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Bakgrund: Fall är vanligt förekommande hos äldre personer och har stora konsekvenser för både individen och samhället. Fallförebyggande multifaktoriella interventioner rekommenderas för äldre personer som bor hemma men det saknas stark evidens för vilka kombinationer av fallpreventiva interventioner som är effektiva. För att få en bättre bild av fördelarna med att inkludera andra interventioner tillsammans med träning är det av vikt att undersöka kombinationen av patientutbildning tillsammans med träning hos hemmaboende äldre. Syfte: Att undersöka effekten av patientutbildning i kombination med träning på antalet fall hos hemmaboende äldre samt redovisa innehållet i patientutbildningarna och träningsinterventionerna. Metod: En systematisk litteraturstudie där sökningen genomfördes i PubMed. Åtta RCT-studier valdes ut. Studiernas kvalitet granskades med PEDro-skalan och tillförlitligheten av det sammanvägda resultatet bedömdes utifrån GRADEstud.   Resultat: Åtta studierna inkluderades med totalt 1557 deltagare där den lägsta medelåldern var 71 år. Fem studier sammanvägdes. Alla studier innehöll patientutbildning och träning, dock varierade komponenterna i interventionerna. Kontrollgrupperna innehöll ingen intervention, sedvanlig vård eller icke fallpreventiva interventioner. Jämfört med kontrollgruppen hade interventionsgruppen ingen effekt av patientutbildning i kombination med träning på antalet fall. De fem studier som sammanvägdes hade bra kvalitet (6-8 poäng) enligt PEDro-skalan medan det sammanvägda resultatet hade låg tillförlitlighet enligt GRADEstud. Konklusion: Patientutbildning i kombination med träning visade ingen fallreducerande effekt på hemmaboende äldre och innehållet i interventionerna skilde sig åt i samtliga studier. Fler framtida studier behövs då tillförlitligheten av det sammanvägda resultatet bedömdes vara låg. / Background: Falling is common among older people and has severe consequences for both the individual and the society. Multifactorial interventions are recommended for community-dwelling elderly, although there is a lack of strong evidence for which combinations of fall preventive interventions that are effective. To get a better picture of the benefits of including other interventions together with exercise it is of most importance to investigate the combination of patient education together with exercise for community-dwelling elderly.   Aim: To investigate the effect of patient education in combination with exercise on the number of falls amongst community-dwelling elderly, and to present the content in the patient education and the exercise interventions.  Method: A systematic literature study was carried out in PubMed. Eight RCT-studies were chosen. The quality was assessed using the PEDro-scale and the combined reliability of the studies was assessed using GRADEstud.  Results: Out of the eight studies five of them were combined with a total of 1557 participants and the lowest average age was 71 years. All of the studies contained patient education and exercise, although the components in the interventions varied. The control groups contained; no intervention, usual care or non-fall preventive interventions. No effects of the patient education in combination with exercise was demonstrated on the number of falls in comparison to the control groups. The five studies that were combined had good quality (6-8 points) according to the PEDro-scale while the combined result had low reliability according to GRADEstud.  Conclusion: Patient education in combination with exercise had no fall reducing effect on community-dwelling elderly and the content in the interventions varied in all the studies. More future studies are needed since the reliability in this study was low.

Bakgrund Omvårdnadspersonalen är viktig för fallpreventivt arbete inom särskilt boende för äldre då de arbetar närmast patienterna. Det är viktigt att undersöka omvårdnadspersonalens syn på fallpreventivt arbete för att få ökad förståelse för hur omvårdnadspersonal kan stöttas i det fallpreventiva arbetet. Syfte Att utforska omvårdnadspersonalens upplevelser av fallprevention och samarbete med fysioterapeut i det fallpreventiva arbetet på särskilt boende. Metod En kvalitativ metod med semistrukturerade intervjuer. 11 personer som arbetade på särskilda boenden ingick i studien. Databearbetning genomfördes i form av en kvalitativ innehållsanalys. Resultat Analysen gav fem kategorier och tjugo subkategorier, De fem huvudkategorierna bestod av: Miljöfaktorer påverkar fallrisk, Individfaktorer påverkar fallrisk, Strategier som omvårdnadspersonalen använder vid ökad fallrisk direkt gentemot kunden, Samarbetsstrategier som omvårdnadspersonalen använder vid ökad fallrisk, Samarbete mellan omvårdnadspersonal och fysioterapeut. Konklusion Studien visade att omvårdnadspersonalens upplevelser av det fallpreventiva arbetet innefattade identifiering av riskfaktorer hos individ och miljö. De använde strategier vid ökad fallrisk direkt gentemot kund och ett bra kommunikativt samarbete med fysioterapeut, anhöriga och övrig vårdpersonal var betydelsefullt för det fallpreventiva arbetet på särskilt boende. Omvårdnadspersonal önskade stöd från fysioterapeut i form av praktisk hjälp med fallriskbedömning och information om specifika och generella fallpreventiva åtgärder.

Fall-related injuries are common problems in elderly care in particular. These can cause brain damage and hip fractures, which in many cases can be serious. To reduce or mitigate the damage, various safety measures have been developed. One of them concerns a change in the surroundings, more specifically, the floor. At KTH within the Division of Neuronic Engineering, research has been done on how the impact of the case can be minimized and a shock absorbing floor (SAF) was developed. Diving problems with this type of flooring are that heavy medical beds sink into the floor, which means increased rolling resistance and thus long-term damage to both the floor and the medical staff. The aim of this thesis was to investigate how much rolling resistance can be minimized by building a downscaled hovering device based on hovercraft technology. The purpose was to enable the device to possibly be mounted under hospital beds and create a lifting force. To evaluate the performance, force measurements were performed on KTH SAF with different weights and with the use of a dynamometer. The results showed that the device reduced rolling resistance by up to 57.4% with additional weight. Four axial fans were used together with manual control of the speed of each fan. The selected components were made taking into account, in particular, cost, weight and dimensions and can thus also be limiting factors for this thesis. For future work, effective soundproofing is needed for this solution to be possible to be implemented in a hospital environment. Furthermore, studies needs to be carried out for a full-scale prototype to confirm that an equally large reduction in rolling resistance can be achieved.

Context. Generally, health monitoring systems are used in hospitals, which are pricey and gigantic. But with the up gradation of sensors and modules, these devices are also available in portable sizes. These devices are divided into different types according to the disease. So, our project aims to provide a device with multiple parameters monitoring with fall detection, and it is budget-friendly.  Objectives. The objective of our project is to provide freedom to users and monitor simultaneously, using IoT and sensors. People with an illness that may be physical or mental, children, and older people with some issues. They are the users of our idea. Generally, they need to be monitored by a person, which is costly and requires endurance. So, the main objective is to monitor the patient’s health condition and alert in an emergency and store the data on the user’s health.  Methods. After a lot of observation, we found that we can monitor the patient’s health status using an ESP32 Wroom dev kit, which is a microcontroller that consists of Bluetooth and Wi-Fi. We use an MPU6050 accelerometer that detects the falling and motion of the user using three axial movements. We use MAX30102 pulse oximetry which measures the oxygen level, pulse rate, and temperature. Along with these, we use a mobile application that receives data and stores it.  Results. The device reads the parameters regularly and stores the data in the cloud or mobile application. It contains a push button that alerts the relatives and respected authorities. It transmits the location. Finally, it will trigger the command of alerting when the user falls. Conclusions. Every person can use our health monitoring system. The person should wear the device properly and be connected to the Wi-Fi. Once the fall is detected, the contacts are notified. And the detection is more accurate. Regular usage of the device increases the accuracy and analysis of the user’s health.

Yes / Ice cover formed on an alluvial channel can significantly alter the flow characteristics, such as the vertical distributions of streamwise velocity and shear stress, and hence the water and sediment transport process. The vertical profile of the suspended sediment concentration in the ice-covered alluvial channels with steady uniform flows is investigated in this study. To calculate the suspended sediment concentration, we are based on the Schmidt O’Brien equation and deduce an analytical model that employs an existing eddy viscosity model and a modified formula of the sediment fall velocity considering the common effects of the upper and lower boundaries. The proposed analytical model is then validated by using available experimental data reported in the literature. The predicted accuracy of the proposed model is evaluated through error statistics by comparing to previous modeled results. The relative concentration profiles of the suspended sediment are subsequently simulated by applying the validated analytical model with different characteristic parameters. Results show that the relative concentration decreases with the increase of both the ice cover roughness and the sediment fall velocity. The uniformity of the relative concentration distribution is closely related to the value of the proportionality parameter σ, revealing the physical mechanism that the more prominent the turbulent diffusion effect is, the more uniform the relative concentration profile is. / This work was supported by the National Natural Science Foundation of China (grant 604 numbers 52020105006 and 11872285) and the Open Funding of State Key Laboratory of Water Resources and Hydropower Engineering Science (WRHES), Wuhan University (Project number 2018HLG01).