Syftet för denna studie var att granska det fallpreventiva arbetet inom samtliga särskilda bo-enden för äldre, i Umeå kommun. Data insamlades primärt via enkäter vilka besvarades av undersköterskor (n 118, 85 % svarsfrekvens). Enkätsvaren kompletterades med en muntlig fråga som enhetschefen för respektive boende besvarade via telefon. Resultatet visade att 76 % av respondenterna ansåg att enheten bedrev ett organiserat fallpre-ventivt arbete. Inom de granskade enheterna var Individuell Vård- Omsorg och rehabiliter-ingsplanering (Ivor) ett viktigt forum för fallpreventiva diskussioner. Mötesfrekvensen var vanligtvis glesare än en gång per månad. Oftast deltog arbetsterapeut, sjukgymnast, sjukskö-terska och undersköterska/vårdbiträde. De vanligaste fallpreventiva åtgärderna var tillsyn, hjälpmedel och miljöförändringar. Mindre vanligt var medicinska åtgärder samt träning och aktivitet. Instrument för fallriskbedömning användes enligt 58 % av respondenterna. Falltill-bud dokumenterades enligt gällande riktlinjer och 84 % skattade det fallpreventiva arbetet som bra, eller mycket bra, vid deras enhet. Slutsatsen är att fallpreventivt arbete utförs inom många enheter, men det finns förbättrings-områden. Viktigt är att enheter som idag saknar organiserat fallpreventivt arbete stimuleras till att utveckla rutiner för detta. Rutiner för informationsspridning vid falltillbud måste förbätt-ras. Medicinska åtgärder, samt träning och aktiviteter bör intensifieras, liksom användandet av instrument för fallriskbedömning. En ökad medverkan av nattpersonal i fallpreventiva diskus-sioner vore önskvärt.

No description available.

In William Golding’s Free Fall, the novel ends without its protagonist, Sammy Mountjoy, receiving the atonement he seeks. As a consequence, the novel ends in an unresolved manner, leaving Sammy in a state of suspension. Despite having a metaphysical awakening in a Nazi POW camp, the consequences of his enlightenment do not reflect the way the Sammy retrospectively narrates the tale of his life. The existentialist theories of Danish thinker and writer Søren Kierkegaard offer a solution to the dilemma. Kierkegaard’s theories concerning the aesthetic, ethical and religious spheres of life, as well as his concept of ‘existential dread’, may be used to show that Sammy is able to make a ‘leap of faith’ from the aesthetic to the ethical sphere. However, because of his inability to make the last leap into the metaphysical sphere of life, he does not attain the insight he needs, namely that he is ‘a child of the finite and infinite’. The essay relates the ways Sammy Mountjoy fits into the Sartrean and Kierkegaardian expressions of existentialism, soon moving on to describe the details of Kierkegaard’s thought concerning the three spheres of life and the concept of ‘dread’. Sammy’s preoccupation with the present, his focus on the exterior rather than the interior and his inability to commit himself to people or situations fit neatly into the criterion for the aesthetic sphere of life. This, in turn, leads him to a state of dread, which reaches its climax in the dark cupboard. When released from his imprisonment Sammy has reached a state of awareness concerning the “vital morality” between people, previously a foreign concept. However, Kierkegaard points out that also the ethical sphere is flawed, leaving the religious/metaphysical sphere as Sammy’s ultimate destination. By failing to make the final ‘leap of faith’, due to a misguided conception of the boundaries between the ethical and the Absolute, Sammy falls short of the resolution he desires and the forgiveness he seeks from the three people that have influenced him the most. Thus an explanation is proposed to the unresolved manner in which Free Fall ends.

The progress of the health among the elderly has a major meaning for the needs of care, nursing and social services. The health of the elderly has improved but fall and fall accidents are a major problem. Acute diseases, activities and environment risks are often related to fall accidents. The aim of the study was to describe health care staffs’ opinions about fall risk and fall prevention. The study had a qualitative approach with a descriptive design. Twelve persons from a primary healthcare centre, a hospital and a community elder care unit in the middle of Sweden were interviewed. The material was analyzed through qualitative content analysis and data from the interviews resulted in two categories; The category “Factors contributing to falls” was formulated from the subcategories; The older persons health status and their care needs, Physical environment, Lack of competence among staff, Lack of time, stress and insufficient staffing, Staffs’ responsibilities and not followed routines and Insufficient cooperation between professional groups. The category “Factors preventing falls” was formulated from the subcategories; Physical environment and physical aid, Competence and fall risk assessment instruments, Different professionals’ responsibilities and Cooperation between different professionals. The results showed that the health care staff viewed several factors, which according to them contributed to falls as well as prevented falls. Cooperation between different professionals, increased competence and use of systematic fall risk assessment instruments were mentioned resulting in advantages for the patient. / Utvecklingen av de äldres hälsa har stor betydelse för behoven av vård och omsorg. Hälsan för äldre har förbättrats men fall och fallskador är ett stort problem och akuta sjukdomar, aktiviteter och omgivningsfaktorer är ofta utösande orsaker till fall. Syftet med denna studie var att beskriva vårdgivares uppfattning om fallrisker och fallprevention. Metoden var en kvalitativ intervjustudie med en beskrivande design. Tolv personer har intervjuats från hälsocentral, sjukhus och kommunalt äldreboende i ett län i Mellansverige. Resultatet redovisas utifrån två kategorier. Kategorin ”Faktorer som kan bidra till fall” framkom ur subkategorierna; Patientens tillstånd och omvårdnadsbehov, Fysisk miljö, Brist på kunskaper hos vårdpersonalen, Tidsbrist, stress och otillräcklig bemanning, Personalens ansvar och att inte följa rutiner samt Otillräcklig samverkan mellan yrkesgrupper och vårdnivåer. Kategorin ”Faktorer som kan motverka fall/fallprevention” framkom ur subkategorierna; Fysisk miljö och hjälpmedel, Kunskaper och utveckling av ett systematiskt arbetssätt, Ansvaret hos olika yrkeskategorier samt Samverkan. Resultatet i studien visade att det finns flera olika faktorer kring en patient som kan bidra till fall och som kan motverka fall. Samverkan mellan olika vårdnivåer, kunskaper och utveckling av ett systematiskt arbetssätt framkom som viktiga faktorer till fördel för patienten.

The title of this work is “Indivisible and Inseparable” the motto of the Austro-Hungarian Empire. This motto is just one of many ways in the Austro-Hungarian Empire fought against the centrifugal forces seeking to destroy it. I argue here that the historic theory of decline and fall is misguided as a model for understanding the collapse of the Austro-Hungarian Empire, and question its usefulness when applied to other nation states and empires as well. I suggest that the Austro-Hungarian military, specifically its condition prior to the First World War, is an ideal lens for exploring the dissolution of the Empire at the end of the war in 1918. The Austro-Hungarian military was composed of over 10 different nationalities at a time of surging nationalism, and was the single most important institution charged with the preservation of the Empire. This unique linkage with the state of the Empire as a whole renders the military, in particular the Common Army, extremely useful for examining this issue. I will discuss the structure of the military, its response to the problems posed by nationalism, and contemporary public views about the military within the Empire.

Preliminary evidence suggests that balance deficits constitute an important secondary impairment in individuals with chronic obstructive pulmonary disease (COPD). The main objective of this thesis was to describe balance impairment and fall risk in individuals with COPD and to examine interventions for improving balance and reducing fall risk in the context of pulmonary rehabilitation. The first study of this thesis showed that falls are common in patients with COPD and that fallers are characterized by impairments in standard clinical balance measures, such as the Berg Balance Scale and Timed Up and Go. In the second study, we found that the exercise component of conventional pulmonary rehabilitation has only modest effects on balance and fall risk in COPD, highlighting the need to examine the role of balance-specific training for these patients. The third study of this thesis identified the postural control subsystems most responsible for the observed balance deficits in COPD. Compared with age-matched controls, individuals with COPD demonstrated reductions in all balance control subsystems and slower reaction times in response to external perturbations. In this study, we also showed that deficits in balance in patients with COPD were associated with peripheral muscle weakness and reduced physical activity levels. These results informed the design of the final study of this thesis, a randomized controlled trial evaluating the addition of specific balance training to pulmonary rehabilitation for improving balance in patients with COPD. Preliminary results from this study suggest that the addition of thrice weekly balance exercises to a conventional pulmonary rehabilitation program is effective for optimizing gains in measures of functional balance and fall risk. The findings from the four studies included in this thesis support the need for incorporating balance assessment and treatment for at-risk patients with COPD, as part of their comprehensive management.

This thesis work designs and implements a wearable system to recognize physical activities and detect fall in real time. Recognizing peoples physical activity has a broad range of applications. These include helping people maintaining their energy balance by developing health assessment and intervention tools, investigating the links between common diseases and levels of physical activity, and providing feedback to motivate individuals to exercise. In addition, fall detection has become a hot research topic due to the increasing population over 65 throughout the world, as well as the serious effects and problems caused by fall.<p> In this work, the Sun SPOT wireless sensor system is used as the hardware platform to recognize physical activity and detect fall. The sensors with tri-axis accelerometers are used to collect acceleration data, which are further processed and extracted with useful information. The evaluation results from various algorithms indicate that Naive Bayes algorithm works better than other popular algorithms both in accuracy and implementation in this particular application.<p> This wearable system works in two modes: indoor and outdoor, depending on users demand. Naive Bayes classifier is successfully implemented in the Sun SPOT sensor. The results of evaluating sampling rate denote that 20 Hz is an optimal sampling frequency in this application. If only one sensor is available to recognize physical activity, the best location is attaching it to the thigh. If two sensors are available, the combination at the left thigh and the right thigh is the best option, 90.52% overall accuracy in the experiment.<p> For fall detection, a master sensor is attached to the chest, and a slave sensor is attached to the thigh to collect acceleration data. The results show that all falls are successfully detected. Forward, backward, leftward and rightward falls have been distinguished from standing and walking using the fall detection algorithm. Normal physical activities are not misclassified as fall, and there is no false alarm in fall detection while the user is wearing the system in daily life.

No description available.

In Tender Is the Night, F. Scott Fitzgerald retells the story of the Fall from Genesis through psychologist Dick Diver and his wife and patient Nicole, drawing poetic and thematic inspiration from John Milton’s Paradise Lost. This essay traces the progression of the Divers’ fall and ultimate separation through the novel’s three books and considers how the highly autobiographical foundation of the novel, which has drawn considerable critical attention, may in fact allow Fitzgerald to craft a work that aligns with and simultaneously expands upon Milton’s interpretation of the Fall.

Olyckor sker vid övning med frifallslivbåtar. Detta borde gå att arbeta bort med bättre utrustning och bättre utbildning. Eftersom olyckor inträffar oftare vid övning ombord i fartygen än vid övning iland borde den senare biten vara mer avgörande: Vid övningar bör vikt läggas vid hur man spänner fast sig på ett korrekt sätt. Ovanstående är en del av vad denna undersökande studie handlar om. Vi har använt en kvalitativ metod för att reda ut frågor om riskerna med frifallslivbåtar. SOLAS ställer inga krav på att det skall finnas hjälpmedel för att underlätta att ta med sig skadade personer i frifallslivbåtar. De tester som genomförts med människor ombord i frifallslivbåtar har bara skett när det råder gynnsamma förhållanden. Med tanke på att fartyg utsätts både för sjöhävning och att båtarna kan komma att landa i vågor borde SOLAS kraven höjas. De livbåtssystem vi har, varken testas eller övas med i vågor. Att frifallslivbåtar i tanken är ett väldigt bra koncept som livräddningsutrustning råder det inga tvivel om, men den borde utvecklas vidare. / Accidents occur when exercising with free-fall lifeboats. This should be possible to avoid with better equipment and better education. Since accidents occur more often when exercise is performed aboard ships than ashore, the later part should be more decisive: During exercise the focus should be put on how to buckle up in a correct way. The above text is a part of what this investigative study is about, we have used a qualitative method for sorting out questions about the risks with free-fall lifeboats. SOLAS does not put any demands on the existence of aiding equipment to facilitate bringing injured persons in a free-fall lifeboat. The tests that have been performed with people onboard free-fall lifeboats have only taken place during favourable conditions. Considering that ships are exposed to the motion of the sea and that the boat could land on a wave the SOLAS demands should be increased. The lifeboat systems we have, is neither tested nor practised with in waves. That free-fall lifeboats is a good concept as a lifesaving equipment, there is no doubt about, but it should be developed further.