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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. 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

  3. Fall Prevention: Simple Tips to Prevent Falls

    MedlinePlus

    ... fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make you slip, stumble ... your stocking feet. Instead, wear properly fitting, sturdy shoes with nonskid soles. Sensible shoes may also reduce ...

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  5. Study protocol for prevention of falls: A randomized controlled trial of effects of vitamin D and exercise on falls prevention

    PubMed Central

    2012-01-01

    Background Falls are the leading cause of unintentional injury and injury-related death among older people. In addition to physical activity, vitamin D also may affect balance and neuromuscular function. Low serum 25-hydroksivitamin D level increases the risk of bone loss, falls and fractures. Thus, an appropriate exercise program and sufficient vitamin D intake may significantly improve not only functional balance, but also balance confidence. Balance represents a complex motor skill determined by reaction time, muscle strength, and speed and coordination of movement. Methods/Design A 2-year randomized double-blind placebo-controlled vitamin D and open exercise trial of 409 home-dwelling women 70 to 80 years of age comprising four study arms: 1) exercise + vitamin D (800 IU/d), 2) exercise + placebo, 3) no exercise + vitamin D (800 IU/d), 4) no exercise + placebo. In addition to monthly fall diaries, general health status, life style, bone health, physical functioning, and vitamin D metabolism will be assessed. The primary outcomes are the rate of falls and fall-related injuries. Secondary outcomes include changes in neuromuscular functioning (e.g. body balance, muscle strength), ADL- and mobility functions, bone density and structure, cardiovascular risk factors, quality of life and fear of falling. Discussion The successful completion of this trial will provide evidence on the effectiveness of exercise and vitamin D for falls reduction. Trial Registration ClinicalTrial.gov -register (NCT00986466). PMID:22448872

  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. Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls

    PubMed Central

    Kim, Sang Chul; Ro, Young Sun; Shin, Sang Do; Kim, Joo Yeong

    2016-01-01

    Introduction: Work-related traumatic brain injury (TBI) caused by falls is a catastrophic event that leads to disabilities and high socio-medical costs. This study aimed to measure the magnitude of the preventive effect of safety helmets on clinical outcomes and to compare the effect across different heights of fall. Methods: We collected a nationwide, prospective database of work-related injury patients who visited the 10 emergency departments between July 2010 and October 2012. All of the adult patients who experienced work-related fall injuries were eligible, excluding cases with unknown safety helmet use and height of fall. Primary and secondary endpoints were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of safety helmet use and height of fall for study outcomes, and adjusted for any potential confounders. Results: A total of 1298 patients who suffered from work-related fall injuries were enrolled. The industrial or construction area was the most common place of fall injury occurrence, and 45.0% were wearing safety helmets at the time of fall injuries. The safety helmet group was less likely to have intracranial injury comparing with the no safety helmet group (the adjusted odds ratios (ORs) (95% confidence interval (CI)): 0.42 (0.24–0.73)), however, there was no statistical difference of in-hospital mortality between two groups (the adjusted ORs (95% CI): 0.83 (0.34–2.03). In the interaction analysis, preventive effects of safety helmet on intracranial injury were significant within 4 m height of fall. Conclusions: A safety helmet is associated with prevention of intracranial injury resulting from work-related fall and the effect is preserved within 4 m height of fall. Therefore, wearing a safety helmet can be an intervention for protecting fall-related intracranial injury in the workplace. PMID:27801877

  8. [Can falls be prevented?].

    PubMed

    Dubousset, Jean

    2014-06-01

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

  9. Hospital Fall Prevention: A Systematic Review of Implementation, Components, Adherence, and Effectiveness

    PubMed Central

    Hempel, Susanne; Newberry, Sydne; Wang, Zhen; Booth, Marika; Shanman, Roberta; Johnsen, Breanne; Shier, Victoria; Saliba, Debra; Spector, William D; Ganz, David A

    2013-01-01

    Objectives To systematically document the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. Design Systematic review. Studies were identified through existing reviews, searching five electronic databases, screening reference lists, and contacting topic experts for studies published through August 2011. Setting U.S. acute care hospitals. Participants Studies reporting in-hospital falls for intervention groups and concurrent (e.g., controlled trials) or historic comparators (e.g., before–after studies). Intervention Fall prevention interventions. Measurements Incidence rate ratios (IRR, ratio of fall rate postintervention or treatment group to the fall rate preintervention or control group) and ratings of study details. Results Fifty-nine studies met inclusion criteria. Implementation strategies were sparsely documented (17% not at all) and included staff education, establishing committees, seeking leadership support, and occasionally continuous quality improvement techniques. Most interventions (81%) included multiple components (e.g., risk assessments (often not validated), visual risk alerts, patient education, care rounds, bed-exit alarms, and postfall evaluations). Fifty-four percent did not report on fall prevention measures applied in the comparison group, and 39% neither reported fidelity data nor described adherence strategies such as regular audits and feedback to ensure completion of care processes. Only 45% of concurrent and 15% of historic control studies reported sufficient data to compare fall rates. The pooled postintervention incidence rate ratio (IRR) was 0.77 (95% confidence interval = 0.52–1.12, P = .17; eight studies; I2: 94%). Meta-regressions showed no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. Conclusion Promising approaches exist, but better reporting of

  10. Preventing Falls and Related Fractures

    MedlinePlus

    ... increases your fracture risk. Catching yourself so you land on your hands or grabbing onto an object as you fall can prevent a hip fracture. Protective responses, such as reflexes and changes in posture that break the fall, can reduce ...

  11. Effects of Visual Biofeedback Training for Fall Prevention in the Elderly

    PubMed Central

    Kang, Kwon-Young

    2013-01-01

    [Purpose] The purpose of this study was to investigate the effects of six weeks of visual biofeedback training for prevention of falling in the elderly. The Tetrax system was used for visual biofeedback training. [Subjects and Methods] Thirty elderly persons (experimental group=15, control group=15) who were above 70 and under 80 years of age participated in biofeedback training. They were trained for 15 minutes a day, three times per week. We measured the weight distribution index, stability index, and fall index in the subjects using the Tetrax system, and paired t-tests were used to evaluate the changes before and after intervention. The difference between the groups was compared using an independent t-test. [Results] The experimental group showed significant differences in weight distribution index, stability index, and fall index. The control group showed no significant differences. According to the comparison of training effects between the two groups, the variables of stability index and fall index revealed a statistically significant difference. [Conclusion] The method of visual biofeedback training used in this study should be considered a therapeutic method for the elderly to improve weight distribution, stability, and effectiveness in preventing falls. PMID:24396196

  12. [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.

  13. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences

    PubMed Central

    Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

    2017-01-01

    Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome measures of functional reach, perceived health status, fear of fall were included. Quality of the included articles was rated using Physiotherapy Evidence Database (PEDro) scale and the pooled effect of SSE was obtained by Review Manager (RevMan5) software. Significant effect of SSE was detected over walking or no treatment to improve balance as well to prevent fear of fall and improve perceived health status. The results of this systematic review proposed that SSE significantly better than walking or no treatment to prevent fall, prevent fear of fall and improve perceived health status. PMID:28349029

  14. Exercises to help prevent falls

    MedlinePlus

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

  15. How Can Older Adults Prevent Falls?

    MedlinePlus

    ... Talk to your doctor about whether you have osteoporosis. Read More "Preventing Falls" Articles Preventing Falls / Great Help for Older Adults / How Can Older Adults Prevent Falls? / Home Improvements ...

  16. Osteosarcopenic obesity and fall prevention strategies.

    PubMed

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

    2015-02-01

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

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

    PubMed

    Martorello, Laura; Swanson, Edward

    2006-01-01

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

  18. 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

  19. 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

  20. Outcomes of a revised apprentice carpenter fall prevention training curriculum.

    PubMed

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

    2012-01-01

    Falls from heights are a leading cause of morbidity and mortality among construction workers, especially inexperienced workers and those performing residential construction. This research reports changes in fall prevention behaviors following revision of fall prevention training in a union-based carpenters' apprenticeship program. We used a comprehensive needs assessment to identify gaps in apprentice carpenters' preparation to work at heights, used these results to guide a school-based fall prevention curriculum to fill these gaps, and measured the effects of the revised curriculum on knowledge, beliefs, and fall prevention behaviors.

  1. A wearable airbag to prevent fall injuries.

    PubMed

    Tamura, Toshiyo; Yoshimura, Takumi; Sekine, Masaki; Uchida, Mitsuo; Tanaka, Osamu

    2009-11-01

    We have developed a wearable airbag that incorporates a fall-detection system that uses both acceleration and angular velocity signals to trigger inflation of the airbag. The fall-detection algorithm was devised using a thresholding technique with an accelerometer and gyro sensor. Sixteen subjects mimicked falls, and their acceleration waveforms were monitored. Then, we developed a fall-detection algorithm that could detect signals 300 ms before the fall. This signal was used as a trigger to inflate the airbag to a capacity of 2.4 L. Although the proposed system can help to prevent fall-related injuries, further development is needed to miniaturize the inflation system.

  2. The therapeutic effects of alfacalcidol on bone strength, muscle metabolism and prevention of falls and fractures.

    PubMed

    Schacht, E; Richy, F; Reginster, J-Y

    2005-01-01

    Established osteoporosis in older patients of both sexes is characterized by decoupled bone remodelling induced by sex hormone deficits and by somatopause, but also by lack of vitamin D and reduced synthesis of the D-Hormone (calcitriol; 1.25 (OH)2D) in the kidneys and bone, as well as from lack of receptors and/or receptor affinity for D-Hormone in the target organs. Parallel to the decreased bone strength a loss of muscle power occurs, together with an increase in balance disorders and an increasing risk of "intrinsic", nonsyncopal locomotoric falls. In alfacalcidol therapy, D-Hormone is provided to the body in circumvention of its own regulation, by means of which higher hormone concentrations can be achieved in the target tissues than by administration of plain vitamin D. In vitro and in vivo experiments have provided growing evidence that D-Hormone analogs tend to normalize PTH, lead to an increase in the number and activity of osteoblasts, reduce the activity of osteoclasts, and might thus normalize the "high bone turnover" in elderly osteoporotic patients ("supercoupling"). In addition, it has been shown that D-Hormone analogs are able to increase muscle power and walking distance in elderly D-Hormone deficient patients. Besides the known effect on the vertebral fracture rate, new clinical data confirm that D-Hormone analogs might reduce peripheral fractures by reducing falls. The expanded understanding of the pathogenesis of glucocorticoid- induced osteoporosis with its disturbed calcium homeostasis and the pharmacological effects of alfacalcidol, which counteract such iatrogenic bone loss, contribute to the understanding of its clinical efficacy in this most frequent form of secondary osteoporosis. Due to its recently discovered immunomodulating properties, alfacalcidol might find a slot in the management of bone loss caused by chronic inflammatory diseases or by organ transplantations. Alfacalcidol has multifactorial effects, among which the best known

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

    PubMed Central

    2013-01-01

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

  5. Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety

    PubMed Central

    Jurkowski, Michal P.; Dymarz, Ania C.; Robinovitch, Stephen N.; Feldman, Fabio; Laing, Andrew C.; Mackey, Dawn C.

    2017-01-01

    Background Compliant flooring, broadly defined as flooring systems or floor coverings with some level of shock absorbency, may reduce the incidence and severity of fall-related injuries in older adults; however, a lack of synthesized evidence may be limiting widespread uptake. Methods Informed by the Arksey and O’Malley framework and guided by a Research Advisory Panel of knowledge users, we conducted a scoping review to answer: 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 in healthcare settings? We searched academic and grey literature databases. Any record that discussed a compliant flooring system and at least one of biomechanical efficacy, clinical effectiveness, cost-effectiveness, or workplace safety was eligible for inclusion. Two independent reviewers screened and abstracted records, charted data, and summarized results. Results After screening 3611 titles and abstracts and 166 full-text articles, we included 84 records plus 56 companion (supplementary) reports. Biomechanical efficacy records (n = 50) demonstrate compliant flooring can reduce fall-related impact forces with minimal effects on standing and walking balance. Clinical effectiveness records (n = 20) suggest that compliant flooring may reduce injuries, but may increase risk for falls. Preliminary evidence suggests that compliant flooring may be a cost-effective strategy (n = 12), but may also result in increased physical demands for healthcare workers (n = 17). Conclusions In summary, compliant flooring is a promising strategy for preventing fall-related injuries from a biomechanical perspective. Additional research is warranted to confirm whether compliant flooring (i) prevents fall-related injuries in real-world settings, (ii) is a cost-effective intervention strategy, and (iii) can be installed without negatively impacting workplace

  6. What Are Ways to Prevent Falls and Related Fractures?

    MedlinePlus

    ... Falls and Fractures What Are Ways to Prevent Falls and Related Fractures? Fast Facts: An Easy-to- ... I Keep My Bones Healthy? Why Do People Fall? Some of the reasons people fall are: Tripping ...

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

    PubMed

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

    2015-07-01

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

  8. Reducing fall risk in the elderly: risk factors and fall prevention, a systematic review.

    PubMed

    Pfortmueller, C A; Lindner, G; Exadaktylos, A K

    2014-08-01

    Falls in the elderly are a major source of injury resulting in disability and hospitalization. They have a significant impact on individual basis (loss of quality of live, nursing home admissions) and social basis (healthcare costs). Even though falls in the elderly are common there are some well studied risk factors. Special emphasis should be put on sarcopenia/frailty, polypharmacy, multimorbidity, vitamin D status and home hazards. There are several well evaluated fall prevention approaches that either target a single fall risk factor or focus on multiple risk factors. It has to be kept in mind that not all fall prevention strategies are useful for all patients as for example dietary substitution of vitamin D is only recommended in people with increased risk for a vitamin D deficiency. Home hazard reduction strategies are more effective when combined with other fall prevention approaches such as for example exercise programs. In conclusion elderly patients should routinely be screened for relevant risk factors and if need an indiviudally targeted fall prevention program compiled.

  9. 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…

  10. Cost-effectiveness of combined oral bisphosphonate therapy and falls prevention exercise for fracture prevention in the USA.

    PubMed

    Mori, T; Crandall, C J; Ganz, D A

    2017-02-01

    We developed a Markov microsimulation model among hypothetical cohorts of community-dwelling US white women without prior major osteoporotic fractures over a lifetime horizon. At ages 75 and 80, adding 1 year of exercise to 5 years of oral bisphosphonate therapy is cost-effective at a conventionally accepted threshold compared with bisphosphonates alone.

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

    PubMed

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

    2016-08-01

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

  12. 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

  13. 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

  14. Evidence-based guidelines for fall prevention in Korea

    PubMed Central

    Kim, Kwang-Il; Jung, Hye-Kyung; Kim, Chang Oh; Kim, Soo-Kyung; Cho, Hyun-Ho; Kim, Dae Yul; Ha, Yong-Chan; Hwang, Sung-Hee; Won, Chang Won; Lim, Jae-Young; Kim, Hyun Jung; Kim, Jae Gyu

    2017-01-01

    Falls and fall-related injuries are common in older populations and have negative effects on quality of life and independence. Falling is also associated with increased morbidity, mortality, nursing home admission, and medical costs. Korea has experienced an extreme demographic shift with its population aging at the fastest pace among developed countries, so it is important to assess fall risks and develop interventions for high-risk populations. Guidelines for the prevention of falls were first developed by the Korean Association of Internal Medicine and the Korean Geriatrics Society. These guidelines were developed through an adaptation process as an evidence-based method; four guidelines were retrieved via systematic review and the Appraisal of Guidelines for Research and Evaluation II process, and seven recommendations were developed based on the Grades of Recommendation, Assessment, Development, and Evaluation framework. Because falls are the result of various factors, the guidelines include a multidimensional assessment and multimodal strategy. The guidelines were developed for primary physicians as well as patients and the general population. They provide detailed recommendations and concrete measures to assess risk and prevent falls among older people. PMID:28049285

  15. Falls, falls prevention and the role of physiotherapy and exercise: perceptions and interpretations of Italian-born and Australian-born older persons living in Australia.

    PubMed

    Lam, Julie; Liamputtong, Pranee; Hill, Keith

    2015-06-01

    Exercise programmes are effective in reducing falls but few older people consider doing an exercise programme for falls prevention. This paper examines older people's perceptions and experiences of falls, physiotherapy and exercise. Individual interviews were conducted with Australian-born and Italian-born older persons who had ≥1 fall in the past 12 months and completed a community-based physiotherapy programme. Although preventing further falls was considered important, participants were unsure whether falls were preventable. Few described evidence-based approaches such as exercise or medication reviews as strategies to prevent falls. Most participants thought that physiotherapy and exercise were beneficial in improving physical function. A clear explanation on the role of exercise for falls prevention, that many falls are preventable, and understanding of personal motivating and de-motivating factors for exercise for falls prevention are important for clinicians to consider in engaging this group of older people.

  16. 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.

  17. [Falls and osteoporotic fractures prevention units: proposed Osteoporosis, Falls and Fractures Group of the Spanish Society of Geriatrics and Gerontology].

    PubMed

    Duaso, Enric; Casas, Alvaro; Formiga, Francesc; Lázaro Del Nogal, Montserrat; Salvà, Antoni; Marcellán, Teresa; Navarro, Carmen

    2011-01-01

    Since forming the Osteoporosis, Falls and Fractures Group of the Spanish Society (GOCF) of Geriatrics and Gerontology (SEGG) a review was performed of the epidemiology of falls, along with a description of measures that have shown a degree of effectiveness in prevention. We also present the proposal of a common basic model of action in fall prevention units, mainly addressed to the community. Finally, a consensus model falls register is presented, common to community level and institutional areas, with the objective of being useful and easy to fill in at any care level.

  18. Integration of Fall Prevention into State Policy in Connecticut

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  19. Remote Video Monitoring: A Novel Approach in Fall Prevention.

    PubMed

    Bradley, Kenesha

    2016-11-01

    Adequate fall prevention interventions are a challenge that nurses continue to endure. Remote video monitoring can be used in conjunction with other fall prevention interventions. This article describes remote video monitoring technology and the benefits and challenges associated with its implementation. J Contin Educ Nurs. 2016;47(11):484-486.

  20. Cost benefit considerations of preventing elderly falls through environmental modifications to homes in Hana, Maui.

    PubMed

    Ling, Christian; Henderson, Stephen; Henderson, Ray; Henderson, Malia; Pedro, Tina; Pang, Lorrin

    2008-03-01

    The community of Hana, Hawai'i began a program of home modifications to help their elderly prevent falls. We estimated the cost benefit of these modifications from construction costs and published reports of effectiveness and cost of treating falls. We interviewed clients to determine risk of falling. The average cost of home modifications was $800. The average annual averted medical cost of falling was $1728.

  1. Development of STEADI: A Fall Prevention Resource for Health Care Providers

    PubMed Central

    Stevens, Judy A.; Phelan, Elizabeth A.

    2015-01-01

    Falls among people aged ≥65 years are the leading cause of both injury deaths and emergency department visits for trauma. Research shows that many falls are preventable. In the clinical setting, an effective fall intervention involves assessing and addressing an individual’s fall risk factors. This individualized approach is recommended in the American and British Geriatrics Societies’ (AGS/BGS) practice guideline. This article describes the development of STEADI (Stopping Elderly Accidents, Deaths, and Injuries), a fall prevention tool kit that contains an array of health care provider resources for assessing and addressing fall risk in clinical settings. As researchers at the Centers for Disease Control and Prevention’s Injury Center, we reviewed relevant literature and conducted in-depth interviews with health care providers to determine current knowledge and practices related to older adult fall prevention. We developed draft resources based on the AGS/BGS guideline, incorporated provider input, and addressed identified knowledge and practice gaps. Draft resources were reviewed by six focus groups of health care providers and revised. The completed STEADI tool kit, Preventing Falls in Older Patients—A Provider Tool Kit, is designed to help health care providers incorporate fall risk assessment and individualized fall interventions into routine clinical practice and to link clinical care with community-based fall prevention programs. PMID:23159993

  2. [Doubts about the efficacy of fall-prevention programmes for the elderly].

    PubMed

    Pijpers, Evelien; Mulder, Wubbo J

    2010-01-01

    Multifactorial fall-prevention programmes are often not effective in preventing falls and functional decline. This is also the case in the recently published study of de Vries et al. Several causes for this lack of efficacy can be given. An important finding in the Dutch population is that a pragmatic multidisciplinary fall-prevention programme has no added benefit over and above normal care. This is probably because in the Dutch situation, the GP has already adapted many aspects of multifactorial fall analysis into the integrated care he or she provides to the elderly patient.

  3. Screening postmenopausal women for fall and fracture prevention.

    PubMed

    Downey, Patricia A; Perry, Susan B; Anderson, Janice M

    2013-01-01

    Fragility fracture prevention has been historically associated with the diagnosis and treatment of osteoporosis. Given that the strongest determinant of fracture is falls, it is critical to add fall risk into clinical decision-making guidelines for fracture prevention. This special interest paper proposes an algorithm based on 2 validated tools: (1) World Health Organization's Fracture Risk Assessment Tool, which evaluates probability of fracture and (2) Functional Gait Assessment, which evaluates fall risk. Physical therapists can use this algorithm to better identify patients at greatest risk for fracture in order to customize interventions designed to promote bone health, minimize falls, and ultimately prevent fractures. Recommendations for referral, patient education, and exercise are provided for categories of varying fall and fracture risk.

  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. Preventing Falls | NIH MedlinePlus the Magazine

    MedlinePlus

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

  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. 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.

  10. Effectiveness of Web-Based Versus Face-To-Face Delivery of Education in Prescription of Falls-Prevention Exercise to Health Professionals: Randomized Trial

    PubMed Central

    Haas, Romi; Keating, Jennifer L; Molloy, Elizabeth; Jolly, Brian; Sims, Jane; Morgan, Prue; Haines, Terry

    2011-01-01

    Background Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention. Objective The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls. Methods This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick’s hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice. Results Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median

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

    PubMed Central

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

    2015-01-01

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

  12. Fall prevention modulates decisional saccadic behavior in aging

    PubMed Central

    Coubard, Olivier A.

    2012-01-01

    As society ages and frequency of falls increases in older adults, counteracting motor decline is a challenging issue for developed countries. Physical activity based on aerobic and strength training as well as motor activity based on skill learning both help benefit balance and reduce the risk of falls, as assessed by clinical or laboratory measures. However, how such programs influence motor control is a neglected issue. This study examined the effects of fall prevention (FP) training on saccadic control in older adults. Saccades were recorded in 12 participants aged 64–91 years before and after 2.5 months training in FP. Traditional analysis of saccade timing and dynamics was performed together with a quantitative analysis using the LATER model, enabling us to examine the underlying motor control processes. Results indicated that FP reduced the rate of anticipatory and express saccades in inappropriate directions and enhanced that of express saccades in the appropriate direction, resulting in decreased latency and higher left-right symmetry of motor responses. FP reduced within-participant variability of saccade duration, amplitude, and peak velocity. LATER analysis suggested that FP modulates decisional thresholds, extending our knowledge of motor training influence on central motor control. We introduce the Threshold Interval Modulation with Early Release-Rate of rIse Deviation with Early Release (TIMER-RIDER) model to account for the results. PMID:22807914

  13. [Drug therapy for prevention of falls and fractures].

    PubMed

    Ringe, Johann D

    2006-06-01

    The primary goal in the practical management of osteoporosis is to prevent first or subsequent fractures and thereby to avoid acute or chronic pain and progressive skeletal deformity. Therapeutic strategies should always take the complex pathogenetic mechanisms of fractures into account, especially the fact that mechanical impacts and falls play an important role in the majority of fracture events. Accordingly, recommendations to patients and the selection of drugs should aim at both, falls and fractures. In this context there is an increasing interest in the dual effects of vitamin D on bone and muscle. Controlled studies proved that adequate vitamin D supplementation is able to improve muscle strength, coordination and body sway and thereby reduce the risk of falls and fractures. Alendronate has been studied extensively by large trials of high quality and its efficacy to reduce the risk of vertebral and nonvertebral fractures is in line with the criteria of evidence-based medicine. The innovative combination of 70 mg alendronate with 2,800 IU vitamin D in a once-weekly tablet guarantees a basic supply with this important prohormone for bone and muscle. Due to a regular combined intake an improved compliance can be anticipated which will be followed by better therapeutic results in osteoporosis patients with increased fracture risk.

  14. Collaborative Falls Prevention: Interprofessional Team Formation, Implementation, and Evaluation.

    PubMed

    Lasater, Kathie; Cotrell, Victoria; McKenzie, Glenise; Simonson, William; Morgove, Megan W; Long, Emily E; Eckstrom, Elizabeth

    2016-12-01

    As health care rapidly evolves to promote person-centered care, evidence-based practice, and team-structured environments, nurses must lead interprofessional (IP) teams to collaborate for optimal health of the populations and more cost-effective health care. Four professions-nursing, medicine, social work, and pharmacy-formed a teaching team to address fall prevention among older adults in Oregon using an IP approach. The teaching team developed training sessions that included interactive, evidence-based sessions, followed by individualized team coaching. This article describes how the IP teaching team came together to use a unique cross-training approach to teach each other. They then taught and coached IP teams from a variety of community practice settings to foster their integration of team-based falls-prevention strategies into practice. After coaching 25 teams for a year each, the authors present the lessons learned from the teaching team's formation and experiences, as well as feedback from practice team participants that can provide direction for other IP teams. J Contin Educ Nurs. 2016;47(12):545-550.

  15. Useful methods in preventing accidental falls from the bed in children at the emergency department.

    PubMed

    Tung, Tzu-Hui; Liu, Min-Cih; Yang, Jia-Yu; Syu, Wei-Yiu; Wu, Han-Ping

    2009-11-01

    The aim of this study was to analyze the general characteristics of children in the pediatric emergency department (PED) who accidentally fall off the crib and to establish useful preventive measures. This prospective research analyzed pediatric patients who accidentally fell off their beds in the observational unit (OU) of the PED from July 2005 to June 2006 (first period). From July 2006 to February 2007 (second period), the causes of children falling off the crib in the first year were analyzed and five related preventive methods were instituted in the OU. From July 2007 to March 2008 (third period), the preventive methods were enhanced to achieve zero-event of accidental falls in the PED. The differences between patients falling off the bed among the three periods were then compared. This study collected 7,281 children admitted to the OU during the first period and recorded 15 cases of accidental falls. After performing the preventive methods in 6,232 patients in the second period, three events of accidental falls were noted. In the third period, there was no accident in the 5,225 patients admitted to the PED. Comparing the occurrences of children falling off the bed among the three periods, accidental falls significantly decreased in the third period (p < 0.001). Effective methods can be instituted to prevent children from falling off the bed, especially in the PED.

  16. Insights about Fall Prevention of Older Adults in the State of Hawai‘i

    PubMed Central

    Hayashida, Cullen T; Yontz, Valerie

    2017-01-01

    The senior population in Hawai‘i is growing at a dramatic pace. In the older population, falls and fall-related injuries are leading causes of morbidity and mortality. Moreover, the health care costs for falls are very high. The State of Hawai‘i has taken measures to prevent falls through the promotion of medication reviews, vision checks, home assessments, and exercise. However, current published examinations of fall preventive measures have been insufficient, and more research is needed to confirm risk factors, effectiveness of preventive measures, and to explore future objectives. This paper examined the validity of fall risk factors and fall preventive measures for Hawai‘i's seniors by conducting mail questionnaire surveys to a sample of seniors using medical alert services from one company in Hawai‘i. The results of chi-square analysis suggest that having reduced ability to perform Activities of Daily Living (ADL) and reduced Instrumental Activities of Daily Living (IADL) were associated with a greater risk of falls (P < .01). In addition, those who fell were more likely to talk about fall preventions with their family members or friends and health providers compared with those who did not (P = .048 and .003, respectively). Evidence-based exercise programs for strengthening muscles and controlling physical balance may be needed to improve ADL and IADL. Furthermore, the results suggest that seniors do not accept that they are at risk of falling before they actually fall. Public health providers should consider how they approach seniors, and how they inform them of the importance of fall prevention across the life span. PMID:28090397

  17. Exergame technology and interactive interventions for elderly fall prevention: A systematic literature review.

    PubMed

    Choi, Sang D; Guo, Liangjie; Kang, Donghun; Xiong, Shuping

    2016-11-05

    Training balance and promoting physical activities in the elderly can contribute to fall-prevention. Due to the low adherence of conventional physical therapy, fall interventions through exergame technologies are emerging. The purpose of this review study is to synthesize the available research reported on exergame technology and interactive interventions for fall prevention in the older population. Twenty-five relevant papers retrieved from five major databases were critically reviewed and analyzed. Results showed that the most common exergaming device for fall intervention was Nintendo Wii, followed by Xbox Kinect. Even though the exergame intervention protocols and outcome measures for assessing intervention effectiveness varied, the accumulated evidences revealed that exergame interventions improved physical or cognitive functions in the elderly. However, it remains inconclusive whether or not the exergame-based intervention for the elderly fall prevention is superior to conventional physical therapy and the effect mechanism of the exergaming on elderly's balance ability is still unclear.

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

    PubMed

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

    2013-01-01

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

  19. 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

  20. Falls prevention training for community health workers: strategies and actions for independent living (SAIL).

    PubMed

    Scott, Victoria J; Votova, Kristine; Gallagher, Elaine

    2006-10-01

    This article describes a quasi-experimental study on falls prevention for clients of home support services in British Columbia, Canada. The study tested a nurse-designed multifactorial intervention, delivered by community health workers. The intervention consisted of 1 day of falls surveillance and prevention training for 51 community health workers, followed by 6 months of evidence-based interventions with their clients (n = 70) using a pretested Checklist and Action Plan. Study findings showed a 43% reduction (chi2 = 8.742, p < .01) in falls and a 44% reduction (chi2 = 5.739, p < .05) for fallers (those who fell once or more) from the 6-month preintervention period to postintervention. The proportion of falls resulting in any injury did not decrease; however, fractures were reduced from seven in the 6-month preintervention period to one following the intervention. The results indicate this intervention is an effective and inexpensive falls prevention strategy for frail recipients of home support services.

  1. Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly.

    PubMed

    Cho, Seong-Il; An, Duk-Hyun

    2014-11-01

    [Purpose] The purpose of this study was to investigate the effects of an 8-week balance exercise and elastic-resistance exercise program on muscle strength and balance of the old-old elderly (over the age of 75). [Subjects and Methods] Fifty-five elderly persons were recruited from the community and assigned to three groups for convenience: balance exercise (intervention group 1; INT 1), resistance exercise (intervention group 2; INT 2), and control (CON) groups. The intervention was performed twice a week at a senior center and three times a week at home for 8 weeks. Muscle strength and balance were evaluated before and at the end of the trial, using a PowertrackIIand Tetrax. [Results] There were significant improvements in the strength of all seven muscle groups and balance in the INT 2 group. In the INT 1 group, there were significant improvements in the strength of all muscle groups except for the knee flexor and ankle plantar flexor muscle groups. [Conclusion] This study demonstrated that an intervention using balance exercises or elastic-resistance exercises is effective at improving the muscle strength and balance of the old-old elderly. These type of exercises should be appropriate for the physical characteristics of the subjects.

  2. Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly

    PubMed Central

    Cho, Seong-Il; An, Duk-Hyun

    2014-01-01

    [Purpose] The purpose of this study was to investigate the effects of an 8-week balance exercise and elastic-resistance exercise program on muscle strength and balance of the old-old elderly (over the age of 75). [Subjects and Methods] Fifty-five elderly persons were recruited from the community and assigned to three groups for convenience: balance exercise (intervention group 1; INT 1), resistance exercise (intervention group 2; INT 2), and control (CON) groups. The intervention was performed twice a week at a senior center and three times a week at home for 8 weeks. Muscle strength and balance were evaluated before and at the end of the trial, using a PowertrackIIand Tetrax. [Results] There were significant improvements in the strength of all seven muscle groups and balance in the INT 2 group. In the INT 1 group, there were significant improvements in the strength of all muscle groups except for the knee flexor and ankle plantar flexor muscle groups. [Conclusion] This study demonstrated that an intervention using balance exercises or elastic-resistance exercises is effective at improving the muscle strength and balance of the old-old elderly. These type of exercises should be appropriate for the physical characteristics of the subjects. PMID:25435697

  3. Prevention of falls during stairway descent in older adults.

    PubMed

    Kim, B J

    2009-05-01

    A prospective design was applied to examine how older adults would adapt stairway intervention stimuli to gait patterns during stairway descent to prevent falls. Ambient lighting and an auditory signal were used as stairway intervention stimuli. The gait pattern changes with and without stimuli were compared. No significant change of angular displacement was found between normal condition and intervention conditions under daylight and nightlight. The lighting intervention tended to increase the knee's angular velocity for both daylight and nightlight conditions, but not the ankle's angular velocity. However, adding the auditory signal to the lighting intervention under nightlight condition increased the ankle's angular velocity. Under the daylight condition, every intervention was significantly helpful to make people step on the floor more confidently compared to the condition without interventions. However, the intervention of lighting had an opposite effect on the confidence of stepping under the nightlight condition. The intervention of lighting may contribute to increase of confidence during stair descent while compromising the declined stride length in older adults and the potential "rush" factor for falls on stairs.

  4. Attempts to Prevent Falls and Injury: A Prospective Community Study.

    ERIC Educational Resources Information Center

    Reinsch, Sibylle; And Others

    1992-01-01

    At 16 senior centers, studied effectiveness of exercise and cognitive-behavioral programs, compared to discussion control program, in reducing falls and injuries among 230 older adults. After one year of programs, observed no significant difference in time to first fall among groups. Secondary outcome measures such as strength, balance, fear of…

  5. Systematic review and meta-analysis: Tai Chi for preventing falls in older adults

    PubMed Central

    Huang, Zhi-Guan; Feng, Yun-Hui; Li, Yu-He; Lv, Chang-Sheng

    2017-01-01

    Objective It remains unclear whether Tai Chi is effective for preventing falls in older adults. We undertook this systematic review to evaluate the preventive effect of Tai Chi by updating the latest trial evidence. Design Systematic review and meta-analysis. Methods The Cochrane Library, MEDLINE and EMBASE were searched up to February 2016 to identify randomised trials evaluating Tai Chi for preventing falls in older adults. We evaluated the risk of bias of included trials using the Cochrane Collaboration's tool. Results were combined using random effects meta-analysis. Outcome measures Number of fallers and rate of falls. Results 18 trials with 3824 participants were included. The Tai Chi group was associated with significantly lower chance of falling at least once (risk ratio (RR) 0.80, 95% CI 0.72 to 0.88) and rate of falls (incidence rate ratio (IRR) 0.69, 95% CI 0.60 to 0.80) than the control group. Subgroup analyses suggested that the preventive effect was likely to increase with exercise frequency (number of fallers: p=0.001; rate of falls: p=0.007) and Yang style Tai Chi was likely to be more effective than Sun style Tai Chi (number of fallers: p=0.01; rate of falls: p=0.001). The results might be influenced by publication bias as the funnel plots showed asymmetry. Sensitivity analyses by sample size, risk of bias and comorbidity showed no major influence on the primary results. Conclusions Tai Chi is effective for preventing falls in older adults. The preventive effect is likely to increase with exercise frequency and Yang style Tai Chi seems to be more effective than Sun style Tai Chi. PMID:28167744

  6. 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

  7. Stepping to stability and fall prevention in adult psychiatric patients.

    PubMed

    Emory, Sara L; Silva, Susan G; Christopher, Eric J; Edwards, Pamela B; Wahl, Leanne E

    2011-12-01

    Fall prevention is a major area of concern in inpatient settings. This article reports on the feasibility of implementing a daily exercise program that features line dancing to promote stability, balance, and flexibility in adult psychiatric patients and describes the impact of that program. Six hundred sixty-five patient charts drawn from before and after the practice change were reviewed. The fall rate after the introduction of line dancing was 2.8% compared with 3.2% before implementation. In a setting that treats both men and women of many ages and with varying levels of mobility, line dancing offers a viable approach to exercise in a secure setting.

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

    PubMed

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

    2012-03-01

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

  9. Programs and Place: Risk and Asset Mapping for Fall Prevention

    PubMed Central

    Smith, Matthew Lee; Towne, Samuel D.; Motlagh, Audry S.; Smith, Donald R.; Boolani, Ali; Horel, Scott A.; Ory, Marcia G.

    2017-01-01

    Identifying ways to measure access, availability, and utilization of health-care services, relative to at-risk areas or populations, is critical in providing practical and actionable information to key stakeholders. This study identified the prevalence and geospatial distribution of fall-related emergency medical services (EMS) calls in relation to the delivery of an evidence-based fall prevention program in Tarrant County, Texas over a 3-year time period. It aims to educate public health professionals and EMS first respondents about the application of geographic information system programs to identify risk-related “hot spots,” service gaps, and community assets to reduce falls among older adults. On average, 96.09 (±108.65) calls were received per ZIP Code (ranging from 0 calls to 386 calls). On average, EMS calls per ZIP Code increased from 30.80 (±34.70) calls in 2009 to 33.75 (±39.58) calls in 2011, which indicate a modest annual call increase over the 3-year study period. The percent of ZIP Codes offering A Matter of Balance/Volunteer Lay Leader Model (AMOB/VLL) workshops increased from 27.3% in 2009 to 34.5% in 2011. On average, AMOB/VLL workshops were offered in ZIP Codes with more fall-related EMS calls over the 3-year study period. Findings suggest that the study community was providing evidence-based fall prevention programming (AMOB/VLL workshops) in higher-risk areas. Opportunities for strategic service expansion were revealed through the identification of fall-related hot spots and asset mapping. PMID:28361049

  10. Programs and Place: Risk and Asset Mapping for Fall Prevention.

    PubMed

    Smith, Matthew Lee; Towne, Samuel D; Motlagh, Audry S; Smith, Donald R; Boolani, Ali; Horel, Scott A; Ory, Marcia G

    2017-01-01

    Identifying ways to measure access, availability, and utilization of health-care services, relative to at-risk areas or populations, is critical in providing practical and actionable information to key stakeholders. This study identified the prevalence and geospatial distribution of fall-related emergency medical services (EMS) calls in relation to the delivery of an evidence-based fall prevention program in Tarrant County, Texas over a 3-year time period. It aims to educate public health professionals and EMS first respondents about the application of geographic information system programs to identify risk-related "hot spots," service gaps, and community assets to reduce falls among older adults. On average, 96.09 (±108.65) calls were received per ZIP Code (ranging from 0 calls to 386 calls). On average, EMS calls per ZIP Code increased from 30.80 (±34.70) calls in 2009 to 33.75 (±39.58) calls in 2011, which indicate a modest annual call increase over the 3-year study period. The percent of ZIP Codes offering A Matter of Balance/Volunteer Lay Leader Model (AMOB/VLL) workshops increased from 27.3% in 2009 to 34.5% in 2011. On average, AMOB/VLL workshops were offered in ZIP Codes with more fall-related EMS calls over the 3-year study period. Findings suggest that the study community was providing evidence-based fall prevention programming (AMOB/VLL workshops) in higher-risk areas. Opportunities for strategic service expansion were revealed through the identification of fall-related hot spots and asset mapping.

  11. 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.

  12. 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

  13. Assessing the Quality of a Nonrandomized Pragmatic Trial for Primary Prevention of Falls among Older Adults

    PubMed Central

    Albert, Steven M.; Edelstein, Offer; King, Jennifer; Flatt, Jason; Lin, Chyongchiou J.; Boudreau, Robert; Newman, Anne B.

    2014-01-01

    Background Current approaches to falls prevention mostly rely on secondary and tertiary prevention and target individuals at high risk of falls. An alternative is primary prevention, in which all seniors are screened, referred as appropriate, and educated regarding falls risk. Little information is available on research designs that allow investigation of this approach in the setting of aging services delivery, where randomization may not be possible. Methods Healthy Steps for Older Adults, a statewide program of the Pennsylvania (PA) Department of Aging, involves a combination of education about falls and screening for balance problems, with referral to personal physicians and home safety assessments. We developed a nonrandomized statewide trial, Falls Free PA, to assess its effectiveness in reducing falls incidence over 12 months. We recruited 814 seniors who completed the program (503 first time participants, 311 people repeating the program) and 1020 who did not participate in the program, from the same sites. We assessed the quality of this nonrandomized design by examining recruitment, follow-up across study groups, and comparability at baseline. Results Of older adults approached in senior centers, 90.5% (n=2219) signed informed consent, and 1834 (82.4%) completed baseline assessments and were eligible for follow-up. Attrition in the three groups over 12 months was low and non-differential (<10% for withdrawal and <2% for other loss to follow-up). Median follow-up, which involved standardized monthly assessment of falls, was 10 months in all study groups. At baseline the groups did not differ in measures of health or falls risk factors. Conclusions Comparable status at baseline, recruitment from common sites, and similar experience with retention suggest that the nonrandomized design will be effective for assessment of this approach to primary prevention of falls. PMID:24488533

  14. 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.

  15. 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

  16. Slow Down and Concentrate: Time for a Paradigm Shift in Fall Prevention among People with Parkinson's Disease?

    PubMed

    Stack, Emma L; Roberts, Helen C

    2013-01-01

    Introduction. We know little about how environmental challenges beyond home exacerbate difficulty moving, leading to falls among people with Parkinson's (PwP). Aims. To survey falls beyond home, identifying challenges amenable to behaviour change. Methods. We distributed 380 questionnaires to PwP in Southern England, asking participants to count and describe falls beyond home in the previous 12 months. Results. Among 255 responses, 136 PwP (diagnosed a median 8 years) reported falling beyond home. They described 249 falls in detail, commonly falling forward after tripping in streets. Single fallers (one fall in 12 months) commonly missed their footing, walking, or changing position and recovered to standing alone or with unfamiliar help. Repeat fallers (median falls, two) commonly felt shaken or embarrassed and sought medical advice. Very frequent fallers (falling at least monthly; median falls beyond home, six) commonly fell backward, in shops and after collapse but often recovered to standing alone. Conclusion. Even independently active PwP who do not fall at home may fall beyond home, often after tripping. Falling beyond home may result in psychological and/or physical trauma (embarrassment if observed by strangers and/or injury if falling backwards onto a hard surface). Prevention requires vigilance and preparedness: slowing down and concentrating on a single task might effectively prevent falling.

  17. 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

    2013-03-05

    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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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

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

    PubMed

    Jeon, Byoung-Jin

    2013-11-01

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

  4. 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.

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

    PubMed

    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.

  6. 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 ...

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

    PubMed

    Lawson, Sara Nicole; Zaluski, Neal; Petrie, Amanda; Arnold, Cathy; Basran, Jenny; Dal Bello-Haas, Vanina

    2013-01-01

    Objectif : Étudier la validité concurrente de l'algorithme de dépistage des risques de chute et de renvoi en consultation (Falls Screening and Referral Algorithm, FSRA) du Saskatoon Falls Prevention Consortium. Méthode : Vingt-neuf personnes âgées (moyenne d'âge [ET] de 77,7 ans [4,0]) vivant dans une résidence pour personnes âgées autonomes satisfaisaient les critères d'inclusion; elles ont rempli un questionnaire démographique et ont été soumises à certaines composantes du FSRA et du test d'équilibre de l'échelle de Berg (EEB). Le FSRA comprend un test de dépistage des risques de chute (Elderly Fall Screening Test, EFST) et le questionnaire multifactoriel en matière de chutes (Multi-Factor Falls Questionnaire, MFQ). Il est conçu pour classer les individus dans trois catégories – risque de chute élevé, modéré ou faible – afin d'établir les approches de gestion appropriées. Un modèle prédictif de probabilité des risques de chute basé sur une étude antérieure a été utilisé pour établir la validité concurrente du FRSA. Résultats : Au total, 79 % des participants ont été classés dans la catégorie à faible risque du FSRA, puisque le modèle prédictif a permis d'établir la probabilité des risques de chute dans leur cas entre 0,04 et 0,74, avec une moyenne de 0,35 (ET=0,25). On n'a pu établir aucune corrélation significative sur le plan statistique entre le FSRA et le modèle prédictif de la probabilité des risques de chute (ρ de Spearman=0,35, p=0,06). Conclusion : Le FSRA manque de validité concurrente si on le compare à un modèle de risques de chute préalablement établi et semble « surclasser » les individus dans le segment à faible risque. D'autres études sur le FSRA en tant qu'outil approprié de dépistage chez les aînés résidant dans la communauté sont recommandées.

  8. Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit.

    PubMed

    Francis-Coad, Jacqueline; Etherton-Beer, Christopher; Bulsara, Caroline; Nobre, Debbie; Hill, Anne-Marie

    2016-03-17

    Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action.Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention.Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy.Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice.What is known about the topic? Audit and feedback is an effective way of measuring clinical quality and safety. CoPs have been established in healthcare using workplace staff to address clinical problems but little is known about their ability to audit and influence practice change.What does this paper add? This study contributes to the body of knowledge on CoPs in healthcare by evaluating the

  9. 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

  10. 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

  11. Evaluation of functional deficits and falls risk in the elderly--methods for preventing falls.

    PubMed

    Narayanan, Michael R; Scalzi, Maria Elena; Redmond, Stephen J; Lord, Steven R; Celler, Branko G; Lovell, Nigel H

    2009-01-01

    Falls in the elderly have a profound impact on their quality of life through injury, increased fear of falling, reduced confidence to perform daily tasks and loss of independence. Falls come at a substantial economic cost. Tools to quantify falls risk and evaluate functional deficits allow interventions to be targeted to those at increased risk of falling and tailored to correct deficits with the aim of reducing falls rate and reducing ones risk of falling. We describe a system to evaluate falls risk and functional deficits in the elderly. The system is based on the evaluation of performance in a simple set of controlled movements known as the directed routine (DR). We present preliminary results of the DR in a cohort of 68 subjects using features extracted from the DR. Linear least-squares models were trained to estimate falls risk, knee-extension strength, proprioception, mediolateral body sway, anteroposterior body sway and contrast sensitivity. The model estimates provided good to fair correlations with (r=0.76 p<0.001), (r=0.65 p<0.001), (r=0.35 p<0.01), (r=0.53 p<0.001), (r=0.48 p<0.001) and (r=0.37 p<0.01) respectively.

  12. Fall prevention practices in adult medical-surgical nursing units described by nurse managers.

    PubMed

    Shever, Leah L; Titler, Marita G; Mackin, Melissa Lehan; Kueny, Angela

    2011-04-01

    The purpose of this article was to describe nursing practices (e.g., assessment, interventions) around fall prevention, as perceived by nurse managers in adult, medical-surgical nursing units. One hundred forty nurse managers from 51 hospitals from across the United States participated. Descriptive frequencies are used to describe nurse manager responses. The most commonly used fall risk assessment tool was the Morse Fall Risk Assessment Tool (40%). The most common fall prevention interventions included bed alarms (90%), rounds (70%), sitters (68%), and relocating the patient closer to the nurses' station (56%). Twenty-nine percent of nurse managers identified physical restraints as an intervention to prevent falls whereas only 10% mentioned ambulation. No nurse manager identified that RN hours per patient-day were adjusted to prevent falls or fall-related injuries. More work is needed to build systems that ensure evidence-based nursing interventions are consistently applied in acute care.

  13. 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…

  14. 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

  15. 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…

  16. The use of non-slip socks to prevent falls among hospitalized older adults: A literature review.

    PubMed

    Hartung, Benjamin; Lalonde, Michelle

    2017-03-09

    Falls among hospitalized older adults are a growing concern. Hospitals are using non-slip socks as an alternative footwear to help prevent falls, however there is limited evidence to support their use. The aim of this article is to review the literature on the effectiveness of non-slip socks to determine if there is sufficient evidence to support their use in the prevention of falls among hospitalized older adults. A comprehensive literature search was conducted using Medline, CINAHL, Scopus, PubMed and the Cochrane Library. Six studies were included in this review. The results suggested that there is inconclusive evident to support the use of non-slip socks to prevent falls among hospitalized older adults. Non-slip socks do not possess the properties of adequate footwear and have the potential to spread infection. The patient's personal footwear from home is the safest footwear option while admitted into hospital.

  17. Falling towards forgetfulness: synaptic decay prevents spontaneous recovery of memory.

    PubMed

    Stone, James V; Jupp, Peter E

    2008-08-22

    Long after a new language has been learned and forgotten, relearning a few words seems to trigger the recall of other words. This "free-lunch learning" (FLL) effect has been demonstrated both in humans and in neural network models. Specifically, previous work proved that linear networks that learn a set of associations, then partially forget them all, and finally relearn some of the associations, show improved performance on the remaining (i.e., nonrelearned) associations. Here, we prove that relearning forgotten associations decreases performance on nonrelearned associations; an effect we call negative free-lunch learning. The difference between free-lunch learning and the negative free-lunch learning presented here is due to the particular method used to induce forgetting. Specifically, if forgetting is induced by isotropic drifting of weight vectors (i.e., by adding isotropic noise), then free-lunch learning is observed. However, as proved here, if forgetting is induced by weight values that simply decay or fall towards zero, then negative free-lunch learning is observed. From a biological perspective, and assuming that nervous systems are analogous to the networks used here, this suggests that evolution may have selected physiological mechanisms that involve forgetting using a form of synaptic drift rather than synaptic decay, because synaptic drift, but not synaptic decay, yields free-lunch learning.

  18. 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

  19. The Role of Pharmacists in Preventing Falls among America’s Older Adults

    PubMed Central

    Karani, Mamta V.; Haddad, Yara; Lee, Robin

    2016-01-01

    Falls are the leading cause of both fatal and non-fatal injuries in people aged 65 years and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient-centered team-based approach, pharmacists can collaborate with the primary care providers to reduce fall risk. They can screen for fall risk, review and optimize medication therapy, recommend vitamin D, and educate patients and caregivers about ways to prevent falls. To help health-care providers implement fall prevention, the Centers for Disease Control and Prevention developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. Based on the established clinical guidelines, STEADI provides members of the health-care team, including pharmacists, with the tools and resources they need to manage their older patients’ fall risk. These tools are being adapted to specifically advance the roles of pharmacists in reviewing medications, identifying those that increase fall risk, and communicating those risks with patients’ primary care providers. Through a multidisciplinary approach, pharmacists along with other members of the health-care team can better meet the needs of America’s growing older adult population and reduce falls. PMID:27882314

  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. 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

  2. Program sustainability of a community-based intervention to prevent falls among older Australians.

    PubMed

    Barnett, L M; Van Beurden, E; Eakin, E G; Beard, J; Dietrich, U; Newman, B

    2004-09-01

    Multi-strategy interventions have been demonstrated to prevent falls among older people, but studies have not explored their sustainability. This paper investigates program sustainability of Stay on Your Feet (SOYF), an Australian multi-strategy falls prevention program (1992-1996) that achieved a significant reduction in falls-related hospital admissions. A series of surveys assessed recall, involvement and current falls prevention activities, 5 years post-SOYF, in multiple original SOYF stakeholder groups within the study area [general practitioners (GPs), pharmacists, community health (CH) staff, shire councils (SCs) and access committees (ACs)]. Focus groups explored possible behavioural changes in the target group. Surveys were mailed, except to CH staff and ACs, who participated in guided group sessions and were contacted via the telephone, respectively. Response rates were: GPs, 67% (139/209); pharmacists, 79% (53/67); CH staff, 63% (129/204); SCs, 90% (9/10); ACs, 80% (8/10). There were 73 older people in eight focus groups. Of 117 GPs who were practising during SOYF, 80% recalled SOYF and 74% of these reported an influence on their practice. Of 46 pharmacists operating a business during SOYF, 45% had heard of SOYF and 79% of these reported being 'somewhat' influenced. Of 76 community health staff (59%) in the area at that time, 99% had heard of SOYF and 82% reported involvement. Four SCs retained a SOYF resource, but none thought current activities were related. Seven ACs reported involvement, but no activities were sustained. Thirty-five focus group participants (48%) remembered SOYF and reported a variety of SOYF-initiated behaviour changes. Program sustainability was clearly demonstrated among health practitioners. Further research is required to assess long-term effect sustainability.

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

    PubMed

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

    2015-01-01

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

  4. 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

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

    PubMed

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

    2015-01-01

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

  6. 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.

  7. 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.

  8. 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…

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed Central

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

    2012-01-01

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

  11. 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.

  12. 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.

  13. Exploring seniors' views on the use of assistive devices in fall prevention.

    PubMed

    Aminzadeh, F; Edwards, N

    1998-08-01

    Falls are a common barrier to independent living among elderly persons. In recent years, growing awareness of the incidence of falls has led to the development of many community-based fall prevention programs for older adults. However, the potential impact of these programs is diminished by the lack of research on factors that may influence older persons' decisions to adopt or reject fall prevention behaviors. This exploratory descriptive study employed a focus group approach to elicit qualitative data on seniors' views on the use of assistive devices in fall prevention. Four focus group interviews were conducted with a convenience sample of 30 community-living older adults from Italian- and British-Canadian backgrounds in Ottawa, Canada. The interviews documented personal experiences with and the meaning of falls, aging, and assistive device use for older adults. The findings have important implications for the public health nursing practice in the realms of individual counseling, social marketing, and policy change to prevent falls among elderly persons. The study also provides direction for future research on this topic.

  14. 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…

  15. 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…

  16. Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial)

    PubMed Central

    Cockayne, Sarah; Adamson, Joy; Clarke, Arabella; Corbacho, Belen; Fairhurst, Caroline; Green, Lorraine; Hewitt, Catherine E.; Hicks, Kate; Kenan, Anne-Maree; Lamb, Sarah E.; McIntosh, Caroline; Menz, Hylton B.; Redmond, Anthony C.; Richardson, Zoe; Rodgers, Sara; Vernon, Wesley; Watson, Judith

    2017-01-01

    Background Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention. Design Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness. Results In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained. Conclusion There was a small reduction in falls. The intervention may be cost-effective. Trial

  17. Assessing knowledge, motivation and perceptions about falls prevention among care staff in a residential aged care setting.

    PubMed

    Hang, Jo-Aine; Francis-Coad, Jacqueline; Burro, Bianca; Nobre, Debbie; Hill, Anne-Marie

    Falls are a serious problem in residential aged care settings. The aims of the study were to determine the feasibility of surveying care staff regarding falls prevention, and describe care staff levels of knowledge and awareness of residents' risk of falls, knowledge about falls prevention, motivation and confidence to implement falls prevention strategies. A custom designed questionnaire was administered to care staff at one site of a large residential aged care organization in Australia. The survey response was 58.8%. Feedback from staff was used to inform the administration of the survey to the wider organization. Seven (29.2%) care staff reported they were unsure or thought residents were at low risk of falls. Only five (20.8%) care staff were able to suggest more than three preventive strategies. These preliminary findings suggest that education to change care staff behavior regarding falls prevention should target improving care staff knowledge and awareness of falls.

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

    PubMed

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

    2016-07-01

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

  19. 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

  20. 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.

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

    PubMed Central

    2013-01-01

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

  2. Cost analysis of a community-based fall prevention program being delivered in South Florida.

    PubMed

    Page, Timothy F; Batra, Anamica; Palmer, Richard

    2012-01-01

    The aim of this study was to measure the costs of delivering a fall prevention program by community agencies in South Florida. Cost data were collected from agencies participating in the delivery of Matter of Balance workshops in South Florida. Cost information included both initial implementation and ongoing workshop delivery costs. Average costs for implementation per program completer were $325 during the first year in which the program was offered and $176 during the second year of the program. Matter of Balance is a relatively inexpensive fall prevention program. This has implications for the further dissemination and sustainability of evidence-based programs for elderly individuals.

  3. An Integrated Approach to Falls Prevention: A Model for Linking Clinical and Community Interventions through the Massachusetts Prevention and Wellness Trust Fund

    PubMed Central

    Coe, Laura J.; St. John, Julie Ann; Hariprasad, Santhi; Shankar, Kalpana N.; MacCulloch, Patricia A.; Bettano, Amy L.; Zotter, Jean

    2017-01-01

    Older adult falls continue to be a public health priority across the United States—Massachusetts (MA) being no exception. The MA Prevention and Wellness Trust Fund (PWTF) program within the MA Department of Public Health aims to reduce the physical and economic burdens of chronic health conditions by linking evidence-based clinical care with community intervention programs. The PWTF partnerships that focused on older adult falls prevention integrated the Centers for Disease Control and Prevention’s Stopping Elderly Accidents, Death and Injuries toolkit into clinical settings. Partnerships also offer referrals for home safety assessments, Tai Chi, and Matter of Balance programs. This paper describes the PWTF program implementation process involving 49 MA organizations, while highlighting the successes achieved and lessons learned. With the unprecedented expansion of the U.S. Medicare beneficiary population, and the escalating incidence of falls, widespread adoption of effective prevention strategies will become increasingly important for both public health and for controlling healthcare costs. The lessons learned from this PWTF initiative offer insights and recommendations for future falls prevention program development and implementation. PMID:28321393

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

    PubMed Central

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

    2014-01-01

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

  5. Barriers and enablers to the implementation of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomised controlled trial

    PubMed Central

    Brand, Caroline A.; Landgren, Fiona S.; Melhem, Mayer M.; Bian, Evelyn; Brauer, Sandra G.; Hill, Keith D.; Livingston, Patricia M.

    2017-01-01

    Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702), and 12 focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment). Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and training for nurses

  6. Exercise and nutritional approaches to prevent frail bones, falls and fractures: an update.

    PubMed

    Daly, R M

    2017-04-01

    Osteoporosis (low bone strength) and sarcopenia (low muscle mass, strength and/or impaired function) often co-exist (hence the term 'sarco-osteoporosis') and have similar health consequences with regard to disability, falls, frailty and fractures. Exercise and adequate nutrition, particularly with regard to vitamin D, calcium and protein, are key lifestyle approaches that can simultaneously optimize bone, muscle and functional outcomes in older people, if they are individually tailored and appropriately prescribed in terms of the type and dose. Not all forms of exercise are equally effective for optimizing musculoskeletal health. Regular walking alone has little or no effect on bone or muscle. Traditional progressive resistance training (PRT) is effective for improving muscle mass, size and strength, but it has mixed effects on muscle function and falls which may be due to the common prescription of slow and controlled movement patterns. At present, targeted multi-modal programs incorporating traditional and high-velocity PRT, weight-bearing impact exercises and challenging balance/mobility activities appear to be most effective for optimizing musculoskeletal health and function. Reducing and breaking up sitting time may also help attenuate muscle loss. There is also evidence to support an interaction between exercise and various nutritional factors, particularly protein and some multi-nutrient supplements, on muscle and bone health in the elderly. This review summary provides an overview of the latest evidence with regard to the optimal type and dose of exercise and the role of various nutritional factors for preventing bone and muscle loss and improving functional capacity in older people.

  7. 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.

  8. 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…

  9. Framework for preventing accidental falls in hospitals - management plan for ADL, medication and medical conditions.

    PubMed

    Kato, Shogo; Tsuru, Satoko; Iizuka, Yoshinori

    2009-01-01

    Prevention and reduction of medical accidents is essential. Among medical accidents, accidental falls remain a serious problem. While "assessment score sheets" have already been used in hospitals to prevent accidental falls, satisfactory results have not actually been achieved. In this study, we aim to establish a methodology for preventing accidental falls. We consider that the 'management plan' for each patient includes three factors. A plan of instructions for patients on actions they can take for safety in their ADL (Activities of Daily Living) is essential as a base. Second, a plan to keep up with any short term change in a patient's state is needed, because the state of a hospitalized patient will usually be temporarily affected by medication and changing medical conditions. We develop a model for preventing accidental falls, which enable us to design appropriate management plan for each patient. Then, we develop a prototype system based on the designed model. Finally, we address the result of verification of the model, by applying the prototype system into actual cases in hospitals.

  10. 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…

  11. 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…

  12. 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.

  13. Preventing falls

    MedlinePlus

    ... important items in. Exercise to Help Build Your Strength When you stand up from a sitting position, ... therapist can show you how to build your strength to make getting up easier. When to Call ...

  14. Current costing models: are they suitable for allocating health resources? The example of fall injury prevention in Australia.

    PubMed

    Moller, Jerry

    2005-01-01

    The example of fall injury among older people is used to define and illustrate how current Australian systems for allocation of health resources perform for funding emerging public health issues. While the examples are Australian, the allocation and priority setting methods are common in the health sector in all developed western nations. With an ageing population the number of falls injuries in Australia and the cost of treatment will rise dramatically over the next 20-50 years. Current methods of allocating funds within the health system are not well suited to meeting this coming epidemic. The information requirements for cost-benefit and cost-effectiveness measures cannot be met. Marginal approaches to health funding are likely to continue to fund already well-funded treatment or politically driven prevention processes and to miss the opportunity for new prevention initiatives in areas that do not have a high political profile. Fall injury is one of many emerging areas that struggle to make claims for funding because the critical mass of intervention and evidence of its impact is not available. The beneficiaries of allocation failure may be those who treat the disease burden that could have been easily prevented. Changes to allocation mechanisms, data systems and new initiative funding practices are required to ensure that preventative strategies are able to compete on an equal footing with treatment approaches for mainstream health funding.

  15. Framework for preventing falls in acute hospitals using passive sensor enabled radio frequency identification technology.

    PubMed

    Visvanathan, Renuka; Ranasinghe, Damith C; Shinmoto Torres, Roberto L; Hill, Keith

    2012-01-01

    We describe a distributed architecture for a real-time falls prevention framework capable of providing a technological intervention to mitigate the risk of falls in acute hospitals through the development of an AmbIGeM (Ambient Intelligence Geritatric Management system). Our approach is based on using a battery free, wearable sensor enabled Radio Frequency Identification device. Unsupervised classification of high risk falls activities are used to facilitate an immediate response from caregivers by alerting them of the high risk activity, the particular patient, and their location. Early identification of high risk falls activities through a longitudinal and unsupervised setting in real-time allows the preventative intervention to be administered in a timely manner. Furthermore, real-time detection allows emergency protocols to be deployed immediately in the event of a fall. Finally, incidents of high risk activities are automatically documented to allow clinicians to customize and optimize the delivery of care to suit the needs of patients identified as being at most risk.

  16. 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

  17. Tailored Education for Older Patients to Facilitate Engagement in Falls Prevention Strategies after Hospital Discharge—A Pilot Randomized Controlled Trial

    PubMed Central

    Hill, Anne-Marie; Etherton-Beer, Christopher; Haines, Terry P.

    2013-01-01

    Background The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients’ self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education. Methods A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers. Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, delivered in addition to usual care. Outcome measures were engagement in falls prevention behaviors in the month after discharge measured at one month after discharge with a structured survey, and participants’ knowledge, confidence and motivation levels before and after receiving the education. The feasibility of providing the intervention was examined and falls outcomes (falls, fall-related injuries) were also collected. Results Forty-eight patients (98%) provided follow-up data. The complete package was provided to 21 (84%) intervention group participants. Participants in the intervention group were significantly more likely to plan how to safely restart functional activities [Adjusted odds ratio 3.80, 95% CI (1.07, 13.52), p = 0.04] and more likely to complete other targeted behaviors such as completing their own home exercise program [Adjusted odds ratio 2.76, 95% CI (0.72, 10.50), p = 0.14] than the control group. The intervention group was significantly more knowledgeable, confident and motivated to engage in falls prevention strategies after receiving the education than the control group. There were 23 falls (n = 5 intervention; n = 18 control) and falls rates were 5.4/1000 patient days (intervention); 18

  18. Outdoor pedestrian fall-related injuries among Swedish senior citizens--injuries and preventive strategies.

    PubMed

    Gyllencreutz, Lina; Björnstig, Johanna; Rolfsman, Ewa; Saveman, Britt-Inger

    2015-06-01

    Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over-represented in injury statistics, and fall-related injuries are common. The aim of this study was to investigate fall-related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self-reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One-fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.

  19. The Effects of the A Matter of Balance Program on Falls and Physical Risk of Falls, Tampa, Florida, 2013

    PubMed Central

    Edwards, Jerri D.; Janke, Megan C.

    2015-01-01

    Introduction This study investigated the effects of the A Matter of Balance (MOB) program on falls and physical risk factors of falling among community-dwelling older adults living in Tampa, Florida, in 2013. Methods A total of 110 adults (52 MOB, 58 comparison) were enrolled in this prospective cohort study. Data on falls, physical risk of falling, and other known risk factors of falling were collected at baseline and at the end of the program. Multivariate analysis of covariance with repeated measures and logistic regressions were used to investigate the effects of this program. Results Participants in the MOB group were less likely to have had a fall and had significant improvements in their physical risk of falling compared with adults in the comparison group. No significant effects of the MOB program on recurrent falls or the number of falls reported were found. Conclusion This study contributes to our understanding of the MOB program and its effectiveness in reducing falls and the physical risk of falling among older adults. The findings support extended use of this program to reduce falls and physical risk of falling among older adults. PMID:26402047

  20. An Exercise Program to Prevent Falls in Institutionalized Elderly with Cognitive Deficits: A Crossover Pilot Study

    PubMed Central

    Peterson, Karen; Gianan, Faith V; Pang, Lorrin

    2013-01-01

    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. PMID:24251085

  1. 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

  2. Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial.

    PubMed

    Barker, Anna L; Morello, Renata T; Ayton, Darshini R; Hill, Keith D; Brand, Caroline A; Livingston, Patricia M; Botti, Mari

    2017-01-01

    There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; 'falls alert' signs; supervision of patients in the bathroom; ensuring patients' walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients' walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting

  3. Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial

    PubMed Central

    Hill, Keith D.; Brand, Caroline A.; Livingston, Patricia M.; Botti, Mari

    2017-01-01

    There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; ‘falls alert’ signs; supervision of patients in the bathroom; ensuring patients’ walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients’ walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised

  4. An integrative review of Tai Chi research: an alternative form of physical activity to improve balance and prevent falls in older adults.

    PubMed

    Wooton, Angela Conrad

    2010-01-01

    The purpose of this integrative review is to analyze the current research literature on Tai Chi (TC) and its potential effect on balance and prevention of falls in older adults. The evidence for improving balance is somewhat conflicting because few research studies identify which balance exercises are effective. The question of how TC achieves improvements in balance remains. To promote functional independence and improve quality of life in the later years of one's life, it is important to improve balance and prevent falls in older adults. TC poses challenges related to the complexity of the practice. By reviewing the current research literature on TC focusing on balance and falls in older adults, strategies may be developed to incorporate TC to improve balance and modify the known risk factors for falling. This article also discusses potential applications and limitations of the current research.

  5. Elderly persons' attitudes towards footwear--a factor in preventing falls.

    PubMed Central

    Dunne, R G; Bergman, A B; Rogers, L W; Inglin, B; Rivara, F P

    1993-01-01

    Injuries from falls are the main cause of trauma morbidity that leads to mortality among the elderly. One prevention strategy is to wear sturdy shoes. This study was undertaken to determine the attitudes towards and use of sturdy shoes among older adults. A random sample of persons ages 65 years and older was contacted by phone; 652 completed interviews. Sturdy shoes were worn by 26 percent of persons at the time of the call; more than two-thirds reported wearing such shoes at some time. Barriers to use of sturdy shoes included foot problems, difficulty putting them on, expense, style, and lack of knowledge about their importance. There was no difference in shoe use by the respondents' history of previous falls. The results provide information useful in the development of a program to increase the use of sturdy shoes by this population. PMID:8464983

  6. The case for Tai Chi in the repertoire of strategies to prevent falls among older people

    PubMed Central

    Nyman, Samuel R.; Skelton, Dawn A.

    2016-01-01

    Falls among older people is a global public health issue. In this article, Dr Samuel Nyman of Bournemouth University Dementia Institute, and Professor Dawn Skelton, Institute for Applied Health Research, Glasgow Caledonian University highlight the effectiveness of Tai Chi as an alternative strategy to physiotherapy to combat this issue. PMID:28244837

  7. Health Promotion Board-Ministry of Health Clinical Practice Guidelines: Falls Prevention among Older Adults Living in the Community.

    PubMed

    Shyamala, Thilagaratnam; Wong, Sweet Fun; Andiappan, Akila; Au Eong, Kah Guan; Bakshi, Anu Birla; Boey, Debbie; Chong, Tsung Wei; Eng, Hui Ping; Ismail, Noor Hafizah; Lau, Tang Ching; Lim, Wei-Yen; Lim, Hsin Wei Wendy; Seong, Lydia; Wong, Wei Chin; Yap, Kai Zhen; Yudah, Sri

    2015-05-01

    The Health Promotion Board (HPB) has developed the Clinical Practice Guidelines (CPG) on Falls Prevention among Older Adults Living in the Community to provide health professionals in Singapore with recommendations for evidence-based assessments and interventions for falls prevention. This article reproduces the introduction and executive summary of the key recommendations from the HPB-MOH CPG on Falls Prevention among Older Adults Living in the Community for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov. sg/cpg-falls-prevention. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

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

    PubMed

    Cheung, Esther; Chan, Albert P C

    2012-09-01

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

  9. Reporting of complex interventions in clinical trials: development of a taxonomy to classify and describe fall-prevention interventions

    PubMed Central

    2011-01-01

    Background Interventions for preventing falls in older people often involve several components, multidisciplinary teams, and implementation in a variety of settings. We have developed a classification system (taxonomy) to describe interventions used to prevent falls in older people, with the aim of improving the design and reporting of clinical trials of fall-prevention interventions, and synthesis of evidence from these trials. Methods Thirty three international experts in falls prevention and health services research participated in a series of meetings to develop consensus. Robust techniques were used including literature reviews, expert presentations, and structured consensus workshops moderated by experienced facilitators. The taxonomy was refined using an international test panel of five health care practitioners. We assessed the chance corrected agreement of the final version by comparing taxonomy completion for 10 randomly selected published papers describing a variety of fall-prevention interventions. Results The taxonomy consists of four domains, summarized as the "Approach", "Base", "Components" and "Descriptors" of an intervention. Sub-domains include; where participants are identified; the theoretical approach of the intervention; clinical targeting criteria; details on assessments; descriptions of the nature and intensity of interventions. Chance corrected agreement of the final version of the taxonomy was good to excellent for all items. Further independent evaluation of the taxonomy is required. Conclusions The taxonomy is a useful instrument for characterizing a broad range of interventions used in falls prevention. Investigators are encouraged to use the taxonomy to report their interventions. PMID:21586143

  10. Fall Risk and Prevention Strategies in an Elderly Latino Population: A Global Health Partnership in a Local Community

    PubMed Central

    Hanlin, Erin R.; Delgado-Rendón, Angélica; Lerner, E. Brooke; Hargarten, Stephen; Farías, René

    2016-01-01

    Background The impact of falls in the elderly presents a significant public health burden throughout the country. Fall risk is not well described in Latino populations nor have fall prevention programs considered the needs of this population. Objectives The objectives of this study were to define the impact of falls in elderly Latinos at the United Community Center (UCC), to determine any possible barriers and recognize possible strengths in this elderly population with regards to fall prevention, to determine the level of interest within this population in various fall prevention methods and to provide medical students from the Medical College of Wisconsin (MCW) an opportunity for participation in a culturally-diverse community project. Methods A prospective survey was conducted by a medical student with a convenience sample of elderly program participants at the UCC. The fall-related survey was developed in collaboration with the community and academic partners in both English and Spanish and pilot tested with UCC staff members who were embedded in the community and were native Spanish speakers. Community center participants were approached by the interviewer during various UCC program activities and asked to participate. Those who agreed were read the survey questions by the medical student interviewer in their preferred language and their answers were recorded. Data was analyzed using descriptive statistics. Results 103 interviews were conducted. 54% of respondents had fallen in the last year, of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. 52% of all respondents had five or more of the 10 surveyed risk factors for falling, and only 4% had no risk factors. 75% of all respondents were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (preferred by 78% and 65%, respectively). Conclusion

  11. Fall and spring tillage effects on sugarbeet production

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The ability to vary primary tillage timing between fall and spring for sugarbeet production could benefit producers by providing flexibility for when field work occurs and may allow earlier planting in the spring. This study was conducted to evaluate the effects of strip and conventional tillage co...

  12. 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.

  13. 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.

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

    PubMed

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

    2014-01-01

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

  15. 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.

  16. “The Right Way at the Right Time”: Insights on the Uptake of Falls Prevention Strategies from People with Dementia and Their Caregivers

    PubMed Central

    Meyer, Claudia; Dow, Briony; Hill, Keith D.; Tinney, Jean; Hill, Sophie

    2016-01-01

    Strong evidence exists for effective falls prevention strategies for community-dwelling older people. Understanding the translation of these strategies into practice for people with dementia has had limited research focus. People with dementia desire to have their voice heard, to engage meaningfully in the health-care decision-making process, making it a priority for researchers and practitioners to better understand how to engage them in this process. This paper reports on the qualitative aspects of a series of studies, which aimed to identify the views of people with dementia and their caregivers regarding perceptions of falls prevention and the successes and challenges of adopting falls prevention strategies. Twenty five people with dementia and their caregivers were interviewed in their homes at baseline, and 24 caregivers and 16 people with dementia were interviewed at completion of a 6-month individualized falls prevention intervention. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Five themes were identified at baseline: perceptions of falls; caregivers navigating the new and the unpredictable; recognition of decline; health services – the need for an appropriate message; and negotiating respectful relationships. At 6 months, caregivers and people with dementia decided on “what we need to know” with firm views that the information regarding falls risk reduction needed to be in “the right way … at the right time.” Rather than caregivers and people with dementia being only recipients of knowledge, they felt they were “more than just empty vessels to be filled” drawing on a “variety of resources” within their circle of influence to be able to positively “adapt to change.” The voices of people with dementia and their caregivers add an important dimension to understanding the translation of falls prevention knowledge for this population. Insights from this study will enable community care health

  17. 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.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    2012-01-01

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

  20. 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

  1. 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

  2. ‘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

  3. 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

  4. Models for effective prevention.

    PubMed

    Perry, C L; Kelder, S H

    1992-07-01

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

  5. 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…

  6. Fall Protection Introduction, #33462

    SciTech Connect

    Chochoms, Michael

    2016-06-23

    The proper use of fall prevention and fall protection controls can reduce the risk of deaths and injuries caused by falls. This course, Fall Protection Introduction (#33462), is designed as an introduction to various types of recognized fall prevention and fall protection systems at Los Alamos National Laboratory (LANL), including guardrail systems, safety net systems, fall restraint systems, and fall arrest systems. Special emphasis is given to the components, inspection, care, and storage of personal fall arrest systems (PFASs). This course also presents controls for falling object hazards and emergency planning considerations for persons who have fallen.

  7. 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.

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

    PubMed Central

    Urton, M M

    1991-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

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

  11. Independent and combined effects of exercise and vitamin D on muscle morphology, function and falls in the elderly.

    PubMed

    Daly, Robin M

    2010-09-01

    Regular exercise, particularly progressive resistance training (PRT), is recognized as one of the most effective strategies to prevent age-related muscle loss (sarcopenia), but its effects on muscle function are mixed. However, emerging data indicates that high velocity PRT (fast concentric muscle contractions) is more effective for improving functional outcomes than traditional PRT. In terms of falls prevention, high-challenging balance training programs appear to be most effective. There is also compelling evidence that supplemental vitamin D is an effective therapeutic option for falls prevention. The findings from a recent meta-analysis revealed that supplemental vitamin D at a dose of at least 700-1,000 IU/d or an achieved serum 25(OH)D level of at least 60 nmol/L was associated with reduced falls risk among older individuals. Based on these findings, it is possible that the combination of exercise and vitamin D could have a synergistic effect on muscle morphology and function, particularly since both interventions have been shown to have beneficial effects on type II "fast twitch" muscle fibers and systemic inflammation, which have both been linked to losses in muscle mass and function. Unfortunately however, the findings from the limited number of factorial 2 × 2 design RCTs indicate that additional vitamin D does not enhance the effects of exercise on measures of muscle morphology, function or falls risk. However, none of these trials were adequately powered to detect a "synergistic" effect between the two treatment strategies, but it is likely that if an exercise-by-vitamin D interaction does exist, it may be limited to situations when vitamin D deficiency/insufficiency is corrected. Further targeted research in "high risk" groups is still needed to address this question, and evaluate whether there is a threshold level of serum 25(OH)D to maximize the effects of exercise on muscle and falls risk.

  12. Benefits of a novel concept of home-based exercise with the aim of preventing aspiration pneumonia and falls in frail older women: a pragmatic controlled trial

    PubMed Central

    Takatori, Katsuhiko; Matsumoto, Daisuke; Nishida, Munenori; Matsushita, Shinnichiro; Noda, Tatsuya; Imamura, Tomoaki

    2016-01-01

    Aim To investigate whether home-based exercise with the aim of preventing aspiration pneumonia and accidental falls improves swallowing-related and physical functions in community-dwelling frail older women. Methods Participants were 266 community-dwelling frail older women in a long-term care prevention class (mean (SD): age 75 (5) years). Participants were allocated to either an intervention group or a control group. In the intervention group, participants were asked to perform, at least three times a week for 6 months, a home-based exercise programme that was specifically developed to prevent aspiration pneumonia and accidental falls. Control group participants were instructed to perform general stretching exercises only. Voluntary peak cough flow and lip closure force were measured as swallowing-related functions. Static and dynamic balance function, lower limb strength and flexibility were measured as secondary outcomes. Intervention effects were determined using t tests; effect sizes were calculated using Cohen's d. Results Voluntary peak cough flow in the intervention group was significantly greater than in the control group (p<0.01, d=0.5). However, lip closure force did not differ between groups. Regarding physical function, results of the Timed Up and Go Test (p<0.05, d=0.4), Chair Stand Test (p<0.01, d=0.4), maximal knee extension strength (p<0.05, d=0.4), and Sit and Reach Test (p<0.05, d=0.3) showed greater improvement in the intervention group. Conclusions Specifically developed home-based exercise as described in this study is simple and can be performed briefly. Improvements in voluntary peak cough flow and physical function indicate the possible usefulness of such exercise in preventing falls and aspiration pneumonia in community-dwelling frail older adults. Trial registration number UMIN Clinical Trials Registry (UMIN-CTR): UMIN000014880. PMID:27900185

  13. 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.

  14. 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

  15. 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…

  16. 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…

  17. [Doping: effectiveness, consequences, prevention].

    PubMed

    Guezennec, C Y

    2001-02-01

    The use of doping is linked with the history of sports. Doping abuse escalated until the mid sixties when government and sports authorities responded with antidoping laws and drug testing. Today, the details of substances detected in controls give a good indication on the importance of doping use. Three classes of pharmaceuticals account for most of the positive controls. They are anabolic steroids, stimulants and narcotics. Their use can be related with the goal of the athletes. Anabolic steroids are mainly used in sports such as bodybuilding or weight lifting in order to develop strength. Stimulants are used in sports were speed favors performance. All the products that enhance blood oxygen transportation are used in endurance sports, their efficacy is not scientifically demonstrated, but their use does result in real risks. Several studies have evidenced the medical problems resulting from prolonged doping. Doping control is impaired by the fact that many products now used, e.g. EPO or rhGH, are not detectable. Regular medical examination of athletes could help prevent use of doping.

  18. Advancing Community-Based Falls Prevention Programs for Older Adults—The Work of the Administration for Community Living/Administration on Aging

    PubMed Central

    Kulinski, Kristie; DiCocco, Casey; Skowronski, Shannon; Sprowls, Phantane

    2017-01-01

    The mission of the Administration for Community Living (ACL) is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers. In direct alignment with this mission is ACL’s support of evidence-based falls prevention programs in communities throughout the United States. Since 2014, the Administration on Aging (AoA), part of ACL, has invested nearly $14 million in entities such as state agencies, nonprofits, and universities to expand access to proven community-based falls prevention programs. The initiatives supported by ACL/AoA bring to bear two primary goals—(1) to significantly increase the number of older adults and older adults with disabilities at risk for falls who participate in evidence-based community programs to reduce falls and falls risks; and (2) to implement innovative funding arrangements, including contracts, partnerships, and collaborations with one or more sustainability partners to support these programs during and beyond the grant period. Support from ACL/AoA has significantly increased the availability of evidence-based falls prevention programs in funded communities, as well as enhanced the network’s sustainable delivery infrastructure to promote continued access to these critical programs beyond the scope of grant funding. This article highlights the successful rollout of ACL/AoA’s falls prevention initiative. PMID:28217688

  19. Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

    PubMed

    Francis-Coad, Jacqueline; Etherton-Beer, Christopher; Bulsara, Caroline; Nobre, Debbie; Hill, Anne-Marie

    2016-10-18

    The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training.

  20. 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.

  1. Can the Otago falls prevention program be delivered by video? A feasibility study

    PubMed Central

    Davis, Jennifer C; Hsu, Chun Liang; Cheung, Winnie; Brasher, Penny M A; Li, Linda C; Khan, Karim M; Sykes, Jonathan; Skelton, Dawn A; Liu-Ambrose, Teresa

    2016-01-01

    Objectives We assessed the feasibility of delivering the Otago Exercise Programme (OEP) via an interactive DVD (ie, OEP-DVD) in combination with monthly physical therapist phone calls to older adults. Design This pre-post (baseline and 6-month follow-up) study included an intervention group (n=61) based in a rural location and a control group (n=21) based in a city. Setting Sechelt and Vancouver, British Columbia. Participants 82 community-dwelling adults ≥75 years. Intervention Individuals in the intervention group received the OEP-DVD and were instructed to do the exercises 3 times a week after their initial home physical therapist visit for 6 months. Primary and secondary outcomes Feasibility was ascertained by withdrawal rate and compliance to the OEP-DVD. The number of participants and the frequency (ie, number of times weekly) they performed the OEP exercises and walking were used to estimate compliance. The potential benefit of the OEP-DVD on falls risk profile (Physiological Profile Assessment (PPA)) and mobility were examined by comparing the change in the intervention group compared with the control group. Self-reported compliance to the exercise programme was assessed by monthly returned diary. Results Of the 82 participants, 2 withdrew from the OEP-DVD group and none withdrew from the control group. We obtained compliance data on 72% of participants in the intervention group. The mean OEP-DVD compliance was 87% and the mean walking compliance was 166%. After adjusting for baseline PPA, baseline age, sex, baseline comorbidities, baseline cognitive status and baseline falls-related self-efficacy, there was a significant between-group improvement in the overall PPA score (OEP group pre-PPA to post-PPA score: 0.79±1.2 to 0.7±0.9; p<0.05) at study completion. Conclusions Although the OEP-DVD resulted in significant reductions in falls risk among community-dwelling older adults, there was a notable loss to follow-up limiting the feasibility of this

  2. 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.

  3. 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

  4. 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.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  6. [Medication and falls in old age].

    PubMed

    Modreker, M K; von Renteln-Kruse, W

    2009-04-01

    Falls with and without injuries in elderly persons commonly have multiple causes. Exposure to drugs does contribute to these causes. Therefore, complete assessment and evaluation of prescription and over the counter drugs are essential parts of fall-prevention concepts. Frail elderly persons frequently treated with several medications are particularly predisposed to adverse drug effects which may increase the risk of falling. Risk increasing drug effects are dose dependent which have been best studied with psychotropic medication. Apart from psychotropic drugs, cardiovascular drugs contribute to FRIDs (Fall-Risk Increasing Drugs). Fall risk is particularly increased with drugs of the same therapeutic class combined or combinations of psychotropics and cardiovascular drugs. Intervention studies on withdrawal and dose reduction of fall-risk increasing drugs were successful in reducing the risk of falling. There is relatively few knowledge on whether and how drug treatment does decrease fall risk in elderly patients by improving safe mobility and walking ability relevant to activities of daily living.

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

    PubMed

    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 transparentiy 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 Tunguska meteor fall indicates that the event may provide a test of current ozone depletion theories.

  8. Tunguska meteor fall of 1908 - Effects on stratospheric ozone

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  9. 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.

  10. [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.

  11. Executive function is independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke: implications for falls prevention

    PubMed Central

    Liu-Ambrose, Teresa; Pang, Marco; Eng, Janice J

    2015-01-01

    Background Stroke survivors have a high incidence of falls. Impaired executive-controlled processes are frequent in stroke survivors and are associated with falls in this population. Better understanding of the independent association between executive-controlled processes and physiological fall risk (i.e. performances of balance and mobility) could enhance future interventions that aim to prevent falls and to promote an independent lifestyle among stroke survivors. Methods Cross-sectional analysis of 63 adults who suffered a mild stroke >1 year prior to the study, aged > or =50 years. Results Cognitive flexibility was independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke, after accounting for age, quadriceps strength of the paretic side and current physical activity level. Conclusions Clinicians may need to consider cognitive function when assessing and treating impaired balance and mobility in community-dwelling older adults after mild stroke. PMID:17143004

  12. Effects of vitamin D in skeletal muscle: falls, strength, athletic performance and insulin sensitivity.

    PubMed

    Girgis, Christian M; Clifton-Bligh, Roderick J; Turner, Nigel; Lau, Sue Lynn; Gunton, Jenny E

    2014-02-01

    Accompanying the high rates of vitamin D deficiency observed in many countries, there is increasing interest in the physiological functions of vitamin D. Vitamin D is recognized to exert extra-skeletal actions in addition to its classic roles in bone and mineral homeostasis. Here, we review the evidence for vitamin D's actions in muscle on the basis of observational studies, clinical trials and basic research. Numerous observational studies link vitamin D deficiency with muscle weakness and sarcopaenia. Randomized trials predominantly support an effect of vitamin D supplementation and the prevention of falls in older or institutionalized patients. Studies have also examined the effect of vitamin D in athletic performance, both inferentially by UV radiation and directly by vitamin D supplementation. Effects of vitamin D in muscle metabolic function, specifically insulin sensitivity, are also addressed in this review. At a mechanistic level, animal studies have evaluated the roles of vitamin D and associated minerals, calcium and phosphate, in muscle function. In vitro studies have identified molecular pathways by which vitamin D regulates muscle cell signalling and gene expression. This review evaluates evidence for the various roles of vitamin D in skeletal muscle and discusses controversies that have made this a dynamic field of research.

  13. Fall fertilization timing effects on nitrate leaching and turfgrass color and growth.

    PubMed

    Mangiafico, Salvatore S; Guillard, Karl

    2006-01-01

    Fall season fertilization is a widely recommended practice for turfgrass. Fertilizer applied in the fall, however, may be subject to substantial leaching losses. A field study was conducted in Connecticut to determine the timing effects of fall fertilization on nitrate N (NO3-N) leaching, turf color, shoot density, and root mass of a 90% Kentucky bluegrass (Poa pratensis L.), 10% creeping red fescue (Festuca rubra L.) lawn. Treatments consisted of the date of fall fertilization: 15 September, 15 October, 15 November, 15 December, or control which received no fall fertilizer. Percolate water was collected weekly with soil monolith lysimeters. Mean log(10) NO3-N concentrations in percolate were higher for fall fertilized treatments than for the control. Mean NO3-N mass collected in percolate water was linearly related to the date of fertilizer application, with higher NO3-N loss for later application dates. Applying fall fertilizer improved turf color and density but there were no differences in color or density among applications made between 15 October and 15 December. These findings suggest that the current recommendation of applying N in mid- to late November in southern New England may not be compatible with water quality goals.

  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. 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,…

  16. Falls risk assessment.

    PubMed

    Gallacher, Rose

    2017-02-22

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article outlined the causes and consequences of falls for older patients. It discussed the falls risk assessment tools, and falls prevention measures.

  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.

  18. Immobility and falls.

    PubMed

    Mahoney, J E

    1998-11-01

    Immobility is a common problem for hospitalized older adults. Excessive bed rest results in multiple adverse physiologic consequences and may contribute to functional decline and increased risk for falls in the hospital setting. About 2% of hospitalized older adults fall during hospitalization. Risk factors for in-hospital falls includes cognitive impairment, mobility impairment, specific diagnoses, multiple comorbidities, and psychotropic medications. Appropriate actions to prevent immobility and falls include increasing exercise and activity levels, improving the hospital environment, and decreasing the use of psychotropic medications. Bed alarms and increased supervision for high-risk patients also may help prevent falls.

  19. [Physical exercises to prevent falls: a clinical trial with institutionalized elderly in the city of Goiânia in Brazil].

    PubMed

    Sá, Ana Claudia Antonio Maranhão; Bachion, Maria Márcia; Menezes, Ruth Losada de

    2012-08-01

    The scope of this study was to evaluate an intervention program with group physical exercises to prevent falls in the elderly in long-term care institutions. This is a non-randomized clinical trial conducted with 20 institutionalized elderly people in the city of Goiânia in Brazil. The interventions occurred over the period of five months, though the proposed exercise program was based on earlier studies. Standardized measures were used to assess falls, balance and gait, muscle strength, flexibility and fear of falling. After the period of 12 months from the start of intervention there was a significant reduction in the number of falls (p = 0.046). Based on the program, significant differences were observed for point allocation of the maneuvers of balance (p = 0.001), total scores of the maneuvers of balance and gait (p = 0.007), muscle strength of hand grip (p = 0.001) and of lower limbs (p < 0.001), flexibility of movement of shoulder flexion (p = 0.001). The intervention using an exercise program proved to be adequate, albeit insufficient to improve the gait, multiple joint flexibility of the spine and hip and fear of falling, or to reduce the number of elderly people who suffered falls from the beginning of the study.

  20. An analysis of the effect of lower extremity strength on impact severity during a backward fall.

    PubMed

    Sandler, R; Robinovitch, S

    2001-12-01

    At least 280 000 hip fractures occur annually in the U.S. at an estimated cost of $9 billion. While over 90 percent of these are caused by falls, only about 2 percent of all falls result in hip fracture. Evidence suggests that the most important determinants of hip fracture risk during a fall are the body's impact velocity and configuration. Accordingly, protective responses for reducing impact velocity and the likelihood for direct impact to the hip, strongly influence fracture risk. One method for reducing the body's impact velocity and kinetic energy during a fall is to absorb energy in the lower extremity muscles during descent, as occurs during sitting and squatting. In the present study, we employed a series of in verted pendulum models to determine: (a) the theoretical effect of this mechanism on impact severity during a backward fall, and (b) the effect on impact severity of age-related declines (or exercise-induced enhancements) in lower extremity strength. Compared to the case of a fall with zero energy absorption in the lower extremity joints, best-case falls (which involved 81 percent activation of ankle and hip muscles, but only 23 percent activation of knees muscles) involved 79 percent attenuation (from 352 J to 74 J) in the body's vertical kinetic energy at impact (KEv), and 48 percent attenuation (from 3.22 to 1.68 m/s) in the downward velocity of the pelvis at impact (v(v)). Among the mechanisms responsible for this were: (1) eccentric contraction of lower extremity muscles during descent, which resulted in up to 150 J of energy absorption; (2) impact with the trunk in an upright configuration, which reduced the change in potential energy associated with the fall by 100 J; and (3) knee extension during the final stage of descent, which "transferred" up to 90 J of impact energy into horizontal (as opposed to vertical) kinetic energy. Declines in joint strength reduced the effectiveness of mechanisms (1) and (3), and thereby increased impact

  1. GENERALIZATION OF TREADMILL-SLIP TRAINING TO PREVENT A FALL FOLLLOWING A SUDDEN (NOVEL) SLIP IN OVER-GROUND WALKING

    PubMed Central

    Yang, Feng; Bhatt, Tanvi; Pai, Yi-Chung

    2012-01-01

    The purposes of the study were to determine 1) whether treadmill-slip training could reduce the likelihood of falls during a novel slip in over-ground walking, and 2) to what extent such (indirect) training would be comparable to (direct) over-ground-slip training. A treadmill-slip training group (Group A, n=17) initially experienced repeated perturbations on treadmill intended to simulate forward-slip in over-ground walking. Perturbation continued and its intensity reduced when necessary to ensure subjects’ successful adaptation (i.e., when they could land their trailing foot ahead of the slipping foot in at least 3 of 5 consecutive trials). They then experienced a novel slip during over-ground walking. Another 17 young adults in Group B experienced an identical novel slip that served as the controls. They then underwent more slip trials during over-ground walking. Their 16th slip trial was analyzed to represent the over-ground-slip training effect. Eight subjects (47%) in Group A fell upon their first treadmill slip, while all adapted successfully after a minimum of 15 slip trials. Upon the novel slip during over-ground walking, none of them fell in comparison to four subjects (23.5%) fell in Group B upon the same trial (p<0.05). Group A’s control of stability, both proactive and reactive, was significantly better than that of Group B’s on their first over-ground slip, while the level of improvement derived from indirect treadmill training was not as strong as that from direct over-ground-slip training, as demonstrated in Group B’s 16th slip trial (p<0.001). These results clearly demonstrated the feasibility of fall reduction through treadmill-slip training. PMID:23141636

  2. 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,…

  3. 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.

  4. Reducing the fear of falling through a community evidence-based intervention.

    PubMed

    Beauvais, Audrey; Beauvais, John E

    2014-02-01

    Falls and the fear of falling are major health concerns among older adults. The purpose of this study was to assess the effects of an evidence-based fall prevention program on the fear of falling and health-related quality of life among community-dwelling elders. The program consisted of 6 classes that covered topics such as risk factors for falls, balance exercises, medications, safe footwear, and home safety. Of those elders who were most fearful at baseline, the fall prevention program decreased their fear of falling and improved 1 dimension of their health-related quality of life.

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

    PubMed

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

    2008-01-01

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... From the Federal Register Online via the Government Publishing Office UNITED STATES INSTITUTE OF PEACE Announcement of the Fall 2010 Annual Grant Competition Effective October 1, 2010 AGENCY: United... international peace and conflict resolution. The Annual Grant Competition is open to any project that...

  7. The effects of fall-risk-increasing drugs on postural control: a literature review.

    PubMed

    de Groot, Maartje H; van Campen, Jos P C M; Moek, Marije A; Tulner, Linda R; Beijnen, Jos H; Lamoth, Claudine J C

    2013-11-01

    Meta-analyses showed that psychotropic drugs (antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs) and some cardiac drugs (digoxin, type IA anti-arrhythmics, diuretics) are associated with increased fall risk. Because balance and gait disorders are the most consistent predictors of future falls, falls due to use of these so-called fall-risk-increasing drugs (FRIDs) might be partly caused by impairments of postural control that these drugs can induce. Therefore, the effects of FRIDs on postural control were examined by reviewing literature. Electronic databases and reference lists of identified papers were searched until June 2013. Only controlled research papers examining the effects of FRIDs on postural control were included. FRIDs were defined according to meta-analyses as antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs, digoxin, type IA anti-arrhythmics, and diuretics. Ninety-four papers were included, of which study methods for quantifying postural control, and the effects of FRIDs on postural control were abstracted. Postural control was assessed with a variety of instruments, mainly evaluating aspects of body sway during quiet standing. In general, postural control was impaired, indicated by an increase in parameters quantifying body sway, when using psychotropic FRIDs. The effects were more pronounced when people were of a higher age, used psychotropics at higher daily doses, with longer half-lives, and administered for a longer period. From the present literature review, it can be concluded that psychotropic drugs cause impairments in postural control, which is probably one of the mediating factors for the increased fall risk these FRIDs are associated with. The sedative effects of these drugs on postural control are reversible, as was proven in intervention studies where FRIDs were withdrawn. The findings of the present literature review highlight the importance of using psychotropic drugs in the older population only at

  8. Effectiveness of a Community-Based Exercise Program on Balance Performance and Fear of Falling in Older Nonfallers at Risk for Falling: A Randomized, Controlled Study.

    PubMed

    Zhao, Yanan; Chung, Pak-Kwong; Tong, Tomas K

    2016-10-01

    This study evaluated the effectiveness of the community-based Exercise for Balance Improvement Program (ExBP) in improving dynamic balance (DB) and static balance with compromised sensations and reducing fear of falling (FF) among older nonfallers. Sixty-one participants (70 ± 3 years) at risk for falling were randomly allocated to receive ExBP practice for 16 weeks, Tai Chi (TC), or no treatment (CON) with an 8-week follow-up. The ExBP group exhibited significant improvements in DB (2.18, 95% CI = 1.16-3.19), static balance with compromised vision and somatosensation (ECSS; 0.46, 95% CI = 0.06-0.85), and FF (8.65, 95% CI = 0.52-16.8). After the intervention, the ExBP group showed significantly more improvement than did the CON group in DB, static balance with compromised somatosensation, and ECSS. No significant difference was observed between the ExBP and TC groups. Therefore, the ExBP can be applied as an effective alternative exercise regimen for improving balance and fall efficacy for older nonfallers.

  9. Prevention

    MedlinePlus

    ... Is Strong Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... to avoid secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  10. 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.

  11. 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 ...

  12. Characterizing the effective stiffness of the pelvis during sideways falls on the hip.

    PubMed

    Laing, Andrew C; Robinovitch, Stephen N

    2010-07-20

    The force applied to the proximal femur during a fall, and thus hip fracture risk, is dependent on the effective stiffness of the body during impact. Accurate estimates of pelvis stiffness are required to predict fracture risk in a fall. However, the dynamic force-deflection properties of the human pelvis have never been measured in-vivo. Our objectives were to (1) measure the force-deflection properties of the pelvis during lateral impact to the hip, and (2) determine whether the accuracy of a mass-spring model of impact in predicting peak force depends on the characterization of non-linearities in stiffness. We used a sling and electromagnet to release the participant's pelvis from heights up to 5 cm, simulating low-severity sideways falls. We measured applied loads with a force plate, and pelvis deformation with a motion capture system. In the 5 cm trials peak force averaged 1004 (SD 115)N and peak deflection averaged 26.3 (5.1)mm. We observed minimal non-linearities in pelvic force-deflection properties characterized by an 8% increase in the coefficient of determination for non-linear compared to linear regression equations fit to the data. Our model consistently overestimated peak force (by 49%) when using a non-linear stiffness equation, while a piece-wise non-linear fit (non-linear for low forces, linear for loads exceeding 300 N) predicted peak force to within 1% at our highest drop height. This study has important implications for mathematical and physical models of falls, including mechanical systems that assess the biomechanical effectiveness of protective devices aimed at reducing hip fracture risk.

  13. A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing

    PubMed Central

    Arkkukangas, Marina; Johnson, Susanna Tuvemo; Hellström, Karin; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

    2015-01-01

    Objective The aim of this investigation was to study the feasibility of a randomised controlled trial (RCT) based on a multicentre fall prevention intervention including exercise with or without motivational interviewing compared to standard care in community-living people 75 years and older. Method The feasibility of a three-armed, randomised controlled trial was evaluated according to the following: process, resources, management by questionnaire, and treatment outcomes. The outcome measures were fall frequency, physical performance and falls self-efficacy evaluated after three months. Twelve physiotherapists conducted the measurements and treatments and responded to the questionnaire. The first 45 participants recruited to the ongoing RCT were included: 16 individuals in the Otago Exercise Program group (OEP), 16 individuals in the OEP combined with motivational interviewing group (MI), and 13 individuals in the control group. The study was conducted from November 2012 to December 2013. Results The feasibility of the study process, resources and management reached the set goals in most aspects; however, the set goal regarding the MI guide and planned exercise for the participating older people was not completely reached. No significant differences were found between the groups regarding the outcome measures. Conclusion This study confirmed the acceptable feasibility for the study protocol in the ongoing RCT. PMID:26844061

  14. [Accidental falls in the elderly].

    PubMed

    Heinimann, Niklas B; Kressig, Reto W

    2014-06-18

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

  15. Effectiveness of Senior Dance on risk factors for falls in older adults (DanSE): a study protocol for a randomised controlled trial

    PubMed Central

    Franco, Marcia R; Sherrington, Catherine; Tiedemann, Anne; Pereira, Leani S; Perracini, Monica R; Faria, Claudia R S; Pinto, Rafael Z; Pastre, Carlos M

    2016-01-01

    Introduction Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. Methods and analysis This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. Ethics and dissemination Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be

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

    PubMed Central

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

    2015-01-01

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

  17. Effectiveness of bullying and violence prevention programs.

    PubMed

    Stagg, Sharon J; Sheridan, Daniel

    2010-10-01

    Workplace bullying is a significant occupational health problem worldwide. Nurses are vulnerable to workplace bullying. During interactions with staff nurses, occupational health nurses have crucial opportunities to identify victims of workplace bullying and provide effective techniques for preventing and managing workplace bullying behaviors. The purpose of this systematic review was to identify best practices for preventing and managing workplace bullying among staff nurses. The best method found to control and stop workplace bullying involves cognitive rehearsal of responses to common bullying behaviors. Translation of the 3-hour workplace bullying prevention and management program is discussed.

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

    PubMed

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

    2011-06-01

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

  19. 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.

  20. A translational research evaluation of the Stay Active and Independent for Life (SAIL) community-based fall prevention exercise and education program.

    PubMed

    York, Sally C; Shumway-Cook, Anne; Silver, Ilene F; Morrison, A Clare

    2011-11-01

    Falls in older adults are the leading cause of injury hospitalizations and fatalities in the United States; primary risk factors are muscle weakness, impaired mobility, and balance deficits. This article describes the 12-month translational research evaluation of the Stay Active and Independent for Life (SAIL) community-based public health, public domain fall prevention exercise and education program. Recruitment reached the target goal by 154%; 331 adults (mean age = 74.6) attended more than one class (mean classes attended = 24.8, SD = 26.6, range = 1-120) at nine community sites in one county in the 12-month period; 173 completed health and demographic forms, 132 completed program surveys, and 91 completed baseline and follow-up physical function tests. Physical function test results showed significant improvements in strength, balance, and mobility in those who were below normal limits at baseline, and in those who attended classes twice a week or more for more than 2 months. Survey results found that 93% of respondents reported improved performance of daily activities; 92% reported improved strength, balance, fitness, or flexibility; and 80% found the SAIL information guide education component helpful.

  1. Impact of maximal strength training on work efficiency and muscle fiber type in the elderly: Implications for physical function and fall prevention.

    PubMed

    Wang, Eivind; Nyberg, Stian Kwak; Hoff, Jan; Zhao, Jia; Leivseth, Gunnar; Tørhaug, Tom; Husby, Otto Schnell; Helgerud, Jan; Richardson, Russell S

    2017-02-21

    Although aging is typically associated with a decreased efficiency of locomotion, somewhat surprisingly, there is also a reduction in the proportion of less efficient fast-twitch Type II skeletal muscle fibers and subsequently a greater propensity for falls. Maximal strength training (MST), with an emphasis on velocity in the concentric phase, improves maximal strength, the rate of force development (RFD), and work efficiency, but the impact on muscle morphology in the elderly is unknown. Therefore we evaluated force production, walking work efficiency, and muscle morphology in 11 old (72±3years) subjects before and after MST of the legs. Additionally, for reference, the MST-induced morphometric changes were compared with 7 old (74±6years) subjects who performed conventional strength training (CST), with focus on hypertrophy, as well as 13 young (24±2years) controls. As expected, MST in the old improved maximal strength (68%), RFD (48%), and work efficiency (12%), restoring each to a level similar to the young. However, of importance, these MST-induced functional changes were accompanied by a significant increase in the size (66%) and shift toward a larger percentage (56%) of Type II skeletal muscle fibers, mirroring the adaptations in the hypertrophy trained old subjects, with muscle composition now being similar to the young. In conclusion, MST can increase both work efficiency and Type II skeletal muscle fiber size and percentage in the elderly, supporting the potential role of MST as a countermeasure to maintain both physical function and fall prevention in this population.

  2. The effect of potential fall distance on hormonal response in rock climbing.

    PubMed

    Baláš, Jiří; Giles, David; Chrastinová, Leona; Kárníková, Kateřina; Kodejška, Jan; Hlaváčková, Alžběta; Vomáčko, Ladislav; Draper, Nick

    2017-05-01

    The aim of this study was to examine the effect of alterations in potential lead fall distance on the hormonal responses of rock climbers. Nine advanced female climbers completed two routes while clipping all (PRO-all) or half (PRO-½) of the fixed points of protection. Venous blood samples were analysed for total catecholamines, noradrenaline (norepinephrine), adrenaline (epinephrine), dopamine, lactate, cortisol and serotonin. Differences between the two conditions pre, immediately post and 15 min post climbing were assessed using a 2 × 3 repeated measures ANOVA. All hormones and blood lactate concentrations increased significantly (P < 0.05) immediately post climb, except for cortisol. Peak cortisol concentrations did not occur until 15 min post ascent. Further, significant interactions between climbing and clipping conditions were found for total catecholamines (890% of basal concentration in PRO-½ vs. 568% in PRO-all), noradrenaline (794% vs. 532%) and dopamine (500% vs. 210%). There were no significant interactions for adrenaline (1920% vs. 1045%), serotonin (150% vs. 127%) or lactate (329% vs. 279%). The study showed a greater catecholamine response with an increase in potential lead fall distance. The most pronounced increases seen in catecholamine concentration were reported for dopamine and noradrenaline.

  3. Uncovering effective strategies for hearing loss prevention.

    PubMed

    Morata, Thais C; Meinke, Deanna

    2016-04-01

    Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations.

  4. Uncovering effective strategies for hearing loss prevention

    PubMed Central

    Morata, Thais C.; Meinke, Deanna

    2016-01-01

    Occupational health agencies, researchers and policy makers have recognized the need for evidence on the effectiveness of interventions designed to reduce or prevent workplace injuries and illnesses. While many workplaces comply with legal or obligatory requirements and implement recommended interventions, few publications exist documenting the effectiveness of these actions. Additionally, some workplaces have discovered through their own processes, novel ways to reduce the risk of injury. Peer-reviewed information on the effectiveness of the many strategies and approaches currently in use could help correct weaknesses, or further encourage their adoption and expansion. The evaluation of intervention effectiveness would certainly contribute to improved worker health and safety. This need is particularly relevant regarding noise exposure in the workplace and hearing loss prevention interventions. In a 2006 review of the U.S. National Institute for Occupational Safety and Health (NIOSH) Hearing Loss Research Program, the independent National Academies of Sciences recommended that NIOSH place greater emphasis on identifying the effectiveness of hearing loss prevention measures on the basis of outcomes that are as closely related as possible to reducing noise exposure and work related hearing loss (http://www.nap.edu/openbook.php?record_id=11721). NIOSH used two different approaches to address that recommendation: the first one was to conduct research, including broad systematic reviews on the effectiveness of interventions to prevent occupational noise-induced hearing loss. The second was to create an award program, the Safe-In-Sound Excellence in Hearing Loss Prevention Award™, to identify and honor excellent real-world examples of noise control and other hearing loss prevention practices and innovations. PMID:27397968

  5. 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.

  6. Effects of a Novel Fish Transport System on the Health of Adult Fall Chinook Salmon

    SciTech Connect

    Geist, David R.; Colotelo, Alison H.; Linley, Timothy J.; Wagner, Katie A.; Miracle, Ann L.

    2016-12-01

    Movement past hydroelectric dams and related in-river structures has important implications for habitat connectivity and population persistence in migratory fish. A major problem is that many of these structures lack effective fish passage facilities, which can fragment spawning and rearing areas and negatively impact recruitment. While traditional fish passage facilities (e.g., ladders, trap and haul) can effectively enable fish to pass over barriers, their capital or operational costs can be significant. We evaluated the utility of a novel transport device that utilizes a flexible tube with differential internal air pressure to pass fish around in-river barriers. Three treatments and a control group were tested. In two of the treatments, adult fall Chinook Salmon nearing maturation were transported through the device via two lengths of tube (12 or 77 m) and their injury, stress, and immune system responses and reproductive function were compared to a third treatment where fish were moved by a standard trap and haul method and also to a control group. We observed no significant differences among the treatment or control groups in post-treatment adult survival, injury or stress. Indicators of immune system response and reproductive readiness were also not significantly different among the four groups. Egg survival was significantly different among the groups, but the differences were highly variable within groups and not consistent with the duration of treatment or degree of handling. Taken together, the results suggest the device did not injure or alter normal physiological functioning of adult fall Chinook Salmon nearing maturation and may provide an effective method for transporting such fish around in-river barriers during their spawning migration. Keywords: Whooshh, transport, in-stream barriers, hydropower

  7. 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.

  8. 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

  9. 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...

  10. 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...

  11. THE EFFECT OF TRANSFEMORAL INTERFACE DESIGN ON GAIT SPEED AND RISK OF FALLS

    PubMed Central

    Kahle, Jason T.; Klenow, Tyler D.; Sampson, William J.; Highsmith, M. Jason

    2016-01-01

    Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients (n = 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different (p ≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7; 77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket (p ≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients. PMID:28066525

  12. THE EFFECT OF TRANSFEMORAL INTERFACE DESIGN ON GAIT SPEED AND RISK OF FALLS.

    PubMed

    Kahle, Jason T; Klenow, Tyler D; Sampson, William J; Highsmith, M Jason

    2016-09-01

    Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients (n = 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different (p ≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7; 77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket (p ≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients.

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

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2006

    2006-01-01

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

  14. 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…

  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. Evaluation of accelerometer-based fall detection algorithms on real-world falls.

    PubMed

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

    2012-01-01

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

  17. 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.

  18. 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.

  19. Novel Hierarchical Fall Detection Algorithm Using a Multiphase Fall Model

    PubMed Central

    Hsieh, Chia-Yeh; Liu, Kai-Chun; Huang, Chih-Ning; Chu, Woei-Chyn; Chan, Chia-Tai

    2017-01-01

    Falls are the primary cause of accidents for the elderly in the living environment. Reducing hazards in the living environment and performing exercises for training balance and muscles are the common strategies for fall prevention. However, falls cannot be avoided completely; fall detection provides an alarm that can decrease injuries or death caused by the lack of rescue. The automatic fall detection system has opportunities to provide real-time emergency alarms for improving the safety and quality of home healthcare services. Two common technical challenges are also tackled in order to provide a reliable fall detection algorithm, including variability and ambiguity. We propose a novel hierarchical fall detection algorithm involving threshold-based and knowledge-based approaches to detect a fall event. The threshold-based approach efficiently supports the detection and identification of fall events from continuous sensor data. A multiphase fall model is utilized, including free fall, impact, and rest phases for the knowledge-based approach, which identifies fall events and has the potential to deal with the aforementioned technical challenges of a fall detection system. Seven kinds of falls and seven types of daily activities arranged in an experiment are used to explore the performance of the proposed fall detection algorithm. The overall performances of the sensitivity, specificity, precision, and accuracy using a knowledge-based algorithm are 99.79%, 98.74%, 99.05% and 99.33%, respectively. The results show that the proposed novel hierarchical fall detection algorithm can cope with the variability and ambiguity of the technical challenges and fulfill the reliability, adaptability, and flexibility requirements of an automatic fall detection system with respect to the individual differences. PMID:28208694

  20. Common Factors in Effective HIV Prevention Programs

    PubMed Central

    Swendeman, Dallas; Flannery, Diane; Rice, Eric; Adamson, David M.; Ingram, Barbara

    2010-01-01

    We propose a set of common factors in evidence-based interventions (EBI) for HIV prevention, which cut across theoretical models of behavior change. Three existing literatures support this agenda: (1) Common factors in psychotherapy; (2) core elements from the Centers for Disease Control and Prevention EBIs; and (3) component analyses of EBI. To stimulate discussion among prevention researchers, we propose a set of common factors at the highest level of abstraction that describe what all effective programs do: (1) establish a framework to understand behavior change; (2) convey issue-specific and population-specific information necessary for healthy actions; (3) build cognitive, affective, and behavioral self-management skills; (4) address environmental barriers to implementing health behaviors; and (5) provide tools to develop ongoing social and community support for healthy actions. A focus on common factors will enhance research on new HIV prevention interventions, encourage collaboration among researchers, provide guidelines for adapting EBI, and simplify and speed the adoption of EBI for providers. PMID:18830813

  1. 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.

  2. [Fall risk and fracture. Aging and fall/fracture].

    PubMed

    Kozaki, Koichi

    2013-05-01

    Fall deteriorates QOL and ADL of elderly people, especially when they suffer from hip and vertebral fractures. It is not easy to identify the cause of falling, because falling usually result from multiple factors. Among various potential causes, osteoporosis, osteoarthritis, medication of hypnotic drugs, and environmental factors are important, because they are frequent and can be modifiable. When evaluating fall risks, grasping power, one-leg standing time, timed up&go test, are useful. On the other hand, fall risk index, 22-item self-assessment test, is easy and even better in predicting future falls. In the Cochrane systematic review article 2009, exercise such as Tai-Chi, withdrawal of hypnotic drugs, and vitamin D supplementation are shown to prevent falls in community-dwelling elderly.

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

    DOE PAGES

    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

  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. Assisted and Unassisted Falls: Different Events, Different Outcomes, Different Implications for Quality of Hospital Care

    PubMed Central

    Staggs, Vincent S.; Mion, Lorraine C.; Shorr, Ronald I.

    2014-01-01

    Background Many hospitals classify inpatient falls as assisted (if a staff member is present to ease the patient’s descent or break the fall) or unassisted for quality measurement purposes. Unassisted falls are more likely to result in injury, but there is limited research quantifying this effect or linking the assisted/unassisted classification to processes of care. A study was conducted to link the assisted/unassisted fall classification to both processes and outcomes of care, thereby demonstrating its suitability for use in quality measurement. This was only the second known published study to quantify the increased risk of injury associated with falling unassisted (versus assisted), and the first to estimate the effects of falling unassisted (versus assisted) on the likelihood of specific levels of injury. Methods A cross-sectional analysis of falls from all available 2011 data for 6,539 adult medical, surgical, and medical-surgical units in 1,464 general hospitals participating in the National Database of Nursing Quality Indicators® (NDNQI®) was performed. Results Participating units reported 166,883 falls (3.44 falls per 1,000 patient-days). Excluding repeat falls, 85.5% of falls were unassisted. Assisted and unassisted falls were associated with different processes and outcomes: Fallers in units without a fall prevention protocol in place were more likely to fall unassisted than those with a protocol in place (adjusted odds ratio [aOR], 1.39 [95% confidence interval (CI), 1.32, 1.46]), and unassisted falls were more likely to result in injury (aOR, 1.59 [95% CI, 1.52, 1.67]). Conclusions The assisted/unassisted fall classification is associated with care processes and patient outcomes, making it suitable for quality measurement. Unassisted falls are more likely than assisted falls to result in injury and should be considered as a target for future prevention efforts. PMID:25208441

  6. Effect of unequal rise and fall times on the autocorrelation function of a PN sequence

    NASA Astrophysics Data System (ADS)

    Churchill, F. E.

    1990-10-01

    The rise and fall times of a pseudo-noise (PN) waveform are of concern in a short-range, CW radar such as a missile fuze radar. An inequality creates a spurious pair of sidelobes and a spiky ripple on the sidelobes of the autocorrelation function, which may cause false alarms in the radar. Analytical expressions are presented which relate the spurious responses of the autocorrelation function to the waveform rise and fall times.

  7. Functional levels of floor surface roughness for the prevention of slips and falls: clean-and-dry and soapsuds-covered wet surfaces.

    PubMed

    Kim, In-Ju; Hsiao, Hongwei; Simeonov, Peter

    2013-01-01

    Literature has shown a general trend that slip resistance performance improves with floor surface roughness. However, whether slip resistance properties are linearly correlated with surface topographies of the floors or what roughness levels are required for effective slip resistance performance still remain to be answered. This pilot study aimed to investigate slip resistance properties and identify functional levels of floor surface roughness for practical design applications in reducing the risk of slip and fall incidents. A theory model was proposed to characterize functional levels of surface roughness of floor surfaces by introducing a new concept of three distinctive zones. A series of dynamic friction tests were conducted using 3 shoes and 9 floor specimens under clean-and-dry as well as soapsuds-covered slippery wet environments. The results showed that all the tested floor-shoe combinations provided sufficient slip resistances performance under the clean-and-dry condition. A significant effect of floor type (surface roughness) on dynamic friction coefficient (DFC) was found in the soapsuds-covered wet condition. As compared to the surface roughness effects, the shoe-type effects were relatively small. Under the soapsuds-covered wet condition, floors with 50 μm in Ra roughness scale seemed to represent an upper bound in the functional range of floor surface roughness for slip resistance because further increase of surface roughness provided no additional benefit. A lower bound of the functional range for slip resistance under the soapsuds-covered wet condition was estimated from the requirement of DFC > 0.4 at Ra ≅ 17 μm. Findings from this study may have potential safety implications in the floor surface design for reducing slip and fall hazards.

  8. The effects of complex exercise on walking ability during direction change and falls efficacy in the elderly

    PubMed Central

    Song, Hyun Seung; Kim, Jin Young

    2015-01-01

    [Purpose] This study was to assessed the efficacy of a complex exercise program for the elderly, with respect to the effects on walking ability during direction change and on falls efficacy. [Subjects] In total, 40 subjects were selected for this study and assigned randomly to either a complex exercise (n = 20) or a general exercise (n = 20) group. [Methods] The complex exercise consisted of resistance and aerobic exercises. The exercise program was conducted three times a week for eight weeks. We assessed outcome measures of the four square step test, the figure-of-8 walk test, and the falls efficacy scale. [Results] After the intervention, the four step square test, figure-of-8 walk test, and falls efficacy scale values increased significantly in both the complex exercise program and general exercise groups. The complex exercise group showed a more significant improvement than the general exercise group in the figure-of-8 walk test step and falls efficacy scale scores. [Conclusion] Complex exercise improved walking ability during direction change and falls efficacy in elderly individuals. PMID:26157220

  9. Effects of Resistivity and Viscosity on m =0 Rise and Fall Time in the RFP

    NASA Astrophysics Data System (ADS)

    Futch, A. M.; Craig, D.; Hesse, R.; Jacobson, C. M.

    2016-10-01

    In the reversed field pinch (RFP), poloidal mode number m =0 fluctuations are driven in a sawtooth cycle via nonlinear coupling with unstable m =1 tearing modes. We explore how the rise and fall time of these m =0 fluctuations depends on resistivity and viscosity in visco-resistive MHD simulations using the DEBS code. Both the Lundquist number (S) and magnetic Prandtl number (Pr) affect the rise/fall time. Analysis of MST experimental data also shows that both the rise and fall times of the m =0 amplitude vary with S. The variation observed in experiment is consistent with simulation results for rise time, but shows some differences for fall time. Rise time is insensitive to the resistivity profile but depends slightly on the viscosity profile. Fall time is strongly correlated with the duration of the crash which depends on both resistivity and viscosity profiles. These results suggest that the rise and fall time of the m =0 modes at the sawtooth crash is not strongly influenced by the local resistivity near the resonant surface but instead is primarily determined by the overall dynamics of the entire sawtooth cycle. The role of viscosity is less clear though the edge viscosity affects the m =0 evolution more than the core. This work has been supported by the U.S.D.O.E.

  10. 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

  11. Falls and mobility in Parkinson's disease: protocol for a randomised controlled clinical trial

    PubMed Central

    2011-01-01

    Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson's disease, this has not yet been confirmed with a large scale randomised controlled clinical trial. The study will investigate the effects on falls, mobility and quality of life of (i) movement strategy training combined with falls prevention education, (ii) progressive resistance strength training combined with falls prevention education, (iii) a generic life-skills social program (control group). Methods/Design People with idiopathic Parkinson's disease who live at home will be recruited and randomly allocated to one of three groups. Each person shall receive therapy in an out-patient setting in groups of 3-4. Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks. All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase. Assessments will occur before therapy, after the 8 week therapy program, and at 3 and 12 months after the intervention. A falls calendar will be kept by each participant for 12 months after outpatient therapy. Consistent with the recommendations of the Prevention of Falls Network Europe group, three falls variables will be used as the primary outcome measures: the number of fallers, the number of multiple fallers and the falls rate. In addition to quantifying falls, we shall measure mobility, activity limitations and quality of life as secondary outcomes. Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson's disease who live at home. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12606000344594 PMID

  12. [Accidental falls].

    PubMed

    Inokuchi, Koichi

    2013-06-01

    Falls are common cause of injuries among elderly people, and fractures are the most serious consequence of falls. For seniors, hip fractures are the second major cause of bedridden. The feature and acute care of head injury, spinal cord injury, vertebrae fracture, and hip fracture are described. Just had fracture fixation, the patient can not go back to the original ADL. In order not to become bedridden, both medication and physical examination are important based on the new disease concept of locomotive syndrome. To do so, requires hospital and clinic cooperation. Sufficient cooperation is not currently possible, and spread of liaison service is essential.

  13. 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.

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

    PubMed

    Kramlich, Debra L; Dende, Denise

    2016-01-01

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

  15. 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.

  16. A spatial model to assess the effects of hydropower operations on Columbia River fall Chinook Salmon spawning habitat

    USGS Publications Warehouse

    Hatten, James R.; Tiffan, Kenneth F.; Anglin, Donald R.; Haeseker, Steven L.; Skalicky, Joseph J.; Schaller, Howard

    2009-01-01

    Priest Rapids Dam on the Columbia River produces large daily and hourly streamflow fluctuations throughout the Hanford Reach during the period when fall Chinook salmon Oncorhynchus tshawytscha are selecting spawning habitat, constructing redds, and actively engaged in spawning. Concern over the detrimental effects of these fluctuations prompted us to quantify the effects of variable flows on the amount and persistence of fall Chinook salmon spawning habitat in the Hanford Reach. Specifically, our goal was to develop a management tool capable of quantifying the effects of current and alternative hydrographs on predicted spawning habitat in a spatially explicit manner. Toward this goal, we modeled the water velocities and depths that fall Chinook salmon experienced during the 2004 spawning season, plus what they would probably have experienced under several alternative (i.e., synthetic) hydrographs, using both one- and two-dimensional hydrodynamic models. To estimate spawning habitat under existing or alternative hydrographs, we used cell-based modeling and logistic regression to construct and compare numerous spatial habitat models. We found that fall Chinook salmon were more likely to spawn at locations where velocities were persistently greater than 1 m/s and in areas where fluctuating water velocities were reduced. Simulations of alternative dam operations indicate that the quantity of spawning habitat is expected to increase as streamflow fluctuations are reduced during the spawning season. The spatial habitat models that we developed provide management agencies with a quantitative tool for predicting, in a spatially explicit manner, the effects of different flow regimes on fall Chinook salmon spawning habitat in the Hanford Reach. In addition to characterizing temporally varying habitat conditions, our research describes an analytical approach that could be applied in other highly variable aquatic systems.

  17. Students fall for Fall Meeting

    NASA Astrophysics Data System (ADS)

    Smedley, Kara

    2012-02-01

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

  18. Effect of Concentration on Evaporation Rate for Lithium Bromide Aqueous Solution in a Falling Film Heater

    NASA Astrophysics Data System (ADS)

    Matsuda, Akira; Ide, Tetsuo

    Experiments on evaporation for lithium bromide aqueous solution (0-55 wt% LiBr) were made in Summary a externally heated wetted-wall column under reduced pressures. The evaporation rates of 5 and 8 wt% LiBr-water solutions were similar to those of water. The evaporation rates, however, owered with further increase of the concentration of LiBr, and at low feed rates the evaporation rates lowered with decrease of the feed rate because the temperature of the falling film rose. On the other hand, at high feed rates the evaporation rates lowered with increase of feed rates because the heat transfer coefficients of the falling film decreased. Therefore, a maximum evaporation rate existed and it was supposed that there is the optimum feed rate. The experimental data agreed with the values that were calculated numerically based on the unidirectional model that lithium bromide didn't move through falling film.

  19. 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.

  20. Coenzyme Q10: Can It Prevent Statin Side Effects?

    MedlinePlus

    ... Q10: Can it prevent statin side effects? Can coenzyme Q10 reduce the risk of side effects from ... Francisco Lopez-Jimenez, M.D. At this time, coenzyme Q10 isn't universally recommended for preventing side ...

  1. The hard fall effect: high working memory capacity leads to a higher, but less robust short-term memory performance.

    PubMed

    Thomassin, Noémylle; Gonthier, Corentin; Guerraz, Michel; Roulin, Jean-Luc

    2015-01-01

    Participants with a high working memory span tend to perform better than low spans in a variety of tasks. However, their performance is paradoxically more impaired when they have to perform two tasks at once, a phenomenon that could be labeled the "hard fall effect." The present study tested whether this effect exists in a short-term memory task, and investigated the proposal that the effect is due to high spans using efficient facilitative strategies under simple task conditions. Ninety-eight participants performed a spatial short-term memory task under simple and dual task conditions; stimuli presentation times either allowed for the use of complex facilitative strategies or not. High spans outperformed low spans only under simple task conditions when presentation times allowed for the use of facilitative strategies. These results indicate that the hard fall effect exists on a short-term memory task and may be caused by individual differences in strategy use.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  3. How to perform a preplanned process evaluation for complex interventions in geriatric medicine: exemplified with the process evaluation of a complex falls-prevention program for community-dwelling frail older fallers.

    PubMed

    Reelick, Miriam F; Faes, Miriam C; Esselink, Rianne A J; Kessels, Roy P C; Olde Rikkert, Marcel G M

    2011-06-01

    Complex interventions are difficult to develop, document, evaluate, and reproduce. Process evaluations aid the interpretation of outcome results by documenting and evaluating each process step in detail. Despite its importance, process evaluations are not embedded in all evaluations of complex interventions. Based on literature, we structured the process evaluation for trials on complex interventions into 3 main components: (1) the success rate of recruitment and quality of the study population, (2) the quality of execution of the complex intervention, and (3) the process of acquisition of the evaluation data. To clarify these process evaluation components and measures, we exemplified them with the preplanned process evaluation of a complex falls-prevention program for community-dwelling frail older fallers and their informal caregivers. The 3 process evaluation components are operationalized, results are presented, and implications discussed. This process evaluation identified several limitations of the intervention and effect study, and resulted in multiple recommendations for improvement of both the intervention as well as the trial. Thus, a good-quality process evaluation gives a detailed description of the most important components of a complex intervention, resulting in an in-depth insight in the actually performed intervention and effect analysis. This allows us to draw the appropriate conclusions on positive or negative trial results, and results in recommendations for implementation, or adjustment of the intervention or effect evaluation, respectively.

  4. [Transdisciplinary Approach for Sarcopenia. Effect of nutritional support for the prevention of sarcopenia].

    PubMed

    Nishioka, Hiroaki

    2014-10-01

    Sarcopenia is defined as the age-related loss of muscle mass and function. Sarcopenia is closely related with decreased physical function, fall, bone fracture, osteoporosis, and insulin resistance, which lead to increased morbidity and mortality in elderly people. The pathogenesis of sarcopenia is complex and multifactorial, which remains not to be fully understood. Inappropriate food intake and reduced physical activity are known to increase the risk of developing sarcopenia. Resistance training and nutritional support have been shown to be an effective intervention for prevention of sarcopenia. Protein, especially branched chain amino acid, and vitamin D have been reported to improve sarcopenia. The intervention together with nutrition and exercise are more effective.

  5. Marangoni effect on the process of steam absorption into falling film of an aqueous solution of LiBr

    SciTech Connect

    Kashiwagi, Takao . Dept. of Mechanical Systems Engineering); Rie, Dongho . Dept. of Industrial Safety Engineering); Nomura, Tomohiro . Dept. of Mechanical Engineering); Omata, Koji ); Kurosawa, Shigekichi

    1994-03-01

    In most commercial machines, absorption enhancement has been done by adding small various kinds of surfactants, thereby reducing the surface tension of the absorbent solution and generating Marangoni convection near the solution surface during the refrigerant vapor-absorption process. This paper clarifies the most effective conditions of surfactant addition for absorption enhancement in the process of refrigerant vapor absorption into a vertical falling absorbent film. H[sub 2]O/LiBr and n-octanol were used as the refrigerant/absorbent combination and additive. Experiments were carried out by using an LiBr aqueous solution with and without n-octanol dissolution. Moreover, n-octanol vapor was supplied to the absorber in order to clarify the effect of an additive on absorption enhancement. The results of these experiments reveal that the presence of dropwise n-octanol in the surface of the absorbent falling film contributed significantly to the generation of violent and irregular Marangoni convection.

  6. 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.

  7. 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.

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

    USGS Publications Warehouse

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

    1999-01-01

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

  9. Wave dynamics on falling films and its effects on heat/mass transfer

    SciTech Connect

    Chang, H.C.

    1992-12-01

    Wave evolution on a falling film is important in many industrial processes such as fiber coating, paper coating, pollutant scrubbing, etc. If the film flows down a cylindrical fiber, the wave transitions are different from those on a vertical plane. Saturated waves are not observed unless film thickness is below a critical value; if above, the waves grow rapidly to form drops with characteristic dimension close to capillary length scale. Some important open problems in these two wave formation processes were studied.

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

    PubMed

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

    1994-05-01

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

  11. Effects of elastic-band resistance exercise on balance, mobility and gait function, flexibility and fall efficacy in elderly people

    PubMed Central

    Kwak, Cheol-Jin; Kim, You Lim; Lee, Suk Min

    2016-01-01

    [Purpose] The purpose of this study was to analyze the effects of elastic-band resistance exercise on balance, gait function, flexibility and fall efficacy in the elderly people of rural community. [Subjects and Methods] It is selected by 45 outpatients. They have come into the clinic continually to treat of physical therapy at least 1–2 times for a week. A group treated with both general physical therapy and elastic-band resistance exercise (23 patients), and the other group treated with only general physical therapy (22 patients). Elastic-band resistance exercise is composed of 8 movements of lower extremity joints. It is performed for 30 minutes during 8 weeks by 3 times for a week. It is measured and recorded at the pre and post test that sit and reach test (SRT), functional reach test (FRT), timed up and go test (TUG) for every subjects by measurement equipments. And, subjects performed for the form of performance and question as its rated scale by Berg’s balance scale (BBS), dynamic gait index (DGI), activities-specific balance confidence scale (ABC). [Results] In the study, both the elastic-band exercise group and the general physical therapy group showed a significant improvement in balance, gait function, flexibility and fall efficacy. And the group with elastic-band resistance exercise showed more effectiveness than the contrast group in value of variation. [Conclusion] From this study, it was confirmed that elastic-band resistance exercise has influence on balance, gait function, flexibility and fall efficacy are working for agriculture of elderly people of rural community. Based on this result, elastic-band resistance exercise can be better instrument and easier to elderly people of rural community for the improvement in balance, gait function, flexibility and fall efficacy as it performing along with and reciprocal physical therapy. PMID:27942147

  12. 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.

  13. 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…

  14. Effects of the Otago exercise program on fall efficacy, activities of daily living and quality of life in elderly stroke patients

    PubMed Central

    Park, Youngju; Chang, Moonyoung

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of the Otago exercise program on fall efficacy, activities of daily living, and quality of life in elderly stroke patients. [Subjects and Methods] Eight subjects performed the Otago exercise program three times per week, for 8 weeks. The outcome measures were the Fall Efficacy Scale score for fall efficacy, modified Barthel index for activities of daily living, and EQ-5D for quality of life. [Results] In our comparison of the results before and after the intervention, we found that the Otago exercise program improved fall efficacy significantly as well as the score for activities of daily living and quality of life, though not significantly. [Conclusion] We consider that the Otago exercise program is an effective method for improving fall efficacy in elderly stroke patients. PMID:26957755

  15. Effect of intra-articular hyaluronic injection on postural stability and risk of fall in patients with bilateral knee osteoarthritis.

    PubMed

    Khalaj, Nafiseh; Abu Osman, Noor Azuan; Mokhtar, Abdul Halim; George, John; Abas, Wan Abu Bakar Wan

    2014-01-01

    Knee osteoarthritis is a common cause of disability which influences the quality of life. It is associated with impaired knee joint proprioception, which affects postural stability. Postural stability is critical for mobility and physical activities. Different types of treatment including nonsurgical and surgical are used for knee osteoarthritis. Hyaluronic acid injection is a nonsurgical popular treatment used worldwide. The aim of this study was to demonstrate the effect of hyaluronic acid injections on postural stability in individuals with bilateral knee osteoarthritis. Fifty patients aged between 50 and 70 years with mild and moderate bilateral knee osteoarthritis participated in our study. They were categorized into treatment (n = 25) and control (n = 25) groups. The treatment group received five weekly hyaluronic acid injections for both knees, whereas the control group did not receive any treatment. Postural stability and fall risk were assessed using the Biodex Stability System and clinical "Timed Up and Go" test. All the participants completed the study. The treatment group showed significant decrease in postural stability and fall risk scores after five hyaluronic acid injections. In contrast, the control group showed significant increase. This study illustrated that five intra-articular hyaluronic acid injections could significantly improve postural stability and fall risk in bilateral knee osteoarthritis patients. This trial is registered with: NCT02063373.

  16. 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.

  17. 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

  18. A randomized controlled trial on Stroke telerehabilitation: The effects on falls self-efficacy and satisfaction with care.

    PubMed

    Chumbler, Neale R; Li, Xinli; Quigley, Patricia; Morey, Miriam C; Rose, Dorian; Griffiths, Patricia; Sanford, Jon; Hoenig, Helen

    2015-04-01

    We determined the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on falls-related self-efficacy and satisfaction with care. We conducted a prospective, randomized, multisite, single-blinded trial in 52 veterans from three Veterans Affairs Medical Centers. Participants who experienced a stroke in the past 24 months were randomized to the STeleR intervention or usual care. Participants in the intervention arm were administered an exit interview to gather specific patient satisfaction data three months after their final outcome measure. The STeleR intervention consisted of three home visits, five telephone calls, and an in-home messaging device provided over three months to instruct patients in functionally based exercises and adaptive strategies. The outcome measures included Falls Efficacy Scale to measure fall-related self-efficacy and a Stroke-Specific Patient Satisfaction with Care (SSPSC) scale, a measure separated into two subscales (satisfaction with home care and satisfaction with hospital care) was employed to measure the participants' satisfaction. At six months, compared with the usual care group, the STeleR group showed statistically significant improvements in one of the two SSPSC scales (satisfaction with hospital care, p = .029) and approached significance in the second SSPSC scale (satisfaction with home care, p = .077). There were no improvements in fall-related self-efficacy. Core concepts identified were: (a) beneficial impact of the trained assistant; (b) exercises helpful; (c) home use of technology. The STeleR intervention improved satisfaction with care, especially as it relates to care following their experience from the hospital. With the limited resources available for in-home rehabilitation for stroke survivors, STeleR (and especially its exercise components) can be a useful complement to traditional post-stroke rehabilitation.

  19. 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

  20. 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.

  1. 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

  2. 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.

  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. 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…

  5. 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 ...

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    2013-01-01

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

  8. 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.

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

    PubMed

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

    2010-11-01

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

  10. 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

  11. Diapause prevention effect of Bombyx mori by dimethyl sulfoxide.

    PubMed

    Yamamoto, Takayuki; Mase, Keisuke; Sawada, Hiroshi

    2013-01-01

    HCl treatment has been, for about 80 years, the primary method for the prevention of entry into embryonic diapauses of Bombyx mori. This is because no method is as effective as the HCl treatment. In this study, we discovered that dimethyl sulfoxide (DMSO) prevented entry into the diapause of the silkworm, Bombyx mori. The effect of diapause prevention was 78% as a result of treatment with 100% DMSO concentration, and the effect was comparable to that of the HCl treatment. In contrast, in the case of non-diapause eggs, hatchability was decreased by DMSO in a concentration-dependent manner. The effect of DMSO was restricted within 24 hours after oviposition of diapause eggs, and the critical period was slightly shorter than the effective period of the HCl treatment. DMSO analogs, such as dimethyl formamide (DMF) and dimethyl sulfide (DMS), did little preventive effect against the diapause. Furthermore, we also investigated the permeation effects of chemical compounds by DMSO. When treated with an inhibitor of protein kinase CK2 (CK2) dissolved in DMSO, the prevention rate of the diapause was less than 40%. This means that the inhibition effect by the CK2 inhibitor was the inhibition of embryonic development after diapause prevention by DMSO. These data suggest that DMSO has the effects of preventing from entering into the diapause and permeation of chemicals into diapause eggs.

  12. Effect of Stroke on Fall Rate, Location and Predictors: A Prospective Comparison of Older Adults with and without Stroke

    PubMed Central

    Simpson, Lisa A.; Miller, William C.; Eng, Janice J.

    2011-01-01

    Background The literature suggests that stroke is a major risk factor for falls, but there is a lack of prospective, controlled studies which quantify fall-risk after stroke. The purpose of this study was to compare the rates, location and predictors among individuals recently discharged home from stroke rehabilitation to age and sex matched controls. Methodology/Principal Findings A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differences in fall rates and contribution of clinical measures to falls were determined using negative binomial regression. Fall location was compared between groups using χ2 statistics. The rate of falls for individuals with stroke was 1.77 times the rate for the control group. People with stroke were more likely to fall at home. Poorer balance (Berg Balance Scale) was associated with greater falls for both stroke and control groups (incidence rate ratio [IRR]: 0.908 and IRR: 0.877 respectively). A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955) while better walking endurance (Six Minute Walk Test) was associated with greater falls for the controls (IRR: 1.004). Balance confidence was not an independent predictor in either group. Conclusions Individuals recently discharged home are at greater risk of falling than individuals without stroke. Attention to home environment is warranted. Balance function can predict falls for both people with stroke and age and sex matched controls. Increased mobility may increase exposure to fall opportunities. PMID:21559367

  13. 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.

  14. 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.

  15. The effect of pulmonary rehabilitation on mortality, balance, and risk of fall in stable patients with chronic obstructive pulmonary disease.

    PubMed

    Hakamy, Ali; Bolton, Charlotte E; McKeever, Tricia M

    2017-02-01

    The aim of this study is to conduct a systematic review of published studies that evaluate the impact of pulmonary rehabilitation (PR) on survival and fall (including balance) in patients with chronic obstructive pulmonary disease at stability. OVID, Medline, EMBASE, and Cochrane collaboration library were searched for literature dating from January 1980 up to November 2014 as well as an update in October 2015. Two reviewers screened titles, abstracts and full text records, extracted data, and assessed studies for risk of bias; any disagreements were resolved by a third member of the team, and consensus was always sought. Initial searches yielded 3216 records but after review only seven studies were included and there were no studies focused solely on falls. Two cohort studies found some positive benefits of PR on balance, but the results were inconsistent across the studies. Regarding survival, two randomized controlled trials were conducted; one study showed significant survival benefit at 1 year, while the other one showed nonsignificant survival benefit at 3 years. Neither were adequately powered and in both, survival was a secondary outcome. There was only limited inconclusive evidence to show that PR has a significant beneficial effect on balance or survival.

  16. Accident Prevention Through Effective Safety Management.

    DTIC Science & Technology

    1992-01-01

    to a 1.4 percent savings on total job costs. This is a conservative figure and 3 some companies have done substantially better. Exxon Corporation ...three categories in order to establish a favorable atmosphere for safe construction. 4.1.1 Communicatine Safety Goals to Employees A chief executive may...CopisFoESSCCO, 3. :al comte Inspetion I-u,, ofmeigCopies to ECMt, JF arid Meeting Note: AN or1igiis go to the corporate loss-prevention end/or safety

  17. Radiation Therapy: Preventing and Managing Side Effects

    MedlinePlus

    ... who share your problems and concerns. Will side effects limit my activity? Side effects might limit your ... that might irritate the area being treated. Side effects can vary. Your cancer care team can tell ...

  18. Do general relativistic effects limit experiments to test the universality of free fall and the weak equivalence principle?

    NASA Astrophysics Data System (ADS)

    Nobili, Anna M.

    2016-12-01

    The universality of free fall and the weak equivalence principle, which are at the basis of general relativity, have been confirmed to 1 part in 1 013. Space experiments with macroscopic test masses of different composition orbiting Earth inside a low altitude satellite aim to improve this precision by 2 orders of magnitude (with the Microscope satellite launched on April 25, 2016) and up to 4 orders of magnitude (with the Galileo Galilei satellite). At such a high precision, many tiny effects must be taken into account in order to be ruled out as the source of a spurious violation signal. In this work, we investigate the general relativistic effects, including those which involve the rotation of both Earth and the test masses, and show that they are by far too small to be considered even in the most challenging experiment.

  19. ["A matter of balance--Netherlands": an effective intervention to reduce concerns about falls and related avoidance of activity in older people].

    PubMed

    Zijlstra, G A R; van Haastregt, J C M; Kempen, G I J M

    2012-09-01

    Concerns about falls and related avoidance behavior are common among older people and may lead to decreased quality of life, decreased physical and psychosocial functioning, and premature admission to a nursing home. In a randomized controlled trial among 540 community-dwelling older people we studied the feasibility and effects of a cognitive behavioral program on concerns about falls, related avoidance of activity, and falls. Data of the process evaluation obtained from participants in the intervention group (n = 280) and the trainers (n = 6) showed that the program was considered as feasible by the trainers, and positively judged by participants and trainers. Furthermore, participants experienced benefits from attending the program (61% still reported benefits one year after the program). Prior to the start of the program 26% of the participants of the intervention dropped out, yet, among the participants who started the program completion was high (84%). The effect evaluation showed positive outcomes for concerns about falls, related avoidance of activity, and daily activity at 2 months (after the program) when comparing the intervention group with the control group (n = 260). Long-term effects were also shown for, amongst others, concerns about falls and recurrent falls. Following these positive results the cognitive behavioral group program is currently made available to geriatric care settings nationwide in the Netherlands.

  20. 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

  1. Coordinating Care for Falls via Emergency Responders: A Feasibility Study of a Brief At-Scene Intervention

    PubMed Central

    Phelan, Elizabeth A.; Herbert, Julia; Fahrenbruch, Carol; Stubbs, Benjamin A.; Meischke, Hendrika

    2016-01-01

    Falls account for a substantial portion of 9-1-1 calls, but few studies have examined the potential for an emergency medical system role in fall prevention. We tested the feasibility and effectiveness of an emergency medical technician (EMT)-delivered, at-scene intervention to link elders calling 9-1-1 for a fall with a multifactorial fall prevention program in their community. The intervention was conducted in a single fire department in King County, Washington and consisted of a brief public health message about the preventability of falls and written fall prevention program information left at scene. Data sources included 9-1-1 reports, telephone interviews with intervention department fallers and sociodemographically comparable fallers from three other fire departments in the same county, and in-person discussions with intervention department EMTs. Interviews elicited faller recall and perceptions of the intervention, EMT perceptions of intervention feasibility, and resultant referrals. Sixteen percent of all 9-1-1 calls during the intervention period were for falls. The intervention was delivered to 49% of fallers, the majority of whom (75%) were left at scene. Their mean age (N = 92) was 80 ± 8 years; 78% were women, 39% had annual incomes under $20K, and 34% lived alone. Thirty-five percent reported that an EMT had discussed falls and fall prevention (vs. 8% of comparison group, P < 0.01); 84% reported that the information was useful. Six percent reported having made an appointment with a fall prevention program (vs. 3% of comparison group). EMTs reported that the intervention was worthwhile and did not add substantially to their workload. A brief, at-scene intervention is feasible and acceptable to fallers and EMTs. Although it activates only a small percent to seek out fall prevention programs, the public health impact of this low-cost strategy may be substantial. PMID:27990416

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

    PubMed

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

    2008-01-01

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

  3. 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

  4. Effective HIV prevention: the indispensable role of social science.

    PubMed

    Kippax, Susan

    2012-04-26

    This paper examines the ways in which HIV prevention is understood including "biomedical", "behavioural", "structural", and "combination" prevention. In it I argue that effective prevention entails developing community capacity and requires that public health addresses people not only as individuals but also as connected members of groups, networks and collectives who interact (talk, negotiate, have sex, use drugs, etc.) together. I also examine the evaluation of prevention programmes or interventions and argue that the distinction between efficacy and effectiveness is often glossed and that, while efficacy can be evaluated by randomized controlled trials, the evaluation of effectiveness requires long-term descriptive strategies and/or modelling. Using examples from a number of countries, including a detailed account of the Australian HIV prevention response, effectiveness is shown to be dependent not only on the efficacy of the prevention technology or tool but also on the responses of people - individuals, communities and governments - to those technologies. Whether a particular HIV prevention technology is adopted and its use sustained depends on a range of social, cultural and political factors. The paper concludes by calling on biomedical and social scientists to work together and describes a "social public health".

  5. 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.

  6. 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

  7. Prevention

    MedlinePlus

    ... Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox Vaccine Guidance Infection Control: Hospital Infection Control: Home ... Mouth Infection) Poxvirus and Rabies Branch Travelers’ Health: Smallpox & Other Orthopoxvirus-Associated Infections Poxvirus Prevention Recommend on ...

  8. 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...

  9. Age related effects of transitional floor surfaces and obstruction of view on gait characteristics related to slips and falls

    PubMed Central

    Bunterngchit, Yuthachai; Lockhart, Thurmon; Woldstad, Jeffrey C.; Smith, James L.

    2010-01-01

    A laboratory study was conducted to examine gait changes between younger and older subjects as they walked across different floor surfaces. Twenty subjects participated in the experiment (five each of older and younger males and females). For half of the trials, subjects carried light loads that blocked their view of the floor surface immediately in front of them. Subjects walked on slippery (soapy water on vinyl) and stable (outdoor carpet) floor surfaces, as well as transitioning from one surface to another. Responses studied included: required coefficient of friction (RCOF), stride length (SL), and minimum toe clearance (MTC). Significant effects were found for the floor surface, load versus no load condition, and some interactions involving age (older versus younger subjects). Not all expected differences due to age were found in this experiment. The lack of significant differences between younger and older subjects could be due to the older subjects that participated in the experiment. They were volunteers at a local medical center, were in good physical shape, and were probably not typical of the population of people over 65 years of age. Relevance to industry Slips and falls in industry are costly safety issues in terms of human suffering as well as financial compensation. In many facilities and at home, people make transitions from one floor surface to another many times each day, while carrying loads or just walking. A better understanding of characteristics of people as they walk on slippery floor surfaces and the changes that might occur with age, will allow engineers to design better floor surfaces to reduce the incidence of slips and falls. PMID:20607122

  10. Age related effects of transitional floor surfaces and obstruction of view on gait characteristics related to slips and falls.

    PubMed

    Bunterngchit, Yuthachai; Lockhart, Thurmon; Woldstad, Jeffrey C; Smith, James L

    2000-02-01

    A laboratory study was conducted to examine gait changes between younger and older subjects as they walked across different floor surfaces. Twenty subjects participated in the experiment (five each of older and younger males and females). For half of the trials, subjects carried light loads that blocked their view of the floor surface immediately in front of them. Subjects walked on slippery (soapy water on vinyl) and stable (outdoor carpet) floor surfaces, as well as transitioning from one surface to another. Responses studied included: required coefficient of friction (RCOF), stride length (SL), and minimum toe clearance (MTC). Significant effects were found for the floor surface, load versus no load condition, and some interactions involving age (older versus younger subjects). Not all expected differences due to age were found in this experiment. The lack of significant differences between younger and older subjects could be due to the older subjects that participated in the experiment. They were volunteers at a local medical center, were in good physical shape, and were probably not typical of the population of people over 65 years of age. RELEVANCE TO INDUSTRY: Slips and falls in industry are costly safety issues in terms of human suffering as well as financial compensation. In many facilities and at home, people make transitions from one floor surface to another many times each day, while carrying loads or just walking. A better understanding of characteristics of people as they walk on slippery floor surfaces and the changes that might occur with age, will allow engineers to design better floor surfaces to reduce the incidence of slips and falls.

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

    PubMed

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

    2009-10-01

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

  12. 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…

  13. 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…

  14. Effect of viscosity on thermocapillary breakdown of a falling liquid film

    NASA Astrophysics Data System (ADS)

    Zaitsev, D. V.; Semenov, A. A.; Kabov, O. A.

    2016-07-01

    Thermocapillary breakdown of a liquid film flowing due to gravity over a vertical plate with a heater of 150×150 mm is studied in a wide range of liquid properties (in particular, dynamic viscosity at the initial temperature varies from 0.91·10-3 to 16.9·10-3 Pa·s) and film Reynolds number (Re = 0.15-53.5). It is found that liquid viscosity has a significant effect on the threshold heat flux corresponding to film breakdown. To take into account the effect of liquid properties, the breakdown criterion traditionally used in literature was modified. This allowed successful generalization of all data obtained.

  15. Aircraft Survivability: UAVs and Manned Aircraft - Increasing Effectiveness and Survivability, Fall 2002

    DTIC Science & Technology

    2002-01-01

    model to compute helicopter flight dynamics with engine power loss due to combat damage. The resulting model is now a standard analysis tool used in... modeling of physical threat/target interactions that cannot be done within current models such as hydro- dynamic ram filling the dry bay, fire...effectiveness. This article will describe the two models and how they are used on a sequen- tial basis to evaluate network-centric EA approaches

  16. 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.

  17. Understanding and preventing the edge effect.

    PubMed

    Cheneau, Edouard; Wolfram, Roswitha; Leborgne, Laurent; Waksman, Ron

    2003-02-01

    Edge stenosis, combining neointimal proliferation and negative remodeling, remains a serious limitation of vascular brachytherapy. This review comprehensively presents terminology, definitions, mechanisms, and treatment strategies to better understand the complexities of edge narrowing. The major contributors to this phenomenon are known; understanding the practical solutions will enable us to further minimize the problem of the edge effect.

  18. An analysis of the accuracy of wearable sensors for classifying the causes of falls in humans.

    PubMed

    Aziz, Omar; Robinovitch, Stephen N

    2011-12-01

    Falls are the number one cause of injury in older adults. Wearable sensors, typically consisting of accelerometers and/or gyroscopes, represent a promising technology for preventing and mitigating the effects of falls. At present, the goal of such "ambulatory fall monitors" is to detect the occurrence of a fall and alert care providers to this event. Future systems may also provide information on the causes and circumstances of falls, to aid clinical diagnosis and targeting of interventions. As a first step towards this goal, the objective of the current study was to develop and evaluate the accuracy of a wearable sensor system for determining the causes of falls. Sixteen young adults participated in experimental trials involving falls due to slips, trips, and "other" causes of imbalance. Three-dimensional acceleration data acquired during the falling trials were input to a linear discriminant analysis technique. This routine achieved 96% sensitivity and 98% specificity in distinguishing the causes of a falls using acceleration data from three markers (left ankle, right ankle, and sternum). In contrast, a single marker provided 54% sensitivity and two markers provided 89% sensitivity. These results indicate the utility of a three-node accelerometer array for distinguishing the cause of falls.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. On the Effect of Structural Response on the Hydrodynamic Loading of a Free-Falling Wedge

    NASA Astrophysics Data System (ADS)

    Ikeda, Christine; Taravella, Brandon; Judge, Carolyn

    2016-11-01

    High-speed planing craft are subjected to repeated slamming events in waves that can be very extreme depending on the wave topography, impact angle of the ship, forward speed of the ship, encounter angle, and height out of the water. The current work examines this fluid-structure interaction problem through the use of wedge drop experiments and a theoretical prediction. The experimental program consisted of two 20° deadrise angle wedges dropped from a range of heights, 0 . 15 <= H <= 0 . 6 m, while pressures and accelerations of the slam were measured. The first wedge had a rigid bottom, and the second wedge had a flexible bottom. Both experiments are compared with a non-linear boundary value flat cylinder theory in order to determine the effects of flexibility on the hydrodynamic pressure. The code assumes a rigid structure, therefore, the results between the code and the first experiment are in good agreement. The second experiment shows pressure magnitudes that are lower than the predictions due to the energy required to deform the structure. This work is funded by the Office of Naval Research and the state of Louisiana Board of Regents Industrial Ties and Reseach Subprogram.

  4. 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.

  5. Effects of physical activity on cancer prevention.

    PubMed

    Na, Hye-Kyung; Oliynyk, Sergiy

    2011-07-01

    Results of most epidemiological and laboratory studies suggest an inverse relationship between regular exercise and the risk of certain malignancies, such as intestinal, colon, pancreatic, breast, lung, skin, mammary, endometrial, and prostate cancer. However, physical activity can have different influence on carcinogenesis, depending on energy supply and the age of the subject as well as strength, frequency, and length of exercise. The biochemical and molecular basis of the interaction between aerobic physical activity and tumorigenic processes remains poorly understood. Physical activity may generate reactive oxygen species (ROS) to a different extent. Mild oxidative stress caused by moderate physical activity can activate cellular stress response signaling and potentiate cellular antioxidant defense capacity. However, accumulation of relatively large amounts of ROS as a consequence of exhaustive exercise can either directly damage DNA, causing mutation, or promote tumorigenesis by activating proinflammatory signaling. This review highlights the effects of physical activity on various malignancies in the context of redox status modulated during exercise.

  6. Effect of fall-grazed sericea lespedeza (Lespedeza cuneata) on gastrointestinal nematode infections of growing goats.

    PubMed

    Mechineni, A; Kommuru, D S; Gujja, S; Mosjidis, J A; Miller, J E; Burke, J M; Ramsay, A; Mueller-Harvey, I; Kannan, G; Lee, J H; Kouakou, B; Terrill, T H

    2014-08-29

    High prevalence of anthelmintic-resistant gastrointestinal nematodes (GIN) in goats has increased pressure to find effective, alternative non-synthetic control methods, one of which is adding forage of the high condensed tannin (CT) legume sericea lespedeza (SL; Lespedeza cuneata) to the animal's diet. Previous work has demonstrated good efficacy of dried SL (hay, pellets) against small ruminant GIN, but information is lacking on consumption of fresh SL, particularly during the late summer-autumn period in the southern USA when perennial warm-season grass pastures are often low in quality. A study was designed to determine the effects of autumn (September-November) consumption of fresh SL forage, grass pasture (predominantly bermudagrass, BG; Cynodon dactylon), or a combination of SL+BG forage by young goats [intact male Spanish kids, 9 months old (20.7 ± 1.1 kg), n = 10/treatment group] on their GIN infection status. Three forage paddocks (0.40 ha) were set up at the Fort Valley State University Agricultural Research Station (Fort Valley, GA) for an 8-week trial. The goats in each paddock were supplemented with a commercial feed pellet at 0.45 kg/head/d for the first 4 weeks of the trial, and 0.27 kg/head/d for the final 4 weeks. Forage samples taken at the start of the trial were analyzed for crude protein (CP), neutral detergent fiber (NDF), and acid detergent fiber (ADF) content, and a separate set of SL samples was analyzed for CT in leaves, stems, and whole plant using the benzyl mercaptan thiolysis method. Animal weights were taken at the start and end of the trial, and fecal and blood samples were collected weekly for determination of fecal egg counts (FEC) and packed cell volume (PCV), respectively. Adult GIN was recovered from the abomasum and small intestines of all goats at the end of the experiment for counting and speciation. The CP levels were highest for SL forage, intermediate for SL+BG, and lowest for BG forage samples, while NDF and ADF values

  7. 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.

  8. Automated Fall Detection With Quality Improvement “Rewind” to Reduce Falls in Hospital Rooms

    PubMed Central

    Rantz, Marilyn J.; Banerjee, Tanvi S.; Cattoor, Erin; Scott, Susan D.; Skubic, Marjorie; Popescu, Mihail

    2014-01-01

    The purpose of this study was to test the implementation of a fall detection and “rewind” privacy-protecting technique using the Microsoft® Kinect™ to not only detect but prevent falls from occurring in hospitalized patients. Kinect sensors were placed in six hospital rooms in a step-down unit and data were continuously logged. Prior to implementation with patients, three researchers performed a total of 18 falls (walking and then falling down or falling from the bed) and 17 non-fall events (crouching down, stooping down to tie shoe laces, and lying on the floor). All falls and non-falls were correctly identified using automated algorithms to process Kinect sensor data. During the first 8 months of data collection, processing methods were perfected to manage data and provide a “rewind” method to view events that led to falls for post-fall quality improvement process analyses. Preliminary data from this feasibility study show that using the Microsoft Kinect sensors provides detection of falls, fall risks, and facilitates quality improvement after falls in real hospital environments unobtrusively, while taking into account patient privacy. PMID:24296567

  9. 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…

  10. 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…

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

    PubMed Central

    Lockhart, Thurmon E.

    2008-01-01

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

  12. 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.

  13. Effects of body configuration on pelvic injury in backward fall simulation using 3D finite element models of pelvis-femur-soft tissue complex.

    PubMed

    Majumder, Santanu; Roychowdhury, Amit; Pal, Subrata

    2009-07-22

    Injuries due to backward fall apart from sideways fall are a major health problem, particularly among the aged populations. The objectives of this study was to evaluate the responses to changing body configurations (angle between the trunk and impacting floor as 0 degrees, 15 degrees, 45 degrees and 80 degrees) during backward fall, based on a previously developed CT-scan-derived 3D non-linear and non-homogeneous finite element (FE) model of pelvis-femur-soft tissue complex with simplified biomechanical representation of the whole body. Under constant impact energy, these FE models evaluated the pelvic injury situations on the basis of peak impact force (7.64-16.74 kN) and peak principal compressive strain (more than 1.5%), consistent with the clinically observed injuries (sacral insufficiency, coccydynia). Also the change in location of peak strain and increase in peak impact force for changing configurations from 0 degrees to 80 degrees indicated the effect of whole body inertia during backward fall. It was also concluded that the inclusion of sacro-iliac and acetabular cartilages in the above FE models will further reduce above findings marginally (9.2% for 15 degrees fall). These quantifications would also be helpful for a better design and development of safety structures such as safety floor for the nursing home or home for the aged persons.

  14. Effect of Whole Body Vibration Exercise in the Horizontal Direction on Balance and Fear of Falling in Elderly People: A Pilot Study

    PubMed Central

    Shim, ChungSin; Lee, YunBok; Lee, DongGeon; Jeong, BeomHo; Kim, JinBeom; Choi, YoungWoo; Lee, GyuChang; Park, Dong-sik

    2014-01-01

    [Purpose] The purpose of the present study was to investigate the effects of whole body vibration exercise in the horizontal direction on balance and fear of falling in the elderly. [Methods] This study was a case series of 17 elderly individuals. Participants performed whole body vibration exercise in the horizontal direction using a whole body vibration device for 15 minutes a day, 3 times a week, for 6 weeks. At baseline and after the 6-week intervention, balance was measured using the Berg Balance Scale and Timed Up and Go test, and fear of falling was assessed using the Falls Efficacy Scale. [Results] After the intervention, significant improvements from baseline values in the Berg Balance Scale, Timed Up and Go test, and Falls Efficacy Scale were observed in the study participants. [Conclusion] Elderly individuals who performed whole body vibration exercise in the horizontal direction showed significant improvements in balance and fear of falling. However, the observed benefits of whole body vibration exercise in the horizontal direction need to be confirmed by additional studies. PMID:25140102

  15. 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.

  16. 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…

  17. Determining a Cost Effective Sampling Technique Which Will Provide Estimates of the Number of Patrons Utilizing the Purdue General Library During the Fall Semester of 1973.

    ERIC Educational Resources Information Center

    Tolliver, Don L.; Lied, Terry R.

    A study examined the feasibility of developing a cost effective sampling technique which would estimate the mean number of patrons using the Purdue University General Library during one semester. The technique employed, called random sampling without replacement, meant that, from the total population of days in the Fall Semester, particular days…

  18. 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

  19. Falling less in kansas: development of a fall risk reduction toolkit.

    PubMed

    Radebaugh, Teresa S; Bahner, Candace A; Ballard-Reisch, Deborah; Epp, Michael; Hale, Ladonna S; Hanley, Rich; Kendrick, Karen; Rogers, Michael E; Rogers, Nicole L

    2011-01-01

    Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas.

  20. Falling Less in Kansas: Development of a Fall Risk Reduction Toolkit

    PubMed Central

    Radebaugh, Teresa S.; Bahner, Candace A.; Ballard-Reisch, Deborah; Epp, Michael; Hale, LaDonna S.; Hanley, Rich; Kendrick, Karen; Rogers, Michael E.; Rogers, Nicole L.

    2011-01-01

    Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas. PMID:21941655

  1. 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.

  2. "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

  3. [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.

  4. The complex interplay of depression and falls in older adults: a clinical review.

    PubMed

    Iaboni, Andrea; Flint, Alastair J

    2013-05-01

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

  5. Neurology Falls. Patient Falls Risk Assessment, Neurology Clinic, Johns Hopkins Hospital, Baltimore, MD

    DTIC Science & Technology

    2009-07-06

    loss, vision loss, and/or peripheral neuropathy . Level C patients are those who upon examination and history pose a possible fall risk, so appropriate...extremities, sensory loss, vision loss, and peripheral neuropathy . Given this high-risk population, it was imperative that falls are prevented from...settings Neurology Falls 21 (Parkinson’s disease, dementia, diabetic neuropathy , change in vision, gait, sensation or weakness, ageing

  6. 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.

  7. 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…

  8. First Aid: Falls

    MedlinePlus

    ... Your 1- to 2-Year-Old First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A en español Folleto de instructiones: Caídas (Falls) With all the running, climbing, and exploring kids ...

  9. 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

  10. Biomechanical evaluation of injury severity associated with patient falls from bed.

    PubMed

    Bowers, Bonnie; Lloyd, John; Lee, W; Powell-Cope, G; Baptiste, A

    2008-01-01

    This study investigated the severity of injuries associated with falling from bed and the effectiveness of injury-prevention strategies. Injury criteria were calculated for head- and feet-first falls from six bed heights onto a tiled surface and floor mat. These values indicated a 25% chance of experiencing a serious head injury as a result of falling feet-first from a bed height of 97.5 cm onto a tiled surface. Risk of injury increased to 40% when extrapolated for the height added by bedrails. Using a floor mat decreased this risk to less than 1% for bedrail height for feet-first falls. Calculated impact forces indicated a risk of skull fracture when hitting the tiled surface. Floor mats and height-adjustable beds positioned to the lowest height should be used to decrease the risk of injury associated with falling from bed.

  11. Modeling and Cost-Effectiveness in HIV Prevention

    PubMed Central

    Jacobsen, Margo M.; Walensky, Rochelle P.

    2016-01-01

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

  12. Modeling and Cost-Effectiveness in HIV Prevention.

    PubMed

    Jacobsen, Margo M; Walensky, Rochelle P

    2016-02-01

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

  13. 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;…

  14. 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…

  15. Influence of non-spatial working memory demands on reach-grasp responses to loss of balance: Effects of age and fall risk

    PubMed Central

    Westlake, Kelly P.; Johnson, Brian P.; Creath, Robert A.; Neff, Rachel M.; Rogers, Mark W.

    2016-01-01

    Reactive balance recovery strategies following an unexpected loss of balance are crucial to the prevention of falls, head trauma and other major injuries in older adults. While a longstanding focus has been on understanding lower limb recovery responses, the upper limbs also play a critical role. However, when a fall occurs, little is known about the role of memory and attention shifting on the reach to grasp recovery strategy and what factors determine the speed and precision of this response beyond simple reaction time. The objective of this study was to compare response time and accuracy of a stabilizing grasp following a balance perturbation in older adult fallers compared to non-fallers and younger adults while loading the processing demands of non-spatial, verbal working memory. Working memory was engaged with a progressively challenging verb-generation task that was interrupted by an unexpected sideways platform perturbation and a pre-instructed reach to grasp response. Results revealed that the older adults, particularly those at high fall risk, demonstrated significantly increased movement time to handrail contact and grasping errors during conditions in which non-spatial memory was actively engaged. These findings provide preliminary evidence of the cognitive deficit in attention shifting away from an ongoing working memory task that underlies delayed and inaccurate protective reach to grasp responses in older adult fallers. PMID:26979883

  16. Influence of non-spatial working memory demands on reach-grasp responses to loss of balance: Effects of age and fall risk.

    PubMed

    Westlake, Kelly P; Johnson, Brian P; Creath, Robert A; Neff, Rachel M; Rogers, Mark W

    2016-03-01

    Reactive balance recovery strategies following an unexpected loss of balance are crucial to the prevention of falls, head trauma and other major injuries in older adults. While a longstanding focus has been on understanding lower limb recovery responses, the upper limbs also play a critical role. However, when a fall occurs, little is known about the role of memory and attention shifting on the reach to grasp recovery strategy and what factors determine the speed and precision of this response beyond simple reaction time. The objective of this study was to compare response time and accuracy of a stabilizing grasp following a balance perturbation in older adult fallers compared to non-fallers and younger adults while loading the processing demands of non-spatial, verbal working memory. Working memory was engaged with a progressively challenging verb-generation task that was interrupted by an unexpected sideways platform perturbation and a pre-instructed reach to grasp response. Results revealed that the older adults, particularly those at high fall risk, demonstrated significantly increased movement time to handrail contact and grasping errors during conditions in which non-spatial memory was actively engaged. These findings provide preliminary evidence of the cognitive deficit in attention shifting away from an ongoing working memory task that underlies delayed and inaccurate protective reach to grasp responses in older adult fallers.

  17. Moving from Efficacy to Effectiveness Trials in Prevention Research

    PubMed Central

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

    2013-01-01

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

  18. How Effective Homelessness Prevention Impacts the Length of Shelter Spells.

    PubMed

    Goodman, Sarena; Messeri, Peter; O'Flaherty, Brendan

    2014-03-01

    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.

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

    PubMed Central

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

    2012-01-01

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

  20. The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson’s Patients: A Report of Four Cases

    PubMed Central

    BALCI, Nilay Çömük; TONGA, Eda; GÜLŞEN, Mustafa

    2013-01-01

    This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson’s disease. Four patients with Parkinson’s disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson’s Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson’s patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson’s disease patients.

  1. 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

  2. Effects of fall-to-winter changes in habitat and frazil ice on the movements and habitat use of juvenile rainbow trout in a Wyoming tailwater

    USGS Publications Warehouse

    Simpkins, D.G.; Hubert, W.A.; Wesche, T.A.

    2000-01-01

    Overwinter declines in the abundance of small rainbow trout Oncorhynchus mykiss have been observed in a section of the Big Horn River that lies downstream from Boysen Reservoir, where reservoir releases prevent surface ice formation. To provide insight into the possible causes of these declines in abundance, radiotelemetry was used to determine movement and microhabitat use of juvenile (20-25 cm total length) rainbow trout during the fall and winter of 1995-1996. Throughout the fall and winter, both stocked (hatchery) and naturally spawned (wild) fish were generally found in main-channel pools with cover that reduced current velocities to less than 2 cm/s near the bottom and with nearby (<2 m) water velocities that were greater than 15 cm/s. These locations provided refuges from the current, with adjacent flowing water that could deliver drifting aquatic invertebrates. The fish were generally associated with cover that was formed by aquatic vegetation early in the fall, but they shifted to cobble and boulder cover (in deeper water) as the aquatic vegetation decomposed and as winter progressed. Episodes of frazil ice in January and early February were associated with movements of wild fish in the upstream portion of the study area - from normal activity areas to refuges at the bottom of deep pools or under shelf ice in shallow water near shore. Frazil-ice episodes often initiated long-term movements among fish. Our results suggest that changing habitat features from fall to winter and frazil-ice episodes can cause juvenile rainbow trout to move and to modify their habitat use, depending on their location in a tailwater.

  3. 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.

  4. Caffeinated coffee does not acutely affect energy intake, appetite, or inflammation but prevents serum cortisol concentrations from falling in healthy men.

    PubMed

    Gavrieli, Anna; Yannakoulia, Mary; Fragopoulou, Elizabeth; Margaritopoulos, Dimitris; Chamberland, John P; Kaisari, Panagiota; Kavouras, Stavros A; Mantzoros, Christos S

    2011-04-01

    Our aim in this crossover study was to investigate the acute effects of caffeinated and decaffeinated coffee consumption on appetite feelings, energy intake, and appetite-, inflammation-, stress-, and glucose metabolism-related markers. Sixteen healthy men (age range, 21-39 y; BMI range, 19.7-28.6 kg/m(2)) received in a random order on 3 separate occasions a standard breakfast snack with 200 mL of either caffeinated coffee (3 mg caffeine/kg body weight), decaffeinated coffee, or water (control). Before intervention (-15 min) and at standard time points following breakfast consumption (0, 15, 30, 60, 90, 120, 150, and 180 min), participants recorded their appetite feelings and we collected blood samples for measurements of circulating glucose, insulin, cortisol, and appetite- and inflammation-related markers. At 180 min, participants consumed a meal ad libitum. The appetite-related ratings, the appetite plasma hormonal responses as well as the plasma glucose, serum insulin, and plasma and serum inflammatory marker responses did not show an overall intervention effect or a time x intervention interaction. Ad libitum energy intake did not differ among the 3 interventions. However, a significant intervention effect (P = 0.04) and a time x intervention interaction (P-interaction = 0.02) were found for serum cortisol; cortisol concentrations were significantly higher following the caffeinated coffee intervention, compared to control, at 60 min and thereafter. In conclusion, the usually consumed amount of caffeinated coffee does not have short-term effects on appetite, energy intake, glucose metabolism, and inflammatory markers, but it increases circulating cortisol concentrations in healthy men.

  5. 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

  6. 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

  7. 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.

  8. 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.

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

    PubMed Central

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

    2015-01-01

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

  10. 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

  11. Local dynamic stability as a responsive index for the evaluation of rehabilitation effect on fall risk in patients with multiple sclerosis: a longitudinal study

    PubMed Central

    2013-01-01

    Background Gait and balance problems are common in patients with multiple sclerosis, leading to high risk for falls. Local Dynamic Stability (LDS), a non-linear gait stability index, has been advocated as an early indicator of risk for falls. With this longitudinal study over three weeks, we aimed to assess the responsiveness of Local Dynamic Stability to a rehabilitation program and to compare it to other measures. Methods Eighteen patients (mean 54 years, median EDSS score: 5) participated. They were admitted to inpatient rehabilitation and received a three weeks individually tailored program. They performed a 3-minute walking test at the beginning and at the end of the stay, as well as pain, wellbeing, fatigue, and balance assessment. The Local Dynamic Stability was computed from the acceleration signals measured with a 3D-accelerometer. Results At the end of the rehabilitation process, patients reported reduced pain (Effect Size: −0.7), fatigue (ES:-0.6), and increased wellbeing (ES: 1.1). A small positive effect on static balance was observed (ES: 0.3). LDS was improved (ES: 0.6), and the effect was higher than walking speed improvement (ES: 0.4). Conclusions The Local Dynamic Stability seemed responsive to assess rehabilitation effects in patients with multiple sclerosis. It could constitute a valuable gait quality index, which could evaluate potential effects of rehabilitation on fall risk. Trial registration Current Controlled Trials ISRCTN69803702. PMID:23835061

  12. The effect of whole body vibration on balance, mobility and falls in older adults: a systematic review and meta-analysis.

    PubMed

    Lam, Freddy M H; Lau, Ricky W K; Chung, Raymond C K; Pang, Marco Y C

    2012-07-01

    This systematic review aimed to examine the effect of WBV on balance, mobility and falls among older adults. The databases used included MEDLINE, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library Databases of Systematic Reviews, Physiotherapy Evidence Database (PEDro), PubMed, and Science Citation Index (last search in October 2011). Randomized controlled trials that investigated the effect of WBV on balance, mobility or falls in older adults were included in this review. The PEDro score was used to examine the methodological quality of the selected studies. The effect of WBV on balance, mobility and fall-related outcomes were extracted. The data extraction and rating were performed by a researcher and the results were confirmed by the principal investigator. Meta-analysis was done if 3 or more studies measured the same outcome of interest. Among 920 articles screened, fifteen articles (thirteen trials) satisfied the criteria and were included in this review. Methodological quality was good for six of the studies (PEDro score=6-7). Meta-analysis revealed that WBV has a significant treatment effect in Tinetti Total Score (p<0.001), Tinetti Body Balance Score (p=0.010) and Timed-Up-and-Go test (p=0.004). No significant improvement was noted in Tinetti Gait Score after WBV training (p=0.120). The effect of WBV on other balance/mobility outcomes and fall rate remains inconclusive. To conclude, WBV may be effective in improving relatively basic balance ability and mobility among older adults, particularly frailer ones. More good-quality WBV trials are required.

  13. Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults

    PubMed Central

    Hill, Anne-Marie; Etherton-Beer, Christopher; McPhail, Steven M; Morris, Meg E; Flicker, Leon; Bulsara, Max; Lee, Den-Ching; Francis-Coad, Jacqueline; Waldron, Nicholas; Boudville, Amanda; Haines, Terry

    2017-01-01

    Introduction Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care. Methods and analyses The ‘Back to My Best’ study is a multisite, single blind, parallel-group randomised controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participant's length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months. Ethics and dissemination Results will be presented in peer-reviewed journals and at conferences worldwide. This

  14. Circumcision rates in the United States: rising or falling? What effect might the new affirmative pediatric policy statement have?

    PubMed

    Morris, Brian J; Bailis, Stefan A; Wiswell, Thomas E

    2014-05-01

    The objective of this review was to assess the trend in the US male circumcision rate and the impact that the affirmative 2012 American Academy of Pediatrics policy statement might have on neonatal circumcision practice. We searched PubMed for the term circumcision to retrieve relevant articles. This review was prompted by a recent report by the Centers for Disease Control and Prevention that found a slight increase, from 79% to 81%, in the prevalence of circumcision in males aged 14 to 59 years during the past decade. There were racial and ethnic disparities, with prevalence rising to 91% in white, 76% in black, and 44% in Hispanic males. Because data on neonatal circumcision are equivocal, we undertook a critical analysis of hospital discharge data. After correction for underreporting, we found that the percentage had declined from 83% in the 1960s to 77% by 2010. A risk-benefit analysis of conditions that neonatal circumcision protects against revealed that benefits exceed risks by at least 100 to 1 and that over their lifetime, half of uncircumcised males will require treatment for a medical condition associated with retention of the foreskin. Other analyses show that neonatal male circumcision is cost-effective for disease prevention. The benefits of circumcision begin in the neonatal period by protection against infections that can damage the pediatric kidney. Given the substantial risk of adverse conditions and disease, some argue that failure to circumcise a baby boy may be unethical because it diminishes his right to good health. There is no long-term adverse effect of neonatal circumcision on sexual function or pleasure. The affirmative 2012 American Academy of Pediatrics policy supports parental education about, access to, and insurance and Medicaid coverage for elective infant circumcision. As with vaccination, circumcision of newborn boys should be part of public health policies. Campaigns should prioritize population subgroups with lower circumcision

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

    PubMed

    Low, Sabina; Van Ryzin, Mark

    2014-09-01

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

  16. Effects of hydropower operations on spawning habitat, rearing habitat, and standing/entrapment mortality of fall Chinook salmon in the Hanford Reach of the Columbia River

    USGS Publications Warehouse

    Anglin, Donald R.; Haeseker, Steven L.; Skalicky, Joseph J.; Schaller, Howard; Tiffan, Kenneth F.; Hatten, James R.; Hoffarth, Paul; Nugent, John; Benner, David; Yoshinaka, Marv

    2006-01-01

    This report describes research conducted primarily in 2003 and 2004 to evaluate the effects of upstream dam operations on spawning and rearing conditions for fall Chinook salmon, Oncorhynchus tshawytscha, in the Hanford Reach of the Columbia River. Results from habitat modeling tasks which continued in 2005 and 2006 are also included in this report. This study is focused on the effects of streamflows and streamflow fluctuations on 1) entrapment and entrapment mortality of juveniles, 2) adult spawning habitat, and 3) juvenile rearing habitat. An independent peer review was conducted on the draft version of this report utilizing three reviewers, each with different areas of expertise and different levels of knowledge regarding hydrodynamic modeling, fall Chinook biology, life history, and habitat requirements, and fishery issues relating to hydropower development and operations. Peer review comments have been incorporated into this final version.

  17. Fall classification by machine learning using mobile phones.

    PubMed

    Albert, Mark V; Kording, Konrad; Herrmann, Megan; Jayaraman, Arun

    2012-01-01

    Fall prevention is a critical component of health care; falls are a common source of injury in the elderly and are associated with significant levels of mortality and morbidity. Automatically detecting falls can allow rapid response to potential emergencies; in addition, knowing the cause or manner of a fall can be beneficial for prevention studies or a more tailored emergency response. The purpose of this study is to demonstrate techniques to not only reliably detect a fall but also to automatically classify the type. We asked 15 subjects to simulate four different types of falls-left and right lateral, forward trips, and backward slips-while wearing mobile phones and previously validated, dedicated accelerometers. Nine subjects also wore the devices for ten days, to provide data for comparison with the simulated falls. We applied five machine learning classifiers to a large time-series feature set to detect falls. Support vector machines and regularized logistic regression were able to identify a fall with 98% accuracy and classify the type of fall with 99% accuracy. This work demonstrates how current machine learning approaches can simplify data collection for prevention in fall-related research as well as improve rapid response to potential injuries due to falls.

  18. 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

  19. Effects of Flow and Spill on the Migratory Behavior and Survival of Juvenile Fall and Summer Chinook Salmon in John Day Reservior : Annual Report 1987.

    SciTech Connect

    Miller, David R.; Glorgi, Albert E.

    1987-12-01

    Juvenile fall chinook salmon, Oncorhynchus tshawytscha, were freeze branded, coded wire tagged, and released into the Columbia River in the tailrace below McNary Dam during the summers of 1981--1983. The objectives of the study were to examine the effects of river flow on the passage time and migrational behavior of the juveniles and to subsequently assess any relationship to adult survival. This report details adult recovery data to June 1987. 2 refs., 11 tabs.

  20. Effects of Step Length, Age, and Fall History on Hip and Knee Kinetics and Knee Co-contraction during the Maximum Step Length Test

    PubMed Central

    Schulz, Brian W.; Jongprasithporn, Manutchanok; Hart-Hughes, Stephanie J.; Bulat, Tatjana

    2017-01-01

    Background Maximum step length is a brief clinical test involving stepping out and back as far as possible with the arms folded across the chest. This test has been shown to predict fall risk, but the biomechanics of this test are not fully understood. Knee and hip kinetics (moments and powers) are greater for longer steps and for younger subjects, but younger subjects also step farther. Methods To separate effects of step length, age, and fall history on joint kinetics; 14 healthy younger, 14 older non-fallers, and 11 older fallers (27(5), 72(5), 75(6) years respectively) all stepped to the same relative target distances of 20-80% of their height. Knee and hip kinetics and knee co-contraction were calculated. Findings Hip and knee kinetics and knee co-contraction all increased with step length, but older non-fallers and fallers utilized greater stepping hip and less stepping knee extensor kinetics. Fallers had greater stepping knee co-contraction than non-fallers. Stance knee co-contraction of non-fallers was similar to young for shorter steps and similar to fallers for longer steps. Interpretation Age had minimal effects and fall history had no effects on joint kinetics of steps to similar distances. Effects of age and fall history on knee co-contraction may contribute to age-related kinetic differences and shorter maximal step lengths of older non-fallers and fallers, but step length correlated with every variable tested. Thus, declines in maximum step length could indicate declines in hip and knee extensor kinetics and impaired performance on similar tasks like recovering from a trip. PMID:23978310

  1. 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.

  2. 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.

  3. The Fall of Fort Eben Emael: The Effects of Emerging Technologies on the Successful Completion of Military Objectives

    DTIC Science & Technology

    2007-11-02

    Martin Evans, The Fall of France Act With Daring (Oxford: Osprey Publishing, 2000), 4 Fort Eben Emael Before World War I, the Belgian fort...the responsibility of Feldwebel Maier and Section 2, which could not be located. Inside the position, Sergeant Cremers , casement commander, saw the...shattered the gunners inside and put the casement out of action. Two hours later, Sergeant Cremers returned and ordered the gun to resume firing. The

  4. Falls Prevention: Unique to Older Adults

    MedlinePlus

    ... kills the cells in the brain that produce dopamine. Dopamine is a neurotransmitter that allows messages to transfer ... extent by drug treatments that increase the brain’s dopamine levels. Very rarely, surgery may be used, or ...

  5. 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 Review Date 2/8/2015 Updated by: Laura ...

  6. Cost-Effectiveness of Fiscal Policies to Prevent Obesity.

    PubMed

    Moodie, Marj; Sheppard, Lauren; Sacks, Gary; Keating, Catherine; Flego, Anna

    2013-01-01

    Cost-effective, sustainable strategies are urgently required to curb the global obesity epidemic. To date, fiscal policies such as taxes and subsidies have been driven largely by imperatives to raise revenue or increase supply, rather than to change population behaviours. This paper reviews the economic evaluation literature around the use of fiscal policies to prevent obesity. The cost-effectiveness literature is limited, and more robust economic evaluation studies are required. However, uncertainty and gaps in the effectiveness evidence base need to be addressed first: more studies are needed that collect 'real-world' empirical data, and larger studies with more robust designs and longer follow-up timeframes are required. Reliability of cross-price elasticity data needs to be investigated, and greater consideration given to moderators of intervention effects and the sustainability of outcomes. Economic evaluations should adopt a societal perspective, incorporate a broader spectrum of economic costs and consider other factors likely to affect the implementation of fiscal measures. The paucity of recent cost-effectiveness studies means that definitive conclusions about the value for money of fiscal policies for obesity prevention cannot yet be drawn. However, as in other public health areas such as alcohol and tobacco, early indications are that population-level fiscal policies are likely to be potentially effective and cost-saving.

  7. Veterans' fall risk profile: a prevalence study.

    PubMed

    Quigley, Patricia A; Palacios, Polly; Spehar, Andrea M

    2006-01-01

    The Veterans Health Administration (VHA) serves the health care needs of an adult, predominantly male, and aging population. The aging profile of VHA patients is 25% greater than the civilian sector (DVA 2001). Aged patients are at higher risk for falls. In February 2002, 6 VHA medical centers profiled their inpatients' fall risk profile as one aspect of program initiatives targeted at reducing veterans' fall risk and fall-related injuries, participating in a one-day collection of fall risk measurement using the Morse Fall Scale (MFS) for all inpatients (n = 1819), acute and long-term care units. Data results are reported for age, MFS score, and the relationship between age and score, and by type of ward/unit, ie, predominately acute and critical care or long-term care. The results of this prevalence study documented that the veteran inpatient population are at high-risk for anticipated physiological falls. This Veteran Integrated Services Network-wide Deployment of an Evidence-based Program to Prevent Patient Falls study was completed as part of a nationally funded clinical initiative, National Program Initiative 20-006-1.

  8. Veterans’ fall risk profile: a prevalence study

    PubMed Central

    Quigley, Patricia A; Palacios, Polly; Spehar, Andrea M

    2006-01-01

    The Veterans Health Administration (VHA) serves the health care needs of an adult, predominantly male, and aging population. The aging profile of VHA patients is 25% greater than the civilian sector (DVA 2001). Aged patients are at higher risk for falls. In February 2002, 6 VHA medical centers profiled their inpatients’ fall risk profile as one aspect of program initiatives targeted at reducing veterans’ fall risk and fall-related injuries, participating in a one-day collection of fall risk measurement using the Morse Fall Scale (MFS) for all inpatients (n=1819), acute and long-term care units. Data results are reported for age, MFS score, and the relationship between age and score, and by type of ward/unit, ie, predominately acute and critical care or long-term care. The results of this prevalence study documented that the veteran inpatient population are at high-risk for anticipated physiological falls. This Veteran Integrated Services Network-wide Deployment of an Evidence-based Program to Prevent Patient Falls study was completed as part of a nationally funded clinical initiative, National Program Initiative 20-006-1. PMID:18044113

  9. 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.

  10. Effective postoperative pain prevention through administration of bupivacaine and diclofenac.

    PubMed Central

    Hyrkäs, T.; Ylipaavalniemi, P.; Oikarinen, V. J.; Paakkari, I.

    1994-01-01

    The efficacies of bupivacaine and lidocaine together with a preoperatively administered single-dose oral combination of normal- and sustained-release preparations of diclofenac in preventing postoperative pain after third molar removal were compared in a double-blind crossover study. Bilaterally impacted lower third molars were removed in two sessions. Each patient was given one type of local anesthetic on one session and the other in the second. Pain was recorded using a visual analog scale. When the diclofenac combination (150 mg) was given before the operation, postoperative analgesia was better with bupivacaine plus diclofenac than with lidocaine plus diclofenac. Twenty-five out of 40 patients preferred bupivacaine to lidocaine for local anesthesia. It is possible to achieve effective postoperative pain prevention by combining bupivacaine and preoperative normal- and sustained-release preparations of diclofenac. PMID:8629744

  11. Physical therapy approaches to reduce fall and fracture risk among older adults.

    PubMed

    Karinkanta, Saija; Piirtola, Maarit; Sievänen, Harri; Uusi-Rasi, Kirsti; Kannus, Pekka

    2010-07-01

    Falls and fall-related injuries, such as fractures, are a growing problem among older adults, often causing longstanding pain, functional impairments, reduced quality of life and excess health-care costs and mortality. These problems have led to a variety of single component or multicomponent intervention strategies to prevent falls and subsequent injuries. The most effective physical therapy approach for the prevention of falls and fractures in community-dwelling older adults is regular multicomponent exercise; a combination of balance and strength training has shown the most success. Home-hazard assessment and modification, as well as assistive devices, such as canes and walkers, might be useful for older people at a high risk of falls. Hip protectors are effective in nursing home residents and potentially among other high-risk individuals. In addition, use of anti-slip shoe devices in icy conditions seems beneficial for older people walking outdoors. To be effective, multifactorial preventive programs should include an exercise component accompanied by individually tailored measures focused on high-risk populations. In this Review, we focus on evidence-based physical therapy approaches, including exercise, vibration training and improvements of safety at home and during periods of mobility. Additionally, the benefits of multifaceted interventions, which include risk factor assessment, dietary supplements, elements of physical therapy and exercise, are addressed.

  12. Probiotic: effectiveness nutrition in cancer treatment and prevention.

    PubMed

    Kich, Débora Mara; Vincenzi, Angélica; Majolo, Fernanda; Volken de Souza, Claucia Fernanda; Goettert, Márcia Inês

    2016-11-29

    Among the neoplasias, colorectal cancer is one of the leading causes of cancer death in men and women. The increasing incidence of this type of cancer is due to the increase in the population's life expectancy, by the increase in chronic inflammatory bowel diseases, primarily ulcerative colitis and Crohn's disease, and the change in eating habits. The American Cancer Society (2011) shows that diet might be responsible for approximately 30% of cancer cases in developed countries, moreover when considering only colorectal cancer, the number can reach 30% to 50%. Probiotics are effective in the prevention and treatment of many bowel diseases as inflammatory bowel disease (IBD), diarrhea, irritable bowel syndrome, gluten intolerance, gastroenteritis, Helicobacter pyloriinfection, and colon cancer. Classical examples are strains from the Lactobacillus, and Bifidobacteriumgenus that have probiotic proprieties with a potential use in the prophylaxis, as well as in the treatment of a variety of gastrointestinal tract disorders. Researchers are focusing on extremely important studies regarding the possibility of using probiotics to promote a balanced microbiota composition, and a sufficient immunological surveillance system as a way to prevent cancer. Considering the fact that the human intestines host 100 trillion bacteria, including more than 1,000 species, there is still need to perform more in depth investigations in order to find probiotics with potential to prevent, and treat cancerous diseases, adding a very promising effect to this already successful panorama. This revision aims to conduct a review of the most recent studies correlating probiotics and its cancer preventing and treatment potential.

  13. Effect of muscle and post-mortem rate of pH and temperature fall on antioxidant enzyme activities in beef.

    PubMed

    Pastsart, Umaporn; De Boever, Maarten; Claeys, Erik; De Smet, Stefaan

    2013-03-01

    The aim of this study was to investigate the effect of muscle, inner and outer Musculus biceps femoris (IBF and OBF respectively) and Musculus longissimus dorsi (LD), on the post-mortem rate of pH and temperature fall, and the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) during simulated retail display. At day 0 of display (2 days post-mortem), the CAT and GSH-Px activities were lower in IBF than in OBF and LD (P<0.001), and the SOD activity was lower in OBF compared to IBF and LD (P<0.001). At day 10 of display, SOD and CAT activities had decreased in all three muscles compared to day 0 (P<0.001), whereas the GSH-Px activity did increase with time of display. Across muscles, there were significant relationships between temperature fall, colour, lipid and colour stability and antioxidant enzyme activities.

  14. Liability for falls.

    PubMed

    Fiesta, J

    1998-03-01

    Reengineering of roles, inexperienced personnel and poor communications among departments has led to an increase in patient falls--a major source of liability. While health care facilities are not liable for all falls, they are expected to take precautions based on patients' deficits.

  15. 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…

  16. Fall management of eastern gamagrass

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recent research has suggested that eastern gamagrass (EGG) may be an effective alternative to chopped straw in the blended diets of dairy heifers and cows. Most extension materials discussing appropriate fall management of EGG recommend avoiding harvest within 6 weeks of first frost. Using this guid...

  17. Falls and Fall-Related Injuries among Community-Dwelling Adults in the United States

    PubMed Central

    Verma, Santosh K.; Willetts, Joanna L.; Corns, Helen L.; Marucci-Wellman, Helen R.; Lombardi, David A.; Courtney, Theodore K.

    2016-01-01

    Introduction Falls are the leading cause of unintentional injuries in the U.S.; however, national estimates for all community-dwelling adults are lacking. This study estimated the national incidence of falls and fall-related injuries among community-dwelling U.S. adults by age and gender and the trends in fall-related injuries across the adult life span. Methods Nationally representative data from the National Health Interview Survey (NHIS) 2008 Balance and Dizziness supplement was used to develop national estimates of falls, and pooled data from the NHIS was used to calculate estimates of fall-related injuries in the U.S. and related trends from 2004–2013. Costs of unintentional fall-related injuries were extracted from the CDC’s Web-based Injury Statistics Query and Reporting System. Results Twelve percent of community-dwelling U.S. adults reported falling in the previous year for a total estimate of 80 million falls at a rate of 37.2 falls per 100 person-years. On average, 9.9 million fall-related injuries occurred each year with a rate of 4.38 fall-related injuries per 100 person-years. In the previous three months, 2.0% of older adults (65+), 1.1% of middle-aged adults (45–64) and 0.7% of young adults (18–44) reported a fall-related injury. Of all fall-related injuries among community-dwelling adults, 32.3% occurred among older adults, 35.3% among middle-aged adults and 32.3% among younger adults. The age-adjusted rate of fall-related injuries increased 4% per year among older women (95% CI 1%–7%) from 2004 to 2013. Among U.S. adults, the total lifetime cost of annual unintentional fall-related injuries that resulted in a fatality, hospitalization or treatment in an emergency department was 111 billion U.S. dollars in 2010. Conclusions Falls and fall-related injuries represent a significant health and safety problem for adults of all ages. The findings suggest that adult fall prevention efforts should consider the entire adult lifespan to ensure a

  18. Enhanced Estimates of the Influenza Vaccination Effect in Preventing Mortality

    PubMed Central

    Castilla, Jesús; Guevara, Marcela; Martínez-Baz, Iván; Ezpeleta, Carmen; Delfrade, Josu; Irisarri, Fátima; Moreno-Iribas, Conchi

    2015-01-01

    Abstract Mortality is a major end-point in the evaluation of influenza vaccine effectiveness. However, this effect is not well known, since most previous studies failed to show good control of biases. We aimed to estimate the effectiveness of influenza vaccination in preventing all-cause mortality in community-dwelling seniors. Since 2009, a population-based cohort study using healthcare databases has been conducted in Navarra, Spain. In 2 late influenza seasons, 2011/2012 and 2012/2013, all-cause mortality in the period January to May was compared between seniors (65 years or over) who received the trivalent influenza vaccine and those who were unvaccinated, adjusting for demographics, major chronic conditions, dependence, previous hospitalization, and pneumococcal vaccination. The cohort included 103,156 seniors in the 2011/2012 season and 105,140 in the 2012/2013 season (58% vaccinated). Seniors vaccinated in the previous season who discontinued vaccination (6% of the total) had excess mortality and were excluded to prevent frailty bias. The final analysis included 80,730 person-years and 2778 deaths. Vaccinated seniors had 16% less all-cause mortality than those unvaccinated (adjusted rate ratio [RR] = 0.84; 95% confidence interval 0.76–0.93). This association disappeared in the post-influenza period (adjusted RR = 0.96; 95% confidence interval 0.85–1.09). A similar comparison did not find an association in January to May of the 2009/2010 pandemic season (adjusted RR = 0.98; 95% confidence interval 0.84–1.14), when no effect of the seasonal vaccine was expected. On average, 1 death was prevented for every 328 seniors vaccinated: 1 for every 649 in the 65 to 74 year age group and 1 for every 251 among those aged 75 and over. These results suggest a moderate preventive effect and a high potential impact of the seasonal influenza vaccine against all-cause mortality. This reinforces the recommendation of annual influenza vaccination in seniors

  19. Research on the influence factors of the fall efficiency of the hospitalized geriatric patients with cerebrovascular diseases.

    PubMed

    Li, Weili; Cheng, Ruilian

    2016-11-01

    To investigate the fall efficiency and its influence factors of the hospitalized geriatric patients with cerebrovascular diseases. The Modified Fall Efficacy Scale (MFES), Morse Fall Risk Assessment Scales (MFS), Berg Balance Scale (BBS) and Tinetti Gait Analysis (TGA) were adopted and the combined ways of questionnaires and observation were utilized to investigate the 113 hospitalized geriatric patients with cerebrovascular diseases. The fall efficiency of the geriatric patients with cerebrovascular diseases were 7.85±2.57 scores. The two projects "walking up and down stairs" and "taking public transport means" have got the lowest scores; The two projects "stretching out the hand to the box or the drawer for taking something" and "sitting up and down to the chair" have got the highest scores. It was found that there were three factors which had significant influences on the fall efficiency, they were myodynamia of the right upper extremity, Berg balance functions and gait. For the sake of helping the geriatric patients with cerebrovascular diseases to establish the self-confidence of preventing the falls, the medical workers need to take further psychological counseling for the patients and befittingly and specifically to improve the fall efficiency of patients so as to effectively prevent the occurring of the fall on the basis of improving the balance ability and gait of patients.

  20. Prevention in psychiatry: effects of healthy lifestyle on cognition.

    PubMed

    Merrill, David A; Small, Gary W

    2011-03-01

    People are living longer than ever. With greater longevity, a critical question becomes whether or not our memories endure across the life span. This article reviews the common forms of age-related memory change and the emerging evidence related to putative risk and protective factors for brain aging. With increasing awareness of Alzheimer disease and related dementias, patients, families, and clinicians are eager for concise and accurate information about the effects and limitations of preventative strategies related to lifestyle choices that may improve cognitive health.

  1. Reducing Fall Risk with Combined Motor and Cognitive Training in Elderly Fallers

    PubMed Central

    Barban, Francesco; Annicchiarico, Roberta; Melideo, Matteo; Federici, Alessia; Lombardi, Maria Giovanna; Giuli, Simone; Ricci, Claudia; Adriano, Fulvia; Griffini, Ivo; Silvestri, Manuel; Chiusso, Massimo; Neglia, Sergio; Ariño-Blasco, Sergio; Cuevas Perez, Raquel; Dionyssiotis, Yannis; Koumanakos, Georgios; Kovačeić, Milo; Montero-Fernández, Nuria; Pino, Oscar; Boye, Niels; Cortés, Ulises; Barrué, Cristian; Cortés, Atia; Levene, Peter; Pantelopoulos, Stelios; Rosso, Roberto; Serra-Rexach, José Antonio; Sabatini, Angelo Maria; Caltagirone, Carlo

    2017-01-01

    Background. Falling is a major clinical problem in elderly people, demanding effective solutions. At present, the only effective intervention is motor training of balance and strength. Executive function-based training (EFt) might be effective at preventing falls according to evidence showing a relationship between executive functions and gait abnormalities. The aim was to assess the effectiveness of a motor and a cognitive treatment developed within the EU co-funded project I-DONT-FALL. Methods. In a sample of 481 elderly people at risk of falls recruited in this multicenter randomised controlled trial, the effectiveness of a motor treatment (pure motor or mixed with EFt) of 24 one-hour sessions delivered through an i-Walker with a non-motor treatment (pure EFt or control condition) was evaluated. Similarly, a 24 one-hour session cognitive treatment (pure EFt or mixed with motor training), delivered through a touch-screen computer was compared with a non-cognitive treatment (pure motor or control condition). Results. Motor treatment, particularly when mixed with EFt, reduced significantly fear of falling (F(1,478) = 6.786, p = 0.009) although to a limited extent (ES −0.25) restricted to the period after intervention. Conclusions. This study suggests the effectiveness of motor treatment empowered by EFt in reducing fear of falling. PMID:28208604

  2. Calorie restriction mimicking effects of roflumilast prevents diabetic nephropathy.

    PubMed

    Tikoo, Kulbhushan; Lodea, Saritha; Karpe, Pinakin Arun; Kumar, Sandeep

    2014-08-08

    Little is known about role of PDE4 in the development and progression of diabetic nephropathy. Here, we investigated the effect of roflumilast, a selective PDE 4 inhibitor in type 1 diabetic nephropathy. Diabetes was induced in male Sprague-Dawley rats using streptozotocin (55 mg/kg). Diabetic rats showed elevated plasma glucose, blood urea nitrogen, creatinine and decrease in plasma albumin confirming signs of nephropathy. Roflumilast at 2 and 3mg/kg normalized these alterations. Roflumilast also suppressed oxidative stress and deposition of an extracellular matrix protein such as fibronectin and collagen in kidney of diabetic rats. TUNEL assay revealed apoptosis in diabetic kidney than control and that roflumilast prevents this effect. We show that kidney of diabetic rats displayed a state of p-AMPK and SIRT1 deficiency and that roflumilast, interestingly, was able to restore their levels. Further, roflumilast prevented an increase in HO-1 and loss in the FoxO1 expression in diabetes. However, it did not improve the reduced NRF2 levels in diabetes. This is the first report to show that, like resveratrol and other SIRT1 activators, roflumilast also mimics calorie restriction effects through activation of AMPK/SIRT1 and protects against diabetic nephropathy. This study unveils the unexplored potential of roflumilast which can be used in treatment of metabolic disorders.

  3. 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

  4. Cost-effectiveness of alternative strategies to prevent trachomatous blindness.

    PubMed

    Frick, Kevin D; Colchero, M Arantxa

    2002-06-01

    The Alliance for the Global Elimination of Blinding Trachoma was formed in the mid 1990s. The Alliance of country representatives and experts on trachoma suggested a four-pronged approach to eliminate incident trachomatous blindness: surgery for trichiasis, antibiotics to treat the disease, facial cleanliness and environmental improvements to limit disease transmission. The efficacy and effectiveness of the components of this approach have been evaluated, but the strategy as a whole has not been compared with different combinations of its components. The relevant cost-outcome and pharmacoeconomics literature is limited. This article reviews the cost-effectiveness of the approach's components. Furthermore, the article mentions ongoing research that will address the cost-effectiveness of the entire strategy for eliminating a major cause of preventable blindness in the developing world.

  5. 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.

  6. 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.

  7. 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

  8. [Effect of vitamin D on bone mineral density; bone strength and fracture prevention].

    PubMed

    Okuizumi, Hiroyasu; Harada, Atsushi

    2006-07-01

    Although vitamin D improves bone mineral density 0.66% per year at spine site and 1.23% per year at femoral neck site, respectively, vitamin D is useful for preventing osteoporotic fractures, especially hip fractures in the elderly. Vitamin D affects microstructure and bone turnover for osteoporotic bone to become strong bone. And vitamin D improves muscle function to prevent falls in the elderly. Moreover the appropriate amount and treatment target of vitamin D must be considered for the elderly with many different diseases.

  9. 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

  10. Reinterpreting Dissemination of Prevention Programs as Widespread Implementation with Effectiveness and Fidelity.

    ERIC Educational Resources Information Center

    Elias, Maurice J.

    This article urges a reexamination of the concept of dissemination of health-related prevention programs. The article discusses factors that serve as sustaining conditions for dissemination of prevention programs including: (1) the nature of preventive intervention and parameters of effective community-based prevention praxis; (2) aspects of the…

  11. Hospital-based fall program measurement and improvement in high reliability organizations.

    PubMed

    Quigley, Patricia A; White, Susan V

    2013-05-31

    Falls and fall injuries in hospitals are the most frequently reported adverse event among adults in the inpatient setting. Advancing measurement and improvement around falls prevention in the hospital is important as falls are a nurse sensitive measure and nurses play a key role in this component of patient care. A framework for applying the concepts of high reliability organizations to falls prevention programs is described, including discussion of the core characteristics of such a model and determining the impact at the patient, unit, and organizational level. This article showcases the components of a patient safety culture and the integration of these components with fall prevention, the role of nurses, and high reliability.

  12. 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)

  13. 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.

  14. Screening for fall risk in patients with haemophilia.

    PubMed

    Flaherty, L M; Josephson, N C

    2013-05-01

    Many risk factors for falls identified in the general population are found in patients with haemophilia. Furthermore, fall risk increases with age and patients with haemophilia are increasingly entering the over 65 age group. After a fall occurs, there are often behavioural changes that have significant health consequences and further increase fall risk. Fall risk can be quickly assessed in the clinical setting with specific questions in the medical history and by a variety of performance-based screening tools. Identification of fall risk enables early intervention, thereby preventing injury and fear of physical activity, both of which have been associated with falling and may carry an increased risk in patients with haemophilia. Review of the existing literature on assessment of fall risk reveals the importance of screening in the clinical setting, which is commonly done via a fall history and performance-based assessment tools. Selecting appropriate fall risk screening tools is an important step in identifying and providing optimal interventions for those at risk. Assessments of fall history, fear of falling, gait velocity, gait variability and vestibular dysfunction are suggested as screening tools for patients with haemophilia. Additional research is needed to determine the optimal screening, evaluation and treatment techniques for these patients. The longitudinal physical therapy care provided by Haemophilia Treatment Centres presents a unique opportunity for instituting measures that will reduce the incidence of falling in patients with haemophilia.

  15. 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.

  16. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study

    PubMed Central

    Robinovitch, Stephen N; Feldman, Fabio; Yang, Yijian; Schonnop, Rebecca; Lueng, Pet Ming; Sarraf, Thiago; Sims-Gould, Joanie; Loughin, Marie

    2012-01-01

    more valid and effective approaches for balance assessment and fall prevention in long-term care. PMID:23083889

  17. 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.

  18. Preventive Effect of Salicylate and Pyridoxamine on Diabetic Nephropathy

    PubMed Central

    Abouzed, Tarek Kamal; Munesue, Seiichi; Harashima, Ai; Masuo, Yusuke; Kato, Yukio; Khailo, Khaled; Yamamoto, Hiroshi

    2016-01-01

    Objective. Diabetic nephropathy is a life-threatening complication in patients with long-standing diabetes. Hemodynamic, inflammatory, and metabolic factors are considered as developmental factors for diabetic nephropathy. In this study, we evaluated whether pharmacological interventions with salicylate, compared to pyridoxamine, could prevent diabetic nephropathy in mice. Methods. Male mice overexpressing inducible nitric oxide synthase in pancreatic β-cells were employed as a diabetic model. Salicylate (3 g/kg diet) or pyridoxamine (1 g/L drinking water; ~200 mg/kg/day) was given for 16 weeks to assess the development of diabetic nephropathy. Treatment with long-acting insulin (Levemir 2 units/kg twice a day) was used as a control. Results. Although higher blood glucose levels were not significantly affected by pyridoxamine, early to late stage indices of nephropathy were attenuated, including kidney enlargement, albuminuria, and increased serum creatinine, glomerulosclerosis, and inflammatory and profibrotic gene expressions. Salicylate showed beneficial effects on diabetic nephropathy similar to those of pyridoxamine, which include lowering blood glucose levels and inhibiting macrophage infiltration into the kidneys. Attenuation of macrophage infiltration into the kidneys and upregulation of antiglycating enzyme glyoxalase 1 gene expression were found only in the salicylate treatment group. Conclusions. Treatment with salicylate and pyridoxamine could prevent the development of diabetic nephropathy in mice and, therefore, would be a potentially useful therapeutic strategy against kidney problems in patients with diabetes. PMID:28042580

  19. Effects of a Comprehensive Police Suicide Prevention Program

    PubMed Central

    Mishara, Brian L.; Martin, Normand

    2012-01-01

    Background: Police suicides are an important problem, and many police forces have high rates. Montreal police suicide rates were slightly higher than other Quebec police rates in the 11 years before the program began (30.5/100,000 per year vs. 26.0/100,000). Aims: To evaluate Together for Life, a suicide prevention program for the Montreal police. Methods: All 4,178 members of the Montreal police participated. The program involved training for all officers, supervisors, and union representatives as well as establishing a volunteer helpline and a publicity campaign. Outcome measures included suicide rates, pre-post assessments of learning, focus groups, interviews, and follow-up of supervisors. Results: In the 12 years since the program began the suicide rate decreased by 79% (6.4/100,000), while other Quebec police rates had a nonsignificant (11%) increase (29.0/100,000). Also, knowledge increased, supervisors engaged in effective interventions, and the activities were highly appreciated. Limitations: Possibly some unidentified factors unrelated to the program could have influenced the observed changes. Conclusions: The decrease in suicides appears to be related to this program since suicide rates for comparable populations did not decrease and there were no major changes in functioning, training, or recruitment to explain the differences. Comprehensive suicide prevention programs tailored to the work environment may significantly impact suicide rates. PMID:22450038

  20. Preventive Effect of Salicylate and Pyridoxamine on Diabetic Nephropathy.

    PubMed

    Abouzed, Tarek Kamal; Munesue, Seiichi; Harashima, Ai; Masuo, Yusuke; Kato, Yukio; Khailo, Khaled; Yamamoto, Hiroshi; Yamamoto, Yasuhiko

    2016-01-01

    Objective. Diabetic nephropathy is a life-threatening complication in patients with long-standing diabetes. Hemodynamic, inflammatory, and metabolic factors are considered as developmental factors for diabetic nephropathy. In this study, we evaluated whether pharmacological interventions with salicylate, compared to pyridoxamine, could prevent diabetic nephropathy in mice. Methods. Male mice overexpressing inducible nitric oxide synthase in pancreatic β-cells were employed as a diabetic model. Salicylate (3 g/kg diet) or pyridoxamine (1 g/L drinking water; ~200 mg/kg/day) was given for 16 weeks to assess the development of diabetic nephropathy. Treatment with long-acting insulin (Levemir 2 units/kg twice a day) was used as a control. Results. Although higher blood glucose levels were not significantly affected by pyridoxamine, early to late stage indices of nephropathy were attenuated, including kidney enlargement, albuminuria, and increased serum creatinine, glomerulosclerosis, and inflammatory and profibrotic gene expressions. Salicylate showed beneficial effects on diabetic nephropathy similar to those of pyridoxamine, which include lowering blood glucose levels and inhibiting macrophage infiltration into the kidneys. Attenuation of macrophage infiltration into the kidneys and upregulation of antiglycating enzyme glyoxalase 1 gene expression were found only in the salicylate treatment group. Conclusions. Treatment with salicylate and pyridoxamine could prevent the development of diabetic nephropathy in mice and, therefore, would be a potentially useful therapeutic strategy against kidney problems in patients with diabetes.

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. Fungal diversity of Norway spruce litter: effects of site conditions and premature leaf fall caused by bark beetle outbreak.

    PubMed

    Przybył, K; Karolewski, P; Oleksyn, J; Labedzki, A; Reich, P B

    2008-08-01

    Fungi play an important role in leaf litter decomposition due to their ability to break down the lignocellulose matrix, which other organisms are unable to digest. However, little is known regarding the factors affecting components of fungal diversity. Here, we quantified richness of internal fungi in relation to litter nutrient and phenolic concentrations, sampling season (spring or fall), and premature leaf shedding due to low precipitation and infestation of bark beetles (mainly Ips typographus and Ips duplicatus). The study was conducted in 37-year-old Norway spruce [Picea abies (L.) Karst.] stands, with three plots each in mixed forest (MF) and coniferous forest (CF) site conditions in south-central Poland. Fifty-four species of sporulating fungi were identified in 2,330 freshly fallen needles sampled during 2003-2005, including 45 species in MF and 31 in CF. The significantly higher number of species in MF was likely related to moister conditions at that site. Among isolated fungi, 22% (12 species) were identified as endophytes of Norway spruce in prior studies. During spring of 2005, we found less than half the number of isolates and fungal species at each forest site as compared to fall for the two prior years. This pattern was observed in typical soil fungi (e.g., Penicillium daleae, Penicillium purpurogenum) and endophytes/epiphytes (e.g., Aureobasidium pullulans, Alternaria alternata, Cladosporium spp., and Lophodermium piceae). Premature shedding of needles was the most likely cause of this decline because it shortened the time period for fungi to infect green needles while on the tree. For all sites and sampling periods, richness of internal fungi was strongly and positively related to the age of freshly fallen litter (assessed using needle Ca concentration as a needle age tracer) and was also negatively related to litter phenolic concentration. Richness of internal fungi in freshly fallen litter may be adversely affected by low soil moisture status

  6. [The biological effects of a nuclear explosion. Introduction of a new system on a colorimetric scale (black, grey, red, orange, yellow and white zone) to estimate the effects of fall-out on civilian populations].

    PubMed

    Nacci, G

    2002-08-01

    Following September 11 the eventuality of terrorist attacks using bags containing nuclear devices is considered possible in western cities like New York, London, Paris, Rome, Berlin, Moscow etc. However, with a modern Civil Defence programme the effects of a catastrophe of this nature can be partially limited, at least as far as Fall-out is concerned. The present paper explains the medical reasons for building anti-fall-out shelters for the larger part of western populations: from the USA to Russia. The paper also sets out a new method for classifying levels of radioactive Fall-out based on a scale of colours (black, grey, red, orange, yellow and white) whatever kind of radioactivity is involved (total gamma levels, Cesium 137 levels, Strontium 90 levels). The arrival times for fall-out in each area of the scale are fixed, whatever the energy of the explosion and the speed of the wind might be. The radioactive decay in each area of the scale, from the time of arrival of the fall-out is described with precision. Also described are the acute radiation syndrome, tumours, miscarriages and genetic diseases. A nomogram is attached for civil defence purposes showing the leeward extension of these areas, easily measurable in just a few minutes, if four parameters are known: ground zero (locality) of the explosion, the energy of the explosion, the direction of the wind and the speed of the wind.

  7. Effective fall treatment of Varroa jacobsoni (Acari: Varroidae) with a new formulation of formic acid in colonies of Apis mellifera (Hymenoptera: Apidae) in the northeastern United States.

    PubMed

    Calderone, N W

    2000-08-01

    New formulations of formic acid and thymol, both individually and in combination with various essential oils, were compared with Apistan to determine their efficacy as fall treatments for control of Varroa jacobsoni (Oudemans), a parasitic mite of the honey bee, Apis mellifera L. Percent mite mortality in colonies treated with 300 ml of 65% formic acid averaged 94.2 +/- 1.41% (least square means +/- SE, n = 24), equivalent to those receiving four, 10% strips of Apistan (92.6 +/- 1.79%, n = 6). Treatment with thymol (n = 24) resulted in an average mite mortality of 75.4 +/- 5.79%, significantly less than that attained with Apistan or formic acid. The addition of essential oils did not affect treatment efficacy of either formic acid or thymol. The ratio of the coefficients of variation for percentage mortality for the formic acid (CVFA) and Apistan (CVA) groups was CVFA/CVA = 0.66. This indicates that the formic acid treatment was as consistent as the Apistan treatment. Thymol treatments did not provide as consistent results as Apistan or formic acid. Coefficient variation ratios for percentage mortality for the thymol group (CVT) with the Apistan and formic acid groups were CVT/CVA = 4.47 and CVT/CVFA = 6.76, respectively. In a second experiment, colonies received a 4-wk fall treatment of either 300 ml of 65% formic acid (n = 24) or four, 10% strips of Apistan (n = 6). The next spring, mite levels in the formic acid group (554.3 +/- 150.20 mites) were similar to those in the Apistan treatment group (571.3 +/- 145.05 mites) (P = 0.93). Additionally, the quantities of bees, brood, pollen, and nectar/honey in the two treatment groups were not significantly different (P > or = 0.50 each variable). These results suggest that formic acid is an effective alternative to Apistan as a fall treatment for varroa mites in temperate climates.

  8. 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

  9. 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

  10. Preventive effect of selenium on T-2 toxin membrane toxicity.

    PubMed

    Keshavarz, S A; Memarbashi, A; Balali, M

    2001-01-01

    T-2 toxin, one of the major toxic trichothecene mycotoxines, has been shown to cause effects such as inhibition of protein synthesis and impairement of mitochondrial function. The use of T-2 toxin as chemical warfare in south east Asia and Iran has been reported . It has been suggested that T-2 toxin may mediate its toxic effect via the cell membrane, but mechanism of action is poorly understood. In cytotoxicity studies, erythrocytes are an excellent model system. In the present study different doses of sodium selenite were injected into male albino mice for 6 days every 48 h. Blood samples were taken from experimental and control groups (normal saline). The red cells were counted in isotonic phosphate buffer containing different doses of T-2 toxin. The mixture was incubated at 37 degrees C for 4 h. The results indicate that selenium is able to prevent erythrocyte membrane damage induced by T-2 toxin. The protective effect of selenium may be due to its membrane stabilizing properties, although inhibition of lipid peroxidation is likely, too.

  11. 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

  12. Thumbsucking and falling asleep.

    PubMed

    Ozturk, M; Ozturk, O M

    1977-03-01

    A review of the studies on the aetiology of habitual thumbsucking reveals either contradictory or inconclusive results. In this study carried out in Turkey, 50 thumbsuckers, 50 non-thumbsuckers, 250 school children and 312 'problem' children were investigated through interviews, questionnaires and other clinical techniques with their mothers. Among variables studied were aspects of feeding, onset and incidence of thumbsucking, strength of sucking drive, sex distribution, educational level and occupation of mothers, parental attitudes toward physical contact with children, mother-child relationships, and particular forms of falling asleep. It was found that thumbsucking was aetiologically more related to ways of falling asleep than to other factors. An attempt was made to explain the social, psychological and physiological basis of the aetiological significance of the falling asleep-stage in habitual thumbsucking. These findings now permit predictive longitudinal investigations to test this accuracy.

  13. 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

    2014-01-01

    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 three-arm randomised controlled trial (RCT) with frail older people in a residential care setting to test the hypothesis that a 14-week modified tai chi or yoga programme 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.

  14. 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.

  15. Preventive effects of different probiotic formulations on travelers' diarrhea model in wistar rats : preventive effects of probiotics on TD.

    PubMed

    Bisson, Jean-François; Hidalgo, Sophie; Rozan, Pascale; Messaoudi, Michaël

    2010-04-01

    A new animal model of travelers' diarrhea has been developed by infecting rats orally with a strain of enterotoxigenic Escherichia coli in order to assess the efficacy of three probiotic formulations for the prevention of travelers' diarrhea. Five groups of six rats were given daily (by oral gavage) either a placebo (negative and positive control groups), the suspension of bacterial probiotics called FF1, the yeast probiotic Saccharomyces boulardii, or a combination of both, called Protecflor(TM). After 14 days of treatment, all groups except the negative control one were infected by oral administration of E. coli. Body temperature, body weight, food and water consumption, stools consistency, behavior, and cytokines secretion were disturbed following E. coli infection. Probiotics-treated groups generally displayed less-pronounced symptoms, the combination of probiotics Protecflor(TM) being the most effective.

  16. Fatal falls among Hispanic construction workers.

    PubMed

    Dong, Xiuwen Sue; Fujimoto, Alissa; Ringen, Knut; Men, Yurong

    2009-09-01

    This study evaluated occupational deaths resulting from fall injuries among Hispanic construction workers using data from the Census of Fatal Occupational Injuries and the Current Population Survey. The demographics and characteristics of fatal falls among Hispanic workers were examined and compared with that of their white, non-Hispanic counterparts. The results show that fatal injuries among Hispanic construction workers were more likely to be caused by a fall than their white, non-Hispanic counterparts (OR=1.48, 95% CI: 1.05-2.10) after controlling for possible confounders. The rate of fatal falls for foreign-born Hispanic construction workers was 5.5 per 100,000 FTE, which is significantly higher than 4.1 per 100,000 FTE for Hispanic workers who were born in the U.S. (OR=1.36, 95% CI: 1.08-1.67). The disparities in fatal injuries from falls were found in age groups, job tenure, occupations, and types of construction projects. This study also found that about every two of three fatal falls in construction occurred in establishments with 10 or fewer employees. More prevention, intervention, and training measures must be applied to Hispanic workers, especially those who are new immigrants. OSHA enforcements should target small construction establishments in order to lower overall fatality rates, costs, and unnecessary losses of life.

  17. Prevention of dental caries: A review of effective treatments

    PubMed Central

    Sicca, Claudio; Bobbio, Elena; Quartuccio, Natale; Nicolò, Giovanni

    2016-01-01

    Background The objective of this study is to review medical and non medical treatments for prevention of caries. Material and Methods A comprehensive literature search of the most relevant and updated published studies from 01/01/2002 through December 2015 in PubMed/MEDLINE, Embase and Scopus databases regarding the efficacy of strategies and treatments aiming to prevent the development of caries was performed selecting papers on the basis of the Evidence-based Medicine Criteria. Results We identified thirty systematic reviews on prevention of caries. Analyzing the data the retrieved literature, performance of prevention treatments seems to be high. Conclusions Prevention treatments may have a relevant impact on the avoiding the development of caries planning. Key words:Dental caries, prevention, fluoride. PMID:27957278

  18. 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

  19. 46 CFR 199.153 - Survival craft launching and recovery arrangements using falls and a winch.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and onto the drums at the same rate when hoisting. (g) Each fall, where exposed to damage or fouling... the falls or davits, unless the motor is designed to prevent such overstressing. (l) Each...

  20. 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

  1. Development of a wearable-sensor-based fall detection system.

    PubMed

    Wu, Falin; Zhao, Hengyang; Zhao, Yan; Zhong, Haibo

    2015-01-01

    Fall detection is a major challenge in the public healthcare domain, especially for the elderly as the decline of their physical fitness, and timely and reliable surveillance is necessary to mitigate the negative effects of falls. This paper develops a novel fall detection system based on a wearable device. The system monitors the movements of human body, recognizes a fall from normal daily activities by an effective quaternion algorithm, and automatically sends request for help to the caregivers with the patient's location.

  2. Analysis of reasons for falls of hemiparetic inpatient rehabilited patients.

    PubMed

    Kwolek, Andrzej; Lewicka, Krystyna

    2002-10-30

    Background. Patients undergoing rehabilitation in rehablitation wards particulary those focused on geriatry or neurology are expose to falls.It is connected with advanced age and also their illness essence.
    This kind of falls appears to be very important problem because some of them could lead to severe physical contusion or loss of trust in own ability and fear against the activities.
    The aim of this study was to analyse incidence of falls in all groups of patients rehabilited in the ward, the causes of falls and consequences of them and estabilshing the preventional rules for hemiparetic patients after stroke or operated brain's tumors.
    Material and methods. The prospective study was conducted during 2000 year. We used erlier prepared record of falls included data conected with age, diagnosis, day of hospitalisation, causes, circumstances and consequences of falls.
    Results. Among 724 observed inpatient rehabilited patients falled 46 persons what is 6,3%.
    The most often falls concerned hemiparetic patients (8,7% rehabilited patients).
    In group with patients after cranio-cerebral trauma falls were registered in 18,1% rehabilited. Walking without support was the most frequent circumstance of falls (27%).
    In 9 % of falled patients suffered from consequences as local petechie, swellings, tenderness of soft tissue whereas 1 patient needed to be transfered and observated in traumatic ward after fall.
    Conclusions. From this analysis come that restriction of ussing sleeping and psychotropic pills, creation of save enviroment, isolation of group of patients predisponated to falls are very important factors in prevention of falls.

  3. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk.

    PubMed

    Zia, Anam; Kamaruzzaman, Shahrul Bahyah; Tan, Maw Pin

    2015-04-01

    The term polypharmacy has negative connotations due to its association with adverse drug reactions and falls. This spectrum of adverse events widens when polypharmacy occurs among the already vulnerable geriatric population. To date, there is no consensus definition of polypharmacy, and diverse definitions have been used by various researchers, the most common being the consumption of multiple number of medications. Taking multiple medications is considered a risk factor for falls through the adverse effects of drug-drug or drug-disease interactions. Falls studies have determined that taking ≥ 4 drugs is associated with an increased incidence of falls, recurrent falls, and injurious falls. In light of existing evidence, careful and regular medication reviews are advised to reduce the effect of polypharmacy on falls. However, intervention studies on medication reviews and their effectiveness on falls reduction have been scarce. This article reviews and discusses the evidence behind polypharmacy and its association with falls among older individuals, and highlights important areas for future research.

  4. Workplace Safety and Health Topics: Safety & Prevention

    MedlinePlus

    ... Equipment Design in Mining Ergonomic Interventions in the Building, Repair, and Dismantling of Ships Eye Safety Fall Injuries Prevention Green, Safe, and Healthy Jobs - Prevention through Design Hierarchy ...

  5. Effectiveness of Diabetes Prevention Program translations among African Americans.

    PubMed

    Samuel-Hodge, C D; Johnson, C M; Braxton, D F; Lackey, M

    2014-10-01

    The Diabetes Prevention Program (DPP) demonstrated risk reduction for incident diabetes through weight loss among all participants, including African Americans. Several DPP translations have been conducted in less controlled settings, including primary care practices and communities; however, there is no detailed compilation of how effective these translations have been for African Americans. This systematic literature review evaluated DPP translations from 2003 to 2012. Eligible records were retrieved using a search strategy of relevant databases and gray literature. Retrieved records (n=1,272) were screened using a priori criteria, which resulted in 21 full-text studies for review. Seventeen studies were included in the full-text qualitative synthesis. Seven studies had 100% African American samples and 10 studies had mixed samples with African American subgroups. African American participants' average weight loss was roughly half of that achieved in the DPP intervention. However, with few higher-quality studies, small sample sizes and differences in intervention designs and implementation, comparisons across interventions were difficult. The suboptimal effectiveness of DPP translations among African American adults, particularly women, signals the need for enhancements to existing evidence-based interventions and more high-quality research that includes other at-risk African American subgroups such as men and younger adults of lower socioeconomic status.

  6. Preventive Effects of Carnosine on Lipopolysaccharide-induced Lung Injury

    PubMed Central

    Tanaka, Ken-Ichiro; Sugizaki, Toshifumi; Kanda, Yuki; Tamura, Fumiya; Niino, Tomomi; Kawahara, Masahiro

    2017-01-01

    Acute respiratory distress syndrome (ARDS) is a potentially devastating form of acute lung injury, which involves neutrophilic inflammation and pulmonary cell death. Reactive oxygen species (ROS) play important roles in ARDS development. New compounds for inhibiting the onset and progression of ARDS are required. Carnosine (β-alanyl-L-histidine) is a small di-peptide with numerous activities, including antioxidant effects, metal chelation, proton buffering capacity and the inhibition of protein carbonylation and glycoxidation. We have examined the preventive effects of carnosine on tissue injury, oedema and inflammation in a murine model for ARDS. Oral administration of carnosine suppressed lipopolysaccharide (LPS)-induced vascular permeability, tissue injury and inflammation in the lung. In vivo imaging analysis revealed that LPS administration increased the level of ROS and that this increase was inhibited by carnosine administration. Carnosine also suppressed LPS-induced neutrophilic inflammation (evaluated by activation of myeloperoxidase in the lung and increased extracellular DNA in bronchoalveolar lavage fluid). Furthermore, carnosine administration suppressed the LPS-induced endoplasmic reticulum stress response in vivo. These results suggest that the oral administration of carnosine suppresses LPS-induced lung injury via carnosine’s ROS-reducing activity. Therefore, carnosine may be beneficial for suppressing the onset and progression of ARDS. PMID:28205623

  7. Denosumab. Limited efficacy in fracture prevention, too many adverse effects.

    PubMed

    2011-06-01

    The standard drug for postmenopausal osteoporotic women with a high risk of fracture is alendronic acid, used in conjunction with non-drug measures. There are no drugs with demonstrated efficacy on the risk of fracture in castrated men with prostate cancer. Denosumab, a monoclonal antibody that inhibits a cytokine acting mainly on bone cells and lymphocytes, has been authorised in the European Union for use in both these settings. There are no trials comparing denosumab versus alendronic acid for symptomatic fracture prevention. In two trials involving 1189 and 504 women, the incidence of clinical fractures, recorded as simple adverse effects, did not differ significantly between the groups. In a placebo-controlled trial in about 7900 elderly osteoporotic women, denosumab significantly reduced the incidence of symptomatic vertebral fractures (0.8% versus 2.6% after 3 years) and hip fractures (0.7% versus 1.2%). An indirect comparison, providing weak evidence, suggests that denosumab is less effective than alendronic acid. In a placebo-controlled trial in 1468 castrated men with prostate cancer, denosumab did not reduce the incidence of symptomatic fractures after 3 years. Only the incidence of vertebral fractures, detected on routine radiographs, showed a statistically significant decline (1.5% versus 3.5%). Denosumab has numerous adverse effects. In placebo-controlled trials, this monoclonal antibody was associated with a higher incidence of deep-seated infections such as endocarditis, cancer, and skin rash. More data are needed on the risk of pancreatitis, long-term bone disorders (atypical fractures, delayed fracture healing, osteonecrosis of the jaw), hypocalcaemia and cataracts, all of which were reported in clinical trials. In practice, denosumab is not sufficiently effective to outweigh its established and potential risks in postmenopausal osteoporotic women or in castrated men with prostate cancer.

  8. Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial.

    PubMed

    Zhao, Yanan; Chung, Pak-Kwong; Tong, Tom K

    2017-03-27

    This study examined the effectivenss of a balance-focused training program (i.e., Exercise for Balance Improvement Program, ExBP) in improving functional fitness of older nonfallers at risk of falling. Sixty-one participants were randomly assigned to receive 16 weeks of ExBP or Tai Chi (TC) training, or no treatment (CON) with an 8-week follow-up. The Senior Fitness Test battery was applied to assess functional fitness. After the intervention, results revealed significant improvements in all fitness components in the ExBP group. Compared with the CON group, the ExBP group demonstrated more improvements in lower extremity muscle strength, agility and balance, and aerobic endurance. The ExBP group also displayed more improvements in aerobic endurance than the TC group in posttest and follow-up test. Therefore, the balance-focused exercise can be applied as an effective way in improving overall functional fitness among older nonfallers who are at risk of falling.

  9. Effects on balance, falls, and bone mineral density of a home-based exercise program without home visits in community-dwelling elderly women: a randomized controlled trial.

    PubMed

    Kamide, Naoto; Shiba, Yoshitaka; Shibata, Hiroshi

    2009-01-01

    The aim of the present study was to investigate the effects of home-based exercise without home visits on physical function, falls, and bone mineral density in community-dwelling elderly women. Sixty community-dwelling, elderly (> or =65 years of age) women were recruited from a Japanese community. Subjects were randomly assigned to a home-based exercise group or a control group. The subjects assigned to the home-based exercise group performed home-based exercise without home visits 3 times per week for 6 months in their homes. Assessments of physical function and bone mineral density were carried out before and after intervention in both groups. Muscle strength, gait velocity, the timed up and go test (TUGT), single leg stance time, the bend reach performance test, and reaction time were measured to assess physical function. The patients' history of falls was also assessed before and after the 12-month follow-up. To determine bone mineral density, the speed of sound (SOS) at the right calcaneus was measured using a quantitative ultrasound device. There were no significant differences between the two groups in baseline characteristics. 82.6% of subjects completed the prescribed exercise program in the home-based exercise group. Compared to the control group, TUGT improved significantly (p<0.05) in the home-based exercise group. Home-based exercise without home visits can be adopted for community-dwelling elderly women, particularly since no specific place or instructor is needed.

  10. 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.

  11. Prevention of Slip-Related Backward Balance Loss: Effect of Session Intensity and Frequency on Long-Term Retention

    PubMed Central

    Bhatt, Tanvi; Pai, Yi-Chung

    2008-01-01

    Objective To examine effects of session intensity (number of slip exposures) and frequency on retention of acquired adaptation for prevention of backward balance loss following repeated-slip training. Setting Biomechanics research laboratory. Participants Healthy young subjects (N=46; 21 males). Intervention Twenty-four subjects experienced a high-intensity session of 24 repeated right-side slips; 12 received additional single-slip sessions at a frequency of 1-week, 2-week, and 1-month, while the rest got no ancillary training. Another 24 subjects received a low-intensity initial session of a single slip; 12 received the same high-frequency ancillary training, while the rest got none. All groups were retested with a single-slip, 4 months after first session. Main Outcome Measures Incidence of backward balance loss, gait stability, and limb support. Results The high-intensity groups irrespective of ancillary training displayed similar improvements in all 3 outcome measures. Remarkably, the low-intensity group receiving ancillary training also significantly improved in all measures, with retention comparable to that observed in the other 2 groups. A single slip exposure without ancillary sessions was insufficient to yield longer-term effect. Conclusions Frequent ancillary sessions may be unnecessary for slip-related fall prevention up to 4 months, if initial session intensity is sufficient. Furthermore, the minimum of a single slip may be as effective, if subject is exposed to frequent ancillary sessions. PMID:19154827

  12. Predicting the Effectiveness of Prevention: A Role for Epidemiological Modeling

    ERIC Educational Resources Information Center

    Walls, Helen L.; Peeters, Anna; Reid, Christopher M.; Liew, Danny; Mcneil, John J.

    2008-01-01

    It is well known that the current combination of aging populations and advances in health technology is resulting in burgeoning health costs in developed countries. Prevention is a potentially important way of containing health costs. In an environment of intense cost pressures, coupled with developments in disease prevention and health promotion,…

  13. 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…

  14. 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…

  15. 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…

  16. 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)

  17. Fall 2005 Enrollment Report

    ERIC Educational Resources Information Center

    West Virginia Higher Education Policy Commission, 2005

    2005-01-01

    This annual report includes the following information presented in tabular form: (1) Location of West Virginia Public Institutions of Higher Education; (2) Location of West Virginia Independent Institutions of Higher Education; (3) Freshmen Headcount Enrollment, by Attendance Status, Early Fall 2005; (4) Headcount Enrollment by Residence,…

  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. Fall Protection in Construction

    DTIC Science & Technology

    1998-01-01

    Fall Protection in Construction U.S. Department of Labor Occupational Safety and Health Administration OSHA 3146 1998(Revised) Report Documentation...Department of Labor Occupational Safety & Health Administration 200 Constitution Avenue Washington, DC 20210 Performing Organization Report Number OSHA 3146...compliance responsibili- ties, which are set forth in OSHA standards themselves, and the Occupational Safety and Health Act. Moreover, because

  20. FHR Iowa Falls Approval

    EPA Pesticide Factsheets

    This October 22, 2015, letter from EPA approves the petition from Flint Hills Resources, LLC, regarding non-grandfathered ethanol produced through the FHR Iowa Falls Process, qualifying under the Clean Air Act for renewable fuel (D-code 6) RINs under the R

  1. Fall 2013 International Comparisons

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2014

    2014-01-01

    This Fall report is an aggregated statistical analysis of Measures of Academic Progress® (MAP®) data from international schools. The report provides a consistent means of comparisons of specific sub-groups by subject and grade, which allows partners to compare their MAP® results with other schools within their region or membership organization.…

  2. 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…

  3. Monitoring of effectiveness of some preventive measures against influenza.

    PubMed

    Masaryková, Lucia; Balázi, Tomás; Fulmeková, Magdaléna; Lehocká, L'ubica

    2012-02-01

    In our study we dealt with the frequently occurring influenza virus that infects humans regardless of age or sex. The flu is not of importance only in health problems but also in the economic ones, such as the treatment costs and patients' ability to work. We focused particularly on the most effective preventive measure against the virus, which is vaccination and the risk groups that are the most vulnerable ones to the virus. One of the objectives of this research was to identify the advantages and disadvantages of vaccination against influenza and available risks of vaccination within a group of 390 patients. We studied a group of 195 vaccinated patients and we tried to determine the effect of the vaccines used in these patients, and to compare this group with the same number of unvaccinated patients. The goal of the research was to identify the advantages and disadvantages of the vaccination against influenza, and the potential risks resulting from the vaccination. Based on our results, we found out that out of 195 vaccinated patients, only 4% returned to the doctor with the flu. Unvaccinated patients, however, visited the doctor four times more frequently, regardless of age. The resulting morbidity ratios clearly showed the importance, effectiveness and safety of the vaccination not only in high-risk groups, but also in people that are "out-of-danger", because the current flu virus spreads by droplet infection very quickly. Appropriate education and increased awareness among the population in Slovakia could improve the general attitude towards the vaccination against influenza and the vaccination rate (Slovakia 12%) could raise to a percentage comparable to that of the EU countries (France 30%, England 32%, the Netherlands 28% and Germany 26%).

  4. The Vitamin D Assessment (ViDA) Study: design of a randomized controlled trial of vitamin D supplementation for the prevention of cardiovascular disease, acute respiratory infection, falls and non-vertebral fractures.

    PubMed

    Scragg, Robert; Waayer, Debbie; Stewart, Alistair W; Lawes, Carlene M M; Toop, Les; Murphy, Judy; Khaw, Kay-Tee; Camargo, Carlos A

    2016-11-01

    Observational studies have shown that low vitamin D status is associated with an increased risk of cardiovascular disease, acute respiratory infection, falls and non-vertebral fractures. We recruited 5110 Auckland adults, aged 50-84 years, into a randomized, double-blind, placebo-controlled trial to test whether vitamin D supplementation protects against these four major outcomes. The intervention is a monthly cholecalciferol dose of 100,000IU (2.5mg) for an estimated median 3.3 years (range 2.5-4.2) during 2011-2015. Participants were recruited primarily from family practices, plus community groups with a high proportion of Maori, Pacific, or South Asian individuals. The baseline evaluation included medical history, lifestyle, physical measurements (e.g. blood pressure, arterial waveform, lung function, muscle function), and a blood sample (stored at -80°C for later testing). Capsules are being mailed to home addresses with a questionnaire to collect data on non-hospitalized outcomes and to monitor adherence and potential adverse effects. Other data sources include New Zealand Ministry of Health data on mortality, hospitalization, cancer registrations and dispensed pharmaceuticals. A random sample of 438 participants returned for annual collection of blood samples to monitor adherence and safety (hypercalcemia), including repeat physical measurements at 12 months follow-up. The trial will allow testing of a priori hypotheses on several other endpoints including: weight, blood pressure, arterial waveform parameters, heart rate variability, lung function, muscle strength, gait and balance, mood, psoriasis, bone density, and chronic pain.

  5. 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.

  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.

  7. 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

  8. Translating Family-Focused Prevention Science Into Effective Practice

    PubMed Central

    Spoth, Richard

    2010-01-01

    Family-focused preventive intervention research could serve as an exemplar for the translation of science into practice on a scale that achieves public health impact. This article outlines advances in the field and translational research that still is needed, presenting these within a heuristic framework. The framework is designed to guide a broad translational research agenda fostering a shift toward a paradigm of public health impact—called a translational impact paradigm. Current advances and needed research in the subfield are mapped onto a set of four translational impact factors: effectiveness of interventions; extensiveness of their population coverage; efficiency of interventions; and engagement of eligible populations or organizations, including widespread adoption and sustained, quality implementation (the “4 Es” of intervention impact). The article then highlights key tasks required to progress in this area: improving practitioner–scientist partnership networks embedded in systems for delivery of evidence-based interventions; application of research guidelines and standards that facilitate translational impact; and policy change that supports needed research. PMID:20523761

  9. 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…

  10. 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

  11. Falls exercise interventions and reduced falls rate: always in the patient's interest?

    PubMed

    Laybourne, A H; Biggs, S; Martin, F C

    2008-01-01

    Falls are a leading cause of mortality and morbidity in older adults. Physical, psychological and social consequences include injury, fall-related fear and loss of self-efficacy. In turn, these may result in decreased physical activity, reduced functional capacity, and increased risk of institutionalisation. Falls prevention exercise programmes (FPEP) are now widespread within the National Health Service, often part of multifactorial interventions, and are designed to minimise impairments that impact physical function, such as strength and balance. Assessment of the clinical efficacy of FPEPs has therefore focused on the measurement of physical function and rate of falls. Whilst important, this approach may be too narrow to capture the highly variable and multidimensional responses that individuals make to a fall and to a FPEP. We argue that the current focus may miss a paradoxical lack of or even deleterious impact on quality of life, despite a reduction in physical performance-related falls risk. We draw upon the Selective Optimisation and Compensation (SOC) model, developed by Paul and Margret Baltes, to explore how this paradox may be a result of the coping strategies adopted by individuals in response to a fall.

  12. Automatic Individual Calibration in Fall Detection – An Integrative Ambulatory Measurement Framework

    PubMed Central

    Liu, Jian; Lockhart, Thurmon E.

    2011-01-01

    The objective of the current study was to demonstrate the utility of a new integrative ambulatory measurement (IAM) framework by developing and evaluating an individual calibration function in fall detection application. Ten healthy elderly were involved in a laboratory study and tested in a protocol composed of various types of activities of daily living (ADLs) and slip-induced backward falls. Inertial measurement units attached to the trunk and thigh segments were used to measure trunk angular kinematics and thigh accelerations. The effect of individual calibration was evaluated with previously developed fall detection algorithm. The results indicated that with individual calibration, the fall detection performance achieved approximately same level of sensitivity (100% vs. 100%) and specificity (95.25% vs. 95.65%), however, response time was significantly lower than without (249ms vs. 255ms). It was concluded that the automatic individual calibration using the IAM framework improves the performance of fall detection, which has a greater implication in preventing/minimizing injuries associated with fall accidents. PMID:22149355

  13. Strength Training May Prevent Side Effect of Breast Cancer Surgery

    MedlinePlus

    ... Lynn Panton. She is a professor of exercise science at Florida State University in Tallahassee. "But we're finding that strength training can really help women recover from treatment and help prevent and reduce ...

  14. Toward the azimuthal characteristics of ionospheric and seismic effects of "Chelyabinsk" meteorite fall according to the data from coherent radar, GPS, and seismic networks

    NASA Astrophysics Data System (ADS)

    Berngardt, O. I.; Perevalova, N. P.; Dobrynina, A. A.; Kutelev, K. A.; Shestakov, N. V.; Bakhtiarov, V. F.; Kusonsky, O. A.; Zagretdinov, R. V.; Zherebtsov, G. A.

    2015-12-01

    We present the results of a study of the azimuthal characteristics of ionospheric and seismic effects of the meteorite `Chelyabinsk,' based on the data from the network of GPS receivers, coherent decameter radar EKB, and network of seismic stations, located near the meteorite fall trajectory. It is shown that 6-14 min after the bolide explosion, GPS network observed the cone-shaped wavefront of traveling ionospheric disturbances (TIDs) that is interpreted as a ballistic acoustic wave. The typical TIDs propagation velocity were observed 661 ± 256 m/s, which corresponds to the expected acoustic wave speed for 240 km height. Fourteen minutes after the bolide explosion, at distances of 200 km, we observed the emergence and propagation of a TID with annular wavefront that is interpreted as gravitational mode of internal atmospheric waves. The propagation velocity of this TID was 337 ± 89 m/s which corresponds to the propagation velocity of these waves in similar situations. At EKB radar, we observed TIDs in the sector of azimuthal angles close to the perpendicular to the meteorite trajectory. The observed TID velocity (400 m/s) and azimuthal properties correlate well with the model of ballistic wave propagating at 120-140 km altitude. It is shown that the azimuthal distribution of the amplitude of vertical seismic oscillations with periods 3-60 s can be described qualitatively by the model of vertical strike-slip rupture, propagating at 1 km/s along the meteorite fall trajectory to distance of about 40 km. These parameters correspond to the direction and velocity of propagation of the ballistic wave peak by the ground. It is shown that the model of ballistic wave caused by supersonic motion and burning of the meteorite in the upper atmosphere can satisfactorily explain the various azimuthal ionospheric effects, observed by the coherent decameter radar EKB, GPS receivers network, and the azimuthal characteristics of seismic waves at large distances.

  15. The Resource. Fall 2001

    DTIC Science & Technology

    2001-01-01

    Adams, Director of Scientific Visualization, initiated a Bring Your Own Data ( BYOD ) workshop for MSRC users. The first workshop was held June 25-26 in...leverage these assets in their future work. The first BYOD workshop was definitely a benefit to the users. Chris Stone, in particular was able to...publications 28 ERDC MSRC The Resource, Fall 2001 ac ro ny m s AG Access Grid AMR Adaptive Mesh Refinement BYOD Bring Your Own Data CDC Control Data

  16. Falling film evaporator

    DOEpatents

    Bruns, Lester E.

    1976-01-01

    A falling film evaporator including a vertically oriented pipe heated exteriorly by a steam jacket and interiorly by a finned steam tube, all heating surfaces of the pipe and steam tube being formed of a material wet by water such as stainless steel, and packing within the pipe consisting of Raschig rings formed of a material that is not wet by water such as polyvinylidene fluoride.

  17. Modeling a falling slinky

    NASA Astrophysics Data System (ADS)

    Cross, R. C.; Wheatland, M. S.

    2012-12-01

    A slinky is an example of a tension spring: in an unstretched state a slinky is collapsed, with turns touching, and a finite tension is required to separate the turns from this state. If a slinky is suspended from its top and stretched under gravity and then released, the bottom of the slinky does not begin to fall until the top section of the slinky, which collapses turn by turn from the top, collides with the bottom. The total collapse time tc (typically ˜0.3 s for real slinkies) corresponds to the time required for a wave front to propagate down the slinky to communicate the release of the top end. We present a modification to an existing model for a falling tension spring [Calkin, Am. J. Phys. 61, 261-264 (1993)] and apply it to data from filmed drops of two real slinkies. The modification of the model is the inclusion of a finite time for collapse of the turns of the slinky behind the collapse front propagating down the slinky during the fall. The new finite-collapse time model achieves a good qualitative fit to the observed positions of the top of the real slinkies during the measured drops. The spring constant k for each slinky is taken to be a free parameter in the model. The best-fit model values for k for each slinky are approximately consistent with values obtained from measured periods of oscillation of the slinkies.

  18. Physical Activity and Falls in Older Men: The Critical Role of Mobility Limitations

    PubMed Central

    JEFFERIS, BARBARA J.; MEROM, DAFNA; SARTINI, CLAUDIO; WANNAMETHEE, S. GOYA; ASH, SARAH; LENNON, LUCY T.; ILIFFE, STEVE; KENDRICK, DENISE; WHINCUP, PETER H.

    2015-01-01

    ABSTRACT Background Physical activity (PA) has many health benefits but may increase falls risk among older adults. We study how objectively measured habitual daily PA is related to falls by exploring the modifying effect of mobility limitations and the mediating roles of fitness and lower-limb strength. Methods One thousand six hundred fifty-five (53%) of 3137 surviving participants (men age 71–91 yr) in an ongoing UK-population-based cohort study wore an ActiGraph GT3x accelerometer over the hip for 1 wk in 2010–2012 to measure PA (exposure) and reported demographic and health status, including mobility limitations. One year later, 825 men reported falls history (outcome). Results Seven hundred of 825 men had ≥600 min·d−1 of accelerometer wear for ≥3 d. Nineteen percent (n = 128) reported falls 1 yr later. Associations between PA and falls differed by presence of mobility limitations. Among 66% (n = 471) of men without mobility limitations, number of falls increased incrementally (for every 30 min of moderate to vigorous PA [MVPA]: incidence rate ratio [IRR], 1.50; 95% confidence interval [CI], 1.10–2.03, adjusted for falls risk factors). Step count was not related to number of falls below 9000 steps per day but was related to number of falls ≥9000 steps per day (for every additional 1000 steps per day: IRR, 1.59; 95% CI, 1.16–2.18). Among 33% (n = 229) of men with mobility limitations, falls risk declined with increasing activity (for every 1000 steps per day: IRR, 0.80; 95% CI, 0.70–0.91; for every 30 min of MVPA: IRR, 0.61; 95% CI, 0.42–0.89; for every additional 30 min of sedentary behavior ≥600 min·d−1: IRR, 1.22; 95% CI, 1.07–1.40). Conclusions Interventions to promote MVPA in older men should incorporate falls prevention strategies. Among adults with mobility limitations, trials should investigate whether increasing MVPA levels can reduce falls risk. PMID:25668406

  19. Increased Fall-Related Mortality Rates in New Mexico, 1999–2005

    PubMed Central

    Wendelboe, Aaron M.; Landen, Michael G.

    2011-01-01

    Objective In 2000, fall injuries affected 30% of U.S. residents aged ≥65 years and cost $19 billion. In 2005, New Mexico (NM) had the highest fall-related mortality rate in the United States. We described factors associated with these elevated fall-related mortality rates. Methods To better understand the epidemiology of fatal falls in NM, we used state and national (Web-based Injury Statistics Query and Reporting System) vital records data for 1999–2005 to identify unintentional falls that were the underlying cause of death. We calculated age-adjusted mortality rates, rate ratios (RRs), and 95% confidence intervals (CIs) by sex, ethnicity, race, and year. Results For 1999–2005 combined, NM's fall-related mortality rate (11.7 per 100,000 population) was 2.1 times higher than the U.S. rate (5.6 per 100,000 population). Elevated RRs persisted when stratified by sex (male RR=2.0, female RR=2.2), ethnicity (Hispanic RR=2.5, non-Hispanic RR=2.1), race (white RR=2.0, black RR=1.7, American Indian RR=2.3, and Asian American/Pacific Islander RR=3.1), and age (≥50 years RR=2.0, <50 years RR=1.2). Fall-related mortality rates began to increase exponentially at age 50 years, which was 15 years younger than the national trend. NM non-Hispanic individuals had the highest demographic-specific fall-related mortality rate (11.8 per 100,000 population, 95% CI 11.0, 12.5). NM's 69.5% increase in fall-related mortality rate was approximately twice the U.S. increase (31.9%); the increase among non-Hispanic people (86.2%) was twice that among Hispanic people (43.5%). Conclusions NM's fall-related mortality rate was twice the U.S. rate; exhibited a greater increase than the U.S. rate; and persisted across sex, ethnicity, and race. Fall-related mortality disproportionately affects a relatively younger population in NM. Characterizing fall etiology will assist in the development of effective prevention measures. PMID:22043102

  20. 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

  1. Prevention of hip fractures.

    PubMed

    Meunier, P J

    1993-11-30

    For a 50-year old Caucasian woman today, the risk of a hip fracture over her remaining life-time is about 17%. Tomorrow the situation will clearly be worse because the continuous increase in life expectancy will cause a three-fold increase in worldwide fracture incidence over the next 60 years. Through diagnostic bone mass measurements at the hip and assessment of biochemical parameters, a great deal has been learned in recent years about reduction of hip fracture risk. Preventive strategies are based on prevention of falls, use of hip protectors, and prevention of bone fragility. The latter includes the optimization of peak bone mass during childhood, postmenopausal estrogen replacement therapy, and also late prevention consisting in reversing senile secondary hyperparathyroidism, which plays an important role in the decrease of skeletal strength. This secondary hyperparathyroidism, which results from both vitamin D insufficiency and low calcium intake, is preventable with vitamin D3 and calcium supplements. They have recently been shown capable of providing effective prevention of hip fractures in elderly women living in nursing homes, with a reduction of about 25% in the number of hip fractures noted in a 3-year controlled study in 3,270 women (intention-to-treat analysis). In conclusion, it is never too early to reduce the risk of osteoporosis and never too late to prevent hip fractures.

  2. Rock fall analysis of slope along state highway in Uttarakhand Himalaya, India using numerical simulation

    NASA Astrophysics Data System (ADS)

    Vishal, V.; Phophliya, M. K.; Purohit, R.

    2014-12-01

    With almost 1% of the reported accidents being associated with slope stability problems, landslides and rock fall have been responsible for nearly 25% of fatalities in hill slopes and surface mines over past few decades. Morpho-dynamic terrain of Himalaya is continually facing challenges in stability of rock/slopes, which are aggravated due to increased disturbance level in rock/soil mass due to human intervention. The lithological and structural variations, orientations and patterns of different water bodies and vegetation are varied along the slopes which indicate site-specific studies of rock fall prone areas in Uttarakhand. Lack of sufficient knowledge and understanding of the phenomenon, frequent occurrences of rock fall along state and national highways, the consequent inconveniences and loss of lives highlight the importance of addressing the subject on a priority basis. Rock fall simulation of the hill cut face along state highway in India was performed to replicate the effects of the falling rock blocks in the valley. The energy, velocity, bounce height and the trajectory of possible rock failures were determined. The slopes were optimised with respect to the intermediate benches to reduce the impact of falling rock blocks on the adjoining road. It was observed that introducing benches near the top did not reduce the impact of falling boulders much, however, the number of rocks crossing the ditch was less. On the contrary, benches at intermediate height reduced the energy of falling blocks but could not restrict the blocks to cross over the ditch on to the road. An optimisation of the angle of inclination of the ditch angle was also carried out. A ditch angle of 15o could restrict the passage of boulders from ditch over to the adjoining road. The study will be very useful for safe design of structures for prevention and mitigation of hazards due to rock failures along these slopes.

  3. Childhood injuries due to falls from apartment balconies and windows

    PubMed Central

    Istre, G; McCoy, M; Stowe, M; Davies, K; Zane, D; Anderson, R; Wiebe, R

    2003-01-01

    Background: Falls from balconies and windows are an important cause of childhood injury. This study investigated the circumstances around such falls and attempted to identify possible measures for their prevention. Population: Children <15 years living in Dallas County, Texas. Methods: Each child treated because of a fall from a building in 1997–99 had information about the injury collected, and a parent was contacted to obtain further information. For apartment related falls, an attempt was made to visit the apartment to measure windows and balcony rails. Results: Ninety eight children were injured in falls from buildings during the three year period; 39 (40%) were admitted to hospital. Seventy five of the falls (77%) involved apartments, and most occurred around noon or evening meal times. Among apartment falls, 39 (52%) fell from windows, 34 (45%) from balconies, and two (3%) from unknown sites. For more than two thirds of balcony related falls, the child fell from between the balcony rails, all of which were spaced more than 4 inches (10 cm) apart. On-site measurement showed the rails were an average of 7.5 inches (19 cm) apart; all of these apartments were built before 1984. For more than two thirds of window related falls, the window was situated within 2 feet (61 cm) of the floor. Conclusions: Two factors are important in falls from apartment windows and balconies: balcony rails more than 4 inches (10 cm) apart, and windows positioned low to the floor. Current building codes do not apply to older apartments, where most of these falls occurred. Nevertheless, these factors may be amenable to environmental modifications that may prevent most of these falls. PMID:14693898

  4. Falls - Multiple Languages: MedlinePlus

    MedlinePlus

    ... sharing features on this page, please enable JavaScript. Arabic (العربية) Bosnian (Bosanski) Chinese - Simplified (简体中文) Chinese - Traditional ( ... Русский) Somali (af Soomaali) Spanish (español) Ukrainian (Українська) Arabic (العربية) Preventing Falls in the Hospital (Arabic) الوقاية ...

  5. A fully relativistic radial fall

    NASA Astrophysics Data System (ADS)

    Spallicci, Alessandro D. A. M.; Ritter, Patxi

    2014-10-01

    Radial fall has historically played a momentous role. It is one of the most classical problems, the solutions of which represent the level of understanding of gravitation in a given epoch. A gedankenexperiment in a modern frame is given by a small body, like a compact star or a solar mass black hole, captured by a supermassive black hole. The mass of the small body itself and the emission of gravitational radiation cause the departure from the geodesic path due to the back-action, that is the self-force. For radial fall, as any other non-adiabatic motion, the instantaneous identity of the radiated energy and the loss of orbital energy cannot be imposed and provide the perturbed trajectory. In the first part of this paper, we present the effects due to the self-force computed on the geodesic trajectory in the background field. Compared to the latter trajectory, in the Regge-Wheeler, harmonic and all others smoothly related gauges, a far observer concludes that the self-force pushes inward (not outward) the falling body, with a strength proportional to the mass of the small body for a given large mass; further, the same observer notes a higher value of the maximal coordinate velocity, this value being reached earlier during infall. In the second part of this paper, we implement a self-consistent approach for which the trajectory is iteratively corrected by the self-force, this time computed on osculating geodesics. Finally, we compare the motion driven by the self-force without and with self-consistent orbital evolution. Subtle differences are noticeable, even if self-force effects have hardly the time to accumulate in such a short orbit.

  6. Accelerating Recovery from Poverty: Prevention Effects for Recently Separated Mothers

    ERIC Educational Resources Information Center

    Forgatch, Marion S.; DeGarmo, David S.

    2007-01-01

    This study evaluated benefits of a preventive intervention to the living standards of recently separated mothers. In the Oregon Divorce Study's randomized experimental design, data were collected 5 times over 30 months and evaluated with Hierarchical Linear Growth Models. Relative to their no-intervention control counterparts, experimental mothers…

  7. Sexually Transmitted Disease Prevention: Adolescents' Perceptions of Possible Side Effects.

    ERIC Educational Resources Information Center

    Furby, Lita; Ochs, Linda M.; Thomas, Catherine W.

    1997-01-01

    Reports on interviews of 48 sexually active adolescents concerning the possible secondary consequences of taking measures to reduce the risk of contracting a sexually transmitted disease (STD). Adolescents generated 134 consequences, suggesting that considering all the relevant consequences for a rational decision about STD prevention is not…