[Measurement and analysis of reflected information from crops canopy suffering from wind disaster influence].

PubMed

Bao, Yu-Long; Zhang, Ji-Quan; Liu, Xiao-Jing; Wang, Yong-Fang; Ma, Dong-Lai; Sun, Zhong-Qiu

2013-04-01

The corn in the grain filling stage fell over in the central region of Jilin province by the Typhoon Bolaven influence. In order to determine the impact of falling over corn canopy on the reflected information, the hyperspectral reflectance was detected at different viewing zenith angles, at the same time, the polarized reflection was also measured. The results from the analysis by combining the reflection and polarization from corn canopy showed that the reflection of falling over corn is low in visible, while increases in the near infrared wavelength. The reflection from falling over corn canopy was more anisotropic than stand-up corn canopy. The reflected light was highly polarized, the polarization of corn canopy provided the probability for distinguishing between falling over corn and stand-up corn. This research provides a basis for estimating the disaster area and lost units.

Fall prevention in central coast community pharmacies.

PubMed

Stuart, Gina M; Kale, Helen L

2018-04-19

Fall injuries among people aged 65 years and over (older people) cause substantial health decline and cost to the health system. In 2009 in New South Wales, 25.6% of older people fell in the previous year, and 10.7% (32 000) were hospitalised. Pharmacists are trusted professionals, who interact extensively with older people and have potential to augment fall prevention in pharmacies. This brief report describes how professional development improved pharmacist's knowledge and confidence in fall prevention, encouraged implementation of fall prevention plans and facilitated the provision of brief fall prevention interventions for older clients, after identification of fall risk. In 2014, pharmacists from all Central Coast pharmacies (n = 76) were invited to free, continuing professional development (CPD) in fall prevention. It provided education and resources to identify clients' fall risk, conduct brief fall prevention interventions and implement fall prevention health promotion plans (FPHPP). Pharmacists completed written: Baseline and post-workshop questionnaires to assess changes in pharmacist's knowledge and confidence, and existing fall prevention in pharmacies. Logs of client fall risk and brief fall prevention interventions offered to clients. Four-month follow-up questionnaires to assess implementation of FPHPPs and pharmacy practice changes. Pharmacists representing 36% of pharmacies participated. At four-month follow-up, 67% had implemented FPHPPs, and 62% delivered brief interventions determined by client fall risk. Fall prevention in pharmacies can be augmented through locally provided CPD tailored for pharmacists. SO WHAT?: This model could increase fall prevention reach. It is transferable to settings where health professionals provide services to older adults and require reregistration through professional development. © 2018 Australian Health Promotion Association.

Electronic Out-fall Inspection Application - 12007

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weymouth, A Kent III; Pham, Minh; Messick, Chuck

2012-07-01

In early 2009 an exciting opportunity was presented to the Geographic Information Systems (GIS) team at the Savannah River Site (SRS). The SRS maintenance group was directed to maintain all Out-falls on Site, increasing their workload from 75 to 183 out-falls with no additional resources. The existing out-fall inspection system consisted of inspections performed manually and documented via paper trail. The inspections were closed out upon completion of activities and placed in file cabinets with no central location for tracking/trending maintenance activities. A platform for meeting new improvements required for documentation by the Department of Health and Environmental Control (DHEC)more » out-fall permits was needed to replace this current system that had been in place since the 1980's. This was accomplished by building a geographically aware electronic application that improved reliability of site out-fall maintenance and ensured consistent standards were maintained for environmental excellence and worker efficiency. Inspections are now performed via tablet and uploaded to a central point. Work orders are completed and closed either in the field using tablets (mobile application) or in their offices (via web portal) using PCs. And finally completed work orders are now stored in a central database allowing trending of maintenance activities. (authors)« less

Schools in the Age of Technology: Ideas for Instructional Innovation.

ERIC Educational Resources Information Center

McGraw, James H., IV; Frank, Charlotte K.

This document profiles five schools that were selected as winners of the "Fifth Annual Business Week Awards for Instructional Innovation: Schools in the Age of Technology": Bailey's Elementary School for the Arts and Sciences (Falls Church, Virginia); Hunterdon Central Regional High School (Flemington, New Jersey); John Muir Elementary School…

Factors associated with developing a fear of falling in subjects with primary open-angle glaucoma.

PubMed

Adachi, Sayaka; Yuki, Kenya; Awano-Tanabe, Sachiko; Ono, Takeshi; Shiba, Daisuke; Murata, Hiroshi; Asaoka, Ryo; Tsubota, Kazuo

2018-02-13

To investigate the relationship between clinical risk factors, including visual field (VF) defects and visual acuity, and a fear of falling, among patients with primary open-angle glaucoma (POAG). All participants answered the following question at a baseline ophthalmic examination: Are you afraid of falling? The same question was then answered every 12 months for 3 years. A binocular integrated visual field was calculated by merging a patient's monocular Humphrey field analyzer VFs, using the 'best sensitivity' method. The means of total deviation values in the whole, superior peripheral, superior central, inferior central, and inferior peripheral VFs were calculated. The relationship between these mean VF measurements, and various clinical factors, against patients' baseline fear of falling and future fear of falling was analyzed using multiple logistic regression. Among 392 POAG subjects, 342 patients (87.2%) responded to the fear of falling question at least twice in the 3 years study period. The optimal regression model for patients' baseline fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. The optimal regression equation for future fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. Defects in the inferior peripheral VF area are significantly related to the development of a fear of falling.

Creating Independent Learners: Placing Students at the Heart of the Assessment Process

ERIC Educational Resources Information Center

Alden, Katie

2018-01-01

Stanley Park High School, Carshalton, was designated a Building Schools for the Future "One School Pathfinder" in 2006 and charged with being innovative in all aspects of schooling. At a time of increasing compliance in schools, with an unwillingness to deviate from centrally controlled orthodoxy for fear of falling foul of…

Leadership Practices Accelerate into High Speed

ERIC Educational Resources Information Center

Novak, Dori; Reilly, Marceta; Williams, Diana

2010-01-01

In fall 2006, the deputy superintendent of Howard County Schools in Maryland asked a small leadership team to rethink leadership support for central office leaders and to come up with an aligned three-point plan that would meet their unique needs. The leadership support system needed to take into account: (1) Leadership standards and indicators of…

Production and nitrogen-use efficiency of oat forage receiving slurry or urea

USDA-ARS?s Scientific Manuscript database

Recently, several research projects have evaluated fall-grown oat for use as emergency fall forage throughout the north-central US; however, using fall-grown oat in cropping programs also allows the practical benefit of summer manure distribution that is completely de-coupled from corn production. ‘...

Cortical Modulation of Motor Control Biofeedback among the Elderly with High Fall Risk during a Posture Perturbation Task with Augmented Reality

PubMed Central

Chang, Chun-Ju; Yang, Tsui-Fen; Yang, Sai-Wei; Chern, Jen-Suh

2016-01-01

The cerebral cortex provides sensorimotor integration and coordination during motor control of daily functional activities. Power spectrum density based on electroencephalography (EEG) has been employed as an approach that allows an investigation of the spatial–temporal characteristics of neuromuscular modulation; however, the biofeedback mechanism associated with cortical activation during motor control remains unclear among elderly individuals. Thirty one community-dwelling elderly participants were divided into low fall-risk potential (LF) and high fall-risk potential (HF) groups based upon the results obtained from a receiver operating characteristic analysis of the ellipse area of the center of pressure. Electroencephalography (EEG) was performed while the participants stood on a 6-degree-of-freedom Stewart platform, which generated continuous perturbations and done either with or without the virtual reality scene. The present study showed that when there was visual stimulation and poor somatosensory coordination, a higher level of cortical response was activated in order to keep postural balance. The elderly participants in the LF group demonstrated a significant and strong correlation between postural-related cortical regions; however, the elderly individuals in the HF group did not show such a relationship. Moreover, we were able to clarify the roles of various brainwave bands functioning in motor control. Specifically, the gamma and beta bands in the parietal–occipital region facilitate the high-level cortical modulation and sensorimotor integration, whereas the theta band in the frontal–central region is responsible for mediating error detection during perceptual motor tasks. Finally, the alpha band is associated with processing visual challenges in the occipital lobe.With a variety of motor control demands, increment in brainwave band coordination is required to maintain postural stability. These investigations shed light on the cortical modulation of motor control among elderly participants with varying fall-risk potentials. The results suggest that, although elderly adults may be without neurological deficits, inefficient central modulation during challenging postural conditions could be an internal factor that contributes to the risk of fall. Furthermore, training that helps to improve coordinated sensorimotor integration may be a useful approach to reduce the risk of fall among elderly populations or when patients suffer from neurological deficits. PMID:27199732

Reading with filtered fixations: adult age differences in the effectiveness of low-level properties of text within central vision.

PubMed

Jordan, Timothy R; McGowan, Victoria A; Paterson, Kevin B

2014-06-01

When reading, low-level visual properties of text are acquired from central vision during brief fixational pauses, but the effectiveness of these properties may differ in older age. To investigate, a filtering technique displayed the low, medium, or high spatial frequencies of text falling within central vision as young (18-28 years) and older (65+ years) adults read. Reading times for normal text did not differ across age groups, but striking differences in the effectiveness of spatial frequencies were observed. Consequently, even when young and older adults read equally well, the effectiveness of spatial frequencies in central vision differs markedly in older age. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Snow deposition and melt under different vegetative covers in central New York

Treesearch

A. R. Eschner; D. R. Satterlund

1963-01-01

Two-thirds of the annual runoff from watersheds in the Allegheny Plateau of central New York comes from the snow-or snow and rain that falls in December through April. Although the amounts of precipitation in this period are fairly uniform from year to year, the proportion that falls as snow varies; so does the amount that accumulates on the ground, and its duration...

Tree stands, not guns, are the midwestern hunter's most dangerous weapon.

PubMed

Crockett, Andrew; Stawicki, Stanislaw P; Thomas, Yalaunda M; Jarvis, Amy M; Wang, Cecily F; Beery, Paul R; Whitmill, Melissa L; Lindsey, David E; Steinberg, Steven M; Cook, Charles H

2010-09-01

Although the prevailing stereotype is that most hunting injuries are gunshot wounds inflicted by intoxicated hunting buddies, our experience led us to hypothesize that falls comprise a significant proportion of hunting related injuries. Trauma databases of two Level I trauma centers in central Ohio were queried for all hunting related injuries during a 10-year period. One hundred and thirty patients were identified (90% male, mean age 41.0 years, range 17-76). Fifty per cent of injuries resulted from falls, whereas gunshot wounds accounted for 29 per cent. Most hunters were hunting deer and 92 per cent of falls were from tree stands. Alcohol was involved in only 2.3 per cent, and drugs of abuse in 4.6 per cent. Of gunshots, 58 per cent were self-inflicted, and 42 per cent were shot by another hunter. Tree stand falls were highly morbid, with 59 per cent of fall victims suffering spinal fractures, 47 per cent lower extremity fractures, 18 per cent upper extremity fractures, and 18 per cent closed head injuries. Surgery was required for 81 per cent of fall-related injuries, and 8.2 per cent of fall victims had permanent neurological deficits. In contrast to prevailing beliefs, in our geographic area tree-stand falls are the most common mechanism of hunting related injury requiring admission to a Level 1 trauma center.

Prevalence of Falls in an Urban Community-Dwelling Older Population of Cape Town, South Africa.

PubMed

Zimba Kalula, S; Ferreira, M; Swingler, G; Badri, M; Aihie Sayer, A

2015-12-01

Falls are a major cause of disability and mortality in older adults. Studies on falls in this population have mainly been conducted in high income countries, and scant attention has been given to the problem in low and middle income countries, including South Africa. The aim of the study was to establish a rate for falls in older adults in South Africa. A cross-sectional survey with a 12-month follow-up survey. Three purposively selected suburbs of Cape Town: Plumstead, Wynberg Central and Gugulethu. Eight hundred and thirty seven randomly sampled ambulant community-dwelling subjects aged ≥ 65 years grouped according to ethnicity in three sub-samples: black Africans, coloureds (people of mixed ancestry) and whites. Data were collected on socio-demographic and health characteristics, and history of falls using a structured questionnaire and a protocol for physical assessments and measurements. Of the total baseline (n=837) and follow-up (n=632) survey participants, 76.5% and 77.2 % were females with a mean (S.D) age of 74 years (6.4) and 75 years (6.2), respectively. Rates of 26.4% and 21.9% for falls and of 11% and 6.3% for recurrent falls, respectively, were calculated at baseline and follow-up. Fall rates differed by ethnic sub-sample at baseline: whites 42 %, coloureds 34.4% and black Africans 6.4 % (p=0.0005). Rates of 236, 406 and 354 falls per 1000 person years were calculated for men, women and both genders, respectively. Recurrent falls were more common in women than in men. Falls are a significant problem in older adults in South Africa. Effective management of falls and falls prevention strategies for older people in South Africa, need to be developed and implemented.

Fall incidents unraveled: a series of 26 video-based real-life fall events in three frail older persons

PubMed Central

2013-01-01

Background For prevention and detection of falls, it is essential to unravel the way in which older people fall. This study aims to provide a description of video-based real-life fall events and to examine real-life falls using the classification system by Noury and colleagues, which divides a fall into four phases (the prefall, critical, postfall and recovery phase). Methods Observational study of three older persons at high risk for falls, residing in assisted living or residential care facilities: a camera system was installed in each participant’s room covering all areas, using a centralized PC platform in combination with standard Internet Protocol (IP) cameras. After a fall, two independent researchers analyzed recorded images using the camera position with the clearest viewpoint. Results A total of 30 falls occurred of which 26 were recorded on camera over 17 months. Most falls happened in the morning or evening (62%), when no other persons were present (88%). Participants mainly fell backward (initial fall direction and landing configuration) on the pelvis or torso and none could get up unaided. In cases where a call alarm was used (54%), an average of 70 seconds (SD=64; range 15–224) was needed to call for help. Staff responded to the call after an average of eight minutes (SD=8.4; range 2–33). Mean time on the ground was 28 minutes (SD=25.4; range 2–59) without using a call alarm compared to 11 minutes (SD=9.2; range 3–38) when using a call alarm (p=0.445). The real life falls were comparable with the prefall and recovery phase of Noury’s classification system. The critical phase, however, showed a prolonged duration in all falls. We suggest distinguishing two separate phases: a prolonged loss of balance phase and the actual descending phase after failure to recover balance, resulting in the impact of the body on the ground. In contrast to the theoretical description, the postfall phase was not typically characterized by inactivity; this depended on the individual. Conclusions This study contributes to a better understanding of the fall process in private areas of assisted living and residential care settings in older persons at high risk for falls. PMID:24090211

Do Canes or Walkers Make Any Difference? NonUse and Fall Injuries.

PubMed

Luz, Clare; Bush, Tamara; Shen, Xiaoxi

2017-04-01

Examine patterns of cane and walker use as related to falls and fall injuries. Among people who fall at home, most do not have an assistive device with them when they fall. Nonusers who fall sustain more severe injuries. This was a cross-sectional study using a self-administered written survey completed by 262 people aged 60 and older who were community dwelling, cognitively intact, and current cane/walker users with a history of falls. They were recruited through clinical practice sites, churches, and senior housing in central Michigan. Outcomes of interest included patterns of device use, reasons for nonuse, device use at time of fall, and fall-related injuries. Seventy-five percent of respondents who fell were not using their device at the time of fall despite stating that canes help prevent falls. Reasons for nonuse included believing it was not needed, forgetfulness, the device made them feel old, and inaccessibility. Perceived risk was not high enough to engage in self-protective behavior. However, nonuse led to a significantly higher proportion of falls resulting in surgery than among device users. Among respondents requiring surgery, 100% were nonusers. Most respondents never received a home safety evaluation (68%) and only 50% received training on proper device use. Providers must place increased emphasis on the importance of cane/walker use for injury prevention through patient education to promote personal relevance, proper fitting, and training. New strategies are needed to improve device acceptability and accessibility. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Preliminary results of a novel hay-hole fall prevention initiative.

PubMed

Batra, Erich K; Gross, Brian W; Jammula, Shreya; Bradburn, Eric H; Baier, Ronald D; Reihart, Michael J; Murphy, Dennis; Moyer, Kay; Hess, Joseph; Lackmann, Susan; Miller, Jo Ann; Rogers, Frederick B

2018-02-01

Hay-hole falls are a prevalent source of trauma among Anabaptists-particularly Anabaptist youth. We sought to decrease hay-hole falls in South Central Pennsylvania through the development and distribution of all-weather hay-hole covers to members of the at-risk Anabaptist community. Following the creation of a rural trauma prevention syndicate, hay-hole cover prototypes co-designed and endorsed by the Pennsylvania Amish Safety Committee were developed and distributed throughout South Central Pennsylvania. Preintervention and postintervention surveys were distributed to recipients to gain an understanding of the hay-hole fall problem in this population, to provide insight into the acceptance of the cover within the community, and to determine the efficacy of the cover in preventing falls. A total of 231 hay-hole covers were distributed throughout eight rural trauma-prone counties in Pennsylvania. According to preintervention survey data, 52% of cover recipients reported at least one hay-hole fall on their property, with 46% reporting multiple falls (median fall rate, 1.00 [1.00-2.00] hay-hole falls per respondent). The median self-reported distance from hay-hole to ground floor was 10.0 (8.00-12.0) feet, and the median number of hay-holes present on-property was 3.00 (2.00-4.00) per respondent. Postintervention survey data found 98% compliance with hay-hole cover installation and no subsequent reported hay-hole falls. With the support of the Pennsylvania Amish Safety Committee, we developed a well-received hay-hole cover which could effectively reduce fall trauma across other rural communities in the United States. Epidemiological study, Level III.

Developing fall armyworms as a model for studying the migratory behavior of lepidopteran pests in the United States.

USDA-ARS?s Scientific Manuscript database

The fall armyworm, Spodoptera frugiperda (J. E. Smith) is a significant economic pest in the western hemisphere, causing substantial losses in corn, sorghum, forage and turf grasses . Although fall armyworm does not survive severe winters, it infests most of the central and eastern United States an...

Rapid Settlement of Majuro Atoll, Central Pacific, Following its Emergence 2000 Years Ago

NASA Astrophysics Data System (ADS)

Kayanne, H.; Yamaguchi, T.; Yamano, H.; Yoneda, M.

2010-12-01

Atoll islands are areas of low, flat land, and the sustainability of habitable land in such environments is sensitive to even slight changes in sea level. The rise in sea level projected to occur during this century may lead to the submergence of atoll islands and the widespread loss of habitable land. However, the actual time sequence of past sea level change, island emergence events, and human settlement of newly emerged islands remain poorly constrained. Our excavation survey, combined with calibrated radiocarbon age dates, at Majuro Atoll, Marshall Islands, central Pacific, reveals that emergence of the island, triggered by a fall in sea level, was quickly followed by human settlement. The elevation of the central body of the island exceeded high water level at 2000 years ago, and the complete formation of the island occurred within an interval of 100 years. The island was colonized by people shortly after emergence, at 2000 years ago, prior to the establishment of dense vegetation, and has been continuously settled since that time. Habitable land was created by a fall in sea level, and any future rise in sea level will have a reverse effect, resulting in a loss of habitable land on atoll islands.

Circulatory failure during severe hyperthermia in dog.

PubMed

Miki, K; Morimoto, T; Nose, H; Itoh, T; Yamada, S

1983-01-01

The effect of acute hyperthermia on circulatory function was studied in 6 mongrel dogs. At a core temperature of about 40 degrees C, central venous pressure and stroke volume were maintained at almost normal level. Cardiac output significantly increased (26 ml/(kg . min)) while systemic vascular resistance significantly decreased (1.2 mmHg . sec/ml). In addition, significant decrease in vascular compliance by 40% was observed. When body temperature was raised further (severe hyperthermia), an abrupt fall of arterial pressure was observed at the rectal temperature of about 41-42 degrees C. Concomitant decreases in central venous pressure (3 mmHg), stroke volume (2.1 ml/beat) and cardiac output (29 ml/(kg . min)) were observed while heart rate increased (48 beats/min). These results suggest that the decrease in cardiac output during severe hyperthermia is due to the fall of central venous pressure, and the fall was attributed to the increase in unstressed vascular volume of systemic circulation due to the heat-induced cutaneous vasodilation. The observed decrease in systemic vascular compliance is considered to have a significant role in the maintenance of central venous pressure under hyperthermia.

The effect of pramipexole therapy on balance disorder and fall risk in Parkinson's disease at early stage: clinical and posturographic assessment.

PubMed

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.

Silviculture-ecology of three native California hardwoods on high sites in north central California

Treesearch

Philip M. McDonald

1978-01-01

Pacific madrone, tanoak, and California black oak are the most economically promising native California hardwoods. Volume and value data indicate upward trends in growing stock levels and prices received for their products. These trends are likely to continue. They suggest research is particularly needed for: (1) seed fall and regeneration, (2) sprout growth and...

Isolation and DNA barcode characterization of a permanent Telenomus (Hymenoptera: Platygastridae) population in Florida that targets fall armyworm (Lepidoptera: Noctuidae)

USDA-ARS?s Scientific Manuscript database

Telenomus remus (Nixon) is a scelionid egg parasite of the fall armworm, Spodoptera frugiperda (J. E. Smith), with a history of use as an augmentative biological control agent in Central and South America. Efforts were made in 1975-1977 to introduce T. remus into the fall armyworm overwintering regi...

The influence of diabetic peripheral neuropathy on local postural muscle and central sensory feedback balance control.

PubMed

Toosizadeh, Nima; Mohler, Jane; Armstrong, David G; Talal, Talal K; Najafi, Bijan

2015-01-01

Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN). Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control) and central-control (postural control using sensory cueing). DPN patients and healthy age-matched adults over 55 years performed two 15-second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2) and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/m2) with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P<0.01), which suggests a compromised local-control balance behavior in DPN patients. Unlike local-control, the rate of sway within central-control was 60% smaller in the DPN group (healthy central-controlslope-Log = 0.39±0.23, P<0.02), which suggests an adaptation mechanism to reduce the overall body sway in DPN patients. Interestingly, significant negative correlations were observed between central-control rate of sway with neuropathy severity (rPearson = 0.65-085, P<0.05) and the history of diabetes (rPearson = 0.58-071, P<0.05). Results suggest that in the lack of sensory feedback cueing, DPN participants were highly unstable compared to controls. However, as soon as they perceived the magnitude of sway using sensory feedback, they chose a high rigid postural control strategy, probably due to high concerns for fall, which may increase the energy cost during extended period of standing; the adaptation mechanism using sensory feedback depends on the level of neuropathy and the history of diabetes.

Rock falls landslides in Abruzzo (Central Italy) after recent earthquakes: morphostructural control

NASA Astrophysics Data System (ADS)

Piacentini, T.; Miccadei, E.; Di Michele, R.; Esposito, G.

2012-04-01

Recent earthquakes show that damages due to collateral effects could, in some cases exceed the economic and social losses directly connected to the seismic shaking. The earthquake heavily damaged urban areas and villages and induced several coseismic deformations and geomorphologic effects, including different types of instability such as: rock falls, debris falls, sink holes, ground collapses, liquefaction, etc. Among the effects induced by the seismic energy release, landslides are one of the most significant in terms of hazard and related risk, owing to the occurrence of exposed elements. This work analyzes the geomorphological effects, and particularly the rock falls, which occurred in the L'Aquila area during and immediately after the April 2009 earthquake. The analysis is focused mainly on the rock fall distribution related to the local morphostructural setting. Rock falls occurred mostly on calcareous bedrock slopes or on scarps developed on conglomerates and breccias of Quaternary continental deposits. Geological and geomorphological surveys have outlined different types of rock falls on different morpho-structural settings, which can be summarized as follow: 1)rock falls on calcareous faulted homoclinal ridges; 2)rock falls on calcareous rock slopes of karst landforms; 3)rock falls on structural scarps on conglomerates and breccias of Quaternary continental deposits. The first type of rockfall occurred particularly along main gorges carved on calcareous rocks and characterised by very steep fault slopes and structural slopes (i.e. San Venanzio Gorges, along the Aterno river). In these cases already unstable slopes due to lithological and structural control were triggered as rockfalls also at high distance from the epicentre area. These elements provide useful indications both at local scale, for seismic microzonation studies and seismic risk prevention, and at regional scale, for updating studies and inventory of landslides.

Developing an Undergraduate Astronomical Research Program

NASA Astrophysics Data System (ADS)

Genet, R. M.

2007-05-01

Time-series astronomical photometry is an area of scientific research well suited to amateurs and undergraduates, and their backyard and campus observatories. I describe two past one-semester community college research programs, one six year ago and one last fall (2006), as well as a program planned for this coming fall (2007). The 2001 program, a course at Central Arizona College, utilized a robotic telescope at the Fairborn Observatory. Results were presented at the 200th meeting of the American Astronomical Society. This past fall, three students, in a 17-week, one-semester course at Cuesta College, were able to plan a research program, make several thousand CCD photometric observations, reduce and analyze their data, write up their results and, on the last day of class, send their paper off to a refereed journal, the JAAVSO. A course is being offered this coming fall (2007) that will involve about a dozen students (including high school students), several local amateur astronomers, and at least three CCD- equipped semi-automatic telescopes. Potential solutions to "scaling up" challenges created by increased class size are discussed.

Isolation and DNA barcode characterization of a permanent Telenomus (Hymenoptera: Platygastridae) population in Florida that targets fall armyworm (Lepidoptera: Noctuidae)

USDA-ARS?s Scientific Manuscript database

Telenomus remus Nixon is a platygastrid egg parasite of the fall armyworm, Spodoptera frugiperda (J. E. Smith), with a history of use as an augmentative biological control agent in Central and South America. Efforts were made in 1975-1977 and again in 1988-1989 to introduce T. remus into the fall ar...

The consumption of two or more fall risk-increasing drugs rather than polypharmacy is associated with falls.

PubMed

Zia, Anam; Kamaruzzaman, Shahrul B; Tan, Maw P

2017-03-01

The presemt study aimed to determine the association between the risk of recurrent and injurious falls with polypharmacy, fall risk-increasing drugs (FRID) and FRID count among community-dwelling older adults. Participants (n = 202) were aged ≥65 years with two or more falls or one injurious fall in the past year, whereas controls (n = 156) included volunteers aged ≥65 years with no falls in the past year. A detailed medication history was obtained alongside demographic data. Polypharmacy was defined as "regular use of five or more prescription drugs." FRID were identified as cardiovascular agents, central nervous system drugs, analgesics and endocrine drugs; multiple FRID were defined as two or more FRID. Multiple logistic regression analyses were used to adjust for confounders. The use of non-steroidal anti-inflammatory drugs was independently associated with an increased risk of falls. Univariate analyses showed both polypharmacy (OR 2.23, 95% CI 1.39-3.56; P = 0.001) and the use of two or more FRID (OR 2.9, 95% CI 1.9-4.5; P = 0.0001) were significantly more likely amongst fallers. After adjustment for age, sex and comorbidities, blood pressure, and physical performance scores, polypharmacy was no longer associated with falls (OR 1.6, 95% CI 0.9-2.9; P = 0.102), whereas the consumption of two or more FRID remained a significant predictor for falls (OR 2.8, 95% CI 1.4-5.3; P = 0.001). Among high risk fallers, the use of two or more FRID was an independent risk factor for falls instead of polypharmacy. Our findings will inform clinical practice in terms of medication reviews among older adults at higher risk of falls. Future intervention studies will seek to confirm whether avoidance or withdrawal of multiple FRID reduces the risk of future falls. Geriatr Gerontol Int 2017; 17: 463-470. © 2016 Japan Geriatrics Society.

[Central cervical cord syndrome: a case report on rehabilitation, with special references to accidental falls in the elderly].

PubMed

Ina, G; Eto, F; Furuichi, T; Suzuki, H; Shibuya, K

1995-03-01

An 81-year-old man with Parkinson's disease was admitted to our hospital with impaired function of all extremities. Four weeks before his symptoms developed, he had tripped on the steps, fallen and bruised his jaw. Following this episode he experienced a few more falls inside his house. On examination his greatest weakness was in the hands and wrists. He was hyper-reflexic in all extremities and had bilateral Babinski's sign. He could not walk and needed physical assistance in most of his daily living activities. X-ray films of the cervical spine showed significant degenerative changes. The magnetic resonance images suggested central cervical cord damage at the level of the C6 vertebral body. After three months' rehabilitation treatment, he became able to walk with a cane and became independent in all the basic activities of daily living except for bathing. He never regained skillful function of his hands despite later levodopa treatment of Parkinson's disease. His clinical features were consistent with the central cervical cord syndrome, described by Schnneider and co-workers in 1954. This syndrome may occur as a result of hyperextension neck injury, occasionally associated with an accidental fall in the elderly with cervical spondylosis. Thirteen patients with cervical spinal cord injury above 65 of age were admitted to our department from 1983 to 1993. Six of them presented with the central cervical cord syndrome, and all patients had a history of accidental injuries related to falling.

Synchronous Crepuscular Flight of Female Asian Gypsy Moths: Relationships of Light Intensity and Ambient and Body Temperatures

Treesearch

Ralph E. Charlton; Ring T. Carde; William E. Wallner; William E. Wallner

1999-01-01

Female gypsy moths (Lymantria dispar) of Asian heritage studied in central Siberia and Germany exhibit a highly synchronous flight at dusk, after light intensity falls to about 2 lux. This critical light intensity sets the timing of flight behaviors independent of ambient temperature. Flight follows several minutes of preflight wing fanning during which females in...

Journal of Special Operations Medicine. Volume 5, Edition 4, Fall 2005

DTIC Science & Technology

2005-01-01

Africa (outside of South Africa), South and Central America, and Mexico .12 The prevention of diarrhea involves careful food and drink selection, water...high threat as these particles can stay suspended in the air for prolonged periods. Other diseases such as measles, varicella , influenza, and...individuals should be employed. Numerous vaccines including those for measles, influenza, varicella , meningococcus, and smallpox have been developed

Rethinking Little Rock: The Cold War Politics of School Integration in the United States

ERIC Educational Resources Information Center

Dejong-Lambert, William

2007-01-01

Though the impact of the cold war on the civil rights movement continued long after the desegregation crisis in Little Rock, the timing of the events in Arkansas, particularly the events at Central High School, constituted a unique moment in the history of the cold war. Up until the fall of 1957, the Soviet Union had been perceived as less…

High yields from young-growth ponderosa pine.

Treesearch

Edwin L. Mowat

1947-01-01

A ponderosa pine stand growing at a net rate of 618 board feet per acre per year may be rather amazing to foresters accustomed to the proverbial slow growth of this species in the virgin forest. Yet that is the average increment for the last 6 years of a 102-year-old even-aged stand on Lookout Mountain in the Pringle Falls Experimental Forest in central Oregon. During...

Central nervous system medications and falls risk in men aged 60-75 years: the Study on Male Osteoporosis and Aging (SOMA).

PubMed

Masud, Tahir; Frost, Morten; Ryg, Jesper; Matzen, Lars; Ibsen, Marlene; Abrahamsen, Bo; Brixen, Kim

2013-01-01

drugs acting on the central nervous system (CNS) increase falls risk. Most data on CNS drugs and falls are in women/mixed-sex populations. This study assessed the relationship between CNS drugs and falls in men aged 60-75 years. a questionnaire was sent to randomly selected Danish men aged 60-75 years. Cross-sectional data on CNS drugs and falls in the previous year were available for 4,696 men. Logistic regression investigated the relationship between falls and CNS drugs. the median age was 66.3 (IQR = 63.1-70.0) years; 21.7% were fallers. The following were associated with fallers (OR; 95% CI): opiates (2.4; 1.5-3.7), other analgesics (1.7; 1.4-2.1), antiepileptics (2.8; 1.5-5.1), antidepressants (2.8; 1.9-4.1) and anxiolytics/hypnotics (1.5; 0.9-2.6). Effects of opiates interacted strongly and significantly with age, with a marked association with falls in the older half of the subjects only. No significant associations were found between antipsychotics and fallers. Selective serotonin reuptake inhibitors and tricyclics were significantly associated with fallers (3.1; 2.0-5.0 and 2.2; 1.0-4.7, respectively). several CNS drug classes are associated with an approximately 2-3-fold increase risk of falls in men aged 60-75 years randomly selected from the population. Further longitudinal data are now required to confirm and further investigate the role of CNS drugs in falls causation in men.

Geographic distribution of the mid-continent population of sandhill cranes and related management applications

USGS Publications Warehouse

Krapu, Gary L.; Brandt, David A.; Jones, Kenneth L.; Johnson, Douglas H.

2011-01-01

The Mid-continent Population (MCP) of sandhill cranes (Grus canadensis) is widely hunted in North America and is separated into the Gulf Coast Subpopulation and Western Subpopulation for management purposes. Effective harvest management of the MCP requires detailed knowledge of breeding distribution of subspecies and subpopulations, chronology of their use of fall staging areas and wintering grounds, and exposure to and harvest from hunting. To address these information needs, we tagged 153 sandhill cranes with Platform Transmitting Terminals (PTTs) during 22 February–12 April 1998–2003 in the Central and North Platte River valleys of south-central Nebraska. We monitored PTT-tagged sandhill cranes, hereafter tagged cranes, from their arrival to departure from breeding grounds, during their fall migration, and throughout winter using the Argos satellite tracking system. The tracking effort yielded 74,041 useable locations over 49,350 tag days; median duration of tracking of individual cranes was 352 days and 73 cranes were tracked >12 months. Genetic sequencing of mitochondrial DNA (mtDNA) from blood samples taken from each of our random sample of tagged cranes indicated 64% were G. c. canadensis and 34% were Grus canadensis tabida. Tagged cranes during the breeding season settled in northern temperate, subarctic, and arctic North America (U.S. [23%, n = 35], Canada [57%, n = 87]) and arctic regions of northeast Asia (Russia [20%, n = 31]). Distribution of tagged cranes by breeding affiliation was as follows: Western Alaska–Siberia (WA–S, 42 ± 4% [SE]), northern Canada–Nunavut (NC–N, 21 ± 4%), west-central Canada–Alaska (WC–A, 23 ± 4%) and East-central Canada–Minnesota (EC–M, 14 ± 3%). All tagged cranes returned to the same breeding affiliation used during the previous year with a median distance of 1.60 km (range: 0.08–7.7 km, n = 53) separating sites used in year 1 and year 2. Fall staging occurred primarily in central and western Saskatchewan (69%), North Dakota (16%), southwestern Manitoba (10%), and northwestern Minnesota (3%). Space-use sharing indices showed that except for NC–N and WC–A birds, probability of finding a crane from one breeding affiliation within the home range of another breeding affiliation was low during fall staging. Tagged cranes from WC–A and EC–M breeding affiliations, on average, spent 25 and 20 days, respectively, longer on fall staging areas in the northern plains than did WA–S and NC–N birds. Cranes in the NC–N, WA–S, and WC–A affiliations spent 99%, 74%, and 64%, respectively, of winter in western Texas in Hunting Zone A; EC–M cranes spent 83% of winter along the Texas Gulf Coast in Hunting Zone C. Tagged cranes that settled within the breeding range of the Gulf Coast Subpopulation spent 28% and 42% of fall staging and winter within the range of the Western Subpopulation, indicating sufficient exchange of birds to potentially limit effectiveness of MCP harvest management. Harvests of EC–M and WC–A cranes during 1998–2003 were disproportionately high to their estimated numbers in the MCP, suggesting more conservative harvest strategies may be required for these subpopulations in the future, and for sandhill cranes to occupy major parts of their historical breeding range in the Prairie Pothole Region. Exceptionally high philopatry of MCP cranes of all 4 subpopulations to breeding sites coupled with strong linkages between crane breeding distribution, and fall staging areas and wintering grounds, provide managers guidance for targeting MCP crane harvest to meet management goals. Sufficient temporal or spatial separation exists among the 4 subpopulations on fall staging areas and wintering grounds to allow harvest to be targeted at the subpopulation level in all states and provinces (and most hunting zones within states and provinces) when conditions warrant. Knowledge gained from our study provides decision-makers in the United States, Canada, Mexico, and Russia with improved guidance for developing sound harvest regulations, focusing conservation efforts, and generating collaborative efforts among these nations on sandhill crane research and management to meet mutually important goals.

Earth observations taken by the Expedition Seven crew

NASA Image and Video Library

2003-09-03

ISS007-E-14361 (4 September 2003) --- This view featuring Victoria Falls and the Zambezi River was photographed by one of the Expedition 7 crewmembers onboard the International Space Station (ISS). Victoria Falls is one of the most famous tourist sites in sub-Saharan Africa. The falls and their famous spray clouds are 1700 meters long, the longest sheet of falling water in the world. The falls appear as a ragged white line in this image. The small town of Victoria Falls in Zimbabwe appears just west of the falls, with smaller tourist facilities on the east bank in Zambia. A major river in south-central Africa, the Zambezi River flows from western Zambia to the Indian Ocean in Mozambique. It flows southeast in a wide bed before plunging suddenly 130 meters over the Victoria Falls into a narrow gorge.

How do children fall asleep? A high-density EEG study of slow waves in the transition from wake to sleep.

PubMed

Spiess, Mathilde; Bernardi, Giulio; Kurth, Salome; Ringli, Maya; Wehrle, Flavia M; Jenni, Oskar G; Huber, Reto; Siclari, Francesca

2018-05-17

Slow waves, the hallmarks of non-rapid eye-movement (NREM) sleep, are thought to reflect maturational changes that occur in the cerebral cortex throughout childhood and adolescence. Recent work in adults has revealed evidence for two distinct synchronization processes involved in the generation of slow waves, which sequentially come into play in the transition to sleep. In order to understand how these two processes are affected by developmental changes, we compared slow waves between children and young adults in the falling asleep period. The sleep onset period (starting 30s before end of alpha activity and ending at the first slow wave sequence) was extracted from 72 sleep onset high-density EEG recordings (128 electrodes) of 49 healthy subjects (age 8-25). Using an automatic slow wave detection algorithm, the number, amplitude and slope of slow waves were analyzed and compared between children (age 8-11) and young adults (age 20-25). Slow wave number and amplitude increased linearly in the falling asleep period in children, while in young adults, isolated high-amplitude slow waves (type I) dominated initially and numerous smaller slow waves (type II) with progressively increasing amplitude occurred later. Compared to young adults, children displayed faster increases in slow wave amplitude and number across the falling asleep period in central and posterior brain regions, respectively, and also showed larger slow waves during wakefulness immediately prior to sleep. Children do not display the two temporally dissociated slow wave synchronization processes in the falling asleep period observed in adults, suggesting that maturational factors underlie the temporal segregation of these two processes. Our findings provide novel perspectives for studying how sleep-related behaviors and dreaming differ between children and adults. Copyright © 2018 Elsevier Inc. All rights reserved.

Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis.

PubMed

Okubo, Yoshiro; Schoene, Daniel; Lord, Stephen R

2017-04-01

To examine the effects of stepping interventions on fall risk factors and fall incidence in older people. Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015. Randomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors. Meta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, p<0.0001, I 2 =0%) and the proportion of fallers (risk ratio=0.51, 95% CI 0.38 to 0.68, p<0.0001, I 2 =0%). Subgroup analyses stratified by reactive and volitional stepping interventions revealed a similar efficacy for rate of falls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36-416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (p<0.05), but not measures of strength. The findings indicate that both reactive and volitional stepping interventions reduce falls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required. CRD42015017357. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Suppression of Plutella xylostella and Trichoplusia ni in cole crops with attracticide formulations.

PubMed

Maxwell, Elly M; Fadamiro, Henry Y; McLaughlin, John R

2006-08-01

The three key lepidopteran pests of cole, Brassica oleracea L., crops in North America are diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae); cabbage looper; Trichoplusia ni (Hübner) (Lepidoptera: Noctuidae); and imported cabbageworm, Pieris rapae (L.) (Lepidoptera: Pieridae). Two species-specific pheromone-based experimental attracticide formulations were evaluated against these pests: LastCall DBM for P. xylostella and LastCall CL for T. ni. No LastCall formulation was available against P. rapae. Laboratory toxicity experiments confirmed the effectiveness of each LastCall formulations in killing conspecific males that made contact. In replicated small plots of cabbage and collards in central Alabama, over four growing seasons (fall 2003, spring 2004, fall 2004, and spring 2005), an attracticide treatment receiving the two LastCall formulations, each applied multiple times at the rate of 1,600 droplets per acre, was compared against Bacillus thuringiensis. subspecies kursatki (Bt) spray at action threshold and a negative untreated control. Efficacy was measured by comparing among the three treatments male capture in pheromone-baited traps, larval counts in plots, and crop damage rating at harvest. LastCall provided significant reductions in crop damage comparable to Bt in three of the four seasons. Efficacy of LastCall was dependent upon lepidopteran population densities, which fluctuated from season to season. In general, reduction in crop damage was achieved with LastCall at low-to-moderate population densities of the three species, such as typically occurs in the fall in central Alabama, but not in the spring when high P. rapae population pressure typically occurs in central Alabama. Significant reductions in pheromone trap captures did not occur in LastCall plots, suggesting that elimination of males by the toxicant (permethrin), rather than interruption of sexual communication, was the main mechanism of effect.

Fall harvest management of eastern gamagrass in central Wisconsin

USDA-ARS?s Scientific Manuscript database

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. Extension materials discussing appropriate fall management of EGG often recommend avoiding harvest within six weeks of first frost. However, pre...

Fall armyworm: Management of a genetically complicated migratory pest

USDA-ARS?s Scientific Manuscript database

Fall armyworm (Spodoptera frugiperda) (Lepidoptera: Noctuidae) is a neotropical pest that migrates each spring from locations in south Texas and south Florida to the central and eastern U.S. Management of this pest in Florida sweet corn involves tactics such as chemical control, host plant manageme...

In situ soil temperature and heat flux measurements during controlled surface burns at a southern Colorado forest site

Treesearch

W. J. Massman; J. M. Frank; W. D. Shepperd; M. J. Platten

2003-01-01

This study presents in situ soil temperature measurements at 5-6 depths and heat flux measurements at 2-5 depths obtained during the fall/winter of 2001/ 2002 at seven controlled (surface) fires within a ponderosa pine forest site at the Manitou Experimental Forest in central Colorado. Six of these burns included three different (low, medium, and high) fuel loadings...

Analysis of Choice Stepping with Visual Interference Can Detect Prolonged Postural Preparation in Older Adults with Mild Cognitive Impairment at High Risk of Falling.

PubMed

Uemura, Kazuki; Hasegawa, Takashi; Tougou, Hiroki; Shuhei, Takahashi; Uchiyama, Yasushi

2015-01-01

We aimed to clarify postural control deficits in older adults with mild cognitive impairment (MCI) at high risk of falling by addressing the inhibitory process. This study involved 376 community-dwelling older adults with MCI. Participants were instructed to execute forward stepping on the side indicated by the central arrow while ignoring the 2 flanking arrows on each side (→→→→→, congruent, or →→←→→, incongruent). Initial weight transfer direction errors [anticipatory postural adjustment (APA) errors], step execution times, and divided phases (reaction, APA, and swing phases) were measured from vertical force data. Participants were categorized as fallers (n = 37) and non-fallers (n = 339) based on fall experiences in the last 12 months. There were no differences in the step execution times, swing phases, step error rates, and APA error rates between groups, but fallers had a significantly longer APA phase relative to non-fallers in trials of the incongruent condition with APA errors (p = 0.005). Fallers also had a longer reaction phase in trials with the correct APA, regardless of the condition (p = 0.01). Analyses of choice stepping with visual interference can detect prolonged postural preparation as a specific falling-associated deficit in older adults with MCI. © 2015 S. Karger AG, Basel.

Characteristics of Gaseous Diffusion Flames with High Temperature Combustion Air in Microgravity

NASA Technical Reports Server (NTRS)

Ghaderi, M.; Gupta, A. K.

2003-01-01

The characteristics of gaseous diffusion flames have been obtained using high temperature combustion air under microgravity conditions. The time resolved flame images under free fall microgravity conditions were obtained from the video images obtained. The tests results reported here were conducted using propane as the fuel and about 1000 C combustion air. The burner included a 0.686 mm diameter central fuel jet injected into the surrounding high temperature combustion air. The fuel jet exit Reynolds number was 63. Several measurements were taken at different air preheats and fuel jet exit Reynolds number. The resulting hybrid color flame was found to be blue at the base of the flame followed by a yellow color flame. The length and width of flame during the entire free fall conditions has been examined. Also the relative flame length and width for blue and yellow portion of the flame has been examined under microgravity conditions. The results show that the flame length decreases and width increases with high air preheats in microgravity condition. In microgravity conditions the flame length is larger with normal temperature combustion air than high temperature air.

Report on National Collegiate Alcohol Awareness Week, Fall 1988.

ERIC Educational Resources Information Center

Rapaport, Ross J.

This document presents a report of the education and prevention activities undertaken at Central Michigan University in Mt. Pleasant, Michiagn, during the fall semester of 1988, in recognition of National Collegiate Alcohol Awareness Week (NCAAW). The document begins with a brief review of the university's campus-wide programs, goals, and…

Raccoon roundworm in raccoons in central West Virginia

Treesearch

Sheldon F. Owen; John W. Edwards; W. Mark Ford; James M. Crum; Petra Bohall Wood

2004-01-01

We investigated the occurrence of raccoon roundworm (Baylisascaris procyonis) in common raccoons (Procyon lotor) in the Allegheny Mountains of West Virginia during spring (n = 9, April-June) and fall (n = 5, August-October) 2001 and spring (n = 1) and fall (n = 4) 2002. We found no evidence of B. procyonis...

After the Fall: A Conflict Management Program to Foster Open Society

ERIC Educational Resources Information Center

Shapiro, Daniel L.

2004-01-01

The fall of the Berlin Wall rocked the sociopolitical equilibrium of eastern and central Europe. Communism lost its grip over much of Europe. The USSR, Yugoslavia, and Czechoslovakia divided along ethnic, religious, and historical lines. Ethnopolitical tensions surfaced across the region, and in Yugoslavia, tensions combusted. Whereas democracy…

Mediterranean climate patterns and wine quality in North and Central Italy.

PubMed

Dalu, John David; Baldi, Marina; Marta, Anna Dalla; Orlandini, Simone; Maracchi, Gianpiero; Dalu, Giovanni; Grifoni, Daniele; Mancini, Marco

2013-09-01

Results show that the year-to-year quality variation of wines produced in North and Central Italy depends on the large-scale climate variability, and that the wine quality improvement in the last four decades is partially due to an increase of temperature and to a decrease of precipitation in West and Central Mediterranean Europe (WME; CME). In addition, wine quality is positively correlated with air temperature throughout the entire active period of the grapevine, weakly negatively correlated with precipitation in spring, and well negatively correlated in summer and fall. The month-to-month composites of the NAO anomaly show that, in years of good quality wine, this anomaly is negative in late spring, oscillates around zero in summer, and is positive in early fall; while, in years of bad quality wine, it is positive in late spring and summer, and negative in early fall, i.e. its polarity has an opposite sign in spring and fall in good versus bad years. The composite seasonal maps show that good wines are produced when the spring jet stream over the Atlantic diverts most of the weather perturbations towards North Europe, still providing a sufficient amount of rainwater to CME; when summer warming induced by southerly winds is balanced by the cooling induced by westerly winds; and when a positive geopotential anomaly over WME shelters CME from fall Atlantic storms. Bad quality wines are produced when the jet stream favors the intrusion of the Atlantic weather perturbations into the Mediterranean. Results suggest that atmospheric pattern persistencies can be used as precursors for wine quality forecast.

TOP CHORD, CENTRAL BRACING DETAIL. AveryBartholomew Patent Railroad Iron ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

TOP CHORD, CENTRAL BRACING DETAIL. - Avery-Bartholomew Patent Railroad Iron Bridge, Town park south of Route 222, west of Owasco Inlet (moved from Elm Street Extension spanning Fall Creek, Nubia, NY), Groton, Tompkins County, NY

Methodology and results of calculating central California surface temperature trends: Evidence of human-induced climate change?

USGS Publications Warehouse

Christy, J.R.; Norris, W.B.; Redmond, K.; Gallo, K.P.

2006-01-01

A procedure is described to construct time series of regional surface temperatures and is then applied to interior central California stations to test the hypothesis that century-scale trend differences between irrigated and nonirrigated regions may be identified. The procedure requires documentation of every point in time at which a discontinuity in a station record may have occurred through (a) the examination of metadata forms (e.g., station moves) and (b) simple statistical tests. From this "homogeneous segments" of temperature records for each station are defined. Biases are determined for each segment relative to all others through a method employing mathematical graph theory. The debiased segments are then merged, forming a complete regional time series. Time series of daily maximum and minimum temperatures for stations in the irrigated San Joaquin Valley (Valley) and nearby nonirrigated Sierra Nevada (Sierra) were generated for 1910-2003. Results show that twentieth-century Valley minimum temperatures are warming at a highly significant rate in all seasons, being greatest in summer and fall (> +0.25??C decade-1). The Valley trend of annual mean temperatures is +0.07?? ?? 0.07??C decade-1. Sierra summer and fall minimum temperatures appear to be cooling, but at a less significant rate, while the trend of annual mean Sierra temperatures is an unremarkable -0.02?? ?? 0.10??C decade-1. A working hypothesis is that the relative positive trends in Valley minus Sierra minima (>0.4??C decade-1 for summer and fall) are related to the altered surface environment brought about by the growth of irrigated agriculture, essentially changing a high-albedo desert into a darker, moister, vegetated plain. ?? 2006 American Meteorological Society.

Cerro Xalapaxco: An Unusual Tuff Cone with Multiple Explosion Craters, in Central Mexico (Puebla)

NASA Technical Reports Server (NTRS)

Abrams, M. J.; Siebe, C.

1994-01-01

The Xalapaxco tuff cone is located on the northeast flank of La Malinche stratovolcano in central Mexico. An unusually large number (10) of explosion craters, concentrated on the central and on the uphill side of the cone, expose alternating beds of stratified surge deposits and massive fall deposits.

Population structure and relatedness among female Northern Pintails in three California wintering regions

USGS Publications Warehouse

Fleskes, Joseph P.; Fowler, Ada C.; Casazza, Michael L.; Eadie, John M.

2010-01-01

Female Northern Pintails (Anas acuta) were sampled in California's three main Central Valley wintering regions (Sacramento Valley, Suisun Marsh, San Joaquin Valley) during September–October before most regional movements occur and microsatellite and mitochondrial DNA were analyzed to examine population structure and relatedness. Despite reportedly high rates of early-fall pairing and regional fidelity, both sets of markers indicated that there was little overall genetic structuring by region. Pintails from Suisun Marsh did exhibit higher relatedness among individuals and capture groups than in the Sacramento or San Joaquin Valleys, likely reflecting a sample comprised of a greater proportion of local breeders. The lack of genetic structuring among regions indicates that a high degree of movement and interchange occurs among pintails wintering in the Central Valley. Thus, although maintaining the existing distribution of pintails among Central Valley regions is important for other reasons, it does not appear to be critical to retain current patterns of population genetic variation. Because of potential lack of independence among highly related study individuals, researchers should consider regional differences in relatedness when designing sampling schemes and interpreting research findings.

Macroeconomic Stabilization When the Natural Real Interest Rate Is Falling

ERIC Educational Resources Information Center

Buttet, Sebastien; Roy, Udayan

2015-01-01

The authors modify the Dynamic Aggregate Demand-Dynamic Aggregate Supply model in Mankiw's widely used intermediate macroeconomics textbook to discuss monetary policy when the natural real interest rate is falling over time. Their results highlight a new role for the central bank's inflation target as a tool of macroeconomic stabilization. They…

Sunn hemp as a ground cover to manage fall armyworm populations

USDA-ARS?s Scientific Manuscript database

Fall armyworm (FAW), Spodoptera frugiperda, is a serious pest of sweet corn in south Florida and a pest of other vegetable, row, and forage crops in the southeastern, mid-Atlantic, and central U.S. It is a migratory pest, moving north each season from overwintering areas in southern Texas and south...

Petrogenesis and depositional history of felsic pyroclastic rocks from the Melka Wakena archaeological site-complex in South central Ethiopia

NASA Astrophysics Data System (ADS)

Resom, Angesom; Asrat, Asfawossen; Gossa, Tegenu; Hovers, Erella

2018-06-01

The Melka Wakena archaeological site-complex is located at the eastern rift margin of the central sector of the Main Ethiopian Rift (MER), in south central Ethiopia. This wide, gently sloping rift shoulder, locally called the "Gadeb plain" is underlain by a succession of primary pyroclastic deposits and intercalated fluvial sediments as well as reworked volcaniclastic rocks, the top part of which is exposed by the Wabe River in the Melka Wakena area. Recent archaeological survey and excavations at this site revealed important paleoanthropological records. An integrated stratigraphic, petrological, and major and trace element geochemical study has been conducted to constrain the petrogenesis of the primary pyroclastic deposits and the depositional history of the sequence. The results revealed that the Melka Wakena pyroclastic deposits are a suite of mildly alkaline, rhyolitic pantellerites (ash falls, pumiceous ash falls and ignimbrites) and slightly dacitic ash flows. These rocks were deposited by episodic volcanic eruptions during early to middle Pleistocene from large calderas along the Wonji Fault Belt (WFB) in the central sector of the MER and from large silicic volcanic centers at the eastern rift shoulder. The rhyolitic ash falls, pumiceous ash falls and ignimbrites have been generated by fractional crystallization of a differentiating basaltic magma while the petrogenesis of the slightly dacitic ash flows involved some crustal contamination and assimilation during fractionation. Contemporaneous fluvial activities in the geomorphologically active Gadeb plain deposited overbank sedimentary sequences (archaeology bearing conglomerates and sands) along meandering river courses while a dense network of channels and streams have subsequently down-cut through the older volcanic and sedimentary sequences, redepositing the reworked volcaniclastic sediments further downstream.

Changes in seasonality and timing of peak streamflow in snow and semi-arid climates of the north-central United States, 1910–2012

USGS Publications Warehouse

Ryberg, Karen R.; Akyüz, F. Adnan; Wiche, Gregg J.; Lin, Wei

2015-01-01

Changes in the seasonality and timing of annual peak streamflow in the north-central USA are likely because of changes in precipitation and temperature regimes. A source of long-term information about flood events across the study area is the U.S. Geological Survey peak streamflow database. However, one challenge of answering climate-related questions with this dataset is that even in snowmelt-dominated areas, it is a mixed population of snowmelt/spring rain generated peaks and summer/fall rain generated peaks. Therefore, a process was developed to divide the annual peaks into two populations, or seasons, snowmelt/spring, and summer/fall. The two series were then tested for the hypotheses that because of changes in precipitation regimes, the odds of summer/fall peaks have increased and, because of temperature changes, snowmelt/spring peaks happen earlier. Over climatologically and geographically similar regions in the north-central USA, logistic regression was used to model the odds of getting a summer/fall peak. When controlling for antecedent wet and dry conditions and geographical differences, the odds of summer/fall peaks occurring have increased across the study area. With respect to timing within the seasons, trend analysis showed that in northern portions of the study region, snowmelt/spring peaks are occurring earlier. The timing of snowmelt/spring peaks in three regions in the northern part of the study area is earlier by 8.7– 14.3 days. These changes have implications for water interests, such as potential changes in lead-time for flood forecasting or changes in the operation of flood-control dams.

Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

PubMed

Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

2016-12-01

To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

Screening and Assessment of Young Children.

ERIC Educational Resources Information Center

Friedlander, Bernard Z.

Most language development hazards in infancy and early childhood fall into the categories of auditory impairment, central integrative dysfunction, inadequate environmental support, and peripheral expressive impairment. Existing knowledge and techniques are inadequate to meet the screening and assessment problems of central integrative dysfunction,…

Migratory patterns of the fall armyworm (Spodoptera frugiperda) in the western hemisphere

USDA-ARS?s Scientific Manuscript database

Fall armyworm (FAW) is a serious pest of sweet corn in south Florida and a pest of other vegetable, row, and forage crops in the southeastern, mid-Atlantic, and central U.S. It is a migratory pest, moving north each season from overwintering areas in southern Texas and southern Florida. For the la...

Fall and winter survival of brook trout and brown trout in a north-central Pennsylvania watershed

USGS Publications Warehouse

Sweka, John A.; Davis, Lori A.; Wagner, Tyler

2017-01-01

Stream-dwelling salmonids that spawn in the fall generally experience their lowest survival during the fall and winter due to behavioral changes associated with spawning and energetic deficiencies during this time of year. We used data from Brook Trout Salvelinus fontinalis and Brown Trout Salmo trutta implanted with radio transmitters in tributaries of the Hunts Run watershed of north-central Pennsylvania to estimate survival from the fall into the winter seasons (September 2012–February 2013). We examined the effects that individual-level covariates (trout species, size, and movement rates) and stream-level covariates (individual stream and cumulative drainage area of a stream) have on survival. Brook Trout experienced significantly lower survival than Brown Trout, especially in the early fall during their peak spawning period. Besides a significant species effect, none of the other covariates examined influenced survival for either species. A difference in life history between these species, with Brook Trout having a shorter life expectancy than Brown Trout, is likely the primary reason for the lower survival of Brook Trout. However, Brook Trout also spawn earlier in the fall than Brown Trout and low flows during Brook Trout spawning may have resulted in a greater risk of predation for Brook Trout compared with Brown Trout, thereby also contributing to the observed differences in survival between these species. Our estimates of survival can aid parameterization of future population models for Brook Trout and Brown Trout through the spawning season and into winter.

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

Deaf-Blind Perspectives Newsletter, 1999-2000.

ERIC Educational Resources Information Center

Reiman, John, Ed.; Malloy, Peggy, Ed.; Klumph, Randy, Ed.

1999-01-01

These three issues address topics relating to the education of children with deaf-blindness. The fall 1999 issue features the article, "Central Auditory Processing Disorders: An Overview of Assessment and Management Practices" (Mignon M. Schminky and Jane A. Baran), which discusses symptoms of Central Auditory Processing Disorder (CAPD),…

Bird migration patterns in the arid southwest-Final report

USGS Publications Warehouse

Ruth, Janet M.; Felix, Rodney K.; Dieh, Robert H.

2010-01-01

To ensure full life-cycle conservation, we need to understand migrant behavior en route and how migrating species use stopover and migration aerohabitats. In the Southwest, birds traverse arid and mountainous landscapes in migration. Migrants are known to use riparian stopover habitats; we know less about how migrant density varies across the Southwest seasonally and annually, and how migrants use other habitat types during migratory stopover. Furthermore, we lack information about migrant flight altitudes, speeds, and directions of travel, and how these patterns vary seasonally and annually across the Southwest. Using weather surveillance radar data, we identified targets likely dominated by nocturnally migrating birds and determined their flight altitudes, speeds, directions over ground, and variations in abundance. Migrating or foraging bats likely are present across the region in some of these data, particularly in central Texas. We found that migrants flew at significantly lower altitudes and significantly higher speeds in spring than in fall. In all seasons migrants maintained seasonally appropriate directions of movement. We detected significant differences in vertical structure of migrant densities that varied both geographically within seasons and seasonally within sites. We also found that in fall there was a greater and more variable passage of migrants through the central part of the borderlands (New Mexico and west Texas); in spring there was some suggestion of greater and more variable passage of migrants in the eastern borderlands (central and south Texas). Such patterns are consistent with the existence of at least two migration systems through western North America and the use of different migration routes in spring and fall for at least some species. Using radar data and satellite land cover data, we determined the habitats with which migrants are associated during migration stopover. There were significant differences in bird densities among habitat types at all sites in at least one season. Upland forest habitat in parts of Arizona and New Mexico supported high migrant densities, especially in fall. Developed habitats in areas with little upland forest habitat also supported high migrant densities. Scrub/shrub and grassland habitats supported low to intermediate migrant densities, but because these habitat types dominate the region, they may support large numbers of migratory birds. This may be especially true for species that do not use forested habitats during migration. Target identity remains a challenge for radar-based studies. Presence of bats in the data complicates interpretation of some observations, particularly from central Texas. Based on our results it is simplistic to: (1) consider the arid west as a largely inhospitable landscape in which there are only relatively small oases of habitat that provide the resources needed by all migrants; (2) think of western riparian and upland forest habitat as supporting the majority of migrants in all cases; or (3) consider a particular habitat type unimportant migrant stopover habitat based solely on migrant densities.

Silvicultural activities in Pringle Falls Experimental Forest, Central Oregon

Treesearch

Andrew Youngblood; Kim Johnson; Jim Schlaich; Boyd Wickman

2004-01-01

Pringle Falls Experimental Forest has been a center for research in ponderosa pine forests east of the crest of the Cascade Range since 1931. Long-term research facilities, sites, and future research opportunities are currently at risk from stand-replacement wildfire because of changes in stand structure resulting from past fire exclusion. At the same time, many of the...

Straw mulch prevents loss of fall-sown seeds to cold temperatures and wildlife predation

Treesearch

J. Wichman; R. Hawkins; P.M. Pijut

2005-01-01

A combination of cover crops and straw mulch effectively protect fall-sown hardwood seeds from cold temperature damage and predation at our nursery in central Indiana. Before using this treatment, we experienced 30% to 90% crop losses on a regular basis, but now our seedbed densities are consistently at target and the resulting seedlings are larger. Specialized...

Effect of whole-body vibration on reduction of bone loss and fall prevention in postmenopausal women: a meta-analysis and systematic review.

PubMed

Ma, Chiyuan; Liu, An; Sun, Miao; Zhu, Hanxiao; Wu, Haobo

2016-02-17

To examine whole-body vibration (WBV) effect on bone mineral density (BMD) and fall prevention in postmenopausal women, we performed a meta-analysis and systematic review of prospective randomized controlled trials (RCTs) comparing change in BMD of the femoral neck and lumbar spine and related factors of falls between WBV group and control group. EMBASE, PubMed, Cochrane Central Register of Controlled Trials, ISI Web of Science, and China National Knowledge Infrastructure (CNKI) were searched up to April 2015; search strategy was used as follows: (vibration) AND (osteoporo* OR muscle* OR bone mineral density OR BMD). All prospective randomized controlled trials comparing related factors of falls and BMD change in the femoral neck and lumbar spine between WBV group and control group were retrieved. Eight of 3599 studies with 1014 patients were included, 477 in the WBV group, and 537 in the control group. We found that there was no significant difference in all magnitude groups of the femoral neck (N = 936, WMD: 0.00 (-0.00, 0.01); p = 0.18). A statistical significance showed in the all magnitude groups (N = 1014, WMD: 0.01 (0.00, 0.01); p = 0.01) and low-magnitude group (N = 838, WMD: 0.01 (0.00, 0.01); p = 0.007) of the lumbar spine. No significant difference was found in high-magnitude group of the lumbar spine (N = 176, WMD: 0.00 (-0.01, 0.02); p = 0.47), low-magnitude group (N = 838, WMD: 0.00 (-0.00, 0.00); p = 0.92) and high-magnitude group (N = 98, WMD: 0.02 (-0.00, 0.05); p = 0.06) of the femoral neck. All the studies provided data of related factors of falls such as strength of the lower limb, balance, and fall rate reported effectiveness of WBV therapy. In addition, no complication was reported. Low-magnitude whole-body vibration therapy can provide a significant improvement in reducing bone loss in the lumbar spine in postmenopausal women. Moreover, whole-body vibration can be used as an intervention for fall prevention.

Chemical brush control on central Oregon ponderosa pine lands.

Treesearch

Walter G. Dahms

1955-01-01

Practical brush control appears to be within sight for some of the problem areas in central Oregon as a result of experiments conducted on the Pringle Falls Experimental Forest and Deschutes National Forest. Small-plot trials to determine which chemicals will kill manzanita (Arctostaphylos parryana var. pinetorum (Rollins)...

Effects of Unit Design on Acute Care Nurses' Walking Distances, Energy Expenditure, and Job Satisfaction: A Pre-Post Relocation Study.

PubMed

Copeland, Darcy; Chambers, Misty

2017-07-01

The purpose of this study was to determine what differences occurred in steps taken and energy expenditure among acute care nurses when their work environment moved from a hospital with centralized nurses' stations to a hospital with decentralized nurses' stations. Additional goals were to determine design features nurses perceived as contributing to or deterring from their work activities and what changes occurred in reported job satisfaction. Since design features can also affect patient outcomes, patient falls were monitored. The construction of a replacement facility for a 224-bed Level 1 trauma center provided the opportunity to compare the effects of centralized versus decentralized nurses' stations on nurses' experiences of their work environments. A pre-post quasi-experimental design was used. RN participants completed an open-ended questionnaire and recorded pedometer data at the end of each shift, working for 3-month pre-relocation and for 3-month post-relocation. Nine months passed between the move and post-relocation data collection. There were significant reductions in nurses' energy expenditure ( p < .001) and steps taken ( p = .041) post-relocation. Overall, nurses' job satisfaction was high and improved post-relocation, and patient falls decreased by 55%. Post-relocation, a number of the dissatisfiers associated with the physical environment were eliminated, and nurses identified more satisfiers (in general and related to the physical environment). Patients are safer post-relocation as indicated by a decrease in falls. This decrease is even more noteworthy when considering that the numbers of patient beds on each unit is higher post-relocation.

First Report of Outbreaks of the Fall Armyworm Spodoptera frugiperda (J E Smith) (Lepidoptera, Noctuidae), a New Alien Invasive Pest in West and Central Africa

PubMed Central

Sankung, Sagnia B.; Togola, Abou; Tamò, Manuele

2016-01-01

The fall armyworm Spodoptera frugiperda is a prime noctuid pest of maize on the American continents where it has remained confined despite occasional interceptions by European quarantine services in recent years. The pest has currently become a new invasive species in West and Central Africa where outbreaks were recorded for the first time in early 2016. The presence of at least two distinct haplotypes within samples collected on maize in Nigeria and São Tomé suggests multiple introductions into the African continent. Implications of this new threat to the maize crop in tropical Africa are briefly discussed. PMID:27788251

First Report of Outbreaks of the Fall Armyworm Spodoptera frugiperda (J E Smith) (Lepidoptera, Noctuidae), a New Alien Invasive Pest in West and Central Africa.

PubMed

Goergen, Georg; Kumar, P Lava; Sankung, Sagnia B; Togola, Abou; Tamò, Manuele

2016-01-01

The fall armyworm Spodoptera frugiperda is a prime noctuid pest of maize on the American continents where it has remained confined despite occasional interceptions by European quarantine services in recent years. The pest has currently become a new invasive species in West and Central Africa where outbreaks were recorded for the first time in early 2016. The presence of at least two distinct haplotypes within samples collected on maize in Nigeria and São Tomé suggests multiple introductions into the African continent. Implications of this new threat to the maize crop in tropical Africa are briefly discussed.

Selection cutting reduces ponderosa pine losses at Pringle Falls.

Treesearch

Edwin L. Mowat

1948-01-01

One of the aims of selection cutting in ponderosa pine forests is to reduce the heavy mortality, from bark beetle attack and other causes that is common in most virgin stands. How much the loss can be reduced is shown by a 10-year record at the Pringle Falls Experimental Forest in central Oregon. Here selection cutting has reduced loss on cutting areas to only about...

Stopover ecology of landbirds migrating along the middle Rio Grande in spring and fall

Treesearch

Wang Yong; Deborah M. Finch

2002-01-01

This research represents the first comprehensive summary of our study of stopover ecology of migratory landbirds in riparian habitats along the middle Rio Grande of central New Mexico. We report results from mist-netting operations conducted during spring and fall migration in 1994, 1995, and 1996. A total of 23,800 individuals of 146 species were captured during the...

Atmospheric rivers and bombs

NASA Astrophysics Data System (ADS)

Zhu, Yong; Newell, Reginald E.

1994-09-01

Filamentary structure is a common feature of atmospheric water vapor transport; the filaments may be termed “atmospheric rivers” because some carry as much water as the Amazon [Newell et al., 1992]. An extratropical cyclone whose central pressure fall averages at least 1 hPa hr-1 for 24 hours is known in meteorology as a “bomb” [Sanders and Gyakum, 1980]. We report here an association between rivers and bombs. When a cyclonic system is penetrated by a river, the cyclonic center moves to be close to the position occupied by the leading edge of the river twelve hours previously and the central pressure falls. If the river then moves away from the cyclone, the central pressure rises. Based on a pilot study of pressure fall and water vapor flux convergence for two winter months, the cause of the explosive deepening appears to be latent heat liberation. This is substantiated by composite maps of seven Atlantic and seven Pacific bombs which show that the flux convergence near the bomb center has a comma cloud signature. The observed association may be useful in forecasting 12-hour direction of motion and pressure change of rapidly developing cyclonic systems; the incorporation of better moisture data into numerical forecasting models may be the reason for the reported increase of skill in the prediction of bombs in recent years.

Central Methysergide Prevents Renal Sympathoinhibition and Bradycardia during Hypotensive Hemorrhage

NASA Technical Reports Server (NTRS)

Veelken, Roland; Johnson, Kim; Scrogin, Karie E.

1998-01-01

Central methysergide prevents renal sympathoinhibition and bradycardia during hypotensive hemorrhage. Mean arterial pressure (MAP), heart rate (HR), and renal sympathetic nerve activity (RSNA) were measured in conscious rats during either hemorrhage or cardiopulmonary receptor stimulation with phenylbiguanide (PBG) after intracerebroventricular injection of the 5-HT1/5-HT2-receptor antagonist, methysergide (40 microg). Progressive hemorrhage caused an initial rise (109 +/- 33%) followed by a fall in RSNA (-60 +/- 7%) and a fall in HR (-126 +/- 7 beats/min). Methysergide delayed the hypotension and prevented both the sympathoinhibitory and bradycardic responses to hemorrhage. Systemic 5-HT3-receptor blockade did not influence responses to hemorrhage. The PBG infusion caused transient depressor(-25 +/- 6 mmHg), bradycardic (-176 +/- 40 beats/min), and renal sympathostimulatory (182 +/-47% baseline) responses that were not affected by central methysergide (-20 +/- 6 mmHg, -162 +/- 18 beats/min, 227 +/- 46% baseline). These data indicate that a central serotonergic receptor-mediated component contributes to the sympathoinhibitory and bradycardic responses to hypotensive hemorrhage in conscious rats. Furthermore, the same central 5-HT-receptor populations involved in reflex responses to hypotensive hemorrhage probably do not mediate the sympathoinhibitory response to cardiopulmonary chemosensitive 5-HT3 receptors.

Low-impact falls: demands on a system of trauma management, prediction of outcome, and influence of comorbidities.

PubMed

Kennedy, R L; Grant, P T; Blackwell, D

2001-10-01

Falls from a low height are an extremely common source of injury, the severity of which is often underestimated. As a result, low fall patients are usually not transferred to Level I trauma centers. There are surprisingly few systematic data relating to the demands made on systems of trauma care by patients with low falls. This study addresses this issue using information from a comprehensive national trauma database. The performance of TRISS methodology, and the factors associated with prolonged hospital stay, in low fall patients is also examined. The study included 31,419 patients. Patients with low falls (< 2 m) were compared with those suffering high falls (> or = 2 m), motor vehicle crashes, assault, sports injuries, and a group with unclassified injuries. Probability of survival was estimated using TRISS, and its performance in different types of injury was assessed using measures of discrimination and calibration. The influence of coexistent medical conditions on mortality and length of stay was investigated using logistic regression. Low falls accounted for 45.5% of all admissions, and 43.9% of the total bed days. The low fall group was older (mean age, 61.6 years), and predominantly female (62.5%) in contrast to the other groups (both p < 0.001). There were fewer severely injured patients than in all of the other groups except sports injuries. The area under the receiver operating characteristic curve for TRISS applied to low falls (0.874) was less than that for high falls (0.969), motor vehicle crashes (0.973), assaults (0.960), sports (1.000), and unclassified injuries (0.965). Also, the calibration of the TRISS model was poor for patients with low falls. A logistic regression model derived from a training set of 5,000 patients gave slightly improved discrimination and markedly improved calibration when compared with TRISS. Although there was a strong relationship between the number of coexistent medical conditions and the risk of dying after a low fall, including data on comorbidities in a predictive model did not improve performance. Prolonged stay (defined as greater than the 90th centile, 23 days) was more likely in women (p < 0.005), or with advanced age (p < 0.001) or low initial calculated probability of survival (p < 0.001). Cardiovascular and central nervous system diseases and diabetes were associated with longer hospital stay (all p < 0.001). A logistic regression model using TRISS variables and comorbidity data gave poor prediction of prolonged stay. There was considerable variation in the length of stay between institutions. Patients with low falls make considerable demands on a system of trauma care. TRISS methodology performs less well in this group than with other types of injury. Chronic medical conditions are associated with increased mortality and more prolonged stay after a low fall. Between-institutional variation in length of stay was considerable and this, along with the poor performance of predictive models derived from routinely collected clinical data, make it unlikely that length of stay could be used as a measure of institutional performance. More robust audit measures for patients with low falls are required.

Benthic sulfate reduction along the Chesapeake Bay central channel. II. Temporal controls

USGS Publications Warehouse

Marvin-DiPasquale, M. C.; Boynton, W.R.; Capone, D.G.

2003-01-01

Seasonal and interannual controls of benthic sulfate reduction (SR) were examined at 3 sites (upper [UB], mid- [MB] and lower [LB] bay) along the Chesapeake Bay central channel, from early spring through fall, for 6 yr (1989 to 1994). The combined influences of temperature, sulfate, organic loading and bioturbation affected seasonal SR rates differently in the 3 regions. Consistently low SR rates at UB resulted from low overlying-water sulfate concentrations and the dominance of refractory organic terrestrial material. Combined seasonal variation in temperature and sulfate accounted for 50% of the annual variability in 0 to 2 cm depth interval SR rates, while sediment organic content had no significant seasonal influence. In contrast, MB and LB sites had high rates of SR fostered by high levels of overlying water SO42- and organic input dominated by labile phytoplankton detritus. New organic loading (measured as chl a) stimulated 0 to 2 cm SR during spring at both sites. Combined organic quantity (as particulate C and/or N) and temperature accounted for > 75% of the variability in 0 to 2 cm SR at MB during spring and fall. Molecular diffusion supplied 25 to 45% of the SO 42- needed to fuel 0 to 12 cm depth interval SR at MB, with the balance presumably supplied by S-recycling. Interannual differences in summertime SR rates were linked to the extent of freshwater flow during spring, with high-flow years associated with high SR rates at UB and MB, and low rates at LB. The negative trend between benthic SR and river flow at LB may result from the up-estuary transport of senescing organic matter in bottom water, which increases in the lower reach of the estuary with increasing freshwater inflow.

The Origin of Molecular Clouds in Central Galaxies

NASA Astrophysics Data System (ADS)

Pulido, F. A.; McNamara, B. R.; Edge, A. C.; Hogan, M. T.; Vantyghem, A. N.; Russell, H. R.; Nulsen, P. E. J.; Babyk, I.; Salomé, P.

2018-02-01

We present an analysis of 55 central galaxies in clusters and groups with molecular gas masses and star formation rates lying between {10}8 {and} {10}11 {M}ȯ and 0.5 and 270 {M}ȯ {{yr}}-1, respectively. Molecular gas mass is correlated with star formation rate, Hα line luminosity, and central atmospheric gas density. Molecular gas is detected only when the central cooling time or entropy index of the hot atmosphere falls below ∼1 Gyr or ∼35 keV cm2, respectively, at a (resolved) radius of 10 kpc. These correlations indicate that the molecular gas condensed from hot atmospheres surrounding the central galaxies. We explore the origins of thermally unstable cooling by evaluating whether molecular gas becomes prevalent when the minimum of the cooling to free-fall time ratio ({t}{cool}/{t}{ff}) falls below ∼10. We find that (1) molecular gas-rich systems instead lie between 10< \\min ({t}{cool}/{t}{ff})< 25, where {t}{cool}/{t}{ff}=25 corresponds approximately to cooling time and entropy thresholds of 1 Gyr and 35 {keV} {{cm}}2, respectively; (2) \\min ({t}{cool}/{t}{ff}) is uncorrelated with molecular gas mass and jet power; and (3) the narrow range 10< \\min ({t}{cool}/{t}{ff})< 25 can be explained by an observational selection effect, although a real physical effect cannot be excluded. These results and the absence of isentropic cores in cluster atmospheres are in tension with models that assume thermal instability ensues from linear density perturbations in hot atmospheres when {t}{cool}/{t}{ff}≲ 10. Some of the molecular gas may instead have condensed from atmospheric gas lifted outward by buoyantly rising X-ray bubbles or by dynamically induced uplift (e.g., mergers, sloshing).

Falls Risk and Simulated Driving Performance in Older Adults

PubMed Central

Gaspar, John G.; Neider, Mark B.; Kramer, Arthur F.

2013-01-01

Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance. PMID:23509627

How Socio-Economic Change Shapes Income Inequality in Post-Socialist Europe

ERIC Educational Resources Information Center

Bandelj, Nina; Mahutga, Matthew C.

2010-01-01

Although income inequality in Central and Eastern Europe was considerably lower during socialism than in other countries at comparable levels of development, it increased significantly in all Central and East European states after the fall of communist regimes. However, some of these countries managed to maintain comparatively low inequality…

Underserved populations in science education: Enhancement through learning community participation

NASA Astrophysics Data System (ADS)

Gray, Jennifer Emily

A positive relationship between college anatomy students' achievement and academic language proficiency in the context of a learning community was established. For many students the barrier to learning science is language. A relationship exists between low academic language proficiency and lack of success among students, in particular failure among at-risk minority and language-minority students. The sample consisted of Anatomy classes during the Fall semesters of the academic years, 2000, 2001, and 2002 at a community college in Central California having a high percentage of culturally and linguistically diverse students. Students from each semester participated in the academic language proficiency and science achievement studies. Twenty-two of the Fall 2002 students (n = 65) enrolled in the Learning Community (LC) that included instruction in academic language in the context of the anatomy course content. Fall 2002 students (n = 19) also participated in Peer-led Support (PLS) sessions. Fall 2001 students participated in a textbook use study (n = 44) and in a Cooperative-Learning (CL) (n = 35) study. Students in the LC and Non-LC groups took the academic language assessment; their results were correlated with course grades and attendance. Fall 2002 students were compared for: (1) differences regarding self-expectations, (2) program impressions, and (3) demographics. Fall 2001 student reading habits and CL participation were analyzed. Results identified: (1) selected academic language tasks as good predictors of science success, (2) a significant positive relationship between science success and participation in support interventions, (3) no differences in self expectations or demographic characteristics of participants and non-participants in the LC group, and (4) poor textbook reading habits. Results showed a significant positive relationship between academic language proficiency and science achievement in participatory instruction.

The elderly recognizing themselves as vulnerable to falls in the concreteness of the femoral fracture.

PubMed

Carvalho, César Junior Aparecido de; Bocchi, Silvia Cristina Mangini

2017-04-01

understand the experience of the elderly with falls followed by femoral fracture and elaborate theoretical model of this process of lived experience. qualitative research with theoretical saturation through analysis of the ninth nondirected interview of elderly who underwent such experience. Interviews were recorded, transcribed, and analyzed according to Grounded Theory. three categories emerged (sub-processes): evaluating signs and symptoms of fracture after the fall; feeling sad and insecure with the new condition; and finding oneself susceptible to fractures. From realignment of these categories (sub-processes) we could abstract the central category (process), recognizing oneself as vulnerable to falls in the concreteness of the fracture. the theoretical model considering the Symbolic Interactionism signals the implementation of continued program for fall prevention, with teaching strategies that encourage the elderly to reflect on the concreteness of contexts in which there is risk of occurring injury to their health.

From Central Planning to Markets: 20 Years of Post-Socialist Transformation in an Eastern German County

ERIC Educational Resources Information Center

Singelmann, Joachim

2011-01-01

The Berlin Wall was one of the most visible symbols of two worlds that could not view each other. Thus, the fall of the Berlin Wall--and the fall of Communist regimes all over Eastern Europe, ultimately including the dissolution of the Soviet Union itself--removed the barrier to visibility. These events were revolutions that resulted in the end of…

Map showing geologic terranes of the Hailey 1 degree x 2 degrees quadrangle and the western part of the Idaho Falls 1 degree x 2 degrees quadrangle, south-central Idaho

USGS Publications Warehouse

Worl, R.G.; Johnson, K.M.

1995-01-01

The paper version of Map Showing Geologic Terranes of the Hailey 1x2 Quadrangle and the western part of the Idaho Falls 1x2 Quadrangle, south-central Idaho was compiled by Ron Worl and Kate Johnson in 1995. The plate was compiled on a 1:250,000 scale topographic base map. TechniGraphic System, Inc. of Fort Collins Colorado digitized this map under contract for N.Shock. G.Green edited and prepared the digital version for publication as a geographic information system database. The digital geologic map database can be queried in many ways to produce a variety of geologic maps.

The effect of a non-steroidal anti-inflammatory drug on two important predictors for accidental falls: postural balance and manual reaction time. A randomized, controlled pilot study.

PubMed

Hegeman, Judith; Nienhuis, Bart; van den Bemt, Bart; Weerdesteyn, Vivian; van Limbeek, Jacques; Duysens, Jacques

2011-04-01

Accidental falls in older individuals are a major health and research topic. Increased reaction time and impaired postural balance have been determined as reliable predictors for those at risk of falling and are important functions of the central nervous system (CNS). An essential risk factor for falls is medication exposure. Amongst the medications related to accidental falls are the non-steroidal anti-inflammatory drugs (NSAIDs). About 1-10% of all users experience CNS side effects. These side effects, such as dizziness, headaches, drowsiness, mood alteration, and confusion, seem to be more common during treatment with indomethacin. Hence, it is possible that maintenance of (static) postural balance and swift reactions to stimuli are affected by exposure to NSAIDs, indomethacin in particular, consequently putting older individuals at a greater risk for accidental falls. The present study investigated the effect of a high indomethacin dose in healthy middle-aged individuals on two important predictors of falls: postural balance and reaction time. Twenty-two healthy middle-aged individuals (59.5 ± 4.7 years) participated in this double-blind, placebo-controlled, randomized crossover trial. Three measurements were conducted with a week interval each. A measurement consisted of postural balance as a single task and while concurrently performing a secondary cognitive task and reaction time tasks. For the first measurement indomethacin 75 mg (slow-release) or a visually identical placebo was randomly assigned. In total, five capsules were taken orally in the 2.5 days preceding assessment. The second measurement was without intervention, for the final one the first placebo group got indomethacin and vice versa. Repeated measures GLM revealed no significant differences between indomethacin, placebo, and baseline in any of the balance tasks. No differences in postural balance were found between the single and dual task conditions, or on the performance of the dual task itself. Similarly, no differences were found on the manual reaction time tasks. The present study showed that a high indomethacin dose does not negatively affect postural balance and manual reaction time in this healthy middle-aged population. Although the relatively small and young sample limits the direct ability to generalize the results to a population at risk of falling, the results indicate that indomethacin alone is not likely to increase fall risk, as far as this risk is related to above mentioned important functions of the CNS, and not affected by comorbidities. Copyright © 2010 Elsevier B.V. All rights reserved.

Flying Through Polytropes

NASA Technical Reports Server (NTRS)

Pesnell, W. Dean

2016-01-01

Dropping objects into a tunnel bored through Earth has been used to visualize simple harmonic motion for many years, and even imagined for use as rapid transport systems. Unlike previous studies that assumed a constant density Earth, here we calculate the fall-through time of polytropes, models of Earth's interior where the pressure varies as a power of the density. This means the fall-through time can be calculated as the central condensation varies from one to large within the family of polytropes. Having a family of models, rather than a single model, helps to explore the properties of planets and stars. Comparing the family of phase space solutions shows that the fall-through time and velocity approach the limit of radial free-fall onto a point mass as the central condensation increases. More condensed models give higher maximum velocities but do not have the right global properties for Earth. The angular distance one can travel along the surface is calculated as a brachistochrone (path of least time) tunnel that is a function of the depth to which the tunnel is bored. We also show that completely degenerate objects, simple models of white dwarf stars supported by completely degenerate electrons, have sizes similar to Earth but their much higher masses mean a much larger gravitational strength and a shorter fall-through time. Numerical integrations of the equations describing polytropes and completely degenerate objects are used to generate the initial models. Analytic solutions and numerical integration of the equations of motion are used to calculate the fall-through time for each model, and numerical integrations with analytic approximations at the boundaries are used to calculate the brachistochrones in the polytropes. Scaling relationships are provided to help use these results in other planets and stars.

Falling-incident detection and throughput enhancement in a multi-camera video-surveillance system.

PubMed

Shieh, Wann-Yun; Huang, Ju-Chin

2012-09-01

For most elderly, unpredictable falling incidents may occur at the corner of stairs or a long corridor due to body frailty. If we delay to rescue a falling elder who is likely fainting, more serious consequent injury may occur. Traditional secure or video surveillance systems need caregivers to monitor a centralized screen continuously, or need an elder to wear sensors to detect falling incidents, which explicitly waste much human power or cause inconvenience for elders. In this paper, we propose an automatic falling-detection algorithm and implement this algorithm in a multi-camera video surveillance system. The algorithm uses each camera to fetch the images from the regions required to be monitored. It then uses a falling-pattern recognition algorithm to determine if a falling incident has occurred. If yes, system will send short messages to someone needs to be noticed. The algorithm has been implemented in a DSP-based hardware acceleration board for functionality proof. Simulation results show that the accuracy of falling detection can achieve at least 90% and the throughput of a four-camera surveillance system can be improved by about 2.1 times. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

Risk of Fall-Related Injury due to Adverse Weather Events, Philadelphia, Pennsylvania, 2006-2011.

PubMed

Gevitz, Kathryn; Madera, Robbie; Newbern, Claire; Lojo, José; Johnson, Caroline C

Following a surge in fall-related visits to local hospital emergency departments (EDs) after a severe ice storm, the Philadelphia Department of Public Health examined the association between inclement winter weather events and fall-related ED visits during a 5-year period. Using a standardized set of keywords, we identified fall-related injuries in ED chief complaint logs submitted as part of Philadelphia Department of Public Health's syndromic surveillance from December 2006 through March 2011. We compared days when falls exceeded the winter fall threshold (ie, "high-fall days") with control days within the same winter season. We then conducted matched case-control analysis to identify weather and patient characteristics related to increased fall-related ED visits. Fifteen high-fall days occurred during winter months in the 5-year period. In multivariable analysis, 18- to 64-year-olds were twice as likely to receive ED care for fall-related injuries on high-fall days than on control days. The crude odds of ED visits occurring from 7:00 am to 10:59 am were 70% higher on high-fall days vs control days. Snow was a predictor of a high-fall day: the adjusted odds of snow before a high-fall day as compared with snow before a control day was 13.4. The association between the number of fall-related ED visits and weather-related fall injuries, age, and timing suggests that many events occurred en route to work in the morning. Promoting work closures or delaying openings after severe winter weather would allow time for better snow or ice removal, and including "fall risk" in winter weather advisories might effectively warn morning commuters. Both strategies could help reduce the number of weather-related fall injuries.

123. MCMULLEN CREEK, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

123. MCMULLEN CREEK, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; SOUTH VIEW OF THE CREEK EMPTYING INTO THE HIGH LINE CANAL. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

A Climatology of Nocturnal-Convection Initiation Over the Central Great Plains

NASA Astrophysics Data System (ADS)

Reif, D. W.; Bluestein, H. B.

2015-12-01

A nocturnal maximum in rainfall and thunderstorm activity over the central Great Plains is widely documented, but the mechanisms for understanding the development of thunderstorms over the region at night are still not well understood. Elevated convection, defined by Colman (1990) as storms formed through ascent above frontal surfaces, is one explanation, but our study shows that many thunderstorms can initiate at night without the presence of an elevated frontal inversion or nearby surface boundary. We address the following questions: Of all the events documented, what percentage fall under this definition of elevated convection, and what percentage fall outside of that definition? How do characteristics differ among the events that fall under that definition and the events that fall outside that definition? This study documents convection initiation (CI) events occurring at night over the central Great Plains from 1996 through 2014 during the months of April through July. Storm characteristics such as storm type (defined as linear, areal, or single cell), storm motion, initiation time and location, and others were documented. Once all of the cases were documented, surface data were examined to locate any nearby surface boundaries. The event's location relative to these boundaries (if they existed) was documented. Three main modes of CI were identified: formation on a surface boundary, formation on the cold side of a surface boundary, and formation without the presence of a surface boundary. A climatology of these events will be presented. There are many differences among the different modes of CI at night. One result is that there appears to be two main peaks of CI time at night: one early at night and one later at night. The later peak is likely due to the events that form in the absence of a nearby surface boundary.

Continuous equilibrium scores: factoring in the time before a fall.

PubMed

Wood, Scott J; Reschke, Millard F; Owen Black, F

2012-07-01

The equilibrium (EQ) score commonly used in computerized dynamic posturography is normalized between 0 and 100, with falls assigned a score of 0. The resulting mixed discrete-continuous distribution limits certain statistical analyses and treats all trials with falls equally. We propose a simple modification of the formula in which peak-to-peak sway data from trials with falls is scaled according the percent of the trial completed to derive a continuous equilibrium (cEQ) score. The cEQ scores for trials without falls remain unchanged from the original methodology. The cEQ factors in the time before a fall and results in a continuous variable retaining the central tendencies of the original EQ distribution. A random set of 5315 Sensory Organization Test trials were pooled that included 81 falls. A comparison of the original and cEQ distributions and their rank ordering demonstrated that trials with falls continue to constitute the lower range of scores with the cEQ methodology. The area under the receiver operating characteristic curve (0.997) demonstrates that the cEQ retained near-perfect discrimination between trials with and without falls. We conclude that the cEQ score provides the ability to discriminate between ballistic falls from falls that occur later in the trial. This approach of incorporating time and sway magnitude can be easily extended to enhance other balance tests that include fall data or incomplete trials. Copyright © 2012 Elsevier B.V. All rights reserved.

Occurrence of entomopathogenic fungi and parasitic nematodes on Spodoptera frugiperda (Lepidoptera: Noctuidae) larvae collected in Central Chiapas, Mexico

USDA-ARS?s Scientific Manuscript database

Fall armyworm larvae (FAW), Spodoptera frugiperda (J. E. Smith) were collected from whorl-stage cornfields, between the V2 and V4 stages, in 22 localities of Central, Chiapas, México, called "La Frailesca" during late June 2009 to determine the occurrence of native entomopathogens and parasitic nema...

Evolving Privatization in Eastern and Central European Higher Education

ERIC Educational Resources Information Center

Levy, Daniel

2014-01-01

With the fall of communism in 1989, Eastern and Central Europe would quickly become part of an already strong global tide of privatization in higher education. Nowhere else did private higher education rise so suddenly or strongly from virtual nonexistence to a major regional presence. A fresh database allows us to analyze the extent and…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khajenabi, Fazeleh, E-mail: f.khajenabi@gu.ac.ir

We investigate the orbital motion of cold clouds in the broad-line region of active galactic nuclei subject to the gravity of a black hole, a force due to a non-isotropic central source, and a drag force proportional to the velocity square. The intercloud is described using the standard solutions for the advection-dominated accretion flows. The orbit of a cloud decays because of the drag force, but the typical timescale of clouds falling onto the central black hole is shorter compared to the linear drag case. This timescale is calculated when a cloud moves through a static or rotating intercloud. Wemore » show that when the drag force is a quadratic function of the velocity, irrespective of the initial conditions and other input parameters, clouds will generally fall onto the central region much faster than the age of whole system, and since cold clouds present in most of the broad-line regions, we suggest that mechanisms for the continuous creation of the clouds must operate in these systems.« less

The 2016 southeastern US drought: an extreme departure from centennial wetting and cooling

NASA Astrophysics Data System (ADS)

Williams, P.; Cook, B. I.; Smerdon, J. E.; Bishop, D. A.; Seager, R.; Mankin, J. S.

2017-12-01

The southeastern United States (SE US) drought in fall 2016 appeared exceptional based on its wildfire and water-supply impacts but the current monitoring framework does not readily facilitate evaluation of moisture-balance anomalies in a centennial context. A new method to extend modeled soil-moisture records back to 1895 is developed using monthly climate data. Since 1895, October-November 2016 soil moisture (0-200 cm) in the SE US was likely the second lowest on record, behind 1954. This severe drought developed rapidly and was brought on by near record-low September-November precipitation and record-high September-November daily maximum temperatures (Tmax). Record Tmax drove record-high atmospheric moisture demand, accounting for 28% of the October-November 2016 soil-moisture anomaly. Drought and heat in fall 2016 contrasted strongly with 20th-century wetting and cooling trends, with few analogs after the mid-1950s. Dynamically, the exceptional drying in fall 2016 was driven by anomalous ridging over the central United States that reduced south-southwesterly moisture transports into the SE US by approximately 75%. These circulation anomalies were promoted by moderate La Niña conditions and warmth in the tropical North Atlantic, but these processes did not account for a majority of the SE US drying in fall 2016 and therefore imply a large role for internal atmospheric variability. The extended analysis back to 1895 indicates that SE US droughts as strong as the 2016 event are more likely than indicated from a shorter 60-year perspective, and continued multi-decadal swings in precipitation may combine with future warming to further enhance the likelihood of such events.

Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis.

PubMed

Schoene, Daniel; Wu, Sandy M-S; Mikolaizak, A Stefanie; Menant, Jasmine C; Smith, Stuart T; Delbaere, Kim; Lord, Stephen R

2013-02-01

To investigate the discriminative ability and diagnostic accuracy of the Timed Up and Go Test (TUG) as a clinical screening instrument for identifying older people at risk of falling. Systematic literature review and meta-analysis. People aged 60 and older living independently or in institutional settings. Studies were identified with searches of the PubMed, EMBASE, CINAHL, and Cochrane CENTRAL data bases. Retrospective and prospective cohort studies comparing times to complete any version of the TUG of fallers and non-fallers were included. Fifty-three studies with 12,832 participants met the inclusion criteria. The pooled mean difference between fallers and non-fallers depended on the functional status of the cohort investigated: 0.63 seconds (95% confidence (CI) = 0.14-1.12 seconds) for high-functioning to 3.59 seconds (95% CI = 2.18-4.99 seconds) for those in institutional settings. The majority of studies did not retain TUG scores in multivariate analysis. Derived cut-points varied greatly between studies, and with the exception of a few small studies, diagnostic accuracy was poor to moderate. The findings suggest that the TUG is not useful for discriminating fallers from non-fallers in healthy, high-functioning older people but is of more value in less-healthy, lower-functioning older people. Overall, the predictive ability and diagnostic accuracy of the TUG are at best moderate. No cut-point can be recommended. Quick, multifactorial fall risk screens should be considered to provide additional information for identifying older people at risk of falls. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

A long-recommended but seldom-used method of analysis for fall injuries found a unique pattern of risk factors in the youngest-old.

PubMed

Legrand, Helen; Pihlsgård, Mats; Nordell, Eva; Elmståhl, Sölve

2015-08-01

Few studies on fall risk factors use long-recommended methods for analysis of recurrent events. Previous falls are the biggest risk factor for future falls, but few fall studies focus on the youngest-old. This study's objective was to apply Cox regression for recurrent events to identify factors associated with injurious falls in the youngest-old. Participants were community-dwelling residents of southern Sweden (n = 1,133), aged 59-67 at baseline (median 61.2), from the youngest cohorts of the larger Good Aging in Skåne (GÅS) study. Exposure variable data were collected from baseline study visits and medical records. Injurious falls, defined as emergency, inpatient, or specialist visits associated with ICD-10 fall codes during the follow-up period (2001-2011), were gathered from national and regional registries. Analysis was conducted using time to event Cox Regression for recurrent events. A majority (77.1 %) of injurious falls caused serious injuries such as fractures and open wounds. Exposure to nervous system medications [hazard ratio (HR) 1.40, 95 % confidence interval (CI) 1.03-1.89], central nervous system disease (HR 1.79, CI 1.18-2.70), and previous injurious fall(s) (HR 2.00, CI 1.50-2.68) were associated with increased hazard of injurious fall. Regression for recurrent events is feasible with typical falls' study data. The association of certain exposures with increased hazard of injurious falls begins earlier than previously studied. Different patterns of risk factors by age can provide insight into the progression of frailty. Tailored fall prevention screening and intervention may be of value in populations younger than those traditionally screened.

A Novel Detection Model and Its Optimal Features to Classify Falls from Low- and High-Acceleration Activities of Daily Life Using an Insole Sensor System

PubMed Central

Cates, Benjamin; Sim, Taeyong; Heo, Hyun Mu; Kim, Bori; Kim, Hyunggun; Mun, Joung Hwan

2018-01-01

In order to overcome the current limitations in current threshold-based and machine learning-based fall detectors, an insole system and novel fall classification model were created. Because high-acceleration activities have a high risk for falls, and because of the potential damage that is associated with falls during high-acceleration activities, four low-acceleration activities, four high-acceleration activities, and eight types of high-acceleration falls were performed by twenty young male subjects. Encompassing a total of 800 falls and 320 min of activities of daily life (ADLs), the created Support Vector Machine model’s Leave-One-Out cross-validation provides a fall detection sensitivity (0.996), specificity (1.000), and accuracy (0.999). These classification results are similar or superior to other fall detection models in the literature, while also including high-acceleration ADLs to challenge the classification model, and simultaneously reducing the burden that is associated with wearable sensors and increasing user comfort by inserting the insole system into the shoe. PMID:29673165

Classroom-Level Predictors of the Social Status of Aggression: Friendship Centralization, Friendship Density, Teacher-Student Attunement, and Gender

ERIC Educational Resources Information Center

Ahn, Hai-Jeong; Rodkin, Philip C.

2014-01-01

This study investigated moderating effects of classroom friendship network structures (centralization and density), teacher-student attunement on aggression and popularity, and gender on changes in the social status of aggression over 1 school year. Longitudinal multilevel analyses with 2 time points (fall and spring) were conducted on a sample of…

Inferring the annual migration patterns of fall armyworm (Lepidoptera: Noctuidae) in the United States from mitochondrial haplotypes

PubMed Central

Nagoshi, Rodney N; Meagher, Robert L; Hay-Roe, Mirian

2012-01-01

Spodoptera frugiperda (J. E. Smith) or fall armyworm is an important agricultural pest of a number of crops in the western hemisphere. In the United States, infestations in corn acreages extend from the Mexican to the Canadian border. Because fall armyworm does not survive prolonged freezing, the infestations annually affecting most of North America are migrants from southern Texas and Florida, where winter temperatures are mild and host plants are available. A haplotype method was developed that can distinguish between these two geographically distant overwintering populations, with the potential to delineate the associated migratory pathways. Several years of collections from major corn-producing areas in the southern, central, and eastern United States were used to map the geographical distribution of the fall armyworm haplotypes. From these haplotype profiles, it was possible to develop the most detailed description yet of the annual northward movements of fall armyworm. The consistency of these results with past studies and the implications on our understanding of fall armyworm biology are discussed. A better understanding of fall armyworm populations and their movement is critical for the development of strategies to predict infestation levels and eventually control this pest in the United States. PMID:22957154

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

PubMed

Blalock, Susan J; Gildner, Paula L; Jones, Jennifer L; Bowling, James M; Casteel, Carri H

2016-06-01

To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. Cross-sectional. Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Ceramic high temperature receiver design and tests

NASA Technical Reports Server (NTRS)

Davis, S. B.

1982-01-01

The High Temperature Solar Thermal Receiver, which was tested a Edwards AFB, CA during the winter of 1980-1981, evolved from technologies developed over a five year period of work. This receiver was tested at the Army Solar Furnace at White Sands, NM in 1976. The receiver, was tested successfully at 1768 deg F and showed thermal efficiencies of 85%. The results were sufficiently promising to lead ERDA to fund our development and test of a 250 kW receiver to measure the efficiency of an open cavity receiver atop a central tower of a heliostat field. This receiver was required to be design scalable to 10, 50, and 100 MW-electric sizes to show applicability to central power tower receivers. That receiver employed rectagular silicon carbide panels and vertical stanchions to achieve scalability. The construction was shown to be fully scalable; and the receiver was operated at temperatures up to 2000 deg F to achieve the performance goals of the experiment during tests at the GIT advanced components test facility during the fall of 1978.

Impact of Diabetic Complications on Balance and Falls: Contribution of the Vestibular System

PubMed Central

Lin, James; Staecker, Hinrich; Whitney, Susan L.; Kluding, Patricia M.

2016-01-01

Diabetes causes many complications, including retinopathy and peripheral neuropathy, which are well understood as contributing to gait instability and falls. A less understood complication of diabetes is the effect on the vestibular system. The vestibular system contributes significantly to balance in static and dynamic conditions by providing spatially orienting information. It is noteworthy that diabetes has been reported to affect vestibular function in both animal and clinical studies. Pathophysiological changes in peripheral and central vestibular structures due to diabetes have been noted. Vestibular dysfunction is associated with impaired balance and a higher risk of falls. As the prevalence of diabetes increases, so does the potential for falls due to diabetic complications. The purpose of this perspective article is to present evidence on the pathophysiology of diabetes-related complications and their influence on balance and falls, with specific attention to emerging evidence of vestibular dysfunction due to diabetes. Understanding this relationship may be useful for screening (by physical therapists) for possible vestibular dysfunction in people with diabetes and for further developing and testing the efficacy of interventions to reduce falls in this population. PMID:26251477

Stable Isotopic Composition of Precipitation from 2015-2016 Central Texas Rainfall Events

NASA Astrophysics Data System (ADS)

Maupin, C. R.; McChesney, C. L.; Roark, B.; Gorman, M. K.; Housson, A. L.

2016-12-01

Central Texas lies within the Southern Great Plains, a region where rainfall is of tremendous agricultural and associated socioeconomic importance. Paleoclimate records from speleothems in central Texas caves may assist in placing historical and recent drought and pluvial events in the context of natural variability. Effective interpretation of such records requires the nature and origin of variations in the meteoric δ18O signal transmitted from cloud to speleothem to be understood. Here we present a record of meteoric δ18O and δD from each individual precipitation event (δ18Op and δDp), collected by rain gauge in Austin, Texas, USA, from April 2015 through 2016. Backwards hybrid single-particle Lagrangian integrated trajectories (HYSPLITs) indicate the broader moisture source for each precipitation event during this time was the Gulf of Mexico. The local meteoric water line is within error of the global meteoric water line, suggesting minimal sourcing of evaporated continental vapor for precipitation. Total monthly rainfall followed the climatological pattern of a dual boreal spring and fall maximum, with highly variable event δ18Op and δDp values. Surface temperature during precipitation often exerts control over continental and mid latitude δ18Op values, but is not significantly correlated to study site δ18Op (p>0.10). Amount of rain falling during each precipitation event ("amount effect") explains a significant 18% of variance in δ18Op. We hypothesize that this relationship can be attributed to the following: 1) minimal recycling of continental water vapor during the study period; 2) the presence of synoptic conditions favoring intense boreal spring and fall precipitation, driven by a developing, and subsequently in-place, strong ENSO event coupled with a southerly flow from the open Gulf of Mexico; and 3) the meteorological nature of the predominant precipitating events over Texas during this time, mesoscale convective systems, which are known to produce an "amount effect" if effective in-storm downdraft-recycling is present. Continued rainfall monitoring and isotopic measurements are required to determine whether this relationship persists during years with synoptic conditions different from 2015-2016.

The Association between Generalized Anxiety Disorder, Subthreshold Anxiety Symptoms and Fear of Falling among Older Adults: Preliminary Results from a Pilot Study.

PubMed

Payette, Marie-Christine; Bélanger, Claude; Benyebdri, Fethia; Filiatrault, Johanne; Bherer, Louis; Bertrand, Josie-Anne; Nadeau, Alexandra; Bruneau, Marie-Andrée; Clerc, Doris; Saint-Martin, Monique; Cruz-Santiago, Diana; Ménard, Caroline; Nguyen, Philippe; Vu, T T Minh; Comte, Francis; Bobeuf, Florian; Grenier, Sébastien

2017-01-01

A relationship between generalized anxiety disorder (GAD) and fear of falling (FOF) has long been proposed but never specifically studied. This study aimed at analyzing the relationship between FOF and GAD or anxiety symptoms, while controlling for major depressive episodes (MDE), depressive symptoms, fall risk, and sociodemographic variables. Twenty-five older adults participated in this pilot study. Assessments included the following: Anxiety Disorder Interview Schedule, Geriatric Anxiety Inventory, Geriatric Depression Scale, Falls-Efficacy Scale-International. A multidisciplinary team evaluated fall risk. FOF was significantly correlated with GAD, MDE, anxiety and depressive symptoms, and fall risk, but not with sociodemographic variables. Multiple regression analyses indicated that GAD and anxiety symptoms were significantly and independently associated with FOF. Although the results of this pilot study should be replicated with larger samples, they suggest that FOF is associated with GAD and anxiety symptoms even when considering physical factors that increase the risk of falling. Treatment of FOF in patients with GAD may present a particular challenge because of the central role of intolerance of uncertainty, which may prevent patients from regaining confidence despite the reduction of fall risk. Clinicians should screen for GAD and anxiety symptoms in patients with FOF to improve detection and treatment.

Effectiveness of an automatic manual wheelchair braking system in the prevention of falls.

PubMed

Martorello, Laura; Swanson, Edward

2006-01-01

The purpose of this study was to evaluate the effectiveness of an automatic manual wheelchair braking system in the reduction of falls for patients at high risk of falls while transferring to and from a manual wheelchair. The study design was a normative survey carried out through the use of a written questionnaire sent to 60 skilled nursing facilities to collect data from the medical charts, which identified patients at high risk for falls who used an automatic wheelchair braking system. The facilities participating in the study identified a frequency of falls of high-risk patients while transferring to and from the wheelchair ranging from 2 to 10 per year, with a median fall rate per facility of 4 falls. One year after the installation of the automatic wheelchair braking system, participating facilities demonstrated a reduction of zero to three falls during transfers by high-risk patients, with a median fall rate of zero falls. This represents a statistically significant reduction of 78% in the fall rate of high-risk patients while transferring to and from the wheelchair, t (18) = 6.39, p < .0001. Incident reports of falls to and from manual wheelchairs were reviewed retrospectively for a 1-year period. This study suggests that high-risk fallers transferring to or from manual wheelchairs sustained significantly fewer falls when the Steddy Mate automatic braking system for manual wheelchairs was installed. The application of the automatic braking system allows clients, families/caregivers, and facility personnel an increased safety factor for the reduction of falls from the wheelchair.

Environmental Assessment for a Gravel Road Training Course Extension Malmstrom Air Force Base, Great Falls, Montana

DTIC Science & Technology

2010-07-01

3,271 acres in Cascade County in west-central Montana (Figure 1-1). The Base lies approximately 0.3 miles east of the city of Great Falls and 75...for future planning. MAFB has defined several land use categories, including Administration, Aircraft Operations, Airfield, Community, Housing ...greenhouse gases during construction. These emissions would be small compared to human-induced releases within the region and the State of Montana. No

Pre-Procedural Patient Education Reduces Fall Risk in an Outpatient Endoscopy Suite.

PubMed

Hilscher, Moira B; Niesen, Cynthia R; Tynsky, Desiree A; Kane, Sunanda V

The purpose of this article was to determine whether scripted pre-procedural fall risk patient education and nurses' intention to assist patients after receiving sedation improves receptiveness of nursing assistance during recovery and decreases fall risk in an outpatient endoscopy suite. We prospectively identified high fall risk patients using the following criteria: (1) use of an assistive device, (2) fallen two or more times within the last year, (3) sustained an injury in a fall within a year, (4) age greater than 85 years, or (5) nursing judgment of high fall risk. Using a scripted dialogue, nurses educated high-risk patients of their fall risk and the nurses' intent to assist them to and in the bathroom. Documentation of patient education, script use, and assistance was monitored. Over 24 weeks, 892 endoscopy patients were identified as high fall risk; 790 (88.5%) accepted post-procedural assistance. Documentation of assistance significantly increased from 33% to 100%. Patients receiving education and postprocedural assistance increased from 27.9% to 100% at week 24. No patient falls occurred 12 months following implementation among patients identified as high fall risk. Scripted pre-procedural fall risk education increases patient awareness and receptiveness to assistance and can lead to decreased fall rates.

Advances in central receivers for concentrating solar applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ho, Clifford K.

This paper provides a review of current state-of-the-art commercial central receiver systems and emerging technologies intended to increase the outlet temperature to >700 °C. Research on particle-based, gas-based, and liquid-based receiver designs that can achieve these higher temperatures are discussed. Particle-based technologies include directly irradiated designs (free-falling, obstructed, centrifugal) and enclosed designs (gravity fed, fluidized). New gas-based receivers include micro-channel designs and light-trapping configurations that increase the surface area, heat transfer, and solar absorptance to enable higher fluxes and pressures. Liquid-based receivers and materials that are reviewed include high-temperature halide salts (chlorides and fluorides), carbonate salts, and liquid metals (sodiummore » and lead bismuth). Advantages and challenges associated with each of the technologies and receiver designs are presented.« less

Advances in central receivers for concentrating solar applications

DOE PAGES

Ho, Clifford K.

2017-04-09

This paper provides a review of current state-of-the-art commercial central receiver systems and emerging technologies intended to increase the outlet temperature to >700 °C. Research on particle-based, gas-based, and liquid-based receiver designs that can achieve these higher temperatures are discussed. Particle-based technologies include directly irradiated designs (free-falling, obstructed, centrifugal) and enclosed designs (gravity fed, fluidized). New gas-based receivers include micro-channel designs and light-trapping configurations that increase the surface area, heat transfer, and solar absorptance to enable higher fluxes and pressures. Liquid-based receivers and materials that are reviewed include high-temperature halide salts (chlorides and fluorides), carbonate salts, and liquid metals (sodiummore » and lead bismuth). Advantages and challenges associated with each of the technologies and receiver designs are presented.« less

90. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

90. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF FILER, IDAHO; CLOSE-UP OF GATES. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

124. MCMULLEN CREEK HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

124. MCMULLEN CREEK HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; OVERALL SOUTH VIEW OF DRAW. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Is fertility falling in Zimbabwe?

PubMed

Udjo, E O

1996-01-01

With an unequalled contraceptive prevalence rate in sub-Saharan Africa, of 43% among currently married women in Zimbabwe, the Central Statistical Office (1989) observed that fertility has declined sharply in recent years. Using data from several surveys on Zimbabwe, especially the birth histories of the Zimbabwe Demographic and Health Survey, this study examines fertility trends in Zimbabwe. The results show that the fertility decline in Zimbabwe is modest and that the decline is concentrated among high order births. Multivariate analysis did not show a statistically significant effect of contraception on fertility, partly because a high proportion of Zimbabwean women in the reproductive age group never use contraception due to prevailing pronatalist attitudes in the country.

88. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

88. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF FILER, IDAHO; WEST VIEW OF CANAL AND GATES. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

91. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

91. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF FILER, IDAHO; NORTHEAST VIEW OF CANAL AND GATES. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

89. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

89. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF FILER, IDAHO; OUTLET SIDE OF CANAL, SOUTHWEST VIEW. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Development and Field Testing of the FootFall Planning System for the ATHLETE Robots

NASA Technical Reports Server (NTRS)

SunSpiral, Vytas; Wheeler, D. W.; Chavez-Clementa, Daniel; Mittman, David

2011-01-01

The FootFall Planning System is a ground-based planning and decision support system designed to facilitate the control of walking activities for the ATHLETE (All-Terrain Hex-Limbed Extra-Terrestrial Explorer) family of robots. ATHLETE was developed at NASA's Jet Propulsion Laboratory (JPL) and is a large six-legged robot designed to serve multiple roles during manned and unmanned missions to the Moon; its roles include transportation, construction and exploration. Over the four years from 2006 through 2010 the FootFall Planning System was developed and adapted to two generations of the ATHLETE robots and tested at two analog field sites (the Human Robotic Systems Project's Integrated Field Test at Moses Lake, Washington, June 2008, and the Desert Research and Technology Studies (D-RATS), held at Black Point Lava Flow in Arizona, September 2010). Having 42 degrees of kinematic freedom, standing to a maximum height of just over 4 meters, and having a payload capacity of 450 kg in Earth gravity, the current version of the ATHLETE robot is a uniquely complex system. A central challenge to this work was the compliance of the high-DOF (Degree Of Freedom) robot, especially the compliance of the wheels, which affected many aspects of statically-stable walking. This paper will review the history of the development of the FootFall system, sharing design decisions, field test experiences, and the lessons learned concerning compliance and self-awareness.

What are the Main Physical Functioning Factors Associated With Falls Among Older People With Different Perceived Fall Risk?

PubMed

Moreira, Mirian N; Bilton, Tereza L; Dias, Rosangela C; Ferriolli, Eduardo; Perracini, Monica R

2017-07-01

Fall risk perceptions may influence the judgement over physical and functional competencies to avoid falls. However, few studies have explored the physical functioning characteristics associated with falls among older people with low perceived fall risk. This study aimed to identify the prevalence of falls and physical functioning factors associated with falling among community-dwelling older adults with low and high perceived fall risk. We conducted a cross-sectional population based study with 773 community-dwelling elders. Perceived fall risk was investigated using Falls Efficacy Scale International. We considered fallers those who reported at least one fall in the previous 12 months. Physical functioning measures used were grip strength, usual gait speed, sit-to-stand test, five step test, timed up and go test, one-legged stance test, anterior and lateral functional reach test. At least one fall was reported by 103 (30%) participants with low perceived fall risk and by 196 (46%) participants with high perceived fall risk. The odds of falling were lower among those with greater grip strength and with a greater stance time in one-legged test, and the odds of falling among elders with high perceived fall risk were higher among those who took more time in performing the five step test. We believe that our results highlight the need of not neglecting the risk of falls among active older adults with low perceived fall risk, particularly in those elders that show reduced stability in a small base of support and a lower leg strength. In addition, we suggest that elders with high perceived fall risk should be assessed using anticipatory postural adjustment tests. Particularly, our results may help physiotherapists to identify eligible elders with different perceptions of fall risk for tailored interventions aimed at reducing falls. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

92. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

92. CEDAR DRAW SPILL, HIGH LINE CANAL, TWIN FALLS COUNTY SOUTH OF FILER, IDAHO; CLOSE-UP OF OUTLET SIDE OF GATES, SOUTH VIEW. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

The probable importance of snow and sediment shielding on cosmogenic ages of north-central Colorado Pinedale and pre-Pinedale moraines

USGS Publications Warehouse

Benson, L.; Madole, R.; Phillips, W.; Landis, G.; Thomas, T.; Kubik, P.

2004-01-01

Eight uncorrected 36Cl ages for Pinedale boulders in north-central Colorado fall in the range 16.5 to 20.9 kyr. 10Be age determinations on four of five boulders are in close agreement (???6% difference) with 36Cl determinations. Hypothetical corrections for snow shielding increased the 36Cl ages of Pinedale boulder surfaces by an average of ???12%. Most ages for pre-Pinedale (Bull Lake) boulders fall within marine-isotope stage (MIS) 5, a time when continental and Sierran ice accumulations were small or nonexistent. Under the assumption that these boulders were deposited on moraines that formed before the end of MIS 6 (???140 kyr BP), calculations indicated that rock-surface erosion rates would have had to range from 5.9 to 10.7 mm kyr-1 to produce the observed 36Cl values. When compared to rates that have been documented for the past 20 kyr, these erosion rates are extremely high. Snow shielding accounts for 0-48% of the additional years needed to shift pre-Pinedale dates to MIS 6. This suggests that some combination of snow shielding, sediment shielding, or 36Cl leakage has greatly decreased the apparent ages of most pre-Pinedale boulders. Inability to account for the effects of these processes seriously hinders the use of cosmogenic ages of pre-Pinedale boulders as estimators of the timing of alpine glaciation.

Medication fall risk in old hospitalized patients: a retrospective study.

PubMed

Costa-Dias, Maria José; Oliveira, Alexandre Santos; Martins, Teresa; Araújo, Fátima; Santos, Ana Sofia; Moreira, Cristina Nogueira; José, Helena

2014-02-01

While the causes of falls in old hospitalized patients are multifactorial, medication has been considered as one of the most significant factors. Given the large impact that this phenomenon has on the lives of the elderly and organizations, it is important to explore such phenomenon in greater depth. The objective of this study was to explore the association between medication and falls and the recurrent falls (n≥2), and identify medication related risk for fall in hospitalized patients, in a large acute hospital. Retrospective and quantitative study from June 2008 to December 2010. The study was conducted in a private hospital for acute patients in Lisbon, Portugal. The study included a sample of 214 episodes of fall event notifications which occurred in 193 patients. The current study was conducted through the "face to face consensus" technique which emerged the treatment groups to investigate. Regarding the data analysis we used Student's t test, ANOVA and Odds Ratio. In the violation of the premises for the use of parametric statistics we used the Kruskal-Wallis test. To assess the fall risk, and the medication-related fall risk, we used the Morse Fall Risk Scale, and the Medication Fall Risk Score. Patients who received drugs from the therapy group of "Central Nervous System", are 10 times more likely to have fall risk (OR 9. 90, 95% CI 1.6-60.63). Association was found between falls (OR 6.09, 95% CI 1.30-28.54) and its recurrence (OR 3.32, 95% CI 1.61-6.85), among patients receiving haloperidol and receiving tramadol for recurrent falls (OR 3.10, 95% CI 1.59-6.07). In 34% of the patients the medication fall risk score was 6 or higher. This current study allowed identifying medication-related risk factors for falls, that nurses should consider when prescribing interventions to prevent falls and its recurrence, when patients are admitted to acute care hospitals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Method of evaporation

NASA Technical Reports Server (NTRS)

Dufresne, Eugene R.

1987-01-01

Liquids, such as juices, milk, molten metal and the like are concentrated by forming uniformly-sized, small droplets in a precision droplet forming assembly and deploying the droplets in free fall downwardly as a central column within an evacuated column with cool walls. A portion of the solvent evaporates. The vapor flows to the wall, condenses, and usually flows down the wall as a film to condensate collector and drain. The vertical column of freely falling droplets enters the splash guard. The condensate can be collected, sent to other towers or recycled.

Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people.

PubMed

Ellison, Ashton C; Campbell, A John; Robertson, M Clare; Sanderson, Gordon F

2014-01-01

Multifocal glasses (bifocals, trifocals, and progressives) increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1) map the prismatic displacement of a progressive lens, and 2) test whether this displacement impaired reaction time and accuracy. The reaction times of healthy ≥75-year-olds (31 participants) were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance) glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter. Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis]) and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007). There was no difference in accuracy between the two types of glasses. Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial.

Characterization of petroleum reservoirs in the Eocene Green River Formation, Central Uinta Basin, Utah

USGS Publications Warehouse

Morgan, C.D.; Bereskin, S.R.

2003-01-01

The oil-productive Eocene Green River Formation in the central Uinta Basin of northeastern Utah is divided into five distinct intervals. In stratigraphically ascending order these are: 1) Uteland Butte, 2) Castle Peak, 3) Travis, 4) Monument Butte, and 5) Beluga. The reservoir in the Uteland Butte interval is mainly lacustrine limestone with rare bar sandstone beds, whereas the reservoirs in the other four intervals are mainly channel and lacustrine sandstone beds. The changing depositional environments of Paleocene-Eocene Lake Uinta controlled the characteristics of each interval and the reservoir rock contained within. The Uteland Butte consists of carbonate and rare, thin, shallow-lacustrine sandstone bars deposited during the initial rise of the lake. The Castle Peak interval was deposited during a time of numerous and rapid lake-level fluctuations, which developed a simple drainage pattern across the exposed shallow and gentle shelf with each fall and rise cycle. The Travis interval records a time of active tectonism that created a steeper slope and a pronounced shelf break where thick cut-and-fill valleys developed during lake-level falls and rises. The Monument Butte interval represents a return to a gentle, shallow shelf where channel deposits are stacked in a lowstand delta plain and amalgamated into the most extensive reservoir in the central Uinta Basin. The Beluga interval represents a time of major lake expansion with fewer, less pronounced lake-level falls, resulting in isolated single-storied channel and shallow-bar sandstone deposits.

Concern about falling in older women with a history of falls: associations with health, functional ability, physical activity and quality of life.

PubMed

Patil, Radhika; Uusi-Rasi, Kirsti; Kannus, Pekka; Karinkanta, Saija; Sievänen, Harri

2014-01-01

Fear of falling has been linked to activity restriction, functional decline, decreased quality of life and increased risk of falling. Factors that distinguish persons with a high concern about falling from those with low concern have not been systematically studied. This study aimed to expose potential health-related, functional and psychosocial factors that correlate with fear of falling among independently living older women who had fallen in the past year. Baseline data of 409 women aged 70-80 years recruited to a randomised falls prevention trial (DEX) (NCT00986466) were used. Participants were classified according to their level of concern about falling using the Falls Efficacy Scale International (FES-I). Multinomial logistic regression analyses were performed to explore associations between health-related variables, functional performance tests, amount of physical activity, quality of life and FES-I scores. 68% of the participants reported a moderate to high concern (FES-I ≥ 20) about falls. Multinomial logistic regression showed that highly concerned women were significantly more likely to have poorer health and quality of life and lower functional ability. Reported difficulties in instrumental activities of daily living, balance, outdoor mobility and poorer quality of life contributed independently to a greater concern about falling. Concern about falling was highly prevalent in our sample of community-living older women. In particular, poor perceived general health and mobility constraints contributed independently to the difference between high and low concern of falling. Knowledge of these associations may help in developing interventions to reduce fear of falling and activity avoidance in old age.

Systematic Review of Falls in Older Adults with Cancer

PubMed Central

Wildes, Tanya M; Dua, Priya; Fowler, Susan A.; Miller, J. Philip; Carpenter, Christopher R.; Avidan, Michael S.; Stark, Susan

2014-01-01

Objectives lder adults frequently experience falls, at great cost to themselves and society. Older adults with cancer may be at greater risk for falls and have unique risk factors. Materials and Methods We undertook a systematic review of the available medical literature to examine the current evidence regarding factors associated with falls in older adults with cancer. PubMed, Embase, CINAHL, CENTRAL, DARE, Cochrane Database of Systematic Reviews and clinical trials.gov were searched using standardized terms for concepts of oncology/cancer, people 60 and older, screening, falls and diagnosis. Eligible studies included cohort or case-control studies or clinical trials in which all patients, or a subgroup of patients, had a diagnosis of cancer and in which falls were either the primary or secondary outcome. Results We identified 31 studies that met our inclusion criteria. Several studies suggest that falls are more common in older adults with a diagnosis of cancer than those without. Among the 11 studies that explored factors associated with outpatient falls, some risk factors for falls established in the general population were also associated with falls in older adults with cancer, including dependence in activities of daily living and prior falls. Other factors associated with falls in a general population, such as age, polypharmacy and opioid use, were not predictive of falls among oncology populations. Falls among older adults with cancer in the inpatient setting were associated with established risk factors for falls in people without cancer, but also with factors unique to an oncology population, such as brain metastases. Conclusions Falls in older adults with cancer are more common than in the general population, and are associated with risk factors unique to people with cancer. Further study is needed to establish methods of screening older adults with cancer for fall risk and ultimately implement interventions to reduce their risk of falls. Identifying which older adults with cancer are at greater risk for falls is a requisite step to ultimately intervene and prevent falls in this vulnerable population. PMID:25454770

Compensatory Postural Adjustments in an Oculus Virtual Reality Environment and the Risk of Falling in Alzheimer's Disease.

PubMed

Gago, Miguel F; Yelshyna, Darya; Bicho, Estela; Silva, Hélder David; Rocha, Luís; Lurdes Rodrigues, Maria; Sousa, Nuno

2016-01-01

Alzheimer's disease (AD) patients have an impaired ability to quickly reweight central sensory dependence in response to unexpected body perturbations. Herein, we aim to study provoked compensatory postural adjustments (CPAs) in a conflicting sensory paradigm with unpredictable visual displacements using virtual reality goggles. We used kinematic time-frequency analyses of two frequency bands: a low-frequency band (LB; 0.3-1.5 Hz; mechanical strategy) and a high-frequency band (HB; 1.5-3.5 Hz; cognitive strategy). We enrolled 19 healthy subjects (controls) and 21 AD patients, divided according to their previous history of falls. The AD faller group presented higher-power LB CPAs, reflecting their worse inherent postural stability. The AD patients had a time lag in their HB CPA reaction. The slower reaction by CPA in AD may be a reflection of different cognitive resources including body schema self-perception, visual motion, depth perception, or a different state of fear and/or anxiety.

Compensatory Postural Adjustments in an Oculus Virtual Reality Environment and the Risk of Falling in Alzheimer's Disease

PubMed Central

Gago, Miguel F.; Yelshyna, Darya; Bicho, Estela; Silva, Hélder David; Rocha, Luís; Lurdes Rodrigues, Maria; Sousa, Nuno

2016-01-01

Background/Aims Alzheimer's disease (AD) patients have an impaired ability to quickly reweight central sensory dependence in response to unexpected body perturbations. Herein, we aim to study provoked compensatory postural adjustments (CPAs) in a conflicting sensory paradigm with unpredictable visual displacements using virtual reality goggles. Methods We used kinematic time-frequency analyses of two frequency bands: a low-frequency band (LB; 0.3-1.5 Hz; mechanical strategy) and a high-frequency band (HB; 1.5-3.5 Hz; cognitive strategy). We enrolled 19 healthy subjects (controls) and 21 AD patients, divided according to their previous history of falls. Results The AD faller group presented higher-power LB CPAs, reflecting their worse inherent postural stability. The AD patients had a time lag in their HB CPA reaction. Conclusion The slower reaction by CPA in AD may be a reflection of different cognitive resources including body schema self-perception, visual motion, depth perception, or a different state of fear and/or anxiety. PMID:27489559

Initial Parameters of Neutron Stars

NASA Astrophysics Data System (ADS)

Popov, S. B.; Turolla, R.

2012-12-01

A subpopulation of neutron stars (NSs), known as central compact objects (CCOs) in supernova remnants, are suspected to be low-field objects basing on P - ṗ measurements for three of them. The birth rate of low-field NSs is probably comparable with the birth rate of normal radio pulsars. However, among compact objects in High-Mass X-ray Binaries (HMXBs) we do not see robust candidates for low-field NSs. We propose that this contradiction can be solved if magnetic fields of CCOs was buried due to strong fall-back, and then the field emerges on the time scale 104 -105 yrs.

Elliptic Flow of Identified Hadrons in Au+Au Collisions at (sNN)=200 GeV

NASA Astrophysics Data System (ADS)

Adler, S. S.; Afanasiev, S.; Aidala, C.; Ajitanand, N. N.; Akiba, Y.; Alexander, J.; Amirikas, R.; Aphecetche, L.; Aronson, S. H.; Averbeck, R.; Awes, T. C.; Azmoun, R.; Babintsev, V.; Baldisseri, A.; Barish, K. N.; Barnes, P. D.; Bassalleck, B.; Bathe, S.; Batsouli, S.; Baublis, V.; Bazilevsky, A.; Belikov, S.; Berdnikov, Y.; Bhagavatula, S.; Boissevain, J. G.; Borel, H.; Borenstein, S.; Brooks, M. L.; Brown, D. S.; Bruner, N.; Bucher, D.; Buesching, H.; Bumazhnov, V.; Bunce, G.; Burward-Hoy, J. M.; Butsyk, S.; Camard, X.; Chai, J.-S.; Chand, P.; Chang, W. C.; Chernichenko, S.; Chi, C. Y.; Chiba, J.; Chiu, M.; Choi, I. J.; Choi, J.; Choudhury, R. K.; Chujo, T.; Cianciolo, V.; Cobigo, Y.; Cole, B. A.; Constantin, P.; D'Enterria, D. G.; David, G.; Delagrange, H.; Denisov, A.; Deshpande, A.; Desmond, E. J.; Dietzsch, O.; Drapier, O.; Drees, A.; Du Rietz, R.; Durum, A.; Dutta, D.; Efremenko, Y. V.; El Chenawi, K.; Enokizono, A.; En'yo, H.; Esumi, S.; Ewell, L.; Fields, D. E.; Fleuret, F.; Fokin, S. L.; Fox, B. D.; Fraenkel, Z.; Frantz, J. E.; Franz, A.; Frawley, A. D.; Fung, S.-Y.; Garpman, S.; Ghosh, T. K.; Glenn, A.; Gogiberidze, G.; Gonin, M.; Gosset, J.; Goto, Y.; Granier de Cassagnac, R.; Grau, N.; Greene, S. V.; Grosse Perdekamp, M.; Guryn, W.; Gustafsson, H.-Å.; Hachiya, T.; Haggerty, J. S.; Hamagaki, H.; Hansen, A. G.; Hartouni, E. P.; Harvey, M.; Hayano, R.; He, X.; Heffner, M.; Hemmick, T. K.; Heuser, J. M.; Hibino, M.; Hill, J. C.; Holzmann, W.; Homma, K.; Hong, B.; Hoover, A.; Ichihara, T.; Ikonnikov, V. V.; Imai, K.; Isenhower, L. D.; Ishihara, M.; Issah, M.; Isupov, A.; Jacak, B. V.; Jang, W. Y.; Jeong, Y.; Jia, J.; Jinnouchi, O.; Johnson, B. M.; Johnson, S. C.; Joo, K. S.; Jouan, D.; Kametani, S.; Kamihara, N.; Kang, J. H.; Kapoor, S. S.; Katou, K.; Kelly, S.; Khachaturov, B.; Khanzadeev, A.; Kikuchi, J.; Kim, D. H.; Kim, D. J.; Kim, D. W.; Kim, E.; Kim, G.-B.; Kim, H. J.; Kistenev, E.; Kiyomichi, A.; Kiyoyama, K.; Klein-Boesing, C.; Kobayashi, H.; Kochenda, L.; Kochetkov, V.; Koehler, D.; Kohama, T.; Kopytine, M.; Kotchetkov, D.; Kozlov, A.; Kroon, P. J.; Kuberg, C. H.; Kurita, K.; Kuroki, Y.; Kweon, M. J.; Kwon, Y.; Kyle, G. S.; Lacey, R.; Ladygin, V.; Lajoie, J. G.; Lebedev, A.; Leckey, S.; Lee, D. M.; Lee, S.; Leitch, M. J.; Li, X. H.; Lim, H.; Litvinenko, A.; Liu, M. X.; Liu, Y.; Maguire, C. F.; Makdisi, Y. I.; Malakhov, A.; Manko, V. I.; Mao, Y.; Martinez, G.; Marx, M. D.; Masui, H.; Matathias, F.; Matsumoto, T.; McGaughey, P. L.; Melnikov, E.; Messer, F.; Miake, Y.; Milan, J.; Miller, T. E.; Milov, A.; Mioduszewski, S.; Mischke, R. E.; Mishra, G. C.; Mitchell, J. T.; Mohanty, A. K.; Morrison, D. P.; Moss, J. M.; Mühlbacher, F.; Mukhopadhyay, D.; Muniruzzaman, M.; Murata, J.; Nagamiya, S.; Nagle, J. L.; Nakamura, T.; Nandi, B. K.; Nara, M.; Newby, J.; Nilsson, P.; Nyanin, A. S.; Nystrand, J.; O'Brien, E.; Ogilvie, C. A.; Ohnishi, H.; Ojha, I. D.; Okada, K.; Ono, M.; Onuchin, V.; Oskarsson, A.; Otterlund, I.; Oyama, K.; Ozawa, K.; Pal, D.; Palounek, A. P.; Pantuev, V. S.; Papavassiliou, V.; Park, J.; Parmar, A.; Pate, S. F.; Peitzmann, T.; Peng, J.-C.; Peresedov, V.; Pinkenburg, C.; Pisani, R. P.; Plasil, F.; Purschke, M. L.; Purwar, A.; Rak, J.; Ravinovich, I.; Read, K. F.; Reuter, M.; Reygers, K.; Riabov, V.; Riabov, Y.; Roche, G.; Romana, A.; Rosati, M.; Rosnet, P.; Ryu, S. S.; Sadler, M. E.; Saito, N.; Sakaguchi, T.; Sakai, M.; Sakai, S.; Samsonov, V.; Sanfratello, L.; Santo, R.; Sato, H. D.; Sato, S.; Sawada, S.; Schutz, Y.; Semenov, V.; Seto, R.; Shaw, M. R.; Shea, T. K.; Shibata, T.-A.; Shigaki, K.; Shiina, T.; Silva, C. L.; Silvermyr, D.; Sim, K. S.; Singh, C. P.; Singh, V.; Sivertz, M.; Soldatov, A.; Soltz, R. A.; Sondheim, W. E.; Sorensen, S. P.; Sourikova, I. V.; Staley, F.; Stankus, P. W.; Stenlund, E.; Stepanov, M.; Ster, A.; Stoll, S. P.; Sugitate, T.; Sullivan, J. P.; Takagui, E. M.; Taketani, A.; Tamai, M.; Tanaka, K. H.; Tanaka, Y.; Tanida, K.; Tannenbaum, M. J.; Tarján, P.; Tepe, J. D.; Thomas, T. L.; Tojo, J.; Torii, H.; Towell, R. S.; Tserruya, I.; Tsuruoka, H.; Tuli, S. K.; Tydesjö, H.; Tyurin, N.; van Hecke, H. W.; Velkovska, J.; Velkovsky, M.; Villatte, L.; Vinogradov, A. A.; Volkov, M. A.; Vznuzdaev, E.; Wang, X. R.; Watanabe, Y.; White, S. N.; Wohn, F. K.; Woody, C. L.; Xie, W.; Yang, Y.; Yanovich, A.; Yokkaichi, S.; Young, G. R.; Yushmanov, I. E.; Zajc, W. A.; Zhang, C.; Zhou, S.; Zolin, L.

2003-10-01

The anisotropy parameter (v2), the second harmonic of the azimuthal particle distribution, has been measured with the PHENIX detector in Au+Au collisions at (sNN)=200 GeV for identified and inclusive charged particle production at central rapidities (|η|<0.35) with respect to the reaction plane defined at high rapidities (|η|=3 4 ). We observe that the v2 of mesons falls below that of (anti)baryons for pT>2 GeV/c, in marked contrast to the predictions of a hydrodynamical model. A quark-coalescence model is also investigated.

130. FORKS DIVERSION, HIGH LINE AND LOW LINE CANALS, TWIN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

130. FORKS DIVERSION, HIGH LINE AND LOW LINE CANALS, TWIN FALLS COUNTY, SOUTH OF HANSEN, IDAHO; OUTLET SIDE OF THE HIGH LINE GATES, NORTH VIEW. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Chapter 7: Precipitation Change in the United States

NASA Technical Reports Server (NTRS)

Easterling, D. R.; Kunkel, K. E.; Arnold, J. R.; Knutson, T.; LeGrande, A. N.; Leung, L. R.; Vose, R. S.; Waliser, D. E.; Wehner, M. F.

2017-01-01

Annual precipitation has decreased in much of the West, Southwest, and Southeast and increased in most of the Northern and Southern Plains, Midwest, and Northeast. A national average increase of 4% in annual precipitation since 1901 is mostly a result of large increases in the fall season. Heavy precipitation events in most parts of the United States have increased in both intensity and frequency since 1901. There are important regional differences in trends, with the largest increases occurring in the northeastern United States. In particular, mesoscale convective systems (organized clusters of thunderstorms)-the main mechanism for warm season precipitation in the central part of the United States-have increased in occurrence and precipitation amounts since 1979. The frequency and intensity of heavy precipitation events are projected to continue to increase over the 21st century (high confidence). Mesoscale convective systems in the central United States are expected to continue to increase in number and intensity in the future. There are, however, important regional and seasonal differences in projected changes in total precipitation: the northern United States, including Alaska, is projected to receive more precipitation in the winter and spring, and parts of the southwestern United States are projected to receive less precipitation in the winter and spring. Northern Hemisphere spring snow cover extent, North America maximum snow depth, snow water equivalent in the western United States, and extreme snowfall years in the southern and western United States have all declined, while extreme snowfall years in parts of the northern United States have increased. Projections indicate large declines in snowpack in the western United States and shifts to more precipitation falling as rain than snow in the cold season in many parts of the central and eastern United States.

Assessment of the risk of fall, related to visual stimulation, in patients with central vestibular disorders.

PubMed

Suárez, H; Musé, P; Suárez, A; Arocena, M

2001-01-01

In order to assess the influence of visual stimulation in the triggering of imbalance and falls in the elderly population, the postural responses of 18 elderly patients with central vestibular disorders and clinical evidence of instability and falls were studied while receiving different types of visual stimuli. The stimulation conditions were: (i) no specific stimuli; (ii) smooth pursuit with pure sinusoids of 0.2 Hz as foveal stimulation; and (iii) optokinetic stimulation (OK) as retinal stimuli. Using a platform AMTI Accusway platform, the 95% confidence ellipse (CE) and sway velocity (SV) were evaluated with a scalogram using wavelets in order to assess the relationship between time and frequency in postural control. Velocity histograms were also constructed in order to observe the distribution of velocity values during the recording. A non-homogeneous postural behavior after visual stimulation was found among this population. In five of the patients the OK stimulation generated: (i) significantly higher average values of CE ( > 3.4+/-0.69 cm2); (ii) a significant increase in the average values of the SV ( > 3.89+/-1.15 cm/s) and a velocity histogram with a homogeneous distribution between 0 and 18 cm/s; and (iii) a scalogram with sway frequencies of up to 4 Hz distributed in both the X and Y directions (backwards and forwards and lateral) during visual stimulation with arbitrary units of energy density > 5. These three qualitative and quantitative aspects could be "markers" of visual dependence in the triggering of the mechanism of lack of equilibrium and hence falls in some elderly patients and should be considered in order to prevent falls and also to assist in the rehabilitation program of these patients.

Tropical cyclone induced asymmetry of sea level surge and fall and its presentation in a storm surge model with parametric wind fields

NASA Astrophysics Data System (ADS)

Peng, Machuan; Xie, Lian; Pietrafesa, Leonard J.

The asymmetry of tropical cyclone induced maximum coastal sea level rise (positive surge) and fall (negative surge) is studied using a three-dimensional storm surge model. It is found that the negative surge induced by offshore winds is more sensitive to wind speed and direction changes than the positive surge by onshore winds. As a result, negative surge is inherently more difficult to forecast than positive surge since there is uncertainty in tropical storm wind forecasts. The asymmetry of negative and positive surge under parametric wind forcing is more apparent in shallow water regions. For tropical cyclones with fixed central pressure, the surge asymmetry increases with decreasing storm translation speed. For those with the same translation speed, a weaker tropical cyclone is expected to gain a higher AI (asymmetry index) value though its induced maximum surge and fall are smaller. With fixed RMW (radius of maximum wind), the relationship between central pressure and AI is heterogeneous and depends on the value of RMW. Tropical cyclone's wind inflow angle can also affect surge asymmetry. A set of idealized cases as well as two historic tropical cyclones are used to illustrate the surge asymmetry.

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

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use - a qualitative study.

PubMed

Bell, Hege Therese; Steinsbekk, Aslak; Granas, Anne Gerd

2017-09-01

The aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use. A qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation. The main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician's choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician. Elderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs.

Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people.

PubMed

Caetano, Maria Joana D; Lord, Stephen R; Brodie, Matthew A; Schoene, Daniel; Pelicioni, Paulo H S; Sturnieks, Daina L; Menant, Jasmine C

2018-01-01

Reduced ability to adapt gait, particularly under challenging conditions, may be an important reason why older adults have an increased risk of falling. This study aimed to identify cognitive, psychological and physical mediators of the relationship between impaired gait adaptability and fall risk in older adults. Fifty healthy older adults (mean±SD: 74±7years) were categorised as high or low fall risk, based on past falls and their performance in the Physiological Profile Assessment. High and low-risk groups were then compared in the gait adaptability test, i.e. an assessment of the ability to adapt gait in response to obstacles and stepping targets under single and dual task conditions. Quadriceps strength, concern about falling and executive function were also measured. The older adults who made errors on the gait adaptability test were 4.76 (95%CI=1.08-20.91) times more likely to be at high risk of falling. Furthermore, each standard deviation reduction in gait speed while approaching the targets/obstacle increased the odds of being at high risk of falling approximately three fold: single task - OR=3.10,95%CI=1.43-6.73; dual task - 3.42,95%CI=1.56-7.52. Executive functioning, concern about falling and quadriceps strength substantially mediated the relationship between the gait adaptability measures and fall risk status. Impaired gait adaptability is associated with high risk of falls in older adults. Reduced executive function, increased concern about falling and weaker quadriceps strength contribute significantly to this relationship. Training gait adaptability directly, as well as addressing the above mediators through cognitive, behavioural and physical training may maximise fall prevention efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

Thermodynamics in landscape ecology: The importance of integrating measurement and modeling of landscape entropy

Treesearch

Samuel A. Cushman

2015-01-01

Entropy and the second law of thermodynamics are the central organizing principles of nature. Or perhaps more accurately, the second law is the central disorganizing principle. Hot things cool down. Cold things warm up. You cannot get something for nothing. You always pay more than you get. Things fall apart. You cannot repeat the past. We grow old and die. It is all...

Evaluation of Accelerometer-Based Fall Detection Algorithms on Real-World Falls

PubMed Central

Bagalà, Fabio; Becker, Clemens; Cappello, Angelo; Chiari, Lorenzo; Aminian, Kamiar; Hausdorff, Jeffrey M.; Zijlstra, Wiebren; Klenk, Jochen

2012-01-01

Despite extensive preventive efforts, falls continue to be a major source of morbidity and mortality among elderly. Real-time detection of falls and their urgent communication to a telecare center may enable rapid medical assistance, thus increasing the sense of security of the elderly and reducing some of the negative consequences of falls. Many different approaches have been explored to automatically detect a fall using inertial sensors. Although previously published algorithms report high sensitivity (SE) and high specificity (SP), they have usually been tested on simulated falls performed by healthy volunteers. We recently collected acceleration data during a number of real-world falls among a patient population with a high-fall-risk as part of the SensAction-AAL European project. The aim of the present study is to benchmark the performance of thirteen published fall-detection algorithms when they are applied to the database of 29 real-world falls. To the best of our knowledge, this is the first systematic comparison of fall detection algorithms tested on real-world falls. We found that the SP average of the thirteen algorithms, was (mean±std) 83.0%±30.3% (maximum value = 98%). The SE was considerably lower (SE = 57.0%±27.3%, maximum value = 82.8%), much lower than the values obtained on simulated falls. The number of false alarms generated by the algorithms during 1-day monitoring of three representative fallers ranged from 3 to 85. The factors that affect the performance of the published algorithms, when they are applied to the real-world falls, are also discussed. These findings indicate the importance of testing fall-detection algorithms in real-life conditions in order to produce more effective automated alarm systems with higher acceptance. Further, the present results support the idea that a large, shared real-world fall database could, potentially, provide an enhanced understanding of the fall process and the information needed to design and evaluate a high-performance fall detector. PMID:22615890

Note: Four-port microfluidic flow-cell with instant sample switching

NASA Astrophysics Data System (ADS)

MacGriff, Christopher A.; Wang, Shaopeng; Tao, Nongjian

2013-10-01

A simple device for high-speed microfluidic delivery of liquid samples to a surface plasmon resonance sensor surface is presented. The delivery platform is comprised of a four-port microfluidic cell, two ports serve as inlets for buffer and sample solutions, respectively, and a high-speed selector valve to control the alternate opening and closing of the two outlet ports. The time scale of buffer/sample switching (or sample injection rise and fall time) is on the order of milliseconds, thereby minimizing the opportunity for sample plug dispersion. The high rates of mass transport to and from the central microfluidic sensing region allow for SPR-based kinetic analysis of binding events with dissociation rate constants (kd) up to 130 s-1. The required sample volume is only 1 μL, allowing for minimal sample consumption during high-speed kinetic binding measurement.

Frequency and volumes of ignimbrite eruptions following the Late Neogene initiation of the Central Oregon High Cascades

NASA Astrophysics Data System (ADS)

Pitcher, Bradley W.; Kent, Adam J. R.; Grunder, Anita L.; Duncan, Robert A.

2017-06-01

The late Neogene Deschutes Formation of central Oregon preserves a remarkable volcanic and sedimentary record of the initial stages of High Cascades activity following an eastward shift in the locus of volcanism at 7.5 Ma. Numerous ignimbrite and tephra-fall units are contained within the formation, and since equivalent deposits are relatively rare for the Quaternary Cascades, the eruptions of the earliest High Cascade volcanoes were likely more explosive than those of the Quaternary arc. In this study, the timing and frequency of eruptions which produced 14 laterally extensive marker ignimbrites within the Deschutes Formation are established using 40Ar/39Ar geochronology. Plagioclase 40Ar/39Ar ages for the lowermost (6.25 ± 0.07 Ma) and uppermost (5.45 ± 0.04 Ma) marker ignimbrites indicate that all major explosive eruptions within the Deschutes Formation occurred within a period of 800 ± 54 k.y. (95% confidence interval). Minimum estimates for the volumes of the 14 ignimbrites, using an ArcGIS-based method, range from 1.0 to 9.4 km3 and have a total volume of 62.5 km3. Taken over the 50 km of arc length, the explosive volcanic production rate of the central Oregon High Cascades during Deschutes Formation time was a minimum of 1.8 km3/m.y./km of arc length. By including estimates of the volumes of tephra-fall components, as well as ignimbrites that may have traveled west, we estimate a total volume range, for these 14 eruptions alone, of 188 to 363 km3 ( 121 to 227 km3 DRE), a rate of 4.7-9.1 km3/m.y./km arc length. This explosive volcanic production rate is much higher than the average Quaternary eruption rates, of all compositions, estimated for the entire Cascade arc (1.5-2.5), Alaska Peninsula segment of the Aleutian arc (0.6-1.0), and the Andean southern volcanic zone (1.1-2.0). We suggest that this atypical explosive pulse may result from the onset of regional extension and migration of the magmatic arc, which had the combined effect of increasing magmatic flux and temporarily enhancing melting of more fusible crust.

Improving prediction of fall risk among nursing home residents using electronic medical records.

PubMed

Marier, Allison; Olsho, Lauren E W; Rhodes, William; Spector, William D

2016-03-01

Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Improving the Method of Roof Fall Susceptibility Assessment based on Fuzzy Approach

NASA Astrophysics Data System (ADS)

Ghasemi, Ebrahim; Ataei, Mohammad; Shahriar, Kourosh

2017-03-01

Retreat mining is always accompanied by a great amount of accidents and most of them are due to roof fall. Therefore, development of methodologies to evaluate the roof fall susceptibility (RFS) seems essential. Ghasemi et al. (2012) proposed a systematic methodology to assess the roof fall risk during retreat mining based on risk assessment classic approach. The main defect of this method is ignorance of subjective uncertainties due to linguistic input value of some factors, low resolution, fixed weighting, sharp class boundaries, etc. To remove this defection and improve the mentioned method, in this paper, a novel methodology is presented to assess the RFS using fuzzy approach. The application of fuzzy approach provides an effective tool to handle the subjective uncertainties. Furthermore, fuzzy analytical hierarchy process (AHP) is used to structure and prioritize various risk factors and sub-factors during development of this method. This methodology is applied to identify the susceptibility of roof fall occurrence in main panel of Tabas Central Mine (TCM), Iran. The results indicate that this methodology is effective and efficient in assessing RFS.

Energy and information near black hole horizons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Freivogel, Ben, E-mail: benfreivogel@gmail.com

2014-07-01

The central challenge in trying to resolve the firewall paradox is to identify excitations in the near-horizon zone of a black hole that can carry information without injuring a freely falling observer. By analyzing the problem from the point of view of a freely falling observer, I arrive at a simple proposal for the degrees of freedom that carry information out of the black hole. An infalling observer experiences the information-carrying modes as ingoing, negative energy excitations of the quantum fields. In these states, freely falling observers who fall in from infinity do not encounter a firewall, but freely fallingmore » observers who begin their free fall from a location close to the horizon are ''frozen'' by a flux of negative energy. When the black hole is ''mined,'' the number of information-carrying modes increases, increasing the negative energy flux in the infalling frame without violating the equivalence principle. Finally, I point out a loophole in recent arguments that an infalling observer must detect a violation of unitarity, effective field theory, or free infall.« less

Rapid settlement of Majuro Atoll, central Pacific, following its emergence at 2000 years CalBP

NASA Astrophysics Data System (ADS)

Kayanne, Hajime; Yasukochi, Toru; Yamaguchi, Toru; Yamano, Hiroya; Yoneda, Minoru

2011-10-01

Atoll islands are areas of low, flat land, and the sustainability of habitable land in such environments is sensitive to even slight changes in sea level. The projected rise in sea level during this century may lead to the submergence of atoll islands and the widespread loss of habitable land. However, the actual time sequence of past sea level change, island emergence events, and human settlement of newly emerged islands remain poorly constrained. The results of geomorphological and archaeological surveys, combined with calibrated radiocarbon age dates, at Majuro Atoll, Marshall Islands, central Pacific, reveal that the emergence of the island, triggered by a fall in sea level, was quickly followed by human settlement. The elevation of the central body of the island exceeded high water level at 2000 years CalBP, and the complete formation of the island occurred within an interval of 100 years. The island was colonized by people shortly after emergence, at 2000 years CalBP, prior to the establishment of dense vegetation, and has been continuously settled since that time.

Assessment of bird populations in a high quality savanna/woodland: a banding approach

USGS Publications Warehouse

Wilmore, Sandra L.; Glowacki, Gary A.; Grundel, Ralph

2005-01-01

During the course of this six year study, the fall migration capture rate declined significantly, suggesting that reduced productivity may have occurred in bird populations. There was a positive response during the spring migration to earlier spring wildfires, indicated by high capture rates in 2000 and 2002 that corresponded with fires affecting most of the bird banding net locations. For several common species found at the Miller Woods site, the ratio of juveniles to adults was compared to ratios at other banding stations in the north central U.S. Breeding site fidelity was documented for 20 species, all common breeders. Variation in capture rates among net locations demonstrated the role of the shrub layer within the savanna habitat mosaic during migration stopover.

Exercise for reducing fear of falling in older people living in the community.

PubMed

Kendrick, Denise; Kumar, Arun; Carpenter, Hannah; Zijlstra, G A Rixt; Skelton, Dawn A; Cook, Juliette R; Stevens, Zoe; Belcher, Carolyn M; Haworth, Deborah; Gawler, Sheena J; Gage, Heather; Masud, Tahir; Bowling, Ann; Pearl, Mirilee; Morris, Richard W; Iliffe, Steve; Delbaere, Kim

2014-11-28

Fear of falling is common in older people and associated with serious physical and psychosocial consequences. Exercise (planned, structured, repetitive and purposive physical activity aimed at improving physical fitness) may reduce fear of falling by improving strength, gait, balance and mood, and reducing the occurrence of falls. To assess the effects (benefits, harms and costs) of exercise interventions for reducing fear of falling in older people living in the community. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (July 2013), the Central Register of Controlled Trials (CENTRAL 2013, Issue 7), MEDLINE (1946 to July Week 3 2013), EMBASE (1980 to 2013 Week 30), CINAHL (1982 to July 2013), PsycINFO (1967 to August 2013), AMED (1985 to August 2013), the World Health Organization International Clinical Trials Registry Platform (accessed 7 August 2013) and Current Controlled Trials (accessed 7 August 2013). We applied no language restrictions. We handsearched reference lists and consulted experts. We included randomised and quasi-randomised trials that recruited community-dwelling people (where the majority were aged 65 and over) and were not restricted to specific medical conditions (e.g. stroke, hip fracture). We included trials that evaluated exercise interventions compared with no intervention or a non-exercise intervention (e.g. social visits), and that measured fear of falling. Exercise interventions were varied; for example, they could be 'prescriptions' or recommendations, group-based or individual, supervised or unsupervised. Pairs of review authors independently assessed studies for inclusion, assessed the risk of bias in the studies and extracted data. We combined effect sizes across studies using the fixed-effect model, with the random-effect model used where significant statistical heterogeneity was present. We estimated risk ratios (RR) for dichotomous outcomes and incidence rate ratios (IRR) for rate outcomes. We estimated mean differences (MD) where studies used the same continuous measures and standardised mean differences (SMD) where different measures or different formats of the same measure were used. Where possible, we performed various, usually prespecified, sensitivity and subgroup analyses. We included 30 studies, which evaluated 3D exercise (Tai Chi and yoga), balance training or strength and resistance training. Two of these were cluster-randomised trials, two were cross-over trials and one was quasi-randomised. The studies included a total of 2878 participants with a mean age ranging from 68 to 85 years. Most studies included more women than men, with four studies recruiting women only. Twelve studies recruited participants at increased risk of falls; three of these recruited participants who also had fear of falling.Poor reporting of the allocation methods in the trials made it difficult to assess the risk of selection bias in most studies. All of the studies were at high risk of performance and detection biases as there was no blinding of participants and outcome assessors and the outcomes were self reported. Twelve studies were at high risk of attrition bias. Using GRADE criteria, we judged the quality of evidence to be 'low' for fear of falling immediately post intervention and 'very low' for fear of falling at short or long-term follow-up and all other outcomes.Exercise interventions were associated with a small to moderate reduction in fear of falling immediately post intervention (SMD 0.37 favouring exercise, 95% confidence interval (CI) 0.18 to 0.56; 24 studies; 1692 participants, low quality evidence). Pooled effect sizes did not differ significantly between the different scales used to measure fear of falling. Although none of the sensitivity analyses changed the direction of effect, the greatest reduction in the size of the effect was on removal of an extreme outlier study with 73 participants (SMD 0.24 favouring exercise, 95% CI 0.12 to 0.36). None of our subgroup analyses provided robust evidence of differences in effect in terms of either the study primary aim (reduction of fear of falling or other aim), the study population (recruitment on the basis of increased falls risk or not), the characteristics of the study exercise intervention or the study control intervention (no treatment or alternative intervention). However, there was some weak evidence of a smaller effect, which included no reduction, of exercise when compared with an alternative control.There was very low quality evidence that exercise interventions may be associated with a small reduction in fear of falling up to six months post intervention (SMD 0.17, 95% CI -0.05 to 0.38; four studies, 356 participants) and more than six months post intervention (SMD 0.20, 95% CI -0.01 to 0.41; three studies, 386 participants).Very low quality evidence suggests exercise interventions in these studies that also reported on fear of falling reduced the risk of falling measured either as participants incurring at least one fall during follow-up or the number of falls during follow-up. Very low quality evidence from four studies indicated that exercise interventions did not appear to reduce symptoms of depression or increase physical activity. The only study reporting the effects of exercise interventions on anxiety found no difference between groups. No studies reported the effects of exercise interventions on activity avoidance or costs. It is important to remember that our included studies do not represent the totality of the evidence of the effect of exercise interventions on falls, depression, anxiety or physical activity as our review only includes studies that reported fear of falling. Exercise interventions in community-dwelling older people probably reduce fear of falling to a limited extent immediately after the intervention, without increasing the risk or frequency of falls. There is insufficient evidence to determine whether exercise interventions reduce fear of falling beyond the end of the intervention or their effect on other outcomes. Although further evidence from well-designed randomised trials is required, priority should be given to establishing a core set of outcomes that includes fear of falling for all trials examining the effects of exercise interventions in older people living in the community.

The Complex Association Between Fear of Falling and Mobility Limitation in Relation to Late-Life Falls: A SHARE-Based Analysis.

PubMed

Litwin, Howard; Erlich, Bracha; Dunsky, Ayelet

2018-07-01

This study examines fear of falling (FOF) in relation to falls in light of mobility limitation. Data on community-dwelling older Europeans, aged 65+, were drawn from two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). The analysis regressed fall status in 2013 on reported FOF 2 to 3 years earlier, controlling for previous falls. FOF predicted subsequent falls when mobility limitation was low to moderate. However, the effect of FOF on fall probability was reversed when mobility limitation was high. The analysis underscores a complex association between FOF and mobility limitation in relation to late-life falls. People who are worried about falling tend to fall more. Those having high mobility limitation but lacking FOF are also more likely to fall. In cases of considerable mobility limitation, FOF may act as a protective buffer. The less worried in this group, however, may be subject to greater falling, and thus require greater attention.

Prevention of fall incidents in patients with a high risk of falling: design of a randomised controlled trial with an economic evaluation of the effect of multidisciplinary transmural care

PubMed Central

Peeters, Geeske MEE; de Vries, Oscar J; Elders, Petra JM; Pluijm, Saskia MF; Bouter, Lex M; Lips, Paul

2007-01-01

Background Annually, about 30% of the persons of 65 years and older falls at least once and 15% falls at least twice. Falls often result in serious injuries, such as fractures. Therefore, the prevention of accidental falls is necessary. The aim is to describe the design of a study that evaluates the efficacy and cost-effectiveness of a multidisciplinary assessment and treatment of multiple fall risk factors in independently living older persons with a high risk of falling. Methods/Design The study is designed as a randomised controlled trial (RCT) with an economic evaluation. Independently living persons of 65 years and older who recently experienced a fall are interviewed in their homes and screened for risk of recurrent falling using a validated fall risk profile. Persons at low risk of recurrent falling are excluded from the RCT. Persons who have a high risk of recurrent falling are blindly randomised into an intervention (n = 100) or usual care (n = 100) group. The intervention consists of a multidisciplinary assessment and treatment of multifactorial fall risk factors. The transmural multidisciplinary appraoch entails close cooperation between geriatrician, primary care physician, physical therapist and occupational therapist and can be extended with other specialists if relevant. A fall calendar is used to record falls during one year of follow-up. Primary outcomes are time to first and second falls. Three, six and twelve months after the home visit, questionnaires for economic evaluation are completed. After one year, during a second home visit, the secondary outcome measures are reassessed and the adherence to the interventions is evaluated. Data will be analysed according to the intention-to-treat principle and also an on-treatment analysis will be performed. Discussion Strengths of this study are the selection of persons at high risk of recurrent falling followed by a multidisciplinary intervention, its transmural character and the evaluation of adherence. If proven effective, implementation of our multidisciplinary assessment followed by treatment of fall risk factors will reduce the incidence of falls. Trial registration Current Controlled Trials ISRCTN11546541. PMID:17605771

131. FORKS DIVERSION, HIGH LINE AND LOW LINE CANALS, TWIN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

131. FORKS DIVERSION, HIGH LINE AND LOW LINE CANALS, TWIN FALLS COUNTY, SOUTH OF HANSEN, IDAHO; INLET SIDE OF LOW LINE CANAL, WEST VIEW. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

133. FORKS DIVERSION, HIGH LINE AND LOW LINE CANALS, TWIN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

133. FORKS DIVERSION, HIGH LINE AND LOW LINE CANALS, TWIN FALLS COUNTY, SOUTH OF HANSEN, IDAHO; VIEW OF OUTLET SIDE OF LOW LINE GATES. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Prismatic displacement effect of progressive multifocal glasses on reaction time and accuracy in elderly people

PubMed Central

Ellison, Ashton C; Campbell, A John; Robertson, M Clare; Sanderson, Gordon F

2014-01-01

Background Multifocal glasses (bifocals, trifocals, and progressives) increase the risk of falling in elderly people, but how they do so is unclear. To explain why glasses with progressive addition lenses increase the risk of falls and whether this can be attributed to false projection, this study aimed to 1) map the prismatic displacement of a progressive lens, and 2) test whether this displacement impaired reaction time and accuracy. Methods The reaction times of healthy ≥75-year-olds (31 participants) were measured when grasping for a bar and touching a black line. Participants performed each test twice, wearing their progressives and new, matched single vision (distance) glasses in random order. The line and bar targets were positioned according to the maximum and minimum prismatic displacement effect through the progressive lens, mapped using a focimeter. Results Progressive spectacle lenses have large areas of prismatic displacement in the central visual axis and edges. Reaction time was faster for progressives compared with single vision glasses with a centrally-placed horizontal grab bar (mean difference 101 ms, P=0.011 [repeated measures analysis]) and a horizontal black line placed 300 mm below center (mean difference 80 ms, P=0.007). There was no difference in accuracy between the two types of glasses. Conclusion Older people appear to adapt to the false projection of progressives in the central visual axis. This adaptation means that swapping to new glasses or a large change in prescription may lead to a fall. Frequently updating glasses may be more beneficial. PMID:24872674

Lumber grade recovery from young ponderosa pine.

Treesearch

James E. Sowder

1953-01-01

Young ponderosa pine produces a good grade of common lumber, and close-grown trees produce better grades than those which were open-grown. This was shown by a study at the Pringle Falls Experimental Forest near Lapine in central Oregon.

Patient Safety Learning Laboratory: Making Acute Care More Patient-Centered

ClinicalTrials.gov

2017-03-22

Central Line-Associated Bloodstream Infection (CLABSI); Venous Thromboembolism; Patient Fall; Catheter-Associated Infection; Severe Hypoglycemia; Opioid-Related Severe Adverse Drug Event; Hospital Acquired Pressure Ulcer; Adverse Drug Event; Severe Hospital Acquired Delerium; Rapid Response Related to Arrhythmia

Climbing in the high volcanoes of central Mexico

USGS Publications Warehouse

Secor, R. J.

1984-01-01

A chain of volcanoes extends across central Mexico along the 19th parallel, a line just south of Mexico City. The westernmost of these peaks is Nevado de Colima at 4,636 feet above sea level. A subsidiary summit of Nevado de Colima is Volcan de Colima, locally called Fuego (fire) it still emits sulphurous fumes and an occasional plume of smoke since its disastrous eruption in 1941. Parictuin, now dormant, was born in the fall of 1943 when a cornfield suddenly erupted. Within 18 months, the cone grew more than 1,700 feet. Nevado de Toluca is a 15,433-foot volcanic peak south of the city of Toluca. Just southeast of Mexico City are two high volcanoes that are permanently covered by snow: Iztaccihuatl (17,342 fet) and Popocatepetl (17,887 feet) Further east is the third highest mountain in North America: 18,700-foot Citlateptl, or El Pico de Orizaba. North of these high peaks are two volcanoes, 14, 436-foot La Malinche and Cofre de Perote at 14,048 feet. This range of mountains is known variously as the Cordillera de Anahuac, the Sierra Volcanica Transversal, or the Cordillera Neovolcanica. 

Central Nervous System Medication Burden and Serious Falls in Older Nursing Home Residents

PubMed Central

Hanlon, Joseph T.; Zhao, Xinhua; Naples, Jennifer G.; Aspinall, Sherrie L.; Perera, Subashan; Nace, David A.; Castle, Nicholas G.; Greenspan, Susan L.; Thorpe, Carolyn T.

2016-01-01

Objectives To examine the association between CNS medication burden and serious falls in those with a recent fall history. Design Nested-case control study; cases matched to four controls by age, gender, and date. Setting US nursing homes Participants 5,556 residents age ≥ 65 with a recent fall history admitted to a nursing home between 1/1–9/30/2010 and followed until discharge, death, or 12/31/2010. Measurements Outcome was serious falls as per Medicare Part A and B ICD/CPT codes. CNS burden, from Medicare Part D data, was calculated by dividing the daily dose of each CNS agent (i.e., specific antidepressants, antiepileptic, antipsychotic, benzodiazepine and opioid receptor agonists) received during the six days prior to the index (outcome) date by the minimum effective geriatric daily dose and summing the results across medications. Results There were 367 cases and 1468 matched controls. Those taking 3+ CNS standardized daily doses were more likely to have a serious fall than those not taking any CNS medications (Adjusted Odds Ratio 1.83; 95% confidence interval 1.35–2.48). There was no significant difference in fall risk for residents taking >0 to <3 CNS standardized daily doses compared to residents taking no CNS medications (Adjusted Odds Ratio 0.85; 95% CI 0.63–1.15). Conclusion CNS medication burden, approximately 3+ standardized daily doses, was associated with an increased risk of serious falls in nursing home residents with recent fall. Clinicians should be vigilant for opportunities to discontinue or decrease the doses of individual CNS medications and/or consider non-pharmacological alternatives. Such interventions that reduce use of CNS medications in nursing homes could reduce fall rates but further research is needed to confirm this. PMID:28152179

United States Air Force Training Extract AFSC 4M0X1 Aerospace Physiology (Active Duty)

DTIC Science & Technology

2002-05-01

Training Emphasis Rating ABOVE AVG = "ABOVE AVERAGE" in Training Emphasis; Tasks that fall between the Mean and 1 SD HIGH...34HIGH" in Training Emphasis; Tasks that fall between 1 SD and 2 SD VERY HIGH = "VERY HIGH" in Training Emphasis; Tasks that fall above...3.97 17 4 28 7 23 28 33 21 5.61 11 fall (PLF) platforms F0209 Instruct or evaluate students during descent

Habitat suitability index models: redhead (wintering)

USGS Publications Warehouse

Howard, Rebecca J.; Kantrud, Harold A.

1983-01-01

The redhead is a North American waterfowl species with economic as well as ecological importance. It is highly desired by hunters. Retrieved redhead kill in the United States averaged 143,000 birds during the three waterfowl seasons from 1975 to 1977 (U.S. Department of the Interior 1981a, 1981b). Populations on the principal breeding grounds of the redhead--the prairie and parkland region of south-central Canada and north-central United States--averaged 710,000 birds from 1955 to 1981 (Bellrose 1976; A. Novara, U.S. Fish and Wildlife Service [USFWS], Jamestown, North Dakota; pers. comm.). Redhead numbers began to decline in the 1960's. Killing redheads became illegal from 1960 to 1963, and strict bag limits were imposed after that (Bellrose 1976). A breeding population low of 387,000 birds occurred in 1963, but prairie populations began to recover after that time. Their numbers peaked in 1980 when 1,146,000 birds were recorded (A. Novara, pers. comm.). During the fall, over a third of the total redhead population uses the migration corridor that extends from the prairie breeding area to the Texas gulf coast. Another migration corridor extends from the second most important breeding area--the Great Salt Basin--to the Texas coast (Bellrose 1976). During the fall, over a third of the total redhead population uses the migration corridor that extends from the prairie breeding area to the Texas gulf coast. Another migration corridor extends from the second most important breeding area--the Great Salt Basin--to the Texas coast (Bellrose 1976).

Does Europe have a centre? Reflections on the history of Western and Central Europe

NASA Astrophysics Data System (ADS)

Mout, Nicolette

2006-05-01

Any definition of Central Europe based on geographical and/or historical facts causes difficulties. The line dividing Europe during the Cold War has a very limited use because it does not take into account Central Europe as a special part of the continent. Historians such as Geoffrey Barraclough, Hugh Seton-Watson and Oskar Halecki discussed the idea of a separate identity of Central Europe during the Cold War. Especially after the fall of the Berlin Wall, this discussion was re-opened. From a historian's point of view, the most important contributions came from Piotr Wandycz and Jeno Szucs. An imaginary centre of Europe can only be found in the continent's common history.

Older fallers attended to by an ambulance but not transported to hospital: a vulnerable population at high risk of future falls.

PubMed

Tiedemann, Anne; Mikolaizak, A Stefanie; Sherrington, Catherine; Segin, Kerrie; Lord, Stephen R; Close, Jacqueline C T

2013-04-01

This prospective cohort study describes older non-transported fallers seen by the Ambulance Service of New South Wales (ASNSW), quantifies the level of risk and identifies predictors of future falls and ambulance use. Participants were 262 people aged 70 years or older with a fall-related ASNSW attendance who were not transported to an emergency department. They completed a questionnaire about health, medical and physical factors previously associated with falling. Falls were monitored for six months after ambulance attendance with monthly fall calendars. Participants had a high prevalence of chronic medical conditions, functional limitations and past falls. During follow-up, 145 participants (58%) experienced 488 falls. Significant predictors of falls during follow-up were three or more falls in the past year, being unable to walk more than 10 minutes without resting, and requiring assistance for personal-care activities of daily living (ADLs). Sixty-two participants (25%) required repeat, fall-related ambulance attendance during the study. Predictors of repeat ambulance use were: 3+ falls in past year, requiring assistance for personal-care ADLs and having disabling pain in past month. Older, non-transported fallers seen by the ASNSW are a vulnerable population with high rates of chronic health conditions. Onward referral for preventive interventions may reduce future falls and ambulance service calls. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Waterbird habitat in California's Central Valley basins under climate, urbanization, and water management scenarios

USGS Publications Warehouse

Matchett, Elliott L.; Fleskes, Joseph

2018-01-01

California's Central Valley provides critical, but threatened habitat and food resources for migrating and wintering waterfowl, shorebirds, and other waterbirds. The Central Valley is comprised of nine basins that were defined by the Central Valley Joint Venture (CVJV) to assist in conservation planning. Basins vary in composition and extent of habitats, which primarily include croplands and wetlands that rely on water supplies shared with other competing human and environmental uses. Changes in climate, urban development, and water supply management are uncertain and could reduce future availability of water supplies supporting waterbird habitats and limit effectiveness of wetland restoration planned by the CVJV to support wintering waterbirds. We modeled 17 plausible scenarios including combinations of three climate projections, three urbanization rates, and five water supply management options to promote agricultural and urban water uses, with and without wetland restoration. Our research examines the reduction in quantity and quality of habitats during the fall migration-wintering period by basin under each scenario, and the efficacy of planned wetland restoration to compensate reductions in flooded areas of wetland habitats. Scenario combinations of projected climate, urbanization, and water supply management options reduced availability of flooded cropland and wetland habitats during fall-winter and degraded the quality of seasonal wetlands (i.e., summer-irrigation for improved forage production), though the extent and frequency of impacts varied by basin. Planned wetland restoration may substantially compensate for scenario-related effects on wetland habitats in each basin. However, results indicate that Colusa, Butte, Sutter, San Joaquin, and Tulare Basins may require additional conservation to support summer-irrigation of seasonal wetlands and winter-flooding of cropland habitats. Still further conservation may be required to provide sufficient areas of flooded seasonal and semi-permanent wetlands in San Joaquin and Tulare Basins during fall-winter. The main objective of this research is to provide decision-support for achieving waterbird conservation goals in the valley and to inform CVJV's regional conservation planning.

Postural stability changes in the elderly with cataract simulation and refractive blur.

PubMed

Anand, Vijay; Buckley, John G; Scally, Andy; Elliott, David B

2003-11-01

To determine the influence of cataractous and refractive blur on postural stability and limb-load asymmetry (LLA) and to establish how postural stability changes with the spatial frequency and contrast of the visual stimulus. Thirteen elderly subjects (mean age, 70.76 +/- 4.14 [SD] years) with no history of falls and normal vision were recruited. Postural stability was determined as the root mean square [RMS] of the center of pressure (COP) signal in the anterior-posterior (A-P) and medial-lateral directions and LLA was determined as the ratio of the average body weight placed on the more-loaded limb to the less-loaded limb, recorded during a 30-second period. Data were collected under normal standing conditions and with somatosensory system input disrupted. Measurements were repeated with four visual targets with high (8 cyc/deg) or low (2 cyc/deg) spatial frequency and high (Weber contrast, approximately 95%) or low (Weber contrast, approximately 25%) contrast. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with cataract simulation. The data were analyzed in a population-averaged linear model. The cataract simulation caused significant increases in postural instability equivalent to that caused by 8-D blur conditions, and its effect was greater when the input from the somatosensory system was disrupted. High spatial frequency targets increased postural instability. Refractive blur, cataract simulation, or eye closure had no effect on LLA. Findings indicate that cataractous and refractive blur increase postural instability, and show why the elderly, many of whom have poor vision along with musculoskeletal and central nervous system degeneration, are at greater risk of falling. Findings also highlight that changes in contrast sensitivity rather than resolution changes are responsible for increasing postural instability. Providing low spatial frequency information in certain environments may be useful in maintaining postural stability. Correcting visual impairment caused by uncorrected refractive error and cataracts could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.

Migration and winter distributions of canvasbacks staging on the Upper Mississippi River

USGS Publications Warehouse

Serie, J.R.; Trauger, D.L.; Sharp, D.E.

1983-01-01

Fall and winter distribution patterns of canvasbacks (Aythya valisineria) staging on the upper Mississippi River near LaCrosse, Wisconsin (navigational Pools 7 and 8) and Keokuk, Iowa (Pool 19) were studied during 1973-77. Sightings and recoveries obtained from 1,488 color-marked males during 1973-75 and 3,789 banded males and females during 1973-77 suggested 2 principal migration corridors: 1 extending eastward from Pools 7 and 8 to the eastern Great Lakes and southeast to the Mid-Atlantic Region and another southward from Pools 7 and 8 to the lower Mississippi Valley, Gulf Coast, and east Texas regions. These discrete populations stage concurrently on Pools 7 and 8 during the fall, but winter in different areas of the Atlantic, Mississippi, and Central flyways. Populations staging on Pool 19 were not discrete from those staging on Pools 7 and 8. A continual turnover of birds passing through these staging areas was indicated. Canvasbacks wintering in the Mississippi and Central flyways were widely dispersed among a variety of habitats, whereas canvasbacks wintering in the Atlantic Flyway were concentrated in a few traditional habitats. Canvasbacks exhibited strong fidelity to wintering areas. Distribution patterns and population attributes of canvasbacks during fall and winter may be explained by the predictability of natural foods and their ability to exploit these foods.

Skeletal effects of central nervous system active drugs: anxiolytics, sedatives, antidepressants, lithium and neuroleptics.

PubMed

Vestergaard, Peter

2008-09-01

Many central nervous system active drugs can alter postural balance, increasing the risk of fractures. Anxiolytics and sedatives include the benzodiazepines, and these have been associated with a limited increase in the risk of fractures, even at low doses, probably from an increased risk of falls. No systematic differences have been shown between benzodiazepines with long and short half-lives. Although the increase in risk of fractures was limited, care must still be taken when prescribing for older fall-prone subjects at risk of osteoporosis. Neuroleptics may be associated with a decrease in bone mineral density and a very limited increase in fracture risk. Antidepressants are associated with a dose-dependent increase in the risk of fractures. The increase in relative risk of fractures seems to be larger with selective serotonin reuptake inhibitors (SSRIs) than with tricyclic antidepressants. The reason for this is not known but may be linked to serotonin effects on bone cells and the risk of falls. With the wide use of SSRIs, more research is needed. Lithium is associated with a decrease in the risk of fractures. This may be linked to its effects on the Wnt glycoprotein family, which is a specialised signalling system for certain cell types.

Clumped Isotope Thermometry Reveals Variations in Soil Carbonate Seasonal Biases Over >4 km of Relief in the Semi-Arid Andes of Central Chile

NASA Astrophysics Data System (ADS)

Burgener, L. K.; Huntington, K. W.; Hoke, G. D.; Schauer, A. J.; Ringham, M. C.; Latorre Hidalgo, C.; Díaz, F.

2015-12-01

The application of carbonate clumped isotope thermometry to soil carbonates has the potential to shed new light on questions regarding terrestrial paleoclimate. In order to better utilize this paleoclimate tool, outstanding questions regarding seasonal biases in soil carbonate formation and the relationship between soil carbonate formation temperatures (T(Δ47)) and surface temperatures must be resolved. We address these questions by comparing C, O, and clumped isotope data from Holocene/modern soil carbonates to modern meteorological data. The data were collected along a 170 km transect with >4 km of relief in central Chile (~30°S). Previous studies have suggested that soil carbonates should record a warm season bias and form in isotopic equilibrium with soil water and soil CO2. We identify two discrete climate zones separated by the local winter snow line (~3200 m). Below this boundary, precipitation falls as rain and soil carbonate T(Δ47) values at depths >40 cm resemble summer soil temperatures; at higher elevations, precipitation falls as snow and T(Δ47) values resemble mean annual soil temperatures. Soil carbonates from the highest sample site (4700 m), which is devoid of vegetation and located near perennial snow fields, yield anomalous δ18O, δ13C, and T(Δ47) values, indicative of kinetic isotope effects that we attribute to cryogenic carbonate formation. Our results suggest that soil carbonates from depths <40 cm are affected by large, high frequency variations in temperature and precipitation, and should not be used as paleotemperature proxies. These findings (1) highlight the role of soil moisture in modulating soil carbonate formation and the resulting T(Δ47) values, (2) underscore the importance of understanding past soil moisture conditions when attempting to reconstruct paleotemperatures using carbonate clumped isotope thermometry, and (3) suggest that soil carbonates from high elevation or high latitude sites may form under non-equilibrium conditions.

Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials.

PubMed

Bischoff-Ferrari, H A; Dawson-Hughes, B; Staehelin, H B; Orav, J E; Stuck, A E; Theiler, R; Wong, J B; Egli, A; Kiel, D P; Henschkowski, J

2009-10-01

To test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals. We searched Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles. Further studies were identified by consulting clinical experts, bibliographies, and abstracts. We contacted authors for additional data when necessary. Review methods Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D(3) (cholecalciferol) or vitamin D(2) (ergocalciferol)) or an active form of vitamin D (1alpha-hydroxyvitamin D(3) (1alpha-hydroxycalciferol) or 1,25-dihydroxyvitamin D(3) (1,25-dihydroxycholecalciferol)) and with sufficiently specified fall assessment were considered for inclusion. Eight randomised controlled trials (n=2426) of supplemental vitamin D met our inclusion criteria. Heterogeneity among trials was observed for dose of vitamin D (700-1000 IU/day v 200-600 IU/day; P=0.02) and achieved 25-hydroxyvitamin D(3) concentration (25(OH)D concentration: <60 nmol/l v >or=60 nmol/l; P=0.005). High dose supplemental vitamin D reduced fall risk by 19% (pooled relative risk (RR) 0.81, 95% CI 0.71 to 0.92; n=1921 from seven trials), whereas achieved serum 25(OH)D concentrations of 60 nmol/l or more resulted in a 23% fall reduction (pooled RR 0.77, 95% CI 0.65 to 0.90). Falls were not notably reduced by low dose supplemental vitamin D (pooled RR 1.10, 95% CI 0.89 to 1.35; n=505 from two trials) or by achieved serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l (pooled RR 1.35, 95% CI 0.98 to 1.84). Two randomised controlled trials (n=624) of active forms of vitamin D met our inclusion criteria. Active forms of vitamin D reduced fall risk by 22% (pooled RR 0.78, 95% CI 0.64 to 0.94). Supplemental vitamin D in a dose of 700-1000 IU a day reduced the risk of falling among older individuals by 19% and to a similar degree as active forms of vitamin D. Doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l may not reduce the risk of falling among older individuals.

Fall season atypically warm weather event leads to substantial CH4 loss in Arctic ecosystems?

NASA Astrophysics Data System (ADS)

Zona, Donatella; Moreaux, Virginie; Liljedahl, Anna; Losacco, Salvatore; Murphy, Patrick; Oechel, Walter

2014-05-01

In the last century (during 1875-2008) high-latitudes are warming at a rate of 1.360C century-1, almost 2 times faster than the Northern Hemisphere trend (Bekryaev et al., 2010). This warming has been more intense outside of the summer season, with anomalies of 1.09, 1.59, 1.730C in the fall, winter, and spring season respectively (Bekryaev et al., 2010). This substantial temperature anomalies have the potential to increase the emission of greenhouse gas (CO2 and CH4) fluxes from arctic tundra ecosystems. In particular, CH4 emissions, which are primarily controlled by temperature (in addition to water table), can steeply increase with warming. Despite the potential relevance of CH4 emissions, very few measurements have been performed outside of the growing season across the entire Arctic, due to logistic constrains. Importantly, no flux measurements achieved a temporal and spatial data coverage sufficient to estimate with confidence an annual CH4 emissions from tundra ecosystem in Alaska, and its sensitivity to warming. Fall 2013 was unusually warm in central and northern Alaska. Following a relatively warm summer with dramatically above-average rainfall, the October mean monthly temperatures was the 4th and top warmest in Barrow (1949-2013) and Ivotuk (1998-2013), respectively. As we just upgraded several eddy covariance towers to measure CO2 and CH4 fluxes year-round, the atypical weather conditions of fall 2013 represented a unique chance for testing the sensitivity of CH4 loss to these atypically warm temperatures. All our sites across a latitudinal gradient (from the northern site, Barrow, to the southern site, Ivotuk), presented substantial CH4 loss in the fall. Importantly, in two of these sites (Barrow, Ivotuk) where the fall weather was substantially warmer than the long term trend, fall CH4 emission represented between 44-63% of the June-November cumulative emission. Surprisingly, in the southernmost site (Ivotuk), when the temperature anomaly was the highest, cumulative fall CH4 emission outpaced even the summer emission. This shows the sensitivity of CH4 loss to abnormal conditions, and the importance of fall periods for the annual CH4 budget in these Arctic ecosystems. Bekryaev, R. V., I. V. Polyakov, and V. A. Alexeev. 2010. Role of polar amplification in long-term surface air temperature variations and modern Arctic warming. Journal of Climate 23(14):3888-3906.

Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials

PubMed Central

Dawson-Hughes, B; Staehelin, H B; Orav, J E; Stuck, A E; Theiler, R; Wong, J B; Egli, A; Kiel, D P; Henschkowski, J

2009-01-01

Objective To test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals. Data sources We searched Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles. Further studies were identified by consulting clinical experts, bibliographies, and abstracts. We contacted authors for additional data when necessary. Review methods Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D3 (cholecalciferol) or vitamin D2 (ergocalciferol)) or an active form of vitamin D (1α-hydroxyvitamin D3 (1α-hydroxycalciferol) or 1,25-dihydroxyvitamin D3 (1,25-dihydroxycholecalciferol)) and with sufficiently specified fall assessment were considered for inclusion. Results Eight randomised controlled trials (n=2426) of supplemental vitamin D met our inclusion criteria. Heterogeneity among trials was observed for dose of vitamin D (700-1000 IU/day v 200-600 IU/day; P=0.02) and achieved 25-hydroxyvitamin D3 concentration (25(OH)D concentration: <60 nmol/l v ≥60 nmol/l; P=0.005). High dose supplemental vitamin D reduced fall risk by 19% (pooled relative risk (RR) 0.81, 95% CI 0.71 to 0.92; n=1921 from seven trials), whereas achieved serum 25(OH)D concentrations of 60 nmol/l or more resulted in a 23% fall reduction (pooled RR 0.77, 95% CI 0.65 to 0.90). Falls were not notably reduced by low dose supplemental vitamin D (pooled RR 1.10, 95% CI 0.89 to 1.35; n=505 from two trials) or by achieved serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l (pooled RR 1.35, 95% CI 0.98 to 1.84). Two randomised controlled trials (n=624) of active forms of vitamin D met our inclusion criteria. Active forms of vitamin D reduced fall risk by 22% (pooled RR 0.78, 95% CI 0.64 to 0.94). Conclusions Supplemental vitamin D in a dose of 700-1000 IU a day reduced the risk of falling among older individuals by 19% and to a similar degree as active forms of vitamin D. Doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l may not reduce the risk of falling among older individuals. PMID:19797342

Operationalization and Validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Fall Risk Algorithm in a Nationally Representative Sample

PubMed Central

Lohman, Matthew C.; Crow, Rebecca S.; DiMilia, Peter R.; Nicklett, Emily J.; Bruce, Martha L.; Batsis, John A.

2017-01-01

Background Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool’s predictive validity or adaptability to survey data. Methods Data from five annual rounds (2011–2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 and older in the US. Analytic sample respondents (n=7,392) were categorized at baseline as having low, moderate, or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. Results Participants classified as having moderate and high fall risk had 2.62 (95% CI: 2.29, 2.99) and 4.76 (95% CI: 3.51, 6.47) times greater odds of falling during follow-up compared to those with low risk, respectively, controlling for sociodemographic and health related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. Conclusion The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardize screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted. PMID:28947669

Fibromyalgia is Associated with Impaired Balance and Falls

PubMed Central

Jones, Kim D.; Horak, Fay B.; Winters, Kerri Stone; Morea, Jessica M.; Bennett, Robert M.

2010-01-01

Background/Objective The purpose of this study was to determine whether FM patients differ from matched healthy controls in clinical tests of balance ability and fall frequency. Methods 34 FM patients and 32 age matched controls were administered the Balance Evaluation-Systems Test (BESTest), rated their balance confidence with the Activities-Specific Balance Confidence Scale (ABC) and reported the number of falls in the last 6 months. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess FM severity. Results FM patients had significantly impaired balance in all components of the BESTest compared to controls. They also scored more poorly on balance confidence. Overall fibromyalgia severity (FIQ) correlated significantly with the BESTest, and the ABC scale. The BESTest and ABC correlated significantly with 6 commonly reported FM symptoms (excluding pain). FM patients reported a total of 37 falls over the last six-months compared to 6 falls in healthy controls. Conclusion Fibromyalgia is associated with balance problems and increased fall frequency. Patients were aware of their balance problems. These results suggest that FM may affect peripheral and/or central mechanisms of postural control. Further objective study is needed to identify the relative contributions of neural and musculoskeletal impairments to postural stability in FM, thus providing clinicians with exercise prescriptions that maximize postural stability. PMID:19125137

Fall Down Detection Under Smart Home System.

PubMed

Juang, Li-Hong; Wu, Ming-Ni

2015-10-01

Medical technology makes an inevitable trend for the elderly population, therefore the intelligent home care is an important direction for science and technology development, in particular, elderly in-home safety management issues become more and more important. In this research, a low of operation algorithm and using the triangular pattern rule are proposed, then can quickly detect fall-down movements of humanoid by the installation of a robot with camera vision at home that will be able to judge the fall-down movements of in-home elderly people in real time. In this paper, it will present a preliminary design and experimental results of fall-down movements from body posture that utilizes image pre-processing and three triangular-mass-central points to extract the characteristics. The result shows that the proposed method would adopt some characteristic value and the accuracy can reach up to 90 % for a single character posture. Furthermore the accuracy can be up to 100 % when a continuous-time sampling criterion and support vector machine (SVM) classifier are used.

Tools for assessing fall risk in the elderly: a systematic review and meta-analysis.

PubMed

Park, Seong-Hi

2018-01-01

The prevention of falls among the elderly is arguably one of the most important public health issues in today's aging society. The aim of this study was to assess which tools best predict the risk of falls in the elderly. Electronic searches were performed using Medline, EMBASE, the Cochrane Library, CINAHL, etc., using the following keywords: "fall risk assessment", "elderly fall screening", and "elderly mobility scale". The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Selected studies were meta-analyzed with MetaDisc 1.4. A total of 33 studies were eligible out of the 2,321 studies retrieved from selected databases. Twenty-six assessment tools for fall risk were used in the selected articles, and they tended to vary based on the setting. The fall risk assessment tools currently used for the elderly did not show sufficiently high predictive validity for differentiating high and low fall risks. The Berg Balance scale and Mobility Interaction Fall chart showed stable and high specificity, while the Downton Fall Risk Index, Hendrich II Fall Risk Model, St. Thomas's Risk Assessment Tool in Falling elderly inpatients, Timed Up and Go test, and Tinetti Balance scale showed the opposite results. We concluded that rather than a single measure, two assessment tools used together would better evaluate the characteristics of falls by the elderly that can occur due to a multitude of factors and maximize the advantages of each for predicting the occurrence of falls.

Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults.

PubMed

Taylor, Morag E; Delbaere, Kim; Lord, Stephen R; Mikolaizak, A Stefanie; Brodaty, Henry; Close, Jacqueline C T

2014-08-01

Older people with cognitive impairment have an elevated fall risk, with 60% falling annually. There is a lack of evidence for fall prevention in this population, in part due to limited understanding of risk factors. This study examined fall risk in older people with cognitive impairment with an emphasis on identifying explanatory and modifiable risk factors. One hundred and seventy-seven community-dwelling older people with mild-moderate cognitive impairment (Mini-Mental State Examination 11-23/Addenbrooke's Cognitive Examination-Revised <83) underwent neuropsychological, physical, and functional assessments. Falls were recorded prospectively for 12 months with the assistance of carers. Of the 174 participants available to follow-up, 111 (64%) fell at least once and 71 (41%) at least twice. Higher fall rates were associated with slower reaction time, impaired balance (sway on floor and foam, semitandem, near-tandem, tandem stance), and reduced functional mobility (co-ordinated stability, timed up-and-go, steps needed to turn 180°, sit-to-stand, gait velocity). Higher fall rates were also associated with increased medication use (central nervous system, total number) and poorer performances in cognitive (Addenbrooke's Cognitive Examination-Revised: visuospatial domain, cube drawing; Trail-Making Test) and psychological (Geriatric Depression Scale, Goldberg Anxiety Scale, Falls Efficacy Scale-International) tests. Multivariate analysis identified increased sway on foam, co-ordinated stability score, and depressive symptoms to be significantly and independently associated with falls while controlling for age, years of education, and Addenbrooke's Cognitive Examination-Revised score. This study identified several risk factors of falls in older people with cognitive impairment, a number of which are potentially modifiable. Future research involving targeted interventions addressing medication use, balance, mood, and functional performance may prove useful for fall prevention in this population. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

NGC 3627: Revealing Hidden Black Holes

NASA Image and Video Library

2012-12-13

The spiral galaxy NGC 3627, located about 30 million light years from Earth as seen by four NASA telescopes; inset shows the central region, which contains a bright X-ray source that is likely powered by material falling onto a supermassive black hole.

Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.

PubMed

Solis, Guillermina R; Champion, Jane Dimmitt

2017-03-01

Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

High fall incidence and fracture rate in elderly dialysis patients.

PubMed

Polinder-Bos, H A; Emmelot-Vonk, M H; Gansevoort, R T; Diepenbroek, A; Gaillard, C A J M

2014-12-01

Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.

[Impact of fall risk and fear of falling on mobility of independently living senior citizens transitioning to frailty: screening results concerning fall prevention in the community].

PubMed

Anders, J; Dapp, U; Laub, S; von Renteln-Kruse, W

2007-08-01

There is a strong relation between mobility, walking safety and living independently in old age. People with walking problems suffer from fear of falling and tend to restrict their mobility and performance level in the community environment--even before falls occur. This study was planned to test the validity and prognostic value of a fall risk screening instrument ("Sturz-Risiko-Check") that has already shown its feasibility, acceptance and reliability, targeting independently living senior citizens. The study sample was recruited from a sheltered housing complex in Hamburg (with written consent). Persons with need of professional care ("Pflegestufe" in Germany) were excluded. The residents were asked to fill in the multidimensional questionnaire ("Sturz-Risiko- Check"). In a second step, a trained nurse asked the participants in a phone call about their competence in the instrumental activities of daily living (I-ADL mod. from Lawton, Brody 1969) and about their usual mobility performance level (e.g. frequency and distance of daily walks, use of public transport). According to the number and weight of self-reported risk factors for falling, three groups: "low fall risk", "medium fall risk" and "high fall risk" were classified. Finally, this classification was re-tested after one year, asking for falls and fall related injuries. A total of 112 senior citizens without need of personal care, living in a sheltered housing facility were asked to participate. Acceptance was high (76.1%). Self-reported data from 79 participants concerning falls, fall-risk, mobility and instrumental activities of daily living were included in the statistical analyses. Mean age was 78 (64 to 93) years and associated by a high percentage of women (75.9%) in this sample. The older participants reported 0 to 13 different factors (mean 5) related to a high risk of future falls. Most participants (78.5%) quit cycling because of fear of falling. There was a high incidence in the study sample and over the three risk groups of chronic disorders like cardiac failure (75.9%) and disturbed vision or hearing (64.6%). According to the rising risk of falling over the three risk groups (low, medium and high), there were symptoms of fast functional decline or frailty like diminished walking speed (6.3 vs 36.8 vs 72.0%), sarcopenia (failed chairrise test: 0 vs 18.4 vs 28%) or already perceived fall events (0 vs 5.3 vs 56.0%) and ongoing restriction in basic activities. Those results were proven by the data on fall frequencies after one year (follow-up). We found an increase in falls over all three risk groups (12.5 vs 31.6 vs 28%) with fall-related severe injuries (fractures) in two persons classified in the high fall-risk group. The results of the fall-risk screening were useful to classify groups with different probability to fall in the near future. Fear-offalling and symptoms of frailty were related to an increasing risk of falling and loss of mobility and autonomy in still independently living senior citizens. The fall-risk screening instrument ("Sturz-Risiko-Check" questionnaire) was useful and valid to predict risk of falling and functional decline in independently living senior citizens transitioning to frailty. This screening will be part of a prevention approach in the City of Hamburg to offer primary and secondary prevention interventions adapted to special target groups of community- dwelling elder people (robust in contrast to frail elderly). The implementation should be accompanied by training sessions for physicians in the primary care sector and health improvement programmes for elder citizens.

Middle Ordovician Astrobleme at Kardla, Hiiumaa Island West Estonian Archipelago

NASA Astrophysics Data System (ADS)

Puura, V.; Suuroja, K.

1992-07-01

The subsurface structure of the buried crater (4 km in diameter) at Kardla town has been studied by means of gravimetry and magnetometry and by drilling more than 300 boreholes in the crater and its surroundings (Puura and Suuroja, 1992). The deepest borehole, reaching 815 m, has revealed that the crater is 420 m deep and has a central peak up to 100 m high. Barely visible in the present-day topography, the crater proper is filled with Palaeozoic and Quaternary deposits and represents mostly low marshy land surrounded in places by a low ridge along the ring wall. In the buried sub-Quaternary bedrock relief, the crater proper occurs as a roundish depression bordered with two 10-30-m high horseshoe-shaped elevations above the buried ring wall. The crater was developed 455 Ma on the bottom of a shallow shelf sea in a composite target consisting of Middle and Lower Ordovician (20 m) and Cambrian (20 m) sedimentary rocks and underlying Precambrian rocks. In the subsurface structure of the crater site quite well preserved elements have been distinguished: in vertical section from the top--a) normally an approximately 100-m-thick cover of Ordovician sedimentary rocks hiding all the elements of the crater, b) strata of different kinds of allochthonous breccias filling the lower part of the crater proper and beds of fall-out breccias and conglomerates, sandstones and sandy limestones consisting of debris of reworked (in marine environments) fall-out breccia, and ring-wall rocks occurring in surroundings of the crater, and c) a body of autochthonous and subautochthonous breccias forming the bottom and the central peak of the crater and also remnants of its rim. Shocked rocks and minerals from autochthonous and allochthonous breccias have been revealed by light microscopy and by studies of fluid inclusions. Among the early Palaeozoic impact structures, Kardla crater is one of the best preserved. According to the recent biostratigraphical data, the Kardla crater is coeval to Tvaren and Lockne craters in central Sweden. The common origin of the three craters--a Middle Ordovician asteroid swarm--has been proposed (Lindstrom et al., 1992).

Variation of Surface Air Temperature in Relation to El Nino and Cataclysmic Volcanic Eruptions, 1796-1882

NASA Technical Reports Server (NTRS)

Wilson, Robert M.

1999-01-01

During the contemporaneous interval of 1796-1882 a number of significant decreases in temperature are found in the records of Central England and Northern Ireland. These decreases appear to be related to the occurrences of El Nino and/or cataclysmic volcanic eruptions. For example, a composite of residual temperatures of the Central England dataset, centering temperatures on the yearly onsets of 20 El Nino of moderate to stronger strength, shows that, on average, the change in temperature varied by about +/- 0.3 C from normal being warmer during the boreal fall-winter leading up to the El Nino year and cooler during the spring-summer of the El Nino year. Also, the influence of El Nino on Central England temperatures appears to last about 1-2 years. Similarly, a composite of residual temperatures of the Central England dataset, centering temperatures on the month of eruption for 26 cataclysmic volcanic eruptions, shows that, on average, the change in temperature decreased by about 0.1 - 0.2 C, typically, 1-2 years after the eruption, although for specific events, like Tambora, the decrease was considerably greater. Additionally, tropical eruptions appear to produce greater changes in temperature than extratropical eruptions, and eruptions occurring in boreal spring-summer appear to produce greater changes in temperature than those occurring in fall-winter.

Epidemiology of malaria in pregnancy in central India.

PubMed Central

Singh, N.; Shukla, M. M.; Sharma, V. P.

1999-01-01

Analysis of three years of data from a malaria clinic operated by the Indian Council of Medical Research (ICMR) in the Government Medical College Hospital in Jabalpur, central India, showed a high malaria prevalence among pregnant women, which was statistically highly significant (P < 0.0001) compared with the situation among nonpregnant women. Cerebral malaria was a common complication of severe Plasmodium falciparum infection, with a high mortality during pregnancy, requiring immediate attention. The study also showed that malaria infection was more frequent in primigravidae, falling progressively with increasing parity. Mean parasite densities were significantly higher in pregnant women compared with nonpregnant women for both P. falciparum (P < 0.001; df = 137) and P. vivax (P < 0.05; df = 72) infection. Pregnant women with falciparum or vivax malaria were significantly more anaemic than noninfected pregnant women or infected nonpregnant women. The average weight of 155 neonates from infected mothers was 350 g less than that of 175 neonates from noninfected mothers. This difference in birth weight was statistically significant for both P. falciparum (P < 0.0001; df = 278) and P. vivax (P < 0.0001; df = 223) infection. Congenital malaria was not recorded. We conclude that pregnant women from this geographical area require systematic intervention owing to their high susceptibility to malaria during pregnancy and the puerperium. PMID:10444880

The Signature of the Central Engine in the Weakest Relativistic Explosions: GRB 100316D

NASA Astrophysics Data System (ADS)

Margutti, R.; Soderberg, A. M.; Wieringa, M. H.; Edwards, P. G.; Chevalier, R. A.; Morsony, B. J.; Barniol Duran, R.; Sironi, L.; Zauderer, B. A.; Milisavljevic, D.; Kamble, A.; Pian, E.

2013-11-01

We present late-time radio and X-ray observations of the nearby sub-energetic gamma-ray burst (GRB)100316D associated with supernova (SN) 2010bh. Our broad-band analysis constrains the explosion properties of GRB 100316D to be intermediate between highly relativistic, collimated GRBs and the spherical, ordinary hydrogen-stripped SNe. We find that ~1049 erg is coupled to mildly relativistic (Γ = 1.5-2), quasi-spherical ejecta, expanding into a medium previously shaped by the progenitor mass-loss with a rate of \\dot{M}\\, {\\sim }\\, 10^{-5}\\,M_{\\odot }\\,yr^{-1} (for an assumed wind density profile and wind velocity vw = 1000 km s-1). The kinetic energy profile of the ejecta argues for the presence of a central engine and identifies GRB 100316D as one of the weakest central-engine-driven explosions detected to date. Emission from the central engine is responsible for an excess of soft X-ray radiation that dominates over the standard afterglow at late times (t > 10 days). We connect this phenomenology with the birth of the most rapidly rotating magnetars. Alternatively, accretion onto a newly formed black hole might explain the excess of radiation. However, significant departure from the standard fall-back scenario is required.

Targeting a high-risk group for fall prevention: strategies for health plans.

PubMed

Jennings, Lee A; Reuben, David B; Kim, Sung-Bou; Keeler, Emmett; Roth, Carol P; Zingmond, David S; Wenger, Neil S; Ganz, David A

2015-09-01

Although Medicare has implemented incentives for health plans to reduce fall risk, the best way to identify older people at high risk of falling and to use screening results to target fall prevention services remains unknown. We evaluated 4 different strategies using a combination of administrative data and patient-reported information that health plans could easily obtain. Observational study. We used data from 1776 patients 75 years or older in 4 community-based primary care practices who screened positive for a fear of falling and/or a history of falls. For these patients, we predicted fall-related injuries in the 24 months after the date of screening using claims/encounter data. After controlling for age and gender, we predicted the number of fall-related injuries by adding Elixhauser comorbidity count, any claim for a fall-related injury during the 12 months prior to screening, and falls screening question responses in a sequential fashion using negative binomial regression models. Basic patient characteristics, including age and Elixhauser comorbidity count, were strong predictors of fall-related injury. Among falls screening questions, a positive response to, "Have you fallen 2 or more times in the past year?" was the most predictive of a fall-related injury (incidence rate ratio [IRR], 1.56; 95% CI, 1.25-1.94). Prior claim for a fall-related injury also independently predicted this type of injury (IRR, 1.41; 95% CI, 1.05-1.89). The best model for predicting fall-related injuries combined all of these approaches. The combination of administrative data and a simple screening item can be used by health plans to target patients at high risk for future fall-related injuries.

High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators.

PubMed

Forslund, Emelie Butler; Jørgensen, Vivien; Franzén, Erika; Opheim, Arve; Seiger, Åke; Ståhle, Agneta; Hultling, Claes; Stanghelle, Johan K; Roaldsen, Kirsti Skavberg; Wahman, Kerstin

2017-01-31

To identify risk indicators for, and incidence of, recurrent falls and fall-related injuries in wheelchair users with traumatic spinal cord injury. Prospective multi-centre study. One hundred and forty-nine wheelchair users with spinal cord injury attending follow-up in Sweden and Norway. Inclusion criteria: wheelchair users ≥ 18 years old with traumatic spinal cord injury ≥ 1 year post-injury. individuals with motor complete injuries above C5. Falls were prospectively reported by text message every second week for one year and were followed-up by telephone interviews. Outcomes were: fall incidence, risk indicators for recurrent (> 2) falls and fall-related injuries. Independent variables were: demographic data, quality of life, risk willingness, functional independence, and exercise habits. Of the total sample (n = 149), 96 (64%) participants fell, 45 (32%) fell recurrently, 50 (34%) were injured, and 7 (5%) severely injured. Multivariate logistic regression analysis showed that reporting recurrent falls the previous year increased the odds ratio (OR) of recurrent falls (OR 10.2, p < 0.001). Higher quality of life reduced the OR of fall-related injuries (OR 0.86, p = 0.037). Previous recurrent falls was a strong predictor of future falls. The incidence of falls, recurrent falls and fall-related injuries was high. Hence, prevention of falls and fall-related injuries is important.

180. Photocopy of Photograph, Twin Falls Canal Company. E. Pettygro, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

180. Photocopy of Photograph, Twin Falls Canal Company. E. Pettygro, Photographer, date unknown. BLASTING TWIN FALLS CANAL, TWIN FALLS COUNTY; BLASTING COTTONWOOD AREA TO REPLACE FLUME BY RUNNING HIGH LINE THROUGH SOLID ROCK. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Reliable method for determination of the velocity of a sinker in a high-pressure falling body type viscometer

NASA Astrophysics Data System (ADS)

Dindar, Cigdem; Kiran, Erdogan

2002-10-01

We present a new sensor configuration and data reduction process to improve the accuracy and reliability of determining the terminal velocity of a falling sinker in falling body type viscometers. This procedure is based on the use of multiple linear variable differential transformer sensors and precise mapping of the sensor signal and position along with the time of fall which is then converted to distance versus fall time along the complete fall path. The method and its use in determination of high-pressure viscosity of n-pentane and carbon dioxide are described.

Efficacy of falls prevention interventions: protocol for a systematic review and network meta-analysis

PubMed Central

2013-01-01

Background Falls are a leading cause of morbidity and mortality in older adults. Although numerous trials of falls prevention interventions have been completed, there is extensive variation in their intervention components and clinical context, such that the key elements of an effective falls prevention program remain unclear to patients, clinicians, and policy-makers. Our objective is to identify the most effective interventions and combinations of interventions that prevent falls though a systematic review and meta-analysis, including a network meta-analysis. Methods/Design We will search for published (e.g., MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Ageline) and unpublished (e.g., trial registries, dissertations) randomised clinical trials (RCTs) in all languages examining interventions to prevent falls compared to usual care or other falls prevention interventions among adults aged ≥65 years from all settings (e.g., community, acute care, long-term care, and rehabilitation). The primary outcomes are number of injurious falls and number of hospitalizations due to falls. Secondary outcomes include falls rate, number of fallers, number of emergency room visits due to falls, number of physician visits due to falls, number of fractures, costs, and number of intervention-related harms (e.g., muscle soreness related to exercise). We will calibrate our eligibility criteria amongst the team and two independent team members will screen the literature search results in duplicate. Conflicts will be resolved through team discussion. A similar process will be used for data abstraction and quality appraisal with the Cochrane risk of bias tool. Our results will be synthesized descriptively and a random effects meta-analysis will be conducted if the studies are deemed methodologically, clinically, and statistically (e.g., I2<60%) similar. If appropriate, a network meta-analysis will be conducted, which will allow the comparison of interventions that have not been compared in head-to-head RCTs, as well as the effectiveness of interventions. Discussion We will identify the most effective interventions and combinations of interventions that prevent falls in older people. Our results will be used to optimize falls prevention strategies, and our goal is to ultimately improve the health of seniors internationally. Trial registration PROSPERO registry number: CRD42013004151 PMID:23738619

Mitigating mass movement caused by earthquakes and typhoons: a case study of central Taiwan

NASA Astrophysics Data System (ADS)

Lin, Jiun-Chuan

2013-04-01

Typhoons caused huge damages to Taiwan at the average of 3.8 times a year in the last 100 years, according to Central Weather Bureau data. After the Chi-Chi earthquake of 1999 at the magnitude of Richard Scale 7.3, typhoons with huge rainfall would cause huge debris flow and deposits at river channels. As a result of earthquakes, loose debris falls and flows became significant hazards in central Taiwan. Analysis of rainfall data and data about the sites of slope failure show that damage from natural hazards was enhanced in the last 20 years, as a result of the Chi-Chi earthquake. There are three main types of mass movement in Central Taiwan: landslides, debris flows and gully erosion. Landslides occurred mainly along hill slopes and river channel banks. Many dams, check dams, housing structures and even river channels can be raised to as high as 60 meters as a result of stacking up floating materials of landslides. Debris flows occurred mainly through typhoon periods and activated ancient debris deposition. New gullies were thus developed from deposits loosened and shaken up by earthquakes. Extreme earthquakes and typhoon events occurred frequently in the last 20 years. This paper analyzes the geological and geomorphologic background for the precarious areas and typhoons in central Taiwan, to make a systematic understanding of mass movement harzards. The mechanism and relations of debris flows and rainfall data in central Taiwan are analyzed. Ways for mitigating mass movement threats are also proposed in this paper. Keywords: mass movement, earthquakes, typhoons, hazard mitigation, central Ta

Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

PubMed

Hoffman, Geoffrey J; Hays, Ron D; Wallace, Steven P; Shapiro, Martin F; Yakusheva, Olga; Ettner, Susan L

2017-04-01

Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk. Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship. Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (P<0.001) had stronger associations with reduced fall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired. Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

Black hole formation in the early Universe

NASA Astrophysics Data System (ADS)

Latif, M. A.; Schleicher, D. R. G.; Schmidt, W.; Niemeyer, J.

2013-08-01

Supermassive black holes with up to a 109 M⊙ dwell in the centres of present-day galaxies, and their presence has been confirmed at z ≥ 6. Their formation at such early epochs is still an enigma. Different pathways have been suggested to assemble supermassive black holes in the first billion years after the big bang. Direct collapse has emerged as a highly plausible scenario to form black holes as it provides seed masses of 105-106 M⊙. Gravitational collapse in atomic cooling haloes with virial temperatures Tvir ≥ 104 K may lead to the formation of massive seed black holes in the presence of an intense background ultraviolet flux. Turbulence plays a central role in regulating accretion and transporting angular momentum. We present here the highest resolution cosmological large eddy simulations to date which track the evolution of high-density regions on scales of 0.25 au beyond the formation of the first peak, and study the impact of subgrid-scale turbulence. The peak density reached in these simulations is 1.2 × 10-8 g cm-3. Our findings show that while fragmentation occasionally occurs, it does not prevent the growth of a central massive object resulting from turbulent accretion and occasional mergers. The central object reaches ˜1000 M⊙ within four free-fall times, and we expect further growth up to 106 M⊙ through accretion in about 1 Myr. The direct collapse model thus provides a viable pathway of forming high-mass black holes at early cosmic times.

Preparing for a Trustworthiness Assessment of the National Transportation Library’s Digital Repository ROSA P

DOT National Transportation Integrated Search

2018-01-01

The National Transportation Library (NTL) is an all-digital repository of transportation knowledge that falls under federal mandates to serve as a central clearinghouse for transportation data and information of the Federal Government. as well ...

Defense Manpower Policies in Northern and Central European NATO.

DTIC Science & Technology

1980-02-01

in the Netherlands generally falling into the follow- ing categories: breadwinners , those personally indispensable, those holding ecclesiastical...in The Military Balance 1977/78, pp. 104-105. Indeed there is only limited utility in comparing just peacetime strengths, since in crisis or conflict

Chloride control and monitoring program in the Wichita River Basin, Texas, 1996-2009

USGS Publications Warehouse

Haynie, M.M.; Burke, G.F.; Baldys, Stanley

2011-01-01

Water resources of the Wichita River Basin in north-central Texas are vital to the water users in Wichita Falls, Tex., and surrounding areas. The Wichita River Basin includes three major forks of the Wichita River upstream from Lake Kemp, approximately 50 miles southwest of Wichita Falls, Tex. The main stem of the Wichita River is formed by the confluence of the North Wichita River and Middle Fork Wichita River upstream from Truscott Brine Lake. The confluence of the South Wichita River with the Wichita River is northwest of Seymour, Tex. (fig. 1). Waters from the Wichita River Basin, which is part of the Red River Basin, are characterized by high concentrations of chloride and other salinity-related constituents from salt springs and seeps (hereinafter salt springs) in the upper reaches of the basin. These salt springs have their origins in the Permian Period when the Texas Panhandle and western Oklahoma areas were covered by a broad shallow sea. Over geologic time, evaporation of the shallow seas resulted in the formation of salt deposits, which today are part of the geologic formations underlying the area. Groundwater in these formations is characterized by high chloride concentrations from these salt deposits, and some of this groundwater is discharged by the salt springs into the Wichita River.

Chronology of rock falls and slides in a desert mountain range: Case study from the Sonoran Desert in south-central Arizona

NASA Astrophysics Data System (ADS)

Dorn, Ronald I.

2014-10-01

In order to respond to the general paucity of information on the chronology of ubiquitous small rock falls and slides that litter the slopes of desert mountain ranges, a case study in the Sonoran Desert reveals new insight into the desert geomorphology of mountain slopes. Rock falls and rock slides in the McDowell Mountains that abut metropolitan Phoenix, USA, fall in three chronometric groupings dated by conventional radiocarbon and rock varnish microlamination methods. First, the oldest events are > 74 ka and take the form of stable colluvial boulder fields - positive relief features that are tens of meters long and a few meters wide. Second, randomly sampled slides and falls of various sizes and positions wasted during wetter periods of the terminal Pleistocene and Holocene. Third, an anomalous clustering of slides and falls occurred during the late Medieval Warm Period (Medieval Climatic Anomaly) when an extreme storm was a possible but unlikely trigger. One speculative hypothesis for the cluster of Medieval Warm Period events is that a small to moderate sized earthquake shook heavily shattered bedrock - close to failure - just enough to cause a spate of rock falls and slides. A second speculative hypothesis is that this dry period enhanced physical weathering processes such as dirt cracking. However, the reasons for the recent clustering of rock falls remain enigmatic. While the temporal distribution of slides and falls suggests a minimal hazard potential for homes and roads on the margins of the McDowell Mountains, this finding may not necessary match other desert ranges in metropolitan Phoenix or mountains with different rock types and structures that abut other arid urban centers.

The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis.

PubMed

Arnold, C M; Faulkner, R A; Gyurcsik, N C

2011-01-01

Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. EE participants with low baseline falls efficacy demonstrated significantly (p<0.05) greater improvement in balance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (p<0.05) correlated with positive balance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes.

The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis

PubMed Central

Faulkner, R.A.; Gyurcsik, N.C.

2011-01-01

ABSTRACT Purpose: Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Method: Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. Results: EE participants with low baseline falls efficacy demonstrated significantly (p<0.05) greater improvement in balance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (p<0.05) correlated with positive balance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Conclusions: Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes. PMID:22942514

Spatial distribution of block falls using volumetric GIS-decision-tree models

NASA Astrophysics Data System (ADS)

Abdallah, C.

2010-10-01

Block falls are considered a significant aspect of surficial instability contributing to losses in land and socio-economic aspects through their damaging effects to natural and human environments. This paper predicts and maps the geographic distribution and volumes of block falls in central Lebanon using remote sensing, geographic information systems (GIS) and decision-tree modeling (un-pruned and pruned trees). Eleven terrain parameters (lithology, proximity to fault line, karst type, soil type, distance to drainage line, elevation, slope gradient, slope aspect, slope curvature, land cover/use, and proximity to roads) were generated to statistically explain the occurrence of block falls. The latter were discriminated using SPOT4 satellite imageries, and their dimensions were determined during field surveys. The un-pruned tree model based on all considered parameters explained 86% of the variability in field block fall measurements. Once pruned, it classifies 50% in block falls' volumes by selecting just four parameters (lithology, slope gradient, soil type, and land cover/use). Both tree models (un-pruned and pruned) were converted to quantitative 1:50,000 block falls' maps with different classes; starting from Nil (no block falls) to more than 4000 m 3. These maps are fairly matching with coincidence value equal to 45%; however, both can be used to prioritize the choice of specific zones for further measurement and modeling, as well as for land-use management. The proposed tree models are relatively simple, and may also be applied to other areas (i.e. the choice of un-pruned or pruned model is related to the availability of terrain parameters in a given area).

Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.

PubMed

Noureldin, Marwa; Hass, Zachary; Abrahamson, Kathleen; Arling, Greg

2017-09-04

Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample. The main outcome was fall occurrence within 30 days of discharge. Factor analyses were used to estimate latent models from variables of interest. A structural equation model (SEM) was estimated to determine the relationship between the emerging latent variables and falls. Fifteen percent of participants fell within 30 days of NH discharge. Factor analysis of fall-related risk factors produced three latent variables: fall concerns/history; activities of daily living impairments; and use of high-risk medications. A supports/services latent variable also emerged that included caregiver support frequency, medication management assistance, durable medical equipment use, discharge location, and receipt of home health or skilled nursing services. In the SEM model, high-risk medications use and fall concerns/history had direct positive effects on falling. Receiving supports/services did not affect falling directly; however, it reduced the effect of high-risk medication use on falling (p < .05). Within the context of a state-implemented transition program, findings highlight the importance of supports/services in mitigating against medication-related risk of falling post NH discharge. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials.

PubMed

Mansfield, Avril; Wong, Jennifer S; Bryce, Jessica; Knorr, Svetlana; Patterson, Kara K

2015-05-01

Older adults and individuals with neurological conditions are at an increased risk for falls. Although physical exercise can prevent falls, certain types of exercise may be more effective. Perturbation-based balance training is a novel intervention involving repeated postural perturbations aiming to improve control of rapid balance reactions. The purpose of this study was to estimate the effect of perturbation-based balance training on falls in daily life. MEDLINE (1946-July 2014), EMBASE (1974-July 2014), PEDro (all dates), CENTRAL (1991-July 2014), and Google Scholar (all dates) were the data sources used in this study. Randomized controlled trials written in English were included if they focused on perturbation-based balance training among older adults or individuals with neurological conditions and collected falls data posttraining. Two investigators extracted data independently. Study authors were contacted to obtain missing information. A PEDro score was obtained for each study. Primary outcomes were proportion of participants who reported one or more falls (ie, number of "fallers") and the total number of falls. The risk ratio (proportion of fallers) and rate ratio (number of falls) were entered into the analysis. Eight studies involving 404 participants were included. Participants who completed perturbation-based balance training were less likely to report a fall (overall risk ratio=0.71; 95% confidence interval=0.52, 0.96; P=.02) and reported fewer falls than those in the control groups (overall rate ratio=0.54; 95% confidence interval=0.34, 0.85; P=.007). Study authors do not always identify that they have included perturbation training in their intervention; therefore, it is possible that some appropriate studies were not included. Study designs were heterogeneous, preventing subanalyses. Perturbation-based balance training appears to reduce fall risk among older adults and individuals with Parkinson disease. © 2015 American Physical Therapy Association.

Nonbreeding isolation and population-specific migration patterns among three populations of Golden-winged Warblers

USGS Publications Warehouse

Kramer, Gunnar R.; Streby, Henry M.; Peterson, Sean M.; Lehman, Justin A.; Buehler, David A.; Wood, Petra B.; McNeil, Darin J.; Larkin, Jeffrey L.; Andersen, David E.

2017-01-01

Golden-winged Warblers (Vermivora chrysoptera) are Nearctic–Neotropical migrants experiencing varied regional population trends not fully explained by breeding-grounds factors such as nest success. A lack of detailed information on the nonbreeding distributions, migration routes, or timing of migration among populations hampers our ability to identify population processes outside the breeding period. We used geolocators to track annual movements of 21 Golden-winged Warblers from 3 North American breeding locations experiencing varying population trends to investigate the potential for nonbreeding site factors to influence breeding populations. We used the template-fit method to estimate locations of individual warblers throughout the year. Geolocator-marked warblers exhibited significant isolation among populations during migration and the nonbreeding period. During the nonbreeding period, Golden-winged Warblers from Minnesota, USA (n = 12) occurred in Central America from southern Mexico to central Nicaragua; warblers from Tennessee, USA (n = 7) occurred along the border of northern Colombia and Venezuela; and warblers from Pennsylvania, USA (n = 2) occurred in north-central Venezuela. Warblers travelled at slower rates over more days in fall migration than spring migration. Fall migration routes at the Gulf of Mexico were population-specific, whereas spring routes were more varied and overlapped among populations. Golden-winged Warblers from Pennsylvania migrated 4,000 and 5,000 km yr−1 farther than Tennessee and Minnesota warblers, respectively, and spent almost twice as long migrating in the fall compared to Minnesota warblers. Our results reveal nearly complete temporal and geographic isolation among 3 populations of Golden-winged Warblers throughout the annual cycle, resulting in opportunities for population- and site-specific factors to differentially influence populations outside the breeding period. Our findings highlight the need for monitoring multiple populations of migratory species to understand and better inform conservation strategies.

A High-yield Fall Risk and Adverse Events Screening Questions From the Stopping Elderly Accidents, Death, and Injuries (STEADI) Guideline for Older Emergency Department Fall Patients.

PubMed

Sri-On, Jiraporn; Tirrell, Gregory Philip; Kamsom, Anucha; Marill, Keith A; Shankar, Kalpana Narayan; Liu, Shan W

2018-03-25

The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall. We conducted a prospective study at two urban, teaching hospitals. We included patients aged ≥ 65 years who presented to the ED for an accidental fall. Data were gathered for fall-relevant comorbidities, high-risk medications for falls, and the responses to 12 questions from the STEADI guideline recommendation. Our outcomes were the number of 6-month adverse events that were defined as mortality, ED revisit, subsequent hospitalization, recurrent falls, and a composite outcome. There were 548 (86.3%) patients who completed follow-up and 243 (44.3%) patients experienced an adverse event after a fall within 6 months. In multivariate analysis, seven questions from the STEADI guideline predicted various outcomes. The question "Had previous fall" predicted recurrent falls (odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.52 to 3.97), the question "Feels unsteady when walking sometimes" (OR = 2.34, 95% CI = 1.44 to 3.81), and "Lost some feeling in their feet" predicted recurrent falls. In addition to recurrent falls risk, the supplemental questions "Use or have been advised to use a cane or walker," "Take medication that sometimes makes them feel light-headed or more tired than usual," "Take medication to help sleep or improve mood," and "Have to rush to a toilet" predicted other outcomes. A STEADI score of ≥4 did not predict adverse outcomes although seven individual questions from the STEADI guidelines were associated with increased adverse outcomes within 6 months. These may be organized into three categories (previous falls, physical activity, and high-risk medications) and may assist emergency physicians to evaluate and refer high-risk fall patients for a comprehensive falls evaluation. © 2018 by the Society for Academic Emergency Medicine.

Preventing falls in assisted living: Results of a quality improvement pilot study.

PubMed

Zimmerman, Sheryl; Greene, Angela; Sloane, Philip D; Mitchell, Madeline; Giuliani, Carol; Nyrop, Kirsten; Walsh, Edith

Residents of assisted living (AL) communities are at high risk for falls, which result in negative outcomes and high health care costs. Adapting effective falls prevention programs for AL quality improvement (QI) has the potential to reduce falls, improve resident quality of life, and reduce costs. This project tested the feasibility and outcomes of an evidence-based multi-component QI program, the Assisted Living Falls Prevention and Monitoring Program (AL-FPMP). Resident posture and gait improved, likely due to exercise and/or physical therapy. Effective falls prevention QI programs can be implemented in AL, and are advised to (1) establish and maintain a falls team to create a culture focused on the reduction of falls risk; (2) teach staff to assess residents using the Morse Falls Scale to increase their awareness of residents' falls risk and improvement; and (3) modify existing exercise programs to address balance and lower body strength. Copyright © 2016 Elsevier Inc. All rights reserved.

177. Photocopy of Photograph, Twin Falls Canal Company, Bisbee Photo, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

177. Photocopy of Photograph, Twin Falls Canal Company, Bisbee Photo, September, 1912. Photographer unknown. COTTONWOOD FLUME, HIGH LINE CANAL, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; SOUTH VIEW FROM UPPER SIDE. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Seismically active structural lineaments in south-central Alaska as seen on ERTS-1 imagery

NASA Technical Reports Server (NTRS)

Gedney, L. (Principal Investigator); Vanwormer, J. D.

1973-01-01

The author has identified the following significant results. A mosaic of south-central Alaska composed of 19 ERTS-1 images, when compared with the seismicity pattern of the area, reveals that the larger earthquakes tend to fall on lineaments which are easily recognizable on the imagery. In most cases, these lineaments have not been mapped as faults. One particular lineament, which was the scene of three earthquakes of magnitude 4 or greater during 1972, passes very close to Anchorage.

Concordance of Motion Sensor and Clinician-Rated Fall Risk Scores in Older Adults.

PubMed

Elledge, Julie

2017-12-01

As the older adult population in the United States continues to grow, developing reliable, valid, and practical methods for identifying fall risk is a high priority. Falls are prevalent in older adults and contribute significantly to morbidity and mortality rates and rising health costs. Identifying at-risk older adults and intervening in a timely manner can reduce falls. Conventional fall risk assessment tools require a health professional trained in the use of each tool for administration and interpretation. Motion sensor technology, which uses three-dimensional cameras to measure patient movements, is promising for assessing older adults' fall risk because it could eliminate or reduce the need for provider oversight. The purpose of this study was to assess the concordance of fall risk scores as measured by a motion sensor device, the OmniVR Virtual Rehabilitation System, with clinician-rated fall risk scores in older adult outpatients undergoing physical rehabilitation. Three standardized fall risk assessments were administered by the OmniVR and by a clinician. Validity of the OmniVR was assessed by measuring the concordance between the two assessment methods. Stability of the OmniVR fall risk ratings was assessed by measuring test-retest reliability. The OmniVR scores showed high concordance with the clinician-rated scores and high stability over time, demonstrating comparability with provider measurements.

Factors associated with fall-related fractures in Parkinson's disease.

PubMed

Cheng, Kuei-Yueh; Lin, Wei-Che; Chang, Wen-Neng; Lin, Tzu-Kong; Tsai, Nai-Wen; Huang, Chih-Cheng; Wang, Hung-Chen; Huang, Yung-Cheng; Chang, Hsueh-Wen; Lin, Yu-Jun; Lee, Lian-Hui; Cheng, Ben-Chung; Kung, Chia-Te; Chang, Ya-Ting; Su, Chih-Min; Chiang, Yi-Fang; Su, Yu-Jih; Lu, Cheng-Hsien

2014-01-01

Fall-related fracture is one of the most disabling features of idiopathic Parkinson's disease (PD). A better understanding of the associated factors is needed to predict PD patients who will require treatment. This prospective study enrolled 100 adult idiopathic PD patients. Stepwise logistic regressions were used to evaluate the relationships between clinical factors and fall-related fracture. Falls occurred in 56 PD patients, including 32 with fall-related fractures. The rate of falls in the study period was 2.2 ± 1.4 per 18 months. The percentage of osteoporosis was 34% (19/56) and 11% in PD patients with and without falls, respectively. Risk factors associated with fall-related fracture were sex, underlying knee osteoarthritis, mean Unified Parkinson's Disease Rating Scale score, mean Morse fall scale, mean Hoehn and Yahr stage, and exercise habit. By stepwise logistic regression, sex and mean Morse fall scale were independently associated with fall-related fracture. Females had an odds ratio of 3.8 compared to males and the cut-off value of the Morse fall scale for predicting fall-related fracture was 72.5 (sensitivity 72% and specificity 70%). Higher mean Morse fall scales (>72.5) and female sex are associated with higher risk of fall-related fractures. Preventing falls in the high-risk PD group is an important safety issue and highly relevant for their quality of life. Copyright © 2013 Elsevier Ltd. All rights reserved.

An evaluation of the Australian Football League Central Australian Responsible Alcohol Strategy 2005-07.

PubMed

Mentha, Ricky; Wakerman, Johne

2009-12-01

In 2004, the Australian Football League Central Australia (AFLCA) implemented the Responsible Alcohol Strategy (RAS), which aimed to decrease alcohol consumption at matches, and to promote healthy lifestyle messages to the youth of Central Australia participating in Australian Rules football. The evaluation adopted a pre- and post-implementation design to monitor a number of performance indicators. The evaluation analysed routinely collected data from AFLCA, its Security Company, Alice Springs Police Department and Alice Springs Hospital; we surveyed AFLCA staff, club officials and umpires; and undertook direct observation at AFLCA events. The volume of alcohol sold at matches decreased. Survey data indicate decreased alcohol related violence, improved spectator behaviour and decreased spectator attendances. Police data suggest declining alcohol-related and violent behaviours, but trends were not statistically significant. Alice Springs Hospital injury admission data indicate a non-significant interaction between year and season effect. In a community context of high alcohol consumption and high rates of interpersonal violence, the strategies implemented were successful in decreasing alcohol consumption and related undesirable behaviours at football games. However, these measures have resulted in unintended consequences: decreased numbers of spectators attending games, decreased canteen sales and falling sponsorship. The decreased revenue has raised serious issues about sustainability of the alcohol intervention, and stimulated discussions with government and others about strategies to maintain this important alcohol reduction policy.

Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample.

PubMed

Lohman, Matthew C; Crow, Rebecca S; DiMilia, Peter R; Nicklett, Emily J; Bruce, Martha L; Batsis, John A

2017-12-01

Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool's predictive validity or adaptability to survey data. Data from five annual rounds (2011-2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 years and older in the USA. Analytic sample respondents (n=7392) were categorised at baseline as having low, moderate or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. Participants classified as having moderate and high fall risk had 2.62 (95% CI 2.29 to 2.99) and 4.76 (95% CI 3.51 to 6.47) times greater odds of falling during follow-up compared with those with low risk, respectively, controlling for sociodemographic and health-related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardise screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Measurement of central venous pressure and determination of hormones in blood serum during weightlessness

NASA Technical Reports Server (NTRS)

Kirsch, K.

1981-01-01

A Spacelab experiment is described which proposes to obtain data on the degree of engorgement of the cephalad circulation during weightlessness by recording central venous pressure. Of practical importance is the question of how close the astronauts are to pulmonary edema and whether the pressure falls toward normal during the time of the mission. Another experiment to investigate deviations from normal fluid and mineral metabolism, possibly initiated by the central engorgement of the low pressure system, is discussed. Hormones responsible for the control of water and mineral balance (vasopressin, catecholamines, renin, aldosterone, corticosteroids, and prostaglandin E1) will be analyzed from blood samples.

ANAEROBIC COMPOST CONSTRUCTED WETLANDS SYSTEM TECHNOLOGY - SITE ITER

EPA Science Inventory

In Fall 1994, anaerobic compost wetlands in both upflow and downflow configurations were constructed adjacent to and received drainage from the Burleigh Tunnel, which forms part of the Clear Creek/Central City Superfund site. The systems were operated over a 3 year period. The e...

Missouri DECA: 2010-2011 Policy Manual

ERIC Educational Resources Information Center

Missouri Department of Elementary and Secondary Education, 2011

2011-01-01

This paper presents the Missouri DECA Policy Manual. This manual contains the following sections: (1) DECA Board of Directors; (2) State Sales Projects; (3) State Officers; (4) Districts; (5) Competitive Events; (6) General Conference Information; (7) Fall Leadership & State Officer Election Conference; (8) Central Region Leadership…

Underachievement, Failing Youth and Moral Panics

ERIC Educational Resources Information Center

Smith, Emma

2010-01-01

This paper considers contemporary "moral panics" around the underachievement of boys in school examinations in the UK and America. In the UK, in particular, the underachievement of boys is central to current "crisis accounts" about falling standards and failing pupils. "Underachievement" is a familiar word to those…

118. COTTONWOOD CREEK SPILL, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

118. COTTONWOOD CREEK SPILL, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; WEST VIEW OF GATES ON HIGH LINE CANAL. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

An Initial Evaluation of the Iowa DE Project to Enhance Students' Authentic Intellectual Work. Fall 2007 to Fall 2011

ERIC Educational Resources Information Center

Iowa Department of Education, 2012

2012-01-01

Case studies of Authentic Intellectual Work (AIW) in the Iowa project included four high schools that have been practicing this professional development model for the last five years. The schools, AHST Secondary School, Cedar Falls High School, Spencer High and Middle Schools and Valley High School were visited in April, 2011. The visits included…

Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study.

PubMed

Wang, Hongwei; Yu, Hailong; Zhou, Yue; Li, Changqing; Liu, Jun; Ou, Lan; Zhao, Yiwen; Song, Guoli; Han, Jianda; Chen, Yu; Xiang, Liangbi

2017-09-01

The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height <2 m). The incidence and pattern were summarized with respect to different age groups, year of admission, etiologies, genders, and the neurological function.This study enrolled 1054 males (74.6%) and 358 females (25.4%) aged 10.8 ± 4.7 years. The etiologies were low fall (1059, 75.0%) and high fall (353, 25.0%). There were 2073 fractures in total and 92 patients (6.5%) presented with multiple fractures. The most common fracture sites were upper extremity fractures in 814 patients (57.6%) and lower extremity fractures in 383 patients (27.1%), followed by craniofacial fractures in 233 patients (16.5%). A total of 231 (16.4%) patients suffered a nerve injury. The frequencies of early and late complications/associated injuries were 19.5% (n = 275) and 9.2% (n = 130). The frequencies of emergency admission, nerve injury, spinal fracture, lower extremity fractures, craniofacial fracture, sternum and rib fracture, and early complications/ASOIs were significantly larger in high fall than low fall (all P <.001, respectively). The frequencies of medical insurance rate (P = .042) and upper extremity fractures (P <.001) were significantly larger in low fall than high fall. The frequencies of spinal fracture (P = .039), lower extremity fractures (P = .048), and craniofacial fracture (P = .041) were significantly larger in female than the male patients. The frequency of upper extremity fractures (P <.001) and the mean age (P <.001) was significantly larger in male than female patients. The frequencies of emergency admission, high fall, spinal fracture, and craniofacial fracture were significantly larger in patients with nerve injury than other patients without nerve injury (all P <.001, respectively).Low falls and upper extremity fractures were the most common etiologies and sites, respectively. High fall, spinal fracture and craniofacial fracture were risk factors for nerve injury. Therefore, we should focus on patients who were caused by high fall and presented with spinal and craniofacial fracture to determine the presence of a nerve injury so that we can provide early, timely diagnosis and targeted treatment to children.

Correlation of sea level falls interpreted from atoll stratigraphy with turbidites in adjacent basins

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lincoln, J.M.

Past sea levels can be derived from any atoll subsurface sediments deposited at or near sea level by determining the ages of deposition and correcting the present depths to the sediments for subsidence of the underlying edifice since the times of deposition. A sea level curve constructed by this method consists of discontinuous segments, each corresponding to a period of rising relative sea level and deposition of a discrete sedimentary package. Discontinuities in the sea level curve derived by this method correspond to relative sea level falls and stratigraphic hiatuses in the atoll subsurface. During intervals of relative sea levelmore » fall an atoll emerges to become a high limestone island. Sea level may fluctuate several times during a period of atoll emergence to become a high limestone island. Sea level may fluctuate several times during a period of atoll emergence without depositing sediments on top of the atoll. Furthermore, subaerial erosion may remove a substantial part of the depositional record of previous sea level fluctuations. For these reasons the authors must look to the adjacent basins to complement the incomplete record of sea level change recorded beneath atolls. During lowstands of sea level, faunas originally deposited near sea level on an atoll may be eroded and redeposited as turbidites in deep adjacent basins. Three such turbidites penetrated during deep-sea drilling at Sites 462 and 315 in the central Pacific correlate well with a late Tertiary sea level curve based on biostratigraphic ages and {sup 87}Sr/{sup 86}Sr chronostratigraphy for core from Enewetak Atoll in the northern Marshall Islands. Further drilling of the archipelagic aprons adjacent to atolls will improve the sea level history that may be inferred from atoll stratigraphy.« less

Risk factors of falls in inpatients and their practical use in identifying high-risk persons at admission: Fukushima Medical University Hospital cohort study.

PubMed

Hayakawa, Takehito; Hashimoto, Shigeatsu; Kanda, Hideyuki; Hirano, Noriko; Kurihara, Yumi; Kawashima, Takako; Fukushima, Tetsuhito

2014-01-01

To clarify the risk factors for falls in hospital settings and to propose the use of such factors to identify high-risk persons at admission. Prospective cohort study. Fukushima Medical University Hospital, Japan, from August 2008 and September 2009. 9957 adult consecutive inpatients admitted to our hospital. Information was collected at admission from clinical records obtained from a structured questionnaire conducted in face-to-face interviews with subjects by nurses and doctors and fall events were collected from clinical records. The proportion of patients who fell during follow-up was 2.5% and the incidence of falls was 3.28 per 100 person-days. There were significant differences in age, history of falling, cognitive dysfunction, planned surgery, wheelchair use, need for help to move, use of a remote caring system, rehabilitation, use of laxative, hypnotic or psychotropic medications and need for help with activities of daily living (ADL) between patients who did and did not fall. Multivariable adjusted ORs for falls showed that age, history of falls and need for help with ADL were common risk factors in both men and women. Using psychotropic medication also increased the risk of falling in men while cognitive dysfunction and use of hypnotic medication increased the risk of falling in women. Planned surgery was associated with a low risk of falls in women. To prevent falls in inpatients it is important to identify high-risk persons. Age, history of falling and the need for help with ADL are the most important pieces of information to be obtained at admission. Care plans for patients including fall prevention should be clear and considered.

Feasibility of using the International Classification of Functioning, Disability and Health Core Set for evaluation of fall-related risk factors in acute rehabilitation settings.

PubMed

Huang, Shih W; Lin, Li F; Chou, Lin C; Wu, Mei J; Liao, Chun D; Liou, Tsan H

2016-04-01

Previously, we reported the use of an International Classification of Functioning (ICF) core set that can provide a holistic framework for evaluating the risk factors of falls; however, data on the feasibility of applying this core set are lacking. To investigate the feasibility of applying the fall-related ICF risk-factor core set in the case of patients in an acute-rehabilitation setting. A cross-sectional and descriptive correlational design. Acute-rehabilitation ward. A total of 273 patients who experienced fall at acute-rehabilitation ward. The data on falls were collected from the hospital's Nursing Information System (NIS) and the fall-reporting system (Adverse Event Reporting System, AERS) between 2010 and 2013. The relationship of both systems to the fall-related ICF core set was analyzed to assess the feasibility of their clinical application. We evaluated the feasibility of using the fall-related ICF risk-factor core set by using the frequency and the percentage of the fall patients in of the listed categories. The fall-related ICF risk-factor core set category b735 (muscle tone functions) exhibited a high feasibility (85.95%) for clinical application, and the category b730 (muscle power functions) covered 77.11% of the patients. The feasibility of application of the category d410 (change basic body position) was also high in the case of all fall patients (81.69%). In the acute-rehabilitation setting, the feasibility of application of the fall-related ICF risk-factor core set is high. The fall-related ICF risk-factor core set can help multidisciplinary teams develop fall-prevention strategies in acute rehabilitation wards.

Risk factors of falls in inpatients and their practical use in identifying high-risk persons at admission: Fukushima Medical University Hospital cohort study

PubMed Central

Hayakawa, Takehito; Hashimoto, Shigeatsu; Kanda, Hideyuki; Hirano, Noriko; Kurihara, Yumi; Kawashima, Takako; Fukushima, Tetsuhito

2014-01-01

Objectives To clarify the risk factors for falls in hospital settings and to propose the use of such factors to identify high-risk persons at admission. Design Prospective cohort study. Setting Fukushima Medical University Hospital, Japan, from August 2008 and September 2009. Participants 9957 adult consecutive inpatients admitted to our hospital. Methods Information was collected at admission from clinical records obtained from a structured questionnaire conducted in face-to-face interviews with subjects by nurses and doctors and fall events were collected from clinical records. Results The proportion of patients who fell during follow-up was 2.5% and the incidence of falls was 3.28 per 100 person-days. There were significant differences in age, history of falling, cognitive dysfunction, planned surgery, wheelchair use, need for help to move, use of a remote caring system, rehabilitation, use of laxative, hypnotic or psychotropic medications and need for help with activities of daily living (ADL) between patients who did and did not fall. Multivariable adjusted ORs for falls showed that age, history of falls and need for help with ADL were common risk factors in both men and women. Using psychotropic medication also increased the risk of falling in men while cognitive dysfunction and use of hypnotic medication increased the risk of falling in women. Planned surgery was associated with a low risk of falls in women. Conclusions To prevent falls in inpatients it is important to identify high-risk persons. Age, history of falling and the need for help with ADL are the most important pieces of information to be obtained at admission. Care plans for patients including fall prevention should be clear and considered. PMID:25232563

122. MCMULLEN CREEK, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

122. MCMULLEN CREEK, TWIN FALLS COUNTY, SOUTH OF KIMBERLY, IDAHO; INLET SIDE OF THE CREEK, ENTRANCE INTO THE HIGH LINE CANAL, SOUTH VIEW. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

Tvashtar Movie

NASA Technical Reports Server (NTRS)

2007-01-01

[figure removed for brevity, see original site] Click on the image for QuickTime movie of Tvashtar Movie

Using its Long Range Reconnaissance Imager (LORRI), the New Horizons spacecraft captured the two frames in this 'movie' of the 330-kilometer (200-mile) high Tvashtar volcanic eruption plume on Jupiter's moon Io on February 28, 2007, from a range of 2.7 million kilometers (1.7 million miles). The two images were taken 50 minutes apart, at 03:50 and 04:40 Universal Time, and because particles in the plume take an estimated 30 minutes to fall back to the surface after being ejected by the central volcano, each image likely shows an entirely different set of particles. The details of the plume structure look quite different in each frame, though the overall brightness and size of the plume remain constant.

Surface details on the nightside of Io, faintly illuminated by Jupiter, show the 5-degree change in Io's central longitude, from 22 to 27 degrees west, between the two frames.

Modeling water quality, temperature, and flow in Link River, south-central Oregon

USGS Publications Warehouse

Sullivan, Annett B.; Rounds, Stewart A.

2016-09-09

The 2.1-km (1.3-mi) Link River connects Upper Klamath Lake to the Klamath River in south-central Oregon. A CE-QUAL-W2 flow and water-quality model of Link River was developed to provide a connection between an existing model of the upper Klamath River and any existing or future models of Upper Klamath Lake. Water-quality sampling at six locations in Link River was done during 2013–15 to support model development and to provide a better understanding of instream biogeochemical processes. The short reach and high velocities in Link River resulted in fast travel times and limited water-quality transformations, except for dissolved oxygen. Reaeration through the reach, especially at the falls in Link River, was particularly important in moderating dissolved oxygen concentrations that at times entered the reach at Link River Dam with marked supersaturation or subsaturation. This reaeration resulted in concentrations closer to saturation downstream at the mouth of Link River.

The Diurnal Profile of Central Hemodynamics in a General Uruguayan Population.

PubMed

Boggia, José; Luzardo, Leonella; Lujambio, Inés; Sottolano, Mariana; Robaina, Sebastián; Thijs, Lutgarde; Olascoaga, Alicia; Noboa, Oscar; Struijker-Boudier, Harry A; Safar, Michel E; Staessen, Jan A

2016-06-01

No previous population study assessed the diurnal profile of central arterial properties. In 167 participants (mean age, 56.1 years; 63.5% women), randomly recruited in Montevideo, Uruguay, we used the oscillometric Mobil-O-Graph 24-h PWA monitor to measure peripheral and central systolic (SBP), diastolic (DBP), and pulse (PP) pressures and central hemodynamics standardized to a heart rate of 75 bpm, including aortic pulse wave velocity, systolic augmentation (first/second peak × 100), and pressure amplification (peripheral PP/central PP). Over 24 hours, day and night, peripheral minus central differences in SBP/DBP and in PP averaged 12.2/-1.1, 14.0/-0.7, and 9.7/0.2mm Hg and 12.6, 14.7, and 9.5mm Hg, respectively (P < 0.001 except for nighttime DBP (P = 0.38)). The central-to-peripheral ratios of SBP, DBP, and PP were 0.89, 1.00, and 0.70 unadjusted, but after accounting for anthropometric characteristics decreased to 0.74, 0.97, and 0.63, respectively, with strong influence of height for SBP and DBP and of sex for PP. From day (10-20h) to nighttime (0-6h), peripheral (-10.4/-10.5 mm Hg) and central (-6.0/-11.3mm Hg) SBP/DBP, pulse wave velocity (-0.7 m/s) and pressure amplification (-0.05) decreased (P < 0.001), whereas central PP (+5.3mm Hg) and systolic augmentation (+2.3%) increased (P < 0.001). The diurnal rhythm of central pressure runs in parallel with that of peripheral pressure, but the nocturnal fall in SBP is smaller centrally than peripherally. pulse wave velocity, systolic augmentation, and pressure amplification loop through the day with high pulse wave velocity and pressure amplification but low systolic augmentation in the evening and opposite trends in the morning. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Fall prediction according to nurses' clinical judgment: differences between medical, surgical, and geriatric wards.

PubMed

Milisen, Koen; Coussement, Joke; Flamaing, Johan; Vlaeyen, Ellen; Schwendimann, René; Dejaeger, Eddy; Surmont, Kurt; Boonen, Steven

2012-06-01

To assess the value of nurses' clinical judgment (NCJ) in predicting hospital inpatient falls. Prospective multicenter study. Six Belgian hospitals. Two thousand four hundred seventy participants (mean age 67.6 ± 18.3; female, 55.7%) on four surgical (n = 812, 32.9%), eight geriatric (n = 666, 27.0%), and four general medical wards (n = 992, 40.1%) were included upon admission. All participants were hospitalized for at least 48 hours. Within 24 hours after admission, nurses gave their judgment on the question "Do you think your patient is at high risk for falling?" Nurses were not trained in assessing fall risk. Falls were documented on a standardized incident report form. During hospitalization, 143 (5.8%) participants experienced one or more falls, accounting for 202 falls and corresponding to an overall rate of 7.9 falls per 1,000 patient days. NCJ of participant's risk of falling had high sensitivity (78-92%) with high negative predictive value (94-100%) but low positive predictive value (4-17%). Although false-negative rates were low (8-22%) for all departments and age groups, false-positive rates were high (55-74%), except on surgical and general medical wards and in participants younger than 75. This analysis, based on multicenter data and a large sample size, suggests that NCJ can be recommended on surgical and general medical wards and in individuals younger than 75, but on geriatric wards and in participants aged 75 and older, NCJ overestimates risk of falling and is thus not recommended because expensive comprehensive fall-prevention measures would be implemented in a large number of individuals who do not need it. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Age-period-cohort analysis of oral cancer mortality in Europe: the end of an epidemic?

PubMed

Bonifazi, Martina; Malvezzi, Matteo; Bertuccio, Paola; Edefonti, Valeria; Garavello, Werner; Levi, Fabio; La Vecchia, Carlo; Negri, Eva

2011-05-01

Over the last decade, mortality from oral and pharyngeal cancer has been declining in most European countries, but it had been increasing substantially in Hungary, Slovakia and a few other countries of central Europe, reaching rates comparable to those of lung cancer in several western European countries in males. To update trends in oral cancer mortality and further analyse the recent epidemic in central Europe, official death certifications for oral and pharyngeal cancer for 37 European countries were derived over the period 1970-2007, and an age-period-cohort model was fitted for selected countries. Male oral cancer mortality continued to decline in most European countries, including the Russian Federation, and, more importantly, it also started to decline in some of the countries with the highest male rates, i.e. Hungary and Slovakia; persisting rises were, however, observed in Belarus, Bulgaria and Romania. Oral cancer mortality rates for women were lower than in men and showed no appreciable trend over recent periods in the EU overall. Estimates from the age-period-cohort analysis for most selected countries showed a fall in effects for the cohorts born after the 1950s. For the period effect displayed a rise for the earlier periods, an inversion in the 1990 s and a continuous fall up to the last studied period. Only some former non-market economy countries, like Romania, Ukraine and Lithuania, had rising cohort effect trends up to most recent generations. The major finding of this updated analysis of oral cancer mortality is the leveling of the epidemic for men in most European countries, including Hungary and other central European countries, where mortality from this cancer was exceedingly high. These trends essentially reflect the changes in alcohol and tobacco consumption in various populations. Copyright © 2010 Elsevier Ltd. All rights reserved.

Core or Cusps: The Central Dark Matter Profile of a Strong Lensing Cluster with a Bright Central Image at Redshift 1 [Core or Cusps: The Central Dark Matter Profile of a Redshift One Strong Lensing Cluster with a Bright Central Image

DOE PAGES

Collett, Thomas E.; Buckley-Geer, Elizabeth; Lin, Huan; ...

2017-07-10

Here, we report on SPT-CLJ2011-5228, a giant system of arcs created by a cluster at z = 1.06. The arc system is notable for the presence of a bright central image. The source is a Lyman break galaxy at z s = 2.39 and the mass enclosed within the Einstein ring of radius 14 arcsec ismore » $$\\sim {10}^{14.2}\\ {M}_{\\odot }$$. We perform a full reconstruction of the light profile of the lensed images to precisely infer the parameters of the mass distribution. The brightness of the central image demands that the central total density profile of the lens be shallow. By fitting the dark matter as a generalized Navarro–Frenk–White profile—with a free parameter for the inner density slope—we find that the break radius is $${270}_{-76}^{+48}$$ kpc, and that the inner density falls with radius to the power –0.38 ± 0.04 at 68% confidence. Such a shallow profile is in strong tension with our understanding of relaxed cold dark matter halos; dark matter-only simulations predict that the inner density should fall as $${r}^{-1}$$. The tension can be alleviated if this cluster is in fact a merger; a two-halo model can also reconstruct the data, with both clumps (density varying as $${r}^{-0.8}$$ and $${r}^{-1.0}$$) much more consistent with predictions from dark matter-only simulations. At the resolution of our Dark Energy Survey imaging, we are unable to choose between these two models, but we make predictions for forthcoming Hubble Space Telescope imaging that will decisively distinguish between them.« less

Core or Cusps: The Central Dark Matter Profile of a Strong Lensing Cluster with a Bright Central Image at Redshift 1 [Core or Cusps: The Central Dark Matter Profile of a Redshift One Strong Lensing Cluster with a Bright Central Image

DOE Office of Scientific and Technical Information (OSTI.GOV)

Collett, Thomas E.; Buckley-Geer, Elizabeth; Lin, Huan

Here, we report on SPT-CLJ2011-5228, a giant system of arcs created by a cluster at z = 1.06. The arc system is notable for the presence of a bright central image. The source is a Lyman break galaxy at z s = 2.39 and the mass enclosed within the Einstein ring of radius 14 arcsec ismore » $$\\sim {10}^{14.2}\\ {M}_{\\odot }$$. We perform a full reconstruction of the light profile of the lensed images to precisely infer the parameters of the mass distribution. The brightness of the central image demands that the central total density profile of the lens be shallow. By fitting the dark matter as a generalized Navarro–Frenk–White profile—with a free parameter for the inner density slope—we find that the break radius is $${270}_{-76}^{+48}$$ kpc, and that the inner density falls with radius to the power –0.38 ± 0.04 at 68% confidence. Such a shallow profile is in strong tension with our understanding of relaxed cold dark matter halos; dark matter-only simulations predict that the inner density should fall as $${r}^{-1}$$. The tension can be alleviated if this cluster is in fact a merger; a two-halo model can also reconstruct the data, with both clumps (density varying as $${r}^{-0.8}$$ and $${r}^{-1.0}$$) much more consistent with predictions from dark matter-only simulations. At the resolution of our Dark Energy Survey imaging, we are unable to choose between these two models, but we make predictions for forthcoming Hubble Space Telescope imaging that will decisively distinguish between them.« less

How Do River Meanders Change with Sea Level Rise and Fall?

NASA Astrophysics Data System (ADS)

Scamardo, J. E.; Kim, W.

2016-12-01

River meander patterns are controlled by numerous factors, including variations in water discharge, sediment input, and base level. However, the effect of sea level rise and fall on meandering rivers has not been thoroughly quantified. This study examines geomorphic changes to meandering rivers as a result of sea level rise and fall. Twenty experimental runs using coarse-grained walnut shell sediment (D50= 500 microns) in a flume tank (2.4m x 0.6m x 0.1m) tested the optimal initial conditions for creating meandering rivers in a laboratory setting as well as variations in base level rise and fall rates. Geomorphic changes were recorded by camera images every 20 seconds for a duration of 4 hours per experiment. Seventeen experiments tested the effects of changes in initial base levels, water discharge between 200 and 400 mL/min, and sediment to water input ratios between 1:1000 and 1:250 while measuring sinuosity, channel geometry, and the timescale of the channel to reach a stable form. Sinuosity and channel activity increased with increasing water discharge, initial base level, and the sediment to water ratio to a point after which the activity decreased with increasing sediment input. Base-level change experiments used initial conditions of 400 mL/min, a 1:750 sediment to water input ratio, and a 6 cm initial base-level to induce river meanders for the initial 2 hours before base-level change occurred. Three separate experiments investigated the effects of increasing rates of sea level change: 0.07 cm/min, 0.1 cm/min, and 0.2 cm/min. Experimental sea level was decreased constantly from a high-stand of 6 cm to a low-stand of 2 cm back to the high-stand base-level in each experiment. The rates of change in the experiments scale roughly from central to glacial cycles. In all three experiments, sea level fall induced meander cut-off while sea level rise prompted greater rates of meander bend erosion and meander growth. Sinuosity increased by 12%, 13.5%, and 24%, respectively in the three experiments, with most sinuosity changes occurring in the downstream reach of the channel. These experiments could provide insight into long term effects of sea level change on modern meandering fluvial systems as well as provide a key to interpreting past fluvial changes in the stratigraphic record.

Older Adult Falls: Effective Approaches to Prevention

PubMed Central

Dellinger, Ann

2017-01-01

Purpose The issue of older adult falls combines a problem with high incidence and high injury susceptibility with an increasing population at risk. A firm understanding of both fall risk factors and effective strategies is required to reduce risk and prevent these injuries. Recent Findings Each year, 28.7% of older adults aged ≥65 sustain a fall. At the national level, this represents 29 million falls resulting in 27,000 deaths and 7 million injuries requiring medical treatment or restricted activity for at least 1 day. There are several strategies that have been shown to effectively reduce the risk or the incidence of falls. Summary More than 90% of older adults see a medical provider at least once a year providing an opportunity to identify and address fall risk factors. Comprehensive fall prevention in the primary care setting is both feasible and practical. PMID:28845383

Sensory integration balance training in patients with multiple sclerosis: A randomized, controlled trial.

PubMed

Gandolfi, Marialuisa; Munari, Daniele; Geroin, Christian; Gajofatto, Alberto; Benedetti, Maria Donata; Midiri, Alessandro; Carla, Fontana; Picelli, Alessandro; Waldner, Andreas; Smania, Nicola

2015-10-01

Impaired sensory integration contributes to balance disorders in patients with multiple sclerosis (MS). The objective of this paper is to compare the effects of sensory integration balance training against conventional rehabilitation on balance disorders, the level of balance confidence perceived, quality of life, fatigue, frequency of falls, and sensory integration processing on a large sample of patients with MS. This single-blind, randomized, controlled trial involved 80 outpatients with MS (EDSS: 1.5-6.0) and subjective symptoms of balance disorders. The experimental group (n = 39) received specific training to improve central integration of afferent sensory inputs; the control group (n = 41) received conventional rehabilitation (15 treatment sessions of 50 minutes each). Before, after treatment, and at one month post-treatment, patients were evaluated by a blinded rater using the Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), Multiple Sclerosis Quality of Life-54, Fatigue Severity Scale (FSS), number of falls and the Sensory Organization Balance Test (SOT). The experimental training program produced greater improvements than the control group training on the BBS (p < 0.001), the FSS (p < 0.002), number of falls (p = 0.002) and SOT (p < 0.05). Specific training to improve central integration of afferent sensory inputs may ameliorate balance disorders in patients with MS. Clinical Trial Registration (NCT01040117). © The Author(s), 2015.

ANAEROBIC COMPOST CONSTRUCTED WETLANDS SYSTEM TECHNOLOGY - SITE TECHNOLOGY CAPSULE

EPA Science Inventory

In fall 1994, anaerobic compost wetlands in both upflow and down flow configurations were constructed adjacent to and received drainage from the Burleigh tunnel, which forms part of the Clear Creek/Central City Superfund site. The systems were operated over a 3 year period. The ...

Gold deposits of the southern Piedmont

USGS Publications Warehouse

Pardee, J.T.; Park, C.F.

1948-01-01

along the southeast front of the .:Appalachian Mountains from the Great Falls of the Potomac River to east-central Alabama, in the gently sloping region known as the Piedmont. The field work was done during parts of 1934 and 1935, on funds allotted by the Public Works Administration.

31 CFR 598.314 - Specially designated narcotics trafficker.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Central Intelligence, the Director of the Federal Bureau of Investigation, the Administrator of the Drug... goods or services in support of, the international narcotics trafficking activities of a specially... trafficking. Note 1 to § 598.314: The names of persons determined to fall within this definition, whose...

Effects of strawberry supplementation on mobility and cognition in older adults

USDA-ARS?s Scientific Manuscript database

During aging, functional changes in the central and peripheral nervous system can alter mobility and cognition - in some cases leading to early cognitive decline, disability, or injurious falls among older adults. Previously, we have shown that two months of dietary supplementation with berry fruit...

Neighborhood Disadvantage and Life-Space Mobility Are Associated with Incident Falls in Community-Dwelling Older Adults.

PubMed

Lo, Alexander X; Rundle, Andrew G; Buys, David; Kennedy, Richard E; Sawyer, Patricia; Allman, Richard M; Brown, Cynthia J

2016-11-01

To determine the relationship between neighborhood-level socioeconomic characteristics, life-space mobility, and incident falls in community-dwelling older adults. Prospective, observational cohort study with a baseline in-home assessment and 6-month telephone follow-up. Central Alabama. Community-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries (N = 1,000). Neighborhood disadvantage was measured using a composite index derived from baseline neighborhood-level residential census tract socioeconomic variables. Data on individual-level socioeconomic characteristics, clinical variables, and life-space collected at baseline were included as covariates in a multivariate model using generalized estimating equations to assess the association with incident falls in the 6 months after baseline. Of the 940 participants who completed baseline and follow-up assessments, 126 (13%) reported one or more new falls in the 6 months after baseline. There was an independent nonlinear association between neighborhood disadvantage (according to increasing quartiles of disadvantage) and incident falls after adjusting for confounders: The lowest quartile served as reference; 2nd quartile odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.2-4.6; 3rd quartile OR = 1.9, 95% CI = 1.0-3.7; 4th quartile OR = 3.2, 95% CI = 1.7-6.0. Each 10-point decrement in life-space (OR = 1.2, 95% CI = 1.0-1.3) was associated with a higher risk of falls. Greater neighborhood disadvantage was associated with greater risk of falls. Life-space also contributes separately to fall risk. Community-dwelling older adults in disadvantaged neighborhoods, particularly those with limited mobility, may benefit from a more-rigorous assessment of their fall risk by healthcare providers. Neighborhood level socioeconomic characteristics should also be an important consideration when identifying vulnerable populations that may benefit the most from fall prevention programs. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Distribution and abundance of Syacium ovale larvae (Pleuronectiformes: Paralichthyidae) in the Gulf of California.

PubMed

Aceves-Medina, Gerardo; Saldierna-Martínez, Ricardo J; González, Enrique A

2003-06-01

The spawning season of the tonguefish Syacium ovale (Günter 1864) was determined by an analysis of the distribution of preflexion stage larvae in the Gulf of California. The larvae were collected during eight oceanographic surveys between 1984 and 1987. The spawning of this species starts in early summer and ends at the beginning of fall, with the highest reproductive activity in mid summer. The central and southern regions of the Gulf are the most important reproductive area. Spawning is associated with high sea surface temperatures and low plankton biomass, both of which are characteristics of the tropical current that invades the study area during summer.

The Discrepancy Between Measured and Modeled Downwelling Solar Irradiance at the Ground: Dependence on Water Vapor

NASA Technical Reports Server (NTRS)

Pilewski, P.; Rabbette, M.; Bergstrom, R.; Marquez, J.; Schmid, B.; Russell, P. B.

2000-01-01

Moderate resolution spectra of the downwelling solar irradiance at the ground in north central Oklahoma were measured during the Department of Energy Atmospheric Radiation Measurement Program Intensive Observation Period in the fall of 1997. Spectra obtained under-cloud-free conditions were compared with calculations using a coarse resolution radiative transfer model to examine the dependency of model-measurement bias on water vapor. It was found that the bias was highly correlated with water vapor and increased at a rate of 9 Wm per cm of water. The source of the discrepancy remains undetermined because of the complex dependencies of other variables, most notably aerosol optical depth, on water vapor.

The Discrepancy Between Measured and Modeled Downwelling Solar Irradiance at the Ground: Dependence on Water Vapor

NASA Technical Reports Server (NTRS)

Pilewskie, P.; Rabbette, M.; Bergstrom, R.; Marquez, J.; Schmid, B.; Russell, P. B.

2000-01-01

Moderate resolution spectra of the downwelling solar irradiance at the ground in north central Oklahoma were measured during the Department of Energy Atmospheric Radiation Measurement Program Intensive Observation Period in the fall of 1997. Spectra obtained under cloud-free conditions were compared with calculations using a coarse resolution radiative transfer model to examine the dependency of model-measurement bias on water vapor. It was found that the bias was highly correlated with water vapor and increased at a rate of 9 Wm(exp -2) per cm of water. The source of the discrepancy remains undetermined because of the complex dependencies of other variables, most notably aerosol optical depth, on water vapor.

Detecting the transport of toxic pesticides from golf courses into watersheds in the Precambrian Shield region of Ontario, Canada.

PubMed

Metcalfe, Tracy L; Dillon, Peter J; Metcalfe, Chris D

2008-04-01

Golf courses impact the environment through alterations to habitat and through the release of nutrients and pesticides. The Precambrian Shield region of central Ontario, Canada, which is a major recreational area, is especially susceptible to the impacts of golf courses as a result of the geology and hydrology of the region. In a monitoring program at two golf courses in the Muskoka region conducted during the spring, summer, and fall of 2002, semipermeable membrane devices (SPMDs) were deployed into streams that drain the golf courses. The extracts from the SPMDs were tested for toxicity using bioassays with early life stages of an aquarium fish, the Japanese medaka (Oryzias latipes). Toxicity was assessed using a scoring system developed for the present study. The bioassays with medaka indicated that toxicity was highest in extracts from SPMDs deployed during the spring and the fall. The peaks in toxicity for the SPMDs deployed at the two golf courses corresponded with the presence in the SPMD extracts of pentachloronitrobenzene (PCNB) at concentrations up to 334 ng/SPMD. Quintozene is the turfgrass fungicide in which PCNB is the active ingredient. Pentachlorothioanisole, an anaerobic degradation product of PCNB, also was detected in the SPMDs deployed during the spring. Extracts prepared from SPMDs with high toxicity contained residues of a surfactant used in pesticide formulations, nonylphenol, at concentrations up to approximately 20 microg/SPMD. Overall, these data indicate that some pesticides applied to golf courses in the Precambrian Shield of central Ontario may have the potential to cause toxic impacts to aquatic organisms in adjacent watersheds.

Influence of a falling edge on high power microwave pulse combination

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Jiawei; Huang, Wenhua; Science and Technology on High Power Microwave Laboratory, Northwest Institute of Nuclear Technology, Xi'an 710024

This paper presents an explanation of the influence of a microwave falling edge on high-power microwave pulse combination. Through particle-in-cell simulations, we discover that the falling edge is the driving factor that limits the output power of the combined pulses. We demonstrate that the space charge field, which accumulates to become comparable to the E-field at the falling edge of the former pulse, will trap the electrons in the gas layer and decrease its energy to attain a high ionization rate. Hence, avalanche discharge, caused by trapped electrons, makes the plasma density to approach the critical density and cuts offmore » the latter microwave pulse. An X-band combination experiment is conducted with different pulse intervals. This experiment confirms that the high density plasma induced by the falling edge can cut off the latter pulse, and that the time required for plasma recombination in the transmission channel is several microseconds. To ensure a high output power for combined pulses, the latter pulse should be moved ahead of the falling edge of the former one, and consequently, a beat wave with high peak power becomes the output by adding two pulses with normal amplitudes.« less

Influence of a falling edge on high power microwave pulse combination

NASA Astrophysics Data System (ADS)

Li, Jiawei; Huang, Wenhua; Zhu, Qi; Xiao, Renzhen; Shao, Hao

2016-07-01

This paper presents an explanation of the influence of a microwave falling edge on high-power microwave pulse combination. Through particle-in-cell simulations, we discover that the falling edge is the driving factor that limits the output power of the combined pulses. We demonstrate that the space charge field, which accumulates to become comparable to the E-field at the falling edge of the former pulse, will trap the electrons in the gas layer and decrease its energy to attain a high ionization rate. Hence, avalanche discharge, caused by trapped electrons, makes the plasma density to approach the critical density and cuts off the latter microwave pulse. An X-band combination experiment is conducted with different pulse intervals. This experiment confirms that the high density plasma induced by the falling edge can cut off the latter pulse, and that the time required for plasma recombination in the transmission channel is several microseconds. To ensure a high output power for combined pulses, the latter pulse should be moved ahead of the falling edge of the former one, and consequently, a beat wave with high peak power becomes the output by adding two pulses with normal amplitudes.

In-hospital fall-risk screening in 4,735 geriatric patients from the LUCAS project.

PubMed

Neumann, L; Hoffmann, V S; Golgert, S; Hasford, J; Von Renteln-Kruse, W

2013-03-01

In-hospital falls in older patients are frequent, but the identification of patients at risk of falling is challenging. Aim of this study was to improve the identification of high-risk patients. Therefore, a simplified screening-tool was developed, validated, and compared to the STRATIFY predictive accuracy. Retrospective analysis of 4,735 patients; evaluation of predictive accuracy of STRATIFY and its single risk factors, as well as age, gender and psychotropic medication; splitting the dataset into a learning and a validation sample for modelling fall-risk screening and independent, temporal validation. Geriatric clinic at an academic teaching hospital in Hamburg, Germany. 4,735 hospitalised patients ≥65 years. Sensitivity, specificity, positive and negative predictive value, Odds Ratios, Youden-Index and the rates of falls and fallers were calculated. There were 10.7% fallers, and the fall rate was 7.9/1,000 hospital days. In the learning sample, mental alteration (OR 2.9), fall history (OR 2.1), and insecure mobility (Barthel-Index items 'transfer' + 'walking' score = 5, 10 or 15) (OR 2.3) had the most strongest association to falls. The LUCAS Fall-Risk Screening uses these risk factors, and patients with ≥2 risk factors contributed to the high-risk group (30.9%). In the validation sample, STRATIFY SENS was 56.8, SPEC 59.6, PPV 13.5 and NPV 92.6 vs. LUCAS Fall-Risk Screening was SENS 46.0, SPEC 71.1, PPV 14.9 and NPV 92.3. Both the STRATIFY and the LUCAS Fall-Risk Screening showed comparable results in defining a high-risk group. Impaired mobility and cognitive status were closely associated to falls. The results do underscore the importance of functional status as essential fall-risk factor in older hospitalised patients.

Net ozone photochemical production over the eastern and central North Pacific as inferred from GTE/CITE 1 observations during fall 1983

NASA Technical Reports Server (NTRS)

Chameides, W. L.; Davis, D. D.; Rodgers, M. O.; Bradshaw, J.; Sandholm, S.; Sachse, G.; Hill, G.; Gregory, G.

1987-01-01

The role of photochemistry in the budget of tropospheric ozone is studied. Measurements of O3, NO, CO, H2O vapor, and temperature obtained during the fall of 1983 during the GTE/CITE project over the eastern and central North Pacific Ocean are analyzed. The effect of altitude on the measurements is discussed. The analysis reveals a correlation between ozone and NO levels; both increase in concentration and variability with altitude. It is observed that an additional source of secondary importance associated wih CO-rich air parcels exists. A photochemical model is utilized to calculate the net rate of ozone production by photochemical reactions. A net photochemical source of ozone in the free troposphere and a net sink in the boundary layer are detected. The relation between the ozone source in the free troposphere and NO is examined. It is estimated that photochemistry provides a net ozone source to the free troposphere overlying the eastern and central North Pacific Ocean of about 5 x 10 to the 10th molecules/sq cm sec and a net sink of ozone to the boundary layer overlying this region of about 3 x 10 to the 10th molecules/sq cm sec.

Reversing cooling flows with AGN jets: shock waves, rarefaction waves and trailing outflows

NASA Astrophysics Data System (ADS)

Guo, Fulai; Duan, Xiaodong; Yuan, Ye-Fei

2018-01-01

The cooling flow problem is one of the central problems in galaxy clusters, and active galactic nucleus (AGN) feedback is considered to play a key role in offsetting cooling. However, how AGN jets heat and suppress cooling flows remains highly debated. Using an idealized simulation of a cool-core cluster, we study the development of central cooling catastrophe and how a subsequent powerful AGN jet event averts cooling flows, with a focus on complex gasdynamical processes involved. We find that the jet drives a bow shock, which reverses cooling inflows and overheats inner cool-core regions. The shocked gas moves outward in a rarefaction wave, which rarefies the dense core and adiabatically transports a significant fraction of heated energy to outer regions. As the rarefaction wave propagates away, inflows resume in the cluster core, but a trailing outflow is uplifted by the AGN bubble, preventing gas accumulation and catastrophic cooling in central regions. Inflows and trailing outflows constitute meridional circulations in the cluster core. At later times, trailing outflows fall back to the cluster centre, triggering central cooling catastrophe and potentially a new generation of AGN feedback. We thus envisage a picture of cool cluster cores going through cycles of cooling-induced contraction and AGN-induced expansion. This picture naturally predicts an anti-correlation between the gas fraction (or X-ray luminosity) of cool cores and the central gas entropy, which may be tested by X-ray observations.

A systematic review and meta-analysis of exercise-based falls prevention strategies in adults aged 50+ years with visual impairment.

PubMed

Dillon, Lisa; Clemson, Lindy; Ramulu, Pradeep; Sherrington, Catherine; Keay, Lisa

2018-05-06

To determine the impact of exercise or physical training on falls or physical function in people aged 50+ years with visual impairment, compared with control (no intervention or usual care). An updated systematic review of randomised controlled trials, investigating the effect of exercise or physical activity on falls prevention or physical function in adults aged 50+ with visual impairment. Searches of CINAHL, the Cochrane Register of Controlled Trials (CENTRAL), Embase, and Medline were undertaken. Three trials were identified for the period February 2013 to July 2017 and added to the four in the original review. New trials evaluated yoga, the Otago Exercise Programme in combination with a home safety programme and the Alexander Technique. Meta-analysis of data from two trials (n = 163) indicated a non-statistically significant positive impact of exercise on the Chair Stand Test (WMD -1.85 s, 95% CI -4.65 to 0.96, p = 0.20, I 2 22%). In this update, two new trials measured falls so meta-analysis was possible for three trials (n = 539) and revealed no impact on falls (RR 1.05, 95% CI 0.73 to 1.50, p = 0.81, I 2 30%). Although exercise or physical training can improve physical function in older adults with visual impairment, and diverse strategies are being evaluated, there are no proven falls prevention strategies. In the few studies available, falls are not consistently reported and more work is required to investigate falls prevention in older adults with visual impairment. © 2018 The Authors Ophthalmic & Physiological Optics © 2018 The College of Optometrists.

Epidemiologic Trends in Medically-attended Tree Stand Fall Injuries among Wisconsin Deer Hunters

PubMed Central

VanWormer, Jeffrey J.; Holsman, Robert H.; Petchenik, Jordan B.; Dhuey, Brian J.; Keifer, Matthew C.

2015-01-01

Background Tree stand falls are the most common injury to hunters in the USA, but there is limited research on the topic. This study examined the 5-year trends in incident tree stand fall injuries in rural north-central Wisconsin and described patient demographics and injury features. Methods A retrospective analysis was conducted on five prior hunting seasons, 2009–2013. Cases were ascertained from electronic health records via natural language processing that identified patients from the Marshfield Epidemiologic Study Area who received medical attention for a tree stand fall. Annual incidence rates were calculated using the number of hunting license holders in the target population, per administrative data from the Wisconsin Department of Natural Resources. Results There were 16,556–16,902 deer hunters in any given year, with 39 (92% male) confirmed medically-attended tree stand fall injuries in 2009–2013. Injuries mainly occurred in the lower extremities (n=23), and included two fatalities and one paralysis case. The risk of tree stand fall injuries went from 6.0 (95% CI: 3.2, 11.1) per 10,000 hunters in 2009 to 3.6 (95% CI: 1.6, 7.9) per 10,000 hunters in 2013, which was not a significant change over five years (p=0.79). Most falls occurred among archery hunters, in the evening and when descending from a tree stand. Cases were demographically similar to the general population of Wisconsin deer hunters. Conclusions The current seasonal incidence rate of tree stand fall injuries is relatively low in rural Wisconsin, but with limited signs of improvement. Continued efforts are needed to promote the long-term safety of the hunting public. PMID:26443558

Dementia Medications and Risk of Falls, Syncope, and Related Adverse Events Meta-Analysis of Randomized Controlled Trials

PubMed Central

Kim, Dae Hyun; Brown, Rebecca T.; Ding, Eric L.; Kiel, Douglas P.; Berry, Sarah D.

2012-01-01

Background Conflicting evidence exists on whether cholinesterase inhibitors and memantine increase the risk of falls, syncope, and related events, defined as fracture and accidental injury. Objectives To evaluate the effect of cholinesterase inhibitors and memantine on the risk of falls, syncope, and related events Design, Setting, Participants, and Intervention Meta-analysis of 54 placebo-controlled randomized trials and extension studies of cholinesterase inhibitors and memantine that reported falls, syncope, and related events in cognitively impaired older adults. Trials were identified from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (no language restriction, through July 2009), and manual search. Measurements Falls, syncope, fracture, and accidental injury Results Compared to placebo, cholinesterase inhibitor use was associated with an increased risk of syncope (odds ratio [95% confidence interval]: 1.53 [1.02-2.30]), but not with other events (falls: 0.88 [0.74-1.04]; fracture: 1.39 [0.75-2.56]; accidental injury: 1.13 [0.87-1.45]). Memantine use was associated with fewer fractures (0.21 [0.05-0.85]), but not with other events (fall: 0.92 [0.72-1.18]; syncope: 1.04 [0.35-3.04]; accidental injury: 0.80 [0.56-1.12]). There was no differential effect by type and severity of cognitive impairment, residential status, nor length of follow-up. However, due to underreporting and small number of events, a potential benefit or risk cannot be excluded. Conclusion Cholinesterase inhibitors may increase the risk of syncope, with no effects on falls, fracture, and accidental injury in cognitively impaired older adults. Memantine may have a favorable effect on fracture, with no effects on other events. More research is needed to confirm the reduction in fractures observed for memantine. PMID:21649634

Epidemiologic trends in medically-attended tree stand fall injuries among Wisconsin deer hunters.

PubMed

VanWormer, Jeffrey J; Holsman, Robert H; Petchenik, Jordan B; Dhuey, Brian J; Keifer, Matthew C

2016-01-01

Tree stand falls are the most common injury to hunters in the USA, but there is limited research on the topic. This study examined the 5-year trends in incident tree stand fall injuries in rural north-central Wisconsin and described patient demographics and injury features. A retrospective analysis was conducted on five prior hunting seasons, 2009-2013. Cases were ascertained from electronic health records via natural language processing that identified patients from the Marshfield Epidemiologic Study Area who received medical attention for a tree stand fall. Annual incidence rates were calculated using the number of hunting license holders in the target population, per administrative data from the Wisconsin Department of Natural Resources. There were 16,556-16,902 deer hunters in any given year, with 39 (92% male) confirmed medically-attended tree stand fall injuries in 2009-2013. Injuries mainly occurred in the lower extremities (n=23), and included two fatalities and one paralysis case. The risk of tree stand fall injuries went from 6.0 (95% CI: 3.2, 11.1) per 10,000 hunters in 2009 to 3.6 (95% CI: 1.6, 7.9) per 10,000 hunters in 2013, which was not a significant change over 5 years (p=0.79). Most falls occurred among archery hunters, in the evening and when descending from a tree stand. Cases were demographically similar to the general population of Wisconsin deer hunters. The current seasonal incidence rate of tree stand fall injuries is relatively low in rural Wisconsin, but with limited signs of improvement. Continued efforts are needed to promote the long-term safety of the hunting public. Copyright © 2015 Elsevier Ltd. All rights reserved.

Association of stressful life events with incident falls and fractures in older men: the Osteoporotic Fractures in Men (MrOS) Study

PubMed Central

Fink, Howard A.; Kuskowski, Michael A.; Marshall, Lynn M.

2014-01-01

Background: small, retrospective studies suggest that major life events and/or sudden emotional stress may increase fall and fracture risk. The current study examines these associations prospectively. Methods: a total of 5,152 men aged ≥65 years in the Osteoporotic Fractures in Men study self-reported data on stressful life events for 1 year prior to study Visit 2. Incident falls and fractures were ascertained for 1 year after Visit 2. Fractures were centrally confirmed. Results: a total of 2,932 (56.9%) men reported ≥1 type of stressful life event. In men with complete stressful life event, fall and covariate data (n = 3,949), any stressful life event was associated with a 33% increased risk of incident fall [relative risk (RR) 1.33, 95% confidence interval (CI) 1.19–1.49] and 68% increased risk of multiple falls (RR = 1.68, 95% CI = 1.40–2.01) in the year following Visit 2 after adjustment for age, education, Parkinson's disease, diabetes, stroke, instrumental activities of daily living (IADL) impairment, chair stand time, walk speed, multiple past falls, depressive symptoms and antidepressant use. Risk increased with the number of types of stressful life events. Though any stressful life event was associated with a 58% increased age-adjusted risk for incident fracture, this association was attenuated and no longer statistically significant after additional adjustment for total hip bone mineral density, fracture after age 50, Parkinson's disease, stroke and IADL impairment. Conclusions: in this cohort of older men, stressful life events significantly increased risk of incident falls independent of other explanatory variables, but did not independently increase incident fracture risk. PMID:24002237

Strength and balance training for adults with peripheral neuropathy and high risk of fall: current evidence and implications for future research.

PubMed

Tofthagen, Cindy; Visovsky, Constance; Berry, Donna L

2012-09-01

To evaluate the evidence for strength- and balance-training programs in patients at high risk for falls, discuss how results of existing studies might guide clinical practice, and discuss directions for additional research. A search of PubMed and CINAHL® databases was conducted in June 2011 using the terms strength, balance training, falls, elderly, and neuropathy. Only clinical trials conducted using specific strength- or balance-training exercises that included community-dwelling adults and examined falls, fall risk, balance, and/or strength as outcome measures were included in this review. One matched case-control study and two randomized, controlled studies evaluating strength and balance training in patients with diabetes-related peripheral neuropathy were identified. Eleven studies evaluating strength and balance programs in community-dwelling adults at high risk for falls were identified. The findings from the reviewed studies provide substantial evidence to support the use of strength and balance training for older adults at risk for falls, and detail early evidence to support strength and balance training for individuals with peripheral neuropathy. The evidence demonstrates that strength and balance training is safe and effective at reducing falls and improving lower extremity strength and balance in adults aged 50 years and older at high risk for falls, including patients with diabetic peripheral neuropathy. Future studies should evaluate the effects of strength and balance training in patients with cancer, particularly individuals with chemotherapy-induced peripheral neuropathy.

Using science and psychology to improve the dissemination and evaluation of scientific work.

PubMed

Buttliere, Brett T

2014-01-01

Here I outline some of what science can tell us about the problems in psychological publishing and how to best address those problems. First, the motivation behind questionable research practices is examined (the desire to get ahead or, at least, not fall behind). Next, behavior modification strategies are discussed, pointing out that reward works better than punishment. Humans are utility seekers and the implementation of current change initiatives is hindered by high initial buy-in costs and insufficient expected utility. Open science tools interested in improving science should team up, to increase utility while lowering the cost and risk associated with engagement. The best way to realign individual and group motives will probably be to create one, centralized, easy to use, platform, with a profile, a feed of targeted science stories based upon previous system interaction, a sophisticated (public) discussion section, and impact metrics which use the associated data. These measures encourage high quality review and other prosocial activities while inhibiting self-serving behavior. Some advantages of centrally digitizing communications are outlined, including ways the data could be used to improve the peer review process. Most generally, it seems that decisions about change design and implementation should be theory and data driven.

3D Micro-tomography on Aggregates from the 2014- 2015 Eruption of Hunga Tonga-Hunga Ha'apai Volcano

NASA Astrophysics Data System (ADS)

Colombier, M.; Scheu, B.; Cronin, S. J.; Tost, M.; Dobson, K. J.; Dingwell, D. B.

2016-12-01

In December 2014- January 2015, a surtseyan eruption at Hunga Tonga-Hunga Ha'apai volcano (Tonga) formed a new island. Three main eruptive phases were distinguished by observation and deposits: (i) mound and cone construction, involving collapse of 300-600 m-high wet tephra jets, grain flows, slope-remobilisation and energetic surges, with little or no convective plume (ii) The upper cone-building phase with lower jets (mainly <300 m) but greater ash production (weak, steam-rich plumes to 6 km) and weak surges, and (iii) final phase with weak surge, fall and ballistic deposits with more vesicular pyroclasts producing proximal capping deposits. Most sampled deposits contain ash, lapilli and bombs, and lapilli-sized aggregates are ubiquitous. We used high-resolution 3D X-ray microcomputed tomography (XCT) to quantify the grain size distribution (GSD) and porosity by sampling multiple stratigraphic units within the main eruptive sequences. We visualized and quantified the internal structure of the aggregates to understand the evolution of this surtseyan eruption. We present here an overview of the textural information: porosity, vesicle size distribution and morphology as well as the variability of the aggregation features. Aggregates from the fall deposits of the early wet phase are mostly loosely packed, poorly-structured ash clusters. Aggregates from the early surge sequence and the main cone building phase dominantly exhibit a central particle coated by ash cluster material. Vesicles in the particles from the early fall deposits tend to be smaller and more isolated than in the particles from the surge sequence and the main cone building phase. The GSD of aggregates obtained by XCT is highly valuable to correct the total GSD of volcaniclastic deposits. The strong variations in the aggregation features across the eruption suggest a range of different formation and deposition mechanisms related to varying degrees of magma-water-interaction, which changed the morphology and textural properties of the individual particles.

Fall-induced spinal cord injury: External causes and implications for prevention.

PubMed

Chen, Yuying; Tang, Ying; Allen, Victoria; DeVivo, Michael J

2016-01-01

To document the demographic and clinical profile of persons who sustained spinal cord injury (SCI) as a result of accidental falls and to determine the usual circumstances surrounding the fall-induced SCI. Cohort study. 21 SCI Model Systems centers throughout the United States. 6,408 individuals with traumatic SCI between 2005 and 2014 were recruited from the National SCI Database. 1,877 (29%) of them were injuries caused by falls. Not applicable. External causes of injury documented by the International Classification of Diseases, 10(th) revision, Clinical Modification (ICD-10-CM). Falls on the same level from slipping, tripping, and stumbling were the most common cause of fall-induced SCI (20%), followed by falls from building (16%), stairs and steps (16%), and ladder (9%). People who were 61 years of age and older had the highest frequency of falls on the same level, while those aged 16-45 years had a higher percentage of falls from buildings, usually work-related. The mechanisms of falls also varied by sex and race. Associated injury and vertebral injury occurred frequently among falls from buildings and ladders. High falls were more likely to be work-related and result in thoracic and complete injury, while low falls were more commonly associated with cervical and motor functionally incomplete injury. The study findings of different mechanisms of falls by age, sex, race and medical consequences provide an insight for future interventions aimed at high risk persons, activities, and environmental factors for preventing or reducing fall-induced SCI.

Migration patterns and movements of sandhill cranes wintering in central and southwestern Louisiana

USGS Publications Warehouse

King, Sammy L.; Pierce, Aaron R.; Hersey, Kent R.; Winstead, Nicholas; Hartup, Barry K.

2010-01-01

In this study we trapped wintering sandhill cranes (Grus canadensis) in Louisiana and fitted them with satellite transmitters to determine their migration routes. Four of the 6 sandhill cranes with validated locations and a terminus point used the Central Flyway for spring migration; 2 of these 4 (the only 2 for which we have data) also used the Central Flyway for fall migration. Two of the 6 birds used the Mississippi Flyway for spring migration. The results of this study suggest that reintroduced whooping cranes (G. americana) that intermix and migrate with sandhill cranes that winter in Louisiana may enter the Central Flyway. In addition, the Mississippi Flyway is a viable option to use as a migration route for whooping cranes if they are reintroduced in Louisiana.

Multidisciplinary Restoration of Traumatized and Displaced Maxillary Central Incisor by Bent Wire System-A Novel Approach.

PubMed

Sasalawad, Shilpa S; Jogani, Vivek; Pai, Suryakanth M; Chour, Rashmi C; Balehosur, Deepti V

2016-11-01

Management of traumatic injuries to teeth is a challenge to dental practice, as it occurs when dentists are least prepared for it. The direction and the force of the object or the fall significantly affects the diagnosis, treatment plan and therefore the outcome of the treatment. These traumatic injuries may present with different clinical situations which demand immediate attention and assessment by the clinician. The maxillary central incisor crown fractures are the most common variant of trauma, because of the anterior and protrusive positioning. This case report describes the novel method to produce expansion of the dental arches to correct the post-traumatic displacement of the central incisor along with aesthetic and functional rehabilitation of Ellis Class IV fracture of permanent maxillary central incisor.

Post-fall-back evolution of multipolar magnetic fields and radio pulsar activation

NASA Astrophysics Data System (ADS)

Igoshev, A. P.; Elfritz, J. G.; Popov, S. B.

2016-11-01

It has long been unclear if the small-scale magnetic structures on the neutron star (NS) surface could survive the fall-back episode. The study of the Hall cascade by Cumming, Arras & Zweibel hinted that energy in small-scales structures should dissipate on short time-scales. Our new 2D magneto-thermal simulations suggest the opposite. For the first ˜10 kyr after the fall-back episode with accreted mass 10-3 M⊙, the observed NS magnetic field appears dipolar, which is insensitive to the initial magnetic topology. In framework of the Ruderman & Sutherland, vacuum gap model during this interval, non-thermal radiation is strongly suppressed. After this time, the initial (I.e. multipolar) structure begins to re-emerge through the NS crust. We distinguish three evolutionary epochs for the re-emergence process: the growth of internal toroidal field, the advection of buried poloidal field, and slow Ohmic diffusion. The efficiency of the first two stages can be enhanced when small-scale magnetic structure is present. The efficient re-emergence of high-order harmonics might significantly affect the curvature of the magnetospheric field lines in the emission zone. So, only after few 104 yr would be the NS starts shining as a pulsar again, which is in correspondence with radio silence of central compact objects. In addition, these results can explain the absence of good candidates for thermally emitting NSs with freshly re-emerged field among radio pulsars (), as NSs have time to cool down, and supernova remnants can already dissipate.

The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly.

PubMed

1987-04-01

Although falls among the elderly carry high costs to individuals and society, the prevention of falls in later life has not received adequate attention from health care professionals. The prevalence of falls appears to involve roughly one-third of persons aged 65 and over, and the risk of falling and suffering serious injury increases substantially up to the eighth decade of life. The proportion of falls which result in fracture is low, but the absolute number of older people who suffer fractures is high and places heavy demands on health care systems. Even falls which result in no physical injury often have serious social and psychological consequences for the elderly, including loss of confidence and restrictions in mobility, and high proportions of older people report fears of falling. There is a need to provide accurate information about the causes and prevention of falls in later life. Falls are not part of the normal aging process. Rather, they are due to underlying physical illnesses, medications, and environmental hazards, often in interaction. This report provides an overview of the elderly population at risk of falling and suffering serious injury, some of the reasons older people fall, and the methods to prevent falls which have been developed in both community and institutional settings. In addition, it suggests some of the practical steps which can be taken by health and social care professionals and by older people and their families in order to prevent falls. Empirical knowledge about the causes of falls by the elderly and the most effective methods of prevention remains limited. Major barriers to research have been the lack of a clear definition of a fall and the fact that falls are not included in medical diagnostic indices. It is recommended that falls be recorded as a disease entity in Index Medicus and in the International Classification of Diseases Xth Revision. To facilitate future comparisons of research findings on falls, a definition of a fall is proposed. The report underscores that the causes of falls are very different for persons of varying ages, health status, and levels of mobility. While the many risk factors for falls are not yet known, poor health status, especially chronic illness, impaired mobility and postural instability, and a history of prior falls have been associated with the risk of falling. Balance, the ability to prevent falls upon displacement, can be impaired by disease or age-related changes in a number of anatomical structures, by medications which reduce their efficient functioning, and by environmental hazards.(ABSTRACT TRUNCATED AT 400 WORDS)

Report on National Collegiate Alcohol Awareness Week Fall 1989.

ERIC Educational Resources Information Center

Rapaport, Ross J.; And Others

Central Michigan University has been systematically addressing alcohol and other drug problems on its campus through an Alcohol and Drug Abuse Intervention and Prevention Program (ADAIPP) which provides structure, coordination, and support for a number of coexisting programs on campus. During the 1988-89 academic year, these programs culminated in…

Community College Student Experiences Questionnaire. Assessment Report #92-1.

ERIC Educational Resources Information Center

South Central Community Coll., New Haven, CT.

During 1991-92, South Central Community College (SCCC), in Connecticut, administered student experience questionnaires to 600 students who were to graduate in June 1991 or were enrolled in fall 1991 and spring 1992 credit courses. The questionnaire sought information on student background, program of study, courses taken, activities, perceptions…

Seasonal timing of fire alters biomass and species composition of northern mixed prairie

USDA-ARS?s Scientific Manuscript database

Fire plays a central role in influencing ecosystem patterns and processes. However, documentation of fire seasonality and plant community response is limited in semi-arid grasslands. Most prescribed burns occur during spring and fall, when windows of safe burning conditions are often broad. Burnin...

Teaching Gender and Geography in Romanian Universities

ERIC Educational Resources Information Center

Voiculescu, Sorina

2011-01-01

The fall of communism in Central-Eastern Europe in 1989 brought major political, social, economic and cultural changes that reshaped the Romanian society as it transitioned from the totalitarian communist regime to a democratic one. The entire process of transition, eventuating in Romanian access to the European Union, brought important changes at…

Genetic and environmental influences on cold hardiness of native and introduced riparian trees

USGS Publications Warehouse

Friedman, Jonathan M.; Roelle, James E.; Cade, Brian S.

2012-01-01

To explore latitudinal genetic variation in cold hardiness and leaf phenology, we planted a common garden of paired collections of native and introduced riparian trees sampled along a latitudinal gradient. The garden in Fort Collins, Colorado (latitude 40.6°N), included 681 native plains cottonwood (Populus deltoides subsp. monilifera) and introduced saltcedar (Tamarix ramosissima, T. chinensis, and hybrids) collected from 15 sites from 29.2 to 47.6°N in the central United States. In the common garden, both species showed latitudinal variation in fall, but not spring, leaf phenology. This suggests that latitudinal gradient field observations in fall phenology are a result, at least in part, of the inherited variation in the critical photoperiod. Conversely, the latitudinal gradient field observations in spring phenology are largely a plastic response to the temperature gradient. Populations from higher latitudes exhibited earlier bud set and leaf senescence. Cold hardiness varied latitudinally in both fall and spring for both species. Although cottonwood was hardier than saltcedar in midwinter, the reverse was true in late fall and early spring. The latitudinal variation in fall phenology and cold hardiness of saltcedar appears to have developed as a result of multiple introductions of genetically distinct populations, hybridization, and natural selection in the 150 years since introduction.

Implementation of evidence-based falls prevention in clinical services for high-risk clients.

PubMed

Day, Lesley; Trotter, Margaret J; Hill, Keith D; Haines, Terry P; Thompson, Catherine

2014-06-01

The extent to which best practice for falls prevention is being routinely delivered by health care providers for community-dwelling older adults is unclear. We investigated falls prevention practice among Hospital Admission Risk Programs (HARP) that provide and coordinate specialized health care for people at high risk of hospitalization. Cross-sectional survey of all HARP services in Victoria, excluding one paediatric programme (n = 34). The questionnaire focused upon medication review and exercise prescription, as these are the evidence-based falls interventions with a good fit with HARP services. Completed questionnaires were received from 24 programmes (70.6%) that service 15,250 older clients (60+ years). All except one programme screened for medicine use; however, a lower proportion (65% of those that screen) target falls risk medications. Among the 17 programmes responding to the exercise prescription question, all routinely include strengthening exercises, and almost all (n = 15) include flexibility, endurance training and movement of the centre of gravity. A lesser proportion (71%) includes reducing the need for upper limb support. The majority of services (88%) undertake falls risk assessments, and all of these either make referral appointments for clients or refer to other services that make referral appointments for clients. Follow-up of appointments and the resulting recommendations was high. Screening for falls risk medications could be improved and staff training in exercise prescription for balance challenge in this high-risk group may be needed. Although evidence-based falls prevention practice within Victorian HARP services appears strong, the effect on falls risk may not be as high as that achieved in randomized trials. © 2014 John Wiley & Sons, Ltd.

An Innovative Approach for Decreasing Fall Trauma Admissions from Geriatric Living Facilities: Preliminary Investigation.

PubMed

Evans, Tracy; Gross, Brian; Rittenhouse, Katelyn; Harnish, Carissa; Vellucci, Ashley; Bupp, Katherine; Horst, Michael; Miller, Jo Ann; Baier, Ron; Chandler, Roxanne; Rogers, Frederick B

2015-12-01

Geriatric living facilities have been associated with a high rate of falls. We sought to develop an innovative intervention approach targeting geriatric living facilities that would reduce geriatric fall admissions to our Level II trauma center. In 2011, a Trauma Prevention Taskforce visited 5 of 28 local geriatric living facilities to present a fall prevention protocol composed of three sections: fall education, risk factor identification, and fall prevention strategies. To determine the impact of the intervention, the trauma registry was queried for all geriatric fall admissions attributed to patients living at local geriatric living facilities. The fall admission rate (total fall admissions/total beds) of the pre-intervention period (2010-2011) was compared with that of the postintervention period (2012-2013) at the 5 intervention and 23 control facilities. A P value < 0.05 was considered statistically significant. From 2010 to 2013, there were 487 fall admissions attributed to local geriatric living facilities (intervention: 179 fall admissions; control: 308 fall admissions). The unadjusted fall rate decreased at intervention facilities from 8.9 fall admissions/bed pre-intervention to 8.1 fall admissions/bed postintervention, whereas fall admission rates increased at control sites from 5.9 to 7.7 fall admissions/bed during the same period [control/intervention odds ratio (OR), 95% confidence interval (CI) = 1.32, 1.05-1.67; period OR, 95%CI = 1.55, 1.18-2.04, P = 0.002; interaction of control/intervention group and period OR 95% CI = 0.68, 0.46-1.00, P = 0.047]. An aggressive intervention program targeting high-risk geriatric living facilities resulted in a statistically significant decrease in geriatric fall admissions to our Level II trauma center.

Prevalence of fall injuries and risk factors for fall among hospitalized children in a specialized childrens hospital in Saudi Arabia.

PubMed

AlSowailmi, Banan Abdullah; AlAkeely, Maha Heshaam; AlJutaily, Hayat Ibrahim; Alhasoon, Mohammad Abdulaziz; Omair, Amir; AlKhalaf, Hamad Abdullah

2018-01-01

Fall injuries among children during hospital stay is a major patient safety issue. Inpatient pediatric falls can lead to numerous negative consequences. In contrast to adults, there is a paucity of information on the prevalence and risk factors associated with children's falls during hospitalization. Identify the prevalence of fall injuries among hospital.ized children and describe the demographic and environmental factors that could predict a higher risk of severe outcomes of fall. Descriptive, cross-sectional prevalence study. Specialized children's hospital. Data was obtained through the electronic Safety Reporting System (SRS). All reported fall events during hospitalization in children less than or equal 14 years of age for the period from 1 April 2015 to 30 April 2016 were included. Fall events that occurred in the day care unit and the outpatient clinic were excluded. Prevalence and possible risk factors for fall events. 48. The prevalence of falls among the 4860 admitted children was 9.9 (95% CI=7.5, 13.1) per 1000 patients (48/4860). A majority of the falls were among boys (n=26, 54%), in the age group from 1-5 years old (n=22, 46%), in children at high risk of falling (n=35, 73%), with normal mobility status (n=21, 44%), and with no history of previ.ous falls (n=33, 69%). Severe injuries accounted for 25% of falls (n=12). However, falls among the moderate risk category (n=9, 69%) were more often severe than falls among the high risk category of children (n=12, 34%) (P=.03). Risk factor identification is required to prevent falls and their severe outcomes. Underreporting and single-centered study. None.

Character, mass, distribution, and origin of tephra-fall deposits of the 1989-1990 eruption of redoubt volcano, south-central Alaska

USGS Publications Warehouse

Scott, W.E.; McGimsey, R.G.

1994-01-01

The 1989-1990 eruption of Redoubt Volcano spawned about 20 areally significant tephra-fall deposits between December 14, 1989 and April 26, 1990. Tephra plumes rose to altitudes of 7 to more than 10 km and were carried mainly northward and eastward by prevailing winds, where they substantially impacted air travel, commerce, and other activities. In comparison to notable eruptions of the recent past, the Redoubt events produced a modest amount of tephra-fall deposits - 6 ?? 107 to 5 ?? 1010 kg for individual events and a total volume (dense-rock equivalent) of about 3-5 ?? 107 m3 of andesite and dacite. Two contrasting tephra types were generated by these events. Pumiceous tephra-fall deposits of December 14 and 15 were followed on December 16 and all later events by fine-grained lithic-crystal tephra deposits, much of which fell as particle aggregates. The change in the character of the tephra-fall deposits reflects their fundamentally different modes of origin. The pumiceous deposits were produced by magmatically driven explosions. The finegrained lithic-crystal deposits were generated by two processes. Hydrovolcanic vent explosions generated tephrafall deposits of December 16 and 19. Such explosions continued as a tephra source, but apparently with diminishing importance, during events of January and February. Ash clouds of lithic pyroclastic flows generated by collapse of actively growing lava domes probably contributed to tephra-fall deposits of all events from January 2 to April 26, and were the sole source of tephra fall for at least the last 4 deposits. ?? 1994.

Applying high resolution remote sensing image and DEM to falling boulder hazard assessment

NASA Astrophysics Data System (ADS)

Huang, Changqing; Shi, Wenzhong; Ng, K. C.

2005-10-01

Boulder fall hazard assessing generally requires gaining the boulder information. The extensive mapping and surveying fieldwork is a time-consuming, laborious and dangerous conventional method. So this paper proposes an applying image processing technology to extract boulder and assess boulder fall hazard from high resolution remote sensing image. The method can replace the conventional method and extract the boulder information in high accuracy, include boulder size, shape, height and the slope and aspect of its position. With above boulder information, it can be satisfied for assessing, prevention and cure boulder fall hazard.

Core or Cusps: The Central Dark Matter Profile of a Strong Lensing Cluster with a Bright Central Image at Redshift 1

NASA Astrophysics Data System (ADS)

Collett, Thomas E.; Buckley-Geer, Elizabeth; Lin, Huan; Bacon, David; Nichol, Robert C.; Nord, Brian; Morice-Atkinson, Xan; Amara, Adam; Birrer, Simon; Kuropatkin, Nikolay; More, Anupreeta; Papovich, Casey; Romer, Kathy K.; Tessore, Nicolas; Abbott, Tim M. C.; Allam, Sahar; Annis, James; Benoit-Lévy, Aurlien; Brooks, David; Burke, David L.; Carrasco Kind, Matias; Castander, Francisco Javier J.; D'Andrea, Chris B.; da Costa, Luiz N.; Desai, Shantanu; Diehl, H. Thomas; Doel, Peter; Eifler, Tim F.; Flaugher, Brenna; Frieman, Josh; Gerdes, David W.; Goldstein, Daniel A.; Gruen, Daniel; Gschwend, Julia; Gutierrez, Gaston; James, David J.; Kuehn, Kyler; Kuhlmann, Steve; Lahav, Ofer; Li, Ting S.; Lima, Marcos; Maia, Marcio A. G.; March, Marisa; Marshall, Jennifer L.; Martini, Paul; Melchior, Peter; Miquel, Ramon; Plazas, Andrs A.; Rykoff, Eli S.; Sanchez, Eusebio; Scarpine, Vic; Schindler, Rafe; Schubnell, Michael; Sevilla-Noarbe, Ignacio; Smith, Mathew; Sobreira, Flavia; Suchyta, Eric; Swanson, Molly E. C.; Tarle, Gregory; Tucker, Douglas L.; Walker, Alistair R.

2017-07-01

We report on SPT-CLJ2011-5228, a giant system of arcs created by a cluster at z = 1.06. The arc system is notable for the presence of a bright central image. The source is a Lyman break galaxy at z s = 2.39 and the mass enclosed within the Einstein ring of radius 14 arcsec is ˜ {10}14.2 {M}⊙ . We perform a full reconstruction of the light profile of the lensed images to precisely infer the parameters of the mass distribution. The brightness of the central image demands that the central total density profile of the lens be shallow. By fitting the dark matter as a generalized Navarro-Frenk-White profile—with a free parameter for the inner density slope—we find that the break radius is {270}-76+48 kpc, and that the inner density falls with radius to the power -0.38 ± 0.04 at 68% confidence. Such a shallow profile is in strong tension with our understanding of relaxed cold dark matter halos; dark matter-only simulations predict that the inner density should fall as {r}-1. The tension can be alleviated if this cluster is in fact a merger; a two-halo model can also reconstruct the data, with both clumps (density varying as {r}-0.8 and {r}-1.0) much more consistent with predictions from dark matter-only simulations. At the resolution of our Dark Energy Survey imaging, we are unable to choose between these two models, but we make predictions for forthcoming Hubble Space Telescope imaging that will decisively distinguish between them.

Core or Cusps: The Central Dark Matter Profile of a Strong Lensing Cluster with a Bright Central Image at Redshift 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Collett, Thomas E.; Buckley-Geer, Elizabeth; Lin, Huan

We report on SPT-CLJ2011-5228, a giant system of arcs created by a cluster atmore » $z=1.06$. The arc system is notable for the presence of a bright central image. The source is a Lyman Break galaxy at $$z_s=2.39$$ and the mass enclosed within the 14 arc second radius Einstein ring is $$10^{14.2}$$ solar masses. We perform a full light profile reconstruction of the lensed images to precisely infer the parameters of the mass distribution. The brightness of the central image demands that the central total density profile of the lens be shallow. By fitting the dark matter as a generalized Navarro-Frenk-White profile---with a free parameter for the inner density slope---we find that the break radius is $$270^{+48}_{-76}$$ kpc, and that the inner density falls with radius to the power $$-0.38\\pm0.04$$ at 68 percent confidence. Such a shallow profile is in strong tension with our understanding of relaxed cold dark matter halos; dark matter only simulations predict the inner density should fall as $$r^{-1}$$. The tension can be alleviated if this cluster is in fact a merger; a two halo model can also reconstruct the data, with both clumps (density going as $$r^{-0.8}$$ and $$r^{-1.0}$$) much more consistent with predictions from dark matter only simulations. At the resolution of our Dark Energy Survey imaging, we are unable to choose between these two models, but we make predictions for forthcoming Hubble Space Telescope imaging that will decisively distinguish between them.« less

Review of fall risk assessment in geriatric populations using inertial sensors

PubMed Central

2013-01-01

Background Falls are a prevalent issue in the geriatric population and can result in damaging physical and psychological consequences. Fall risk assessment can provide information to enable appropriate interventions for those at risk of falling. Wearable inertial-sensor-based systems can provide quantitative measures indicative of fall risk in the geriatric population. Methods Forty studies that used inertial sensors to evaluate geriatric fall risk were reviewed and pertinent methodological features were extracted; including, sensor placement, derived parameters used to assess fall risk, fall risk classification method, and fall risk classification model outcomes. Results Inertial sensors were placed only on the lower back in the majority of papers (65%). One hundred and thirty distinct variables were assessed, which were categorized as position and angle (7.7%), angular velocity (11.5%), linear acceleration (20%), spatial (3.8%), temporal (23.1%), energy (3.8%), frequency (15.4%), and other (14.6%). Fallers were classified using retrospective fall history (30%), prospective fall occurrence (15%), and clinical assessment (32.5%), with 22.5% using a combination of retrospective fall occurrence and clinical assessments. Half of the studies derived models for fall risk prediction, which reached high levels of accuracy (62-100%), specificity (35-100%), and sensitivity (55-99%). Conclusions Inertial sensors are promising sensors for fall risk assessment. Future studies should identify fallers using prospective techniques and focus on determining the most promising sensor sites, in conjunction with determination of optimally predictive variables. Further research should also attempt to link predictive variables to specific fall risk factors and investigate disease populations that are at high risk of falls. PMID:23927446

Barriers faced by healthcare professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study

PubMed Central

Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun

2015-01-01

Objective To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling. Research design The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. Participants 20 HCPs who managed falls in older people. Setting This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia. Results Four categories of barriers emerged—these were related to perceived barriers for older people, HCPs’ barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs. Conclusions This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs. PMID:26546140

Probability of survival during accidental immersion in cold water.

PubMed

Wissler, Eugene H

2003-01-01

Estimating the probability of survival during accidental immersion in cold water presents formidable challenges for both theoreticians and empirics. A number of theoretical models have been developed assuming that death occurs when the central body temperature, computed using a mathematical model, falls to a certain level. This paper describes a different theoretical approach to estimating the probability of survival. The human thermal model developed by Wissler is used to compute the central temperature during immersion in cold water. Simultaneously, a survival probability function is computed by solving a differential equation that defines how the probability of survival decreases with increasing time. The survival equation assumes that the probability of occurrence of a fatal event increases as the victim's central temperature decreases. Generally accepted views of the medical consequences of hypothermia and published reports of various accidents provide information useful for defining a "fatality function" that increases exponentially with decreasing central temperature. The particular function suggested in this paper yields a relationship between immersion time for 10% probability of survival and water temperature that agrees very well with Molnar's empirical observations based on World War II data. The method presented in this paper circumvents a serious difficulty with most previous models--that one's ability to survive immersion in cold water is determined almost exclusively by the ability to maintain a high level of shivering metabolism.

Falls risk assessment outcomes and factors associated with falls for older Indigenous Australians.

PubMed

Hill, Keith D; Flicker, Leon; LoGiudice, Dina; Smith, Kate; Atkinson, David; Hyde, Zoë; Fenner, Stephen; Skeaf, Linda; Malay, Roslyn; Boyle, Eileen

2016-12-01

To describe the prevalence of falls and associated risk factors in older Indigenous Australians, and compare the accuracy of validated falls risk screening and assessment tools in this population in classifying fall status. Cross-sectional study of 289 Indigenous Australians aged ≥45 years from the Kimberley region of Western Australia who had a detailed assessment including self-reported falls in the past year (n=289), the adapted Elderly Falls Screening Tool (EFST; n=255), and the Falls Risk for Older People-Community (FROP-Com) screening tool (3 items, n=74) and FROP-Com falls assessment tool (n=74). 32% of participants had ≥1 fall in the preceding year, and 37.3% were classified high falls risk using the EFST (cut-off ≥2). In contrast, for the 74 participants assessed with the FROP-Com, only 14.9% were rated high risk, 35.8% moderate risk, and 49.3% low risk. The FROP-Com screen and assessment tools had the highest classification accuracy for identifying fallers in the preceding year (area under curve >0.85), with sensitivity/specificity highest for the FROP-Com assessment (cut-off ≥12), sensitivity=0.84 and specificity=0.73. Falls are common in older Indigenous Australians. The FROP-Com falls risk assessment tool appears useful in this population, and this research suggests changes that may improve its utility further. © 2016 Public Health Association of Australia.

Centrality and pseudorapidity dependence of elliptic flow for charged hadrons in Au+Au collisions at √(sNN)=200 GeV

NASA Astrophysics Data System (ADS)

Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; George, N. K.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Mignerey, A. C.; Nguyen, M.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steinberg, P.; Stephans, G. S.; Sukhanov, A.; Tang, J.-L.; Tonjes, M. B.; Trzupek, A.; Vale, C. M.; Nieuwenhuizen, G. J.; Verdier, R.; Veres, G. I.; Wolfs, F. L.; Wosiek, B.; Woźniak, K.; Wuosmaa, A. H.; Wysłouch, B.

2005-11-01

This Rapid Communication describes the measurement of elliptic flow for charged particles in Au+Au collisions at √(sNN)=200 GeV using the PHOBOS detector at the Relativistic Heavy Ion Collider. The measured azimuthal anisotropy is presented over a wide range of pseudorapidity for three broad collision centrality classes for the first time at this energy. Two distinct methods of extracting the flow signal were used to reduce systematic uncertainties. The elliptic flow falls sharply with increasing |η| at 200 GeV for all the centralities studied, as observed for minimum-bias collisions at √(sNN)=130 GeV.

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults.

PubMed

Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

2018-05-01

Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults. In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions. High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor. The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status. Copyright © 2018 Elsevier B.V. All rights reserved.

Cost-effectiveness of a day hospital falls prevention programme for screened community-dwelling older people at high risk of falls.

PubMed

Irvine, Lisa; Conroy, Simon P; Sach, Tracey; Gladman, John R F; Harwood, Rowan H; Kendrick, Denise; Coupland, Carol; Drummond, Avril; Barton, Garry; Masud, Tahir

2010-11-01

multifactorial falls prevention programmes for older people have been proved to reduce falls. However, evidence of their cost-effectiveness is mixed. economic evaluation alongside pragmatic randomised controlled trial. randomised trial of 364 people aged ≥70, living in the community, recruited via GP and identified as high risk of falling. Both arms received a falls prevention information leaflet. The intervention arm were also offered a (day hospital) multidisciplinary falls prevention programme, including physiotherapy, occupational therapy, nurse, medical review and referral to other specialists. self-reported falls, as collected in 12 monthly diaries. Levels of health resource use associated with the falls prevention programme, screening (both attributed to intervention arm only) and other health-care contacts were monitored. Mean NHS costs and falls per person per year were estimated for both arms, along with the incremental cost-effectiveness ratio (ICER) and cost effectiveness acceptability curve. in the base-case analysis, the mean falls programme cost was £349 per person. This, coupled with higher screening and other health-care costs, resulted in a mean incremental cost of £578 for the intervention arm. The mean falls rate was lower in the intervention arm (2.07 per person/year), compared with the control arm (2.24). The estimated ICER was £3,320 per fall averted. the estimated ICER was £3,320 per fall averted. Future research should focus on adherence to the intervention and an assessment of impact on quality of life.

Preliminary peak stage and streamflow data at selected U.S. Geological Survey streamgages for flooding in the central and southeastern United States during December 2015 and January 2016

USGS Publications Warehouse

Holmes, Robert R.; Watson, Kara M.; Harris, Thomas E.

2016-06-16

Flooding occurred in the central and southeastern United States during December 2015 and January 2016. The flooding was the result of more than 20 inches of rain falling in a 19 day period from December 12 to December 31, 2015. U.S. Geological Survey streamgages recorded 23 peaks of record during the subsequent flooding, with a total of 172 streamgages recording peaks that ranked in the top 5 all time for the period of record.

Significance of a near-source tephra-stratigraphic sequence to the eruptive history of Hayes Volcano, south-central Alaska

USGS Publications Warehouse

Wallace, Kristi; Coombs, Michelle L.; Hayden, Leslie A.; Waythomas, Christopher F.

2014-01-01

Bluffs along the Hayes River valley, 31 km northeast and 40 km downstream from Hayes Volcano, reveal volcanic deposits that shed new light on its eruptive history. Three thick (>10 cm) and five thin (<10 cm) tephra-fall deposits are dacitic in whole rock composition and contain high proportions of amphibole to pyroxene and minor biotite and broadly correlate to Hayes tephra set H defined by earlier investigators. Two basal ages for the tephra-fall sequence of 3,690±30 and 3,750±30 14C yr B.P. are also consistent with the Hayes tephra set H timeframe. Distinguishing among Hayes tephra set H units is critical because the set is an important time-stratigraphic marker in south-central Alaska and this section provides a new reference section for Hayes tephra set H. Analysis of Fe-Ti oxide grains in the tephras shows promise for identifying individual Hayes deposits. Beneath the dacitic tephra sequence lies an older, poorly sorted tephra (tephra A) that contains dacite and rhyolite lapilli and whose basal age is 4,450±30 14C yr B.P. Immediately below the tephra-fall sequence (Unit III) lies a series of mass-flow deposits that are rich in rhyodacitic clasts (Unit II). Below Unit II and possibly coeval with it, is a 20–30 m thick pumiceous pyroclastic-flow deposit (Unit I) that extends to the valley floor. Here informally named the Hayes River ignimbrite, this deposit contains pumice clasts of rhyolite with quartz, sanidine, plagioclase, and biotite phenocrysts, an assemblage that is unique among known Quaternary volcanic products of Hayes and other Alaskan volcanoes. Units I, II, and tephra A of Unit III represent at least two previously unrecognized eruptions of Hayes Volcano that occurred prior to ~3,700 yr B.P. No compositionally equivalent distal tephra deposits correlative with Hayes Volcano rhyodacites or rhyolites have yet been identified, perhaps indicating that some of these deposits are pre-Holocene, and were largely removed by glacial ice during the last ice age. More field and analytical work is needed to further refine the eruptive history of Hayes Volcano.

Trends in timing, magnitude, and duration of summer and fall/winter streamflows for unregulated coastal river basins in Maine during the 20th century

USGS Publications Warehouse

Dudley, Robert W.; Hodgkins, Glenn A.

2005-01-01

The U.S. Geological Survey (USGS), in cooperation with the Maine Atlantic Salmon Commission (ASC), began a study in 2003 to examine the timing, magnitude, and duration of summer (June through October) and fall/early winter (September through January) seasonal streamflows of unregulated coastal river basins in Maine and to correlate them to meteorological variables and winter/spring (January through May) seasonal streamflows. This study overlapped the summer seasonal window with the fall/early winter seasonal window to completely bracket the low-streamflow period during July, August, and September between periods of high streamflows in June and October. The ASC is concerned with the impacts of potentially changing meteorological and hydrologic conditions on Atlantic salmon survival. Because winter/spring high streamflows appear to have trended toward earlier dates over the 20th century in coastal Maine, it was hypothesized that the spring/summer recession to low streamflows could have a similar trend toward earlier, and possibly lower, longer lasting, late summer/early fall low streamflows during the 20th century. There were few statistically significant trends in the timing, magnitude, or duration of summer low streamflows for coastal river basins in Maine during the 20th century. The hypothesis that earlier winter/spring high streamflows may result in earlier or lower low streamflows is not supported by the data. No statistically significant trends in the magnitude of total runoff volume during the low-streamflow months of August and September were observed. The magnitude and timing of summer low streamflows correlated with the timing of fall/winter high streamflows and the amount of summer precipitation. The magnitude and timing of summer low streamflows did not correlate with the timing of spring snowmelt runoff. There were few correlations between the magnitude and timing of summer low streamflows and monthly mean surface air temperatures. There were few statistically significant trends in the timing or duration of fall/winter high streamflows for coastal river basins in Maine during the 20th century. The timing of the bulk of fall/winter high streamflows correlated with seasonal precipitation. Earlier fall/winter center-of-volume dates correlated with higher September and October precipitation. In general, little evidence was observed of trends in the magnitude of seasonal runoff volume during fall/winter. The magnitude of fall/winter high streamflows positively correlated with November and December precipitation amounts. There were few correlations between the magnitude and timing of fall/winter high streamflows and monthly mean surface air temperatures.

Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home.

PubMed

Russell, Katherine; Taing, Darcie; Roy, Jacqueline

2017-12-01

This study surveyed awareness of, and adherence to, six national fall prevention recommendations among community-dwelling older adults (n = 1050) in Ottawa. Although 76 per cent of respondents agreed falling is a concern and preventable, fewer perceived susceptibility to falling (63%). Respondents had high awareness that home modifications and physical activity can prevent falls. Reported modifications included grab bars (50%), night lights (44%), and raised toilet seats (19%). Half met aerobic activity recommendations; 38 per cent met strength recommendations. Respondents had lower awareness that an annual medication review, annual eye and physical examination, and daily vitamin D supplementation could reduce fall risk. However, reported annual medication review (79%) and eye examination (75%) was high. Nearly half met recommendations for vitamin D intake. These findings suggest a gap in knowledge of awareness and adherence to national recommendations, highlighting the ones that may require attention from those who work to prevent falls.

Fall-induced spinal cord injury: External causes and implications for prevention

PubMed Central

Tang, Ying; Allen, Victoria; DeVivo, Michael J

2016-01-01

Objective To document the demographic and clinical profile of persons who sustained spinal cord injury (SCI) as a result of accidental falls and to determine the usual circumstances surrounding the fall-induced SCI. Design Cohort study. Setting 21 SCI Model Systems centers throughout the United States. Participants 6,408 individuals with traumatic SCI between 2005 and 2014 were recruited from the National SCI Database. 1,877 (29%) of them were injuries caused by falls. Interventions Not applicable. Outcomes Measures External causes of injury documented by the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM). Results Falls on the same level from slipping, tripping, and stumbling were the most common cause of fall-induced SCI (20%), followed by falls from building (16%), stairs and steps (16%), and ladder (9%). People who were 61 years of age and older had the highest frequency of falls on the same level, while those aged 16–45 years had a higher percentage of falls from buildings, usually work-related. The mechanisms of falls also varied by sex and race. Associated injury and vertebral injury occurred frequently among falls from buildings and ladders. High falls were more likely to be work-related and result in thoracic and complete injury, while low falls were more commonly associated with cervical and motor functionally incomplete injury. Conclusion The study findings of different mechanisms of falls by age, sex, race and medical consequences provide an insight for future interventions aimed at high risk persons, activities, and environmental factors for preventing or reducing fall-induced SCI. PMID:25832327

Falls in people with Parkinson's disease: A prospective comparison of community and home-based falls.

PubMed

Lamont, Robyn M; Morris, Meg E; Menz, Hylton B; McGinley, Jennifer L; Brauer, Sandra G

2017-06-01

Falls are common and debilitating in people with Parkinson's disease (PD) and restrict participation in daily activities. Understanding circumstances of falls in the community and at home may assist clinicians to target therapy more effectively. To compare the characteristics of community and home fallers and the circumstances that contribute to falls in people living with PD. People with mild-moderately severe PD (n=196) used a daily falls diary and telephone hotline to report prospectively the occurrence, location and circumstances of falls over 14 months. 62% of people with PD fell, with most falling at least once in the community. Compared to people who fell at home, the community-only fallers had shorter durations of PD (p=0.012), less severe disease (p=0.008) and reported fewer falls in the year prior to the study (p=0.003). Most falls occurred while people were ambulant, during postural transitions and when medication was working well. Community-based falls were frequently attributed to environmental factors such as challenging terrains (p<0.001), high attention demands (p=0.029), busy or cluttered areas (p<0.001) and tasks requiring speed (p=0.020). Physical loads were more often present in home than community-based falls (p=0.027). Falls that occur in the community typically affect people with earlier PD and less severe disease than home-based falls. Individuals experiencing community-based falls may benefit from physiotherapy to manage challenging environments and high attention demands. Copyright © 2017 Elsevier B.V. All rights reserved.

Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: a systematic review and meta-analysis.

PubMed

Chan, Wai Chi; Yeung, Jerry Wing Fai; Wong, Corine Sau Man; Lam, Linda Chiu Wa; Chung, Ka Fai; Luk, James Ka Hay; Lee, Jenny Shun Wah; Law, Andrew Chi Kin

2015-02-01

Numerous studies have reported the prevention of falls through exercise among cognitively healthy older people. This study aimed to determine whether the current evidence supports that physical exercise is also efficacious in preventing falls in older adults with cognitive impairment. Two independent reviewers searched MEDLINE; EMBASE; PsycINFO; the Cumulative Index to Nursing & Allied Health Literature; the Cochrane Central Register of Controlled Trials; the Cochrane Bone, Joint, and Muscle Trauma Group Specialized Register; ClinicalTrials.gov; and the UK Clinical Research Network Study Portfolio up to July 2013 without language restriction. We included randomized controlled trials that examined the efficacy of physical exercise in older adults with cognitive impairment. The methodological qualities of the included trials were appraised according to the criteria developed for the Cochrane review of fall prevention trials. The primary outcome measure was the rate ratio of falls. A meta-analysis was performed to estimate the pooled rate ratio and summarize the results of the trials on fall prevention through physical exercise. Seven randomized controlled trials involving 781 participants were included, 4 of which examined solely older people with cognitive impairment. Subgroup data on persons with cognitive impairment were obtained from the other 3 trials that targeted older populations in general. The meta-analysis showed that physical exercise had a significant effect in preventing falls in older adults with cognitive impairment, with a pooled estimate of rate ratio of 0.68 (95% confidence interval 0.51-0.91). The present analysis suggests that physical exercise has a positive effect on preventing falls in older adults with cognitive impairment. Further studies will be required to determine the modality and frequency of exercise that are optimal for the prevention of falls in this population. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

[Muscle and bone health as a risk factor of fall among the elderly. Fear of falling and the post-fall syndrome].

PubMed

Niino, Naoakira; Nishita, Yukiko

2008-06-01

Fear of falling and the post-fall syndrome (fear-related activity restriction) are serious psychological symptoms associated with falls. This paper reported the definition and prevalence of fear of falling. Prevalence has yielded highly varying estimates due to the various definitions and instruments used to measure fear. Correlates of fear of falling by a longitudinal study were also described. As most of the research on fear of falling has been cross-sectional, more longitudinal studies are needed. As to the post-fall syndrome, definition and prevalence among community-dwelling elderly was discussed. It is difficult to measure general prevalence due to the lack of solid criteria of this syndrome.

Interdisciplinary Approach to Fall Prevention in a High-Risk Inpatient Pediatric Population: Quality Improvement Project.

PubMed

Stubbs, Kendra E; Sikes, Lindsay

2017-01-01

Within a tertiary care pediatric medical center, the largest number of inpatient falls (8.84 falls per 1,000 patient days) occurred within a 14-bed rehabilitation/transitional care unit between February and September 2009. An interdisciplinary fall prevention program, called "Red Light, Green Light," was developed to better educate all staff and family members to ensure safety of transfers and ambulation of children with neurological impairments. The purpose of this study was to develop and implement an interdisciplinary pediatric fall prevention program to reduce total falls and falls with family members present in this population. Preintervention 2009 data and longitudinal data from 2010-2014 were obtained from retrospective review of event/incident reports. This quality improvement project was based on inpatient pediatric admissions to a rehabilitation care unit accommodating children with neurological impairments. Data extraction included: total falls, falls with caregiver (alone versus staff versus family), type of falls, and falls by diagnosis. Descriptive statistics were obtained on outcome measures; chi-square statistics were calculated on preintervention and postintervention comparisons. Total falls decreased steadily from 8.84 falls per 1,000 patient days in 2009 to 1.79 falls per 1,000 patient days in 2014 (χ12=3.901, P=.048). Falls with family members present decreased 50% postintervention. (χ12=6.26, P=.012). Limitations included unit size nearly doubled postintervention, event reporting changed to both uncontrolled and controlled therapy falls (safely lowering patient to bed, chair, or floor), and enhanced reporting increased numbers of postintervention falls. The Red Light, Green Light program has resulted in reductions in overall fall rates, falls with family members present, increased staff collaboration, heightened staff and family safety awareness, and a safer environment for patients at high risk for neurological or musculoskeletal impairments. © 2017 American Physical Therapy Association

Two-year trajectory of fall risk in people with Parkinson’s disease: a latent class analysis

PubMed Central

Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

2015-01-01

Objective To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson’s disease (PD). Design Latent class analysis, specifically growth mixture modeling (GMM) of longitudinal fall risk trajectories. Setting Not applicable. Participants 230 community-dwelling PD participants of a longitudinal cohort study who attended at least two of five assessments over a two year period. Interventions Not applicable. Main Outcome Measures Fall risk trajectory (low, medium or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6-monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. Results The GMM optimally grouped participants into three fall risk trajectories that closely mirrored baseline fall risk status (p=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium risk trajectories (p<.001). Fluctuating fall risk (posterior probability <0.8 of belonging to any trajectory) was found in only 22.6% of the sample, most commonly among individuals who were transitioning to PIGD predominance. Conclusions Regardless of their baseline characteristics, most participants had clear and stable fall risk trajectories over two years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. PMID:26606871

Highly Portable, Sensor-Based System for Human Fall Monitoring.

PubMed

Mao, Aihua; Ma, Xuedong; He, Yinan; Luo, Jie

2017-09-13

Falls are a very dangerous situation especially among elderly people, because they may lead to fractures, concussion, and other injuries. Without timely rescue, falls may even endanger their lives. The existing optical sensor-based fall monitoring systems have some disadvantages, such as limited monitoring range and inconvenience to carry for users. Furthermore, the fall detection system based only on an accelerometer often mistakenly determines some activities of daily living (ADL) as falls, leading to low accuracy in fall detection. We propose a human fall monitoring system consisting of a highly portable sensor unit including a triaxis accelerometer, a triaxis gyroscope, and a triaxis magnetometer, and a mobile phone. With the data from these sensors, we obtain the acceleration and Euler angle (yaw, pitch, and roll), which represents the orientation of the user's body. Then, a proposed fall detection algorithm was used to detect falls based on the acceleration and Euler angle. With this monitoring system, we design a series of simulated falls and ADL and conduct the experiment by placing the sensors on the shoulder, waist, and foot of the subjects. Through the experiment, we re-identify the threshold of acceleration for accurate fall detection and verify the best body location to place the sensors by comparing the detection performance on different body segments. We also compared this monitoring system with other similar works and found that better fall detection accuracy and portability can be achieved by our system.

Highly Portable, Sensor-Based System for Human Fall Monitoring

PubMed Central

Mao, Aihua; Ma, Xuedong; He, Yinan; Luo, Jie

2017-01-01

Falls are a very dangerous situation especially among elderly people, because they may lead to fractures, concussion, and other injuries. Without timely rescue, falls may even endanger their lives. The existing optical sensor-based fall monitoring systems have some disadvantages, such as limited monitoring range and inconvenience to carry for users. Furthermore, the fall detection system based only on an accelerometer often mistakenly determines some activities of daily living (ADL) as falls, leading to low accuracy in fall detection. We propose a human fall monitoring system consisting of a highly portable sensor unit including a triaxis accelerometer, a triaxis gyroscope, and a triaxis magnetometer, and a mobile phone. With the data from these sensors, we obtain the acceleration and Euler angle (yaw, pitch, and roll), which represents the orientation of the user’s body. Then, a proposed fall detection algorithm was used to detect falls based on the acceleration and Euler angle. With this monitoring system, we design a series of simulated falls and ADL and conduct the experiment by placing the sensors on the shoulder, waist, and foot of the subjects. Through the experiment, we re-identify the threshold of acceleration for accurate fall detection and verify the best body location to place the sensors by comparing the detection performance on different body segments. We also compared this monitoring system with other similar works and found that better fall detection accuracy and portability can be achieved by our system. PMID:28902149

Preoperative and postoperative serial assessments of postural balance and fall risk in patients with arthroscopic anterior cruciate ligament reconstruction.

PubMed

Gokalp, Oguzhan; Akkaya, Semih; Akkaya, Nuray; Buker, Nihal; Gungor, Harun R; Ok, Nusret; Yorukoglu, Cagdas

2016-04-27

Impaired postural balance due to somatosensory data loss with mechanical instability has been shown in patients with ACL deficiency. To assess postural balance in patients with ACL insufficiency prior to surgery and following reconstruction with serial evaluations. Thirty patients (mean age of 27.7 ± 6.7 years) who underwent arthroscopic reconstruction of ACL with bone-patellar tendon-bone autograft were examined for clinical and functional variables at preoperative day and postoperative 12th week. Posturographic analysis were performed by using Tetrax Interactive Balance System (Sunlight Medical Ltd, Israel) at preoperative day, at 4th, 8th, and 12th weeks following reconstruction. Data computed by posturographic software by the considerations of the oscillation velocities of body sways is fall risk as a numeric value (0-100, lower values indicate better condition). All of the patients (mean age of 27.7 ± 6.7 years) had significant improvements for clinical, functional evaluations and fall risk (p< 0.05). Mean fall risk was within high-risk category (59.9 ± 22.8) preoperatively. The highest fall risk was detected at postoperative 4th week. Patients had high fall risk at 8th week similar to preoperative value. Mean fall risk decreased to low level risk at 12th week. Preoperative symptom duration had relationships with preoperative fall risk and postoperative improvement of fall risk (p= 0.001, r= -0.632, p= 0.001, r= -0.870, respectively). The improvement of fall risk was higher in patients with symptoms shorter than 6 months (p= 0.001). According to these results, mean fall risk of patients with ACL insufficiency was within high risk category preoperatively, and fall risk improves after surgical reconstruction, but as the duration of complaints lengthens especially longer than 6 months, the improvement of fall risk decreases following reconstruction.

Rapid black hole growth under anisotropic radiation feedback

NASA Astrophysics Data System (ADS)

Sugimura, Kazuyuki; Hosokawa, Takashi; Yajima, Hidenobu; Omukai, Kazuyuki

2017-07-01

Discovery of high-redshift (z > 6) supermassive black holes (BHs) may indicate that the rapid (or super-Eddington) gas accretion has aided their quick growth. Here, we study such rapid accretion of the primordial gas on to intermediate-mass (102-105 M⊙) BHs under anisotropic radiation feedback. We perform two-dimensional radiation hydrodynamics simulations that solve the flow structure across the Bondi radius, from far outside of the Bondi radius down to a central part that is larger than a circum-BH accretion disc. The radiation from the unresolved circum-BH disc is analytically modelled considering self-shadowing effect. We show that the flow settles into a steady state, where the flow structure consists of two distinct parts: (1) bipolar ionized outflowing regions, where the gas is pushed outward by thermal gas pressure and super-Eddington radiation pressure, and (2) an equatorial neutral inflowing region, where the gas falls towards the central BH without affected by radiation feedback. The resulting accretion rate is much higher than that in the case of isotropic radiation, far exceeding the Eddington-limited rate to reach a value slightly lower than the Bondi one. The opening angle of the equatorial inflowing region is determined by the luminosity and directional dependence of the central radiation. We find that photoevaporation from its surfaces set the critical opening angle of about 10° below which the accretion to the BH is quenched. We suggest that the shadowing effect allows even stellar-remnant BHs to grow rapidly enough to become high-redshift supermassive BHs.

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,…

The Rise and Fall of Modern American Childhood in the Twentieth Century.

ERIC Educational Resources Information Center

Strickland, Charles

1984-01-01

Three factors central to the development of modern attitudes toward childhood are awareness that children and adults differ, the definition of women's primary role as maternal, and the increasingly complex demands made on adults. The combined pressures of feminism and the accessibility of broadcast media are changing these factors significantly.…

Circulation (Organs). MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): PRODUCER: Micro Power and Light Company, Keystone Park, Suite 1108, 13773 N. Central Expressway, Dallas, TX 75243. LOCAL DISTRIBUTORS: Contact producer for list. EVALUATION COMPLETED: Fall 1981. VERSION: Apple II. COST: $29.95. ABILITY LEVEL: Grades 5-12.…

Microsoft in Southeast Europe: A Conversation with Goran Radman

ERIC Educational Resources Information Center

Pendergast, William; Frayne, Colette; Kelley, Patricia

2009-01-01

Goran Radman (GR) joined Microsoft in 1996 and served until Fall 2008 as Microsoft Chairman, Southeast Europe (SEE) and Chairman, East and Central Europe (ECEE). Based in Croatia, where he enjoys sailing the Adriatic coast and islands, he spoke with the authors during 2008 and 2009 about his experience launching Microsoft's commercial presence in…

The Elderly of Appalachia. Appalachian Data Bank Report #3.

ERIC Educational Resources Information Center

Rowles, Graham D.; And Others

Analysis of 1980 census data reveals that elderly people (age 65 and over) living in Central and Southern Appalachia suffer more inferior life circumstances than the elderly population in the nation as a whole, falling well below national averages in terms of income, access to transportation, availability of telephones, and presence of resources…

Breaking the Mold: How Do School Entrepreneurs Create Change?

ERIC Educational Resources Information Center

Williams, Joe

2006-01-01

Disgusted by what he and his staff considered to be poorly written, poorly stapled, and generally disorganized mandatory citywide exams sent to Fritsche Middle School by the Milwaukee Public Schools central office in the fall of 1999, Principal Bill Andrekopoulos committed an act of ownership theretofore unheard of in the 100,000-student school…

Rekindling Our Energy for Neglected Children

ERIC Educational Resources Information Center

Rooney, Joanne

2006-01-01

Educators often fall into the trap of blaming--blaming parents, former schools, the central office, or even an economic system that permits poverty and violence to flourish in a society replete with resources. In this article, the author rekindles her experience in teaching a special education student named Deidre who, resembles the truth of most…

NOAA Photo Library

Science.gov Websites

NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes Collections page. Takes you to the search page. Takes you to the Links page. NOAA Photo Library Image ) Collection Location: Texas, Wichita Falls Photo Date: April 10, 1979 Credit: NOAA Photo Library, NOAA Central

Early fire history near Seguin Falls, Ontario

Treesearch

Daniel C. Dey; Richard P. Guyette

1996-01-01

This report is one of a series of site-specfic fire histories being developed for red oak (Quercus rubra L.)-pine ecosystems in central Ontario. Collectively, these studies documents the role of fire in upland oak forests. this information also provides an ecological basis for developing silviculture prescriptions that use prescribed burning to...

The Mathematics and Computer Science Learning Center (MLC).

ERIC Educational Resources Information Center

Abraham, Solomon T.

The Mathematics and Computer Science Learning Center (MLC) was established in the Department of Mathematics at North Carolina Central University during the fall semester of the 1982-83 academic year. The initial operations of the MLC were supported by grants to the University from the Burroughs-Wellcome Company and the Kenan Charitable Trust Fund.…

Report of National Collegiate Alcohol Awareness Week Activities Fall 1987.

ERIC Educational Resources Information Center

Owens, Ann English; And Others

This document presents a report of the education and prevention activities recognizing National Collegiate Alcohol Awareness (NCAA) Week undertaken at Central Michigan University in Mt. Pleasant, Michigan during October and early November, 1987. It begins with a brief review of the university's campus-wide programs, goals, and activities to reduce…

Long Range Planning for Computer Use--A Task Force Model.

ERIC Educational Resources Information Center

Raucher, S. M.; Koehler, T. J.

A Management Operations Review and Evaluation (MORE) study of the Department of Management Information and Computer Services, which was completed in the fall of 1980, strongly recommended that the Montgomery County Public Schools (MCPS) develop a long-range plan to meet the computer needs of schools and central offices. In response to this…

H2O masers and protoplanetary disk dynamics in IC 1396 N

NASA Astrophysics Data System (ADS)

Bayandina, O. S.; Val'tts, I. E.; Kurtz, S. E.; Rudnitskij, G. M.; Alakoz, A. V.

2017-06-01

We report H2O maser line observations of the bright-rimmed globule IC 1396 N using a ground-space interferometer with the 10-m RadioAstron radio telescope as the space-based element. The source was not detected on projected baselines >2.3. Earth diameters, which indicates a lower limit on the maser size of L > 0.03 AU and an upper limit on the brightness temperature of 6.25 × 1012 K. Fringe-rate maps are prepared based on data from ground-ground baselines. Positions, velocities and flux densities of maser spots were determined. Multiple low-velocity features from -4.5 km/s to +0.7 km/s are seen, and two high-velocity features of V LSR = -9.4 km/s and V LSR = +4.4 km/s are found at projected distances of 157 AU and 70 AU, respectively, from the strongest low-velocity feature at V LSR = +0.3 km/s. Maser components from the central part of the spectrum fall into four velocity groups but into three spatial groups. Three spatial groups of low-velocity features detected in the 2014 observations are arranged in a linear structure about 200 AU in length. Two of these groups were not detected in 1996 and possibly are jets which formed between 1996 and 2014. The putative jet seems to have changed direction in 18 years, which we explain by the precession of the jet under the influence of the gravity of material surrounding the globule. The jet collimation can be provided by a circumstellar protoplanetary disk. There is a straight line orientation in the " V LSR-Right Ascension" diagram between the jet and the maser group at V LSR = +0.3 km/s. However, the central group with the same position but at the velocity V LSR -3.4 km/s falls on a straight line between two high-velocity components detected in 2014. Comparison of the low-velocity positions from 2014 and 1996, based on the same V LSR-Right Ascension diagram for low-velocity features, shows that the majority of the masers maintain their positions near the central velocity V LSR = 0.3 km/s during the 18 year period.

Two-Year Trajectory of Fall Risk in People With Parkinson Disease: A Latent Class Analysis.

PubMed

Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

2016-03-01

To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson disease (PD). Latent class analysis, specifically growth mixture modeling (GMM), of longitudinal fall risk trajectories. Assessments were conducted at 1 of 4 universities. Community-dwelling participants with PD of a longitudinal cohort study who attended at least 2 of 5 assessments over a 2-year follow-up period (N=230). Not applicable. Fall risk trajectory (low, medium, or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6 monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. The GMM optimally grouped participants into 3 fall risk trajectories that closely mirrored baseline fall risk status (P=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium fall risk trajectories (P<.001). Fluctuating fall risk (posterior probability <0.8 of belonging to any trajectory) was found in only 22.6% of the sample, most commonly among individuals who were transitioning to PIGD predominance. Regardless of their baseline characteristics, most participants had clear and stable fall risk trajectories over 2 years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Drinking water systems, hydrology, and childhood gastrointestinal illness in Central and Northern Wisconsin.

PubMed

Uejio, Christopher K; Yale, Steven H; Malecki, Kristen; Borchardt, Mark A; Anderson, Henry A; Patz, Jonathan A

2014-04-01

This study investigated if the type of drinking water source (treated municipal, untreated municipal, and private well water) modifies the effect of hydrology on childhood (aged < 5 years) gastrointestinal illness. We conducted a time series study to assess the relationship between hydrologic and weather conditions with childhood gastrointestinal illness from 1991 to 2010. The Central and Northern Wisconsin study area includes households using all 3 types of drinking water systems. Separate time series models were created for each system and half-year period (winter/spring, summer/fall). More precipitation (summer/fall) systematically increased childhood gastrointestinal illness in municipalities accessing untreated water. The relative risk of contracting gastrointestinal illness was 1.4 in weeks with 3 centimeters of precipitation and 2.4 in very wet weeks with 12 centimeters of precipitation. By contrast, gastrointestinal illness in private well and treated municipal areas was not influenced by hydrologic conditions, although warmer winter temperatures slightly increased incidence. Our study suggests that improved drinking water protection, treatment, and delivery infrastructure may improve public health by specifically identifying municipal water systems lacking water treatment that may transmit waterborne disease.

Climatic factors contributing to long-term variations in surface fine dust concentration in the United States

NASA Astrophysics Data System (ADS)

Pu, Bing; Ginoux, Paul

2018-03-01

High concentrations of dust particles can cause respiratory problems and increase non-accidental mortality. Studies found fine dust (with an aerodynamic diameter of less than 2.5 µm) is an important component of the total PM2.5 mass in the western and central US in spring and summer and has positive trends. This work examines climatic factors influencing long-term variations in surface fine dust concentration in the US using station data from the Interagency Monitoring Protected Visual Environments (IMPROVE) network during 1990-2015. The variations in the fine dust concentration can be largely explained by the variations in precipitation, surface bareness, and 10 m wind speed. Moreover, including convective parameters such as convective inhibition (CIN) and convective available potential energy (CAPE) that reveal the stability of the atmosphere better explains the variations and trends over the Great Plains from spring to fall.While the positive trend of fine dust concentration in the southwestern US in spring is associated with precipitation deficit, the increase in fine dust over the central Great Plains in summer is largely associated with enhanced CIN and weakened CAPE, which are caused by increased atmospheric stability due to surface drying and lower-troposphere warming. The strengthening of the Great Plains low-level jet also contributes to the increase in fine dust concentration in the central Great Plains in summer via its positive correlation with surface winds and negative correlation with CIN.Summer dusty days in the central Great Plains are usually associated with a westward extension of the North Atlantic subtropical high that intensifies the Great Plains low-level jet and also results in a stable atmosphere with subsidence and reduced precipitation.

[Establishment and application effect of fall prevention and control information system in elderly community].

PubMed

Zhao, Ting; Pi, Hong-Ying; Ku, Hong-An; Pan, Li; Gong, Zhu-Yun

2018-02-08

To investigate establishing, applying and evaluating the fall prevention and control information system in elderly community. Relying on internet technology and informatization means, the fall comprehensive prevention and control strategy of elderly was guided into online from offline. The fall prevention and control information system which was a collection of risk assessment, remote education and feedback was established. One hundred and twenty-six elderly (over 60 years old) in community were screened in this study and 84 high-risk elders who were involved in the remote continuous comprehensive intervention were screened out. Intervening measures included distributing propaganda album, making mission slides and video used to play with the interpretation remotely. Then fall related situation before and after intervention was analyzed and the effectiveness of system evaluated. After remote intervention, the fall incidence of high-risk group decreased from 21.43% to 4.76%( P <0.01). The body balance and gait stability improved clearly( P <0. 01). The rate of taking proper prevention and control behavior significantly improved( P <0.01). They believed in themselves not to fall down with more confidence when taking complex behaviors( P <0.01). The security of environment at home significantly enhanced( P <0. 01). Fall prevention and control information system in elderly community was innovative and convenient. The system could roundly assess the status related to fall and accurately screen out high-risk group. The system could implement the remote continuous comprehensive intervention so that the incident of fall was decrease. In conclusion, the system is stable and effective, can be further popularization and application as a successful pilot.

Fall Frequency among Men and Women with or at Risk for HIV Infection

PubMed Central

Erlandson, Kristine M.; Plankey, Michael W.; Springer, Gayle; Cohen, Helen S.; Cox, Christopher; Hoffman, Howard J.; Yin, Michael T.; Brown, Todd T.

2016-01-01

Background Falls and fall-related injuries are a major public health concern. HIV-infected adults have been shown to have a high incidence of falls. Identification of major risk factors for falls that are unique to HIV or similar to the general population will inform development of future interventions for fall prevention. Methods HIV-infected and uninfected men and women participating in a Hearing and Balance Sub-study of the Multicenter AIDS Cohort Study and Women’s Interagency HIV Study were asked about balance symptoms and falls during the prior 12 months. Falls were categorized as 0, 1, or ≥ 2; proportional odds logistic regression models were used to investigate relationships between falls and demographic and clinical variables and multivariable models were created. Results 24% of 303 HIV-infected participants reported ≥1 fall compared to 18% of 233 HIV-uninfected participants (p=0.27). HIV-infected participants were demographically different from HIV-uninfected participants, and were more likely to report clinical imbalance symptoms (p≤0.035). In univariate analyses, more falls were associated with hepatitis C, female sex, obesity, smoking, and clinical imbalance symptoms, but not age, HIV serostatus, or other comorbidities. In multivariable analyses, female sex and imbalance symptoms were independently associated with more falls. Among HIV-infected participants, smoking, number of medications, and imbalance symptoms remained independent fall predictors while current protease inhibitor use was protective. Discussion Similar rates of falls among HIV-infected and uninfected participants were largely explained by a high prevalence of imbalance symptoms. Routine assessment of falls and dizziness/imbalance symptoms should be considered, with interventions targeted at reducing symptomatology. PMID:27028463

Equivalent Fall Risk in Elderly Patients on Hemodialysis and Peritoneal Dialysis.

PubMed

Farragher, Janine; Rajan, Tasleem; Chiu, Ernest; Ulutas, Ozkan; Tomlinson, George; Cook, Wendy L; Jassal, Sarbjit V

2016-01-01

♦ Accidental falls are common in the hemodialysis (HD) population. The high fall rate has been attributed to a combination of aging, kidney disease-related morbidity, and HD treatment-related hazards. We hypothesized that patients maintained on peritoneal dialysis (PD) would have fewer falls than those on chronic HD. The objective of this study was to compare the falls risk between cohorts of elderly patients maintained on HD and PD, using prospective data from a large academic dialysis facility. ♦ Patients aged 65 years or over on chronic in-hospital HD and PD at the University Health Network were recruited. Patients were followed biweekly, and falls occurring within the first year recorded. Fall risk between the 2 groups was compared using both crude and adjusted Poisson lognormal random effects modeling. ♦ Out of 258 potential patients, 236 were recruited, assessed at baseline, and followed biweekly for falls. Of 74 PD patients, 40 (54%) experienced 86 falls while 76 out of 162 (47%) HD patients experienced a total of 305 falls (crude fall rate 1.25 vs 1.60 respectively, odds ratio [OR] falls in PD patients 0.78, 95% confidence interval [CI] 0.61 - 0.92, p = 0.04). After adjustment for differences in comorbidity, number of medications, and other demographic differences, PD patients were no less likely to experience accidental falls than HD patients (OR 1.63, 95% CI 0.88 - 3.04, p = 0.1). ♦ We conclude that accidental falls are equally common in the PD population and the HD population. These data argue against post-HD hypotension as the sole contributor to the high fall risk in the dialysis population. Copyright © 2016 International Society for Peritoneal Dialysis.

Development and evaluation of an automated fall risk assessment system.

PubMed

Lee, Ju Young; Jin, Yinji; Piao, Jinshi; Lee, Sun-Mi

2016-04-01

Fall risk assessment is the first step toward prevention, and a risk assessment tool with high validity should be used. This study aimed to develop and validate an automated fall risk assessment system (Auto-FallRAS) to assess fall risks based on electronic medical records (EMRs) without additional data collected or entered by nurses. This study was conducted in a 1335-bed university hospital in Seoul, South Korea. The Auto-FallRAS was developed using 4211 fall-related clinical data extracted from EMRs. Participants included fall patients and non-fall patients (868 and 3472 for the development study; 752 and 3008 for the validation study; and 58 and 232 for validation after clinical application, respectively). The system was evaluated for predictive validity and concurrent validity. The final 10 predictors were included in the logistic regression model for the risk-scoring algorithm. The results of the Auto-FallRAS were shown as high/moderate/low risk on the EMR screen. The predictive validity analyzed after clinical application of the Auto-FallRAS was as follows: sensitivity = 0.95, NPV = 0.97 and Youden index = 0.44. The validity of the Morse Fall Scale assessed by nurses was as follows: sensitivity = 0.68, NPV = 0.88 and Youden index = 0.28. This study found that the Auto-FallRAS results were better than were the nurses' predictions. The advantage of the Auto-FallRAS is that it automatically analyzes information and shows patients' fall risk assessment results without requiring additional time from nurses. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Voluntary sway and rapid orthogonal transitions of voluntary sway in young adults, and low and high fall-risk older adults.

PubMed

Tucker, Murray G; Kavanagh, Justin J; Morrison, Steven; Barrett, Rod S

2009-10-01

Falls amongst older people have been linked to reduced postural stability and slowed movement responses. The objective of this study was to examine differences in postural stability and the speed of response between young adults, low fall-risk older adults, and high fall-risk older adults during voluntary postural sway movements. Twenty-five young adults (25+/-4 years), and 32 low fall-risk (74+/-5 years), and 16 high fall-risk (79+/-7 years) older adults performed voluntary sway and rapid orthogonal transitions of voluntary sway between the anterior-posterior and medial-lateral directions. Measures included reaction and movement time and the amplitudes of the centre of pressure, centre of mass, and the separation distance between the centre of pressure and centre of mass. Both fall-risk groups compared to the young had slower reaction and movement time, greater centre of pressure and/or centre of mass amplitude in the orthogonal (non-target) direction during voluntary sway, and reduced anterior-posterior and medial-lateral separation between the centre of pressure and centre of mass during voluntary sway and orthogonal transitions. High compared to low fall-risk individuals had slower reaction and movement time, increased non-target centre of mass amplitude during voluntary sway, and reduced medial-lateral centre of pressure and centre of mass separation during voluntary sway and orthogonal transitions. Age-related deterioration of postural control resulted in slower reactive responses and reduced control of the direction of body movement during voluntary sway and orthogonal transitions. Slower postural reaction and movement time and reduced medial-lateral control of the centre of mass during voluntary sway movements are associated with increased fall-risk in community-living older people.

Pop goes the O2: a case of popper-induced methaemoglobinamia

PubMed Central

McCabe, Aileen; McCann, Brendan; Kelly, Paul

2012-01-01

A 39-year-old man presented to the emergency department after falling downstairs after he consumed a large quantity of alcohol. On examination, he had altered mental state (GCS 14), central cyanosis and low oxygen saturation of 86%, despite 100% oxygen being administered. His arterial blood gas confirmed diagnosis of methaemoglobinaemia with a methaemoglobin percentage of 14.08. He was treated successfully with methylthioninium chloride. The patient later admitted to use of recreational poppers (amyl nitrates) the previous evening. The emergency physician is challenged by the presentation of a patient with altered mental state and unexplained low oxygen saturation with concurrent alcohol intoxication but must have a high index of suspicion for methaemoglobinaemia particularly with a history of recreational drug ingestion. PMID:23175012

Protecting children from toxic chemicals: putting it on Australia's public health agenda.

PubMed

Lantz, Sarah

2013-11-01

The high volume and widespread use of industrial chemicals, the backlog of internationally untested chemicals, the uptake of synthetic chemicals found in babies in utero, cord blood, and in breast milk, and the lack of a unified and comprehensive regulatory framework all necessitate developing policies that protect the most vulnerable in our society - our children. Australia's failure to do so raises profound intergenerational ethical issues. This article tells a story of international policy, and where Australia is falling down. It demonstrates that we can learn from countries already taking critical steps to reduce the toxic chemical exposure, and that the development of a comprehensive, child-centered chemical regulation framework is central to turning around Australia's failure.

High-resolution three-dimensional imaging and analysis of rock falls in Yosemite valley, California

USGS Publications Warehouse

Stock, Gregory M.; Bawden, G.W.; Green, J.K.; Hanson, E.; Downing, G.; Collins, B.D.; Bond, S.; Leslar, M.

2011-01-01

We present quantitative analyses of recent large rock falls in Yosemite Valley, California, using integrated high-resolution imaging techniques. Rock falls commonly occur from the glacially sculpted granitic walls of Yosemite Valley, modifying this iconic landscape but also posing signifi cant potential hazards and risks. Two large rock falls occurred from the cliff beneath Glacier Point in eastern Yosemite Valley on 7 and 8 October 2008, causing minor injuries and damaging structures in a developed area. We used a combination of gigapixel photography, airborne laser scanning (ALS) data, and ground-based terrestrial laser scanning (TLS) data to characterize the rock-fall detachment surface and adjacent cliff area, quantify the rock-fall volume, evaluate the geologic structure that contributed to failure, and assess the likely failure mode. We merged the ALS and TLS data to resolve the complex, vertical to overhanging topography of the Glacier Point area in three dimensions, and integrated these data with gigapixel photographs to fully image the cliff face in high resolution. Three-dimensional analysis of repeat TLS data reveals that the cumulative failure consisted of a near-planar rock slab with a maximum length of 69.0 m, a mean thickness of 2.1 m, a detachment surface area of 2750 m2, and a volume of 5663 ?? 36 m3. Failure occurred along a surfaceparallel, vertically oriented sheeting joint in a clear example of granitic exfoliation. Stress concentration at crack tips likely propagated fractures through the partially attached slab, leading to failure. Our results demonstrate the utility of high-resolution imaging techniques for quantifying far-range (>1 km) rock falls occurring from the largely inaccessible, vertical rock faces of Yosemite Valley, and for providing highly accurate and precise data needed for rock-fall hazard assessment. ?? 2011 Geological Society of America.

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

PubMed Central

Pai, Yi-Chung (Clive); Bhatt, Tanvi; Ting, Lena H.

2016-01-01

How does the robust control of walking and balance break down during a fall? Here, as a first step in identifying the neuromuscular determinants of falls, we tested the hypothesis that falls and recoveries are characterized by differences in neuromuscular responses. Using muscle synergy analysis, conventional onset latencies, and peak activity, we identified differences in muscle coordination between older adults who fell and those who recovered from a laboratory-induced slip. We found that subjects who fell recruited fewer muscle synergies than those who recovered, suggesting a smaller motor repertoire. During slip trials, compared with subjects who recovered, subjects who fell had delayed knee flexor and extensor onset times in the leading/slip leg, as well as different muscle synergy structure involving those muscles. Therefore, the ability to coordinate muscle activity around the knee in a timely manner may be critical to avoiding falls from slips. Unique to subjects who fell during slip trials were greater bilateral (interlimb) muscle activation and the recruitment of a muscle synergy with excessive coactivation. These differences in muscle coordination between subjects who fell and those who recovered could not be explained by differences in gait-related variables at slip onset (i.e., initial motion state) or variations in slip difficulty, suggesting that differences in muscle coordination may reflect differences in neural control of movement rather than biomechanical constraints imposed by perturbation or initial walking mechanics. These results are the first step in determining the causation of falls from the perspective of muscle coordination. They suggest that there may be a neuromuscular basis for falls that could provide new insights into treatment and prevention. Further research comparing the muscle coordination and mechanics of falls and recoveries within subjects is necessary to establish the neuromuscular causation of falls. NEW & NOTEWORTHY A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip. PMID:27832608

Neuromuscular responses differ between slip-induced falls and recoveries in older adults.

PubMed

Sawers, Andrew; Pai, Yi-Chung Clive; Bhatt, Tanvi; Ting, Lena H

2017-02-01

How does the robust control of walking and balance break down during a fall? Here, as a first step in identifying the neuromuscular determinants of falls, we tested the hypothesis that falls and recoveries are characterized by differences in neuromuscular responses. Using muscle synergy analysis, conventional onset latencies, and peak activity, we identified differences in muscle coordination between older adults who fell and those who recovered from a laboratory-induced slip. We found that subjects who fell recruited fewer muscle synergies than those who recovered, suggesting a smaller motor repertoire. During slip trials, compared with subjects who recovered, subjects who fell had delayed knee flexor and extensor onset times in the leading/slip leg, as well as different muscle synergy structure involving those muscles. Therefore, the ability to coordinate muscle activity around the knee in a timely manner may be critical to avoiding falls from slips. Unique to subjects who fell during slip trials were greater bilateral (interlimb) muscle activation and the recruitment of a muscle synergy with excessive coactivation. These differences in muscle coordination between subjects who fell and those who recovered could not be explained by differences in gait-related variables at slip onset (i.e., initial motion state) or variations in slip difficulty, suggesting that differences in muscle coordination may reflect differences in neural control of movement rather than biomechanical constraints imposed by perturbation or initial walking mechanics. These results are the first step in determining the causation of falls from the perspective of muscle coordination. They suggest that there may be a neuromuscular basis for falls that could provide new insights into treatment and prevention. Further research comparing the muscle coordination and mechanics of falls and recoveries within subjects is necessary to establish the neuromuscular causation of falls. A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip. Copyright © 2017 the American Physiological Society.

The difference between the potentiometric surfaces of the Magothy Aquifer of September 1986 and September 1988 in southern Maryland

USGS Publications Warehouse

Mack, Frederick K.; Andreasen, David C.; Curtin, Stephen E.; Wheeler, Judith C.

1990-01-01

A map was prepared that shows the net change in the potentiometric surface of the Magothy aquifer (in the Cretaceous Magothy Formation) in southern Maryland from the fall of 1986 to the fall of 1988. The map, based on water level measurements from 79 observation wells, shows that during the 2 year period the potentiometric surface declined less than 5 ft in most of the northern part of the study area and more than 10 ft in a 4-sq-mi area in northern Charles County. Net water-level rises of as much as 2 ft were measured in central Charles County. (USGS)

[Study on incidence and risk factors of fall in the elderly in a rural community in Beijing].

PubMed

Zhang, D; He, Y; Liu, M; Yang, H B; Wu, L; Wang, J H; Yang, S S; Chen, J; Wang, Y Y; Zeng, J; Yao, Y; Guo, M L

2016-05-01

To investigate the incidence of fall in the old farmers of Miyun county in Beijing. The old farmers who lived in Jugezhuang and Fengjiayu townships of Miyun county were selected for a questionnaire survey to collect the information about the incidence of fall and their health status. A total of 2 397 old farmers, including 967 males and 1 430 females, were surveyed. Fall occurred in 347 old farmers(14.5%). The difference in the incidence of fall was significant between males(9.6%)and females(17.8%). A total of 282 falls occurred in courtyards, 45 falls occurred in field/hilly areas. Among the falls occurred, 216(27.2%)led to injuries. The most common site of injuries was hip(45 falls). Logistic regression analysis showed that physical exercise and high income were protective factors, but difficult standing up and walking, visual problem and stroke were the risk factors. In the males, the special risk factor was mid cognitive impairment, and in the females, the special risk factor was urinary incontinence, but afternoon nap was a protective factor. The incidence of fall in the rural community was relatively high with distinct area distribution, which has caused serious influence on the mental and physical health of the elderly.

Utilizing a Meals on Wheels program to teach falls risk assessment to medical students.

PubMed

Demons, Jamehl L; Chenna, Swapna; Callahan, Kathryn E; Davis, Brooke L; Kearsley, Linda; Sink, Kaycee M; Watkins, Franklin S; Williamson, Jeff D; Atkinson, Hal H

2014-01-01

Falls are a critical public health issue for older adults, and falls risk assessment is an expected competency for medical students. The aim of this study was to design an innovative method to teach falls risk assessment using community-based resources and limited geriatrics faculty. The authors developed a Fall Prevention Program through a partnership with Meals-on-Wheels (MOW). A 3rd-year medical student accompanies a MOW client services associate to a client's home and performs a falls risk assessment including history of falls, fear of falling, medication review, visual acuity, a Get Up and Go test, a Mini-Cog, and a home safety evaluation, reviewed in a small group session with a faculty member. During the 2010 academic year, 110 students completed the in-home falls risk assessment, rating it highly. One year later, 63 students voluntarily completed a retrospective pre/postsurvey, and the proportion of students reporting moderate to very high confidence in performing falls risk assessments increased from 30.6% to 87.3% (p < .001). Students also reported using most of the skills learned in subsequent clerkships. A single educational intervention in the MOW program effectively addressed geriatrics competencies with minimal faculty effort and could be adopted by many medical schools.

Fall prevention in high-risk patients.

PubMed

Shuey, Kathleen M; Balch, Christine

2014-12-01

In the oncology population, disease process and treatment factors place patients at risk for falls. Fall bundles provide a framework for developing comprehensive fall programs in oncology. Small sample size of interventional studies and focus on ambulatory and geriatric populations limit the applicability of results. Additional research is needed. Copyright © 2014 Elsevier Inc. All rights reserved.

A comprehensive review of observational and site evaluation data of migrant whooping cranes in the United States, 1943-1999

USGS Publications Warehouse

Austin, Jane E.; Richert, Amy L.

2001-01-01

This report is a comprehensive analysis of existing observational data (1943–99) and site evaluation data (1977–99) for locations used by whooping cranes (Grus americana) during migration through the United States portion of the Wood Buffalo–Aransas flyway. The apparent migration path, as outlined by the distribution of whooping crane observations, is very similar to that delineated in earlier reports, following a relatively straight line north-northwest from Aransas National Wildlife Refuge (NWR) to central North Dakota then curving northwest along the Missouri Coteau to the North Dakota–Saskatchewan border. The distribution of spring and fall observations were relatively similar, except for the higher frequency of fall observations on Quivira NWR and Cheyenne Bottoms State Wildlife Area in Kansas, Salt Plains NWR in Oklahoma, and in Texas. Timing of spring and fall migrations also appears similar to that described earlier and shows no changes over the 57-year period of data collection. Regardless of season, most sightings included 1–3 whooping cranes, but groups with as many as 14 and 19 cranes have been sighted in spring and fall, respectively.

Recent increases in atmospheric deposition of mercury to North-Central Wisconsin lakes inferred from sediment analyses

USGS Publications Warehouse

Rada, R.G.; Wiener, J.G.; Winfrey, M.R.; Powell, D.E.

1989-01-01

Profiles of total mercury (Hg) concentrations in sediments were examined in 11 lakes in north-central Wisconsin having a broad range of pH (5.1 to 7.8) and alkalinity (-12 to 769 μeq/L). Mercury concentrations were greatest in the top 15 cm of the cores and were much lower in the deeper strata. The Hg content in the most enriched stratum of individual cores ranged from 0.09 to 0.24 μg/g dry weight, whereas concentrations in deep, precolonial strata ranged from 0.04 to 0.07 μg/g. Sediment enrichment factors varied from 0.8 to 2.8 and were not correlated with lake pH. The increase in the Hg content of recent sediments was attributed to increased atmospheric deposition of the metal. Eight of the 11 systems studied were low-alkalinity lakes that presumably received most (≥90%) of their hydrologic input from precipitation falling directly onto the lake surface. Thus, the sedimentary Hg in these lakes seems more likely linked to direct atmospheric deposition onto the lake surfaces than to influxes from the watershed. The data imply that a potentially significant fraction of the high Hg burdens measured in game fish in certain lakes in north-central Wisconsin originated from atmospheric sources.

Central powering of the largest Lyman-α nebula is revealed by polarized radiation.

PubMed

Hayes, Matthew; Scarlata, Claudia; Siana, Brian

2011-08-17

High-redshift Lyman-α (Lyα) blobs are extended, luminous but rare structures that seem to be associated with the highest peaks in the matter density of the Universe. Their energy output and morphology are similar to those of powerful radio galaxies, but the source of the luminosity is unclear. Some blobs are associated with ultraviolet or infrared bright galaxies, suggesting an extreme starburst event or accretion onto a central black hole. Another possibility is gas that is shock-excited by supernovae. But not all blobs are associated with galaxies, and these ones may instead be heated by gas falling into a dark-matter halo. The polarization of the Lyα emission can in principle distinguish between these options, but a previous attempt to detect this signature returned a null detection. Here we report observations of polarized Lyα from the blob LAB1 (ref. 2). Although the central region shows no measurable polarization, the polarized fraction (P) increases to ∼20 per cent at a radius of 45 kiloparsecs, forming an almost complete polarized ring. The detection of polarized radiation is inconsistent with the in situ production of Lyα photons, and we conclude that they must have been produced in the galaxies hosted within the nebula, and re-scattered by neutral hydrogen.

Central attention is serial but mid-level and peripheral attention are parallel—a hypothesis

PubMed Central

Marois, Rene

2016-01-01

In this brief review, we will argue that attention falls along a hierarchy from peripheral through central mechanisms. We further argue that these mechanisms are distinguished not just by their functional roles in cognition, but also by a distinction between serial mechanisms (associated with central attention) and parallel mechanisms (associated with mid-level and peripheral attention). In particular, we suggest that peripheral attentional deployments in distinct representational systems may be maintained simultaneously with little or no interference, but that the serial nature of central attention means that even tasks that largely rely on distinct representational systems will come into conflict when central attention is demanded. We go on to review both behavioral and neural evidence for this prediction. We conclude that even though the existing evidence mostly favors our account of serial central and parallel non-central attention, we know of no experiment that has conclusively borne out these claims. As such, this paper offers a framework of attentional mechanisms that will aid in guiding future research on this topic. PMID:27388496

The Evolution of the Globular Cluster System in a Triaxial Galaxy: Can a Galactic Nucleus Form by Globular Cluster Capture?

NASA Astrophysics Data System (ADS)

Capuzzo-Dolcetta, Roberto

1993-10-01

Among the possible phenomena inducing evolution of the globular cluster system in an elliptical galaxy, dynamical friction due to field stars and tidal disruption caused by a central nucleus is of crucial importance. The aim of this paper is the study of the evolution of the globular cluster system in a triaxial galaxy in the presence of these phenomena. In particular, the possibility is examined that some galactic nuclei have been formed by frictionally decayed globular clusters moving in a triaxial potential. We find that the initial rapid growth of the nucleus, due mainly to massive clusters on box orbits falling in a short time scale into the galactic center, is later slowed by tidal disruption induced by the nucleus itself on less massive clusters in the way described by Ostriker, Binney, and Saha. The efficiency of dynamical friction is such to carry to the center of the galaxy enough globular cluster mass available to form a compact nucleus, but the actual modes and results of cluster-cluster encounters in the central potential well are complicated phenomena which remains to be investigated. The mass of the resulting nucleus is determined by the mutual feedback of the described processes, together with the initial spatial, velocity, and mass distributions of the globular cluster family. The effect on the system mass function is studied, showing the development of a low- and high-mass turnover even with an initially flat mass function. Moreover, in this paper is discussed the possibility that the globular cluster fall to the galactic center has been a cause of primordial violent galactic activity. An application of the model to M31 is presented.

On the Role of SST Forcing in the 2011 and 2012 Extreme U.S. Heat and Drought: A Study in Contrasts

NASA Technical Reports Server (NTRS)

Wang, Hailan; Schubert, Siegfried; Koster, Randal; Ham, Yoo-Geun; Suarez, Max

2013-01-01

This study compares the extreme heat and drought that developed over the United States in 2011 and 2012 with a focus on the role of SST forcing. Experiments with the NASA GEOS-5 atmospheric general circulation model show that the winter/spring response over the U.S. to the Pacific SST is remarkably similar for the two years despite substantial differences in the tropical Pacific SST. As such, the pronounced winter and early spring temperature differences between the two years (warmth confined to the south in 2011 and covering much of the continent in 2012) primarily reflect differences in the contributions from the Atlantic and Indian Oceans, with both acting to cool the east and upper mid-west during 2011, while during 2012 the Indian Ocean reinforced the Pacific-driven continental-wide warming and the Atlantic played a less important role. During late spring and summer of 2011 the tropical Pacific SST force a continued warming and drying over the southern U.S., though considerably weaker than observed. Nevertheless, the observed anomalies fall within the models intra-ensemble spread. In contrast, the rapid development of intense heat and drying over the central U.S. during June and July of 2012 falls outside the models intra-ensemble spread. The response to the SST (a northward expansion of a modest summer warming linked to the Atlantic) gives little indication that 2012 would produce record-breaking precipitation deficits and heat in the central Great Plains. A diagnosis of the 2012 observed circulation anomalies shows that the most extreme heat and drought was tied to the development of a stationary Rossby wave and an associated anomalous upper tropospheric high maintained by weather transients.

Force platform measurements as predictors of falls among older people - a review.

PubMed

Piirtola, Maarit; Era, Pertti

2006-01-01

Poor postural balance is one of the major risk factors for falling. A great number of reports have analyzed the risk factors and predictors of falls but the results have for the most part been unclear and partly contradictory. Objective data on these matters are thus urgently needed. The force platform technique has widely been used as a tool to assess balance. However, the ability of force platform measures to predict falls remains unknown. The purpose of this systematic review was to extract and critically review the findings of prospective studies where force platform measurements have been used as predictors of falls among elderly populations. The study was done as a systematic literature review. PubMed, the Cochrane Central Register of Controlled Trials, and CINAHL databases from 1950 to April 2005 were used. The review includes prospective follow-up studies using the force platform as a tool to measure postural balance. Nine original prospective studies were included in the final analyses. In five studies fall-related outcomes were associated with some force platform measures and in the remaining four studies associations were not found. For the various parameters derived on the basis of the force platform data, the mean speed of the mediolateral (ML) movement of the center of pressure (COP) during normal standing with the eyes open and closed, the mean amplitude of the ML movement of the COP with the eyes open and closed, and the root-mean-square value of the ML displacement of COP were the indicators that showed significant associations with future falls. Measures related to dynamic posturography (moving platforms) were not predictive of falls. Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various indicators of the lateral control of posture. However, the small number of studies available makes it difficult to draw definitive conclusions. Copyright 2006 S. Karger AG, Basel.

Association between physiological falls risk and physical performance tests among community-dwelling older adults.

PubMed

Singh, Devinder K A; Pillai, Sharmila G K; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

2015-01-01

Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman's rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=-0.33), and FRT (r=-0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments.

High-mass Star Formation through Filamentary Collapse and Clump-fed Accretion in G22

NASA Astrophysics Data System (ADS)

Yuan, Jinghua; Li, Jin-Zeng; Wu, Yuefang; Ellingsen, Simon P.; Henkel, Christian; Wang, Ke; Liu, Tie; Liu, Hong-Li; Zavagno, Annie; Ren, Zhiyuan; Huang, Ya-Fang

2018-01-01

How mass is accumulated from cloud-scale down to individual stars is a key open question in understanding high-mass star formation. Here, we present the mass accumulation process in a hub-filament cloud G22 that is composed of four supercritical filaments. Velocity gradients detected along three filaments indicate that they are collapsing with a total mass infall rate of about 440 M ⊙ Myr‑1, suggesting the hub mass would be doubled in six free-fall times, adding up to ∼2 Myr. A fraction of the masses in the central clumps C1 and C2 can be accounted for through large-scale filamentary collapse. Ubiquitous blue profiles in HCO+ (3–2) and 13CO (3–2) spectra suggest a clump-scale collapse scenario in the most massive and densest clump C1. The estimated infall velocity and mass infall rate are 0.31 km s‑1 and 7.2 × 10‑4 M ⊙ yr‑1, respectively. In clump C1, a hot molecular core (SMA1) is revealed by the Submillimeter Array observations and an outflow-driving high-mass protostar is located at the center of SMA1. The mass of the protostar is estimated to be 11–15 M ⊙ and it is still growing with an accretion rate of 7 × 10‑5 M ⊙ yr‑1. The coexistent infall in filaments, clump C1, and the central hot core in G22 suggests that pre-assembled mass reservoirs (i.e., high-mass starless cores) may not be required to form high-mass stars. In the course of high-mass star formation, the central protostar, the core, and the clump can simultaneously grow in mass via core-fed/disk accretion, clump-fed accretion, and filamentary/cloud collapse.

Fall risk as a function of time after admission to sub-acute geriatric hospital units.

PubMed

Rapp, Kilian; Ravindren, Johannes; Becker, Clemens; Lindemann, Ulrich; Jaensch, Andrea; Klenk, Jochen

2016-10-07

There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014. Falls, personal characteristics and functional status at admission were extracted from the hospital information system. The rehabilitation stay was divided in 3-day time-intervals. The fall rate was calculated for each time-interval in all patients combined and in subgroups of patients. To analyse the influence of covariates on fall risk over time multivariate negative binomial regression models were applied for each of 5 time-intervals. The overall fall rate was 10.2 falls/1,000 person-days with highest fall risks during the first week and decreasing risks within the following weeks. A particularly pronounced risk pattern with high fall risks during the first days and decreasing risks thereafter was observed in men, disoriented people, and people with a low functional status or impaired cognition. In disoriented patients, for example, the fall rate decreased from 24.6 falls/1,000 person-days in day 2-4 to about 13 falls/1,000 person-days 2 weeks later. The incidence rate ratio of baseline characteristics changed also over time. Fall risk differs considerably over time during sub-acute hospitalisation. The strongest association between time and fall risk was observed in functionally limited patients with high risks during the first days after admission and declining risks thereafter. This should be considered in the planning and application of fall prevention measures.

The influence of an overactive bladder on falling: a study of females aged 40 and older in the community.

PubMed

Moon, Seung-Jin; Kim, Yong Tae; Lee, Tchun Yong; Moon, Hongsang; Kim, Mi Jung; Kim, Shin Ah; Choi, Bo Youl

2011-03-01

An overactive bladder (OAB) affects a person's quality of life. Patients who suffer from OAB run to the toilet frequently to prevent incontinence, and this behavior increases their risk of falling and fear of falling. This study evaluated the influence of OAB on falls and concern about falling in females aged 40 and over living in urban and rural communities. We conducted a population-based cohort study using King's Health Questionnaire (KHQ), the Korean version of Falls Efficacy Scale-International (KFES-I) and a questionnaire regarding falls, in females aged 40 and over in Guri city and Yangpyeong county. The data from 514 responders were analyzed. The definition of OAB was 'moderately' or 'a lot' of urgency, or urge incontinence in KHQ. Falls was defined as experience of falls in the last year. High fear of falling was defined as a score of 24 or over in KFES-I. The factors were analyzed by the exact chi-square test and Student's t-test. The multivariate logistic regression model was adopted in order to examine the effects of OAB on falls and concern about falling. Of the 514 responders, 98 fitted the criterion of OAB. Eighty-nine (17.3%) of the responders had experienced falls in the last year: twenty-seven (27.5%) in the group with OAB and 62 (14.9%) in the group without OAB. There was a significant association between falls and OAB (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.00 to 3.08; P=0.0485), and between high fear of falling and OAB (OR, 2.72; 95% CI, 1.42 to 5.20; P=0.0024). Urgency and symptoms of urge incontinence increase the risk of falls in women aged 40 or older in the community. Early diagnosis and proper treatment may prevent falls and improve quality of life in OAB patients.

The Influence of an Overactive Bladder on Falling: A Study of Females Aged 40 and Older in the Community

PubMed Central

Moon, Seung-Jin; Kim, Yong Tae; Lee, Tchun Yong; Kim, Mi Jung; Kim, Shin Ah; Choi, Bo Youl

2011-01-01

Purpose An overactive bladder (OAB) affects a person's quality of life. Patients who suffer from OAB run to the toilet frequently to prevent incontinence, and this behavior increases their risk of falling and fear of falling. This study evaluated the influence of OAB on falls and concern about falling in females aged 40 and over living in urban and rural communities. Methods We conducted a population-based cohort study using King's Health Questionnaire (KHQ), the Korean version of Falls Efficacy Scale-International (KFES-I) and a questionnaire regarding falls, in females aged 40 and over in Guri city and Yangpyeong county. The data from 514 responders were analyzed. The definition of OAB was 'moderately' or 'a lot' of urgency, or urge incontinence in KHQ. Falls was defined as experience of falls in the last year. High fear of falling was defined as a score of 24 or over in KFES-I. The factors were analyzed by the exact chi-square test and Student's t-test. The multivariate logistic regression model was adopted in order to examine the effects of OAB on falls and concern about falling. Results Of the 514 responders, 98 fitted the criterion of OAB. Eighty-nine (17.3%) of the responders had experienced falls in the last year: twenty-seven (27.5%) in the group with OAB and 62 (14.9%) in the group without OAB. There was a significant association between falls and OAB (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.00 to 3.08; P=0.0485), and between high fear of falling and OAB (OR, 2.72; 95% CI, 1.42 to 5.20; P=0.0024). Conclusions Urgency and symptoms of urge incontinence increase the risk of falls in women aged 40 or older in the community. Early diagnosis and proper treatment may prevent falls and improve quality of life in OAB patients. PMID:21468286

Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement

PubMed Central

Garcia, Patrícia A.; Dias, João M. D.; Silva, Silvia L. A.; Dias, Rosângela C.

2015-01-01

Background: The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. Objectives: (i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. Method: A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. Results: There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa=0.595) and recurrent fallers (Kappa=0.589). The limits of agreement were 0.35±1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Conclusion: Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning. PMID:26083603

Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study

PubMed Central

Netscher, George; Agrawal, Pulkit; Tabb Noyce, Lynn; Bayen, Alexandre

2017-01-01

Background Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool. Objective The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care. Methods A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents’ falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice. Results Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents. Conclusions Video monitoring offers high potential to support conventional care in memory care facilities. PMID:29042342

Hospitalizations for fall-related injuries among active-duty Army soldiers, 1980–1998

PubMed Central

Senier, Laura; Bell, Nicole S.; Yore, Michelle M.; Amoroso, Paul J.

2007-01-01

Data from the Total Army Injury and Health Outcomes Database (TAIHOD) were used to describe 28,352 fall-related hospitalizations among active-duty Army soldiers between 1980 and 1998. Soldiers who were younger than age 26, single, and had a high school education or less were at greatest risk. Falls from a height were more likely to be fatal than other types of falls, accounting for 88% of all fatalities. In cases where duty status was known, 64% of the falls took place while the soldier was on duty and half of these occurred during training. The most common type of fall during training was fall from a height (37%). Falls on stairs and ladders accounted for 49% of all off-duty falls. Future research should include identification of specific behavioral and occupational risk factors for falls, particularly those occurring during training activities, and falls occurring off duty. PMID:12441580

No Bridge Too High: Infants Decide Whether to Cross Based on the Probability of Falling not the Severity of the Potential Fall

ERIC Educational Resources Information Center

Kretch, Kari S.; Adolph, Karen E.

2013-01-01

Do infants, like adults, consider both the probability of falling and the severity of a potential fall when deciding whether to cross a bridge? Crawling and walking infants were encouraged to cross bridges varying in width over a small drop-off, a large drop-off, or no drop-off. Bridge width affects the probability of falling, whereas drop-off…

The end-Permian regression in the western Tethys: sedimentological and geochemical evidence from offshore the Persian Gulf, Iran

NASA Astrophysics Data System (ADS)

Tavakoli, Vahid; Naderi-Khujin, Mehrangiz; Seyedmehdi, Zahra

2018-04-01

Detailed sedimentological and geochemical records across the Permian-Triassic boundary (PTB) in five offshore wells of the central Persian Gulf served to interpret the end-Permian sea-level change in this region. A decrease in sea level at the PTB was established by petrographical and geochemical study of the boundary. Thin sections showed that Upper Permian strata are composed of dolomite with minor anhydrite, changing into limestone in Lower Triassic sediments. Brine dilution toward the boundary supports sea-level fall in the Permian-Triassic transition, reflected by a decrease in anhydrite content and a shallowing-upward trend from lagoonal to peritidal facies. Isotopic changes at the boundary are in favor of sea-level fall. Changes in both carbon (from about 4 to -1‰) and oxygen (from 2 to -5‰) stable isotopes show negative excursions. The shift in carbon isotope values is a global phenomenon and is interpreted as resulting from carbonate sediment interaction with 12C-rich waters at the end-Permian sea-level fall. However, the oxygen isotope shift is attributed to the effect of meteoric waters with negative oxygen isotope values. The increase in strontium isotope ratios is also consistent with the high rate of terrestrial input at the boundary. The effect of meteoric conditions during diagenesis is evident from vuggy and moldic porosities below the PTB. The following transgression at the base of the Triassic is evident from the presence of reworked fossils and intraclasts resulting from deposition from agitated water.

Unusual July 10, 1996, rock fall at Happy Isles, Yosemite National Park, California

USGS Publications Warehouse

Wieczorek, G.F.; Snyder, J.B.; Waitt, R.B.; Morrissey, M.M.; Uhrhammer, R.A.; Harp, E.L.; Norris, R.D.; Bursik, M.I.; Finewood, L.G.

2000-01-01

Effects of the July 10, 1996, rock fall at Happy Isles in Yosemite National Park, California, were unusual compared to most rock falls. Two main rock masses fell about 14 s apart from a 665-m-high cliff southeast of Glacier Point onto a talus slope above Happy Isles in the eastern part of Yosemite Valley. The two impacts were recorded by seismographs as much as 200 km away. Although the impact area of the rock falls was not particularly large, the falls generated an airblast and an abrasive dense sandy cloud that devastated a larger area downslope of the impact sites toward the Happy Isles Nature Center. Immediately downslope of the impacts, the airblast had velocities exceeding 110 m/s and toppled or snapped about 1000 trees. Even at distances of 0.5 km from impact, wind velocities snapped or toppled large trees, causing one fatality and several serious injuries beyond the Happy Isles Nature Center. A dense sandy cloud trailed the airblast and abraded fallen trunks and trees left standing. The Happy Isles rock fall is one of the few known worldwide to have generated an airblast and abrasive dense sandy cloud. The relatively high velocity of the rock fall at impact, estimated to be 110-120 m/s, influenced the severity and areal extent of the airblast at Happy Isles. Specific geologic and topographic conditions, typical of steep glaciated valleys and mountainous terrain, contributed to the rock-fall release and determined its travel path, resulting in a high velocity at impact that generated the devastating airblast and sandy cloud. The unusual effects of this rock fall emphasize the importance of considering collateral geologic hazards, such as airblasts from rock falls, in hazard assessment and planning development of mountainous areas.

Promoting Exercise as Part of a Physiotherapy-Led Falls Pathway Service for Adults with Intellectual Disabilities: A Service Evaluation

ERIC Educational Resources Information Center

Crockett, Jennifer; Finlayson, Janet; Skelton, Dawn A.; Miller, Gillian

2015-01-01

Background: People with intellectual disabilities experience high rates of falls. Balance and gait problems are common in people with intellectual disabilities, increasing the likelihood of falls; thus, tailored exercise interventions to improve gait and balance are recommended. The present authors set up a physiotherapy-led falls pathway service…

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…

36 CFR 13.1226 - Brooks Falls area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Brooks Falls area. 13.1226... Developed Area § 13.1226 Brooks Falls area. The area within 50 yards of the ordinary high water marks of the Brooks River from the Riffles Bear Viewing Platform to a point 100 yards above Brooks Falls is closed to...

36 CFR 13.1226 - Brooks Falls area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Brooks Falls area. 13.1226... Developed Area § 13.1226 Brooks Falls area. The area within 50 yards of the ordinary high water marks of the Brooks River from the Riffles Bear Viewing Platform to a point 100 yards above Brooks Falls is closed to...

36 CFR 13.1226 - Brooks Falls area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Brooks Falls area. 13.1226... Developed Area § 13.1226 Brooks Falls area. The area within 50 yards of the ordinary high water marks of the Brooks River from the Riffles Bear Viewing Platform to a point 100 yards above Brooks Falls is closed to...

36 CFR 13.1226 - Brooks Falls area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Brooks Falls area. 13.1226... Developed Area § 13.1226 Brooks Falls area. The area within 50 yards of the ordinary high water marks of the Brooks River from the Riffles Bear Viewing Platform to a point 100 yards above Brooks Falls is closed to...

Radiative shocks produced from spherical cryogenic implosions at the National Ignition Facility

DOE PAGES

Pak, A.; Divol, L.; Gregori, G.; ...

2013-05-20

Spherically expanding radiative shock waves have been observed from inertially confined implosion experiments at the National Ignition Facility. In these experiments, a spherical fusion target, initially 2 mm in diameter, is compressed via the pressure induced from the ablation of the outer target surface. At the peak compression of the capsule, x-ray and nuclear diagnostics indicate the formation of a central core, with a radius and ion temperature of ~20 μm and ~ 2 keV, respectively. This central core is surrounded by a cooler compressed shell of deuterium-tritium fuel that has an outer radius of ~40 μm and a densitymore » of >500 g/cm 3. Using inputs from multiple diagnostics, the peak pressure of the compressed core has been inferred to be of order 100 Gbar for the implosions discussed here. Furthermore, the shock front, initially located at the interface between the high pressure compressed fuel shell and surrounding in-falling low pressure ablator plasma, begins to propagate outwards after peak compression has been reached.« less

Unintentional falls mortality among elderly in the United States: time for action.

PubMed

Alamgir, Hasanat; Muazzam, Sana; Nasrullah, Muazzam

2012-12-01

Fall injury is a leading cause of death and disability among older adults. The objective of this study is to identify the groups among the ≥ 65 population by age, gender, race, ethnicity and state of residence which are most vulnerable to unintentional fall mortality and report the trends in falls mortality in the United States. Using mortality data from the Centers for Disease Control and Prevention, the age specific and age-adjusted fall mortality rates were calculated by gender, age, race, ethnicity and state of residence for a five year period (2003-2007). Annual percentage changes in rates were calculated and linear regression using natural logged rates were used for time-trend analysis. There were 79,386 fall fatalities (rate: 40.77 per 100,000 population) reported. The annual mortality rate varied from a low of 36.76 in 2003 to a high of 44.89 in 2007 with a 22.14% increase (p=0.002 for time-related trend) during 2003-2007. The rates among whites were higher compared to blacks (43.04 vs. 18.83; p=0.01). While comparing falls mortality rate for race by gender, white males had the highest mortality rate followed by white females. The rate was as low as 20.19 for Alabama and as high as 97.63 for New Mexico. The relative attribution of falls mortality among all unintentional injury mortality increased with age (23.19% for 65-69 years and 53.53% for 85+ years), and the proportion of falls mortality was significantly higher among females than males (46.9% vs. 40.7%: p<0.001) and among whites than blacks (45.3% vs. 24.7%: p<0.001). The burden of fall related mortality is very high and the rate is on the rise; however, the burden and trend varied by gender, age, race and ethnicity and also by state of residence. Strategies will be more effective in reducing fall-related mortality when high risk population groups are targeted. Copyright © 2011 Elsevier Ltd. All rights reserved.

Is there substructure around M87?

NASA Astrophysics Data System (ADS)

Oldham, L. J.; Evans, N. W.

2016-10-01

We present a general method to identify infalling substructure in discrete data sets with position and line-of-sight velocity data. We exploit the fact that galaxies falling on to a brightest cluster galaxy (BCG) in a virialized cluster, or dwarf satellites falling on to a central galaxy like the Milky Way, follow nearly radial orbits. If the orbits are exactly radial, we show how to find the probability distribution for a satellite's energy, given a tracer density for the satellite population, by solving an Abel integral equation. This is an extension of Eddington's classical formula for the isotropic distribution function. When applied to a system of galaxies, clustering in energy space can then be quantified using the Kullback-Leibler divergence, and groups of objects can be identified which, though separated in the sky, may be falling in on the same orbit. This method is tested using mock data and applied to the satellite galaxy population around M87, the BCG in Virgo, and a number of associations that are found, which may represent infalling galaxy groups.

Conditioning of sandhill cranes during fall migration

USGS Publications Warehouse

Krapu, Gary L.; Johnson, Douglas H.

1990-01-01

Body mass of adult female and male sandhill cranes (Grus canadensis) increased an average of 17 and 20%, respectively, from early September to late October on staging areas in central North Dakota and varied by year. Increases in body mass averaged 550 and 681 g among female and male G. c. canadensis, respectively, and 616 and 836 g among female and male G. c. rowani. Adult and juvenile G. c. rowani were lean at arrival, averaging 177 and 83 g of fat, respectively, and fat reserves increased to 677 and 482 g by mid-October. Fat-free dry mass increased by 12% among juveniles, reflecting substantial growth, but remained constant among adults. The importance of fall staging areas as conditioning sites for sandhill cranes, annual variation in body mass, and vulnerability of cranes to habitat loss underscore the need to monitor status of fall staging habitat in the northern plains region and to take steps to maintain suitable habitat where necessary.

Individual differences in fifth graders’ reading and language predict their comprehension monitoring development: An eye-movement study

PubMed Central

Connor, Carol McDonald; Radach, Ralph; Vorstius, Christian; Day, Stephanie L.; McLean, Leigh; Morrison, Frederick J.

2015-01-01

In this study, we investigated fifth-graders’ (n=52) fall literacy, academic language, and motivation, and how these skills predicted fall and spring comprehension monitoring on an eye movement task. Comprehension monitoring was defined as the identification and repair of misunderstandings when reading text. In the eye movement task, children read two sentences; the second included either a plausible or implausible word in the context of the first sentence. Stronger readers had shorter reading times overall suggesting faster processing of text. Generally fifth-graders reacted to the implausible word (i.e., longer gaze duration on the implausible v. the plausible word, which reflects lexical access). Students with stronger academic language, compared to those with weaker academic language, generally spent more time re-reading the implausible target compared to the plausible target. This difference increased from fall to spring. Results support the centrality of academic language for meaning integration, setting standards of coherence, and utilizing comprehension repair strategies. PMID:27065721

Relationships between large-scale circulation patterns and carbon dioxide exchange by a deciduous forest

NASA Astrophysics Data System (ADS)

Zhang, Jingyong; Wu, Lingyun; Huang, Gang; Notaro, Michael

2011-02-01

In this study, we focus on a deciduous forest in central Massachusetts and investigate the relationships between global climate indices and CO2 exchange using eddy-covariance flux measurements from 1992 to 2007. Results suggest that large-scale circulation patterns influence the annual CO2 exchange in the forest through their effects on the local surface climate. Annual gross ecosystem exchange (GEE) in the forest is closely associated with spring El Niño-Southern Oscillation (ENSO) and Pacific Decadal Oscillation (PDO), previous fall Atlantic Multidecadal Oscillation (AMO), and previous winter East Pacific-North Pacific (EP-NP) pattern. Annual net ecosystem exchange (NEE) responds to previous fall AMO and PDO, while annual respiration (R) is impacted by previous fall ENSO and Pacific/North American Oscillation (PNA). Regressions based on these relationships are developed to simulate the annual GEE, NEE, and R. To avoid problems of multicollinearity, we compute a "Composite Index for GEE (CIGEE)" based on a linear combination of spring ENSO and PDO, fall AMO, and winter EP-NP and a "Composite Index for R (CIR)" based on a linear combination of fall ENSO and PNA. CIGEE, CIR, and fall AMO and PDO can explain 41, 27, and 40% of the variance of the annual GEE, R, and NEE, respectively. We further apply the methodology to two other northern midlatitude forests and find that interannual variabilities in NEE of the two forests are largely controlled by large-scale circulation patterns. This study suggests that global climate indices provide the potential for predicting CO2 exchange variability in the northern midlatitude forests.

A review of stairway falls and stair negotiation: Lessons learned and future needs to reduce injury.

PubMed

Jacobs, Jesse V

2016-09-01

Stairways are a common location for falls, and they result in a disproportionate risk of death or severe injury. Stairway falls are a significant problem across the lifespan and are often coincident with risky behaviors during stair use. The mechanics of successful stair negotiation for healthy young and older adults have been well described. These studies imply that current stair design does not offer an optimal universal design to meet the needs of older adults or people with health conditions. In addition, impaired stair negotiation associates with more than impaired strength, including functional impairments of cognitive load, sensory function and central motor coordination. Identification of behavioral strategies or stairway environments that assist or hinder recovery from a loss of balance on stairs remains incomplete. Therefore, future studies should investigate the mechanisms of balance recovery on stairs as well as the effectiveness of environmental interventions to mitigate stairway falls and injuries. Potential areas for evaluation may include modifying stair dimensions, surfaces, handrails, visual cues, and removing distractors of attention. Studies should also evaluate combinatorial interventions on person-related factors, such as behavioral interventions to decrease risky behaviors during stair use as well as interventions on cognitive, sensory, and motor functions relevant to stair use. Moreover, future studies should take advantage of new technologies to record stair use outside the laboratory in order to identify people or locations at risk for stairway falls. Such studies would inform the potential for broad-spectrum programs that decrease the risk of stairway falls and injuries. Copyright © 2016 The Author. Published by Elsevier B.V. All rights reserved.

Epidemiological survey of the feasibility of broadband ultrasound attenuation measured using calcaneal quantitative ultrasound to predict the incidence of falls in the middle aged and elderly.

PubMed

Ou, Ling-Chun; Chang, Yin-Fan; Chang, Chin-Sung; Chiu, Ching-Ju; Chao, Ting-Hsing; Sun, Zih-Jie; Lin, Ruey-Mo; Wu, Chih-Hsing

2017-01-09

We investigated whether calcaneal quantitative ultrasound (QUS-C) is a feasible tool for predicting the incidence of falls. Prospective epidemiological cohort study. Community-dwelling people sampled in central western Taiwan. A cohort of community-dwelling people who were ≥40 years old (men: 524; women: 676) in 2009-2010. Follow-up questionnaires were completed by 186 men and 257 women in 2012. Structured questionnaires and broadband ultrasound attenuation (BUA) data were obtained in 2009-2010 using QUS-C, and follow-up surveys were done in a telephone interview in 2012. Using a binary logistic regression model, the risk factors associated with a new fall during follow-up were analysed with all significant variables from the bivariate comparisons and theoretically important variables. The incidence of falls was determined when the first new fall occurred during the follow-up period. The mean follow-up time was 2.83 years. The total incidence of falls was 28.0 per 1000 person-years for the ≥40 year old group (all participants), 23.3 per 1000 person-years for the 40-70 year old group, and 45.6 per 1000 person-years for the ≥70 year old group. Using multiple logistic regression models, the independent factors were current smoking, living alone, psychiatric drug usage and lower BUA (OR 0.93; 95% CI 0.88 to 0.99, p<0.05) in the ≥70 year old group. The incidence of falls was highest in the ≥70 year old group. Using QUS-C-derived BUA is feasible for predicting the incidence of falls in community-dwelling elderly people aged ≥70 years. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Bridging the gap between research and practice: review of a targeted hospital inpatient fall prevention programme.

PubMed

Barker, A; Kamar, J; Morton, A; Berlowitz, D

2009-12-01

Falls among older inpatients are frequent and have negative consequences. In this study, the effectiveness of a fall prevention programme in reducing falls and fall injuries in an acute hospital was studied. Retrospective audit. The Northern Hospital, an acute, metropolitan, hospital in Australia. A multi-factorial fall prevention programme that included establishment of a multidisciplinary committee, risk assessment of all patients on "high-risk" wards and targeted interventions for patients identified as high risk. Fall and fall injury rates per 1000 occupied bed-days were analysed using generalised additive models (GAM) and, because of the presence of autocorrelation, generalised additive mixed models (GAMM), respectively. During the 9-year observation of 271 095 patients, there were 2910 falls and 843 fall injuries. The GAM predicted rate of falls was stable in the 3 years after the programme was implemented, increased in 2006, then decreased between October 2006 and December 2007 from 4.13 (95% CI 3.65 to 4.67) to 2.83 (95% CI 2.24 to 3.59; p = 0.005). The GAMM predicted rate of fall injuries reduced from 1.66 (95% CI 1.24 to 2.21) to 0.61 (95% CI 0.43 to 0.88) after programme implementation (p<0.001). The falls rate varied throughout the observation period, and no significant change in the rate from preprogramme to postprogramme implementation was observed. The finding of no reduction in falls during the observation period may be explained by improved reporting throughout the observation period. The reduction in fall injuries was substantial and sustained. Identification of a local problem, use of a fall risk assessment to guide the delivery of simple interventions, integration of processes into daily clinical practice and creating systems that demand accountability of staff are factors that appear to have contributed to the programme's success.

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study.

PubMed

Fleming, Jane; Matthews, Fiona E; Brayne, Carol

2008-03-17

The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Re-survey of over-90-year-olds in a longitudinal cohort study - cross-sectional interview and intensive 12-month follow-up. 90 women and 20 men participating in a population-based cohort (aged 91-105 years, in care-homes and community-dwelling) recruited from representative general practices in Cambridge, UKMeasurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%), as were fall rates (1.6 and 2.8 falls/person-year respectively). Repeated falls in the past year were more highly predictive of falls during the following year - IRR 4.7, 95% CI 2.6-8.7 - than just one - IRR 3.6, 95% CI 2.0-6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions of people who fell were reported by retrospective and prospective methods covering two consecutive years. Recall methods may underestimate numbers of repeated falls and the extent of recurrent falling. Professionals caring for people of advanced age can easily ask routinely whether someone has fallen at all, or more than once, in the past year to identify those at high risk of subsequent falls.

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

PubMed

Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

2017-11-01

New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed overall (mean, 0.03 [SE, 0.01] points on a 5-point scale; P = .03) and for communication timeliness (mean, 0.8 [SE, 0.03] points on a 5-point scale; P = .02). There was wide variation across facilities in intervention penetration. An intervention targeting gaps in staff communication and coordination did not improve the impact of a falls quality improvement program. New approaches to implementing evidence-based care for complex conditions in the nursing home are urgently needed. clinicaltrials.gov Identifier: NCT00636675.

Constraints Militating against the Implementation of Production/Service Work in Technical Colleges in North Central Nigeria

ERIC Educational Resources Information Center

Agu, Peter A.

2016-01-01

Skill acquisition is a critical component of any vocational technical training program. When this component is missing or falls below expectation, it tends to defeat the objectives of the program. In Nigeria, many skill-oriented schools experience great challenges in trying to provide for the necessary facilities required for effective technical…

After the Fall: The Use of Surplus Capacity in an Academic Library Automation System.

ERIC Educational Resources Information Center

Wright, A. J.

The possible uses of excess central processing unit capacity in an integrated academic library automation system discussed in this draft proposal include (1) in-house services such as word processing, electronic mail, management decision support using PERT/CPM techniques, and control of physical plant operation; (2) public services such as the…

Stopover ecology of neotropical migrants in central Veracruz, México

Treesearch

Ernesto Ruelas Inzunza; Stephen W. Hoffman; Laurie J. Goodrich

2005-01-01

Available information on the ecology of neotropical migrants during the winter season and especially during migration is far behind the existing knowledge of birds during the breeding season. This paper presents a stopover ecology case study. We document the occurrence of species, outline the prevailing weather patterns during spring and fall migration seasons, and...

Temperament does not affect steer weight gains on extensively managed semiarid rangeland

USDA-ARS?s Scientific Manuscript database

Between 2011 and 2013, a five category flight speed score (1=walk; 2=trot; 3=bolt; 4=jump; and 5=fall) was used to assess the temperament of 1643 yearling steers of mixed breeds following release from a hydraulic squeeze chute at the USDA-ARS Central Plains Experimental Range near Nunn, CO, USA. Sco...

Learning Curve: Adapting Library Workspaces

ERIC Educational Resources Information Center

Haug, James C.

2008-01-01

One of the hubs of campus life at Longwood University--located in the small central Virginia town of Farmville--is the Janet D. Greenwood Library. In fall 2004, reference materials were relocated to free up space, and 15 computer workstations, which had been lined up against a wall, were replaced with 48 new PCs. In 2005, library staff began…

AmeriFlux US-Pon Ponca City

DOE Data Explorer

Verma, Shashi [University of Nebraska - Lincoln

2016-01-01

This is the AmeriFlux version of the carbon flux data for the site US-Pon Ponca City. Site Description - The Ponca Winter Wheat site is a 65 ha rainfed wheat field in north central Oklahoma. Planting of winter wheat takes place annually in mid-fall. By late May, most of the wheat reaches maturity, allowing for mid-summer harvest.

The College Environment: Contrasts Between CYCC Freshmen and Transfers and a Nationwide Freshman Sample, Fall, 1975.

ERIC Educational Resources Information Center

Kirby, E. B.

In order to analyze the environment of Central YMCA Community College (CYCC), information was requested on the Student Information Form, 1975, which dealt with three large areas: social issues, personal behavior, and future behavior in the noncollege world. This report compares the responses of three student samples--CYCC first-time entering…

Natural regeneration of lodgepole pine in south-central Oregon

Treesearch

P.H. Cochran

1973-01-01

A sequence of events is necessary for natural regeneration in the pumice soil region: Adequate seed must be probed and distributed over the area, germination must be favored by warm and moist surface soils, daily surface temperature variation must be moderate, seedlings must survive summer drought, and weather conditions must prevent severe frost heaving the fall after...

Library Skills: What's There and How to Find It. MicroSIFT Courseware Evaluation.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT (Except for the Evaluation Summary Table): PRODUCER: Micro Power and Light Company, Keystone Park, Suite 1108, 13773 N. Central Expressway, Dallas, TX 75243. LOCAL DISTRIBUTORS: Contact producer for list. EVALUATION COMPLETED: Fall 1981. VERSION: Apple II. COST: $24.95. ABILITY LEVEL: Grades 4+.…

On Robustness of Deadlock Detection Algorithms for Distributed Computing Systems.

DTIC Science & Technology

1982-02-01

temrs : nake it much,- ore Eff’: -ult -,o detect, avcii :r -revenn -hsr fn -,he earlier muJtiroaming centralized computing systems. :eadlock :)rever...failure of site C would not have been critical after the B ^ad ’ teen sent. The effect of a type c site (site _ in our examrle’ falling would have no

After the Fall: Educational Contracting in the USA and the Global Financial Crisis

ERIC Educational Resources Information Center

Burch, Patricia

2010-01-01

Key legislative objectives for the US Federal educational policy over the past several decades relied heavily on quasi-market strategies (such as school rating, school closure, the contracting out of schools) as central levers in "reforming" public schools. Using financial data on 11 national for-profit firms contracting with schools and…

77 FR 38620 - Idaho Power Company; Notice of Application for Amendment of License And Soliciting Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

... Falls Hydroelectric Project. f. Location: The project is located in south-central Idaho on the Snake... reproduction at the Commission's Public Reference Room, located at 888 First Street NE., Room 2A, Washington... inspection and reproduction at the address in item (h) above. m. Individuals desiring to be included on the...

77 FR 38618 - Idaho Power Company; Notice of Application for Amendment of License and Soliciting Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

... Falls Hydroelectric Project. f. Location: The project is located in south-central Idaho on the Snake... inspection and reproduction at the Commission's Public Reference Room, located at 888 First Street NE., Room... inspection and reproduction at the address in item (h) above. m. Individuals desiring to be included on the...

Gap-phase regeneration inlongleaf pine wiregrass ecosystems

Treesearch

D.G. Brockway; K.W. Outcalt

1998-01-01

Naturally regenerated seedlings of longleaf pine are typically observed to cluster in the center of tree fall canopy gaps and be encircled by a wide zone from which they are generally excluded. Twelve representative canopy gaps distributed across 600 ha of a naturally regenerated uneven-agedlongleaf pine forest in the sandhills of north central Florida were examined to...

Preimpoundment water quality of Raystown Branch Juniata River and six tributary streams, south-central Pennsylvania

USGS Publications Warehouse

Williams, Donald R.

1976-01-01

The Raystown Branch Juniata River watershed, which is the main water source for Raystown Lake, is a 960-square-mile (2,490 square kilometres) drainage basin in south-central Pennsylvania. Preimpoundment water-quality data were collected on the Raystown Branch and six tributary st.reams in the basin. Specific conductance values varied inversely with water discharge. The pH values were extremely low only at the Shoup Run site. Dissolved oxygen concentrations observed at all sites indicated a relatively high oxygen saturation level throughout the year. Seasonal variations in nitrate-N and orthophosphate-P levels were measured at the main inflow station at Saxton, Pa. The highest concentrations of nitrate-N and orthophosphate-P occurred in the winter and spring months and the lowest concentrations were measured dur:l.ng the swnmer and fall. Bacteriological data indicated no excessive -amounts of fecal matter present at the inflows. Soil samples collected at four sites in the impoundment area were predominantly of the Barbour, Philo, and Basher series, which are considered to be highly fertile soils with silt-loam and sandy~loam textures. Morphological features of the lake basin and low nutrient levels at the inflows should prevent excessive weed growth around the lake perimeter.

Optimising the use of marine tephrochronology in the North Atlantic: a detailed investigation of the Faroe Marine Ash Zones II, III and IV

NASA Astrophysics Data System (ADS)

Griggs, Adam J.; Davies, Siwan M.; Abbott, Peter M.; Rasmussen, Tine L.; Palmer, Adrian P.

2014-12-01

Tephrochronology is central to the INTIMATE goals for testing the degree of climatic synchroneity during abrupt climatic events that punctuated the last glacial period. Since their identification in North Atlantic marine sequences, the Faroe Marine Ash Zone II (FMAZ II), FMAZ III and FMAZ IV have received considerable attention due to their potential for high-precision synchronisation with the Greenland ice-cores. In order to optimise the use of these horizons as isochronous markers, a detailed re-investigation of their geochemical composition, sedimentology and the processes that deposited each ash zone is presented. Shard concentration profiles, geochemical homogeneity and micro-sedimentological structures are investigated for each ash zone preserved within core JM11-19PC, retrieved from the southeastern Norwegian Sea on the central North Faroe Slope. This approach allows a thorough assessment of primary ash-fall preservation and secondary depositional features and demonstrates its value for assessing depositional integrity in the marine environment. Results indicate that the FMAZ II and IV are well-resolved primary deposits that can be used as isochrons for high-precision correlation studies. We outline key recommendations for future marine tephra studies and provide a protocol for optimising the application of tephrochronology to meet the INTIMATE synchronisation goals.

Using science and psychology to improve the dissemination and evaluation of scientific work

PubMed Central

Buttliere, Brett T.

2014-01-01

Here I outline some of what science can tell us about the problems in psychological publishing and how to best address those problems. First, the motivation behind questionable research practices is examined (the desire to get ahead or, at least, not fall behind). Next, behavior modification strategies are discussed, pointing out that reward works better than punishment. Humans are utility seekers and the implementation of current change initiatives is hindered by high initial buy-in costs and insufficient expected utility. Open science tools interested in improving science should team up, to increase utility while lowering the cost and risk associated with engagement. The best way to realign individual and group motives will probably be to create one, centralized, easy to use, platform, with a profile, a feed of targeted science stories based upon previous system interaction, a sophisticated (public) discussion section, and impact metrics which use the associated data. These measures encourage high quality review and other prosocial activities while inhibiting self-serving behavior. Some advantages of centrally digitizing communications are outlined, including ways the data could be used to improve the peer review process. Most generally, it seems that decisions about change design and implementation should be theory and data driven. PMID:25191261

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

PubMed Central

Chen, Ying; Zhu, Ling-Ling; Zhou, Quan

2014-01-01

Background Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Results Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer’s agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug–drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of FRIDs, pharmacist-conducted clinical medication review, and computerized drug alerts, were effective in reducing fall risk. Conclusion Based on the literature review, clear practical recommendations for clinicians to prevent falls in the elderly included making a list of FRIDs, establishing a computerized alert system for when to e-prescribe FRIDs, seeking an alternative drug with lower fall risk, withdrawing FRIDs if clinically indicated, taking pertinent cautions when the use of FRIDs cannot be avoidable, paying attention to prescribing appropriateness, simplifying the medication regimen, strengthening pharmacist-conducted clinical medication review, ensuring the label of each FRID dispensed contains a corresponding warning sign, being careful when medication change occurs, enhancing medication adherence, and mandating for periodic reassessment of potential risk associated with the patient’s medication regimen. Further studies should be conducted in this area, such as investigating whether medication reconciliation and improving medication adherence could decrease the rate of falls. PMID:24966681

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients.

PubMed

Chen, Ying; Zhu, Ling-Ling; Zhou, Quan

2014-01-01

Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer's agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug-drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of FRIDs, pharmacist-conducted clinical medication review, and computerized drug alerts, were effective in reducing fall risk. Based on the literature review, clear practical recommendations for clinicians to prevent falls in the elderly included making a list of FRIDs, establishing a computerized alert system for when to e-prescribe FRIDs, seeking an alternative drug with lower fall risk, withdrawing FRIDs if clinically indicated, taking pertinent cautions when the use of FRIDs cannot be avoidable, paying attention to prescribing appropriateness, simplifying the medication regimen, strengthening pharmacist-conducted clinical medication review, ensuring the label of each FRID dispensed contains a corresponding warning sign, being careful when medication change occurs, enhancing medication adherence, and mandating for periodic reassessment of potential risk associated with the patient's medication regimen. Further studies should be conducted in this area, such as investigating whether medication reconciliation and improving medication adherence could decrease the rate of falls.

Gravitational Collapse of Spherical Interstellar Clouds

NASA Astrophysics Data System (ADS)

Ogino, Shinya; Tomisaka, Kohji; Nakamura, Fumitaka

1999-10-01

In this paper, the gravitational collapse of spherical interstellar clouds is discussed based on hydro\\-dynamical simulations. The evolution is divided into two phases: former runaway collapse phase, in which the central density increases greatly on a finite time scale, and later contraction, associated with accretion onto a newborn star. The initial density distribution is expressed using a ratio of the gravitational force to the pressure force alpha . The equation of state for a polytropic gas is used. The central, high-density part of the solution converges on a self-similar solution, which was first derived for the runaway collapse by Larson and Penston (LP). In the later accretion phase, gas behaves like a particle, and the infall speed is accelerated by the gravity of the central object. The solution at this stage is qualitatively similar to the inside-out similarity solutions first found by Shu. However, it is shown that the gas-inflow (accretion) rate is time-dependent, in contrast to the constant rate of the inside-out similarity solutions. For isothermal models in which the pressure is important, 1 <~ alpha <~ 3.35, the accretion rate reaches its maximum when the central part, which obeys the LP solution, contracts and accretes. On the other hand, in isothermal models in which gravity is dominant, alpha >~ 3.35, the accretion becomes most active at the epoch when the outer part of the cloud falls onto the center. The effect of the non-isothermal equation of state is discussed.

Validation of Fall Risk Assessment Specific to the Inpatient Rehabilitation Facility Setting.

PubMed

Thomas, Dan; Pavic, Andrea; Bisaccia, Erin; Grotts, Jonathan

2016-09-01

To evaluate and compare the Morse Fall Scale (MFS) and the Casa Colina Fall Risk Assessment Scale (CCFRA) for identification of patients at risk for falling in an acute inpatient rehabilitation facility. The primary objective of this study was to perform a retrospective validation study of the CCFRAS, specifically for use in the inpatient rehabilitation facility (IRF) setting. Retrospective validation study. The study was approved under expedited review by the local Institutional Review Board. Data were collected on all patients admitted to Cottage Rehabiliation Hospital (CRH), a 38-bed acute inpatient rehabilitation hospital, from March 2012 to August 2013. Patients were excluded from the study if they had a length of stay less than 3 days or age less than 18. The area under the receiver operating characteristic curve (AUC) and the diagnostic odds ratio were used to examine the differences between the MFS and CCFRAS. AUC between fall scales was compared using the DeLong Test. There were 931 patients included in the study with 62 (6.7%) patient falls. The average age of the population was 68.8 with 503 males (51.2%). The AUC was 0.595 and 0.713 for the MFS and CCFRAS, respectively (0.006). The diagnostic odds ratio of the MFS was 2.0 and 3.6 for the CCFRAS using the recommended cutoffs of 45 for the MFS and 80 for the CCFRAS. The CCFRAS appears to be a better tool in detecting fallers vs. nonfallers specific to the IRF setting. The assessment and identification of patients at high risk for falling is important to implement specific precautions and care for these patients to reduce their risk of falling. The CCFRAS is more clinically relevant in identifying patients at high risk for falling in the IRF setting compared to other fall risk assessments. Implementation of this scale may lead to a reduction in fall rate and injuries from falls as it more appropriately identifies patients at high risk for falling. © 2015 Association of Rehabilitation Nurses.

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.

Prediction of Falls in Subjects Suffering From Parkinson Disease, Multiple Sclerosis, and Stroke.

PubMed

Beghi, Ettore; Gervasoni, Elisa; Pupillo, Elisabetta; Bianchi, Elisa; Montesano, Angelo; Aprile, Irene; Agostini, Michela; Rovaris, Marco; Cattaneo, Davide

2018-04-01

To compare the risk of falls and fall predictors in patients with Parkinson disease (PD), multiple sclerosis (MS), and stroke using the same study design. Multicenter prospective cohort study. Institutions for physical therapy and rehabilitation. Patients (N=299) with PD (n=94), MS (n=111), and stroke (n=94) seen for rehabilitation. Not applicable. Functional scales were applied to investigate balance, disability, daily performance, self-confidence with balance, and social integration. Patients were followed for 6 months. Telephone interviews were organized at 2, 4, and 6 months to record falls and fall-related injuries. Incidence ratios, Kaplan-Meier survival curves, and Cox proportional hazards models were used. Of the 299 patients enrolled, 259 had complete follow-up. One hundred and twenty-two patients (47.1%) fell at least once; 82 (31.7%) were recurrent fallers and 44 (17.0%) suffered injuries; and 16%, 32%, and 40% fell at 2, 4, and 6 months. Risk of falls was associated with disease type (PD, MS, and stroke in decreasing order) and confidence with balance (Activities-specific Balance Confidence [ABC] scale). Recurrent fallers were 7%, 15%, and 24% at 2, 4, and 6 months. The risk of recurrent falls was associated with disease type, high educational level, and ABC score. Injured fallers were 3%, 8%, and 12% at 2, 4, and 6 months. The only predictor of falls with injuries was disease type (PD). PD, MS, and stroke carry a high risk of falls. Other predictors include perceived balance confidence and high educational level. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

PubMed

Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won

2018-01-01

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

Holocene coseismic and aseismic uplift of Isla Mocha, south-central Chile

USGS Publications Warehouse

Nelson, A.R.; Manley, W.F.

1992-01-01

During the past 6000 years Isla Mocha, a 12 km-long island 30 km off the coast of south-central Chile, experienced a 38 m fall of relative sea level caused primarily by rapid tectonic uplift of the island. As many as 18 raised shorelines (strandlines) record this uplift. Historic accounts of uplift during the great earthquakes (M > 8) of 1835 and 1960 suggest some of the more prominent prehistoric strandlines also emerged during great earthquakes on the interface between the Nazca and South America plates. But the close elevational spacing of strandlines, subdued morphology of strandline beaches, scarcity of exposed bedrock wave-cut platforms, and the extremely high rates of aseismic uplift (ca. 70 mm/yr) of the island since the last great earthquake suggest that many strandlines were raised by aseismic rather than coseismic uplift. Strandline heights and 14 new radiocarbon ages on marine shells show that the present-day uplift rate is more than three times the net rate (ca. 20 mm/yr) of the past 1000 years. The recent high rate probably reflects increased aseismic slip on an inferred thrust fault in the overriding South America plate. Isla Mocha overlies an area of high stress concentration between two major segments of the Chilean subduction zone. The inferred high rate of slip on the thrust fault may be a response to stress changes on the plate interface near the boundary between the segments. ?? 1992.

Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis.

PubMed

Tricco, Andrea C; Thomas, Sonia M; Veroniki, Areti Angeliki; Hamid, Jemila S; Cogo, Elise; Strifler, Lisa; Khan, Paul A; Robson, Reid; Sibley, Kathryn M; MacDonald, Heather; Riva, John J; Thavorn, Kednapa; Wilson, Charlotte; Holroyd-Leduc, Jayna; Kerr, Gillian D; Feldman, Fabio; Majumdar, Sumit R; Jaglal, Susan B; Hui, Wing; Straus, Sharon E

2017-11-07

Falls result in substantial burden for patients and health care systems, and given the aging of the population worldwide, the incidence of falls continues to rise. To assess the potential effectiveness of interventions for preventing falls. MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Ageline databases from inception until April 2017. Reference lists of included studies were scanned. Randomized clinical trials (RCTs) of fall-prevention interventions for participants aged 65 years and older. Pairs of reviewers independently screened the studies, abstracted data, and appraised risk of bias. Pairwise meta-analysis and network meta-analysis were conducted. Injurious falls and fall-related hospitalizations. A total of 283 RCTs (159 910 participants; mean age, 78.1 years; 74% women) were included after screening of 10 650 titles and abstracts and 1210 full-text articles. Network meta-analysis (including 54 RCTs, 41 596 participants, 39 interventions plus usual care) suggested that the following interventions, when compared with usual care, were associated with reductions in injurious falls: exercise (odds ratio [OR], 0.51 [95% CI, 0.33 to 0.79]; absolute risk difference [ARD], -0.67 [95% CI, -1.10 to -0.24]); combined exercise and vision assessment and treatment (OR, 0.17 [95% CI, 0.07 to 0.38]; ARD, -1.79 [95% CI, -2.63 to -0.96]); combined exercise, vision assessment and treatment, and environmental assessment and modification (OR, 0.30 [95% CI, 0.13 to 0.70]; ARD, -1.19 [95% CI, -2.04 to -0.35]); and combined clinic-level quality improvement strategies (eg, case management), multifactorial assessment and treatment (eg, comprehensive geriatric assessment), calcium supplementation, and vitamin D supplementation (OR, 0.12 [95% CI, 0.03 to 0.55]; ARD, -2.08 [95% CI, -3.56 to -0.60]). Pairwise meta-analyses for fall-related hospitalizations (2 RCTs; 516 participants) showed no significant association between combined clinic- and patient-level quality improvement strategies and multifactorial assessment and treatment relative to usual care (OR, 0.78 [95% CI, 0.33 to 1.81]). Exercise alone and various combinations of interventions were associated with lower risk of injurious falls compared with usual care. Choice of fall-prevention intervention may depend on patient and caregiver values and preferences.

OHI--Randomized Control Trial to Evaluate Efficacy, Acceptability, and Perception of Benefit of an Innovative Custom AFO

ClinicalTrials.gov

2018-05-25

Accidental Falls; Fall Due to Loss of Equilibrium; High Risk of Falls Due to Mobility Limitation; Diabetes; Arthritis; Cancer; Peripheral Arterial Disease; Parkinson's Disease; End Stage Renal Failure on Dialysis

Fall rates of prescribed fire-killed ponderosa pine. Forest Service research paper

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harrington, M.G.

1996-05-01

Fall rates of prescribed fire-killed ponderosa pine were evaluated relative to tree and fire damage characteristics. High crown scorch and short survival time after fire injury were factors leading to a high probability of early tree fall. The role of chemical defense mechanisms is discussed. Results apply to prescribed-fire injured, second-growth ponderosa pine less than 16 inches diameter at breast height.

Atmospheric pollution for trace elements in the remote high-altitude atmosphere in central Asia as recorded in snow from Mt. Qomolangma (Everest) of the Himalayas.

PubMed

Lee, Khanghyun; Hur, Soon Do; Hou, Shugui; Hong, Sungmin; Qin, Xiang; Ren, Jiawen; Liu, Yapping; Rosman, Kevin J R; Barbante, Carlo; Boutron, Claude F

2008-10-01

A series of 42 snow samples covering over a one-year period from the fall of 2004 to the summer of 2005 were collected from a 2.1-m snow pit at a high-altitude site on the northeastern slope of Mt. Everest. These samples were analyzed for Al, V, Cr, Mn, Co, Ni, Cu, Zn, As, Rb, Sr, Cd, Sb, Pb, and Bi in order to characterize the relative contributions from anthropogenic and natural sources to the fallout of these elements in central Himalayas. Our data were also considered in the context of monsoon versus non-monsoon seasons. The mean concentrations of the majority of the elements were determined to be at the pg g(-1) level with a strong variation in concentration with snow depth. While the mean concentrations of most of the elements were significantly higher during the non-monsoon season than during the monsoon season, considerable variability in the trace element inputs to the snow was observed during both periods. Cu, Zn, As, Cd, Sb, and Bi displayed high crustal enrichment factors (EFc) in most samples, while Cr, Ni, Rb, and Pb show high EFc values in some of the samples. Our data indicate that anthropogenic inputs are potentially important for these elements in the remote high-altitude atmosphere in the central Himalayas. The relationship between the EFc of each element and the Al concentration indicates that a dominant input of anthropogenic trace elements occurs during both the monsoon and non-monsoon seasons, when crustal contribution is relatively minor. Finally, a comparison of the trace element fallout fluxes calculated in our samples with those recently obtained at Mont Blanc, Greenland, and Antarctica provides direct evidence for a geographical gradient of the atmospheric pollution with trace elements on a global scale.

Cause and Effect of Feedback: Multiphase Gas in Cluster Cores Heated by AGN Jets

NASA Astrophysics Data System (ADS)

Gaspari, M.; Ruszkowski, M.; Sharma, P.

2012-02-01

Multiwavelength data indicate that the X-ray-emitting plasma in the cores of galaxy clusters is not cooling catastrophically. To a large extent, cooling is offset by heating due to active galactic nuclei (AGNs) via jets. The cool-core clusters, with cooler/denser plasmas, show multiphase gas and signs of some cooling in their cores. These observations suggest that the cool core is locally thermally unstable while maintaining global thermal equilibrium. Using high-resolution, three-dimensional simulations we study the formation of multiphase gas in cluster cores heated by collimated bipolar AGN jets. Our key conclusion is that spatially extended multiphase filaments form only when the instantaneous ratio of the thermal instability and free-fall timescales (t TI/t ff) falls below a critical threshold of ≈10. When this happens, dense cold gas decouples from the hot intracluster medium (ICM) phase and generates inhomogeneous and spatially extended Hα filaments. These cold gas clumps and filaments "rain" down onto the central regions of the core, forming a cold rotating torus and in part feeding the supermassive black hole. Consequently, the self-regulated feedback enhances AGN heating and the core returns to a higher entropy level with t TI/t ff > 10. Eventually, the core reaches quasi-stable global thermal equilibrium, and cold filaments condense out of the hot ICM whenever t TI/t ff <~ 10. This occurs despite the fact that the energy from AGN jets is supplied to the core in a highly anisotropic fashion. The effective spatial redistribution of heat is enabled in part by the turbulent motions in the wake of freely falling cold filaments. Increased AGN activity can locally reverse the cold gas flow, launching cold filamentary gas away from the cluster center. Our criterion for the condensation of spatially extended cold gas is in agreement with observations and previous idealized simulations.

LiF TLD-100 as a Dosimeter in High Energy Proton Beam Therapy-Can It Yield Accurate Results?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zullo, John R.; Kudchadker, Rajat J.; Zhu, X. Ronald

In the region of high-dose gradients at the end of the proton range, the stopping power ratio of the protons undergoes significant changes, allowing for a broad spectrum of proton energies to be deposited within a relatively small volume. Because of the potential linear energy transfer dependence of LiF TLD-100 (thermolumescent dosimeter), dose measurements made in the distal fall-off region of a proton beam may be less accurate than those made in regions of low-dose gradients. The purpose of this study is to determine the accuracy and precision of dose measured using TLD-100 for a pristine Bragg peak, particularly inmore » the distal fall-off region. All measurements were made along the central axis of an unmodulated 200-MeV proton beam from a Probeat passive beam-scattering proton accelerator (Hitachi, Ltd., Tokyo, Japan) at varying depths along the Bragg peak. Measurements were made using TLD-100 powder flat packs, placed in a virtual water slab phantom. The measurements were repeated using a parallel plate ionization chamber. The dose measurements using TLD-100 in a proton beam were accurate to within {+-}5.0% of the expected dose, previously seen in our past photon and electron measurements. The ionization chamber and the TLD relative dose measurements agreed well with each other. Absolute dose measurements using TLD agreed with ionization chamber measurements to within {+-} 3.0 cGy, for an exposure of 100 cGy. In our study, the differences in the dose measured by the ionization chamber and those measured by TLD-100 were minimal, indicating that the accuracy and precision of measurements made in the distal fall-off region of a pristine Bragg peak is within the expected range. Thus, the rapid change in stopping power ratios at the end of the range should not affect such measurements, and TLD-100 may be used with confidence as an in vivo dosimeter for proton beam therapy.« less

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.

PubMed

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years ( P <0.001), body mass index (BMI) <23.5 ( P =0.007), Mini-Mental State Examination <20 ( P =0.004), Barthel Index <65 ( P =0.002), hemoglobin <7.69 mmol/L ( P =0.017), serum protein <70 g/L ( P =0.008), albumin <32 g/L ( P =0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P <0.001), history of falls (OR =2.55; 95% CI =1.05-6.19; P =0.039), age (OR =1.14; 95% CI =1.05-1.23; P =0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P =0.034). Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

Comparison of real-life accidental falls in older people with experimental falls in middle-aged test subjects.

PubMed

Kangas, M; Vikman, I; Nyberg, L; Korpelainen, R; Lindblom, J; Jämsä, T

2012-03-01

Falling is a common accident among older people. Automatic fall detectors are one method of improving security. However, in most cases, fall detectors are designed and tested with data from experimental falls in younger people. This study is one of the first to provide fall-related acceleration data obtained from real-life falls. Wireless sensors were used to collect acceleration data during a six-month test period in older people. Data from five events representing forward falls, a sideways fall, a backwards fall, and a fall out of bed were collected and compared with experimental falls performed by middle-aged test subjects. The signals from real-life falls had similar features to those from intentional falls. Real-life forward, sideways and backward falls all showed a pre impact phase and an impact phase that were in keeping with the model that was based on experimental falls. In addition, the fall out of bed had a similar acceleration profile as the experimental falls of the same type. However, there were differences in the parameters that were used for the detection of the fall phases. The beginning of the fall was detected in all of the real-life falls starting from a standing posture, whereas the high pre impact velocity was not. In some real-life falls, multiple impacts suggested protective actions. In conclusion, this study demonstrated similarities between real-life falls of older people and experimental falls of middle-aged subjects. However, some fall characteristics detected from experimental falls were not detectable in acceleration signals from corresponding heterogeneous real-life falls. Copyright © 2011 Elsevier B.V. All rights reserved.

Fall hazard control observed on residential construction sites.

PubMed

Kaskutas, Vicki; Dale, Ann Marie; Nolan, James; Patterson, Dennis; Lipscomb, Hester J; Evanoff, Bradley

2009-06-01

Falls are a leading cause of mortality and morbidity in the construction industry. This study measured fall hazards at residential construction sites. Trained carpenters administered the St. Louis Audit of Fall Risks and interviewed carpenters. The prevalence of fall prevention practices meeting safety criteria was counted and correlations explored. We identified a high prevalence of fall hazards at the 197 residential sites audited. Roof sheathing met safety criteria most consistently (81%) and truss setting least consistently (28%). Use of personal fall arrest and monitoring of unguarded floor openings were rare. Safer performance on several scales was correlated. Construction sites of large-sized contractors were generally safer than smaller contractors. Apprentice carpenters were less familiar with their employers' fall prevention plan than experienced workers. Safety could be improved with consistent use of recognized fall prevention practices at residential construction sites.

The Johns Hopkins Fall Risk Assessment Tool: A Study of Reliability and Validity.

PubMed

Poe, Stephanie S; Dawson, Patricia B; Cvach, Maria; Burnett, Margaret; Kumble, Sowmya; Lewis, Maureen; Thompson, Carol B; Hill, Elizabeth E

Patient falls and fall-related injury remain a safety concern. The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) was developed to facilitate early detection of risk for anticipated physiologic falls in adult inpatients. Psychometric properties in acute care settings have not yet been fully established; this study sought to fill that gap. Results indicate that the JHFRAT is reliable, with high sensitivity and negative predictive validity. Specificity and positive predictive validity were lower than expected.

A modified fall risk assessment tool that is specific to physical function predicts falls in community-dwelling elderly people.

PubMed

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2014-01-01

Developing a practical fall risk assessment tool to predict the occurrence of falls in the primary care setting is important because investigators have reported deterioration of physical function associated with falls. Researchers have used many performance tests to predict the occurrence of falls. These performance tests predict falls and also assess physical function and determine exercise interventions. However, the need for such specialists as physical therapists to accurately conduct these tests limits their use in the primary care setting. Questionnaires for fall prediction offer an easy way to identify high-risk fallers without requiring specialists. Using an existing fall assessment questionnaire, this study aimed to identify items specific to physical function and determine whether those items were able to predict falls and estimate physical function of high-risk fallers. The analysis consisted of both retrospective and prospective studies and used 2 different samples (retrospective, n = 1871; prospective, n = 292). The retrospective study and 3-month prospective study comprised community-dwelling individuals aged 65 years or older and older adults using community day centers. The number of falls, risk factors for falls (15 risk factors on the questionnaire), and physical function determined by chair standing test (CST) and Timed Up and Go Test (TUGT) were assessed. The retrospective study selected fall risk factors related to physical function. The prospective study investigated whether the number of selected risk factors could predict falls. The predictive power was determined using the area under the receiver operating characteristic curve. Seven of the 15 risk factors were related to physical function. The area under the receiver operating characteristic curve for the sum of the selected risk factors of previous falls plus the other risk factors was 0.82 (P = .00). The best cutoff point was 4 risk factors, with sensitivity and specificity of 84% and 68%, respectively. The mean values for the CST and TUGT at the best cutoff point were 12.9 and 12.5 seconds, respectively. In the retrospective study, the values for the CST and TUGT corresponding to the best cutoff point from the prospective study were 13.2 and 11.4 seconds, respectively. This study confirms that a screening tool comprising 7 fall risk factors can be used to predict falls. The values for the CST and TUGT corresponding to the best cutoff point for the selected 7 risk factors determined in our prospective study were similar to the cutoff points for the CST and TUGT in previous studies for fall prediction. We propose that the sum of the selected risk factors of previous falls plus the other risk factors may be identified as the estimated value for physical function. These findings may contribute to earlier identification of high-risk fallers and intervention for fall prevention.

Association between physiological falls risk and physical performance tests among community-dwelling older adults

PubMed Central

Singh, Devinder KA; Pillai, Sharmila GK; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

2015-01-01

Background Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. Methods One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman’s rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Results Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=−0.33), and FRT (r=−0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). Conclusion The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments. PMID:26316727

Genome-Wide Identification of Different Dormant Medicago sativa L. MicroRNAs in Response to Fall Dormancy

PubMed Central

Du, Hongqi; Sun, Xiaoge; Shi, Yinghua; Wang, Chengzhang

2014-01-01

Background MicroRNAs (miRNAs) are a class of regulatory small RNAs (sRNAs) that regulate gene post-transcriptional expression in plants and animals. High-throughput sequencing technology is capable of identifying small RNAs in plant species. Alfalfa (Medicago sativa L.) is one of the most widely cultivated perennial forage legumes worldwide, and fall dormancy is an adaptive characteristic related to the biomass production and winter survival in alfalfa. Here, we applied high-throughput sRNA sequencing to identify some miRNAs that were responsive to fall dormancy in standard variety (Maverick and CUF101) of alfalfa. Results Four sRNA libraries were generated and sequenced from alfalfa leaves in two typical varieties at distinct seasons. Through integrative analysis, we identified 51 novel miRNA candidates of 206 families. Additionally, we identified 28 miRNAs associated with fall dormancy in standard variety (Maverick and CUF101), including 20 known miRNAs and eight novel miRNAs. Both high-throughput sequencing and RT-qPCR confirmed that eight known miRNA members were up-regulated and six known miRNA members were down-regulated in response to fall dormancy in standard variety (Maverick and CUF101). Among the 51 novel miRNA candidates, five miRNAs were up-regulated and three miRNAs were down-regulated in response to fall dormancy in standard variety (Maverick and CUF101), and five of them were confirmed by Northern blot analysis. Conclusion We identified 20 known miRNAs and eight new miRNA candidates that were responsive to fall dormancy in standard variety (Maverick and CUF101) by high-throughput sequencing of small RNAs from Medicago sativa. Our data provide a useful resource for investigating miRNA-mediated regulatory mechanisms of fall dormancy in alfalfa, and these findings are important for our understanding of the roles played by miRNAs in the response of plants to abiotic stress in general and fall dormancy in alfalfa. PMID:25473944

Genome-wide identification of different dormant Medicago sativa L. MicroRNAs in response to fall dormancy.

PubMed

Fan, Wenna; Zhang, Senhao; Du, Hongqi; Sun, Xiaoge; Shi, Yinghua; Wang, Chengzhang

2014-01-01

MicroRNAs (miRNAs) are a class of regulatory small RNAs (sRNAs) that regulate gene post-transcriptional expression in plants and animals. High-throughput sequencing technology is capable of identifying small RNAs in plant species. Alfalfa (Medicago sativa L.) is one of the most widely cultivated perennial forage legumes worldwide, and fall dormancy is an adaptive characteristic related to the biomass production and winter survival in alfalfa. Here, we applied high-throughput sRNA sequencing to identify some miRNAs that were responsive to fall dormancy in standard variety (Maverick and CUF101) of alfalfa. Four sRNA libraries were generated and sequenced from alfalfa leaves in two typical varieties at distinct seasons. Through integrative analysis, we identified 51 novel miRNA candidates of 206 families. Additionally, we identified 28 miRNAs associated with fall dormancy in standard variety (Maverick and CUF101), including 20 known miRNAs and eight novel miRNAs. Both high-throughput sequencing and RT-qPCR confirmed that eight known miRNA members were up-regulated and six known miRNA members were down-regulated in response to fall dormancy in standard variety (Maverick and CUF101). Among the 51 novel miRNA candidates, five miRNAs were up-regulated and three miRNAs were down-regulated in response to fall dormancy in standard variety (Maverick and CUF101), and five of them were confirmed by Northern blot analysis. We identified 20 known miRNAs and eight new miRNA candidates that were responsive to fall dormancy in standard variety (Maverick and CUF101) by high-throughput sequencing of small RNAs from Medicago sativa. Our data provide a useful resource for investigating miRNA-mediated regulatory mechanisms of fall dormancy in alfalfa, and these findings are important for our understanding of the roles played by miRNAs in the response of plants to abiotic stress in general and fall dormancy in alfalfa.

Novel Infection Site and Ecology of Cryptic Didymocystis sp. (Trematoda) in the Fish Scomberomorus maculatus.

PubMed

Schrandt, Meagan N; Andres, Michael J; Powers, Sean P; Overstreet, Robin M

2016-06-01

An undescribed, cryptic species of Didymocystis, as determined from sequences of 2 ribosomal genes and superficially similar to Didymocystis scomberomori ( MacCallum and MacCallum, 1916 ), infected the skin of the Spanish mackerel, Scomberomorus maculatus , in the north-central Gulf of Mexico (GOM). An analysis of 558 fish from 2011 to 2013 from Louisiana, Mississippi, Alabama, and the Florida panhandle showed the prevalence of the trematode varied both spatially and temporally but not with sex of the fish host. Month, year, and geographic location were identified by a negative binomial generalized linear model as indicators of the abundance and intensity of infection. Prevalence, abundance, and intensity of infection were greatest in spring and fall months off the Florida panhandle. Furthermore, the abundance and intensity of infection correlated negatively with fork length, weight, and gonad weight of mature fish but positively with longitude. Therefore, smaller adult fish tended to be more infected than larger adults, and prevalence and intensity increased from west to east (Louisiana to Florida). Spatial and temporal trends seemed to result from physical factors (e.g., water temperature, salinity, bottom type), but they also coincided with the annual migration of S. maculatus as fish moved northward along the GOM coastline from the southern tip of Florida in the spring months and returned in the fall, being present in the north-central GOM from late spring through fall. This pattern suggests the possibility that acquisition of infections occurred from a molluscan host in waters off the Florida panhandle.

An anticipative escape system for vehicles in water crashes

NASA Astrophysics Data System (ADS)

Shen, Chuanliang; Wang, Jiawei; Yin, Qi; Zhu, Yantao; Yang, Jiawei; Liao, Mengdi; Yang, Liming

2017-07-01

In this article, it designs an escape system for vehicles in water crashes. The structure mainly contains sensors, control organs and actuating mechanism for both doors and windows. Sensors judge whether the vehicle falls into water or is in the falling process. The actuating mechanism accepts the signal delivered by the control organs, then open the electronic central lock on doors and meanwhile lower the window. The water escape system is able to anticipate drowning situations for vehicles and controls both doors and windows in such an emergency. Under the premise of doors staying in an undamaged state, it is for sure that people in the vehicle can open the door while drowning in the water and safely escape.

[The rise and fall of an physician entrepreneur].

PubMed

Dörnyei, Sándor

2002-01-01

In 1927 one of the most up-to-date and most beautiful sanatoriums of Central Europe was built on the hills of Buda by László Jakab MD (1875-1940), who at that time had already run - since 1909 - a successful health-resort, the rather popular and successful "Liget-Sanatorium": following a period of expansion and flourishing, his enterprise bankrupted. (The building itself was renewed after World War II - it served first as a hospital for tuberculosis patients and later as a university clinic for internal medicine.) This article tells the story of an entrepreneur physician, including his former and more successful attempts to run a health-care business, and gives detailed account of the rise and fall of private health-resort in prewar Hungary.

New methods for fall risk prediction.

PubMed

Ejupi, Andreas; Lord, Stephen R; Delbaere, Kim

2014-09-01

Accidental falls are the leading cause of injury-related death and hospitalization in old age, with over one-third of the older adults experiencing at least one fall or more each year. Because of limited healthcare resources, regular objective fall risk assessments are not possible in the community on a large scale. New methods for fall prediction are necessary to identify and monitor those older people at high risk of falling who would benefit from participating in falls prevention programmes. Technological advances have enabled less expensive ways to quantify physical fall risk in clinical practice and in the homes of older people. Recently, several studies have demonstrated that sensor-based fall risk assessments of postural sway, functional mobility, stepping and walking can discriminate between fallers and nonfallers. Recent research has used low-cost, portable and objective measuring instruments to assess fall risk in older people. Future use of these technologies holds promise for assessing fall risk accurately in an unobtrusive manner in clinical and daily life settings.

High-k shallow traps observed by charge pumping with varying discharging times

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ho, Szu-Han; Chen, Ching-En; Tseng, Tseung-Yuen

2013-11-07

In this paper, we investigate the influence of falling time and base level time on high-k bulk shallow traps measured by charge pumping technique in n-channel metal-oxide-semiconductor field-effect transistors with HfO{sub 2}/metal gate stacks. N{sub T}-V{sub high} {sub level} characteristic curves with different duty ratios indicate that the electron detrapping time dominates the value of N{sub T} for extra contribution of I{sub cp} traps. N{sub T} is the number of traps, and I{sub cp} is charge pumping current. By fitting discharge formula at different temperatures, the results show that extra contribution of I{sub cp} traps at high voltage are inmore » fact high-k bulk shallow traps. This is also verified through a comparison of different interlayer thicknesses and different Ti{sub x}N{sub 1−x} metal gate concentrations. Next, N{sub T}-V{sub high} {sub level} characteristic curves with different falling times (t{sub falling} {sub time}) and base level times (t{sub base} {sub level}) show that extra contribution of I{sub cp} traps decrease with an increase in t{sub falling} {sub time}. By fitting discharge formula for different t{sub falling} {sub time}, the results show that electrons trapped in high-k bulk shallow traps first discharge to the channel and then to source and drain during t{sub falling} {sub time}. This current cannot be measured by the charge pumping technique. Subsequent measurements of N{sub T} by charge pumping technique at t{sub base} {sub level} reveal a remainder of electrons trapped in high-k bulk shallow traps.« less

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

PubMed

Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001). Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness.

PubMed

Callander, Emily J; Schofield, Deborah J

2018-04-17

This paper aimed to identify whether high psychological distress is associated with an increased risk of income and multidimensional poverty amongst older adults in Australia. We undertook longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using modified Poisson regression models to estimate the relative risk of falling into income poverty and multidimensional poverty between 2010 and 2012 for males and females, adjusting for age, employment status, place of residence, marital status and housing tenure; and Population Attributable Risk methodology to estimate the proportion of poverty directly attributable to psychological distress, measured by the Kessler 10 scale. For males, having high psychological distress increased the risk of falling into income poverty by 1.68 (95% CI: 1.02 to 2.75) and the risk of falling into multidimensional poverty by 3.40 (95% CI: 1.91 to 6.04). For females, there was no significant difference in the risk of falling into income poverty between those with high and low psychological distress (p = 0.1008), however having high psychological distress increased the risk of falling into multidimensional poverty by 2.15 (95% CI: 1.30 to 3.55). Between 2009 and 2012, 8.0% of income poverty cases for people aged 65 and over (95% CI: 7.8% to 8.4%), and 19.5% of multidimensional poverty cases for people aged 65 and over (95% CI: 19.2% to 19.9%) can be attributed to high psychological distress. The elevated risk of falling into income and multidimensional poverty has been an overlooked cost of poor mental health.

[Assessment of central hemodynamic properties of the arterial wall in women with previous preeclampsia].

PubMed

Polónia, Jorge; Olival, Catarina; Ribeiro, Sílvia; Silva, José A; Barbosa, Loide

2014-06-01

We investigated viscoelastic properties of the arterial wall in women with previous preeclampsia (PE) compared to those with normal pregnancy (NP). In a cross-sectional study 45 women with previous PE and 55 with NP were included, matched for age (PE 38±6 vs. NP 38±5 years, NS) and body mass index: (PE 25±4 vs. NP 26±4 kg/m(2), NS) studied, respectively, 76±34 and 86±48 months after delivery. We assessed arterial distensibility - pulse wave velocity (PWV, Complior) and reflected waves (augmentation pressure [AP], mmHg) and augmentation index (AIx) - in the central pressure wave and blood pressure (BP) on 24-h ambulatory BP monitoring (ABPM). PE showed higher (p<0.01) peripheral systolic blood pressure (SBP): PE 131±18 vs. NP 121±19, and central SBP: PE 122±18 vs. NP 110±19 mmHg, with less amplification of central-peripheral pressure: PE 10±4 vs. NP 12±5, p=0.041, and higher (p<0.05) AP: PE 10±3 vs. NP 8±2, and AIx: PE 26±5 vs. NP 20±5 mmHg, but PE and NP did not differ in pulse wave velocity. On ABPM, PE (n=39) vs. NP (n=33) had higher nighttime SBP: PE 121±10 vs. NP 108±10 mmHg and lower percentage nocturnal SBP fall: PE 11±6 vs. NP 18±11%, both p<0.02. During follow-up, the need for antihypertensive medication was seven times higher in PE than in NP. Women with previous PE have a greater risk of hypertension, higher nighttime BP values, blunted nocturnal BP fall and changes in central pressure suggestive of increased reflected waves and peripheral vascular resistance. These factors may contribute to their higher cardiovascular risk after pregnancy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

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

Clinical history and biologic age predicted falls better than objective functional tests.

PubMed

Gerdhem, Paul; Ringsberg, Karin A M; Akesson, Kristina; Obrant, Karl J

2005-03-01

Fall risk assessment is important because the consequences, such as a fracture, may be devastating. The objective of this study was to find the test or tests that best predicted falls in a population-based sample of elderly women. The fall-predictive ability of a questionnaire, a subjective estimate of biologic age and objective functional tests (gait, balance [Romberg and sway test], thigh muscle strength, and visual acuity) were compared in 984 randomly selected women, all 75 years of age. A recalled fall was the most important predictor for future falls. Only recalled falls and intake of psycho-active drugs independently predicted future falls. Women with at least five of the most important fall predictors (previous falls, conditions affecting the balance, tendency to fall, intake of psychoactive medication, inability to stand on one leg, high biologic age) had an odds ratio of 11.27 (95% confidence interval 4.61-27.60) for a fall (sensitivity 70%, specificity 79%). The more time-consuming objective functional tests were of limited importance for fall prediction. A simple clinical history, the inability to stand on one leg, and a subjective estimate of biologic age were more important as part of the fall risk assessment.

Risk of falling among hospitalized patients with high modified Morse scores could be further Stratified.

PubMed

Gringauz, Irina; Shemesh, Yael; Dagan, Amir; Israelov, Irina; Feldman, Dana; Pelz-Sinvani, Naama; Justo, Dan; Segal, Gad

2017-11-13

Falls during hospitalization harbor both clinical and financial outcomes. The modified Morse fall scale [MMFS] is widely used for an in-hospital risk-of-fall assessment. Nevertheless, the majority of patients at risk of falling, i.e. with high MMFS, do not fall. The aim of this study was to ascertain our study hypothesis that certain patients' characteristics (e.g. serum electrolytes, usage of a walking device etc.) could further stratify the risk of falls among hospitalized patients with MMFS. This was a retrospective cohort analysis of adult patients hospitalized in Internal Medicine departments. The final cohort included 428 patients aged 76.8±14.0 years. All patients had high (9 or more) MMFS upon admission, and their mean MMFS was 16.2±6.1. A group of 139 (32.5%) patients who fell during their hospitalization was compared with a control group of 289 (67.5%) patients who did not fall. The fallers had higher MMFS, a higher prevalence of mild dependence, and a greater use of a cane or no walking device. Regression analysis showed the following patients' characteristics to be independently associated with an increased risk of falling: mild dependence (OR=3.99, 95% CI 1.97-8.08; p<0.0001), treatment by anti-epileptics (OR=3.9, 95% CI 1.36-11.18; p=0.011), treatment by hypoglycemic agents (OR=2.64, 95% CI 1.08-6.45; p= 0.033), and hypothyroidism (OR=3.66, 05%CI 1.62-8.30; p=0.002). In contrast to their role in the MMFS, the use of a walker or a wheelchair was found to decrease the risk of falling (OR=0.3, 95% CI 0.13-0.69; p=0.005 and OR=0.25, 95% CI 0.11-0.59; p= 0.002). Further risk stratification of hospitalized patients, already known to have a high MMFS, which would take into account the characteristics pointed out in this study, should be attained.

Are triage questions sufficient to assign fall risk precautions in the ED?

PubMed

Southerland, Lauren T; Slattery, Lauren; Rosenthal, Joseph A; Kegelmeyer, Deborah; Kloos, Anne

2017-02-01

The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls. Prospective pilot study of a convenience sample of ambulatory adults 65 years and older in the ED. All participants received the standard nursing triage fall risk assessment. After patients were stabilized in their ED room, the 4SBT was administered. The 58 participants had an average age of 74.1 years (range, 65-94), 40.0% were women, and 98% were community dwelling. Five (8.6%) presented to the ED for a fall-related chief complaint. The nursing triage screen identified 39.7% (n=23) as at risk for falls, whereas the 4SBT identified 43% (n=25). Combining triage questions with the 4SBT identified 60.3% (n=35) as at high risk for falls, as compared with 39.7% (n=23) with triage questions alone (P<.01). Ten (17%) of the patients at high risk by 4SBT and missed by triage questions were inpatients unaware that they were at risk for falls (new diagnoses). Incorporating a quick functional test of balance into the ED assessment for fall risk is feasible and significantly increases the detection of older adults at risk for falls. Copyright © 2016 Elsevier Inc. All rights reserved.

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study

PubMed Central

Fleming, Jane; Matthews, Fiona E; Brayne, Carol

2008-01-01

Background The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Methods Design: Re-survey of over-90-year-olds in a longitudinal cohort study – cross-sectional interview and intensive 12-month follow-up. Participants and setting: 90 women and 20 men participating in a population-based cohort (aged 91–105 years, in care-homes and community-dwelling) recruited from representative general practices in Cambridge, UK Measurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. Results 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%), as were fall rates (1.6 and 2.8 falls/person-year respectively). Repeated falls in the past year were more highly predictive of falls during the following year – IRR 4.7, 95% CI 2.6–8.7 – than just one – IRR 3.6, 95% CI 2.0–6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Conclusion Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions of people who fell were reported by retrospective and prospective methods covering two consecutive years. Recall methods may underestimate numbers of repeated falls and the extent of recurrent falling. Professionals caring for people of advanced age can easily ask routinely whether someone has fallen at all, or more than once, in the past year to identify those at high risk of subsequent falls. PMID:18366645

Falls and cognitive decline in Mexican Americans 75 years and older

PubMed Central

Padubidri, Anokha; Al Snih, Soham; Samper-Ternent, Rafael; Markides, Kyriakos S; Ottenbacher, Kenneth J; Raji, Mukaila A

2014-01-01

Background Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls–cognition association among cognitively intact Hispanic Elders. Methods We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results At baseline, participants’ mean age was 80.8 years (range, 74–109), mean education was 6.3 years (range, 0–17), and mean MMSE was 25.2 (range, 21–30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =−0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =−0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls–cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. Conclusion Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls–cognition association. PMID:24790424

Gypsum ground: a new occurrence of gypsum sediment in playas of central Australia

NASA Astrophysics Data System (ADS)

Xiang Yang Chen; Bowler, James M.; Magee, John W.

1991-06-01

There are many playas (dry salt lakes) in arid central Australia (regional rainfall about 250 mm/y and pan evaporation around 3000 mm/y). Highly soluble salts, such as halite, only appear as a thin (several centimetres thick), white, ephemeral efflorescent crust on the dry surface. Gypsum is the major evaporite precipitating both at present and preserved in sediment sequences. One type of gypsum deposit forms a distinctive surface feature, which is here termed "gypsum ground". It consists of a thick (up to 80 cm) gypsum zone which rises from the surrounding smooth white playa surface and is overlain by a heaved brown crust. The gypsum zone, with an average gypsum content above 60%, consists of pure gypsum sublayers and interlayered clastic bands of sandy clay. The gypsum crystals are highly corroded, especially in the direction parallel to the c-axis and on the upper sides where illuviated clay has accumulated in corrosion hollows. Overgrowth parallel to the a- and b-axes is very common, forming highly discoidal habits. These secondary changes (corrosion and overgrowth) are well-developed in the vadose zone and absent from crystals below the long-term watertable (depth around 40 cm). These crystal characteristics indicate a rainwater leaching process. At Lake Amadeus, one of the largest playas (800 km 2) of central Australia, such gypsum ground occupies 16% of the total area. The gypsum ground is interpreted as an alteration of a pre-existing gypsum deposit which probably extended across the whole playa before breaking down, leaving a playa marginal terrace and several terrace islands within the gypsum ground. This pre-existing gypsum deposit, preserved in the residual islands, consists of pure, pale, sand-sized lenticular crystals. It is believed to have been deposited during an episode of high regional watertable, causing active groundwater seepage and more frequent surface brine in the playa. A later fall in watertable, probably resulting from climatic change, caused the degradation of the gypsum deposit by dissolution and leaching processes. The common distribution of the gypsum ground and marginal terraces in the playas of central Australia demonstrates the extent of this hydrologic and climatic history.

Intracranial recordings and human memory.

PubMed

Johnson, Elizabeth L; Knight, Robert T

2015-04-01

Recent work involving intracranial recording during human memory performance provides superb spatiotemporal resolution on mnemonic processes. These data demonstrate that the cortical regions identified in neuroimaging studies of memory fall into temporally distinct networks and the hippocampal theta activity reported in animal memory literature also plays a central role in human memory. Memory is linked to activity at multiple interacting frequencies, ranging from 1 to 500Hz. High-frequency responses and coupling between different frequencies suggest that frontal cortex activity is critical to human memory processes, as well as a potential key role for the thalamus in neocortical oscillations. Future research will inform unresolved questions in the neuroscience of human memory and guide creation of stimulation protocols to facilitate function in the damaged brain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fall from heights: does height really matter?

PubMed

Alizo, G; Sciarretta, J D; Gibson, S; Muertos, K; Romano, A; Davis, J; Pepe, A

2018-06-01

Fall from heights is high energy injuries and constitutes a fraction of all fall-related trauma evaluations while bearing an increase in morbidity and mortality. We hypothesize that despite advancements in trauma care, the overall survivability has not improved in this subset of trauma patients. All adult trauma patients treated after sustaining a fall from heights during a 40-month period were retrospectively reviewed. Admission demographics, clinical data, fall height (ft), injury patterns, ISS, GCS, length of stay, and mortality were reviewed. 116 patients sustained a fall from heights, 90.4% accidental. A mean age of 37± 14.7 years, 86% male, and a fall height of 19 ± 10 ft were encountered. Admission GCS was 13 ± 2 with ISS 10 ± 11. Overall LOS was 6.6 ± 14.9 days and an ICU LOS of 2.8 ± 8.9 days. Falls ≥ 25 ft.(16%) had lower GCS 10.4 ± 5.8, increased ISS 22.6 ± 13.8, a fall height 37.9 ± 13.1 ft and associated increased mortality (p < 0.001). Mortality was 5.2%, a mean distance fallen of 39 ± 22 ft. and an ISS of 31.5 ±16.5. Brain injury was the leading cause of death, 50% with open skull fractures. Level of height fallen is a good predictor of overall outcome and survival. Despite advances in trauma care, death rates remain unchanged. Safety awareness and injury prevention programs are needed to reduce the risk of high-level falls.

Mechanical falls: are patients willing to discuss their risk with a health care provider?

PubMed

Greenberg, Marna Rayl; Nguyen, Michael C; Stello, Brian; Goldberg, Arnold R; Barraco, Robert D; Porter, Bernadette G; Kurt, Anita; Dusza, Stephen W; Kane, Bryan G

2015-01-01

Falls in the elderly cause serious injury. We aimed to determine subjects' comfort in discussing fall risk and home safety evaluations. This prospective study surveyed a convenience sample of subjects (≥50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey-validated surveys measuring fall concern and functional decline. Other data-environmental living conditions, participant behaviors, fall frequency-were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. Participants (n = 416, 38% males, 62% females) had a mean age of 67.6 years; 35% were high fall risk. Previous year falls (p = 0.002), use of assistive device (p < 0.001), having at least one alcoholic drink/week (p = 0.043), and poor or fair perceived health status (p < 0.001) were associated with perceived fall risk. HF respondents were more willing than FP respondents to discuss falls (84.9% vs. 73.1%, p = 0.025). The difference was not significant between the HF and ED respondents (84.9% vs. 76.9, p = 0.11). HF subjects were more willing than FP to have a home safety inspection (68.9% vs. 45.9%, p < 0.001). The difference was not significant between the HF and ED respondents (68.9% vs 58.5, p = 0.09). Perceived and actual fall risks are highly associated. Most participants are willing to discuss their fall risk and a home safety evaluation. HF subjects were most willing to have these discussions; ED subjects were less willing than HF, but not significantly different from health fair participants. FP participants were significantly less willing to have these discussions than HF participants. This may suggest a meaningful opportunity for fall risk prevention in outpatient settings such as health fairs and the ED. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

PubMed

Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

2017-03-01

To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations. © 2016 John Wiley & Sons Ltd.

Fall prevention: is the STRATIFY tool the right instrument in Italian Hospital inpatient? A retrospective observational study.

PubMed

Castellini, Greta; Demarchi, Antonia; Lanzoni, Monica; Castaldi, Silvana

2017-09-15

Although several risk assessment tools are in use, uncertainties on their accuracy in detecting fall risk already exist. Choosing the most accurate tool for hospital inpatient is still a challenge for the organizations. We aimed to retrospectively assess the appropriateness of a fall risk prevention program with the STRATIFY assessment tool in detecting acute-care inpatient fall risk. Number of falls and near falls, occurred from January 2014 to March 2015, was collected through the incident reporting web-system implemented in the hospital's intranet. We reported whether the fall risk was assessed with the STRATIFY assessment tool and, if so, which was the judgement. Primary outcome was the proportion of inpatients identified as high risk of fall among inpatients who fell (True Positive Rate), and the proportion of inpatients identified as low-risk that experienced a fall howsoever (False Negative Rate). Characteristics of population and fall events were described among subgroups of low risk and high risk inpatients. We collected 365 incident reports from 40 hospital units, 349 (95.6%) were real falls and 16 (4.4%) were near falls. The fall risk assessment score at patient's admission had been reported in 289 (79%) of the overall incident reports. Thus, 74 (20.3%) fallers were actually not assessed with the STRATIFY, even though the majority of them presented risk recommended to be assessed. The True Positive Rate was 35.6% (n = 101, 95% CI 30% - 41.1%). The False Negative Rate was 64.4% (n = 183, 95% CI 58.9%-70%) of fallers, nevertheless they incurred in a fall. The STRATIFY mean score was 1.3 ± 1.4; the median was 1 (IQQ 0-2). The prevention program using only the STRATIFY tool was found to be not adequate to screen our inpatients population. The incorrect identification of patients' needs leads to allocate resources to erroneous priorities and to untargeted interventions, decreasing healthcare performance and quality.

Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study.

PubMed

Bayen, Eleonore; Jacquemot, Julien; Netscher, George; Agrawal, Pulkit; Tabb Noyce, Lynn; Bayen, Alexandre

2017-10-17

Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool. The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care. A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents' falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice. Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents. Video monitoring offers high potential to support conventional care in memory care facilities. ©Eleonore Bayen, Julien Jacquemot, George Netscher, Pulkit Agrawal, Lynn Tabb Noyce, Alexandre Bayen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.10.2017.

Using the Hendrich II Inpatient Fall Risk Screen to Predict Outpatient Falls After Emergency Department Visits.

PubMed

Patterson, Brian W; Repplinger, Michael D; Pulia, Michael S; Batt, Robert J; Svenson, James E; Trinh, Alex; Mendonça, Eneida A; Smith, Maureen A; Hamedani, Azita G; Shah, Manish N

2018-04-01

To evaluate the utility of routinely collected Hendrich II fall scores in predicting returns to the emergency department (ED) for falls within 6 months. Retrospective electronic record review. Academic medical center ED. Individuals aged 65 and older seen in the ED from January 1, 2013, through September 30, 2015. We evaluated the utility of routinely collected Hendrich II fall risk scores in predicting ED visits for a fall within 6 months of an all-cause index ED visit. For in-network patient visits resulting in discharge with a completed Hendrich II score (N = 4,366), the return rate for a fall within 6 months was 8.3%. When applying the score alone to predict revisit for falls among the study population the resultant receiver operating characteristic (ROC) plot had an area under the curve (AUC) of 0.64. In a univariate model, the odds of returning to the ED for a fall in 6 months were 1.23 times as high for every 1-point increase in Hendrich II score (odds ratio (OR)=1.23 (95% confidence interval (CI)=1.19-1.28). When included in a model with other potential confounders or predictors of falls, the Hendrich II score is a significant predictor of a return ED visit for fall (adjusted OR=1.15, 95% CI=1.10-1.20, AUC=0.75). Routinely collected Hendrich II scores were correlated with outpatient falls, but it is likely that they would have little utility as a stand-alone fall risk screen. When combined with easily extractable covariates, the screen performs much better. These results highlight the potential for secondary use of electronic health record data for risk stratification of individuals in the ED. Using data already routinely collected, individuals at high risk of falls after discharge could be identified for referral without requiring additional screening resources. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Restoring longleaf pine forest ecosystems in the southern U.S

Treesearch

Dale G. Brockway; Kenneth W. Outcalt; Donald J. Tomczak; Everett E. Johnson

2005-01-01

Longleaf pine (Pinus palustris) ecosystems are native to nine states of the southern region of the U.S. Longleaf pine can grow on a variety of site types including wet flatwoods and savannas along the Atlantic and Gulf coastal plain, higher droughty sand deposits from the fall line sandhills to the central ridge of Florida (Stout and Marion 1993),...

Visitor meanings of place: using computer content analysis to examine visitor meanings at three national capitol sites

Treesearch

Wei-Li Jasmine Chen; Chad L. Pierskalla; Theresa L. Goldman; David L. Larsen

2002-01-01

A mix method study designed to explore the meanings, interest, and connections visitors ascribe to three National Park Service sites: National Capital Parks Central, Rock Creek Park, and George Washington Memorial Parkway's Great Falls Park. The researchers employed the focus group interview technique and asked visitors prior to and then after an interpretive...

Falls the Shadow and the Light: Liminality and Natality in Social Work Field Education

ERIC Educational Resources Information Center

Hurlock, Debb; Barlow, Constance; Phelan, Anne; Myrick, Florence; Sawa, Russell; Rogers, Gayla

2008-01-01

This article is situated within an experience of conflict for Tina, a social work student, who is caught between her beliefs about the virtues of social work practice, and her disillusioning encounter with the school's administration. In this paper, we interpret Tina's experience of conflict by drawing on the central concepts of liminality and…

Cutting a young-growth, mixed-conifer stand to California Forest Practice Act Standards

Treesearch

Philip M. McDonald

1973-01-01

Cutting by the minimum standard of the Rules of California's North Sierra Pine Forest District was evaluated for effects on species composition, seed fall, regeneration, and residual growth at the Challenge Experimental Forest, central California. Cutting removed 74 percent of the stand basal area and 94 percent of the merchantable volume. The heavy cut changed...

KSC-02pd0434

NASA Image and Video Library

2002-03-29

KENNEDY SPACE CENTER, FLA. - Water droplets fall from the broad bill of a Roseate Spoonbill after lifting its head from the water. The site is near Kennedy Space Center. Spoonbills obtain food by sweeping their broad bills from side to side. They inhabit mangroves, ranging from the coasts of southern Florida and Texas (sometimes Louisiana), the West Indies, Mexico and Central and South America.

Annual cycles of soil and water temperatures at Hubbard Brook

Treesearch

C. Anthony Federer

1973-01-01

Soil temperatures in the Hubbard Brook Experimental Forest in central New Hampshire decline very slowly from December to March and are restricted from falling below OºC by insulation of snow and organic matter. Soil in the hardwood forest on a moderate south slope warms rapidly in the spring leafless period after snowmelt and reaches a maximum temperature in...

Photosynthetic temperature adaptation of Pinus cembra within the timberline ecotone of the Central Austrian Alps

PubMed Central

Wieser, Gerhard; Oberhuber, Walter; Walder, Lisa; Spieler, Daniela; Gruber, Andreas

2011-01-01

Temperature is suggested to determine the upper limit of tree life. Therefore, future climate warming may be of importance for tree distribution within the European Alps, where low temperatures limit carbon metabolism. We focused on the effects of air and soil temperature on net photosynthesis (Pn) of Pinus cembra an evergreen climax species of the timberline ecotone of the Central Austrian Alps. Light response and temperature response curves were estimated along an altitudinal gradient ranging from the forest limit up to the krummholz limit in both summer and fall. In general, Pn was significantly lower in fall as compared to summer. Nevertheless, independent from season mean Pn values tended to increase with elevation and were positively correlated with root zone temperatures. The specific leaf area by contrast declined with increasing elevation. Furthermore, the temperature optimum of net photosynthesis declined with increasing elevation and was positively correlated with the mean maximum air temperature of the 10 days prior the date of measurement. Thus, our findings appear to reflect a long-term adaptation of the photosynthetic apparatus of Pinus cembra to the general temperature conditions with respect to elevation combined with a short term acclimation to the prevailing temperature regime. PMID:21379394

Drinking Water Systems, Hydrology, and Childhood Gastrointestinal Illness in Central and Northern Wisconsin

PubMed Central

Uejio, Christopher K.; Yale, Steven H.; Malecki, Kristen; Borchardt, Mark A.; Anderson, Henry A.; Patz, Jonathan A.

2014-01-01

Objectives. This study investigated if the type of drinking water source (treated municipal, untreated municipal, and private well water) modifies the effect of hydrology on childhood (aged < 5 years) gastrointestinal illness. Methods. We conducted a time series study to assess the relationship between hydrologic and weather conditions with childhood gastrointestinal illness from 1991 to 2010. The Central and Northern Wisconsin study area includes households using all 3 types of drinking water systems. Separate time series models were created for each system and half-year period (winter/spring, summer/fall). Results. More precipitation (summer/fall) systematically increased childhood gastrointestinal illness in municipalities accessing untreated water. The relative risk of contracting gastrointestinal illness was 1.4 in weeks with 3 centimeters of precipitation and 2.4 in very wet weeks with 12 centimeters of precipitation. By contrast, gastrointestinal illness in private well and treated municipal areas was not influenced by hydrologic conditions, although warmer winter temperatures slightly increased incidence. Conclusions. Our study suggests that improved drinking water protection, treatment, and delivery infrastructure may improve public health by specifically identifying municipal water systems lacking water treatment that may transmit waterborne disease. PMID:24524509

Older adults at high risk of falling need more time for anticipatory postural adjustment in the precrossing phase of obstacle negotiation.

PubMed

Uemura, Kazuki; Yamada, Minoru; Nagai, Koutatsu; Ichihashi, Noriaki

2011-08-01

Obstacles are a common cause of falls among older adults. Anticipatory motor planning for obstacle negotiation must be completed during the precrossing phase in order to step over the obstacle safely. This cognitive load may affect anticipatory postural adjustments (APAs) in older adults at high risk of falling. This study explored the effect of obstacle negotiation on APA during gait initiation in older adults at high risk of falling. Seventy-six elderly volunteers (mean age: 80.5 [7.6 years]) from the community participated in this study. Participants performed gait initiation tasks from a starting position on a force platform under the following two conditions: (1) unobstructed (smooth walkway) and (2) obstructed (walkway with an obstacle placed at 1 m from the initial position). The reaction and APA phases were measured from the data of center of pressure. Each participant was categorized as a high-risk or a low-risk individual according to the presence or absence of a fall experience within the past year. High-risk participants had significantly longer APA phases than low-risk participants under the obstructed condition even though there was no significant difference between groups under the unobstructed condition. Reaction phase was not significantly different between groups in either the unobstructed or the obstructed condition. Motor performance deterioration occurred in high-risk participants in the beginning of the precrossing phase of obstacle negotiation. A slow and inefficient APA at the precrossing phase of obstacle negotiation might be one of the causes of accidental falls.

Identifying Risk Factors for Elder Falls in Geriatric Rehabilitation in Israel.

PubMed

Ben Natan, Merav; Heyman, Neomi; Ben Israel, Joshua

2016-01-01

To identify risk factors for elder falls in a geriatric rehabilitation center in Israel. Retrospective chart review study. Four hundred and twelve medical records of inpatients in geriatric rehabilitation were retrospectively analyzed to compare between elders who sustained falls and those who did not. Of elders hospitalized during this year, 14% sustained falls. Fallers included a high proportion of males, with little comorbidity, not obese, and cardiovascular patients. Falls occurred frequently during patients' first week at the facility, mostly during the daytime. The falls occurred frequently in patients' rooms, and a common scenario was a fall during transition. The research findings single out patients who are allegedly at a lower risk of falls than more complex patients. Caregivers in geriatric rehabilitation settings should pay attention to patients who are allegedly at a lower risk of falls than more complex patients, and to cardiovascular patients in particular. © 2014 Association of Rehabilitation Nurses.

Seasonal surface circulation, temperature, and salinity in Prince William Sound, Alaska

NASA Astrophysics Data System (ADS)

Musgrave, David L.; Halverson, Mark J.; Scott Pegau, W.

2013-02-01

Salinity, temperature, and depth profiles from 1973 to 2010 were used to construct a seasonal climatology of surface temperature, surface salinity, mixed layer depth (MLD), potential energy of mixing, and surface geostrophic circulation in Prince William Sound (PWS) and the adjacent Gulf of Alaska. Surface salinity is greatest in winter and least in summer due to the influence of increased freshwater runoff in summer. It is generally lowest in the northwest and highest in the Gulf of Alaska. The surface temperature is lowest in the winter and highest in the summer when surface heating is greatest, with little spatial variability across the Sound. The MLD is deepest in winter (9-27 m) and shallowest in summer (4-5 m). The work by winds was estimated from meteorological buoy data in central PWS and compared to the potential energy of mixing of the upper water column. The potential depth to which winds mix the upper water column was generally consistent with the MLD. The surface geostrophic circulation in the central Sound has: a southerly flow in the western central Sound in the winter; a closed, weak anticyclonic cell in spring; a closed, cyclonic cell in the summer; an open, cyclonic circulation in the fall. In the western passages, a southerly flow occurs in spring, summer, and fall. These results have important implications for oil spill response in PWS, the use of oil dispersants, and for comparison to numerical studies.

Detection of a population replacement at the Classic–Postclassic transition in Mexico

PubMed Central

González-José, Rolando; Martínez-Abadías, Neus; González-Martín, Antonio; Bautista-Martínez, Josefina; Gómez-Valdés, Jorge; Quinto, Mirsha; Hernández, Miquel

2006-01-01

The Mexica Empire reached an outstanding social, economic and politic organization among Mesoamerican civilizations. Even though archaeology and history provide substantial information about their past, their biological origin and the demographic consequences of their settlement in the Central Valley of Mexico remain unsolved. Two main hypotheses compete to explain the Mexica origin: a social reorganization of the groups already present in the Central Valley after the fall of the Classic centres or a population replacement of the Mesoamerican groups by migrants from the north and the consequent setting up of the Mexica society. Here, we show that the main changes in the facial phenotype occur during the Classic–Postclassic transition, rather than in the rise of the Mexica. Furthermore, Mexica facial morphology seems to be already present in the early phases of the Postclassic epoch and is not related to the northern facial pattern. A combination of geometric morphometrics with Relethford–Blangero analyses of within- versus among-group variation indicates that Postclassic groups are more variable than expected. This result suggests that intense gene exchange was likely after the fall of the Classic and maybe responsible for the Postclassic facial phenotype. The source population for the Postclassic groups could be located somewhere in western Mesoamerica, since North Mexico and Central Mesoamerican Preclassic and Classic groups are clearly divergent from the Postclassic ones. Similarity among Preclassic and Classic groups and those from Aridoamerica could be reflecting the ancestral phenotypic pattern characteristic of the groups that first settled Mesoamerica. PMID:17254992

Key issues to consider and innovative ideas on fall prevention in the geriatric department of a teaching hospital.

PubMed

Chan, Daniel Ky; Sherrington, Cathie; Naganathan, Vasi; Xu, Ying Hua; Chen, Jack; Ko, Anita; Kneebone, Ian; Cumming, Robert

2018-06-01

Falls in hospital are common and up to 70% result in injury, leading to increased length of stay and accounting for 10% of patient safety-related deaths. Yet, high-quality evidence guiding best practice is lacking. Fall prevention strategies have worked in some trials but not in others. Differences in study setting (acute, subacute, rehabilitation) and sampling of patients (cognitively intact or impaired) may explain the difference in results. This article discusses these important issues and describes the strategies to prevent falls in the acute hospital setting we have studied, which engage the cognitively impaired who are more likely to fall. We have used video clips rather than verbal instruction to educate patients, and are optimistic that this approach may work. We have also explored the option of co-locating high fall risk patients in a close observation room for supervision, with promising results. Further studies, using larger sample sizes are required to confirm our findings. © 2018 AJA Inc.

Medium doses of daily vitamin D decrease falls and higher doses of daily vitamin D3 increase falls: A randomized clinical trial.

PubMed

Smith, Lynette M; Gallagher, J Christopher; Suiter, Corinna

2017-10-01

Falls are a serious health problem in the aging population. Because low levels of vitamin D have been associated with increased fall rates, many trials have been performed with vitamin D; two meta-analyses showed either a small effect or no effect of vitamin D on falls. We conducted a study of the effect of vitamin D on serum 25 hydroxyvitamin D (25OHD) and data on falls was collected as a secondary outcome. In a 12-month double blind randomized placebo trial, elderly women, mean age 66 years, were randomized to one of seven daily oral doses of vitamin D or placebo. The main inclusion criterion for study was a baseline serum 25OHD<20ng/ml (50nmol/L). A history of falls was collected at baseline and fall events were collected every 3 months. Results showed that the effect of vitamin D on falls followed a U-shaped curve whether analyzed by dose or serum 25OHD levels. There was no decrease in falls on low vitamin D doses 400, 800 IU, a significant decrease on medium doses 1600, 2400,3200 IU (p=0.020) and no decrease on high doses 4000, 4800 IU compared to placebo (p=0.55). When compared to 12-month serum 25OHD quintiles, the faller rate was 60% in the lowest quintile <25ng/ml (<50nmol/L), 21% in the low middle quintile 32-38ng/ml (80-95nmo/L), 72% in the high middle quintile 38-46ng/ml (95-115nmo/L) and 45% in the highest quintile 46-66ng/ml (115-165nmol/L). In the subgroup with a fall history, fall rates were 68% on low dose, 27% on medium doses and 100% on higher doses. Fall rates on high doses were increased compared to medium doses (Odds Ratio 5.6.95% CI: 2.1-14.8). In summary, the maximum decrease in falls corresponds to a 12- month serum 25OHD of 32-38ng/ml (80-95nmol/L) and faller rates increase as serum 25OHD exceed 40-45ng/ml (100-112.5nmol/L). The Tolerable upper limit (TUL) recently increased in 2010 from 2000 to 4000 IU/day may need to be reduced in elderly women especially in those with a fall history. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fall prevention modulates decisional saccadic behavior in aging.

PubMed

Coubard, Olivier A

2012-01-01

As society ages and frequency of falls increases in older adults, counteracting motor decline is a challenging issue for developed countries. Physical activity based on aerobic and strength training as well as motor activity based on skill learning both help benefit balance and reduce the risk of falls, as assessed by clinical or laboratory measures. However, how such programs influence motor control is a neglected issue. This study examined the effects of fall prevention (FP) training on saccadic control in older adults. Saccades were recorded in 12 participants aged 64-91 years before and after 2.5 months training in FP. Traditional analysis of saccade timing and dynamics was performed together with a quantitative analysis using the LATER model, enabling us to examine the underlying motor control processes. Results indicated that FP reduced the rate of anticipatory and express saccades in inappropriate directions and enhanced that of express saccades in the appropriate direction, resulting in decreased latency and higher left-right symmetry of motor responses. FP reduced within-participant variability of saccade duration, amplitude, and peak velocity. LATER analysis suggested that FP modulates decisional thresholds, extending our knowledge of motor training influence on central motor control. We introduce the Threshold Interval Modulation with Early Release-Rate of rIse Deviation with Early Release (TIMER-RIDER) model to account for the results.

[Fall events in geriatric hospital in-patients. Results of prospective recording over a 3 year period].

PubMed

von Renteln-Kruse, W; Krause, T

2004-02-01

For a period of 3 consecutive years, all fall events were prospectively recorded in geriatric hospital in-patients by using a standardized protocol. The incidence was 9.1 fall events/1000 hospital days in 5946 patients, and 41.0/1000 hospital days in 1015 patients (17.0%) who actually had falls. The fall rate varied between 35.0-57.0/1000 hospital days according to the main diagnostic group. Fall events were more often recorded in men than women. Recurrent falls (> or =3 falls) which contributed 13% to the 1596 falls were recorded more frequently in male patients. The majority of fall events (73.5%) occurred in patient rooms, another 20% on the floor between the patient's bedroom and toilet/bath, or in the toilet/bath, respectively. The absolute numbers of falls during night and day were not different. However, there were different patterns in the time distribution of high fall frequencies according to the main diagnostic groups. Confusion and dehydration were recorded more frequently with fall events in patients 80 years and older, and more often in fall events during the night. Injuries due to falls which had to be treated were rare, and fall-related fractures were very rare. The average duration of in-hospital stay was longer for patients with than without falls.

Conodont and k-bentonite stratigraphy across the Blackriveran/Trentonian (Ordovician) boundary, north-central New York

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leslie, S.A.; Bergstroem, S.M.

1993-03-01

Integrated conodont and K-bentonite stratigraphy at City Brook and Watertown, New York reveals a pattern that is correlatable to coeval strata in the Midcontinent. The portion of the City Brook section examined consists of upper Lowville Limestone (upper Blackriveran) unconformably overlain by King Falls Limestone (lower Trentonian). The Lowville conodont fauna is a typical Blackriveran assemblage dominated by neurodontiform (hyaline) species of Curtognathus and Erismodus in association with Belodina compressa, Drepanoistodus suberectus, Panderodus and Plectodina aculeatus. The King Falls conodont fauna is dominated by Phragmodus undatus in association with Dapsilodus cf. D. mutatus, Oistodus cf. O. venustus, Panderodus, Periodon cf.more » P. grandis and Scandodus. Blackriveran faunal elements are also present in low abundance throughout the King Falls. The King Falls fauna is present and dominant in a packstone at the top of the upper Lowville below the unconformity. This occurrence supports the idea that these faunas are to some degree facies controlled. Four K-bentonite beds are present, 3 in the Lowville and 1 in the King Falls. A 6-cm thick K-bentonite in the King Falls has the approximate stratigraphic position of the Hounsfield K-bentonite. The Watertown section examined consists of upper Lowville Limestone overlain conformably or para conformable by the Watertown Limestone. The conodont fauna in both the Lowville and Watertown is identical to the Lowville fauna from City Brook, but lacks any Trentonian faunal elements. There is a 6-cm thick K-bentonite in the Lowville in virtually the same stratigraphic position as the lowest K-bentonite in the City Brook section. The stratigraphic positions and conodont faunal patterns observed in the City Brook and Watertown sections are similar to those in coeval sections in the Midcontinent.« less

Home Camera-Based Fall Detection System for the Elderly.

PubMed

de Miguel, Koldo; Brunete, Alberto; Hernando, Miguel; Gambao, Ernesto

2017-12-09

Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow) as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

Home Camera-Based Fall Detection System for the Elderly

PubMed Central

de Miguel, Koldo

2017-01-01

Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow) as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%. PMID:29232846

Falls and Hospitalizations Among Persons With Dementia and Associated Caregiver Emotional Difficulties.

PubMed

Leggett, Amanda N; Polenick, Courtney A; Maust, Donovan T; Kales, Helen C

2018-03-19

Falls and hospitalizations are adverse health events commonly experienced by persons with dementia (PWDs). These events often require urgent care from a family caregiver and may increase caregiver stress. We examine falls and hospitalizations among PWDs as predictors of caregivers' reported care-related emotional difficulty, in addition to care-related stressors. Cross-sectional telephone survey of 652 informal caregivers for PWDs. A multinomial logistic regression examined falls (last month) and hospitalizations (prior year) experienced by PWDs as predictors of caregivers' care-related emotional difficulty, accounting for demographic characteristics and primary and secondary caregiving stressors. Over 20% of caregivers reported high levels of care-related emotional difficulty. Controlling for demographic characteristics and primary and secondary caregiving stressors, the PWD's prior month fall was significantly associated with greater care-related emotional difficulty; the PWD's hospitalizations were not associated with care-related emotional difficulty. Approximately 30% of PWDs had experienced a past year hospitalization and prior month fall, and one in five caregivers reported high emotional difficulty related to care. Although secondary strains and resources of caregiving were strong predictors of care-related emotional difficulty, PWDs' falls represent a significant stressor that increases odds of caregiver emotional difficulty over and above other strains. Consequently, a fall experienced by a PWD may represent a key time for clinicians to assess caregiver well-being.

Analog-model analysis of effect of wastewater management on the ground-water reservoir in Nassau and Suffolk Counties, New York: Report I: Proposed and current sewerage

USGS Publications Warehouse

Kimmel, Grant E.; Harbaugh, Arlen W.

1976-01-01

By 1995, the water table may fall by as much as 5 metres (16 feet) in east-central Nassau County and as much as 1.8 metres (6 feet) in central Suffolk County as a result of proposed sewerage programs. similar, but generally slightly less, change may occur in the potentiometric head in the Magothy aquifer. Streamflow may decrease by as much as 55 percent in streams draining from Nassau County Sewage Disposal District 3 and as much as 56 percent in streams draining from the Huntington-Northport Sewer District.

Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program.

PubMed

Huded, Jill M; Dresden, Scott M; Gravenor, Stephanie J; Rowe, Theresa; Lindquist, Lee A

2015-12-01

Seniors represent the fasting growing population in the U.S., accounting for 20.3 million visits to emergency departments (EDs) annually. The ED visit can provide an opportunity for identifying seniors at high risk of falls. We sought to incorporate the Timed Up & Go Test (TUGT), a commonly used falls screening tool, into the ED encounter to identify seniors at high fall risk and prompt interventions through a geriatric nurse liaison (GNL) model. Patients aged 65 and older presenting to an urban ED were evaluated by a team of ED nurses trained in care coordination and geriatric assessment skills. They performed fall risk screening with the TUGT. Patients with abnormal TUGT results could then be referred to physical therapy (PT), social work or home health as determined by the GNL. Gait assessment with the TUGT was performed on 443 elderly patients between 4/1/13 and 5/31/14. A prior fall was reported in 37% of patients in the previous six months. Of those screened with the TUGT, 368 patients experienced a positive result. Interventions for positive results included ED-based PT (n=63, 17.1%), outpatient PT referrals (n=56, 12.2%) and social work consultation (n=162, 44%). The ED visit may provide an opportunity for older adults to be screened for fall risk. Our results show ED nurses can conduct the TUGT, a validated and time efficient screen, and place appropriate referrals based on assessment results. Identifying and intervening on high fall risk patients who visit the ED has the potential to improve the trajectory of functional decline in our elderly population.

Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis.

PubMed

2008-01-01

In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To identify interventions that may be effective in reducing the probability of an elderly person's falling and/or sustaining a fall-related injury. Although estimates of fall rates vary widely based on the location, age, and living arrangements of the elderly population, it is estimated that each year approximately 30% of community-dwelling individuals aged 65 and older, and 50% of those aged 85 and older will fall. Of those individuals who fall, 12% to 42% will have a fall-related injury. Several meta-analyses and cohort studies have identified falls and fall-related injuries as a strong predictor of admission to a long-term care (LTC) home. It has been shown that the risk of LTC home admission is over 5 times higher in seniors who experienced 2 or more falls without injury, and over 10 times higher in seniors who experienced a fall causing serious injury. Falls result from the interaction of a variety of risk factors that can be both intrinsic and extrinsic. Intrinsic factors are those that pertain to the physical, demographic, and health status of the individual, while extrinsic factors relate to the physical and socio-economic environment. Intrinsic risk factors can be further grouped into psychosocial/demographic risks, medical risks, risks associated with activity level and dependence, and medication risks. Commonly described extrinsic risks are tripping hazards, balance and slip hazards, and vision hazards. NOTE: It is recognized that the terms "senior" and "elderly" carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. EVIDENCE-BASED ANALYSIS OF EFFECTIVENESS: Since many risk factors for falls are modifiable, what interventions (devices, systems, programs) exist that reduce the risk of falls and/or fall-related injuries for community-dwelling seniors? English language;published between January 2000 and September 2007;population of community-dwelling seniors (majority aged 65+); andrandomized controlled trials (RCTs), quasi-experimental trials, systematic reviews, or meta-analyses. special populations (e.g., stroke or osteoporosis; however, studies restricted only to women were included);studies only reporting surrogate outcomes; orstudies whose outcome cannot be extracted for meta-analysis. number of fallers, andnumber of falls resulting in injury/fracture. A search was performed in OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), The Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published between January 2000 and September 2007. Furthermore, all studies included in a 2003 Cochrane review were considered for inclusion in this analysis. Abstracts were reviewed by a single author, and studies meeting the inclusion criteria outlined above were obtained. Studies were grouped based on intervention type, and data on population characteristics, fall outcomes, and study design were extracted. Reference lists were also checked for relevant studies. The quality of the evidence was assessed as high, moderate, low, or very low according to the GRADE methodology. The following 11 interventions were identified in the literature search: exercise programs, vision assessment and referral, cataract surgery, environmental modifications, vitamin D supplementation, vitamin D plus calcium supplementation, hormone replacement therapy (HRT), medication withdrawal, gait-stabilizing devices, hip protectors, and multifactorial interventions. Exercise programs were stratified into targeted programs where the exercise routine was tailored to the individuals' needs, and untargeted programs that were identical among subjects. Furthermore, analyses were stratified by exercise program duration (<6 months and ≥6 months) and fall risk of study participants. Similarly, the analyses on the environmental modification studies were stratified by risk. Low-risk study participants had had no fall in the year prior to study entry, while high-risk participants had had at least one fall in the previous year. A total of 17 studies investigating multifactorial interventions were identified in the literature search. Of these studies, 10 reported results for a high-risk population with previous falls, while 6 reported results for study participants representative of the general population. One study provided stratified results by fall risk, and therefore results from this study were included in each stratified analysis. Executive Summary Table 1:Summary of Meta-Analyses of Studies Investigating the Effectiveness of Interventions on the Risk of Falls in Community-Dwelling Seniors(*)InterventionRR [95% CI]GRADEExercise programs  1. Targeted programs        General population0.81 [0.67-0.98]Low      High-risk population0.93 [0.82-1.06]High      Short duration0.91 [0.73-1.13]High      Long duration0.89 [0.79-1.01]Moderate  2. Untargeted programs        General population0.78 [0.66-0.91]Moderate      High-risk population0.89 [0.72-1.10]Very low      Short duration0.85 [0.71-1.01]Low      Long duration0.76 [0.64-0.91]Moderate  3. Combined targeted vs. untargeted programs        General populationN/AN/A      High-risk population0.87 [0.57-1.34]Moderate      Short duration1.11 [0.73-1.70]High      Long duration0.73 [0.57-0.95]HighVision intervention      Assessment/referral1.12 [0.82-1.53]Moderate      Cataract surgery1.11 [0.92-1.35]ModerateEnvironmental modifications      Low-risk population1.03 [0.75-1.41]High      High-risk population0.66 [0.54-0.81]High      General population0.85 [0.75-0.97]HighDrugs/Nutritional supplements      Vitamin D (men and women)0.94 [0.77-1.14]High      Vitamin D (women only)0.55 [0.29-1.08]Moderate      Vitamin D and calcium (men and women)0.89 [0.74-1.07]Moderate      Vitamin D and calcium (women only)0.83 [0.73-0.95]Moderate      Hormone replacement therapy0.98 [0.80-1.20]Low      Medication withdrawal0.34 [0.16-0.74]†LowGait-stabilizing device0.43 [0.29-0.64]ModerateMultifactorial intervention      Geriatric screening (general population)0.87 [0.69-1.10]Very low      High-risk population0.86 [0.75-0.98]Low*CI refers to confidence interval; RR, relative risk.†Hazard ratio is reported, because RR was not available.Executive Summary Table 2:Summary of Meta-Analyses of Studies Investigating the Effectiveness of Interventions on the Risk of Fall-Related Injuries in Community-Dwelling Seniors*InterventionRR [95% CI]GRADEExercise programs      Targeted programs0.67 [0.51-0.89]Moderate    Untargeted programs0.57 [0.38-0.86]Low    Combined targeted vs untargeted programs0.31 [0.13-0.74]HighDrugs/nutritional supplements      Vitamin D plus calcium (women only)0.77 [0.49-1.21]ModerateGait-stabilizing device0.10 [0.01-0.74]ModerateHip protectors3.49 [0.68-17.97]†LowMultifactorial intervention      Geriatric screening (general population)0.90 [0.53-1.51]Low    High-risk population0.86 [0.66-1.11]Moderate*CI refers to confidence interval; RR, relative risk.†Odds ratio is reported, because RR was not available. High-quality evidence indicates that long-term exercise programs in mobile seniors and environmental modifications in the homes of frail elderly persons will effectively reduce falls and possibly fall-related injuries in Ontario's elderly population.A combination of vitamin D and calcium supplementation in elderly women will help reduce the risk of falls by more than 40%.The use of outdoor gait-stabilizing devices for mobile seniors during the winter in Ontario may reduce falls and fall-related injuries; however, evidence is limited and more research is required in this area.While psychotropic medication withdrawal may be an effective method for reducing falls, evidence is limited and long-term compliance has been demonstrated to be difficult to achieve.Multifactorial interventions in high-risk populations may be effective; however, the effect is only marginally significant, and the quality of evidence is low.

Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors

PubMed Central

2008-01-01

Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) Objective To identify interventions that may be effective in reducing the probability of an elderly person’s falling and/or sustaining a fall-related injury. Background Although estimates of fall rates vary widely based on the location, age, and living arrangements of the elderly population, it is estimated that each year approximately 30% of community-dwelling individuals aged 65 and older, and 50% of those aged 85 and older will fall. Of those individuals who fall, 12% to 42% will have a fall-related injury. Several meta-analyses and cohort studies have identified falls and fall-related injuries as a strong predictor of admission to a long-term care (LTC) home. It has been shown that the risk of LTC home admission is over 5 times higher in seniors who experienced 2 or more falls without injury, and over 10 times higher in seniors who experienced a fall causing serious injury. Falls result from the interaction of a variety of risk factors that can be both intrinsic and extrinsic. Intrinsic factors are those that pertain to the physical, demographic, and health status of the individual, while extrinsic factors relate to the physical and socio-economic environment. Intrinsic risk factors can be further grouped into psychosocial/demographic risks, medical risks, risks associated with activity level and dependence, and medication risks. Commonly described extrinsic risks are tripping hazards, balance and slip hazards, and vision hazards. Note: It is recognized that the terms “senior” and “elderly” carry a range of meanings for different audiences; this report generally uses the former, but the terms are treated here as essentially interchangeable. Evidence-Based Analysis of Effectiveness Research Question Since many risk factors for falls are modifiable, what interventions (devices, systems, programs) exist that reduce the risk of falls and/or fall-related injuries for community-dwelling seniors? Inclusion and Exclusion Criteria Inclusion Criteria English language; published between January 2000 and September 2007; population of community-dwelling seniors (majority aged 65+); and randomized controlled trials (RCTs), quasi-experimental trials, systematic reviews, or meta-analyses. Exclusion Criteria special populations (e.g., stroke or osteoporosis; however, studies restricted only to women were included); studies only reporting surrogate outcomes; or studies whose outcome cannot be extracted for meta-analysis. Outcomes of Interest number of fallers, and number of falls resulting in injury/fracture. Search Strategy A search was performed in OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), The Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published between January 2000 and September 2007. Furthermore, all studies included in a 2003 Cochrane review were considered for inclusion in this analysis. Abstracts were reviewed by a single author, and studies meeting the inclusion criteria outlined above were obtained. Studies were grouped based on intervention type, and data on population characteristics, fall outcomes, and study design were extracted. Reference lists were also checked for relevant studies. The quality of the evidence was assessed as high, moderate, low, or very low according to the GRADE methodology. Summary of Findings The following 11 interventions were identified in the literature search: exercise programs, vision assessment and referral, cataract surgery, environmental modifications, vitamin D supplementation, vitamin D plus calcium supplementation, hormone replacement therapy (HRT), medication withdrawal, gait-stabilizing devices, hip protectors, and multifactorial interventions. Exercise programs were stratified into targeted programs where the exercise routine was tailored to the individuals’ needs, and untargeted programs that were identical among subjects. Furthermore, analyses were stratified by exercise program duration (<6 months and ≥6 months) and fall risk of study participants. Similarly, the analyses on the environmental modification studies were stratified by risk. Low-risk study participants had had no fall in the year prior to study entry, while high-risk participants had had at least one fall in the previous year. A total of 17 studies investigating multifactorial interventions were identified in the literature search. Of these studies, 10 reported results for a high-risk population with previous falls, while 6 reported results for study participants representative of the general population. One study provided stratified results by fall risk, and therefore results from this study were included in each stratified analysis. Executive Summary Table 1: Summary of Meta-Analyses of Studies Investigating the Effectiveness of Interventions on the Risk of Falls in Community-Dwelling Seniors* Intervention RR [95% CI] GRADE Exercise programs   1. Targeted programs           General population 0.81 [0.67–0.98] Low       High-risk population 0.93 [0.82–1.06] High       Short duration 0.91 [0.73–1.13] High       Long duration 0.89 [0.79–1.01] Moderate   2. Untargeted programs           General population 0.78 [0.66–0.91] Moderate       High-risk population 0.89 [0.72–1.10] Very low       Short duration 0.85 [0.71–1.01] Low       Long duration 0.76 [0.64–0.91] Moderate   3. Combined targeted vs. untargeted programs           General population N/A N/A       High-risk population 0.87 [0.57–1.34] Moderate       Short duration 1.11 [0.73–1.70] High       Long duration 0.73 [0.57–0.95] High Vision intervention       Assessment/referral 1.12 [0.82–1.53] Moderate       Cataract surgery 1.11 [0.92–1.35] Moderate Environmental modifications       Low-risk population 1.03 [0.75–1.41] High       High-risk population 0.66 [0.54–0.81] High       General population 0.85 [0.75–0.97] High Drugs/Nutritional supplements       Vitamin D (men and women) 0.94 [0.77–1.14] High       Vitamin D (women only) 0.55 [0.29–1.08] Moderate       Vitamin D and calcium (men and women) 0.89 [0.74–1.07] Moderate       Vitamin D and calcium (women only) 0.83 [0.73–0.95] Moderate       Hormone replacement therapy 0.98 [0.80–1.20] Low       Medication withdrawal 0.34 [0.16–0.74]† Low Gait-stabilizing device 0.43 [0.29–0.64] Moderate Multifactorial intervention       Geriatric screening (general population) 0.87 [0.69–1.10] Very low       High-risk population 0.86 [0.75–0.98] Low * CI refers to confidence interval; RR, relative risk. † Hazard ratio is reported, because RR was not available. Executive Summary Table 2: Summary of Meta-Analyses of Studies Investigating the Effectiveness of Interventions on the Risk of Fall-Related Injuries in Community-Dwelling Seniors* Intervention RR [95% CI] GRADE Exercise programs         Targeted programs 0.67 [0.51–0.89] Moderate     Untargeted programs 0.57 [0.38–0.86] Low     Combined targeted vs untargeted programs 0.31 [0.13–0.74] High Drugs/nutritional supplements         Vitamin D plus calcium (women only) 0.77 [0.49–1.21] Moderate Gait-stabilizing device 0.10 [0.01–0.74] Moderate Hip protectors 3.49 [0.68–17.97]† Low Multifactorial intervention         Geriatric screening (general population) 0.90 [0.53–1.51] Low     High-risk population 0.86 [0.66–1.11] Moderate * CI refers to confidence interval; RR, relative risk. † Odds ratio is reported, because RR was not available. Conclusions High-quality evidence indicates that long-term exercise programs in mobile seniors and environmental modifications in the homes of frail elderly persons will effectively reduce falls and possibly fall-related injuries in Ontario’s elderly population. A combination of vitamin D and calcium supplementation in elderly women will help reduce the risk of falls by more than 40%. The use of outdoor gait-stabilizing devices for mobile seniors during the winter in Ontario may reduce falls and fall-related injuries; however, evidence is limited and more research is required in this area. While psychotropic medication withdrawal may be an effective method for reducing falls, evidence is limited and long-term compliance has been demonstrated to be difficult to achieve. Multifactorial interventions in high-risk populations may be effective; however, the effect is only marginally significant, and the quality of evidence is low. PMID:23074507

Evaluating the impact of fires on slope instability processes: a case study in Central Italy (Invited)

NASA Astrophysics Data System (ADS)

Rossi, M.; Torri, D.; Bacaro, G.; Mondini, A.; Reichenbach, P.; Fiorucci, F.; Marchesini, I.

2013-12-01

Fires can change significantly the characteristics of slopes. Their effect on vegetation, soil properties, and fauna can influence slope instability processes, including channeled erosion and mass movements. Even if in the literature attempts to estimate these effects were made using mostly empirical approaches, evaluating quantitatively the impact of fires on slope instability processes remain challenging. In a small basin in Central Italy, where an intense arson occurred in July 2012, we estimated the effects of fire on the hazard posed by different type of instability processes. For the purpose we modelled separately channeled erosion phenomena and rock falls, for which a significant impact of fires was expected. For the former we exploited the LANDPLANER (LANDscape, Plants, LANdslides and ERosion) model, which is able to simulate the hydrological response of a slope, and their effect on instability processes, under human-induced or natural changing scenarios, including climatic, land use, and slope morphology changes. For the latter we exploited two different modeling approaches considering directly (Rockyfor3D model) or indirectly (STONE model) the effect of the vegetation on the movement of rock masses along the slope. All the model simulations were repeated considering land use scenarios before and after the fire. Those were derived through field surveys and though the supervised classification of high resolution satellite images acquired inthe study area before and after the fire. The analysis of the effect of the fire on channeled phenomena included the estimation of (i) the overland flow on the basin, (ii) the location of the gully head, (iii) the channel eroded volume, and (iii) the change of the connectivity inside the basin. The analysis of the effect of the fire on rock fall phenomena included the estimation of (i) the increase of rock fall source areas, (ii) the increase of distances travelled by rock masses along the slopes, and (iii) the spatial distribution of the fallen rock blocks. In all models and scenarios we considered the effect of roads. Results showed a significant increase of the susceptibility to slope instability processes after the fire, mainly due to (i) the formation of hydro repellent soil horizons, (ii) the removal of the litter, (iii) the burning of vegetation.

Survival of high-velocity free-falls in water.

DOT National Transportation Integrated Search

1965-04-01

Forty-four cases of free-falls survived by individuals impacting water environments under conditions of high velocity (50 to 116 ft/sec, corrected for aerodynamic drag) have been intensively investigated and analyzed. Ages varied from 7 to 80 years a...

Anomalous concentrations of seismically triggered rock falls in Pacoima Canyon: Are they caused by highly susceptible slopes or local amplification of seismic shaking?

USGS Publications Warehouse

Harp, Edwin L.; Jibson, Randall W.

2002-01-01

Anomalously high concentrations of rock falls were triggered in Pacoima Canyon (Los Angeles, California) during the 1994 Northridge earthquake. Similar concentrations were also documented from the 1971 San Fernando earthquake. Using an engineering rock-mass classification that evaluates the susceptibility of rock slopes to seismic failure based on the fracture properties of a rock mass (in terms of a numerical "Q-value" that describes rock quality), the rock slopes in Pacoima Canyon were compared with rock slopes in sorrounding areas where topography and lithology are similar, but rock-fall concentrations from the earthquakes were much lower. A statistical comparison of Q-values from five sites surrounding Pacoima Canyon indicates that seismic susceptibilities are similar to those within Pacoima Canyon; differences in the characteristics of rock slopes between these sites are not sufficient to account for the relatively high concentrations of rock falls within Pacoima Canyon as compared to low concentrations elsewhere. By eliminating susceptibility differences as a cause, the most likely explanations for the differences in rock-fall concentrations is anomalously high shaking levels in Pacoima Canyon, possibly resulting from topographic amplification within the canyon.

A Homeostatic Sleep-Stabilizing Pathway in Drosophila Composed of the Sex Peptide Receptor and Its Ligand, the Myoinhibitory Peptide

PubMed Central

Zhang, Qi; Chae, Hyo-Seok; Daubnerová, Ivana; Shafer, Orie T.; Choe, Joonho; Kim, Young-Joon

2014-01-01

Sleep, a reversible quiescent state found in both invertebrate and vertebrate animals, disconnects animals from their environment and is highly regulated for coordination with wakeful activities, such as reproduction. The fruit fly, Drosophila melanogaster, has proven to be a valuable model for studying the regulation of sleep by circadian clock and homeostatic mechanisms. Here, we demonstrate that the sex peptide receptor (SPR) of Drosophila, known for its role in female reproduction, is also important in stabilizing sleep in both males and females. Mutants lacking either the SPR or its central ligand, myoinhibitory peptide (MIP), fall asleep normally, but have difficulty in maintaining a sleep-like state. Our analyses have mapped the SPR sleep function to pigment dispersing factor (pdf) neurons, an arousal center in the insect brain. MIP downregulates intracellular cAMP levels in pdf neurons through the SPR. MIP is released centrally before and during night-time sleep, when the sleep drive is elevated. Sleep deprivation during the night facilitates MIP secretion from specific brain neurons innervating pdf neurons. Moreover, flies lacking either SPR or MIP cannot recover sleep after the night-time sleep deprivation. These results delineate a central neuropeptide circuit that stabilizes the sleep state by feeding a slow-acting inhibitory input into the arousal system and plays an important role in sleep homeostasis. PMID:25333796

A homeostatic sleep-stabilizing pathway in Drosophila composed of the sex peptide receptor and its ligand, the myoinhibitory peptide.

PubMed

Oh, Yangkyun; Yoon, Sung-Eun; Zhang, Qi; Chae, Hyo-Seok; Daubnerová, Ivana; Shafer, Orie T; Choe, Joonho; Kim, Young-Joon

2014-10-01

Sleep, a reversible quiescent state found in both invertebrate and vertebrate animals, disconnects animals from their environment and is highly regulated for coordination with wakeful activities, such as reproduction. The fruit fly, Drosophila melanogaster, has proven to be a valuable model for studying the regulation of sleep by circadian clock and homeostatic mechanisms. Here, we demonstrate that the sex peptide receptor (SPR) of Drosophila, known for its role in female reproduction, is also important in stabilizing sleep in both males and females. Mutants lacking either the SPR or its central ligand, myoinhibitory peptide (MIP), fall asleep normally, but have difficulty in maintaining a sleep-like state. Our analyses have mapped the SPR sleep function to pigment dispersing factor (pdf) neurons, an arousal center in the insect brain. MIP downregulates intracellular cAMP levels in pdf neurons through the SPR. MIP is released centrally before and during night-time sleep, when the sleep drive is elevated. Sleep deprivation during the night facilitates MIP secretion from specific brain neurons innervating pdf neurons. Moreover, flies lacking either SPR or MIP cannot recover sleep after the night-time sleep deprivation. These results delineate a central neuropeptide circuit that stabilizes the sleep state by feeding a slow-acting inhibitory input into the arousal system and plays an important role in sleep homeostasis.

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls.

PubMed

Phelan, Elizabeth A; Aerts, Sally; Dowler, David; Eckstrom, Elizabeth; Casey, Colleen M

2016-01-01

A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79 ± 8 years; 68% were female, and 10% were non-white. They averaged six primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall-risk factors varied from 24% (for home safety) to 78% (for vitamin D). An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21%) and home safety (24%). Use of a structured visit note template independently predicted assessment of fall-risk factors (p = 0.003). Geriatrics specialists were more likely to use a structured note template (p = 0.04) and perform more fall-risk factor assessments (4.6 vs. 3.6, p = 0.007) than general internists. These results suggest opportunities for improving multifactorial fall-risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

PubMed Central

Phelan, Elizabeth A.; Aerts, Sally; Dowler, David; Eckstrom, Elizabeth; Casey, Colleen M.

2016-01-01

A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79 ± 8 years; 68% were female, and 10% were non-white. They averaged six primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall-risk factors varied from 24% (for home safety) to 78% (for vitamin D). An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21%) and home safety (24%). Use of a structured visit note template independently predicted assessment of fall-risk factors (p = 0.003). Geriatrics specialists were more likely to use a structured note template (p = 0.04) and perform more fall-risk factor assessments (4.6 vs. 3.6, p = 0.007) than general internists. These results suggest opportunities for improving multifactorial fall-risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice. PMID:27660753

Lower Urinary Tract Symptoms and Incident Falls in Community Dwelling Older Men: The Concord Health and Ageing in Men Project.

PubMed

Noguchi, Naomi; Chan, Lewis; Cumming, Robert G; Blyth, Fiona M; Handelsman, David J; Seibel, Markus J; Waite, Louise M; Le Couteur, David G; Naganathan, Vasi

2016-12-01

We sought to determine which lower urinary tract symptoms are associated with incident falls in community dwelling older men. The Concord Health and Ageing in Men Project involves a representative sample of community dwelling men 70 years old or older in a defined geographic region in Sydney, New South Wales, Australia. Included in analysis were 1,090 men without neurological diseases, poor mobility or dementia at baseline. Lower urinary tract symptoms were assessed using I-PSS (International Prostate Symptom Score) and incontinence was assessed using ICIQ (International Consultation on Incontinence Questionnaire) at baseline. I-PSS subscores were calculated for storage and voiding symptoms. Incident falls in 1 year were determined by telephone followup every 4 months. I-PSS storage and voiding subscores were associated with falls. Urgency incontinence was associated with falls (adjusted incidence rate ratio 2.57, 95% CI 1.54-4.30). In addition, intermediate to high I-PSS storage subscores without urgency incontinence were associated with falls (adjusted incidence rate ratio 1.72, 95% CI 1.24-2.38). Other types of incontinence and urgency alone without urgency incontinence were not associated with falls. Lower urinary tract storage and voiding symptoms were associated with falls in community dwelling older men. Of the symptoms of overactive bladder urgency incontinence carried a high risk of falls. Storage symptoms also contributed to the fall risk independently of urgency incontinence. Circumstances of falls among men with lower urinary tract symptoms should be explored to understand how lower urinary tract symptoms increase the fall risk and generate hypotheses regarding potential interventions. Furthermore, trials to treat lower urinary tract symptoms in older men should include falls as an end point. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups

PubMed Central

2012-01-01

Background Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2). Methods A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances. Results The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity. Conclusions Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified automatically from existing geriatric assessment data, especially when combined with domain knowledge in a hybrid classification model. Further work is necessary to validate our approach in a controlled prospective setting. PMID:22417403

Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups.

PubMed

Marschollek, Michael; Gövercin, Mehmet; Rust, Stefan; Gietzelt, Matthias; Schulze, Mareike; Wolf, Klaus-Hendrik; Steinhagen-Thiessen, Elisabeth

2012-03-14

Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2). A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances. The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity. Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified automatically from existing geriatric assessment data, especially when combined with domain knowledge in a hybrid classification model. Further work is necessary to validate our approach in a controlled prospective setting.

A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).

PubMed

Neyens, Jacques C L; Dijcks, Béatrice P J; Twisk, Jos; Schols, Jos M G A; van Haastregt, Jolanda C M; van den Heuvel, Wim J A; de Witte, Luc P

2009-03-01

to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients. cluster-randomised controlled 12-month trial. psychogeriatric wards in 12 nursing homes in The Netherlands. psychogeriatric nursing home patients (n = 518). a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities. falls. there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43-0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme. the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors

PubMed Central

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Background Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Objective Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Methods Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( χ¯ ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. Results About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (P<0.001), body mass index (BMI) <23.5 (P=0.007), Mini-Mental State Examination <20 (P=0.004), Barthel Index <65 (P=0.002), hemoglobin <7.69 mmol/L (P=0.017), serum protein <70 g/L (P=0.008), albumin <32 g/L (P=0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76–19.49; P<0.001), history of falls (OR =2.55; 95% CI =1.05–6.19; P=0.039), age (OR =1.14; 95% CI =1.05–1.23; P=0.001), and BMI (OR =0.91; 95% CI =0.83–0.99; P=0.034). Conclusion Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls. PMID:27695303

Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program.

PubMed

LaStayo, Paul; Marcus, Robin; Dibble, Leland; Wong, Bob; Pepper, Ginette

2017-07-17

Addressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period. Randomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis. The MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up <50% had experienced a fall or near fall. There were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival. NCT01080196 ; March 2, 2010 (retrospectively registered).

Risk Profiles for Injurious Falls in People Over 60: A Population-Based Cohort Study

PubMed Central

Ek, Stina; Rizzuto, Debora; Fratiglioni, Laura; Johnell, Kristina; Xu, Weili

2018-01-01

Abstract Background Although falls in older adults are related to multiple risk factors, these factors have commonly been studied individually. We aimed to identify risk profiles for injurious falls in older adults by detecting clusters of established risk factors and quantifying their impact on fall risk. Methods Participants were 2,566 people, aged 60 years and older, from the population-based Swedish National Study on Aging and Care in Kungsholmen. Injurious falls was defined as hospitalization for or receipt of outpatient care because a fall. Cluster analysis was used to identify aggregation of possible risk factors including chronic diseases, fall-risk increasing drugs (FRIDs), physical and cognitive impairments, and lifestyle-related factors. Associations between the clusters and injurious falls over 3, 5, and 10 years were estimated using flexible parametric survival models. Results Five clusters were identified including: a “healthy”, a “well-functioning with multimorbidity”, a “well-functioning, with multimorbidity and high FRID consumption”, a “physically and cognitively impaired”, and a “disabled” cluster. The risk of injurious falls for all groups was significantly higher than for the first cluster of healthy individuals in the reference category. Hazard ratios (95% confidence intervals) ranged from 1.71 (1.02–2.66) for the second cluster to 12.67 (7.38–21.75) for the last cluster over 3 years of follow-up. The highest risk was observed in the last two clusters with high burden of physical and cognitive impairments. Conclusion Risk factors for injurious fall tend to aggregate, representing different levels of risk for falls. Our findings can be useful to tailor and prioritize clinical and public health interventions. PMID:28605455

Golden West College FACTS: Fall Enrollment Trends through 1999.

ERIC Educational Resources Information Center

Golden West Coll., Huntington Beach, CA. Research Office.

This report presents the fall enrollment trends through 1999 at California's Golden West College (GWC). This report contains charts and graphs of the following enrollment trend topics: (1) fall 1998 student enrollment snapshot, which includes counts and percentages by gender, time of day, age, educational goal, entrance level, high school…

Hippocampal neurogenesis and volume in migrating and wintering semipalmated sandpipers (Calidris pusilla)

PubMed Central

de Morais Magalhães, Nara Gyzely; Guerreiro Diniz, Daniel; Pereira Henrique, Ediely; Corrêa Pereira, Patrick Douglas; Matos Moraes, Isis Ananda; Damasceno de Melo, Mauro André; Sherry, David Francis; Wanderley Picanço Diniz, Cristovam

2017-01-01

Long distance migratory birds find their way by sensing and integrating information from a large number of cues in their environment. These cues are essential to navigate over thousands of kilometers and reach the same breeding, stopover, and wintering sites every year. The semipalmated sandpiper (Calidris pusilla) is a long-distance migrant that breeds in the arctic tundra of Canada and Alaska and winters on the northeast coast of South America. Its fall migration includes a 5,300-kilometer nonstop flight over the Atlantic Ocean. The avian hippocampus has been proposed to play a central role in the integration of multisensory spatial information for navigation. Hippocampal neurogenesis may contribute to hippocampal function and a variety of factors including cognitive activity, exercise, enrichment, diet and stress influence neurogenesis in the hippocampus. We quantified hippocampal neurogenesis and volume in adult migrating and wintering semipalmated sandpipers using stereological counts of doublecortin (DCX) immunolabeled immature neurons. We found that birds captured in the coastal region of Bragança, Brazil during the wintering period had more DCX positive neurons and larger volume in the hippocampus than individuals captured in the Bay of Fundy, Canada during fall migration. We also estimate the number of NeuN immunolabeled cells in migrating and wintering birds and found no significant differences between them. These findings suggest that, at this time window, neurogenesis just replaced neurons that might be lost during the transatlantic flight. Our findings also show that in active fall migrating birds, a lower level of adult hippocampal neurogenesis is associated with a smaller hippocampal formation. High levels of adult hippocampal neurogenesis and a larger hippocampal formation found in wintering birds may be late occurring effects of long distance migratory flight or the result of conditions the birds experienced while wintering. PMID:28591201

Hippocampal neurogenesis and volume in migrating and wintering semipalmated sandpipers (Calidris pusilla).

PubMed

de Morais Magalhães, Nara Gyzely; Guerreiro Diniz, Cristovam; Guerreiro Diniz, Daniel; Pereira Henrique, Ediely; Corrêa Pereira, Patrick Douglas; Matos Moraes, Isis Ananda; Damasceno de Melo, Mauro André; Sherry, David Francis; Wanderley Picanço Diniz, Cristovam

2017-01-01

Long distance migratory birds find their way by sensing and integrating information from a large number of cues in their environment. These cues are essential to navigate over thousands of kilometers and reach the same breeding, stopover, and wintering sites every year. The semipalmated sandpiper (Calidris pusilla) is a long-distance migrant that breeds in the arctic tundra of Canada and Alaska and winters on the northeast coast of South America. Its fall migration includes a 5,300-kilometer nonstop flight over the Atlantic Ocean. The avian hippocampus has been proposed to play a central role in the integration of multisensory spatial information for navigation. Hippocampal neurogenesis may contribute to hippocampal function and a variety of factors including cognitive activity, exercise, enrichment, diet and stress influence neurogenesis in the hippocampus. We quantified hippocampal neurogenesis and volume in adult migrating and wintering semipalmated sandpipers using stereological counts of doublecortin (DCX) immunolabeled immature neurons. We found that birds captured in the coastal region of Bragança, Brazil during the wintering period had more DCX positive neurons and larger volume in the hippocampus than individuals captured in the Bay of Fundy, Canada during fall migration. We also estimate the number of NeuN immunolabeled cells in migrating and wintering birds and found no significant differences between them. These findings suggest that, at this time window, neurogenesis just replaced neurons that might be lost during the transatlantic flight. Our findings also show that in active fall migrating birds, a lower level of adult hippocampal neurogenesis is associated with a smaller hippocampal formation. High levels of adult hippocampal neurogenesis and a larger hippocampal formation found in wintering birds may be late occurring effects of long distance migratory flight or the result of conditions the birds experienced while wintering.

Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis.

PubMed

Youkhana, Sabrina; Dean, Catherine M; Wolff, Moa; Sherrington, Catherine; Tiedemann, Anne

2016-01-01

one-third of community-dwelling older adults fall annually. Exercise that challenges balance is proven to prevent falls. We conducted a systematic review with meta-analysis to determine the impact of yoga-based exercise on balance and physical mobility in people aged 60+ years. searches for relevant trials were conducted on the following electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Allied and Complementary Medicine Database and the Physiotherapy Evidence Database (PEDro) from inception to February 2015. Trials were included if they evaluated the effect of physical yoga (excluding meditation and breathing exercises alone) on balance in people aged 60+ years. We extracted data on balance and the secondary outcome of physical mobility. Standardised mean differences and 95% confidence intervals (CI) were calculated using random-effects models. Methodological quality of trials was assessed using the 10-point Physiotherapy Evidence Database (PEDro) Scale. six trials of relatively high methodological quality, totalling 307 participants, were identified and had data that could be included in a meta-analysis. Overall, yoga interventions had a small effect on balance performance (Hedges' g = 0.40, 95% CI 0.15-0.65, 6 trials) and a medium effect on physical mobility (Hedges' g = 0.50, 95% CI 0.06-0.95, 3 trials). yoga interventions resulted in small improvements in balance and medium improvements in physical mobility in people aged 60+ years. Further research is required to determine whether yoga-related improvements in balance and mobility translate to prevention of falls in older people. PROSPERO Registration number CRD42015015872. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Precipitation Response Over the Continental United States to Cold Tropical Pacific Sea Surface Temperatures

NASA Technical Reports Server (NTRS)

Wang, Hailan; Schubert, Siegfried D.

2013-01-01

The dominant pattern of annual mean SST variability in the Pacific (in its cold phase) produces pronounced precipitation deficits over the continental United States (U.S.) throughout the annual cycle. This study investigates the physical and dynamical processes through which the cold Pacific pattern affects the U.S. precipitation, particularly the causes for the peak dry impacts in fall, as well as the nature of the differences between the summer and fall responses. Results, based on observations and reanalyses, show that the peak precipitation deficit over the U.S. during fall is primarily due to reduced atmospheric moisture transport from the Gulf of Mexico into the central and eastern U.S., and secondarily due to a reduction in local evaporation from land-atmosphere feedback. The former is associated with a strong and systematic low-level northeasterly flow anomaly over the southeastern U.S. that counteracts the northwest branch of the climatological flow associated with the north Atlantic subtropical high. The above northeasterly anomaly is maintained by both diabatic heating anomalies in the nearby Intra-American Seas and diabatic cooling anomalies in the tropical Pacific. In contrast, the modest summertime precipitation deficit over the U.S. is mainly the result of local land-atmosphere feedback; the rather weak and disorganized atmospheric circulation anomalies over and to the south of the U.S. make little contribution. An evaluation of NSIPP-1 AGCM simulations shows it to be deficient in simulating the warm season tropical convection responses over the Intra-American Seas to the cold Pacific pattern and thereby the precipitation responses over the U.S., a problem that appears to be common to many AGCMs.

Vibration perception threshold in relation to postural control and fall risk assessment in elderly.

PubMed

de Mettelinge, Tine Roman; Calders, Patrick; Palmans, Tanneke; Vanden Bossche, Luc; Van Den Noortgate, Nele; Cambier, Dirk

2013-09-01

This study investigates (i) the potential discriminative role of a clinical measure of peripheral neuropathy (PN) in assessing postural performance and fall risk and (ii) whether the integration of a simple screening vibration perception threshold (VPT) for PN in any physical (fall risk) assessment among elderly should be recommended, even if they do not suffer from DM. One hundred and ninety-five elderly were entered in a four-group model: DM with PN (D+; n = 75), DM without PN (D-; n = 28), non-diabetic elderly with idiopathic PN (C+; n = 31) and non-diabetic elderly without PN (C-; n = 61). Posturographic sway parameters were captured during different static balance conditions (AMTI AccuGait, Watertown, MA). VPT, fall data, Mini-Mental State Examination and Clock Drawing Test were registered. Two-factor repeated-measures ANOVA was used to compare between groups and across balance conditions. The groups with PN demonstrated a strikingly comparable, though bigger sway, and a higher prospective fall incidence than their peers without PN. The indication of PN, irrespective of its cause, interferes with postural control and fall incidence. The integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. Implications for Rehabilitation The indication of peripheral neuropathy (PN), irrespective of its cause, interferes with postural control and fall incidence. Therefore, the integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. It might be useful to integrate somatosensory stimulation in rehabilitation programs designed for fall prevention.

Clinical and neurophysiological risk factors for falls in patients with bilateral vestibulopathy.

PubMed

Schniepp, Roman; Schlick, Cornelia; Schenkel, Fabian; Pradhan, Cauchy; Jahn, Klaus; Brandt, Thomas; Wuehr, Max

2017-02-01

Patients with bilateral vestibular failure (BVF) exhibit imbalance when standing and walking that is linked to a higher fall risk. The purpose of this study was to identify risk factors for falls in BVF. We therefore systematically investigated the interrelationship of clinical and demographic characteristics, gait impairments, and the fall frequency of these patients. Clinical and demographic characteristics as well as quantitative measures of gait performance on a pressure-sensitive gait carpet were collected from 55 patients with different etiologies of BVF. Clinical and demographic data as well as spatiotemporal gait characteristics were used for ANOVA testing and a logistic regression model with categorized fall events as dependent variables. The impairment of peripheral vestibular function, duration of disease, and the overall gait status were not associated with the history of falls in patients with BVF. In contrast, the most predictive factors for falls in BVF were an increase in temporal gait variability, especially at slow walking speeds (p < 0.001; OR = 1.3), and the presence of a concomitant peripheral neuropathy (p < 0.045; OR = 3.6). BVF patients with a high risk of falling exhibit specific gait alterations in a speed-dependent manner. In particular, increased gait fluctuations during slow walking are most predictive for an increased fall risk. The presence of a concomitant peripheral neuropathy further critically impairs postural stability in these patients. Clinical assessment of both these aspects is therefore important to identify those patients at a particularly high fall risk and to initiate preventive procedures early.

History and mobility exam index to identify community-dwelling elderly persons at risk of falling.

PubMed

Covinsky, K E; Kahana, E; Kahana, B; Kercher, K; Schumacher, J G; Justice, A C

2001-04-01

Falls are common in community-dwelling elderly persons and are a frequent source of morbidity. Simple indices to prospectively stratify people into categories at different fall-risk would be useful to health care practitioners. Our goal was to develop a fall-risk index that discriminated between people at high and low risk of falling. We evaluated the risk of falling over a one-year period in 557 elderly persons (mean age 81.6) living in a retirement community. On the baseline interview, we asked subjects if they had fallen in the previous year and evaluated risk factors in six additional conceptual categories. On the follow-up interview one year later, we again asked subjects if they had fallen in the prior year. We evaluated risk factors in the different conceptual categories and used logistic regression to determine the independent predictors of falling over a one-year period. We used these independent predictors to create a fall-risk index. We compared the ability of a prior falls history with other risk factors and with the combination of a falls history and other risk factors to discriminate fallers from nonfallers. A fall in the previous year (OR = 2.42, 95% CI = 1.49-3.93), a symptom of either balance difficulty or dizziness (OR = 1.83, 95% CI = 1.16-2.89), or an abnormal mobility exam (OR = 2.64, 95% CI = 1.64-4.26) were independent predictors of falling over the subsequent year. These three risk factors together (c statistic =.71) discriminated fallers from nonfallers better than previous history of falls alone (c statistic =.61) or the symptomatic and exam risk factors alone (c statistic =.68). When combined into a risk index, the three independent risk factors stratify people into groups whose risk for falling over the subsequent year ranges from 10% to 51%. A history of falling over the prior year, a risk factor that can be obtained from a clinical history (balance difficulty or dizziness), and a risk factor that can be obtained from a physical exam (mobility difficulty) stratify people into groups at low and high risk of falling over the subsequent year. This risk index may provide a simple method of assessing fall risk in community-dwelling elderly persons. However, it requires validation in other subjects before it can be recommended for widespread use.

The Chelyabinsk Fall Highly Siderophile Element Abundance and 187Os/188Os Composition and Comparison with Ordinary and Carbonaceous Chondrites

NASA Astrophysics Data System (ADS)

Day, J. M. D.; Corder, C. A.; Dhaliwal, J. K.; Liu, Y.; Taylor, L. A.

2014-09-01

New osmium isotope and highly siderophile element abundance data are presented for the Chelyabinsk ordinary chondrite fall (February 2013) and placed into context with new data for ordinary and carbonaceous chondrites.

Head and neck injury patterns in fatal falls: epidemiologic and biomechanical considerations.

PubMed

Freeman, Michael D; Eriksson, Anders; Leith, Wendy

2014-01-01

Fatal falls often involve a head impact, which are in turn associated with a fracture of the skull or cervical spine. Prior authors have noted that the degree of inversion of the victim at the time of impact is an important predictor of the distribution of skull fractures, with skull base fractures more common than skull vault fractures in falls with a high degree of inversion. The majority of fatal fall publications have focused on skull fractures, and no research has described the association between fall circumstances and the distribution of fractures in the skull and neck. In the present study, we accessed data regarding head and neck fractures resulting from fatal falls from a Swedish autopsy database for the years 1992-2010, for the purposes of examining the relationships between skull and cervical spine fracture distribution and the circumstances of the fatal fall. Out of 102,310 medico-legal autopsies performed there were 1008 cases of falls associated with skull or cervical spine fractures. The circumstances of the falls were grouped in 3 statistically homogenous categories; falls occurring at ground level, falls from a height of <3 m or down stairs, and falls from ≥3 m. Only head and neck injuries and fractures that were associated with the fatal CNS injuries were included for study, and categorized as skull vault and skull base fractures, upper cervical injuries (C0-C1 dislocation, C1 and C2 fractures), and lower cervical fractures. Logistic regression modeling revealed increased odds of skull base and lower cervical fracture in the middle and upper fall severity groups, relative to ground level falls (lower cervical <3 m falls, OR = 2.55 [1.32, 4.92]; lower cervical ≥3 m falls, OR = 2.23 [0.98, 5.08]; skull base <3 m falls, OR = 1.82 [1.32, 2.50]; skull base ≥3 m falls, OR = 2.30 [1.55, 3.40]). C0-C1 dislocations were strongly related to fall height, with an OR of 8.3 for ≥3 m falls versus ground level. The findings of increased odds of skull base and lower cervical spine fracture in falls from a height are consistent with prior observations that the risk of such injuries is related to the degree of victim inversion at impact. The finding that C0-C1 dislocations are most common in falls from more than 3 m is unique, an indication that the injuries likely result from high energy shear forces rather than pure tension, as previously thought. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Falls and fall-related injuries in older dialysis patients.

PubMed

Cook, Wendy L; Tomlinson, George; Donaldson, Meghan; Markowitz, Samuel N; Naglie, Gary; Sobolev, Boris; Jassal, Sarbjit V

2006-11-01

Dialysis patients are increasingly older and more disabled. In community-dwelling seniors without kidney disease, falls commonly predict hospitalization, the onset of frailty, and the need for institutional care. Effective fall prevention strategies are available. On the basis of retrospective data, it was hypothesized that the fall rates of older (> or =65 yr) chronic outpatient hemodialysis (HD) patients would be higher than published rates for community-dwelling seniors (0.6 to 0.8 falls/patient-year). It also was hypothesized that risk factors for falls in dialysis outpatients would include polypharmacy, dialysis-related hypotension, cognitive impairment, and decreased functional status. Using a prospective cohort study design, HD patients who were > or =65 yr of age at a large academic dialysis unit were recruited. All study participants underwent baseline screening for fall risk factors. Patients were followed prospectively for a minimum of 1 yr. Falls were identified through biweekly patient interviews in the HD unit. A total of 162 patients (mean age 74.7 yr) were recruited; 57% were male. A total of 305 falls occurred in 76 (47%) patients over 190.5 person-years of follow-up (fall-incidence 1.60 falls/person-year). Injuries occurred in 19% of falls; 41 patients had multiple falls. Associated risk factors included age, comorbidity, mean predialysis systolic BP, and a history of falls. In the HD population, the fall risk is higher than in the general community, and fall-related morbidity is high. Better identification of HD patients who are at risk for falls and targeted fall intervention strategies are required.

Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care.

PubMed

Potter, Patricia; Allen, Kelly; Costantinou, Eileen; Klinkenberg, William Dean; Malen, Jill; Norris, Traci; O'Connor, Elizabeth; Roney, Wilhemina; Tymkew, Heidi Hahn; Wolf, Laurie

2017-08-01

Sensor technology that dynamically identifies hospitalized patients' fall risk and detects and alerts nurses of high-risk patients' early exits out of bed has potential for reducing fall rates and preventing patient harm. During Phase 1 (August 2014-January 2015) of a previously reported performance improvement project, an innovative depth sensor was evaluated on two inpatient medical units to study fall characteristics. In Phase 2 (April 2015-January 2016), a combined depth and bed sensor system designed to assign patient fall probability, detect patient bed exits, and subsequently prevent falls was evaluated. Fall detection depth sensors remained in place on two medicine units; bed sensors used to detect patient bed exits were added on only one of the medicine units. Fall rates and fall with injury rates were evaluated on both units. During Phase 2, the designated evaluation unit had 14 falls, for a fall rate of 2.22 per 1,000 patient-days-a 54.1% reduction compared with the Phase 1 fall rate. The difference in rates from Phase 1 to Phase 2 was statistically significant (z = 2.20; p = 0.0297). The comparison medicine unit had 30 falls-a fall rate of 4.69 per 1,000 patient-days, representing a 57.9% increase as compared with Phase 1. A fall detection sensor system affords a level of surveillance that standard fall alert systems do not have. Fall prevention remains a complex issue, but sensor technology is a viable fall prevention option. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis.

PubMed

Arnold, Cathy M; Busch, Angela J; Schachter, Candice L; Harrison, Liz; Olszynski, Wojciech

2005-07-01

Cross-sectional descriptive analysis investigating intrinsic fall risk factors in postmenopausal women with osteoporosis. To examine the relationships between history of recent falls and balance, pain, quality of life, function, posture, strength, and mobility. Women with osteoporosis who fall are at a high risk of fracture due to decreased bone strength. Identifying fall risk factors for older women with osteoporosis is a crucial step in decreasing the incidence of falls and fracture. METHOD AND MEASURES: Seventy-three women over 60 years of age with established osteoporosis participated in comprehensive testing of fall history, physical function, and quality of life. Significant correlations were found between a recent history of falls and degree of kyphosis (r = 0.29), fear of falls/emotional status (r = -0.27), and balance (r = -0.27). Degree of kyphosis and fear of falls/emotional status explained 20% of the variance of recent fall history using binary logistic regression. Women with an increased kyphosis were more likely to have had a recent fall (odds ratio [OR], 1.17; 95% CI, 1.03-1.34) and those with better emotional status and less fear of falling were less likely to have had a recent fall (OR, 0.61; 95% CI, 0.38-0.97). Increased thoracic kyphosis and fear of falling are 2 intrinsic factors associated with recent falls in women with osteoporosis. To design more effective interventions to decrease fall risk in this population, future prospective, longitudinal studies should monitor kyphosis, fear of falling, balance reactions, and other potential risk factors not identified in this study.

Sufficient Forecasting Using Factor Models

PubMed Central

Fan, Jianqing; Xue, Lingzhou; Yao, Jiawei

2017-01-01

We consider forecasting a single time series when there is a large number of predictors and a possible nonlinear effect. The dimensionality was first reduced via a high-dimensional (approximate) factor model implemented by the principal component analysis. Using the extracted factors, we develop a novel forecasting method called the sufficient forecasting, which provides a set of sufficient predictive indices, inferred from high-dimensional predictors, to deliver additional predictive power. The projected principal component analysis will be employed to enhance the accuracy of inferred factors when a semi-parametric (approximate) factor model is assumed. Our method is also applicable to cross-sectional sufficient regression using extracted factors. The connection between the sufficient forecasting and the deep learning architecture is explicitly stated. The sufficient forecasting correctly estimates projection indices of the underlying factors even in the presence of a nonparametric forecasting function. The proposed method extends the sufficient dimension reduction to high-dimensional regimes by condensing the cross-sectional information through factor models. We derive asymptotic properties for the estimate of the central subspace spanned by these projection directions as well as the estimates of the sufficient predictive indices. We further show that the natural method of running multiple regression of target on estimated factors yields a linear estimate that actually falls into this central subspace. Our method and theory allow the number of predictors to be larger than the number of observations. We finally demonstrate that the sufficient forecasting improves upon the linear forecasting in both simulation studies and an empirical study of forecasting macroeconomic variables. PMID:29731537

Post-fall reporting in aged acute inpatient mental health units: an 18-month observational cohort study.

PubMed

Furness, Trentham; Mnatzaganian, George; Garlick, Robyn; Ireland, Susan; McKenna, Brian; Hill, Keith D

2017-12-01

Despite the high risk of falling for people with severe mental illness, there is limited falls research in mental health settings. Therefore, the objective of this observational cohort study was to conduct a focused post-fall review of fall episodes within aged acute inpatient mental health units at one of Australia's largest publicly funded mental health organizations. A post-fall reporting tool was developed to collect intrinsic and extrinsic fall risk factors among three aged acute mental health inpatient units over an 18-month period. Descriptive and inferential analyses were conducted to describe fall risk factors and predictors of fall risk. There were a total of 115 falls, of which the tool was used for 93 (80.9%) episodes. Falls occurred most often in consumer's bedroom/bathroom and were unwitnessed. Intrinsic risk factors were most often attributed to postural drop and losing balance during walking. However, that was in contrast to consumer's who self-reported feeling dizzy as the reason of the fall. Based on the cohort, future falls could be reduced by targeting those aged above 82 years, or with a diagnosis of dementia. Recurrent falls during admission could be reduced by targeting those with psychotic illness and males with a diagnosis of dementia. A clearer dialogue among consumers and clinical staff reporting about fall episodes may support future remedial interventions and inform programs to reduce fall risk and assist the challenge of describing unwitnessed falls in aged acute inpatient mental health settings.

Comparisons of Interventions for Preventing Falls in Older Adults

PubMed Central

Tricco, Andrea C.; Thomas, Sonia M.; Veroniki, Areti Angeliki; Hamid, Jemila S.; Cogo, Elise; Strifler, Lisa; Khan, Paul A.; Robson, Reid; Sibley, Kathryn M.; MacDonald, Heather; Riva, John J.; Thavorn, Kednapa; Wilson, Charlotte; Holroyd-Leduc, Jayna; Kerr, Gillian D.; Feldman, Fabio; Majumdar, Sumit R.; Jaglal, Susan B.; Hui, Wing

2017-01-01

Importance Falls result in substantial burden for patients and health care systems, and given the aging of the population worldwide, the incidence of falls continues to rise. Objective To assess the potential effectiveness of interventions for preventing falls. Data Sources MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Ageline databases from inception until April 2017. Reference lists of included studies were scanned. Study Selection Randomized clinical trials (RCTs) of fall-prevention interventions for participants aged 65 years and older. Data Extraction and Synthesis Pairs of reviewers independently screened the studies, abstracted data, and appraised risk of bias. Pairwise meta-analysis and network meta-analysis were conducted. Main Outcomes and Measures Injurious falls and fall-related hospitalizations. Results A total of 283 RCTs (159 910 participants; mean age, 78.1 years; 74% women) were included after screening of 10 650 titles and abstracts and 1210 full-text articles. Network meta-analysis (including 54 RCTs, 41 596 participants, 39 interventions plus usual care) suggested that the following interventions, when compared with usual care, were associated with reductions in injurious falls: exercise (odds ratio [OR], 0.51 [95% CI, 0.33 to 0.79]; absolute risk difference [ARD], −0.67 [95% CI, −1.10 to −0.24]); combined exercise and vision assessment and treatment (OR, 0.17 [95% CI, 0.07 to 0.38]; ARD, −1.79 [95% CI, −2.63 to −0.96]); combined exercise, vision assessment and treatment, and environmental assessment and modification (OR, 0.30 [95% CI, 0.13 to 0.70]; ARD, −1.19 [95% CI, −2.04 to −0.35]); and combined clinic-level quality improvement strategies (eg, case management), multifactorial assessment and treatment (eg, comprehensive geriatric assessment), calcium supplementation, and vitamin D supplementation (OR, 0.12 [95% CI, 0.03 to 0.55]; ARD, −2.08 [95% CI, −3.56 to −0.60]). Pairwise meta-analyses for fall-related hospitalizations (2 RCTs; 516 participants) showed no significant association between combined clinic- and patient-level quality improvement strategies and multifactorial assessment and treatment relative to usual care (OR, 0.78 [95% CI, 0.33 to 1.81]). Conclusions and Relevance Exercise alone and various combinations of interventions were associated with lower risk of injurious falls compared with usual care. Choice of fall-prevention intervention may depend on patient and caregiver values and preferences. PMID:29114830

Fall from a car driving at high speed: A case report.

PubMed

Maujean, Géraldine; Guinet, Tiphaine; Malicier, Daniel

2016-04-01

In cases of falls, the key issue for forensic scientists is to determine the manner of death. They must distinguish between accidental falls, suicidal falls, falls including blows and falls caused by a blow. Several strategies have been proposed in the literature to help explain injury patterns. Here, we report an original case of a man who died after jumping from a car moving at high speed. A mathematical and modeling approach was developed to reconstruct the trajectory of the body in order to understand the injury pattern and apparent discrepancy between the high speed of the car from which the victim jumped and the topography of the bone fractures, which were limited to the skull. To define the initial values of the model's parameters, a technical vehicle evaluation and several test jumps at low speed were carried out. We studied in greater detail the trajectory of three characteristic points corresponding to the dummy's center of gravity, head and right foot. Calculations were made with and without the air friction effect to show its influence. Finally, we were successful in modeling the initial trajectory of the body and the variation of its head energy over time, which were consistent with the injuries observed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Physical therapy approaches to reduce fall and fracture risk among older adults.

PubMed

Karinkanta, Saija; Piirtola, Maarit; Sievänen, Harri; Uusi-Rasi, Kirsti; Kannus, Pekka

2010-07-01

Falls and fall-related injuries, such as fractures, are a growing problem among older adults, often causing longstanding pain, functional impairments, reduced quality of life and excess health-care costs and mortality. These problems have led to a variety of single component or multicomponent intervention strategies to prevent falls and subsequent injuries. The most effective physical therapy approach for the prevention of falls and fractures in community-dwelling older adults is regular multicomponent exercise; a combination of balance and strength training has shown the most success. Home-hazard assessment and modification, as well as assistive devices, such as canes and walkers, might be useful for older people at a high risk of falls. Hip protectors are effective in nursing home residents and potentially among other high-risk individuals. In addition, use of anti-slip shoe devices in icy conditions seems beneficial for older people walking outdoors. To be effective, multifactorial preventive programs should include an exercise component accompanied by individually tailored measures focused on high-risk populations. In this Review, we focus on evidence-based physical therapy approaches, including exercise, vibration training and improvements of safety at home and during periods of mobility. Additionally, the benefits of multifaceted interventions, which include risk factor assessment, dietary supplements, elements of physical therapy and exercise, are addressed.

How Do Community-Dwelling Persons with Alzheimer Disease Fall? Falls in the FINALEX Study.

PubMed

Perttila, Niko M; Öhman, Hannareeta; Strandberg, Timo E; Kautiainen, Hannu; Raivio, Minna; Laakkonen, Marja-Liisa; Savikko, Niina; Tilvis, Reijo S; Pitkala, Kaisu H

2017-01-01

People with dementia are at high risk for falls. However, little is known of the features causing falls in Alzheimer disease (AD). Our aim was to investigate how participants with AD fall. In the FINALEX (Finnish Alzheimer Disease Exercise Trial) study, participants' ( n = 194) falls were followed up for 1 year by diaries kept by their spouses. The most common reason for falls ( n = 355) was stumbling ( n = 61). Of the falls, 123 led to injuries, 50 to emergency department visits, and 13 to fractures. The participants without falls ( n = 103) were younger and had milder dementia than those with 1 ( n = 34) or ≥2 falls ( n = 57). Participants with a Mini Mental State Examination score of around 10 points were most prone to fall. In adjusted regression models, good nutritional status, good physical functioning, and use of antihypertensive medication (incident rate ratio [IRR] 0.68, 95% confidence interval [CI] 0.54-0.85) protected against falls, whereas fall history (IRR 2.71, 95% CI 2.13-3.44), osteoarthritis, diabetes mellitus, chronic obstructive pulmonary disease, higher number of drugs, drugs with anticholinergic properties, psychotropics, and opioids (IRR 4.27, 95% CI 2.92-6.24) were risk factors for falls. Our study provides a detailed account on how and why people with AD fall, suggesting several risk and protective factors.

How Do Community-Dwelling Persons with Alzheimer Disease Fall? Falls in the FINALEX Study

PubMed Central

Perttila, Niko M.; Öhman, Hannareeta; Strandberg, Timo E.; Kautiainen, Hannu; Raivio, Minna; Laakkonen, Marja-Liisa; Savikko, Niina; Tilvis, Reijo S.; Pitkala, Kaisu H.

2017-01-01

Background People with dementia are at high risk for falls. However, little is known of the features causing falls in Alzheimer disease (AD). Our aim was to investigate how participants with AD fall. Methods In the FINALEX (Finnish Alzheimer Disease Exercise Trial) study, participants' (n = 194) falls were followed up for 1 year by diaries kept by their spouses. Results The most common reason for falls (n = 355) was stumbling (n = 61). Of the falls, 123 led to injuries, 50 to emergency department visits, and 13 to fractures. The participants without falls (n = 103) were younger and had milder dementia than those with 1 (n = 34) or ≥2 falls (n = 57). Participants with a Mini Mental State Examination score of around 10 points were most prone to fall. In adjusted regression models, good nutritional status, good physical functioning, and use of antihypertensive medication (incident rate ratio [IRR] 0.68, 95% confidence interval [CI] 0.54–0.85) protected against falls, whereas fall history (IRR 2.71, 95% CI 2.13–3.44), osteoarthritis, diabetes mellitus, chronic obstructive pulmonary disease, higher number of drugs, drugs with anticholinergic properties, psychotropics, and opioids (IRR 4.27, 95% CI 2.92–6.24) were risk factors for falls. Conclusions Our study provides a detailed account on how and why people with AD fall, suggesting several risk and protective factors. PMID:28690633

Psychotropic drug initiation or increased dosage and the acute risk of falls: a prospective cohort study of nursing home residents

PubMed Central

2013-01-01

Background Previous studies suggest that psychotropic drug changes may signal an acute period of time whereby a person is highly vulnerable to fall. It is unknown whether certain classes of psychotropic agents are less safe with respect to the acute risk of falls. Our purpose was to compare fall rates in the 7 days following a change of an antidepressant, antipsychotic, or benzodiazepine. We also identified specific times when residents are at high risk for falls with respect to a psychotropic drug change. Methods Residents in our one-year study included 851 long term care residents from two nursing home facilities in Boston, MA, U.S.A. (May 2010 - May 2011). Drug changes (i.e., new prescriptions or increased dose of a previously used drug) were ascertained using the computerized provider order entry system, whereas falls were ascertained by incident reports. Negative binomial regression was used to compare the rate of falls following a drug change between medication classes. Further, we calculated the rate of falls for each of the 7 days before and 7 days after a psychotropic drug change. Results Forty-eight percent of residents were prescribed a new prescription or increased dose of a psychotropic drug during the study. The rate of falls was similar in the 7 days following a change to a SSRI versus non-SSRI antidepressant (11.9 versus 14.4 falls/1,000 person years; p = 0.58), a typical versus an atypical antipsychotic (25.4 versus 17.1 falls/1,000 person years; p = 0.10), or a short versus long acting benzodiazepine (15.2 versus 13.9 falls/1,000 person years; p = 0.23). Fall risk was highest on day 4 before the drug change (19.0 falls/1,000 person days), on the day of the drug change through 2 days after the drug change (17.6-20.3 falls/1,000 person days), and 5-6 days after the drug change (17.6-19.0 falls/1,000 person days). Conclusions In the nursing home, risk of falls was similar following a psychotropic drug change of any class. We observed higher fall risk in the days before, but mostly after the drug change. We recommend that nursing home residents be closely monitored following a psychotropic drug change in an effort to reduce falls. PMID:23432790

Probing parton dynamics of QCD matter with Ω and ϕ production

NASA Astrophysics Data System (ADS)

Adamczyk, L.; Adkins, J. K.; Agakishiev, G.; Aggarwal, M. M.; Ahammed, Z.; Alekseev, I.; Aparin, A.; Arkhipkin, D.; Aschenauer, E. C.; Attri, A.; Averichev, G. S.; Bai, X.; Bairathi, V.; Bellwied, R.; Bhasin, A.; Bhati, A. K.; Bhattarai, P.; Bielcik, J.; Bielcikova, J.; Bland, L. C.; Bordyuzhin, I. G.; Bouchet, J.; Brandenburg, J. D.; Brandin, A. V.; Bunzarov, I.; Butterworth, J.; Caines, H.; Calderón de la Barca Sánchez, M.; Campbell, J. M.; Cebra, D.; Chakaberia, I.; Chaloupka, P.; Chang, Z.; Chatterjee, A.; Chattopadhyay, S.; Chen, J. H.; Chen, X.; Cheng, J.; Cherney, M.; Christie, W.; Contin, G.; Crawford, H. J.; Das, S.; De Silva, L. C.; Debbe, R. R.; Dedovich, T. G.; Deng, J.; Derevschikov, A. A.; di Ruzza, B.; Didenko, L.; Dilks, C.; Dong, X.; Drachenberg, J. L.; Draper, J. E.; Du, C. M.; Dunkelberger, L. E.; Dunlop, J. C.; Efimov, L. G.; Engelage, J.; Eppley, G.; Esha, R.; Evdokimov, O.; Eyser, O.; Fatemi, R.; Fazio, S.; Federic, P.; Fedorisin, J.; Feng, Z.; Filip, P.; Fisyak, Y.; Flores, C. E.; Fulek, L.; Gagliardi, C. A.; Garand, D.; Geurts, F.; Gibson, A.; Girard, M.; Greiner, L.; Grosnick, D.; Gunarathne, D. S.; Guo, Y.; Gupta, S.; Gupta, A.; Guryn, W.; Hamad, A. I.; Hamed, A.; Haque, R.; Harris, J. W.; He, L.; Heppelmann, S.; Heppelmann, S.; Hirsch, A.; Hoffmann, G. W.; Horvat, S.; Huang, T.; Huang, X.; Huang, B.; Huang, H. Z.; Huck, P.; Humanic, T. J.; Igo, G.; Jacobs, W. W.; Jang, H.; Jentsch, A.; Jia, J.; Jiang, K.; Judd, E. G.; Kabana, S.; Kalinkin, D.; Kang, K.; Kauder, K.; Ke, H. W.; Keane, D.; Kechechyan, A.; Khan, Z. H.; Kikoła, D. P.; Kisel, I.; Kisiel, A.; Kochenda, L.; Koetke, D. D.; Kosarzewski, L. K.; Kraishan, A. F.; Kravtsov, P.; Krueger, K.; Kumar, L.; Lamont, M. A. C.; Landgraf, J. M.; Landry, K. D.; Lauret, J.; Lebedev, A.; Lednicky, R.; Lee, J. H.; Li, X.; Li, C.; Li, X.; Li, Y.; Li, W.; Lin, T.; Lisa, M. A.; Liu, F.; Ljubicic, T.; Llope, W. J.; Lomnitz, M.; Longacre, R. S.; Luo, X.; Ma, R.; Ma, G. L.; Ma, Y. G.; Ma, L.; Magdy, N.; Majka, R.; Manion, A.; Margetis, S.; Markert, C.; Matis, H. S.; McDonald, D.; McKinzie, S.; Meehan, K.; Mei, J. C.; Minaev, N. G.; Mioduszewski, S.; Mishra, D.; Mohanty, B.; Mondal, M. M.; Morozov, D. A.; Mustafa, M. K.; Nandi, B. K.; Nasim, Md.; Nayak, T. K.; Nigmatkulov, G.; Niida, T.; Nogach, L. V.; Noh, S. Y.; Novak, J.; Nurushev, S. B.; Odyniec, G.; Ogawa, A.; Oh, K.; Okorokov, V. A.; Olvitt, D.; Page, B. S.; Pak, R.; Pan, Y. X.; Pandit, Y.; Panebratsev, Y.; Pawlik, B.; Pei, H.; Perkins, C.; Pile, P.; Pluta, J.; Poniatowska, K.; Porter, J.; Posik, M.; Poskanzer, A. M.; Pruthi, N. K.; Putschke, J.; Qiu, H.; Quintero, A.; Ramachandran, S.; Raniwala, S.; Raniwala, R.; Ray, R. L.; Ritter, H. G.; Roberts, J. B.; Rogachevskiy, O. V.; Romero, J. L.; Ruan, L.; Rusnak, J.; Rusnakova, O.; Sahoo, N. R.; Sahu, P. K.; Sakrejda, I.; Salur, S.; Sandweiss, J.; Sarkar, A.; Schambach, J.; Scharenberg, R. P.; Schmah, A. M.; Schmidke, W. B.; Schmitz, N.; Seger, J.; Seyboth, P.; Shah, N.; Shahaliev, E.; Shanmuganathan, P. V.; Shao, M.; Sharma, A.; Sharma, B.; Sharma, M. K.; Shen, W. Q.; Shi, Z.; Shi, S. S.; Shou, Q. Y.; Sichtermann, E. P.; Sikora, R.; Simko, M.; Singha, S.; Skoby, M. J.; Smirnov, N.; Smirnov, D.; Solyst, W.; Song, L.; Sorensen, P.; Spinka, H. M.; Srivastava, B.; Stanislaus, T. D. S.; Stepanov, M.; Stock, R.; Strikhanov, M.; Stringfellow, B.; Sumbera, M.; Summa, B.; Sun, Z.; Sun, X. M.; Sun, Y.; Surrow, B.; Svirida, D. N.; Tang, Z.; Tang, A. H.; Tarnowsky, T.; Tawfik, A.; Thäder, J.; Thomas, J. H.; Timmins, A. R.; Tlusty, D.; Todoroki, T.; Tokarev, M.; Trentalange, S.; Tribble, R. E.; Tribedy, P.; Tripathy, S. K.; Tsai, O. D.; Ullrich, T.; Underwood, D. G.; Upsal, I.; Van Buren, G.; van Nieuwenhuizen, G.; Vandenbroucke, M.; Varma, R.; Vasiliev, A. N.; Vertesi, R.; Videbæk, F.; Vokal, S.; Voloshin, S. A.; Vossen, A.; Wang, F.; Wang, G.; Wang, J. S.; Wang, H.; Wang, Y.; Wang, Y.; Webb, G.; Webb, J. C.; Wen, L.; Westfall, G. D.; Wieman, H.; Wissink, S. W.; Witt, R.; Wu, Y.; Xiao, Z. G.; Xie, W.; Xie, G.; Xin, K.; Xu, Y. F.; Xu, Q. H.; Xu, N.; Xu, H.; Xu, Z.; Xu, J.; Yang, S.; Yang, Y.; Yang, Y.; Yang, C.; Yang, Y.; Yang, Q.; Ye, Z.; Ye, Z.; Yepes, P.; Yi, L.; Yip, K.; Yoo, I.-K.; Yu, N.; Zbroszczyk, H.; Zha, W.; Zhang, X. P.; Zhang, Y.; Zhang, J.; Zhang, J.; Zhang, S.; Zhang, S.; Zhang, Z.; Zhang, J. B.; Zhao, F.; Zhao, J.; Zhong, C.; Zhou, L.; Zhu, X.; Zoulkarneeva, Y.; Zyzak, M.; STAR Collaboration

2016-02-01

We present measurements of Ω and ϕ production at midrapidity from Au+Au collisions at nucleon-nucleon center-of-mass energies √{sN N}=7.7 , 11.5 , 19.6 , 27, and 39 GeV by the STAR experiment at the BNL Relativistic Heavy Ion Collider (RHIC). Motivated by the coalescence formation mechanism for these strange hadrons, we study the ratios of N (Ω-+Ω¯+) /[2 N (ϕ ) ] . These ratios as a function of transverse momentum pT fall on a consistent trend at high collision energies, but start to show deviations in peripheral collisions at √{sN N}=19.6 , 27, and 39 GeV, and in central collisions at 11.5 GeV in the intermediate pT region of 2.4 -3.6 GeV/c . We further evaluate empirically the strange quark pT distributions at hadronization by studying the Ω /ϕ ratios scaled by the number of constituent quarks (NCQ). The NCQ-scaled Ω /ϕ ratios show a suppression of strange quark production in central collisions at 11.5 GeV compared to √{sN N}≥19.6 GeV. The shapes of the presumably thermal strange quark distributions in 0-60% most central collisions at 7.7 GeV show significant deviations from those in 0-10% most central collisions at higher energies. These features suggest that there is likely a change of the underlying strange quark dynamics in the transition from quark matter to hadronic matter at collision energies below 19.6 GeV.

Probing parton dynamics of QCD matter with Ω and Φ production

DOE PAGES

Adamczyk, L.

2016-02-24

In this paper, we present measurements of Ω and Φ production at midrapidity from Au+Au collisions at nucleon-nucleon center-of-mass energies √sNN = 7.7, 11.5, 19.6 , 27, and 39 GeV by the STAR experiment at the BNL Relativistic Heavy Ion Collider (RHIC). Motivated by the coalescence formation mechanism for these strange hadrons, we study the ratios of N(Ω - +more » $$\\overline{Ω}$$ +) / [2N (Φ)] . These ratios as a function of transverse momentum p T fall on a consistent trend at high collision energies, but start to show deviations in peripheral collisions at √sNN = 19.6, 27, and 39 GeV, and in central collisions at 11.5 GeV in the intermediate p T region of 2.4 - 3.6 GeV/ . We further evaluate empirically the strange quark p T distributions at hadronization by studying the Ω/Φ ratios scaled by the number of constituent quarks (NCQ). The NCQ-scaled Ω/Φ ratios show a suppression of strange quark production in central collisions at 11.5 GeV compared to √sNN ≥ 19.6 GeV. The shapes of the presumably thermal strange quark distributions in 0–60% most central collisions at 7.7 GeV show significant deviations from those in 0–10% most central collisions at higher energies. Lastly, these features suggest that there is likely a change of the underlying strange quark dynamics in the transition from quark matter to hadronic matter at collision energies below 19.6 GeV.« less

InfoDOMAIN. Fall 2011

DTIC Science & Technology

2011-09-01

magazine of Navy Cyber Forces that promotes the advancement of Information Dominance through an open exchange of better practices, tactics, and... Information Dominance Corps is central to that effort. For the Department of Defense and the Navy to operate freely within the cyber domain, we must...Officer (CIO) Division on the staff of the Deputy Chief of Naval Operations for Information Dominance (OPNAV N2/N6). Fleet assignments include combat

Power Lines: The Rhetoric of Maps as Social Change in the Post-Cold War Landscape

ERIC Educational Resources Information Center

Barney, Timothy

2009-01-01

After the fall of the Berlin Wall and the collapse of state socialism in Eastern and Central Europe, cartographers were faced with choices on how the new post-Cold War political landscape would be mapped. One such group called the Pluto Project had been producing atlases since 1981 with a progressive point of view about the nature of state power…

Evaluation of Animal Hazard to Spot-Seeded White Ash In Central Tennessee

Treesearch

T.E. Russell

1976-01-01

Screen protection of seedspots more than doubled white ash seedling establishnient on forested sites of the Cumberland Plateau. For 3 years seeds were sown in fall and spring and given either no protection, or covered with 1-inch mesh screen, or covered with ¼-inch mesh hardware cloth. Unprotected seeds and those covered with 1-inch mesh screen suffered heavy...

77 FR 41975 - Central Vermont Public Service Corporation; Green Mountain Power Corporation; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

...-031, 2399-037, 2400-033, 2445- 024, 2489-046, 2490-028, 2558-032, 2731-042, 2737-022, 11475-015, 11478..., Vermont. 2399 Arnold Falls Passumpsic River in Caledonia Hydroelectric. County, Vermont. 2400 Passumpsic...- 12766-004, P-2490-028, P-2731-042, P-2396-034, P-2397-031, P-2399-037, P-2400-033, P-2445-024, P-2489...

An Analysis of Medical Imaging Costs in Military Treatment Facilities

DTIC Science & Technology

2014-09-01

authority to completely control the medical systems of each service, the DHA 7 was given management responsibility for specific shared services , functions...efficient health operations through enhanced enterprise-wide shared services . • Deliver more comprehensive primary care and integrated health...of shared services that will fall under central control: • facility planning • medical logistics • health information technology • Tricare health

Planning for Life: Program Guidebook. Career Planning: Definitions, Improvement Ideas and Self-Review Process, Application Guidelines.

ERIC Educational Resources Information Center

National Consortium of State Career Guidance Supervisors, Columbus, OH.

Career and life planning are central to education and provide a unifying focus for school guidance efforts. There is growing evidence that individuals who have goals and dreams often attain them, while those who set no objectives in life frequently fall short of their potential. This guidebook was prepared for schools and institutions to use to…