The fall descriptions and health characteristics of older adults with hip fracture : a mixed methods study

Background: In light of the multifactorial etiology of fall-related hip fracture, knowledge of fall circumstances may be especially valuable when placed in the context of the health of the person who falls. We aimed to investigate the circumstances surrounding fall-related hip fractures and to describe fall circumstances in relation to participants' health and functional characteristics. Methods: The fall circumstances of 125 individuals (age >= 50 years) with hip fracture were investigated using semi-structured interviews. Data concerning participants' health (comorbidities and medications) and function (self-reported performance of mobility, balance, personal activities of daily living and physical activity, previous falls and hand grip strength) were collected via medical records, questionnaires and dynamometry. Using a mixed methods design, both data sets were analysed separately and then merged in order to provide a comprehensive description of fall events and identify eventual patterns in the data. Results: Fall circumstances were described as i) Activity at the time of the fall: Positional change (n = 24, 19%); Standing (n = 16, 13%); Walking (n = 71, 57%); Balance challenging (n = 14, 11%) and ii) Nature of the fall: Environmental (n = 32, 26%); Physiological (n = 35, 28%); Activity-related indoor (n = 8, 6%) and outdoor (n = 8, 6%); Trips and slips on snow (n = 20, 16%) and in snow-free conditions (n = 12, 10%) and Unknown (n = 10, 8%). We observed the following patterns regarding fall circumstances and participants' health: those who fell i) during positional change had the poorest functional status; ii) due to environmental reasons (indoors) had moderate physical function, but high levels of comorbidity and fall risk increasing medications; iii) in snow-free environments (outdoors) appeared to have a poorer health and functional status than other outdoor groups. Conclusions: Our findings indicate that patterns exist in relation to the falls circumstances and health characteristics of people with hip fracture which build upon that previously reported. These patterns, when verified, can provide useful information as to the ways in which fall prevention strategies can be tailored to individuals of varying levels of health and function who are at risk for falls and hip fracture.

Distance teacher education ��� some experiences from Dalarna University, SwedenPaper presented at the 33rd Annual ATEE Conference Brussels, Belgium, 23rd ��� 27th August 2008

Distance teaching is now-a-days used in different shapes. However, it is something different from traditional campus organised education as it systematically uses Information Communication Technology (ICT) as a key element. When the distance teacher education started in Sweden many teacher educators doubted the wisdom of this. They expressed that the educational process to become a teacher would be deteriorated. For instance, they feared for high drop out rates and difficulties to examine in a proper way. The Swedish National Agency for Higher Education has recently edited a report that showed that this form of teacher education was well adapted to the labour market, but the possibilities for the teacher students to shape their education were relatively limited. However, we still know quite little about the effects of this way to educate teacher students. This paper explores the possibility of using distance teacher education.In a case study 20 students, who were the first to finish a complete a distance teacher education at Högskolan Dalarna, were asked in a questionnaire how they had apprehended their education. We also interviewed four of these students, as well as five teacher educators.One of our findings were that the distance teacher education reached new target groups, who not had been able to participate in university studies if it not had been offered in this form. Especially, this was valid for the middle-aged women, living a long distance away from a university, with social responsibilities for children or old parents. Other findings were that these students in general were target oriented and ambitious, wrote more than the campus students and developed that kind of skill better. Marratech, an ICT system for small groups, e-mail and chat were used for the communication. Marratech was considered to permit free and spontaneous communication, both of the teacher educators and the students. Initially the teacher educators were sceptical to distance teacher education, but afterwards they were surprised of how well it had worked. They declared that they had better and nearer contact with their students and more control over the students´ performance, but some parts of the teacher education were better suitable for campus education, for example, power of creating characters. Distance teacher education was considered time consuming and demanded much activity from the teacher educators as the students wanted rapid responses. This study indicates that distance teacher education works well for mature individuals with high motivation. However, it demands more time from the teacher educators, but it gives in general good results. Still, there are pedagogical challenges to overcome. Maybe we should reflect on a mix of distance teacher education and campus based teacher education, instead of separated ways of accomplishing teacher education?

Degree projects improving co-operation between the teacher education program and schools : - Swedish experiences

In 1977, when teacher education inSwedenwas incorporated into the university system, the main reason was to transform it into an academic tradition. Now, nearly 30 years later, there is still tension between the academic and the vocational tradition; they show up as different and separated elements in a program that is meant to prepare students for a career as a teacher and for a possible future career as a researcher in this field. This tension gives rise to a risk of allowing parallel ���tracks��� to develop and of isolating the degree thesis work from other courses. On the teacher-training program in which we are involved, close co-operation with partner-schools, where the practical part of the program takes place, has been established. Here, the students�� degree theses are an important factor in making this co-operation work on a concrete level. Accordingly, the purpose of the degree thesis is both to reflect problems in schools and contribute to better teaching in the individual school, but also to offer relevant educational subject matter to the students, which may be adapted as an element in the university���s research environments. From these points of view, the degree thesis is an important part of teacher education and rather more than just a single course. The degree thesis should be an element that gives the students an opportunity to show that they have reached central goals in the teacher education program. It should also be an integral part in the development of critical and scholarly thinking, deepening pedagogical and didactic knowledge and giving the students an opportunity to apply research methods. We will here use two minor case studies: one that compares teacher education programs in five Swedish universities and one minor study at one of those universities, in order to elaborate on the questions: -��What purpose has a degree thesis and what role does it play in teacher education? -��What criteria are relevant to assessing a degree thesis and what qualities do the degree theses have? -��Is it possible to assess a degree thesis fairly and what happens to students who do not pass? -��How could the degree thesis be used to improve the contact between the teacher education program and its partner schools in order to contribute to the development of the individual school?