Falls continue to be a major problem in the residential construction industry and account for a large number of injuries and fatalities each year (US Department of Labor, 2012).  The effects of a fall are catastrophic to the workers and their families as well as the construction company and surrounding community.  Prevention of these incidents has been the primary focus of organizations such as the Occupational Safety and Health Administration (OSHA).  To reduce the number of falls on residential construction sites, OSHA has put forth several standards that require the use of fall protection.  Although guidelines have been provided, there have been concerns and complaints regarding the standards as well as methods and materials that should be used. The goal of this research was to measure the behavior of a five truss roof system with various anchor points and bracing configurations loaded by a horizontal force.  A lab built roof system was used to test three different anchor types with three forms of temporary bracing.  The materials and methodology used in this testing were based on common materials and practices currently used in the residential construction industry. The results of this research show that anchors must engage multiple trusses to spread the applied load throughout the roof system.  Several forms of temporary bracing such as lateral, diagonal, and sway bracing, are also required to strengthen the roof system allowing it to withstand an applied load. / Master of Science

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Falls are a serious issue for the elderly living in long-term care facilities, as falls contribute to signi�cant health problems such as increased dependence, loss of autonomy, confusion, immobilization, depression, restriction in daily activities, and, in some cases, death. An estimated 424,000 fatal falls in elderly patients residing in long-term facilities occur annually in the United States costing $34 billion in direct medical costs. One way to reduce falls among elderly patients in long-term care is to assess for fall risk frequently and implement evidence-based strategies to prevent falls. Patients in this project site facility had been assessed for fall risk via the Briggs Fall Risk Assessment Tool with implementation of fall risk iinterventions only upon admission or when there was a fall. The purpose of this project was to assess whether changing to weekly use of the Briggs Fall Risk Assessment Tool with implementation of fall risk interventions by nursing staff could decrease fall rates in the elderly in long-term care in Harris County, Texas. The model of prevention served as the conceptual framework for this project. Thirty participants (20 females and 10 males) between the ages of 65-115 participated in the program. Pre-implementation data were collected for 1 month and post-implementation data were collected for 1 month. The total number of falls reported weekly was counted before and after the weekly implementation of the Briggs Fall Risk Assessment Tool. The number of falls decreased from 12(70.6%) before the implementation of the assessment tool to 5(29.4%) falls afterwards. A fall prevention program in long-term care may affect social change positively by reducing fall risk in long term care by reinforcing the importance of increased awareness of risk of falls to implement fall prevention strategies

A Magnet-recognized academic hospital system experienced an increase in patient falls and patient falls with injury after transitioning to a new electronic health record. The purpose of the project was to evaluate the effectiveness of a system-wide quality improvement practice change. The practice-focused question addressed a Magnet model implementation of a standardized, system-wide, evidence-based Hester Davis Scale (HDS) fall risk assessment and intervention tool and the impact on the nursing-sensitive indicators of patient fall rates and fall rates with injury. Successful implementation and sustained, correct use of the HDS fall risk assessment and targeted fall-prevention-intervention tools added to the evidence of multifactorial fall-intervention-prevention strategies designed to reduce patient falls and patient injury associated with falls. Two models were used to inform the project: the American Nurses Credentialing Center next-generation Magnet model and the Institute for Healthcare Improvement framework for spread. The primary source of evidence was the National Database of Nursing Quality Indicators. A run chart approach to process improvement was determined to be the best method to assess the effectiveness of the HDS Falls Prevention Program for 28 months post implementation. The run chart for patient fall rates and fall with injury rates demonstrated a reduction in falls and sustained improvement over 28 months. The decreases in falls and fall with injury rates of this project have implications for positive social change. Magnet recognition supports the implementation of the evidence-based HDS Fall Reduction Program, thereby improving the quality of life for patients and families and reducing the burden and cost of health care associated with falls.

Abstract High age is a distinguished risk factor of falling, but there remains gaps in epidemiological data among very old people. Also, effects of exercise-oriented intervention implemented by geriatric teams is not known. The aims were to describe the incidence and risk factors of falls, the risk of fall-related injuries associated with physical activity, and to investigate the effect of pragmatic exercise intervention on fall risk among a home-dwelling population aged 85 years and older. The target population consisted of home-dwelling citizens of Oulu aged 85 years or more (N = 827). Altogether 555 people (mean age 88 SD ± 3), representing 67% of the population sample, were evaluated by interviews and clinical assessments. Falls and physical activity were monitored via telephone nine times during a 27-month follow-up constituting 1114 person years. Risk factors of falls were determined during an 11-month period before intervention, as were the effects of the intervention during a 16-month period thereafter. Negative binomial regression, pooled logistic regression and Cox regression analyses were used to analyze data. The incidence rates of falls, major soft tissue injuries and fractures were 1039 (95% CI 974–1093), 74 (58–92) and 89 (72–108), respectively. The probability of getting injured was higher in the morning and evening than in the daytime. The contribution of the ongoing activity and the type of falling to the risk of injury was less than that previously reported among younger home-dwellers. The risk factors of falls were a history of recurrent falling, trouble with vision when moving, use of an antipsychotic drug, and feelings of anxiety, nervousness or fear. Exercise other than walking was associated with a reduced risk of injury-causing falls. Pragmatic intervention wasn’t effective in preventing falls, but it was effective in preserving balance performance. Among those with better functional abilities, intervention was effective in reducing the risk of the first four falls. Adherence to recommended interventions was relatively low. In conclusion, the frequency of falls and fall-related fractures increases up to the highest ages. Anxiety-related disorders may be more important risk factors of falls than are drugs commonly used in treatment. Exercise related to everyday activities is safe among the most elderly. The effects of practical exercise intervention are promising, but attention needs to be paid to adherence to exercise in order to improve these effects.

One and a half million people are currently living in residential care facilities; as the baby boomer generation ages, this number will increase to 3 million. Approximately 3 out of 4 residents of these facilities fall each year, and 10% to 20% of those falls result in serious injuries such as fractures, disability, and a decreased quality of living. The BOUNCE Back fall initiative is a multifactorial program that uses a systematic approach starting on admission and to re-evaluate a resident following a fall. Nursing and therapy uses the Morse Fall Scale and the Elderly Mobility Scale to assess and categorize the resident's risk for falls. Guided by Lewin's theory of change, this project was designed to assess the effectiveness of the fall initiative as a quality improvement 60-day (August 2016- September 2016) pilot study in a skilled nursing and rehabilitation facility as a potential means to reduce the number of resident falls. Sixty residents (aged 64 to 98, mean age 81) were assessed at a minimum 2 time points to determine their level of fall risk and needed intervention, within 60 minutes of admission to the facility and 7 days postadmission. De-identified pre- and post-implementation data were provided from the corporate quality measure database, entered into a spreadsheet, and numbers were compared. As a result of the fall prevention pilot, for August 2016, 5 falls occurred with no repeat fallers; September 2016, 3 falls with 1 repeat faller which is a significant decrease from 14-22 falls occurring per month for 2 consecutive years. Following implementation, the facility scored 3%-5% for the number of falls, which is below the 7% threshold set forth by the pilot facility's corporate office. Prior to the implementation of the initiative, the facility had not met the 7% fall threshold in 2 years

Introduktion: Byggsektorn är en utsatt bransch där många arbetsrelaterade olyckor inträffar, inklusive olyckor med dödlig utgång. Fallolyckor är en av de vanligaste förkommande typerna av olyckor, trots säkerhetsåtgärder som fallskyddsutrustning och säkerhetsrutiner. Totalt nio byggnadsarbetare omkom på grund av fallolyckor 2018 och åtta 2019 i Sverige. Arbetsmiljöverket och Sveriges regering har länge arbetat tillsammans för att motverka dödsolyckor genom deras nollvision. Trots att mycket arbete har gjorts för att förebygga fallolyckor finns det mycket kvar att göra inom arbetsmiljöområdet. Arbetet genomförs i samarbete med Cramo AB, specifikt Cramoskolan, och kommer undersöka yrkesarbetares inställning till fallsäkerhet innan respektive efter ett utbildningstillfälle inom fallskydd. Målet är att utvärdera hur utbildningsinsatser påverkar yrkesarbetares medvetenhet om fallsäkerhet utifrån de fem nivåerna: 1) individen, 2) fysisk miljö, 3) systemet, 4) organisationen samt 5) säkerhetsklimat och säkerhetskultur. Metod: I studien användes en kvalitativ forskningsmetod för att besvara syftet och frågeställningarna. Datainsamling utfördes genom intervjuer och en litteraturgenomgång. Studien innefattade tolv intervjuer totalt, där sex personer från olika befattningar inom byggsektorn intervjuades både före och efter ett utbildningstillfälle. Resultat: Resultatet visade att fallskyddsutbildning hade en effektiv påverkan på yrkesarbetares medvetenhet om fallsäkerhet, däremot i varierande grad beroende på vad deras attityd samt bakgrund var sedan tidigare. De nivåer som yrkesarbetarna ansåg viktigast att arbeta vidare med för att öka fallsäkerheten var individen samt säkerhetsklimat och säkerhetskultur. Analys: Synen på fallsäkerhet förändrades mest hos de yrkesarbetare som inte hade några större erfarenheter kring att arbeta med säkerhet sedan tidigare, i kombination med en allmänt bristfällig syn på fallsäkerhet. Synen på fallsäkerhet förändrades minst hos de yrkesarbetare som dagligen arbetar med säkerhetsfrågor och som generellt har ett gott säkerhetstänk sedan tidigare. Diskussion: Studiens ändamål har uppnåtts med hjälp av undersökningens kvalitativa datainsamlingar. Resultatet från den insamlade empirin ansågs trovärdig eftersom informationen gav en relevant beskrivning som besvarade undersökningens samtliga frågeställningar. Några väsentliga brister som framkom var att några av de intervjuade relaterade till säkerhet generellt i stället för att specifikt anknyta till just fallsäkerhet, samt att vissa inte hade haft tillfälle att omsätta kunskaperna de innefattade från fallskyddsutbildningen i praktiken. Nyckelord: Bygg, byggnadsarbetare, fallolycka, fallsäkerhet, olycka, säkerhet, säkerhetsutbildning, utbildning. / Introduction: The construction sector is a vulnerable industry where many work-related accidents occur, including accidents resulting in fatalities. Fall accidents are one of the most common types of accidents, despite safety measures such as fall protection equipment and safety procedures. In Sweden year 2018, a total of nine construction workers lost their lives due to fall accidents and eight in 2019. The Swedish Work Environment Authority and the Swedish government has long been working to combat this with their zero-tolerance policy towards fatal accidents. Despite much work being done to prevent fall accidents, there is still a lot of work that needs to be accomplished in this field. The work is conducted in collaboration with Cramo AB, specifically Cramo School, and will investigate the attitudes of professional workers towards fall safety before and after training in fall protection. The goal is to evaluate how educational interventions affect professional workers' awareness regarding fall safety based on the five levels: 1) the individual, 2) the physical environment, 3) the system, 4) the organization, and 5) the safety climate and culture. Method: The study utilized a qualitative research method to answer the purpose and research questions. Data collection was carried out through interviews and a literature review. The study included a total of twelve interviews, where six individuals from different positions within the construction industry were interviewed both before and after a training session. Results: The results showed that fall protection training had an effective impact on professional workers' awareness regarding fall safety, but to varying degrees depending on their attitudes and previous backgrounds. The levels considered most important to work on to increase fall safety were the individual and the safety climate and culture, according to the professional workers. Analysis: The perception of fall safety had changed the most among professional workers who had no significant experience working with safety before and had a generally poor perception of fall safety. The perception of fall safety had changed the least among professional workers who had already worked with safety issues and generally had a good safety mindset before. Discussion: The study's purpose was achieved through the qualitative data collection of the survey. The result from the collected data was considered credible because the information provided a relevant description that answered all the survey questions. Some relevant shortcomings that emerged were that some of the interviewees associated safety in general instead of specifically relating to fall safety, and that some had not had the opportunity to apply the knowledge they gained from the fall protection training in practice. Keywords: Accident, construction, construction worker, education, fall accident, fall saftey, fall protection education and saftey.

This thesis attempts to construct a systematic Irenaean Pneumatology, making a contribution in the history of dogma. The aim of this thesis is to develop a theological system, based on the Irenaean writings, that demonstrates that the area of Pneumatology was one of the central constructs in Irenaeus' thought. The methods employed in this thesis are: An evaluation of the data available in the context of Irenaeus' premise in the light of Scripture's presentation; a detailed analysis of literary contributions on the subject; and a research of the patristic thought and how other Church Fathers have identified and interpreted the Spirit's involvement in its development. This thesis compares Irenaeus' pneumatological writings with biblical and patristic texts, and presents the opinions of various Ireanaean scholars, offering either positive comments or academic disagreements on these opinions. Irenaeus' pneumatological thought is presented and evaluated in five particular chapters: The creation and spiritual destiny of humanity; the fall of humanity; the spiritual redemption of humanity; the Church and the Holy Spirit; and eschatology and the Holy Spirit. The final conclusion of the thesis is that the person and the work of the Holy Spirit governed Irenaeus' understanding of most -if not all- other theological concepts. / PhD (Church and Dogma History), North-West University, Potchefstroom Campus, in association with Greenwich School of Theology, UK, 2011

This thesis attempts to construct a systematic Irenaean Pneumatology, making a contribution in the history of dogma. The aim of this thesis is to develop a theological system, based on the Irenaean writings, that demonstrates that the area of Pneumatology was one of the central constructs in Irenaeus' thought. The methods employed in this thesis are: An evaluation of the data available in the context of Irenaeus' premise in the light of Scripture's presentation; a detailed analysis of literary contributions on the subject; and a research of the patristic thought and how other Church Fathers have identified and interpreted the Spirit's involvement in its development. This thesis compares Irenaeus' pneumatological writings with biblical and patristic texts, and presents the opinions of various Ireanaean scholars, offering either positive comments or academic disagreements on these opinions. Irenaeus' pneumatological thought is presented and evaluated in five particular chapters: The creation and spiritual destiny of humanity; the fall of humanity; the spiritual redemption of humanity; the Church and the Holy Spirit; and eschatology and the Holy Spirit. The final conclusion of the thesis is that the person and the work of the Holy Spirit governed Irenaeus' understanding of most -if not all- other theological concepts. / PhD (Church and Dogma History), North-West University, Potchefstroom Campus, in association with Greenwich School of Theology, UK, 2011

Sideways fall-induced hip fracture is a major worldwide health problem among the elderly population. Biomechanical modeling is a practical way to study hip fracture risk. However, all existing biomechanical models for assessing hip fracture risk mainly consider the femur-related parameters. Their accuracy is limited as hip fracture is significantly affected by loading conditions as well. The objective of this study is to introduce a two-level subject-specific model to improve the assessment of hip fracture risk. The proposed biomechanical model consists of a whole-body dynamics model and a proximal femur finite element model, which are constructed from the subject’s whole-body and hip DXA (dual energy X-ray absorptiometry) scan. The whole-body dynamics model is used to determine the impact force onto the hip during a sideways fall. Obtained load/constraint conditions are applied to the finite element model in order to determine the stress/strain distribution in the proximal femur. Fracture risk index is then defined over the critical locations of the femur using the finite element solutions. It is found that hip fracture risk is significantly affected by the subject’s body configuration during the fall, body anthropometric parameters, trochanteric soft tissue thickness, load/constraint conditions, and bone mineral density, which are not effectively taken into account by currently available hip fracture discriminatory tools. Predicted hip fracture risk of 130 clinical cases, including 80 females and 50 males, by the proposed model reveals that biomechanical determinants of hip fracture differ widely from individual to individual. This study presents the first in-depth subject-specific model that provides a comprehensive, fast, accurate, and non-expensive method for assessing the hip fracture risk. The proposed model can be easily adopted in clinical centers to identify patients at high risk of hip fracture who may benefit from the in-time treatment to reduce the fracture risk. / May 2016