Jämförelse av två system för att bedöma vinter väglag : Ett nytt system i utvecklingen för att säkra Sveriges vägar

Trafikverket, är den statliga verksamhet som har hand om alla Sveriges vägar och järnvägar har den så kallade nollvisionen som ett huvudmål. Tanken bakom nollvisionen är att de som använder vägarna skall vara säkra och inte komma till skada. En del av uppfyllandet av detta mål är att Trafikverket ger ut korttidsprognoser för väglag och körförhållande. I nuläget så används ett mycket manuellt systemet som heter NTIS, men man håller på att utveckla det nya automatiska systemet RCC som skall kunna ta fram korttidsprognoser baserat på olika former av data, t.ex. data från väderstationer. Syftet med denna studie är att utvärdera hur väl de två olika systemen utför en korttidsprognos och jämföra de mot varandra, samt verkligheten. Denna studie gjordes i form av en förklarande fallstudie. Som datainsamling används dokument i olika former och analysen var kvantitativ då resultatet av utvärdering ger olika procenttal av hur rätt respektive system har. Under undersökningen gång så kom vi fram till att båda systemen hade sina fördelar och nackdelar. T.ex. så det gamla NTIS systemet fortfarande bäst på isigt och moddigt väglag. Medans det nya RCC systemet hade sina egna fördelar, t.ex. snöigt väglag och vått väglag. Samt så hade RCC en klar fördel med sin rapporteringstid, vilket var ett problem man såg med NTIS. Resultat var som sagt ett procenttal av hur rätt de två olika systemen hade, men även förslag till förbättringar. T.ex. hur man skulle kunna ändra RCC regler för bättre resultat.

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.

Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke : an explorative observational study

BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds ratio (OR) 7.05) at three months, and associated with hand function (SIS) (OR 4.38) and poor self-rated recovery (SIS) (OR 2.46) at 12 months. Dissatisfaction with care was predicted by SOC (OR 4.18) and participation (SIS) (OR 3.78), and associated with SOC (OR 3.63) and strength (SIS) (OR 3.08). CONCLUSIONS: Thirty-three percent of the participants reported unmet needs for rehabilitation and fourteen percent were dissatisfied with the care received. In order to attend to rehabilitation needs when they arise, rehabilitation services may need to be more flexible in terms of when rehabilitation is provided. Long term services with scheduled re-assessments and with more emphasis on understanding the experiences of both the patients and their social networks might better be able to provide services that attend to patients' needs and aid peoples' reorientation; this would apply particularly to those with poor coping capacity.

The hand of God is over their hands (Q. 48:10) : on the notion of covenant in al-Ṭabarī’s account of Karbalāʾ

This article is an analysis of the story of the killing of Ḥusayn b. ʿAlī at Karbalāʾ in 61/680, as it is presented by Abū Jaʿfar Muḥammad b. Jarīr al-Ṭabarī (d. 310/923). The main argument is that the notion of the divine covenant, which permeates the Qur’an, constitutes a framework through which al-Ṭabarī views this event. The Qur’anic idea of the covenant is read in structural/thematic continuity with the Hebrew Bible account of the covenant between Yahweh and the Hebrew people, which has, in turn, been traced back in its basic form to Late Bronze Era treaties between rulers and their vassals.   The present study focusses on four speeches ascribed to Ḥusayn during the encounter he and his group had with the vanguard of the Kūfan army led by al-Ḥurr. These are analysed in accordance with their use of Qur’anic covenant vocabulary. They are also categorised within the broader framework of the eight standard characteristics of Ancient West Asian and Biblical covenants, as presented by George Mendenhall and Gary Herion, which have recently been developed in a Qur’anic context by Rosalind Ward Gwynne. This article argues that al-Ṭabarī’s Karbalāʾ narrative presents the pact of loyalty to Ḥusayn as a clear extension of the divine covenant.