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Sample records for effective falls prevention

  1. Preventing Falls

    MedlinePlus

    ... from osteoporosis. Lower-body strength exercises and balance exercises can help you prevent falls and avoid the disability that may result from falling. Here are some fall prevention tips from Go4Life : l Have your eyes and hearing tested often. Always wear your glasses when you ...

  2. Preventing falls

    MedlinePlus

    ... worsened. Improving your vision will help reduce falls. Images ... for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: ...

  3. Home Improvements Prevent Falls

    MedlinePlus

    ... on. Feature: Falls and Older Adults Home Improvements Prevent Falls Past Issues / Winter 2014 Table of Contents ... or home modification programs to help older people prevent falls. Check with your local health department, senior ...

  4. The Effectiveness of a Participatory Program on Fall Prevention in Oncology Patients

    ERIC Educational Resources Information Center

    Huang, Li-Chi; Ma, Wei-Fen; Li, Tsai-Chung; Liang, Yia-Wun; Tsai, Li-Yun; Chang, Fy-Uan

    2015-01-01

    Falls are known to be one of the most common in patient adverse events. A high incidence of falls was reported on patients with cancer. The purpose of this study was to explore the effect of a participatory program on patient's knowledge and self-efficacy of fall prevention and fall incidence in an oncology ward. In this quasi-experimental study,…

  5. Osteoporosis: Preventing Falls

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Preventing Falls Past Issues / Winter 2011 Table of ... next to your bed Free NIH Videos About Osteoporosis The NIHSeniorHealth Web site features five brief, informative ...

  6. The Effects of an Education Program on Home Renovation for Fall Prevention of Korean Older People

    ERIC Educational Resources Information Center

    Jang, Miseon; Lee, Yeunsook

    2015-01-01

    This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…

  7. [Can falls be prevented?].

    PubMed

    Dubousset, Jean

    2014-06-01

    Most recommendations and measures intended to prevent falls focus on the elderly (see HAS guideline of April 2009) but, in our opinion, this isfar too late: prevention must begin much earlier, not only by identifying persons at risk, but also by providing personalized lifestyle advice adapted to each individual's biomechanical, somatic, neurological and biological characteristics. The first preventive measure is to identify a possible deterioration of balance, starting with a physical examination at the age of 45 and repeated regularly throughout life. Extrinsic preventive measures focusing on the domestic and external environments are clearly necessary. But what is most important is to detect and, if necessary, correct any degradation of intrinsic (intracorporeal or somatic) factors starting at the age of 45 years; these include vision, vestibular function and balance, proprioception, and psychological and neurological status. Chronic illnesses and their treatments must also be taken into account: treatment must be limited to indispensable drugs; sedative psychotropics must be avoided if possible; and polymedication must be tightly controlled, as it is a major risk factor for falls. Prevention also requires a diet sufficiently rich in protein, calcium and vitamin D3 (to prevent osteoporosis), and regular daily exercise adapted to the individual, if possible associated with a simultaneous cognitive task. The last key point is the absolute need for thorough functional rehabilitation after any accidental or medical trauma, regardless of age, with the aim of restoring functional status to that existing prior to the accident. PMID:26983186

  8. Falls prevention for the elderly

    PubMed Central

    Balzer, Katrin; Bremer, Martina; Schramm, Susanne; Lühmann, Dagmar; Raspe, Heiner

    2012-01-01

    Background An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention. Research questions The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years), living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Methods Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT), the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed. Results Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria

  9. Fall prevention in the elderly

    PubMed Central

    Ungar, Andrea; Rafanelli, Martina; Iacomelli, Iacopo; Brunetti, Maria Angela; Ceccofiglio, Alice; Tesi, Francesca; Marchionni, Niccolò

    2013-01-01

    Summary Falls are frequent in the elderly and affect mortality, morbidity, loss of functional capacity and institutionalization. In the older patient the incidence of falls can sometimes be underestimated, even in the absence of a clear cognitive impairment, because it is often difficult to reconstruct the dynamics. It is quite common that forms due to syncope are associated with retrograde amnesia and in 40 to 60% of the cases falls happen in the absence of witnesses. The pathogenesis of falls is often multifactorial, due to physiological age-related changes or more properly pathological factors, or due to the environment. The identification of risk factors is essential in the planning of preventive measures. Syncope is one of major causes of falls. About 20% of cardiovascular syncope in patients older than 70 appears as a fall and more than 20% of older people with Carotid Sinus Syndrome complain of falls as well as syncope. These data clearly state that older patients with history of falls should undergo a cardiovascular and neuroautonomic assessment besides the survey of other risk factors. Multifactorial assessment requires a synergy of various specialists. The geriatrician coordinates the multidisciplinary intervention in order to make the most effective evaluation of the risk of falling, searching for all predisposing factors, aiming towards a program of prevention. In clear pathological conditions it is possible to enact a specific treatment. Particular attention must indeed be paid to the re-evaluation of drug therapy, with dose adjustments or withdrawal especially for antihypertensive, diuretics and benzodiazepines. The Guidelines of the American Geriatrics Society recommend modification of environmental hazards, training paths, hip protectors and appropriate use of support tools (sticks, walkers), which can be effective elements of a multifactorial intervention program. Balance exercises are also recommended. In conclusion, an initial assessment

  10. A preliminary study of the effectiveness of an otolaryngology-based multidisciplinary falls prevention clinic.

    PubMed

    Alvord, Lynn S; Benninger, Michael S; Stach, Brad A

    2008-09-01

    Because the cause of falls is often multifactorial, efforts to identify risk factors and promote prevention would benefit from a multidisciplinary approach in which the contributions of a broad range of body systems are considered. We describe the practices and procedures followed at the otolaryngology-based multidisciplinary Falls Prevention Clinic at Henry Ford Hospital in Detroit. Our team is made up of an otolaryngologist, an audiologist, an internist, and a physical therapist. Our multidisciplinary approach involves evaluations of vestibular and balance function, cardiovascular function, and visual function; lower-extremity strength and sensation; cognition and mood; and medication use. We also assess a number of nonmedical risk factors. Evaluations are made over the course of two clinic visits. To assess the effectiveness of our approach, we conducted a preliminary study based on chart reviews and telephone interviews of 52 patients who had been referred to our clinic for evaluation and counseling. The basis of our study was a comparison of the number of falls that patients had experienced during the 6 months prior to their first visit to our clinic and the number of falls they experienced during the 6 months after their second visit. We found that among "true fallers" (i.e., those who had actually experienced a fall at some point during the study), 64.7% reported that they had experienced fewer falls after their clinic visits than before (p < 0.001). Also, 59.1% of patients who had been "frequent fallers" prior to their clinic evaluation (i.e., >or=3 falls during the previous 6 mo) reported that they had not fallen at all during the 6 months following their last visit. Finally, our evaluations identified a substantial number of risk factors in individual patients that had been missed previously, including many nonvestibular factors that might not have been detected without a multidisciplinary approach. We conclude that the results of this preliminary study

  11. Building an infrastructure to prevent falls in older Californians: the Fall Prevention Center of Excellence.

    PubMed

    Rose, Debra J; Alkema, Gretchen E; Choi, In Hee; Nishita, Christy M; Pynoos, Jon

    2007-10-01

    The Fall Prevention Center of Excellence (Center), a consortium of federal, state, and private organizations, was established in 2005 to guide the implementation of a statewide initiative to prevent falls among older Californians. The process began with the convening of a representative group of recognized leaders in California's health and human services in 2003. This group engaged in a 2-day strategic planning process that culminated in the development of the California Blueprint for Fall Prevention. The overarching goal of the Blueprint is to build a statewide infrastructure for fall prevention services and programs that will serve as a model for the rest of the country. The specific goals of the Center are to establish fall prevention as a key public health priority in California; create, test, and evaluate effective and sustainable fall prevention programs; and build a comprehensive and sustainable fall prevention system in California. To accomplish these goals, the Center is currently engaged in developing and disseminating fall prevention tools and informational resources directed at the needs of both consumer and professional audiences; linking organizations involved in fall prevention while increasing awareness of fall prevention as an important public health issue; and helping communities build their capacity to effectively address falls in older adults through the delivery of integrated fall prevention services and "best practice" programs. PMID:17986582

  12. Exercises to help prevent falls

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000493.htm Exercises to help prevent falls To use the sharing ... and easily. Do not hold your breath. Balance exercises You can do some balance exercises during everyday ...

  13. How Can Older Adults Prevent Falls?

    MedlinePlus

    ... Falls and Older Adults How Can Older Adults Prevent Falls? Past Issues / Winter 2014 Table of Contents ... healthy and happy. There are simple ways to prevent most falls. "Injuries from falls are a major ...

  14. Tailored Prevention of Inpatient Falls

    PubMed Central

    ZUYEV, LYUBOV; BENOIT, ANGELA N.; CHANG, FRANK Y.; DYKES, PATRICIA C.

    2011-01-01

    Patient falls and fall-related injuries are serious problems in hospitals. The Fall TIPS application aims to prevent patient falls by translating routine nursing fall risk assessment into a decision support intervention that communicates fall risk status and creates a tailored evidence-based plan of care that is accessible to the care team, patients, and family members. In our design and implementation of the Fall TIPS toolkit, we used the Spiral Software Development Life Cycle model. Three output tools available to be generated from the toolkit are bed poster, plan of care, and patient education handout. A preliminary design of the application was based on initial requirements defined by project leaders and informed by focus groups with end users. Preliminary design partially simulated the paper version of the Morse Fall Scale currently used in hospitals involved in the research study. Strengths and weaknesses of the first prototype were identified by heuristic evaluation. Usability testing was performed at sites where research study is implemented. Suggestions mentioned by end users participating in usability studies were either directly incorporated into the toolkit and output tools, were slightly modified, or will be addressed during training. The next step is implementation of the fall prevention toolkit on the pilot testing units. PMID:20975543

  15. Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program

    PubMed Central

    Li, Fuzhong; Harmer, Peter; Glasgow, Russell; Mack, Karin A.; Sleet, David; Fisher, K. John; Kohn, Melvin A.; Millet, Lisa M.; Mead, Jennifer; Xu, Junheng; Lin, Mei-Li; Yang, Tingzhong; Sutton, Beth; Tompkins, Yvaughn

    2008-01-01

    Tai Chi—Moving for Better Balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the RE-AIM framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings. PMID:18511723

  16. Osteosarcopenic obesity and fall prevention strategies.

    PubMed

    Hita-Contreras, Fidel; Martínez-Amat, Antonio; Cruz-Díaz, David; Pérez-López, Faustino R

    2015-02-01

    Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal women's balance, leading to a decreased risk of falls. PMID:25533145

  17. Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review

    PubMed Central

    Ishigaki, Erika Y.; Ramos, Lidiane G.; Carvalho, Elisa S.; Lunardi, Adriana C.

    2014-01-01

    Background Falls are a geriatric syndrome that is considered a significant public health problem in terms of morbidity and mortality because they lead to a decline in functional capacity and an impaired quality of life in the elderly. Lower limb muscle strengthening seems to be an effective intervention for preventing falls; however, there is no consensus regarding the best method for increasing lower limb muscle strength. Objectives To analyze the effectiveness of lower limb muscle strengthening and to investigate and describe the protocols used for preventing falls in elderly subjects. Method We performed a systematic review of randomized and controlled clinical trials published between 2002 and 2012 in the databases PubMed, EMBASE, Scopus, Web of Science, and PEDro that cited some type of lower limb muscle strengthening protocol and that evaluated the incidence of falls as the primary outcome exclusively in elderly subjects. Twelve studies met the inclusion criteria. Qualitative analysis was performed by independent reviewers applying the PEDro scale. Results The data obtained from the selected studies showed lower fall rates in the intervention groups compared to controls. Six studies described the lower limb muscle strengthening protocol in detail. High methodological quality was found in 6 studies (PEDro score ≥7/10 points). Conclusions The methodological quality of the studies in this area appears to leave little doubt regarding the effectiveness of lower limb strengthening exercises for preventing falls in elderly subjects, however the interventions in these studies were poorly reported. PMID:24760166

  18. Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series

    PubMed Central

    Rimland, Joseph M.; Abraha, Iosief; Dell’Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Soiza, Roy; Gudmusson, Adalsteinn; Petrovic, Mirko; O’Mahony, Denis; Todd, Chris; Cherubini, Antonio

    2016-01-01

    Background Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making. Objectives To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals. Methods We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions. Results Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis. Conclusions The aim of this overview of

  19. Cost effectiveness of patient education for the prevention of falls in hospital: economic evaluation from a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Falls are one of the most frequently occurring adverse events that impact upon the recovery of older hospital inpatients. Falls can threaten both immediate and longer-term health and independence. There is need to identify cost-effective means for preventing falls in hospitals. Hospital-based falls prevention interventions tested in randomized trials have not yet been subjected to economic evaluation. Methods Incremental cost-effectiveness analysis was undertaken from the health service provider perspective, over the period of hospitalization (time horizon) using the Australian Dollar (A$) at 2008 values. Analyses were based on data from a randomized trial among n = 1,206 acute and rehabilitation inpatients. Decision tree modeling with three-way sensitivity analyses were conducted using burden of disease estimates developed from trial data and previous research. The intervention was a multimedia patient education program provided with trained health professional follow-up shown to reduce falls among cognitively intact hospital patients. Results The short-term cost to a health service of one cognitively intact patient being a faller could be as high as A$14,591 (2008). The education program cost A$526 (2008) to prevent one cognitively intact patient becoming a faller and A$294 (2008) to prevent one fall based on primary trial data. These estimates were unstable due to high variability in the hospital costs accrued by individual patients involved in the trial. There was a 52% probability the complete program was both more effective and less costly (from the health service perspective) than providing usual care alone. Decision tree modeling sensitivity analyses identified that when provided in real life contexts, the program would be both more effective in preventing falls among cognitively intact inpatients and cost saving where the proportion of these patients who would otherwise fall under usual care conditions is at least 4.0%. Conclusions This economic

  20. Falls Prevention: Unique to Older Adults

    MedlinePlus

    ... Prevention Sleep Problems Stroke Join our e-newsletter! Aging & Health A to Z Falls Prevention Unique to ... difficulties. Optimizing Management of Congestive Heart Failure and COPD Congestive Heart Failure (CHF) Many older people develop ...

  1. Patient Engagement in Hospital Fall Prevention.

    PubMed

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2015-01-01

    Injurious falls are the most prevalent in-hospital adverse event, and hospitalized patients are at a greater risk of falling than the general population. Patient engagement in hospital fall prevention could be a possible approach to reducing falls and fall-related injuries. To engage patients, bedside nursing staff must first understand the concept of patient centeredness and then incorporate patient centeredness in clinical practice. Clinicians should move from being experts to being enablers. To conceptualize the knowledge gaps identified, a conceptual model was developed to guide future research and quality improvement efforts in hospital settings. This model could be used as a guide to advance nursing leadership in hospital fall prevention via promoting patient engagement (e.g., developing patient-centered fall prevention interventions with patients' input). PMID:26845821

  2. Orthopedic Injuries: Protocols to Prevent and Manage Patient Falls.

    PubMed

    Parsons, Lynn C; Revell, Maria A

    2015-12-01

    Health care organizations must adopt a culture of safety and implement effective fall prevention protocols. The teach-back method is a useful strategy for health providers to determine patient understanding of information taught to maintain a safe environment and prevent falls. Purposeful rounding is a proactive approach to ensure that patient assessments are accurate and research supports that patients use the call light less when nurses participate in hourly rounding. This article provides the reader with evidence-based fall prevention interventions, tips for using the teach-back method, and fall prevention tools to safely care for patients of all ages. PMID:26596654

  3. Preventing falls in your elderly patients.

    PubMed

    Costa, A J

    1991-01-01

    An elderly patient who falls is at significant risk for disability or death. In this article, Dr Costa explains how a carefully taken history, detailed physical examination, and appropriate laboratory studies can help to discern the cause of a fall. He also describes a multifaceted approach to preventing falls in elderly patients that involves a partnership of the physician, the patient, and the family. PMID:1985306

  4. Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil)

    PubMed Central

    2013-01-01

    Background Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Methods/design Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle.The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression

  5. Fall prevention in Australia: policies and activities.

    PubMed

    Clemson, Lindy; Finch, Caroline F; Hill, Keith D; Lewin, Gill

    2010-11-01

    Fall prevention recommendations and plans have been prolific in Australia since 1986, but Commonwealth recommendations have rarely been acted on from a national perspective and the funds for prevention at a national level have been limited. At a state level, although increasing annually, funds for fall prevention have also remained as only a low proportion of total health spending. Several Australian states have developed their own strategic plans and their activities have developed separately and uniquely, although referring to national guidelines. This article presents a perspective of Australian fall prevention policy over time, provides insights into the current focus, and draws on some specific examples of activities from the 2 most populous Australian states (New South Wales and Victoria) and from our largest geographic state, Western Australia. PMID:20934619

  6. Exercises to help prevent falls

    MedlinePlus

    ... can be active You can do the following exercises anytime and almost anywhere. As you get stronger, ... your ankles. This will increase how effective the exercise is. Try to exercise 2 or more days ...

  7. Fall prevention and bathroom safety in the epilepsy monitoring unit.

    PubMed

    Spritzer, Scott D; Riordan, Katherine C; Berry, Jennnifer; Corbett, Bryn M; Gerke, Joyce K; Hoerth, Matthew T; Crepeau, Amy Z; Drazkowski, Joseph F; Sirven, Joseph I; Noe, Katherine H

    2015-07-01

    Falls are one of the most common adverse events occurring in the epilepsy monitoring unit (EMU) and can result in significant injury. Protocols and procedures to reduce falls vary significantly between institutions as it is not yet known what interventions are effective in the EMU setting. This study retrospectively examined the frequency of falls and the impact of serial changes in fall prevention strategies utilized in the EMU between 2001 and 2014 at a single institution. Overall fall rate was 2.81 per 1000 patient days and varied annually from 0 to 9.02 per 1000 patient days. Both seizures and psychogenic nonepileptic events occurring in the bathroom were more likely to result in falls compared with events occurring elsewhere in the room. With initiation of increased patient education, hourly nurse rounding, nocturnal bed alarms, having two persons assisting for high fall risk patients when out of bed, and immediate postfall team review between 2001 and 2013, there was a trend of decreasing fall frequency; however, no specific intervention could be identified as having a particular high impact. In late 2013, a ceiling lift system extending into the bathroom was put in place for use in all EMU patients when out of bed. In the subsequent 15 months, there have been zero falls. The results reinforce both the need for diligent safety standards to prevent falls in the EMU as well as the challenges in identifying the most effective practices to achieve this goal. PMID:26074343

  8. Barriers to senior centre implementation of falls prevention programmes.

    PubMed

    Zachary, Ciara; Casteel, Carri; Nocera, Maryalice; Runyan, Carol W

    2012-08-01

    This study examined the prevalence of senior centres providing multi-component falls prevention education and the perceived barriers in implementing this education. A telephone interview was conducted in 2006 with 500 senior centres nationwide. Centre directors were asked about the types of multi-component falls prevention education offered (ie, balance exercise classes, medication management, home safety information) and barriers to offering this education. Seventy percent of senior centres offered balance exercise classes, 68% offered medication management and 53% provided home safety information. Thirty-two percent offered all three components. Lack of staff, time and staff not feeling they had sufficient knowledge to deliver falls prevention education were the leading barriers to providing multi-component education. Senior centres provide components of effective falls prevention education and, while some may not address all components of a multifaceted programme, many have existing resources that may be adapted for translation of evidence-based programmes. PMID:22328631

  9. Exercise in preventing falls and fall related injuries in older people: a review of randomised controlled trials

    PubMed Central

    Gardner, M.; Robertson, M; Campbell, A

    2000-01-01

    Objective—To assess the effectiveness of exercise programmes in preventing falls (and/or lowering the risk of falls and fall related injuries) in older people. Design—A review of controlled clinical trials designed with the aim of lowering the risk of falling and/or fall injuries through an exercise only intervention or an intervention that included an exercise component Main outcome measures—Falls, fall related injuries, time between falls, costs, cost effectiveness. Subjects—A total of 4933 men and women aged 60 years and older. Results—Eleven trials meeting the criteria for inclusion were reviewed. Eight of these trials had separate exercise interventions, and three used interventions with an exercise programme component. Five trials showed a significant reduction in the rate of falls or the risk of falling in the intervention group. Conclusions—Exercise is effective in lowering falls risk in selected groups and should form part of falls prevention programmes. Lowering fall related injuries will reduce health care costs but there is little available information on the costs associated with programme replication or the cost effectiveness of exercise programmes aimed at preventing falls in older people. Key Words: exercise; elderly; falls; cost effectiveness PMID:10690444

  10. Evaluation of a Nurse-Led Fall Prevention Education Program in Turkish Nursing Home Residents

    ERIC Educational Resources Information Center

    Uymaz, Pelin E.; Nahcivan, Nursen O.

    2016-01-01

    Falls are a major cause of morbidity and mortality among the elderly living in nursing homes. There is a need to implement and evaluate fall prevention programs in nursing homes to reduce the number of falls. The purpose of this research was to examine the effect of a nurse-led fall prevention education program in a sample of nursing home…

  11. Nurses' Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors.

    PubMed

    Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G

    2016-08-01

    Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. PMID:27106881

  12. Research on Fall Prevention and Protection from Heights in Japan

    PubMed Central

    OHDO, Katsutoshi; HINO, Yasumichi; TAKAHASHI, Hiroki

    2014-01-01

    The high frequency of fall accidents is a serious problem in Japan. Thus, more stringent countermeasures for preventing falls from scaffolds were developed and incorporated into institutional guidelines. These countermeasures aim to decrease deaths caused by falls from scaffolds. Despite the improvements in such measures, however, the rate of accidental fall deaths remains high in Japan’s construction industries. To improve the rigor of the countermeasures, a committee was established in our institute by the Japan Ministry of Health, Labour, and Welfare. This committee investigated the regulations applied in other countries and evaluated construction industry compliance with existing fall prevention guidelines. After considerable research and discussion, the Occupational Safety and Health Regulations and Guidelines were amended in 2009. The effects of the amended regulations have recently been investigated on the basis of accident reports. This paper describes the investigation and its results. The paper also discusses other research and workplace safety countermeasures for preventing falls and ensuring fall protection from heights. PMID:25098387

  13. Investigating the effect of education based on need to prevent falling during activities of daily living among the elderlies referring to health centers of Isfahan

    PubMed Central

    Ghasemi, Marziyeh; RezaeiDehaghani, Abdollah; Mehrabi, Tayebeh

    2016-01-01

    Background: Falling has a great importance among the elderlies. Even if no physical injury occurs, it can cause fear of falling down again and, consequently, reduce older adults’ activities. With regard to the prevalence of falling among older adults, its prevention is essential. Therefore, the present study was aimed to define the effect of need-based education on prevention of older adults’ falling during their everyday life activities. Materials and Methods: This is a quasi-experimental study. Study population comprised all the older adults of age 60 years and over referring to health care centers in Isfahan. Through multiple random sampling, 15 older adults were selected from four health care centers. Data collection tool in the present study was Daily Activity Questionnaire. Results: Results showed a significant difference between the mean of daily activity scores in the intervention group before, immediately after, and 1 month after the intervention (12, 13.6, and 13.5, respectively; P = 0.01). Meanwhile, there was no significant deference between the scores immediately after and 1 month after the intervention. There was no significant difference observed between the three time points in the control group (mean = 12.3; P = 0.907). Conclusion: Implementation of education concerning prevention of older adults’ falling led to improvement of their daily activity in the intervention group. PMID:27563329

  14. Establishing the effectiveness, cost-effectiveness and student experience of a Simulation-based education Training program On the Prevention of Falls (STOP-Falls) among hospitalised inpatients: a protocol for a randomised controlled trial

    PubMed Central

    Williams, Cylie; Kiegaldie, Debra; Kaplonyi, Jessica; Haines, Terry

    2016-01-01

    Introduction Simulation-based education (SBE) is now commonly used across health professional disciplines to teach a range of skills. The evidence base supporting the effectiveness of this approach for improving patient health outcomes is relatively narrow, focused mainly on the development of procedural skills. However, there are other simulation approaches used to support non-procedure specific skills that are in need of further investigation. This cluster, cross-over randomised controlled trial with a concurrent economic evaluation (cost per fall prevented) trial will evaluate the effectiveness, cost-effectiveness and student experience of health professional students undertaking simulation training for the prevention of falls among hospitalised inpatients. This research will target the students within the established undergraduate student placements of Monash University medicine, nursing and allied health across Peninsula Health acute and subacute inpatient wards. Methods and analysis The intervention will train the students in how to provide the Safe Recovery program, the only single intervention approach demonstrated to reduce falls in hospitals. This will involve redevelopment of the Safe Recovery program into a one-to-many participant SBE program, so that groups of students learn the communication skills and falls prevention knowledge necessary for delivery of the program. The primary outcome of this research will be patient falls across participating inpatient wards, with secondary outcomes including student satisfaction with the SBE and knowledge gain, ward-level practice change and cost of acute/rehabilitation care for each patient measured using clinical costing data. Ethics and dissemination The Human Research Ethics Committees of Peninsula Health (LRR/15/PH/11) and Monash University (CF15/3523-2015001384) have approved this research. The participant information and consent forms provide information on privacy, storage of results and dissemination

  15. Fall Incidence as the Primary Outcome in Multiple Sclerosis Falls-Prevention Trials

    PubMed Central

    Sosnoff, Jacob J.; Gunn, Hilary

    2014-01-01

    The aim of this article is to provide recommendations on behalf of the International MS Falls Prevention Research Network (IMSFPRN) for the primary outcome measure for multiple sclerosis (MS) falls-prevention interventions. The article will consider the definition of a fall, methods of measuring falls, and the elements of falls that should be recorded, as well as how these elements should be presented and analyzed. While this information can be used to inform the content of falls-prevention programs, the primary aim of the article is to make recommendations on how the outcome of these programs should be captured. PMID:25694776

  16. Preventing Falls in Older Adults Who Live in Community Settings

    MedlinePlus

    ... Preventing Falls in Older Adults Who Live in Community Settings: U.S. Preventive Services Task Force Recommendation Summaries ... full report is titled “Prevention of Falls in Community-Dwelling Older Adults: U.S. Preventive Services Task Force ...

  17. Hourly rounding for falls prevention: a change initiative.

    PubMed

    Dyck, Daryl; Thiele, Tracy; Kebicz, Rodney; Klassen, Michelle; Erenberg, Carly

    2013-01-01

    Fall-related injuries are a particular concern within the elderly population, and trends toward an aging demographic will keep this issue at the forefront in health care. We are challenged to develop creative strategies to significantly reduce harm and fall rates among the elderly. This article describes the process of establishing an hourly rounding initiative in a health care facility. Hourly rounding is supported by the literature as an effective strategy for falls prevention and patient safety. When the initiative was not successfully adopted initially, the implementation process was critically examined and an innovative sustainability plan was developed to ensure that the change would be embedded in the organization's culture. Through this opportunity, nurses and allied health members from all levels were able to collaborate on strategies for this patient safety initiative. PMID:24400470

  18. Integration of Fall Prevention into State Policy in Connecticut

    ERIC Educational Resources Information Center

    Murphy, Terrence E.; Baker, Dorothy I.; Leo-Summers, Linda S.; Bianco, Luann; Gottschalk, Margaret; Acampora, Denise; King, Mary B.

    2013-01-01

    Purpose of Study: To describe the ongoing efforts of the Connecticut Collaboration for Fall Prevention (CCFP) to move evidence regarding fall prevention into clinical practice and state policy. Methods: A university-based team developed methods of networking with existing statewide organizations to influence clinical practice and state policy.…

  19. Basis for a Swiss perspective on fall prevention in vulnerable older people.

    PubMed

    Gschwind, Yves J; Wolf, Irene; Bridenbaugh, Stephanie A; Kressig, Reto W

    2011-01-01

    During the 20th century Switzerland, like many other Western countries, experienced significant ageing of the population over the age of 65. As the lifespan of the Swiss population increases, so does the prevalence of falls. A multiplicity of fall prevention programmes are available, but extracting their most effective components remains a challenge. This article summarises the results of current studies on fall prevention, with a particular focus on methodological quality and successful reduction of fall incidence in vulnerable older people. Characteristics of effective fall prevention programmes in the fields of exercise, home modifications, appropriate footwear and walking aids are assessed. We then briefly discuss how these study results can be adapted to the Swiss context. This knowledge emphasises an interdisciplinary approach in the prevention of falls, the objective being to reinforce autonomy, promote health and enhance quality of life in vulnerable older people. PMID:22101891

  20. Engaging Community-Based Organizations in Fall Prevention Education

    ERIC Educational Resources Information Center

    Kramer, B. Josea; Vivrette, Rebecca L.; Rubenstein, Laurence Z.

    2011-01-01

    Falls are a major public health problem for older adults, and community-based organizations play a key role in educating seniors about falls prevention (FP). We conducted a qualitative process evaluation at six sites to report community-based centers' perspectives on adoption, adaptation, and sustainability of an evidence-based multifactorial FP…

  1. Preventing Death and Serious Injury from Falling Trees and Branches

    ERIC Educational Resources Information Center

    Brookes, Andrew

    2007-01-01

    Of 128 outdoor education related deaths examined since 1960, 14 have been due to falling trees or branches. This article examines the grounds on which death or serious injury due to falling trees or branches can be regarded as an inherent risk in outdoor education, and the extent to which such incidents can be regarded as preventable. It compares…

  2. Preventing Falls | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Preventing Falls Past Issues / Winter 2011 Table of ... next to your bed Free NIH Videos About Osteoporosis The NIHSeniorHealth Web site features five brief, informative ...

  3. Falls among Older Adults: Public Health Impact and Prevention Strategies.

    ERIC Educational Resources Information Center

    Stevens, Judy A.

    2003-01-01

    Provides an overview of the epidemiology of falls among older adults, describes current prevention strategies, and highlights key areas that need to be addressed, including risk assessments, exercise, and environmental changes. (Contains 50 references.) (JOW)

  4. Preventing Falls: Great Help for Older Americans

    MedlinePlus

    ... that may prevent or delay disability. Claude D. Pepper Older American Independence Centers (OAICs) University of California ... Wake Forest University P.I. Stephen Kritchevsky, PhD Pepper Coordinating Center Kevin High, MD University of Florida ...

  5. Fall prevention intervention technologies: A conceptual framework and survey of the state of the art.

    PubMed

    Hamm, Julian; Money, Arthur G; Atwal, Anita; Paraskevopoulos, Ioannis

    2016-02-01

    In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge. PMID:26773345

  6. Validation of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm

    PubMed Central

    Lawson, Sara Nicole; Zaluski, Neal; Petrie, Amanda; Arnold, Cathy; Basran, Jenny

    2013-01-01

    ABSTRACT Purpose: To investigate the concurrent validity of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm (FSRA). Method: A total of 29 older adults (mean age 77.7 [SD 4.0] y) residing in an independent-living senior's complex who met inclusion criteria completed a demographic questionnaire and the components of the FSRA and Berg Balance Scale (BBS). The FSRA consists of the Elderly Fall Screening Test (EFST) and the Multi-factor Falls Questionnaire (MFQ); it is designed to categorize individuals into low, moderate, or high fall-risk categories to determine appropriate management pathways. A predictive model for probability of fall risk, based on previous research, was used to determine concurrent validity of the FSRI. Results: The FSRA placed 79% of participants into the low-risk category, whereas the predictive model found the probability of fall risk to range from 0.04 to 0.74, with a mean of 0.35 (SD 0.25). No statistically significant correlation was found between the FSRA and the predictive model for probability of fall risk (Spearman's ρ=0.35, p=0.06). Conclusion: The FSRA lacks concurrent validity relative to to a previously established model of fall risk and appears to over-categorize individuals into the low-risk group. Further research on the FSRA as an adequate tool to screen community-dwelling older adults for fall risk is recommended. PMID:24381379

  7. Falls and Fractures: A systematic approach to screening and prevention.

    PubMed

    Ambrose, Anne Felicia; Cruz, Lisanne; Paul, Geet

    2015-09-01

    Falls are one of the major causes of mortality and morbidity in older adults. Every year, an estimated 30-40% of patients over the age of 65 will fall at least once. Falls lead to moderate to severe injuries, fear of falling, loss of independence and death in a third of those patients. Falls account for 87 % of all fractures in the elderly. These fractures are almost always due to low impact injuries in osteoporotic bones. Several organizations have recommended screening older patients to identify those with a high risk of falling and, or fractures. The present review provides a brief summary and update of the relevant literature, summarizing screening tools and interventions to prevent falls and fractures. The major risk factors identified are impaired balance and gait, polypharmacy, and history of previous falls. Other risk factors include advancing age, female gender, visual impairments, cognitive decline especially attention and executive dysfunction, and environmental factors. Recommendations for the clinician to screen and prevent falls in older patients are also summarized. PMID:26255681

  8. Developing an Evidence-Based Fall Prevention Curriculum for Community Health Workers

    PubMed Central

    St. John, Julie A.; Shubert, Tiffany E.; Smith, Matthew Lee; Rosemond, Cherie A.; Howell, Doris A.; Beaudoin, Christopher E.; Ory, Marcia G.

    2015-01-01

    This perspective paper describes processes in the development of an evidence-based fall prevention curriculum for community health workers/promotores (CHW/P) that highlights the development of the curriculum and addresses: (1) the need and rationale for involving CHW/P in fall prevention; (2) involvement of CHW/P and content experts in the curriculum development; (3) best practices utilized in the curriculum development and training implementation; and (4) next steps for dissemination and utilization of the CHW/P fall prevention curriculum. The project team of CHW/P and content experts developed, pilot tested, and revised bilingual in-person training modules about fall prevention among older adults. The curriculum incorporated the following major themes: (1) fall risk factors and strategies to reduce/prevent falls; (2) communication strategies to reduce risk of falling and strategies for developing fall prevention plans; and (3) health behavior change theories utilized to prevent and reduce falls. Three separate fall prevention modules were developed for CHW/P and CHW/P Instructors to be used during in-person trainings. Module development incorporated a five-step process: (1) conduct informal focus groups with CHW/P to inform content development; (2) develop three in-person modules in English and Spanish with input from content experts; (3) pilot-test the modules with CHW/P; (4) refine and finalize modules based on pilot-test feedback; and (5) submit modules for approval of continuing education units. This project contributes to the existing evidence-based literature by examining the role of CHW/P in fall prevention among older adults. By including evidence-based communication strategies such as message tailoring, the curriculum design allows CHW/P to personalize the information for individuals, which can result in an effective dissemination of a curriculum that is evidence-based and culturally appropriate. PMID:25964920

  9. Iterative user centered design for development of a patient-centered fall prevention toolkit.

    PubMed

    Katsulis, Zachary; Ergai, Awatef; Leung, Wai Yin; Schenkel, Laura; Rai, Amisha; Adelman, Jason; Benneyan, James; Bates, David W; Dykes, Patricia C

    2016-09-01

    Due to the large number of falls that occur in hospital settings, inpatient fall prevention is a topic of great interest to patients and health care providers. The use of electronic decision support that tailors fall prevention strategy to patient-specific risk factors, known as Fall T.I.P.S (Tailoring Interventions for Patient Safety), has proven to be an effective approach for decreasing hospital falls. A paper version of the Fall T.I.P.S toolkit was developed primarily for hospitals that do not have the resources to implement the electronic solution; however, more work is needed to optimize the effectiveness of the paper version of this tool. We examined the use of human factors techniques in the redesign of the existing paper fall prevention tool with the goal of increasing ease of use and decreasing inpatient falls. The inclusion of patients and clinical staff in the redesign of the existing tool was done to increase adoption of the tool and fall prevention best practices. The redesigned paper Fall T.I.P.S toolkit showcased a built in clinical decision support system and increased ease of use over the existing version. PMID:27184319

  10. Emerging concept: 'central benefit model' of exercise in falls prevention.

    PubMed

    Liu-Ambrose, Teresa; Nagamatsu, Lindsay S; Hsu, Chun Liang; Bolandzadeh, Niousha

    2013-01-01

    Falls are a common geriatric syndrome and are the third leading cause of chonic disability worldwide. Falls are not random events and occur, at least in part, due to impaired physiological function, such as impaired balance, and cognitive impairment. The clinical syndrome of falls is important for Sports and Exercise Medicine Clinicians as there is Level 1 evidence that targeted exercise prescription is an effective intervention strategy. The widely accepted dogma is that improved physical function, balance and muscle strength, underlies the effectiveness of the exercise in reducing falls. However, findings from randomised controlled trials suggest that exercise reduce falls via mechanisms other than improved physiological function. The authors propose that improved cognitive function - specifically, executive functions - and associated functional plasticity may be an important yet underappreciated mechanism by which the exercise reduces falls in older adults. PMID:22522589

  11. Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis

    PubMed Central

    2014-01-01

    Background Limited attention has been paid in the literature to multiple component fall prevention interventions that comprise two or more fixed combinations of fall prevention interventions that are not individually tailored following a risk assessment. The study objective was to determine the effect of multiple component interventions on fall rates, number of fallers and fall-related injuries among older people and to establish effect sizes of particular intervention combinations. Methods Medline, EMBASE, CINAHL, PsychInfo, Cochrane, AMED, UK Clinical Research Network Study Portfolio, Current Controlled Trials register and Australian and New Zealand Clinical Trials register were systematically searched to August 2013 for randomised controlled trials targeting those aged 60 years and older with any medical condition or in any setting that compared multiple component interventions with no intervention, placebo or usual clinical care on the outcomes reported falls, number that fall or fall-related injuries. Included studies were appraised using the Cochrane risk of bias tool. Estimates of fall rate ratio and risk ratio were pooled across studies using random effects meta-analysis. Data synthesis took place in 2013. Results Eighteen papers reporting 17 trials were included (5034 participants). There was a reduction in the number of people that fell (pooled risk ratio = 0.85, 95% confidence interval (95% CI) 0.80 to 0.91) and the fall rate (pooled rate ratio = 0.80, 95% CI 0.72 to 0.89) in favour of multiple component interventions when compared with controls. There was a small amount of statistical heterogeneity (I2 = 20%) across studies for fall rate and no heterogeneity across studies examining number of people that fell. Conclusions This systematic review and meta-analysis of randomised controlled trials found evidence that multiple component interventions that are not tailored to individually assessed risk factors are effective at reducing both the

  12. Survey on Fall Detection and Fall Prevention Using Wearable and External Sensors

    PubMed Central

    Delahoz, Yueng Santiago; Labrador, Miguel Angel

    2014-01-01

    According to nihseniorhealth.gov (a website for older adults), falling represents a great threat as people get older, and providing mechanisms to detect and prevent falls is critical to improve people's lives. Over 1.6 million U.S. adults are treated for fall-related injuries in emergency rooms every year suffering fractures, loss of independence, and even death. It is clear then, that this problem must be addressed in a prompt manner, and the use of pervasive computing plays a key role to achieve this. Fall detection (FD) and fall prevention (FP) are research areas that have been active for over a decade, and they both strive for improving people's lives through the use of pervasive computing. This paper surveys the state of the art in FD and FP systems, including qualitative comparisons among various studies. It aims to serve as a point of reference for future research on the mentioned systems. A general description of FD and FP systems is provided, including the different types of sensors used in both approaches. Challenges and current solutions are presented and described in great detail. A 3-level taxonomy associated with the risk factors of a fall is proposed. Finally, cutting edge FD and FP systems are thoroughly reviewed and qualitatively compared, in terms of design issues and other parameters. PMID:25340452

  13. A student-led demonstration project on fall prevention in a long-term care facility.

    PubMed

    Bonner, Alice; MacCulloch, Patricia; Gardner, Terri; Chase, Chantel W

    2007-01-01

    Falls are a frequent and serious problem facing people aged 65 and older. The incidence of falls increases with greater numbers of intrinsic and extrinsic risk factors and can be reduced by risk modification and targeted interventions. Falls account for 70% of accidental deaths in persons aged 75 and older. Mortality due to falls is significantly higher for older adults living in extended care facilities versus those living in the community. Our objective was to evaluate the effectiveness of a fall prevention training program in a long-term care setting. A single-group repeated-measure design was used, guided by the Precede-Proceed framework. A comprehensive review of the literature and a concept analysis guided the development of testing and educational materials for all nursing and ancillary facility staff. Preliminary testing provided baseline data on knowledge related to fall prevention. Pre- and posttests, a fall prevention newsletter, and informational brochures were distributed to nursing staff and ancillary personnel at training sessions. Certified nursing assistant (CNA) champions were identified and given peer leadership training. "Quick Tips" fall prevention badges were also distributed to staff. Graduate students led interdisciplinary environmental rounds weekly, and new falls were reviewed on a daily basis by the interdisciplinary team. A 60-day posttest evaluated retention of fall prevention knowledge. Fall rates at baseline and for 2 months after the intervention were compared. Preliminary survey data revealed fall prevention learning opportunities, with a pretest mean score of 86.78%. Qualitative data were coded and revealed specific learning gaps in intrinsic, extrinsic, and organizational causes of falls. The 60-day posttest mean score was 90.69%; a paired t test (t score = -1.050; P = .057) suggested that learning may have taken place; however, differences in scores did not reach statistical significance. The fall rate before training was 16

  14. Physical activity interventions to prevent falls among older people: update of the evidence.

    PubMed

    Sherrington, C; Lord, S R; Finch, C F

    2004-04-01

    Injuries resulting from falls are a significant public health issue, particularly for older people. This review provides an update of the evidence on the effects of various physical activity (PA) or exercise intervention strategies for the prevention of unintentional falls among older people. Six systematic reviews, and three randomised controlled trials not incorporated in previous reviews, were located with a literature search. There is clear evidence that a targeted supervised home exercise program of strength and balance exercise and walking practice, prescribed by a trained health professional, can prevent falls among older community dwellers. There is also an indication that untargeted group exercise (ie, not individually prescribed) can prevent falls among community dwellers, particularly if it involves Tai Chi or other exercises which challenge balance. There is some indication that individual prescription of PA is more important in frailer groups. Further investigation is required to establish the effects of PA in residential aged care, and the relative effects of different types of PA in different populations. In addition, multidisciplinary, multifactorial. health/environmental risk factor screening/intervention programs have been found to be effective in preventing falls. For many individuals with physical risk factors for falls (eg, impaired strength, balance or functional ability), PA alone is likely to reduce the risk of falls. For those with additional risk factors (eg, visual impairments, psychoactive medication use), other interventions may also be required. PMID:15214601

  15. Engaging community-based organizations in fall prevention education.

    PubMed

    Kramer, B Josea; Vivrette, Rebecca L; Rubenstein, Laurence Z

    2011-01-01

    Falls are a major public health problem for older adults, and community-based organizations play a key role in educating seniors about falls prevention (FP). We conducted a qualitative process evaluation at six sites to report community-based centers' perspectives on adoption, adaptation, and sustainability of an evidence-based multifactorial FP model. Wide dissemination of new health-oriented programs requires marketing to center directors, who must consider sustainability options. The diversity and independence of community-based organizations, together with current staffing and funding limitations, suggest that fidelity to multifactorial evidence-based interventions will be difficult to achieve. PMID:21598150

  16. A DVD program on fall prevention skills training for cancer family caregivers.

    PubMed

    Potter, Patricia; Olsen, Sarah; Kuhrik, Marilee; Kuhrik, Nancy; Huntley, Lance R

    2012-03-01

    This feasibility study tested an instructional DVD program for improving cancer family caregivers' knowledge and preparedness in fall prevention and reducing fall occurrence among the patients they care for at home. DVD program features included training caregivers on safe mobility skills. Family caregivers of cancer patients were surveyed before and after viewing the DVD program on "Moving Safely" in the home. Cancer patients were followed 4 months postintervention to determine if fall occurrence was reduced. There was a decrease in the number of patients who fell postintervention compared with those who fell preintervention. Caregivers' perceptions of knowledge about fall prevention improved significantly after viewing the DVD. An instructional DVD program is an effective educational tool for preparing family caregivers with the knowledge and skills needed to reduce the incidence of falls in the home setting. Educators must develop programs for preparing family caregivers to perform nursing skills within the home. PMID:22057986

  17. Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial

    PubMed Central

    Delbaere, K; Valenzuela, T; Woodbury, A; Davies, T; Yeong, J; Steffens, D; Miles, L; Pickett, L; Zijlstra, G A R; Clemson, L; Close, J C T; Howard, K; Lord, S R

    2015-01-01

    Introduction In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people. Methods and analysis Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective. Ethics and dissemination Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. Trial registration number

  18. Fall prevention in postmenopausal women: the role of Pilates exercise training.

    PubMed

    Hita-Contreras, F; Martínez-Amat, A; Cruz-Díaz, D; Pérez-López, F R

    2016-06-01

    Falls and fall-related injuries are a major public health concern for postmenopausal women. Fear of falling, impairments in gait and postural control, and changes in body composition have been identified as important risk factors for falling. Physical exercise is an important tool in fall prevention and management. The Pilates method is a non-impact activity that can be adapted to different physical conditions and health status and is recommended for various populations. In postmenopausal women, it has been deemed an effective way to improve some fall-related physical and psychological aspects, such as postural and dynamic balance. In addition, some physical capacities, such as flexibility, personal autonomy, mobility, and functional ability have also shown to benefit from Pilates interventions involving women in their second half of life, as well as certain psychological aspects including fear of falling, depressive status, and quality of life. Pilates exercise has shown effectively to prevent falls in postmenopausal women by improving their balance, physical and psychological functioning, and independence. Nevertheless, further studies are needed to demonstrate its validity in different clinical situations. PMID:26849849

  19. Is there a role for neck manipulation in elderly falls prevention? – An overview

    PubMed Central

    Kendall, Julie C.; Hartvigsen, Jan; French, Simon D.; Azari, Michael F.

    2015-01-01

    Many risk factors exist for falls in the elderly. Dizziness is an important risk factor for such falls. Spinal pain has also been identified as a risk factor for these falls. In this overview of the literature, we examine studies, including trials, of neck manipulation for neck pain, unsteadiness and falls risk relevant to the elderly. We also examine two related, but not mutually exclusive, mechanisms through which a putative beneficial effect may be mediated. These are the effects of neck manipulation on neck pain and on non-specific dizziness. We focus on the available evidence primarily in terms of clinical data rather than laboratory-based measures of balance. We conclude that chiropractors may have a role in falls prevention strategies in the subpopulation of the elderly that suffer from mechanical neck pain or dysfunction and non-specific dizziness. However, this role remains to be rigorously studied and properly defined. PMID:25729086

  20. Fall Prevention Knowledge, Attitude, and Practices of Community Stakeholders and Older Adults

    PubMed Central

    Laing, Sharon S.; Silver, Ilene F.; York, Sally; Phelan, Elizabeth A.

    2011-01-01

    We assessed knowledge, attitude, and provision of recommended fall prevention (FP) practices by employees of senior-serving organization and participation in FP practices by at-risk elders. The Washington State Department of Health administered structured telephone surveys to 50 employees and 101 elders in Washington State. Only 38% of employees felt “very knowledgeable” about FP, and a majority of their organizations did not regularly offer FP services. Almost half (48%) of seniors sustained a fall within the past 12 months; however, one-third perceived falling to be among their least important health concerns, and most had minimal working knowledge of proven FP practices. Seniors who perceived avoiding falls as important to their well-being were more likely to participate in practices about which they had the least knowledge (risk assessment, medication management). Increased awareness and availability of FP services might help engage older adults in FP practices and reduce the adverse effects of falls. PMID:21915377

  1. Yale FICSIT: risk factor abatement strategy for fall prevention.

    PubMed

    Tinetti, M E; Baker, D I; Garrett, P A; Gottschalk, M; Koch, M L; Horwitz, R I

    1993-03-01

    Based on finding a strong association between number of impairments and risk of falling in earlier studies, Yale FICSIT investigators are conducting an intervention trial comparing the effectiveness of usual care plus social visits (SV) and a targeted risk abatement intervention (TI) strategy in reducing falls among at risk community elderly persons. Subjects include members of a participating HMO who are > or = 70 years of age, cognitively intact, not terminally ill, not too physically active, and possess at least one fall risk factor. The targeted risk factors include postural hypotension; sedative use; at least four targeted medications; upper and lower extremity strength and range of motion impairments; foot problems; and balance, gait, and transfer dysfunctions. The interventions include medication adjustments, behavioral change recommendations, education and training, and home-based exercise regimens targeting the identified risk factors. The interventions are carried out by the study nurse practitioner and physical therapist in TI subjects' homes. The SV subjects receive a comparable number of home visits as the TI subjects during which a structured life review is performed by social work students. The primary outcome is occurrence of falls during the 12-month followup. Secondary outcomes include change in mobility performance and fall-related efficacy. PMID:8440856

  2. Randomised factorial trial of falls prevention among older people living in their own homes

    PubMed Central

    Day, Lesley; Fildes, Brian; Gordon, Ian; Fitzharris, Michael; Flamer, Harold; Lord, Stephen

    2002-01-01

    Objective To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. Design A randomised controlled trial with a full factorial design. Setting Urban community in Melbourne, Australia. Participants 1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. Interventions Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. Main outcome measure Time to first fall ascertained by an 18 month falls calendar and analysed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. Results The rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P<0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. Conclusions Group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduced vision management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their

  3. Preventing falls among older people with mental health problems: a systematic review

    PubMed Central

    2014-01-01

    Background Falls are a leading cause of mortality and morbidity in older people and the risk of falling is exacerbated by mental health conditions. Existing reviews have focused on people with dementia and cognitive impairment, but not those with other mental health conditions or in mental health settings. The objective of this review is to evaluate the effectiveness of fall prevention interventions for older people with mental health problems being cared for across all settings. Methods A systematic review of fall prevention interventions for older people with mental health conditions. We undertook electronic database and lateral searches to identify studies reporting data on falls or fall related injuries. Searches were initially conducted in February 2011 and updated in November 2012 and October 2013; no date restrictions were applied. Studies were assessed for risk of bias. Due to heterogeneity results were not pooled but are reported narratively. Results Seventeen RCTs and four uncontrolled studies met the inclusion criteria; 11 involved single interventions and ten multifactorial. Evidence relating to fall reduction was inconsistent. Eight of 14 studies found a reduction in fallers (statistically significant in five), and nine of 14 reported a significant reduction in rate or number of falls. Four studies found a non-significant increase in falls. Multifactorial, multi-disciplinary interventions and those involving exercise, medication review and increasing staff awareness appear to reduce the risk of falls but evidence is mixed and study quality varied. Changes to the environment such as increased supervision or sensory stimulation to reduce agitation may be promising for people with dementia but further evaluation is needed. Most of the studies were undertaken in nursing and residential homes, and none in mental health hospital settings. Conclusions There is a dearth of falls research in mental health settings or which focus on patients with mental health

  4. Changes in fall prevention training for apprentice carpenters based on a comprehensive needs assessment☆

    PubMed Central

    Kaskutas, Vicki; Dale, Ann Marie; Lipscomb, Hester; Gaal, John; Fuchs, Mark; Evanoff, Bradley

    2013-01-01

    Problem Falls from heights in residential construction are common, especially among inexperienced workers. Methods We conducted a comprehensive needs assessment to determine gaps in the school-based apprentice carpenters' fall prevention training. A team of carpenter instructors and researchers revised the fall prevention training to fill these gaps. Apprentice evaluation and feedback guided ongoing curricular improvements. Results Most apprentice carpenters performed work tasks at heights prior to training and fall protection techniques were not commonly used at residential construction sites. Priorities of the revised school-based training included safe ladder habits, truss setting, scaffold use, guarding floor openings, and using personal fall arrest systems. New apprentices were targeted to ensure training prior to exposure at the workplace. We used adult learning principles to emphasize hands-on experiences. A framed portion of a residential construction site was fabricated to practice fall protection behaviors in a realistic setting. The revised curriculum has been delivered consistently and apprentice feedback has been very favorable. Conclusions Integration of needs assessment results was invaluable in revising the school-based carpenters apprentice fall prevention curriculum. Working closely with the instructors to tailor learning experiences has provided preliminary positive results. Impact on Industry The fall safety of the residential construction industry continues to lag behind commercial construction and industrial settings. The National Occupational Research Agenda includes a Strategic Goal to strengthen and extend the reach of quality training and education in the construction industry via mechanisms such as construction safety and health training needs assessments. This study demonstrates how a structured process can be used to identify and remedy gaps and improve training effectiveness. We encourage others to take steps to assess and increase the

  5. ["Jaques-Dalcroze eurhythmics" improves gait and prevents falls in the elderly].

    PubMed

    Trombetti, Andrea; Hars, Mélany; Herrmann, François; Kressig, Reto; Ferrari, Serge; Rizzoli, René

    2011-06-15

    Given the significant health and socioeconomic consequences of falls, to develop and promote effective falls prevention strategies among older adults represents a major issue. Jaques-Dalcroze eurhythmics is a music education program through movement method developed in Geneva, Switzerland, in the early 20th century. This new exercise form, adapted for elderly people, features various multitask exercises performed to the rhythm of improvised piano music and mainly challenge gait and balance, but also memory, attention and coordination. We report here the results of a randomized controlled trial conducted in Geneva showing that Jaques-Dalcroze eurythmics practice can improve gait performance under single and dual-task conditions, and balance, as well as reduce both rate of falls and the risk of falling in at-risk elderly community-dwellers. PMID:21793420

  6. Can social dancing prevent falls in older adults? a protocol of the Dance, Aging, Cognition, Economics (DAnCE) fall prevention randomised controlled trial

    PubMed Central

    2013-01-01

    Background Falls are one of the most common health problems among older people and pose a major economic burden on health care systems. Exercise is an accepted stand-alone fall prevention strategy particularly if it is balance training or regular participation in Tai chi. Dance shares the ‘holistic’ approach of practices such as Tai chi. It is a complex sensorimotor rhythmic activity integrating multiple physical, cognitive and social elements. Small-scale randomised controlled trials have indicated that diverse dance styles can improve measures of balance and mobility in older people, but none of these studies has examined the effect of dance on falls or cognition. This study aims to determine whether participation in social dancing: i) reduces the number of falls; and ii) improves cognitive functions associated with fall risk in older people. Methods/design A single-blind, cluster randomised controlled trial of 12 months duration will be conducted. Approximately 450 participants will be recruited from 24 self-care retirement villages that house at least 60 residents each in Sydney, Australia. Village residents without cognitive impairment and obtain medical clearance will be eligible. After comprehensive baseline measurements including physiological and cognitive tests and self-completed questionnaires, villages will be randomised to intervention sites (ballroom or folk dance) or to a wait-listed control using a computer randomisation method that minimises imbalances between villages based on two baseline fall risk measures. Main outcome measures are falls, prospectively measured, and the Trail Making cognitive function test. Cost-effectiveness and cost-utility analyses will be performed. Discussion This study offers a novel approach to balance training for older people. As a community-based approach to fall prevention, dance offers older people an opportunity for greater social engagement, thereby making a major contribution to healthy ageing. Providing

  7. Fall Prevention Research and Practice: A Total Worker Safety Approach

    PubMed Central

    HSIAO, Hongwei

    2014-01-01

    Slips, trips, and falls (STF) represent a serious hazard to workers and occupants in many industries, homes, and communities. Often, the cause of a STF incident is multifactorial, encompassing human, environmental, and task risk factors. A STF-related disability can greatly diminish the occupational capability and quality of life of individuals in both the workplace and the home. Countering STF hazards and risks both on and off the job and on all aspects of control measures is a “total worker safety” matter, a challenging yet tangible undertaking. As the federal organization responsible for conducting research for the prevention of work-related injuries in the United States, the National Institute for Occupational Safety and Health (NIOSH) has been conducting research on STF controls for some decades. Many NIOSH research outcomes have been utilized for STF prevention in workplaces, with potential for prevention in homes as well. This paper summarizes the concept of total worker safety for STF control, NIOSH priority research goals, major activities, and accomplishments, and some emerging issues on STF. The strategic planning process for the NIOSH research goals and some identified research focuses are applicable to the development and implementation of global STF research goals. PMID:25345424

  8. Quantifying Temperature Effects on Fall Chinook Salmon

    SciTech Connect

    Jager, Yetta

    2011-11-01

    The motivation for this study was to recommend relationships for use in a model of San Joaquin fall Chinook salmon. This report reviews literature pertaining to relationships between water temperature and fall Chinook salmon. The report is organized into three sections that deal with temperature effects on development and timing of freshwater life stages, temperature effects on incubation survival for eggs and alevin, and temperature effects on juvenile survival. Recommendations are made for modeling temperature influences for all three life stages.

  9. Laboratory review: the role of gait analysis in seniors' mobility and fall prevention.

    PubMed

    Bridenbaugh, Stephanie A; Kressig, Reto W

    2011-01-01

    Walking is a complex motor task generally performed automatically by healthy adults. Yet, by the elderly, walking is often no longer performed automatically. Older adults require more attention for motor control while walking than younger adults. Falls, often with serious consequences, can be the result. Gait impairments are one of the biggest risk factors for falls. Several studies have identified changes in certain gait parameters as independent predictors of fall risk. Such gait changes are often too discrete to be detected by clinical observation alone. At the Basel Mobility Center, we employ the GAITRite electronic walkway system for spatial-temporal gait analysis. Although we have a large range of indications for gait analyses and several areas of clinical research, our focus is on the association between gait and cognition. Gait analysis with walking as a single-task condition alone is often insufficient to reveal underlying gait disorders present during normal, everyday activities. We use a dual-task paradigm, walking while simultaneously performing a second cognitive task, to assess the effects of divided attention on motor performance and gait control. Objective quantification of such clinically relevant gait changes is necessary to determine fall risk. Early detection of gait disorders and fall risk permits early intervention and, in the best-case scenario, fall prevention. We and others have shown that rhythmic movement training such as Jaques-Dalcroze eurhythmics, tai chi and social dancing can improve gait regularity and automaticity, thus increasing gait safety and reducing fall risk. PMID:20980732

  10. The effects of obesity on fall efficacy in elderly people.

    PubMed

    Jeon, Byoung-Jin

    2013-11-01

    [Purpose] The aim of this study was to identify the effects of obesity on falls as a practical verification of the importance of obesity-targeting interventions as part of future fall prevention programs. [Subjects and Methods] The study involved 351 elderly people (172 men, 179 women) living in rural areas. The dependent variable, fall efficacy, was measured using the Falls Efficacy Scale, while the independent variables, body mass index (BMI) and visceral fat, were measured using the InBody 720. The Faces Pain Scale was used to measure pain. Mobility was measured using the Timed Up and Go Test, and balance ability was measured according to the duration subjects could stand on one foot with their eyes closed. Hierarchical multiple regression analysis was performed for the final data analysis. [Results] Investigation of the correlations between the variables revealed a negative correlation between fall efficacy and the other variables. Ultimatley, investigation of the causality of fall efficacy revealed that the BMI, pain, and mobility were influential factors. In other words, fall efficacy tends to be lower when there are higher degrees of obesity, increased pain, and decreased mobility. [Conclusion] To improve the fall efficacy of elderly people living in rural areas, pain management and the maintenance of physical functionality are required. The present study confirms that the elderly need continuous obesity management to lead healthy lives. PMID:24396217

  11. Effect of free fall on higher plants.

    NASA Technical Reports Server (NTRS)

    Gordon, S. A.

    1973-01-01

    The influence of exposure to the free-fall state on the orientation, morphogenesis, physiology, and radiation response of higher plants is briefly summarized. It is proposed that the duration of the space-flight experiments has been to brief to permit meaningful effects of free fall on general biochemistry, growth, and development to appear. However, two types of significant effect did occur. The first is on differential growth - i.e., tropism and epinasty - resulting from the absence of a normal geostimulus. For these phenomena it is suggested that ground-based experiments with the clinostat would suffice to mimic the effect of the free-fall state. The second is an apparent interaction between the radiation response and some flight condition, yielding an enhanced microspore abortion, a disturbed spindle function, and a stunting of stamen hairs. It is suggested that this apparent interaction may be derived from a shift in the rhythm of the cell cycle, induced by the free fall.

  12. Preventing Falls | NIH MedlinePlus the Magazine

    MedlinePlus

    ... But many cannot and need long-term care. Fear of Falling Fear of falling becomes more common with age, even ... and restore your walking confidence. Getting over your fear can help you to stay active, maintain your ...

  13. Falls

    MedlinePlus

    ... problems with circulation, thyroid or nervous systems. Some medicines make people dizzy. Eye problems or alcohol can be factors. Any of these things can make a fall more likely. Babies and young children are also at risk of falling - off ...

  14. ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial

    PubMed Central

    2014-01-01

    Background Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission’s Seventh Framework Program (FP7) project ‘iStoppFalls’ an Information and Communication Technology (ICT) based system has been developed to regularly assess a person’s risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people. Methods/Design This international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars. Discussion We hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise

  15. A Comprehensive Initiative to Prevent Falls Among Newborns.

    PubMed

    Ainsworth, Rose Mary; Summerlin-Long, Shelley; Mog, Cathy

    2016-01-01

    Our hospital experienced seven instances of newborns falling over a 7-month period. Until that time, there had been no reported newborn falls. We formed a committee to study the situation and make recommendations for change. Common factors observed were early morning hours and an exhausted parent, usually the mother, falling asleep while feeding the newborn. The committee developed a policy and procedure addressing falls among newborns, created staff education and tools, and posted signage in mothers' rooms. We also updated crib cards to include information about falls and safe sleep, and we revised newborn admission education for parents with additional information about falls. The incidence of newborns falling has decreased since we implemented these changes. PMID:27287351

  16. Compliant flooring to prevent fall-related injuries: a scoping review protocol

    PubMed Central

    Lachance, Chantelle C; Jurkowski, Michal P; Dymarz, Ania C; Mackey, Dawn C

    2016-01-01

    Introduction Fall-related injuries can have serious consequences for older adults, including increased risk of dependence in daily activities and mortality. Compliant flooring is a passive intervention that may reduce the incidence and severity of fall-related injuries in healthcare settings, including acute and long-term care, but few sites have implemented compliant flooring, in part because synthesised evidence about key performance aspects has not been available. Methods and analysis We will conduct a scoping review to address the question: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries? We will conduct a comprehensive and systematic literature search of academic databases (AgeLine, CINAHL, EBM Reviews, MEDLINE (Ovid), SportDiscus and Web of Science) and grey literature (clinical trial registries, theses/dissertations, abstracts/conference proceedings and relevant websites). 2 team members will independently screen records (first titles and abstracts, then full text) and extract data from included records. Numerical and narrative analyses will be presented by theme (biomechanical efficacy, clinical effectiveness, cost-effectiveness, workplace safety). Ethics and dissemination This scoping review responds to the information needs of healthcare decision-makers tasked with preventing fall-related injuries. This review will summarise evidence about compliant flooring as a potential intervention for preventing fall-related injuries in older adults and identify gaps in evidence and new avenues for research. Results will be especially useful in long-term care, but also applicable in acute care, assisted living and home care. We will disseminate the review's findings via open-access publications, conference presentations, a webinar, a Stakeholder Symposium and a Knowledge-to-Action Report. PMID:27531731

  17. Does a Falls Prevention Program Impact Perceived Participation in Everyday Occupations? A Pilot Randomized Controlled Trial.

    PubMed

    Johansson, Erika; Dahlberg, Raymond; Jonsson, Hans; Patomella, Ann-Helen

    2015-10-01

    This study aimed to evaluate the effectiveness of a multi-disciplinary, client-centered, fall prevention program on the experiences of participation and autonomy in everyday occupations among community-dwelling older adults. In total, 131 older adults (65+) were included and randomly allocated into two groups. Intention-to-treat analysis was used. Results of this pilot study showed that the program had a limited effect on the subjective experiences of participation and autonomy in everyday occupations among the participants. However, a trend of increased perceived participation and a decrease in the experience of perceived problems with participation among the participants in the intervention group was shown. Perceived participation and autonomy seem to be subjective experiences, and they seem to vary depending on the individual. To properly understand the impact of fall prevention interventions on participation and autonomy, measurements that capture both subjective and objective experiences are essential to use. PMID:27505900

  18. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study)

    PubMed Central

    Pahor, Marco; Guralnik, Jack M; McDermott, Mary M; King, Abby C; Buford, Thomas W; Strotmeyer, Elsa S; Nelson, Miriam E; Sink, Kaycee M; Demons, Jamehl L; Kashaf, Susan S; Walkup, Michael P; Miller, Michael E

    2016-01-01

    Objective To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. Design Multicenter, single blinded randomized trial (Lifestyle Interventions and Independence for Elders (LIFE) study). Setting Eight centers across the United States, February 2010 to December 2011. Participants 1635 sedentary adults aged 70-89 years with functional limitations, defined as a short physical performance battery score ≤9, but who were able to walk 400 m. Interventions A permuted block algorithm stratified by field center and sex was used to allocate interventions. Participants were randomized to a structured, moderate intensity physical activity program (n=818) conducted in a center (twice a week) and at home (3-4 times a week) that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching exercises. Main outcome measures Serious fall injuries, defined as a fall that resulted in a clinical, non-vertebral fracture or that led to a hospital admission for another serious injury, was a prespecified secondary outcome in the LIFE Study. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. All participants were included in the analysis. Results Over a median follow-up of 2.6 years, a serious fall injury was experienced by 75 (9.2%) participants in the physical activity group and 84 (10.3%) in the health education group (hazard ratio 0.90, 95% confidence interval 0.66 to 1.23; P=0.52). These results were consistent across several subgroups, including sex. However, in analyses that were not prespecified, sex specific differences were observed for rates of all serious fall injuries (rate ratio 0.54, 95% confidence interval 0.31 to 0.95 in men

  19. Are Older Adults Receiving Evidence-Based Advice to Prevent Falls Post-Discharge from Hospital?

    ERIC Educational Resources Information Center

    Lee, Den-Ching A.; Brown, Ted; Stolwyk, Rene; O'Connor, Daniel W.; Haines, Terry P.

    2016-01-01

    Background: Older adults experience a high rate of falls when they transition to community-living following discharge from hospital. Objectives: To describe the proportion of older adults who could recall having discussed falls and falls prevention strategies with a health professional within 6 months following discharge from hospital. To describe…

  20. Older People's Views of Advice about Falls Prevention: A Qualitative Study

    ERIC Educational Resources Information Center

    Yardley, L.; Donovan-Hall, M.; Francis, K.; Todd, C.

    2006-01-01

    The aim of this study was to gain an understanding of older people's perceptions of falls prevention advice, and how best to design communications that will encourage older people to take action to prevent falls. Focus groups and interviews were carried out with 66 people aged 61-94 years recruited from a variety of settings, using falls…

  1. Accident patterns and prevention measures for fatal occupational falls in the construction industry.

    PubMed

    Chi, Chia-Fen; Chang, Tin-Chang; Ting, Hsin-I

    2005-07-01

    Contributing factors to 621 occupational fatal falls have been identified with respect to the victim's individual factors, the fall site, company size, and cause of fall. Individual factors included age, gender, experience, and the use of personal protective equipment (PPE). Accident scenarios were derived from accident reports. Significant linkages were found between causes for the falls and accident events. Falls from scaffold staging were associated with a lack of complying scaffolds and bodily action. Falls through existing floor openings were associated with unguarded openings, inappropriate protections, or the removal of protections. Falls from building girders or other structural steel were associated with bodily actions and improper use of PPE. Falls from roof edges were associated with bodily actions and being pulled down by a hoist, object or tool. Falls through roof surfaces were associated with lack of complying scaffolds. Falls from ladders were associated with overexertion and unusual control and the use of unsafe ladders and tools. Falls down stairs or steps were associated with unguarded openings. Falls while jumping to a lower floor and falls through existing roof openings were associated with poor work practices. Primary and secondary prevention measures can be used to prevent falls or to mitigate the consequences of falls and are suggested for each type of accident. Primary prevention measures would include fixed barriers, such as handrails, guardrails, surface opening protections (hole coverings), crawling boards/planks, and strong roofing materials. Secondary protection measures would include travel restraint systems (safety belt), fall arrest systems (safety harness), and fall containment systems (safety nets). PMID:15892934

  2. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies

    PubMed Central

    2012-01-01

    Background More than a third of people over the age of 65 years fall each year. Falling can lead to a reduction in quality of life, mortality, and a risk of prolonged hospitalisation. Reducing and preventing falls has become an international health priority. To help understand why research evidence has often not been translated into changes in clinical practice, we undertook a systematic review and synthesis of qualitative research in order to identify what factors serve as barriers and facilitators to the successful implementation of fall-prevention programmes. Methods We conducted a review of literature published between 1980 and January 2012 for qualitative research studies that examined barriers and facilitators to the effective implementation of fall-prevention interventions among community-dwelling older people and healthcare professionals. Two reviewers independently screened studies for inclusion, extracted data, and assessed methodological quality according to predefined criteria. Findings were synthesised using meta-ethnography. Results Of the 5010 articles identified through database searching, 19 were included in the review. Analysis of the 19 studies revealed limited information about the mechanisms by which barriers to implementation of fall-prevention interventions had been overcome. Data synthesis produced three overarching concepts: (1) practical considerations, (2) adapting for community, and (3) psychosocial. A line of argument synthesis describes the barriers and facilitators to the successful implementation of fall-prevention programmes. These concepts show that the implementation of fall-prevention programmes is complex and multifactorial. This is the first systematic review and synthesis of qualitative studies to examine factors influencing the implementation of fall-prevention programmes from the perspectives of both the healthcare professional and the community-dwelling older person. Conclusions The current literature on barriers and

  3. Wearable technology and ECG processing for fall risk assessment, prevention and detection.

    PubMed

    Melillo, Paolo; Castaldo, Rossana; Sannino, Giovanna; Orrico, Ada; de Pietro, Giuseppe; Pecchia, Leandro

    2015-08-01

    Falls represent one of the most common causes of injury-related morbidity and mortality in later life. Subjects with cardiovascular disorders (e.g., related to autonomic dysfunctions and postural hypotension) are at higher risk of falling. Autonomic dysfunctions increasing the risk of falling in the short and mid-term could be assessed by Heart Rate Variability (HRV) extracted by electrocardiograph (ECG). We developed three trials for assessing the usefulness of ECG monitoring using wearable devices for: risk assessment of falling in the next few weeks; prevention of imminent falls due to standing hypotension; and fall detection. Statistical and data-mining methods are adopted to develop classification and regression models, validated with the cross-validation approach. The first classifier based on HRV features enabled to identify future fallers among hypertensive patients with an accuracy of 72% (sensitivity: 51.1%, specificity: 80.2%). The regression model to predict falls due to orthostatic dropdown from HRV recorded before standing achieved an overall accuracy of 80% (sensitivity: 92%, specificity: 90%). Finally, the classifier to detect simulated falls using ECG achieved an accuracy of 77.3% (sensitivity: 81.8%, specificity: 72.7%). The evidence from these three studies showed that ECG monitoring and processing could achieve satisfactory performances compared to other system for risk assessment, fall prevention and detection. This is interesting as differently from other technologies actually employed to prevent falls, ECG is recommended for many other pathologies of later life and is more accepted by senior citizens. PMID:26738086

  4. Does a fall prevention educational programme improve knowledge and change exercise prescribing behaviour in health and exercise professionals? A study protocol for a randomised controlled trial

    PubMed Central

    Tiedemann, A; Sturnieks, D L; Hill, A-M; Lovitt, L; Clemson, L; Lord, S R; Harvey, L; Sherrington, C

    2014-01-01

    Introduction Falling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on health and exercise professionals’ knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people. Methods and analysis A randomised controlled trial involving 220 consenting health and exercise professionals will be conducted. Participants will be individually randomised to an intervention group (n=110) to receive an educational workshop plus access to internet-based support resources, or a wait-list control group (n=110). The two primary outcomes, measured 3 months after randomisation, are: (1) knowledge about fall prevention and (2) self-perceived change in fall prevention exercise prescription behaviour. Secondary outcomes include: (1) participants’ confidence to prescribe fall prevention exercises; (2) the proportion of people aged 60+ years seen by trial participants in the past month who were prescribed fall prevention exercise; and (3) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines. Outcomes will be measured with a self-report questionnaire designed specifically for the trial. Ethics and dissemination The trial protocol was approved by the Human Research Ethics Committee, The University of Sydney, Australia. Trial results will be disseminated via peer reviewed journals, presentations at international conferences and participants’ newsletters. Trial registration number Trial

  5. Design, delivery, and outcomes from an interprofessional fall prevention course.

    PubMed

    Dauenhauer, Jason A; Glose, Susan; Watt, Celia

    2015-01-01

    This article describes the development, delivery, and outcomes from an interprofessional evidence-based falls management course for undergraduate and graduate students. The 3-credit elective course was developed by a gerontological social work and nursing faculty member in partnership with community-based housing and case management organizations. Creation of the course was in response to a mandate by the Health Resources and Services Administration, funding source for federal Geriatric Education Centers, to train interprofessional students using an evidence-based approach while tying the outcomes to improved health measures in the target population. Therefore, this article describes student competencies pre- and postcourse completion and outcomes of community-dwelling older adults completing a Matter of Balance (MOB) program delivered by these students. A total of 16 students completed the course which included delivery of the MOB program to 41 older adults. Results indicate statistically significant improvements in student outcomes from a pre/post falls knowledge test. For older adult participants, many screened positively for fall risk factors pre-post MOB participation showed statistically significant improvements in falls efficacy, control, management, and overall mobility. Opportunities and challenges associated with course delivery are also described. PMID:25941927

  6. Bayesian hierarchical modeling for a non-randomized, longitudinal fall prevention trial with spatially correlated observations

    PubMed Central

    Murphy, T. E.; Allore, H. G.; Leo-Summers, L.; Carlin, B. P.

    2012-01-01

    Because randomization of participants is often not feasible in community-based health interventions, non-randomized designs are commonly employed. Non-randomized designs may have experimental units that are spatial in nature, such as zip codes that are characterized by aggregate statistics from sources like the U.S. census and the Centers for Medicare and Medicaid Services. A perennial concern with non-randomized designs is that even after careful balancing of influential covariates, bias may arise from unmeasured factors. In addition to facilitating the analysis of interventional designs based on spatial units, Bayesian hierarchical modeling can quantify unmeasured variability with spatially correlated residual terms. Graphical analysis of these spatial residuals demonstrates whether variability from unmeasured covariates is likely to bias the estimates of interventional effect. The Connecticut Collaboration for Fall Prevention is the first large-scale longitudinal trial of a community-wide healthcare intervention designed to prevent injurious falls in older adults. Over a two-year evaluation phase, this trial demonstrated a rate of fall-related utilization at hospitals and emergency departments by persons 70 years and older in the intervention area that was 11 per cent less than that of the usual care area, and a 9 per cent lower rate of utilization from serious injuries. We describe the Bayesian hierarchical analysis of this non-randomized intervention with emphasis on its spatial and longitudinal characteristics. We also compare several models, using posterior predictive simulations and maps of spatial residuals. PMID:21294148

  7. Smartphone-Based Solutions for Fall Detection and Prevention: Challenges and Open Issues

    PubMed Central

    Habib, Mohammad Ashfak; Mohktar, Mas S.; Kamaruzzaman, Shahrul Bahyah; Lim, Kheng Seang; Pin, Tan Maw; Ibrahim, Fatimah

    2014-01-01

    This paper presents a state-of-the-art survey of smartphone (SP)-based solutions for fall detection and prevention. Falls are considered as major health hazards for both the elderly and people with neurodegenerative diseases. To mitigate the adverse consequences of falling, a great deal of research has been conducted, mainly focused on two different approaches, namely, fall detection and fall prevention. Required hardware for both fall detection and prevention are also available in SPs. Consequently, researchers' interest in finding SP-based solutions has increased dramatically over recent years. To the best of our knowledge, there has been no published review on SP-based fall detection and prevention. Thus in this paper, we present the taxonomy for SP-based fall detection and prevention solutions and systematic comparisons of existing studies. We have also identified three challenges and three open issues for future research, after reviewing the existing articles. Our time series analysis demonstrates a trend towards the integration of external sensing units with SPs for improvement in usability of the systems. PMID:24759116

  8. Smartphone-based solutions for fall detection and prevention: challenges and open issues.

    PubMed

    Habib, Mohammad Ashfak; Mohktar, Mas S; Kamaruzzaman, Shahrul Bahyah; Lim, Kheng Seang; Pin, Tan Maw; Ibrahim, Fatimah

    2014-01-01

    This paper presents a state-of-the-art survey of smartphone (SP)-based solutions for fall detection and prevention. Falls are considered as major health hazards for both the elderly and people with neurodegenerative diseases. To mitigate the adverse consequences of falling, a great deal of research has been conducted, mainly focused on two different approaches, namely, fall detection and fall prevention. Required hardware for both fall detection and prevention are also available in SPs. Consequently, researchers' interest in finding SP-based solutions has increased dramatically over recent years. To the best of our knowledge, there has been no published review on SP-based fall detection and prevention. Thus in this paper, we present the taxonomy for SP-based fall detection and prevention solutions and systematic comparisons of existing studies. We have also identified three challenges and three open issues for future research, after reviewing the existing articles. Our time series analysis demonstrates a trend towards the integration of external sensing units with SPs for improvement in usability of the systems. PMID:24759116

  9. Outcomes of a Falls Prevention Education Program Among Older Adults in Grenada.

    PubMed

    Lyons, Beverly P; Hall, Raphael J

    2016-10-01

    In Latin America and the Caribbean, there is a scarcity of data on falls, the leading cause of death as a result of unintentional injuries, among older adults aged 65+ years of age. By 2050, 80 % of the 2 billion older adults worldwide are expected to be living in this region; therefore, it is imperative that this issue receive urgent attention from community health practitioners, health educators and policy makers. Guided by Pillar 1-awareness of the WHO fall prevention model for community-dwelling older adults, the purpose of this paper was to describe the feasibility of implementing a falls prevention awareness educational initiative in the Eastern Caribbean Island of Grenada. Sixty-two older adults, average age 67, participated in a falls awareness workshop. An anonymous pre-workshop falls assessment checklist was distributed to establish baseline information followed by an interactive workshop. Eight fall risks were identified and 52 % of the participants reported a history of falls. Based on the group's eagerness to participate, we are encouraged that falls prevention intervention initiatives are feasible among others of similar characteristics in Grenada and plan to implement Pillar II-objective falls assessment and Pillar III-on-going interventions. PMID:27013223

  10. Steady As You Go (SAYGO): A Falls-Prevention Program for Seniors Living in the Community.

    ERIC Educational Resources Information Center

    Robson, Ellie; Edwards, Joy; Gallagher, Elaine; Baker, Dorothy

    2003-01-01

    In a randomized trial of Steady as You Go, a falls-prevention program for the elderly, the treatment group (n=235) reduced eight of nine risk factors. Over a 4-month follow-up, the treatment group fell less than controls (n=236) and significantly fewer treatment group participants who had fallen before experienced falls (20%) compared to 35% of…

  11. Obstacle Course Training Can Improve Mobility and Prevent Falls in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Van Hanegem, E.; Enkelaar, L.; Smulders, E.; Weerdesteyn, V.

    2014-01-01

    Background: Persons with intellectual disabilities (ID) constitute a special-needs population at high risk of falling. This is the first study to evaluate whether obstacle course training can improve mobility and prevent falls in this population. Methods: The intervention was implemented as part of an institution-wide health care improvement plan…

  12. In response to Dr. Jose AP da Silva: fall prevention with vitamin D clarifications needed

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We agree with Dr. da Silva, and wish to clarify three issues raised by the recent IOM report concerning our 2009 meta-analysis on vitamin D and fall prevention. 1. The IOM questioned the inclusion of Broe et al., which did not pre-specify falls as a primary or secondary outcome. While this did viol...

  13. Are prevention programs falling prey to political pressure?

    PubMed

    2002-03-01

    AIDS advocates and clinicians express alarm about an investigation that has been launched targeting all federally funded HIV/AIDS prevention programs. The Department of Health and Human Services intends to assess the programs' materials to make certain they adhere to 1992 requirements of the Centers for Disease Control and Prevention. Critics say these programs already are thoroughly reviewed by local program review panels that assess content according to community obscenity standards and that the federal government should not second-guess their decisions. Meanwhile, the investigation has already resulted in one state turning down an HIV/AIDS prevention project until it's given a green light by the feds. PMID:12206091

  14. Intervention to prevent further falls in older people who call an ambulance as a result of a fall: a protocol for the iPREFER randomised controlled trial

    PubMed Central

    2013-01-01

    Background An increasing number of falls result in an emergency call and the subsequent dispatch of paramedics. In the absence of physical injury, abnormal physiological parameters or change in usual functional status, it could be argued that routine conveyance by ambulance to the Emergency Department (ED) is not the most effective or efficient use of resources. Further, it is likely that non-conveyed older fallers have the potential to benefit from timely access to fall risk assessment and intervention. The aim of this randomised controlled trial is to evaluate the effect of a timely and tailored falls assessment and management intervention on the number of subsequent falls and fall-related injuries for non-conveyed older fallers. Methods Community dwelling people aged 65 years or older who are not conveyed to the ED following a fall will be eligible to be visited at home by a research physiotherapist. Consenting participants will receive individualised intervention strategies based on risk factors identified at baseline. All pre-test measures will be assessed prior to randomisation. Post-test measures will be undertaken by a researcher blinded to group allocation 6 months post-baseline. Participants in the intervention group will receive individualised pro-active fall prevention strategies from the clinical researcher to ensure that risk factors are addressed adequately and interventions carried out. The primary outcome measure will be the number of falls recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the subsequent use of medical and emergency services and uptake of recommendations. Data will be analysed using the intention-to-treat principle. Discussion As there is currently little evidence regarding the effectiveness or feasibility of alternate models of care following ambulance non-conveyance of older fallers, there is a need to explore assessment and intervention programs to

  15. Heterogeneity of Falls Among Older Adults: Implications for Public Health Prevention

    PubMed Central

    Kelsey, Jennifer L.; Procter-Gray, Elizabeth; Hannan, Marian T.

    2012-01-01

    Objectives. We examined risk factors for falls among older people according to indoor and outdoor activity at the time of the fall and explored risk factors for seriously injurious falls. Methods. Data came from MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older. Over 4.3 years, 1737 falls were recorded, along with indoor or outdoor activity at the time of the fall. Results. Participants with poor baseline health characteristics had elevated rates of indoor falls while transitioning, walking, or not moving. Healthy, active people had elevated rates of outdoor falls during walking and vigorous activity. For instance, participants with fast, rather than normal, gait speed, had a rate ratio of 7.36 (95% confidence interval [CI] = 2.54, 21.28) for outdoor falls during vigorous activity. The likelihood of a seriously injurious fall also varied by personal characteristics, activity, and location. For example, the odds ratio for serious injury from an outdoor fall while walking outside compared to inside a participant’s neighborhood was 3.31 (95% CI = 1.33, 8.23). Conclusions. Fall prevention programs should be tailored to personal characteristics, activities, and locations. PMID:22994167

  16. Drawing on Related Knowledge to Advance Multiple Sclerosis Falls-Prevention Research

    PubMed Central

    Deshpande, Nandini; Latimer-Cheung, Amy E.; Finlayson, Marcia

    2014-01-01

    There is much to be learned from falls-related research outside the field of multiple sclerosis (MS), as well as from work within the MS field but not specific to falls or falls prevention. This article describes three examples of such bodies of work that have potential to broaden approaches to falls-prevention research: 1) sensory components of postural control among older adults, 2) lessons learned from physical activity promotion among people with spinal cord injury (SCI), and 3) aging among people with MS. Age-related deterioration in visual, vestibular, and somatosensory systems or in sensory integration can adversely affect postural control and can contribute to falls in older people. Sensory-specific interventions designed for improving balance in older people could be adapted for preventing falls in individuals with MS. Spinal Cord Injury (SCI) Action Canada's strategy for disseminating physical activity promotion interventions for adults with SCI has been successful and widely accepted by community partners. Many of the peer-based interventions developed by SCI Action Canada are potentially relevant and could be adapted to the MS population for both physical activity promotion and falls prevention. Considering that older people with MS constitute a growing proportion of the MS population and over 70% of older people with MS report moderate to extreme balance problems, falls prevention should be one of the key components, particularly for MS management in older or more disabled groups. Overall, given people's different ages, symptoms, strengths, and barriers, a tailored MS falls-prevention intervention that includes peer/caregiver support is critical. PMID:25694774

  17. Beyond Socks, Signs, and Alarms: A Reflective Accountability Model for Fall Prevention.

    PubMed

    Hoke, Linda M; Guarracino, Dana

    2016-01-01

    Despite standard fall precautions, including nonskid socks, signs, alarms, and patient instructions, our 48-bed cardiac intermediate care unit (CICU) had a 41% increase in the rate of falls (from 2.2 to 3.1 per 1,000 patient days) and a 65% increase in the rate of falls with injury (from 0.75 to 1.24 per 1,000 patient days) between fiscal years (FY) 2012 and 2013. An evaluation of the falls data conducted by a cohort of four clinical nurses found that the majority of falls occurred when patients were unassisted by nurses, most often during toileting. Supported by the leadership team, the clinical nurses developed an accountability care program that required nurses to use reflective practice to evaluate each fall, including sending an e-mail to all staff members with both the nurse's and the patient's perspective on the fall, as well as the nurse's reflection on what could have been done to prevent the fall. Other program components were a postfall huddle and guidelines for assisting and remaining with fall risk patients for the duration of their toileting. Placing the accountability for falls with the nurse resulted in decreases in the unit's rates of falls and falls with injury of 55% (from 3.1 to 1.39 per 1,000 patient days) and 72% (from 1.24 to 0.35 per 1,000 patient days), respectively, between FY2013 and FY2014. Prompt call bell response (less than 60 seconds) also contributed to the goal of fall prevention. PMID:26710147

  18. Falls Prevention Education for Older Adults during and after Hospitalization: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Lee, Den-Ching A.; Pritchard, Elizabeth; McDermott, Fiona; Haines, Terry P.

    2014-01-01

    Objectives: To assess the effectiveness of patient education in reducing falls, promoting behavioural change and the uptake of prevention activities in older adults during and after hospitalization. Design: Systematic review and meta-analysis. Methods: A systematic search of five health science databases was performed up to November 2012. Studies…

  19. Falls after Discharge from Hospital: Is There a Gap between Older Peoples' Knowledge about Falls Prevention Strategies and the Research Evidence?

    ERIC Educational Resources Information Center

    Hill, Anne-Marie; Hoffmann, Tammy; Beer, Christopher; McPhail, Steven; Hill, Keith D.; Oliver, David; Brauer, Sandra G.; Haines, Terry P.

    2011-01-01

    Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital. Design and Methods: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies…

  20. Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial

    PubMed Central

    El-Khoury, Fabienne; Cassou, Bernard; Latouche, Aurélien; Aegerter, Philippe; Charles, Marie-Aline

    2015-01-01

    Objective To assess the effectiveness of a two year exercise programme of progressive balance retraining in reducing injurious falls among women aged 75-85 at increased risk of falls and injuries and living in the community. Design Pragmatic multicentre, two arm, parallel group, randomised controlled trial. Setting 20 study sites in 16 medium to large cities throughout France. Participants 706 women aged 75-85, living in their own home, and with diminished balance and gait capacities, randomly allocated to the experimental intervention group (exercise programme, n=352) or the control group (no intervention, n=354). Intervention Weekly supervised group sessions of progressive balance training offered in community based premises for two years, supplemented by individually prescribed home exercises. Outcome measures A geriatrician blinded to group assignment classified falls into one of three categories (no consequence, moderate, severe) based on physical damage and medical care. The primary outcome was the rate of injurious falls (moderate and severe). The two groups were compared for rates of injurious falls with a “shared frailty” model. Other outcomes included the rates of all falls, physical functional capacities (balance and motor function test results), fear of falling (FES-I), physical activity level, and perceived health related quality of life (SF-36). Analysis was by intention to treat. Results There were 305 injurious falls in the intervention group and 397 in the control group (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). The difference in severe injuries (68 in intervention group v 87 in control group) was of the same order of magnitude (0.83, 0.60 to 1.16). At two years, women in the intervention group performed significantly better on all physical tests and had significantly better perception of their overall physical function than women in the control group. Among women who started the intervention (n=294), the median number of group

  1. Community fall prevention programs: comparing three InSTEP models by levels of intensity.

    PubMed

    Kramer, B Josea; Creekmur, Beth; Mitchell, Michael N; Rose, Debra J; Pynoos, Jon; Rubenstein, Laurence Z

    2014-07-01

    The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12-15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N = 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved selfperception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model significantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults. PMID:23945593

  2. Strength in Numbers: A Community Education Program to Prevent Falls in Older Adults.

    PubMed

    Yount, John

    2016-01-01

    The incidence and consequences of falls for older adults are well documented and well known to home care clinicians. In the absence of a falls-prevention program targeting older adults living in the community, home healthcare professionals at Cooley Dickinson VNA & Hospice in Northampton, MA, observed a high rate of falls and hip fractures. The clinicians designed a falls reduction program titled Strength in Numbers, an evidence-informed, multifaceted approach offered in community settings such as local senior centers and retirement communities. Physical and occupational therapists presented sessions that addressed risk factors for falls: fear of falling, strength, balance, medications, vision, and home safety. This article describes the program, its evolution and expansion, and outcomes. Between 2008 and 2015, 1,974 people received falls-prevention education through one of several variations of Strength in Numbers. Nearly 20% of those returning for a follow-up session who had fallen before did not fall again after completing it. Presenters recorded statistically significant improvement for participants in Single-Leg Standing, Timed Up and Go, and Functional Reach tests. PMID:27348030

  3. Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis

    PubMed Central

    Frankel, Debra; Tompkins, Sara A.; Cameron, Michelle

    2016-01-01

    Background: People with multiple sclerosis (MS) fall frequently. In 2011, the National Multiple Sclerosis Society launched a multifactorial fall-prevention group exercise and education program, Free From Falls (FFF), to prevent falls in MS. The objective of this study was to assess the impact of participation in the FFF program on balance, mobility, and falls in people with MS. Methods: This was a retrospective evaluation of assessments from community delivery of FFF. Changes in Activities-specific Balance Confidence scale scores, Berg Balance Scale scores, 8-foot Timed Up and Go performance, and falls were assessed. Results: A total of 134 participants completed the measures at the first and last FFF sessions, and 109 completed a 6-month follow-up assessment. Group mean scores on the Activities-specific Balance Confidence scale (F1,66 = 17.14, P < .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P < .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P < .05, η2 = 0.06) all improved significantly from the first to the last session. At the 6-month follow-up, fewer falls were reported (χ2 [4, N = 239] = 10.56, P < .05, Phi = 0.21). Conclusions: These observational data suggest that the FFF group education and exercise program improves balance confidence, balance performance, and functional mobility and reduces falls in people with MS. PMID:26917997

  4. Pre-impact fall detection.

    PubMed

    Hu, Xinyao; Qu, Xingda

    2016-01-01

    Pre-impact fall detection has been proposed to be an effective fall prevention strategy. In particular, it can help activate on-demand fall injury prevention systems (e.g. inflatable hip protectors) prior to fall impacts, and thus directly prevent the fall-related physical injuries. This paper gave a systematical review on pre-impact fall detection, and focused on the following aspects of the existing pre-impact fall detection research: fall detection apparatus, fall detection indicators, fall detection algorithms, and types of falls for fall detection evaluation. In addition, the performance of the existing pre-impact fall detection solutions were also reviewed and reported in terms of their sensitivity, specificity, and detection/lead time. This review also summarized the limitations in the existing pre-impact fall detection research, and proposed future research directions in this field. PMID:27251528

  5. Older Adult Perceptions of Participation in Group- and Home-Based Falls Prevention Exercise.

    PubMed

    Robins, Lauren M; Hill, K D; Day, Lesley; Clemson, Lindy; Finch, Caroline; Haines, Terry

    2016-07-01

    This paper describes why older adults begin, continue, and discontinue group- and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group- (66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23-39%), health professional recommendation (13-19%), and social interaction (4-16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41-67%) and health (15-31%). Disliking groups was the main barrier (2-14%). Home-based falls prevention exercise was started for rehabilitation (46-63%) or upon health professional recommendation (22-48%) and stopped due to recovery (30%). Improvement in health (18-46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial. PMID:26539657

  6. A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT)

    PubMed Central

    Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

    2016-01-01

    Introduction Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. Methods and analysis A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver ‘active’ interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to ‘active’ intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. Ethics and dissemination The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention

  7. Falls prevention within the Australian general practice data model: methodology, information model, and terminology issues.

    PubMed

    Liaw, Siaw-Teng; Sulaiman, Nabil; Pearce, Christopher; Sims, Jane; Hill, Keith; Grain, Heather; Tse, Justin; Ng, Choon-Kiat

    2003-01-01

    The iterative development of the Falls Risk Assessment and Management System (FRAMS) drew upon research evidence and early consumer and clinician input through focus groups, interviews, direct observations, and an online questionnaire. Clinical vignettes were used to validate the clinical model and program logic, input, and output. The information model was developed within the Australian General Practice Data Model (GPDM) framework. The online FRAMS implementation used available Internet (TCP/IP), messaging (HL7, XML), knowledge representation (Arden Syntax), and classification (ICD10-AM, ICPC2) standards. Although it could accommodate most of the falls prevention information elements, the GPDM required extension for prevention and prescribing risk management. Existing classifications could not classify all falls prevention concepts. The lack of explicit rules for terminology and data definitions allowed multiple concept representations across the terminology-architecture interface. Patients were more enthusiastic than clinicians. A usable standards-based online-distributed decision support system for falls prevention can be implemented within the GPDM, but a comprehensive terminology is required. The conceptual interface between terminology and architecture requires standardization, preferably within a reference information model. Developments in electronic decision support must be guided by evidence-based clinical and information models and knowledge ontologies. The safety and quality of knowledge-based decision support systems must be monitored. Further examination of falls and other clinical domains within the GPDM is needed. PMID:12807809

  8. Falls prevention advice and visual feedback to those at risk of falling: study protocol for a pilot randomized controlled trial

    PubMed Central

    2013-01-01

    Background Studies have shown that functional strength and balance exercises can reduce the risk of falling in older people if they are done on a regular basis. However, the repetitive nature of these exercises; combined with the inherent lack of feedback of progress may discourage seniors from exercising in the home, thereby rendering such an intervention ineffective. This study hypothesizes that the use of visual feedback and multimodal games will be more effective in encouraging adherence to home rehabilitation than standard care; thereby promoting independence and improving the quality of life in older adults at risk of falling. Methods A pllel-group pilot randomized controlled trial with 3 groups of participants will be conducted in the home for 12 weeks. Participants will include older adults who have been identified as at risk of falling (n = 48), over the age of 65, living in the community, and suitable for a home exercise intervention. The primary outcome is adherence to exercise. Secondary outcomes include: variability in stride length, stride time and double support time (DST); walking speed; Timed up and go test (TUG); Falls Efficacy Scale International (FES-I); CONFbal scale; Romberg’s test; and quality of life measures (SF-12 and EuroQol EQ-5D). Qualitative assessments on personal experiences with rehabilitation tools will be done before and after the trial. Discussion This study will investigate the use of visual feedback and engaging multimodal activities to address the problem of non-compliance to home exercises for falls rehabilitation. One of the unique qualities of this study is the adaptation of special participatory design methods through which the end users (fallers) will be involved in the design of the proposed rehabilitation tools at various stages of the design process. Trial registration ISRCTN79967470 PMID:23510162

  9. Striving to prevent falls in an acute care setting--action to enhance quality.

    PubMed

    Mitchell, A; Jones, N

    1996-07-01

    Although most falls do not result in serious physical injury, they can contribute to a loss of confidence and mobility which can culminate in a significant reduction in quality of life. Furthermore, the potential to fall is often increased when an individual is institutionalized because of frailty or confusion. The purpose of the study was, therefore, to establish whether a structured intervention would assist in preventing falls in an acute setting. This pre-test/post-test study was carried out over a 12-month period. Interventions included risk assessment, an alert system, reinforcing preventive actions, staff education and ongoing audits and feedback. Initial analysis of the data and comparison of fall rates indicated a significant reduction in the rate of falls between the pre- and post-intervention phases, although subsequent statistical analysis did not identify any significant relationships. It must be noted that no controls existed for extraneous variables, although patient profiles varied minimally during the period of the study. Outcomes include: a reduction in fall numbers and rates, enhanced staff morale with ownership of the programme, provision of a learning experience for staff (on which to build), and the fostering of a professional approach to improving the quality of patient care. PMID:8718053

  10. The REFORM study protocol: a cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people

    PubMed Central

    Cockayne, Sarah; Adamson, Joy; Corbacho Martin, Belen; Fairhurst, Caroline; Hewitt, Catherine; Hicks, Kate; Hull, Robin; Keenan, Anne Maree; Lamb, Sarah E; Loughrey, Lorraine; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony C; Rodgers, Sara; Vernon, Wesley; Watson, Judith; Torgerson, David

    2014-01-01

    Introduction Falls and fall-related injuries are a serious cause of morbidity and cost to society. Foot problems and inappropriate footwear may increase the risk of falls; therefore podiatric interventions may play a role in reducing falls. Two Cochrane systematic reviews identified only one study of a podiatry intervention aimed to reduce falls, which was undertaken in Australia. The REFORM trial aims to evaluate the clinical and cost-effectiveness of a multifaceted podiatry intervention in reducing falls in people aged 65 years and over in a UK and Irish setting. Methods and analysis This multicentre, cohort randomised controlled trial will recruit 2600 participants from routine podiatry clinics in the UK and Ireland to the REFORM cohort. In order to detect a 10% point reduction in falls from 50% to 40%, with 80% power 890 participants will be randomised to receive routine podiatry care and a falls prevention leaflet or routine podiatry care, a falls prevention leaflet and a multifaceted podiatry intervention. The primary outcome is rate of falls (falls/person/time) over 12 months assessed by patient self-report falls diary. Secondary self-report outcome measures include: the proportion of single and multiple fallers and time to first fall over a 12-month period; Short Falls Efficacy Scale—International; fear of falling in the past 4 weeks; Frenchay Activities Index; fracture rate; Geriatric Depression Scale; EuroQoL-five dimensional scale 3-L; health service utilisation at 6 and 12 months. A qualitative study will examine the acceptability of the package of care to participants and podiatrists. Ethics and dissemination The trial has received a favourable opinion from the East of England—Cambridge East Research Ethics Committee and Galway Research Ethics Committee. The trial results will be published in peer-reviewed journals and at conference presentations. Trial registration number Current Controlled Trials ISRCTN68240461assigned 01/07/2011. PMID

  11. Rationale for Strengthening Muscle to Prevent Falls and Fractures: A Review of the Evidence.

    PubMed

    Benichou, Olivier; Lord, Stephen R

    2016-06-01

    Falls represent a major public health problem in older people, predominantly due to the resulting injuries which lead to progressive disability, immobilization and resulting comorbidities, dependency, institutionalization, and death. Reduced muscle strength and power have been consistently identified as risk factors for falls and related injuries, and it is likely these associations result from the central role played by reduced muscle strength and power in poor balance recovery. In addition, muscle strength and power are involved with protective responses that reduce the risk of an injury if a fall occurs. Progressive resistance training (PRT) is the standard way to increase muscle strength and power, and this training forms one of the main components of fall prevention exercise interventions. However, PRT has rarely been implemented in routine practice due to multiple challenges inherent to frail older people. The ongoing development of drugs expected to increase muscle power offers a new opportunity to reduce the risk of falls and fall-related injuries. The intent here is not to replace exercise training with drugs but rather to offer a pharmacologic alternative when exercise is not possible or contraindicated. The target population would be those most likely to benefit from this mechanism of action, i.e., weak older people without major causes for falls independent of muscle weakness. Provided such a tailored strategy was followed, a muscle anabolic may address this major unmet need. PMID:26847435

  12. Announcement: National Campaign to Prevent Falls in Construction - United States, May 2-6, 2016.

    PubMed

    2016-01-01

    The National Safety Stand-Down to Prevent Falls in Construction* will be observed May 2-6, 2016, and is hosted by the federal Occupational Safety and Health Administration and stakeholders, including CDC's National Institute for Occupational Safety and Health. During the voluntary stand-down, construction employers are asked to speak directly to their employees about fall hazards to reinforce the importance of adhering to fall prevention measures. Employers are encouraged to have a Spanish speaker deliver the stand-down message to Spanish-speaking employees (simultaneous translation is an alternative). Across the United States, state agencies, public health practitioners, and private contractors will promote participation in the event. PMID:27100265

  13. Psychosocial Issues in Engaging Older People with Physical Activity Interventions for the Prevention of Falls

    ERIC Educational Resources Information Center

    Nyman, Samuel R.

    2011-01-01

    This article presents an overview of the psychosocial factors that influence older people's participation in physical activity interventions to prevent falls. The importance of psychosocial factors is stressed inasmuch as interventions will be rendered useless if they do not successfully gain the active participation of older people. The theory of…

  14. Quality of Austrian and Dutch Falls-Prevention Information: A Comparative Descriptive Study

    ERIC Educational Resources Information Center

    Schoberer, Daniela; Mijnarends, Donja M.; Fliedner, Monica; Halfens, Ruud J. G.; Lohrmann, Christa

    2016-01-01

    Objectives: The aim of this study was to evaluate and compare the quality of written patient information material available in Austrian and Dutch hospitals and nursing homes pertaining to falls prevention. Design: Comparative descriptive study design Setting: Hospitals and nursing homes in Austria and the Netherlands. Method: Written patient…

  15. Development of a Fall Prevention Survey to Determine Educational Needs for Primary Care Providers

    ERIC Educational Resources Information Center

    Kramer, B. Josea; Ganz, David A.; Vivrette, Rebecca L.; Harker, Judith O.; Josephson, Karen R.; Saliba, Debra

    2010-01-01

    Quality indicators are standardized measures of health care quality. We designed a survey to assess how knowledge, attitude, and organizational practices might affect healthcare provider behaviors in meeting quality indicators for fall prevention to plan curricula for a continuing educational intervention. The survey was pilot tested in the…

  16. Implementing a Community-Based Falls-Prevention Program: From Drawing Board to Reality

    ERIC Educational Resources Information Center

    Filiatrault, Johanne; Parisien, Manon; Laforest, Sophie; Genest, Carole; Gauvin, Lise; Fournier, Michel; Trickey, Francine; Robitaille, Yvonne

    2007-01-01

    Several studies have demonstrated the efficacy of falls-prevention programs designed for community-dwelling seniors using randomized designs. However, little is known about the feasibility of implementing these programs under natural conditions and about the success of these programs when delivered under such conditions. The objectives of this…

  17. Preventing Falls

    MedlinePlus

    ... of Innovation on Disability & Rehabilitation Research Center of Innovation on Disability & Rehabilitation Research Menu Menu CINDRR Home ... and their families. Learn more » The Center of Innovation on Disability and Rehabilitation Research (CINDRR) is a ...

  18. Recommendations for assessing and preventing falls in adults of all ages with rheumatoid arthritis.

    PubMed

    Stanmore, Emma K

    2015-11-01

    Rheumatoid arthritis (RA) is a debilitating disease that affects younger as well as older adults. It is associated with a high risk of injurious falls due to problems such as lower-limb muscle weakness, balance impairment, swollen and tender joints, pain, and fatigue. Falls are typically associated with older people; hence, many professionals do not recognise the risks for younger persons with diseases such as RA. Falls can lead to devastating consequences, such as fatalities, hip fractures (with 50% of those affected never regaining their previous level of mobility and 30% dying within 1 year), or loss of independence and confidence. Research has shown that many people are either unaware or deny their risk of falling. Therefore, it is important that health professionals, such as community nurses, are aware of the risk factors, methods of assessment, and evidence-based preventative measures, so that falls can be avoided in this population. This article presents research and practice implications for community nurses to enable them to assess, treat, and appropriately refer adults with RA who are also at risk of falls. PMID:26551381

  19. A novel web-based depth video rewind approach toward fall preventive interventions in hospitals.

    PubMed

    Enayati, Moein; Banerjee, Tanvi; Popescu, Mihail; Skubic, Marjorie; Rantz, Marilyn

    2014-01-01

    The purpose of this study was to implement a web based application to provide the ability to rewind and review depth videos captured in hospital rooms to investigate the event chains that led to patient's fall at a specific time. In this research, Kinect depth images are being used to capture shadow-like images of the patient and their room to resolve concerns about patients' privacy. As a result of our previous research, a fall detection system has been developed and installed in hospital rooms, and fall alarms are generated if any falls are detected by the system. Then nurses will go through the stored depth videos to investigate for possible injury as well as the reasons and events that may have caused the patient's fall to prevent future occurrences. This paper proposes a novel web application to ease the process of search and reviewing the videos by means of new visualization techniques to highlight video frames that contain potential risk of fall based on our previous research. PMID:25570994

  20. Involving the consumers: An exploration of users' and caregivers' needs and expectations on a fall prevention brochure: A qualitative study.

    PubMed

    Schoberer, Daniela; Breimaier, Helga E; Mandl, Manuela; Halfens, Ruud J G; Lohrmann, Christa

    2016-01-01

    This study aims to explore and compare nursing home residents', family members', and nursing staff's needs and expectations regarding a fall prevention brochure. Focus groups were carried out with 25 residents, 12 family members and 14 nursing staff separately, from three randomly selected nursing homes. Qualitative content analysis was used to analyze the data using a concept-driven coding frame. Results showed that residents want to be informed about dealing with extrinsic fall risks and coping strategies after a fall event. In addition, family members wanted to have detailed information on intrinsic fall risks as well as specific fall prevention strategies, such as body exercises. Of special importance for nursing staff was that not all falls are preventable even when preventive measures were taken. As the need and expectations of users differ substantially, one brochure could not comprise all postulated criteria and different brochures are necessary for residents and for family members. PMID:26975837

  1. Prevention of falls and fractures in old people by administration of calcium and vitamin d. randomized clinical trial

    PubMed Central

    2011-01-01

    knowledge on the problem studied and the available information justifies the performance of the study and its possible risk for the participants. If calcium and vitamin D supplementation is effective in the prevention of falls and fractures in the elderly population, a recommendation may be issued with the aim of preventing some of the consequences of falls that affect quality of life and the ensuing personal, health and social costs. Trial Registration ClinicalTrials.gov: NCT01452243 Clinical trial authorized by the Spanish Medicines Agency: EudraCT number 2006-001643-63. PMID:22151975

  2. Radar walking speed measurements of seniors in their apartments: technology for fall prevention.

    PubMed

    Cuddihy, Paul E; Yardibi, Tarik; Legenzoff, Zachary J; Liu, Liang; Phillips, Calvin E; Abbott, Carmen; Galambos, Colleen; Keller, James; Popescu, Mihail; Back, Jessica; Skubic, Marjorie; Rantz, Marilyn J

    2012-01-01

    Falls are a significant cause of injury and accidental death among persons over the age of 65. Gait velocity is one of the parameters which have been correlated to the risk of falling. We aim to build a system which monitors gait in seniors and reports any changes to caregivers, who can then perform a clinical assessment and perform corrective and preventative actions to reduce the likelihood of falls. In this paper, we deploy a Doppler radar-based gait measurement system into the apartments of thirteen seniors. In scripted walks, we show the system measures gait velocity with a mean error of 14.5% compared to the time recorded by a clinician. With a calibration factor, the mean error is reduced to 10.5%. The radar is a promising sensing technology for gait velocity in a day-to-day senior living environment. PMID:23365880

  3. Home or away? Choosing a setting for a falls-prevention program for people with multiple sclerosis.

    PubMed

    Gunn, Hilary; Cattaneo, Davide; Finlayson, Marcia; Freeman, Jennifer; Sosnoff, Jacob J

    2014-01-01

    Evidence suggests that choice of setting may be important in influencing the outcomes of rehabilitation programs, as well as optimizing participant satisfaction and adherence. This article aims to examine the factors that may inform the choice of setting for a falls-prevention program tailored to the needs of people with multiple sclerosis, including the influence of setting on program effectiveness, participant engagement, cost, and sustainability. Any new program should ensure that the choice of setting is informed by the intended program outcomes as well as an awareness of the opportunities and challenges presented by each type of setting. Evaluations of falls programs for older people suggest that immediate outcomes are similar regardless of setting; however, long-term outcomes may differ by setting, possibly owing to differential effects on adherence. Programs based away from home may offer benefits in terms of maintaining motivation, providing peer-support opportunities, and allowing regular access to facilitator input, while home-based programs offer unique opportunities for context-based practice and the integration of falls-prevention activities into real life. Additionally, home-based programs may address some of the long-term feasibility issues associated with programs away from home. A "mixed" program incorporating elements of home- and community-based activity may be the most sustainable and effective choice to achieve both long- and short-term goals within a falls-prevention program. However, currently there are significant gaps in knowledge relating to comparative program outcomes, cost, and long-term sustainability. PMID:25694777

  4. Falls prevention and support: translating research, integrating services and promoting the contribution of service users for quality and innovative programmes of care.

    PubMed

    Gormley, Kevin J

    2011-12-01

    Falls are a significant threat to the safety, health and independence of older citizens. Despite the substantial evidence that is available around effective falls prevention programmes and interventions, their translation into falls reduction programmes and policies has yet to be fully realised. While hip fracture rates are decreasing, the number and incidence of fall-related hospital admissions among older people continue to rise. Given the demographic trends that highlight increasing numbers of older people in the UK, which is broadly reflected internationally, there is a financial and social imperative to minimise the rate of falls and associated injuries. Falling is closely aligned to growing older (Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010). According to the World Health Organization, around 30% of older people aged over 65 and 50% of those over 80 will fall each year (Falls Fact Sheet Number 344, WHO, Geneva, 2010). Falls happen as a result of many reasons and can have harmful consequences, including loss of mobility and independence, confidence and in many cases even death (Cochrane Database Syst Rev 15, 2009, 146; Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010; Falling Standards, Broken Promises: Report of the National Audit of Falls and Bone Health in Older People 2010, Health Care Quality Improvement Partnership, London, 2011). What is neither fair nor correct is the common belief by old and young alike that falls are just another inconvenience to put up with. The available evidence justifiably supports the view that well-organised services, based upon national standards and expert guidance, can prevent future falls among older people and reduce death and disability from fractures. This paper will draw from the UK, as an exemplar for policy

  5. Exercise-Based Fall Prevention in the Elderly: What About Agility?

    PubMed

    Donath, Lars; van Dieën, Jaap; Faude, Oliver

    2016-02-01

    Annually, one in three seniors aged over 65 years fall. Balance and strength training can reduce neuromuscular fall risk factors and fall rates. Besides conventional balance and strength training, explosive or high-velocity strength training, eccentric exercises, perturbation-based balance training, trunk strength, and trunk control have also been emphasized. In contrast, aerobic exercise has to date not been included in fall-prevention studies. However, well-developed endurance capacity might attenuate fatigue-induced declines in postural control in sports-related or general activities of daily living. Physical performance indices, such as balance, strength, and endurance, are generally addressed independently in exercise guidelines. This approach seems time consuming and may impede integrative training of sensorimotor, neuromuscular, and cardiocirculatory functions required to deal with balance-threatening situations in the elderly. An agility-based conceptual training framework comprising perception and decision making (e.g., visual scanning, pattern recognition, anticipation) and changes of direction (e.g., sudden starts, stops and turns; reactive control; concentric and eccentric contractions) might enable an integrative neuromuscular, cardiocirculatory, and cognitive training. The present paper aims to provide a scientific sketch of how to build such an integrated modular training approach, allowing adaptation of intensity, complexity, and cognitive challenge of the agility tasks to the participant's capacity. Subsequent research should address the (1) link between agility and fall risk factors as well as fall rates, (2) benefit-risk ratios of the proposed approach, (3) psychosocial aspects of agility training (e.g., motivation), and (4) logistical requirements (e.g., equipment needed). PMID:26395115

  6. Children can't fly: a program to prevent childhood morbidity and mortality from window falls.

    PubMed Central

    Spiegel, C N; Lindaman, F C

    1977-01-01

    "Children Can't Fly" is a health education program developed by the New York City Department of Health to combat the high incidence of child mortality and morbidity due to falls from windows. The success of the program, begun in 1972, in drastically reducing death and injury persuaded the New York City Board of Health to amend the Health Code in 1976 to require that landlords provide window guards in apartments where children ten years old and younger reside. The law is the first and only one of its kind in the nation. The program has four major components: 1) reporting of falls by hospital emergency rooms and police precincts, followed up by counseling, referral, and data collecting by public health nurses; 2) a media campaign to inform the public and elevate their awareness of the hazards; 3) community education for prevention through door-to-door hazard identification, counseling by outreach workers, community organization efforts with schools, tenant groups, clinics, churches, health care providers, etc; 4) provision of free, easily installed window guards to families with young children living in high-risk areas. Significant reduction in falls resulted, particularly in the Bronx, where reported falls declined 50 percent from 1973 to 1975. The program is one solution to an urgent urban problem which other cities might consider to avert the loss of life and limb, and the corollary financial burden for hospitalization, rehabilitation, and maintenance of the injured and permanently disabled. PMID:596496

  7. Children can't fly: a program to prevent childhood morbidity and mortality from window falls

    PubMed Central

    Spiegel, Charlotte N; Lindaman, Francis C

    1995-01-01

    `Children Can't Fly' is a health education program developed by the New York City Department of Health to combat the high incidence of child mortality and morbidity due to falls from windows. The success of the program, begun in 1972, in drastically reducing death and injury persuaded the New York City Board of Health to amend the Health Code in 1976 to require that landlords provide window guards in apartments where children 10 years old and younger reside. The law is the first and only one of its kind in the nation. The program has four major components: (1) reporting of falls by hospital emergency rooms and police precincts, followed up by counseling, referral and data collecting by public health nurses; (2) a media campaign to inform the public and elevate their awareness of the hazards; (3) community education for prevention through door-to-door hazard identification, counseling by outreach workers, community organization efforts with schools, tenant groups, clinics, churches, health care providers, etc; (4) provision of free, easily installed window guards to families with young children living in high-risk areas. Significant reduction in falls resulted, particularly in the Bronx, where reported falls declined 50% from 1973 to 1975. The program is one solution to an urgent urban problem which other cities might consider to avert the loss of life and limb, and the corollary financial burden for hospitalization, rehabilitation and maintenance of the injured and permanently disabled. PMID:9346026

  8. Mobility is a key predictor of changes in wellbeing among older fallers: Evidence from the Vancouver Falls Prevention Cohort

    PubMed Central

    Davis, Jennifer C.; Bryan, Stirling; Best, John R.; Li, Linda C; Hsu, Chun Liang; Gomez, Caitlin; Vertes, Kelly; Liu-Ambrose, Teresa

    2015-01-01

    Introduction Falls and injuries resulting from falls in older adults represent a significant public health, personal and societal burden worldwide. Valuing wellbeing or quality of life more broadly may be a more appropriate method of measuring the full impact of falls prevention interventions. Our primary objective was to identify key factors relating to mobility and cognitive function explaining variation in wellbeing among community dwelling older fallers. Methods We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (Available Case Set: n=244/245). We constructed linear mixed models where assessment month (0, 6, 12) was entered as a within-subjects repeated measure, the intercept was specified as a random effect, and predictors and covariates were entered as between-subjects fixed effects. We included the predictors (i.e., Short Performance Physical Battery (SPPB) or Timed Up and Go (TUG) or Montreal Cognitive Assessment (MoCA)) to investigate sex differences over time in the relations between the predictor variable and the outcome variable, the ICECAP-O, a measure of wellbeing/quality of life. Results The SPPB and TUG were associated with wellbeing at baseline (p<0.05). Further a SPPB and TUG by time by sex interaction (p<0.05) was observed. Conclusion This study highlights a significant interaction of balance and mobility with wellbeing by time and sex. This study demonstrates that sex differences exist in the relationship between mobility and wellbeing with all men declining over time regardless of baseline mobility status and with women’s trajectories being dependent on their baseline function. PMID:25862255

  9. Rapid demountable platform (RDP)--a device for preventing fall from height accidents.

    PubMed

    Cheung, Esther; Chan, Albert P C

    2012-09-01

    The prevention of fall from height accidents has long been a popular topic in the field of construction safety. Previous research has indicated one of the potential hazards was induced by the use of steel bracket as scaffold support. While researchers are focusing to improve the existing scaffolding system, this research introduces a newly developed device to minimize fall accidents. The working platform, namely Rapid Demountable Platform (RDP) can be applied across window frames without fixing anchor bolts. Emphasizing on the rapid installation/dismantling, the RDP provides another safer option for working at height. The development of the RDP has incorporated modular concept and aesthetic factor into the design, achieving a more user-friendly platform. Although the RDP is not intended to totally replace the traditional bamboo truss-out scaffold, it is designed to act as an alternative or a supplement to the existing bamboo truss-out scaffold. The RDP is the first of this kind to minimize fall from height accidents especially in cities similar to Hong Kong where external working at height is frequently encountered. PMID:22664686

  10. Nurses' perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals

    PubMed Central

    Koh, Serena SL; Manias, Elizabeth; Hutchinson, Alison M; Donath, Susan; Johnston, Linda

    2008-01-01

    Background Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. The aim of this study was to assess the perceived barriers to practice change by eliciting nurses' opinions with regard to barriers to, and facilitators of, implementation of a Fall Prevention clinical practice guideline in five acute care hospitals in Singapore. Methods Nurses were surveyed to identify their perceptions regarding barriers to implementation of clinical practice guidelines in their practice setting. The validated questionnaire, 'Barriers and facilitators assessment instrument', was administered to nurses (n = 1830) working in the medical, surgical, geriatric units, at five acute care hospitals in Singapore. Results An 80.2% response rate was achieved. The greatest barriers to implementation of clinical practice guidelines reported included: knowledge and motivation, availability of support staff, access to facilities, health status of patients, and, education of staff and patients. Conclusion Numerous barriers to the use of the Fall Prevention Clinical Practice Guideline have been identified. This study has laid the foundation for further research into implementation of clinical practice guidelines in Singapore by identifying barriers to change in acute care settings. PMID:18485235

  11. What do community-dwelling Caucasian and South Asian 60–70 year olds think about exercise for fall prevention?

    PubMed Central

    Horne, Maria; Speed, Shaun; Skelton, Dawn; Todd, Chris

    2009-01-01

    Background: strategies to prevent falls often recommend regular exercise. However, 40% of over 50s in the UK report less physical activity than is recommended. Even higher rates of sedentary behaviour have been reported among South Asian older adults. Objective: to identify salient beliefs that influence uptake and adherence to exercise for fall prevention among community-dwelling Caucasian and South Asian 60–70 year olds in the UK. Methods: we undertook an ethnographic study using participant observation, 15 focus groups (n = 87; mean age = 65.7 years) and 40 individual semi-structured interviews (mean age = 64.8 years). Data analysis used framework analysis. Results: young older adults do not acknowledge their fall risk and are generally not motivated to exercise to prevent falls. Those who had fallen are more likely to acknowledge risk of future falls. Whilst many of the beliefs about falls and exercise expressed were very similar between Caucasians and South Asians, there was a tendency for South Asians to express fatalistic beliefs more often. Conclusion: fall prevention should not be the focus of strategies to increase uptake and adherence to exercise. The wider benefits of exercise, leading to an active healthy lifestyle should be encouraged. PMID:19039019

  12. Fall prevention in community settings: results from implementing tai chi: moving for better balance in three States.

    PubMed

    Ory, Marcia G; Smith, Matthew Lee; Parker, Erin M; Jiang, Luohua; Chen, Shuai; Wilson, Ashley D; Stevens, Judy A; Ehrenreich, Heidi; Lee, Robin

    2014-01-01

    Tai Chi: Moving for Better Balance (TCMBB) is an evidence-based fall prevention exercise program being disseminated in selected communities through state injury prevention programs. This study: (1) describes the personal characteristics of TCMBB participants; (2) quantifies participants' functional and self-reported health status at enrollment; and (3) measures changes in participants' functional and self-reported health status post-intervention. There were 421 participants enrolled in 36 TCMBB programs delivered in Colorado, New York, and Oregon. Of the 209 participants who completed both baseline enrollment and post-intervention surveys, the average age of participants was 75.3 (SD ± 8.2) years. Most participants were female (81.3%), non-Hispanic (96.1%), White (94.1%), and described themselves as in excellent or very good health (52.2%). Paired t-test and general estimating equation models assessed changes over the 3-month program period. Pre- and post-assessment self-reported surveys and objective functional data [Timed Up and Go (TUG) test] were collected. On average, TUG test scores decreased (p < 0.001) for all participants; however, the decrease was most noticeable among high-risk participants (mean decreased from 18.5 to 15.7 s). The adjusted odds ratio of reporting feeling confident that a participant could keep themselves from falling was five times greater after completing the program. TCMBB, which addresses gait and balance problems, can be an effective way to reduce falls among the older adult population. By helping older adults maintain their functional abilities, TCMBB can help community-dwelling older adults continue to live independently. PMID:25964934

  13. A Population-Based Intervention for the Prevention of Falls and Fractures in Home Dwelling People 65 Years and Older in South Germany: Protocol

    PubMed Central

    Rapp, Kilian; Küpper, Michaela; Becker, Clemens; Fischer, Torben; Büchele, Gisela; Benzinger, Petra

    2014-01-01

    Background Falls and fall-related injuries pose a major threat to older peoples’ health, and are associated with increased morbidity and mortality. In the course of demographic changes, development and implementation of fall prevention strategies have been recognized as an urgent public health challenge. Various risk factors for falls and a number of effective interventions have been recognized. A substantial proportion of falls occur for people who are neither frail nor at high risk. Therefore, population-based approaches reaching the entire older population are needed. Objective The objective of the study presented is the development, implementation, and evaluation of a population-based intervention for the prevention of falls and fall-related injuries in a medium sized city in Germany. Methods The study is designed as a population-based approach. The intervention community is a mid sized city named Reutlingen in southern Germany with a population of 112,700 people. All community dwelling inhabitants 65 years and older are addressed. There are two main measures that are defined: (1) increase of overall physical activity, and (2) reduction of modifiable risk factors for falls such as deficits in strength and balance, home and environmental hazards, impaired vision, unsafe footwear, and improper use of assistive devices. The implementation strategies are developed in a participatory community planning process. These might include, for example, training of professionals and volunteers, improved availability of exercise classes, and education and raising awareness via newspaper, radio, or lectures. Results The study starts in September 2010 and ends in December 2013. It is evaluated primarily by process evaluation as well as by telephone survey. Conclusions Physical activity as a key message entails multiple positive effects with benefits on a range of geriatric symptoms. The strength of the design is the development of implementation strategies in a participatory

  14. Robot-assisted home hazard assessment for fall prevention: a feasibility study.

    PubMed

    Sadasivam, Rajani S; Luger, Tana M; Coley, Heather L; Taylor, Benjamin B; Padir, Taskin; Ritchie, Christine S; Houston, Thomas K

    2014-01-01

    We examined the feasibility of using a remotely manoeuverable robot to make home hazard assessments for fall prevention. We employed use-case simulations to compare robot assessments with in-person assessments. We screened the homes of nine elderly patients (aged 65 years or more) for fall risks using the HEROS screening assessment. We also assessed the participants' perspectives of the remotely-operated robot in a survey. The nine patients had a median Short Blessed Test score of 8 (interquartile range, IQR 2-20) and a median Life-Space Assessment score of 46 (IQR 27-75). Compared to the in-person assessment (mean = 4.2 hazards identified per participant), significantly more home hazards were perceived in the robot video assessment (mean = 7.0). Only two checklist items (adequate bedroom lighting and a clear path from bed to bathroom) had more than 60% agreement between in-person and robot video assessment. Participants were enthusiastic about the robot and did not think it violated their privacy. The study found little agreement between the in-person and robot video hazard assessments. However, it identified several research questions about how to best use remotely-operated robots. PMID:24352900

  15. The Effect of Tai Chi on Reducing the Risk of Falling: A Systematic Review and Meta-Analysis.

    PubMed

    Del-Pino-Casado, Rafael; Obrero-Gaitán, Esteban; Lomas-Vega, Rafael

    2016-01-01

    Tai Chi has frequently been used as a preventive measure against falling in at-risk populations. However, studies have yielded contradictory results, and literature reviews have considered only a small number of trials and have not addressed some key aspects, such as sources of heterogeneity and publication bias. This study includes 13 controlled trials published before June 2015 that analyzed the effectiveness of Tai Chi in fall prevention in populations of frail and at-risk adults. The effect measure used in this meta-analysis was absolute risk reduction (ARR) with a 95% confidence interval (CI). According to our findings, practice of Tai Chi significantly prevents the risk of falling (ARR, [Formula: see text]; 95% CI: [Formula: see text], [Formula: see text]). The heterogeneity of results across the trials was low, with a reduced risk of publication bias, and no significant effect differences were observed between studies comparing Tai Chi with other interventions or non-treatment. We therefore conclude that Tai Chi is more effective than other measures, or no intervention, for fall prevention in at-risk populations. Further research is warranted to analyze the consequences of falls and to study the episodes rather than the cases of falls. PMID:27430918

  16. Models for effective prevention.

    PubMed

    Perry, C L; Kelder, S H

    1992-07-01

    The social influence models do provide some optimism for primary prevention efforts. Prevention programs appear most effective when 1) the target behavior of the intervention has received increasing societal disapproval (such as cigarette smoking), 2) multiple years of behavioral health education are planned, and 3) community-wide involvement or mass media complement a school-based peer-led program (45,46). Short-term programs and those involving alcohol use have had less favorable outcomes. Future research in primary prevention should address concerns of high-risk groups and high-risk countries, such as lower income populations in the United States or countries that have large adolescent homeless populations. The utilization of adolescent leaders for program dissemination might be particularly critical in these settings. A second major and global concern should focus upon alcohol use and alcohol-related problems. In many communities adolescent alcohol use is normative and even adult supported. Thus, young people are getting quite inconsistent messages on alcohol from their schools, from TV, from peers, and from parents. This inconsistency may translate into many tragic and avoidable deaths for young people. Clearly, in the area of alcohol-related problems, community-wide involvement may be necessary. A third direction for prevention research should involve issues of norms, access, and enforcement including policy interventions, such as involve the availability of cigarette vending machines or the ease of under-age buying or levels of taxation. These methods affect adolescents more acutely since their financial resources, for the most part, are more limited. These policy level methods also signify to adolescents what adults consider appropriate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1390786

  17. You Can't Reach for the Stars if You are Tripping Over the Ground! (Preventing Slips, Trips, and Falls)

    NASA Technical Reports Server (NTRS)

    Miller, Darcy; Raysich, Mark; Kirkland, Mary

    2016-01-01

    Although there are very few mishaps related to ground, vehicle or payload processing at the Kennedy Space Center (KSC), employees have experienced a significant number of injuries due to slips, trips, and falls outside of performing flight processing operations. Slips, trips, and falls are major causes of occupational injuries at KSC, the National Aeronautics and Space Administration (NASA), and in general industry. To help KSC employees avoid these injuries, and allow them to be fully productive, KSC launched an initiative in 2013 to reduce slips, trips, and falls. This initiative is based on a four-part model focusing on DATA analysis, HAZARD awareness, PREVENTIVE methods, and BALANCE.

  18. Do We Try Mending Humpty Dumpty or Prevent His Fall? An Alzheimer's Disease Dilemma.

    PubMed

    de la Torre Jack, C

    2015-01-01

    In the popular nursery rhyme, Humpty Dumpty's great fall and the inability to put him together again has been used to demonstrate the second law of thermodynamics. An oversimplification of this law states that all things in the universe tend to move from order to disorder, an occurrence that can be applied allegorically to the development and clinical outcome of Alzheimer's disease (AD). An important argument relevant to the future use of resources and primary focus of AD research arises from the question, do we make it a priority to mend the shattered brain of AD patients or attempt to prevent the brain from shattering? If the former approach continues to be the priority it has become, how exactly do we mend the irreparable neuronal loss and associated cognitive failure in advanced cases of AD? Or, must we change direction and make prevention the primary goal of AD research? The latter approach would identify asymptomatic or mildly symptomatic patients with high risk of developing dementia by means of establishing multidisciplinary heart-brain clinics that would provide either close observation or a tailored therapeutic intervention. This is an important challenge that needs to be achieved if the AD incidence, societal costs and suffering, is to be significantly reduced. PMID:25777513

  19. Effects of Exercise on Falls, Balance, and Gait Ability in Parkinson's Disease: A Meta-analysis.

    PubMed

    Shen, Xia; Wong-Yu, Irene S K; Mak, Margaret K Y

    2016-07-01

    Postural instability and falls are complex and disabling features of Parkinson's disease (PD) and respond poorly to anti-Parkinsonian medication. There is an imperative need to evaluate the effectiveness of exercise interventions in enhancing postural stability and decreasing falls in the PD population. The objectives of our study were to determine the effects of exercise training on the enhancement of balance and gait ability and reduction in falls for people with PD and to investigate potential factors contributing to the training effects on balance and gait ability of people with PD. We included 25 randomized control trials of a moderate methodological quality in our meta-analysis. The trials examined the effects of exercise training on balance and gait ability and falls against no intervention and placebo intervention. The results showed positive effects of exercise intervention on enhancing balance and gait performance (Hedges' g = 0.303 over the short-term in 24 studies and 0.419 over the long-term in 12 studies; P < .05) and reducing the fall rate (rate ratio = 0.485 over the short-term in 4 studies and 0.413 over the long-term in 5 studies; P < .05). The longest follow-up duration was 12 months. There was no evidence that training decreased the number of fallers over the short- or long-term (P > .05). The results of our metaregression and subgroup analysis showed that facility-based training produced greater training effects on improving PD participants' balance and gait ability (P < .05). The findings support the application of exercise training to improve balance and gait ability and prevent falls in people with PD. PMID:26493731

  20. Children’s perceptions about falls and their prevention: a qualitative study from a rural setting in Bangladesh

    PubMed Central

    2013-01-01

    Background Childhood falls is a major public health problem in Bangladesh. In-depth understanding of the situation by the target groups and their families is necessary for successful development, implementation and evaluation of any intervention. The study aimed at knowing the views of Bangladeshi rural children about childhood falls and their suggestions for prevention. Methods Children of 10–17 were selected purposely from 4 villages of Sherpur Sadar upazila (sub-district), Sherpur district of Bangladesh. Six focus group discussions and ten in-depth interviews were conducted during July-August 2010 for this study. Gender and education of the participants were considered. Major themes were identified, coded and categorized from content analysis. Results Participants stated that young children (<5 years of age) and boys appeared to be the main victims of falls and majority of these injuries occurred in and around the households. Boys commonly fall from the tree around their premises and high places. Girls usually fall when they remain busy in household chores and playing with friends around their premises. Participants also mentioned that children mostly sustained injury when they are unsupervised. Supervision, public awareness and putting barriers (e.g. door barrier, putting pillow and use net around the bed etc.) were suggested as the preventive measures. Conclusion Findings of this study could be considered as part of knowledge-base in designing interventions to address childhood falls. PMID:24168265

  1. Fall prevention and safety communication training for foremen:Report of a pilot project designed to improve residential construction safety

    PubMed Central

    Kaskutas, Vicki; Dale, Ann Marie; Lipscomb, Hester; Evanoff, Brad

    2013-01-01

    Problem Falls from heights account for 64% of residential construction worker fatalities and 20% of missed work days. We hypothesized that worker safety would improve with foremen training in fall prevention and safety communication. Method Training priorities identified through foreman and apprentice focus groups and surveys were integrated into an 8-hour training. We piloted the training with ten foremen employed by a residential builder. Carpenter trainers contrasted proper methods to protect workers from falls with methods observed at the foremen’s worksites. Trainers presented methods to deliver toolbox talks and safety messages. Results from worksite observational audits (n=29) and foremen/crewmember surveys (n=97) administered before and after training were compared. Results We found that inexperienced workers are exposed to many fall hazards that they are often not prepared to negotiate. Fall protection is used inconsistently and worksite mentorship is often inadequate. Foremen feel pressured to meet productivity demands and some are unsure of the fall protection requirements. After the training, the frequency of daily mentoring and toolbox talks increased, and these talks became more interactive and focused on hazardous daily work tasks. Foremen observed their worksites for fall hazards more often. We observed increased compliance with fall protection and decreased unsafe behaviors during worksite audits. Discussion Designing the training to meet both foremen’s and crewmembers’ needs ensured the training was learner-centered and contextually-relevant. This pilot suggests that training residential foremen can increase use of fall protection, improve safety behaviors, and enhance on-the-job training and safety communication at their worksites. Impact on Industry Construction workers’ training should target safety communication and mentoring skills with workers who will lead work crews. Interventions at multiple levels are necessary to increase safety

  2. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes

    PubMed Central

    2012-01-01

    Background Quality improvement (QI) programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occurs within the context of relationships and interactions among individuals. Thus, QI programs will not result in optimal changes in staff behavior unless the context for social learning is present. Accordingly, we developed CONNECT, an intervention to foster systematic use of management practices, which we propose will enhance effectiveness of a nursing home Falls QI program by strengthening the staff-to-staff interactions necessary for clinical problem-solving about complex problems such as falls. The study aims are to compare the impact of the CONNECT intervention, plus a falls reduction QI intervention (CONNECT + FALLS), to the falls reduction QI intervention alone (FALLS), on fall-related process measures, fall rates, and staff interaction measures. Methods/design Sixteen nursing homes will be randomized to one of two study arms, CONNECT + FALLS or FALLS alone. Subjects (staff and residents) are clustered within nursing homes because the intervention addresses social processes and thus must be delivered within the social context, rather than to individuals. Nursing homes randomized to CONNECT + FALLS will receive three months of CONNECT first, followed by three months of FALLS. Nursing homes randomized to FALLS alone receive three months of FALLs QI and are offered CONNECT after data collection is completed. Complexity science measures, which reflect staff perceptions of communication, safety climate, and care quality, will be collected from staff at baseline, three months after, and six months after baseline to evaluate immediate and sustained impacts. FALLS measures including quality indicators (process measures) and fall rates will be collected for the six months prior to baseline and the six months after the

  3. Visually Impaired OLder people's Exercise programme for falls prevenTion (VIOLET): a feasibility study protocol

    PubMed Central

    Skelton, Dawn A; Bailey, Cathy; Howel, Denise; Cattan, Mima; Deary, Vincent; Coe, Dot; de Jong, Lex D; Gawler, Sheena; Gray, Joanne; Lampitt, Rosy; Wilkinson, Jennifer; Adams, Nicola

    2016-01-01

    Introduction In the UK, 1 in 5 people aged 75 and over live with sight loss. Visually impaired older people (VIOP) have an above average incidence of falls and 1.3–1.9 times more likely to experience hip fractures, than the general population. Older people with eye diseases are ∼3 times more likely than those with good vision, to limit activities due to fear of falling. This feasibility study aims to adapt the group-based Falls Management Exercise (FaME) programme to the needs of VIOP and carry out an external pilot trial to inform the design of a future definitive randomised controlled trial. Methods and design A UK based 2-centre mixed methods, randomised, feasibility study will be conducted over 28 months. Stakeholder panels, including VIOP, will make recommendations for adaptations to an existing exercise programme (FaME), to meet the needs of VIOP, promoting uptake and adherence, while retaining required effective components of the exercise programme. 80 VIOP aged 60 and over, living at home, ambulant with or without a walking aid, will be recruited in Newcastle (n=40) and Glasgow (n=40) through National Health Service (NHS) Trusts and third sector partners. Participants randomised into the intervention arm will receive the adapted FaME programme. Participants randomised into the control arm will continue with usual activity. Outcomes are, recruitment rate, adherence and validated measures including fear of falling and quality of life. Postintervention in-depth qualitative interviews will be conducted with a purposive sample of VIOP (N=10). Postural stability instructors will be interviewed, before trial-specific training and following the intervention. Ethics and dissemination Ethics approval was secured through the National Research Ethics Service (NRES) Committee North East, Newcastle and North Tyneside 2. Glasgow Caledonian University was approved as a non-NHS site with local ethics approval. Findings will be disseminated through peer

  4. ‘My independent streak may get in the way’: how older adults respond to falls prevention education in hospital

    PubMed Central

    Hill, Anne-Marie; Francis-Coad, Jacqueline; Haines, Terry P; Waldron, Nicholas; Etherton-Beer, Christopher; Flicker, Leon; Ingram, Katharine; McPhail, Steven M

    2016-01-01

    Objectives The aim of the study was to determine how providing individualised falls prevention education facilitated behaviour change from the perspective of older hospital patients on rehabilitation wards and what barriers they identified to engaging in preventive strategies. Design A prospective qualitative survey. Methods Older patients (n=757) who were eligible (mini-mental state examination score>23/30) received falls prevention education while admitted to eight rehabilitation hospital wards in Western Australia. Subsequently, 610 participants were surveyed using a semistructured questionnaire to gain their response to the in-hospital education and their identified barriers to engaging in falls prevention strategies. Deductive content analysis was used to map responses against conceptual frameworks of health behaviour change and risk taking. Results Participants who responded (n=473) stated that the education raised their awareness, knowledge and confidence to actively engage in falls prevention strategies, such as asking for assistance prior to mobilising. Participants’ thoughts and feelings about their recovery were the main barriers they identified to engaging in safe strategies, including feeling overconfident or desiring to be independent and thinking that staff would be delayed in providing assistance. The most common task identified as potentially leading to risk-taking behaviour was needing to use the toilet. Conclusions Individualised education assists older hospital rehabilitation patients with good levels of cognition to engage in suitable falls prevention strategies while on the ward. Staff should engage with patients to understand their perceptions about their recovery and support patients to take an active role in planning their rehabilitation. PMID:27466244

  5. The Effect of Personalization on Smartphone-Based Fall Detectors.

    PubMed

    Medrano, Carlos; Plaza, Inmaculada; Igual, Raúl; Sánchez, Ángel; Castro, Manuel

    2016-01-01

    The risk of falling is high among different groups of people, such as older people, individuals with Parkinson's disease or patients in neuro-rehabilitation units. Developing robust fall detectors is important for acting promptly in case of a fall. Therefore, in this study we propose to personalize smartphone-based detectors to boost their performance as compared to a non-personalized system. Four algorithms were investigated using a public dataset: three novelty detection algorithms--Nearest Neighbor (NN), Local Outlier Factor (LOF) and One-Class Support Vector Machine (OneClass-SVM)--and a traditional supervised algorithm, Support Vector Machine (SVM). The effect of personalization was studied for each subject by considering two different training conditions: data coming only from that subject or data coming from the remaining subjects. The area under the receiver operating characteristic curve (AUC) was selected as the primary figure of merit. The results show that there is a general trend towards the increase in performance by personalizing the detector, but the effect depends on the individual being considered. A personalized NN can reach the performance of a non-personalized SVM (average AUC of 0.9861 and 0.9795, respectively), which is remarkable since NN only uses activities of daily living for training. PMID:26797614

  6. The Effect of Personalization on Smartphone-Based Fall Detectors

    PubMed Central

    Medrano, Carlos; Plaza, Inmaculada; Igual, Raúl; Sánchez, Ángel; Castro, Manuel

    2016-01-01

    The risk of falling is high among different groups of people, such as older people, individuals with Parkinson's disease or patients in neuro-rehabilitation units. Developing robust fall detectors is important for acting promptly in case of a fall. Therefore, in this study we propose to personalize smartphone-based detectors to boost their performance as compared to a non-personalized system. Four algorithms were investigated using a public dataset: three novelty detection algorithms—Nearest Neighbor (NN), Local Outlier Factor (LOF) and One-Class Support Vector Machine (OneClass-SVM)—and a traditional supervised algorithm, Support Vector Machine (SVM). The effect of personalization was studied for each subject by considering two different training conditions: data coming only from that subject or data coming from the remaining subjects. The area under the receiver operating characteristic curve (AUC) was selected as the primary figure of merit. The results show that there is a general trend towards the increase in performance by personalizing the detector, but the effect depends on the individual being considered. A personalized NN can reach the performance of a non-personalized SVM (average AUC of 0.9861 and 0.9795, respectively), which is remarkable since NN only uses activities of daily living for training. PMID:26797614

  7. Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention.

    PubMed

    Sinaki, Mehrsheed

    2012-11-01

    Maintenance of bone health and quality requires mechanical strain, but the mechanical force needs to be within the bone's biomechanical competence. In osteoporosis, compression of vertebral bodies can be insidious. Therefore, absence of pain does not necessarily indicate absence of vertebral microfracture and deformity. Further, patients with previous vertebral fractures are at risk for further vertebral fractures and their associated morbidity. Exercise is a part of the comprehensive management of patients with osteoporosis and has been associated with improvement of quality of life and lowered risk of future fracture. The exercise prescription needs to match the needs of the patient. If exercise is not prescribed properly, then it may have negative consequences. In general, an exercise program, therapeutic or recreational, needs to address flexibility, muscle strength, core stability, cardiovascular fitness, and gait steadiness. As with pharmacotherapy, therapeutic exercises need to be individualized on the basis of musculoskeletal status and an individual's exercise interest. In osteoporosis, axial strength and stability are of primary importance. In particular, a spinal extensor strengthening program should be performed with progressive measured resistance as tolerated. To address falls and fractures, an exercise program should also include balance and lower extremity strength training. Proper dosing of oral cholecalciferol and calcium supplements can enhance the effect of strengthening exercises. Finally, a coordinated approach, such as the Spinal Proprioception Extension Exercise Dynamic (SPEED) program, can improve back extensor strength, the level of physical activity, and locomotion, and reduce back pain and fear and risk of falls. PMID:23174554

  8. Fall prevention with supplemental and alpha-hydroxylated vitamin D: a meta-analysis of randomized controlled trials

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Results from fall prevention trials with supplemental vitamin D have been mixed and a possible differential benefit of supplemental versus alpha-hydroxylated vitamin D (activeD) has not been established. We performed a meta-analysis on the efficacy of supplemental vitamin D and activeD with or witho...

  9. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.

    PubMed Central

    Campbell, A. J.; Robertson, M. C.; Gardner, M. M.; Norton, R. N.; Tilyard, M. W.; Buchner, D. M.

    1997-01-01

    OBJECTIVE: To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing falls and injuries in elderly women. DESIGN: Randomised controlled trial of an individually tailored programme of physical therapy in the home (exercise group, n = 116) compared with the usual care and an equal number of social visits (control group, n = 117). SETTING: 17 general practices in Dunedin, New Zealand. SUBJECTS: Women aged 80 years and older living in the community and registered with a general practice in Dunedin. MAIN OUTCOME MEASURES: Number of falls and injuries related to falls and time between falls during one year of follow up; changes in muscle strength and balance measures after six months. RESULTS: After one year there were 152 falls in the control group and 88 falls in the exercise group. The mean (SD) rate of falls was lower in the exercise than the control group (0.87 (1.29) v 1.34 (1.93) falls per year respectively; difference 0.47; 95% confidence interval 0.04 to 0.90). The relative hazard for the first four falls in the exercise group compared with the control group was 0.68 (0.52 to 0.90). The relative hazard for a first fall with injury in the exercise group compared with the control group was 0.61 (0.39 to 0.97). After six months, balance had improved in the exercise group (difference between groups in change in balance score 0.43 (0.21 to 0.65). CONCLUSIONS: An individual programme of strength and balance retraining exercises improved physical function and was effective in reducing falls and injuries in women 80 years and older. PMID:9366737

  10. Older People's Views of Falls-Prevention Interventions in Six European Countries

    ERIC Educational Resources Information Center

    Yardley, Lucy; Bishop, Felicity L.; Beyer, Nina; Hauer, Klaus; Kempen, Gertrudis I. J. M.; Piot-Ziegler, Chantal; Todd, Chris J.; Cuttelod, Therese; Horne, Maria; Lanta, Kyriaki; Holt, Anne Rosell

    2006-01-01

    Purpose: Our study identified factors common to a variety of populations and settings that may promote or inhibit uptake and adherence to falls-related interventions. Design and Methods: Semistructured interviews to assess perceived advantages and barriers to taking part in falls-related interventions were carried out in six European countries…

  11. A public health approach to fall prevention among older persons in Canada.

    PubMed

    Scott, Vicky; Wagar, Brandon; Sum, Alison; Metcalfe, Sarah; Wagar, Lori

    2010-11-01

    In 2008 to 2009, there were 53,545 fall-related hospitalizations among Canadian seniors, accounting for 85% of all injury-related hospitalizations and 7% of all hospitalizations for those aged 65 years and older. The estimated cost of fall-related injuries to the Canadian health care system in 2004 was more than $2 billion among a population of 4.1 million seniors. This article describes highlights of how policy makers, researchers, and practitioners are applying a public health approach to the issue of seniors' falls in Canada, including the successes, challenges, and recommendations for the future. PMID:20934617

  12. How Can Older Adults Prevent Falls? | NIH MedlinePlus the Magazine

    MedlinePlus

    ... cdc.gov/ncipc National Resource Center on Supportive Housing and Home Modifications University of Southern California Fall ... home-monitoring systems, be sure to ask about costs. Hip fractures—In 2010, there were 258,000 ...

  13. A community home inspection approach to preventing falls among the elderly.

    PubMed

    Urton, M M

    1991-01-01

    Falls are the leading cause of accidents among those ages 65 and older and the largest single cause of death due to injury of the elderly. Environmental factors play a key role in the probability of a fall in the homes of the elderly. A community health promotion team approach can reduce the prevalence rate of injuries due to falls by eliminating the risk factors precipitating the injuries. A comprehensive program in Wilmington, OH, will incorporate the use of the community senior citizens' center, the local college, fire department, local radio stations and newspapers, community churches, local merchants, educators, and the medical community. Extrinsic factors that previously have been linked directly to falls will be identified in the home inspections. The "Fixer-Up-Team," composed of college students and community volunteers, will rectify any unsafe conditions found by the inspection team. Local merchants and lumber yards will donate materials to make needed repairs. Active senior citizens will be trained as part of the inspection team, allowing this program to be self-perpetuating. Compared with the national prevalence rates, this program will show a decrease in injuries caused by falls in the homes of the participants of this program. PMID:1902313

  14. Smartphone-based solutions for fall detection and prevention: the FARSEEING approach.

    PubMed

    Mellone, S; Tacconi, C; Schwickert, L; Klenk, J; Becker, C; Chiari, L

    2012-12-01

    Falls are not an inevitable consequence of aging. The risk and rate of falls can be reduced. Recent improvements in smartphone technology enable implementation of a wide variety of services and applications, thus making the smartphone more of a digital companion than simply a communication tool. This paper presents the results obtained by the FARSEEING project where smartphones are one example of intervention in a population-based scenario. The applications developed take advantage of the smartphone-embedded inertial sensors and require that subjects wear the smartphone by means of a waist belt. The uFall Android application has been developed for monitoring the user's motor activities at home. The application does not require any direct interaction with the user and it is also capable of running a real-time fall-detection algorithm. uTUG is a stand-alone application for instrumenting the Timed Up and Go test, which is a test often included in fall risk assessment protocols. The application acts like a pocket-sized motion laboratory, since it is capable not only of recording the trial but also of processing the data and immediately displaying the results. uTUG is designed to be self-administrable at home. PMID:23184298

  15. Effective detection method for falls according to the distance between two tri-axial accelerometers

    NASA Astrophysics Data System (ADS)

    Kim, Jae-Hyung; Park, Geun-Chul; Kim, Soo-Hong; Kim, Soo-Sung; Lee, Hae-Rim; Jeon, Gye-Rok

    2016-04-01

    Falls and fall-related injuries are a significant problem in the elderly population. A number of different approaches for detecting falls and activities of daily living (ADLs) have been conducted in recent years. However, distinguishing between real falls and certain fall-like ADL is often difficult. The aim of this study is to discriminate falls from fall-like ADLs such as jogging, jumping, and jumping down. The distance between two tri-axial accelerometers attached to the abdomen and the sternum was increased from 10 to 30 cm in 10-cm intervals. Experiments for falls and ADLs were performed to investigate the feasibility of the detection system for falls developed in this study. When the distances between the two tri-axial electrometers were 20 and 30 cm, fall-like ADLs were effectively distinguished from falls. The thresholds for three parameters — SVM, Diff Z, and Sum_diff_Z — were set; falls could be distinguished from ADL action sequences when the SVM value was larger than 4 g (TH1), the Diff_Z parameter was larger than 1.25 g (TH2), and the Sum_diff_Z parameter was larger than 15 m/s (TH3). In particular, when the SVM, Diff_Z, and Sum_diff_Z parameter were sequentially applied to thresholds (TH1, TH2, and TH3), fall-like ADL action sequences were accurately discriminated from falls.

  16. Difficulties Experienced in Setting and Achieving Goals by Participants of a Falls Prevention Programme: A Mixed-Methods Evaluation

    PubMed Central

    Mason, Wendy; Haines, Terry P.

    2014-01-01

    ABSTRACT Purpose: To evaluate the ability of participants of a falls prevention programme to set and achieve goals. Methods: The study used a prospective longitudinal design and a mixed-methods approach to data collection. Study participants were (1) 220 older adults participating in a 15-week combined exercise and education falls prevention programme and (2) 9 practitioners (3 home-care nurses, 5 community workers, and an exercise physiologist) involved in delivering the programme. Data from goal-setting forms were analyzed, and descriptive statistics were used to determine the number of appropriate goals set and achieved. Data were analyzed according to programme setting (home- or group-based) and whether or not participants were classified as being from a Culturally and Linguistically Diverse (CALD) background in the Australian context. Semi-structured interviews with programme practitioners were thematically analyzed. Results: A total of 144 respondents (n=75 CALD group, n=41 non-CALD group, n=6 CALD home, n=22 non-CALD home) set 178 goals. Only 101 (57%) goals could be evaluated according to achievement, because participants set goals that focused on health state instead of behaviour, set goals not relevant to falls prevention, used inappropriate constructs to measure goal achievement, and either did not review their goals or dropped out of the programme before goal review. Of these 101 goals, 64 were achieved. Practitioners described their own difficulties in understanding the process of setting health behaviour goals along with communication, cultural, and logistic difficulties. Conclusions: Both CALD and non-CALD participants and those participating in both group- and home-based programmes experienced difficulty in setting and achieving goals to facilitate behaviour change for falls prevention. Data suggest that home-based participants had more difficulty in setting goals than their group-based counterparts and, to a lesser extent, that CALD participants

  17. The PARAChute Project: Remote Monitoring of Posture and Gait for Fall Prevention

    NASA Astrophysics Data System (ADS)

    Hewson, David J.; Duchêne, Jacques; Charpillet, François; Saboune, Jamal; Michel-Pellegrino, Valérie; Amoud, Hassan; Doussot, Michel; Paysant, Jean; Boyer, Anne; Hogrel, Jean-Yves

    2007-12-01

    Falls in the elderly are a major public health problem due to both their frequency and their medical and social consequences. In France alone, more than two million people aged over 65 years old fall each year, leading to more than 9 000 deaths, in particular in those over 75 years old (more than 8 000 deaths). This paper describes the PARAChute project, which aims to develop a methodology that will enable the detection of an increased risk of falling in community-dwelling elderly. The methods used for a remote noninvasive assessment for static and dynamic balance assessments and gait analysis are described. The final result of the project has been the development of an algorithm for movement detection during gait and a balance signature extracted from a force plate. A multicentre longitudinal evaluation of balance has commenced in order to validate the methodologies and technologies developed in the project.

  18. Planting date effects on the nutritive value of fall-grown oat cultivars

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fall-grown oat (Avena sativa L.) shows potential to fill an important niche as emergency fall forage throughout central Wisconsin. Our objectives were to assess the effects of planting date on the nutritive value of fall-grown oat from four cultivars exhibiting diverse maturation characteristics. Du...

  19. Stochastic analysis of motor-control stability, polymer based force sensing, and optical stimulation as a preventive measure for falls

    NASA Astrophysics Data System (ADS)

    Landrock, Clinton K.

    Falls are the leading cause of all external injuries. Outcomes of falls include the leading cause of traumatic brain injury and bone fractures, and high direct medical costs in the billions of dollars. This work focused on developing three areas of enabling component technology to be used in postural control monitoring tools targeting the mitigation of falls. The first was an analysis tool based on stochastic fractal analysis to reliably measure levels of motor control. The second focus was on thin film wearable pressure sensors capable of relaying data for the first tool. The third was new thin film advanced optics for improving phototherapy devices targeting postural control disorders. Two populations, athletes and elderly, were studied against control groups. The results of these studies clearly show that monitoring postural stability in at-risk groups can be achieved reliably, and an integrated wearable system can be envisioned for both monitoring and treatment purposes. Keywords: electro-active polymer, ionic polymer-metal composite, postural control, motor control, fall prevention, sports medicine, fractal analysis, physiological signals, wearable sensors, phototherapy, photobiomodulation, nano-optics.

  20. Preventing Slips and Falls through Leisure-Time Physical Activity: Findings from a Study of Limited-Service Restaurants

    PubMed Central

    Caban-Martinez, Alberto J.; Courtney, Theodore K.; Chang, Wen-Ruey; Lombardi, David A.; Huang, Yueng-Hsiang; Brennan, Melanye J.; Perry, Melissa J.; Katz, Jeffrey N.; Verma, Santosh K.

    2014-01-01

    Background/Objective Physical activity has been shown to be beneficial at improving health in some medical conditions and in preventing injury. Epidemiologic studies suggest that physical activity is one factor associated with a decreased risk for slips and falls in the older (≥65 years) adult population. While the risk of slips and falls is generally lower in younger than in older adults; little is known of the relative contribution of physical activity in preventing slips and falls in younger adults. We examined whether engagement in leisure-time physical activity (LTPA) was protective of slips and falls among a younger/middle-aged (≤50 years old) working population. Methods 475 workers from 36 limited-service restaurants in six states in the U.S. were recruited to participate in a prospective cohort study of workplace slipping. Information on LTPA was collected at the time of enrollment. Participants reported their slip experience and work hours weekly for up to 12 weeks. We investigated the association between the rate of slipping and the rate of major slipping (i.e., slips that resulted in a fall and/or injury) and LTPA for workers 50 years of age and younger (n = 433, range 18–50 years old) using a multivariable negative binomial generalized estimating equation model. Results The rate of major slips among workers who engaged in moderate (Adjusted Rate Ratio (RR)  = 0.65; 95% Confidence Interval (CI)  =  [0.18–2.44]) and vigorous (RR = 0.64; 95%CI  =  [0.18–2.26]) LTPA, while non-significant, were approximately one-third lower than the rate of major slips among less active workers. Conclusion While not statistically significant, the results suggest a potential association between engagement in moderate and vigorous LTPA and the rate of major slips in younger adults. Additional studies that examine the role of occupational and non-occupational physical activity on the risk of slips, trips and falls among younger and middle aged

  1. Middle College. National Dropout Prevention Center/Network Newsletter. Volume 17, Number 4, Fall 2005

    ERIC Educational Resources Information Center

    Duckenfield, Marty, Ed.

    2005-01-01

    The "National Dropout Prevention Newsletter" is published quarterly by the National Dropout Prevention Center/Network. This issue contains the following articles: (1) College As A Bridge to High School Graduation (Terry Cash); (2) 2005 NDPN Crystal Star Awards of Excellence; (3) Mott Middle College (Chery S. Wagonlander); (4) Gateway to College: A…

  2. Towards falls prevention: a wearable wireless and battery-less sensing and automatic identification tag for real time monitoring of human movements.

    PubMed

    Ranasinghe, Damith C; Shinmoto Torres, Roberto L; Sample, Alanson P; Smith, Joshua R; Hill, Keith; Visvanathan, Renuka

    2012-01-01

    Falls related injuries among elderly patients in hospitals or residents in residential care facilities is a significant problem that causes emotional and physical trauma to those involved while presenting a rising healthcare expense in countries such as Australia where the population is ageing. Novel approaches using low cost and privacy preserving sensor enabled Radio Frequency Identification (RFID) technology may have the potential to provide a low cost and effective technological intervention to prevent falls in hospitals. We outline the details of a wearable sensor enabled RFID tag that is battery free, low cost, lightweight, maintenance free and can be worn continuously for automatic and unsupervised remote monitoring of activities of frail patients at acute hospitals or residents in residential care. The technological developments outlined in the paper forms part of an overall technological intervention developed to reduce falls at acute hospitals or in residential care facilities. This paper outlines the details of the technology, underlying algorithms and the results (where an accuracy of 94-100% was achieved) of a successful pilot trial. PMID:23367394

  3. Fall rice straw management and winter flooding treatment effects on a subsequent soybean crop

    USGS Publications Warehouse

    Anders, M.M.; Windham, T.E.; McNew, R.W.; Reinecke, K.J.

    2005-01-01

    The effects of fall rice (Oryza sativa L.) straw management and winter flooding on the yield and profitability of subsequent irrigated and dryland soybean [Glycine max (L.) Merr.] crops were studied for 3 years. Rice straw treatments consisted of disking, rolling, or standing stubble. Winter flooding treatments consisted of maintaining a minimum water depth of 10 cm by pumping water when necessary, impounding available rainfall, and draining fields to prevent flooding. The following soybean crop was managed as a conventional-tillage system or no-till system. Tillage system treatments were further divided into irrigated or dryland. Results indicated that there were no significant effects from either fall rice straw management or winter flooding treatments on soybean seed yields. Soybean seed yields for, the conventional tillage system were significantly greater than those for the no-till system for the first 2 yrs and not different in the third year. Irrigated soybean seed yields were significantly greater than those from dryland plots for all years. Net economic returns averaged over the 3 yrs were greatest ($390.00 ha-1) from the irrigated no-till system.

  4. Substance Abuse among Black Youth. Prevention Research Update. Number Four/Fall 1989.

    ERIC Educational Resources Information Center

    Prendergast, Michael L.; And Others

    This report discusses the substance use patterns and problems of black adults and youth relative to other groups (primarily whites). In addition, the report examines recent and older literature in order to reveal factors that may influence use and issues that need to be considered in designing prevention programs. The following sections are…

  5. Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial

    PubMed Central

    Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine

    2016-01-01

    Introduction Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. Methods and analysis This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Ethics and

  6. Prophylactic Fresh Frozen Plasma Infusion is Ineffective in Reversing Warfarin Anticoagulation and Preventing Delayed Intracranial Hemorrhage After Falls

    PubMed Central

    Reddy, Subhash; Sharma, Rohit; Grotts, Jonathan; Ferrigno, Lisa

    2015-01-01

    Background: Elderly patients, with considerable fall risk, are increasingly anticoagulated to prevent thromboembolic disease. We hypothesized that a policy of prophylactic fresh frozen plasma (FFP) infusion in patients having falls would reverse vitamin K antagonists (VKAs) and that reversal would decrease delayed intracranial hemorrhage (ICH). Methods: A retrospective review of patients with trauma admitted to a level 2 community trauma center was performed from January 2010 until November 2012. Inclusion criteria were: ground level fall (GLF) with suspected head trauma, on VKA, an international normalized ratio (INR) of >1.5, and a negative head computed tomography (CT). Patients were transfused with FFP to a goal INR of <1.5 while observed. Patients were classified as reversed (REV) if the lowest INR achieved within 4 to 24 hours after initial INR was <1.5 or unreversed (NREV) if lowest INR achieved was >1.5. Chi-square and logistic regression were performed. Results: A total of 194 patients met the criteria. In all, 43 (22%) patients were able to be REV, and 151 (78%) patients remained NREV. Unreversed patients were male and younger (P < .05). There was no difference in mean FFP received. Unreversed patients had a higher initial INR of 3.0 compared to REV patients (2.5; P = .018). One patient developed a delayed ICH and belonged to the REV group. Conclusion: The incidence of delayed hemorrhage was 0.5%. A strategy of prophylactic FFP infusion was ineffective in VKA reversal. We recommend against prophylactic infusion of FFP during a period of observation for patients on VKA with suspected head trauma and a negative initial CT. PMID:26425246

  7. Usability and acceptability of a website that provides tailored advice on falls prevention activities for older people.

    PubMed

    Nyman, Samuel R; Yardley, Lucy

    2009-03-01

    This article presents the usability and acceptability of a website that provides older people with tailored advice to help motivate them to undertake physical activities that prevent falls. Views on the website from interviews with 16 older people and 26 sheltered housing wardens were analysed thematically. The website was well received with only one usability difficulty with the action plan calendar. The older people selected balance training activities out of interest or enjoyment, and appeared to carefully add them into their current routine. The wardens were motivated to promote the website to their residents, particularly those who owned a computer, had balance problems, or were physically active. However, the participants noted that currently a minority of older people use the Internet. Also, some older people underestimated how much activity was enough to improve balance, and others perceived themselves as too old for the activities. PMID:19218310

  8. Effect of eastern gamagrass on fall armyworm and corn earworm development

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The fall armyworm, Spodoptera frugiperda (J.E. Smith) and the corn earworm, Helicoverpa zea (Boddie) are two important corn pests in the southern U.S. states. Effect of the leaves from the corn relative, the Eastern gamagrass (Tripsacum dactyloides L.) on fall armyworm and corn earworm development ...

  9. Improvements in Balance in Older Adults Engaged in a Specialized Home Care Falls Prevention Program

    PubMed Central

    Whitney, Susan L.; Marchetti, Gregory F.; Ellis, Jennifer L.; Otis, Laurie

    2016-01-01

    Background and Purpose To determine if persons older than 65 years receiving a combination of physical therapy, occupational therapy, speech, or nursing interventions in their home demonstrated changes in gait/balance function after an episode of home care services. Methods Charts from 11 667 persons who were at risk for falling and who were participating in an exercise program in the home were included. Study design Data were retrieved from the Outcome and Assessment Information Set, Version B, and the computerized database of physical therapist–collected outcome data. Recorded physical therapist–data may have included a neuropathic pain rating, the Berg Balance Scale (BBS), the Performance Oriented Measurement Assessment (POMA), the Dynamic Gait Index (DGI), and the modified Clinical Test of Sensory Integration and Balance (mCTSIB). Data analysis Data were extracted by an honest broker and were analyzed. Mean (SD) change in each performance test and the percentage of participants in the total sample and in the 9 age/health condition strata that exceeded the minimum detectable change (MDC) for each gait/balance measure were described. The value of MDC95 describes the amount of true change in participant status beyond measurement error with 95% certainty. Results The gait/balance measures demonstrated MDCs ranging between 68% and 91% for the study sample. Mean (SD) of improvement on the BBS was 12 (8) points, with 88% of all participants exceeding the BBS MDC95 value of 5 points. Mean (SD) of improvement in gait/balance performance as measured by the POMA was 8 (4) points, with 91% of all participants exceeding the POMA MDC95 value of 3 points. Among all patients, mean (SD) of improvement on the DGI was 7 (4) points with 91% of all participants exceeding the DGI MDC95 value of 2 points by discharge. At admission, the median number of mCTSIB conditions that could be completed was 1 and the median number of completed conditions on the mCTSIB increased to 3 at

  10. Tunguska meteor fall of 1908: effects on stratospheric ozone

    SciTech Connect

    Turco, R.P.; Toon, O.B.; Park, C.; Whitten, R.C.; Pollack, J.B.; Noerdlinger, P.

    1981-10-02

    In 1908, when the giant Tunguska meteor disintegrated in the earth's atmosphere over Siberia, it may have generated as much as 30 million metric tons of nitric oxide (NO) in the stratosphere and mesosphere. The photochemical aftereffects of the event have been simulated using a comprehensive model of atmospheric trace composition. Calculations indicate that up to 45 percent of the ozone in the Northern Hemisphere may have been depleted by Tunguska's nitric oxide cloud early in 1909 and large ozone reductions may have persisted until 1912. Measurements of atmospheric transparency by the Smithsonian Astrophysical Observatory for the years 1909 to 1911 show evidence of a steady ozone recovery from unusually low levels in early 1909, implying a total ozone deficit of 30 +- 15 percent. The coincidence in time between the observed ozone recovery and the Tungska meteor fall indicates that the event may provide a test of current ozone depletion theories.

  11. [Interventions based on exercise and physical environment for preventing falls in cognitively impaired older people living in long-term care facilities: A systematic review and meta-analysis].

    PubMed

    González-Román, Loreto; Bagur-Calafat, Caritat; Urrútia-Cuchí, Gerard; Garrido-Pedrosa, Jèssica

    2016-01-01

    This systematic review aims to report the effectiveness of interventions based on exercise and/or physical environment for reducing falls in cognitively impaired older adults living in long-term care facilities. In July 2014, a literature search was conducted using main databases and specialised sources. Randomised controlled trials assessing the effectiveness of fall prevention interventions, which used exercise or physical environment among elderly people with cognitive impairment living in long-term care facilities, were selected. Two independent reviewers checked the eligibility of the studies, and evaluated their methodological quality. If it was adequate, data were gathered. Fourteen studies with 3,539 participants using exercise and/or physical environment by a single or combined approach were included. The data gathered from studies that used both interventions showed a significant reduction in fall rate. Further research is needed to demonstrate the effectiveness of those interventions for preventing falls in the elderly with cognitive impairment living in long-term care establishments. PMID:26811122

  12. Older Adults' Participation in a Community-Based Falls Prevention Exercise Program: Relationships between the Easy Tool, Program Attendance, and Health Outcomes

    ERIC Educational Resources Information Center

    Smith, Matthew Lee; Ory, Marcia G.; Ahn, SangNam; Bazzarre, Terry L.; Resnick, Barbara

    2011-01-01

    Purpose of the Study: The Exercise Assessment Screening for You (EASY) tool was developed to encourage older adults at every functional level to be more physically active. The purposes of this study were to examine characteristics of older adults who participated in an evidence-based falls prevention program by their entry to EASY tool scores,…

  13. [Nursing care of elderly persons: reactions to the use of a security blanket to prevent falling out of bed].

    PubMed

    Ntetu, A L; Courville, F; Chouinard, M C; Tremblay, H

    2001-03-01

    This article presents the results of the first part of a survey aiming at assessing the chances for adoption and use of the safety blanket, a new device preventing the falls from the beds. In this part, the resarchers wanted to know how the caretakers reacted to the use of this material. Thirty four people with five beneficiaries among them, nine family members, fifteen contributors and five managers, interacting in the context of a care unit for elderly people of a hospital centre were interviewed. The data of the interviews were analysed according to a six step procedure: listening to the interviews and reading the descriptions; deriving the significant statements, analysing and reformulating the meaning of the statements; regrouping the signification units under more global themes; gathering the analysis results and describing exhaustively the studied phenomenon; validating the exhaustive description. As a whole, the reactions recorded were positive and indicate that the safety blanket has big chances to be adopted by the healthcare units. PMID:12037882

  14. The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients

    PubMed Central

    Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

    2015-01-01

    [Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also took part in trampoline training for thirty minutes per day, three times a week for six weeks. We evaluated balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results] Both the trampoline and the control group showed significant improvements in balance, gait, and falls efficacy compared to before the intervention, and the improvements were significantly greater in the trampoline group than in the control group. [Conclusion] Modified trampoline training resulted in significantly improved balance, dynamic gait, and falls efficacy of stroke patients compared to the control group. These results suggest that modified trampoline training is feasible and effective at improving balance, dynamic gait, and falls efficacy after stroke. PMID:26696696

  15. Falls in the Elderly

    PubMed Central

    Hodgetts, P. Geoffrey

    1992-01-01

    Falls are a significant cause of morbidity and mortality in the elderly. One in three older people will fall every year. Assessing intrinsic (patient) factors and extrinsic (environmental) factors that increase the risk of falling is an important part of caring for the elderly. Physicians can readily assess balance and mobility as part of a preventive approach. PMID:21221300

  16. Combination prevention: a deeper understanding of effective HIV prevention.

    PubMed

    Hankins, Catherine A; de Zalduondo, Barbara O

    2010-10-01

    Evidence-informed and human rights-based combination prevention combines behavioural, biomedical, and structural interventions to address both the immediate risks and underlying causes of vulnerability to HIV infection, and the pathways that link them. Because these are context-specific, no single prescription or standard package will apply universally. Anchored in 'know your epidemic' estimates of where the next 1000 infections will occur and 'know your response' analyses of resource allocation and programming gaps, combination prevention strategies seek to realign programme priorities for maximum effect to reduce epidemic reproductive rates at local, regional, and national levels. Effective prevention means tailoring programmes to local epidemics and ensuring that components are delivered with the intensity, quality, and scale necessary to achieve intended effects. Structural interventions, addressing the social, economic, cultural, and legal constraints that create HIV risk environments and undermine the agency of individuals to protect themselves and others, are also public goods in their own right. Applying the principles of combination prevention systematically and consistently in HIV programme planning, with due attention to context, can increase HIV programme effectiveness. Better outcome and impact measurement using multiple methods and data triangulation can build the evidence base on synergies between the components of combination prevention at individual, group, and societal levels, facilitating iterative knowledge translation within and among programmes. PMID:21042055

  17. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults.

    PubMed

    Zhuang, Jie; Huang, Liang; Wu, Yanqiang; Zhang, Yanxin

    2014-01-01

    This study aimed to evaluate the effectiveness of an innovative exercise program on muscle strength, balance, and gait kinematics in elderly community-dwellers. The exercise program included strength and balance training and the 8-form Tai Chi Chuan. The measurements were carried out at baseline and 12 weeks, and consisted of four physical performance tests, joint isokinetic strength tests, and three-dimensional gait analysis. Fifty-six community-dwelling older adults aged 60-80 years old were randomly assigned to an intervention or control group. After 12 weeks, the intervention group showed a 17.6% improvement in the timed up and go test, accompanied by a 54.7% increase in the 30-second chair stand test score. Significant increases in the score of star excursion balance tests, and the strength of the extensor and flexor muscles at knee and ankle joints were also observed. In addition, the intervention group walked at a faster speed with a longer step length, shorter support phase, and a greater sagittal plane range of motion at the hip and ankle joints. No statistical improvements were seen in the control group. This study provided an effective, evidence-based falls prevention program that can be implemented in community settings to improve physical fitness and reduce fall risks among community-dwelling older adults. The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people. PMID:24453483

  18. Mt. Hood Community College Institutional Effectiveness (IE) Report Fall 2001.

    ERIC Educational Resources Information Center

    Walleri, R. Dan

    This report examines the indicators of institutional effectiveness for Mount Hood Community College (MHCC) (Oregon). The document reports on five institutional goals: (1) knowledge-based workforce education and services; (2) access for members of the community and development of an environment in which diversity thrives; (3) economic development,…

  19. Effect of a falling gas-liquid absorption film temperature on entropy generation

    NASA Astrophysics Data System (ADS)

    Chermiti, Imen; Hidouri, Nejib; Brahim, Ammar Ben

    2013-08-01

    In this paper, an analytical study about the effect of a falling gas-liquid absorption film temperature on entropy generation is carried out. Entropy generation formulations due to viscous effects and mass transfer are derived. Results in terms of viscous, mass transfer and total irreversibilities are graphically presented and discussed.

  20. What Works in Prevention: Principles of Effective Prevention Programs.

    ERIC Educational Resources Information Center

    Nation, Maury; Crusto, Cindy; Wandersman, Abraham; Kumpfer, Karol L.; Seybolt, Diana; Morrisey-Kane, Erin; Davino, Katrina

    2003-01-01

    Uses a review-of-reviews approach across four areas (substance abuse, risky sexual behavior, school failure, and juvenile delinquency and violence) to identify characteristics consistently associated with effective prevention programs. Programs were comprehensive, included varied teaching methods, provided sufficient dosage, were theory driven,…

  1. The Development of a Community-Based, Pharmacist-Provided Falls Prevention MTM Intervention for Older Adults: Relationship Building, Methods, and Rationale

    PubMed Central

    Mott, David A.; Martin, Beth; Breslow, Robert; Michaels, Barb; Kirchner, Jeff; Mahoney, Jane; Margolis, Amanda

    2014-01-01

    The objectives of this article are to discuss the process of community engagement experienced to plan and implement a pilot study of a pharmacist-provided MTM intervention focused on reducing the use of medications associated with falling, and to present the research methods that emerged from the community engagement process to evaluate the feasibility, acceptance, and preliminary impact of the intervention. Key lessons learned from the community engagement process also are presented and discussed. The relationship building and planning process took twelve months. The RE-AIM framework broadly guided the planning process since an overarching goal for the community partners was developing a program that could be implemented and sustained in the future. The planning phase focused on identifying research questions that were of most interest to the community partners, the population to study, the capacity of partners to perform activities, process evaluation. Much of the planning phase was accomplished with face-to-face meetings. After all study processes, study materials, and data collection tools were developed, a focus group of older adults who represented the likely targets of the MTM intervention provided feedback related to the concept and process of the intervention. Nine key lessons were identified from the community engagement process. One key to successful community engagement is partners taking the time to educate each other about experiences, processes, and success and failures. Additionally, partners must actively listen to each other to better understand barriers and facilitators that likely will impact the planning and implementation process. Successful community engagement will be important to develop both formative and summative evaluation processes that will help to produce valid evidence about the effectiveness of pharmacists in modifying drug therapy and preventing falls as well as promote adoption and implementation of the intervention in other

  2. Cost-effectiveness and budget impact of Empirical vitamin D therapy on unintentional falls in older adults in the UK

    PubMed Central

    Poole, C D; Smith, J; Davies, J S

    2015-01-01

    Objectives To evaluate the health outcomes and economics associated with the current guidance relating to the prevention of falls in the elderly through vitamin D supplementation. Setting UK. Participants UK population aged 60 years and above. Interventions A Markov health state transition model simulated patient transitions between key fall-related outcomes using a 5-year horizon and annual cycles to assess the costs and benefits of empirical treatment with colecalciferol 800 iu daily. Primary and secondary outcome measures Costs and health outcomes attributable to fall prevention following vitamin D supplementation. Results Our model shows that treating the UK population aged 60 years and above with 800 iu colecalciferol would, over a 5-year period: (1) prevent in excess of 430 000 minor falls; (2) avoid 190 000 major falls; (3) prevent 1579 acute deaths; (4) avoid 84 000 person-years of long-term care and (5) prevent 8300 deaths associated with increased mortality in long-term care. The greatest gains are seen among those 75 years and older. Based on reduction in falls alone, the intervention in all adults aged 65+ is cost-saving and leads to increased quality adjusted life years. Treating all adults aged 60+ incurs an intervention cost of £2.70bn over 5 years, yet produces a −£3.12bn reduction in fall-related costs; a net saving of £420M. Increasing the lower bound age limit by 5-year increments increases budget impact to −£1.17bn, −£1.75bn, and −£2.06bn for adults 65+, 70+ and 75+, respectively. Conclusions This study shows that treatment of the elderly UK population with colecalciferol 800 iu daily would be associated with reductions in mortality and substantial cost-savings through fall prevention. PMID:26419680

  3. Exercise and Fall Prevention: Narrowing the Research-to-Practice Gap and Enhancing Integration of Clinical and Community Practice.

    PubMed

    Li, Fuzhong; Eckstrom, Elizabeth; Harmer, Peter; Fitzgerald, Kathleen; Voit, Jan; Cameron, Kathleen A

    2016-02-01

    Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence-based, exercise-focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practice, including lack of evidence of the transferability of efficacy trial results to clinical and community settings, insufficient local expertise to roll out community exercise programs, and inadequate infrastructure to integrate evidence-based programs into clinical and community practice. The practical solutions highlighted in this article can be used to address these evidence-to-practice challenges. Falls and their associated healthcare costs can be reduced by better integrating research on exercise intervention into clinical practice and community programs. PMID:26825429

  4. Data acquisition system using six degree-of-freedom inertia sensor and ZigBee wireless link for fall detection and prevention.

    PubMed

    Dinh, A; Teng, D; Chen, L; Ko, S B; Shi, Y; Basran, J; Del Bello-Hass, V

    2008-01-01

    Fall detection and prevention require logged physiological activity data of a patient for a long period of time. This work develops a data acquisition system to collect motion data from multiple patients and store in a data base. A wireless sensor network is built using high precision inertia sensors and low power Zigbee wireless transceivers. Testing results prove the system function properly. Researchers and physicians can now retrieve and analyze the accurate data of the patient movement with ease. PMID:19163174

  5. Effect of magnetic field profile on the anode fall in a Hall-effect thruster discharge

    SciTech Connect

    Dorf, L.; Raitses, Y.; Fisch, N.J.

    2006-05-15

    The effect of the magnetic field configuration on the anode fall in an E-vectorxB-vector discharge of a Hall thruster is studied both experimentally and theoretically. Plasma potential, electron temperature, and plasma density in the near-anode region are measured with a biased probe in three configurations of the magnetic field. It is observed that the anode fall in a Hall thruster can be changed from negative to positive by creating a magnetic field configuration with a zero magnetic field region. Similar configurations are utilized in some advanced Hall thrusters, like an ATON thruster. Results of the measurements are employed to model a Hall thruster with different magnetic field configurations, including the one with a zero-field region. Different anode sheath regimes observed experimentally are used to set the boundary conditions for the quasineutral plasma. Numerical solutions obtained with a hydrodynamic quasi-one-dimensional model suggest that varying the magnetic field configuration affects the electron mobility both inside and outside the channel, as well as the plasma density distribution along the axis.

  6. 75 FR 27625 - Announcement of the Fall 2010 Annual Grant Competition Effective October 1, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... PEACE Announcement of the Fall 2010 Annual Grant Competition Effective October 1, 2010 AGENCY: United States Institute of Peace. ACTION: Notice. SUMMARY: The Agency announces its Annual Grant Competition... international peace and conflict resolution. The Annual Grant Competition is open to any project that...

  7. Recommendations abstracted from the American Geriatrics Society Consensus Statement on vitamin D for Prevention of Falls and Their Consequences.

    PubMed

    2014-01-01

    The goal of this Consensus Statement is to help primary care practitioners achieve adequate vitamin D intake from all sources in their older patients, with the goal of reducing falls and fall-related injuries. The workgroup graded the quality of evidence and assigned an evidence level using established criteria. Based on the evidence for fall and fracture reduction in the clinical trials of older community-dwelling and institutionalized persons and metaanalyses, the workgroup concluded that a serum 25 hydroxyvitamin D (25(OH)D) concentration of 30 ng/mL (75 nmol/L) should be a minimum goal to achieve in older adults, particularly in frail adults, who are at higher risk of falls, injuries, and fractures. The workgroup concluded that the goal--to reduce fall injuries related to low vitamin D status--could be achieved safely and would not require practitioners to measure serum 25(OH)D concentrations in older adults in the absence of underlying conditions that increase the risk of hypercalcemia (e.g., advanced renal disease, certain malignancies, sarcoidosis). PMID:24350602

  8. The effect of walking on falls in older people: the 'Easy Steps to Health' randomized controlled trial study protocol

    PubMed Central

    2011-01-01

    Background Falls in older people continue to be a major public health issue in industrialized countries. Extensive research into falls prevention has identified exercise as a proven fall prevention strategy. However, despite over a decade of promoting physical activity, hospitalisation rates due to falls injuries in older people are still increasing. This could be because efforts to increase physical activity amongst older people have been unsuccessful, or the physical activity that older people engage in is insufficient and/or inappropriate. The majority of older people choose walking as their predominant form of exercise. While walking has been shown to lower the risk of many chronic diseases its role in falls prevention remains unclear. This paper outlines the methodology of a study whose aims are to determine: if a home-based walking intervention will reduce the falls rate among healthy but inactive community-dwelling older adults (65 + years) compared to no intervention (usual activity) and; whether such an intervention can improve risk factors for falls, such as balance, strength and reaction time. Methods/Design This study uses a randomised controlled trial design. A total of 484 older people exercising less than 120 minutes per week will be recruited through the community and health care referrals throughout Sydney and neighboring regions. All participants are randomised into either the self-managed walking program group or the health-education waiting list group using a block randomization scheme. Outcome measures include prospective falls and falls injuries, quality of life, and physical activity levels. A subset of participants (n = 194) will also receive physical performance assessments comprising of tests of dynamic balance, strength, reaction time and lower limb functional status. Discussion Certain types of physical activity can reduce the risk of falls. As walking is already the most popular physical activity amongst older people, if walking is

  9. Fall of blood ionized calcium on watching a provocative TV program and its prevention by active absorbable algal calcium (AAA Ca).

    PubMed

    Fujita, T; Ohgitani, S; Nomura, M

    1999-01-01

    In December 1997, more than 680 children developed convulsive seizures while watching a notorious audiovisually provocative TV program, "Pocket Monster." Emotional stimulation via hyperventilation may cause respiratory alkalosis, fall of blood ionized calcium (Ca), and sensitization of the nervous system to excessive emotional stress. A study was therefore undertaken to follow the changes of blood ionized Ca in eight healthy volunteers after watching the "Pocket Monster" and also a quiet program, "Classical Music," as a control for 20min from 4 P.M. Although neither marked hyperventilation nor convulsions developed in any of these adult volunteers, blood ionized Ca showed a significantly more pronounced fall during and after watching "Pocket Monster," and their plasma intact parathyroid hormone (iPTH) was significantly higher 120min after the beginning of "Pocket Monster" than the "Classical Music" program. Plasma total Ca, pH, and albumin were free of detectable changes. Ingestion of 600mg Ca as active absorbable algal Ca (AAA Ca) with high bioavailability completely prevented the fall of ionized Ca and suppressed iPTH. Plama osteocalcin was also significantly suppressed after ingestion of AAA Ca. It may be worthwhile to ingest AAA Ca before anticipated emotional stress such as watching a provocative TV program to prevent possible neuromuscular instability. PMID:10340641

  10. Cancer preventive effects of vitamin E.

    PubMed

    Wada, Sayori

    2012-01-01

    Vitamin E is well known as an antioxidant, with 8 natural isoforms, such as α-, bgr;-, γ- and δ-tocopherols and α-, β-, gamma;- and δ-tocotrienols. It has been suggested that both tocopherols and tocotrienols have anti-tumor effects due to the antioxidant effect. The results of several studies have indicated that the tocotrienols may have a stronger bioactivity than the tocopherols. Both types have shown antiproliferative, proapoptotic and cyclooxygenase-2- inhibiting effects in in vitro studies. Several animal studies have demonstrated that vitamin E has cancer-preventing effects. However, clinical trials have not shown similar results for the cancer prevention effect of tocopherol. Although the Linxian Trials demonstrated that the supplementation of β-carotene, α-tocopherol and selenium reduced cancer risk, the beneficial effects of α- tocopherol on prostate cancer disappeared after several years in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Vitamin E, especially tocotrienols, seems to be a potent agent for cancer prevention, however no large-scale clinical trial on the cancer prevention effect of tocotrienols has been conducted yet. Therefore it is expected that clinical trials overcoming the lower bioavailability of tocotrienols will be conducted, and it is urgently needed to assess the safety and the efficacy of the administration of the tocotrienols as a part of a cancer prevention regimen. PMID:21466429

  11. A feasibility study and pilot randomised trial of a tailored prevention program to reduce falls in older people with mild dementia

    PubMed Central

    2013-01-01

    Background People with dementia have a disproportionately high rate of falls and fractures and poorer outcomes, yet there is currently no evidence to guide falls prevention in this population. Methods A randomised trial design was used to test feasibility of study components and acceptability of a home hazard reduction and balance and strength exercise fall prevention program. The program was tailored to participant’s individual cognitive levels and implemented as a carer-supported intervention. Feasibility of recruitment, retention and implementation of intervention were recorded through observation and documented in field notes. Adherence, carer burden and use of task simplification strategies were also monitored. Outcome measures, collected at 12 weeks included physiological, fear of falling, cognitive and functional measures. Results Recruitment was achievable but may be more challenging in a multisite trial. Twenty two dyads of persons with mild dementia and their carers were randomised to intervention or usual care control group. Of 38 dyads referred to the study, there was a high rate of willingness to participate, with 6 (16%) declining and 10 (26%) not meeting inclusion criteria. The intervention was well received by participants and carers and adherence to both program components was very good. All participants implemented some home safety recommendations (range 19-80%) with half implementing 50% or more. At the end of 12 weeks, 72% of the intervention group were exercising. Both the rate of falling and the risk of a fall were lower in the intervention group but these findings were not significant (RR= 0.50 (95% CI 0.11-2.19). There were no differences in physiological outcome measures between the control and intervention groups. However results were influenced by the small study size and incomplete data primarily in the intervention group at follow up. Conclusions The pilot study was feasible and acceptable to people with mild dementia and their

  12. Translating Evidence-Based Falls Prevention into Clinical Practice in Nursing Facilities: Results and Lessons from a Quality Improvement Collaborative

    PubMed Central

    Colón-Emeric, Cathleen; Schenck, Anna; Gorospe, Joel; McArdle, Jill; Dobson, Lee; DePorter, Cindy; McConnell, Eleanor

    2007-01-01

    OBJECTIVES To describe the changes in process of care before and after an evidence-based fall reduction quality improvement collaborative in nursing facilities. DESIGN Natural experiment with nonparticipating facilities serving as controls. SETTING Community nursing homes. PARTICIPANTS Thirty-six participating and 353 non-participating nursing facilities in North Carolina. INTERVENTION Two in-person learning sessions, monthly teleconferences, and an e-mail discussion list over 9 months. The change package emphasized screening, labeling, and risk-factor reduction. MEASUREMENTS Compliance was measured using facility self-report and chart abstraction (n = 832) before and after the intervention. Fall rates as measured using the Minimum Data Set (MDS) were compared with those of nonparticipating facilities as an exploratory outcome. RESULTS Self-reported compliance with screening, labeling, and risk-factor reduction approached 100%. Chart abstraction revealed only modest improvements in screening (51% to 68%, P<.05), risk-factor reduction (4% to 7%, P = .30), and medication assessment (2% to 6%, P = .34). There was a significant increase in vitamin D prescriptions (40% to 48%, P = .03) and decrease in sedative-hypnotics (19% to 12%, P = .04) but no change in benzodiazepine, neuroleptic, or calcium use. No significant changes in proportions of fallers or fall rates were observed according to chart abstraction (28.6% to 37.5%, P = .17), MDS (18.2% to 15.4%, P = .56), or self-report (6.1–5.6 falls/1,000 bed days, P = .31). CONCLUSON Multiple-risk-factor reduction tasks are infrequently implemented, whereas screening tasks appear more easily modifiable in a real-world setting. Substantial differences between self-reported practice and medical record documentation require that additional data sources be used to assess the change-in-care processes resulting from quality improvement programs. Interventions to improve interdisciplinary collaboration need to be developed. PMID

  13. The geomorphological effect of cornice fall avalanches in the Longyeardalen valley, Svalbard

    NASA Astrophysics Data System (ADS)

    Eckerstorfer, M.; Christiansen, H. H.; Rubensdotter, L.; Vogel, S.

    2013-09-01

    The study of snow avalanches and their geomorphological effect in the periglacial parts of the cryosphere is important for enhanced geomorphological process understanding as well as hazard-related studies. Only a few field studies, and particularly few in the High Arctic, have quantified avalanche sedimentation. Snow avalanches are traditionally ranked behind rockfall in terms of their significance for mass-wasting processes of rockslopes. Cornice fall avalanches are at present the most dominant snow avalanche type at two slope systems, called Nybyen and Larsbreen, in the valley Longyeardalen in central Svalbard. Both slope systems are on northwest-facing lee slopes underneath a large summit plateau, with annual cornices forming on the top. High-frequency and magnitude cornice fall avalanching is observed by daily automatic time-lapse photography. In addition, rock debris sedimentation by cornice fall avalanches was measured directly in permanent sediment traps or by snow inventories. The results from a maximum of seven years of measurements in a total of 13 catchments show maximum mean rock debris sedimentation rates ranging from 8.2 to 38.7 kg m-2 at Nybyen, and from 0.8 to 55.4 kg m-2 at Larsbreen. Correspondingly, avalanche fan surfaces accreted from 2.6 to 8.8 mm yr-1 at Nybyen, and from 0.2 to 13.9 mm yr-1 at Larsbreen. This comparably efficient rockslope mass wasting is due to collapsing cornices producing cornice fall avalanches containing large amounts of rock debris throughout the entire winter. The rock debris of different origin stems from the plateau crests, the adjacent free rock face and the transport pathway, accumulating distinct avalanche fans at both slope systems. Cornice fall avalanche sedimentation also contributed to the development of a rock glacier at the Larsbreen site during the Holocene. We have recorded present maximum rockwall retreat rates of 0.9 mm yr-1 at Nybyen, but as much as 6.7 mm yr-1 at Larsbreen, while average Holocene

  14. First Aid: Falls

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A Text Size en ... Floors, Doors & Windows, Furniture, Stairways: Household Safety Checklist First Aid: Broken Bones Head Injuries Preventing Children's Sports Injuries ...

  15. Brainstem auditory evoked responses in man. 1: Effect of stimulus rise-fall time and duration

    NASA Technical Reports Server (NTRS)

    Hecox, K.; Squires, N.; Galambos, R.

    1975-01-01

    Short latency (under 10 msec) responses elicited by bursts of white noise were recorded from the scalps of human subjects. Response alterations produced by changes in the noise burst duration (on-time), inter-burst interval (off-time), and onset and offset shapes were analyzed. The latency of the most prominent response component, wave V, was markedly delayed with increases in stimulus rise time but was unaffected by changes in fall time. Increases in stimulus duration, and therefore in loudness, resulted in a systematic increase in latency. This was probably due to response recovery processes, since the effect was eliminated with increases in stimulus off-time. The amplitude of wave V was insensitive to changes in signal rise and fall times, while increasing signal on-time produced smaller amplitude responses only for sufficiently short off-times. It was concluded that wave V of the human auditory brainstem evoked response is solely an onset response.

  16. Effects of seeding rate on the dry matter yield and nutritive value of fall-oat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Several recent research projects have evaluated fall-grown oat as a fall-forage option for harvest as silage, or to extend the fall grazing season. Producers frequently ask about the appropriate seeding rates for fall-grown oat and whether or not it is the same as the traditional recommendation for ...

  17. Pressure sensor-based tongue-placed electrotactile biofeedback for balance improvement--biomedical application to prevent pressure sores formation and falls.

    PubMed

    Vuillerme, N; Chenu, O; Pinsault, N; Moreau-Gaudry, A; Fleury, A; Demongeot, J; Payan, Y

    2007-01-01

    We introduce the innovative technologies, based on the concept of "sensory substitution", we are developing in the fields of biomedical engineering and human disability. Precisely, our goal is to design, develop and validate practical assistive biomedical and/or technical devices and/or rehabilitating procedures for persons with disabilities, using artificial tongue-placed tactile biofeedback systems. Proposed applications are dealing with: (1) pressure sores prevention in case of spinal cord injuries (persons with paraplegia, or tetraplegia); and (2) balance control improvement to prevent fall in older and/or disabled adults. This paper describes the architecture and the functioning principle of these biofeedback systems and presents preliminary results of two feasibility studies performed on young healthy adults. PMID:18003410

  18. The medical effects of radioactive fall-out: role of stable end-products?

    PubMed Central

    Burrows, B. A.; Cardarelli, J. C.; Boling, E. A.; Sinex, F. M.

    1981-01-01

    To summarize, from preliminary observations on the possible effects of radioactive fall-out, it may be inferred that in addition to the secondary products of ionizing irradiation per se, the stable end-products of the transmutation of certain radionuclides may adversely influence cellular metabolism, including mutagenesis. The discussion of the possible role of intracellular barium as an end-product of 137Cs decay is offered as an example of an unpredictable number of broad ecological, as well as the more limited medical, effects that may be of both clinical and climatological significance. Images Fig. 1 Fig. 2 PMID:7281411

  19. The effect of enhanced trunk control on balance and falls through bilateral upper extremity exercises among chronic stroke patients in a standing position

    PubMed Central

    Shin, Ji Won; Don Kim, Kyoung

    2016-01-01

    [Purpose] This study examined the effects of bilateral upper extremity exercises on trunk control, balance, and risk of falls in stroke patients. [Subjects and Methods] A total of 30 study subjects were selected and randomly divided into experimental and control groups containing 15 subjects each, who received bilateral upper extremity activities and conventional rehabilitation treatment, respectively. [Results] There were statistically significant differences between groups in all sub-items and total trunk impairment and Berg Balance scale scores. Significant differences between groups were also observed in all sub-items of the trunk impairment scale, except for static sitting balance. [Conclusion] Bilateral upper extremity exercises are effective for trunk control and balance as well as for fall prevention. PMID:26957756

  20. [Accidental falls in the elderly].

    PubMed

    Heinimann, Niklas B; Kressig, Reto W

    2014-06-18

    Falls in the elderly are common with consecutive high mortality and morbidity. Recent consecutive data focus on identification and therapy of intrinsic risk factors. Sarcopenia, imbalance and gait disorders represent the major risk factors. Sarcopenia is caused by a disequilibrium of protein synthesis and breakdown, probably in consequence of age-related changes in protein metabolism. Protein supplements in combination with strength training shows the best benefit. Disorders in balance and gait are caused by age-related or pathologic changes in a complex regulation system of gait. The individual fall risk correlates with the gait variability and even increases with bad dual task performance. Activities with high requirements of attention and body awareness are the most effective prevention for falls in the elderly (-50%). PMID:24938159

  1. Surface tension effects on the motion of a free-falling liquid sheet

    NASA Astrophysics Data System (ADS)

    Coppola, Gennaro; De Rosa, Fortunato; de Luca, Luigi

    2013-06-01

    The stationary motion of a liquid curtain falling under the effects of inertia, gravity, and surface tension is analyzed. An original equation governing the streamwise distribution of thickness and velocity is derived by means of a Taylor expansion in the lateral distance from the mean line of the sheet. Approximate solutions are obtained by means of perturbation approaches involving the two parameters governing the problem, namely, the slenderness ratio ɛ and the Weber number We. The numerical procedure employed in order to integrate the non-linear equation is discussed and a parametric study is presented, together with a comparison with the approximate asymptotic solutions valid for small ɛ and We.

  2. Moving forward in fall prevention: an intervention to improve balance among patients in a quasi-experimental study of hospitalized patients.

    PubMed

    Villafañe, Jorge H; Pirali, Caterina; Buraschi, Riccardo; Arienti, Chiara; Corbellini, Camilo; Negrini, Stefano

    2015-12-01

    We investigated the effectiveness of three different rehabilitative programs: group exercise, individual core stability or balance training intervention with a stabilometric platform to improve balance ability in elderly hospitalized patients. We used a prospective quasi-experimental study design. Twenty-eight patients, 39.3% women [age (mean±SD) 72.4±6.5 years], known to have had at least a fall in the last 12 months, were consecutively assigned to one of the following three groups: group exercise intervention, individual core stability or balance training with a stabilometric platform (five sessions a week for 3 weeks in each group). Outcomes were collected at baseline and immediately following the intervention period. In each intervention group, patients showed improvement in balance and mobility, shown as an improvement in the three functional tests score (the Tinetti scale, the Berg Balance Scale, and the Time Up and Go test) (all, P<0.05), whereas, generally, the changes in the score of the test of the stabilometric platform (Postural Stability Test and Fall Risk Test) were not significant for all the interventions. No significant group-by-time interaction was detected for any of the intervention groups, which suggests that the groups improved in the same way. These findings indicate that participation in an exercise program can improve balance and functional mobility, which might contribute toward the reductions of the falls of elderly hospitalized patients and the subsequent fall-related costs. Functional scales might be more appropriate than an instrumental test (Postural Stability Test and Fall Risk Test of the Biodex Balance System) in detecting the functional improvement because of a rehabilitative intervention. PMID:26230947

  3. Physiological and Psychological Effects of a Walk in Urban Parks in Fall.

    PubMed

    Song, Chorong; Ikei, Harumi; Igarashi, Miho; Takagaki, Michiko; Miyazaki, Yoshifumi

    2015-11-01

    In recent times, attention has been focused on the role of urban green spaces in promoting human health and well-being. However, there is a lack of evidence-based research on the physiological effects of walking in urban green areas. This study aimed to clarify the physiological and psychological effects of walking in urban parks during fall. Twenty-three males (mean age 22.3 ± 1.2 years) were instructed to walk predetermined 15-min courses in an urban park and in a nearby city area (control). Heart rate and heart rate variability were measured to assess physiological responses, and the semantic differential method, Profile of Mood States, and State-Trait Anxiety Inventory were used to measure psychological responses. We observed that walking in an urban park resulted in a significantly lower heart rate, higher parasympathetic nerve activity, and lower sympathetic nerve activity than walking through the city area. In subjective evaluations, participants were more "comfortable," "natural," "relaxed," and "vigorous" after a walk in the urban park. Furthermore, they exhibited significantly lower levels of negative emotions and anxiety. These findings provide scientific evidence for the physiological and psychological relaxation effects of walking in urban parks during fall. PMID:26569271

  4. Physiological and Psychological Effects of a Walk in Urban Parks in Fall

    PubMed Central

    Song, Chorong; Ikei, Harumi; Igarashi, Miho; Takagaki, Michiko; Miyazaki, Yoshifumi

    2015-01-01

    In recent times, attention has been focused on the role of urban green spaces in promoting human health and well-being. However, there is a lack of evidence-based research on the physiological effects of walking in urban green areas. This study aimed to clarify the physiological and psychological effects of walking in urban parks during fall. Twenty-three males (mean age 22.3 ± 1.2 years) were instructed to walk predetermined 15-min courses in an urban park and in a nearby city area (control). Heart rate and heart rate variability were measured to assess physiological responses, and the semantic differential method, Profile of Mood States, and State-Trait Anxiety Inventory were used to measure psychological responses. We observed that walking in an urban park resulted in a significantly lower heart rate, higher parasympathetic nerve activity, and lower sympathetic nerve activity than walking through the city area. In subjective evaluations, participants were more “comfortable,” “natural,” “relaxed,” and “vigorous” after a walk in the urban park. Furthermore, they exhibited significantly lower levels of negative emotions and anxiety. These findings provide scientific evidence for the physiological and psychological relaxation effects of walking in urban parks during fall. PMID:26569271

  5. The cancer preventive effects of edible mushrooms.

    PubMed

    Xu, Tongtong; Beelman, Robert B; Lambert, Joshua D

    2012-12-01

    An increasing body of scientific literature suggests that dietary components may exert cancer preventive effects. Tea, soy, cruciferous vegetables and other foods have been investigated for their cancer preventive potential. Some non-edible mushrooms like Reishi (Ganoderma lucidum) have a history use, both alone and in conjunction with standard therapies, for the treatment of various diseases including cancer in some cultures. They have shown efficacy in a number of scientific studies. By comparison, the potential cancer preventive effects of edible mushrooms have been less well-studied. With similar content of putative effective anticancer compounds such as polysaccharides, proteoglycans, steroids, etc., one might predict that edible mushrooms would also demonstrate anticancer and cancer preventive activity. In this review, available data for five commonly-consumed edible mushrooms: button mushrooms (Agaricus bisporus), A. blazei, oyster mushrooms (Pleurotus ostreatus), shiitake mushrooms (Lentinus edodes), and maitake (Grifola frondosa) mushrooms is discussed. The results of animal model and human intervention studies, as well as supporting in vitro mechanistic studies are critically evaluated. Weaknesses in the current data and topics for future work are highlighted. PMID:22583406

  6. Physical Activity and the Association With Self-Reported Impairments, Walking Limitations, Fear of Falling, and Incidence of Falls in Persons With Late Effects of Polio.

    PubMed

    Winberg, Cecilia; Brogårdh, Christina; Flansbjer, Ulla-Britt; Carlsson, Gunilla; Rimmer, James; Lexell, Jan

    2015-07-01

    The purpose of this study was to determine the association between physical activity and self-reported disability in ambulatory persons with mild to moderate late effects of polio (N = 81, mean age 67 years). The outcome measures were: Physical Activity and Disability Survey (PADS), a pedometer, Self-Reported Impairments in Persons with Late Effects of Polio Scale (SIPP), Walking Impact Scale (Walk-12), Falls Efficacy Scale-International (FES-I), and self-reported incidence of falls. The participants were physically active on average 158 min per day and walked 6,212 steps daily. Significant associations were found between PADS and Walk-12 (r = -.31, p < .001), and between the number of steps and SIPP, Walk-12, and FES-I (r = -.22 to -.32, p < .05). Walk-12 and age explained 14% of the variance in PADS and FES-I explained 9% of the variance in number of steps per day. Thus, physical activity was only weakly to moderately associated with self-reported disability. PMID:25268608

  7. [The preventive effects of physical activity in the elderly].

    PubMed

    Blain, H; Vuillemin, A; Blain, A; Jeandel, C

    2000-06-24

    PHYSICAL ACTIVITY AND AGING: Physical activity prevents some age-related impairment. Physical activity reduces the decline of physical capacity which remains limited by maximal heart rate, and reduces the incidence of cardiovascular diseases by decreasing and preventing associated risk factors. Physical activity reduces age-related bone loss, its effect being potentialized by hormonal replacement therapy, and improves balance function, leading to a lower incidence of falls and fractures in older subjects. Physical activity helps to preserve nutritional balance and lean mass/fat mass ratio and reduces age-related insulin resistance. Moreover, physical activity has a beneficial influence on psychological function by improving cognitive performances and decreasing incidence of depression. Lastly, physical activity seems to reduce the incidence of several cancers, colic and mammary cancers particularly. PHYSICAL ACTIVITY, QUANTITY AND QUALITY OF LIFE: These multiple actions explain that physical activity, if it's adapted to subject's specificities increases longevity, delay entry in dependence and improves quality of life in older subjects. WHAT ARE THE RECOMMENDED ACTIVITIES: There is a superiority of individualized programs giving greater place to warm-up and associated endurance and resistive exercises intended to improve simultaneously cardiovascular and muscular functions. SPECIAL INTERESTS OF PHYSICAL ACTIVITY IN FRAIL AND VERY OLD SUBJECTS: Throughout its beneficial effects on aerobic capacity, muscular function, social integration, cognitive function and autonomy, physical activity may have a particular interest in frail subjects, when programs are adapted to physical capacities of these subjects and associated with nutritional supplements. PMID:10916538

  8. The nursing rounds system: effect of patient's call light use, bed sores, fall and satisfaction level.

    PubMed

    Saleh, Bassem S; Nusair, Hussam; Al Zubadi, Nariman; Al Shloul, Shams; Saleh, Usama

    2011-06-01

    The nursing round system (NRS) means checking patients on an hourly basis during the A (0700-2200 h) shift and once every 2 h during the B (2200-0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre-Sultan Bin Abdulaziz Humanitarian City-in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients' fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients' satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009-17 February 2010) All Nursing staff on the unit will record each call light and the patient's need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009-17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors' developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. Also, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05). PMID:21605271

  9. Toxic Stress: Effects, Prevention and Treatment

    PubMed Central

    Franke, Hillary A.

    2014-01-01

    Children who experience early life toxic stress are at risk of long-term adverse health effects that may not manifest until adulthood. This article briefly summarizes the findings in recent studies on toxic stress and childhood adversity following the publication of the American Academy of Pediatrics (AAP) Policy Report on the effects of toxic stress. A review of toxic stress and its effects is described, including factors of vulnerability, resilience, and the relaxation response. An integrative approach to the prevention and treatment of toxic stress necessitates individual, community and national focus. PMID:27417486

  10. Selection effects and prevention program outcomes.

    PubMed

    Hill, Laura G; Rosenman, Robert; Tennekoon, Vidhura; Mandal, Bidisha

    2013-12-01

    A primary goal of the paper is to provide an example of an evaluation design and analytic method that can be used to strengthen causal inference in nonexperimental prevention research. We used this method in a nonexperimental multisite study to evaluate short-term outcomes of a preventive intervention, and we accounted for effects of two types of selection bias: self-selection into the program and differential dropout. To provide context for our analytic approach, we present an overview of the counterfactual model (also known as Rubin's causal model or the potential outcomes model) and several methods derived from that model, including propensity score matching, the Heckman two-step approach, and full information maximum likelihood based on a bivariate probit model and its trivariate generalization. We provide an example using evaluation data from a community-based family intervention and a nonexperimental control group constructed from the Washington State biennial Healthy Youth Survey (HYS) risk behavior data (HYS n = 68,846; intervention n = 1,502). We identified significant effects of participant, program, and community attributes in self-selection into the program and program completion. Identification of specific selection effects is useful for developing recruitment and retention strategies, and failure to identify selection may lead to inaccurate estimation of outcomes and their public health impact. Counterfactual models allow us to evaluate interventions in uncontrolled settings and still maintain some confidence in the internal validity of our inferences; their application holds great promise for the field of prevention science as we scale up to community dissemination of preventive interventions. PMID:23417667

  11. Testing the effects of a pharmaceutical program on fall rates in older adults.

    PubMed

    Zanetos, Joanne Marie; Lux, Kathleen Mary; Richardson, Luann G

    2014-01-01

    A pretest-posttest no control group design was used to test knowledge on fall incidence in residents of a rehabilitation center. Twenty-six staff nurses were educated on fundamental geriatric pharmacology. Results of a two-tailed t test showed a significant increase in posttest scores (t test(50) = 3.53, p = .003). Retrospective fall and medication data collected over 2 months in 2011 and 2 months in 2012 were compared. The incidence of falls decreased (44.7%) with total number of residents falling (30.7%) post intervention in 2012. Staff nurses need to have continuing pharmaceutical education and medication management classes about the elderly. PMID:24845093

  12. Effect of compliant flooring on impact force during falls on the hip.

    PubMed

    Laing, Andrew C; Tootoonchi, Iman; Hulme, Paul A; Robinovitch, Stephen N

    2006-07-01

    Compliant flooring represents a promising but understudied strategy for reducing impact force and hip fracture risk due to falls in high-risk environments such as nursing homes, hospitals, gymnasiums, and senior centers. We conducted "pelvis release experiments" with young women (n=15) to determine whether floor stiffness influences peak hip impact force during safe, low-height falls. During the trials, we used a pelvic sling and electromagnet to lift and instantly release the participant from a height of 5 cm above a force plate, which measured the force applied to the hip region during impact. Trials were conducted for rigid floor conditions and with layers of ethylene vinyl acetate foam rubber overlying the floor that we regarded as firm (1.5-cm thick; stiffness=263 kN/m), semifirm (4.5-cm thick; stiffness=95 kN/m), semisoft (7.5-cm thick; stiffness=67 kN/m), and soft (10.5-cm thick; stiffness=59 kN/m). When compared to the rigid condition, peak hip impact force averaged 8% lower in the firm condition and 15% lower in the semifirm condition. Peak forces were not significantly different between the semifirm, semisoft, and soft floor conditions, indicating that a 4.5 cm-thick foam mat provides nearly the same force attenuation as a 10.5 cm-thick mat. These results support the need for laboratory experiments to measure the effect of floor stiffness on postural stability and for clinical trials to determine the effect of compliant flooring on hip fracture incidence in high-risk environments. PMID:16705716

  13. Strategies for Success: New Pathways to Drug Abuse Prevention. Volume 1, Issue 1, Fall/Winter 2006

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2006

    2006-01-01

    Published twice a year and distributed nationwide, "Strategies for Success" keeps readers informed about events and developments in the field of drug testing. It reports the latest research findings on the effectiveness of drug testing as a tool for reducing substance abuse. Each issue also provides a wealth of guidance and resources on student…

  14. Vitamin D: A Review on Its Effects on Muscle Strength, the Risk of Fall, and Frailty

    PubMed Central

    Halfon, Matthieu; Phan, Olivier; Teta, Daniel

    2015-01-01

    Vitamin D is the main hormone of bone metabolism. However, the ubiquitary nature of vitamin D receptor (VDR) suggests potential for widespread effects, which has led to new research exploring the effects of vitamin D on a variety of tissues, especially in the skeletal muscle. In vitro studies have shown that the active form of vitamin D, calcitriol, acts in myocytes through genomic effects involving VDR activation in the cell nucleus to drive cellular differentiation and proliferation. A putative transmembrane receptor may be responsible for nongenomic effects leading to rapid influx of calcium within muscle cells. Hypovitaminosis D is consistently associated with decrease in muscle function and performance and increase in disability. On the contrary, vitamin D supplementation has been shown to improve muscle strength and gait in different settings, especially in elderly patients. Despite some controversies in the interpretation of meta-analysis, a reduced risk of falls has been attributed to vitamin D supplementation due to direct effects on muscle cells. Finally, a low vitamin D status is consistently associated with the frail phenotype. This is why many authorities recommend vitamin D supplementation in the frail patient. PMID:26000306

  15. Adoption of a Tai Chi Intervention, Tai Ji Quan: Moving for Better Balance, for Fall Prevention by Rural Faith-Based Organizations, 2013–2014

    PubMed Central

    Starcher, Rachael W.; Eicher, Jennifer L.; Wilcox, Sara

    2016-01-01

    Background Translating evidence-based, community-delivered, fall-prevention exercise programs into new settings is a public health priority. Community Context Older adults (aged ≥65 y) are at high risk for falls. We conducted a community engagement project in West Virginia to evaluate the adoption of a tai chi exercise program, Tai Ji Quan: Moving for Better Balance, by rural faith-based organizations (FBOs) and exercise instructors by recruiting 20 FBOs and 20 or more exercise instructors and by obtaining input from key stakeholders (representatives of FBOs, community representatives, exercise instructors) regarding potential barriers and facilitators to program adoption. Methods We used both multistage, purposeful random sampling and snowball sampling to recruit FBOs and exercise instructors in 7 West Virginia counties. Two forums were held with stakeholders to identify barriers and facilitators to program adoption. We calculated separate adoption rates for organizations and exercise instructors. Outcome It took up to 3 months to recruit each FBO with an adoption rate of 94%. We made 289 telephone calls, sent 193 emails and 215 letters, distributed brochures and flyers to 69 FBOs, held 118 meetings, and made 20 trips over a period of 31 days (8,933 miles traveled). Nineteen of 22 trained exercise instructors started classes, an instructor adoption rate of 86%. Key issues regarding adoption were the age requirement for participants, trust, education, and competing priorities. Interpretation Although we had recruitment challenges, our adoption rates were similar to or higher than those reported in other studies, and the objectives of the community engagement project were met. Clustering the FBOs and having them located closer geographically to our location may have reduced our resource use, and using a recruitment coordinator from the local community may have enabled us to gain the trust of congregants and clergy support. PMID:27418214

  16. Feeding deterrence and inhibitory effects of bee balm (Monarda didyma) leaves on fall armyworm

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The fall armyworm [Spodoptera frugiperda (J.E. Smith)] is a serious pest of many field and horticulture crops. Because of the many advantages for the use of plant-derived pesticides, we tested whether bee balm (Monarda didyma L.) leaves could have feeding deterrence on fall armyworm. When S. frugipe...

  17. Planting date effects on the yield and nutritive value of fall-grown oat cultivars

    Technology Transfer Automated Retrieval System (TEKTRAN)

    For the dairy industry within the north-central U.S., options for producing emergency forage are limited when late-summer or fall inventories are inadequate, primarily because of the relatively short growing season. Fall-grown cereal crops can fill this niche, but knowing what to plant and when to p...

  18. Effects of fall and spring seeding date and other agronomic factors on infestations of root maggots, Delia spp. (Diptera: Anthomyiidae), in canola.

    PubMed

    Dosdall, L M; Clayton, G W; Harker, K N; O'Donovan, J T; Stevenson, F C

    2006-10-01

    Several agronomic benefits can result from fall seeding of canola (Brassica spp.), but extensive research data are lacking on the potential impact of this practice on infestations of root maggots (Delia spp.) (Diptera: Anthomyiidae), which are major pests of the crop in western Canada. Field experiments making up 13 location by year combinations were conducted in central Alberta, Canada, from 1998 to 2001 to determine the effect of fall versus spring seeding of canola on root maggot damage. Depending on the experiment, interactions with seeding rate, seed treatment, timing of weed removal, and canola species (cultivar) also were investigated. Root maggot damage declined with an increase in seeding rate for plots seeded in May but not in fall or April. Susceptibility to infestation was greater for plants of Brassica rapa L. than Brassica napus L., but seed treatment had no effect on damage by these pests. Combined analysis using data from all experiment by location by year combinations indicated that seeding date had no significant effect on root maggot damage. The extended emergence of Delia spp. adults, which spans the appearance of crop stages vulnerable to oviposition regardless of seeding date, prevented reduced root maggot attack. Covariance analysis demonstrated the importance of increasing seeding rate for reducing root maggot infestations, a practice that can be especially beneficial for May-seeded canola when growing conditions limit the ability of plants to compensate for root maggot damage. Results determined with the small plot studies described here should be validated in larger plots or on a commercial field scale, but both the combined and covariance analyses indicate that seeding canola in fall does not predispose plants to greater damage by larval root maggots than seeding in spring. PMID:17066797

  19. Fall- and spring-applied poultry litter effectiveness as corn fertilizer in the mid-southern United States

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effectiveness of fall- or winter-applied poultry litter, relative to spring-applied litter, as row crop fertilizer in the southern and southeastern US has not been well researched. A 3-yr field research was conducted in northern Mississippi to determine the effectiveness of litter as corn fertil...

  20. Hydrolysis of wheat starch and its effect on the falling number procedure: mathematical model.

    PubMed

    Chang, Shih-Ying; Delwiche, Stephen R; Wang, Nam Sun

    2002-09-30

    A population balance model was developed for wheat starch hydrolysis to simulate the performance parameters of a viscosity-based device, known as the Falling Number instrument. The instrument is widely used as an indirect means to gauge the level of preharvest sprout activity in cereal grains such as wheat and barley. The model consists of three competing kinetics: starch gelatinization, enzymatic hydrolysis, and enzyme thermal deactivation. Using established principles of starch rheology and fluid mechanics, the model simulates the velocity profiles of the falling stirrer, starch gel viscosity, and the Falling Number readings at various levels of alpha-amylase. Model predictions for the velocity of the stirrer at any time during the downward fall, as well as the prediction of the total time needed for the fall, defined as the Falling Number, were in fair agreement with experimental measurements. There was better agreement between the modeled viscosity and the final viscosity of the starch gel as measured by a precision rheometer than there was with the measured Falling Number. PMID:12209799

  1. Survival of falling robots

    NASA Technical Reports Server (NTRS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  2. Survival of falling robots

    NASA Astrophysics Data System (ADS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  3. Experiments in Free Fall

    ERIC Educational Resources Information Center

    Art, Albert

    2006-01-01

    A model lift containing a figure of Albert Einstein is released from the side of a tall building and its free fall is arrested by elastic ropes. This arrangement allows four simple experiments to be conducted in the lift to demonstrate the effects of free fall and show how they can lead to the concept of the equivalence of inertial and…

  4. Long-run effects of falling cellulosic ethanol production costs on the US agricultural economy

    DOE PAGESBeta

    Bryant, Henry L.; Campiche, Jody L.; Richardson, James W.

    2010-03-09

    Renewable energy production has been expanding at a rapid pace. New advances in cellulosic ethanol technologies have the potential to displace the use of petroleum as a transportation fuel, and could have significant effects on both the agricultural economy and the environment. In this letter, the effects of falling cellulosic ethanol production costs on the mix of ethanol feedstocks employed and on the US agricultural economy are examined. Results indicate that, as expected, cellulosic ethanol production increases by a substantial amount as conversion technology improves. Corn production increases initially following the introduction of cellulosic technology, because producers enjoy new revenuemore » from sales of corn stover. After cellulosic ethanol production becomes substantially cheaper, however, acres are shifted from corn production to all other agricultural commodities. Essentially, this new technology could facilitate the exploitation of a previously under-employed resource (corn stover), resulting in an improvement in overall welfare. Thus in the most optimistic scenario considered, 68% of US ethanol is derived from cellulosic sources, coarse grain production is reduced by about 2%, and the prices of all food commodities are reduced modestly.« less

  5. Long-run effects of falling cellulosic ethanol production costs on the US agricultural economy

    SciTech Connect

    Bryant, Henry L.; Campiche, Jody L.; Richardson, James W.

    2010-03-09

    Renewable energy production has been expanding at a rapid pace. New advances in cellulosic ethanol technologies have the potential to displace the use of petroleum as a transportation fuel, and could have significant effects on both the agricultural economy and the environment. In this letter, the effects of falling cellulosic ethanol production costs on the mix of ethanol feedstocks employed and on the US agricultural economy are examined. Results indicate that, as expected, cellulosic ethanol production increases by a substantial amount as conversion technology improves. Corn production increases initially following the introduction of cellulosic technology, because producers enjoy new revenue from sales of corn stover. After cellulosic ethanol production becomes substantially cheaper, however, acres are shifted from corn production to all other agricultural commodities. Essentially, this new technology could facilitate the exploitation of a previously under-employed resource (corn stover), resulting in an improvement in overall welfare. Thus in the most optimistic scenario considered, 68% of US ethanol is derived from cellulosic sources, coarse grain production is reduced by about 2%, and the prices of all food commodities are reduced modestly.

  6. Long-run effects of falling cellulosic ethanol production costs on the US agricultural economy

    NASA Astrophysics Data System (ADS)

    Campiche, Jody L.; Bryant, Henry L.; Richardson, James W.

    2010-01-01

    Renewable energy production has been expanding at a rapid pace. New advances in cellulosic ethanol technologies have the potential to displace the use of petroleum as a transportation fuel, and could have significant effects on both the agricultural economy and the environment. In this letter, the effects of falling cellulosic ethanol production costs on the mix of ethanol feedstocks employed and on the US agricultural economy are examined. Results indicate that, as expected, cellulosic ethanol production increases by a substantial amount as conversion technology improves. Corn production increases initially following the introduction of cellulosic technology, because producers enjoy new revenue from sales of corn stover. After cellulosic ethanol production becomes substantially cheaper, however, acres are shifted from corn production to all other agricultural commodities. Essentially, this new technology could facilitate the exploitation of a previously under-employed resource (corn stover), resulting in an improvement in overall welfare. In the most optimistic scenario considered, 68% of US ethanol is derived from cellulosic sources, coarse grain production is reduced by about 2%, and the prices of all food commodities are reduced modestly.

  7. Central and Peripheral Visual Impairment and the Risk of Falls and Falls with Injury

    PubMed Central

    Patino, Cecilia M.; McKean-Cowdin, Roberta; Azen, Stanley P.; Allison, Jessica Chung; Choudhury, Farzana; Varma, Rohit

    2009-01-01

    Objective To evaluate central and peripheral visual impairment as independent risk factors for falls and falls with injury among adults. Design Population-based prospective cohort study. Participants A total of 3,203 LALES participants. Methods Baseline presenting binocular central distance acuity was measured and impairment was classified as mild (20/40–20/63), moderate/severe (20/80 or worse). Peripheral visual impairment was classified as mild (−6dBFalls and falls with injury in the past 12 months were assessed by self-report at 4-year follow-up visit. Results Out of 3,203 individuals, 19% reported falls and 10% falls with injury; participants with falls were more likely to: be ≥ 60 years of age, be female, report lower income, have more than two co-morbidities, report alcohol use, report wearing bifocal glasses and report obesity. Among those who reported falls, 7% had central visual impairment (visual acuity≥20/40) compared to 4% who did not report falls; and 49% had peripheral visual impairment (mean deviation<−2dB) compared to 39% of those who did not report falls (both p-values<.0001). After adjusting for confounders, moderate to severe central and peripheral visual impairment were associated with increased risk for falls (odds ratio 2.36 95% confidence interval 1.02–5.45, p-trend= .04 and odds ratio 1.42 95% confidence interval 1.06–1.91, p-trend= .01, respectively) and with falls with injury (odds ratio 2.76 95% confidence interval 1.10–7.02, p-value= .03, and odds ratio 1.40 95% confidence interval .94–2.05, p-trend= .04, respectively). Conclusion Both central and peripheral visual impairment were independently associated with increased risk for falls and falls with injury in a dose-response manner. Although vision related interventions for preventing falls have mainly focused on correcting central visual impairment, this

  8. Preventing Falls and Related Fractures

    MedlinePlus

    ... Reflexes are automatic responses to stimuli in the environment. Examples of reflexes include quickly slamming on the ... cannot be corrected completely, making even the home environment hazardous. Medications That May Increase the Risk of ...

  9. Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis

    PubMed Central

    Burton, Elissa; Cavalheri, Vinicius; Adams, Richard; Oakley Browne, Colleen; Bovery-Spencer, Petra; Fenton, Audra M; Campbell, Bruce W; Hill, Keith D

    2015-01-01

    Objective The objective of this systematic review and meta-analysis is to evaluate the effectiveness of exercise programs to reduce falls in older people with dementia who are living in the community. Method Peer-reviewed articles (randomized controlled trials [RCTs] and quasi-experimental trials) published in English between January 2000 and February 2014, retrieved from six electronic databases – Medline (ProQuest), CINAHL, PubMed, PsycInfo, EMBASE and Scopus – according to predefined inclusion criteria were included. Where possible, results were pooled and meta-analysis was conducted. Results Four articles (three RCT and one single-group pre- and post-test pilot study) were included. The study quality of the three RCTs was high; however, measurement outcomes, interventions, and follow-up time periods differed across studies. On completion of the intervention period, the mean number of falls was lower in the exercise group compared to the control group (mean difference [MD] [95% confidence interval {CI}] =−1.06 [−1.67 to −0.46] falls). Importantly, the exercise intervention reduced the risk of being a faller by 32% (risk ratio [95% CI] =0.68 [0.55–0.85]). Only two other outcomes were reported in two or more of the studies (step test and physiological profile assessment). No between-group differences were observed in the results of the step test (number of steps) (MD [95% CI] =0.51 [−1.77 to 2.78]) or the physiological profile assessment (MD [95% CI] =−0.10 [−0.62 to 0.42]). Conclusion Findings from this review suggest that an exercise program may potentially assist in preventing falls of older people with dementia living in the community. However, further research is needed with studies using larger sample sizes, standardized measurement outcomes, and longer follow-up periods, to inform evidence-based recommendations. PMID:25709416

  10. Host effects on fitness in two strains of the fall armyworm (Noctuidae) and a parasitoid of the family Eulophidae

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The fall armyworm is known to be a pest of many species of the family Poaceae. In this study we compared the effects of two host plants (Zea mays and Cynodon nlemfuensis var. nlemfuensis) on survivorship of two strains of the FAW and the parasitoid Euplectrus platyhypenae....

  11. Effect of the living environment on falls among the elderly in Thailand.

    PubMed

    Sophonratanapokin, Benjawan; Sawangdee, Yothin; Soonthorndhada, Kusol

    2012-11-01

    The household environment influences the health of the elderly. We studied home hazards and living arrangements and their association with falls among the elderly in Thailand. The data were obtained from a national survey among the elderly in Thailand conducted by the National Statistical Office in 2007. The survey asked about a history of falls, the household environment and possible risk factors for falls. The survey was conducted in 26,689 subjects aged > or = 60 years. The factors associated with a chance of falls were: a slippery floor in the first storey of the house (OR 1.39; 95% CI 1.21-1.59, p = 0.000), a slippery floor in the bathroom or toilet (OR 1.32; 95% CI 1.16-1.49, p = 0.000) and bathroom or toilet located outside the house (OR 1.23; 95%CI 1.12-1.35, p = 0.000). Elderly people who lived with spouse had a 32% lower chance (OR 0.68; 95%CI 0.59-0.78, p = 0.000) of experiencing a fall than those who lived alone in the house. PMID:23413718

  12. Pre-landing muscle timing and post-landing effects of falling with continuous vision and in blindfold conditions.

    PubMed

    Liebermann, Dario G; Goodman, David

    2007-04-01

    The present study examined the effect of continuous vision and its occlusion in timing of pre-landing actions during free falls. When vision is occluded, muscle activation is hypothesized to start relative to onset of the fall. However, when continuous vision is available onset of action is hypothesized to be relative to the moment of touchdown. Six subjects performed 6 randomized sets of 6 trials after becoming familiar with the task. The 36 trials were divided in 2 visual conditions (vision and blindfold) and 3 heights of fall (15, 45 and 75 cm). EMG activity was recorded from the gastrocnemius and rectus femoris muscles during the falls. The latency of onset (L(o)) and the lapse from EMG onset to touchdown (T(c)) were obtained from these muscles. Vertical forces were recorded to assess the effects of pre-landing activity on the impacts at collision with and without continuous vision. Peak amplitude (F(max)), time to peak (T(max)) and peak impulse normalized to momentum (I(norm)) were used as outcome measures. Within flight time ranges of approximately 50-400 ms, the results showed that L(o) and T(c) follow a similar linear trend whether continuous vision was available or occluded. However, the variability of T(c) for each of the muscles was larger in the vision occluded condition. Analyses of variance showed that the rectus femoris muscle started consistently earlier in no vision trials. Finally, impact forces were not different in vision or blindfold conditions, and thus, they were not affected by minor differences in the timing of muscles prior to landing. Thus, it appears that knowing the surroundings before falling may help to reduce the need for a continuous visual input. The relevance of such input cannot be ruled out for falls from high landing heights, but cognitive factors (e.g., attention to specific cues and anticipation of a fall) may play a dominant role in timing actions during short duration falls encountered daily. PMID:16600637

  13. Perchlorate in dust fall and indoor dust in Malta: An effect of fireworks.

    PubMed

    Vella, Alfred J; Chircop, Cynthia; Micallef, Tamara; Pace, Colette

    2015-07-15

    We report on the presence of perchlorate in the settleable dust of Malta, a small central Mediterranean island. Both dust fall collected directly as it precipitated from atmosphere over a period of one month and deposited indoor dust from domestic residences were studied. Perchlorate was determined by ion chromatography of water extracts of the collected dusts. Dust fall was collected from 43 towns during 2011 to 2013 and indoor dust was sampled from homes in the same localities. Perchlorate was detected in 108 of 153 samples of dust fall (71%) and in 28 of 37 indoor dust samples (76%). Detectable perchlorate in dust fall ranged from 0.52μgg(-1) to 561μgg(-1) with a median value of 6.2μgg(-1); in indoor dust, levels were from 0.79μgg(-1) to 53μgg(-1) with a median value of 7.8μgg(-1), the highest recorded anywhere to date. Statistical analysis suggested that there was no significant difference in perchlorate content of indoor dust and dust fall. Perchlorate levels in dust fall escalate during the summer in response to numerous religious feasts celebrated with fireworks and perchlorate persists at low μgg(-1) concentrations for several months beyond the summer festive period. In Malta, perchlorate derives exclusively from KClO4, imported for fireworks manufacture. Its residue in dust presents an exposure risk to the population, especially via ingestion by hand to mouth transfer. Our results suggest that wherever intensive burning of fireworks takes place, the environmental impact may be much longer lived than realised, mainly due to re-suspension and deposition of contaminated settled dust in the urban environment. PMID:25828411

  14. Development of a Pediatric Fall Risk And Injury Reduction Program.

    PubMed

    Kramlich, Debra L; Dende, Denise

    2016-01-01

    Fall prevention programs that include reliable, valid, and clinically tested screening tools have demonstrated more positive effects for adult and geriatric populations than those not including such assessment. In contrast, because falling is a natural part of growth and development for pediatric patients, progression toward effective prevention programs for this population has proven to be a challenge; a significant impediment is the lack of definition regarding what constitutes a reportable fall. This project explored pediatric health care providers' perceptions of patient falls in order to define a reportable pediatric fall and inform development of a prevention program. A concept analysis of defining attributes, antecedents, and consequences of pediatric falls from literature formed the basis for a set of questions; a convenience sample of 28 pediatric health care providers in an acute care hospital in New England participated in six moderated focus groups. Constant comparison method was used to code the qualitative data and develop themes. Participants unanimously agreed on several points; as expected, their years of experience in pediatric practice provided valuable insight. Three major themes emerged: patient characteristics, caregiver characteristics, and environmental characteristics. Based on factors identified by staff, a screening tool was adopted and integrated into the electronic medical record. Staff were actively engaged in developing definitions, selecting tools, and identifying next steps toward a comprehensive fall reduction program for their patients. As a result, they have embraced changes and advocated successfully for endorsement by the organization. PMID:27254976

  15. Students fall for Fall Meeting

    NASA Astrophysics Data System (ADS)

    Smedley, Kara

    2012-02-01

    From Boston to Beijing, thousands of students traveled to San Francisco for the 2011 AGU Fall Meeting. Of those who participated, 183 students were able to attend thanks to AGU's student travel grant program, which assists students with travel costs and seeks to enrich the meeting through ethnic and gender diversity. Students at Fall Meeting enjoyed a variety of programs and activities designed to help them better network with their peers, learn about new fields, and disseminate their research to the interested public. More than 800 students attended AGU's first annual student mixer, sharing drinks and ideas with fellow student members and future colleagues as well as forging new friendships and intellectual relationships.

  16. Developmental approach to prevent adolescent suicides: research pathways to effective upstream preventive interventions.

    PubMed

    Wyman, Peter A

    2014-09-01

    The 2012 National Strategy for Suicide Prevention expands the current suicide prevention paradigm by including a strategic direction aimed at promoting healthy populations. Childhood and adolescence are key suicide prevention window periods, yet knowledge of suicide prevention pathways through universal interventions is limited (Aspirational Goal 11). Epidemiologic evidence suggests that prevention programs in normative social systems such as schools are needed for broad suicide prevention impact. Prevention trial results show that current universal prevention programs for children and young adolescents are effective in reducing adolescent emotional and behavioral problems that are risk factors for suicidal behavior, and in the case of the Good Behavior Game, suicide attempts. A developmentally sequenced upstream suicide prevention approach is proposed: (1) childhood programs to strengthen a broad set of self-regulation skills through family and school-based programs, followed by (2) adolescent programs that leverage social influences to prevent emerging risk behaviors such as substance abuse and strengthen relationships and skills. Key knowledge breakthroughs needed are evidence linking specific intervention strategies to reduced suicidal behaviors and mortality and their mechanisms of action. Short- and long-term objectives to achieve these breakthroughs include combining evidence from completed prevention trials, increasing motivators for prevention researchers to assess suicide-related outcome, and conducting new trials of upstream interventions in populations using efficient designs acceptable to communities. In conclusion, effective upstream prevention programs have been identified that modify risk and protective factors for adolescent suicide, and key knowledge breakthroughs can jump-start progress in realizing the suicide prevention potential of specific strategies. PMID:25145747

  17. Nutrient losses from fall- and winter-applied manure: effects of timing and soil temperature

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil temperature is a major environmental factor that affects meltwater and precipitation infiltration and nutrient cycling. The objective of this study was to determine nutrient losses in runoff and leachate from fall- and winter-applied dairy manure as affected by soil temperature at the time of a...

  18. Nutrient losses from Fall and Winter-applied manure: Effects of timing and soil temperature

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil temperature is a major environmental factor that affects both the infiltration of meltwater and precipitation, and nutrient cycling. The objectives of this study were to determine nutrient losses in runoff and leachate from fall and winter-applied dairy manure based on the soil temperature at t...

  19. Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

    PubMed

    Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

    2008-06-01

    This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented. PMID:18351452

  20. Preventing Challenging Behaviors in Preschool: Effective Strategies for Classroom Teachers

    ERIC Educational Resources Information Center

    Coleman, Janelle C.; Crosby, Megan G.; Irwin, Heather K.; Dennis, Lindsay R.; Simpson, Cynthia G.; Rose, Chad A.

    2013-01-01

    This article provides practical strategies and techniques that early childhood educators can implement in their classrooms to effectively manage challenging behaviors. The specific strategies addressed fall under the following categories: (a) classroom management, (b) reinforcement, and (c) communication. Suggestions are made for how parents can…

  1. The effects of caffeine on the postprandial fall of blood pressure in the elderly.

    PubMed

    Lenders, J W; Morre, H L; Smits, P; Thien, T

    1988-07-01

    In a double-blind placebo-controlled study, we examined the effect of caffeine pretreatment on the haemodynamic and humoral changes after a standardized breakfast in 15 healthy elderly subjects (mean age 75.4 +/- 6.6 years). After placebo, the preprandial blood pressure did not change and the postprandial blood pressure declined by a maximum of 6.1%. After oral ingestion of 250 mg caffeine, 60 min before breakfast, the preprandial blood pressure increased by 12.5%. Although the decrease of the postprandial blood pressure was not altered, blood pressure remained above its basal value. The increase in plasma noradrenaline after the meal was similar in the placebo and the caffeine tests. Plasma adrenaline decreased after placebo (-19%) but did not change after caffeine. Thus, despite the unchanged decrease of the postprandial blood pressure, the preprandial pressor effect of caffeine prevented the decline of the postprandial blood pressure below its baseline value. The clinical relevance of this finding has still to be determined. PMID:3177083

  2. Effect of the ash Fall on the Human Health at Colima Volcano During 2005-2006.

    NASA Astrophysics Data System (ADS)

    Nieto, A.; Martin, A. L.; Fonseca, R.; Garcia, M.

    2007-05-01

    Colima Volcano in western Mexico had several small ash emitting eruptions during 2005-2006. In this time period we studied the impact of the ash fall on human health through field observations, interviews and health data processing. The volcano was most active in May-June 2005. Data from 15.000 medical records of the Colima and Jalisco State Health Departments show two main health problems in humans during this time: Conjunctivitis was detected in 1,933 people and respiratory disease in 12,630 people in an area of 1,841,283 km2 which was affected by small amounts of ash fall near the volcano in 2005. Ash emissions from Colima Volcano correlate well with increased affections. When emissions increased so did the frequency of these health problems in the population.

  3. Brainstem auditory evoked responses in man. 1: Effect of stimulus rise-fall time and duration

    NASA Technical Reports Server (NTRS)

    Hecox, K.; Squires, N.; Galambos, R.

    1975-01-01

    Short latency (under 10 msec) evoked responses elicited by bursts of white noise were recorded from the scalp of human subjects. Response alterations produced by changes in the noise burst duration (on-time) inter-burst interval (off-time), and onset and offset shapes are reported and evaluated. The latency of the most prominent response component, wave V, was markedly delayed with increases in stimulus rise-time but was unaffected by changes in fall-time. The amplitude of wave V was insensitive to changes in signal rise-and-fall times, while increasing signal on-time produced smaller amplitude responses only for sufficiently short off-times. It is concluded that wave V of the human auditory brainstem evoked response is solely an onset response.

  4. Sleep in fall/winter seasonal affective disorder: effects of light and changing seasons.

    PubMed

    Anderson, J L; Rosen, L N; Mendelson, W B; Jacobsen, F M; Skwerer, R G; Joseph-Vanderpool, J R; Duncan, C C; Wehr, T A; Rosenthal, N E

    1994-05-01

    Disturbances of sleep are a hallmark of seasonal affective disorders (SAD), as they are of other mood disorders. Fall/winter SAD patients most often report hypersomnia. Among responses of 293 SAD patients on a symptom questionnaire, complaints of winter hypersomnia (80%) greatly exceeded insomnia (10%), hypersomnia plus insomnia (5%), or no sleep difficulty (5%). Increased sleep length in fall/winter is not unique to SAD. Among 1571 individuals across four latitudes surveyed at random from the general population, winter sleep increases of < or = 2 hr/day relative to summer were reported by nearly half. However, hypersomnia had a low correlation (r = 0.29) with the total number of other SAD symptoms that were reported in this sample. Ten SAD patients kept daily sleep logs across 1 yr that showed increases in fall and winter (sleeping most in October; least in May) whose maximum averaged 2.7 hr per day more weekend sleep than in spring and summer. These winter increases might have been somewhat attenuated since most received light therapy during part of the winter. Nocturnal EEG recordings of depressed SAD patients in winter showed decreased sleep efficiency, decreased delta sleep percentage, and increased REM density (but normal REM latency) in comparison with recordings: (1) from themselves in summer; (2) from themselves after > or = 9 days of light therapy; or (3) from age- and gender-matched healthy controls. Thus, the extent of fall/winter oversleeping recorded by our SAD patients did not differ dramatically from that reported by the general population, but sleep complaints of our SAD patients have been accompanied by features of sleep architecture that are different from healthy controls and are reversed by summer or by bright-light therapy. PMID:8064650

  5. Lava Falls Rapid in Grand Canyon; effects of late Holocene debris flows on the Colorado River

    USGS Publications Warehouse

    Webb, Robert H.; Melis, Theodore S.; Griffiths, Peter G.; Elliott, John G.; Cerling, Thure E.; Poreda, Robert J.; Wise, Thomas W.; Pizzuto, James E.

    1999-01-01

    Lava Falls Rapid is the most formidable reach of whitewater on the Colorado River in Grand Canyon and is one of the most famous rapids in the world. Debris flows in 1939, 1954, 1955, 1966, and 1995, as well as prehistoric events, completely changed flow through the rapid. Floods cleared out much of the increased constrictions, but releases from Glen Canyon Dam, including the 1996 controlled flood, are now required to remove the boulders deposited by the debris flows.

  6. Research on patient safety: falls and medications.

    PubMed

    Boddice, Sandra Dawn; Kogan, Polina

    2009-10-01

    Below you will find summaries of published research describing investigations into patient safety issues related to falls and medications. The first summary provides details on the incidence of falls associated with the use of walkers and canes. This is followed by a summary of a fall-prevention intervention study that evaluated the effectiveness of widespread dissemination of evidence-based strategies in a community in Connecticut. The third write up provides information on three classes of medications that are associated with a significant number of emergency room visits. The last summary describes a pharmacist-managed medication reconciliation intervention pilot program. For additional details about the study findings and interventions, we encourage readers to review the original articles. PMID:19820661

  7. The Effects of Medicaid and CHIP Policy Changes on Receipt of Preventive Care among Children

    PubMed Central

    Kenney, Genevieve M; Marton, James; Klein, Ariel E; Pelletier, Jennifer E; Talbert, Jeffery

    2011-01-01

    Objective To examine changes in children's receipt of well-child and preventive dental care in Medicaid/Children's Health Insurance Program (CHIP) in two states that adopted policies aimed at promoting greater preventive care receipt. Data Sources The 2004–2008 Medicaid/CHIP claims and enrollment data from Idaho and Kentucky. Study Design Logistic and hazard pre–post regression models, controlling for age, gender, race/ethnicity, and eligibility category. Data Extraction Methods Claims and enrollment data were de-identified and merged. Principal Findings Increased reimbursement had a small, positive association with well-child care in Idaho, but no consistent effects were found in Kentucky. A premium forgiveness program in Idaho was associated with a substantial increase (between 20 and 113 percent) in receipt of any well-child care and quicker receipt of well-child care following enrollment. In Kentucky, children saw modest increases in receipt of preventive dental care and received such care more quickly following increased dental reimbursement, while the move to managed care in Idaho was associated with a small increase in receipt of preventive dental care. Conclusions Policy changes such as reimbursement increases, incentives, and delivery system changes can lead to increases in preventive care use among children in Medicaid and CHIP, but reported preventive care receipt still falls short of recommended levels. PMID:21054374

  8. Bullying: Effective Strategies for Its Prevention

    ERIC Educational Resources Information Center

    Scarpaci, Richard T.

    2006-01-01

    Some people view bullying as a normal aspect of childhood; teachers who prevent bullying know that this is not true. Bullying is a deliberate act that hurts young victims, both emotionally and physically. Aside from the victims, bullying affects people around them by distracting, intimidating, and upsetting them. Basically, bullying in the…

  9. The Moderating Effects of School Climate on Bullying Prevention Efforts

    ERIC Educational Resources Information Center

    Low, Sabina; Van Ryzin, Mark

    2014-01-01

    Bullying prevention efforts have yielded mixed effects over the last 20 years. Program effectiveness is driven by a number of factors (e.g., program elements and implementation), but there remains a dearth of understanding regarding the role of school climate on the impact of bullying prevention programs. This gap is surprising, given research…

  10. Prevention

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Prevention Basic Facts & Information Some factors that affect your ... control of the things that you can change. Preventive Recommendations for Adults Aged 65 and Older The ...

  11. The Effects of Augmented Reality-based Otago Exercise on Balance, Gait, and Falls Efficacy of Elderly Women

    PubMed Central

    Yoo, Ha-na; Chung, EunJung; Lee, Byoung-Hee

    2013-01-01

    [Purpose] The purpose of this study was to determine the effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. [Subjects] The subjects were 21 elderly women, who were randomly divided into two groups: an augmented reality-based Otago exercise group of 10 subjects and an Otago exercise group of 11 subjects. [Methods] All subjects were evaluated for balance (Berg Balance Scale, BBS), gait parameters (velocity, cadence, step length, and stride length), and falls efficacy. Within 12 weeks, Otago exercise for muscle strengthening and balance training was conducted three times, for a period of 60 minutes each, and subjects in the experimental group performed augmented reality-based Otago exercise. [Results] Following intervention, the augmented reality-based Otago exercise group showed significant increases in BBS, velocity, cadence, step length (right side), stride length (right side and left side) and falls efficacy. [Conclusion] The results of this study suggest the feasibility and suitability of this augmented reality-based Otago exercise for elderly women. PMID:24259856

  12. Effects of a Multicomponent Exercise Program on Spatiotemporal Gait Parameters, Risk of Falling and Physical Activity in Dementia Patients

    PubMed Central

    Perrochon, Anaïck; Tchalla, Achille E.; Bonis, Joelle; Perucaud, Florian; Mandigout, Stéphane

    2015-01-01

    Background Exercise programs are presumed to rehabilitate gait disorders and to reduce the risk of falling in dementia patients. This study aimed to analyze the specific effects of multicomponent exercise on gait disorders and to determine the association between gait impairments and the risk of falling in dementia patients before and after intervention. Methods We conducted an 8-week multicomponent exercise program in 16 dementia patients (age 86.7 ± 5.4 years). All participants were assessed several times for gait analysis (Locométrix®), Tinetti score and physical activity (Body Media SenseWear® Pro armband). Results After 8 weeks of the exercise program, the mean gait speed was 0.12 m/s faster than before the intervention (0.55 ± 0.17 vs. 0.67 ± 0.14 m/s). The multicomponent exercise program improved gait performance and Tinetti score (p < 0.05). Gait performance (gait speed, stride length) was correlated with the Tinetti score (p < 0.05). Conclusion Analysis of spatiotemporal gait parameters using an accelerometer method provided a quick and easy tool to estimate the benefits of an exercise program and the risk of falling. PMID:26557134

  13. Counterintuitive effect of fall mixed layer deepening on eukaryotic new production in the Sargasso Sea

    NASA Astrophysics Data System (ADS)

    Fawcett, S. E.; Lomas, M. W.; Ward, B. B.; Sigman, D. M.

    2012-12-01

    The Sargasso Sea is characterized by a short period of deep vertical mixing in the late winter and early spring, followed by strong thermal stratification during the summer. Stratification persists into the fall, impeding the upward flux of nitrate from depth so that recycled forms of nitrogen (N) such as ammonium are thought to support most primary production. We collected particles from surface waters during March, July, October, and December, used flow cytometry to separate the prokaryotic and eukaryotic phytoplankton, and analyzed their respective 15N/14N. In all months, the 15N/14N of the prokaryotic genera, Prochlorococcus and Synechococcus, was low, indicative of reliance on recycled N throughout the year. In July, the 15N/14N of eukaryotic phytoplankton was variable but consistently higher than that of the prokaryotes, reflecting eukaryotic consumption of subsurface nitrate. Two eukaryotic profiles from October and December were similar to those from July. In three other fall profiles, the eukaryotes had a 15N/14N similar to that of the prokaryotes, suggesting a switch toward greater reliance on recycled N. This change in the dominant N source supporting eukaryotic production appears to be driven by the density structure of the upper water column. The very shallow low-density surface "mixed layer" (≤20 m) that develops in early-to-mid summer does not contribute to stratification at the base of the euphotic zone, and subsurface nitrate can mix up into the lower euphotic zone, facilitating continued production. The deepening of the mixed layer into the fall, typically taken as an indication of weaker overall stratification, actually strengthens the isolation of the euphotic zone as a whole, reducing the upward supply of nitrate to the photosynthetically active layer. The same counterintuitive dynamic explains the latitudinal patterns in a set of three October depth profiles. Two northern stations (32°N and 27°N) were characterized by a thick, low

  14. Effects of communal exercise with visual and auditory feedback provided by a smart application on gait ability and fear of falling in Parkinson's disease patients.

    PubMed

    Park, Yun-Jin

    2014-10-01

    Parkinson's disease is a chronically developing neurodegenerative disease showing typical motor symptoms of the following triad: resting tremor, freezing of gait, and bradykinesia-hypokinesia. In the present study, we investigated the effects of a communal exercise program, using the visual and auditory feedback provided by a smart application, to assess gait ability, fear of falling, and fall efficacy in Parkinson's disease patients. Subjects consisted of 29 Parkinson's disease patients who were non-demented individuals. The subjects were randomly divided into three groups: the control group (n= 9, CG), the communal exercise group using the smart application (n= 10, CCEG), and the individual exercise group using the smart application (n= 10, ICEG). The communal exercise program consisted of a warm up (10 min) followed by communal exercise using the smart application (40 min), and a cool down (10 min) for 3 days per week over 10 weeks. The results presented here show that velocity and cadence were significantly increased among groups. Step and stride length were significantly increased among times. Fear of falling and fall efficacy were significantly different among groups and times. In particular, fear of falling was lower and fall efficacy was higher in the CCEG than in the ICEG and CG. These findings indicate that 10 weeks of the communal exercise program using the smart application can be effective in improving gait ability, fear of falling, and fall efficacy in Parkinson's disease patients. PMID:25426465

  15. Automatic Fall Monitoring: A Review

    PubMed Central

    Pannurat, Natthapon; Thiemjarus, Surapa; Nantajeewarawat, Ekawit

    2014-01-01

    Falls and fall-related injuries are major incidents, especially for elderly people, which often mark the onset of major deterioration of health. More than one-third of home-dwelling people aged 65 or above and two-thirds of those in residential care fall once or more each year. Reliable fall detection, as well as prevention, is an important research topic for monitoring elderly living alone in residential or hospital units. The aim of this study is to review the existing fall detection systems and some of the key research challenges faced by the research community in this field. We categorize the existing platforms into two groups: wearable and ambient devices; the classification methods are divided into rule-based and machine learning techniques. The relative merit and potential drawbacks are discussed, and we also outline some of the outstanding research challenges that emerging new platforms need to address. PMID:25046016

  16. Will it rise or will it fall? Managing the complex effects of urbanization on base flow

    USGS Publications Warehouse

    Bhaskar, Aditi; Beesley, Leah; Burns, Matthew J.; Fletcher, T. D.; Hamel, Perrine; Oldham, Carolyn; Roy, Allison

    2016-01-01

    Sustaining natural levels of base flow is critical to maintaining ecological function as stream catchments are urbanized. Research shows a variable response of stream base flow to urbanization, with base flow or water tables rising in some locations, falling in others, or elsewhere remaining constant. The variable baseflow response is due to the array of natural (e.g., physiographic setting and climate) and anthropogenic (e.g., urban development and infrastructure) factors that influence hydrology. Perhaps as a consequence of this complexity, few simple tools exist to assist managers to predict baseflow change in their local urban area. This paper addresses this management need by presenting a decision support tool. The tool considers the natural vulnerability of the landscape, together with aspects of urban development in predicting the likelihood and direction of baseflow change. Where the tool identifies a likely increase or decrease it guides managers toward strategies that can reduce or increase groundwater recharge, respectively. Where the tool finds an equivocal result, it suggests a detailed water balance be performed. The decision support tool is embedded within an adaptive-management framework that encourages managers to define their ecological objectives, assess the vulnerability of their ecological objectives to changes in water table height, and monitor baseflow responses to urbanization. We trial our framework using two very different case studies: Perth, Western Australia, and Baltimore, Maryland, USA. Together, these studies show how pre-development water table height, climate and geology together with aspects of urban infrastructure (e.g., stormwater practices, leaky pipes) interact such that urbanization has overall led to rising base flow (Perth) and falling base flow (Baltimore). Greater consideration of subsurface components of the water cycle will help to protect and restore the ecology of urban freshwaters.

  17. Falls - Multiple Languages: MedlinePlus

    MedlinePlus

    ... السقوط في المستشفى - العربية Bilingual PDF Health Information Translations Safety Tips to Prevent Falls at Home (Arabic) العربية Bilingual PDF Health Information Translations Bosnian (Bosanski) Preventing Falls in the Hospital Sprječavanje ...

  18. The effects of high frequency subthalamic stimulation on balance performance and fear of falling in patients with Parkinson's disease

    PubMed Central

    Nilsson, Maria H; Fransson, Per-Anders; Jarnlo, Gun-Britt; Magnusson, Måns; Rehncrona, Stig

    2009-01-01

    Background Balance impairment is one of the most distressing symptoms in Parkinson's disease (PD) even with pharmacological treatment (levodopa). A complementary treatment is high frequency stimulation in the subthalamic nucleus (STN). Whether STN stimulation improves postural control is under debate. The aim of this study was to explore the effects of STN stimulation alone on balance performance as assessed with clinical performance tests, subjective ratings of fear of falling and posturography. Methods Ten patients (median age 66, range 59–69 years) with bilateral STN stimulation for a minimum of one year, had their anti-PD medications withdrawn overnight. Assessments were done both with the STN stimulation turned OFF and ON (start randomized). In both test conditions, the following were assessed: motor symptoms (descriptive purposes), clinical performance tests, fear of falling ratings, and posturography with and without vibratory proprioceptive disturbance. Results STN stimulation alone significantly (p = 0.002) increased the scores of the Berg balance scale, and the median increase was 6 points. The results of all timed performance tests, except for sharpened Romberg, were significantly (p ≤ 0.016) improved. The patients rated their fear of falling as less severe, and the total score of the Falls-Efficacy Scale(S) increased (p = 0.002) in median with 54 points. All patients completed posturography when the STN stimulation was turned ON, but three patients were unable to do so when it was turned OFF. The seven patients with complete data showed no statistical significant difference (p values ≥ 0.109) in torque variance values when comparing the two test situations. This applied both during quiet stance and during the periods with vibratory stimulation, and it was irrespective of visual input and sway direction. Conclusion In this sample, STN stimulation alone significantly improved the results of the clinical performance tests that mimic activities in

  19. [Effective interventions to prevent child injuries: a review of the literature].

    PubMed

    Nguyen Thanh, Viêt; Clément, Juliette; Thélot, Bertrand; Richard, Jean-Baptiste; Lamboy, Béatrice; Arwidson, Pierre

    2015-01-01

    Child injuries represent an important public health problem. The aim of this paper is to review the current scientific knowledge on interventions designed to prevent child injuries. The current state of knowledge in this area was assessed by means of a specific method involving a review of literature reviews and a classification of health promotion interventions identified in these reviews (rapid reviews). We found a large number of effective or promising programmes devoted to the prevention of the most common child injuries: drowning, burns, falls, poisoning, electrocution, sports and leisure injuries. Some interventions are based on environmental measures, while others are educational or use law and regulatory processes. Some are primary prevention measures, others are secondary prevention measures, while others are multidimensional and can effectively reduce several types of injuries. For example, home safety education and provision of safety equipment, or home-based parenting interventions, can have an impact on injury rates. These findings present a number of limitations due to the marked diversity of the quality of the documents reviewed. It should also be stressed that interventions that are not listed in this article are not necessarily ineffective: they may simply lack a rigorous evaluation enabling them to be identified in our review. PMID:26751923

  20. A wakeup call to the prevention field: are prevention programs for substance use effective for girls?

    PubMed

    Kumpfer, Karol L; Smith, Paula; Summerhays, Julia Franklin

    2008-07-01

    Substance misuse in adolescent girls has increased dramatically since 1992. This article reviews trends in use rates and etiological theories tested by gender that suggest that family protective factors have more influence on girls. Next, a literature review reveals that few prevention programs have published their outcomes by gender or developed gender-specific programs. Nationwide community coalition results found positive effects on boys but increased drug use in young girls. The most effective programs are family focused targeting family bonding, supervision, and communication. Recent gender-specific prevention programs with positive results address stress, depression, social assertiveness, and body image. The authors recommend additional research testing programs by gender and also gender-specific versus generic versions of evidence-based programs to determine how to improve prevention program effectiveness for girls. PMID:18649225

  1. Effects of a Potash Mine Roof Fall Observed in Nearby Monitoring Wells

    NASA Astrophysics Data System (ADS)

    Kuhlman, K. L.

    2012-12-01

    At approximately 5 AM on March 18, 2012, a significant collapse occurred in a potash mine near the Department of Energy's Waste Isolation Pilot Plant (WIPP). The US Geological Survey estimated the event to be magnitude 2.9. Two wells in the WIPP regional groundwater monitoring network experienced oscillatory water level fluctuations greater than 5 feet in response to the event. The changes in water level decayed slowly over several weeks following the event. The potash mine is located in the McNutt Potash zone of the Salado Formation, which is 1000-1400 feet below ground surface (BGS) near the location of the roof fall. The monitoring wells are completed in the semi-confined Culebra Dolomite member of the Rustler Formation, which is 375 feet BGS. The observed response is compared to published well responses to earthquakes and other seismic events. We explore the potential for using the event to characterize aquifer parameters. This research is funded by WIPP programs administered by the Office of Environmental Management (EM) of the U.S Department of Energy. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000

  2. Effects of Hyporheic Exchange Flows on Egg Pocket Water Temperature in Snake River Fall Chinook Salmon Spawning Areas

    SciTech Connect

    Hanrahan, Timothy P.; Geist, David R.; Arntzen, Evan V.; Abernethy, Cary S.

    2004-09-24

    suggested that there was significant vertical hydrologic exchange during all time periods. The combined results of temperature monitoring and numerical modeling indicate that only two sites were significantly affected by short-term (hourly to daily) large magnitude changes in discharge. Although the two sites exhibited acute flux reversals between river water and hyporheic water resulting from short-term large magnitude changes in discharge, these flux reversals had minimal effect on emergence timing estimates. Indeed, the emergence timing estimates at all sites was largely unaffected by the changes in river stage resulting from hydropower operations at Hells Canyon Dam. Our results indicate that the range of emergence timing estimates due to differences among the eggs from different females can be as large as or larger than the emergence timing estimates due to site differences (i.e., bed temperatures within and among sites). We conclude that during the 2002-2003 fall chinook salmon incubation period, hydropower operations of Hells Canyon Dam had an insignificant effect on fry emergence timing at the study sites. It appears that short-term (i.e., hourly to daily) manipulations of discharge from the Hells Canyon Complex during the incubation period would not substantially alter egg pocket incubation temperatures, and thus would not affect fry emergence timing at the study sites. However, the use of hydropower operational manipulations at the Hells Canyon Complex to accelerate egg incubation and fry emergence should not be ruled out on the basis of only one water year's worth of study. Further investigation of the incubation environment of Snake River fall chinook salmon is warranted based on the complexity of hyporheic zone characteristics and the variability of surface/subsurface interactions among dry, normal, and wet water years.

  3. Effects of perturbation-based slip training using a virtual reality environment on slip-induced falls.

    PubMed

    Parijat, Prakriti; Lockhart, Thurmon E; Liu, Jian

    2015-04-01

    The purpose of the current study was to design and evaluate the effectiveness of virtual reality training in improving recovery reactions and reducing fall frequency in older adults. Twenty-four older adults were recruited and randomly assigned to two groups (virtual reality training and control). Both groups underwent three sessions including baseline slip, training and transfer of training on slippery surface. Both groups experienced two slips, one during baseline and the other during the transfer of training trial. The training group underwent 12 simulated slips using a visual perturbation induced by tilting a virtual reality scene while walking on the treadmill and the control group performed normal walking during the training session. Kinematic and kinetic data were collected during all the sessions. Results demonstrated a reduced incidence of falls in the training group during the transfer of training trial as compared to the control group. The training group was able to transfer reactive control strategies learned during training to the second slip trial. The reactive adjustments included reduced slip distance. Additionally, gait parameters reflective of gait instability (stride length, step width, variability in stride velocity) reduced after walking in the VR environment for 15-20 min. The results indicated a beneficial effect of the virtual reality training in reducing slip severity and recovery kinematics in healthy older adults. PMID:25245221

  4. A model of the effects of flow fluctuations on fall Chinook salmon spawning habitat availability in the Columbia River

    SciTech Connect

    Geist, David R.; Murray, Christopher J.; Hanrahan, Timothy P.; Xie, YuLong

    2008-12-01

    Previously we reported that about 30% to 60% of the area predicted to be used by fall Chinook salmon (Oncorhynchus tshawytscha) for spawning in the Hanford Reach of the Columbia River did not contain redds. One explanation for the overprediction of habitat was that our model did not incorporate streamflow fluctuation. Daily fluctuation in flow caused by load-following operations (power generation to meet short-term electrical demand) at Priest Rapids Dam, situated at the upper end of the Hanford Reach, changes the hydraulic characteristics to which fish respond in selecting redd sites. The purpose of the study described here was to examine the effect of flow changes on spawning habitat modeling and, in particular, to look at the connection between spawning and the variability and persistence of habitat variables caused by rapid changes in flow resulting from load-following operations at Priest Rapids Dam. We found that spawning habitat use by fall Chinook salmon was consistent with previous fall Chinook salmon studies in the Reach. Dynamic variables that were based on hourly time series were used to account for the variability in habitat as a result of flow fluctuations. The analysis showed that the proportion of velocities that fell within the range of 1.0 to 2.5 m/s differed significantly between locations that were predicted to be spawning by the logistic regression model where spawning actually occurred and locations that were predicted to be spawning where spawning did not occur. However, the resulting sequential logistic regression model that incorporated the dynamic variables did not provide significant improvement in the percentage of errors for areas predicted to be spawning; the model’s overprediction errors still ranged from 63% to 78%. We suggest that while flow fluctuation may affect spawning habitat and individual fish behavior, the high correlation between time-averaged velocities and the proportion of hourly velocities that fell within the most

  5. Drug-induced falls in older persons: is there a role for therapeutic drug monitoring?

    PubMed Central

    Hartholt, Klaas A.; Becker, Matthijs L.; van der Cammen, Tischa J. M.

    2016-01-01

    Background: Falls are the leading cause of injuries among older persons. Because of ageing societies worldwide, falls are expected to become a prominent public health problem. The usage of several types of drugs has been associated with an increased fall and fracture risk. In order to reduce future falls, preventative measures are needed. Therapeutic drug monitoring may help to identify persons who are at risk for falls due to drug use. The aim was to demonstrate how drugs can contribute to falls and the role of therapeutic drug monitoring. Methods: We present a descriptive case series of four patients. Results: All patients were referred to the geriatric outpatient clinic of a university medical center. The presented cases contained different underlying mechanisms contributing to an increased fall risk in older adults, including renal failure, genetic variation, overdose and ageing. Conclusion/discussion: Older adults are more prone to the side effects of drug use, including falls. Therapeutic drug monitoring may be useful to identify the patients who have an increased drug-related fall risk and to prevent future falls by individualizing the drug regime. PMID:27034772

  6. Prevention

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  7. Factors associated with falls among older adults living in institutions

    PubMed Central

    2013-01-01

    Background Falls have enormous impact in older adults. Yet, there is insufficient evidence regarding the effectiveness of preventive interventions in this setting. The objectives were to measure the frequency of falls and associated factors among older people living institutions. Methods Data were obtained from a survey on a probabilistic sample of residents aged ≥65 years, drawn in 1998-99 from institutions of Madrid (Spain). Residents, their caregivers, and facility physicians were interviewed. Fall rates were computed based on the number of physician-reported falls in the preceding 30 days. Adjusted rate ratios were computed using negative binomial regression models, including age, sex, cognitive status, functional dependence, number of diseases, and polypharmacy. Results The final sample comprised 733 residents. The fall rate was 2.4 falls per person-year (95% confidence interval [CI], 2.04-2.82). The strongest risk factor was number of diseases, with an adjusted rate ratio (RR) of 1.32 (95% CI, 1.17-1.50) for each additional diagnosis. Other variables associated with falls were: urinary incontinence (RR = 2.56 [95% CI, 1.32-4.94]); antidepressant use (RR = 2.32 [95% CI, 1.22-4.40]); arrhythmias (RR = 2.00 [95% CI, 1.05-3.81]); and polypharmacy (RR = 1.07 [95% CI, 0.95-1.21], for each additional medication). The attributable fraction for number of diseases (with reference to those with ≤ 1 condition) was 84% (95% CI, 45-95%). Conclusions Number of diseases was the main risk factor for falls in this population of institutionalized older adults. Other variables associated with falls, probably more amenable to preventive action, were urinary incontinence, antidepressants, arrhythmias, and polypharmacy. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3916151157277337 PMID:23320746

  8. Vision and falls in older people: risk factors and intervention strategies.

    PubMed

    Lord, Stephen R; Smith, Stuart T; Menant, Jasmine C

    2010-11-01

    Poor vision impairs balance and increases the risk of falls and fractures in older people. Multifocal glasses can add to this risk by impairing contrast sensitivity, depth perception, and ability to negotiate obstacles. Vision assessment and provision of new spectacles may not reduce, and may even increase, the risk of falls. Restriction of the use of multifocal glasses may reduce falls in active older people. Other effective fall prevention strategies include maximizing vision through cataract surgery and occupational therapy interventions in visually impaired older people. PMID:20934611

  9. Reducing Aversion to Side Effects in Preventive Medical Treatment Decisions

    ERIC Educational Resources Information Center

    Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen M.

    2007-01-01

    Laypeople tend to be overly sensitive to side effects of treatments that prevent illness, possibly leading them to refuse beneficial therapies. This Internet-based study attempted to reduce such side effect aversion by adding graphic displays to the numerical risk probabilities. It also explored whether graphics reduce side effect aversion by…

  10. Effects of acute thermal stress on the survival, predator avoidance, and physiology of juvenile fall Chinook salmon

    USGS Publications Warehouse

    Mesa, M.G.; Weiland, L.K.; Wagner, P.

    2002-01-01

    We subjected juvenile fall chinook salmon from the Hanford Reach of the Columbia River to acute thermal stressors in the laboratory that were derived from field data. We assessed the effects of thermal stress on: (1) the extent of direct mortality; (2) the vulnerability of fish to predation by smallmouth bass; and (3) some general physiological stress responses and synthesis of heat shock protein 70 (hsp70). Thermally-stressed fish showed little direct mortality and no increases in vulnerability to predation. However, these fish showed transient increases in plasma concentrations of cortisol, glucose, and lactate, and a dramatic (25-fold higher than controls) and persistent (lasting 2 wk) increase in levels of liver hsp70. Our results indicate that exposure of Hanford Reach juvenile fall chinook salmon to such stressors did not lead to significant increases in direct mortality or vulnerability to predation, but did alter physiological homeostasis, which should be of concern to those managing this resource. Because our fish received only a single exposure to one of the stressors we examined, we are also concerned about the consequences of exposing fish to multiple, cumulative stressors - a likely scenario for fish in the wild.

  11. The effect of Pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults.

    PubMed

    Pata, Rachel W; Lord, Katrina; Lamb, Jamie

    2014-07-01

    Falls are a common problem in older adults. Impaired balance, mobility and postural stability are risk factors for falling. Limited research has been performed on Pilates exercise and the ability to decrease fall risk. In this quasi-experimental study, 35 adults (61-87 years old) participated in an 8-week Pilates based exercise program. Blind examiners conducted the Timed Up and Go (TUG), Forward Reach Test, and Turn 180 Test before and after the intervention. Number of falls, perception of Pilates, and fear of falling was also recorded. Thirty-two (91.4%) participants completed post-test measures. Significant improvements were seen in the TUG (p <0.001) and Turn 180 Test (p = 0.002). Improvements were also demonstrated in the Forward Reach Test (p = 0.049). A positive perception of the Pilates program and decreased fear of falling was shown. Results suggest a Pilates based exercise program may be effective in improving balance, mobility and postural stability to decrease fall risk. PMID:25042305

  12. Possible effects of elk harvest on fall distribution of grizzly bears in the Greater Yellowstone Ecosystem

    USGS Publications Warehouse

    Haroldson, M.A.; Schwartz, C.C.; Cherry, S.; Moody, D.

    2004-01-01

     The tradition of early elk (Cervus elaphus) hunting seasons adjacent to Yellowstone National Park (YNP), USA, provides grizzly bears (Ursus arctos horribilis) with ungulate remains left by hunters. We investigated the fall (Aug–Oct) distribution of grizzly bears relative to the boundaries of YNP and the opening of September elk hunting seasons. Based on results from exact tests of conditional independence, we estimated the odds of radiomarked bears being outside YNP during the elk hunt versus before the hunt. Along the northern boundary, bears were 2.40 times more likely to be outside YNP during the hunt in good whitebark pine (Pinus albicaulis) seed-crop years and 2.72 times more likely in poor seed-crop years. The level of confidence associated with 1-sided confidence intervals with a lower endpoint of 1 was approximately 94% in good seed-crop years and 61% in poor years. Along the southern boundary of YNP, radiomarked bears were 2.32 times more likely to be outside the park during the hunt in good whitebark pine seed-crop years and 4.35 times more likely in poor seed-crop years. The level of confidence associated with 1-sided confidence intervals with a lower endpoint of 1 was approximately 93% in both cases. Increased seasonal bear densities and human presence in early hunt units increases potential for conflicts between bears and hunters. Numbers of reported hunting-related grizzly bear mortalities have increased in the Greater Yellowstone Ecosystem (GYE) during the last decade, and nearly half of this increase is due to bear deaths occurring in early hunt units during September. Human-caused grizzly bear mortality thresholds established by the U.S. Fish and Wildlife Service (USFWS) have not been exceeded in recent years. This is because agency actions have reduced other sources of human-caused mortalities, and because population parameters that mortality thresholds are based on have increased. Agencies must continue to monitor and manage hunter

  13. A Randomized Controlled Trial to Examine the Effect of 2-Year Vitamin B12 and Folic Acid Supplementation on Physical Performance, Strength, and Falling: Additional Findings from the B-PROOF Study.

    PubMed

    Swart, Karin M A; Ham, Annelies C; van Wijngaarden, Janneke P; Enneman, Anke W; van Dijk, Suzanne C; Sohl, Evelien; Brouwer-Brolsma, Elske M; van der Zwaluw, Nikita L; Zillikens, M Carola; Dhonukshe-Rutten, Rosalie A M; van der Velde, Nathalie; Brug, Johannes; Uitterlinden, André G; de Groot, Lisette C P G M; Lips, Paul; van Schoor, Natasja M

    2016-01-01

    Elevated homocysteine concentrations are associated with a decline in physical function in elderly persons. Homocysteine-lowering therapy may slow down this decline. This study aimed to examine the effect of a 2-year intervention of vitamin B12 and folic acid supplementation on physical performance, handgrip strength, and risk of falling in elderly subjects in a double-blind, randomized placebo-controlled trial. Participants aged ≥65 years with elevated plasma homocysteine concentrations [12-50 µmol/L (n = 2919)] were randomly assigned to daily supplementation of 500 µg vitamin B12, 400 µg folic acid, and 600 IU vitamin D3, or to placebo with 600 IU vitamin D3. Physical performance (range 0-12) and handgrip strength (kg) were measured at baseline and after 2 years. Falls were reported prospectively on a research calendar. Intention-to-treat (primary) and per-protocol (secondary) analyses were performed. Physical performance level and handgrip strength significantly decreased during the follow-up period, but this decline did not differ between groups. Moreover, time to first fall was not significantly different (HR: 1.0, 95% CI 0.9-1.2). Secondary analyses on a per-protocol base identified an interaction effect with age on physical performance. In addition, the treatment was associated with higher follow-up scores on the walking test (cumulative OR: 1.3, 95% CI 1.1-1.5). Two-year supplementation of vitamin B12 and folic acid was neither effective in reducing the age-related decline in physical performance and handgrip strength, nor in the prevention of falling in elderly persons. Despite the overall null-effect, the results provide indications for a positive effect of the intervention on gait, as well as on physical performance among compliant persons >80 years. These effects should be further tested in future studies. PMID:26412463

  14. Preventive effect of taurine on experimental type II diabetic nephropathy

    PubMed Central

    2010-01-01

    Background It has been verified that taurine has some preventive effects on diabetes and its complications when used alone or together with other drugs, but there are few reports about taurine on the prevention of diabetic nephropathy, the mechanisms of which are still unknown. Methods Taurine was administered to type Ⅱ diabetic rats induced by high fat high sugar diet combined with STZ injection. The preventive effect of taurine on diabetic nephropathy was investigated by detecting blood glucose, lipid metabolism, kidney function and glomerular basement membrane metabolism. Results Taurine could lower blood glucose, TG, TC, BUN, Scr, NAG, U-PRO, the expression of laminin B1( LBN1) mRNA, and increase HDL-C of diabetic rats. Conclusions The results indicated that taurine could prevent the occurrence and development of diabetic nephropathy by decreasing blood glucose, improving lipid metabolism, glomerular basement membrane metabolism, and kidney function. PMID:20804623

  15. [Falls during hospitalization--prevalence and consequences].

    PubMed

    Dzieża-Grudnik, Anna; Czekaj, Dominika; Wójcik-Bugajska, Małgorzata; Grodzicki, Tomasz

    2014-01-01

    A systematic growth in the number of the elderly among hospitalized patients, including the number of patients in the oldest age group, is being observed over the last few years. A stay in hospital conditions is connected with deterioration of their fitness, reduction of their independence. It also entails the risk of hallucination, falls and hospital-acquired infections. The present analysis concerns 60 patients who fell during their hospitalization in the Internal Diseases and Geriatrics Unit of University Hospital in Krakow in 2012 and 2013 (in the total of 6,061 patients admitted to the Unit in this period), which was recorded in the registry of adverse events. An attempt at characterization of this group was made on the basis of medical record, assessment of fall circumstances and its consequences. This was followed by an attempt at tracing the later outcomes of these patients both during their stay in the unit as well as after the discharge from hospital (telephone contact with patient or with person indicated as contact). Analysis of the data (probably underevaluated due to the lack of unambiguous definition of a fall as well as a retrospective character of study) reveals a relation between falls in hospital and various degrees of body injuries, extended hospitalization time, increasing disability and, in some cases, even death. In the face of the observed growth in the number of hospitalized patients in advanced age, a clear definition and careful monitoring of falls as well as an attempt at an early identification of people at risk of falls may prove to be an effective means of their prevention. PMID:25826977

  16. Automatic fall detection using wearable biomedical signal measurement terminal.

    PubMed

    Nguyen, Thuy-Trang; Cho, Myeong-Chan; Lee, Tae-Soo

    2009-01-01

    In our study, we developed a mobile waist-mounted device which can monitor the subject's acceleration signal and detect the fall events in real-time with high accuracy and automatically send an emergency message to a remote server via CDMA module. When fall event happens, the system also generates an alarm sound at 50Hz to alarm other people until a subject can sit up or stand up. A Kionix KXM52-1050 tri-axial accelerometer and a Bellwave BSM856 CDMA standalone modem were used to detect and manage fall events. We used not only a simple threshold algorithm but also some supporting methods to increase an accuracy of our system (nearly 100% in laboratory environment). Timely fall detection can prevent regrettable death due to long-lie effect; therefore increase the independence of elderly people in an unsupervised living environment. PMID:19964661

  17. Optimizing footwear for older people at risk of falls.

    PubMed

    Menant, Jasmine C; Steele, Julie R; Menz, Hylton B; Munro, Bridget J; Lord, Stephen R

    2008-01-01

    Footwear influences balance and the subsequent risk of slips, trips, and falls by altering somatosensory feedback to the foot and ankle and modifying frictional conditions at the shoe/floor interface. Walking indoors barefoot or in socks and walking indoors or outdoors in high-heel shoes have been shown to increase the risk of falls in older people. Other footwear characteristics such as heel collar height, sole hardness, and tread and heel geometry also influence measures of balance and gait. Because many older people wear suboptimal shoes, maximizing safe shoe use may offer an effective fall prevention strategy. Based on findings of a systematic literature review, older people should wear shoes with low heels and firm slip-resistant soles both inside and outside the home. Future research should investigate the potential benefits of tread sole shoes for preventing slips and whether shoes with high collars or flared soles can enhance balance when challenging tasks are undertaken. PMID:19235118

  18. Differential Susceptibility to Prevention: GABAergic, Dopaminergic, and Multilocus Effects

    PubMed Central

    Brody, Gene H.; Chen, Yi-fu; Beach, Steven R. H.

    2013-01-01

    Background Randomized prevention trials provide a unique opportunity to test hypotheses about the interaction of genetic predispositions with contextual processes to create variations in phenotypes over time. Methods Using two longitudinal, randomized prevention trials, molecular genetic and alcohol use outcome data were gathered from more than 900 youths to determine whether prevention program participation would, across 2 years, moderate genetic risk for increased alcohol use conferred by the dopaminergic and GABAergic systems. Results We found that (a) variance in dopaminergic (DRD2, DRD4, ANKK1) and GABAergic (GABRG1, GABRA2) genes forecast increases in alcohol use across 2 years, and (b) youths at genetic risk who were assigned to the control condition displayed greater increases in alcohol use across 2 years than did youths at genetic risk who were assigned to the prevention condition or youths without genetic risk who were assigned to either condition. Conclusions This study is unique in combining data from two large prevention trials to test hypotheses regarding genetic main effects and gene × prevention interactions. Focusing on gene systems purported to confer risk for alcohol use and abuse, the study demonstrated that participation in efficacious prevention programs can moderate genetic risk. The results also support the differential susceptibility hypothesis that some youths, for genetic reasons, are more susceptible than others to both positive and negative contextual influences. PMID:23294086

  19. Effective Instruction: An Inconspicuous Strategy for Dropout Prevention

    ERIC Educational Resources Information Center

    Bost, Loujeania Williams; Riccomini, Paul J.

    2006-01-01

    Although researchers have clearly connected dropping out of school to prolonged low achievement, to date, effective teaching practices are largely absent from the milieu of interventions and programs that are employed by schools to address dropout prevention. As such, effective instructional design and delivery as a focus for keeping students with…

  20. Falls and Older Adults

    MedlinePlus

    ... rises with age. Click for more information Falls Lead to Fractures, Trauma Each year, more than 1. ... and injury deaths. Fractures caused by falls can lead to hospital stays and disability. Most often, fall- ...

  1. Falls in Nursing Homes

    MedlinePlus

    ... for health care providers. Learn More Falls in Nursing Homes Recommend on Facebook Tweet Share Compartir On ... 5 Why do falls occur more often in nursing homes? Falling can be a sign of other ...

  2. Perceived Cause, Environmental Factors, and Consequences of Falls in Adults with Cerebral Palsy: A Preliminary Mixed Methods Study

    PubMed Central

    McDonald, Rachael; McGinley, Jennifer

    2015-01-01

    Objective. Describe perceived cause, environmental influences, and consequences of falls or near-falls in ambulant adults with cerebral palsy (CP). Methods. Adults with CP completed postal surveys and follow-up semistructured interviews. Surveys sought information on demographic data, self-nominated Gross Motor Function Classification Score (GMFCS-E&R), falls, and near-falls. Interviews gathered additional information on falls experiences, near-falls, and physical and psychosocial consequences. Results. Thirty-four adults with CP participated. Thirty-three participants reported at least one fall in the previous year. Twenty-six participants reported near-falls. Most commonly, falls occurred indoors, at home, and whilst engaged in nonhazardous ambulation. Adults with CP experienced adverse falls consequences, lower limb injuries predominant (37%), and descriptions of fear, embarrassment, powerlessness, and isolation. Discussion. Adults with CP may experience injurious falls. Further investigation into the impact of falls on health-related quality of life and effective remediation strategies is warranted to provide comprehensive falls prevention programs for this population. PMID:25802759

  3. Improving Institutional Effectiveness through Programmatic Assessment. Professional File Number 109, Fall 2008

    ERIC Educational Resources Information Center

    Brown, Dina

    2008-01-01

    This article identifies concrete steps used at Argosy University/Orange County (Argosy or AUOC) to integrate assessment in daily institutional operations and utilize assessment data for educational and organizational improvements. Additionally, the article addresses the role of an institutional effectiveness committee in facilitating the…

  4. Effects of Fall Applications of Chemical Defoliants, Urea, and Gibberellic Acid on Defoliation in the Fall and Performance of Hydrangeas during Forcing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In two separate experiments, Hydrangea macrophylla (Thunb.) Ser. ‘Merritt’s Supreme’ plants were used to study the effects of foliar sprays of Def 6 (tributyl phosphorotrithioate, 2500, 5000, 7500 and 10000 mg·L-1), gibberellic acid, (GA, 50 mg·L-1), copper-EDTA (CuEDTA, 0.5% and 1.0%), Florel (2000...

  5. The Fort McMurray Demonstration Project in Social Marketing: no demonstrable effect on already falling injury rates following intensive community and workplace intervention.

    PubMed

    Guidotti, Tee L; Deb, Pooja; Bertera, Robert; Ford, Lynda

    2009-10-01

    The Fort McMurray Demonstration Project in Social Marketing attempted to achieve mutually reinforcing effects from thematically coordinated educational and awareness efforts in the community as a whole and in the workplace and the inclusion of occupational safety within the framework of a community health promotion project. The study community was Fort McMurray, a small, industrial city in northern Alberta. The Mistahiai Health Region, several hundred kilometers to the west and also dominated by one city, Grande Prairie, served as the reference community. The intervention was based on media and events staged at public events, with supporting educational activities in schools and the community. It relied heavily on community-based partners and volunteers. Data on healthcare utilization of selected preventable injuries were obtained from Alberta Health for the time period 1990-1996 for the Regional Health Authorities of Northern Lights, where the only large population centre is Fort McMurray, and Mistahia. Age-adjusted aggregate injury rates were analyzed for evidence of an effect of the intervention. Severity was measured by proxy, using the number of diagnostic claims submitted for reimbursement for medical services in a given year. The communities differed in age-specific injury rates, with Fort McMurray showing higher rates for residents aged less than 55. Young adults and older adolescents showed higher levels of severity. Injury rates fell substantially and at similar rates in both communities over the five-year period. However, in both communities injury rates were already falling before the intervention in Fort McMurray began and continued to fall at about the same rate, slowing toward the end of the period. No evidence was found for an effect of the Project or for acceleration of the reduction in injury frequency in the intervention area. Over the period, fewer medical services were delivered in office settings and more in emergency rooms, in both

  6. Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

    PubMed Central

    Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

    2016-01-01

    Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

  7. Rise and fall of endrin usage in Washington state fruit orchards: Effects on wildlife

    USGS Publications Warehouse

    Blus, L.J.; Henny, C.J.; Grove, R.A.

    1989-01-01

    A study of the effects of endrin on wildlife was conducted from 1981 to 1983 in fruit orchards in central Washington state. The single post-harvest application of endrin as a rodenticide resulted in both acute and chronic toxicity to a variety of avian species. Most mortality occurred soon after application, but several raptors died during the spring and summer. Most wildlife sampled in the orchard system contained residues of endrin. There was on evidence that endrin depressed reproductive success.

  8. Cost-Effectiveness of Antiretroviral Therapy for Prevention

    PubMed Central

    Kahn, James G; Marseille, Elliot A; Bennett, Rod; Williams, Brian G; Granich, Reuben

    2011-01-01

    Recent empirical studies and analyses have heightened interest in the use of expanded antiretroviral therapy (ART) for prevention of HIV transmission. However, ART is expensive, approximately $600 per person per year, raising issues of the cost and cost-effectiveness of ambitious ART expansion. The goal of this review is to equip the reader with the conceptual tools and substantive background needed to understand and evaluate the policy and programmatic implications of cost-effectiveness assessments of ART for prevention. We provide this review in six sections. We start by introducing and explaining basic concepts of health economics as they relate to this issue, including resources, costs, health metrics (such as Disability-Adjusted Life Years), and different types of economic analysis. We then review research on the cost and cost-effectiveness of ART as treatment, and on the cost-effectiveness of traditional HIV prevention. We describe critical issues in the epidemic impact of ART, such as suppression of transmission and the role of the acute phase of infection. We then present a conceptual model for conducting and interpreting cost-effectiveness analyses of ART as prevention, and review the existing preliminary estimates in this area. We end with a discussion of future directions for programmatic demonstrations and evaluation. PMID:21999776

  9. Prevalence of falls in elderly women

    PubMed Central

    Vitor, Priscila Regina Rorato; de Oliveira, Ana Carolina Kovaleski; Kohler, Renan; Winter, Gabriele Regiane; Rodacki, Cintia; Krause, Maressa Priscila

    2015-01-01

    OBJECTIVE: To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. METHODS: Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. RESULTS: The prevalence of falls in this sample was 32.4%. Among women fallers, 40% self-reported a high fear of falling. CONCLUSION: It is recommended that functional and resistance exercises are included in the preventive strategies for reducing risk factors for falls and its determinants in elderly women. Level of Evidence II, Prognostic-Prospective Study. PMID:26207095

  10. Rise and fall of endrin usage in Washington state fruit orchards: Effects on wildlife

    USGS Publications Warehouse

    Blus, L.J.; Henny, Charles J.; Grove, Robert A.

    1989-01-01

    A study of the effects of endrin on wildlife was conducted from 1981 to 1983 in fruit orchards in central Washington State. The single post-harvest application of endrin as a rodenticide resulted in both acute and chronic toxicity to a variety of avian species. Of 194 birds found dead, brains of 125 were analysed; endrin toxicosis accounted for >24% of the total and 37% of those analysed. Most mortality occurred soon after application, but several raptors died during the spring and summer. Most wildlife sampled in the orchard system contained residues of endrin. There was no evidence that endrin depressed reproductive success. Use of endrin abruptly declined during this study and its use is currently limited to emergency situations. Wildlife mortality from endrin also decreased; only six endrin-related mortalities were detected the last year of the study and there have been no reports of die-offs since the study ended.

  11. Modeling and Cost-Effectiveness in HIV Prevention.

    PubMed

    Jacobsen, Margo M; Walensky, Rochelle P

    2016-02-01

    With HIV funding plateauing and the number of people living with HIV increasing due to the rollout of life-saving antiretroviral therapy, policy makers are faced with increasingly tighter budgets to manage the ongoing HIV epidemic. Cost-effectiveness and modeling analyses can help determine which HIV interventions may be of best value. Incidence remains remarkably high in certain populations and countries, making prevention key to controlling the spread of HIV. This paper briefly reviews concepts in modeling and cost-effectiveness methodology and then examines results of recently published cost-effectiveness analyses on the following HIV prevention strategies: condoms and circumcision, behavioral- or community-based interventions, prevention of mother-to-child transmission, HIV testing, pre-exposure prophylaxis, and treatment as prevention. We find that the majority of published studies demonstrate cost-effectiveness; however, not all interventions are affordable. We urge continued research on combination strategies and methodologies that take into account willingness to pay and budgetary impact. PMID:26830283

  12. Effective Dropout Prevention and College Attendance Programs for Latino Students.

    ERIC Educational Resources Information Center

    Fashola, Olatokunbo S.; Slavin, Robert E.

    This paper reviews research related to effective secondary school programs aimed at dropout prevention and increasing college enrollment rates for at-risk Latino youth. The review identifies programs that have demonstrated a significant impact on dropout rates, college attendance, school performance, or related outcomes in rigorous evaluations;…

  13. Anger and Violence Prevention: Enhancing Treatment Effects through Booster Sessions

    ERIC Educational Resources Information Center

    Bundy, Alysha; McWhirter, Paula T.; McWhirter, J. Jeffries

    2011-01-01

    This study was designed to evaluate the effectiveness of booster sessions on the maintenance of intervention gains following an anger management prevention program: "Student Created Aggression Replacement Education Program" ("SCARE"). Participants who had completed the "SCARE" program a year earlier were randomly assigned into either a booster…

  14. Dose Effect of Cosmic Rays in Aircraft at SPE in Fall of 2003

    NASA Astrophysics Data System (ADS)

    Fujitaka, K.; Uchihori, Y.; Kitamura, H.; Nojima, K.; Takada, M.; Yasuda, N.; Okano, M.

    A large solar flare occurred in October 28, 2003, which caused a sensation around the world. Our group decided to measure the aviation dose promptly and started the survey within two days. Measurements have been conducted in Oct.30-Oct.30, Oct.30*-Nov.11*, Oct. 31-Oct.31, Oct.31*-Nov.3*, Nov.3-Nov.3, Nov.5-Nov.5, Nov.5*-Nov.7*, and Nov.6-Nov.6. Here, days with asterisks represent Tokyo to JFK (and vice versa) airport, while others represent Tokyo from/to Sapporo. Unfortunately, the measurement met the flare only once (Nov.3), but the dose was suppressed considerably in the nearby date, and a typical Forbush decrease is seen (Oct.31). While the dose measured in the Tokyo/JFK flight (Oct.31) varied largely, we cannot infer the net dose contribution from the flare. That is because any small variation of the dose tends to be masked by other large one. In short, we do not have to worry about effect of solar activity on board airplane in the present case.

  15. Effects of bacillus thuringiensis transgenic corn on corn earworm and fall armyworm (Lepidoptera: Noctuidae) densities.

    PubMed

    Chilcutt, Charles F; Odvody, Gary N; Correa, J Carlos; Remmers, Jeff

    2007-04-01

    We examined 17 pairs of near-isogenic hybrids of Bacillus thuringiensis (Bt) (176, Mon810, and Bt11) and non-Bt corn, Zea mays L., to examine the effects of Bt on larval densities of Helicoverpa zea (Boddie) and Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) during 2 yr. During ear formation, instar densities of H. zea and S. frugiperda were recorded for each hybrid. We found that H. zea first, second, and fifth instar densities were each affected by Mon810 and Bt11 Bt corn but not by 176 corn. Surprisingly, first and second instars were found in higher numbers on ears of Mon810 and Bt11 corn than on non-Bt corn. Densities of third and fourth instars were equal on Bt and non-Bt hybrids, whereas densities of fifth instars were lower on Bt plants. S. frugiperda larval densities were only affected during 1 yr when second, and fourth to sixth instars were lower on ears of Mon810 and Bt11 hybrids compared with their non-Bt counterparts. Two likely explanations for early instar H. zea densities being higher on Bt corn than non-Bt corn are that (1) Bt toxins delay development, creating a greater abundance of early instars that eventually die, and (2) reduced survival of H. zea to later instars on Bt corn decreased the normal asymmetric cannibalism or H. zea-S. frugiperda intraguild predation of late instars on early instars. Either explanation could explain why differences between Bt and non-Bt plants were greater for H. zea than S. frugiperda, because H. zea is more strongly affected by Bt toxins and more cannibalistic. PMID:17461054

  16. Moving from Efficacy to Effectiveness Trials in Prevention Research

    PubMed Central

    Marchand, Erica; Stice, Eric; Rohde, Paul; Becker, Carolyn Black

    2013-01-01

    Efficacy trials test whether interventions work under optimal, highly controlled conditions whereas effectiveness trials test whether interventions work with typical clients and providers in real-world settings. Researchers, providers, and funding bodies have called for more effectiveness trials to understand whether interventions produce effects under ecologically valid conditions, which factors predict program effectiveness, and what strategies are needed to successfully implement programs in practice settings. The transition from efficacy to effectiveness with preventive interventions involves unique considerations, some of which are not shared by treatment research. The purpose of this article is to discuss conceptual and methodological issues that arise when making the transition from efficacy to effectiveness research in primary, secondary, and tertiary prevention, drawing on the experiences of two complimentary research groups as well as the existing literature. We address (a) program of research, (b) intervention design and conceptualization, (c) participant selection and characteristics, (d) providers, (e) context, (f) measurement and methodology, (g) outcomes, (h) cost, and (i) sustainability. We present examples of research in eating disorder prevention that demonstrate the progression from efficacy to effectiveness trials. PMID:21092935

  17. Challenges in Defining and Categorizing Falls on Diverse Unit Types

    PubMed Central

    Davidson, Jan; Dunton, Nancy; Crosser, Brandon

    2015-01-01

    In 2012, the National Database of Nursing Quality Indicators launched a project to expand its falls indicator for use on pediatric, neonatal, and psychiatric units. We discuss challenges encountered, argue that schemes for categorizing falls by cause or supposed preventability are not suitable for large-scale efforts to track and prevent falls, express concern about the growing burden of collecting increasingly granular quality data, and discuss limitations of total and injurious fall rates as quality measures. PMID:25188525

  18. Fall Enrollment Report. 2014

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2014

    2014-01-01

    This report summarizes and analyzes fall enrollment in Iowa's community colleges. Each year, Iowa's 15 community colleges submit data on enrollment on the 10th business day of the fall semester. Some highlights from this report include: (1) Fall 2014 enrollment was 93,772 students--a decline of 0.49 percent from last fall; (2) Enrollment continues…

  19. Results of research to develop cost effective biomonitoring at oil shale lease tracts. Phase I. Fall sampling report

    SciTech Connect

    Skalski, J.R.; Fitzner, R.E.; Gano, K.A.

    1982-05-01

    This report presents the results of censuses conducted during October 1981 to estimate the fall abundance of small mammals and avifauna on replicate plots in the vicinity of Federal Tract C-a (Rio Blanco Oil Shale Company). The objectives of the fall censuses were to evaluate alternative census techniques, test assumptions vital to the use of indices and abundance estimators, determine cost-functions associated with monitoring efforts, and estimate variance components needed to devise optimal monitoring designs. Analyses of the fall census data on small mammal abundance were performed.

  20. [The new German prevention act: an effective strategy?].

    PubMed

    Garlichs, Dietrich

    2015-10-01

    The new German prevention act attempts to deal with the influx of obesity and chronic diseases by educating and informing. It seeks to change individual behaviour and supress lifestyle-related risk factors. In the past, however this behavioural prevention strategy has proved ineffective. A structural prevention strategy, as requested by the WHO, should additionally be put into effect with measures that reach all walks of life, not just the health-conscious people in society. It proposes the following: · At least one hour of daily physical activity or sport at school and kindergarten. · A differential food tax that makes unhealthy foods more expensive and healthy foods cheaper (taxing sugary / fatty foods). · Mandatory quality standards for kindergarten and school meals. · Banning food advertising targeted at children. PMID:26445263

  1. The beneficial effects of taurine in preventing metabolic syndrome.

    PubMed

    Chen, Wen; Guo, Junxia; Zhang, Yanzhen; Zhang, Jing

    2016-04-20

    Metabolic syndrome, a cluster of risk factors for diabetes and cardiovascular disease, has become a very serious public health concern. A number of studies have provided evidence that taurine has an efficient action against metabolic syndrome, which includes reducing triglycerides to prevent obesity, improving insulin resistance to regulate glucose metabolism, lowering cholesterol (especially decreasing VLDL + LDL cholesterol and increasing HDL cholesterol) to prevent diet-induced hypercholesterolemia, and regulating the renin-angiotensin-aldosterone system and the kallikrein-kinin system etc. to reduce blood pressure. This review summarizes the data from in vitro, animal and limited human studies of beneficial effects of taurine on obesity, dyslipidaemia, diabetes mellitus and hypertension, and addresses the possible metabolic and molecular mechanisms of the prevention of metabolic syndrome by taurine. PMID:26918249

  2. Falls in the Elderly Secondary to Urinary Symptoms

    PubMed Central

    Soliman, Yousef; Meyer, Richard; Baum, Neil

    2016-01-01

    Falls and fractures have a significant impact on our patients, their families, and caregivers, and cost the health care system billions of dollars. Each year, millions of adults aged 65 and older fall. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable. Because many patients with falls and subsequent fractures have urologic conditions, urologists are positioned to help with the prevention of these significant and costly injuries. This article discusses the epidemiology of falls and fractures, and the urologic comorbidities that increase their risk. PMID:27162509

  3. Cost-Effectiveness of a School-Based Obesity Prevention Program

    ERIC Educational Resources Information Center

    Wang, Li Yan; Gutin, Bernard; Barbeau, Paule; Moore, Justin B.; Hanes, John, Jr.; Johnson, Maribeth H.; Cavnar, Marlo; Thornburg, Janet; Yin, Zenong

    2008-01-01

    Background: A school-based obesity prevention study (Medical College of Georgia FitKid Project) started in the fall of 2003 in 18 elementary schools. Half of the schools were randomized to an after-school program that included moderate-to-vigorous physical activity, healthy snacks, homework assistance, and academic enrichment. All third graders…

  4. Parenting through change: an effective prevention program for single mothers.

    PubMed

    Forgatch, M S; DeGarmo, D S

    1999-10-01

    This randomized experimental prevention study (a) evaluated the effectiveness of a parent-training program in a sample of 238 divorcing mothers with sons in Grades 1-3 and (b) provided an experimental test of coercion theory. The intervention produced reductions in observed coercive parenting, prevented decay in positive parenting, and generally improved effective parenting practices in comparisons of mothers in experimental and control groups. Moreover, coercion theory was supported. Improved parenting practices correlated significantly with improvements in teacher-reported school adjustment, child-reported maladjustment, and mother-reported maladjustment. The intervention indirectly benefitted child outcomes through improved parenting practices for a model based on child report and, to a lesser extent, on teacher report. The intervention did not produce direct effects on child outcomes. PMID:10535238

  5. An Ounce of Prevention, a Pound of Uncertainty: The Cost-Effectiveness of School-Based Drug Prevention Programs.

    ERIC Educational Resources Information Center

    Caulkins, Jonathan P.; Rydell, C. Peter; Everingham, Susan S.; Chiesa, James; Bushway, Shawn

    This book describes an analysis of the cost-effectiveness of model school-based drug prevention programs at reducing cocaine consumption. It compares prevention's cost-effectiveness with that of several enforcement programs and with that of treating heavy cocaine users. It also assesses the cost of nationwide implementation of model prevention…

  6. An integrated approach towards identifying age-related mechanisms of slip initiated falls

    PubMed Central

    Lockhart, Thurmon E.

    2008-01-01

    The causes of slip and fall accidents, both in terms of extrinsic and intrinsic factors and their associations are not yet fully understood. Successful intervention solutions for reducing slip and fall accidents require a more complete understanding of the mechanisms involved. Before effective fall prevention strategies can be put into practice, it is central to examine the chain of events in an accident, comprising the exposure to hazards, initiation of events and the final outcome leading to injury and disability. These events can be effectively identified and analyzed by applying epidemiological, psychophysical, biomechanical and tribological research principles and methodologies. In this manuscript, various methods available to examine fall accidents and their underlying mechanisms are presented to provide a comprehensive array of information to help pinpoint the needs and requirements of new interventions aimed at reducing the risk of falls among the growing elderly population. PMID:17768070

  7. Automatic fall detectors and the fear of falling.

    PubMed

    Brownsell, Simon; Hawley, Mark S

    2004-01-01

    We studied the effect of automatic fall detection units on the fear of falling. Participants were community alarm users living in the community aged over 75 years or those aged 60-74 years who had experienced a fall in the previous six months. Of those approached, 31% consented to take part; the main reason given for potential participants declining involvement was that they were happy with the technology they already had. Subjects were assigned to a control group (n = 21) or intervention group (n = 34) based on age, the number of self-reported falls in the previous six months and their score on the self-administered Falls Efficacy Scale (FES), which measures fear of falling on a scale of 0-100, with higher scores indicating less fear. The monitoring period lasted a mean of 17 weeks (SD 3.1). There was no significant difference between the intervention and control groups in their mean ratings of fear of falls (40.3 vs 37.5, difference 2.8, 95% CI 6.2 to 11.8), health-related quality of life or morale. Differences in fear of falling between an intervention subgroup who wore their detector at least occasionally (62%) and those who did not (38%) suggested that some people may benefit from a fall detector while others may lose confidence if they are provided with one. Most users who wore their detectors at least occasionally felt more confident and independent and considered that the detector improved their safety. PMID:15494083

  8. The effects of aquatic walking and jogging program on physical function and fall efficacy in patients with degenerative lumbar spinal stenosis

    PubMed Central

    Lee, Jae-Hyun; Sung, Eunsook

    2015-01-01

    The purpose of this study was to evaluate the effects of 12-week aqua walking and jogging program on muscle function, ankle range of motion (ROM), balance and fell efficacy in degenerative lumbar spinal stenosis (DLSS) patients. Six patients (2 males, 4 females) with DLSS participated in aquatic exercise program 3 times per week with each session of 60 min (warming-up, aqua walking, aqua jogging and cool down) at 1 m 20 cm–1 m 30 cm deep pool. Janda’s muscle function test, ankle ROM, Berg balance scale (BBS) and fall efficacy scale (FES) were analyzed before and after the training intervention. We found significant increases in balance, muscle function, ankle ROM and fall efficacy after training intervention. In conclusion, aquatic exercise seems to affect physical function and fall efficacy positively in elderly DLSS patients. PMID:26535218

  9. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

    PubMed

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung

    2016-01-01

    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period. PMID:25642949

  10. The Effects of Head Start on Children's Kindergarten Retention, Reading and Math Achievement in Fall Kindergarten--An Application of Propensity Score Method and Sensitivity Analysis

    ERIC Educational Resources Information Center

    Dong, Nianbo

    2009-01-01

    Using data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), this paper applied optimal propensity score matching method to evaluate the effects of Head Start on children's kindergarten retention, reading and math achievement in fall kindergarten comparing with center-based care. Both parametric and nonparametric…

  11. Child Sexual Abuse Prevention Programs: What Makes them Effective in Protecting Children?

    ERIC Educational Resources Information Center

    Kraizer, Sherryll; And Others

    1989-01-01

    Describes a school-based child abuse prevention program. The program's effectiveness is evaluated in terms of prevention of sexual abuse, the age of maximum receptivity to prevention education, and implications of the evaluation for early childhood educators. (RJC)

  12. "The Great Cataract" - Effects of Late Holocene Debris Flows on Lava Falls Rapid, Grand Canyon National National Park, Arizona

    USGS Publications Warehouse

    Webb, Robert H.; Melis, Theodore S.; Wise, Thomas W.; Elliott, John G.

    1996-01-01

    firehose effect. Floods in Prospect Valley above the waterfall are generated during regional winter storms, localized summer thunderstorms, and occasional tropical cyclones. Winter precipitation has increased in the Grand Canyon region since the early 1960s, and the most recent debris flows have occurred during winter storms. Summer rainfall has declined in the same period, decreasing the potential for debris flows in the summer months. The history of river reworking of the Prospect Canyon debris fan illustrates the interrelation between tributary debris fans and mainstem floods in bedrock canyons. Lava Falls Rapid did not change despite Colorado River floods of 8,500 m3/s in 1884 and 6,230 m3/s in 1921. Floods up to 3,540 m3/s that occurred after the historical, pre-dam debris flows removed most of the deposits within 3 years. Releases in 1965 from Glen Canyon Dam that were above powerplant capacity but less than 1,640 m3/s removed most of the debris fan deposited in 1963, and the combination of dam releases and a 1973 flood on the Little Colorado River removed the 1966 aggradation. About 4,800 m3 of the 1995 deposit was reworked on the day of the 1995 debris flow, dam releases of less than 570 m3/s had not reworked the remainder of the aggraded debris fan. Lava Falls Rapid has been the most unstable reach of whitewater in Grand Canyon during the late Holocene and particularly during the last 120 years. Rapids in bedrock canyons controlled by tributary deposition in the main channel are aggradational features that reflect the net effect of tributary-mainstem interactions. Boulders that form the core of rapids in Grand Canyon are essentially immobile by both regulated and unregulated Colorado River flows. Historical operation of Glen Canyon Dam, which was completed in 1963, has reduced the potential for reworking of debris fans, and has accelerated the rate of net aggradation at the mouths of tributary canyons. Because debris fans that formed after 196

  13. HIV prevention cost-effectiveness: a systematic review

    PubMed Central

    2009-01-01

    Background After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion criteria included: HIV prevention intervention, year for publication (2005-2008), setting (low- and middle-income countries), and CE estimation (empirical or modeling) using outcomes in terms of cost per HIV infection averted and/or cost per disability-adjusted life year (DALY) or quality-adjusted life year (QALY). Results We found 21 distinct studies analyzing the CE of HIV-prevention interventions published in the past four years (2005-2008). Seventeen CE studies analyzed biomedical interventions; only a few dealt with behavioral and environmental/structural interventions. Sixteen studies focused on sub-Saharan Africa, and only a handful on Asia, Latin America and Eastern Europe. Many HIV-prevention interventions are very cost effective in absolute terms (using costs per DALY averted), and also in country-specific relative terms (in cost per DALY measured as percentage of GDP per capita). Conclusion There are several types of interventions for which CE studies are still not available or insufficient, including surveillance, abstinence, school-based education, universal precautions, prevention for positives and most structural interventions. The sparse CE evidence available is not easily comparable; thus, not very useful for decision

  14. Role of adapted physical activity to prevent the adverse effects of the sarcopenia. A pilot study.

    PubMed

    Marini, Mirca; Sarchielli, Erica; Brogi, Lucia; Lazzeri, Renzo; Salerno, Roberto; Sgambati, Eleonora; Monaci, Marco

    2008-01-01

    Sarcopenia is the physiological age related decline in muscle mass and strength. It is a main cause of muscle weakness and reduced locomotory ability and its adverse effects contributes to a reduction in physical function and performance with decreased independence and quality of life. In fact, sarcopenia has been associated with disability and morbidity in the elderly population. Therefore, prevention and treatment of sarcopenia are areas of intense interest. The studies suggest that the pathogenesis of sarcopenia is multifactorial, but the decreased physical activity with aging appears to be a key factor involved in producing this pathology. We investigated the role of adapted physical activity on the adverse effects of the sarcopenia: we examined the effect of a specific resistance training program in twenty sedentary older men, 60-80 years old, with sarcopenia. The program was performed three days a week for 18 total weeks with isotonic machines; in particular the exercises effected with leg press, chest press and vertical row were monitored using a Globus-Tesys dynamometer with Real Power. The maximum repetition test (1RM) was used to calculate the percentage of work and formulate the methodology. Our results demonstrated that the proposed training can improve the dynamic characteristics of muscle strength. In particular, we showed that a medium-low intensity training, structured in series and repetitions with gradual increased workload, produced a time-dependent improvement of strength. Our training increased the muscle strength mainly in the lower limbs reducing the risk of falls which frequently occurs in the elderly. Therefore, a planned resistance training could be an effective countermeasure to prevent or reduce the adverse effects of the sarcopenia improving the quality of life. The physical activity should be personalized and adapted to subject's age and/or disability. PMID:19507462

  15. The moderating effects of school climate on bullying prevention efforts.

    PubMed

    Low, Sabina; Van Ryzin, Mark

    2014-09-01

    Bullying prevention efforts have yielded mixed effects over the last 20 years. Program effectiveness is driven by a number of factors (e.g., program elements and implementation), but there remains a dearth of understanding regarding the role of school climate on the impact of bullying prevention programs. This gap is surprising, given research suggesting that bullying problems and climate are strongly related. The current study examines the moderating role of school climate on the impacts of a stand-alone bullying prevention curriculum. In addition, the current study examined 2 different dimensions of school climate across both student and staff perceptions. Data for this study were derived from a Steps to Respect (STR) randomized efficacy trial that was conducted in 33 elementary schools over a 1-year period. Schools were randomly assigned to intervention or wait-listed control condition. Outcome measures (pre-to-post) were obtained from (a) all school staff, (b) a randomly selected subset of 3rd-5th grade teachers in each school, and (c) all students in classrooms of selected teachers. Multilevel analyses revealed that psychosocial climate was strongly related to reductions in bullying-related attitudes and behaviors. Intervention status yielded only 1 significant main effect, although, STR schools with positive psychosocial climate at baseline had less victimization at posttest. Policies/administrative commitment to bullying were related to reduced perpetration among all schools. Findings suggest positive psychosocial climate (from both staff and student perspective) plays a foundational role in bullying prevention, and can optimize effects of stand-alone programs. PMID:25089333

  16. IDENTIFYING ROOF FALL PREDICTORS USING FUZZY CLASSIFICATION

    SciTech Connect

    Bertoncini, C. A.; Hinders, M. K.

    2010-02-22

    Microseismic monitoring involves placing geophones on the rock surfaces of a mine to record seismic activity. Classification of microseismic mine data can be used to predict seismic events in a mine to mitigate mining hazards, such as roof falls, where properly bolting and bracing the roof is often an insufficient method of preventing weak roofs from destabilizing. In this study, six months of recorded acoustic waveforms from microseismic monitoring in a Pennsylvania limestone mine were analyzed using classification techniques to predict roof falls. Fuzzy classification using features selected for computational ease was applied on the mine data. Both large roof fall events could be predicted using a Roof Fall Index (RFI) metric calculated from the results of the fuzzy classification. RFI was successfully used to resolve the two significant roof fall events and predicted both events by at least 15 hours before visual signs of the roof falls were evident.

  17. False fame prevented: avoiding fluency effects without judgmental correction.

    PubMed

    Topolinski, Sascha; Strack, Fritz

    2010-05-01

    Three studies show a way to prevent fluency effects independently of judgmental correction strategies by identifying and procedurally blocking the sources of fluency variations, which are assumed to be embodied in nature. For verbal stimuli, covert pronunciations are assumed to be the crucial source of fluency gains. As a consequence, blocking such pronunciation simulations through a secondary oral motor task decreased the false-fame effect for repeatedly presented names of actors (Experiment 1) as well as prevented increases in trust due to repetition for brand names and names of shares in the stock market (Experiment 2). Extending this evidence beyond repeated exposure, we demonstrated that blocking oral motor simulations also prevented fluency effects of word pronunciation on judgments of hazardousness (Experiment 3). Concerning the realm of judgment correction, this procedural blocking of (biasing) associative processes is a decontamination method not considered before in the literature, because it is independent of exposure control, mood, motivation, and post hoc correction strategies. The present results also have implications for applied issues, such as advertising and investment decisions. PMID:20438220

  18. The counterintuitive effect of summer-to-fall mixed layer deepening on eukaryotic new production in the Sargasso Sea

    NASA Astrophysics Data System (ADS)

    Fawcett, Sarah E.; Lomas, Michael W.; Ward, Bess B.; Sigman, Daniel M.

    2014-02-01

    The Sargasso Sea is characterized by strong summertime stratification that is thought to drive oligotrophy, but export production is surprisingly similar to that of high-latitude regions with ample major nutrient supply. Here we use the summer-to-fall progression in the northwestern Sargasso Sea to investigate the relationship between upper ocean stratification and phytoplankton nitrogen (N) uptake. Euphotic zone particles collected in July, October, and December were sorted by flow cytometry, and the 15N/14N of separated prokaryotic and eukaryotic phytoplankton was analyzed. The 15N/14N of Prochlorococcus and Synechococcus was always low, indicating uniform reliance on recycled N. In July and in two fall profiles, the 15N/14N of eukaryotic phytoplankton was high, reflecting consumption of subsurface nitrate. In three other fall profiles, eukaryotic 15N/14N was similar to prokaryote 15N/14N, suggesting a shift toward more complete reliance on recycled N. The progressive deepening of the mixed layer from summer to fall, although reducing the surface-to-deep density contrast, increases the density difference of the euphotic zone as a whole from underlying nutrient-rich waters, which may play a role in the observed decline in euphotic zone nitrate supply into the fall. The apparent summertime nitrate supply to the euphotic zone, when the mixed layer is shallowest, may help to explain the surprisingly high export production of the subtropical and tropical ocean.

  19. Summary of factors contributing to falls in older adults and nursing implications.

    PubMed

    Enderlin, Carol; Rooker, Janet; Ball, Susan; Hippensteel, Dawn; Alderman, Joanne; Fisher, Sarah Jean; McLeskey, Nanci; Jordan, Kerry

    2015-01-01

    Falls are a common cause of serious injury and injury-related death in the older adult population, and may be associated with multiple risks such as age, history of falls, impaired mobility, balance and gait problems, and medications. Sensory and environmental factors as well as the fear of falling may also increase the risk of falls. The purpose of this article is to review current best practice on screening fall risks and fear of falling, fall prevention strategies, and fall prevention resources to assist gerontological nurses in reducing falls by their older adult clients. PMID:26343008

  20. Assessment of channel changes, model of historical floods, and effects of backwater on flood stage, and flood mitigation alternatives for the Wichita River at Wichita Falls, Texas

    USGS Publications Warehouse

    Winters, Karl E.; Baldys, Stanley

    2011-01-01

    In cooperation with the City of Wichita Falls, the U.S. Geological Survey assessed channel changes on the Wichita River at Wichita Falls, Texas, and modeled historical floods to investigate possible causes and potential mitigation alternatives to higher flood stages in recent (2007 and 2008) floods. Extreme flooding occurred on the Wichita River on June 30, 2007, inundating 167 homes in Wichita Falls. Although a record flood stage was reached in June 2007, the peak discharge was much less than some historical floods at Wichita Falls. Streamflow and stage data from two gages on the Wichita River and one on Holliday Creek were used to assess the interaction of the two streams. Changes in the Wichita River channel were evaluated using historical aerial and ground photography, comparison of recent and historical cross sections, and comparison of channel roughness coefficients with those from earlier studies. The floods of 2007 and 2008 were modeled using a one-dimensional step-backwater model. Calibrated channel roughness was larger for the 2007 flood compared to the 2008 flood, and the 2007 flood peaked about 4 feet higher than the 2008 flood. Calibration of the 1941 flood yielded a channel roughness coefficient (Manning's n) of 0.030, which represents a fairly clean natural channel. The step-backwater model was also used to evaluate the following potential mitigation alternatives: (1) increasing the capacity of the bypass channel near River Road in Wichita Falls, Texas; (2) removal of obstructions near the Scott Avenue and Martin Luther King Junior Boulevard bridges in Wichita Falls, Texas; (3) widening of aggraded channel banks in the reach between Martin Luther King Junior Boulevard and River Road; and (4) reducing channel bank and overbank roughness. Reductions in water-surface elevations ranged from 0.1 foot to as much as 3.0 feet for the different mitigation alternatives. The effects of implementing a combination of different flood-mitigation alternatives were

  1. Distinguishing the causes of falls in humans using an array of wearable tri-axial accelerometers.

    PubMed

    Aziz, Omar; Park, Edward J; Mori, Greg; Robinovitch, Stephen N

    2014-01-01

    Falls are the number one cause of injury in older adults. Lack of objective evidence on the cause and circumstances of falls is often a barrier to effective prevention strategies. Previous studies have established the ability of wearable miniature inertial sensors (accelerometers and gyroscopes) to automatically detect falls, for the purpose of delivering medical assistance. In the current study, we extend the applications of this technology, by developing and evaluating the accuracy of wearable sensor systems for determining the cause of falls. Twelve young adults participated in experimental trials involving falls due to seven causes: slips, trips, fainting, and incorrect shifting/transfer of body weight while sitting down, standing up from sitting, reaching and turning. Features (means and variances) of acceleration data acquired from four tri-axial accelerometers during the falling trials were input to a linear discriminant analysis technique. Data from an array of three sensors (left ankle+right ankle+sternum) provided at least 83% sensitivity and 89% specificity in classifying falls due to slips, trips, and incorrect shift of body weight during sitting, reaching and turning. Classification of falls due to fainting and incorrect shift during rising was less successful across all sensor combinations. Furthermore, similar classification accuracy was observed with data from wearable sensors and a video-based motion analysis system. These results establish a basis for the development of sensor-based fall monitoring systems that provide information on the cause and circumstances of falls, to direct fall prevention strategies at a patient or population level. PMID:24148648

  2. Inoculation effect in prevention of increased verbal aggression in schools.

    PubMed

    Rosenberg, Steven

    2004-12-01

    This paper presents an argument for the use of intervention programs as inoculation agents in adolescents' social behavior, specifically the prevention of abusive and antisocial verbal aggression. The theoretical substance of the intervention is social-cognitive and eclectic, borrowing from several strategies known to be effective. The bridge between theory and curriculum is an inoculation-like process. Inoculation is not a strategy to change beliefs but rather to reinforce prosocial attitudes and assist students in overcoming influences that might lessen their prosocial stance. Results must include a control group to assess the effect of inoculation. PMID:15762403

  3. The Effect of Pramipexole Therapy on Balance Disorder and Fall Risk in Parkinson's Disease at Early Stage: Clinical and Posturographic Assessment

    PubMed Central

    Güler, Sibel; Bir, Levent Sinan; Akdag, Beyza; Ardıc, Fusun

    2012-01-01

    The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson's patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson's patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson's disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy. PMID:22919514

  4. Caries-preventive effect of fissure sealants: a systematic review.

    PubMed

    Mejàre, Ingegerd; Lingström, Peter; Petersson, Lars G; Holm, Anna-Karin; Twetman, Svante; Källestål, Carina; Nordenram, Gunilla; Lagerlöf, Folke; Söder, Birgitta; Norlund, Anders; Axelsson, Susanna; Dahlgren, Helena

    2003-12-01

    The objectives of this study were to evaluate systematically the evidence of the caries-preventive effect of fissure sealing of occlusal tooth surfaces and to examine factors potentially modifying the effect. The search strategies included electronic databases, reference lists of articles, and selected textbooks. Inclusion criteria were randomized or quasi-randomized clinical trials or controlled clinical trials comparing fissure sealing with no treatment or another preventive treatment in children up to 14 years of age at the start; the outcome measure was caries increment; the diagnostic criteria had been described; and the follow-up time was at least 2 years. Inclusion decisions were taken and grading of the studies was done independently by two of the authors. The main measure of effect was relative risk reduction. Thirteen studies using resin-based or glass ionomer sealant materials were included in the final analysis. The results showed that most studies were performed during the 1970s and a single application had been utilized. The relative caries risk reduction pooled estimate of resin-based sealants on permanent 1st molars was 33% (relative risk = 0.67; CI = 0.55-0.83). The effect depended on retention of the sealant. In conclusion, the review suggests limited evidence that fissure sealing of 1st permanent molars with resin-based materials has a caries-preventive effect. The evidence is incomplete for permanent 2nd molars, premolars and primary molars and for glass ionomer cements. Overall, there remains a need for further trials of high quality, particularly in child populations with a low and a high caries risk, respectively. PMID:14960003

  5. The Complex Interplay of Depression and Falls in Older Adults: A Clinical Review

    PubMed Central

    Iaboni, Andrea; Flint, Alastair J.

    2016-01-01

    Depression and falls have a significant bidirectional relationship. Excessive fear of falling, which is frequently associated with depression, also increases the risk of falls. Both depression and fear of falling are associated with impairment of gait and balance, an association that is mediated through cognitive, sensory, and motor pathways. The management of depression in fall-prone individuals is challenging, since antidepressant medications can increase the risk of falls, selective serotonin reuptake inhibitors may increase the risk of fragility fractures, and data are lacking about the effect of fall rehabilitation programs on clinically significant depression. Based on the current state of knowledge, exercise (particularly Tai Chi) and cognitive–behavioral therapy should be considered for the first-line treatment of mild depression in older fallers. Antidepressant medications are indicated to treat moderate to severe depression in fall-prone individuals, but with appropriate precautions including low starting dose and slow dose titration, use of psychotropic monotherapy whenever possible, and monitoring for orthostatic hypotension and hyponatremia. To date, there have been no recommendations for osteoporosis monitoring and treatment in individuals prescribed antidepressant medications, beyond the usual clinical guidelines. However, treatment of the older depressed person who is at risk of falls provides the opportunity to inquire about his or her adherence with osteoporosis and fracture-prevention guidelines. PMID:23570891

  6. Effectiveness of light paths coupled with personal emergency response systems in preventing functional decline among the elderly

    PubMed Central

    Lachal, Florent; Tchalla, Achille Edem; Cardinaud, Noëlle; Saulnier, Isabelle; Nessighaoui, Hichem; Laubarie-Mouret, Cécile; Dantoine, Thierry

    2016-01-01

    Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more) living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0) and at the end of the study (T12-month). Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5) at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54), p = 0.002). Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies.

  7. Kinematic effect of Nintendo Wii(TM) sports program exercise on obstacle gait in elderly women with falling risk.

    PubMed

    Jung, Dae-In; Ko, Dae-Sik; Jeong, Mi-Ae

    2015-05-01

    [Purpose] This study evaluated the changes in balance ability and obstacle gait after lumbar stabilization exercise and Nintendo Wii(TM) Sports in elderly at risk for falls. [Subjects and Methods] Twenty-four elderly women with at risk for falls were randomly divided into the control, lumbar stabilization exercise, and Nintendo Wii Sports groups. Static balance was measured by the Berg Balance Scale and functional reach test, dynamic balance by the timed up-and-go test, and obstacle negotiation function by crossing velocity and maximum vertical heel clearance. [Results] Both the lumbar stabilization exercise and Nintendo Wii Sports groups showed significant improvements in obstacle negotiation function after the exercise compared to the control group. Berg Balance Scale and functional reach test scores were greater in the lumbar stabilization exercise group, while the timed up-and-go test time was significantly better in the Nintendo Wii Sports groups. [Conclusion] Lumbar stabilization exercises and Nintendo Wii Sports improve falling related balance and obstacle negotiation function in elderly women at risk for falls. PMID:26157228

  8. Kinematic effect of Nintendo WiiTM sports program exercise on obstacle gait in elderly women with falling risk

    PubMed Central

    Jung, Dae-In; Ko, Dae-Sik; Jeong, Mi-Ae

    2015-01-01

    [Purpose] This study evaluated the changes in balance ability and obstacle gait after lumbar stabilization exercise and Nintendo WiiTM Sports in elderly at risk for falls. [Subjects and Methods] Twenty-four elderly women with at risk for falls were randomly divided into the control, lumbar stabilization exercise, and Nintendo Wii Sports groups. Static balance was measured by the Berg Balance Scale and functional reach test, dynamic balance by the timed up-and-go test, and obstacle negotiation function by crossing velocity and maximum vertical heel clearance. [Results] Both the lumbar stabilization exercise and Nintendo Wii Sports groups showed significant improvements in obstacle negotiation function after the exercise compared to the control group. Berg Balance Scale and functional reach test scores were greater in the lumbar stabilization exercise group, while the timed up-and-go test time was significantly better in the Nintendo Wii Sports groups. [Conclusion] Lumbar stabilization exercises and Nintendo Wii Sports improve falling related balance and obstacle negotiation function in elderly women at risk for falls. PMID:26157228

  9. Effects of hyporheic exchange flows on egg pocket water temperature in Snake River fall Chinook salmon spawning areas

    SciTech Connect

    Hanrahan, T. P.; Geist, D. R.; Arntzen, E. V.; Abernethy, C. S.

    2004-09-01

    The development of the Snake River hydroelectric system has affected fall Chinook salmon smolts by shifting their migration timing to a period (mid- to late-summer) when downstream reservoir conditions are unfavorable for survival. Subsequent to the Snake River Chinook salmon fall-run Evolutionary Significant Unit being listed as Threatened under the Endangered Species Act, recovery planning has included changes in hydrosystem operations (e.g., summer flow augmentation) to improve water temperature and flow conditions during the juvenile Chinook salmon summer migration period. In light of the limited water supplies from the Dworshak reservoir for summer flow augmentation, and the associated uncertainties regarding benefits to migrating fall Chinook salmon smolts, additional approaches for improved smolt survival need to be evaluated. This report describes research conducted by the Pacific Northwest National Laboratory (PNNL) that evaluated relationships among river discharge, hyporheic zone characteristics, and egg pocket water temperature in Snake River fall Chinook salmon spawning areas. This was a pilot-scale study to evaluate these relationships under existing operations of Hells Canyon Dam (i.e., without any prescribed manipulations of river discharge) during the 2002–2003 water year.

  10. Cardiovascular disease prevention and lifestyle interventions: effectiveness and efficacy.

    PubMed

    Haskell, William L

    2003-01-01

    Over the past half century scientific data support the strong relationship between the way a person or population lives and their risk for developing or dying from cardiovascular disease (CVD). While heredity can be a major factor for some people, their personal health habits and environmental/cultural exposure are more important factors. CVD is a multifactor process that is contributed to by a variety of biological and behavioral characteristics of the person including a number of well-established and emerging risk factors. Not smoking, being physically active, eating a heart healthy diet, staying reasonably lean, and avoiding major stress and depression are the major components of an effective CVD prevention program. For people at high risk of CVD, medications frequently need to be added to a healthy lifestyle to minimize their risk of a heart attack or stroke, particularly in persons with conditions such as hypertension, hypercholesterolemia, or hyperglycemia. Maintaining an effective CVD prevention program in technologically advanced societies cannot be achieved by many high-risk persons without effective and sustained support from a well-organized health care system. Nurse-provided or nurse-coordinated care management programs using an integrated or multifactor approach have been highly effective in reducing CVD morbidity and mortality of high-risk persons. PMID:14518600

  11. The role of primary care providers in managing falls.

    PubMed

    Demons, Jamehl L; Duncan, Pamela W

    2014-01-01

    Falls threaten the ability of older adults to live independently in the community. Fortunately, national and state organizations have created tools that allow primary care providers to easily assess fall risk, and small changes in practice patterns can provide patients with the resources necessary to prevent falls, thus helping to reverse a costly, deadly epidemic. PMID:25237872

  12. Economic Evaluation of a Tai Ji Quan Intervention to Reduce Falls in People With Parkinson Disease, Oregon, 2008–2011

    PubMed Central

    Harmer, Peter

    2015-01-01

    Introduction Exercise is effective in reducing falls in people with Parkinson disease. However, information on the cost effectiveness of this approach is lacking. We conducted a cost-effectiveness analysis of Tai Ji Quan for reducing falls among patients with mild-to-moderate Parkinson disease. Methods We used data from a previous intervention trial to analyze resource use costs related to intervention delivery and number of falls observed during a 9-month study period. Cost effectiveness was estimated via incremental cost-effectiveness ratio (ICER) in which Tai Ji Quan was compared with 2 alternative interventions (Resistance training and Stretching) on the primary outcome of per fall prevented and the secondary outcome of per participant quality-adjusted life years (QALY) gained. We also conducted subgroup and sensitivity analyses. Results Tai Ji Quan was more effective than either Resistance training or Stretching; it had the lowest cost and was the most effective in improving primary and secondary outcomes. Compared with Stretching, Tai Ji Quan cost an average of $175 less for each additional fall prevented and produced a substantial improvement in QALY gained at a lower cost. Results from subgroup and sensitivity analyses showed no variation in cost-effectiveness estimates. However, sensitivity analyses demonstrated a much lower ICER ($27) when only intervention costs were considered. Conclusion Tai Ji Quan represents a cost-effective strategy for optimizing spending to prevent falls and maximize health gains in people with Parkinson disease. While these results are promising, they warrant further validation. PMID:26226067

  13. Contextualism and the development of effective prevention practices.

    PubMed

    Biglan, Anthony

    2004-03-01

    Widespread and effective implementation of research-based prevention practices will be facilitated by the explicit adoption of a functional contextualist framework for prevention research. Such a framework has as its central goal predicting and influencing behavior and cultural practices. Research within this framework is evaluated in terms of its ability to contribute to that goal. As a result, it contributes directly to the ultimate goals of prevention science-affecting the incidence and prevalence of problems in populations. The approach contrasts with the mechanist framework, which is implicit in much behavioral science research. The mechanist framework has as its truth criterion the predictive verification of models of the interrelationships among variables. Such models can-but need not-identify manipulable variables that can be exploited to affect problems of interest. Such models require the inclusion of multiple cases for testing and this requirement may impede the tendency of scientists to work with a single school or community. Functional contextualism is suited to the study of the individual case. It provides a framework within which researchers can more readily collaborate with practitioners in the development and further evaluation of practices within the settings where practitioners will ultimately use those practices. PMID:15058908

  14. Prevention of periprosthetic joint infection: what are the effective strategies?

    PubMed

    Alijanipour, Pouya; Heller, Snir; Parvizi, Javad

    2014-08-01

    Periprosthetic joint infection (PJI) following total knee arthroplasty is a major burden for patients and health systems. Prevention of this challenging complication through implementation of effective strategies should be a priority. These strategies should encompass various levels of patient care. Multiple modifiable risk factors such as uncontrolled hyperglycemia, obesity, smoking, substance abuse, and nasal colonization with Staphylococcus aureus have been described for PJI. Preoperative recognition and mitigation of these risk factors along with optimization of nonmodifiable risk factors such as kidney, liver, or immune system insufficiency can considerably decrease the risk of PJI. A comprehensive perioperative protocol should involve optimization of the operative environment to reduce the number of bacteria and particulates in the air. Several surgical and nonsurgical details of intraoperative care such as maintenance of normothermia, skin preparation, surgical field irrigation, wound closure, and duration of surgical and anesthetic procedure can influence the occurrence of PJI. Prophylactic perioperative antibiotic administration is probably one of the most important strategies in preventing PJI. Implementation of surgical safety checklist can diminish the risk of perioperative complications, particularly surgical site infection. Controversy regarding efficacy, efficiency, and optimization of some preventive measures continues to exist due to inconsistency or inadequacy of available evidence. Novel research has focused on designing PJI-resistant implants and developing vaccines that target molecule components with major role in the process of bacterial adhesion to the implant or periprosthetic tissues. PMID:24792971

  15. Gestational diabetes mellitus: does an effective prevention strategy exist?

    PubMed

    Agha-Jaffar, Rochan; Oliver, Nick; Johnston, Desmond; Robinson, Stephen

    2016-09-01

    The overall incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Preventing pathological hyperglycaemia during pregnancy could have several benefits: a reduction in the immediate adverse outcomes during pregnancy, a reduced risk of long-term sequelae and a decrease in the economic burden to healthcare systems. In this Review we examine the evidence supporting lifestyle modification strategies in women with and without risk factors for GDM, and the efficacy of dietary supplementation and pharmacological approaches to prevent this disease. A high degree of heterogeneity exists between trials so a generalised recommendation is problematic. In population studies of dietary or combined lifestyle measures, risk of developing GDM is not improved and those involving a physical activity intervention have yielded conflicting results. In pregnant women with obesity, dietary modification might reduce fetal macrosomia but in these patients, low compliance and no significant reduction in the incidence of GDM has been observed in trials investigating physical activity. Supplementation with probiotics or myoinositol have reduced the incidence of GDM but confirmatory studies are still needed. In randomized controlled trials, metformin does not prevent GDM in certain at-risk groups. Given the considerable potential for reducing disease burden, further research is needed to identify strategies that can be easily and effectively implemented on a population level. PMID:27339886

  16. Enhanced Estimates of the Influenza Vaccination Effect in Preventing Mortality

    PubMed Central

    Castilla, Jesús; Guevara, Marcela; Martínez-Baz, Iván; Ezpeleta, Carmen; Delfrade, Josu; Irisarri, Fátima; Moreno-Iribas, Conchi

    2015-01-01

    Abstract Mortality is a major end-point in the evaluation of influenza vaccine effectiveness. However, this effect is not well known, since most previous studies failed to show good control of biases. We aimed to estimate the effectiveness of influenza vaccination in preventing all-cause mortality in community-dwelling seniors. Since 2009, a population-based cohort study using healthcare databases has been conducted in Navarra, Spain. In 2 late influenza seasons, 2011/2012 and 2012/2013, all-cause mortality in the period January to May was compared between seniors (65 years or over) who received the trivalent influenza vaccine and those who were unvaccinated, adjusting for demographics, major chronic conditions, dependence, previous hospitalization, and pneumococcal vaccination. The cohort included 103,156 seniors in the 2011/2012 season and 105,140 in the 2012/2013 season (58% vaccinated). Seniors vaccinated in the previous season who discontinued vaccination (6% of the total) had excess mortality and were excluded to prevent frailty bias. The final analysis included 80,730 person-years and 2778 deaths. Vaccinated seniors had 16% less all-cause mortality than those unvaccinated (adjusted rate ratio [RR] = 0.84; 95% confidence interval 0.76–0.93). This association disappeared in the post-influenza period (adjusted RR = 0.96; 95% confidence interval 0.85–1.09). A similar comparison did not find an association in January to May of the 2009/2010 pandemic season (adjusted RR = 0.98; 95% confidence interval 0.84–1.14), when no effect of the seasonal vaccine was expected. On average, 1 death was prevented for every 328 seniors vaccinated: 1 for every 649 in the 65 to 74 year age group and 1 for every 251 among those aged 75 and over. These results suggest a moderate preventive effect and a high potential impact of the seasonal influenza vaccine against all-cause mortality. This reinforces the recommendation of annual influenza vaccination in seniors

  17. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial

    PubMed Central

    Morello, Renata T; Wolfe, Rory; Brand, Caroline A; Haines, Terry P; Hill, Keith D; Brauer, Sandra G; Botti, Mari; Cumming, Robert G; Livingston, Patricia M; Sherrington, Catherine; Zavarsek, Silva; Lindley, Richard I; Kamar, Jeannette

    2016-01-01

    Objective To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. Design Cluster randomised controlled trial. Setting Six Australian hospitals. Participants All patients admitted to 24 acute wards during the trial period. Interventions Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: “falls alert” sign, supervision of patients in the bathroom, ensuring patients’ walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. Main outcome measures The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. Results During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients’ characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; P<0.001). In all, 1831 falls and 613 fall injuries occurred, and the rates of falls (incidence rate ratio 1.04, 0.78 to 1.37; P=0.796) and fall injuries (0.96, 0.72 to 1.27; P=0.766) were similar in intervention and control wards. Conclusions Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611000332921. PMID:26813674

  18. Long-term effects of adolescent marijuana use prevention on adult mental health services utilization: the midwestern prevention project.

    PubMed

    Riggs, Nathaniel R; Pentz, Mary Ann

    2009-01-01

    Evaluated were effects of a drug abuse(1) prevention program, previously shown to prevent marijuana use in adolescence, on adulthood mental health service use. Analyses were conducted on 961 6th (41%) and 7th (59%) grade participants randomly assigned to intervention or control groups at baseline in 1984. These participants were followed-up through 2003 representing 15 waves of data collection. Eighty-five percent of participants were Caucasian and 56% were female. The hypothesis was that direct program effects on early adulthood mental health service use would be mediated by program effects on high school marijuana use trajectories. Structural equation models, imputing for missing data, demonstrated that MPP (Midwestern Prevention Project) program effects on mental health were mediated by the marijuana use growth curve intercept. Findings support the role of early adolescent drug use prevention programs in impacting later mental health problems. The study's limitations are noted. PMID:19360536

  19. Local dynamic stability as a responsive index for the evaluation of rehabilitation effect on fall risk in patients with multiple sclerosis: a longitudinal study

    PubMed Central

    2013-01-01

    Background Gait and balance problems are common in patients with multiple sclerosis, leading to high risk for falls. Local Dynamic Stability (LDS), a non-linear gait stability index, has been advocated as an early indicator of risk for falls. With this longitudinal study over three weeks, we aimed to assess the responsiveness of Local Dynamic Stability to a rehabilitation program and to compare it to other measures. Methods Eighteen patients (mean 54 years, median EDSS score: 5) participated. They were admitted to inpatient rehabilitation and received a three weeks individually tailored program. They performed a 3-minute walking test at the beginning and at the end of the stay, as well as pain, wellbeing, fatigue, and balance assessment. The Local Dynamic Stability was computed from the acceleration signals measured with a 3D-accelerometer. Results At the end of the rehabilitation process, patients reported reduced pain (Effect Size: −0.7), fatigue (ES:-0.6), and increased wellbeing (ES: 1.1). A small positive effect on static balance was observed (ES: 0.3). LDS was improved (ES: 0.6), and the effect was higher than walking speed improvement (ES: 0.4). Conclusions The Local Dynamic Stability seemed responsive to assess rehabilitation effects in patients with multiple sclerosis. It could constitute a valuable gait quality index, which could evaluate potential effects of rehabilitation on fall risk. Trial registration Current Controlled Trials ISRCTN69803702. PMID:23835061

  20. Fall Risk Assessment Tools for Elderly Living in the Community: Can We Do Better?

    PubMed Central

    Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Chiari, Lorenzo

    2015-01-01

    Background Falls are a common, serious threat to the health and self-confidence of the elderly. Assessment of fall risk is an important aspect of effective fall prevention programs. Objectives and methods In order to test whether it is possible to outperform current prognostic tools for falls, we analyzed 1010 variables pertaining to mobility collected from 976 elderly subjects (InCHIANTI study). We trained and validated a data-driven model that issues probabilistic predictions about future falls. We benchmarked the model against other fall risk indicators: history of falls, gait speed, Short Physical Performance Battery (Guralnik et al. 1994), and the literature-based fall risk assessment tool FRAT-up (Cattelani et al. 2015). Parsimony in the number of variables included in a tool is often considered a proxy for ease of administration. We studied how constraints on the number of variables affect predictive accuracy. Results The proposed model and FRAT-up both attained the same discriminative ability; the area under the Receiver Operating Characteristic (ROC) curve (AUC) for multiple falls was 0.71. They outperformed the other risk scores, which reported AUCs for multiple falls between 0.64 and 0.65. Thus, it appears that both data-driven and literature-based approaches are better at estimating fall risk than commonly used fall risk indicators. The accuracy–parsimony analysis revealed that tools with a small number of predictors (~1–5) were suboptimal. Increasing the number of variables improved the predictive accuracy, reaching a plateau at ~20–30, which we can consider as the best trade-off between accuracy and parsimony. Obtaining the values of these ~20–30 variables does not compromise usability, since they are usually available in comprehensive geriatric assessments. PMID:26716861

  1. Predicting Falls in Parkinson Disease: What Is the Value of Instrumented Testing in OFF Medication State?

    PubMed Central

    Hoskovcová, Martina; Dušek, Petr; Sieger, Tomáš; Brožová, Hana; Zárubová, Kateřina; Bezdíček, Ondřej; Šprdlík, Otakar; Jech, Robert; Štochl, Jan; Roth, Jan; Růžička, Evžen

    2015-01-01

    Background Falls are a common complication of advancing Parkinson's disease (PD). Although numerous risk factors are known, reliable predictors of future falls are still lacking. The objective of this prospective study was to investigate clinical and instrumented tests of balance and gait in both OFF and ON medication states and to verify their utility in the prediction of future falls in PD patients. Methods Forty-five patients with idiopathic PD were examined in defined OFF and ON medication states within one examination day including PD-specific clinical tests, instrumented Timed Up and Go test (iTUG) and computerized dynamic posturography. The same gait and balance tests were performed in 22 control subjects of comparable age and sex. Participants were then followed-up for 6 months using monthly fall diaries and phone calls. Results During the follow-up period, 27/45 PD patients and 4/22 control subjects fell one or more times. Previous falls, fear of falling, more severe motor impairment in the OFF state, higher PD stage, more pronounced depressive symptoms, higher daily levodopa dose and stride time variability in the OFF state were significant risk factors for future falls in PD patients. Increased stride time variability in the OFF state in combination with faster walking cadence appears to be the most significant predictor of future falls, superior to clinical predictors. Conclusion Incorporating instrumented gait measures into the baseline assessment battery as well as accounting for both OFF and ON medication states might improve future fall prediction in PD patients. However, instrumented testing in the OFF state is not routinely performed in clinical practice and has not been used in the development of fall prevention programs in PD. New assessment methods for daylong monitoring of gait, balance and falls are thus required to more effectively address the risk of falling in PD patients. PMID:26443998

  2. Ultraviolet radiation and health: from hazard identification to effective prevention.

    PubMed

    Yamaguchi, N; Kinjo, Y; Akiba, S; Watanabe, S

    1999-12-01

    The increased exposure to ultraviolet (UV) radiation due to ozone depletion is one of the most serious global health problems. The UV exposure is known to cause skin carcinoma, cataract and deteriorated immune function, but for countries like Japan, the magnitude of health effects of UV radiation is yet to be elucidated. The International Workshop on the Health Effects of Ultraviolet Radiation was held in Tokyo, Japan, on February 17-19, 1999, in attempts to visualize the size of this problem and to identify better solutions. Through this workshop, several lines of scientific evidence were provided, which clearly show that the risk of cataract and skin cancer among people living in Japan increases with the increasing level of sun exposure. We must seek, therefore, the extent to which the UV exposure of given intensity causes adverse health effects in Japanese population. Through the workshop, the importance of preventive measure was confirmed. The scientific basis of prevention is, of course, the knowledge of dose-response relationship and the current exposure status in Japanese population. It is hoped that the communications between researchers in Japan and other countries are strengthened through this workshop. PMID:10709343

  3. Prevention of dipyrone (metamizole) induced inhibition of aspirin antiplatelet effects.

    PubMed

    Polzin, Amin; Richter, Stefan; Schrör, Karsten; Rassaf, Tienush; Merx, Marc W; Kelm, Malte; Hohlfeld, Thomas; Zeus, Tobias

    2015-07-01

    We have recently shown that dipyrone (metamizole), a non-opioid analgesic, can nullify aspirin (acetylsalicylic acid; ASA) antiplatelet effects in patients with coronary artery disease (CAD). In this study, we analysed the aspirin and dipyrone drug-drug interaction in order to identify strategies to prevent the dipyrone induced inhibition of asprin antiplatelet effects. Platelet function was measured by arachidonic acid-induced light-transmission aggregometry, thromboxane (TX) B2- formation by immunoassay. Dipyrone metabolite plasma levels were determined by high-performance-liquid-chromatography (HPLC). In seven healthy individuals, in vitro ASA (30 µM/ 100 µM/ 300 µM/ 1,000 µM) and dipyrone (10 µM) coincubation revealed, that the aspirin and dipyrone interaction can be overcome by increasing doses of aspirin. In 36 aspirin and dipyrone comedicated CAD patients, addition of ASA (30 µM/ 100 µM) in vitro inhibited, but did not completely overcome the dipyrone induced reduction of aspirin antiplatelet effects. Notably, the inhibition of thromboxane formation in aspirin and dipyrone comedicated CAD patients coincided with dipyrone plasma levels. In a cross-over designed study in four healthy individuals, we were able to prove that inhibition of aspirin (100 mg/ day) effects by dipyrone (750 mg/ day) was reversible. Furthermore, aspirin (100 mg/ day) medication prior to dipyrone (750 mg/ day) intake prevented the inhibition of antiplatelet effects by dipyrone in 12 healthy individuals. In conclusion, aspirin medication prior to dipyrone intake preserves antiplatelet effects, circumventing the pharmacodynamic drug-drug interaction at the level of cyclooxygenase-1. PMID:25789542

  4. Preventive Effects of Houttuynia cordata Extract for Oral Infectious Diseases.

    PubMed

    Sekita, Yasuko; Murakami, Keiji; Yumoto, Hiromichi; Amoh, Takashi; Fujiwara, Natsumi; Ogata, Shohei; Matsuo, Takashi; Miyake, Yoichiro; Kashiwada, Yoshiki

    2016-01-01

    Houttuynia cordata (HC) (Saururaceae) has been used internally and externally as a traditional medicine and as an herbal tea for healthcare in Japan. Our recent survey showed that HC poultice (HCP) prepared from smothering fresh leaves of HC had been frequently used for the treatment of purulent skin diseases with high effectiveness. Our experimental study also demonstrated that ethanol extract of HCP (eHCP) has antibacterial, antibiofilm, and anti-inflammatory effects against S. aureus which caused purulent skin diseases. In this study, we focused on novel effects of HCP against oral infectious diseases, such as periodontal disease and dental caries. We determined the antimicrobial and antibiofilm effects of water solution of HCP ethanol extract (wHCP) against important oral pathogens and investigated its cytotoxicity and anti-inflammatory effects on human oral epithelial cells. wHCP had moderate antimicrobial effects against some oral microorganisms and profound antibiofilm effects against Fusobacterium nucleatum, Streptococcus mutans, and Candida albicans. In addition, wHCP had no cytotoxic effects and could inhibit interleukin-8 and CCL20 productions by Porphyromonas gingivalis lipopolysaccharide-stimulated human oral keratinocytes. Our findings suggested that wHCP may be clinically useful for preventing oral infectious diseases as a mouthwash for oral care. PMID:27413739

  5. Preventive Effects of Houttuynia cordata Extract for Oral Infectious Diseases

    PubMed Central

    Sekita, Yasuko; Murakami, Keiji; Amoh, Takashi; Ogata, Shohei; Matsuo, Takashi; Miyake, Yoichiro; Kashiwada, Yoshiki

    2016-01-01

    Houttuynia cordata (HC) (Saururaceae) has been used internally and externally as a traditional medicine and as an herbal tea for healthcare in Japan. Our recent survey showed that HC poultice (HCP) prepared from smothering fresh leaves of HC had been frequently used for the treatment of purulent skin diseases with high effectiveness. Our experimental study also demonstrated that ethanol extract of HCP (eHCP) has antibacterial, antibiofilm, and anti-inflammatory effects against S. aureus which caused purulent skin diseases. In this study, we focused on novel effects of HCP against oral infectious diseases, such as periodontal disease and dental caries. We determined the antimicrobial and antibiofilm effects of water solution of HCP ethanol extract (wHCP) against important oral pathogens and investigated its cytotoxicity and anti-inflammatory effects on human oral epithelial cells. wHCP had moderate antimicrobial effects against some oral microorganisms and profound antibiofilm effects against Fusobacterium nucleatum, Streptococcus mutans, and Candida albicans. In addition, wHCP had no cytotoxic effects and could inhibit interleukin-8 and CCL20 productions by Porphyromonas gingivalis lipopolysaccharide-stimulated human oral keratinocytes. Our findings suggested that wHCP may be clinically useful for preventing oral infectious diseases as a mouthwash for oral care. PMID:27413739

  6. Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand

    PubMed Central

    2010-01-01

    Background Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand. Methods A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria. Results The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner. Conclusion We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand. PMID:20604975

  7. Preventing falls - what to ask your doctor

    MedlinePlus

    ... Ankle replacement Bunion removal Cataract removal Corneal transplant Hip joint replacement Knee joint replacement Spinal fusion Patient Instructions ... discharge Stroke - discharge Taking care of your new hip joint Update Date 2/8/2015 Updated by: Laura ...

  8. Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial

    PubMed Central

    Shaw, Fiona E; Bond, John; Richardson, David A; Dawson, Pamela; Steen, I Nicholas; McKeith, Ian G; Kenny, Rose Anne

    2003-01-01

    Objective To determine the effectiveness of multifactorial intervention after a fall in older patients with cognitive impairment and dementia attending the accident and emergency department. Design Randomised controlled trial. Participants 274 cognitively impaired older people (aged 65 or over) presenting to the accident and emergency department after a fall: 130 were randomised to assessment and intervention and 144 were randomised to assessment followed by conventional care (control group). Setting Two accident and emergency departments, Newcastle upon Tyne. Main outcome measures Primary outcome was number of participants who fell in year after intervention. Secondary outcomes were number of falls (corrected for diary returns), time to first fall, injury rates, fall related attendances at accident and emergency department, fall related hospital admissions, and mortality. Results Intention to treat analysis showed no significant difference between intervention and control groups in proportion of patients who fell during 1 year's follow up (74% (96/130) and 80% (115/144), relative risk ratio 0.92, 95% confidence interval 0.81 to 1.05). No significant differences were found between groups for secondary outcome measures. Conclusions Multifactorial intervention was not effective in preventing falls in older people with cognitive impairment and dementia presenting to the accident and emergency department after a fall. What is already known on this topicMultifactorial intervention prevents falls in cognitively normal older people living in the community and in those who present to the accident and emergency department after a fallFall prevention strategies have not been tested by controlled trials in patients with cognitive impairment and dementia who fallWhat this study addsNo benefit was shown from multifactorial assessment and intervention after a fall in patients with cognitive impairment and dementia presenting to the accident and emergency department

  9. Gait characteristics of patients with phobic postural vertigo: effects of fear of falling, attention, and visual input.

    PubMed

    Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Brandt, Thomas; Jahn, Klaus

    2014-04-01

    Phobic postural vertigo (PPV) is the most common cause of chronic dizziness in middle-aged patients. Many patients report symptoms involving gait. We investigated the gait performance and its relationship to the fear of falling and attention of PPV patients in a prospective study of 24 patients with PPV and 24 healthy subjects (HS) using a pressure-sensitive mat (GAITRite(®)). Subjects walked at three different speeds (slow, preferred, fast), both during cognitive dual tasks (DTc) and with eyes closed (EC). Falls efficacy and balance confidence were rated by the Falls Efficacy Scale-International (FES-I) and the Activities-specific Balance Confidence Scale (ABC). PPV patients walked slower, with reduced cadence (all p < 0.01), stride length (p < 0.05), and increased double support (p < 0.01) compared to HS. These changes correlated with FES-I (R = -0.528, p < 0.001) and ABC (R = 0.481, p < 0.01). Walking deterioration under DTc did not differ between PPV patients and HS, but patients showed a reduced cognitive processing speed (p < 0.05). When walking with EC, gait speed decreased more in PPV patients compared to HS (p < 0.05). Patients with PPV show gait changes which correlate with their fear of falling and balance confidence. Absent visual feedback leads to more pronounced gait deteriorations in PPV patients than in HS, indicating a higher reliance of patients on visual information during walking. These findings support the view that the gait characteristics of PPV can be attributed to an inadequate, cautious gait control. PMID:24519356

  10. [Falls and renal function: a dangerous association].

    PubMed

    De Giorgi, Alfredo; Fabbian, Fabio; Pala, Marco; Mallozzi Menegatti, Alessandra; Misurati, Elisa; Manfredini, Roberto

    2012-01-01

    Falls are an important health problem and the risk of falling increases with age. The costs due to falls are related to the progressive decline of patients' clinical conditions, with functional inability inducing increasing social costs, morbidity and mortality. Renal dysfunction is mostly present in elderly people who often have several comorbidities. Risk factors for falls have been classified as intrinsic and extrinsic, and renal dysfunction is included among the former. Chronic kidney disease per se is an important risk factor for falls, and the risk correlates negatively with creatinine clearance. Vitamin D deficiency, dysfunction of muscles and bones, nerve degeneration, cognitive decline, electrolyte imbalance, anemia, and metabolic acidosis have been reported to be associated with falls. Falls seem to be very frequent in dialysis patients: 44% of subjects on hemodialysis fall at least once a year with a 1-year mortality due to fractures of 64%. Male sex, comorbidities, predialysis hypotension, and a history of previous falls are the main risk factors, together with events directly related to renal replacement therapy such as biocompatibility of the dialysis membrane, arrhythmias, fluid overload and length of dialysis treatment. Peripheral nerve degeneration and demyelination as well as altered nerve conduction resulting in muscular weakness and loss of peripheral sensitivity are frequent when the glomerular filtration rate is less than 12 mL/min. Moreover, depression and sleep disorders can also increase the risk of falls. Kidney function is an important parameter to consider when evaluating the risk of falls in the elderly, and the development of specific guidelines for preventing falls in the uremic population should be considered. PMID:22718453

  11. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

    PubMed Central

    Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul

    2016-01-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  12. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention.

    PubMed

    Gernand, Alison D; Schulze, Kerry J; Stewart, Christine P; West, Keith P; Christian, Parul

    2016-05-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences for the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce risk of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanistic and association research links multiple antenatal micronutrients with plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and filling extensive gaps in knowledge. Multiple micronutrient supplements reduce the risks of being born with low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure might persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  13. Reinterpreting Dissemination of Prevention Programs as Widespread Implementation with Effectiveness and Fidelity.

    ERIC Educational Resources Information Center

    Elias, Maurice J.

    This article urges a reexamination of the concept of dissemination of health-related prevention programs. The article discusses factors that serve as sustaining conditions for dissemination of prevention programs including: (1) the nature of preventive intervention and parameters of effective community-based prevention praxis; (2) aspects of the…

  14. Proximate Effects of a Child Sexual Abuse Prevention Program in Elementary School Children.

    ERIC Educational Resources Information Center

    Hebert, Martine; Lavoie, Francine; Piche, Christiane; Poitras, Michele

    2001-01-01

    The effects of the sexual child abuse prevention program ESPACE were evaluated with 133 Canadian children (grades 1-3). Children participating in the prevention program showed greater preventive knowledge and skills relative to children not participating. Follow-up data showed knowledge gains were maintained while the preventive skill gains may…

  15. Does aging with a cortical lesion increase fall-risk: Examining effect of age versus stroke on intensity modulation of reactive balance responses from slip-like perturbations.

    PubMed

    Patel, Prakruti J; Bhatt, Tanvi

    2016-10-01

    We examined whether aging with and without a cerebral lesion such as stroke affects modulation of reactive balance response for recovery from increasing intensity of sudden slip-like stance perturbations. Ten young adults, older age-match adults and older chronic stroke survivors were exposed to three different levels of slip-like perturbations, level 1 (7.75m/s(2)), Level II (12.00m/s(2)) and level III (16.75m/s(2)) in stance. The center of mass (COM) state stability was computed as the shortest distance of the instantaneous COM position and velocity relative to base of support (BOS) from a theoretical threshold for backward loss of balance (BLOB). The COM position (XCOM/BOS) and velocity (ẊCOM/BOS) relative to BOS at compensatory step touchdown, compensatory step length and trunk angle at touchdown were also recorded. At liftoff, stability reduced with increasing perturbation intensity across all groups (main effect of intensity p<0.05). At touchdown, while the young group showed a linear improvement in stability with increasing perturbation intensity, such a trend was absent in other groups (intensity×group interaction, p<0.05). Between-group differences in stability at touchdown were thus observed at levels II and III. Further, greater stability at touchdown positively correlated with anterior XCOM/BOS however not with ẊCOM/BOS. Young adults maintained anterior XCOM/BOS by increasing compensatory step length and preventing greater trunk extension at higher perturbation intensities. The age-match group attempted to increase step length from intensity I to II to maintain stability however could not further increase step length at intensity III, resulting in lower stability on this level compared with the young group. Stroke group on the other hand was unable to modulate compensatory step length or control trunk extension at higher perturbation intensities resulting in reduced stability on levels II and III compared with the other groups. The findings reflect

  16. Effect of muscle and post-mortem rate of pH and temperature fall on antioxidant enzyme activities in beef.

    PubMed

    Pastsart, Umaporn; De Boever, Maarten; Claeys, Erik; De Smet, Stefaan

    2013-03-01

    The aim of this study was to investigate the effect of muscle, inner and outer Musculus biceps femoris (IBF and OBF respectively) and Musculus longissimus dorsi (LD), on the post-mortem rate of pH and temperature fall, and the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) during simulated retail display. At day 0 of display (2 days post-mortem), the CAT and GSH-Px activities were lower in IBF than in OBF and LD (P<0.001), and the SOD activity was lower in OBF compared to IBF and LD (P<0.001). At day 10 of display, SOD and CAT activities had decreased in all three muscles compared to day 0 (P<0.001), whereas the GSH-Px activity did increase with time of display. Across muscles, there were significant relationships between temperature fall, colour, lipid and colour stability and antioxidant enzyme activities. PMID:23273481

  17. Evaluation of fall and fall recovery in a simulated seismic environment: a pilot study.

    PubMed

    Abu-Faraj, Ziad O; Akar, Hassan A; Assaf, Elie H; Al-Qadiri, Mohamad N; Youssef, Elssy G

    2010-01-01

    Fall-related injuries, disabilities, and fatalities are known to seriously affect the healthcare and industry sectors. Nevertheless, an abled individual, as well as a trained senior citizen, is believed to be capable of withstanding and overcoming unusual environmental variations in terms of postural stability and balance. Understanding the biomechanics of fall and fall recovery through quantitative measurements could provide academic and methodical means to maintain human postural stability, of various ages, in such environments. This study assesses human performance and endurance in the most hazardous environment of a simulated violent seismic activity of a magnitude of 6.5 degrees on the Richter's scale. The objective is to evaluate fall and fall recovery in young abled adults using dynamic plantar pressure measurements. The obtained results support the hypothesis that falls in young adults could be prevented via exercise intervention programs. Further investigation is done by our research group to validate the same concept for senior citizens. PMID:21097092

  18. Do weight categories prevent athletes from relative age effect?

    PubMed

    Delorme, Nicolas

    2014-01-01

    The aim of this study was to investigate whether weight categories prevent young athletes from being exposed to a relative age effect. The dates of birth of all French female (n = 727) and male (n = 5440) amateur boxers who participated in the 2010-2011 season were collected from the federation database. The dates of birth of all French male professional boxers (n = 354) were also collected. The results show an absence of a relative age effect among French female and male amateur boxers. The results also show an absence of this phenomenon among French male professional boxers. The male 18-18+ age category reveal an inverse relative age effect. This inverse relative age effect might be interpreted as the result of a strategic adaptation from relatively younger children who shift from one sport to another where there are weight categories in order to ensure fair competition. The results of this study suggest that the weight category system is a possible solution within the relative age effect phenomenon. PMID:23879217

  19. The effectiveness of HIV prevention and the epidemiological context.

    PubMed Central

    Grassly, N. C.; Garnett, G. P.; Schwartländer, B.; Gregson, S.; Anderson, R. M.

    2001-01-01

    Planning an intervention to prevent infections with the human immunodeficiency virus (HIV) should be guided by local epidemiological and socioeconomic conditions. The socioeconomic setting and existing public service capacity determine whether an intervention can have a significant outcome in terms of a reduction in a defined risk. The epidemiological context determines whether such risk reduction translates into a measurable impact on HIV incidence. Measurement of variables describing the epidemiological context can be used to determine the local suitability of interventions, thereby guiding planners and policy-makers in their choice of intervention. Such measurements also permit the retrospective analysis of the impact of interventions where HIV incidence was not recorded. The epidemiological context is defined for four different categories of intervention, shown to be effective in lower-income countries by randomized controlled trials. Appropriate indicators for the epidemiological context and methodological guidelines for their measurement are proposed. Their use in the transfer of a successful intervention from one context to another and in scaling up the effort to control HIV infection is explored. These indicators should provide a useful resource for those involved in planning HIV prevention interventions. PMID:11799444

  20. Effectiveness of Financial Incentives in a Worksite Diabetes Prevention Program

    PubMed Central

    Faghri, Pouran D.; Li, Rui

    2016-01-01

    Purpose To evaluate the effect of financial incentive in a diabetes prevention weight loss program at worksites. Design Group-level randomized intervention study. Setting Four long-term care facilities, randomly assigned to “incentive-IG” or “non incentive-NIG” groups. Participants Ninety-nine employees, all overweight or obese (BMI= mean 34.8±7.4 kg/m2) and at risk for type 2 diabetes. Intervention A 16 week weight loss program (diabetes prevention program) with a 3 month follow up. IG could either choose a "standard incentive" to receive cash award when achieving the projected weight loss or to participate in a "standard plus deposit incentive" to get additional money matched with their deposit for projected weight loss. All of the participants received a one-hour consultation for a healthy weight loss at the beginning. Measures Weight-loss, diabetes risk score (DRS), and cardiovascular risk outcomes. Analyses Linear and logistic regressions for completed cases with adjustments for clustering effect at group level. Results IG lost on average more pounds (p=0.027), reduced BMI (p=0.04), and reduced in DRS (p=0.011) compared to NIG at week 16. At the 12-week follow-up period, those in IG plus deposit subgroup had twice the odds (OR=2.2, p=0.042) and those in the standard IG had three times the odds of achieving weight loss goals than NIG; those in the IG plus deposit group reduced DRS by 0.4 (p=0.045). Conclusion Monetary incentives appear to be effective in reducing weight and diabetes risk.

  1. Long-term Impact of Prevention Programs to Promote Effective Parenting: Lasting Effects but Uncertain Processes

    PubMed Central

    Sandler, Irwin; Schoenfelder, Erin; Wolchik, Sharlene; MacKinnon, David

    2010-01-01

    This chapter reviews findings from 46 randomized experimental trials of preventive parenting interventions. The findings of these trials provide evidence of effects to prevent a wide range of problem outcomes and to promote competencies from one to twenty years later. However, there is a paucity of evidence concerning the processes that account for program effects. Three alternative pathways are proposed as a framework for future research on the long-term effects of preventive parenting programs; 1) through program effects on parenting skills, perceptions of parental efficacy and reduction in barriers to effective parenting; 2) through program-induced reductions in short-term problems of youth that persist over time, improvements in youth adaptation to stress, and improvements in youth belief systems concerning the self and their relationships with others; and 3) through effects on contexts in which youth become involved and on youth-environment transactions. PMID:20822438

  2. Effective primary prevention programs in public health and their applicability to the prevention of child maltreatment.

    PubMed

    Rivara, Frederick P; Johnston, Brian

    2013-01-01

    Principles of public health practice can be applied to problems, such as child maltreatment, that have behavioral antecedents and injury outcomes. Successful campaigns to promote bicycle helmet use to prevent brain injury and to promote supine sleeping to prevent sudden infant death are described. These programs were universally applied, featured simple behavioral goals, were based on the best available evidence, and monitored both behavioral and health-related outcomes. PMID:24199326

  3. Connect: An Effective Community-Based Youth Suicide Prevention Program

    ERIC Educational Resources Information Center

    Bean, Gretchen; Baber, Kristine M.

    2011-01-01

    Youth suicide prevention is an important public health issue. However, few prevention programs are theory driven or systematically evaluated. This study evaluated Connect, a community-based youth suicide prevention program. Analysis of pre and posttraining questionnaires from 648 adults and 204 high school students revealed significant changes in…

  4. The effect of static muscle forces on the fracture strength of the intact distal radius in vitro in response to simulated forward fall impacts.

    PubMed

    Reeves, Jacob M; Burkhart, Timothy A; Dunning, Cynthia E

    2014-08-22

    The distal radius fracture (DRF) is a particularly dominant injury of the wrist, commonly resulting from a forward fall on an outstretched hand. In an attempt to reduce the prevalence, costs, and potential long-term pain/deformities associated with this injury, in vivo and in vitro investigations have sought to classify the kinematics and kinetics of DRFs. In vivo forward fall work has identified a preparatory muscle contraction that occurs in the upper extremity prior to peak impact force. The present investigation constitutes the first attempt to systematically determine the effect of static muscle forces on the fracture threshold of the distal radius in vitro. Paired human cadaveric forearm specimens were divided into two groups, one that had no muscle forces applied (i.e., right arms) and the other that had muscle forces applied to ECU, ECRL, FCU and FCR (i.e., left arms), with magnitudes based on peak muscle forces and in vivo lower bound forward fall activation patterns. The specimens were secured in a custom-built pneumatic impact loading device and subjected to incremental impacts at pre-fracture (25 J) and fracture (150 J) levels. Similar fracture forces (6565 (866)N and 8665 (5133)N), impulses (47 (6)Ns and 57 (30)Ns), and energies (152 (38)J and 144 (45)J) were observed for both groups of specimens (p>0.05). Accordingly, it is suggested that, at the magnitudes presently simulated, muscle forces have little effect on the way the distal radius responds to forward fall initiated impact loading. PMID:24927979

  5. [Injury prevention in the elderly population].

    PubMed

    Richter, M; Becker, C; Seifert, J; Gebhard, F; Pieske, O; Holch, M; Lob, G

    2002-12-01

    Injuries in the elderly population have more considerable consequences (more difficult treatment, higher costs,worse outcome) than in the younger population. Therefore, the prevention is especially important. The majority of the injuries are caused by traffic accidents and falls. TRAFFIC ACCIDENTS: An analysis of the current injury situation in elderly road users (65 years and older) involved in road traffic accidents was intended to allow conclusions regarding future prophylaxis. FALLS: Falls are mostly caused by numerous factors. The most important predictors for falls are dementia,Parkinson-Syndrome and neurologic deficits after cerebrovascular insults. The most important symptoms, that indicate an increased risk for fall are gait abnormalities, balance lack and underweight. The most important anamnestic indications are more than one falls in the recent 90 days, need for assistance in daily living and prevailing medication. Another important factor is the residential setting (lighting, stairs, floor conditions,bath installations). The most affective protective interventions involve multiple factors. The incidence of falls could be reduced by 30%. The hip protector is an effective protection against proximal femur fractures. which is the most frequent fracture in the elderly population that requires treatment as an inpatient. Injury prevention in the elderly population is an interdisciplinary task as for example shown by the successful fall clinics in the anglo-american area. PMID:12486574

  6. The toxic effects of tumor necrosis factor in vivo and their prevention by cyclooxygenase inhibitors.

    PubMed Central

    Kettelhut, I C; Fiers, W; Goldberg, A L

    1987-01-01

    Tumor necrosis factor (TNF) is a macrophage product under active study as an anticancer drug. However, this agent can be very toxic and has been implicated in the pathogenesis of endotoxic shock. After intravenous injection of human recombinant TNF (4 micrograms/g), growing rats showed an unusual constellation of physiological responses, and all died within 2-4 hr. In 1 hr, TNF caused a sharp fall (2.5 degrees C) in body temperature and a large increase in plasma prostaglandin E2 levels. Blood glucose initially increased, but then a profound hypoglycemia developed by 2 hr. The TNF-treated animals also showed diarrhea, cyanosis, and a severe metabolic acidosis. A single injection of the cyclooxygenase inhibitors indomethacin or ibuprofen before the TNF treatment completely prevented the rapid killing and reduced eventual lethality by 70%. These agents blocked prostaglandin E2 production and prevented the hypothermia, changes in blood glucose, acidosis, and other symptoms. Since similar physiological changes have been reported after endotoxin injection, our data support the suggestion that TNF production is a critical factor in the development of septic shock. These findings also indicate that increased production of prostaglandins or thromboxanes is important in endotoxic shock and argue that cyclooxygenase inhibitors should be useful in its therapy. Indomethacin did not block the cytotoxic effects of TNF in vitro on several transformed cell lines (HeLa, Me 180, or L929). Therefore, combined use of TNF with a cyclooxygenase inhibitor may allow safer administration of high doses of this polypeptide to cancer patients. PMID:3108890

  7. [Care for the elderly with frequent falls: the fall clinic in Zeeuws-Vlaanderen, the Netherlands].

    PubMed

    Faber, M; Vet-Heijne, F

    2005-09-01

    A fall-clinic forms part of the fall-prevention program in Zeeuws-Vlaanderen. In this paper it is explained how elderly who are prone to falling are examined in the fall-clinic to find the underlying cause of their fall problem. The complete examination is termed the fall-risk analysis (FRA). In a six year period 121 elderly visited the fall-clinic. On average they were 78 +/- 8 years of age (mean +/- standarddeviation) and 76% was female. An insufficient muscle force of the hip flexors was the most prominent limitation that could be related to the increased fall risk. Based on the FRA on average 4.3 +/- 1.7 actions were proposed, where a referral to a specialist or physical therapist was most frequently proposed. The fall-clinic is integrated into existing structures of the Dutch health care services. Additional attention is given to case finding by means of district-nurses and family physicians. In this way a highly qualitative health care chain is being created for the falling elderly. PMID:16194064

  8. Accelerating Recovery from Poverty: Prevention Effects for Recently Separated Mothers

    PubMed Central

    Forgatch, Marion S.; DeGarmo, David S.

    2008-01-01

    This study evaluated benefits of a preventive intervention to the living standards of recently separated mothers. In the Oregon Divorce Study’s randomized experimental design, data were collected 5 times over 30 months and evaluated with Hierarchical Linear Growth Models. Relative to their no-intervention control counterparts, experimental mothers had greater improvements in gross annual income, discretionary annual income, poverty threshold, income-to-needs ratios, and financial stress. Comparisons showed the intervention to produce a greater increase in income-to-needs and a greater rise-above-poverty threshold. Benefits to income-to-needs were statistically independent of maternal depressed mood, divorce status, child support, and repartnering. Financial stress reductions were explained by the intervention effect on income-to-needs. The importance of helping disadvantaged families with evidence-based programs is discussed. PMID:19043620

  9. Fall management of eastern gamagrass

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recent research has suggested that eastern gamagrass (EGG) may be an effective alternative to chopped straw in the blended diets of dairy heifers and cows. Most extension materials discussing appropriate fall management of EGG recommend avoiding harvest within 6 weeks of first frost. Using this guid...

  10. Fall Leaf Portraits

    ERIC Educational Resources Information Center

    O'Hara, Cristina

    2012-01-01

    In this article, the author describes how students can create a stunning as well as economical mosaic utilizing fall's brilliantly colored leaves, preserved at their peak in color. Start by choosing a beautiful fall day to take students on a nature walk to collect a variety of leaves in different shapes, sizes, and colors. Focus on collecting a…

  11. Fall armyworm migration patterns.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fall armyworm, Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae), infestations in most of North America arise from annual migrations of populations that overwinter in southern Texas and Florida. Cytochrome Oxidase I haplotype profiles within the fall armyworm corn-strain, the subgroup tha...

  12. Learning From Falling

    ERIC Educational Resources Information Center

    Joh, Amy, S.; Adolph, Karen, E.

    2006-01-01

    Walkers fall frequently, especially during infancy. Children (15, 21, 27, 33, and 39 month-olds) and adults were tested in a novel foam pit paradigm to examine age-related changes in the relationship between falling and prospective control of locomotion. In trial 1, participants walked and fell into a deformable foam pit marked with distinct…

  13. Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States

    PubMed Central

    Verma, Santosh K.; Willetts, Joanna L.; Corns, Helen L.; Marucci-Wellman, Helen R.; Lombardi, David A.; Courtney, Theodore K.

    2016-01-01

    Introduction Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a

  14. Effects of Hyporheic Exchange Flows on Egg Pocket Water Temperature in Snake River Fall Chinook Salmon Spawning Areas, 2002-2003 Final Report.

    SciTech Connect

    Hanrahan, T.; Geist, D.; Arntzen, C.

    2004-09-01

    ) downstream to the upper end of Lower Granite Reservoir near rkm 240. We randomly selected 14 fall Chinook salmon spawning locations as study sites, which represents 25% of the most used spawning areas throughout the HCR. Interactions between river water and pore water within the riverbed (i.e., hyporheic zone) at each site were quantified through the use of self-contained temperature and water level data loggers suspended inside of piezometers. Surrounding the piezometer cluster at each site were 3 artificial egg pockets. In mid-November 2002, early-eyed stage fall Chinook salmon eggs were placed inside of perforated polyvinyl chloride (PVC) tubes, along with a temperature data logger, and buried within the egg pockets. Fall Chinook salmon eggs were also incubated in the laboratory for the purpose of developing growth curves that could be used as indicators of emergence timing. The effects of discharge on vertical hydrologic exchange between the river and riverbed were inferred from measured temperature gradients between the river and riverbed, and the application of a numerical model. The hydrologic regime during the 2002-2003 sampling period exhibited one of the lowest, most stable daily discharge patterns of any of the previous 12 water years. The vertical hydraulic gradients (VHG) between the river and the riverbed suggested the potential for predominantly small magnitude vertical exchange. The VHG also showed little relationship to changes in river discharge at most sites. Despite the relatively small vertical hydraulic gradients at most sites, results from the numerical modeling of riverbed pore water velocity and hyporheic zone temperatures suggested that there was significant vertical hydrologic exchange during all time periods. The combined results of temperature monitoring and numerical modeling indicate that only 2 of 14 sites were significantly affected by short-term (hourly to daily) large magnitude changes in discharge. Although the two sites exhibited acute

  15. Caries-preventive Effect of Supervised Toothbrushing and Sealants.

    PubMed

    Hilgert, L A; Leal, S C; Mulder, J; Creugers, N H J; Frencken, J E

    2015-09-01

    To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was assessed at the tooth surface level, through a combination of ICDAS II (International Caries Detection and Assessment System) and fissure depth codes. High-caries risk occlusal surfaces were treated according to daily supervised toothbrushing (STB) at school and 2 sealants: composite resin (CR) and atraumatic restorative treatment-high-viscosity glass-ionomer cement (ART-GIC). Low-caries risk occlusal surfaces received STB or no intervention. Evaluations were performed after 0.5, 1, 2, and 3 y. A cavitated dentine carious lesion was considered a failure. Data were analyzed according to the proportional hazard rate regression model with frailty correction, Wald test, analysis of variance, and t test, according to the jackknife procedure for calculating standard errors. The cumulative survival rates of cavitated dentine carious lesion-free, high-caries risk occlusal surfaces were 95.6%, 91.4%, and 90.2% for STB, CR, and ART-GIC, respectively, over 3 y, which were not statistically significantly different. For low-caries risk occlusal surfaces, no statistically significant difference was observed between the cumulative survival rate of the STB group (94.8%) and the no-intervention group (92.1%) over 3 y. There was neither a difference among STB, CR, and ART-GIC on school premises in preventing cavitated dentine carious lesions in high-caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low-caries risk occlusal surfaces of first permanent molars over 3 y. PMID:26116491

  16. Patient falls in hospitals: an increasing problem.

    PubMed

    Weil, Thomas P

    2015-01-01

    Despite six decades of worldwide efforts that include publishing virtually hundreds of related epidemiological-type studies, there has been an increase (estimated to be 46% per 1000 patient days from 1954-6 to 2006-10) in the number of patient falls in hospitals and other health care facilities. These still occur most frequently near the bedside or in the bathroom, among mentally confused or physically impaired patients, and often involve those with greater comorbidity. The reasons that hospitals during the past half century have demonstrated a significant increase in patient falls per discharge or per patient days are numerous, are not completely surprising, and are certainly interrelated: improved accident reporting systems; on the average older, more impaired, more acutely ill, and more heavily sedated patients; and, less time spent by nursing personnel at the bedside. Most safety committees are not as effective as they should be, since they have difficulty in implementing a long-term, aggressive, facility-wide prevention program. Within that context, it may be worthwhile to discuss the advantages of nursing leadership rather than a representative of the facility's management staff to chair these safety committees. PMID:26304626

  17. Designing an Effective Prevention Program: Principles Underlying the Rand Smoking and Drug Prevention Experiment.

    ERIC Educational Resources Information Center

    Ellickson, Phyllis L.

    This paper describes the Project ALERT program (Adolescent Learning Experiences in Resistance Training) which was established by the Rand Corporation to prevent smoking and drug use among seventh graders. The program is based on the social influence model of drug use initiation. Curriculum features are described including motivation to resist and…

  18. Effect of Education on Prevention of Domestic Violence against Women

    PubMed Central

    Noughani, Fatemeh

    2011-01-01

    Objective Family violence, specifically domestic violence, has been identified by the medical community as a serious, no remitting epidemic with adverse health consequences. World Health Organization(WHO) has stated that violence against women is a priority issue in the fields of health and human rights. A quasi experimental study were conducted in different faculties of Tehran University of Medical Sciences to determine the effect of teaching on prevention of domestic violence against female employees. Methods Forty four women working in various faculties of Tehran University of Medical Sciences in 2004 were selected. A designed questionnaire was given to the participants to identify kinds, causes and consequences of domestic violence. Then an educational booklet was given to subjects. This booklet contained information about kinds, causes and consequences of domestic violence and how to manage them. To compare the impact of teaching, the same questionnaires were distributed among the subjects after six months. The questionnaire was specifically tested for content validity. Results The results indicated that the incidence rate of domestic violence pre test and post test education was 5.17%. Conclusion Our study showed that education had no effect on domestic violence. Solving problems relating to domestic violence due to cardinal roots in short time seems to be impossible and impracticable. PMID:22952527

  19. Effects of dam removal on Tule Fall Chinook salmon spawning habitat in the White Salmon River, Washington

    USGS Publications Warehouse

    Hatten, James R.; Batt, Thomas R.; Skalicky, Joseph J.; Engle, Rod; Barton, Gary J.; Fosness, Ryan L.; Warren, Joe

    2016-01-01

    Condit Dam is one of the largest hydroelectric dams ever removed in the USA. Breached in a single explosive event in October 2011, hundreds-of-thousands of cubic metres of sediment washed down the White Salmon River onto spawning grounds of a threatened species, Columbia River tule fall Chinook salmon Oncorhynchus tshawytscha. We investigated over a 3-year period (2010–2012) how dam breaching affected channel morphology, river hydraulics, sediment composition and tule fall Chinook salmon (hereafter ‘tule salmon’) spawning habitat in the lower 1.7 km of the White Salmon River (project area). As expected, dam breaching dramatically affected channel morphology and spawning habitat due to a large load of sediment released from Northwestern Lake. Forty-two per cent of the project area that was previously covered in water was converted into islands or new shoreline, while a large pool near the mouth filled with sediments and a delta formed at the mouth. A two-dimensional hydrodynamic model revealed that pool area decreased 68.7% in the project area, while glides and riffles increased 659% and 530%, respectively. A spatially explicit habitat model found the mean probability of spawning habitat increased 46.2% after dam breaching due to an increase in glides and riffles. Shifting channels and bank instability continue to negatively affect some spawning habitat as sediments continue to wash downstream from former Northwestern Lake, but 300 m of new spawning habitat (river kilometre 0.6 to 0.9) that formed immediately post-breach has persisted into 2015. Less than 10% of tule salmon have spawned upstream of the former dam site to date, but the run sizes appear healthy and stable. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  20. Injuries sustained by falls.

    PubMed Central

    Rozycki, G S; Maull, K I

    1991-01-01

    During a recent 4-year period, 381 patients were admitted with injuries sustained from falls. Equal numbers of patients were less than and greater than 50 years of age and included 53 children (less than or equal to 16 years) and 214 elderly (greater than or equal to 55 years). Falls from heights occurred predominantly in young males (mean age 34.2 years), were most commonly job or recreation related and resulted in higher injury severity scores (ISS). Falls in the elderly occurred more commonly in women, typically on a flat surface, and were less severe. Despite lower mean ISS, fall victims over 55 years of age had longer hospitalizations (11.4 vs. 4.5 days) and incurred higher hospital charges compared to younger patients. There were 35 deaths (9.2%). In patients under 55 years, deaths resulted from fall-related central nervous system (CNS) injury and/or multisystem trauma. In patients over 55 years, fatalities were most commonly related to pre-existent medical conditions. Based on a review of this experience, we conclude that: (1) unlike other causes of blunt and penetrating trauma, both sexes are equally at risk from fall-related injuries but sex incidence is age related; (2) falls from heights are more common in men; (3) advanced age and pre-existing medical conditions account for the increased morbidity and mortality following falls and; (4) cost containment measures for fall-related trauma must consider not only injury severity, but the age and pre-existent medical conditions of the patient. PMID:1772536

  1. Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting

    PubMed Central

    Lopez, Karen Dunn; Cary, Michael P; Kanak, Mary F

    2010-01-01

    Objective To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. Design A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Measurements Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time–motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Results Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive ‘head data’, temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Conclusion Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units. PMID:20442150

  2. Predicting the Effectiveness of Prevention: A Role for Epidemiological Modeling

    ERIC Educational Resources Information Center

    Walls, Helen L.; Peeters, Anna; Reid, Christopher M.; Liew, Danny; Mcneil, John J.

    2008-01-01

    It is well known that the current combination of aging populations and advances in health technology is resulting in burgeoning health costs in developed countries. Prevention is a potentially important way of containing health costs. In an environment of intense cost pressures, coupled with developments in disease prevention and health promotion,…

  3. Effects of Nicotine Fading and Relapse Prevention on Smoking Cessation.

    ERIC Educational Resources Information Center

    Brown, Richard A.; And Others

    1984-01-01

    Conducted a pilot study which combined nicotine-fading and relapse prevention with smokers (N=30) and compared this program to conditions where subjects (N=46) received nicotine-fading or relapse prevention only. Results showed no difference among groups in abstinence or rate at any follow-up point. (LLL)

  4. Differential Susceptibility to Prevention: GABAergic, Dopaminergic, and Multilocus Effects

    ERIC Educational Resources Information Center

    Brody, Gene H.; Chen, Yi-fu; Beach, Steven R. H.

    2013-01-01

    Background: Randomized prevention trials provide a unique opportunity to test hypotheses about the interaction of genetic predispositions with contextual processes to create variations in phenotypes over time. Methods: Using two longitudinal, randomized prevention trials, molecular genetic and alcohol use outcome data were gathered from more than…

  5. Effectiveness of a Social Change Approach to Sexual Assault Prevention

    ERIC Educational Resources Information Center

    Edwards, Keith E.

    2009-01-01

    The author examined the impact on resident assistants of a social change approach to sexual assault prevention. The interactive multi-media program focused on engaging men on sexual assault prevention, accurately defining rape for college men and women, identifying aspects of the rape culture in society and on-campus, and empowering college…

  6. Evaluation of R. Paul Smith Steam Electric Station thermal discharge effects on finfish and macroinvertebrate communities, summer/fall 1980. Final report

    SciTech Connect

    Not Available

    1981-02-01

    The objectives of the study were to evaluate the thermal effects of the R. P. Smith steam Electric Station upon the finfish and macroinvertebrates communities during summer and fall, on the Potomac River. The finfish community was sampled during August and September 1980 with electrofishing gear. The increased water temperature along the Maryland shore appeared to influence the distribution of spotfin shiner and smallmouth bass. Carp, although not statistically tested, appeared to be more abundant in the thermal plume than at stations outside the thermal plume. The thermal discharge exhibited no discernible influence on the composition of the benthic or drift macroinvertebrate communities.

  7. Cost-effectiveness of a helpline for suicide prevention.

    PubMed

    Pil, Lore; Pauwels, Kirsten; Muijzers, Ekke; Portzky, Gwendolyn; Annemans, Lieven

    2013-07-01

    We evaluated the cost-effectiveness and budget impact of a suicide helpline in Belgium, consisting of a telephone- and a chat service. An age- and gender-dependent Markov model with a ten-year time horizon and a one-year cycle length was developed, assuming a societal perspective, to predict cumulative costs and quality-adjusted life-years (QALYs) in the helpline users. The model included six transition states: the initial state (at risk), first attempt, re-attempt, follow-up, suicide and death from other causes. Data on the effect of the helpline and costs associated with model states were obtained from the literature. One-way and probabilistic sensitivity analyses were performed to capture uncertainty. In addition, the budget impact of the helpline was analysed. Over ten years, the telephone- as well as the chat service could avoid about 36% of suicides and attempts in this high-risk population. In males, 0.063 QALYs (95% confidence interval, CI 0.030-0.097) and 0.035 QALYs (95%CI -0.026-0.096) were gained by users of the telephone- and chat service respectively. The corresponding values for females were 0.019 QALYs (95%CI -0.015-0.052) and a QALY-neutral result of -0.005 (95%CI -0.071-0.062). There were net societal savings of respectively €2382 (95%CI 1953-2859) and €2282 (95%CI 1855-2758) in male users; €2171 (95%CI 1735-2664) and €2458 (95%CI 1945-3025) in female users. At the population level, an investment of €218,899 saved €1,452,022 for the public health service (national health insurance), mainly due to the telephone service. The analysis predicted that both means of telemedicine for suicide prevention in Flanders are cost-saving, and have a modest effect on QALYs. PMID:24163237

  8. Pathogenesis and treatment of falls in elderly

    PubMed Central

    Pasquetti, Pietro; Apicella, Lorenzo; Mangone, Giuseppe

    2014-01-01

    Summary Falls in the elderly are a public health problem. Consequences of falls are increased risk of hospitalization, which results in an increase in health care costs. It is estimated that 33% of individuals older than 65 years undergoes falls. Causes of falls can be distinguished in intrinsic and extrinsic predisposing conditions. The intrinsic causes can be divided into age-related physiological changes and pathological predisposing conditions. The age-related physiological changes are sight disorders, hearing disorders, alterations in the Central Nervous System, balance deficits, musculoskeletal alterations. The pathological conditions can be Neurological, Cardiovascular, Endocrine, Psychiatric, Iatrogenic. Extrinsic causes of falling are environmental factors such as obstacles, inadequate footwear. The treatment of falls must be multidimensional and multidisciplinary. The best instrument in evaluating elderly at risk is Comprehensive Geriatric Assessment (CGA). CGA allows better management resulting in reduced costs. The treatment should be primarily preventive acting on extrinsic causes; then treatment of chronic and acute diseases. Rehabilitation is fundamental, in order to improve residual capacity, motor skills, postural control, recovery of strength. There are two main types of exercises: aerobic and muscular strength training. Education of patient is a key-point, in particular through the Back School. In conclusion falls in the elderly are presented as a “geriatric syndrome”; through a multidimensional assessment, an integrated treatment and a rehabilitation program is possible to improve quality of life in elderly. PMID:25568657

  9. Editors' Fall Picks

    ERIC Educational Resources Information Center

    Hoffert, Barbara; Heilbrun, Margaret; Kuzyk, Raya; Kim, Ann; McCormack, Heather; Katterjohn, Anna; Burns, Ann; Williams, Wilda

    2008-01-01

    From the fall's cascade of great new books, "Library Journal's" editors select their favorites--a dark rendition of Afghan life, a look at the "self-esteem trap," a celebration of Brooklyn activism, and much more.

  10. A Concise History of School-Based Smoking Prevention Research: A Pendulum Effect Case Study

    ERIC Educational Resources Information Center

    Sussman, Steve; Black, David S.; Rohrbach, Louise A.

    2010-01-01

    School-based cigarette smoking prevention was initiated shortly after the first Surgeon General's Report in 1964. This article highlights a sequence of events by which school-based tobacco use prevention research developed as a science, and illustrates a pendulum effect, with confidence in tobacco use prevention increasing and decreasing at…

  11. Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk.

    PubMed

    Brent, David

    2016-04-01

    In this commentary, the effects of four family-based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long-term, effects on suicidal ideation and behavior. PMID:27094110

  12. [Preventive effect of changzhankang in experimental intestinal adhesions in rats].

    PubMed

    Wang, Y Q; Wei, J Q; Dai, D Z

    1991-08-01

    Intestinal adhesions were induced in rats by stabbing the terminal part of the ileum. Adhesion prevention by ibuprofen and changzhankang (CZK), which was composed by traditional Chinese medicines, was evaluated with a grading system. All of the 13 rats in the non-treated group created severe adhesions. The severity was significantly modified by orally administered CZK of 20 g/kg (in crude drugs) once or twice daily for five days (P less than 0.01 and P less than 0.05 compared with the non-treated). Intramuscular injection of ibuprofen (35 mg/kg, 3 times daily) also alleviated the severity of adhesions. There was no significant difference between the ibuprofen-treated and CZK-treated groups though some of the rats were virtually free from adhesion formation in the latter. It is plausible to expect CZK to become a promising drug used in treating intestinal adhesions, for the natural drug has greater security and less side effects than synthesized drugs. PMID:1954667

  13. Falling and fall risk factors in adults with haemophilia: an exploratory study.

    PubMed

    Sammels, M; Vandesande, J; Vlaeyen, E; Peerlinck, K; Milisen, K

    2014-11-01

    Falls are a particular risk in persons with haemophilia (PWH) because of damaged joints, high risk of bleeding, possible impact on the musculoskeletal system and functioning and costs associated with treatment for these fall-related injuries. In addition, fall risk increases with age and PWH are increasingly entering the over 65 age group. The aim of this study was to determine the occurrence of falls during the past year and to explore which fall risk factors are present in community-dwelling PWH. Dutch speaking community-dwelling adults were included from the age of 40 years with severe or moderate haemophilia A or B, independent in their mobility and registered at the University Hospitals Leuven. They were asked to come to the haemophilia centre; otherwise a telephone survey was conducted. Demographic and social variables, medical variables, fall evaluation and clinical variables were queried. From the 89 PWH, 74 (83.1%) participated in the study. Twenty-four (32.4%) fell in the past year, and 10 of them (41.7%) more than once with an average of four falls. Living conditions, physical activity, avoidance of winter sports due to fear of falling, orthopaedic status, urinary incontinence and mobility impairments are potential fall risk factors in adult PWH. This exploratory study indicates that PWH are attentive to falling since they are at higher risk for falls and because of the serious consequences it might have. Screening and fall prevention should be stimulated in the daily practice of haemophilia care. PMID:25354771

  14. Medications Are Associated with Falls in People with Multiple Sclerosis

    PubMed Central

    Karstens, Lisa; Hoang, Phu; Bourdette, Dennis; Lord, Stephen

    2015-01-01

    Background: Medication use is associated with falls in many populations, but the relationship between medications and falls in people with multiple sclerosis (MS) is not well understood. Methods: The number and types of medications used by 248 ambulatory adults with MS in the United States (n = 53) and Australia (n = 195) were assessed. Participants completed fall diaries for 6 months. Associations between number and type of medications reported and falls, adjusting for age, disease severity, comorbidities, sex, and country, were evaluated using multiple logistic regression. Results: Participants reported taking a median of three medications and two supplements. A total of 143 participants (58%) fell at least once in the 6 months, and 110 (44%) experienced one or more injurious falls. The adjusted relative odds of a fall or an injurious fall increased by 13% (P = .048) and 11% (P = .049), respectively, for each medication and by 43% (P = .015) and 55% (P = .001) for each neurologically active medication. Reported use of MS disease-modifying therapy was associated with 48% decreased odds of falling (P = .035) but not significantly decreased odds of injurious falls. Conclusions: Reporting use of more medications and more neurologically active medications is associated with falls and injurious falls in people with MS. Close evaluation of the need for each medication, with associated minimization of neurologically active medications in patients with MS, may help prevent falls. Use of MS disease-modifying therapies may be associated with fewer falls. This relationship needs further evaluation. PMID:26472941

  15. Seniors Falls Investigative Methodology (SFIM): a systems approach to the study of falls in seniors.

    PubMed

    Zecevic, Aleksandra A; Salmoni, Alan W; Lewko, John H; Vandervoort, Anthony A

    2007-01-01

    An in-depth understanding of human factors and human error is lacking in current research on seniors' falls. Additional knowledge is needed to understand why seniors are falling. The purpose of this article is to describe the adapting of the Integrated Safety Investigation Methodology (ISIM) (used for investigating transportation and industrial accidents) to studying seniors' falls. An adapted version-the Seniors Falls Investigative Methodology (SFIM)-uses a systems approach to take an investigation beyond the immediate cause of an incident and reveal unsafe acts and deeply imbedded unsafe conditions that contribute to adverse outcomes. An example case study is used to describe six phases of the investigative process in detail. The SFIM has the potential to identify safety deficiencies; utilize existing knowledge about falls; establish a standardized reporting system; shift focus from the faller to the system; and guide targeted prevention. PMID:18238732

  16. The effect of resveratrol on the prevention of cisplatin ototoxicity.

    PubMed

    Erdem, T; Bayindir, Tuba; Filiz, A; Iraz, M; Selimoglu, E

    2012-10-01

    One of the most important adverse effects of cisplatin, a chemotherapeutic agent which is widely used in the treatment of cancer patients, is hearing loss. This has primarily been associated with the loss of inner ear hairy and spiral ganglion cells due to oxidative stress. Resveratrol is known to be an antioxidant agent, which has the theoretical potential of preventing cisplatin-related ototoxicity. This experimental study was approved by Animal Ethics Committee of Inonu University (2008-20) and supported by Inonu University Scientific Research Projects Support Fund (2009-17). Thirty-four 3-month-old Wistar albino female rats weighing 210-270 g were used in the study. The animals were allocated into four groups: in cisplatin group (Group A), a single dose of 12 mg/kg cisplatin was administered intraperitoneally to 10 rats; in cisplatin + resveratrol group (Group B), a single dose of 12 mg/kg cisplatin and 10 mg/kg resveratrol were administered intraperitoneally for 5 days to 10 rats; in resveratrol group (Group C), 10 mg/kg resveratrol was administered intraperitoneally for 5 days to seven rats and in control group (Group D), resveratrol solvent (5% alcohol-95% physiological saline) was administered intraperitoneally for 5 days to seven rats. Resveratrol administration has begun 1 day before cisplatin administration in the group treated with cisplatin and resveratrol combination. Distortion product otoacoustic emission (DPOAE) (Grason Stadler, Madison, USA) measurements were performed in the same ear of all rats (right ear) under general anesthesia at baseline, 1st and 5th days after drug administration. Statistically significant distortion product amplitude reductions were found in the cisplatin group at 1,418, 2,003, 3,363, 5,660, 8,003 and 9,515 Hz frequencies. Whereas in the cisplatin + resveratrol group, statistically significant difference was found between 1st and 5th day measurements only at 3,996 Hz frequency. No significant differences were noted

  17. 1991 Fall Meeting Report

    NASA Astrophysics Data System (ADS)

    Chapman, David S.

    The AGU 1991 Fall Meeting, held in San Francisco December 9-13, was the largest national AGU meeting ever held. Meeting participation continued the steady growth trend set throughout the previous decade. A total of 4,037 papers and posters were presented, and by Friday noon of the meeting over 5,500 members had registered.Several special events were scheduled to inform and engage members on societal and programmatic aspects of our science. AGU's Committee on Education and Human Resources sponsored an open forum that addressed opportunities and problems associated with dual-career couples. A discussion of NASA's strategic plan by Berrien Moore and Joseph Alexander drew a large audience, and a special session on societal aspects of the Mt. Pinatubo eruption drew an overflow crowd. Two special lectures— “Plumes, Plates, and Deep Earth Structure” by Don L. Anderson and “New Frontiers in Aeronomy: Effects of Global Atmospheric Change” by P. M. Banks-also drew overflow crowds.

  18. Keeping children safe at home: protocol for three matched case–control studies of modifiable risk factors for falls

    PubMed Central

    Kendrick, Denise; Stewart, Jane; Clacy, Rose; Coffey, Frank; Cooper, Nicola; Coupland, Carol; Hayes, Mike; McColl, Elaine; Reading, Richard; Sutton, Alex; M L Towner, Elizabeth; Craig Watson, Michael

    2012-01-01

    Background Childhood falls result in considerable morbidity, mortality and health service use. Despite this, little evidence exists on protective factors or effective falls prevention interventions in young children. Objectives To estimate ORs for three types of medically attended fall injuries in young children in relation to safety equipment, safety behaviours and hazard reduction and explore differential effects by child and family factors and injury severity. Design Three multicentre case–control studies in UK hospitals with validation of parental reported exposures using home observations. Cases are aged 0–4 years with a medically attended fall injury occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression to adjust for potential confounding variables. Unmatched analyses will use unconditional logistic regression, adjusted for age, sex, deprivation and distance from hospital in addition to other confounders. Each study requires 496 cases and 1984 controls to detect an OR of 0.7, with 80% power, 5% significance level, a correlation between cases and controls of 0.1 and a range of exposure prevalences. Main outcome measures Falls on stairs, on one level and from furniture. Discussion As the largest in the field to date, these case control studies will adjust for potential confounders, validate measures of exposure and investigate modifiable risk factors for specific falls injury mechanisms. Findings should enhance the evidence base for falls prevention for young children. PMID:22628151

  19. Falls risk assessment in older patients in hospital.

    PubMed

    Matarese, Maria; Ivziku, Dhurata

    2016-07-27

    Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. All hospitals in NHS organisations develop risk prevention policies that include falls risk assessment. Falls risk assessment involves the use of risk screening tools, aimed at identifying patients at increased risk of falls, and risk assessment tools, which identify a patient's risk factors for falls. Various risk screening tools have been used in clinical practice, but no single tool is able to identify all patients at risk of falls or to accurately exclude all those who are not at risk of falls. Guidelines recommend that patients aged 65 years and over who are admitted to hospital should be considered at high risk of falls and that a multifactorial falls risk assessment should be performed. Therefore, falls risk assessment tools should be used to identify the risk factors for each inpatient aged 65 years or over, in order to determine the most appropriate care plan for falls prevention and to maximise patient mobility and independence. PMID:27461329

  20. [The biological effects of a nuclear explosion. Introduction of a new system on a colorimetric scale (black, grey, red, orange, yellow and white zone) to estimate the effects of fall-out on civilian populations].

    PubMed

    Nacci, G

    2002-08-01

    Following September 11 the eventuality of terrorist attacks using bags containing nuclear devices is considered possible in western cities like New York, London, Paris, Rome, Berlin, Moscow etc. However, with a modern Civil Defence programme the effects of a catastrophe of this nature can be partially limited, at least as far as Fall-out is concerned. The present paper explains the medical reasons for building anti-fall-out shelters for the larger part of western populations: from the USA to Russia. The paper also sets out a new method for classifying levels of radioactive Fall-out based on a scale of colours (black, grey, red, orange, yellow and white) whatever kind of radioactivity is involved (total gamma levels, Cesium 137 levels, Strontium 90 levels). The arrival times for fall-out in each area of the scale are fixed, whatever the energy of the explosion and the speed of the wind might be. The radioactive decay in each area of the scale, from the time of arrival of the fall-out is described with precision. Also described are the acute radiation syndrome, tumours, miscarriages and genetic diseases. A nomogram is attached for civil defence purposes showing the leeward extension of these areas, easily measurable in just a few minutes, if four parameters are known: ground zero (locality) of the explosion, the energy of the explosion, the direction of the wind and the speed of the wind. PMID:12207196

  1. Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial

    PubMed Central

    Román, Eva; García-Galcerán, Cristina; Torrades, Teresa; Herrera, Silvia; Marín, Ana; Doñate, Maite; Alvarado-Tapias, Edilmar; Malouf, Jorge; Nácher, Laura; Serra-Grima, Ricard; Guarner, Carlos; Soriano, German

    2016-01-01

    Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time. Trial Registration: ClinicalTrials.gov NCT01447537 PMID:27011355

  2. Effective fall treatment of Varroa jacobsoni (Acari: Varroidae) with a new formulation of formic acid in colonies of Apis mellifera (Hymenoptera: Apidae) in the northeastern United States.

    PubMed

    Calderone, N W

    2000-08-01

    New formulations of formic acid and thymol, both individually and in combination with various essential oils, were compared with Apistan to determine their efficacy as fall treatments for control of Varroa jacobsoni (Oudemans), a parasitic mite of the honey bee, Apis mellifera L. Percent mite mortality in colonies treated with 300 ml of 65% formic acid averaged 94.2 +/- 1.41% (least square means +/- SE, n = 24), equivalent to those receiving four, 10% strips of Apistan (92.6 +/- 1.79%, n = 6). Treatment with thymol (n = 24) resulted in an average mite mortality of 75.4 +/- 5.79%, significantly less than that attained with Apistan or formic acid. The addition of essential oils did not affect treatment efficacy of either formic acid or thymol. The ratio of the coefficients of variation for percentage mortality for the formic acid (CVFA) and Apistan (CVA) groups was CVFA/CVA = 0.66. This indicates that the formic acid treatment was as consistent as the Apistan treatment. Thymol treatments did not provide as consistent results as Apistan or formic acid. Coefficient variation ratios for percentage mortality for the thymol group (CVT) with the Apistan and formic acid groups were CVT/CVA = 4.47 and CVT/CVFA = 6.76, respectively. In a second experiment, colonies received a 4-wk fall treatment of either 300 ml of 65% formic acid (n = 24) or four, 10% strips of Apistan (n = 6). The next spring, mite levels in the formic acid group (554.3 +/- 150.20 mites) were similar to those in the Apistan treatment group (571.3 +/- 145.05 mites) (P = 0.93). Additionally, the quantities of bees, brood, pollen, and nectar/honey in the two treatment groups were not significantly different (P > or = 0.50 each variable). These results suggest that formic acid is an effective alternative to Apistan as a fall treatment for varroa mites in temperate climates. PMID:10985013

  3. Effects of educating local government officers and healthcare and welfare professionals in suicide prevention.

    PubMed

    Kaniwa, Isao; Kawanishi, Chiaki; Suda, Akira; Hirayasu, Yoshio

    2012-03-01

    Suicide is a major public health issue. In Japan, local governments are responsible for suicide prevention, and local government officers are therefore expected to act as gatekeepers for suicide prevention. In this study, through a questionnaire survey, the authors examined the current knowledge and attitudes concerning suicide prevention among local government officers and healthcare and welfare professionals, and the effects of providing suicide prevention education on their knowledge of and attitudes toward suicide and its prevention. One hundred eighty-three local government officers and 432 healthcare/welfare professionals completed the survey before and after a single education session. Before the session, the local government officers and healthcare/welfare professionals showed mainly positive attitudes toward suicide prevention efforts, with little difference between the two groups. After the training, knowledge and attitudes were further improved for most questionnaire items. Respondents with one or more experiences of suicide prevention training showed significantly more knowledge and positive attitudes before the training than those with no such experience. Moreover, knowledge of depression and having a sympathetic attitude were found to be especially associated with the overall attitude that "suicide can be prevented". Training in suicide prevention was shown to be effective in promoting appropriate knowledge and attitudes among local government officers and healthcare/welfare professionals who are gatekeepers for preventing suicide. Our findings confirm the importance of suicide prevention education, and will contribute to creating a standard educational program on suicide prevention in Japan. PMID:22690158

  4. Accidents due to falls from roof slabs.

    PubMed

    Rudelli, Bruno Alves; Silva, Marcelo Valerio Alabarce da; Akkari, Miguel; Santili, Claudio

    2013-01-01

    CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. METHODS Data were collected from 29 cases of falls from roof slabs involving children and adolescents between October 2008 and October 2009. RESULTS Cases involving males were more prevalent, accounting for 84%. The predominant age group was schoolchildren (7 to 12 years old; 44%). Leisure activities were most frequently being practiced on the roof slab at the time of the fall (86%), and flying a kite was the most prevalent game (37.9%). In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places. PMID:23903263

  5. Hysteresis Effect in the Activity Indices of the Atmospheres of the Sun and Solar-Type Stars During the Rising and Falling Phases of Cycles

    NASA Astrophysics Data System (ADS)

    Bruevich, E. A.; Yakunina, G. V.

    2016-09-01

    The hysteresis effect that shows up as a nonunique relationship among the emissions from the photosphere, chromosphere, and corona during the rising and falling phases of solar and stellar activity is analyzed. The following solar indices are analyzed and compared in different phases of the cycle: the radiative flux in the hydrogen Lyman alpha line FLα, radio emission at 10.7 cm F10.7, the sunspot number SSN, the radiative flux in the 530.0 nm green coronal line F530.3, the solar constant TSI, and the relative flux ratio c/w (ratio of the fluxes in the center and in the wings) for the 280 nm Mg II line. In stars with cycles, a hysteresis effect is observed between the CaII chromospheric S-activity index for stars in the Mount Wilson HK project and the photospheric flux Fph for these stars.

  6. Experimental Analysis of the Effects of Vapor Flow Characteristics on Falling Film Absorption Rate in NH3-H2O Systems

    NASA Astrophysics Data System (ADS)

    Kang, Yong Tae; Fujita, Yasushi; Akisawa, Atsushi; Kashiwagi, Takao

    In this paper, experimental analysis was performed for ammonia-water falling film absorption process in a plate heat exchanger with enhanced surfaces such as offset strip fin. This paper examined the effect of vapor flow characteristics, inlet subcooling of the liquid flow and inlet concentration difference on heat and mass transfer performance. The inlet liquid concentration was kept constant at 0% while the inlet vapor concentration was varied from70. 36 to 77.31% It was found that before absorption started there was rectification process at the top of the test section by the inlet subcooling effect. Water desorption phenomenon was found near the bottom of test section. The lower inlet liquid temperature, the higher Nusselt and Sherwood numbers were obtained. NusseIt and Sherwood correlations were developed as functions of vapor Reynolds number ReV, inlet subcooling and inlet concentration difference with ±10% and ±5% error bands, respectively.

  7. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk.

    PubMed

    Zia, Anam; Kamaruzzaman, Shahrul Bahyah; Tan, Maw Pin

    2015-04-01

    The term polypharmacy has negative connotations due to its association with adverse drug reactions and falls. This spectrum of adverse events widens when polypharmacy occurs among the already vulnerable geriatric population. To date, there is no consensus definition of polypharmacy, and diverse definitions have been used by various researchers, the most common being the consumption of multiple number of medications. Taking multiple medications is considered a risk factor for falls through the adverse effects of drug-drug or drug-disease interactions. Falls studies have determined that taking ≥ 4 drugs is associated with an increased incidence of falls, recurrent falls, and injurious falls. In light of existing evidence, careful and regular medication reviews are advised to reduce the effect of polypharmacy on falls. However, intervention studies on medication reviews and their effectiveness on falls reduction have been scarce. This article reviews and discusses the evidence behind polypharmacy and its association with falls among older individuals, and highlights important areas for future research. PMID:25539567

  8. Disseminating Effective Community Prevention Practices: Opportunities for Social Work Education

    ERIC Educational Resources Information Center

    Hawkins, J. David; Shapiro, Valerie B.; Fagan, Abigail A.

    2010-01-01

    In the United States, about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral (MEB) disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect one in five families and cost $247 million annually. Some strategies for preventing MEB…

  9. Finding Ways to Effectively Prevent Sexual Abuse by Youth

    ERIC Educational Resources Information Center

    Klein, Alisa; Tabachnick, Joan

    2002-01-01

    Youth with sexual behavior problems pose a complicated challenge to the society. Yet the society has succeeded in developing only a limited range of actions and attitudes to grapple with and prevent this problem. Very few of the social service and criminal justice systems have rallied to create compassionate models that not only address and…

  10. Accelerating Recovery from Poverty: Prevention Effects for Recently Separated Mothers

    ERIC Educational Resources Information Center

    Forgatch, Marion S.; DeGarmo, David S.

    2007-01-01

    This study evaluated benefits of a preventive intervention to the living standards of recently separated mothers. In the Oregon Divorce Study's randomized experimental design, data were collected 5 times over 30 months and evaluated with Hierarchical Linear Growth Models. Relative to their no-intervention control counterparts, experimental mothers…

  11. Adolescent Pregnancy Prevention Programs: Theoretical Models for Effective Program Development

    ERIC Educational Resources Information Center

    Saunders, Jeanne A.

    2005-01-01

    Adolescent pregnancy and parenting remains a pressing social and public health concern because the United States continues to have the highest teen pregnancy rate among Western developed nations and because of the attendant social, psychological, and physical problems for young parents and their children. Prevention efforts to reduce the incidence…

  12. Teen Depression and Suicide: Effective Prevention and Intervention Strategies

    ERIC Educational Resources Information Center

    King, Keith A.; Vidourek, Rebecca A.

    2012-01-01

    Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

  13. Prevention of intracerebral haemorrhage.

    PubMed

    Mitchell, Patrick; Mitra, Dipayan; Gregson, Barbara A; Mendelow, A David

    2007-07-01

    Nontraumatic intracerebral haemorrhages arise from a wide range of causes falling into two broad groups: discreet vascular "ictohaemorrhagic" lesions such as aneurysms, arteriovenous malformations, cavernomas, tumours, and dural fistulae; and more generalised amyloid or hypertension related conditions. It is now possible using family history, associated risk factors and gradient echo MRI to predict cases at high risk of hypertensive or amyloid related haemorrhage. There is considerable potential for prevention of hypertensive haemorrhages by treatment of high risk cases with antihypertensive medication. As yet no effective preventative treatment for amyloid angiopathy related ICH has emerged although a variety of drugs are under investigation. Prevention of haemorrhage from ictohaemorrhagic lesions revolves around removal or obliteration of the lesion. Although there is a wide range of such lesions available treatments come down to three modalities. These are surgical excision, stereotactic radiosurgery and endovascular embolisation. PMID:17630936

  14. The Cost and Effectiveness of School-Based Preventive Dental Care.

    ERIC Educational Resources Information Center

    Klein, Stephen P.; And Others

    1985-01-01

    The cost and effectiveness of various types and combinations of school-based preventive dental care procedures were assessed in the National Preventive Dentistry Demonstration Program, a four-year study involving more than 20,000 students, from ten schools nationwide. Communal water fluoridation was reaffirmed as the most cost-effective means of…

  15. Getting inside the House: The Effectiveness of a Rape Prevention Program for College Fraternity Men.

    ERIC Educational Resources Information Center

    Davis, Tracy L.; Liddell, Debora L.

    2002-01-01

    Investigates the effectiveness of a socialization-focused rape prevention program designed specifically for college fraternity men. Results suggest that a socialization approach to rape education was as effective as a more traditional prevention program with regard to attitudes and knowledge. Although attitudes rebounded to previous levels at the…

  16. Optimizing Violence Prevention Programs: An Examination of Program Effectiveness among Urban High School Students

    ERIC Educational Resources Information Center

    Thompkins, Amanda C.; Chauveron, Lisa M.; Harel, Ofer; Perkins, Daniel F.

    2014-01-01

    Background: While demand for youth violence prevention programs increases, the ability of the school-day schedule to accommodate their time requirements has diminished. Viable school-based prevention programs must strike a balance between brevity and effectiveness. This article reports results from an effectiveness trial of a 12-session…

  17. Evaluating the Effectiveness of Premarital Prevention Programs: A Meta-Analytic Review of Outcome Research.

    ERIC Educational Resources Information Center

    Carroll, Jason S.; Doherty, William J.

    2003-01-01

    Presents a comprehensive, meta-analytic review and critical evaluation of outcome research pertaining to the effectiveness of premarital prevention programs. Findings suggest that premarital prevention programs are generally effective in producing immediate and short-term gains in interpersonal skills and overall relationship quality. (Contains 67…

  18. Student Enrollments, Fall 1995.

    ERIC Educational Resources Information Center

    Arkansas State Dept. of Higher Education, Little Rock.

    This document presents demographic information about enrollment at public and independent institutions of higher education in Arkansas as of fall 1995. A listing of abbreviations for the public four-year, public two-year, and independent institutions is followed by a map of their locations. An executive summary identifies highlights such as the…

  19. Falling into Winter.

    ERIC Educational Resources Information Center

    Harrington, Carolyn Lang

    2000-01-01

    Presents an activity that connects art, science, and nature in which elementary school students learn about deciduous trees. Explains that students create a torn-tissue collage, using fall colors for a background and drawing a silhouette of a tree without leaves on top of the background with black crayon. (CMK)

  20. Editors' Fall Picks

    ERIC Educational Resources Information Center

    Heilbrun, Margaret; McCormack, Heather; Katterjohn, Anna; Kuzyk, Raya; Roncevic, Mirela; Fox, Bette-Lee; Hoffert, Barbara

    2009-01-01

    "Library Journal's" review editors select fall titles readers won't want to miss--"Waiting on a Train: The Embattled Future of Passenger Rail Service" (James McCommons); "Happy" (Alex Lemon); "Free for All: Joe Papp, the Public, and the Greatest Theater Story Ever Told" (Kenneth Turan & Joseph Papp); "In My Father's Shadow: A Daughter Remembers…

  1. Fall 2013 International Comparisons

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2014

    2014-01-01

    This Fall report is an aggregated statistical analysis of Measures of Academic Progress® (MAP®) data from international schools. The report provides a consistent means of comparisons of specific sub-groups by subject and grade, which allows partners to compare their MAP® results with other schools within their region or membership organization.…

  2. The News, Fall 2002.

    ERIC Educational Resources Information Center

    Giles, Ray, Ed.

    2002-01-01

    This fall 2002 newsletter from the Community College League of California contains several articles, news stories, and the brochure from the 2002 Annual Convention, "Celebrating the Way California LEARNS." Articles include: (1) "Nursing Shortage Poses Dilemma for Colleges: Access vs. Efficiency," a discussion of the debate over how to increase the…

  3. Freshmen Survey. Fall 1985.

    ERIC Educational Resources Information Center

    Goodyear, Don

    In 1985, College of the Sequoias (COS) was asked by the Cooperative Institutional Research Program (conducted jointly by the American Council on Education and the University of California, Los Angeles) to participate in a survey of incoming freshmen for the fall 1985 semester. During the summer counseling session, 259 new COS freshmen were…

  4. Prevention System Mediation of Communities That Care Effects on Youth Outcomes

    PubMed Central

    Hawkins, J. David; Rhew, Isaac C.; Shapiro, Valerie B.; Abbott, Robert D.; Oesterle, Sabrina; Arthur, Michael W.; Briney, John S.; Catalano, Richard F.

    2013-01-01

    This study examined whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students (Hawkins et al. Archives of Pediatrics and Adolescent Medicine 163:789–798 2009) were mediated by community-level prevention system constructs posited in the CTC theory of change. Potential prevention system constructs included the community’s degree of (a) adoption of a science-based approach to prevention, (b) collaboration on prevention activities, (c) support for prevention, and (d) norms against adolescent drug use as reported by key community leaders in 24 communities. Higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Results support CTC’s theory of change that encourages communities to adopt a science- based approach to prevention as a primary mechanism for improving youth outcomes. PMID:23828448

  5. Prevention system mediation of communities that care effects on youth outcomes.

    PubMed

    Brown, Eric C; Hawkins, J David; Rhew, Isaac C; Shapiro, Valerie B; Abbott, Robert D; Oesterle, Sabrina; Arthur, Michael W; Briney, John S; Catalano, Richard F

    2014-10-01

    This study examined whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students (Hawkins et al. Archives of Pediatrics and Adolescent Medicine 163:789-798 2009) were mediated by community-level prevention system constructs posited in the CTC theory of change. Potential prevention system constructs included the community's degree of (a) adoption of a science-based approach to prevention, (b) collaboration on prevention activities, (c) support for prevention, and (d) norms against adolescent drug use as reported by key community leaders in 24 communities. Higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Results support CTC's theory of change that encourages communities to adopt a science-based approach to prevention as a primary mechanism for improving youth outcomes. PMID:23828448

  6. Preventive effects of geranylgeranylacetone on rat ethanol-induced gastritis

    PubMed Central

    Ning, Jian-Wen; Lin, Guan-Bin; Ji, Feng; Xu, Jia; Sharify, Najeeb

    2012-01-01

    AIM: To establish a rat ethanol gastritis model, we evaluated the effects of ethanol on gastric mucosa and studied the preventive effects of geranylgeranylacetone on ethanol-induced chronic gastritis. METHODS: One hundred male Sprague-Dawley rats were randomly divided into 4 equal groups: normal control group, undergoing gastric perfusion of normal saline (NS) by gastrogavage; model control group and 2 model therapy groups that underwent gastric perfusion with ethanol (distillate spirits with 56% ethanol content) by gastrogavage for 4 wk. Low or high doses of geranylgeranylacetone were added 1 h before ethanol perfusion in the 2 model therapy groups, while the same amount of NS, instead of geranylgeranylacetone was used in that model control group. The rats were then sacrificed and stomachs were removed. The injury level of the gastric mucosa was observed by light and electron microscopy, and the levels of prostaglandin 2 (PGE2), endothelin-1 (ET-1) and nitric oxide (NO) were measured by radioimmunoassay and the Griess method. RESULTS: The gastric mucosal epidermal damage score (EDS; 4.5) and ulcer index (UI; 12.0) of the model control group were significantly higher than that of the normal control group (0 and 0 respectively, all P = 0.000). The gastric mucosal EDS and UI of the 2 model therapy groups (EDS: 2.5 and 2.0; UI: 3.5 and 3.0) were significantly lower than that of the model control group (all P < 0.01). There was no statistically significant difference between the low-dose and high-dose model therapy groups. The expression value of plasma ET-1 of the model control group was higher than that of the normal control group (P < 0.01) and the 2 model therapy groups (all P < 0.01). The expression values of gastric mucosal PGE2 and serum NO of the model control group were lower than those of the normal control group (all P < 0.05) and the 2 model therapy groups (all P < 0.05). The thickness of the gastric mucous layerand the hexosamine content in the model

  7. Multicomponent delirium prevention: not as effective as NICE suggest?

    PubMed

    Teale, Elizabeth; Young, John

    2015-11-01

    Multicomponent delirium prevention strategies have been shown in intervention studies consistently to reduce the occurrence of delirium. Based on this convincing evidence base, the National Institute for Health and Care Excellence has advocated the widespread adoption of multicomponent delirium prevention interventions into the routine inpatient care of older people. However, despite successful reductions in incident delirium of about a third, anticipated reductions in mortality or admissions to long-term care--both clinically important endpoints statistically correlated with the occurrence of delirium--have not been conclusively observed. We hypothesise that the reasons for this disconnection are partly methodological, due to difficulties in delirium detection and blinding of study personnel to the intervention, but predominantly due to the underlying relationship between delirium and the abnormal health state of frailty; the interaction between these two geriatric syndromes is currently poorly understood. PMID:26316509

  8. Use and effectiveness of lapse prevention strategies among pregnant smokers.

    PubMed

    Naughton, Felix; McEwen, Andy; Sutton, Stephen

    2015-11-01

    Little is known about the use of lapse prevention strategies to help smokers manage situation-triggered urges to smoke. Pregnant smokers (N = 174) participating in an intervention trial reported use of cognitive-behavioural lapse prevention strategies and smoking abstinence (biochemically verified). Participants typically enacted few strategies. Distraction strategies were most commonly used. Total number of strategies used did not predict abstinence. However, using 'self-talk' (odds ratio (OR) = 3.44, 95% confidence interval = 1.14-10.40) or 'avoiding spending time with other smokers' (OR = 4.01, 95% confidence interval = 1.34-11.95) independently increased the odds of abstinence. The promotion of these and other under-utilised evidence-based strategies warrants further attention. PMID:24296735

  9. The Effect of Educational Intervention Regarding the Knowledge of Mothers on Prevention of Accidents in Childhood

    PubMed Central

    Silva, Elayne Cristina Soares; Fernandes, Maria Neyrian de Fátima; Sá, Márcia Caroline Nascimento; Mota de Souza, Layane; Gordon, Ariadne Siqueira de Araújo; Costa, Ana Cristina Pereira de Jesus; Silva de Araújo, Thábyta; Carvalho, Queliane Gomes da Silva; Maia, Carlos Colares; Machado, Ana Larissa Gomes; Gubert, Fabiane do Amaral; Alexandrino da Silva, Leonardo; Vieira, Neiva Francenely Cunha

    2016-01-01

    Early guidance emphasizes the provision of information to families about growth and normal development in childhood such as specific information about security at home. This research aimed to analyze mothers' knowledge about the prevention of accidents in childhood before and after an educational intervention. It was conducted as a quasi-experimental study with 155 mothers in a Basic Health Unit in northeastern of Brazil in April and May of 2015. The data were collected in two stages through a self-report questionnaire performed before and after the educational intervention by the subjects. The results revealed a significant increase in knowledge about prevention of accidents in childhood in all the self-applied questions (p<0.05). After the educational intervention, there seemed to be a significant difference with the questions regarding the knowledge on preventing fall (p=0.000), drowning (p=0.000), and intoxication (p=0.007). The authors concluded that the educational intervention performed in this study increased the subjects’ knowledge on prevention of accidents in childhood. PMID:27583061

  10. The Effect of Educational Intervention Regarding the Knowledge of Mothers on Prevention of Accidents in Childhood.

    PubMed

    Silva, Elayne Cristina Soares; Fernandes, Maria Neyrian de Fátima; Sá, Márcia Caroline Nascimento; Mota de Souza, Layane; Gordon, Ariadne Siqueira de Araújo; Costa, Ana Cristina Pereira de Jesus; Silva de Araújo, Thábyta; Carvalho, Queliane Gomes da Silva; Maia, Carlos Colares; Machado, Ana Larissa Gomes; Gubert, Fabiane do Amaral; Alexandrino da Silva, Leonardo; Vieira, Neiva Francenely Cunha

    2016-01-01

    Early guidance emphasizes the provision of information to families about growth and normal development in childhood such as specific information about security at home. This research aimed to analyze mothers' knowledge about the prevention of accidents in childhood before and after an educational intervention. It was conducted as a quasi-experimental study with 155 mothers in a Basic Health Unit in northeastern of Brazil in April and May of 2015. The data were collected in two stages through a self-report questionnaire performed before and after the educational intervention by the subjects. The results revealed a significant increase in knowledge about prevention of accidents in childhood in all the self-applied questions (p<0.05). After the educational intervention, there seemed to be a significant difference with the questions regarding the knowledge on preventing fall (p=0.000), drowning (p=0.000), and intoxication (p=0.007). The authors concluded that the educational intervention performed in this study increased the subjects' knowledge on prevention of accidents in childhood. PMID:27583061

  11. Toward the azimuthal characteristics of ionospheric and seismic effects of "Chelyabinsk" meteorite fall according to the data from coherent radar, GPS, and seismic networks

    NASA Astrophysics Data System (ADS)

    Berngardt, O. I.; Perevalova, N. P.; Dobrynina, A. A.; Kutelev, K. A.; Shestakov, N. V.; Bakhtiarov, V. F.; Kusonsky, O. A.; Zagretdinov, R. V.; Zherebtsov, G. A.

    2015-12-01

    We present the results of a study of the azimuthal characteristics of ionospheric and seismic effects of the meteorite `Chelyabinsk,' based on the data from the network of GPS receivers, coherent decameter radar EKB, and network of seismic stations, located near the meteorite fall trajectory. It is shown that 6-14 min after the bolide explosion, GPS network observed the cone-shaped wavefront of traveling ionospheric disturbances (TIDs) that is interpreted as a ballistic acoustic wave. The typical TIDs propagation velocity were observed 661 ± 256 m/s, which corresponds to the expected acoustic wave speed for 240 km height. Fourteen minutes after the bolide explosion, at distances of 200 km, we observed the emergence and propagation of a TID with annular wavefront that is interpreted as gravitational mode of internal atmospheric waves. The propagation velocity of this TID was 337 ± 89 m/s which corresponds to the propagation velocity of these waves in similar situations. At EKB radar, we observed TIDs in the sector of azimuthal angles close to the perpendicular to the meteorite trajectory. The observed TID velocity (400 m/s) and azimuthal properties correlate well with the model of ballistic wave propagating at 120-140 km altitude. It is shown that the azimuthal distribution of the amplitude of vertical seismic oscillations with periods 3-60 s can be described qualitatively by the model of vertical strike-slip rupture, propagating at 1 km/s along the meteorite fall trajectory to distance of about 40 km. These parameters correspond to the direction and velocity of propagation of the ballistic wave peak by the ground. It is shown that the model of ballistic wave caused by supersonic motion and burning of the meteorite in the upper atmosphere can satisfactorily explain the various azimuthal ionospheric effects, observed by the coherent decameter radar EKB, GPS receivers network, and the azimuthal characteristics of seismic waves at large distances.

  12. [Tail-biting in pigs. Causes, effects and prevention].

    PubMed

    van den Berg, J

    1982-10-01

    Although much is known of the causes and prevention of tail-biting, this continues to be a common vice in pigs. The animals seek diversion by chewing on the tails of their fellows as they feel uncomfortable. This may result in inflammation of the tail. Prevention should be directed towards improvement of the conditions which cause the animal to feel uncomfortable. As this will often not be possible or only in part, efforts are made to prevent tail-biting by docking the tails. When tail-docking is performed according to the rule in one- to three-day-old animals, tail-biting obviously will no longer be possible. However, this does not mean removing the causes of tail-biting. This procedure is therefore undesirable from the point of view of welfare of the animals. Inflammation of the tail may result in metastasis to the spinal column and/or lungs. This is frequently associated with bacteraemia. Moreover, the resulting abscess formation will be highly objectionable from the point of view of hygiene. PMID:7147219

  13. A structural equation model relating physical function, pain, impaired mobility (IM), and falls in older adults.

    PubMed

    Dai, Boyi; Ware, William B; Giuliani, Carol A

    2012-01-01

    The current study used a structural equation model to investigate the interrelationships among physical function, pain, IM, and falls in 511 American older adults. The model included 11 measurement variables (tandem stance, single leg stance, 360° turn, chair stand, arm curl, sit and reach, back scratch, normative score of 6-min walk or 2-min step, timed up and go, pain, and fall) and four latent variables (balance, strength, flexibility, and IM). The final model with the combined sample demonstrated good fit with the participant data (χ(2)(31)=30.0, N=499, p=0.52; Goodness of Fit Index (GFI)=0.99). Balance had a significant and the largest effect on IM (standardized regression weights=-1.05, p<0.001). Strength, endurance, flexibility, and pain had small effects on IM (standardized regression weights<0.2). The findings suggest that balance and mobility testing should be a priority in fall screening and prevention programs. PMID:22766209

  14. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors.

    PubMed

    Nam, Ki Yeun; Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2016-02-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls. PMID:26839487

  15. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

    PubMed Central

    Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho

    2016-01-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls. PMID:26839487

  16. When Are Statins Cost-Effective in Cardiovascular Prevention? A Systematic Review of Sponsorship Bias and Conclusions in Economic Evaluations of Statins

    PubMed Central

    Catalá-López, Ferrán; Sanfélix-Gimeno, Gabriel; Ridao, Manuel; Peiró, Salvador

    2013-01-01

    Background We examined sponsorship of published cost-effectiveness analyses of statin use for cardiovascular (CV) prevention, and determined whether the funding source is associated with study conclusions. Methods and Findings We searched PubMed/MEDLINE (up to June 2011) to identify cost-effectiveness analyses of statin use for CV prevention reporting outcomes as incremental costs per quality-adjusted life years (QALY) and/or life years gained (LYG). We examined relationships between the funding source and the study conclusions by means of tests of differences between proportions. Seventy-five studies were included. Forty-eight studies (64.0%) were industry-sponsored. Fifty-two (69.3%) articles compared statins versus non-active alternatives. Secondary CV prevention represented 42.7% of articles, followed by primary CV prevention (38.7%) and both (18.7%). Overall, industry-sponsored studies were much less likely to report unfavourable or neutral conclusions (0% versus 37.1%; p<0.001). For primary CV prevention, the proportion with unfavourable or neutral conclusions was 0% for industry-sponsored studies versus 57.9% for non-sponsored studies (p<0.001). Conversely, no statistically significant differences were identified for studies evaluating secondary CV prevention (0% versus 12.5%; p=0.222). Incremental costs per QALY/LYG estimates reported in industry-sponsored studies were generally more likely to fall below a hypothetical willingness-to-pay threshold of US $50,000. Conclusions Our systematic analysis suggests that pharmaceutical industry sponsored economic evaluations of statins have generally favored the cost-effectiveness profile of their products particularly in primary CV prevention. PMID:23861972

  17. Inpatient falls: the impact of family and personal caregivers.

    PubMed

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2009-08-01

    The impact of family and personal caregivers on inpatients with fall-related injuries in a Taiwanese medical center is investigated in this study. Taiwan has a prevalent custom for families to accompany their hospitalized loved ones during hospital stays. During the 95-day data collection period, 228 falls occurred. Results showed that if no family members were present when a patient fell, the fall-related injury was less serious. Nurses in Taiwan tend to depend on family members to help provide patient care. Regardless of whether an inpatient has a family member present, frequent bedside nursing visits are important to prevent falls. PMID:19616163

  18. Testing the universality of the effects of the communities that care prevention system for preventing adolescent drug use and delinquency.

    PubMed

    Oesterle, Sabrina; Hawkins, J David; Fagan, Abigail A; Abbott, Robert D; Catalano, Richard F

    2010-12-01

    Universal community-oriented interventions are an important component in the prevention of youth health and behavior problems. Testing the universality of the effects of an intervention that was designed to be universal is important because it provides information about how the program operates and for whom and under what conditions it is most effective. The present study examined whether the previously established significant effects of the universal, community-based Communities That Care (CTC) prevention program on the prevalence of substance use and the variety of delinquent behaviors held equally for boys and girls and in risk-related subgroups defined by early substance use, early delinquency, and high levels of community-targeted risk at baseline. Interaction analyses of data from a panel of 4,407 students followed from Grade 5 to Grade 8 in the first randomized trial of CTC in 12 matched community pairs suggests that CTC reduced students' substance use and delinquency equally across risk-related subgroups and gender, with two exceptions: The effect of CTC on reducing substance use in 8th grade was stronger for boys than girls and the impact of CTC on reducing 8th-grade delinquency was stronger for students who were nondelinquent at baseline. PMID:20422289

  19. The Shape of Nuclear Falls and Their Effect on the Perception of Pitch and Prominence: Peaks vs. Plateaux

    ERIC Educational Resources Information Center

    Knight, Rachael-Anne

    2008-01-01

    This article investigates the perceptual effect of a high plateau in the intonation contour. Plateaux are flat stretches of contour and have been observed associated with high tones in Standard Southern British (SSB) English. The hypothesis that plateaux may make the accents with which they are associated sound higher in pitch than sharp peaks of…

  20. Technology Innovation Enabling Falls Risk Assessment in a Community Setting.

    PubMed

    Ni Scanaill, Cliodhna; Garattini, Chiara; Greene, Barry R; McGrath, Michael J

    2011-06-01

    Approximately one in three people over the age of 65 will fall each year, resulting in significant financial, physical, and emotional cost on the individual, their family, and society. Currently, falls are managed using on-body sensors and alarm pendants to notify others when a falls event occurs. However these technologies do not prevent a fall from occurring. There is now a growing focus on falls risk assessment and preventative interventions. Falls risk is currently assessed in a clinical setting by expert physiotherapists, geriatricians, or occupational therapists following the occurrence of an injurious fall. As the population ages, this reactive model of care will become increasingly unsatisfactory, and a proactive community-based prevention strategy will be required. Recent advances in technology can support this new model of care by enabling community-based practitioners to perform tests that previously required expensive technology or expert interpretation. Gait and balance impairment is one of the most common risk factors for falls. This paper reviews the current technical and non-technical gait and balance assessments, discusses how low-cost technology can be applied to objectively administer and interpret these tests in the community, and reports on recent research where body-worn sensors have been utilized. It also discusses the barriers to adoption in the community and proposes ethnographic research as a method to investigate solutions to these barriers. PMID:21660088

  1. TJC: Time to curb patient falls in healthcare settings.

    PubMed

    2015-12-01

    Noting that there are far too many falls in healthcare settings, The Joint Commission (TJC) has issued a Sentinel Event Alert, telling hospitals and other providers to take steps to identify patients at risk for a fall, and implement preventive interventions. However, while most falls occur in hospitals, preventing falls in the emergency setting presents some unique challenges. Since 2009, TJC says it has received 465 reports of patient falls with serious injury, and more than half of these have resulted in death. Most fall risk assessment tools are too cumbersome and take too long to complete at triage in the ED. The ED at Hartford Hospital in Hartford, CT, has implemented a streamlined risk assessment tool with just five "yes or no" factors for the triage nurse to consider. In concert with the risk assessment tool, the hospital has implemented a series of prevention interventions, including hourly rounding, bed alarms, post-fall huddles, and a non-punitive culture for reporting falls. PMID:26677481

  2. Falling film evaporator

    DOEpatents

    Bruns, Lester E.

    1976-01-01

    A falling film evaporator including a vertically oriented pipe heated exteriorly by a steam jacket and interiorly by a finned steam tube, all heating surfaces of the pipe and steam tube being formed of a material wet by water such as stainless steel, and packing within the pipe consisting of Raschig rings formed of a material that is not wet by water such as polyvinylidene fluoride.

  3. Preventive effects of cranberry products on experimental colitis induced by dextran sulphate sodium in mice.

    PubMed

    Xiao, Xiao; Kim, Jonggun; Sun, Quancai; Kim, Daeyoung; Park, Cheon-Seok; Lu, Tzong-Shi; Park, Yeonhwa

    2015-01-15

    With the prevalence of inflammatory bowel disease (IBD) and its associated risk for development of colorectal cancer, it is of great importance to prevent and treat IBD. However, due to the complexity of etiology and potentially serious adverse effects, treatment options for IBD are relatively limited. Thus, the purpose of this study was to identify a safe food-based approach for the prevention and treatment of IBD. In this study, we tested the effects of cranberry products on preventing dextran sulphate sodium-induced murine colitis. Our results suggest that both cranberry extract and dried cranberries-fed groups had a significantly reduced disease activity index, where dried cranberries were more effective in preventing colitis than cranberry extract. Shortening of colon length, colonic myeloperoxidase activity and production of pro-inflammatory cytokines were attenuated in animals fed dried cranberries compared to the controls. The current report suggests that cranberries can be applied to prevent and reduce the symptoms of IBD. PMID:25149009

  4. Preventive Effects of Multi-Lamellar Emulsion on Low Potency Topical Steroid Induced Local Adverse Effect

    PubMed Central

    Sul, Geun Dong; Park, Hyun Jung; Bae, Jong Hwan; Hong, Keum Duck; Park, Byeong Deog; Chun, Jaesun; Jeong, Se Kyoo; Lee, Seung Hun; Ahn, Sung Ku

    2013-01-01

    Background Topical steroid treatment induces diverse local Wand systemic adverse effects. Several approaches have been tried to reduce the steroid-induced adverse effects. Simultaneous application of physiological lipid mixture is also suggested. Objective Novel vehicles for topical glucocorticoids formulation were evaluated for the efficacy of reducing side-effects and the drug delivery properties of desonide, a low potency topical steroid. Methods Transcutaneous permeation and skin residual amount of desonide were measured using Franz diffusion cells. The in vivo anti-inflammatory activity was evaluated using murine model. Results Topical steroids formulation containing desonide, in either cream or lotion form, were prepared using multi-lamellar emulsion (MLE), and conventional desonide formulations were employed for comparison. MLE formulations did not affect the anti-inflammatory activity of the desonide in phobol ester-induced skin inflammation model, compared with conventional formulations. While the penetrated amounts of desonide were similar for all the tested formulations at 24 hours after application, the increased lag time was observed for the MLE formulations. Interestingly, residual amount of desonide in epidermis was significantly higher in lotion type MLE formulation. Steroid-induced adverse effects, including permeability barrier function impairment, were partially prevented by MLE formulation. Conclusion Topical desonide formulation using MLE as a vehicle showed a better drug delivery with increased epidermal retention. MLE also partially prevented the steroid-induced side effects, such as skin barrier impairment. PMID:23467730

  5. Effects of a Single-Lesson Tobacco Prevention Curriculum on Knowledge, Skill Identification and Smoking Intention

    ERIC Educational Resources Information Center

    Brown, Stephen; Birch, David; Thyagaraj, Sujan; Teufel, James; Phillips, Cheryl

    2007-01-01

    One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not…

  6. Effective Instruction. National Dropout Prevention Center/Network Newsletter. Volume 21, Number 2

    ERIC Educational Resources Information Center

    Duckenfield, Marty, Ed.

    2009-01-01

    The "National Dropout Prevention Newsletter" is published quarterly by the National Dropout Prevention Center/Network. This issue contains the following articles: (1) Strategies for Success (Charles W. Hatch); (2) 2009 NDPN Crystal Star Winners; (3) Strategies for More Effective Instruction (Micki Gibson); (4) Some Thoughts on Teaching Strategies…

  7. Testing Mediators of Intervention Effects in Randomized Controlled Trials: An Evaluation of Three Depression Prevention Programs

    ERIC Educational Resources Information Center

    Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

    2010-01-01

    Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB…

  8. The Cost and Effectiveness of School-Based Preventive Dental Care.

    ERIC Educational Resources Information Center

    Klein, Stephen P.; And Others

    The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five non-fluoridated communities. These children were examined at baseline and…

  9. The European Smoking Prevention Framework Approach (ESFA): Effects after 24 and 30 Months

    ERIC Educational Resources Information Center

    de Vries, Hein; Dijk, Froukje; Wetzels, Joyce; Mudde, Aart; Kremers, Stef; Ariza, Carles; Vitoria, Paulo Duarte; Fielder, Anne; Holm, Klavs; Janssen, Karin; Lehtovuori, Riku; Candel, Math

    2006-01-01

    The European Smoking Prevention Framework Approach (ESFA) study in six countries tested the effects of a comprehensive smoking prevention approach after 24 (T3; N = 10751) and 30 months (T4; N = 9282). The programme targeted four levels, i.e. adolescents in schools, school policies, parents and the community. In Portugal, 12.4% of the T1…

  10. Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

    ERIC Educational Resources Information Center

    Collier, Crystal

    2013-01-01

    The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

  11. Effects of Training and Feedback on Teachers' Use of Classroom Preventive Practices

    ERIC Educational Resources Information Center

    Artman-Meeker, Kathleen M.; Hemmeter, Mary Louise

    2013-01-01

    This study examined the effects of in-service training with performance feedback on preschool teachers' use of classroom preventive practices. Three practices designed to prevent challenging behavior were selected: transition preparations, rule reminders, and social-emotional teaching strategies. Following a brief training on each practice,…

  12. Building and Maintaining an Effective Campus-Wide Coalition for Suicide Prevention

    ERIC Educational Resources Information Center

    Kaslow, Nadine J.; Garcia-Williams, Amanda; Moffitt, Lauren; McLeod, Mark; Zesiger, Heather; Ammirati, Rachel; Berg, John P.; McIntosh, Belinda J.

    2012-01-01

    Preventing suicide is a commonly shared priority among college administrators, faculty, staff, students, and family members. Coalitions are popular health promotion mechanisms for solving community-wide problems and are valuable in campus-wide suicide prevention efforts. This article provides an example of an effective suicide prevention…

  13. Initial Indicators of Effectiveness for a High School Drug Prevention Program

    ERIC Educational Resources Information Center

    Fearnow-Kenney, Melodie D.; Wyrick, David L.; Jackson-Newsom, Julia; Wyrick, Cheryl H.; Hansen, William B.

    2003-01-01

    All Stars, Sr. is a comprehensive high school health education supplement designed to prevent high-risk behaviors among adolescents. The program includes topics such as personal health, nutrition, interpersonal relationships, and stress, with a special emphasis on drug prevention. Effective research-based programs that target late onset prevention…

  14. The Effect of a College Sexual Assault Prevention Program on First-Year Students' Victimization Rates

    ERIC Educational Resources Information Center

    Rothman, Emily; Silverman, Jay

    2007-01-01

    Objective: Although a variety of sexual assault prevention programs are currently available to college health professionals, there is a dearth of information about the effect of these programs on sexual assault victimization rates. Participants: The authors evaluated the efficacy of a sexual assault prevention program for first-year students at a…

  15. Introduction and Overview: Prevention Services--From Optimistic Promise to Widespread, Effective Practice.

    ERIC Educational Resources Information Center

    Weissberg, Roger P.; Kuster, Carol Bartels; Gullotta, Thomas P.

    This opening chapter provides an overview of the book, "Healthy Children 2010: Establishing Preventive Services." The article describes the purpose of the work, which is to provide strategies to establish and successfully implement effective prevention services in key socializing settings that powerfully affect the growth an development of…

  16. Stacked Deck: An Effective, School-Based Program for the Prevention of Problem Gambling

    ERIC Educational Resources Information Center

    Williams, Robert J.; Wood, Robert T.; Currie, Shawn R.

    2010-01-01

    School-based prevention programs are an important component of problem gambling prevention, but empirically effective programs are lacking. Stacked Deck is a set of 5-6 interactive lessons that teach about the history of gambling; the true odds and "house edge"; gambling fallacies; signs, risk factors, and causes of problem gambling; and skills…

  17. Stick balancing, falls and Dragon-Kings

    NASA Astrophysics Data System (ADS)

    Cabrera, J. L.; Milton, J. G.

    2012-05-01

    The extent to which the occurrence of falls, the dominant feature of human attempts to balance a stick at their fingertip, can be predicted is examined in the context of the "Dragon-King" hypothesis. For skilled stick balancers, fluctuations in the controlled variable, namely the vertical displacement angle θ, exhibit power law behaviors. When stick balancing is made less stable by either decreasing the length of the stick or by requiring the subject to balance the stick on the surface of a table tennis racket, systematic departures from the power law behaviors are observed in the range of large θ. This observation raises the possibility that the presence of departures from the power law in the large length scale region, possibly Dragon-Kings, may identify situations in which the occurrence of a fall is more imminent. However, whether or not Dragon-Kings are observed, there is a Weibull-type survival function for stick falling. The possibility that increased risk of falling can, at least to some extent, be predicted from fluctuations in the controlled variable before the event occurs has important implications for the development of preventative strategies for the management of phenomena ranging from earthquakes to epileptic seizures to falls in the elderly.

  18. Preventing Breast Cancer: Making Progress

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Preventing Breast Cancer: Making Progress Past Issues / Fall 2006 Table of ... inhibitor, can do an even better job of preventing breast cancer than the SERMs. Aromatase inhibitors stop an enzyme ...

  19. Effect of solid body degrees of freedom on the path instabilities of freely falling or rising flat cylinders

    NASA Astrophysics Data System (ADS)

    Chrust, M.; Bouchet, G.; Dušek, J.

    2014-05-01

    In 2007 Fernandes et al. reported a surprising delay of the onset of instabilities for freely rising cylinders of aspect ratio (χ=diameter/thickness of the cylinder) 10 and more. At Reynolds numbers at which instabilities develop in the wake of the same body kept fixed, the path was still found to be vertical and the wake axisymmetric. In this paper, we explain this delay by investigating numerically the transition scenario of the solid-fluid system represented by the freely moving body interacting with the ambient fluid by hydrodynamic forces. We show that the free body degrees of freedom can have a stabilizing effect on the onset of the primary bifurcation. This effect explains, however, only partly the experimental observation. We show that the primary bifurcation is followed by a sequence of weakly oscillating, virtually unobservable, bifurcating states before the observable path oscillations set in. For aspect ratio smaller than 8, the free body degrees of freedom destabilize the system in agreement with expectations. The primary bifurcation is, however, a Hopf bifurcation instead of regular one in the wake of a fixed body. In our study we focus to the intermediate interval of aspect ratio between 8 and 10. We show that, for χ>8, the primary Hopf bifurcation is replaced by a new one with much lower frequency and leading to weakly oscillating periodic oscillations, later (for χ>9) the Hopf bifurcation is replaced by a regular one disappearing again for very thin cylinders (χ>10).

  20. Massive Bone Loss Due to Orchidectomy and Localized Disuse: Preventive Effects of a Biosphonsphonate

    NASA Astrophysics Data System (ADS)

    Libouban, H.; Moreau, M. F.; Chappard, D.

    2008-06-01

    Orchidectomy (ORX) and hindlimb paralysis induced by botulinum neurotoxin (BTX) were combined to see if their effects were cumulative and if bone loss could be prevented by an antiresorptive agent (risedronate) or testosterone. Four groups of mature rats were studied for 1 month: SHAM operated; ORX and right hindlimb immobilization (BTX); ORX+BTX+risedronate or testosterone. Bone loss and microarchitecture deterioration were maximized on the immobilized bone. Risedronate but not testosterone prevented trabecular bone loss but was less effective on cortical bone loss. ORX and BTX had additive effects on bone loss which can be prevented by risedronate but not testosterone.

  1. CRITICAL IMPERMEABILITY PRESSU RE OF LEAK PREVENTED SEAL BY BLOCKING EFFECT

    NASA Astrophysics Data System (ADS)

    Kaga, Munehiko

    We have carried out the research on the impermeability of segment joint of shield tunnel used in a new water-expansion rubber material of injected ty pe. As the result, we found a new mechanism of impermeability by blocking effect. As next step, we investigated the impermeability function of a hard rubber leak prevented seal. It can be estimated that the critical imperm eability pressure rapidly increases if the hard rubber leak prevented seal has a cut-off performance by blockage effect. Consequently, we clarified that the hard rubber leak prevented seal has impermeability function by blocking effect. This result can be utilized for the development of impermeability method.

  2. Falls - Multiple Languages: MedlinePlus

    MedlinePlus

    ... sharing features on this page, please enable JavaScript. Arabic (العربية) Bosnian (Bosanski) Chinese - Simplified (简体中文) Chinese - Traditional ( ... Русский) Somali (af Soomaali) Spanish (español) Ukrainian (Українська) Arabic (العربية) Preventing Falls in the Hospital (Arabic) الوقاية ...

  3. Effectiveness of HIV prevention social marketing with injecting drug users.

    PubMed

    Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

    2010-10-01

    Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide. PMID:20724686

  4. Rock fall analysis of slope along state highway in Uttarakhand Himalaya, India using numerical simulation

    NASA Astrophysics Data System (ADS)

    Vishal, V.; Phophliya, M. K.; Purohit, R.

    2014-12-01

    With almost 1% of the reported accidents being associated with slope stability problems, landslides and rock fall have been responsible for nearly 25% of fatalities in hill slopes and surface mines over past few decades. Morpho-dynamic terrain of Himalaya is continually facing challenges in stability of rock/slopes, which are aggravated due to increased disturbance level in rock/soil mass due to human intervention. The lithological and structural variations, orientations and patterns of different water bodies and vegetation are varied along the slopes which indicate site-specific studies of rock fall prone areas in Uttarakhand. Lack of sufficient knowledge and understanding of the phenomenon, frequent occurrences of rock fall along state and national highways, the consequent inconveniences and loss of lives highlight the importance of addressing the subject on a priority basis. Rock fall simulation of the hill cut face along state highway in India was performed to replicate the effects of the falling rock blocks in the valley. The energy, velocity, bounce height and the trajectory of possible rock failures were determined. The slopes were optimised with respect to the intermediate benches to reduce the impact of falling rock blocks on the adjoining road. It was observed that introducing benches near the top did not reduce the impact of falling boulders much, however, the number of rocks crossing the ditch was less. On the contrary, benches at intermediate height reduced the energy of falling blocks but could not restrict the blocks to cross over the ditch on to the road. An optimisation of the angle of inclination of the ditch angle was also carried out. A ditch angle of 15o could restrict the passage of boulders from ditch over to the adjoining road. The study will be very useful for safe design of structures for prevention and mitigation of hazards due to rock failures along these slopes.

  5. Statistical evaluation of the effects of fall and winter flows on the spring condition of rainbow and brown trout in the green river downstream of Flaming Gorge Dam.

    SciTech Connect

    Magnusson, A. K.; LaGory, K. E.; Hayse, J. W.; Environmental Science Division

    2009-01-09

    Flaming Gorge Dam, a hydroelectric facility operated by the Bureau of Reclamation (Reclamation), is located on the Green River in Daggett County, northeastern Utah. In recent years, single peak releases each day or steady flows have been the operational pattern during the winter period. A double-peak pattern (two flow peaks each day) was implemented during the winter of 2006-2007 by Reclamation. Because there is no recent history of double-peaking at Flaming Gorge Dam, the potential effects of double-peaking operations on the body condition of trout in the dam's tailwater are not known. A study plan was developed that identified research activities to evaluate potential effects from double-peaking operations during winter months. Along with other tasks, the study plan identified the need to conduct a statistical analysis of existing data on trout condition and macroinvertebrate abundance to evaluate potential effects of hydropower operations. This report presents the results of this analysis. We analyzed historical data to (1) describe temporal patterns and relationships among flows, benthic macroinvertebrate abundance, and condition of brown trout (Salmo trutta) and rainbow trout (Oncorhynchus mykiss) in the tailwaters of Flaming Gorge Dam and (2) to evaluate the degree to which flow characteristics (i.e., flow volumes and flow variability) and benthic macroinvertebrate abundance affect the condition of trout in this area. This information, together with further analyses of size-stratified trout data, may also serve as baseline data to which the effects of potential future double-peaking flows can be compared. The condition (length, weight and/or relative weight) of rainbow trout (Oncorhynchus mykiss) at two sites in the Green River downstream of Flaming Gorge Dam (Tailrace and Little Hole) and weight of brown trout (Salmo trutta) at the Little Hole site has been decreasing since 1990 while the abundance of brown trout has been increasing at the two sites. At the

  6. A fully relativistic radial fall

    NASA Astrophysics Data System (ADS)

    Spallicci, Alessandro D. A. M.; Ritter, Patxi

    2014-10-01

    Radial fall has historically played a momentous role. It is one of the most classical problems, the solutions of which represent the level of understanding of gravitation in a given epoch. A gedankenexperiment in a modern frame is given by a small body, like a compact star or a solar mass black hole, captured by a supermassive black hole. The mass of the small body itself and the emission of gravitational radiation cause the departure from the geodesic path due to the back-action, that is the self-force. For radial fall, as any other non-adiabatic motion, the instantaneous identity of the radiated energy and the loss of orbital energy cannot be imposed and provide the perturbed trajectory. In the first part of this paper, we present the effects due to the self-force computed on the geodesic trajectory in the background field. Compared to the latter trajectory, in the Regge-Wheeler, harmonic and all others smoothly related gauges, a far observer concludes that the self-force pushes inward (not outward) the falling body, with a strength proportional to the mass of the small body for a given large mass; further, the same observer notes a higher value of the maximal coordinate velocity, this value being reached earlier during infall. In the second part of this paper, we implement a self-consistent approach for which the trajectory is iteratively corrected by the self-force, this time computed on osculating geodesics. Finally, we compare the motion driven by the self-force without and with self-consistent orbital evolution. Subtle differences are noticeable, even if self-force effects have hardly the time to accumulate in such a short orbit.

  7. Corrosion of retractable type fall arresters.

    PubMed

    Baszczyński, Krzysztof; Jachowicz, Marcin

    2009-01-01

    Retractable type fall arresters constitute a most effective group of components used in personal protection systems protecting against falls from a height. They are designed primarily for outdoor use, which results in exposure to atmospheric factors associated with risk of corrosion of metal elements. This paper presents the results of a study, in which retractable type fall arresters were exposed to a simulated corrosive environment, a neutral salt spray. It discusses the development of corrosion processes depending on the duration of exposure to corrosive conditions. Tests demonstrated that corrosion of elements decreased their strength and impaired the functioning of mobile parts. The article presents methods of testing the correct functioning of devices, necessary for assessing their resistance to corrosion, which have been developed for this purpose. It also analyzes the correlation between corrosion-related damage of retractable type fall arresters and potential hazards for their users. PMID:19744368

  8. Some adverse effects of antipsychotics: prevention and treatment.

    PubMed

    Lader, M

    1999-01-01

    Antipsychotic medication causes a wide range of adverse effects, which can be serious and may further imperil both the physical and psychological health of schizophrenic patients. The range of side effects patients commonly encounter includes weight gain, endocrine disturbances, sedation, anticholinergic effects, hypotension, seizures, and extrapyramidal symptoms. Less common and unpredictable reactions are blood dyscrasias, cardiotoxicity, sudden death, and the neuroleptic malignant syndrome. Antipsychotic drugs differ significantly regarding their propensity to cause these reactions. Patients should undergo comprehensive health checks before an antipsychotic is prescribed, and drug therapy should be individualized to take account of any preexisting symptoms. Side effects and the wider implications of drug treatment, such as effects on occupational and social functioning, should be discussed with the patient before initiating therapy. Patients should be regularly monitored for side effects during treatment and switched to alternative therapy if side effects are serious and/or persistent. PMID:10372605

  9. Understanding fall meaning and context in marketing balance classes to older adults.

    PubMed

    Clark, Lauren; Thoreson, Sallie; Goss, Cynthia W; Zimmer, Lorena Marquez; Marosits, Mark; DiGuiseppi, Carolyn

    2013-02-01

    This study explored older, community-dwelling adults' attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥ 60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their "comfort zones" to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success. PMID:25473927

  10. `In free fall'

    NASA Astrophysics Data System (ADS)

    Beijerinck, Herman C. W.

    2014-01-01

    Physicists in the lead of a fiction book or a play, that's a rare event! Writers in general do not understand physics, while physicists seldom have the talent of writing for a large audience. So when it happens, we should rejoice. The up-and-coming German author Juli Zeh [1] (1974), who studied law, has succeeded in combining beautiful prose, psychological drama, crime and physics in a challenging book `In free fall' [2]. A good friend of hers, Bettina Bruinier, has put the core message of the book into a compelling play in the `Volkstheater' in Munich [1]. Yes, it can be done.

  11. Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm

    PubMed Central

    Haberer, Jessica E.; Bangsberg, David R.; Baeten, Jared M.; Curran, Kathryn; Koechlin, Florence; Amico, K. Rivet; Anderson, Peter; Mugo, Nelly; Venter, Francois; Goicochea, Pedro; Caceres, Carlos; O’Reilly, Kevin

    2015-01-01

    Clinical trial data have shown that oral pre-exposure prophylaxis (PrEP) is efficacious when taken as prescribed; however, PrEP adherence is complex and must be understood within the context of variable risk for HIV infection and use of other HIV prevention methods. Different levels of adherence may be needed in different populations to achieve HIV prevention, and the optimal methods for achieving the necessary adherence for both individual and public health benefits are unknown. Guidance for PrEP use must consider these questions to determine the success of PrEP-based HIV prevention programs. In this article, we propose a new paradigm for understanding and measuring PrEP adherence, termed prevention-effective adherence, which incorporates dynamic HIV acquisition risk behaviors and the use of HIV alternative prevention strategies. We discuss the need for daily PrEP use only during periods of risk for HIV exposure, describe key issues for measuring and understanding relevant behaviors, review lessons from another health prevention field (i.e., family planning), and provide guidance for prevention-effective PrEP use. Moreover, we challenge emerging calls for sustained, near perfect PrEP adherence regardless of risk exposure and offer a more practical and public health-focused vision for this prevention intervention. PMID:26103095

  12. Participation in Older Adult Physical Activity Programs and Risk for Falls Requiring Medical Care, Washington State, 2005–2011

    PubMed Central

    Rosenberg, Dori E.; Phelan, Elizabeth A.; Fitzpatrick, Annette L.

    2015-01-01

    Introduction Physical activity is known to prevent falls; however, use of widely available exercise programs for older adults, including EnhanceFitness and Silver Sneakers, has not been examined in relation to effects on falls among program participants. We aimed to determine whether participation in EnhanceFitness or Silver Sneakers is associated with a reduced risk of falls resulting in medical care. Methods A retrospective cohort study examined a demographically representative sample from a Washington State integrated health system. Health plan members aged 65 or older, including 2,095 EnhanceFitness users, 13,576 Silver Sneakers users, and 55,127 nonusers from 2005 through 2011, were classified as consistent users (used a program ≥2 times in all years they were enrolled in the health plan during the study period); intermittent users (used a program ≥2 times in 1 or more years enrolled but not all years), or nonusers of EnhanceFitness or Silver Sneakers. The main outcome was measured as time-to-first-fall requiring inpatient or out-of-hospital medical treatment based on the International Classification of Diseases, 9th Revision, Clinical Modification, Sixth Edition and E-codes. Results In fully adjusted Cox proportional hazards models, consistent (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.63–0.88) and intermittent (HR, 0.87; 95% CI, 0.8–0.94) EnhanceFitness participation were both associated with a reduced risk of falls resulting in medical care. Intermittent Silver Sneakers participation showed a reduced risk (HR, 0.93; 95% CI, 0.90–0.97). Conclusion Participation in widely available community-based exercise programs geared toward older adults (but not specific to fall prevention) reduced the risk of medical falls. Structured programs that include balance and strength exercise, as EnhanceFitness does, may be effective in reducing fall risk. PMID:26068411

  13. Economic effects of mastitis prevention strategies for dairy producers.

    PubMed

    Miller, G Y; Bartlett, P C

    1991-01-15

    For efficient disease management in dairy production, the influence of disease prevention strategies on farm profitability must be known. A survey of mastitis control practices, milking machine function and maintenance, and cow environmental conditions was conducted with 406 dairy producers on the Michigan Dairy Herd Improvement-somatic cell counting program responding. These survey data, in conjunction with Dairy Herd Improvement production data, were used to develop a model estimating the marginal value products of mastitis control practices. Lost milk production associated with increased somatic cell count was calculated for each herd. Mastitis control practices, milking machine function and maintenance, and cow environmental conditions were used as independent variables in an analysis of covariance model with lost milk production as the dependent variable. Variables significant in explaining changes in production from increased somatic cell count were the use of teat dip, use of sanitizer in the wash water, milking cow bedding, summer nonlactating cow housing, summer calving locations, type of regulator, alternating pulsation, and rolling herd average milk production. The marginal value product (change in revenues received) from the use of iodine, chlorhexidine, and quaternary ammonium-type teat dips were $13.79, $16.09, and $22.17/cow/year, respectively, and these changes were statistically significant. However, sanitizer in the wash water was associated with a decrease in production. Management practices that have previously been shown to be economical and did not appear in the final model included nonlactating cow therapy and single-use paper towels. PMID:2004979

  14. Effects of Hydroelectric Dam Operations on the Restoration Potential of Snake River Fall Chinook Salmon (Oncorhynchus tshawytscha) Spawning Habitat Final Report, October 2005 - September 2007.

    SciTech Connect

    Hanrahan, Timothy P.; Richmond, Marshall C.; Arntzen, Evan V.

    2007-11-13

    This report describes research conducted by the Pacific Northwest National Laboratory for the Bonneville Power Administration (BPA) as part of the Fish and Wildlife Program directed by the Northwest Power and Conservation Council. The study evaluated the restoration potential of Snake River fall Chinook salmon spawning habitat within the impounded lower Snake River. The objective of the research was to determine if hydroelectric dam operations could be modified, within existing system constraints (e.g., minimum to normal pool levels; without partial removal of a dam structure), to increase the amount of available fall Chinook salmon spawning habitat in the lower Snake River. Empirical and modeled physical habitat data were used to compare potential fall Chinook salmon spawning habitat in the Snake River, under current and modified dam operations, with the analogous physical characteristics of an existing fall Chinook salmon spawning area in the Columbia River. The two Snake River study areas included the Ice Harbor Dam tailrace downstream to the Highway 12 bridge and the Lower Granite Dam tailrace downstream approximately 12 river kilometers. These areas represent tailwater habitat (i.e., riverine segments extending from a dam downstream to the backwater influence from the next dam downstream). We used a reference site, indicative of current fall Chinook salmon spawning areas in tailwater habitat, against which to compare the physical characteristics of each study site. The reference site for tailwater habitats was the section extending downstream from the Wanapum Dam tailrace on the Columbia River. Fall Chinook salmon spawning habitat use data, including water depth, velocity, substrate size and channelbed slope, from the Wanapum reference area were used to define spawning habitat suitability based on these variables. Fall Chinook salmon spawning habitat suitability of the Snake River study areas was estimated by applying the Wanapum reference reach habitat

  15. Saxon Falls Dam rehabilitation

    SciTech Connect

    Rudolph, R.M.; Quist, J.E.

    1995-12-31

    The Saxon Falls Hydro Project is a high-head hydro owned and operated by Northern States Power Company (NSP) in northwest Wisconsin. Saxon Falls comprises a concrete buttress overflow spillway; mass-concrete tainter gate spillway, conduit intake, and nonoverflow section; earth dam; 1,600-foot-long, 72-inch-diameter steel conduit; two 150-foot-long, 54-inch-diameter penstocks; steel surge tank; and reinforced concrete powerhouse. All structures are founded on bedrock. Engineering inspections revealed severe concrete deterioration and leakage within the intake and deterioration of the middle nonoverflow section. Subsequent to the inspection, concrete cores confirmed the level of deterioration and indicated that immediate measures were necessary to correct the deficiencies and restore project integrity. Because the dam is located on the border between Michigan and Wisconsin, coordination with the respective Departments of Natural Resources was crucial to obtain permits to construct the repairs. Due to concerns regarding a sensitive fishery, a reservoir drawdown was not allowed. To accomplish the work and allow for a suitable construction area, a special braced sheetpile cofferdam was required to complete the project. NSP elected to complete the construction using its own special-construction crews. Close coordination allowed construction personnel, the owner, and the engineer to overcome difficulties encountered during construction.

  16. Detecting Falling Snow from Space

    NASA Technical Reports Server (NTRS)

    Jackson, Gail Skofronick; Johnson, Ben; Munchak, Joe

    2012-01-01

    There is an increased interest in detecting and estimating the amount of falling snow reaching the Earth's surface in order to fully capture the atmospheric water cycle. An initial step toward global spaceborne falling snow algorithms includes determining the thresholds of detection for various active and passive sensor channel configurations, snow event cloud structures and microphysics, snowflake particle electromagnetic properties, and surface types. In this work, cloud resolving model simulations of a lake effect and synoptic snow event were used to determine the minimum amount of snow (threshold) that could be detected by the following instruments: the W -band radar of CloudSat, Global Precipitation Measurement (GPM) Dual-frequency Precipitation Radar (DPR) Ku and Ka band, and the GPM Microwave Imager (GMI) channels from 10 to 183 plus or minus 7 GHz. Eleven different snowflake shapes were used to compute radar reflectivities and passive brightness temperatures. Notable results include: (1) the W-Band radar has detection thresholds more than an order of magnitude lower than the future GPM sensors, (2) the cloud structure macrophysics influences the thresholds of detection for passive channels, (3) the snowflake microphysics plays a large role in the detection threshold for active and passive instruments, (4) with reasonable assumptions, "the passive 166 GHz channel has detection threshold values comparable to the GPM DPR Ku and Ka band radars with approximately 0.05 g per cubic meter detected at the surface, or an approximately 0.5-1 millimeter per hr. melted snow rate (equivalent to 0.5-2 centimeters per hr. solid fluffy snowflake rate). With detection levels of falling snow known, we can focus current and future retrieval efforts on detectable storms and concentrate advances on achievable results. We will also have an understanding of the light snowfall events missed by the sensors and not captured in the global estimates.

  17. Slip, trip, and fall injuries among nursing care facility workers.

    PubMed

    Bell, Jennifer L; Collins, James W; Tiesman, Hope M; Ridenour, Marilyn; Konda, Srinivas; Wolf, Laurie; Evanoff, Bradley

    2013-04-01

    The objective of this research was to describe the slip, trip, and fall injury experience and trends in a population of nursing home workers, identify risk factors for slip, trip, and fall injuries, and develop prevention strategies for slip, trip, and fall hazards. Workers' compensation injury claims data and payroll data from 1996 through 2003 were obtained from six nursing homes and used to calculate injury incidence rates. Narrative information was used to describe details of slip, trip, and fall events. A total of 86 slip, trip, and fall-related workers' compensation claims were filed during the 8-year period. Slip, trip, and fall claim rates showed a nonsignificant increase during the 8-year period. Most slips, trips, and falls were attributed to hazards that can be mitigated (e.g., water on the floor or loose cords in a walkway). Nursing home workers experience more slip, trip, and fall-related injury claims than workers in other industries. Preventive programs should be implemented and evaluated in this industry. PMID:23521142

  18. Modeling the effectiveness of isolation strategies in preventing STD epidemics

    SciTech Connect

    Hyman, J.M.; Li, J.

    1998-06-01

    The authors formulate and analyze a two-group, selective-mixing, susceptible-infective-susceptible (SIS), sexually transmitted disease (STD) model where the infection-dependent desirability and acceptability in partnership formations are zero at high infection levels. They analyze two strategies to limit the spread of the epidemic by avoiding forming partnerships with people in a highly infected group. In one approach, the people in the highly infected group protect themselves by forming partnerships with only people outside their own group. They show that the transmission dynamics for this approach are similar to the situation where people continue to have both intragroup and intergroup partnerships. In the second approach, when one group becomes highly infected, the people in the other group adopt an isolation strategy and stop forming any partnerships with people in this highly infected group. They show that the second approach can limit the epidemic to the highly infected group. The other group will be infection-free, but as long as the epidemic in the total population exceeds the epidemic threshold, the epidemic will continue to persist. If the group reproductive number of the infection-free group is greater than one, and the infection should ever invade the infection-free group, then it will lead to an epidemic similar to the one that would have occurred if they had not isolated themselves from the other group. In this simple two-group model, although these isolation strategies may reduce the extent of an STD epidemic, they are ineffective in preventing an epidemic.

  19. Doppler radar fall activity detection using the wavelet transform.

    PubMed

    Su, Bo Yu; Ho, K C; Rantz, Marilyn J; Skubic, Marjorie

    2015-03-01

    We propose in this paper the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. The radar senses any motions from falls as well as nonfalls due to the Doppler effect. The WT is very effective in distinguishing the falls from other activities, making it a promising technique for radar fall detection in nonobtrusive inhome elder care applications. The proposed radar fall detector consists of two stages. The prescreen stage uses the coefficients of wavelet decomposition at a given scale to identify the time locations in which fall activities may have occurred. The classification stage extracts the time-frequency content from the wavelet coefficients at many scales to form a feature vector for fall versus nonfall classification. The selection of different wavelet functions is examined to achieve better performance. Experimental results using the data from the laboratory and real inhome environments validate the promising and robust performance of the proposed detector. PMID:25376033

  20. A Randomized Trial of a Multifaceted Intervention to Reduce Falls among Community-Dwelling Adults

    ERIC Educational Resources Information Center

    Fox, Patrick J.; Vazquez, Laurie; Tonner, Chris; Stevens, Judy A.; Fineman, Norman; Ross, Leslie K.

    2010-01-01

    Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in…

  1. [Falls in patients with dementia].

    PubMed

    Yamaguchi, Kiyoshi

    2008-11-01

    People with cognitive impairment are at about 2 to 3 times higher risk of falling compared with cognitively intact elderly. Incidence of falls among patients with Alzheimer's disease (AD) is high, nevertheless the clinical feature common in patients with mild to moderate AD is the absence of motor impairment. Recent studies suggest that the divided attention markedly impairs the ability of patients with AD to regulate the gait. Falls are particularly common in Dementia with Lewy bodies (DLB) patients and may aid diagnosis, and the falls are associated with parkinsonism and other unclear factors. Treatment studies evaluating fall reduction strategies in dementia patients are a priority. PMID:18974447

  2. Simulated unobtrusive falls detection with multiple persons.

    PubMed

    Ariani, Arni; Redmond, Stephen J; Chang, David; Lovell, Nigel H

    2012-11-01

    One serious issue related to falls among the elderly living at home or in a residential care facility is the "long lie" scenario, which involves being unable to get up from the floor after a fall for 60 min or more. This research uses a simulated environment to investigate the potential effectiveness of using wireless ambient sensors (dual-technology (microwave/infrared) motion detectors and pressure mats) to track the movement of multiple persons and to unobtrusively detect falls when they occur, therefore reducing the rate of occurrence of "long lie" scenarios. A path-finding algorithm (A*) is used to simulate the movement of one or more persons through the residential area. For analysis, the sensor network is represented as an undirected graph, where nodes in the graph represent sensors, and edges between nodes in the graph imply that these sensors share an overlapping physical region in their area of sensitivity. A second undirected graph is used to represent the physical adjacency of the sensors (even where they do not overlap in their monitored regions). These graphical representations enable the tracking of multiple subjects/groups within the environment, by analyzing the sensor activation and adjacency profiles, hence allowing individuals/groups to be isolated when multiple persons are present, and subsequently monitoring falls events. A falls algorithm, based on a heuristic decision tree classifier model, was tested on 15 scenarios, each including one or more persons; three scenarios of activity of daily living, and 12 different types of falls (four types of fall, each with three postfall scenarios). The sensitivity, specificity, and accuracy of the falls algorithm are 100.00%, 77.14%, and 89.33%, respectively. PMID:22835529

  3. Retrospective analysis of fatal falls.

    PubMed

    Thierauf, Annette; Preuss, Johanna; Lignitz, Eberhard; Madea, Burkhard

    2010-05-20

    Fatal falls are frequent and inhomogeneous events and affect every age. The criminalistic classification can often only be done on the basis of extensive investigations and the autopsy results. We retrospectively surveyed 291 cases of fatal falls on which a post-mortem examination had been carried out in the institutes of Forensic Medicine in Bonn and Greifswald. In large part, these cases are falls from height (n=123) and ground-level falls (n=122). These are compared to fatal falls down a stairs (n=46); the analysis is confined to injuries to the cranium. In ground-level falls the injury pattern in falls under the influence of alcohol differs from that of falls with no alcohol in the case history: all injuries are seen in higher relative frequency in casualties after the consumption of alcohol. In falls from height, the previous consumption of alcohol did not influence the injury pattern; the intracranial traumas are seen in decreasing frequency with increasing heights. The aim of this retrospective analysis is to present injury patterns and influencing factors like fall heights and alcohol for the different kinds of falls on the basis of our collective and to demonstrate similarities and differences between the subgroups. PMID:20176452

  4. Effects of Flow on the Migratory Behavior and Survival of Juvenile Fall and Summer Chinook Salmon in John Day Reservior, 1982 Annual Report of Research.

    SciTech Connect

    Miller, David R.; Sims, Carl W.

    1983-11-01

    The National Marine Fisheries Service in cooperation with the Bonneville Power Administration is conducting a 6-year study of the effects of instream flows on the passage time, survival, and migrational behavior of juvenile fall and summer (O-age) chinook salmon in John Day Reservoir. In 1982, the second year of the study, research activities concentrated on refining distribution and behavior data in John Day Reservoir and on releasing and recapturing marked fish needed to define flow/travel time relationships. Twenty-two groups (61,887 fish) of marked O-age chinook salmon were wire-tagged, branded, and released into the tailrace at McNary Dam, and forty-four groups (13,128 fish) were branded and released into the reservoir at various other sites. Sampling at the John Day Dam airlift facility captured 54,647 subyearling chinook salmon including 482 marked recoveries. Additional marks (279) were recovered from purse seine samples taken at various sites throughout the reservoir. The average passage time to John Day Dam for marked O-age chinook salmon released in the McNary tailrace was 23 days. Weekend flow reductions at McNary Dam did not affect passage time of subyearling chinook salmon in John Day Reservoir. There was no statistical evidence to indicate that instream flows affected either the rate of movement or residence time of O-age chinook salmon in John Day Reservoir.

  5. The effects of flying: processes, consequences and prevention.

    PubMed

    Shepherd, Laura; Edwards, Sharon L

    The dangers of flying have recently been highlighted in the media; however, the available literature is contradictory, as are current recommendations for travellers. The purpose of this article is to provide an account of the research that has been undertaken to investigate the possible consequences of air travel. It will examine the effect that flying has on the body, especially the respiratory and circulatory systems, by studying the theoretical and empirical literature. The aim is to provide nurses with a sound insight into the effects of long-distance flying on the body, and the potential adverse effects/complications, such as deep vein thrombosis and pulmonary embolism, that may occur as a result. In addition, it provides information on the treatment options available and should enable nurses to give sound prophylactic advice after discharge. By encouraging passengers to take precautions, the number of people affected by flight could be reduced. PMID:14966449

  6. Preventive and Therapeutic Effects of Chinese Herbal Compounds against Hepatocellular Carcinoma.

    PubMed

    Hu, Bing; An, Hong-Mei; Wang, Shuang-Shuang; Chen, Jin-Jun; Xu, Ling

    2016-01-01

    Traditional Chinese Medicines, unique biomedical and pharmaceutical resources, have been widely used for hepatocellular carcinoma (HCC) prevention and treatment. Accumulated Chinese herb-derived compounds with significant anti-cancer effects against HCC have been identified. Chinese herbal compounds are effective in preventing carcinogenesis, inhibiting cell proliferation, arresting cell cycle, inducing apoptosis, autophagy, cell senescence and anoikis, inhibiting epithelial-mesenchymal transition, metastasis and angiogenesis, regulating immune function, reversing drug resistance and enhancing the effects of chemotherapy in HCC. This paper comprehensively reviews these compounds and their effects on HCC. Finally, the perspectives and rational application of herbal compounds for HCC management are discussed. PMID:26828466

  7. Effectiveness of Residence Restrictions in Preventing Sex Offense Recidivism

    ERIC Educational Resources Information Center

    Nobles, Matt R.; Levenson, Jill S.; Youstin, Tasha J.

    2012-01-01

    Many municipalities have recently extended residence restrictions for sex offenders beyond the provisions of state law, although the efficacy of these measures in reducing recidivism has not been empirically established. This study used arrest histories in Jacksonville, Florida, to assess the effects of a recently expanded municipal 2,500-foot…

  8. Assessing Organizational Effectiveness in Higher Education Drug Prevention Consortia.

    ERIC Educational Resources Information Center

    Sheldon-Keller, A. E.; And Others

    1995-01-01

    Eighty-three consortia of institutions of higher education were surveyed for the purpose of measuring organization effectiveness. Generalized satisfaction was reported. Satisfaction with goal attainment was significantly related to the presence of at least one "internal" goal for the consortium. (Author/KW)

  9. Effectiveness of Secondary Pregnancy Prevention Programs: A Meta-Analysis

    ERIC Educational Resources Information Center

    Corcoran, Jacqueline; Pillai, Vijayan K.

    2007-01-01

    Because subsequent pregnancy in teen parents often worsens the impact of adolescent parenting; therefore, a common goal of teenage parent programs has been to reduce repeat pregnancy. To examine the impact of this goal, a meta-analysis was conducted on 16 control-comparison group studies that evaluated the effect of teenage pregnancy and parenting…

  10. Effects of the cyberbullying prevention program media heroes (Medienhelden) on traditional bullying.

    PubMed

    Chaux, Enrique; Velásquez, Ana María; Schultze-Krumbholz, Anja; Scheithauer, Herbert

    2016-01-01

    There is considerable debate over whether cyberbullying is just another form of bullying, or whether it is a problem distinct enough to require specific intervention. One way to explore this issue is to analyze whether programs designed to prevent traditional bullying help prevent cyberbullying, and whether programs designed to prevent cyberbullying prevent traditional bullying. The main goal of the current study was to analyze the spillover effects of the cyberbullying prevention program Media Heroes (Medienhelden) on traditional bullying. Media Heroes promotes empathy, knowledge of risks and consequences, and strategies that allow bystanders to defend victims from cyberbullying. Mixed ANOVAs were conducted comparing pretest and post-test (6 months after intervention) measures of 722 students (ages 11-17) assigned to a long (15 sessions) intervention, a short (1 day) intervention, and a control group. In addition to confirming the previously reported effects on cyberbullying, Media Heroes was found to reduce traditional bullying. Effects were larger for the long-version of the program than for the short 1-day version. No effects were found on victimization by either cyberbullying or traditional bullying. Strategies to complement traditional and cyberbullying prevention efforts are discussed. Aggr. Behav. 42:157-165, 2016. © 2016 Wiley Periodicals, Inc. PMID:26879895

  11. Preventive effect of antihistaminics on mouse skin photosensitization with hematoporphyrin derivative

    NASA Astrophysics Data System (ADS)

    Fu, Nai-wu; Yan, Li-xue

    1993-03-01

    Beta-carotene 100 mg/kg per day or vitamin C 50 mg/kg per day was administered orally for two days and did not prevent mouse skin photosensitization caused by hematoporphyrin derivative (HpD). However, (beta) -carotene 100 mg/kg per day administered intramuscularly for two days prevented mouse skin reaction. Cimetidine and benadryl 10 mg/kg per day, P.O.X 2, effectively prevented mouse skin reaction. This suggests histamine may be involved in skin photoreaction induced by HpD.

  12. The effectiveness of a multimedia program to prevent fetal alcohol syndrome.

    PubMed

    Lachausse, Robert G

    2008-07-01

    Fetal alcohol syndrome (FAS) continues to be the leading preventable cause of mental retardation in the United States. Because abstaining from alcohol prior to and throughout pregnancy is the only way to prevent FAS, some prevention programs try to target women before they become pregnant. The Fetal Alcohol Spectrum Teaching and Research Awareness Campaign (FASTRAC) is a multimedia, peer-delivered educational presentation designed to reduce the incidence of FAS. Results from an ethnically diverse sample of high school students indicate that the program increased participants' knowledge regarding FAS but had no significant effect on participants' attitudes, beliefs about the dangers of FAS or intention to use alcohol during pregnancy. The FASTRAC program failed partly because of its didactic approach and the lack of health education principles that have been shown to be effective in changing other substance use behaviors. Suggestions for improving FAS prevention education programs are offered. PMID:16803934

  13. Effectiveness of an Ongoing, Community-Based Breast Cancer Prevention Program for Korean American Women.

    PubMed

    Koh, Eun; Choi, Ga-Young; Cho, Ji Young

    2016-02-01

    The study evaluates the effectiveness of an ongoing, community-based breast cancer prevention program offered by a local social services agency in the Washington, DC, metropolitan area. Korean American women who participated in this breast cancer prevention program were compared with those who did not participate in their knowledge, attitude, and screening behaviors. The study found that the intervention group was more knowledgeable on breast cancer and related services and reported more positive attitudes toward breast cancer screening services than the comparison group. The participants in the intervention group were also more likely to plan to receive a mammogram than those in the comparison group. However, significant differences were not observed in the two groups in their intention to receive a clinical breast examination. The study findings suggest that an ongoing, community-based breast cancer prevention program can be an effective method of addressing breast cancer prevention disparities observed among Korean American women. PMID:26946886

  14. Preventive effects of Lentinus edodes on homocysteinemia in mice

    PubMed Central

    YANG, HYUN; HWANG, INHO; KIM, SUN; AHN, CHANGHWAN; HONG, EUI-JU; JEUNG, EUI-BAE

    2013-01-01

    Homocysteinemia is associated with cardiovascular and neuronal degenerative diseases. Deficiencies of the B vitamins lead to high homocysteine serum levels. Lentinus edodes (L. edodes) is also known as the Shiitake mushroom and may have beneficial effects on vascular and lipid metabolic diseases, including hypertension, homocysteinemia and lipidemia. In this study, we induced a homocysteinemia-like condition in mice by the administration of a folate- and vitamin B12-deficient diet and evaluated the effect of L. edodes on the homocysteinemia-like condition. Homocysteinemia was induced by the administration of a diet deficient in folate and vitamin B12 (DFV) for 6 weeks to mice aged 4–10 weeks. The homocysteinemic mice were treated with L. edodes flour (5, 10 and 20%), eritadenine (10 mg/kg) or DFV only (negative control) for 2 weeks. The DFV induced a significant increase in serum homocysteine levels. The increased homocysteine serum levels were reduced by eritadenine and L. edodes flour (5, 10 and 20%). Hepatic levels of S-adenosyl-L-homocysteine hydrolase (SAH) were significantly higher under DFV administration and the elevated SAH levels were reduced by treatment with L. edodes in a dose-dependent manner. The mRNA expression levels of DNA methyl transferases, DNMT1 and DNMT3a, were reduced in the DFV group, and the reduced levels of DNMT1 and DNMT3a mRNA expression were recovered in the eritadenine and L. edodes (5, 10 and 20%) groups. These results suggest that components of L. edodes, including eritadenine may have beneficial effects on hyperhomocysteinemia and its therapeutic effects may be involved in the regulation of DNA methylation-related genes in mice. PMID:24137209

  15. Effectiveness of broadcasting guidelines for photosensitive seizure prevention.

    PubMed

    Takahashi, Yukitoshi; Fujiwara, Tateki

    2004-03-23

    Emissions from TV programs are a dangerous light source for photosensitive individuals, because 48.9% of patients have photosensitive seizures caused by TV programs. The authors used a national survey to verify the effectiveness of current Japanese guidelines, which are based on neurophysiologic principles of photosensitivity. They show that the guidelines successfully control TV images to protect many photosensitive persons from harmful TV emissions. PMID:15037709

  16. Effect of removing user fees on attendance for curative and preventive primary health care services in rural South Africa.

    PubMed Central

    Wilkinson, D.; Gouws, E.; Sach, M.; Karim, S. S.

    2001-01-01

    User fees are used to recover costs and discourage unnecessary attendance at primary care clinics in many developing countries. In South Africa, user fees for children aged under 6 years and pregnant women were removed in 1994, and in 1997 all user fees at all primary health care clinics were abolished. The intention of these policy changes was to improve access to health services for previously disadvantaged communities. We investigated the impact of these changes on clinic attendance patterns in Hlabisa health district. Average quarterly new registrations and total attendances for preventive services (antenatal care, immunization, growth monitoring) and curative services (treatment of ailments) at a mobile primary health care unit were studied from 1992 to 1998. Regression analysis was undertaken to assess whether trends were statistically significant. There was a sustained increase in new registrations (P = 0.0001) and total attendances (P = 0.0001) for curative services, and a fall in new registrations (P = 0.01) and total attendances for immunization and growth monitoring (P = 0.0002) over the study period. The upturn in demand for curative services started at the time of the first policy change. The decreases in antenatal registrations (P = 0.07) and attendances (P = 0.09) were not statistically significant. The number of new registrations for immunization and growth monitoring increased following the first policy change but declined thereafter. We found no evidence that the second policy change influenced underlying trends. The removal of user fees improved access to curative services but this may have happened at the expense of some preventive services. Governments should remain vigilant about the effects of new health policies in order to ensure that objectives are being met. PMID:11477970

  17. Riemann pendulum in free fall systems

    NASA Astrophysics Data System (ADS)

    Fargion, Daniele

    2016-07-01

    The possible detection in space and in different free fall system of the tidal effects via a Riemann pendulum rate, is considered. The possibility to perform such an experiment for educational purpouse by a Moire' or Holographic double exposure detection is described. The International Space Station may obtain high quality test of 3D Riemann pendulum effects.

  18. Methodological Issues in Studies of the Effectiveness of Pressure Ulcer Prevention Interventions

    PubMed Central

    Baumgarten, Mona; Shardell, Michelle; Rich, Shayna

    2010-01-01

    PURPOSE To enhance the wound care practitioner's understanding of the research methods used to obtain information about the effectiveness of pressure ulcer prevention interventions. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES After reading this article and taking this test, the reader should be able to: 1. Differentiate between randomized, historical, and nonrandomized comparison studies. 2. Explain terminology and concepts associated with pressure ulcer prevention research. PMID:19325278

  19. [EFFEKT-E: Effectiveness of a Prevention Programme for Children and their Depressed Mothers].

    PubMed

    Bühler, A; Kötter, C; Stemmler, M; Jaursch, S; Lösel, F

    2015-09-01

    The aim of this study was to develop an effective selective preventive programme for the risk group of children of depressed mothers. A universal parent and child training concept was adapted to the target group and to mother-child rehabilitation clinic conditions. A quasi-experimental design was implemented with 13 clinics. Evaluation of the results reveals that EFFEKT-E is an accepted, feasible selective programme which has the potential to enhance maternal competence and prevent children's emotional disruption. PMID:23572470

  20. Progress in the Development of Effective Vaccines to Prevent Selected Gram Positive Bacterial Infections

    PubMed Central

    Bronze, Michael S.; Dale, James B.

    2010-01-01

    Infections due to virulent gram positive bacteria, such as Staphylococcus aureus, group B streptococci and group A streptococci remain significant causes of morbidity and mortality despite progress in antimicrobial therapy. Despite significant advances in the understanding of the pathogenesis of infection due to these organisms, there are only limited strategies to prevent infection. In this paper, we review efforts to develop safe and effective vaccines that would prevent infections due to these 3 pathogens. PMID:20697258