreventiva omvårdnadsåtgärder i äldre personers hem. Metod: En litteraturöversikt med induktiv ansats utfördes, baserad på 14 vetenskapliga artiklar med både kvantitativt- och kvalitativt innehåll. Artiklarna söktes i databaserna Cinahl, Psykinfo och Pubmed, och kvalitetsgranskades med hjälp av granskningsmall från Statens beredning för medicinsk och social utvärdering (SBU). Resultat: Tre kategorier framkom; fallrelaterade skador kan minskas med fallpreventionsprogram, fallriskutredning och samverkan, samt utbildning leder till välbefinnande. Diskussion: I resultatet framkom att distriktssköterskan bör samverka med andra yrkesprofessioner inom vårdteamet för att informera och utbilda äldre personer om fallrisker. Riskbedömningsinstrument var ett bra screeningverkyg. Resultatet diskuterades med stöd av Katie Erikssons omvårdnadsteori om vårdandets idé. Slutsats: Denna litteraturöversikt visade att distriktssköterskans olika fallpreventiva omvårdnadsåtgärder framgångsrikt förebygger fall hos äldre personer och det viktigaste är att förebygga det första fallet. / Background: In her work, the district nurse often meets an aging population in their homes where she should work for the improvement of their safety and well-being. Fall accidents of elderly people form a major public health problem as injuries often are complicated and rehabilitation is extensive. The district nurse is a key person in fall-prevention and should work with a holistic view of the older person, in situations where care measures are taken to prevent falls. The purpose of this study is to describe the district nurse's fall preventative care measures in the homes of older people. Method: A literature review based on an inductive approach was conducted, comprising 14 scientific articles with both quantitative and qualitative content. The articles were found in the databases Cinahl, Psykinfo and Pubmed, and were quality assured using a review template from the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). Results: Three categories emerged: Fall-related injuries can be reduced with fall prevention programs, fall risk assessment and cooperation, and how education leads to well-being. Discussion: The result indicates that the district nurse should work with other occupational professionals within the health care team to inform and educate older people about fall risks. Risk assessment methods proved to be a good tool for screening. The result was discussed with the support of “Katie Eriksson's nursing theory” on the idea of care. Conclusion: This literature review showed that the district nurse's various fall preventative care measures successfully prevent fall accidents of elderly people, and that preventing the first fall is most important. / <p>Godkännandedatum: 2019-12-11</p>

Bakgrund: Fallolyckor bland äldre är vanligt. År 2019 var drygt 5% av vårdskadorna på sjukhus fallolyckor. Fallolyckor får konsekvenser för samhället i form av stora kostnader, men även för den äldre i form av bland annat social isolation. Idag finns många fallpreventiva åtgärder och riskbedömningsinstrument och det är sjuksköterskans ansvar att bedriva säker vård och förhindra fallolyckor som skapar ett vårdlidande hos patienterna. Syfte: Att undersöka faktorer som orsakar fallolyckor bland äldre patienter på sjukhus. Metod: Metoden som användes var en allmän litteraturöversikt av vetenskapliga artiklar med både kvalitativ och kvantitativ ansats som tagits fram genom systematisk artikelsökning i flera databaser.Resultat: Tre huvudkategorier identifierades: inre faktorer, yttre faktorer och mänskliga faktorer. Inre faktorer som orsakar fall är sjukdomar och läkemedel. Yttre faktorer är miljöfaktorer, eller tid, rum och aktivitet där de flesta fall sker nattetid vid förflyttning till badrummet eller i samband vid toalettbesök. Mänskliga faktorer är faktorer orsakat av patient och anhörig, eller på grund av brister i sjuksköterskans omvårdnad i form av brister i riskbedömning, åtgärder och information. Konklusion: Orsaken till fall hos äldre patienter är ofta multifaktoriella men det vanligaste är fall nattetid på väg till toaletten. Den mänskliga faktorn är en stor bidragande faktor till fall. / Background: Fall accidents among older persons are common. In 2019, just over 5% of health care injuries in hospitals were fall accidents. Fall accidents have consequences for the society such as large costs, but also for the older patients who become socially isolated. Today, there are many fall prevention interventions and risk assessment instruments. It is the nurse’s responsibility to provide safe care and to prevent falls that cause patients to suffer. Aim: To investigate factors that cause fall accidents among elderly inpatients.Method: The method used was a general literature review of articles with both a qualitative and quantitative approach, which was found through a systematic article search in several databases.Findings: Three main categories were identified: internal factors, external factors and human factors. Internal factors that cause falls are diagnoses and drug treatments. External factors are environmental factors, or time, space and activity where most falls occur at night when transferring to the bathroom or in near connection to toilet visits. Human factors are factors caused by the patients and relatives, or due to lacks in the nurse's care such as risk assessment, measures and information.Conclusion: Cause of falls in older patients is often multifactorial, but the most common fall is falling at night on the way to the toilet. The human factor is a major contributing factor to falls.

Despite the availability of many fall prevention measures, many patients fall in U.S. hospitals each year. Experts view patient fall rates as the measure that can be most affected by a nurse-led, evidence-based intervention. The purpose of this quality improvement project was to implement and evaluate the impact of patient engagement strategies on patient compliance to fall prevention education and the reduction of falls. The quality improvement framework used for this project was the Iowa Model. Interventions for this project included patient engagement strategies including the teach-back (TB) method and video-based fall prevention education paired with the project site's existing fall prevention program. A prospective quantitative design was used to answer the practice-focused question of whether the implementation of a falls protocol incorporating patient engagement strategies improves patient compliance with the fall prevention plan of care and reduces patient falls. A total of 58 patients were included in this project, conducted from July to October 2017. The results showed a 75% reduction in the fall rate compared to the same three month period in 2016. This finding suggests that reinforcement of oral and written instruction through video education follow-up and the use of the TB method to assess patient understanding are effective measures to reduce patient falls and increase patient compliance to the fall prevention plan of care. These patient engagement strategies can be replicated by nurses in similar acute care settings. Adoption of such evidence-based changes in nursing practice may improve patient safety and decrease harm in hospital settings as implications for positive social change.

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This research focused on the implementation of a reliable intelligent fall detection system so as to reduce accidental falls among the elderly people. A video-based detection system was used because it preserved privacy while monitoring the activities of the senior citizens. Another advantage of the video-based system is that the senior citizens are able to move freely without experiencing any hassles in wearing them as opposed to portable fall detection sensors so that they can have a more independent and happy life. A scientific research method was employed to improve the existing fall detection systems in terms of reliability and accuracy. This thesis consists of four stages where the first stage reviews the literature on the current fall detection systems, the second stage investigates the various algorithms of these existing fall detection systems, the third stage describes the proposed fall detection algorithm in detecting falls using two distinct approaches. The first approach deals with the use of specific features of the silhouette, an extracted binary map obtained from the subtraction of the foreground from the background, to determine the fall angle (FA), the bounding box (BB) ratio, the Hidden Markov Models (HMM) and the combination of FA, BB, and HMM. The second approach used is the neural network approach which is incorporated in the algorithm to identify a predetermined set of situations such as praying, sitting, standing, bending, kneeling, and lying down. The fourth stage involves the evalua- tion of the developed video-based fall detection system using different metrics which measure sensitivity (i.e. the capacity of the fall detection system to detect as well as declare a fall) and specificity (i.e. the capacity of the algorithm to detect only falls) of this algorithm. The video camera was properly positioned to avoid any occluding objects and also to cover a certain range of motion of the stunt participants performing the falls. The silhouette is extracted using an approximate median filtering approach and the threshold criteria value of 30 pixels was used. Morphological filtering methods that were dilation and erosion were used to remove any spurious noises from the extracted image prior to subsequent feature analysis. Then, this extracted silhouette was scaled and quantised using 8 bits/pixel and compared to the set of predetermined scenarios using a neural network of perceptrons. This neural network was trained based on various situations and the falls of the participants which represent inputs to the neural network algorithm during the neural learning process. In this research study, the built neural network consisted of 600 inputs, as well as 10 neurons in the hidden layer together with 7 distinct outputs which represent the set of predefined situations. Furthermore, an alarm generation algorithm was included in the fall detection algorithm such that there were three states that were STATE NULL (set at 0), STATE LYING (set at 1) and STATE ALL OTHERS (set at 2) and the initial alarm count was set to 90 frames (meaning 3 seconds of recorded consecutive images at 30 frames per second). Therefore, an alarm was generated only when the in-built counter surpassed this threshold of 90 frames to signal that a fall occurred. Following the evaluation stage, it was found that the combination of the first approach fall detection algorithm method (fall angle, bounding box, and hidden Markov) was 89% with specificity and 84.2% with sensitivity which is better than individual performance. Moreover, it was found that the second approach fall detection algorithm method (neural network performance) 94.3% of the scenarios were successfully classified whereby the specificity of the developed algorithm was determined to be 94.8% and the sensitivity was 93.8% which altogether show a promising overall performance of the fall detection video-based intelligent system. Moreover, the developed fall detection system were tested using two types of handicaps such as limping and stumbling stunt participants to observe how well this detection algorithm can detect falls as in the practical situations encountered or present in elderly people. In these cases it was found that about 90.2% of the falls were detected which showed still that the developed algorithm was quite robust and reliable subjected to these two physical handicaps motion behaviours.

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Detta är en rapportering av ett examinationsprojekt inom högskoleingenjörsprogrammet i innovationsteknik och design. Uppdragsgivaren och projektbeställaren var Stefan Bäckström, VD för Roofac AB. Syftet med projektet var att göra en förundersökning om möjligheten att applicera RSS (Roof Safety Systems) fallskyddssystem på tak med fotrännor genom en tillbehörsprodukt. Denna förundersökning skulle därmed leda till en kunskapsbank och material som skulle kunna vara till nytta för vidare utvecklingsarbete av tillbehörsprodukten. Syftet var också att göra en bedömning kring potentialen att erhålla en prototyp som är tillräckligt bra att användas som en tillbehörsprodukt. Metoden att uppfylla syftet med projektet och uppnå de uppsatta målen har varit att använda PU-processen som har präglats i utbildningens olika projektarbeten. I planeringen av projektet har verktyg som WBS, PERT-schema, Gant-schema och projektmodell använts för att strukturera projektet. I förstudien har research, användarundersökning och analyser utförts för att samla kunskap och underlag till konceptframtagningsarbetet. Analyserna resulterade i en kravspecifikation som kan användas som ett underlag för utvärdering av genererade koncept. Även en mockup-modell av tak med fotränna har konstruerats för att underlätta testning och utvärdering av fysiska koncept-prototyper. Konceptframtagningsarbetet har utgjorts av idégenerering, konceptgenerering och konceptutvärdering. Idégenereringen baserades på tre idégenereringssessioner, en med ett gäng studenter, en med produktutvecklingsingenjörer på Semcon i Karlstad och en med uppdragsgivaren och kollega på Roofac. Utifrån idéerna genererades sedan CAD-modeller som användes till att generera koncept. Koncepten utvärderades sedan med hjälp av för- och nackdelslista och matris. Resultatet av utvärderingen blev tre slutgiltiga koncept. För att uppnå målet med att leverera en fysisk modell/prototyp att använda som uppvisningsmaterial under utställningen av projektet, avgränsades prototypframtagnings- och testningsarbetet med att gå vidare med den lämpligaste av de tre slutgiltiga koncepten. Från prototypframtagningen och testningen erhölls en fysisk modell av det koncept som valdes att gå vidare med efter konceptframtagningen. Denna modell användes tillsammans med en mockup-modell vid utställningen av projektet. Baserat på resultatet från förstudien, konceptframtagningen, prototypframtagningen samt mockupbygget har en kunskapsbank samt material erhållits att kunna använda i vidare arbeten. Utifrån detta anses därför att syftet med projektet vara uppfyllt.