Cette thèse propose un regard transitif sur l'art contemporain en RDA des années 1970 et 1980 et dans les nouveaux Länder en s'appuyant sur l'exemple de deux artistes, Lutz Dammbeck et Karla Sachse. Leurs productions artistiques réalisées avant et après la chute du mur de Berlin, reflètent le processus de construction identitaire en RDA et questionnent également la construction de la mémoire collective allemande. Le premier chapitre propose un aperçu des éléments d'histoire qui ont contribué à cette construction identitaire est-allemande qui touchait toute la société. Les artistes présenté-e-s dans le deuxième et troisième chapitre de cette thèse sont exemplaires pour un grand nombre d'artistes pouravoir refusé la doctrine du réalisme socialiste et n’avoir pas attendu la fin de la RDA pour créer des oeuvres pertinentes et subversives. Les années 1989 et 1990, l'année de la chute du mur et l'année de la réunification allemande, représentent bien un tournant géo-politique important, mais ne signifient pas réellement une rupture pour les artistes issu-e-s des scènes alternatives est-allemandes, comme c’est le cas pour Lutz Dammbeck et Karla Sachse / This thesis proposes a transitive view on contemporary art in the GDR in the 1970s and 1980s and in the new Länder based on the example of two artists, and Lutz Dammbeck and Karla Sachse. Their artistic productions performed before and after the fall of the Berlin Wall, reflect the process of identity construction in the GDR and also question the construction of Germany's collective memory. The first chapter provides an overview of the history that contributed to the construction of identity affecting the whole German society. The artists presented in the second and third chapter of this thesis are exemplary for many artists who refused the doctrine of socialist realism and did not wait for the end of the GDR tocreate important and subversive works. The years 1989 and 1990, the year the Berlin Wall fell and the year of German reunification, represent an important geo-political turn, but mean not really an aesthetic rupture for artists from east German alternative scenes as it is the case for Lutz Dammbeck and Karla Sachse

Abstract There are no definitive laboratory tests for osteoporosis, and little is known of their age-related variation. Furthermore, the knowledge of factors contributing to the occurrence of hip fracture, the most important complication of osteoporosis, during the fall is insufficient. Hip fracture is known to impair the function of elderly patients considerably at short term, but here is only limited information of the potential permanence of this impairment. The goal of treatment is to restore the patient's pre-fracture lifestyle. In this respect, intensive rehabilitation has been recommended and applied in many institutions. However, the number of critical reports on this topic is limited, and the results are heterogeneous. An assessment of the effects of age on some commonly used parameters of bone metabolism in females was performed on 238 healthy Caucasian women aged 40–86 years. It was observed that the markers of bone formation, alkaline phosphatase and osteocalcin, and the marker of bone resorption, tartrate-resistant acid phosphatase (TRACP) as well as parathyroid hormone (PTH), phosphorus and creatinine increased with age, whereas 25-hydroxyvitamin D [25(OH)D] and oestradiol decreased. All these parameters except calcium showed a significant age relation. An evaluation of the factors contributing to the occurrence of hip fracture during a fall on the hip was performed by comparing 123 hip fracture patients to 132 persons who had experienced a fall that caused a visible soft tissue injury in the hip or gluteal region without a fracture. The hip fracture patients more commonly than the fallers were women, lived in long-term institutional care, had had previous stroke with hemiparesis, had Parkinsonism, used neuroleptics, were dependent in ADL and had lower body mass indexes. According to the logistic regression model, institutional residence, low body mass index and a history of stroke with hemiplegic status differed between the fracture cases and controls. The long-term effects (mean follow-up 7 years) of trochanteric hip fracture on outcome were studied by comparing 200 consecutive patients (mean age 77 years) and age- and sex-matched controls representing the average population from the same area. Mortality increased gradually, being 4.5% above the control level at one month and 9% at six years after the fracture. 48% the surviving patients and 90% of the surviving controls were still living in their own homes or service apartments ,whereas 48% of the patients and 5% of the controls were instutionalized. The ambulatory capacity of the patients was significantly worse than controls. The patients managed their ADL activities significantly less well, required more home help and had fewer social contacts and outdoor hobbies than the controls. An assessment of the effect of intensive rehabilitation on the coping of hip fracture patients was done in a prospective randomised study on 154 patients, half of whom were treated postoperatively in a rehabilitation clinic and the other half at health care centre hospitals. Seven of the 70 survival patients of the rehabilitation group 5 of the 71 respective controls were institutionalized at one year. No difference was either observed in the walking ability or ADL functions between the groups.

Fallolyckor är vanligt förekommande bland äldre personer i Sverige. Trots detta saknas studier på de drabbades upplevelse efter ett fall. Syfte: Examensarbetets syfte var därför att beskriva hur äldre upplever sina dagliga aktiviteter efter fall. Metod: Metoden för examensarbetet var kvalitativ med semistrukturerade intervjuer. Nio personer i södra Sverige mellan 71–94 år har deltagit. Materialet har analyserats genom en kvalitativ innehållsanalys. Resultat: Resultatet mynnade ut i tre kategorier, känslor som påverkar utförandet av aktiviteter, fysiska upplevelser som leder till begränsningar samt strategier för att hantera vardagen. Efter fall upplevde många trötthet, rädsla och oro. Även smärta och försämrad rörelseförmåga förekom bland deltagarna. Konsekvenserna efter fall upplevdes påverka och begränsa vardagliga aktiviteter. Slutsats: I resultatet framkom att de personliga erfarenheterna, känslorna och upplevelsen av fall hade minst lika stor påverkan på vardagen som den tillhörande fysiska skadan. / Fall accidents are common among older people in Sweden. Despite that there is lack of studies about the affected person's experience after a fall. Purpose: The purpose of the study is therefore to describe how older people’s experience their daily activities after falling. Method: The study was a qualitative interview study with semi-structured interviews. Nine people 71-94 years old from south Sweden have been participating in the interview study. The collected data was analyzed with a qualitative content analysis. Result: The result was divided into three categories:  Feelings that affect the performance of activities, physical experiences that lead to limitations and strategies for managing everyday life. Many experienced tiredness, fear and anxiety after a fall. Even pain and impaired mobility occurred among the participants. The consequences after a fall were found to affect and limit the everyday life. Conclusion: Based on the results of this study the personal experiences, feelings and the experience of the fall had at least as much influence on the daily life as the physical injury.

Le vieillissement démographique français constitue un défi majeur de santé publique. Il se caractérise par des changements physiologiques pouvant provoquer des troubles moteurs. Il en résulte à plus ou moins long terme une perte d'autonomie nécessitant parfois l'institutionnalisation de la personne. L'examen des déficits posturaux se réalise en pratique clinique courante par une évaluation stabilométrique. L'enregistrement des déplacements du centre des pressions peut être analysé selon deux approches : la première, traditionnelle, analysant leur cinématique à l'aide de statistiques descriptives ; la seconde, dynamique, quantifiant leur complexité notamment en termes de régularité. Dans ce travail, nous montrons statistiquement la complémentarité de ces deux approches. Nous mettons également en évidence les intérêts cliniques de l'approche dynamique au travers de deux études : (i) une exploration de la relation entre les résultats d'un test fonctionnel validé et l'évaluation posturale chez des femmes âgées sédentaires ; (ii) une comparaison basée sur une analyse dynamique des fluctuations posturales de deux groupes de personnes âgées institutionnalisées : avec et sans antécédents de chute. / In France, aging is a major public health challenge. Specific aging-associated physiologic modifications can produce movement disorders and lead to dependency and institutionalization in nursing homes. Clinical examination of postural deficits is generally achieved by means of stabilometric evaluation. Recordings of center of pressure (COP) displacements can be analyzed in two ways : (i) a classical approach based on kinematics and descriptive statistics or (ii) a dynamical approach which provides a quantification of the complexity of COP time series in terms of regularity. In this work, we statistically show the complementarity of these two approaches. We also highlight the clinical interest of the dynamical approach with two clinical studies : (i) an exploration of the relationship between a functional test and postural evaluation in asymptomatic sedentary older women ; (ii) a comparison of institutionalized elderly non-fallers and fallers based on a dynamical analysis of COP fluctuations.

There is a growth of wind power development in icing climates, in which ice accumulation on objects takes place. This leads to specific challenges including ice throw, the detachment of ice from wind turbine blades. The lack of understanding of the ice throw phenomenon among authorities leads to the fact that there is no coherence in the applied ice throw mitigation policies in various countries and regions, which can cause safety- and financial hazards for wind farms in icing climates. This research focusses on ice throw risk mitigation methods and their effect on a wind farms yield. Qualitative research is applied, interviewing six experts in the field of cold climate wind power development. The participants are from academic, public and private research institutions in five countries. The qualitative research focusses on policies that are plausible but non-preferred, as well as preference suggestions from the experts on how to treat the ice throw risks. The non-preferred policies involve shutting down wind farms during icing periods and conditionally allowed operation with applied heating systems. These policy scenarios are applied to a virtual wind farm near Slagnäs, Sweden, in order to indicate the impact on the yield and underline the impact that these policies would have on the turnover of a wind farm in a sever icing climate. The non-preferred policies have a significant impact on the Slagnäs wind farms yield with 2,28% annual yield losses in case of 200 annual icing hours. Apart from the impact on yield, the policies might not reduce the danger of ice throw significantly, as from a standing still turbine, detached ice can still travel a horizontal distance of up to one time the turbine height. Therefore, policies should according to the interviewed experts not focus on limitations, however focus on understanding risks and taking appropriate action for risk mitigation. International guidelines are the best tool to create a deeper understanding of ice throw risk assessments and their limitations, as well as an understanding of risk mitigation methods. In this case, the risk assessment process shall be standardised, however the risk mitigation methods shall be site specific.

Falls are the primary cause of injuries among older adults, and accidents that result from falls can lead to personal suffering and extensive societal burdens. The overall aims of this thesis were to explore and describe falls and fall prevention strategies in community-dwelling older adults and to evaluate a fall prevention home exercise program, the Otago Exercise Program (OEP), with or without motivational interviewing (MI). Methods: Qualitative and quantitative research methods were uses. The designs were as follows: a cross-sectional, descriptive and comparative study (study I); a descriptive feasibility investigation (study II) and a randomized controlled trial (RCT) with two interventions, the OEP and OEP+MI, as well as a control group, with a 12-month follow-up (study III); and a prospective and descriptive study (study IV). The four studies comprised community-dwelling individuals aged 75 years or older. Study I included 262 individuals and studies II-IV had 175 participants who needed walking aids or home support. Study II also included 12 physical therapists.  Data collection was performed via self-reported questionnaires, fall calendars, exercise diaries, physical performance tests and a semi-structured questionnaire.  Results and conclusions: Suggested actions to prevent falls significantly differed between high and low active older adults (study I). Support for self-directed behavioral strategies could be important for preventing falls in older adults who have low physical activity levels. The study protocol for the RCT had acceptable feasibility (study II), and only minor changes of the protocol were needed. There were no benefits for OEP or OEP+MI with personal support implemented nine times over the 12-month period. However, all groups maintained physical functioning and activity (study III). To increase physical functioning and reduce falls in this sub-group of older adults, more frequent personal support and/or an alternative delivery format may be required for efficient intensity and challenge in home exercises. Over 12 months, falls and fall-related injuries in the RCT sample were the most common when moving around within the home and transitioning from sitting to standing (study IV). Special attention to these activities might be important for preventing falls in community-dwelling older adults who need walking aids or home support.

Syftet med denna studie var att undersöka elevers och studie- och yrkesvägledares upplevelser av studieavbrott i Komvux vuxenutbildning. Studien tar upp vad som har orsakat studieavbrotten och om vuxenutbildningen hade kunnat göra något för att hjälpa eleverna att undvika dessa. En kvalitativ forskningsansats användes för studien med inspiration från fenomenografisk metodansats. Kvalitativa halvstrukturerade intervjuer genomfördes. Datainsamlingen skedde dels med stöd av en chatt-dialog med de elever som hade avbrutit sina studier och ansikte mot ansikte i intervjuer med studie- och yrkesvägledare. Datainsamlingen omfattar tio intervjuer med studie- och yrkesvägledare och med nio elever. Alla elever har deltagit i gymnasial teoretisk Komvux, men valt att avbryta sina studier. Ett teoretiskt ramverk användes för att analysera och kategorisera orsakerna till studieavbrotten. Kategorierna omfattade begreppen "pull out", "push out" och "fall out". Teorin hämtades från tidigare studier som har haft avsikten att titta närmare på just orsaker bakom studieavbrott. Resultatet visade att de tre kategorierna fanns representerade även i resultatet i den här studien orsaker bakom studieavbrott inom Komvux verksamhet. Ett tema som framkom under analysen av data som kan ses väsentligt att följa upp var enskilda studieplaneringar och lokala insatser. Det var något som i hög grad efterfrågades av de studerande för att klara studierna och även lyftes fram av studie- och yrkesvägledarna i samtalen. Anpassningar för att svara upp mot enskilda studerandes behov av stöd för sina studier saknades. Uppdraget och behovet behöver tydliggöras i organisationen. Studien har därmed synliggjort och lyft fram ny kvalitativ information

Bakgrund: Senior alert är ett nationellt kvalitetsregister. Registret vänder sig till äldre personer över 65 år som har någon form av kontakt med vård och omsorg som särskilt boende, korttidsboende, hemsjukvård, primärvård och/eller sjukhusvård insatser. Senior alert är ett register i vårdprevention som förebygger trycksår, undernäring, fall, munhälsa, och blåsdysfunktion. Det handlar om att göra riskbedömningar, definiera orsaker, planera åtgärder och uppföljningar. Registret hjälper vårdpersonalen att uppfylla arbetet i förebyggande vård.Syfte: Syftet var att beskriva hur Senior alert fungerar i vården av äldre på särskilt boende. Metod: Intervju med fem sjuksköterskor på särskilt boende, Graneheim & Lundmans (2004) kvalitativa innehållsanalys användes för att bearbeta data. Resultat: Senior alert är ett bra arbetsverktyg ger översikt och struktur och en bättre omvårdnad av äldre. Sjuksköterskor upplever att arbetet med Senior alert är tidskrävande och det finns brister i arbetssätt och rutiner i kommunen. Senior alert kan förbättras. Slutsats: Senior alert är ett bra system när det finns rutiner och möjlighet att arbeta med det. Sjuksköterskor upplever däremot att Senior alert inte fungerar i vården av äldre på särskilt boende i den valda kommunen. Det saknas utbildning och tydliga mål med hur Senior alert ska fungerar i kommunen och det bör skapas förutsättningar.

No andar, o risco de quedas em idosos é maior. O objetivo é estudar o risco de quedas na locomoção sem visão e a relação entre orientação espacial, veering e controle postural. Participaram 27 adultos (25,2±4,5 anos, 1,68±0,10m, 63,8±10,3kg); 27 idosos AF (72,1±4,3 anos, 1,60±0,09m, 68,5±13kg); 12 idosos RQ (72,3±6 anos, 1,57±0,08m, 67,4±10,9kg). Eles caminharam 15m sem visão com um acelerômetro fixo entre L1 e L2. Variáveis: grupo; variabilidade do desvio; erro absoluto e variável; DFA; Tc; HST; DLT. O idoso RQ teve maior variabilidade do desvio (F(2,63)=4,6, p=0,01), erro absoluto (F(2,63)=16,64, p<0,0001) e variável (F(2,63)=4,5, p=0,01). Grupo (F(2,652)=48,9, p<0,0001) e direção (F(1,652)=444,5, p<0,0001) afetaram o DFA, e foi maior nos idosos e em AP (p<0,0001). O grupo (F(2,652)=29,3, p<0,0001) e direção (F(1,652)=605, p<0,0001) afetaram o HST, no idoso RQ e na ML (p<0,0001). O grupo (F(2,652)=30,8, p<0,0001) e direção (F(1,652)=178, p<0,0001) afetaram HLT,que foi maior nos idosos e em ML (p<0,0001). A forma como o indivíduo caminha nas direções ML e AP são diferentes. O controle da oscilação é anti-persistente na direção ML e persistente na AP. Os idosos dependem mais da visão na estabilização ML na locomoção. Os idosos RQ apresentam maior veering, os idosos AF e adultos têm veering semelhante. A AF pode retardar o envelhecimento quanto à estabilidade dinâmica e à memória espacial durante a locomoção sem visão, diminuindo o risco de quedas / For elderly, the risk to fall increases during walking. The aim of this project is to study the risk to fall in elderly during gait without vision and its relation to spatial orientation, veering and postural control. The subjects were 27 adults (25.2±4.5 years old, 1.68±0,10 m height, 63.8±10.3 kg weight); 27 elderly AF (72.1±4.3 years old, 1.60±0.09 m height, 68.5±13 kg weight); 12 elderly RQ (72.3±6 years old, 1.57±0.08m height, 67.4±10.9 kg weight). The subjects were instructed to walk straight ahead with their eyes closed for 15 m, with an accelerometer fixed between L1 and L2. The variables were: group; target variability; absolute and variable error; DFA; Tc; HST; DLT. The elderly RQ showed the highest target variability (F(2,63)=4.6, p=0.01), absolute (F(2,63)=16.6, p<0,0001) and variable error (F(2,63)=4.5, p=0.01). Group (F(2,652)=48.9, p<0.0001) and direction (F(1,652)=444, p<0.0001) affected DFA, AP and elderly showed the highest values (p<0.0001). Group (F(2,652)=29.3, p<0.0001) and direction (F(1,652)=605, p<0.0001) affected HST, elderly RQ and ML showed the highest values (p<0.0001). Group (F(2,652)=30.8, p<0.0001) and direction (F(1,652)=178, p<0.0001) affected HLT, all elderly and ML showed the highest values (p<0.0001). The direction affects gait control, it is anti-persistent for ML direction and persistent for AP direction. The lack of visual information affects more the elderly in ML direction. The elderly RQ showed larger veering; while the others were similar. Physical activity may slow down the aging process by affecting the dynamic stability and spatial memory during gait without vision, leading to reduce the risk of fall

Falls are a contributing factor to increased morbidity in the elderly and chronically ill populations and can affect overall quality of life. The literature indicates that oncology patients are a particularly vulnerable population who are further at risk for falls due to increased age, treatment related fatigue, side effects of medications, co-morbidities, decreased muscle tone, altered mental status, and anemia. Although patients with cancer are at a high risk for falls, this is not a well-documented patient problem in the nursing literature. This study examined the validity of the use of the Morse Fall Assessment Tool for use with Bone Marrow Transplant patients and explored other variables that might influence fall outcomes. This study was a retrospective chart review. The sample consisted of a total of 59 patients, which included 29 fallers and 30 non-fallers on a bone marrow transplant unit. There were 22 males and 37 females, ranging in age from 20 to 70 with a mean age of 53.9 (SD= 12.2).The results of this study indicate that there is a significant difference between fallers' (M= 43.8) and non-fallers' (M= 26.8) scores on the Morse Fall Scale (p= 0.000). Significant differences between groups were found with history of falls (p= 0.042), secondary diagnosis (p= 0.015), and muscle weakness (p= 0.025). Laboratory results from fallers and non-fallers revealed significant differences in platelet count (p= 0.003), BUN (p= 0.032), glucose (p= 0.009), and phosphorous (p= 0.001). This is the first study to document falls in the bone marrow transplant population. This study should be a stimulus for future studies conducted in the oncology and/or bone marrow transplant population. Studying falls in these patients is essential to understanding the physiological risk factors that may contribute to patient falls. Findings lay the foundation for studying falls in the bone marrow transplant population. It is crucial to study falls in this population in order to make appropriate assessments and interventions to keep this population free from injury.