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Sample records for effective falls prevention

  1. Effectiveness of team training on fall prevention.

    PubMed

    Spiva, LeeAnna; Robertson, Bethany; Delk, Marcia L; Patrick, Sara; Kimrey, Margaret Michelle; Green, Beverly; Gallagher, Erin

    2014-01-01

    A longitudinal, repeated-measures design with intervention and comparison groups was used to evaluate the effect of a training curriculum based on TeamSTEPPS with video vignettes focusing on fall prevention. Questionnaires, behavioral observations, and fall data were collected over 9 months from both groups located at separate hospitals. The intervention group questionnaire scores improved on all measures except teamwork perception, while observations revealed an improvement in communication compared with the control group. Furthermore, a 60% fall reduction rate was reported in the intervention group. Team training may be a promising intervention to reduce falls.

  2. Preventing falls

    MedlinePlus

    Dalbaere K, Sherrington C, Lord SR. Falls prevention interventions. In: Marchus R, Feldman D, Depmster DW, Luckey M, Cauley JA, eds. Osteoporosis . 4th ed. Philadelphia, PA: Elsevier; 2013:chap 70. Rubenstein ...

  3. Effects of a multifactorial fall prevention program on balance, gait, and fear of falling in post-stroke inpatients.

    PubMed

    Jung, Younuk; Lee, Kyeongbong; Shin, Seonhae; Lee, Wanhee

    2015-06-01

    [Purpose] This study investigated the effects of a multifactorial fall prevention program on balance, gait, and fear of falling in stroke patients. [Subjects] Twenty-five stroke patients were divided randomly into multifactorial fall prevention program group (n=15) and control treadmill group (n=10). [Methods] All interventions were applied for 30 min, five times per week, for five weeks. The fall prevention program included interventions based on the "Step Up to Stop Falls" initiative and educational interventions based on the Department of Health guidelines. For those in the treadmill group, the speed was increased gradually. The Korean falls efficacy scale and Korean activities-specific balance confidence scale were used to assess fear of falling. To assess balance and walking ability, the Korean performance-oriented mobility assessment scale and the 10-m and 6-minute walk tests were used. [Results] The fall prevention program interventions were found to be very effective at improving gait, balance, and fear of falling compared with the treadmill intervention and therefore seem appropriate for stroke patients. [Conclusion] A multifactorial fall prevention program is effective at improving balance, gait ability, and fear of falling. It is a more specific and broad intervention for reducing falls among inpatients in facilities and hospitals.

  4. Effects of a multifactorial fall prevention program on balance, gait, and fear of falling in post-stroke inpatients

    PubMed Central

    Jung, Younuk; Lee, Kyeongbong; Shin, Seonhae; Lee, Wanhee

    2015-01-01

    [Purpose] This study investigated the effects of a multifactorial fall prevention program on balance, gait, and fear of falling in stroke patients. [Subjects] Twenty-five stroke patients were divided randomly into multifactorial fall prevention program group (n=15) and control treadmill group (n=10). [Methods] All interventions were applied for 30 min, five times per week, for five weeks. The fall prevention program included interventions based on the “Step Up to Stop Falls” initiative and educational interventions based on the Department of Health guidelines. For those in the treadmill group, the speed was increased gradually. The Korean falls efficacy scale and Korean activities-specific balance confidence scale were used to assess fear of falling. To assess balance and walking ability, the Korean performance-oriented mobility assessment scale and the 10-m and 6-minute walk tests were used. [Results] The fall prevention program interventions were found to be very effective at improving gait, balance, and fear of falling compared with the treadmill intervention and therefore seem appropriate for stroke patients. [Conclusion] A multifactorial fall prevention program is effective at improving balance, gait ability, and fear of falling. It is a more specific and broad intervention for reducing falls among inpatients in facilities and hospitals. PMID:26180337

  5. 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,…

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

    ERIC Educational Resources Information Center

    Jang, Miseon; Lee, Yeunsook

    2015-01-01

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

  7. [Is vitamin D supplementation effective for the prevention of falls in elderly people?].

    PubMed

    Scheel, Franco; Carrasco, Marcela

    2016-01-26

    Falls in elderly people are common and come with important effects on morbidity and mortality, dependence and institutionalization. It has been proposed that supplementation of vitamin D could prevent the occurrence of this event. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 18 systematic reviews including 31 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded the use of vitamin D probably leads to little or no difference in the risk of falling in elderly people.

  8. [Is vitamin D supplementation effective for the prevention of falls in elderly people?].

    PubMed

    Scheel, Franco; Carrasco, Marcela

    2016-01-01

    Falls in elderly people are common and come with important effects on morbidity and mortality, dependence and institutionalization. It has been proposed that supplementation of vitamin D could prevent the occurrence of this event. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 18 systematic reviews including 31 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded the use of vitamin D probably leads to little or no difference in the risk of falling in elderly people. PMID:26817676

  9. Fall prevention conceptual framework.

    PubMed

    Abraham, Sam

    2011-01-01

    Falls can have lasting psychological and physical consequences, particularly fractures and slow-healing processes, and patients may also lose confidence in walking. Injuries from falls lead to functional decline, institutionalization, higher health care costs, and decreased quality of life. The process related to the problem of patient falls in the hospital, using the nursing model developed by the theorist, Ida Jean Orlando, is explained in this article. The useful tool that provides guidance to marketers in this endeavor is Maslow's hierarchy of needs. During acute illness, individuals are greatly in need of satisfying their physiological needs. If these needs are not met, patients leave the hospital lacking a positive experience. Initial fall risk assessment is critical to plan intervention and individualize care plan. Interventions depend on the severity of fall risk factors.

  10. Exercises to help prevent falls

    MedlinePlus

    ... D, Dempster DW, Luckey M, Cauley J, eds. Osteoporosis . 4th ed. Philadelphia, PA: Elsevier; 2013:chap 70. Donath L, van Dieen J, Faude O. Exercise-based fall prevention in the elderly: what about ...

  11. [Prevention programs of risk factors for falls].

    PubMed

    Kumagai, Shuzo; Sakita, Masahiro

    2014-10-01

    Approximately 17% of Japanese older people fall for a year. The femoral neck fractures with falls caused by various functional problems make them depress remarkably activities of daily living and quality of life. In risk factors for falls in old people, muscle weakness, balance and gait disorders particularly increases to falls. The major results from recent systematic reviews have indicated that interventions of exercise, multifactorial, environmental modification and gradual withdrawal of psychotropic medication in community-dwelling elderly people were effective for preventing falls. Regarding the older people in hospitals and sanatoriums, it appeared that comprehensive multifactorial interventions and vitamin D supplementation could be effective in falls rather than exercises intervention only. However, the short period of the exercise intervention may affect ineffectiveness in preventing falls.

  12. Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects

    PubMed Central

    2010-01-01

    Preventing falls and fall-related fractures in the elderly is an objective yet to be reached. There is increasing evidence that a supplementation of vitamin D and/or of calcium may reduce the fall and fracture rates. A vitamin D-calcium supplement appears to have a high potential due to its simple application and its low cost. However, published studies have shown conflicting results as some studies failed to show any effect, while others reported a significant decrease of falls and fractures. Through a 15-year literature overview, and after a brief reminder on mechanism of falls in older adults, we reported evidences for a vitamin D action on postural adaptations - i.e., muscles and central nervous system - which may explain the decreased fall and bone fracture rates and we underlined the reasons for differences and controversies between published data. Vitamin D supplementation should thus be integrated into primary and secondary fall prevention strategies in older adults. PMID:20937091

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

    PubMed Central

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

    2008-01-01

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

  14. Review of Tai Chi as an effective exercise on falls prevention in elderly.

    PubMed

    Schleicher, Molly M; Wedam, Lauren; Wu, Ge

    2012-01-01

    The risk of accidental falls and fall-related injuries increases with age. Regular physical exercises can delay the age-related changes affecting postural balance and reduce the risk of falls. Although Tai Chi (TC) has become a popular exercise among the elderly, does regular TC exercise lead to fewer falls and fall-related injuries? Who would receive the most benefit from TC exercise? What style of TC is best for fall risk reductions? What is the minimum amount of TC exercise needed before its positive effect is observed? How does the effect of TC exercise compare to other physical exercises? The goal of this study is to conduct a systematic review of recent literature on TC's effectiveness for reducing fall risks in elders. A summary and analysis is provided for the following variables: targeted subject population, TC curriculum, comparative effect, and outcome measures.

  15. Osteosarcopenic obesity and fall prevention strategies.

    PubMed

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

    2015-02-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  18. Fall prevention in hospitals: an integrative review.

    PubMed

    Spoelstra, Sandra L; Given, Barbara A; Given, Charles W

    2012-02-01

    This article summarizes research and draws overall conclusions from the body of literature on fall prevention interventions to provide nurse administrators with a basis for developing evidence-based fall prevention programs in the hospital setting. Data are obtained from published studies. Thirteen articles are retrieved that focused on fall interventions in the hospital setting. An analysis is performed based on levels of evidence using an integrative review process. Multifactoral fall prevention intervention programs that included fall-risk assessments, door/bed/patient fall-risk alerts, environmental and equipment modifications, staff and patient safety education, medication management targeted to specific types, and additional assistance with transfer and toileting demonstrate reduction in both falls and fall injuries in hospitalized patients. Hospitals need to reduce falls by using multifactoral fall prevention programs using evidence-based interventions to reduce falls and injuries.

  19. Fall TIPS: strategies to promote adoption and use of a fall prevention toolkit.

    PubMed

    Dykes, Patricia C; Carroll, Diane L; Hurley, Ann; Gersh-Zaremski, Ronna; Kennedy, Ann; Kurowski, Jan; Tierney, Kim; Benoit, Angela; Chang, Frank; Lipsitz, Stuart; Pang, Justine; Tsurkova, Ruslana; Zuyov, Lyubov; Middleton, Blackford

    2009-11-14

    Patient falls are serious problems in hospitals. Risk factors for falls are well understood and nurses routinely assess for fall risk on all hospitalized patients. However, the link from nursing assessment of fall risk, to identification and communication of tailored interventions to prevent falls is yet to be established. The Fall TIPS (Tailoring Interventions for Patient Safety) Toolkit was developed to leverage existing practices and workflows and to employ information technology to improve fall prevention practices. The purpose of this paper is to describe the Fall TIPS Toolkit and to report on strategies used to drive adoption of the Toolkit in four acute care hospitals. Using the IHI "Framework for Spread" as a conceptual model, the research team describes the "spread" of the Fall TIPS Toolkit as means to integrate effective fall prevention practices into the workflow of interdisciplinary caregivers, patients and family members.

  20. Preventing falls and fall-related injuries in hospitals.

    PubMed

    Oliver, David; Healey, Frances; Haines, Terry P

    2010-11-01

    Falls are a widespread concern in hospitals settings, with whole hospital rates of between 3 and 5 falls per 1000 bed-days representing around a million inpatient falls occurring in the United States each year. Between 1% and 3% of falls in hospitals result in fracture, but even minor injuries can cause distress and delay rehabilitation. Risk factors most consistently found in the inpatient population include a history of falling, muscle weakness, agitation and confusion, urinary incontinence or frequency, sedative medication, and postural hypotension. Based on systematic reviews, recent research, and clinical and ethical considerations, the most appropriate approach to fall prevention in the hospital environment includes multifactorial interventions with multiprofessional input. There is also some evidence that delirium avoidance programs, reducing sedative and hypnotic medication, in-depth patient education, and sustained exercise programs may reduce falls as single interventions. There is no convincing evidence that hip protectors, movement alarms, or low-low beds reduce falls or injury in the hospital setting. International approaches to developing and maintaining a fall prevention program suggest that commitment of management and a range of clinical and support staff is crucial to success.

  1. Patient Engagement in Hospital Fall Prevention.

    PubMed

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2015-01-01

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

  2. Falls Prevention: Unique to Older Adults

    MedlinePlus

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

  3. Prevention of construction falls by organizational intervention

    PubMed Central

    Becker, P; Fullen, M; Akladios, M; Hobbs, G

    2001-01-01

    Objectives—Determine if a university based (third party) intervention can improve construction contractor organizational performance to increase use of fall prevention practices and technologies. Setting—Falls are the leading cause of worker injury and death in the construction industry. Equipment and practices that can prevent falls are often not used appropriately in the dynamic construction work environment. Methods—A contractual partnership between a university and construction contractors created management systems to ensure use of fall protection measures. Audits by university faculty provided accountability for implementing the fall prevention system. Evaluation was conducted by quasiexperimental methodology comparing changes in audit score from baseline to fifth quarter from baseline for intervention and control contractors. Results—Audit scores improvement was greater for intervention than for control contractor group. Conclusion—A third party intervention can improve contractor fall prevention performance. PMID:11565975

  4. [Improving fall prevention in the elderly].

    PubMed

    Bongue, Bienvenu; Hugues, Julie; Achour, Émilie; Colvez, Alain; Sass, Catherine

    2016-01-01

    The prevention of falls in the elderly requires action on several levels. Firstly, it is essential to identify those at risk of a fall. They must then be encouraged to do appropriate physical and sports activities, a factor of prevention. Social workers have a major role to play in supporting elderly people and encouraging them to participate in such programmes. PMID:27449306

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

    PubMed

    Parsons, Lynn C; Revell, Maria A

    2015-12-01

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

  6. Assessment and prevention of falls in older people.

    PubMed

    Barker, Wendy

    2014-07-01

    In June 2013 the National Institute for Health and Care Excellence updated and replaced its 2004 clinical guideline 21 (CG21) on falls with clinical guideline 161 (CG161). Two priorities were outlined in the latter: preventing falls in older people (unchanged from CG21) and preventing falls in older people during a hospital stay (new). CG161 is for health and social care clinicians who care for older people who have fallen or who are at risk of falling. It provides clinicians and commissioners with evidence to implement effective care pathways and recommendations on the assessment and prevention of falls in older people. The amalgamation of the two guidelines has resulted in some disconnection. This article summarises the evidence and supports clinicians in the interpretation of the revised falls guideline.

  7. Influences on modern multifactorial falls prevention interventions and fear of falling in non-frail older adults: a literature review.

    PubMed

    Svantesson, Ulla; Babagbemi, Buki; Foster, Lakicia; Alricsson, Marie

    2014-10-01

    This review explores underlying features that may influence fear of falling and the effectiveness of multifactorial falls prevention programs in community dwelling non-frail adults aged 65 and older. It also examines the interrelationship between fear of falling and multifactorial falls prevention interventions. A literature search of medical databases was conducted to identify articles that address the fear of falling and multifactorial programs as either a primary or secondary component of their findings. Multifactorial interventions were assessed in terms of their program content, design, demographics, implementation techniques, and cost-effectiveness. Falls are a common, but preventable, cause of morbidity and injury in older adults 65 and over. In addition to physiological variables, fear of falling and self-efficacy are psychosocial factors that impact the incidence of falls in this population. Addressing fear of falling in addition to physiological parameters may influence the success of multifactorial falls prevention programs for adults 65 and over.

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

    PubMed Central

    2013-01-01

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

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

    PubMed

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

    2015-07-01

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

  10. Exercise for falls prevention in Parkinson disease

    PubMed Central

    Sherrington, Catherine; Lord, Stephen R.; Close, Jacqueline C.T.; Heritier, Stephane; Heller, Gillian Z.; Howard, Kirsten; Allen, Natalie E.; Latt, Mark D.; Murray, Susan M.; O'Rourke, Sandra D.; Paul, Serene S.; Song, Jooeun; Fung, Victor S.C.

    2015-01-01

    Objective: To determine whether falls can be prevented with minimally supervised exercise targeting potentially remediable fall risk factors, i.e., poor balance, reduced leg muscle strength, and freezing of gait, in people with Parkinson disease. Methods: Two hundred thirty-one people with Parkinson disease were randomized into exercise or usual-care control groups. Exercises were practiced for 40 to 60 minutes, 3 times weekly for 6 months. Primary outcomes were fall rates and proportion of fallers during the intervention period. Secondary outcomes were physical (balance, mobility, freezing of gait, habitual physical activity), psychological (fear of falling, affect), and quality-of-life measures. Results: There was no significant difference between groups in the rate of falls (incidence rate ratio [IRR] = 0.73, 95% confidence interval [CI] 0.45–1.17, p = 0.18) or proportion of fallers (p = 0.45). Preplanned subgroup analysis revealed a significant interaction for disease severity (p < 0.001). In the lower disease severity subgroup, there were fewer falls in the exercise group compared with controls (IRR = 0.31, 95% CI 0.15–0.62, p < 0.001), while in the higher disease severity subgroup, there was a trend toward more falls in the exercise group (IRR = 1.61, 95% CI 0.86–3.03, p = 0.13). Postintervention, the exercise group scored significantly (p < 0.05) better than controls on the Short Physical Performance Battery, sit-to-stand, fear of falling, affect, and quality of life, after adjusting for baseline performance. Conclusions: An exercise program targeting balance, leg strength, and freezing of gait did not reduce falls but improved physical and psychological health. Falls were reduced in people with milder disease but not in those with more severe Parkinson disease. Classification of evidence: This study provides Class III evidence that for patients with Parkinson disease, a minimally supervised exercise program does not reduce fall risk. This study lacked

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

    PubMed Central

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

    2000-01-01

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

  12. [Policy recommendations for the implementation of fall and fracture prevention in community-dwelling older persons].

    PubMed

    Vlaeyen, Ellen; Etienne, Jan; Geeraerts, Annelies; Leysens, Greet; Dejaeger, Eddy; Milisen, Koen

    2016-09-01

    Several factors impede the implementation of effective strategies for fall and fracture prevention. The Centre of Expertise for Fall & Fracture prevention Flanders organized a symposium, "Implementation of fall en fracture prevention in older people", with the aim to elaborate on the facilitation of effective strategies for falls and fall-related injuries in community-dwelling older people in Flanders. This article summarizes the main bottlenecks for implementation and provides recommendations for optimizing dissemination and implementation. PMID:27549629

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

    ERIC Educational Resources Information Center

    Uymaz, Pelin E.; Nahcivan, Nursen O.

    2016-01-01

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

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

    PubMed Central

    OHDO, Katsutoshi; HINO, Yasumichi; TAKAHASHI, Hiroki

    2014-01-01

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

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

    PubMed Central

    Ghasemi, Marziyeh; RezaeiDehaghani, Abdollah; Mehrabi, Tayebeh

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Factors associated with the completion of falls prevention program.

    PubMed

    Batra, Anamica; Page, Timothy; Melchior, Michael; Seff, Laura; Vieira, Edgar Ramos; Palmer, Richard C

    2013-12-01

    Falls and fear of falling can affect independence and quality of life of older adults. Falls prevention programs may help avoiding these issues if completed. Understanding factors that are associated with completion of falls prevention programs is important. To reduce fear of falling and increase activity levels, a Matter of Balance (MOB) and un Asunto de Equilibrio (ADE) workshops were offered to 3420 older adults in South Florida between 1 October 2008 and 31 December 2011. Workshops were conducted in English or Spanish over eight, 2-hour sessions. Participants completed a demographic and a pre-post questionnaire. Factors associated with program completion were identified using logistic regression. For MOB, females were more likely to complete the program (OR = 2.076, P = 0.02). For ADE, females, moderate and extreme interference by falls in social activities were found to affect completion (OR = 2.116, P = 0.001; OR = 2.269, P = 0.003 and OR = 4.133, P = 0.008, respectively). Different factors predicted completion of both programs. Awareness of these factors can help lower the attrition rates, increase benefits and cost effectiveness of program. Future research needs to explore why certain groups had a higher likelihood of completing either program.

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

    MedlinePlus

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

  19. Postpartum safety: a patient-centered approach to fall prevention.

    PubMed

    Lockwood, Suzy; Anderson, Kandace

    2013-01-01

    Falls in the perinatal setting have received minimal attention and have not been well documented. Women are at risk for falling following vaginal or cesarean birth, especially during initial attempts at ambulation. Recently, a women's hospital that averages over 500 births per month recorded a postpartum fall rate that exceeded the national mean for adult surgical patient falls. A fall prevention team (FPT) of five nurses was formed with a goal to decrease the incidence of postpartum patient falls to zero within the following 7 months. A patient-centered fall prevention strategy was developed. The results of this project have laid the foundation for additional research of a program that will consider not only prevention of falls in a healthy population but also the development of a risk assessment tool specific to women in the immediate postpartum period.

  20. Postoperative prevention of falls in older adults with fragility fractures.

    PubMed

    Demontiero, Oddom; Gunawardene, Piumali; Duque, Gustavo

    2014-05-01

    The postoperative period after correction of a fragility fracture is usually associated with functional deconditioning. This deconditioning is caused by multiple factors associated with a higher risk of falls during the immediate postoperative period and after discharge. Identification of risk and appropriate fall prevention interventions in these patients are pivotal. In this article, an overview is presented of the strategies to identify falls risk in postoperative patients after suffering a fragility fracture. Evidence is presented favoring targeted multicomponent intervention for falls prevention rather than a single intervention in fractured older patients at high risk of new falls and fractures.

  1. Integration of Fall Prevention into State Policy in Connecticut

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  2. Development and Process Evaluation of a 5-Week Exercise Program to Prevent Falls in People after Stroke: The FALLS Program

    PubMed Central

    van Duijnhoven, H. J. R.; De Kam, D.; Hellebrand, W.; Smulders, E.; Geurts, A. C. H.; Weerdesteyn, V.

    2012-01-01

    Falls are a common complication after stroke, with balance and gait deficits being the most important risk factors. Taking into account the specific needs and capacities of people with stroke, we developed the FALLS program (FALL prevention after Stroke), based on the “Nijmegen falls prevention program” (a proven-effective 5-week exercise program designed for community-dwelling elderly people). The program was tested in twelve community-dwelling persons with stroke, and a process evaluation was conducted with patients, trainers, health care professionals, and managers. The FALLS program was considered suitable and feasible by people with stroke in the study and relevant health care professionals, and recommendations for implementation in clinical practice have been suggested. PMID:22195292

  3. Community-based falls prevention: lessons from an Interprofessional Mobility Clinic

    PubMed Central

    Bauman, Craig A.; Milligan, James D.; Patel, Tejal; Pritchard, Sarah; Labreche, Tammy; Dillon-Martin, Sharon; Ilich, Alexandra; Riva, John J.

    2014-01-01

    Falls are a common and serious risk with an aging population. Chiropractors commonly see firsthand the effects of falls and resulting injuries in their senior patients and they can reduce falls risk through active screening. Ongoing research has provided proven approaches for making falls less likely. Screening for falls should be done yearly for all patients 65 years and older or in those with a predisposing medical condition. Additional specific falls prevention professional education would enable the chiropractor to best assist these patients. Collaboration and communication with the patient’s family physician offers an opportunity for improved interprofessional dialogue to enhance patient care related to falls risk. Frequently falls prevention strategies are implemented by an interprofessional team. Chiropractors increasingly contribute within multidisciplinary teams. Collaboration by the chiropractor requires both simple screening and knowledge of health care system navigation. Such awareness can permit optimal participation in the care of their patient and the best outcome. PMID:25202159

  4. Engaging Community-Based Organizations in Fall Prevention Education

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Brookes, Andrew

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Stevens, Judy A.

    2003-01-01

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

  7. Tailored prevention of inpatient falls: development and usability testing of the fall TIPS toolkit.

    PubMed

    Zuyev, Lyubov; Benoit, Angela N; Chang, Frank Y; Dykes, Patricia C

    2011-02-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2015-09-01

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

  11. Preventing in-hospital newborn falls: a literature review.

    PubMed

    Matteson, Tara; Henderson-Williams, Audery; Nelson, Jessica

    2013-01-01

    In-hospital newborn falls are arguably one of the most underresearched and underreported issues for organizations that care for newborn patients. From the few published statistics of in-hospital fall rates, we know that perhaps 600 to 1,600 newborn falls occur annually. Many of these falls can result in injury or even death of the newborn, legal issues for the institution, and severe emotional stress to the caregiver(s) and parents. Therefore, we searched the literature to ascertain causation and associated risks associated with in-hospital newborn falls. This is an important issue for nurses to understand because not only can the newborn be harmed due to a fall, but the actual newborn fall can also elicit strong feelings of guilt and culpability in the caregiver(s). This article reviews the literature to examine what is known about the factors associated with in-hospital newborn falls, to explore prevention measures, and to present best practices for how to adopt safe-sleep policy to prevent newborn falls. PMID:24013477

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

    PubMed

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

    2016-09-01

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

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

    PubMed

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

    2016-09-01

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

  14. Fall prevention in our healthiest patients: assessing risk and preventing injury for moms and babies.

    PubMed

    Gaffey, Ann D

    2015-01-01

    Attention is needed in preventing patient falls in newborns and in obstetric units of hospitals. The majority of prenatal, postpartum, and newborn falls are preventable. Little effort has been made to address fall risk during the prenatal period, during labor, and after delivery in the postpartum period for moms and babies. Risk factors for falls in these populations have been identified, and targeted risk assessments and fall prevention interventions have been developed to eliminate these falls. Evidence demonstrates success in reducing falls with a variety of low-cost but high-return initiatives, comprising prenatal education, patient and family engagement, implementation of unique fall risk assessment tools, postpartum mobility assessments, and changes in patient rounding frequency.

  15. Practice Development Section Paper 1 Older People’s Perspectives on Fall Risk and Fall Prevention Programs: A Literature Review

    PubMed Central

    McMahon, Siobhan; Talley, Kristine M.; Wyman, Jean F.

    2011-01-01

    Despite evidence supporting fall prevention methods, fall-related injury and death rates continue to rise. Understanding older people’s views on fall risk and prevention will help nurses and other health professionals in the design of fall prevention strategies that will broaden their scope, reach, and adoption. This literature review synthesized 19 qualitative and quantitative studies examining older people’s perspectives about fall risk and prevention using a social ecological framework. Three themes emerged about fall risk; fearing vulnerability, maintaining autonomy and independence, and interpreting risk. Four themes emerged about fall prevention programs; influence of participant and program characteristics, need for personal relevance and preference, maintaining autonomy and independence, and increased support for and access to programs. Implications for practice include individual, interpersonal, organizational and community level considerations for improving fall prevention efforts. PMID:22078019

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

    PubMed Central

    Delahoz, Yueng Santiago; Labrador, Miguel Angel

    2014-01-01

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

  17. Economic evaluation of a community based exercise programme to prevent falls

    PubMed Central

    Robertson, M; Devlin, N.; Scuffham, P.; Gardner, M.; Buchner, D.; Campbell, A

    2001-01-01

    OBJECTIVE—To assess the incremental costs and cost effectiveness of implementing a home based muscle strengthening and balance retraining programme that reduced falls and injuries in older women.
DESIGN—An economic evaluation carried out within a randomised controlled trial with two years of follow up. Participants were individually prescribed an exercise programme (exercise group, n=116) or received usual care and social visits (control group, n=117).
SETTING—17 general practices in Dunedin, New Zealand.
PARTICIPANTS—Women aged 80 years and older living in the community and invited by their general practitioner to take part.
MAIN OUTCOME MEASURES—Number of falls and injuries related to falls, costs of implementing the intervention, healthcare service costs resulting from falls and total healthcare service costs during the trial. Cost effectiveness was measured as the incremental cost of implementing the exercise programme per fall event prevented.
MAIN RESULTS—27% of total hospital costs during the trial were related to falls. However, there were no significant differences in health service costs between the two groups. Implementing the exercise programme for one and two years respectively cost $314 and $265 (1995 New Zealand dollars) per fall prevented, and $457 and $426 per fall resulting in a moderate or serious injury prevented.
CONCLUSIONS—The costs resulting from falls make up a substantial proportion of the hospital costs for older people. Despite a reduction in falls as a result of this home exercise programme there was no significant reduction in healthcare costs. However, the results reported will provide information on the cost effectiveness of the programme for those making decisions on falls prevention strategies.


Keywords: falls; exercise; elderly PMID:11449021

  18. Insights obtained from an evaluation of a falls prevention program set in a rural hospital.

    PubMed

    Hathaway, J; Walsh, J; Lacey, C; Saenger, H

    2001-08-01

    An evaluation of a Falls Prevention Program that took place in a 29-bed rural hospital in New South Wales is described. The aim of the project was to ascertain the overall effectiveness of the Program and to explore the usefulness of the assessment criteria in predicting falls. The sample consisted of 111 participants, representing all patients 65 years and over who were admitted to the general ward of the hospital between January and December 1997. The Falls Prevention Program had reduced the incidence of falls and was found to be effective for those patients requiring minimal assistance with walking. However, it was less effective for those using pick-up frames or forearm support frames. The patients who fell were more likely to be in the high risk category and it was concluded that while the assessment criteria was useful in predicting falls, the Falls Prevention Program could only limit the number of falls but not prevent them altogether. Age, mental status and mobility of patients in combination with time and location of falls suggested a pattern that was possibly peculiar to this rural hospital, which has implications for funding and staffing.

  19. Exercise and Sports Science Australia position statement on exercise and falls prevention in older people.

    PubMed

    Tiedemann, Anne; Sherrington, Catherine; Close, Jacqueline C T; Lord, Stephen R

    2011-11-01

    Falls affect a significant number of older Australians and present a major challenge to health care providers and health systems. The purpose of this statement is to inform and guide exercise practitioners and health professionals in the safe and effective prescription of exercise for older community-dwelling people with the goal of preventing falls. Falls in older people are not random events but can be predicted by assessing a number of risk factors. Of particular importance are lower limb muscle strength, gait and balance, all of which can be improved with appropriate exercise. There is now extensive evidence to demonstrate that many falls are preventable, with exercise playing a crucial role in prevention. Research evidence has identified that programs which include exercises that challenge balance are more effective in preventing falls than those which do not challenge balance. It is important for exercise to be progressively challenging, ongoing and of sufficient dose to maximise its benefits in reducing falls. Other (non-exercise) interventions are necessary for certain people with complex medical conditions or recent hospitalisation and risk factors relating to vision and the use of psychotropic medications. Qualified exercise professionals are well placed to implement the research evidence and to prescribe and supervise specific exercise aimed at preventing falls in both healthy older community-dwelling people and those with co-morbidities.

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

    PubMed

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

    2007-01-01

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

  1. Implementing an Evidence-Based Fall Prevention Intervention in Community Senior Centers

    PubMed Central

    Harmer, Peter; Fitzgerald, Kathleen

    2016-01-01

    Objectives. To evaluate the impact of implementing an evidence-based fall prevention intervention in community senior centers. Methods. We used a single-group design to evaluate the Tai Ji Quan: Moving for Better Balance (TJQMBB) program’s adoption, population reach, implementation, effectiveness, and maintenance among 36 senior centers in 4 Oregon counties between 2012 and 2016. The primary outcome measure, as part of the effectiveness evaluation, was number of falls as ascertained by self-report. Trained TJQMBB instructors delivered the program to community-dwelling older adults for 48 weeks, with a 6-month postintervention follow-up. Results. TJQMBB was adopted by 89% of the senior centers approached and reached 90% of the target population. The program resulted in a 49% reduction in the total number of falls and improved physical performance. Participation was well maintained after the program’s completion. The average cost-effectiveness ratio for the 48-week program implementation was $917 per fall prevented and $676 per fall prevented for multiple falls. Conclusions. TJQMBB is an effective public health program that can be broadly implemented in community senior centers for primary prevention of falls among community-dwelling older adults. PMID:27631751

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Is there a role for neck manipulation in elderly falls prevention? - An overview.

    PubMed

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

    2015-03-01

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

  6. Falls prevention in persons with intellectual disabilities: development, implementation, and process evaluation of a tailored multifactorial fall risk assessment and intervention strategy.

    PubMed

    Smulders, Ellen; Enkelaar, Lotte; Schoon, Yvonne; Geurts, Alexander C; van Schrojenstein Lantman-de Valk, Henny; Weerdesteyn, Vivian

    2013-09-01

    In the general elderly population, multifactorial screening of fall risks has been shown to be effective. Although persons with intellectual disabilities (ID) fall more often, there appears to be no targeted screening for them. The aim of this study was to develop, implement, and evaluate a falls clinic for persons with ID. Based on guidelines, literature, and expert meetings, a falls clinic for persons with ID was developed. In total, 26 persons with ID and a fall history participated in the study. Process evaluation was conducted with evaluation forms and focus groups. Fifty interventions (0-8 per person) were prescribed. The (para)medical experts, clients, and caregivers described the falls clinic as useful. Advice for improvement included minor changes to clinic content. Logistics were the largest challenge for the falls clinic, for example organizing meetings, completing questionnaires prior to meetings, and ensuring that a personal caregiver accompanied the person with ID. Furthermore, the need for a screening tool to determine whether a person would benefit from the falls clinic was reported. In conclusion, the falls clinic for persons with ID was considered feasible and useful. Some minor content changes are necessary and there is a need for a screening tool. However, logistics concerning the falls clinic need improvement. More attention and time for multifactorial and multidisciplinary treatment of persons with ID is necessary. Implementation on a larger scale would also make it possible to investigate the effectiveness of the falls clinic with regard to the prevention of falls in this population.

  7. The FLASSH study: protocol for a randomised controlled trial evaluating falls prevention after stroke and two sub-studies

    PubMed Central

    Batchelor, Frances A; Hill, Keith D; Mackintosh, Shylie F; Said, Catherine M; Whitehead, Craig H

    2009-01-01

    Background Falls are common in stroke survivors returning home after rehabilitation, however there is currently a lack of evidence about preventing falls in this population. This paper describes the study protocol for the FLASSH (FaLls prevention After Stroke Survivors return Home) project. Methods and design This randomised controlled trial aims to evaluate the effectiveness of a multi-factorial falls prevention program for stroke survivors who are at high risk of falling when they return home after rehabilitation. Intervention will consist of a home exercise program as well as individualised falls prevention and injury minimisation strategies based on identified risk factors for falls. Additionally, two sub-studies will be implemented in order to explore other key areas related to falls in this population. The first of these is a longitudinal study evaluating the relationship between fear of falling, falls and function over twelve months, and the second evaluates residual impairment in gait stability and obstacle crossing twelve months after discharge from rehabilitation. Discussion The results of the FLASSH project will inform falls prevention practice for stroke survivors. If the falls prevention program is shown to be effective, low cost strategies to prevent falls can be implemented for those at risk around the time of discharge from rehabilitation, thus improving safety and quality of life for stroke survivors. The two sub-studies will contribute to the overall understanding and management of falls risk in stroke survivors. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN012607000398404). PMID:19335909

  8. Hand breakaway strength model-effects of glove use and handle shapes on a person's hand strength to hold onto handles to prevent fall from elevation.

    PubMed

    Hur, Pilwon; Motawar, Binal; Seo, Na Jin

    2012-04-01

    This study developed biomechanical models for hand breakaway strength that account for not only grip force but also hand-handle frictional coupling in generation of breakaway strength. Specifically, models for predicting breakaway strength for two commonly-used handle shapes (circular and rectangular handles) and varying coefficients of friction (COF) between the hand and handle were proposed. The models predict that (i) breakaway strength increases with increasing COF and (ii) a circular handle with a 50.8 mm-diameter results in greater mean breakaway strength than a handle with a rectangular cross-section of 38.1 by 38.1 mm for COFs greater than 0.42. To test these model predictions, breakaway strengths of thirteen healthy young adults were measured for three frequently-encountered COF conditions (represented by three glove types of polyester (COF=0.32), bare hand (COF=0.50), and latex (COF=0.74) against an aluminum handle) and for the two handle shapes. Consistent with the model predictions, mean breakaway strength increased with increasing COF and was greater for the circular than rectangular handle for COFs of 0.50 and 0.74. Examination of breakaway strength normalized to body weight reveals that modification of COF and handle shapes could influence whether one can hold his/her body using the hands or not (thus must fall), highlighting the importance of considering these parameters for fall prevention. The biomechanical models developed herein have the potential to be applied to general handle shapes and COF conditions. These models can be used to optimize handle design to maximize breakaway strength and minimize injuries due to falls from ladders or scaffolds.

  9. Inpatient fall prevention programs as a patient safety strategy: a systematic review.

    PubMed

    Miake-Lye, Isomi M; Hempel, Susanne; Ganz, David A; Shekelle, Paul G

    2013-03-01

    Falls are common among inpatients. Several reviews, including 4 meta-analyses involving 19 studies, show that multicomponent programs to prevent falls among inpatients reduce relative risk for falls by as much as 30%. The purpose of this updated review is to reassess the benefits and harms of fall prevention programs in acute care settings and to identify factors associated with successful implementation of these programs. We searched for new evidence using PubMed from 2005 to September 2012. Two new, large, randomized, controlled trials supported the conclusions of the existing meta-analyses. An optimal bundle of components was not identified. Harms were not systematically examined, but potential harms included increased use of restraints and sedating drugs and decreased efforts to mobilize patients. Eleven studies showed that the following themes were associated with successful implementation: leadership support, engagement of front-line staff in program design, guidance of the prevention program by a multidisciplinary committee, pilot-testing interventions, use of information technology systems to provide data about falls, staff education and training, and changes in nihilistic attitudes about fall prevention. Future research would advance knowledge by identifying optimal bundles of component interventions for particular patients and by determining whether effectiveness relies more on the mix of the components or use of certain implementation strategies.

  10. Fall prevention in the elderly: analysis and comprehensive review of methods used in the hospital and in the home.

    PubMed

    Clyburn, Terry A; Heydemann, John A

    2011-07-01

    Falls in the elderly are a significant problem both in and out of the hospital. The Deficit Reduction Act of 2005 and the Fiscal Year 2009 Inpatient Prospective Payment System Final Rule, as outlined by the Centers for Medicare & Medicaid Services, placed on hospitals the financial burden of fall prevention for falls (ie, hospital-acquired conditions) that could have been prevented by following evidence-based guidelines. Multifaceted and individualized programs have been created to prevent falls in the elderly. Many of these interventions are based on expert opinion and statistical trends. Our review of the literature revealed that the risk of fall is only slightly greater in the hospital environment than in the home and that there is no medical evidence that evidence-based guidelines are effective in fall prevention.

  11. Bed-exit alarms. A component (but only a component) of fall prevention.

    PubMed

    2004-05-01

    Patient falls are a common cause of morbidity, nonfatal injuries, and trauma-related hospitalizations in the United States. Sometimes, they're even fatal. Falls typically occur either while the patient is getting into or out of bed or shortly after the patient has exited the bed. One means of helping to reduce the number of patient falls is the bed-exit alarm. Such alarms can be either built-in devices incorporated into the beds themselves or stand-alone units consisting of a portable control unit and a pressure- or position-sensitive sensor. They can serve as an "early warning system" alerting nursing staff when patients attempt to leave their beds unassisted. However, bed-exit alarms do not themselves prevent falls--a fact that is not always clearly understood. To be effective, they need to be implemented with care and with a clear understanding of their limitations. In this article, we describe the types of stand-alone bed-exit alarms currently available on the market and provide guidance to facilities on how to implement them effectively. We also review the elements of an effective fall-prevention program and recount one hospital's success in reducing patient falls. We are in the process of conducting a comparative evaluation of a number of bed-exit alarms, which will be published in an upcoming issue of Health Devices.

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

    PubMed Central

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

    2002-01-01

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

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2011-06-15

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

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

    PubMed Central

    2013-01-01

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

  17. Quantifying Temperature Effects on Fall Chinook Salmon

    SciTech Connect

    Jager, Yetta

    2011-11-01

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

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

    PubMed Central

    HSIAO, Hongwei

    2014-01-01

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

  19. The strategic development of the NSW Health Plan for Prevention of Falls and Harm from Falls Among Older People: 2011-2015; translating research into policy and practice.

    PubMed

    Milat, Andrew J; Monger, Claire; Smith, Joanne; Bauman, Adrian; Redman, Sally; Goodger, Brendan

    2011-06-01

    With our rapidly ageing population there is an urgent imperative to minimise the rate of falls and associated injuries. A key challenge to public health is to better conceptualise and contextualise falls prevention evidence for more effective policy making and practice. This paper describes how NSW Health adopted the Nutbeam and Bauman Stages of Research and Evaluation Model in the strategic development of the NSW Health Plan for Prevention of Falls and Harm from Falls Among Older People: 2011-2015. Research evidence has been comprehensively applied to every stage of the development of the Plan and research and evaluation is a key action area within the new Plan. The Stages of Research and Evaluation Model provides a useful overarching framework for policy makers to contextualise and more effectively apply research evidence throughout the policy making process from problem definition to program monitoring.

  20. Effect of free fall on higher plants.

    NASA Technical Reports Server (NTRS)

    Gordon, S. A.

    1973-01-01

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

  1. The role of culture and diversity in the prevention of falls among older Chinese people.

    PubMed

    Horton, Khim; Dickinson, Angela

    2011-03-01

    This grounded-theory study explored the perceptions of Chinese older people, living in England, on falls and fear of falling, and identified facilitators and barriers to fall prevention interventions. With a sample of 30 Chinese older people, we conducted two focus groups and 10 in-depth interviews in Mandarin or Cantonese. Interview transcripts, back translated, were analyzed using N6. Constant comparative analysis highlighted a range of health-seeking behaviors after a fall: Chinese older people were reluctant to use formal health services; talking about falls was avoided; older people hid falls from their adult children to avoid worrying them; and fatalistic views about falls and poor knowledge about availability and content of interventions were prevalent. Cost of interventions was important. Chinese older adults valued their independence, and cultural intergenerational relations had an impact on taking action to prevent falls. Cultural diversity affects older adults' acceptance of fall prevention interventions.

  2. Preventing Falls | NIH MedlinePlus the Magazine

    MedlinePlus

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

  3. Educators’ perspectives about how older hospital patients can engage in a falls prevention education programme: a qualitative process evaluation

    PubMed Central

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

    2015-01-01

    Objectives Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators’ perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education. Design A qualitative exploratory study. Methods Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during the primary study. The educators delivered the programme on eight rehabilitation wards for periods of between 10 and 40 weeks. They provided older patients with individualised education to engage in falls prevention and provided staff with education to support patient actions. Data were thematically analysed and presented using a conceptual framework. Results Falls prevention education led to mutual understanding between staff and patients which assisted patients to engage in falls prevention behaviours. Mutual understanding was derived from the following observations: the educators perceived that they could facilitate an effective three-way interaction between staff actions, patient actions and the ward environment which led to behaviour change on the wards. This included engaging with staff and patients, and assisting them to reconcile differing perspectives about falls prevention behaviours. Conclusions Individualised falls prevention education effectively provides patients who receive it with the capability and motivation to develop and undertake behavioural strategies that reduce their falls, if supported by staff and the ward environment. PMID:26656027

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

    PubMed Central

    2014-01-01

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

  5. A Comprehensive Initiative to Prevent Falls Among Newborns.

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed Central

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

    2016-01-01

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

  9. 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…

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

    MedlinePlus

    ... page please turn JavaScript on. Feature: Falls and Older Adults How Can Older Adults Prevent Falls? Past Issues / Winter 2014 Table of Contents Falls are not inevitable, even as we age. But ... you could break a bone. For older people, breaks can lead to more serious problems. ...

  11. 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.

  12. 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

  13. Prevention of falls in Parkinson's disease: a review of fall risk factors and the role of physical interventions.

    PubMed

    Canning, Colleen G; Paul, Serene S; Nieuwboer, Alice

    2014-01-01

    Falls in people with Parkinson's disease (PD) are frequent and recurrent events with devastating and widespread consequences. Despite this, understanding of the predictive and explanatory value of fall risk factors, as well as the development and testing of interventions aimed at reducing falls, are in their infancy. This review focuses on fall prediction and risk factors that are potentially remediable with physical interventions. We show that falls can be predicted with high accuracy using a simple three-step clinical tool. Evidence from recently published randomized controlled trials supports the implementation of balance-challenging exercises in reducing falls. Larger scale trials utilizing technologically advanced monitoring methods will further elucidate those interventions most likely to be cost effective according to individual risk factor profiles.

  14. Implementation of a home-based interactive training system for fall prevention: requirements and challenges.

    PubMed

    Kiselev, Jörn; Haesner, Marten; Gövercin, Mehmet; Steinhagen-Thiessen, Elisabeth

    2015-01-01

    A critical need exists for rehabilitation for improving older adults' physical abilities, especially in the field of fall prevention. Although virtual reality and ambient-assistive technology-based approaches are promising, they are cost intensive and frequently face significant obstacles during the developmental process. The authors of the current article developed a motivational interactive training system for fall prevention and stroke rehabilitation and planned a pilot study to measure its usability, user acceptance, and effect on physical abilities and quality of life. Usability results from a field trial are presented. The purpose of the current article is to describe the technological and organizational problems during the development process and field trial. Recommendations for overcoming these barriers are described. These experiences should be taken into account when planning further field trials with assistive technology and older adults.

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

    PubMed

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

    2005-07-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  17. Home Improvements Prevent Falls | NIH MedlinePlus the Magazine

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues For an enhanced version of this page please turn JavaScript on. Feature: Falls ... rugs. In Bathrooms and Powder Rooms Mount grab bars near toilets and on both the inside and ...

  18. Crude price free-fall. Yamanis mission: to prevent it

    SciTech Connect

    Not Available

    1985-01-30

    On January 30, 1985, OPEC announced price cuts effective February 1 for very-light and medium-light grades of crude, except for Nigeria's which, already having cut US $2/bbl on its own, increased its price for 37/sup 0/ API Bonny Light by US $0.65. The traditional OPEC marker crude, 34/sup 0/ API Arabian Light, is cut US $1.00 to $28.00/bbl. Arabian Heavy, about 27/sup 0/ API, stays at US $26.50. Prior to the cuts, the maximum spread between extra-light OPEC crude and Arabian Heavy was US $4.00/bbl. The spread between extra-light and the then-benchmark was US $1.50 at most, and between Arabian Heavy and the then-benchmark, US $2.50. Now, the official spreads are: Bonny Light-Arabian Heavy, US $2.15/bbl; Bonny Light-Arabian Light, US $0.65/bbl; Arabian Light-Arabian Heavy, US $1.50/bbl. These decisions have brought OPEC instant credibility, and could calm skeptics still warning of a free-fall in prices. This issue presents the refining netback data, US Gulf and West Coasts, late January 1985. The issue also contains the fuel price/tax series and the principal industrial fuel prices for December 1984 for countries of the Western Hemisphere. Asphalt export prices to the US for each month of 1984 are also listed.

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

    PubMed Central

    2012-01-01

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

  20. Differing approaches to falls and fracture prevention between Australia and Colombia

    PubMed Central

    Gomez, Fernando; Curcio, Carmen Lucia; Suriyaarachchi, Pushpa; Demontiero, Oddom; Duque, Gustavo

    2013-01-01

    Falls and fractures are major causes of morbidity and mortality in older people. More importantly, previous falls and/or fractures are the most important predictors of further events. Therefore, secondary prevention programs for falls and fractures are highly needed. However, the question is whether a secondary prevention model should focus on falls prevention alone or should be implemented in combination with fracture prevention. By comparing a falls prevention clinic in Manizales (Colombia) versus a falls and fracture prevention clinic in Sydney (Australia), the objective was to identify similarities and differences between these two programs and to propose an integrated model of care for secondary prevention of fall and fractures. A comparative study of services was performed using an internationally agreed taxonomy. Service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE) and previous reports in the literature. Comparison included organization, administration, client characteristics, and interventions. Several similarities and a number of differences that could be easily unified into a single model are reported here. Similarities included population, a multidisciplinary team, and a multifactorial assessment and intervention. Differences were eligibility criteria, a bone health assessment component, and the therapeutic interventions most commonly used at each site. In Australia, bone health assessment is reinforced whereas in Colombia dizziness assessment and management is pivotal. The authors propose that falls clinic services should be operationally linked to osteoporosis services such as a “falls and fracture prevention clinic,” which would facilitate a comprehensive intervention to prevent falls and fractures in older persons. PMID:23378748

  1. Vibration Therapy to Prevent Bone Loss and Falls: Mechanisms and Efficacy.

    PubMed

    Beck, Belinda R

    2015-12-01

    A considerable volume of evidence has accumulated to suggest that whole-body vibration (WBV) may have a therapeutic role to play in the prevention of osteoporotic fracture, particularly for individuals who are unable to tolerate vigorous exercise interventions. There is moderate to strong evidence that WBV will prevent falls (likely due to enhanced neuromuscular function), but also some indication that the effects of WBV do not outstrip those of targeted exercise. Animal data indicates that WBV will also improve bone mass, including preventing loss due to hormone withdrawal, disuse and glucocorticoid exposure. Human trials, however, have produced equivocal outcomes for bone. Positive trends are apparent at the hip and spine, but shortcomings in study designs have limited statistical power. The mechanism of the vibration effect on bone tissue is likely to be mechanical coupling between an oscillating cell nucleus and the cytoskeleton. More robust dose-response human data are required before therapeutic guidelines can be developed.

  2. 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

  3. 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.

  4. 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. PMID:27660753

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Lyons, Beverly P; Hall, Raphael J

    2016-10-01

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

  9. Exercise for falls prevention in older people: assessing the knowledge of exercise science students.

    PubMed

    Sturnieks, Daina L; Finch, Caroline F; Close, Jacqueline C T; Tiedemann, Anne; Lord, Stephen R; Pascoe, Deborah A

    2010-01-01

    Participation in appropriate exercise can help reduce the risk of falls and falls injury in older people. Delivery of population-level exercise interventions requires an expert workforce with skills in development and delivery of group exercise programs and prescription of individually targeted exercise. This study assessed the current knowledge of university exercise science students (as future exercise professionals) across different levels of study. A structured survey designed to assess knowledge in relation to falls in older people and exercise prescription for falls prevention was administered during second, third and fourth year lectures in seven Australian universities. Students' knowledge was assessed as the percent of correct responses. Overall, 566 students completed the survey and knowledge levels increased significantly with study year. Mean knowledge levels were significantly <70%, indicating limited knowledge. They were lowest for falls risk factor questions and highest for issue/cost related questions in second and third year students. Fourth year students had best knowledge about falls interventions and this was the only group and topic with a mean score >70%. In conclusion, knowledge about falls and exercise prescription for falls prevention in current students does not meet a desired competency level of 70% and is therefore insufficient to ensure an adequately equipped future workforce in this area. There is a clear need for the development and widespread delivery of an evidence-based "exercise for falls prevention" curriculum module for exercise professionals.

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    PubMed

    Hoke, Linda M; Guarracino, Dana

    2016-01-01

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

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

    PubMed

    Hoke, Linda M; Guarracino, Dana

    2016-01-01

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

  14. A case control study to improve accuracy of an electronic fall prevention toolkit.

    PubMed

    Dykes, Patricia C; I-Ching, Evita Hou; Soukup, Jane R; Chang, Frank; Lipsitz, Stuart

    2012-01-01

    Patient falls are a serious and commonly report adverse event in hospitals. In 2009, our team conducted the first randomized control trial of a health information technology-based intervention that significantly reduced falls in acute care hospitals. However, some patients on intervention units with access to the electronic toolkit fell. The purpose of this case control study was to use data mining and modeling techniques to identify the factors associated with falls in hospitalized patients when the toolkit was in place. Our ultimate aim was to apply our findings to improve the toolkit logic and to generate practice recommendations. The results of our evaluation suggest that the fall prevention toolkit logic is accurate but strategies are needed to improve adherence with the fall prevention intervention recommendations generated by the electronic toolkit.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  17. Journey to a safe environment: fall prevention in an emergency department at a level I trauma center.

    PubMed

    Alexander, Danette; Kinsley, Terry L; Waszinski, Christine

    2013-07-01

    Predicting which patients will fall is a challenging task, especially in the often unpredictable setting of an emergency department of a Level I Trauma Center. Unfortunately, there is a great potential for falls to occur in this environment. Fall risk assessment tools used in inpatient settings do not adequately capture the risk factors of patients presenting to the emergency department. The ability to accurately identify patients at risk for falling at the point of entry is the first step toward preventing patient harm. Once patients are identified as at risk for a fall, the next challenge is to be sure that they do not fall. We created the KINDER1 Fall Risk Assessment Tool for use in the emergency department. This instrument was specifically designed for the rapid identification of patients at risk for a fall as well as the re-evaluation of patients for fall risk throughout their stay in the emergency department. Once we had an appropriate assessment tool, our next challenge was for staff to consistently apply fall prevention interventions. Performing a mini-root cause analysis on each fall showed trends and in turn led to the design and implementation of specific fall prevention interventions to motivate the nursing staff to focus on fall prevention that the ED nursing leadership used to select change strategies. With improved identification of fall risk patients and consistent application of innovative prevention strategies, we were able to show a trend toward reduction of falls and fall-related injuries in our emergency department.

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

    PubMed Central

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

    2015-01-01

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

  19. Older Adults' Perceptions of Clinical Fall Prevention Programs: A Qualitative Study

    PubMed Central

    Calhoun, Rebecca; Meischke, Hendrika; Hammerback, Kristen; Bohl, Alex; Poe, Pamela; Williams, Barbara; Phelan, Elizabeth A.

    2011-01-01

    Objective. To investigate motivational factors and barriers to participating in fall risk assessment and management programs among diverse, low-income, community-dwelling older adults who had experienced a fall. Methods. Face-to-face interviews with 20 elderly who had accepted and 19 who had not accepted an invitation to an assessment by one of two fall prevention programs. Interviews covered healthy aging, core values, attributions/consequences of the fall, and barriers/benefits of fall prevention strategies and programs. Results. Joiners and nonjoiners of fall prevention programs were similar in their experience of loss associated with aging, core values they expressed, and emotional response to falling. One difference was that those who participated endorsed that they “needed” the program, while those who did not participate expressed a lack of need. Conclusions. Interventions targeted at a high-risk group need to address individual beliefs as well as structural and social factors (transportation issues, social networks) to enhance participation. PMID:21629712

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2014-07-01

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

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

    PubMed

    Yount, John

    2016-01-01

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

  3. [Prevention with hip protectors. Biomechanical aspects in falls and hip fractures].

    PubMed

    Lauritzen, J B

    1996-12-01

    The cascade of events leading to hip fracture is: a fall, protective responses, impact to the hip, local energy absorption and bone strength. A fall from standing height on the hip corresponds to a force of about 3500 N and the bone strength of the proximal femur in elderly women and men ranges between 2000 to 6000 N. Efficient hip protective systems have been developed and may be a significant factor in the prevention of hip fractures among the elderly with propensity to fall and osteoporosis. Theoretically, more than 90 per cent of all hip fractures can be prevented, and a substantial reduction in the rate of hip fractures can be obtained, when systematic intervention programs are initiated among nursing home residents. Prevention of hip fractures among home dwellers may be a greater challenge, although preliminary results seem promising. Improvement in design has made the protectors more compliant and may facilitate the aim of preventing hip fractures.

  4. Pre-impact fall detection.

    PubMed

    Hu, Xinyao; Qu, Xingda

    2016-06-01

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

  5. Pre-impact fall detection.

    PubMed

    Hu, Xinyao; Qu, Xingda

    2016-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Mitchell, A; Jones, N

    1996-07-01

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

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

    PubMed

    2016-01-01

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

  10. Vision and Relevant Risk Factor Interventions for Preventing Falls among Older People: A Network Meta-analysis.

    PubMed

    Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping

    2015-05-28

    Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis.

  11. Vision and Relevant Risk Factor Interventions for Preventing Falls among Older People: A Network Meta-analysis.

    PubMed

    Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping

    2015-01-01

    Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis. PMID:26020415

  12. Vision and Relevant Risk Factor Interventions for Preventing Falls among Older People: A Network Meta-analysis

    PubMed Central

    Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping

    2015-01-01

    Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis. PMID:26020415

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

    ERIC Educational Resources Information Center

    Nyman, Samuel R.

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  17. Preventing falls

    NASA Astrophysics Data System (ADS)

    Wright, Peter

    2014-06-01

    In reply to Lawrence Normie's article “Serving an ageing population” (Careers, April pp42-43), in which the author, who is executive director of the gerontechnology firm GeronTech, described his work on devices that improve the lives of older adults.

  18. What works to prevent falls in older adults dwelling in long term care facilities and hospitals? An umbrella review of meta-analyses of randomised controlled trials.

    PubMed

    Stubbs, Brendon; Denkinger, Michael D; Brefka, Simone; Dallmeier, Dhayana

    2015-07-01

    Preventing falls in long term care facilities (LTCF) and hospitals is an international priority. Many interventions have been investigated and summarised in meta-analyses (MA) and there is a need to synthesise the top of the hierarchy of evidence in one place. Therefore we conducted an umbrella review of MA of randomised controlled trials (RCTs) of falls prevention interventions LTCF and hospitals. Two independent reviewers searched major electronic databases from inception till October 2014 for MA containing ≥3 RCTs investigating any intervention to prevent falls in LTCF or hospitals in older adults aged ≥60 years. Methodological quality was assessed by the AMSTAR tool and data were narratively synthesised. The methodological quality of the MA was moderate to high across the 10 included MA. Nine MA provided data for LTCF and only two considered hospital settings. Only one MA defined a fall and two reported adverse events (although minor). Consistent evidence suggests that multifactorial interventions reduce falls (including the rate, risk and odds of falling) in LTCF and hospitals. Inconsistent evidence exists for exercise and vitamin D as single interventions in LTCF, whilst no MA has investigated this in hospitals. No evidence exists for hip protectors and medication review on falls in LTCF. In conclusion, multifactorial interventions appear to be the most effective interventions to prevent falls in LTCF and hospital settings. This is not without limitations and more high quality RCTs are needed in hospital settings in particular. Future RCTs and MA should clearly report adverse events.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

    Stanmore, Emma K

    2015-11-01

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

  1. An interprofessional team approach to fall prevention for older home care clients ‘at risk’ of falling: health care providers share their experiences

    PubMed Central

    Baxter, Pamela; Markle-Reid, Maureen

    2009-01-01

    Background Providing care for older home care clients ‘at risk’ of falling requires the services of many health care providers due to predisposing chronic, complex conditions. One strategy to ensure that quality care is delivered is described in the integrated care literature; interprofessional collaboration. Engaging in an interprofessional team approach to fall prevention for this group of clients seems to make sense. However, whether or not this approach is feasible and realistic is not well described in the literature. As well, little is known about how teams function in the community when an interprofessional approach is engaged in. The barriers and facilitators of such an approach are also not known. Purpose The purpose of this qualitative study was to describe the experiences of five different health care professionals as they participated in an interprofessional team approach to care for the frail older adult living at home and at risk of falling. Methodology This study took place in Hamilton, ON, Canada and was part of a randomized controlled trial, the aim of which was to determine the effects and costs of a multifactorial and interdisciplinary team approach to fall prevention for older home care clients ‘at risk’ of falling. The current study utilized an exploratory descriptive design to answer the following research questions: how do interprofessional teams describe their experiences when involved in a research intervention requiring collaboration for a 9-month period of time? What are the barriers and facilitators to teamwork? Four focus groups were conducted with the care-provider teams (n=9) 6 and 9 months following group formation. Results This study revealed several themes which included, team capacity, practitioner competencies, perceived outcomes, support and time. Overall, care providers were positive about their experiences and felt that through an interprofessional approach benefits could be experienced by both the provider and the

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2012-01-01

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

  5. Falls prevention and the value of exercise: salient beliefs among South asian and white british older adults.

    PubMed

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

    2014-02-01

    The importance of increasing exercise to prevent falls among older adults remains a key worldwide public health priority. However, older adults do not necessarily take up exercise as a preventative measure for falls. This qualitative study aimed to explore the beliefs of community-dwelling South Asian and White British older adults aged 60 to 70 about falls and exercise for fall prevention through 15 focus groups (n = 87) and 40 in-depth interviews. Data were transcribed verbatim and analyzed using a framework approach. Data analysis identified six salient beliefs that influenced older adults' intention to exercise for fall prevention. In general, older adults aged 60 to 70 did not acknowledge their risk of falling and were not motivated to exercise simply to help prevent falls. Positive beliefs were found to be an unlikely barrier to taking up exercise for fall prevention for those who had experienced a fall. The implications for health promotion and health professionals with this group of older adults are discussed.

  6. An exercise program to prevent falls in institutionalized elderly with cognitive deficits: a crossover pilot study.

    PubMed

    DeSure, Ariell R; Peterson, Karen; Gianan, Faith V; Pang, Lorrin

    2013-11-01

    Falls are the leading cause of injury among older adults in the United States, with the institutionalized elderly at elevated risk for injury and death. Physical weakness and mental frailty, prevalent in institutionalized elderly, are major risk factors for falls. The purpose of this study was to evaluate a program that addresses both the physical and mental aspects of exercise to reduce falls in institutionalized elderly. Twenty-seven volunteer subjects residing in an assisted living facility participated in the 24 week randomized crossover study. After demographic, fall history, and mental status examinations, subjects were randomly assigned first to ten weeks of either an exercise class or a control group, followed by a four week "washout period" of no activity, then cross assigned to ten weeks as either a control group or exercise class, respectively. Falls as well as mental status changes were monitored during the study. After adjusting for differences in baseline risk between the control and treatment groups, and for potential residual effects of the treatment during the crossover phase, a statistically significant (P = .025) reduction in falls was found during treatment compared to the control periods. No change in mental status was seen. This small, pilot study shows that exercise programs, which emphasize mental strengthening as well as physical fitness, have the potential to reduce falls among mentally impaired, institutionalized seniors.

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

    PubMed

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

    2014-01-01

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

  8. An educational video to promote multi-factorial approaches for fall and injury prevention in long-term care facilities

    PubMed Central

    2014-01-01

    Background Older adults living in long term care (LTC) settings are vulnerable to fall-related injuries. There is a need to develop and implement evidence-based approaches to address fall injury prevention in LTC. Knowledge translation (KT) interventions to support the uptake of evidence-based approaches to fall injury prevention in LTC need to be responsive to the learning needs of LTC staff and use mediums, such as videos, that are accessible and easy-to-use. This article describes the development of two unique educational videos to promote fall injury prevention in long-term care (LTC) settings. These videos are unique from other fall prevention videos in that they include video footage of real life falls captured in the LTC setting. Methods Two educational videos were developed (2012–2013) to support the uptake of findings from a study exploring the causes of falls based on video footage captured in LTC facilities. The videos were developed by: (1) conducting learning needs assessment in LTC settings via six focus groups (2) liaising with LTC settings to identify learning priorities through unstructured conversations; and (3) aligning the content with principles of adult learning theory. Results The videos included footage of falls, interviews with older adults and fall injury prevention experts. The videos present evidence-based fall injury prevention recommendations aligned to the needs of LTC staff and: (1) highlight recommendations deemed by LTC staff as most urgent (learner-centered learning); (2) highlight negative impacts of falls on older adults (encourage meaning-making); and, (3) prompt LTC staff to reflect on fall injury prevention practices (encourage critical reflection). Conclusions Educational videos are an important tool available to researchers seeking to translate evidence-based recommendations into LTC settings. Additional research is needed to determine their impact on practice. PMID:24884899

  9. The Harstad injury prevention study: community based prevention of fall-fractures in the elderly evaluated by means of a hospital based injury recording system in Norway.

    PubMed Central

    Ytterstad, B

    1996-01-01

    STUDY OBJECTIVE: To describe a community based programme to prevent fractures resulting from falls and evaluate the outcome in terms of changes in fracture rates and short term hospital care costs. DESIGN: Prospective intervention study. SETTING: The Norwegian municipalities of Harstad (intervention) and Trondheim (reference) from 1 July 1985 to 30 June 1993. PARTICIPANTS: The person-years of the study were estimated from yearly census data on people aged 65 years and over. There were 22970 person years in Harstad and 158911 in Trondheim. MEASUREMENTS AND MAIN RESULTS: The variables were selected and coded according to the Nordic system and the data were collected as part of a national injury surveillance system. The first three years of the study provided baseline data, while the last five years involved community based interventions-eg, the removal of environmental hazards in homes and promotion of the use of safe footwear outdoors in winter. Rates of fracture from falls did not decline in nursing homes but decreased 26.3% in private homes (p < 0.01). In 65-79 year olds, there was a 48.7% reduction in fall-fracture rates for men in traffic areas in winter (p < 0.05). The data from the reference city, Trondheim, suggested a significant rise in fractures caused by falls. There was a 16.7% reduction in hospital admission rates of fall-fracture patients from private homes, indicating a substantial saving in short term hospital costs. The observed fall-fracture rate reductions in private homes and traffic areas suggest that major parts of the interventions were effective. CONCLUSION: Fall-fracture prophylaxis in the aged is possible in a community based setting that utilises high quality, local injury data. PMID:8944864

  10. Falls prevention for elders in acute care: an evidence-based nursing practice initiative.

    PubMed

    Murphy, Tamara H; Labonte, Paula; Klock, Monica; Houser, Larry

    2008-01-01

    The purpose of this article is to describe and measure the impact of a multifaceted program developed to reduce the falls rate on an acute medical unit at an academic tertiary care center. According to national benchmarks, this unit was one of the hospital's top 3 units for numbers of falls for several years. That distinction drove the hospital and unit leadership and a staff-led unit practice council to develop an evidence-based intervention plan. Interventions included a campaign to raise geriatric awareness, creation of "falls tool boxes," education of staff and family, and implementation of a structured hourly patient rounds schedule. The success of these interventions is discussed, including the effect on the falls rate benchmark. The discussion addresses implications and outcomes associated with the empowerment of nursing staff to respond to benchmarking measures, implement evidence-based practices, and use the same benchmarking procedure to measure outcomes.

  11. Nursing staff's awareness of keeping beds in the lowest position to prevent falls and fall injuries in an adult acute surgical inpatient care setting.

    PubMed

    Tzeng, Huey-Ming; Yin, Chang-Yi; Anderson, Allison; Prakash, Atul

    2012-01-01

    High beds are a safety concern. This qualitative study used pre-existing nurse interview data and confirmed nurses' awareness of the importance of keeping patient beds in the lowest position. Lowering the bed helps promote patient safety and prevent falls.

  12. The Falls In Care Home study: a feasibility randomized controlled trial of the use of a risk assessment and decision support tool to prevent falls in care homes

    PubMed Central

    Walker, Gemma M; Armstrong, Sarah; Gordon, Adam L; Gladman, John; Robertson, Kate; Ward, Marie; Conroy, Simon; Arnold, Gail; Darby, Janet; Frowd, Nadia; Williams, Wynne; Knowles, Sue; Logan, Pip A

    2015-01-01

    Objective: To explore the feasibility of implementing and evaluating the Guide to Action Care Home fall prevention intervention. Design: Two-centre, cluster feasibility randomized controlled trial and process evaluation. Setting: Purposive sample of six diverse old age/learning disability, long stay care homes in Nottinghamshire, UK. Subjects: Residents aged over 50 years, who had fallen at least once in the past year, not bed-bound, hoist-dependent or terminally ill. Interventions: Intervention homes (n = 3) received Guide to Action Care Home fall prevention intervention training and support. Control homes (n = 3) received usual care. Outcomes: Recruitment, attrition, baseline and six-month outcome completion, contamination and intervention fidelity, compliance, tolerability, acceptance and impact. Results: A total of 81 of 145 (56%) care homes expressed participatory interest. Six of 22 letter respondent homes (27%) participated. The expected resident recruitment target was achieved by 76% (52/68). Ten (19%) residents did not complete follow-up (seven died, three moved). In intervention homes 36/114 (32%) staff attended training. Two of three (75%) care homes received protocol compliant training. Staff valued the training, but advised greater management involvement to improve intervention implementation. Fall risks were assessed, actioned and recorded in care records. Of 115 recorded falls, 533/570 (93%) of details were complete. Six-month resident fall rates were 1.9 and 4.0 per year for intervention and control homes, respectively. Conclusions: The Guide to Action Care Home is implementable under trial conditions. Recruitment and follow-up rates indicate that a definitive trial can be completed. Falls (primary outcome) can be ascertained reliably from care records. PMID:26385358

  13. Fall Prevention in Community Settings: Results from Implementing Tai Chi: Moving for Better Balance in Three States

    PubMed Central

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

    2015-01-01

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

  14. Chair alarm for patient fall prevention based on gesture recognition and interactivity.

    PubMed

    Knight, Heather; Lee, Jae-Kyu; Ma, Hongshen

    2008-01-01

    The Gesture Recognition Interactive Technology (GRiT) Chair Alarm aims to prevent patient falls from chairs and wheelchairs by recognizing the gesture of a patient attempting to stand. Patient falls are one of the greatest causes of injury in hospitals. Current chair and bed exit alarm systems are inadequate because of insufficient notification, high false-alarm rate, and long trigger delays. The GRiT chair alarm uses an array of capacitive proximity sensors and pressure sensors to create a map of the patient's sitting position, which is then processed using gesture recognition algorithms to determine when a patient is attempting to stand and to alarm the care providers. This system also uses a range of voice and light feedback to encourage the patient to remain seated and/or to make use of the system's integrated nurse-call function. This system can be seamlessly integrated into existing hospital WiFi networks to send notifications and approximate patient location through existing nurse call systems.

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Miller, Darcy; Raysich, Mark; Kirkland, Mary

    2016-01-01

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

  20. Vision and agility training in community dwelling older adults: incorporating visual training into programs for fall prevention.

    PubMed

    Reed-Jones, Rebecca J; Dorgo, Sandor; Hitchings, Maija K; Bader, Julia O

    2012-04-01

    This study aimed to examine the effect of visual training on obstacle course performance of independent community dwelling older adults. Agility is the ability to rapidly alter ongoing motor patterns, an important aspect of mobility which is required in obstacle avoidance. However, visual information is also a critical factor in successful obstacle avoidance. We compared obstacle course performance of a group that trained in visually driven body movements and agility drills, to a group that trained only in agility drills. We also included a control group that followed the American College of Sports Medicine exercise recommendations for older adults. Significant gains in fitness, mobility and power were observed across all training groups. Obstacle course performance results revealed that visual training had the greatest improvement on obstacle course performance (22%) following a 12 week training program. These results suggest that visual training may be an important consideration for fall prevention programs.

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-18

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

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

    PubMed

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

    2016-01-01

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

  5. Prevention of falls on the level in occupational situations: a major issue, a risk to be managed.

    PubMed

    Leclercq, Sylvie

    2002-01-01

    The terminology used to designate falls on the level is broadly based and the accidents concerned are only very rarely defined explicitly. A definition of falls on the level in occupational situations is therefore proposed. We attempt to define the issue represented by the prevention of such accidents on the basis of statistical data, prior to explaining the twin objectives focused on in the field of their prevention. We then propose a summary of unbalance risk factors in occupational situations. These factors are associated with different components of the occupational situation they concern: individuals, their tasks, the equipment used, or the working environment. The diversity of accident contexts and different in-company prevention possibilities are thereby highlighted. Finally, we discuss a number of consequences in prevention terms.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    1997-01-01

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

  9. Sleeping patterns observation for bedsores and bed-side falls prevention.

    PubMed

    Wai, Aung Aung Phyo; Yuan-Wei, Kow; Fook, Foo Siang; Jayachandran, Maniyeri; Biswas, Jit; Cabibihan, John-John

    2009-01-01

    Disabled or cognition impaired elderly may lie in the bed most of their time. It is important to monitor their health conditions and look out for life threatening events in and around the bed continuously. Abrupt unassisted movements may lead to falls whereas the lack of desirable movements may cause bedsores. In order to alleviate these problems, we propose automated means of continuous and unobtrusive sleeping pattern observation through pressure sensing bed. By understanding of subjects' states from observed pressure evidences, timely intervention and nursing care can be provided to subjects immediately. This enables provision of high quality care to frail and dependent elderly, and also enhances their quality of life in a cost-effective and resource-efficient manner.

  10. [Cognitive Function and Calcium. Vitamin D and calcium for the prevention of falls and fractures in patients with dementia].

    PubMed

    Hanyu, Haruo

    2015-02-01

    The prevalence of dementia and fractures has been increasing with age. There is strong evidence that dementia or cognitive impairment in older people has an established fall risk factor. Subjects with dementia have a doubled to threefold risk of falls. In addition to motor impairments (impaired gait, reduced muscular strength and impaired balance) , executive functional impairment is also associated with an increased risk of falls. Falls are more likely found in subjects with dementia with Lewy bodies and vascular dementia and those who had advanced dementia. Patients with AD are at higher risk for fractures and have a lower bone mineral density than healthy controls. Vitamin D decreases vertebral fractures, and moreover, appears to reduce the risk of falls in older subjects. A recent meta-analysis showed that vitamin D concentrations are associated with poor cognitive function and a higher risk of AD. However, treatment with vitamin D alone shows no significant effect on cognition in patients with AD. PMID:25634053

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  12. The effect of window size and lead time on pre-impact fall detection accuracy using support vector machine analysis of waist mounted inertial sensor data.

    PubMed

    Aziz, Omar; Russell, Colin M; Park, Edward J; Robinovitch, Stephen N

    2014-01-01

    Falls are a major cause of death and morbidity in older adults. In recent years many researchers have examined the role of wearable inertial sensors (accelerometers and/or gyroscopes) to automatically detect falls. The primary goal of such fall monitors is to alert care providers of the fall event, who can then commence earlier treatment. Although such fall detection systems may reduce time until the arrival of medical assistance, they cannot help to prevent or reduce the severity of traumatic injury caused by the fall. In the current study, we extend the application of wearable inertial sensors beyond post-impact fall detection, by developing and evaluating the accuracy of a sensor system for detecting falls prior to the fall impact. We used support vector machine (SVM) analysis to classify 7 fall and 8 non-fall events. In particular, we focused on the effect of data window size and lead time on the accuracy of our pre-impact fall detection system using signals from a single waist sensor. We found that our system was able to detect fall events at between 0.0625-0.1875 s prior to the impact with at least 95% sensitivity and at least 90% specificity for window sizes between 0.125-1 s.

  13. An intergenerational approach in the promotion of balance and strength for fall prevention - a mini-review.

    PubMed

    Granacher, Urs; Muehlbauer, Thomas; Gollhofer, Albert; Kressig, Reto W; Zahner, Lukas

    2011-01-01

    The risk of sustaining a fall is particularly high in children and seniors. Deficits in postural control and muscle strength either due to maturation, secular declines or biologic aging are two important intrinsic risk factors for falls. During life span, performance in variables of static postural control follows a U-shaped curve with children and seniors showing larger postural sway than healthy adults. Measures of dynamic postural control (i.e. gait speed) as well as isometric (i.e. maximal strength) and dynamic muscle strength (i.e. muscular power) follow an inverted U-shaped curve during life span, again with children and seniors showing deficits compared to adults. There is evidence that particularly balance and resistance training are effective in counteracting these neuromuscular constraints in both children and seniors. Further, these training regimens are able to reduce the rate of sustaining injuries and falls in these age groups. An intergenerational intervention approach is suggested to enhance the effectiveness of these training programs by improving compliance and increasing motivation of children and seniors exercising together. Thus, the objectives of this mini-review are: (1) to describe the epidemiology and etiology of falls in children and seniors; (2) to discuss training programs that counteract intrinsic fall risk factors by reducing the rate of falling, and (3) to present an intergenerational approach that has the potential to make training programs even more effective by including children and seniors together in one exercise group.

  14. Towards a light-weight query engine for accessing health sensor data in a fall prevention system.

    PubMed

    Kreiner, Karl; Gossy, Christian; Drobics, Mario

    2014-01-01

    Connecting various sensors in sensor networks has become popular during the last decade. An important aspect next to storing and creating data is information access by domain experts, such as researchers, caretakers and physicians. In this work we present the design and prototypic implementation of a light-weight query engine using natural language processing for accessing health-related sensor data in a fall prevention system. PMID:25160350

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

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

    PubMed

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

    2012-12-01

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

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

    PubMed Central

    Mason, Wendy; Haines, Terry P.

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Landrock, Clinton K.

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

  19. A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Methods/Design Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale – International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with

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

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Duckenfield, Marty, Ed.

    2005-01-01

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

  2. Legionnaires` disease: Seeking effective prevention

    SciTech Connect

    Millar, J.D.; Morris, G.K.; Shelton, B.G.

    1997-01-01

    During the Bicentennial summer of 1976, American Legion Conventioneers in Philadelphia suffered a dramatic epidemic that left 34 dead. Near the end of 1976, scientists at the Centers for Disease Control (CDC) in Atlanta discovered the bacterium that caused Legionnaires` disease and named it Legionella. Nearly two decades later, a wealth of scientific information exists about the organism, its health effects, epidemiology, microbiology, aquatic ecology, molecular biology, immunology, pathophysiology, etc. Fortunately, for the engineer seeking to prevent Legionnaires` disease, it is unnecessary to master this complexity; the practice of prevention requires understanding a few, straightforward facts. The purpose of this paper is to present four messages about Legionnaires` disease that provide a conceptual framework to guide the crucial role of practical prevention. Those messages are: Legionnaires` disease is important; Legionnaires` disease is an environmental disease; Legionnaires` disease is preventable; and Legionnaires` disease prevention requires the right strategy.

  3. Magnet children's hospitals: leading knowledge development and quality standards for inpatient pediatric fall prevention programs.

    PubMed

    Graf, Elaine

    2011-04-01

    Magnet hospitals are required to monitor nursing-sensitive indicators and be above the mean/median of national benchmarks for those indicators. When there is no valid national benchmark, as is the case for most of the pediatric indicators, a hospital seeking Magnet designation or redesignation is charged with taking a leadership role in developing a mechanism that leads to the establishment of a national benchmark for the indicator of choice. This article will present the efforts taken by Magnet Children's hospitals to establish valid pediatric screening tools and benchmark inpatient pediatric falls.

  4. Representing and Retrieving Patients' Falls Risk Factors and Risk for Falls among Adults in Acute Care through the Electronic Health Record

    ERIC Educational Resources Information Center

    Pfaff, Jann

    2013-01-01

    Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care…

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

    USGS Publications Warehouse

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

    2005-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  7. Obesity and falls in older people: mediating effects of disease, sedentary behavior, mood, pain and medication use.

    PubMed

    Mitchell, Rebecca J; Lord, Stephen R; Harvey, Lara A; Close, Jacqueline C T

    2015-01-01

    Obesity has been associated with an increased risk of falls among older people. However, it is not certain whether factors commonly associated with falls and/or obesity mediate this risk. This research examines whether specific diseases, sedentary behavior, mood, pain, and medication use mediate the association between obesity and falls. A representative sample of community-living individuals aged 65+ years in New South Wales (NSW), Australia were surveyed regarding their experience of falls, height, weight, lifestyle and general health within a 12 month period. Intervening variable effects were examined using Freedman and Schatzkin's difference in coefficients tests and regression analyses were used to estimate relative risks. Obesity was associated with a 25% higher risk (95%confidence interval (CI) 1.11-1.41; p<0.0003) of having fallen in the previous 12 months compared to non-obese individuals. The strongest mediators of the association between obesity and falls were sleeping tablets (t=-5.452; p<0.0001), sitting for more than 8h per day on weekdays (t=5.178; p<0.0001), heart disease/angina (t=3.526; p<0.0001), anti-depressant use (t=3.102; p=0.002), moderate/extreme anxiety or depression (t=3.038; p=0.002), and diabetes (t=3.032; p=0.002). Sedentary behavior, chronic health conditions and medication use were identified as mediators for the association between obesity and falls in community living older people. Interventions aimed at weight reduction and increased activity may have benefits not only for fall prevention, but also for the mediating health, mood and lifestyle factors identified here.

  8. Obesity and falls in older people: mediating effects of disease, sedentary behavior, mood, pain and medication use.

    PubMed

    Mitchell, Rebecca J; Lord, Stephen R; Harvey, Lara A; Close, Jacqueline C T

    2015-01-01

    Obesity has been associated with an increased risk of falls among older people. However, it is not certain whether factors commonly associated with falls and/or obesity mediate this risk. This research examines whether specific diseases, sedentary behavior, mood, pain, and medication use mediate the association between obesity and falls. A representative sample of community-living individuals aged 65+ years in New South Wales (NSW), Australia were surveyed regarding their experience of falls, height, weight, lifestyle and general health within a 12 month period. Intervening variable effects were examined using Freedman and Schatzkin's difference in coefficients tests and regression analyses were used to estimate relative risks. Obesity was associated with a 25% higher risk (95%confidence interval (CI) 1.11-1.41; p<0.0003) of having fallen in the previous 12 months compared to non-obese individuals. The strongest mediators of the association between obesity and falls were sleeping tablets (t=-5.452; p<0.0001), sitting for more than 8h per day on weekdays (t=5.178; p<0.0001), heart disease/angina (t=3.526; p<0.0001), anti-depressant use (t=3.102; p=0.002), moderate/extreme anxiety or depression (t=3.038; p=0.002), and diabetes (t=3.032; p=0.002). Sedentary behavior, chronic health conditions and medication use were identified as mediators for the association between obesity and falls in community living older people. Interventions aimed at weight reduction and increased activity may have benefits not only for fall prevention, but also for the mediating health, mood and lifestyle factors identified here. PMID:25307955

  9. The effect of physical restraints on fall rates in older adults who are institutionalized.

    PubMed

    Dunn, K S

    2001-10-01

    Since the Omnibus Budget Reconciliation Act (OBRA) of 1987, there has been a significant reduction in the use of physical restraints to prevent falls in older adults who are institutionalized because of the developing awareness of the physical and psychological problems associated with them. The purpose of this ex post facto descriptive study was to determine if there is a difference in falls when physical restraints are allowed or prohibited in one older adult population. Data from incident reports from a purposive sample of 97 older adults in one long-term care facility were analyzed before and after the implementation of a restraint-free policy. The results indicated no significant difference in the number of falls before and after the policy change. However, there was a significantly lower number of falls with injuries and a significantly higher number of falls without injuries. These findings suggest older adults will continue to fall with or without the use of physical restraints because of changes associated with the aging process and risk factors. Removing physical barriers from older adults and allowing freedom of movement may decrease the severity of injury sustained in a fall.

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

    PubMed

    Nyman, Samuel R; Yardley, Lucy

    2009-03-01

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

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

    SciTech Connect

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

    1981-10-02

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

  12. Measurement of the effect of playground surface materials on hand impact forces during upper limb fall arrests.

    PubMed

    Choi, Woochol J; Kaur, Harjinder; Robinovitch, Stephen N

    2014-04-01

    Distal radius fractures are common on playgrounds. Yet current guidelines for the selection of playground surface materials are based only on protection against fall-related head injuries. We conducted "torso release" experiments to determine how common playground surface materials affect impact force applied to the hand during upper limb fall arrests. Trials were acquired for falls onto a rigid surface, and onto five common playground surface materials: engineered wood fiber, gravel, mulch, rubber tile, and sand. Measures were acquired for arm angles of 20 and 40 degrees from the vertical. Playground surface materials influenced the peak resultant and vertical force (P<.001), but not the peak horizontal force (P=.159). When compared with the rigid condition, peak resultant force was reduced 17% by sand (from 1039 to 864 N), 16% by gravel, 7% by mulch, 5% by engineered wood fiber, and 2% by rubber tile. The best performing surface provided only a 17% reduction in peak resultant force. These results help to explain the lack of convincing evidence from clinical studies on the effectiveness of playground surface materials in preventing distal radius fractures during playground falls, and highlight the need to develop playground surface materials that provide improved protection against these injuries.

  13. [FALLS IN PATIENTS WITH DEMENTIA].

    PubMed

    Aizen, Efraim

    2015-05-01

    Older people with dementia are at increased risk of falls and their consequences. Patients with dementia fall twice as often as elderly cognitively intact people and are at greater risk of injurious falls. Falls in older people with dementia cause higher rates of morbidity, mortality and institutionalization. There is limited literature attempting to show specific risk factors for falls in this population, mainly: Lewy body dementia, dementia related to Parkinson's disease and depression, psychotropic medication, functional disability and behavioral disturbances. The Physiological Profile Assessment (PPAJ has been found to be a good fall risk screening tool in this population. There are few trials that have shown limited effectiveness of targeted fall prevention programs in community-dwelling cognitively impaired elderly. The evidence from hospitals and residential care is not conclusive. However, it has been demonstrated that some interventions, primarily exercise interventions, can modify certain risk factors in patients with dementia. Further research is required in specifically targeting fall prevention in older people with dementia. PMID:26168645

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed

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

    2001-03-01

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

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

    ERIC Educational Resources Information Center

    Walleri, R. Dan

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

  19. The effects of multidirectional stepping training on balance, gait ability, and falls efficacy following stroke

    PubMed Central

    Park, Gi-Deok; Choi, Jin-Uk; Kim, Young-Min

    2016-01-01

    [Purpose] The purpose of this study was to determine whether a multidirectional stepping training improves balance, gait ability, and falls efficacy in stroke patients. [Subjects] Firty patients who met the selection criteria and agreed to participate in research at hospital N were randomly allocated and enrolled in this study. Twenty of the subjects were assigned to an experimental group that participated in combined stepping exercise, and the other twenty subjects were assigned to a control group that received general physical therapy. [Methods] In the two groups, balance was measured using the Berg Balance Scale, gait ability was measured using the 10-m Walk Test, and falls efficacy was measured using the Falls Efficacy Scale before training and after 6 weeks of training. [Results] Comparative analysis of the experimental group’s pretest and post-test results showed statistically significant differences in the Berg Balance Scale, 10-m Walk Test, and Falls Efficacy Scale scores. There were significant between-group differences in the Berg Balance Scale, 10-m Walk Test, and Falls Efficacy Scale scores. [Conclusion] The results suggest that a combined stepping exercise can be an effective intervention to improve the balance, gait ability, and falls efficacy in stroke patients. PMID:26957733

  20. The Fall of Oil Prices and the Effects on Biofuels.

    PubMed

    Reboredo, Fernando H; Lidon, Fernando; Pessoa, Fernanda; Ramalho, José C

    2016-01-01

    This analysis is focused on the effect of the abrupt decline of oil prices on biofuels, particularly second-generation ethanol. The efforts to decrease the production costs of biofuels, especially cellulosic ethanol (CE), will be greatly threatened if current oil prices remain low, especially since production is not slowing. Only huge state subsidies could alleviate this threat, but the challenge is to persuade citizens that this sacrifice is worthwhile.

  1. Musculoskeletal Strength, Balance Performance, and Self-Efficacy in Elderly Ving Tsun Chinese Martial Art Practitioners: Implications for Fall Prevention

    PubMed Central

    Fong, Shirley S. M.; Ng, Shamay S. M.; Liu, Karen P. Y.; Pang, Marco Y. C.; Lee, H. W.; Chung, Joanne W. Y.; Lam, Priscillia L.; Guo, X.

    2014-01-01

    Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = −0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly. PMID:25530782

  2. Musculoskeletal strength, balance performance, and self-efficacy in elderly ving tsun chinese martial art practitioners: implications for fall prevention.

    PubMed

    Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Pang, Marco Y C; Lee, H W; Chung, Joanne W Y; Lam, Priscillia L; Guo, X

    2014-01-01

    Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = -0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

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

    PubMed

    Hankins, Catherine A; de Zalduondo, Barbara O

    2010-10-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  6. Effects of CG location on the launch behavior of free-fall lifeboats

    SciTech Connect

    Nelson, J.K.; Fallon, D.J.; Hirsch, T.J.

    1995-05-01

    The free-fall lifeboat was developed to reduce the risk of injury during evacuation in a maritime emergency. It is a generally accepted concept for lifesaving appliances that currently is in use on many ships and offshore platforms. Three concerns during launch of these lifeboats are the attitude of the boat at water entry, the headway immediately after water entry, and the acceleration forces to which the occupants are subjected. Limited quantitative data is available about the behavior of the boats during launch and, in particular, on the effects of mass distribution on the launch behavior of free-fall lifeboats. The purpose of this paper is to discuss quantitatively the launch behavior of free-fall lifeboats, with particular emphasis on the effects of changes in the location of the CG.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

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

  10. Effectiveness of blast-mitigation for rock fall endangered critical infrastructure using terrestrial laser scanning (LIDAR).

    NASA Astrophysics Data System (ADS)

    Kos, A.; Lunghi, A.; Naenni, C.; Conforti, D.; Tompkinson, W.

    2009-04-01

    Following a national rock fall risk assessment undertaken by the Swiss Federal Roads Office (FEDRO) a potential rock fall area located above the San Bernardino highway (A13) at Brusei, Canton Graubünden was identified. The rockslope at Brusei was characterized by a previous record of rock fall, large overhanging outcrops and open tension cracks up to 2 metres. Combined with the fact that the A13 is a critical north-south traffic corridor in Switzerland and the geological situation, the Public Works Department of the Canton Graubünden made the decision to mitigate the rock fall risk with the use of explosives. We report on the use of terrestrial laser scanning for evaluating the effectiveness of mitigation using explosives for the protection of critical infrastructure. Although modern blast mitigation methods allow for accurate control on removed volumes of rock, it is important to calculate how much was actually removed particularly when protection structures, such as rock fall galleries are located in the transit/deposition zone of the blasted area. High resolution laser scanning is an appropriate technology for monitoring the pre- and post blast situation and provides the basis for: 1) Geological investigations for understanding the initial cause of instabilities; 2) Monitoring the formation of potential new instabilities following blast mitigation; and 3) Integration with other spatial monitoring technologies, such as ground-based radar interferometry.

  11. Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices

    ERIC Educational Resources Information Center

    Tinetti, Mary E.; Gordon, Catherine; Sogolow, Ellen; Lapin, Pauline; Bradley, Elizabeth H.

    2006-01-01

    One third of older adults fall each year, placing them at risk for serious injury, functional decline, and health care utilization. Despite the availability of effective preventive approaches, policy and clinical efforts at preventing falls among older adults have been limited. In this article we present the burden of falls, review evidence…

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

    PubMed

    Fujita, T; Ohgitani, S; Nomura, M

    1999-01-01

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

  13. First Aid: Falls

    MedlinePlus

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

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

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  16. Effect of temperature on rate of left ventricular pressure fall in humans.

    PubMed Central

    Luke, R A; Gillbe, C E; Bonser, R S; Paneth, M; Somerset, D; Thomas, J; Gibson, D G

    1989-01-01

    The time constant (T) of left ventricular pressure fall is widely used as an index of ventricular "relaxation". It is not known whether its rate limiting step is deactivation, an enzymic energy consuming reaction whose rate is therefore sensitive to temperature, or elastic recoil. To distinguish between these possibilities, the time constant was measured by simple logarithmic (Tlog) and exponential (Texp) methods in 12 patients during cooling before coronary artery grafting. Ventricular loading conditions were altered by transfusion from bypass to maintain arterial and left atrial pressures constant in individual patients, though heart rate fell from 86 (8.4) to 68 (10) beats/min. Tlog increased from 49 (10) ms mean (SD), at 37 degrees C to 86 (15) ms at 31 degrees C, and Texp from 63(14) at 37 degrees C to 112 (23) ms at 31 degrees C with intermediate values at 34 degrees C. Texp proved sensitive to "noise" at low temperatures, but the overall change in Tlog with temperature was 9% per degree C--considerably less than that observed experimentally for the rate of tension decline of isolated myocardium, and possibly itself an overestimate because of the concomitant fall in heart rate. The relatively small effect of temperature on Tlog in humans, associated with a considerable load sensitivity appearing under hypothermic conditions, does not favour simple dependence on deactivation as the rate limiting step of left ventricular pressure fall, but suggests that its determinants may be complex. PMID:2736194

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

    PubMed

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

    2015-11-09

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

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

    PubMed

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

    2015-11-01

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

  19. Tobacco use prevention and health facilitator effectiveness.

    PubMed

    Young, R L; Elder, J P; Green, M; de Moor, C; Wildey, M B

    1988-11-01

    Tobacco prevention programs often use peers to teach refusal skills to other adolescents. College undergraduate health facilitators delivered a tobacco prevention intervention to sixth and seventh grade students in six schools. Outside observers evaluated facilitators in seven categories: being prepared, maintaining class control, keeping students' attention, encouraging participation, communication, relating to students, and working well in a team. Facilitators were rated highly in all categories. Higher rated health facilitators had more effect in reducing tobacco use than poorly rated facilitators. Facilitators who worked well in a team, related well to students, and were well-prepared were especially effective in positively influencing program outcomes.

  20. Falling chains

    NASA Astrophysics Data System (ADS)

    Wong, Chun Wa; Yasui, Kosuke

    2006-06-01

    The one-dimensional fall of a folded chain with one end suspended from a rigid support and a chain falling from a resting heap on a table is studied. Because their Lagrangians contain no explicit time dependence, the falling chains are conservative systems. Their equations of motion are shown to contain a term that enforces energy conservation when masses are transferred between subchains. We show that Cayley's 1857 energy nonconserving solution for a chain falling from a resting heap is incorrect because it neglects the energy gained when a link leaves a subchain. The maximum chain tension measured by Calkin and March for the falling folded chain is given a simple if rough interpretation. Other aspects of the falling folded chain are briefly discussed.

  1. Prevention of falls to a lower level: evaluation of an occupational health and safety intervention via subsidies for the replacement of scaffolding.

    PubMed

    Rubio-Romero, Juan Carlos; Carrillo-Castrillo, Jesús Antonio; Gibb, Alistair

    2015-01-01

    The objective of this study is to evaluate the impact of a subsidy policy for construction companies in Andalusia (Spain), which enables them to acquire new scaffolds. The rate of falls from scaffolds within the Andalusian construction sector in the period 2009-2011 was analysed. A randomised controlled trial was not possible as the subsidy was granted according to a public and competitive call. A quasi-experimental design based on an intervention group (subsidised companies) and a control group was chosen. Companies in the control group were selected from the social security census of companies in order to avoid selection bias. The subsidy policy has led to an overall 71% decrease in the rate of accident involving falls to a lower level in the companies that received grants in the period 2009-2011. The confidence interval for the comparison for the before-after difference in rates between the intervention group and the control group is found significant (confidence 95%, p = 0.05). The improvement of scaffolds was effective in reducing rates of accident with falls to a lower level. This intervention should be a priority in public policies. The process of standardisation of equipment with high accident risk should be developed further.

  2. The cancer preventive effects of edible mushrooms.

    PubMed

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

    2012-12-01

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

  3. Understanding unassisted falls: effects of nurse staffing level and nursing staff characteristics.

    PubMed

    Staggs, Vincent S; Knight, Jeff E; Dunton, Nancy

    2012-01-01

    Hierarchical Poisson modeling was used to explore hospital and nursing unit characteristics as predictors of the unassisted fall rate. Longitudinal data were collected from 1502 units in 248 US hospitals. The relation between the fall rate and total nurse staffing was positive at lower staffing levels and negative for levels around and above the median. The fall rate was negatively associated with registered nurse skill mix and average registered nurse tenure on the unit.

  4. 75 FR 27625 - Announcement of the Fall 2010 Annual Grant Competition Effective October 1, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... international peace and conflict resolution. The Annual Grant Competition is open to any project that falls within the Institute's broad mandate of international conflict resolution. Deadline: October 1,...

  5. Effects of firm size on risks and reporting of elevation fall injury in construction trades.

    PubMed

    Kines, Pete; Mikkelsen, Kim Lyngby

    2003-10-01

    Although many occupational safety programs are targeted toward large firms, the construction industry is dominated by smaller firms. This study examines the differential effect of firm size on the risk and the reporting of over 3000 serious and minor nonfatal elevation fall injuries in Danish construction industry trades (1993 to 1999). Small firms (<20 employees) accounted for 93% of all firms and 55% of worker-years. There was an inverse relationship between firm size and serious injury rates and a direct relationship between firm size and minor injury rates. An inverse relationship between firm size and injury severity odds ratios (serious versus minor) was found for carpentry, electrical work, general contracting, and the remaining other trades. Health and safety issues, legislation, and enforcement in the construction industry should, to a greater degree, be focused on smaller firms.

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

    PubMed

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

    2006-07-01

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

  7. Analyzing the problem of falls among older people

    PubMed Central

    Dionyssiotis, Yannis

    2012-01-01

    Falls are a serious problem facing the elderly. The prevention of falls that contribute to disability, mainly in elderly people, is an important issue. Ensuring the greatest possible functionality for elderly people is an important element in the prevention of disability. This paper analyzes the importance of falls, risk factors for falls, and interventions to prevent falls. Recent publications as well as research regarding the prevention and rehabilitation for falls are reviewed. PMID:23055770

  8. Effects of density on displacement, falls, injuries, and orientation during horse transportation(1).

    PubMed

    Collins; Friend; Jousan; Chen

    2000-04-01

    Three groups of slaughter-type horses, totaling 30 mares and 29 geldings, were used to determine density effects on displacement (distance moved during a stop), falls, injuries, and orientation using a single-deck, open-topped commercial semi-trailer. Each horse was assigned to one of two treatments: high density (1.28 m(2)/horse with 14 horses) or low density (2.23 m(2)/horse with eight horses). Both treatments occurred sequentially on the same day (treatment order was alternated each trial), using the middle 2.44x7.32 m compartment of a large semi-tractor trailer. The horses were transported for two laps around a 7.28-km course, averaging 25 min and 36+/-89 s. Each lap consisted of two 60 degrees turns, four 90 degrees turns, two 120 degrees turns, one 180 degrees turn, six hard brakes, and six rapid accelerations, which were more severe than conditions usually experienced in commercial transport. Displacement, falls, and orientation were recorded for each horse using overhead video cameras. Average displacement between the two densities was not different (P=0.47). The proportion of horses that fell in the high-density treatment (40%) was greater (P=0.046) than the low-density treatment (17%). The proportion of horses injured was greater (P=0.006) in high density (64%) than low density (29%). However, there was not a significant difference in the average severity of injury for the high-density treatment (1.77) versus the low-density treatment (0.92), P=0.48. Overall, the horses did not show a preference (P=0.38) for facing toward (47.5%) or away (40.7%) from the direction of travel and orientation did not differ (P0.18) between the high and low-density treatments. High stocking density of horses during transport increases the incidence of falls and injuries, and made it more difficult to get up when a subject was floored.

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

    PubMed Central

    Halfon, Matthieu; Phan, Olivier; Teta, Daniel

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2006

    2006-01-01

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

  11. Priorities among effective clinical preventive services: methods.

    PubMed

    Maciosek, Michael V; Edwards, Nichol M; Coffield, Ashley B; Flottemesch, Thomas J; Nelson, Winnie W; Goodman, Michael J; Solberg, Leif I

    2006-07-01

    Decision makers want to know which healthcare services matter the most, but there are no well-established, practical methods for providing evidence-based answers to such questions. Led by the National Commission on Prevention Priorities, the authors update the methods for determining the relative health impact and economic value of clinical preventive services. Using new studies, new preventive service recommendations, and improved methods, the authors present a new ranking of clinical preventive services in the companion article. The original ranking and methods were published in this journal in 2001. The current methods report focuses on evidence collection for a priority setting exercise, guidance for which is effectively lacking in the literature. The authors describe their own standards for searching, tracking, and abstracting literature for priority setting. The authors also summarize their methods for making valid comparisons across different services. This report should be useful to those who want to understand additional detail about how the ranking was developed or who want to adapt the methods for their own purposes.

  12. Lasers effects on enamel for caries prevention

    NASA Astrophysics Data System (ADS)

    Ana, P. A.; Bachmann, L.; Zezell, D. M.

    2006-05-01

    The aim of this study was to ascertain whether laser irradiation is able to reduce caries incidence. For this purpose, the effects of laser on enamel and on fluoride uptake were discussed. Current literature regarding the preventive effect of laser irradiation on dental hard tissue has been reviewed. An evaluation of the results of the available in vitro and in vivo studies on the efficacy of anticaries and induced changes on enamel by laser irradiation were also performed. Articles were selected using the Medline, Web of Science, Embase, and Cochrane databases, and the results of these studies were described. The most common lasers employed for caries prevention on enamel are Nd:YAG; CO2; Er:YAG; Er,Cr:YSGG; and argon. The percentage of inhibition of dental caries varied from 30 to 97.2%, and the association with fluoride has demonstrated the best results on inhibition of caries development. Laser irradiation under specific conditions can change the crystallographic properties of apatite crystals, increasing the acid resistance of lased enamel. The combined treatment of laser irradiation with fluoride propitiates an expressive fluoride uptake, reducing the progression of carieslike lesions, and this treatment is more effective than laser or fluoride alone. Available data suggest that lasers combined with fluoride is a promising treatment in caries prevention.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2006-10-01

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

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

    PubMed

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

    2006-10-01

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

  18. Quantum Incompressibility of a Falling Rydberg Atom, and a Gravitationally-Induced Charge Separation Effect in Superconducting Systems

    NASA Astrophysics Data System (ADS)

    Chiao, R. Y.; Minter, S. J.; Wegter-McNelly, K.; Martinez, L. A.

    2012-01-01

    Freely falling point-like objects converge toward the center of the Earth. Hence the gravitational field of the Earth is inhomogeneous, and possesses a tidal component. The free fall of an extended quantum mechanical object such as a hydrogen atom prepared in a high principal-quantum-number state, i.e. a circular Rydberg atom, is predicted to fall more slowly than a classical point-like object, when both objects are dropped from the same height above the Earth's surface. This indicates that, apart from transitions between quantum states, the atom exhibits a kind of quantum mechanical incompressibility during free fall in inhomogeneous, tidal gravitational fields like those of the Earth. A superconducting ring-like system with a persistent current circulating around it behaves like the circular Rydberg atom during free fall. Like the electronic wavefunction of the freely falling atom, the Cooper-pair wavefunction is quantum mechanically incompressible. The ions in the lattice of the superconductor, however, are not incompressible, since they do not possess a globally coherent quantum phase. The resulting difference during free fall in the response of the nonlocalizable Cooper pairs of electrons and the localizable ions to inhomogeneous gravitational fields is predicted to lead to a charge separation effect, which in turn leads to a large Coulomb force that opposes the convergence caused by the tidal gravitational force on the superconducting system. A "Cavendish-like" experiment is proposed for observing the charge separation effect induced by inhomogeneous gravitational fields in a superconducting circuit. The charge separation effect is determined to be limited by a pair-breaking process that occurs when low frequency gravitational perturbations are present.

  19. Survival of falling robots

    NASA Astrophysics Data System (ADS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

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

  20. Survival of falling robots

    NASA Technical Reports Server (NTRS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

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

  1. Experiments in Free Fall

    ERIC Educational Resources Information Center

    Art, Albert

    2006-01-01

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

  2. Prevention Education Effects on Fundamental Memory Processes

    PubMed Central

    Ames, Susan L.; Krank, Marvin; Grenard, Jerry L.; Sussman, Steve; Stacy, Alan W.

    2014-01-01

    This study evaluated effects of a key session from a nationally recognized drug abuse prevention program on basic memory processes in 211 high-risk youth in Southern California. In a randomized, between-subject design, the authors manipulated assignment to a Myth and Denial program session and the time of assessment (immediate vs. one-week delay). The authors examined program decay effects on memory accessibility and judgment errors. Those participants exposed to the program session generated more myths and facts from the program than those in the control group, suggesting that even a single program session influenced students’ memory for program information and this was retained at least one week and detectable with indirect tests of memory accessibility. However, consistent with basic research perspectives, participants in the program delayed assessment group erroneously generated more fact-related information from the session to the prompt “It is a myth that_____” than the participants in the program immediate assessment group; that is, they retained more facts as myths. These types of program effects, anticipated by basic memory theory, were not detected with a traditional judgment task in the present sample. The results suggest that basic science approaches offer a novel way of conceptually recasting prevention effects to more completely understand how these effects may operate. Implications for program evaluation and conceptualization are discussed. PMID:22544598

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

    PubMed Central

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

    2009-01-01

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

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

    SciTech Connect

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

    2010-03-09

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

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

    DOE PAGESBeta

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

    2010-03-09

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

  6. Preventing Falls and Related Fractures

    MedlinePlus

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

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

    PubMed Central

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

    2015-01-01

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

  8. The effects of objectively measured physical activity and fitness on fear of falling among Korean older women

    PubMed Central

    Kim, Myung; Lim, Seung-Kil; Shin, Sohee; Lee, Jae-Hyun

    2016-01-01

    We examined the effects of objectively measured physical activity (PA) and physical fitness (PF) on fear of falling (FOF) among older adults. The subjects were 94 Korean females aged 65–79. PA was measured with accelerometers, PF with the senior fitness test and FOF with the Korean Survey of Activities and Fear of Falling in the Elderly. With the subjects’ age, number of chronic conditions, and history of falls included as correction factors, a multiple regression analysis showed that PA (P=0.016) and agility/dynamic balance measured by the 8-foot up-and-go test (UNG) (P=0.001) significantly influenced FOF. The FOF of the slowest UNG quartile was significantly higher than those of other groups (P=0.002). This study concludes that among female older adults agility/dynamic balance as measured by UNG is the main factor impacting FOF and individuals with markedly low UNG tend to have high FOF. PMID:27807530

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

    PubMed

    Sophonratanapokin, Benjawan; Sawangdee, Yothin; Soonthorndhada, Kusol

    2012-11-01

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

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

    PubMed

    Liebermann, Dario G; Goodman, David

    2007-04-01

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

  11. Effectiveness of condoms in preventing HIV transmission.

    PubMed

    Pinkerton, S D; Abramson, P R

    1997-05-01

    The consistent use of latex condoms continues to be advocated for primary prevention of HIV infection despite limited quantitative evidence regarding the effectiveness of condoms in blocking the sexual transmission of HIV. Although recent meta-analyses of condom effectiveness suggest that condoms are 60 to 70% effective when used for HIV prophylaxis, these studies do not isolate consistent condom use, and therefore provide only a lower bound on the true effectiveness of correct and consistent condom use. A reexamination of HIV seroconversion studies suggests that condoms are 90 to 95% effective when used consistently, i.e. consistent condom users are 10 to 20 times less likely to become infected when exposed to the virus than are inconsistent or non-users. Similar results are obtained utilizing model-based estimation techniques, which indicate that condoms decrease the per-contact probability of male-to-female transmission of HIV by about 95%. Though imperfect, condoms provide substantial protection against HIV infection. Condom promotion therefore remains an important international priority in the fight against AIDS.

  12. Reduction in falling after a falls-assessment.

    PubMed

    Hansma, A H G; Emmelot-Vonk, M H; Verhaar, H J J

    2010-01-01

    The aim of this single-center retrospective cohort study was to evaluate the effect of a multidisciplinary falls-assessment, consisting of identification and possible modification of risk factors for falls, on the frequency of falls among elderly individuals attending the geriatric outpatient department of the University Medical Center (UMC) Utrecht, the Netherlands. The characteristics of 70 elderly people who visited the outpatient department because of a fall in the period from May 2005 till February 2007 were evaluated. The effectiveness of the falls-assessment was evaluated by telephone interview of those individuals who had attended the falls-assessment. Fifty-three patients (mean age=79.8 years) were interviewed after a mean+/-S.D. of 1.47+/-0.41 years (ranging 0.72-2.34 years) subsequent to the falls-assessment. Falls-assessment led to significantly fewer falls, from 3.78+/-4.66 at the time of the assessment at baseline to 1.10+/-1.86 at the time of the interview (p=0.000041). Fear of falling was also significantly diminished. In conclusion, falls-assessment leads to fewer falls and less fear of falling among elderly individuals.

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

    PubMed

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

    2015-07-15

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

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

    PubMed

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

    2015-07-15

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

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

    PubMed

    Kramlich, Debra L; Dende, Denise

    2016-01-01

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

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

    PubMed

    Kramlich, Debra L; Dende, Denise

    2016-01-01

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

  17. Do continence management strategies reduce falls? a systematic review.

    PubMed

    Batchelor, Frances A; Dow, Briony; Low, May-Ann

    2013-12-01

    Urinary incontinence is associated with increased fall risk, and fall prevention programs include recommendations to manage continence as one component of fall reduction. However, the evidence to support this recommendation is unclear. The aim of this study was to identify continence management interventions that are effective in decreasing falls. A systematic review of the literature was conducted. Studies were included if they evaluated the effect of any type of continence management strategy on falls in older adults. The included studies were assessed for quality, and data relating to participants, interventions and outcomes were extracted by two independent reviewers. Four articles met the inclusion criteria. Two studies were randomised controlled trials, one a retrospective cohort study and one an uncontrolled intervention study. Interventions included pharmacological agents, a toileting regime combined with physical activity and an individualised continence program. Only the study evaluating the combination of physical activity and prompted voiding found an effect on falls. It is surprising that there has been so little research into continence management interventions that include fall outcomes. A toileting regime combined with physical activity may reduce falls in residential care. There is a need for further studies investigating the impact of continence management on falls.

  18. Effects of cultivar and grazing initiation date on fall-grown oat for replacement dairy heifers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fall-grown oat has shown promise for extending the grazing season in Wisconsin, but the optimum date for initiating grazing has not been evaluated. Our objectives for this project were: i) to assess the pasture productivity and nutritive value of 2 oat cultivars (Ogle and ForagePlus; OG and FP, resp...

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

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-05-01

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

  1. Vitamin D and Sarcopenia/Falls.

    PubMed

    Lappe, Joan M; Binkley, Neil

    2015-01-01

    Maintenance of adequate vitamin D status is a stratagem to consider for sarcopenia prevention and treatment. Vitamin D deficiency is common and involves all ages of most racial/ethnic groups and both sexes. Evidence suggests that vitamin D is important for muscle strength and function, and prospective studies are underway to further define these effects. This article summarizes the potential effects of vitamin D on skeletal muscle structure and function and provides guidance for vitamin D supplementation in prevention and treatment of sarcopenia and falls. PMID:26059567

  2. Falling Sticks and Falling Balls

    NASA Astrophysics Data System (ADS)

    Bacon, M. E.; Harpst, Michael R.; Nakazawa, Ryohei

    2002-09-01

    The behavior of a falling stick, pivoted at one end, and a ball released from the same height as the end of the stick, is investigated theoretically and experimentally. The study is made possible through the use of the computer to perform the numerical computations and analysis of the experimental data. The study provides undergraduates with an opportunity to carry out a relatively simple project with interesting results.

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

    PubMed

    Wyman, Peter A

    2014-09-01

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

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

    PubMed

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

    2008-06-01

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

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

    PubMed

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

    2008-06-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  7. Comparison of the analgesic effects of bisphosphonates: etidronate, alendronate and risedronate by electroalgometry utilizing the fall of skin impedance.

    PubMed

    Fujita, Takuo; Ohue, Mutsumi; Fujii, Yoshio; Miyauchi, Akimitsu; Takagi, Yasuyuki

    2009-01-01

    Analgesic effects of etidronate, alendronate and risedronate were compared in patients with osteoporosis and/or osteoarthritis by measuring the fall of skin impedance along with conventional subjective pain-estimation by visual rating scale (VRS). One hundred ninety-nine postmenopausal women consulting the Osteoporosis and Osteoarthritis Clinic of Katsuragi Hospital complaining of back and/or knee pain were randomly divided into four groups; Group A (49 subjects) given 5 mg/day alendronate, Group E (50 subjects) 200 mg/day etidronate, Group R (50 subjects) 2.5 mg/day risedronate and Group P no bisphosphonate. None of the four groups showed significant deviation from others as to age and parameters of bone metabolism. Proportions of subjects with osteoporosis was 18-40%. Those with osteoarthritis of the spine and knee, higher than Grade II according to the Nathan and Lawrence-Kellgren scale, respectively, was 45 and 61%, respectively, without a significant difference among the four groups. Significant positive correlation was found between the fall of skin impedance and pain expressed in VRS. Attenuation of exercise-induced fall of skin impedance and also subjective pain expressed in VRS was greatest in Group E with a highly significant difference from Groups A (P = 0.0002 and P < 0.0001), R (P < 0.0001 and P = 0.0014) and P (P < 0.0001 and P < 0.0001). Neither A nor R showed significant difference from P as to the fall of skin impedance. Among the three bisphosphonates tested, etidronate appeared to be outstanding in analgesic effects.

  8. Effect of a horizontal plane boundary on a falling horizontal cylinder at low Reynolds number

    NASA Astrophysics Data System (ADS)

    Chen, Y.-J.; Hussey, R. G.

    1980-05-01

    Experimental results are presented for the change in velocity of a slender cylinder with its axis horizontal as it falls through a viscous fluid toward a horizontal plane boundary. When the boundary influence is strong, the deceleration of the cylinder is observed to be constant, and the velocity extrapolates to zero at the boundary. When the relative change in velocity is small (less than 20%), it is observed to depend inversely on the square of the distance from the boundary. The Reynolds number based on cylinder diameter ranges from 2.9 to 0.015 and the Reynolds number based on cylinder length ranges from 122 to 0.16.

  9. The effect of falling particles on the shape and spin rate of an asteroid

    NASA Astrophysics Data System (ADS)

    Vasilkova, O.

    2003-05-01

    This simulation is focused on the specific influence of the gravitational field of a very elongated rotating asteroid on the location of zones of the most intensive bombardment by falling particles. It is assumed that the particles are distributed uniformly in the space surrounding the asteroid. The asteroid shape is approximated by a triaxial ellipsoid with semiaxes 28,12,10.5 km (equal to those of asteroid 243 Ida) and by a dumb-bell of the same mass. The computations and appropriate figures show that at a rotation period faster than approximately 9.1 hours for the triaxial ellipsoid model and 3.3 hours for the dumb-bell one the leading sides of the asteroid receive a higher flux of impacting particles than the trailing sides while at slower periods the situation is the opposite. The zones of possible erosion are computed depending on the asteroid rotation period and on the ratio of impact and rebound velocities of particles. The contribution of all impacting particles to the angular momentum of the asteroid is computed, which leads to the conclusion that falling out of particles damps the asteroid rotation at any spin period.

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

    PubMed

    Yoo, Ha-Na; Chung, Eunjung; Lee, Byoung-Hee

    2013-07-01

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

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

    PubMed Central

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

    2015-01-01

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

  12. Effect of self-vibration on accuracy of free-fall absolute gravity measurement with laser interferometer

    NASA Astrophysics Data System (ADS)

    Feng, Jin-yang; Wu, Shu-qing; Li, Chun-jian; Su, Duo-wu; Yu, Mei

    2015-02-01

    A free-fall absolute gravimeter was used to measure the gravity acceleration of a corner-cube released in high vacuum, and the gravity acceleration was determined by fitting the free-falling trajectories obtained through optical interferometry. During the measurement, the self-vibration of an absolute gravimeter caused ground vibration and the change in optical path length due to vibration of vacuum-air interface, which resulted in a measurement error. Numerical simulation was run by introducing vibration disturbance to the trajectories of free-fall. The effect of disturbance under different instrumental self-vibration conditions was analyzed. Simulation results indicated that the deviation of calculated gravity acceleration from the preset value and residuals amplitude after fitting depended on the amplitude and initial phase of the vibration disturbance. The deviation value and fitting residuals amplitude increased with the increasing of amplitude and there was a one-to-one correspondence between the two. The deviation of calculated gravity acceleration decreases by properly setting the initial phase difference of vibration disturbance with respect to the interference fringe signal.

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

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

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

  14. Automatic Fall Monitoring: A Review

    PubMed Central

    Pannurat, Natthapon; Thiemjarus, Surapa; Nantajeewarawat, Ekawit

    2014-01-01

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

  15. Bullying: Effective Strategies for Its Prevention

    ERIC Educational Resources Information Center

    Scarpaci, Richard T.

    2006-01-01

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

  16. Disseminating Effective Community Prevention Practices: Opportunities for Social Work Education.

    PubMed

    Hawkins, J David; Shapiro, Valerie B; Fagan, Abigail A

    2010-01-01

    In the United States about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect 1 in 5 families and cost $247 million annually (O'Connell, Boat, & Warner, 2009). Some strategies for preventing mental, emotional, and behavioral disorders in young people have been developed, tested, and found to be effective in preventing the onset, persistence, and severity of psychological disorders, drug abuse, and delinquency. Unfortunately, tested and effective prevention policies, programs, and practices are not widely used (O'Connell, Boat, & Warner, 2009). This paper highlights recent advances in prevention science and describes some opportunities and challenges in advancing the use of science-based prevention in communities. The chapter concludes by exploring the potential role of social work education in developing a workforce ready to increase community access to effective prevention strategies.

  17. Disseminating Effective Community Prevention Practices: Opportunities for Social Work Education

    PubMed Central

    Hawkins, J. David; Shapiro, Valerie B.; Fagan, Abigail A.

    2009-01-01

    In the United States about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect 1 in 5 families and cost $247 million annually (O'Connell, Boat, & Warner, 2009). Some strategies for preventing mental, emotional, and behavioral disorders in young people have been developed, tested, and found to be effective in preventing the onset, persistence, and severity of psychological disorders, drug abuse, and delinquency. Unfortunately, tested and effective prevention policies, programs, and practices are not widely used (O'Connell, Boat, & Warner, 2009). This paper highlights recent advances in prevention science and describes some opportunities and challenges in advancing the use of science-based prevention in communities. The chapter concludes by exploring the potential role of social work education in developing a workforce ready to increase community access to effective prevention strategies. PMID:21072250

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

    ERIC Educational Resources Information Center

    Low, Sabina; Van Ryzin, Mark

    2014-01-01

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

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

    USGS Publications Warehouse

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

    2016-01-01

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

  20. Falls - Multiple Languages: MedlinePlus

    MedlinePlus

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

  1. Prevention

    MedlinePlus

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

  2. Portable, Non-Invasive Fall Risk Assessment in End Stage Renal Disease Patients on Hemodialysis.

    PubMed

    Lockhart, Thurmon E; Barth, Adam T; Zhang, Xiaoyue; Songra, Rahul; Abdel-Rahman, Emaad; Lach, John

    2010-01-01

    Patients with end stage renal diseases (ESRD) on hemodialysis (HD) have high morbidity and mortality due to multiple causes, one of which is dramatically higher fall rates than the general population. The mobility mechanisms that contribute to falls in this population must be understood if adequate interventions for fall prevention are to be achieved. This study utilizes emerging non-invasive, portable gait, posture, strength, and stability assessment technologies to extract various mobility parameters that research has shown to be predictive of fall risk in the general population. As part of an ongoing human subjects study, mobility measures such as postural and locomotion profiles were obtained from five (5) ESRD patients undergoing HD treatments. To assess the effects of post-HD-fatigue on fall risk, both the pre- and post-HD measurements were obtained. Additionally, the effects of inter-HD periods (two days vs. three days) were investigated using the non-invasive, wireless, body-worn motion capture technology and novel signal processing algorithms. The results indicated that HD treatment influenced strength and mobility (i.e., weaker and slower after the dialysis, increasing the susceptibility to falls while returning home) and inter-dialysis period influenced pre-HD profiles (increasing the susceptibility to falls before they come in for a HD treatment). Methodology for early detection of increased fall risk - before a fall event occurs - using the portable mobility assessment technology for out-patient monitoring is further explored, including targeting interventions to identified individuals for fall prevention.

  3. Alteration of the phenology of leaf senescence and fall in winter deciduous species by climate change: effects on nutrient proficiency.

    PubMed

    Estiarte, Marc; Peñuelas, Josep

    2015-03-01

    Leaf senescence in winter deciduous species signals the transition from the active to the dormant stage. The purpose of leaf senescence is the recovery of nutrients before the leaves fall. Photoperiod and temperature are the main cues controlling leaf senescence in winter deciduous species, with water stress imposing an additional influence. Photoperiod exerts a strict control on leaf senescence at latitudes where winters are severe and temperature gains importance in the regulation as winters become less severe. On average, climatic warming will delay and drought will advance leaf senescence, but at varying degrees depending on the species. Warming and drought thus have opposite effects on the phenology of leaf senescence, and the impact of climate change will therefore depend on the relative importance of each factor in specific regions. Warming is not expected to have a strong impact on nutrient proficiency although a slower speed of leaf senescence induced by warming could facilitate a more efficient nutrient resorption. Nutrient resorption is less efficient when the leaves senesce prematurely as a consequence of water stress. The overall effects of climate change on nutrient resorption will depend on the contrasting effects of warming and drought. Changes in nutrient resorption and proficiency will impact production in the following year, at least in early spring, because the construction of new foliage relies almost exclusively on nutrients resorbed from foliage during the preceding leaf fall. Changes in the phenology of leaf senescence will thus impact carbon uptake, but also ecosystem nutrient cycling, especially if the changes are consequence of water stress.

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

    NASA Astrophysics Data System (ADS)

    Kuhlman, K. L.

    2012-12-01

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

  5. Preventive effectiveness of pre-employment medical assessments.

    PubMed Central

    de Kort, W; van Dijk, F

    1997-01-01

    OBJECTIVE AND METHODS: Health gain, prevention of health loss, and avoidance of financial risk all seem to be driving forces for the use of pre-employment medical assessment. An attempt is made to measure the effect of implementing the pre-employment medical assessment on these end points. The anticipated maximum preventive effect (preventive effectiveness) of selection by means of pre-employment medical assessments for work related risks and the potential for disablement in individual workers can be calculated or estimated. Necessary parameters include test validity characteristics and epidemiological data for both the adverse outcome to be prevented, and risk factors of concern. RESULTS: The preventive effectiveness can be expressed as the effort (number of actions) needed to prevent one adverse event-for example, one case of occupational disease or one case of long term disablement. Actions include: a pre-employment health assessment, rejection of the candidate, individual precautions, adjustments of the job, and adjustments of the job environment. It seems that the preventive effectiveness of many actions can be low, implying that large numbers of actions are needed to prevent one adverse outcome. DISCUSSION: The medical assessment should consist of no more questions and tests than are required relevant to the stated aim. Particularly, when the pre-employment medical assessment is used to reject candidates at risk, the use of tests should be carefully weighed. If the preventive effectiveness is considered to be too low, then the question or test should not be incorporated for selection purposes. The application of a so called "expert judgment" should be based on professional guidelines wherever possible and should be made clear. The benefit of reducing the incidence of a serious adverse event by one may outweigh the costs of rejecting many candidates. CONCLUSIONS: The concept of preventive effectiveness may help to reach evidence based occupational medicine

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

    SciTech Connect

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

    2004-09-24

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

  7. Effects of Perturbation-Based Slip Training using a Virtual Reality Environment on Slip-induced Falls

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    2008-12-01

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

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

    PubMed Central

    2013-01-01

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

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

    PubMed

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

    2014-07-01

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

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

    USGS Publications Warehouse

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

    2002-01-01

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

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

    USGS Publications Warehouse

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

    2004-01-01

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

  13. The effects of cranberries on preventing urinary tract infections.

    PubMed

    Shin, Cha-Nam

    2014-02-01

    Despite considerable controversy about their effects, cranberries in various forms have been used widely for several decades to prevent as well as treat urinary tract infections (UTIs). The purpose of this article is to present a review of research-based information regarding the ability of cranberries to prevent UTIs in adults at risk for UTIs. Current evidence suggests that cranberries decrease bacterial adherence to uroepithelial cells and thus decrease the incidence of UTIs without adverse effects in most individuals. Thus clinicians may safely advise patients that cranberries are helpful in preventing UTIs. Cranberries may be a viable adjunct to antibiotics for patients with repeated UTIs.

  14. Falls in elderly hemodialysis patients.

    PubMed

    Abdel-Rahman, E M; Turgut, F; Turkmen, K; Balogun, R A

    2011-10-01

    The elderly, (age ≥ 65 years) hemodialysis (HD) patient population is growing rapidly across the world. The risk of accidental falls is very high in this patient population due to multiple factors which include aging, underlying renal disease and adverse events associated with HD treatments. Falls, the most common cause of fatal injury among elderly, not only increase morbidity and mortality, but also increase costs to the health system. Prediction of falls and interventions to prevent or minimize fall risk and associated complications will be a major step in helping these patients as well as decreasing financial and social burdens. Thus, it is vital to learn how to approach this important problem. In this review, we will summarize the epidemiology, risk factors, pathophysiology and complications of falls in elderly HD patients. We will also focus on available methods to assess and predict the patients at higher risk of falling and will provide recommendations for interventions to reduce the occurrence of falls in this population.

  15. Inertial sensing-based pre-impact detection of falls involving near-fall scenarios.

    PubMed

    Lee, Jung Keun; Robinovitch, Stephen N; Park, Edward J

    2015-03-01

    Although near-falls (or recoverable imbalances) are common episodes for many older adults, they have received a little attention and were not considered in the previous laboratory-based fall assessments. Hence, this paper addresses near-fall scenarios in addition to the typical falls and activities of daily living (ADLs). First, a novel vertical velocity-based pre-impact fall detection method using a wearable inertial sensor is proposed. Second, to investigate the effect of near-fall conditions on the detection performance and feasibility of the vertical velocity as a fall detection parameter, the detection performance of the proposed method (Method 1) is evaluated by comparing it to that of an acceleration-based method (Method 2) for the following two different discrimination cases: falls versus ADLs (i.e., excluding near-falls) and falls versus non-falls (i.e., including near-falls). Our experiment results show that both methods produce similar accuracies for the fall versus ADL detection case; however, Method 1 exhibits a much higher accuracy than Method 2 for the fall versus non-fall detection case. This result demonstrates the superiority of the vertical velocity over the peak acceleration as a fall detection parameter when the near-fall conditions are included in the non-fall category, in addition to its capability of detecting pre-impact falls.

  16. Effective plasma volume in cirrhosis with ascites. Evidence that a decreased value does not account for renal sodium retention, a spontaneous reduction in glomerular filtration rate (GFR), and a fall in GFR during drug-induced diuresis

    PubMed Central

    Lieberman, Fred L.; Ito, Sosuke; Reynolds, Telfer B.

    1969-01-01

    A reduction in effective (nonportal) plasma volume is considered the basis for renal sodium retention, a spontaneous reduction in glomerular filtration rate (GFR), and a fall in GFR occurring during drug-induced diuresis in patients with cirrhosis and ascites. In the present study the concept of a reduced effective plasma volume in cirrhosis is challenged by two lines of evidence, even though effective plasma volume itself could not be measured. (a) Total plasma volume failed to rise in 10 patients with the spontaneous loss of ascites, the appearance of sodium in the urine, and a rise in GFR. Portal pressure remained constant in these patients as ascites left, suggesting that effective plasma volume had not increased while portal plasma volume decreased. (b) Reduction of GFR could not be prevented in five patients with cirrhosis and ascites while total plasma volume was prevented from falling with albumin infusions during drug-induced diuresis. Reduction of GFR during drug-induced diuresis in 15 patients with cirrhosis and ascites was completely reversed with saline infusion despite continued diuresis with the identical drugs, excluding drug nephrotoxicity as the cause for the reduced GFR. The ascites of cirrhosis might no longer be regarded as a cause of effective plasma volume contraction, stimulating renal sodium retention and a reduction in GFR. More likely, this form of ascites is a result of plasma volume expansion and sodium retention. The causes for renal sodium retention and a spontaneous reduction in GFR remain unknown. The cause for a fall in GFR during drug-induced diuresis also remains unknown, but effective plasma volume contraction and drug nephrotoxicity seem excluded. Images PMID:5771197

  17. Alteration of the phenology of leaf senescence and fall in winter deciduous species by climate change: effects on nutrient proficiency.

    PubMed

    Estiarte, Marc; Peñuelas, Josep

    2015-03-01

    Leaf senescence in winter deciduous species signals the transition from the active to the dormant stage. The purpose of leaf senescence is the recovery of nutrients before the leaves fall. Photoperiod and temperature are the main cues controlling leaf senescence in winter deciduous species, with water stress imposing an additional influence. Photoperiod exerts a strict control on leaf senescence at latitudes where winters are severe and temperature gains importance in the regulation as winters become less severe. On average, climatic warming will delay and drought will advance leaf senescence, but at varying degrees depending on the species. Warming and drought thus have opposite effects on the phenology of leaf senescence, and the impact of climate change will therefore depend on the relative importance of each factor in specific regions. Warming is not expected to have a strong impact on nutrient proficiency although a slower speed of leaf senescence induced by warming could facilitate a more efficient nutrient resorption. Nutrient resorption is less efficient when the leaves senesce prematurely as a consequence of water stress. The overall effects of climate change on nutrient resorption will depend on the contrasting effects of warming and drought. Changes in nutrient resorption and proficiency will impact production in the following year, at least in early spring, because the construction of new foliage relies almost exclusively on nutrients resorbed from foliage during the preceding leaf fall. Changes in the phenology of leaf senescence will thus impact carbon uptake, but also ecosystem nutrient cycling, especially if the changes are consequence of water stress. PMID:25384459

  18. Prevention

    MedlinePlus

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

  19. Falls and Older Adults

    MedlinePlus

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

  20. Falls in Nursing Homes

    MedlinePlus

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  2. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review.

    PubMed

    Cadore, Eduardo Lusa; Rodríguez-Mañas, Leocadio; Sinclair, Alan; Izquierdo, Mikel

    2013-04-01

    The aim of this review was to recommend training strategies that improve the functional capacity in physically frail older adults based on scientific literature, focusing specially in supervised exercise programs that improved muscle strength, fall risk, balance, and gait ability. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus, and ScienceDirect databases were searched from 1990 to 2012. Studies must have mentioned the effects of exercise training on at least one of the following four parameters: Incidence of falls, gait, balance, and lower-body strength. Twenty studies that investigated the effects of multi-component exercise training (10), resistance training (6), endurance training (1), and balance training (3) were included in the present revision. Ten trials investigated the effects of exercise on the incidence of falls in elderly with physical frailty. Seven of them have found a fewer falls incidence after physical training when compared with the control group. Eleven trials investigated the effects of exercise intervention on the gait ability. Six of them showed enhancements in the gait ability. Ten trials investigated the effects of exercise intervention on the balance performance and seven of them demonstrated enhanced balance. Thirteen trials investigated the effects of exercise intervention on the muscle strength and nine of them showed increases in the muscle strength. The multi-component exercise intervention composed by strength, endurance and balance training seems to be the best strategy to improve rate of falls, gait ability, balance, and strength performance in physically frail older adults.

  3. Performance of High Strength Rock Fall Meshes: Effect of Block Size and Mesh Geometry

    NASA Astrophysics Data System (ADS)

    Buzzi, Olivier; Leonarduzzi, E.; Krummenacher, B.; Volkwein, A.; Giacomini, A.

    2015-05-01

    In rockfall science, the bullet effect refers to the perforation of a rockfall mesh by a small block traveling at high speed. To date, there is still no comprehensive experimental data set investigating the underlying mechanisms of such effect. The bullet effect illustrates the fact that the capacity of a rockfall mesh depends on the size and speed of the impacting block. This paper presents the results of an experimental study on the effect of block size and mesh geometry (aperture and wire diameter) on the mesh performance. The results clearly show that the amount of energy required to perforate the mesh drops as the blocks get smaller. They also suggest that the mesh performance reaches a maximum and reduces to zero when the mesh cannot sustain the static load imposed by very large blocks. The outcome of the first series validates an analytical model for mesh perforation, making it the first simple model capturing the bullet effect. A second series of tests focused on the effect of mesh geometry and it was found that decreasing the mesh aperture by 19 % improves the performance by 50 % while only an extra 30 % could be gained by increasing the wire diameter by 33 %. The outcomes of the second series were used to discuss and redefine a dimensionless geometrical parameter G* and to validate a simple power type equation relating the mesh characteristics and the mesh performance.

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

    PubMed Central

    McDonald, Rachael; McGinley, Jennifer

    2015-01-01

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

  5. Allergy-preventive effects of the flowers of Impatiens textori.

    PubMed

    Iwaoka, Emiko; Oku, Hisae; Iinuma, Munekazu; Ishiguro, Kyoko

    2010-01-01

    The allergy-preventive activity of a 35% EtOH extract (IT) of flowers of Impatiens textori MIQ. was demonstrated in a continuing search for allergy-preventive substances from natural sources. The evaluation of its activity used an in vivo assay method for monitoring the blood flow decrease in the tail vein microcirculation of mice subjected to sensitization with hen-egg white lysozyme. Among the principal compounds in IT, apigenin (1), luteolin (3), and luteolin 7-glucoside (4) showed significant allergy-preventive effects. PMID:20410612

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

    Brown, Dina

    2008-01-01

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

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

    USGS Publications Warehouse

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

    1989-01-01

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

  9. BIOACTIVE SUBSTANCES WITH PREVENTIVE EFFECT IN CARDIOVASCULAR DISEASES.

    PubMed

    Mulero, Juana; Abellán, José; Zafrilla, Pilar; Amores, Diego; Hernández Sánchez, Pilar

    2015-10-01

    The effect of diet on cardiovascular disease prevention has been widely studied for many years. Numerous studies have confirmed that diets rich in fruits and vegetables (Mediterranean diet) are beneficial to the cardiovascular system and various bioactive food components have preventive effect on chronic diseases such as cardiovascular disease. In this paper we review the effect of bioactive substances included in the group of flavonoids (catechins and proanthocyanidins, anthocyanins and isoflavones), stilbenes such as resveratrol, bioactive peptides, plant sterols and polyunsaturated fatty acids omega- 3 on the cardiovascular system.

  10. 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

  11. Effects of Correspondence Training in an Abduction Prevention Training Program.

    ERIC Educational Resources Information Center

    Olsen-Woods, Laurie A.; Miltenberger, Raymond G.; Foreman, Greg

    1998-01-01

    Examines the effects of adding correspondence training to a behavioral skills training package that taught abduction prevention skills to 31 children, ages 4-5 years. Results indicate that correspondence training did not improve correspondence between saying and doing target behaviors. However, both training approaches were equally effective in…

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

    USGS Publications Warehouse

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

    1989-01-01

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

  13. Effectiveness of HIV prevention for women: what is working?

    PubMed

    Gil-Llario, María Dolores; Ballester-Arnal, Rafael; Giménez-García, Cristina; Salmerón-Sánchez, Pedro

    2014-10-01

    The HIV-AIDS remains a public health problem which disproportionally affects women. However, prevention strategies have rarely considered their specific efficacy for them. For this reason, this study examines the differential effectiveness of six intervention elements based on socio-cognitive theories addressing young women. A controlled between-groups design examined the change in risk profile among 167 young Spanish women (mean age 21.3 years old) involved in five sexual risk prevention interventions (informative talk, attitudinal discussion, role-play, fear induction and informative website) and one control non-intervening group (waiting list). Our findings support the differential efficacy of some HIV preventive intervention elements comparing others for women. In particular, the attitudinal discussion stands out followed by the informative talk and the role play. Contrarily, the fear induction component did not reveal relevant improvements. This study provides new evidence related to HIV prevention. Particularly, the higher efficacy of motivational components for these young Spanish women is revealed.

  14. Fall Enrollment Report. 2014

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2014

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    PubMed

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

    2007-04-01

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

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

    PubMed

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

    2007-04-01

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

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

    SciTech Connect

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

    1982-05-01

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

  19. Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

    PubMed Central

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

    2016-01-01

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

  20. Resource Effective Strategies to Prevent and Treat Cardiovascular Disease.

    PubMed

    Schwalm, J D; McKee, Martin; Huffman, Mark D; Yusuf, Salim

    2016-02-23

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

  1. Resource Effective Strategies to Prevent and Treat Cardiovascular Disease.

    PubMed

    Schwalm, J D; McKee, Martin; Huffman, Mark D; Yusuf, Salim

    2016-02-23

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

  2. Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation.

    PubMed

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

    2014-11-01

    [Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessing physical performances. We evaluated depression and fear of falling for assessing psychological functions. [Results] Relative to the control group, the core stability training group showed statistically significant overall changes after the training session: an increase in POMA scores, faster CV, lower MVHC, and a decrease in knee flexion angle. Furthermore, depression and fear of falling decreased significantly. [Conclusion] CSE can have a positive effect on the improvement of physical and psychological performances of older women who are vulnerable to falls as they negotiate everyday obstacles.

  3. Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation

    PubMed Central

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

    2014-01-01

    [Purpose] The aim of the present study was to investigate the effects of core stability exercise (CSE) on the physical and psychological functions of elderly women while negotiating general obstacles. [Subjects and Methods] After allocating 10 elderly women each to the core stability training group and the control group, we carried out Performance-Oriented Mobility Assessment (POMA) and measured crossing velocity (CV), maximum vertical heel clearance (MVHC), and knee flexion angle for assessing physical performances. We evaluated depression and fear of falling for assessing psychological functions. [Results] Relative to the control group, the core stability training group showed statistically significant overall changes after the training session: an increase in POMA scores, faster CV, lower MVHC, and a decrease in knee flexion angle. Furthermore, depression and fear of falling decreased significantly. [Conclusion] CSE can have a positive effect on the improvement of physical and psychological performances of older women who are vulnerable to falls as they negotiate everyday obstacles. PMID:25435680

  4. [Effectiveness of the preparation Gavinton in preventing motion sickness].

    PubMed

    Bodo, D; Kotovskaia, A R; Galle, R R; Gavrilova, L N; Gusakova, G A

    1982-01-01

    The effectiveness of the Hungarian drug kavinton used to prevent motion sickness was assessed. During the study 8 motion sickness susceptible test subjects were kept in a chamber rotating at a rate of 6 rpm for 5 hours. The effectiveness of the drug taken regularly during the exposure was compared with that of scopolamine and placebo taken as a single dose. The results obtained are suggestive of a positive effect of kavinton as an antimotion drug.

  5. The Fall and Fall of Gary Hart.

    ERIC Educational Resources Information Center

    Rowland, Robert C.

    The fall of Gary Hart, brought about because of his indiscretions during the 1988 presidential campaign, should not be treated exclusively as a consequence of Hart's moral failings. Rather, the fall of Hart can be traced to a complex of factors including bad judgment, the near total control that the press exercises over the political agenda, and…

  6. [Stress prevention programs--strategies, techniques, effectiveness. Part II. Organizational activities to prevent stress at work].

    PubMed

    Małgorzata, W; Merecz, Dorota; Drabek, Marcin

    2010-01-01

    This is the second part of the publication on approaches to occupational stress prevention and a state of the art in different European countries. In this part, stress prevention within an organization is described and discussed. Although there is no one way of tackling stress at work, some recommendations can be formulated to increase the effectiveness of such interventions. The effective stress reducing programs should be aimed both at changes in the organization itself and empowerment of employees' coping with stress resources. It is also important to take the advantage of wide spectrum of methods and techniques (e.g., work redesign, participation, team work, cognitive behavioral methods, relaxation, etc.) remembering that one size does not fit all. The intervention should be carefully planned and adopted to the various branches, an individual organization or department and should be preceded by the identification of stress risks and risk groups. To have the stress prevention program successfully introduced one should also consider factors which may influence (positively or negatively) the process of program implementation.

  7. Motorized two-point safety belt effectiveness in preventing fatalities.

    PubMed

    Evans, L

    1991-01-01

    The effectiveness of two-point motorized restraint systems in preventing fatalities to outboard front-seat car occupants is estimated using published fatality data for one model car equipped with a motorized two-point-belt system, together with a number of assumptions. Effectiveness estimates are obtained for the motorized belt system as used in the field, which reflects the mix of occupants who do and do not fasten the manual lap belt, and for effectiveness when the lap belt is not used. This latter estimate is, therefore, an estimate of the effectiveness of shoulder belts in preventing fatalities. In the data for the one car model, 18% of the fatally injured occupants were ejected. By assuming that three-point belt systems prevent ejection, these data are used to compute the difference in effectiveness between two-point and three-point systems. The result applies to the two-point belt system used in conjunction with whatever manual belt-use rates occurred in traffic. From published observations of lap-belt-use rates for this same vehicle, the effectiveness of the shoulder belt only is estimated. It is found that effectiveness of the two-point restraint system in conjunction with the lap-belt use that occurred in traffic is (32 +/- 5)%. The effectiveness of the shoulder belt only is estimated as (29 +/- 8)%. PMID:2029317

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

    ERIC Educational Resources Information Center

    Fashola, Olatokunbo S.; Slavin, Robert E.

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  10. Numerical study on the freely falling plate: Effects of density ratio and thickness-to-length ratio

    NASA Astrophysics Data System (ADS)

    Wang, Y.; Shu, C.; Teo, C. J.; Yang, L. M.

    2016-10-01

    A numerical study on two-dimensional (2D) rectangular plates falling freely in water is carried out in the range of 1.2 ≤ ρs/f ≤ 5.0 and 1/20 ≤ β ≤ 1/4, where ρs/f is the solid-to-water density ratio and β is the plate thickness-to-length ratio. To study this problem, the immersed boundary-lattice Boltzmann flux solver in a moving frame is applied and validated. For the numerical result, a phase diagram is constructed for fluttering, tumbling, and apparent chaotic motions of the plate parameterized using ρs/f and β. The evolution of vortical structures in both modes is decomposed into three typical stages of initial transient, deep gliding, and pitching-up. Various mean and instantaneous fluid properties are illustrated and analyzed. It is found that fluttering frequencies have a linear relationship with the Froude number for all cases considered. Lift forces on fluttering plates are linearly dependent on the angle of attack α at the cusp-like turning point when |" separators=" α | ≥ π / 5 . Hysteresis of the lift force on fluttering plates is observed and explained whilst the drag forces are the same when |" separators=" α | has the same value. Meanwhile, the drag force in the tumbling motion may have a positive propulsive effect when the plate begins a tumbling rotation from α = π/2.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Lee, Jae-Hyun; Sung, Eunsook

    2015-10-01

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

  13. How Effective Homelessness Prevention Impacts the Length of Shelter Spells

    PubMed Central

    Goodman, Sarena; Messeri, Peter; O’Flaherty, Brendan

    2014-01-01

    Homelessness prevention programs intervene with households apparently in imminent danger of becoming homeless, and try to keep them housed. If they are at least partially successful, how do they change the average shelter spell of households actually becoming homeless? We use data from 2003 to 2008 for Homebase, a New York City homelessness prevention program that studies have found to be effective in reducing shelter entries. Homebase made no difference in average shelter spells at the community level. This result, like many results about shelter spell length, is not easy to reconcile with the idea that shelter spell length is a reflection of the seriousness of underlying problems. PMID:24610995

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

    ERIC Educational Resources Information Center

    Dong, Nianbo

    2009-01-01

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

  15. Validating a multifactorial falls risk assessment.

    PubMed

    James, Michele B; Kimmons, Nancy J; Schasberger, Britta; Lefkowitz, Abigail

    2014-01-01

    Reducing risk of falls has been identified as a national safety goal by The Joint Commission (TJC). The purpose was to determine if the total score on the multifactorial Falls Risk Assessment accurately identifies the risk of falls in a homebound client. In addition, the study examined if any individual item had a higher predictive power with the incidence of falls. One hundred clients (> 65 years old) who sustained an avoidable fall during a home care episode of care, plus 25 home care clients in the same age range and time period, who did not fall. A retrospective chart review, including Falls Risk Assessment (FRA) performed at start of care, demographic information, specific physical therapy (PT) evaluation, and visit notes if necessary to determine if the fall met the inclusion criteria. Scores for each individual area of the assessment were collected for statistical analysis. Data were analyzed by a biostatistician using simple linear regression, t-tests, and regression of variable combinations. The total score on the multifactorial risk assessment tool was shown to have a strong relationship with incidence of falls. The average scores of individuals who fell after assessment were significantly higher than those of individuals who did not fall. No single factors were found to be highly predictive. A single approach to decreasing falls is likely to be less effective than a multipronged approach. Caregivers and providers are advised to consider the entirety of the falls risk and direct comprehensive interventions to address the multiple factors that lead to falls.

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    PubMed

    Garlichs, Dietrich

    2015-10-01

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

  18. IDENTIFYING ROOF FALL PREDICTORS USING FUZZY CLASSIFICATION

    SciTech Connect

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

    2010-02-22

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

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

    USGS Publications Warehouse

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

    1996-01-01

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

  20. Effectiveness of condoms in preventing sexually transmitted infections.

    PubMed

    Holmes, King K; Levine, Ruth; Weaver, Marcia

    2004-06-01

    In June 2000, the United States National Institutes of Health (NIH) organized a review of the scientific evidence on the effectiveness of condoms in preventing sexually transmitted infections (STIs). The review concluded that condoms were effective in protecting against transmission of HIV to women and men and in reducing the risk of men becoming infected with gonorrhoea. Evidence for the effectiveness of condoms in preventing other STIs was considered to be insufficient. We review the findings of prospective studies published after June 2000 that evaluated the effectiveness of condoms in preventing STIs. We searched Medline for publications in English and included other articles, reports, and abstracts of which we were aware. These prospective studies, published since June 2000, show that condom use is associated with statistically significant protection of men and women against several other types of STIs, including chlamydial infection, gonorrhoea, herpes simplex virus type 2, and syphilis. Condoms may also be associated with protecting women against trichomoniasis. While no published prospective study has found protection against genital human papillomavirus (HPV) infection, two studies reported that condom use was associated with higher rates of regression of cervical intraepithelial neoplasia and clearance of cervical HPV infection in women and with regression of HPV-associated penile lesions in men. Research findings available since the NIH review add considerably to the evidence of the effectiveness of condoms against STIs. Although condoms are not 100% effective, partial protection can substantially reduce the spread of STIs within populations.

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

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

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

  2. Meteorite Falls in Morocco

    NASA Astrophysics Data System (ADS)

    Chennaoui Aoudjehane, H.

    2016-08-01

    The number of meteorite falls reported in Morocco since 2000 is highest than any other place compared to the other countries in the world, that call into question the efficiency of the randomly meteorite falls on Earth.

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

    PubMed

    Forgatch, M S; DeGarmo, D S

    1999-10-01

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

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

    USGS Publications Warehouse

    Winters, Karl E.; Baldys, Stanley

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

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

  6. Gender Differences in Utilization of Effective Cardiovascular Secondary Prevention: A Cleveland Clinic Prevention Database Study

    PubMed Central

    CHO, LESLIE; HOOGWERF, BYRON; HUANG, JULIE; BRENNAN, DANIELLE M.; HAZEN, STANLEY L.

    2010-01-01

    Background Previous studies have suggested that women with cardiovascular disease may receive less aggressive care than men. Using a large cardiology database from a tertiary referral center, we sought to determine if treatment differences still persist in the current era. Methods We analyzed data on 2462 patients who were referred for secondary prevention to the Preventive Cardiology Clinic at The Cleveland Clinic Foundation between 1997 and 2004. The primary objective was to evaluate use of effective secondary preventive therapies, by gender, as outlined in the ACC/AHA guidelines, such as antiplatelet therapy, beta-blockers, statins, and angiotensin-converting enzyme (ACE) inhibitors. Multivariate logistic regression analysis was performed to assess the independent effect of gender on all cause mortality. Results Women were older (62.2 ± 11.1 vs. 59.4 ± 11.0, p < 0.001) and more likely to be hypertensive (68.1% vs. 56.1%, p < 0.001) than men. Overall, women were more likely than men to have higher baseline C-reactive protein (CRP) (6.14 ± 13.4 vs. 4.9 ± 10.7, p < 0.001), low-density lipoprotein cholesterol (LDL-C) (135 ± 66 vs. 116 ± 46, p < 0.001), high-density lipoprotein cholesterol (HDL-C) (52 ± 17 vs. 41 ± 11, p < 0.001), and total cholesterol (238 ± 98 vs. 202 ± 65, p < 0.001). Women were less likely to be on antiplatelet therapy (76.6 % vs. 85.0%, p < 0.001) and statins or any lipid-lowering therapy (62.6% vs. 67.1%, p = 0.04) compared with men on presentation. Conclusions Even in the current era, women with established cardiovascular disease continue to receive less aggressive care than men. They are less likely to be on aspirin and statin therapy. More aggressive efforts should be made to treat both men and women with standard secondary preventive efforts. PMID:18345999

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

    ERIC Educational Resources Information Center

    Kraizer, Sherryll; And Others

    1989-01-01

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

  8. HIV prevention cost-effectiveness: a systematic review

    PubMed Central

    2009-01-01

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

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

    PubMed

    Low, Sabina; Van Ryzin, Mark

    2014-09-01

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

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

    PubMed

    Low, Sabina; Van Ryzin, Mark

    2014-09-01

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

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

    PubMed

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

    2015-05-01

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

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

    SciTech Connect

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

    2004-09-01

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

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

    PubMed

    Demons, Jamehl L; Duncan, Pamela W

    2014-01-01

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

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

    PubMed

    Topolinski, Sascha; Strack, Fritz

    2010-05-01

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

  15. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial

    PubMed Central

    Morello, Renata T; Wolfe, Rory; Brand, Caroline A; Haines, Terry P; Hill, Keith D; Brauer, Sandra G; Botti, Mari; Cumming, Robert G; Livingston, Patricia M; Sherrington, Catherine; Zavarsek, Silva; Lindley, Richard I; Kamar, Jeannette

    2016-01-01

    Objective To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. Design Cluster randomised controlled trial. Setting Six Australian hospitals. Participants All patients admitted to 24 acute wards during the trial period. Interventions Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: “falls alert” sign, supervision of patients in the bathroom, ensuring patients’ walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. Main outcome measures The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. Results During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients’ characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; P<0.001). In all, 1831 falls and 613 fall injuries occurred, and the rates of falls (incidence rate ratio 1.04, 0.78 to 1.37; P=0.796) and fall injuries (0.96, 0.72 to 1.27; P=0.766) were similar in intervention and control wards. Conclusions Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611000332921. PMID:26813674

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

    PubMed Central

    Harmer, Peter

    2015-01-01

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

  17. [Clinical effectiveness and economical evaluation of preventive vaccination].

    PubMed

    Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, Margarida

    2011-01-01

    The value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the history of mass vaccination and its scientists, responsible for synthesis and marketing of these drugs. In second place we present a group of a few disease preventable by vaccines as well as the Portuguese National Vaccination Plan and its benefits. In third place we identified groups of subjects in which a well structured vaccination plan is particularly important, as well as the correspondent diseases to be covered by vaccination. Fourthly, we discussed the ethical considerations of vaccination, and its tensions between subject autonomy and society advantages in com pulsive programs. Fifthly, we analyzed clinical effectiveness of vaccines through the concept of herd immunity, clinical evaluation of immune response to vaccines and some examples of systematic reviews on three relevant diseases (influenza, meningococcal and pneumococcal infections). In sixth place we discussed vaccine safety presenting monitoring methods of vaccination risks, as well as discussing the public myths concerning vaccines. Finally we present a economic analysis of preventive vaccination with a review of some published literature on specific diseases. We conclude that mass vaccination is a efficacious preventive measure, as well as a economic rational choice, and that this public health intervention should be a pillar of a modern preventive system.

  18. Predicting Falls in Parkinson Disease: What Is the Value of Instrumented Testing in OFF Medication State?

    PubMed Central

    Hoskovcová, Martina; Dušek, Petr; Sieger, Tomáš; Brožová, Hana; Zárubová, Kateřina; Bezdíček, Ondřej; Šprdlík, Otakar; Jech, Robert; Štochl, Jan; Roth, Jan; Růžička, Evžen

    2015-01-01

    Background Falls are a common complication of advancing Parkinson's disease (PD). Although numerous risk factors are known, reliable predictors of future falls are still lacking. The objective of this prospective study was to investigate clinical and instrumented tests of balance and gait in both OFF and ON medication states and to verify their utility in the prediction of future falls in PD patients. Methods Forty-five patients with idiopathic PD were examined in defined OFF and ON medication states within one examination day including PD-specific clinical tests, instrumented Timed Up and Go test (iTUG) and computerized dynamic posturography. The same gait and balance tests were performed in 22 control subjects of comparable age and sex. Participants were then followed-up for 6 months using monthly fall diaries and phone calls. Results During the follow-up period, 27/45 PD patients and 4/22 control subjects fell one or more times. Previous falls, fear of falling, more severe motor impairment in the OFF state, higher PD stage, more pronounced depressive symptoms, higher daily levodopa dose and stride time variability in the OFF state were significant risk factors for future falls in PD patients. Increased stride time variability in the OFF state in combination with faster walking cadence appears to be the most significant predictor of future falls, superior to clinical predictors. Conclusion Incorporating instrumented gait measures into the baseline assessment battery as well as accounting for both OFF and ON medication states might improve future fall prediction in PD patients. However, instrumented testing in the OFF state is not routinely performed in clinical practice and has not been used in the development of fall prevention programs in PD. New assessment methods for daylong monitoring of gait, balance and falls are thus required to more effectively address the risk of falling in PD patients. PMID:26443998

  19. Fall Risk Assessment Tools for Elderly Living in the Community: Can We Do Better?

    PubMed Central

    Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Chiari, Lorenzo

    2015-01-01

    Background Falls are a common, serious threat to the health and self-confidence of the elderly. Assessment of fall risk is an important aspect of effective fall prevention programs. Objectives and methods In order to test whether it is possible to outperform current prognostic tools for falls, we analyzed 1010 variables pertaining to mobility collected from 976 elderly subjects (InCHIANTI study). We trained and validated a data-driven model that issues probabilistic predictions about future falls. We benchmarked the model against other fall risk indicators: history of falls, gait speed, Short Physical Performance Battery (Guralnik et al. 1994), and the literature-based fall risk assessment tool FRAT-up (Cattelani et al. 2015). Parsimony in the number of variables included in a tool is often considered a proxy for ease of administration. We studied how constraints on the number of variables affect predictive accuracy. Results The proposed model and FRAT-up both attained the same discriminative ability; the area under the Receiver Operating Characteristic (ROC) curve (AUC) for multiple falls was 0.71. They outperformed the other risk scores, which reported AUCs for multiple falls between 0.64 and 0.65. Thus, it appears that both data-driven and literature-based approaches are better at estimating fall risk than commonly used fall risk indicators. The accuracy–parsimony analysis revealed that tools with a small number of predictors (~1–5) were suboptimal. Increasing the number of variables improved the predictive accuracy, reaching a plateau at ~20–30, which we can consider as the best trade-off between accuracy and parsimony. Obtaining the values of these ~20–30 variables does not compromise usability, since they are usually available in comprehensive geriatric assessments. PMID:26716861

  20. State of science: occupational slips, trips and falls on the same level *

    PubMed Central

    Chang, Wen-Ruey; Leclercq, Sylvie; Lockhart, Thurmon E.; Haslam, Roger

    2016-01-01

    Abstract Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions. Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial. PMID:26903401

  1. State of science: occupational slips, trips and falls on the same level.

    PubMed

    Chang, Wen-Ruey; Leclercq, Sylvie; Lockhart, Thurmon E; Haslam, Roger

    2016-07-01

    Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions. Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial. PMID:26903401

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

    Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more) living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0) and at the end of the study (T12-month). Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5) at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54), p = 0.002). Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies. PMID:27635246

  4. Implementing Research-Based Substance Abuse Prevention in Communities: Effects of a Coalition-Based Prevention Initiative in Vermont

    ERIC Educational Resources Information Center

    Flewelling, Robert L.; Austin, David; Hale, Kelly; LaPlante, Marcia; Liebig, Melissa; Piasecki, Linda; Uerz, Lori

    2005-01-01

    Despite the popularity and perceived potential effectiveness of community-based coalitions in helping to prevent and reduce adolescent substance use, empirical evidence supporting this approach is sparse. Many reasons have been suggested for why coalition-based prevention initiatives, and community-level interventions in general, have not…

  5. Can chaos theory be used to increase preventive maintenance effectiveness?

    PubMed

    Rice, W P

    1996-01-01

    Clinical engineering programs typically establish the content and frequency of a device's inspection and preventive maintenance procedures at the time of implementation. In some programs, these are not altered throughout the device's useful life. In others, history data and traditional statistical methods are used to adapt procedures to change in risk measures. Such methods are essentially reactive in that they are based upon past trends and do not readily consider potentialities for future change in the performance and utilization environments. Chaos theoretical concepts and related measures, when implemented in artificial intelligence programs such as neural networks and genetic algorithms, and used as an adjunct with computerized technology management programs, can assist in asking and answering the more dynamic, proactive questions necessary for effective inspection and preventive maintenance optimization. Today's healthcare environment is ideal for exploring their utilization. PMID:10159655

  6. Cost-effectiveness analysis of rheumatic heart disease prevention strategies.

    PubMed

    Manji, Rizwan A; Witt, Julia; Tappia, Paramjit S; Jung, Young; Menkis, Alan H; Ramjiawan, Bram

    2013-12-01

    Rheumatic heart disease (RHD), secondary to group A streptococcal infection is endemic in the developing as well as parts of the developed world with significant costs to the patient, and to the healthcare system. We briefly review the prevalence and cost of RHD in developed and developing nations. We subsequently develop a Markov model to evaluate the cost-effectiveness of three strategies (vs standard no prevention) for preventing RHD in a developing world country: primary prophylaxis (throat swab to detect and subsequently treat group A streptococci as needed); primary prophylaxis (antibiotic prophylaxis for all) with benzathine penicillin G once monthly to all patients (ages 5-21 years) regardless of evidence of infection; and secondary prophylaxis with monthly only to those with echocardiographic evidence of early RHD. Our model suggests that echocardiographic screening and secondary prophylaxis is the best strategy although the strategies change depending on parameters used.

  7. Preventing falls - what to ask your doctor

    MedlinePlus

    ... Ankle replacement Bunion removal Cataract removal Corneal transplant Hip joint replacement Knee joint replacement Spinal fusion Patient Instructions ... discharge Stroke - discharge Taking care of your new hip joint Update Date 2/8/2015 Updated by: Laura ...

  8. Effect of simulated fall heat waves on cold hardiness and winter survival of hemlock looper, Lambdina fiscellaria (Lepidoptera: Geometridae).

    PubMed

    Vallières, Rosemarie; Rochefort, Sophie; Berthiaume, Richard; Hébert, Christian; Bauce, Éric

    2015-02-01

    The hemlock looper (Lambdina fiscellaria) is an important pest of eastern Canadian forests. The ongoing climate warming could modify the seasonal ecology of this univoltine species that lays eggs at the end of summer and overwinters at this stage. Indeed, the increase in frequency and intensity of extreme climatic events such as fall heat waves could interfere with the winter metabolism of the hemlock looper. Moreover, the host plant quality, which influences the quantity of insect energetic reserves, the geographic origin of populations and the conditions prevailing during the cold acclimation period, could cause various responses of this pest to climate warming. The main objective of this study is to determine the impact of these factors on hemlock looper winter biology. In October 2010, hemlock looper eggs initially collected from two geographic areas in the province of Québec, and from parents reared on two host plants, were exposed to fall heat waves of different intensities during 5 consecutive days. Supercooling points and cryoprotectant levels were measured on eggs on four different dates in 2010-2011 and survival rate was measured in April 2011. Our results show that hemlock looper eggs have a very low supercooling point and high levels of trehalose, glucose and mannitol in September and November. However, there is no clear relationship between the concentration of these compounds and the decrease in supercooling points. Contents in trehalose, glucose and mannitol were significantly influenced by fall heat waves and by the origin of the population. Winter survival of eggs from the temperate population was negatively affected by strong heat waves while the boreal population was not affected. This study suggests that the metabolism and winter survival of temperate hemlock looper populations in Québec will be more affected by fall heat waves that will increase in frequency due to climate change, than boreal populations.

  9. Gait characteristics of patients with phobic postural vertigo: effects of fear of falling, attention, and visual input.

    PubMed

    Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Brandt, Thomas; Jahn, Klaus

    2014-04-01

    Phobic postural vertigo (PPV) is the most common cause of chronic dizziness in middle-aged patients. Many patients report symptoms involving gait. We investigated the gait performance and its relationship to the fear of falling and attention of PPV patients in a prospective study of 24 patients with PPV and 24 healthy subjects (HS) using a pressure-sensitive mat (GAITRite(®)). Subjects walked at three different speeds (slow, preferred, fast), both during cognitive dual tasks (DTc) and with eyes closed (EC). Falls efficacy and balance confidence were rated by the Falls Efficacy Scale-International (FES-I) and the Activities-specific Balance Confidence Scale (ABC). PPV patients walked slower, with reduced cadence (all p < 0.01), stride length (p < 0.05), and increased double support (p < 0.01) compared to HS. These changes correlated with FES-I (R = -0.528, p < 0.001) and ABC (R = 0.481, p < 0.01). Walking deterioration under DTc did not differ between PPV patients and HS, but patients showed a reduced cognitive processing speed (p < 0.05). When walking with EC, gait speed decreased more in PPV patients compared to HS (p < 0.05). Patients with PPV show gait changes which correlate with their fear of falling and balance confidence. Absent visual feedback leads to more pronounced gait deteriorations in PPV patients than in HS, indicating a higher reliance of patients on visual information during walking. These findings support the view that the gait characteristics of PPV can be attributed to an inadequate, cautious gait control.

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

    PubMed

    Haskell, William L

    2003-01-01

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

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

    PubMed

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

    2016-09-01

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

  12. Contextualism and the development of effective prevention practices.

    PubMed

    Biglan, Anthony

    2004-03-01

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

  13. Effectiveness of interventions in the prevention of childhood obesity.

    PubMed

    Bautista-Castaño, Inmaculada; Doreste, Jorge; Serra-Majem, Lluis

    2004-01-01

    The prevalence of childhood obesity, as with that of adulthood, has increased considerably over the past few years and has become a serious public health problem. Once established, its treatment is very difficult and, hence, prevention of childhood obesity using different types of intervention appears promising. The objective of this present report is to review interventions that had been conducted over the past 11 years in the environment of the family, schools and community, and directed towards the prevention of childhood obesity. We reviewed the different strategies employed, the different criteria used in defining weight status, the evaluation and follow-up methods, and the degree of effectiveness. Benefits other than reduced weight gain were assessed, as well. In our review, we selected 14 intervention studies. The differences in design, duration and outcome assessments make direct comparison difficult. Nevertheless, it seems that nutritional education and promotion of physical activity together with behaviour modifications, decrease in sedentary activities and the collaboration of the family could be the determining factors in the prevention of childhood obesity. Other important benefits regarding healthy habits apart from the changes in weight status were pursued in the majority of the studies reviewed. The need for well-designed studies that examine a range of interventions remains a priority.

  14. Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

    PubMed Central

    2012-01-01

    Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST), extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs) in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor. As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent. Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination. Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy makers and programme planners

  15. Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains.

    PubMed

    Korenromp, Eline L

    2012-03-28

    Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST), extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs) in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor. As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent.Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination.Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy makers and programme planners

  16. Promoting successful aging through effective prevention and management of osteoporosis.

    PubMed

    Cavalieri, Thomas A; Noll, Donald R

    2013-02-01

    Successful aging has been described as having 3 components: a low probability of disease and disease-related disability, a capacity for high cognitive and physical function, and active engagement with social and productive activities. Osteopathic physicians play a critical role in the promotion of successful aging through the prevention, early detection, and management of osteoporosis. Not many years ago, osteoporosis was viewed as an age-related disorder for which there was a lack of effective approaches for early intervention and management. Now, that view has changed.

  17. Assessing organizational effectiveness in higher education drug prevention consortia.

    PubMed

    Sheldon-Keller, A E; Lloyd-McGarvey, E; Canterbury, R J

    1995-01-01

    Eighty-three consortia of institutions of higher education, organized under funding from the Fund for the Improvement of Post-Secondary Education (FIPSE) Drug Prevention Programs of the Department of Education, were surveyed to measure organizational effectiveness. Generalized satisfaction with the functioning of the consortia was related to the number of active members, the average miles traveled to meetings, satisfaction with performance of task functions, members' roles, the level of trust among members and the level of creativity and innovation in problem-solving. Satisfaction with goal attainment was significantly related to the presence of at least one "internal" goal for the consortium.

  18. Proposal for a multiphase fall model based on real-world fall recordings with body-fixed sensors.

    PubMed

    Becker, C; Schwickert, L; Mellone, S; Bagalà, F; Chiari, L; Helbostad, J L; Zijlstra, W; Aminian, K; Bourke, A; Todd, C; Bandinelli, S; Kerse, N; Klenk, J

    2012-12-01

    Falls are by far the leading cause of fractures and accidents in the home environment. The current Cochrane reviews and other systematic reviews report on more than 200 intervention studies about fall prevention. A recent meta-analysis has summarized the most important risk factors of accidental falls. However, falls and fall-related injuries remain a major challenge. One novel approach to recognize, analyze, and work better toward preventing falls could be the differentiation of the fall event into separate phases. This might aid in reconsidering ways to design preventive efforts and diagnostic approaches. From a conceptual point of view, falls can be separated into a pre-fall phase, a falling phase, an impact phase, a resting phase, and a recovery phase. Patient and external observers are often unable to give detailed comments concerning these phases. With new technological developments, it is now at least partly possible to examine the phases of falls separately and to generate new hypotheses.The article describes the practicality and the limitations of this approach using body-fixed sensor technology. The features of the different phases are outlined with selected real-world fall signals.

  19. Prevention of dipyrone (metamizole) induced inhibition of aspirin antiplatelet effects.

    PubMed

    Polzin, Amin; Richter, Stefan; Schrör, Karsten; Rassaf, Tienush; Merx, Marc W; Kelm, Malte; Hohlfeld, Thomas; Zeus, Tobias

    2015-07-01

    We have recently shown that dipyrone (metamizole), a non-opioid analgesic, can nullify aspirin (acetylsalicylic acid; ASA) antiplatelet effects in patients with coronary artery disease (CAD). In this study, we analysed the aspirin and dipyrone drug-drug interaction in order to identify strategies to prevent the dipyrone induced inhibition of asprin antiplatelet effects. Platelet function was measured by arachidonic acid-induced light-transmission aggregometry, thromboxane (TX) B2- formation by immunoassay. Dipyrone metabolite plasma levels were determined by high-performance-liquid-chromatography (HPLC). In seven healthy individuals, in vitro ASA (30 µM/ 100 µM/ 300 µM/ 1,000 µM) and dipyrone (10 µM) coincubation revealed, that the aspirin and dipyrone interaction can be overcome by increasing doses of aspirin. In 36 aspirin and dipyrone comedicated CAD patients, addition of ASA (30 µM/ 100 µM) in vitro inhibited, but did not completely overcome the dipyrone induced reduction of aspirin antiplatelet effects. Notably, the inhibition of thromboxane formation in aspirin and dipyrone comedicated CAD patients coincided with dipyrone plasma levels. In a cross-over designed study in four healthy individuals, we were able to prove that inhibition of aspirin (100 mg/ day) effects by dipyrone (750 mg/ day) was reversible. Furthermore, aspirin (100 mg/ day) medication prior to dipyrone (750 mg/ day) intake prevented the inhibition of antiplatelet effects by dipyrone in 12 healthy individuals. In conclusion, aspirin medication prior to dipyrone intake preserves antiplatelet effects, circumventing the pharmacodynamic drug-drug interaction at the level of cyclooxygenase-1. PMID:25789542

  20. Prevention of dipyrone (metamizole) induced inhibition of aspirin antiplatelet effects.

    PubMed

    Polzin, Amin; Richter, Stefan; Schrör, Karsten; Rassaf, Tienush; Merx, Marc W; Kelm, Malte; Hohlfeld, Thomas; Zeus, Tobias

    2015-07-01

    We have recently shown that dipyrone (metamizole), a non-opioid analgesic, can nullify aspirin (acetylsalicylic acid; ASA) antiplatelet effects in patients with coronary artery disease (CAD). In this study, we analysed the aspirin and dipyrone drug-drug interaction in order to identify strategies to prevent the dipyrone induced inhibition of asprin antiplatelet effects. Platelet function was measured by arachidonic acid-induced light-transmission aggregometry, thromboxane (TX) B2- formation by immunoassay. Dipyrone metabolite plasma levels were determined by high-performance-liquid-chromatography (HPLC). In seven healthy individuals, in vitro ASA (30 µM/ 100 µM/ 300 µM/ 1,000 µM) and dipyrone (10 µM) coincubation revealed, that the aspirin and dipyrone interaction can be overcome by increasing doses of aspirin. In 36 aspirin and dipyrone comedicated CAD patients, addition of ASA (30 µM/ 100 µM) in vitro inhibited, but did not completely overcome the dipyrone induced reduction of aspirin antiplatelet effects. Notably, the inhibition of thromboxane formation in aspirin and dipyrone comedicated CAD patients coincided with dipyrone plasma levels. In a cross-over designed study in four healthy individuals, we were able to prove that inhibition of aspirin (100 mg/ day) effects by dipyrone (750 mg/ day) was reversible. Furthermore, aspirin (100 mg/ day) medication prior to dipyrone (750 mg/ day) intake prevented the inhibition of antiplatelet effects by dipyrone in 12 healthy individuals. In conclusion, aspirin medication prior to dipyrone intake preserves antiplatelet effects, circumventing the pharmacodynamic drug-drug interaction at the level of cyclooxygenase-1.

  1. Preventive Effects of Houttuynia cordata Extract for Oral Infectious Diseases.

    PubMed

    Sekita, Yasuko; Murakami, Keiji; Yumoto, Hiromichi; Amoh, Takashi; Fujiwara, Natsumi; Ogata, Shohei; Matsuo, Takashi; Miyake, Yoichiro; Kashiwada, Yoshiki

    2016-01-01

    Houttuynia cordata (HC) (Saururaceae) has been used internally and externally as a traditional medicine and as an herbal tea for healthcare in Japan. Our recent survey showed that HC poultice (HCP) prepared from smothering fresh leaves of HC had been frequently used for the treatment of purulent skin diseases with high effectiveness. Our experimental study also demonstrated that ethanol extract of HCP (eHCP) has antibacterial, antibiofilm, and anti-inflammatory effects against S. aureus which caused purulent skin diseases. In this study, we focused on novel effects of HCP against oral infectious diseases, such as periodontal disease and dental caries. We determined the antimicrobial and antibiofilm effects of water solution of HCP ethanol extract (wHCP) against important oral pathogens and investigated its cytotoxicity and anti-inflammatory effects on human oral epithelial cells. wHCP had moderate antimicrobial effects against some oral microorganisms and profound antibiofilm effects against Fusobacterium nucleatum, Streptococcus mutans, and Candida albicans. In addition, wHCP had no cytotoxic effects and could inhibit interleukin-8 and CCL20 productions by Porphyromonas gingivalis lipopolysaccharide-stimulated human oral keratinocytes. Our findings suggested that wHCP may be clinically useful for preventing oral infectious diseases as a mouthwash for oral care. PMID:27413739

  2. Preventive Effects of Houttuynia cordata Extract for Oral Infectious Diseases

    PubMed Central

    Sekita, Yasuko; Murakami, Keiji; Amoh, Takashi; Ogata, Shohei; Matsuo, Takashi; Miyake, Yoichiro; Kashiwada, Yoshiki

    2016-01-01

    Houttuynia cordata (HC) (Saururaceae) has been used internally and externally as a traditional medicine and as an herbal tea for healthcare in Japan. Our recent survey showed that HC poultice (HCP) prepared from smothering fresh leaves of HC had been frequently used for the treatment of purulent skin diseases with high effectiveness. Our experimental study also demonstrated that ethanol extract of HCP (eHCP) has antibacterial, antibiofilm, and anti-inflammatory effects against S. aureus which caused purulent skin diseases. In this study, we focused on novel effects of HCP against oral infectious diseases, such as periodontal disease and dental caries. We determined the antimicrobial and antibiofilm effects of water solution of HCP ethanol extract (wHCP) against important oral pathogens and investigated its cytotoxicity and anti-inflammatory effects on human oral epithelial cells. wHCP had moderate antimicrobial effects against some oral microorganisms and profound antibiofilm effects against Fusobacterium nucleatum, Streptococcus mutans, and Candida albicans. In addition, wHCP had no cytotoxic effects and could inhibit interleukin-8 and CCL20 productions by Porphyromonas gingivalis lipopolysaccharide-stimulated human oral keratinocytes. Our findings suggested that wHCP may be clinically useful for preventing oral infectious diseases as a mouthwash for oral care. PMID:27413739

  3. The effect of static muscle forces on the fracture strength of the intact distal radius in vitro in response to simulated forward fall impacts.

    PubMed

    Reeves, Jacob M; Burkhart, Timothy A; Dunning, Cynthia E

    2014-08-22

    The distal radius fracture (DRF) is a particularly dominant injury of the wrist, commonly resulting from a forward fall on an outstretched hand. In an attempt to reduce the prevalence, costs, and potential long-term pain/deformities associated with this injury, in vivo and in vitro investigations have sought to classify the kinematics and kinetics of DRFs. In vivo forward fall work has identified a preparatory muscle contraction that occurs in the upper extremity prior to peak impact force. The present investigation constitutes the first attempt to systematically determine the effect of static muscle forces on the fracture threshold of the distal radius in vitro. Paired human cadaveric forearm specimens were divided into two groups, one that had no muscle forces applied (i.e., right arms) and the other that had muscle forces applied to ECU, ECRL, FCU and FCR (i.e., left arms), with magnitudes based on peak muscle forces and in vivo lower bound forward fall activation patterns. The specimens were secured in a custom-built pneumatic impact loading device and subjected to incremental impacts at pre-fracture (25 J) and fracture (150 J) levels. Similar fracture forces (6565 (866)N and 8665 (5133)N), impulses (47 (6)Ns and 57 (30)Ns), and energies (152 (38)J and 144 (45)J) were observed for both groups of specimens (p>0.05). Accordingly, it is suggested that, at the magnitudes presently simulated, muscle forces have little effect on the way the distal radius responds to forward fall initiated impact loading. PMID:24927979

  4. [A study on fall accident].

    PubMed

    Lee, H S; Kim, M J

    1997-01-01

    The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis spss/pc+ program was utilized for descriptive statistics, adjusted standardized X2-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245 (59.5%) were men and 167 (40.5%) were women. Age were 0-14 years 79 (19.2%), 15-44 years 125 (30.4%), 45-64 years 104 (25.2%), over 65 years 104 (25.2%). 2) There was significant association between age and the sexes (X2 = 39.17, P = 0.00). 3) There was significant association between age and history of falls (X2 = 44.41, P = .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis (X2 = 140.66, P = .00), chief medical diagnosis were hypertension (34), diabetes mellitus (22), arthritis (11), stroke (8), fracture (7), pulmonary tuberculosis (6), dementia (5) and cataract (5). 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives, antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness (X2 = 2.87, P = .41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips (35

  5. Fall Enrollment Report 2009

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2009

    2009-01-01

    This report summarizes fall enrollment in Iowa's community colleges. Every year Iowa's 15 community college districts submit data on students enrolled on the 10th day of the fall semester. Highlights include: (1) Enrollment grew at its fastest pace since 1975 to a record high of 100,736 students; (2) Year-to-year growth was 14.3 percent, which is…

  6. Learning From Falling

    ERIC Educational Resources Information Center

    Joh, Amy, S.; Adolph, Karen, E.

    2006-01-01

    Walkers fall frequently, especially during infancy. Children (15, 21, 27, 33, and 39 month-olds) and adults were tested in a novel foam pit paradigm to examine age-related changes in the relationship between falling and prospective control of locomotion. In trial 1, participants walked and fell into a deformable foam pit marked with distinct…

  7. Fall Leaf Portraits

    ERIC Educational Resources Information Center

    O'Hara, Cristina

    2012-01-01

    In this article, the author describes how students can create a stunning as well as economical mosaic utilizing fall's brilliantly colored leaves, preserved at their peak in color. Start by choosing a beautiful fall day to take students on a nature walk to collect a variety of leaves in different shapes, sizes, and colors. Focus on collecting a…

  8. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

    PubMed Central

    Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul

    2016-01-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  9. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention.

    PubMed

    Gernand, Alison D; Schulze, Kerry J; Stewart, Christine P; West, Keith P; Christian, Parul

    2016-05-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences for the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce risk of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanistic and association research links multiple antenatal micronutrients with plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and filling extensive gaps in knowledge. Multiple micronutrient supplements reduce the risks of being born with low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure might persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  10. Proximate Effects of a Child Sexual Abuse Prevention Program in Elementary School Children.

    ERIC Educational Resources Information Center

    Hebert, Martine; Lavoie, Francine; Piche, Christiane; Poitras, Michele

    2001-01-01

    The effects of the sexual child abuse prevention program ESPACE were evaluated with 133 Canadian children (grades 1-3). Children participating in the prevention program showed greater preventive knowledge and skills relative to children not participating. Follow-up data showed knowledge gains were maintained while the preventive skill gains may…

  11. Selective attentional processing to fall-relevant stimuli among older adults who fear falling.

    PubMed

    Brown, Lesley A; White, Patti; Doan, Jonathan B; de Bruin, Natalie

    2011-05-01

    Fear of falling is known to affect more than half of community-dwelling older adults over 60 years of age. This fear is associated with physical and psychological effects that increase the risk of falling. The authors' theory is that attentional processing biases may exist in this population that serve to perpetuate fear of falling and subsequently increase fall risk. As a starting point in testing this proposition, the authors examined selective attentional processing bias to fall-relevant stimuli among older adults. Thirty older adult participants (M(age) = 70.8 ± 5.8), self-categorized to be Fearful of Falling (FF, n = 15) or Non-Fearful of Falling (NF, n = 15) completed a visual dot-probe paradigm to determine detection latencies to fall-threatening and general-threat stimuli. Attentional processing was defined using three index scores: attentional bias, congruency index, and incongruency index. Bias indicates capture of attention, whereas congruency and incongruency imply vigilance and disengagement difficulty, respectively. Both groups showed an attentional bias to fall-threat words but those who were fearful of falling also showed an incongruency effect for fall-threat words. These findings confirm that selective attentional processing profiles for fall-relevant stimuli differ between older adults who exhibit fear of falling and those who do not have this fear. Moreover, in accordance with current interpretations of selective attentional processing, the incongruency effect noted among fall-fearful older adults presents a possibility for a difficulty disengaging from fall-threatening stimuli.

  12. THE EFFECT OF THE C-LEG KNEE PROSTHESIS ON SENSORY DEPENDENCY AND FALLS DURING SENSORY ORGANIZATION TESTING

    PubMed Central

    Highsmith, M. Jason; Kahle, Jason T.; Shepard, Neil T.; Kaufman, Kenton R.

    2014-01-01

    A mechanistic explanation for previously observed safety improvements with microprocessor-controlled prosthetic knees is needed. A repeated measures design of 15 subjects with unilateral transfemoral amputation was used to assess changes between baseline use of their standard of care, mechanical pros-theses, and a C-Leg microprocessor-controlled prosthetic knee. The primary outcome measures were sensory dependency scores for somatosensory, visual, vestibular, and visual preference, which were calculated based on a Sensory Organization Test. Falls during posturographic assessment were also recorded. Somatosensory system dependency significantly increased (p = 0.047) while using the C-Leg compared to a nonmicroprocessor prosthetic knee (NMPK). Reliance on visual with vestibular input and reliance on vestibular input alone were not significantly increased with C-Leg use (p = 0.41 and p = 0.15, respectively). When utilizing the C-Leg, there was a significant reduction in the average number of falls (p = 0.03). Hence, increased reliance on somatosensory input is a possible explanation for improved balance with use of a microprocessor prosthetic knee (MPK). PMID:25075259

  13. Path instabilities of heavy bodies in free fall in a viscous fluid: wake dynamics vs. aerodynamic effects

    NASA Astrophysics Data System (ADS)

    Fabre, David; Selvam, Kamal; Tchoufag, Joël; Assemat, Pauline; Magnaudet, Jacques

    2013-11-01

    Solid bodies in free fall in a viscous fluid generally fall along a non-straight path, and a variety of periodic (fluttering, tumbling) and non-periodic regimes can be observed. We analyze the structure of the couplings between the fluid and the body, restricting to a linear stability framework. Introducing a simple toy model consisting of a infinitely long plate sliding along a vertical wall, we show that in the limit of large solid-to-fluid masses a decoupling takes place, allowing us to distinguish two kinds of modes: ``wake'' modes in which the body motion has virtually no influence, and ``body'' modes for which the intrinsic wake dynamics can be neglected. Turning to more realistic objects, we show that the ``body'' modes can be described through a rationally derived aerodynamic model (based on quasi-static assumptions), yielding either a static instability, or a dynamic, low-frequency, instability. Considering 2D rectangular rods and 3D disks, we explore the competition between the three kinds of instabilities. For objects elongated in the spanwise direction, it is found that wake instability dominates in case of 2D rectangles and low-frequency instability dominates in case of disks. For objects elongated in the streamwise direction, static instability always dominate.

  14. Do weight categories prevent athletes from relative age effect?

    PubMed

    Delorme, Nicolas

    2014-01-01

    The aim of this study was to investigate whether weight categories prevent young athletes from being exposed to a relative age effect. The dates of birth of all French female (n = 727) and male (n = 5440) amateur boxers who participated in the 2010-2011 season were collected from the federation database. The dates of birth of all French male professional boxers (n = 354) were also collected. The results show an absence of a relative age effect among French female and male amateur boxers. The results also show an absence of this phenomenon among French male professional boxers. The male 18-18+ age category reveal an inverse relative age effect. This inverse relative age effect might be interpreted as the result of a strategic adaptation from relatively younger children who shift from one sport to another where there are weight categories in order to ensure fair competition. The results of this study suggest that the weight category system is a possible solution within the relative age effect phenomenon.

  15. The effectiveness of HIV prevention and the epidemiological context.

    PubMed Central

    Grassly, N. C.; Garnett, G. P.; Schwartländer, B.; Gregson, S.; Anderson, R. M.

    2001-01-01

    Planning an intervention to prevent infections with the human immunodeficiency virus (HIV) should be guided by local epidemiological and socioeconomic conditions. The socioeconomic setting and existing public service capacity determine whether an intervention can have a significant outcome in terms of a reduction in a defined risk. The epidemiological context determines whether such risk reduction translates into a measurable impact on HIV incidence. Measurement of variables describing the epidemiological context can be used to determine the local suitability of interventions, thereby guiding planners and policy-makers in their choice of intervention. Such measurements also permit the retrospective analysis of the impact of interventions where HIV incidence was not recorded. The epidemiological context is defined for four different categories of intervention, shown to be effective in lower-income countries by randomized controlled trials. Appropriate indicators for the epidemiological context and methodological guidelines for their measurement are proposed. Their use in the transfer of a successful intervention from one context to another and in scaling up the effort to control HIV infection is explored. These indicators should provide a useful resource for those involved in planning HIV prevention interventions. PMID:11799444

  16. Effectiveness of Financial Incentives in a Worksite Diabetes Prevention Program

    PubMed Central

    Faghri, Pouran D.; Li, Rui

    2016-01-01

    Purpose To evaluate the effect of financial incentive in a diabetes prevention weight loss program at worksites. Design Group-level randomized intervention study. Setting Four long-term care facilities, randomly assigned to “incentive-IG” or “non incentive-NIG” groups. Participants Ninety-nine employees, all overweight or obese (BMI= mean 34.8±7.4 kg/m2) and at risk for type 2 diabetes. Intervention A 16 week weight loss program (diabetes prevention program) with a 3 month follow up. IG could either choose a "standard incentive" to receive cash award when achieving the projected weight loss or to participate in a "standard plus deposit incentive" to get additional money matched with their deposit for projected weight loss. All of the participants received a one-hour consultation for a healthy weight loss at the beginning. Measures Weight-loss, diabetes risk score (DRS), and cardiovascular risk outcomes. Analyses Linear and logistic regressions for completed cases with adjustments for clustering effect at group level. Results IG lost on average more pounds (p=0.027), reduced BMI (p=0.04), and reduced in DRS (p=0.011) compared to NIG at week 16. At the 12-week follow-up period, those in IG plus deposit subgroup had twice the odds (OR=2.2, p=0.042) and those in the standard IG had three times the odds of achieving weight loss goals than NIG; those in the IG plus deposit group reduced DRS by 0.4 (p=0.045). Conclusion Monetary incentives appear to be effective in reducing weight and diabetes risk. PMID:27347276

  17. House fire injury prevention update. Part II. A review of the effectiveness of preventive interventions

    PubMed Central

    Warda, L.; Tenenbein, M.; Moffatt, M.

    1999-01-01

    Objective—To evaluate and summarize the house fire injury prevention literature. Methods—MEDLINE (1983 to March 1997) was searched by keyword: fire, burn, etiology, cause, prevention, epidemiology, and smoke detector/alarm. ERIC (1966 to March 1997) and PSYCLIT (1974 to June 1997) were searched by keyword: as above, and safety, skills, education, and training. Other sources included references of retrieved publications, review articles, and books; Injury Prevention hand search; government documents; and internet sources. Sources relevant to residential fire injury prevention were selected, evaluated, and summarized. Results—Forty three publications were selected for review, including seven randomized controlled trials, nine quasiexperiments, two natural experiments, 21 prospective cohort studies, two cross sectional surveys, one case report, and one program evaluation. These studies examined the following types of interventions: school (9), preschool (1), and community based educational programs (5); fire response training programs for children (7), blind adolescents (2), and mentally retarded adults (5) and children (1); office based counseling (4); home inspection programs (3); smoke detector giveaway campaigns (5); and smoke detector legislation (1). Conclusions—This review of house fire prevention interventions underscores the importance of program evaluation. There is a need for more rigorous evaluation of educational programs, particularly those targeted at schools. An evidence based, coordinated approach to house fire injury prevention is critical, given current financial constraints and the potential for program overload for communities and schools. PMID:10518271

  18. Patient falls in hospitals: an increasing problem.

    PubMed

    Weil, Thomas P

    2015-01-01

    Despite six decades of worldwide efforts that include publishing virtually hundreds of related epidemiological-type studies, there has been an increase (estimated to be 46% per 1000 patient days from 1954-6 to 2006-10) in the number of patient falls in hospitals and other health care facilities. These still occur most frequently near the bedside or in the bathroom, among mentally confused or physically impaired patients, and often involve those with greater comorbidity. The reasons that hospitals during the past half century have demonstrated a significant increase in patient falls per discharge or per patient days are numerous, are not completely surprising, and are certainly interrelated: improved accident reporting systems; on the average older, more impaired, more acutely ill, and more heavily sedated patients; and, less time spent by nursing personnel at the bedside. Most safety committees are not as effective as they should be, since they have difficulty in implementing a long-term, aggressive, facility-wide prevention program. Within that context, it may be worthwhile to discuss the advantages of nursing leadership rather than a representative of the facility's management staff to chair these safety committees. PMID:26304626

  19. Connect: An Effective Community-Based Youth Suicide Prevention Program

    ERIC Educational Resources Information Center

    Bean, Gretchen; Baber, Kristine M.

    2011-01-01

    Youth suicide prevention is an important public health issue. However, few prevention programs are theory driven or systematically evaluated. This study evaluated Connect, a community-based youth suicide prevention program. Analysis of pre and posttraining questionnaires from 648 adults and 204 high school students revealed significant changes in…

  20. Long-term Impact of Prevention Programs to Promote Effective Parenting: Lasting Effects but Uncertain Processes

    PubMed Central

    Sandler, Irwin; Schoenfelder, Erin; Wolchik, Sharlene; MacKinnon, David

    2010-01-01

    This chapter reviews findings from 46 randomized experimental trials of preventive parenting interventions. The findings of these trials provide evidence of effects to prevent a wide range of problem outcomes and to promote competencies from one to twenty years later. However, there is a paucity of evidence concerning the processes that account for program effects. Three alternative pathways are proposed as a framework for future research on the long-term effects of preventive parenting programs; 1) through program effects on parenting skills, perceptions of parental efficacy and reduction in barriers to effective parenting; 2) through program-induced reductions in short-term problems of youth that persist over time, improvements in youth adaptation to stress, and improvements in youth belief systems concerning the self and their relationships with others; and 3) through effects on contexts in which youth become involved and on youth-environment transactions. PMID:20822438

  1. Effects of dam removal on Tule Fall Chinook salmon spawning habitat in the White Salmon River, Washington

    USGS Publications Warehouse

    Hatten, James R.; Batt, Thomas R.; Skalicky, Joseph J.; Engle, Rod; Barton, Gary J.; Fosness, Ryan L.; Warren, Joe

    2016-01-01

    Condit Dam is one of the largest hydroelectric dams ever removed in the USA. Breached in a single explosive event in October 2011, hundreds-of-thousands of cubic metres of sediment washed down the White Salmon River onto spawning grounds of a threatened species, Columbia River tule fall Chinook salmon Oncorhynchus tshawytscha. We investigated over a 3-year period (2010–2012) how dam breaching affected channel morphology, river hydraulics, sediment composition and tule fall Chinook salmon (hereafter ‘tule salmon’) spawning habitat in the lower 1.7 km of the White Salmon River (project area). As expected, dam breaching dramatically affected channel morphology and spawning habitat due to a large load of sediment released from Northwestern Lake. Forty-two per cent of the project area that was previously covered in water was converted into islands or new shoreline, while a large pool near the mouth filled with sediments and a delta formed at the mouth. A two-dimensional hydrodynamic model revealed that pool area decreased 68.7% in the project area, while glides and riffles increased 659% and 530%, respectively. A spatially explicit habitat model found the mean probability of spawning habitat increased 46.2% after dam breaching due to an increase in glides and riffles. Shifting channels and bank instability continue to negatively affect some spawning habitat as sediments continue to wash downstream from former Northwestern Lake, but 300 m of new spawning habitat (river kilometre 0.6 to 0.9) that formed immediately post-breach has persisted into 2015. Less than 10% of tule salmon have spawned upstream of the former dam site to date, but the run sizes appear healthy and stable. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  2. Effects of the Strategic Prevention Framework State Incentives Grant (SPF SIG) on state prevention infrastructure in 26 states.

    PubMed

    Orwin, Robert G; Stein-Seroussi, Alan; Edwards, Jessica M; Landy, Ann L; Flewelling, Robert L

    2014-06-01

    The Strategic Prevention Framework State Incentive Grant (SPF SIG) program is a national public health initiative sponsored by the U.S. Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention to prevent substance abuse and its consequences. State grantees used a data-driven planning model to allocate resources to 450 communities, which in turn launched over 2,200 intervention strategies to target prevention priorities in their respective populations. An additional goal was to build prevention capacity and infrastructure at the state and community levels. This paper addresses whether the state infrastructure goal was achieved, and what contextual and implementation factors were associated with success. The findings are consistent with claims that, overall, the SPF SIG program met its goal of increasing prevention capacity and infrastructure across multiple infrastructure domains, though the mediating effects of implementation were evident only in the evaluation/monitoring domain. The results also show that an initiative like the SPF SIG, which could easily have been compartmentalized within the states, has the potential to permeate more broadly throughout state prevention systems.

  3. Examining Dosage Effects on Prevention Outcomes: Results from a Multi-Modal Longitudinal Preventive Intervention for Young Disruptive Boys

    ERIC Educational Resources Information Center

    Charlebois, Pierre; Brendgen, Mara; Vitaro, Frank; Normandeau, Sylvie; Boudreau, Jean-Francois

    2004-01-01

    The present study examined (a) the predictive effect of disruptive boys' attendance to a prevention program (i.e., dosage) on post-intervention academic achievement and behavior and (b) the potential moderating effects of child and family characteristics in this context. The 3-year intervention program included reading, self-regulation, and social…

  4. Seneca Falls. Classroom Focus.

    ERIC Educational Resources Information Center

    Balantic, Jeannette; Libresco, Andrea S.

    1995-01-01

    Presents a secondary school lesson based on the Seneca Falls Declaration of Sentiments. Provides lesson objectives and step-by-step instructional procedures. Includes quoted sections of the Declaration of Sentiments. (CFR)

  5. Editors' Fall Picks

    ERIC Educational Resources Information Center

    Hoffert, Barbara; Heilbrun, Margaret; Kuzyk, Raya; Kim, Ann; McCormack, Heather; Katterjohn, Anna; Burns, Ann; Williams, Wilda

    2008-01-01

    From the fall's cascade of great new books, "Library Journal's" editors select their favorites--a dark rendition of Afghan life, a look at the "self-esteem trap," a celebration of Brooklyn activism, and much more.

  6. Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting

    PubMed Central

    Lopez, Karen Dunn; Cary, Michael P; Kanak, Mary F

    2010-01-01

    Objective To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. Design A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Measurements Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time–motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Results Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive ‘head data’, temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Conclusion Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units. PMID:20442150

  7. 6. NARADA FALLS, WITH FIRST CROSSING BRIDGE SHOWN ABOVE FALLS, ...

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

    6. NARADA FALLS, WITH FIRST CROSSING BRIDGE SHOWN ABOVE FALLS, VIEW FACING NORTHEAST - Paradise River First Crossing Bridge, Spanning Paradise River at Narada Falls on Service Road, Longmire, Pierce County, WA

  8. Martial arts fall techniques decrease the impact forces at the hip during sideways falling.

    PubMed

    Groen, B E; Weerdesteyn, V; Duysens, J

    2007-01-01

    Falls to the side and those with impact on the hip are risky for hip fractures in the elderly. A previous study has indicated that martial arts (MA) fall techniques can reduce hip impact force, but the underlying mechanism is unknown. Furthermore, the high impact forces at the hand used to break the fall have raised concerns because of the risk for wrist fractures. The purpose of the study was to get insight into the role of hand impact, impact velocity, and trunk orientation in the reduction of hip impact force in MA techniques. Six experienced judokas performed sideways falls from kneeling height using three fall techniques: block with arm technique (control), MA technique with use of the arm to break the fall (MA-a), and MA technique without use of the arm (MA-na). The results showed that the MA-a and MA-na technique reduced the impact force by 27.5% and 30%, respectively. Impact velocity was significantly reduced in the MA falls. Trunk orientation was significantly less vertical in the MA-a falls. No significant differences were found between the MA techniques. It was concluded that the reduction in hip impact force was associated with a lower impact velocity and less vertical trunk orientation. Rolling after impact, which is characteristic for MA falls, is likely to contribute to the reduction of impact forces, as well. Using the arm to break the fall was not essential for the MA technique to reduce hip impact force. These findings provided support for the incorporation of MA fall techniques in fall prevention programs for elderly.

  9. End Results What Happens Next?: Effect of plasticine on falling rods Insights and Conundrums: de Broglie's wavelength has many applications in the study of gases Signing Off: The life and work of Marie Curie

    NASA Astrophysics Data System (ADS)

    2011-07-01

    What Happens Next?: Effect of plasticine on falling rods David Featonby Insights and Conundrums: de Broglie's wavelength has many applications in the study of gases Rick Marshall Signing Off: The life and work of Marie Curie David Smith

  10. 1991 Fall Meeting Report

    NASA Astrophysics Data System (ADS)

    Chapman, David S.

    The AGU 1991 Fall Meeting, held in San Francisco December 9-13, was the largest national AGU meeting ever held. Meeting participation continued the steady growth trend set throughout the previous decade. A total of 4,037 papers and posters were presented, and by Friday noon of the meeting over 5,500 members had registered.Several special events were scheduled to inform and engage members on societal and programmatic aspects of our science. AGU's Committee on Education and Human Resources sponsored an open forum that addressed opportunities and problems associated with dual-career couples. A discussion of NASA's strategic plan by Berrien Moore and Joseph Alexander drew a large audience, and a special session on societal aspects of the Mt. Pinatubo eruption drew an overflow crowd. Two special lectures— “Plumes, Plates, and Deep Earth Structure” by Don L. Anderson and “New Frontiers in Aeronomy: Effects of Global Atmospheric Change” by P. M. Banks-also drew overflow crowds.

  11. Caries-preventive Effect of Supervised Toothbrushing and Sealants.

    PubMed

    Hilgert, L A; Leal, S C; Mulder, J; Creugers, N H J; Frencken, J E

    2015-09-01

    To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was assessed at the tooth surface level, through a combination of ICDAS II (International Caries Detection and Assessment System) and fissure depth codes. High-caries risk occlusal surfaces were treated according to daily supervised toothbrushing (STB) at school and 2 sealants: composite resin (CR) and atraumatic restorative treatment-high-viscosity glass-ionomer cement (ART-GIC). Low-caries risk occlusal surfaces received STB or no intervention. Evaluations were performed after 0.5, 1, 2, and 3 y. A cavitated dentine carious lesion was considered a failure. Data were analyzed according to the proportional hazard rate regression model with frailty correction, Wald test, analysis of variance, and t test, according to the jackknife procedure for calculating standard errors. The cumulative survival rates of cavitated dentine carious lesion-free, high-caries risk occlusal surfaces were 95.6%, 91.4%, and 90.2% for STB, CR, and ART-GIC, respectively, over 3 y, which were not statistically significantly different. For low-caries risk occlusal surfaces, no statistically significant difference was observed between the cumulative survival rate of the STB group (94.8%) and the no-intervention group (92.1%) over 3 y. There was neither a difference among STB, CR, and ART-GIC on school premises in preventing cavitated dentine carious lesions in high-caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low-caries risk occlusal surfaces of first permanent molars over 3 y.

  12. Designing an Effective Prevention Program: Principles Underlying the Rand Smoking and Drug Prevention Experiment.

    ERIC Educational Resources Information Center

    Ellickson, Phyllis L.

    This paper describes the Project ALERT program (Adolescent Learning Experiences in Resistance Training) which was established by the Rand Corporation to prevent smoking and drug use among seventh graders. The program is based on the social influence model of drug use initiation. Curriculum features are described including motivation to resist and…

  13. Falls risk assessment in older patients in hospital.

    PubMed

    Matarese, Maria; Ivziku, Dhurata

    2016-07-27

    Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. All hospitals in NHS organisations develop risk prevention policies that include falls risk assessment. Falls risk assessment involves the use of risk screening tools, aimed at identifying patients at increased risk of falls, and risk assessment tools, which identify a patient's risk factors for falls. Various risk screening tools have been used in clinical practice, but no single tool is able to identify all patients at risk of falls or to accurately exclude all those who are not at risk of falls. Guidelines recommend that patients aged 65 years and over who are admitted to hospital should be considered at high risk of falls and that a multifactorial falls risk assessment should be performed. Therefore, falls risk assessment tools should be used to identify the risk factors for each inpatient aged 65 years or over, in order to determine the most appropriate care plan for falls prevention and to maximise patient mobility and independence. PMID:27461329

  14. A Randomized Comparative Effectiveness Trial for Preventing Type 2 Diabetes

    PubMed Central

    2015-01-01

    OBJECTIVE To evaluate the weight loss effectiveness of a ‘YMCA Model’ for the Diabetes Prevention Program (DPP) lifestyle intervention METHODS 509 overweight/obese, low-income, non-diabetic, adult primary care patients with elevated blood glucose were individually randomized to (1) standard care plus brief lifestyle counseling (SC); or (2) being offered a group-based adaption of the DPP offered free-of-charge by the YMCA (YDPP). Primary outcome was mean difference in weight loss at 12 months. Intention-to-treat (ITT) analyses used longitudinal linear or logistic regression, with missing observations multiply imputed. Instrumental variables (IV) regression estimated weight loss effectiveness among participants completing ≥9 intervention lessons. RESULTS In the YDPP arm, 161 (62.6%) participants attended ≥1 lesson and 103 (40.0%) completed ≥9 lessons. In ITT analysis, mean 12-month weight loss was 2.3 kg (95% CI 1.1 to 3.4 kg) more for YDPP arm participants, compared to SC. In IV analyses, persons attending ≥9 lessons had a 5.3 kg (95% CI, 2.8 to 7.9 kg) greater weight loss than with standard care alone. CONCLUSIONS The YMCA model for DPP delivery achieves meaningful weight losses at 12 months among low income adults. TRIAL REGISTRATION National Clinical Trials Registry (NCT00656682) PMID:26378828

  15. Hair-Loss Preventing Effect of Grateloupia elliptica

    PubMed Central

    Kang, Jung-Il; Kim, Sang-Cheol; Han, Sang-Chul; Hong, Hye-Jin; Jeon, You-Jin; Kim, Bora; Koh, Young-Sang; Yoo, Eun-Sook; Kang, Hee-Kyoung

    2012-01-01

    This study was conducted to evaluate the effect of Grateloupia elliptica, a seaweed native to Jeju Island, Korea, on the prevention of hair loss. When immortalized rat vibrissa dermal papilla cells were treated with extract of G. elliptica, the proliferation of dermal papilla cells significantly increased. In addition, the G. elliptica extract significantly inhibited the activity of 5α-reductase, which converts testosterone to dihydrotestosterone (DHT), a main cause of androgenetic alopecia. On the other hand, the G. elliptica extract promoted PGE2 production in HaCaT cells in a dose-dependent manner. The G. elliptica extract exhibited particularly high inhibitory effect on LPS-stimulated IL-12, IL-6, and TNF-α production in lipopolysaccharide (LPS)-stimulated bone marrow-derived dendritic cells. The G. elliptica extract also showed inhibitory activity against Pityrosporum ovale, a main cause of dandruff. These results suggest that G. elliptica extract has the potential to treat alopecia via the proliferation of dermal papilla, 5α-reductase inhibition, increase of PGE2 production, decrease of LPS-stimulated pro-inflammatory cytokines and inhibitory activity against Pityrosporum ovale. PMID:24116284

  16. Hair-Loss Preventing Effect of Grateloupia elliptica.

    PubMed

    Kang, Jung-Il; Kim, Sang-Cheol; Han, Sang-Chul; Hong, Hye-Jin; Jeon, You-Jin; Kim, Bora; Koh, Young-Sang; Yoo, Eun-Sook; Kang, Hee-Kyoung

    2012-01-01

    This study was conducted to evaluate the effect of Grateloupia elliptica, a seaweed native to Jeju Island, Korea, on the prevention of hair loss. When immortalized rat vibrissa dermal papilla cells were treated with extract of G. elliptica, the proliferation of dermal papilla cells significantly increased. In addition, the G. elliptica extract significantly inhibited the activity of 5α-reductase, which converts testosterone to dihydrotestosterone (DHT), a main cause of androgenetic alopecia. On the other hand, the G. elliptica extract promoted PGE2 production in HaCaT cells in a dose-dependent manner. The G. elliptica extract exhibited particularly high inhibitory effect on LPS-stimulated IL-12, IL-6, and TNF-α production in lipopolysaccharide (LPS)-stimulated bone marrow-derived dendritic cells. The G. elliptica extract also showed inhibitory activity against Pityrosporum ovale, a main cause of dandruff. These results suggest that G. elliptica extract has the potential to treat alopecia via the proliferation of dermal papilla, 5α-reductase inhibition, increase of PGE2 production, decrease of LPS-stimulated pro-inflammatory cytokines and inhibitory activity against Pityrosporum ovale. PMID:24116284

  17. The effects of loading and unloading treadmill walking on balance, gait, fall risk, and daily function in Parkinsonism.

    PubMed

    Toole, Tonya; Maitland, Charles G; Warren, Earl; Hubmann, Monica F; Panton, Lynn

    2005-01-01

    Our study aims were: 1) to determine whether assisted weight bearing or additional weight bearing is more beneficial to the improvement of function and increased stability in gait and dynamic balance in patients with Parkinsonism, compared with matched controls (treadmill alone). Twenty-three men and women participants (M +/- SD = 74.5 +/- 9.7 yrs; Males = 19, Females = 4) with Parkinsonism were in the study. Participants staged at 1-7 (M +/- SD = 3.96 +/- 1.07) using the Hoehn & Yahr scale. All participants were tested before, after the intervention (within one week), and four weeks later on: 1) dynamic posturography, 2) Berg Balance scale, 3) United Parkinson's Disease Rating Scale (UPDRS), 4) biomechanical assessment of strength and range of motion, and 5) Gaitrite force sensitive gait mat. Group 1 (treadmill control group), received treadmill training with no loading or unloading. Group 2 (unweighted group), walked on the treadmill assisted by the Biodex Unweighing System at a 25% body weight reduction. Group 3 (weighted group), ambulated wearing a weighted scuba-diving belt, which increased their normal body weight by 5%. All subjects walked on the treadmill for 20 minutes per day for 3 days per week for 6 weeks. Improvements in dynamic posturography, falls during balance testing, Berg Balance, UPDRS (Motor Exam), and gait for all groups lead us to believe that neuromuscular regulation can be facilitated in all Parkinson's individuals no matter what treadmill intervention is employed.

  18. Effectiveness of a Social Change Approach to Sexual Assault Prevention

    ERIC Educational Resources Information Center

    Edwards, Keith E.

    2009-01-01

    The author examined the impact on resident assistants of a social change approach to sexual assault prevention. The interactive multi-media program focused on engaging men on sexual assault prevention, accurately defining rape for college men and women, identifying aspects of the rape culture in society and on-campus, and empowering college…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    Background: Randomized prevention trials provide a unique opportunity to test hypotheses about the interaction of genetic predispositions with contextual processes to create variations in phenotypes over time. Methods: Using two longitudinal, randomized prevention trials, molecular genetic and alcohol use outcome data were gathered from more than…

  20. Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss

    PubMed Central

    Lacerda, Clara Fonseca; Silva, Luciana Oliveira e; de Tavares Canto, Roberto Sérgio; Cheik, Nadia Carla

    2012-01-01

    Summary Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS) and Functional Capacity (CF) and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. Conclusion: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss. PMID:25991930

  1. Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial

    PubMed Central

    Román, Eva; García-Galcerán, Cristina; Torrades, Teresa; Herrera, Silvia; Marín, Ana; Doñate, Maite; Alvarado-Tapias, Edilmar; Malouf, Jorge; Nácher, Laura; Serra-Grima, Ricard; Guarner, Carlos; Soriano, German

    2016-01-01

    Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time. Trial Registration: ClinicalTrials.gov NCT01447537 PMID:27011355

  2. Cost-effectiveness of a helpline for suicide prevention.

    PubMed

    Pil, Lore; Pauwels, Kirsten; Muijzers, Ekke; Portzky, Gwendolyn; Annemans, Lieven

    2013-07-01

    We evaluated the cost-effectiveness and budget impact of a suicide helpline in Belgium, consisting of a telephone- and a chat service. An age- and gender-dependent Markov model with a ten-year time horizon and a one-year cycle length was developed, assuming a societal perspective, to predict cumulative costs and quality-adjusted life-years (QALYs) in the helpline users. The model included six transition states: the initial state (at risk), first attempt, re-attempt, follow-up, suicide and death from other causes. Data on the effect of the helpline and costs associated with model states were obtained from the literature. One-way and probabilistic sensitivity analyses were performed to capture uncertainty. In addition, the budget impact of the helpline was analysed. Over ten years, the telephone- as well as the chat service could avoid about 36% of suicides and attempts in this high-risk population. In males, 0.063 QALYs (95% confidence interval, CI 0.030-0.097) and 0.035 QALYs (95%CI -0.026-0.096) were gained by users of the telephone- and chat service respectively. The corresponding values for females were 0.019 QALYs (95%CI -0.015-0.052) and a QALY-neutral result of -0.005 (95%CI -0.071-0.062). There were net societal savings of respectively €2382 (95%CI 1953-2859) and €2282 (95%CI 1855-2758) in male users; €2171 (95%CI 1735-2664) and €2458 (95%CI 1945-3025) in female users. At the population level, an investment of €218,899 saved €1,452,022 for the public health service (national health insurance), mainly due to the telephone service. The analysis predicted that both means of telemedicine for suicide prevention in Flanders are cost-saving, and have a modest effect on QALYs.

  3. Effects of Hyporheic Exchange Flows on Egg Pocket Water Temperature in Snake River Fall Chinook Salmon Spawning Areas, 2002-2003 Final Report.

    SciTech Connect

    Hanrahan, T.; Geist, D.; Arntzen, C.

    2004-09-01

    ) downstream to the upper end of Lower Granite Reservoir near rkm 240. We randomly selected 14 fall Chinook salmon spawning locations as study sites, which represents 25% of the most used spawning areas throughout the HCR. Interactions between river water and pore water within the riverbed (i.e., hyporheic zone) at each site were quantified through the use of self-contained temperature and water level data loggers suspended inside of piezometers. Surrounding the piezometer cluster at each site were 3 artificial egg pockets. In mid-November 2002, early-eyed stage fall Chinook salmon eggs were placed inside of perforated polyvinyl chloride (PVC) tubes, along with a temperature data logger, and buried within the egg pockets. Fall Chinook salmon eggs were also incubated in the laboratory for the purpose of developing growth curves that could be used as indicators of emergence timing. The effects of discharge on vertical hydrologic exchange between the river and riverbed were inferred from measured temperature gradients between the river and riverbed, and the application of a numerical model. The hydrologic regime during the 2002-2003 sampling period exhibited one of the lowest, most stable daily discharge patterns of any of the previous 12 water years. The vertical hydraulic gradients (VHG) between the river and the riverbed suggested the potential for predominantly small magnitude vertical exchange. The VHG also showed little relationship to changes in river discharge at most sites. Despite the relatively small vertical hydraulic gradients at most sites, results from the numerical modeling of riverbed pore water velocity and hyporheic zone temperatures suggested that there was significant vertical hydrologic exchange during all time periods. The combined results of temperature monitoring and numerical modeling indicate that only 2 of 14 sites were significantly affected by short-term (hourly to daily) large magnitude changes in discharge. Although the two sites exhibited acute

  4. Family planning. A most effective preventive health measure.

    PubMed

    Rowley, J

    1984-06-01

    Family planning is widely regarded as among the most effective of preventive health measures and can contribute to break the vicious cycle of infection, malnutrition, and uncontrolled fertility widespread among mothers and children in the Third World. Significant achievements have been scored in the past 2 decades in educating people about the health implications of reproduction and providing contraceptive services to those who want them. Increasing numbers of women in developing countries are aware of the advantages of fewer and better spaced children. However, this awareness is often not reflected in practice. Only 2/% of women in developing countries, compared with 70% in developed countries, practice family planning. This situation is considered serious in view of the fact that the number of couples in Asia, Africa, Latin America, and Oceania who require contraceptive protection will double to 1 billion by the year 2000. The gap between awareness and practice reflects numerous factors, including nonavailability of services, inaccurate knowledge about family planning, and women's oppression. Overcoming the cultural, economic, and social barriers to family planning requires sensitive and diverse communication strategies. High-level political support, village-based community programs, a high level of female education, and a well-developed primary health care system have contributed to the success of family planning efforts. Since family planning to a large extent reflects individual decision making, attention should be directed toward the role of fieldworkers and local family planning acceptors in influencing others to adopt contraception. PMID:6469252

  5. Preventive effects of ulinastatin on complications related to pancreaticoduodenectomy

    PubMed Central

    Zhang, Hao; Tan, Chunlu; Wang, Xing; Kang, Deying; Chen, Yonghua; Xiong, Junjie; Tian, Bole; Li, Kezhou; Hu, Weiming; Chen, Xiaoli; Ke, Nengwen; Li, Ang; Liu, Xubao

    2016-01-01

    Abstract Postoperative pancreatic fistula (POPF) is one of the most common major complications after pancreaticoduodenectomy (PD). Ulinastatin is an intrinsic trypsin inhibitor and mainly used to treat acute pancreatitis, chronic recurrent pancreatitis, and acute circulatory failure. The study aims to investigate the efficacy of ulinastatin on pancreatic fistula and other complications after PD. This prospective, randomized, double-blind, placebo-controlled trial was conducted in West China Hospital of Sichuan University from December 2012 to December 2014. A total of 106 consecutive patients undergoing PD were randomly assigned to receive ulinastatin or placebo during and after the surgery for 5 days. Baseline clinical characteristics and outcomes of patients were recorded and analyzed. Ninety-two patients including 42 in the ulinastatin group and 50 in the placebo group were available for outcome assessment. The POPF rates were comparable between ulinastatin group (43%) and placebo group (26%), whereas the severe pancreatic fistula rate (grade B + C) was significantly less in ulinastatin group than that in placebo group (7% vs 24%, P = 0.045). For patients with small pancreatic duct diameter (≤3 mm), ulinastatin could significantly reduce the risk of POPF (P = 0.022). Ulinastatin had protective effects for patients undergoing PD on the prevention of severe postoperative pancreatic fistula. PMID:27310952

  6. Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis

    PubMed Central

    Ruxton, Kimberley; Woodman, Richard J; Mangoni, Arduino A

    2015-01-01

    Aim The aim was to investigate associations between drugs with anticholinergic effects (DACEs) and cognitive impairment, falls and all-cause mortality in older adults. Methods A literature search using CINAHL, Cochrane Library, Embase and PubMed databases was conducted for randomized controlled trials, prospective and retrospective cohort and case-control studies examining the use of DACEs in subjects ≥65 years with outcomes on falls, cognitive impairment and all-cause mortality. Retrieved articles were published on or before June 2013. Anticholinergic exposure was investigated using drug class, DACE scoring systems (anticholinergic cognitive burden scale, ACB; anticholinergic drug scale, ADS; anticholinergic risk scale, ARS; anticholinergic component of the drug burden index, DBIAC) or assessment of individual DACEs. Meta-analyses were performed to pool the results from individual studies. Results Eighteen studies fulfilled the inclusion criteria (total 124 286 participants). Exposure to DACEs as a class was associated with increased odds of cognitive impairment (OR 1.45, 95% CI 1.16, 1.73). Olanzapine and trazodone were associated with increased odds and risk of falls (OR 2.16, 95% CI 1.05, 4.44; RR 1.79, 95% CI 1.60, 1.97, respectively), but amitriptyline, paroxetine and risperidone were not (RR 1.73, 95% CI 0.81, 2.65; RR 1.80, 95% CI 0.81, 2.79; RR 1.39, 95% CI 0.59, 3.26, respectively). A unit increase in the ACB scale was associated with a doubling in odds of all-cause mortality (OR 2.06, 95% CI 1.82, 2.33) but there were no associations with the DBIAC (OR 0.88, 95% CI 0.55, 1.42) or the ARS (OR 3.56, 95% CI 0.29, 43.27). Conclusions Certain individual DACEs or increased overall DACE exposure may increase the risks of cognitive impairment, falls and all-cause mortality in older adults. PMID:25735839

  7. A Concise History of School-Based Smoking Prevention Research: A Pendulum Effect Case Study

    ERIC Educational Resources Information Center

    Sussman, Steve; Black, David S.; Rohrbach, Louise A.

    2010-01-01

    School-based cigarette smoking prevention was initiated shortly after the first Surgeon General's Report in 1964. This article highlights a sequence of events by which school-based tobacco use prevention research developed as a science, and illustrates a pendulum effect, with confidence in tobacco use prevention increasing and decreasing at…

  8. Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk.

    PubMed

    Brent, David

    2016-04-01

    In this commentary, the effects of four family-based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long-term, effects on suicidal ideation and behavior. PMID:27094110

  9. The effect of resveratrol on the prevention of cisplatin ototoxicity.

    PubMed

    Erdem, T; Bayindir, Tuba; Filiz, A; Iraz, M; Selimoglu, E

    2012-10-01

    One of the most important adverse effects of cisplatin, a chemotherapeutic agent which is widely used in the treatment of cancer patients, is hearing loss. This has primarily been associated with the loss of inner ear hairy and spiral ganglion cells due to oxidative stress. Resveratrol is known to be an antioxidant agent, which has the theoretical potential of preventing cisplatin-related ototoxicity. This experimental study was approved by Animal Ethics Committee of Inonu University (2008-20) and supported by Inonu University Scientific Research Projects Support Fund (2009-17). Thirty-four 3-month-old Wistar albino female rats weighing 210-270 g were used in the study. The animals were allocated into four groups: in cisplatin group (Group A), a single dose of 12 mg/kg cisplatin was administered intraperitoneally to 10 rats; in cisplatin + resveratrol group (Group B), a single dose of 12 mg/kg cisplatin and 10 mg/kg resveratrol were administered intraperitoneally for 5 days to 10 rats; in resveratrol group (Group C), 10 mg/kg resveratrol was administered intraperitoneally for 5 days to seven rats and in control group (Group D), resveratrol solvent (5% alcohol-95% physiological saline) was administered intraperitoneally for 5 days to seven rats. Resveratrol administration has begun 1 day before cisplatin administration in the group treated with cisplatin and resveratrol combination. Distortion product otoacoustic emission (DPOAE) (Grason Stadler, Madison, USA) measurements were performed in the same ear of all rats (right ear) under general anesthesia at baseline, 1st and 5th days after drug administration. Statistically significant distortion product amplitude reductions were found in the cisplatin group at 1,418, 2,003, 3,363, 5,660, 8,003 and 9,515 Hz frequencies. Whereas in the cisplatin + resveratrol group, statistically significant difference was found between 1st and 5th day measurements only at 3,996 Hz frequency. No significant differences were noted

  10. Modern Rehabilitation in Osteoporosis, Falls, and Fractures

    PubMed Central

    Dionyssiotis, Yannis; Skarantavos, Grigorios; Papagelopoulos, Panayiotis

    2014-01-01

    In prevention and management of osteoporosis, modern rehabilitation should focus on how to increase muscular and bone strength. Resistance exercises are beneficial for muscle and bone strength, and weight-bearing exercises help maintain fitness and bone mass. In subjects at higher risk for osteoporotic fractures, particular attention should be paid to improving balance – the most important element in falls prevention. Given the close interaction between osteoporosis and falls, prevention of fractures should be based on factors related to bone strength and risk factors for falls. Fractures are the most serious complication of osteoporosis and may be prevented. The use of modern spinal orthosis helps to reduce pain and improve posture. Vibration platforms are used in rehabilitation of osteoporosis, based on the concept that noninvasive, short-duration, mechanical stimulation could have an impact on osteoporosis risk. Pharmacologic therapy should be added for those at high risk of fracture, and vitamin D/calcium supplementation is essential in all prevention strategies. Success of rehabilitation in osteoporotic and fractured subjects through an individualized educational approach optimizes function to the highest level of independence while improving the overall quality of life. PMID:24963273

  11. Effect of Emergent Aquatic Vegetation on Sediment Transport Within the St. Anthony Falls Laboratory Outdoor StreamLab

    NASA Astrophysics Data System (ADS)

    Lightbody, A.; Rominger, J. T.; Nepf, H. M.; Paola, C.

    2008-12-01

    Riparian vegetation on channel bars and banks can significantly influence flow, sediment transport, and channel morphology within fluvial systems. Changes in flow and sedimentation, caused by vegetation, may reciprocally affect biological stability and growth. Model predictions were tested against field-scale measurements obtained within the Outdoor StreamLab~(OSL) at the St. Anthony Falls Laboratory~(SAFL). Two floodway basins adjacent to SAFL's main building are being transformed into a new outdoor laboratory to study physical, chemical, and biological interactions among a channel, its floodplain, and wetland vegetation. Experiments were conducted within a 3-m-wide, 30-cm-deep, and 50-m-long sand-bed meandering channel constructed within the first of two OSL basins, which has a total length of 40~m and a total width of 20~m. Water discharge varied between 36 ± 6~L/s at base flow to 210 ± 20~L/s during weekly 9-hour-long bankfull flood events. Bed sediment (d50 = 0.7~mm) was also metered continuously into the channel. When constructed, the bed was flat, but beginning with the first flood event the streamflow created point bars on the inside of two replicate meander bends. Seedlings of native wetland vegetation species, including Juncus effusus and Scirpus atrovirens, were planted from the baseflow waterline to the top of bank along one side of the meandering channel, including all exposed areas of one point bar. Vegetation frontal area was measured in situ using photographs of the vegetation against a red board. Bed erosion was quantified as the time for a thin layer of sediment to be removed from flexible contrasting-color tiles mounted flush with the bed surface. All trials were repeated at different neighboring locations to sample the spatial heterogeneity at the stem scale. Erosion rates were significantly higher on the inside of meander bends, when compared both to the outside of meander bends and to riffle (straight) reaches. Moreover, in all of these

  12. The influence of tai chi and yoga on balance and falls in a residential care setting: a randomised controlled trial.

    PubMed

    Saravanakumar, Padmapriya; Higgins, Isabel Johanna; Van Der Riet, Pamela Jane; Marquez, Jodie; Sibbritt, David

    2014-07-23

    Abstract Falls amongst older people is a global public health concern. Whilst falling is not a typical feature of ageing, older people are more likely to fall. Fall injuries amongst older people are a leading cause of death and disability. Many older people do not do regular exercise so that they lose muscle tone, strength, and flexibility which affect balance and predispose them to falls. The management of falls in residential care settings is a major concern with strategies for prevention and monitoring a focus in this setting. Yoga and tai chi have shown potential to improve balance and prevent falls in older adults. They also have potential to improve pain and quality of life. The aim of this study was to determine the feasibility of conducting a 3-arm RCT with frail older people in a residential care setting to test the hypothesis that a 14 week modified tai chi or yoga program is more effective than usual care activity in improving balance function, quality of life, pain experience and in reducing number of falls. There were no statistically significant differences between the three groups in the occurrence of falls. Yoga demonstrated a slight decrease in fall incidence; quality of life improved for the tai chi group. Only the yoga group experienced a reduction in average pain scores though not statistically significant. The findings of the study suggest it is possible to safely implement modified yoga and tai chi in a residential care setting and evaluate this using RCT design. They show positive changes to balance, pain and quality of life and a high level of interest through attendance amongst the older participants. The results support offering tai chi and yoga to older people who are frail and dependent with physical and cognitive limitations.

  13. Hysteresis Effect in the Activity Indices of the Atmospheres of the Sun and Solar-Type Stars During the Rising and Falling Phases of Cycles

    NASA Astrophysics Data System (ADS)

    Bruevich, E. A.; Yakunina, G. V.

    2016-09-01

    The hysteresis effect that shows up as a nonunique relationship among the emissions from the photosphere, chromosphere, and corona during the rising and falling phases of solar and stellar activity is analyzed. The following solar indices are analyzed and compared in different phases of the cycle: the radiative flux in the hydrogen Lyman alpha line FLα, radio emission at 10.7 cm F10.7, the sunspot number SSN, the radiative flux in the 530.0 nm green coronal line F530.3, the solar constant TSI, and the relative flux ratio c/w (ratio of the fluxes in the center and in the wings) for the 280 nm Mg II line. In stars with cycles, a hysteresis effect is observed between the CaII chromospheric S-activity index for stars in the Mount Wilson HK project and the photospheric flux Fph for these stars.

  14. Preventive effects of chitosan on peritoneal adhesion in rats

    PubMed Central

    Zhang, Zhi-Liang; Xu, Si-Wei; Zhou, Xie-Lai

    2006-01-01

    AIM: To study the effects of chitosan gel and blending chiston/gelatin film on preventing peritoneal adhesion in rats. METHODS: SD rats were randomly divided into 2 groups, group A treated with chitosan gel and group B with blending chiston/gelatin film. In group A, rats were randomly subdivided into 3 subgroups as groups A1, A2 and A3, and different methods were used to induce peritoneal adhesions at the dead end of vermiform process in each group as follows: Group A1 with trauma, A2 with talc powder and A3 with ligation of blood vessel. In each subgroup, rats were redivided into control group and experimental group whose treated vermiform processes were respectively coated with chitosan gel and normal saline immediately after the adhesion-induced treatments. In group B, all the rats received traumatic adhesion-induced treatments and then were randomly divided into 4 groups (groups B1, B2, B3, B4). Group B1 served as control group and were coated with normal saline in the vermiform processes immediately after the treatments, and groups B2, B3 and B4 with 100% chitosan film, chitosan film containing 10% gelatin and chiston film containing 50% gelatin, respectively. At 2 and 4 wk after the above treatments, half of the rats in each terminal group were belly opened, and the peritoneal adhesive situation was graded and histopathological changes were examined. RESULTS: (1) In group A, regarding peritoneal adhesion situation: At both 2 and 4 wk after the treatments, for groups A1 and A3, the adhesive grades of experimental groups were significantly lower than those of the control group (2 wk: H = 4.305, P < 0.05 for A1, H = 6.743, P < 0.01 for A3; 4 wk: H = 4.459, P < 0.05 for A1, H = 4.493, P < 0.05 for A3). However, of group A2, there was no significant difference between the experimental and control groups (2 wk: H = 0.147, P > 0.05; 4 wk: H = 1.240, P > 0.05). Regarding pathological changes: In groups A1 and A3, the main pathological change was fibroplasia. In group

  15. Falling into Winter.

    ERIC Educational Resources Information Center

    Harrington, Carolyn Lang

    2000-01-01

    Presents an activity that connects art, science, and nature in which elementary school students learn about deciduous trees. Explains that students create a torn-tissue collage, using fall colors for a background and drawing a silhouette of a tree without leaves on top of the background with black crayon. (CMK)

  16. Education and Falling Wages.

    ERIC Educational Resources Information Center

    Thurow, Lester C.

    1994-01-01

    Discusses why today's American workforce is experiencing falling wages and suggests that the answer to reversing this trend lies in improving the American education system to world class levels. Suggests the need to develop a postsecondary training system for those who do not go on to college, and highlights ways this might be implemented. (GR)

  17. Fall 2013 International Comparisons

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2014

    2014-01-01

    This Fall report is an aggregated statistical analysis of Measures of Academic Progress® (MAP®) data from international schools. The report provides a consistent means of comparisons of specific sub-groups by subject and grade, which allows partners to compare their MAP® results with other schools within their region or membership organization.…

  18. Freshmen Survey. Fall 1985.

    ERIC Educational Resources Information Center

    Goodyear, Don

    In 1985, College of the Sequoias (COS) was asked by the Cooperative Institutional Research Program (conducted jointly by the American Council on Education and the University of California, Los Angeles) to participate in a survey of incoming freshmen for the fall 1985 semester. During the summer counseling session, 259 new COS freshmen were…

  19. The News, Fall 2002.

    ERIC Educational Resources Information Center

    Giles, Ray, Ed.

    2002-01-01

    This fall 2002 newsletter from the Community College League of California contains several articles, news stories, and the brochure from the 2002 Annual Convention, "Celebrating the Way California LEARNS." Articles include: (1) "Nursing Shortage Poses Dilemma for Colleges: Access vs. Efficiency," a discussion of the debate over how to increase the…

  20. Editors' Fall Picks

    ERIC Educational Resources Information Center

    Heilbrun, Margaret; McCormack, Heather; Katterjohn, Anna; Kuzyk, Raya; Roncevic, Mirela; Fox, Bette-Lee; Hoffert, Barbara

    2009-01-01

    "Library Journal's" review editors select fall titles readers won't want to miss--"Waiting on a Train: The Embattled Future of Passenger Rail Service" (James McCommons); "Happy" (Alex Lemon); "Free for All: Joe Papp, the Public, and the Greatest Theater Story Ever Told" (Kenneth Turan & Joseph Papp); "In My Father's Shadow: A Daughter Remembers…

  1. Precision Falling Body Experiment

    ERIC Educational Resources Information Center

    Blackburn, James A.; Koenig, R.

    1976-01-01

    Described is a simple apparatus to determine acceleration due to gravity. It utilizes direct contact switches in lieu of conventional photocells to time the fall of a ball bearing. Accuracies to better than one part in a thousand were obtained. (SL)

  2. 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

  3. Effects of educating local government officers and healthcare and welfare professionals in suicide prevention.

    PubMed

    Kaniwa, Isao; Kawanishi, Chiaki; Suda, Akira; Hirayasu, Yoshio

    2012-03-01

    Suicide is a major public health issue. In Japan, local governments are responsible for suicide prevention, and local government officers are therefore expected to act as gatekeepers for suicide prevention. In this study, through a questionnaire survey, the authors examined the current knowledge and attitudes concerning suicide prevention among local government officers and healthcare and welfare professionals, and the effects of providing suicide prevention education on their knowledge of and attitudes toward suicide and its prevention. One hundred eighty-three local government officers and 432 healthcare/welfare professionals completed the survey before and after a single education session. Before the session, the local government officers and healthcare/welfare professionals showed mainly positive attitudes toward suicide prevention efforts, with little difference between the two groups. After the training, knowledge and attitudes were further improved for most questionnaire items. Respondents with one or more experiences of suicide prevention training showed significantly more knowledge and positive attitudes before the training than those with no such experience. Moreover, knowledge of depression and having a sympathetic attitude were found to be especially associated with the overall attitude that "suicide can be prevented". Training in suicide prevention was shown to be effective in promoting appropriate knowledge and attitudes among local government officers and healthcare/welfare professionals who are gatekeepers for preventing suicide. Our findings confirm the importance of suicide prevention education, and will contribute to creating a standard educational program on suicide prevention in Japan.

  4. The variability of meteoroid falling

    NASA Astrophysics Data System (ADS)

    Velasco Herrera, V. M.; Cordero, G.

    2016-10-01

    We analysed a historical catalogue of meteoroid falling during the last 400 years. We report here for the first time the synchronization between observed meteors and solar barycentric parameters in 19.6 and 13.2 years periodicities using a new multiple cross wavelet. The group of moderated number of meteors is distributed around the positive phase of the solar barycentric periodicity of 13.2 years. While the group of severe number of meteors are distributed on the positive phase of the solar barycentric periodicity of 19.6 years. These periodicities could be associated with Jupiter periodicities. So understanding the modulation of meteoroid falling is important for determining the falling patterns of these objects and for knowing when it is more likely to expect the entry of one of these objects into the Earth's atmosphere, because bodies falling onto the Earth can cause damage from minor impacts to mass-extinctions events. One of the most extreme events was the formation of the Chicxulub impact crater 65,000,000 years ago that caused one of the five major mass extinctions in the last 500,000,000 years. During the 20th and 21st centuries, a series of events demonstrated the importance of collisions between planets and small bodies (comets and asteroids), which included our own planet. In the case of the Earth, we can cite three examples: Tunguska, Curuça and Chelyabinsk. These events invite us to think that perhaps the occurrence of this phenomenon might be more common than we realize, but the lack of communication or people in the area where they happened prevents us from having a complete record. Modern man has not witnessed the impact of large asteroids or comets on our planet, but it has been observed on other planetary bodies. The most spectacular of these events was the collision of fragments of the comet Shoemaker-Levy 9 with Jupiter in 1994. The total energy of the 21 impacts on Jupiter's atmosphere was estimated as the equivalent of tens of millions of

  5. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

    PubMed Central

    Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho

    2016-01-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls. PMID:26839487

  6. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors.

    PubMed

    Nam, Ki Yeun; Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2016-02-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls. PMID:26839487

  7. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    PubMed

    van der Zijden, A M; Groen, B E; Tanck, E; Nienhuis, B; Verdonschot, N; Weerdesteyn, V

    2012-06-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances.

  8. Effects of time of weaning, supplement, and sire breed of calf during the fall grazing period on cow and calf performance.

    PubMed

    Short, R E; Grings, E E; MacNeil, M D; Heitschmidt, R K; Haferkamp, M R; Adams, D C

    1996-07-01

    A 4-yr experiment was conducted to determine effects of protein supplementation, age at weaning, and calf sire breed on cow and calf performance during fall grazing. Each year 48 pregnant, crossbred cows nursing steer calves (mean calving date = April 8) were assigned to a 2 x 2 x 2 factorial experiment replicated in three native range pastures. Treatment factors were: 1) no supplement (NS) or an individually fed supplement (S, 3 kg of a 34% protein supplement fed to cows every 3rd d); 2) calves weaned at the beginning (W, mid to late September) or at the end (NW, mid to late December) of the trial each year; or 3) calves sired by Hereford or Charolais bulls. Data were adjusted for cow size (initial hip height and initial and final weights and condition scores) by analyses of covariance using principal component coefficients as covariates. Change in cow weight and condition score were increased by S and W (P < .01), but these responses interacted and were not the same each year (yr x S, year x W, and year x S x W, P < .01). Forage intake was decreased (P < .1) by S and W. Total intake (forage+supplement) was not affected by S but was decreased by W (P < .1). Digestibility of OM was decreased by S (P < .01). Some carryover effects of treatments were observed the next spring in cow weight, condition score, and birth weight (NW decreased birth weight by 2 kg, P < .01), but there were no effects by the next fall on weaning weights or pregnancy rates. Milk yield decreased during the experimental period, and S maintained higher milk production in late lactation (P < .01). Calf ADG was increased by S and Charolais sires (P < .01). Efficiency (grams of output/ megacalorie of input) was not affected by sire breed but was enhanced by S (P < .01). Our conclusions are that 1) effects of feeding a 34% protein supplement to cows were to increase calf gains and improve persistency of lactation and efficiency; 2) delaying weaning decreased cow weight and condition score; 3

  9. Finding Ways to Effectively Prevent Sexual Abuse by Youth

    ERIC Educational Resources Information Center

    Klein, Alisa; Tabachnick, Joan

    2002-01-01

    Youth with sexual behavior problems pose a complicated challenge to the society. Yet the society has succeeded in developing only a limited range of actions and attitudes to grapple with and prevent this problem. Very few of the social service and criminal justice systems have rallied to create compassionate models that not only address and…

  10. Fifteen Effective Strategies for Improving Student Attendance and Truancy Prevention

    ERIC Educational Resources Information Center

    Smink, Jay; Reimer, Mary S.

    2005-01-01

    Improving student attendance and truancy prevention have always been areas of concern for educators, as well as, community members, and legislators. Students who are not in school cannot learn, and frequently drop out. Truant students often engage in high-risk behaviors that eventually entangle them in the juvenile justice system. Since 1986, the…

  11. Teen Depression and Suicide: Effective Prevention and Intervention Strategies

    ERIC Educational Resources Information Center

    King, Keith A.; Vidourek, Rebecca A.

    2012-01-01

    Teen depression and suicidal behaviors are intricately intertwined, with untreated depression being a leading cause of adolescent suicide. Most depressed or suicidal teens tend to show warning signs and possess specific risk factors. A key component to preventing teen depression is for adults to remain aware of such warning signs and risk factors…

  12. Disseminating Effective Community Prevention Practices: Opportunities for Social Work Education

    ERIC Educational Resources Information Center

    Hawkins, J. David; Shapiro, Valerie B.; Fagan, Abigail A.

    2010-01-01

    In the United States, about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral (MEB) disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect one in five families and cost $247 million annually. Some strategies for preventing MEB…

  13. A cost-effective pressure damage prevention strategy.

    PubMed

    Large, Jenny

    This article describes the development of a pressure ulcer prevention strategy, with the aim of establishing if the implementation of best practice would impact on the incidence of pressure ulcers in a healthcare setting. The strategy was piloted in a large 78-bedded nursing home. A full audit of the patients' notes and existing care pathways was conducted in order to inform the structure of the prevention plan. It was found that there were no protocols for the use of Cavilon barrier products and that it was not part of a standard care pathway. A prevention strategy was designed based on these findings and an education package delivered to all staff. Training in the appropriate use of Aderma (TM) Dermal Pads was also provided so that they could be put in place as an early preventative measure in patients at risk of pressure damage or those showing the symptoms. The results of the study showed that by establishing a best practice care pathway, the incidence of pressure ulcers could be reduced.

  14. Adolescent Pregnancy Prevention Programs: Theoretical Models for Effective Program Development

    ERIC Educational Resources Information Center

    Saunders, Jeanne A.

    2005-01-01

    Adolescent pregnancy and parenting remains a pressing social and public health concern because the United States continues to have the highest teen pregnancy rate among Western developed nations and because of the attendant social, psychological, and physical problems for young parents and their children. Prevention efforts to reduce the incidence…

  15. Optimizing Violence Prevention Programs: An Examination of Program Effectiveness among Urban High School Students

    ERIC Educational Resources Information Center

    Thompkins, Amanda C.; Chauveron, Lisa M.; Harel, Ofer; Perkins, Daniel F.

    2014-01-01

    Background: While demand for youth violence prevention programs increases, the ability of the school-day schedule to accommodate their time requirements has diminished. Viable school-based prevention programs must strike a balance between brevity and effectiveness. This article reports results from an effectiveness trial of a 12-session…

  16. Getting inside the House: The Effectiveness of a Rape Prevention Program for College Fraternity Men.

    ERIC Educational Resources Information Center

    Davis, Tracy L.; Liddell, Debora L.

    2002-01-01

    Investigates the effectiveness of a socialization-focused rape prevention program designed specifically for college fraternity men. Results suggest that a socialization approach to rape education was as effective as a more traditional prevention program with regard to attitudes and knowledge. Although attitudes rebounded to previous levels at the…

  17. The Cost and Effectiveness of School-Based Preventive Dental Care.

    ERIC Educational Resources Information Center

    Klein, Stephen P.; And Others

    1985-01-01

    The cost and effectiveness of various types and combinations of school-based preventive dental care procedures were assessed in the National Preventive Dentistry Demonstration Program, a four-year study involving more than 20,000 students, from ten schools nationwide. Communal water fluoridation was reaffirmed as the most cost-effective means of…

  18. Technology Innovation Enabling Falls Risk Assessment in a Community Setting.

    PubMed

    Ni Scanaill, Cliodhna; Garattini, Chiara; Greene, Barry R; McGrath, Michael J

    2011-06-01

    Approximately one in three people over the age of 65 will fall each year, resulting in significant financial, physical, and emotional cost on the individual, their family, and society. Currently, falls are managed using on-body sensors and alarm pendants to notify others when a falls event occurs. However these technologies do not prevent a fall from occurring. There is now a growing focus on falls risk assessment and preventative interventions. Falls risk is currently assessed in a clinical setting by expert physiotherapists, geriatricians, or occupational therapists following the occurrence of an injurious fall. As the population ages, this reactive model of care will become increasingly unsatisfactory, and a proactive community-based prevention strategy will be required. Recent advances in technology can support this new model of care by enabling community-based practitioners to perform tests that previously required expensive technology or expert interpretation. Gait and balance impairment is one of the most common risk factors for falls. This paper reviews the current technical and non-technical gait and balance assessments, discusses how low-cost technology can be applied to objectively administer and interpret these tests in the community, and reports on recent research where body-worn sensors have been utilized. It also discusses the barriers to adoption in the community and proposes ethnographic research as a method to investigate solutions to these barriers. PMID:21660088

  19. The Shape of Nuclear Falls and Their Effect on the Perception of Pitch and Prominence: Peaks vs. Plateaux

    ERIC Educational Resources Information Center

    Knight, Rachael-Anne

    2008-01-01

    This article investigates the perceptual effect of a high plateau in the intonation contour. Plateaux are flat stretches of contour and have been observed associated with high tones in Standard Southern British (SSB) English. The hypothesis that plateaux may make the accents with which they are associated sound higher in pitch than sharp peaks of…

  20. Prevention System Mediation of Communities That Care Effects on Youth Outcomes

    PubMed Central

    Hawkins, J. David; Rhew, Isaac C.; Shapiro, Valerie B.; Abbott, Robert D.; Oesterle, Sabrina; Arthur, Michael W.; Briney, John S.; Catalano, Richard F.

    2013-01-01

    This study examined whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students (Hawkins et al. Archives of Pediatrics and Adolescent Medicine 163:789–798 2009) were mediated by community-level prevention system constructs posited in the CTC theory of change. Potential prevention system constructs included the community’s degree of (a) adoption of a science-based approach to prevention, (b) collaboration on prevention activities, (c) support for prevention, and (d) norms against adolescent drug use as reported by key community leaders in 24 communities. Higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Results support CTC’s theory of change that encourages communities to adopt a science- based approach to prevention as a primary mechanism for improving youth outcomes. PMID:23828448

  1. Preventive effects of geranylgeranylacetone on rat ethanol-induced gastritis

    PubMed Central

    Ning, Jian-Wen; Lin, Guan-Bin; Ji, Feng; Xu, Jia; Sharify, Najeeb

    2012-01-01

    AIM: To establish a rat ethanol gastritis model, we evaluated the effects of ethanol on gastric mucosa and studied the preventive effects of geranylgeranylacetone on ethanol-induced chronic gastritis. METHODS: One hundred male Sprague-Dawley rats were randomly divided into 4 equal groups: normal control group, undergoing gastric perfusion of normal saline (NS) by gastrogavage; model control group and 2 model therapy groups that underwent gastric perfusion with ethanol (distillate spirits with 56% ethanol content) by gastrogavage for 4 wk. Low or high doses of geranylgeranylacetone were added 1 h before ethanol perfusion in the 2 model therapy groups, while the same amount of NS, instead of geranylgeranylacetone was used in that model control group. The rats were then sacrificed and stomachs were removed. The injury level of the gastric mucosa was observed by light and electron microscopy, and the levels of prostaglandin 2 (PGE2), endothelin-1 (ET-1) and nitric oxide (NO) were measured by radioimmunoassay and the Griess method. RESULTS: The gastric mucosal epidermal damage score (EDS; 4.5) and ulcer index (UI; 12.0) of the model control group were significantly higher than that of the normal control group (0 and 0 respectively, all P = 0.000). The gastric mucosal EDS and UI of the 2 model therapy groups (EDS: 2.5 and 2.0; UI: 3.5 and 3.0) were significantly lower than that of the model control group (all P < 0.01). There was no statistically significant difference between the low-dose and high-dose model therapy groups. The expression value of plasma ET-1 of the model control group was higher than that of the normal control group (P < 0.01) and the 2 model therapy groups (all P < 0.01). The expression values of gastric mucosal PGE2 and serum NO of the model control group were lower than those of the normal control group (all P < 0.05) and the 2 model therapy groups (all P < 0.05). The thickness of the gastric mucous layerand the hexosamine content in the model

  2. Resolving conflict creatively: evaluating the developmental effects of a school-based violence prevention program in neighborhood and classroom context.

    PubMed

    Aber, J L; Jones, S M; Brown, J L; Chaudry, N; Samples, F

    1998-01-01

    This study evaluated the short-term impact of a school-based violence prevention initiative on developmental processes thought to place children at risk for future aggression and violence and examined the influence of classroom and neighborhood contexts on the effectiveness of the violence prevention initiative. Two waves of developmental data (fall and spring) were analyzed from the 1st year of the evaluation of the Resolving Conflict Creatively Program (RCCP), which includes 5053 children from grades two to six from 11 elementary schools in New York City. Three distinct profiles of exposure to the intervention were derived from Management Information System (MIS) data on between classroom differences in teacher Training and Coaching in RCCP, Classroom Instruction in RCCP, and percentages of students who are Peer Mediators. Developmental processes that place children at risk were found to increase over the course of the school year. Children whose teachers had a moderate amount of training and coaching from RCCP and who taught many lessons showed significantly slower growth in aggression-related processes, and less of a decrease in competence-related processes, compared to children whose teachers taught few or no lessons. Contrary to expectation, children whose teachers had a higher level of training and coaching in the RCCP but taught few lessons showed significantly faster growth over time in aggressive cognitions and behaviors. The impact of the intervention on children's social cognitions (but not on their interpersonal behaviors) varied by context. Specifically the positive effect of High Lessons was dampened for children in high-risk classrooms and neighborhoods. Implications for future research on developmental psychopathology in context and for the design of preventive interventions are discussed.

  3. Stick balancing, falls and Dragon-Kings

    NASA Astrophysics Data System (ADS)

    Cabrera, J. L.; Milton, J. G.

    2012-05-01

    The extent to which the occurrence of falls, the dominant feature of human attempts to balance a stick at their fingertip, can be predicted is examined in the context of the "Dragon-King" hypothesis. For skilled stick balancers, fluctuations in the controlled variable, namely the vertical displacement angle θ, exhibit power law behaviors. When stick balancing is made less stable by either decreasing the length of the stick or by requiring the subject to balance the stick on the surface of a table tennis racket, systematic departures from the power law behaviors are observed in the range of large θ. This observation raises the possibility that the presence of departures from the power law in the large length scale region, possibly Dragon-Kings, may identify situations in which the occurrence of a fall is more imminent. However, whether or not Dragon-Kings are observed, there is a Weibull-type survival function for stick falling. The possibility that increased risk of falling can, at least to some extent, be predicted from fluctuations in the controlled variable before the event occurs has important implications for the development of preventative strategies for the management of phenomena ranging from earthquakes to epileptic seizures to falls in the elderly.

  4. The Effect of Educational Intervention Regarding the Knowledge of Mothers on Prevention of Accidents in Childhood

    PubMed Central

    Silva, Elayne Cristina Soares; Fernandes, Maria Neyrian de Fátima; Sá, Márcia Caroline Nascimento; Mota de Souza, Layane; Gordon, Ariadne Siqueira de Araújo; Costa, Ana Cristina Pereira de Jesus; Silva de Araújo, Thábyta; Carvalho, Queliane Gomes da Silva; Maia, Carlos Colares; Machado, Ana Larissa Gomes; Gubert, Fabiane do Amaral; Alexandrino da Silva, Leonardo; Vieira, Neiva Francenely Cunha

    2016-01-01

    Early guidance emphasizes the provision of information to families about growth and normal development in childhood such as specific information about security at home. This research aimed to analyze mothers' knowledge about the prevention of accidents in childhood before and after an educational intervention. It was conducted as a quasi-experimental study with 155 mothers in a Basic Health Unit in northeastern of Brazil in April and May of 2015. The data were collected in two stages through a self-report questionnaire performed before and after the educational intervention by the subjects. The results revealed a significant increase in knowledge about prevention of accidents in childhood in all the self-applied questions (p<0.05). After the educational intervention, there seemed to be a significant difference with the questions regarding the knowledge on preventing fall (p=0.000), drowning (p=0.000), and intoxication (p=0.007). The authors concluded that the educational intervention performed in this study increased the subjects’ knowledge on prevention of accidents in childhood. PMID:27583061

  5. The Effect of Educational Intervention Regarding the Knowledge of Mothers on Prevention of Accidents in Childhood.

    PubMed

    Silva, Elayne Cristina Soares; Fernandes, Maria Neyrian de Fátima; Sá, Márcia Caroline Nascimento; Mota de Souza, Layane; Gordon, Ariadne Siqueira de Araújo; Costa, Ana Cristina Pereira de Jesus; Silva de Araújo, Thábyta; Carvalho, Queliane Gomes da Silva; Maia, Carlos Colares; Machado, Ana Larissa Gomes; Gubert, Fabiane do Amaral; Alexandrino da Silva, Leonardo; Vieira, Neiva Francenely Cunha

    2016-01-01

    Early guidance emphasizes the provision of information to families about growth and normal development in childhood such as specific information about security at home. This research aimed to analyze mothers' knowledge about the prevention of accidents in childhood before and after an educational intervention. It was conducted as a quasi-experimental study with 155 mothers in a Basic Health Unit in northeastern of Brazil in April and May of 2015. The data were collected in two stages through a self-report questionnaire performed before and after the educational intervention by the subjects. The results revealed a significant increase in knowledge about prevention of accidents in childhood in all the self-applied questions (p<0.05). After the educational intervention, there seemed to be a significant difference with the questions regarding the knowledge on preventing fall (p=0.000), drowning (p=0.000), and intoxication (p=0.007). The authors concluded that the educational intervention performed in this study increased the subjects' knowledge on prevention of accidents in childhood. PMID:27583061

  6. [Effective prevention through nutritional and food additives: barriers and resistance].

    PubMed

    Lux, R; Walter, U

    2006-06-01

    The population-wide and individual preventive potentials of nutritional and food additives such as vitamins and trace elements are generally accepted in the international literature. Iodisation and fluoridation were and are a main focus of activity. The enrichment of food with folic acid is also partly population-related. Until now, however, the theoretical possibilities of nutritional supplementations have not been fully exploited. Various barriers and resistances arise in programme development and implementation. Interviews with key stakeholders and community groups can clarify decade-long discussions in the literature and the media. The study on hand is based on a structural analysis. It shows the various arguments as well as beneficial and impeding factors for a population-wide prevention programme, for specific target groups and individuals. The findings of this research could also be applied to other Public Health challenges.

  7. Multicomponent delirium prevention: not as effective as NICE suggest?

    PubMed

    Teale, Elizabeth; Young, John

    2015-11-01

    Multicomponent delirium prevention strategies have been shown in intervention studies consistently to reduce the occurrence of delirium. Based on this convincing evidence base, the National Institute for Health and Care Excellence has advocated the widespread adoption of multicomponent delirium prevention interventions into the routine inpatient care of older people. However, despite successful reductions in incident delirium of about a third, anticipated reductions in mortality or admissions to long-term care--both clinically important endpoints statistically correlated with the occurrence of delirium--have not been conclusively observed. We hypothesise that the reasons for this disconnection are partly methodological, due to difficulties in delirium detection and blinding of study personnel to the intervention, but predominantly due to the underlying relationship between delirium and the abnormal health state of frailty; the interaction between these two geriatric syndromes is currently poorly understood.

  8. The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis.

    PubMed

    Johnsen, Tom J; Friborg, Oddgeir

    2015-07-01

    A meta-analysis examining temporal changes (time trends) in the effects of cognitive behavioral therapy (CBT) as a treatment for unipolar depression was conducted. A comprehensive search of psychotherapy trials yielded 70 eligible studies from 1977 to 2014. Effect sizes (ES) were quantified as Hedge's g based on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). Rates of remission were also registered. The publication year of each study was examined as a linear metaregression predictor of ES, and as part of a 2-way interaction with other moderators (Year × Moderator). The average ES of the BDI was 1.58 (95% CI [1.43, 1.74]), and 1.69 for the HRSD (95% CI [1.48, 1.89]). Subgroup analyses revealed that women profited more from therapy than did men (p < .05). Experienced psychologists (g = 1.55) achieved better results (p < .01) than less experienced student therapists (g = 0.98). The metaregressions examining the temporal trends indicated that the effects of CBT have declined linearly and steadily since its introduction, as measured by patients' self-reports (the BDI, p < .001), clinicians' ratings (the HRSD, p < .01) and rates of remission (p < .01). Subgroup analyses confirmed that the declining trend was present in both within-group (pre/post) designs (p < .01) and controlled trial designs (p = .02). Thus, modern CBT clinical trials seemingly provided less relief from depressive symptoms as compared with the seminal trials. Potential causes and possible implications for future studies are discussed. (PsycINFO Database Record

  9. Fall-grown oat to extend the fall grazing season for replacement dairy heifers.

    PubMed

    Coblentz, W K; Brink, G E; Hoffman, P C; Esser, N M; Bertram, M G

    2014-03-01

    Our objective was to assess the pasture productivity and forage characteristics of 2 fall-grown oat (Avena sativa L.) cultivars, specifically for extending the grazing season and reducing reliance on harvested forages by replacement dairy heifers. A total of 160 gravid Holstein heifers (80 heifers/yr) were stratified by weight, and assigned to 1 of 10 identical research pens (8 heifers/pen). Initial body weights were 480 ± 43.5 kg in 2011 and 509 ± 39.4 kg in 2012. During both years of the trial, four 1.0-ha pasture replicates were seeded in August with Ogle oat (Schumitsch Seed Inc., Antigo, WI), and 4 separate, but similarly configured, pasture replicates were seeded with Forage Plus oat (Kratz Farms, Slinger, WI). Heifer groups were maintained as units, assigned to specific pastures, and then allowed to graze fall-oat pastures for 6h daily before returning to the barn, where they were offered a forage-based basal total mixed ration. Two heifer groups were retained in confinement (without grazing) as controls and offered the identical total mixed ration as pasture groups. During 2011, available forage mass increased with strong linear and quadratic effects for both cultivars, peaking at almost 9 Mg/ha on October 31. In contrast, forage mass was not affected by evaluation date in 2012, remaining ≤ 2,639 kg/ha across all dates because of droughty climatic conditions. During 2012, Ogle exhibited greater forage mass than Forage Plus across all sampling dates (2,678 vs. 1,856 kg/ha), largely because of its more rapid maturation rate and greater canopy height. Estimates of energy density for oat forage ranged from 59.6 to 69.1% during 2011, and ranged narrowly from 68.4 to 70.4% during 2012. For 2011, responses for both cultivars had strong quadratic character, in which the most energy-dense forages occurred in mid November, largely due to accumulation of water-soluble carbohydrates that reached maximum concentrations of 18.2 and 15.1% for Forage Plus and Ogle

  10. Fall-grown oat to extend the fall grazing season for replacement dairy heifers.

    PubMed

    Coblentz, W K; Brink, G E; Hoffman, P C; Esser, N M; Bertram, M G

    2014-03-01

    Our objective was to assess the pasture productivity and forage characteristics of 2 fall-grown oat (Avena sativa L.) cultivars, specifically for extending the grazing season and reducing reliance on harvested forages by replacement dairy heifers. A total of 160 gravid Holstein heifers (80 heifers/yr) were stratified by weight, and assigned to 1 of 10 identical research pens (8 heifers/pen). Initial body weights were 480 ± 43.5 kg in 2011 and 509 ± 39.4 kg in 2012. During both years of the trial, four 1.0-ha pasture replicates were seeded in August with Ogle oat (Schumitsch Seed Inc., Antigo, WI), and 4 separate, but similarly configured, pasture replicates were seeded with Forage Plus oat (Kratz Farms, Slinger, WI). Heifer groups were maintained as units, assigned to specific pastures, and then allowed to graze fall-oat pastures for 6h daily before returning to the barn, where they were offered a forage-based basal total mixed ration. Two heifer groups were retained in confinement (without grazing) as controls and offered the identical total mixed ration as pasture groups. During 2011, available forage mass increased with strong linear and quadratic effects for both cultivars, peaking at almost 9 Mg/ha on October 31. In contrast, forage mass was not affected by evaluation date in 2012, remaining ≤ 2,639 kg/ha across all dates because of droughty climatic conditions. During 2012, Ogle exhibited greater forage mass than Forage Plus across all sampling dates (2,678 vs. 1,856 kg/ha), largely because of its more rapid maturation rate and greater canopy height. Estimates of energy density for oat forage ranged from 59.6 to 69.1% during 2011, and ranged narrowly from 68.4 to 70.4% during 2012. For 2011, responses for both cultivars had strong quadratic character, in which the most energy-dense forages occurred in mid November, largely due to accumulation of water-soluble carbohydrates that reached maximum concentrations of 18.2 and 15.1% for Forage Plus and Ogle

  11. [Tail-biting in pigs. Causes, effects and prevention].

    PubMed

    van den Berg, J

    1982-10-01

    Although much is known of the causes and prevention of tail-biting, this continues to be a common vice in pigs. The animals seek diversion by chewing on the tails of their fellows as they feel uncomfortable. This may result in inflammation of the tail. Prevention should be directed towards improvement of the conditions which cause the animal to feel uncomfortable. As this will often not be possible or only in part, efforts are made to prevent tail-biting by docking the tails. When tail-docking is performed according to the rule in one- to three-day-old animals, tail-biting obviously will no longer be possible. However, this does not mean removing the causes of tail-biting. This procedure is therefore undesirable from the point of view of welfare of the animals. Inflammation of the tail may result in metastasis to the spinal column and/or lungs. This is frequently associated with bacteraemia. Moreover, the resulting abscess formation will be highly objectionable from the point of view of hygiene. PMID:7147219

  12. Efficacy, effectiveness and side effects of medications used to prevent fractures.

    PubMed

    Reid, I R

    2015-06-01

    There is an increasing number of effective therapies for fracture prevention in adults at risk of osteoporosis. However, shortcomings in the evidence underpinning our management of osteoporosis still exist. Evidence of antifracture efficacy in the groups of patients who most commonly use calcium and vitamin D supplements is lacking, the safety of calcium supplements is in doubt, and the safety and efficacy of high doses of vitamin D give cause for concern. Alendronate, risedronate, zoledronate and denosumab have been shown to prevent spine, nonspine and hip fractures; in addition, teriparatide and strontium ranelate prevent both spine and nonspine fractures, and raloxifene and ibandronate prevent spine fractures. However, most trials provide little information regarding long-term efficacy or safety. A particular concern at present is the possibility that oral bisphosphonates might cause atypical femoral fractures. Observational data suggest that the incidence of this type of fracture increases steeply with duration of bisphosphonate use, resulting in concern that the benefit-risk balance may become negative in the long term, particularly in patients in whom the osteoporotic fracture risk is not high. Therefore, reappraisal of ongoing use of bisphosphonates after about 5 years is endorsed by expert consensus, and 'drug holidays' should be considered at this time. Further studies are needed to guide clinical practice in this area. PMID:25495429

  13. Effect of solid body degrees of freedom on the path instabilities of freely falling or rising flat cylinders

    NASA Astrophysics Data System (ADS)

    Chrust, M.; Bouchet, G.; Dušek, J.

    2014-05-01

    In 2007 Fernandes et al. reported a surprising delay of the onset of instabilities for freely rising cylinders of aspect ratio (χ=diameter/thickness of the cylinder) 10 and more. At Reynolds numbers at which instabilities develop in the wake of the same body kept fixed, the path was still found to be vertical and the wake axisymmetric. In this paper, we explain this delay by investigating numerically the transition scenario of the solid-fluid system represented by the freely moving body interacting with the ambient fluid by hydrodynamic forces. We show that the free body degrees of freedom can have a stabilizing effect on the onset of the primary bifurcation. This effect explains, however, only partly the experimental observation. We show that the primary bifurcation is followed by a sequence of weakly oscillating, virtually unobservable, bifurcating states before the observable path oscillations set in. For aspect ratio smaller than 8, the free body degrees of freedom destabilize the system in agreement with expectations. The primary bifurcation is, however, a Hopf bifurcation instead of regular one in the wake of a fixed body. In our study we focus to the intermediate interval of aspect ratio between 8 and 10. We show that, for χ>8, the primary Hopf bifurcation is replaced by a new one with much lower frequency and leading to weakly oscillating periodic oscillations, later (for χ>9) the Hopf bifurcation is replaced by a regular one disappearing again for very thin cylinders (χ>10).

  14. `In free fall'

    NASA Astrophysics Data System (ADS)

    Beijerinck, Herman C. W.

    2014-01-01

    Physicists in the lead of a fiction book or a play, that's a rare event! Writers in general do not understand physics, while physicists seldom have the talent of writing for a large audience. So when it happens, we should rejoice. The up-and-coming German author Juli Zeh [1] (1974), who studied law, has succeeded in combining beautiful prose, psychological drama, crime and physics in a challenging book `In free fall' [2]. A good friend of hers, Bettina Bruinier, has put the core message of the book into a compelling play in the `Volkstheater' in Munich [1]. Yes, it can be done.

  15. Statistical evaluation of the effects of fall and winter flows on the spring condition of rainbow and brown trout in the green river downstream of Flaming Gorge Dam.

    SciTech Connect

    Magnusson, A. K.; LaGory, K. E.; Hayse, J. W.; Environmental Science Division

    2009-01-09

    Flaming Gorge Dam, a hydroelectric facility operated by the Bureau of Reclamation (Reclamation), is located on the Green River in Daggett County, northeastern Utah. In recent years, single peak releases each day or steady flows have been the operational pattern during the winter period. A double-peak pattern (two flow peaks each day) was implemented during the winter of 2006-2007 by Reclamation. Because there is no recent history of double-peaking at Flaming Gorge Dam, the potential effects of double-peaking operations on the body condition of trout in the dam's tailwater are not known. A study plan was developed that identified research activities to evaluate potential effects from double-peaking operations during winter months. Along with other tasks, the study plan identified the need to conduct a statistical analysis of existing data on trout condition and macroinvertebrate abundance to evaluate potential effects of hydropower operations. This report presents the results of this analysis. We analyzed historical data to (1) describe temporal patterns and relationships among flows, benthic macroinvertebrate abundance, and condition of brown trout (Salmo trutta) and rainbow trout (Oncorhynchus mykiss) in the tailwaters of Flaming Gorge Dam and (2) to evaluate the degree to which flow characteristics (i.e., flow volumes and flow variability) and benthic macroinvertebrate abundance affect the condition of trout in this area. This information, together with further analyses of size-stratified trout data, may also serve as baseline data to which the effects of potential future double-peaking flows can be compared. The condition (length, weight and/or relative weight) of rainbow trout (Oncorhynchus mykiss) at two sites in the Green River downstream of Flaming Gorge Dam (Tailrace and Little Hole) and weight of brown trout (Salmo trutta) at the Little Hole site has been decreasing since 1990 while the abundance of brown trout has been increasing at the two sites. At the

  16. Comparison of the effects of elcatonin and risedronate on back and knee pain by electroalgometry using fall of skin impedance and quality of life assessment using SF-36.

    PubMed

    Fujita, Takuo; Ohue, Mutsumi; Nakajima, Mikio; Fujii, Yoshio; Miyauchi, Akimitsu; Takagi, Yasuyuki

    2011-09-01

    Back and knee pain is a widespread health problem and a serious threat to the quality of life (QOL) in middle-aged and older adults, as it frequently accompanies osteoporosis and osteoarthritis. In order to compare the effects of elcatonin and risedronate on such pain, 20 units of elcatonin was intramuscularly injected to 18 patients, and 5 mg of risedronate was orally administered daily to 20 others with similar backgrounds. Exercise-induced pain was analyzed by measuring the fall of skin impedance by electroalgometry (EAM), and subjective pain was recorded by a visual rating system (VRS) on a scale of 0 (no pain) to 100 (unbearable pain). In patients treated with elcatonin, the mean EAM-estimated pain was significantly reduced after 4, 5 and 6 months of treatment, and the VRS score after 3, 5 and 6 months, indicating a significant analgesic effect. In the risedronate group, however, improvement was less remarkable. Two-way analysis of variance using pain as a dependent variable and treatment group and time as independent variables revealed a significantly greater effect of elcatonin over risedronate on both the EAM and VRS scores, and the influence of treatment time on pain was indistinguishable between the two treatment groups. Effect of exercise load on pain was less on knee load than knee and spine load and spine load, but indistinguishable between the two groups. Changes in QOL were evaluated by the SF-36 system. Norm-based scoring showed significant improvements in 3 of 4 categories for elcatonin and in 2 of 4 for risedronate, suggesting comparable effects on the physical aspects of QOL, whereas responses to emotionally and socially directed questions indicated significant improvements in all 4 categories for risedronate, but none for elcatonin, suggesting a more physical than emotional component in elcatonin effects compared to risedronate.

  17. Understanding fall meaning and context in marketing balance classes to older adults.

    PubMed

    Clark, Lauren; Thoreson, Sallie; Goss, Cynthia W; Zimmer, Lorena Marquez; Marosits, Mark; DiGuiseppi, Carolyn

    2013-02-01

    This study explored older, community-dwelling adults' attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥ 60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their "comfort zones" to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success.

  18. Understanding fall meaning and context in marketing balance classes to older adults.

    PubMed

    Clark, Lauren; Thoreson, Sallie; Goss, Cynthia W; Zimmer, Lorena Marquez; Marosits, Mark; DiGuiseppi, Carolyn

    2013-02-01

    This study explored older, community-dwelling adults' attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥ 60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their "comfort zones" to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success. PMID:25473927

  19. A Falls Wheel in a Large Academic Medical Center: An Intervention to Reduce Patient Falls With Harm.

    PubMed

    Hefner, Jennifer L; McAlearney, Ann Scheck; Mansfield, Jerry; Knupp, Amy M; Moffatt-Bruce, Susan D

    2015-01-01

    This article presents an evaluation of a multifaceted fall prevention initiative. The main element of this initiative was the creation and implementation of a Falls Wheel--a visual communication tool of a patient's fall injury risk for all care team members placed on every patient door throughout the health system. The Falls Wheel allows for patient categorization along two dimensions simultaneously: risk of fall and risk of injury from a fall. During the yearlong implementation, the rate of falls with harm dropped by almost 50%. A process audit revealed that there was high fidelity to the intervention components, including displaying the wheel correctly 95% of the time, and the Falls Wheel was updated to match the risk level in the electronic health record 70% of the time. The goal of this article was to share the experience of one health system and encourage others to adopt and rigorously test the Falls Wheel. Replication and extension of this program at other hospitals and health systems will enable staff and empower patients to reduce falls with harm and their unintended consequences.

  20. Standards of Evidence for Efficacy, Effectiveness, and Scale-up Research in Prevention Science: Next Generation.

    PubMed

    Gottfredson, Denise C; Cook, Thomas D; Gardner, Frances E M; Gorman-Smith, Deborah; Howe, George W; Sandler, Irwin N; Zafft, Kathryn M

    2015-10-01

    A decade ago, the Society of Prevention Research (SPR) endorsed a set of standards for evidence related to research on prevention interventions. These standards (Flay et al., Prevention Science 6:151-175, 2005) were intended in part to increase consistency in reviews of prevention research that often generated disparate lists of effective interventions due to the application of different standards for what was considered to be necessary to demonstrate effectiveness. In 2013, SPR's Board of Directors decided that the field has progressed sufficiently to warrant a review and, if necessary, publication of "the next generation" of standards of evidence. The Board convened a committee to review and update the standards. This article reports on the results of this committee's deliberations, summarizing changes made to the earlier standards and explaining the rationale for each change. The SPR Board of Directors endorses "The Standards of Evidence for Efficacy, Effectiveness, and Scale-up Research in Prevention Science: Next Generation."

  1. Preventive effects of cranberry products on experimental colitis induced by dextran sulphate sodium in mice.

    PubMed

    Xiao, Xiao; Kim, Jonggun; Sun, Quancai; Kim, Daeyoung; Park, Cheon-Seok; Lu, Tzong-Shi; Park, Yeonhwa

    2015-01-15

    With the prevalence of inflammatory bowel disease (IBD) and its associated risk for development of colorectal cancer, it is of great importance to prevent and treat IBD. However, due to the complexity of etiology and potentially serious adverse effects, treatment options for IBD are relatively limited. Thus, the purpose of this study was to identify a safe food-based approach for the prevention and treatment of IBD. In this study, we tested the effects of cranberry products on preventing dextran sulphate sodium-induced murine colitis. Our results suggest that both cranberry extract and dried cranberries-fed groups had a significantly reduced disease activity index, where dried cranberries were more effective in preventing colitis than cranberry extract. Shortening of colon length, colonic myeloperoxidase activity and production of pro-inflammatory cytokines were attenuated in animals fed dried cranberries compared to the controls. The current report suggests that cranberries can be applied to prevent and reduce the symptoms of IBD.

  2. Towards the prevention of potential aluminum toxic effects and an effective treatment for Alzheimer's disease.

    PubMed

    Percy, Maire E; Kruck, Theo P A; Pogue, Aileen I; Lukiw, Walter J

    2011-11-01

    In 1991, treatment with low dose intramuscular desferrioxamine (DFO), a trivalent chelator that can remove excessive iron and/or aluminum from the body, was reported to slow the progression of Alzheimer's disease (AD) by a factor of two. Twenty years later this promising trial has not been followed up and why this treatment worked still is not clear. In this critical interdisciplinary review, we provide an overview of the complexities of AD and involvement of metal ions, and revisit the neglected DFO trial. We discuss research done by us and others that is helping to explain involvement of metal ion catalyzed production of reactive oxygen species in the pathogenesis of AD, and emerging strategies for inhibition of metal-ion toxicity. Highlighted are insights to be considered in the quests to prevent potentially toxic effects of aluminum toxicity and prevention and intervention in AD.

  3. Preventive Effects of Multi-Lamellar Emulsion on Low Potency Topical Steroid Induced Local Adverse Effect

    PubMed Central

    Sul, Geun Dong; Park, Hyun Jung; Bae, Jong Hwan; Hong, Keum Duck; Park, Byeong Deog; Chun, Jaesun; Jeong, Se Kyoo; Lee, Seung Hun; Ahn, Sung Ku

    2013-01-01

    Background Topical steroid treatment induces diverse local Wand systemic adverse effects. Several approaches have been tried to reduce the steroid-induced adverse effects. Simultaneous application of physiological lipid mixture is also suggested. Objective Novel vehicles for topical glucocorticoids formulation were evaluated for the efficacy of reducing side-effects and the drug delivery properties of desonide, a low potency topical steroid. Methods Transcutaneous permeation and skin residual amount of desonide were measured using Franz diffusion cells. The in vivo anti-inflammatory activity was evaluated using murine model. Results Topical steroids formulation containing desonide, in either cream or lotion form, were prepared using multi-lamellar emulsion (MLE), and conventional desonide formulations were employed for comparison. MLE formulations did not affect the anti-inflammatory activity of the desonide in phobol ester-induced skin inflammation model, compared with conventional formulations. While the penetrated amounts of desonide were similar for all the tested formulations at 24 hours after application, the increased lag time was observed for the MLE formulations. Interestingly, residual amount of desonide in epidermis was significantly higher in lotion type MLE formulation. Steroid-induced adverse effects, including permeability barrier function impairment, were partially prevented by MLE formulation. Conclusion Topical desonide formulation using MLE as a vehicle showed a better drug delivery with increased epidermal retention. MLE also partially prevented the steroid-induced side effects, such as skin barrier impairment. PMID:23467730

  4. Participation in Older Adult Physical Activity Programs and Risk for Falls Requiring Medical Care, Washington State, 2005–2011

    PubMed Central

    Rosenberg, Dori E.; Phelan, Elizabeth A.; Fitzpatrick, Annette L.

    2015-01-01

    Introduction Physical activity is known to prevent falls; however, use of widely available exercise programs for older adults, including EnhanceFitness and Silver Sneakers, has not been examined in relation to effects on falls among program participants. We aimed to determine whether participation in EnhanceFitness or Silver Sneakers is associated with a reduced risk of falls resulting in medical care. Methods A retrospective cohort study examined a demographically representative sample from a Washington State integrated health system. Health plan members aged 65 or older, including 2,095 EnhanceFitness users, 13,576 Silver Sneakers users, and 55,127 nonusers from 2005 through 2011, were classified as consistent users (used a program ≥2 times in all years they were enrolled in the health plan during the study period); intermittent users (used a program ≥2 times in 1 or more years enrolled but not all years), or nonusers of EnhanceFitness or Silver Sneakers. The main outcome was measured as time-to-first-fall requiring inpatient or out-of-hospital medical treatment based on the International Classification of Diseases, 9th Revision, Clinical Modification, Sixth Edition and E-codes. Results In fully adjusted Cox proportional hazards models, consistent (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.63–0.88) and intermittent (HR, 0.87; 95% CI, 0.8–0.94) EnhanceFitness participation were both associated with a reduced risk of falls resulting in medical care. Intermittent Silver Sneakers participation showed a reduced risk (HR, 0.93; 95% CI, 0.90–0.97). Conclusion Participation in widely available community-based exercise programs geared toward older adults (but not specific to fall prevention) reduced the risk of medical falls. Structured programs that include balance and strength exercise, as EnhanceFitness does, may be effective in reducing fall risk. PMID:26068411

  5. The European Smoking Prevention Framework Approach (ESFA): Effects after 24 and 30 Months

    ERIC Educational Resources Information Center

    de Vries, Hein; Dijk, Froukje; Wetzels, Joyce; Mudde, Aart; Kremers, Stef; Ariza, Carles; Vitoria, Paulo Duarte; Fielder, Anne; Holm, Klavs; Janssen, Karin; Lehtovuori, Riku; Candel, Math

    2006-01-01

    The European Smoking Prevention Framework Approach (ESFA) study in six countries tested the effects of a comprehensive smoking prevention approach after 24 (T3; N = 10751) and 30 months (T4; N = 9282). The programme targeted four levels, i.e. adolescents in schools, school policies, parents and the community. In Portugal, 12.4% of the T1…

  6. Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

    ERIC Educational Resources Information Center

    Collier, Crystal

    2013-01-01

    The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

  7. The Cost and Effectiveness of School-Based Preventive Dental Care.

    ERIC Educational Resources Information Center

    Klein, Stephen P.; And Others

    The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five non-fluoridated communities. These children were examined at baseline and…

  8. Effects of Training and Feedback on Teachers' Use of Classroom Preventive Practices

    ERIC Educational Resources Information Center

    Artman-Meeker, Kathleen M.; Hemmeter, Mary Louise

    2013-01-01

    This study examined the effects of in-service training with performance feedback on preschool teachers' use of classroom preventive practices. Three practices designed to prevent challenging behavior were selected: transition preparations, rule reminders, and social-emotional teaching strategies. Following a brief training on each practice,…

  9. Initial Indicators of Effectiveness for a High School Drug Prevention Program

    ERIC Educational Resources Information Center

    Fearnow-Kenney, Melodie D.; Wyrick, David L.; Jackson-Newsom, Julia; Wyrick, Cheryl H.; Hansen, William B.

    2003-01-01

    All Stars, Sr. is a comprehensive high school health education supplement designed to prevent high-risk behaviors among adolescents. The program includes topics such as personal health, nutrition, interpersonal relationships, and stress, with a special emphasis on drug prevention. Effective research-based programs that target late onset prevention…

  10. Stacked Deck: An Effective, School-Based Program for the Prevention of Problem Gambling

    ERIC Educational Resources Information Center

    Williams, Robert J.; Wood, Robert T.; Currie, Shawn R.

    2010-01-01

    School-based prevention programs are an important component of problem gambling prevention, but empirically effective programs are lacking. Stacked Deck is a set of 5-6 interactive lessons that teach about the history of gambling; the true odds and "house edge"; gambling fallacies; signs, risk factors, and causes of problem gambling; and skills…

  11. Testing Mediators of Intervention Effects in Randomized Controlled Trials: An Evaluation of Three Depression Prevention Programs

    ERIC Educational Resources Information Center

    Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

    2010-01-01

    Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB…

  12. Effects of a Single-Lesson Tobacco Prevention Curriculum on Knowledge, Skill Identification and Smoking Intention

    ERIC Educational Resources Information Center

    Brown, Stephen; Birch, David; Thyagaraj, Sujan; Teufel, James; Phillips, Cheryl

    2007-01-01

    One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not…

  13. Effective Instruction. National Dropout Prevention Center/Network Newsletter. Volume 21, Number 2

    ERIC Educational Resources Information Center

    Duckenfield, Marty, Ed.

    2009-01-01

    The "National Dropout Prevention Newsletter" is published quarterly by the National Dropout Prevention Center/Network. This issue contains the following articles: (1) Strategies for Success (Charles W. Hatch); (2) 2009 NDPN Crystal Star Winners; (3) Strategies for More Effective Instruction (Micki Gibson); (4) Some Thoughts on Teaching Strategies…

  14. Detecting Falling Snow from Space

    NASA Technical Reports Server (NTRS)

    Jackson, Gail Skofronick; Johnson, Ben; Munchak, Joe

    2012-01-01

    There is an increased interest in detecting and estimating the amount of falling snow reaching the Earth's surface in order to fully capture the atmospheric water cycle. An initial step toward global spaceborne falling snow algorithms includes determining the thresholds of detection for various active and passive sensor channel configurations, snow event cloud structures and microphysics, snowflake particle electromagnetic properties, and surface types. In this work, cloud resolving model simulations of a lake effect and synoptic snow event were used to determine the minimum amount of snow (threshold) that could be detected by the following instruments: the W -band radar of CloudSat, Global Precipitation Measurement (GPM) Dual-frequency Precipitation Radar (DPR) Ku and Ka band, and the GPM Microwave Imager (GMI) channels from 10 to 183 plus or minus 7 GHz. Eleven different snowflake shapes were used to compute radar reflectivities and passive brightness temperatures. Notable results include: (1) the W-Band radar has detection thresholds more than an order of magnitude lower than the future GPM sensors, (2) the cloud structure macrophysics influences the thresholds of detection for passive channels, (3) the snowflake microphysics plays a large role in the detection threshold for active and passive instruments, (4) with reasonable assumptions, "the passive 166 GHz channel has detection threshold values comparable to the GPM DPR Ku and Ka band radars with approximately 0.05 g per cubic meter detected at the surface, or an approximately 0.5-1 millimeter per hr. melted snow rate (equivalent to 0.5-2 centimeters per hr. solid fluffy snowflake rate). With detection levels of falling snow known, we can focus current and future retrieval efforts on detectable storms and concentrate advances on achievable results. We will also have an understanding of the light snowfall events missed by the sensors and not captured in the global estimates.

  15. Doppler radar fall activity detection using the wavelet transform.

    PubMed

    Su, Bo Yu; Ho, K C; Rantz, Marilyn J; Skubic, Marjorie

    2015-03-01

    We propose in this paper the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. The radar senses any motions from falls as well as nonfalls due to the Doppler effect. The WT is very effective in distinguishing the falls from other activities, making it a promising technique for radar fall detection in nonobtrusive inhome elder care applications. The proposed radar fall detector consists of two stages. The prescreen stage uses the coefficients of wavelet decomposition at a given scale to identify the time locations in which fall activities may have occurred. The classification stage extracts the time-frequency content from the wavelet coefficients at many scales to form a feature vector for fall versus nonfall classification. The selection of different wavelet functions is examined to achieve better performance. Experimental results using the data from the laboratory and real inhome environments validate the promising and robust performance of the proposed detector.

  16. Doppler radar fall activity detection using the wavelet transform.

    PubMed

    Su, Bo Yu; Ho, K C; Rantz, Marilyn J; Skubic, Marjorie

    2015-03-01

    We propose in this paper the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. The radar senses any motions from falls as well as nonfalls due to the Doppler effect. The WT is very effective in distinguishing the falls from other activities, making it a promising technique for radar fall detection in nonobtrusive inhome elder care applications. The proposed radar fall detector consists of two stages. The prescreen stage uses the coefficients of wavelet decomposition at a given scale to identify the time locations in which fall activities may have occurred. The classification stage extracts the time-frequency content from the wavelet coefficients at many scales to form a feature vector for fall versus nonfall classification. The selection of different wavelet functions is examined to achieve better performance. Experimental results using the data from the laboratory and real inhome environments validate the promising and robust performance of the proposed detector. PMID:25376033

  17. Slip, trip, and fall injuries among nursing care facility workers.

    PubMed

    Bell, Jennifer L; Collins, James W; Tiesman, Hope M; Ridenour, Marilyn; Konda, Srinivas; Wolf, Laurie; Evanoff, Bradley

    2013-04-01

    The objective of this research was to describe the slip, trip, and fall injury experience and trends in a population of nursing home workers, identify risk factors for slip, trip, and fall injuries, and develop prevention strategies for slip, trip, and fall hazards. Workers' compensation injury claims data and payroll data from 1996 through 2003 were obtained from six nursing homes and used to calculate injury incidence rates. Narrative information was used to describe details of slip, trip, and fall events. A total of 86 slip, trip, and fall-related workers' compensation claims were filed during the 8-year period. Slip, trip, and fall claim rates showed a nonsignificant increase during the 8-year period. Most slips, trips, and falls were attributed to hazards that can be mitigated (e.g., water on the floor or loose cords in a walkway). Nursing home workers experience more slip, trip, and fall-related injury claims than workers in other industries. Preventive programs should be implemented and evaluated in this industry. PMID:23521142

  18. A Randomized Trial of a Multifaceted Intervention to Reduce Falls among Community-Dwelling Adults

    ERIC Educational Resources Information Center

    Fox, Patrick J.; Vazquez, Laurie; Tonner, Chris; Stevens, Judy A.; Fineman, Norman; Ross, Leslie K.

    2010-01-01

    Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in…

  19. Simulated unobtrusive falls detection with multiple persons.

    PubMed

    Ariani, Arni; Redmond, Stephen J; Chang, David; Lovell, Nigel H

    2012-11-01

    One serious issue related to falls among the elderly living at home or in a residential care facility is the "long lie" scenario, which involves being unable to get up from the floor after a fall for 60 min or more. This research uses a simulated environment to investigate the potential effectiveness of using wireless ambient sensors (dual-technology (microwave/infrared) motion detectors and pressure mats) to track the movement of multiple persons and to unobtrusively detect falls when they occur, therefore reducing the rate of occurrence of "long lie" scenarios. A path-finding algorithm (A*) is used to simulate the movement of one or more persons through the residential area. For analysis, the sensor network is represented as an undirected graph, where nodes in the graph represent sensors, and edges between nodes in the graph imply that these sensors share an overlapping physical region in their area of sensitivity. A second undirected graph is used to represent the physical adjacency of the sensors (even where they do not overlap in their monitored regions). These graphical representations enable the tracking of multiple subjects/groups within the environment, by analyzing the sensor activation and adjacency profiles, hence allowing individuals/groups to be isolated when multiple persons are present, and subsequently monitoring falls events. A falls algorithm, based on a heuristic decision tree classifier model, was tested on 15 scenarios, each including one or more persons; three scenarios of activity of daily living, and 12 different types of falls (four types of fall, each with three postfall scenarios). The sensitivity, specificity, and accuracy of the falls algorithm are 100.00%, 77.14%, and 89.33%, respectively. PMID:22835529

  20. Simulated unobtrusive falls detection with multiple persons.

    PubMed

    Ariani, Arni; Redmond, Stephen J; Chang, David; Lovell, Nigel H

    2012-11-01

    One serious issue related to falls among the elderly living at home or in a residential care facility is the "long lie" scenario, which involves being unable to get up from the floor after a fall for 60 min or more. This research uses a simulated environment to investigate the potential effectiveness of using wireless ambient sensors (dual-technology (microwave/infrared) motion detectors and pressure mats) to track the movement of multiple persons and to unobtrusively detect falls when they occur, therefore reducing the rate of occurrence of "long lie" scenarios. A path-finding algorithm (A*) is used to simulate the movement of one or more persons through the residential area. For analysis, the sensor network is represented as an undirected graph, where nodes in the graph represent sensors, and edges between nodes in the graph imply that these sensors share an overlapping physical region in their area of sensitivity. A second undirected graph is used to represent the physical adjacency of the sensors (even where they do not overlap in their monitored regions). These graphical representations enable the tracking of multiple subjects/groups within the environment, by analyzing the sensor activation and adjacency profiles, hence allowing individuals/groups to be isolated when multiple persons are present, and subsequently monitoring falls events. A falls algorithm, based on a heuristic decision tree classifier model, was tested on 15 scenarios, each including one or more persons; three scenarios of activity of daily living, and 12 different types of falls (four types of fall, each with three postfall scenarios). The sensitivity, specificity, and accuracy of the falls algorithm are 100.00%, 77.14%, and 89.33%, respectively.