Non-fatal construction industry fall-related injuries treated in US emergency departments, 1998-2005.

PubMed

Shishlov, Kirill S; Schoenfisch, Ashley L; Myers, Douglas J; Lipscomb, Hester J

2011-02-01

There is a growing recognition that common occupational injury surveillance systems in the US fail to reflect true injury risk; this failure limits efforts to accurately monitor efforts to prevent work-related injuries on a national level. Data from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work) were used to describe fall-related injuries treated in US emergency departments among workers in the construction industry (1998-2005). These data do not require workers' compensation as the payer in order to be classified as work-related. Based on NEISS-Work estimates, a total of 555,700 (95% confidence interval (CI): 390,700-720,800) non-fatal work-related injuries among workers in the construction industry were the result of a fall, resulting in an annual rate of 70 (95% CI: 49-91) per 10,000 full-time equivalents. Younger workers had higher rates of falls, whereas older workers were more likely to suffer serious injuries. The majority of the injuries (70%) were precipitated by falls to a lower level from roofs, ladders, and scaffolding. The patterns of fall-related injuries identified in these data are consistent with other reports. In contrast to the declining rates of falls requiring days away from work reported through the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses, construction industry fall-related injury rates estimated through NEISS-Work remained unchanged from 1998 to 2005 providing another perspective on this serious cause of morbidity in the construction industry. Copyright © 2010 by John Wiley & Sons, Ltd.

Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

PubMed

Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

2017-03-01

To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations. © 2016 John Wiley & Sons Ltd.

Walking Distance as a Predictor of Falls in People With Multiple Sclerosis.

PubMed

Nilsagård, Ylva; Westerdahl, Elisabeth; Wittrin, Anna; Gunnarsson, Martin

2016-06-01

People with multiple sclerosis (PwMS) experience falls, usually when walking and transferring. The aim was to investigate if walking distance and patient overestimate of walking distance are predictors of falls in PwMS. A prospective study was conducted, with a single test occasion followed by prospective registration of falls for 3 months. All PwMS in Region Örebro County with a previously registered Expanded Disability Status Scale score between 3.0 and 7.0 in the Swedish MS Registry were invited to participate (n = 149). Altogether, data from 49 PwMS being relapse free for at least 3 months and with a confirmed Expanded Disability Status Scale between 1.5 and 7.0 upon study entry were analysed. Twenty-two PwMS (45%) fell during the study period, providing information of 66 falls. Walking distance or overestimate of one's walking distance, as compared with test results, did not predict falls in this MS sample. Walking and standing activities are associated with numerous falls in PwMS. Our data do not clearly support routine measurements of walking distance in assessing individual fall risk. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd.

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

PubMed

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

2017-07-01

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

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

PubMed

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

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

Improving the Capture of Fall Events in Hospitals: Combining a Service for Evaluating Inpatient Falls with an Incident Report System

PubMed Central

Shorr, Ronald I.; Mion, Lorraine C.; Chandler, A. Michelle; Rosenblatt, Linda C.; Lynch, Debra; Kessler, Lori A.

2008-01-01

OBJECTIVES To determine the utility of a fall evaluation service to improve the ascertainment of falls in acute care. DESIGN Six-month observational study. SETTING Sixteen adult nursing units (349 beds) in an urban, academically affiliated, community hospital. PARTICIPANTS Patients admitted to the study units during the study period. INTERVENTION Nursing staff identifying falls were instructed to notify, using a pager, a trained nurse ‘‘fall evaluator.’’ Fall evaluators provided 24-hour-per-day 7-day-per-week coverage throughout the study. Data on patient falls gathered by fall evaluators were compared with falls data obtained through the hospital’s incident reporting system. RESULTS During 51,180 patient-days of observation, 191 falls were identified according to incident reports (3.73 falls/1,000 patient-days), whereas the evaluation service identified 228 falls (4.45 falls/1,000 patient-days). Combining falls reported from both data sources yielded 266 falls (5.20 falls/1,000 patient-days), a 39% relative rate increase compared with incident reports alone (P<.001). For falls with injury, combining data from both sources yielded 79 falls (1.54 injurious falls/1,000 patient-days), compared with 57 falls (1.11 injurious falls/1,000 patient-days) filed in incident reports—a 28% increase (P = .06). In the 16 nursing units, the relative percentage increase of captured fall events using the combined data sources versus the incident reporting system alone ranged from 13% to 125%. CONCLUSION Incident reports significantly underestimate both injurious and noninjurious falls in acute care settings and should not be used as the sole source of data for research or quality improvement initiatives. PMID:18205761

Temperature Regulation in Critical Salmon Habitat of the Middle Fork of the John Day River, Oregon.

NASA Astrophysics Data System (ADS)

Buskirk, B. A.; Selker, J. S.

2016-12-01

Flow and temperature within the Middle Fork of the John Day River, an arid Eastern Oregon river, is dominated primarily by contributions from groundwater fed tributaries. The hydrology of arid streams is an important metric for understanding the critical environment in which salmon spawn and salmonids reside. The regulation of temperature within these streams is considered the primary metric for survival rates of these fish. Since 2007 Oregon State University has conducted stream monitoring efforts on the Middle Fork of the John Day River at the Oxbow and Forrest Conservation Areas. These sites were chosen through collaborative effort with the Confederated Tribes of the Warm Springs Reservation of Oregon, who have been restoring remnant mining canals back to their natural sinuous river pattern. The John Day River is also one of the few undammed reaches in which salmon runs occur. Efforts have focused on fiber optic distributed temperature sensing (DTS), groundwater gradient, stream discharge, bed permeability, GPS location and stream bathymetry across the conservation sites. During the peak of summer, stream temperature exhibits a strong diurnal cycle ranging from 9° C to 23° C depending on the daily maximum observed within the reach. Salmon have been found to be sensitive to stream temperatures above 15° C and are unable to survive temperatures above 24° C (Bell et al, 1991). The synthesis of temperature and stream flow data we collected show that very little groundwater is contributing to flow and temperature in the main channel of our study site while tributaries provide a constant, typically 0.5 to 2° C cooler, input of water to the main river channel and significant source of flow (0.01 - 0.1 m3/s). Due to the minimal rain fall in this arid environment, snow melt infiltration is likely the primary annual source of recharge into the head waters of the tributaries while also providing temperature regulation through input of near 0° C water. This cold water input from tributaries in addition to bank overhanging sedge grass provide cool safe zones for the young and mature fish during peak summer temperatures.

2. Wayne Chandler, Photographer, November 2000 Photographic copy of photograph ...

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

2. Wayne Chandler, Photographer, November 2000 Photographic copy of photograph (original print in possession of Heritage Research, Ltd. Menomonee Falls, WI) John N. Vogel, Photographer, July 2000 View to southeast. Aerial view of Soo Complex. From left to right, locks are Sabin, Davis, New Poe, and MacArthur - St. Mary's Falls Canal, Soo Locks, St. Mary's River at Falls, Sault Ste. Marie, Chippewa County, MI

Geologic Reconnaissance of the Antelope-Ashwood Area, North-Central Oregon: With Emphasis on the John Day Formation of Late Oligocene and Early Miocene Age

USGS Publications Warehouse

Peck, Dallas L.

1964-01-01

This report briefly describes the geology of an area of about 750 square miles in Jefferson, Wasco, Crook, and Wheeler Counties, Oregon. About 16,000 feet of strata that range in age from pre-Tertiary to Quaternary are exposed. These include the following units: pre-Tertiary slate, graywacke, conglomerate, and meta-andesite; Clarno Formation of Eocene age - lava flows, volcanic breccia, tuff, and tuffaceous mudstone, chiefly of andesitic composition; John Day Formation of late Oligocene and early Miocene age - pyroclastic rocks, flows, and domes, chiefly of rhyolitic composition; Columbia River Basalt of middle Miocene age - thick, columnar jointed flows of very fine grained dense dark-gray basalt; Dalles Formation of Pliocene age - bedded tuffaceous sandstone, siltstone, and conglomerate; basalt of Pliocene or Pleistocene age - lava flows of porous-textured olivine basalt; and Quaternary loess, landslide debris, and alluvium. Unconformities separate pre-Tertiary rocks and Clarno Formation, Clarno and John Day Formations, John Day Formation and Columbia River Basalt, and Columbia River Basalt and Dalles Formation. The John Day Formation, the only unit studied in detail, consists of about 4,000 feet of tuff, lapilli tuff, strongly to weakly welded rhyolite ash flows, and less abundant trachyandesite flows and rhyolite flows and domes. The formation was divided into nine mappable members in part of the area, primarily on the basis of distinctive ledge-forming welded ash-flow sheets. Most of the sheets are composed of stony rhyolite containing abundant lithophysae and sparse phenocrysts. One sheet contains 10 to 20 percent phenocrysts, mostly cryptoperthitic soda sanidine, but including less abundant quartz, myrmekitic intergrowths of quartz and sanidine, and oligoclase. The rhyolitic ash flows and lava flows were extruded from nearby vents, in contrast to some of the interbedded air-fall tuff and lapilli tuff of dacitic and andesitic composition that may have been derived from vents in an ancestral Cascade Range. The John Day is dated on the basis of a late Oligocene flora near the base of the formation and early Miocene faunas near the top of the formation. The middle Miocene and older rocks in the Antelope-Ashwood area are broadly folded and broken along northeast-trending faults. Over much of the area the rocks dip gently eastward from the crest of a major fold and are broken along a series of steeply dipping antithetic strike faults. Pliocene and Quaternary strata appear to be undeformed. At the Priday agate deposit, chalcedony-filled spherulites (thunder-eggs) occur in the lower part of a weakly welded rhyolitic ash flow. The so-called thunder-eggs are small spheroidal bodies, about 3 inches in average diameter; each consists of a chalcedonic core surrounded by a shell of welded tuff that is altered to radially oriented fibers of cristobalite and alkalic feldspar.

75 FR 5803 - John Day/Snake Resource Advisory Council; Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

...] John Day/Snake Resource Advisory Council; Meetings AGENCY: Bureau of Land Management, Interior. ACTION: Meeting Notice for the John Day/Snake Resource Advisory Council. SUMMARY: Pursuant to the Federal Land..., Bureau of Land Management (BLM) John Day/Snake Resource Advisory Council (JDSRAC) will meet as indicated...

Journal of Special Operations Medicine, Volume 4, Edition 4, Fall 2004

DTIC Science & Technology

2004-01-01

Zaichik D, Caspi G, Kotler D, Freund HR. Evacuation priorities in mass casualty terror-related events: Implications for contingency plan- ning. Annals of...John Prados Vietnam Above The Tree Tops: A Forward Air Controller Reports John F Flanagan Vietnam in American Literature Philip H Melling Vietnam

Food-allergic infants have impaired regulatory T-cell responses following in vivo allergen exposure.

PubMed

Dang, Thanh D; Allen, Katrina J; J Martino, David; Koplin, Jennifer J; Licciardi, Paul V; Tang, Mimi L K

2016-02-01

Regulatory T cells (Tregs) are critical for development of oral tolerance, and studies suggest that dysfunction of Tregs may lead to food allergy. However, to date, no study has investigated Treg responses following in vivo exposure to peanut or egg allergens in humans. To examine changes in peripheral blood CD4(+) CD25(+) Foxp3(+) Treg populations (total, activated and naive) in food-allergic, food-sensitized but tolerant, and healthy (non-sensitized non-allergic) patients over time following in vivo allergen exposure. A subset of infants from the HealthNuts study with egg or peanut allergy (n = 37), egg or peanut sensitization (n = 35), or who were non-sensitized non-allergic (n = 15) were studied. All subjects underwent oral food challenge (OFC) to egg or peanut. PBMCs were obtained within 1 h of OFC (in vivo allergen exposure), and Treg populations enumerated ex vivo on day 0, and after 2 and 6 days rest in vitro. Non-allergic infants showed stable total Treg frequencies over time; food-sensitized infants had a transient fall in Treg percentage with recovery to baseline by day 6 (6.87% day 0, 5.27% day 2, 6.5% day 6); and food-allergic infants showed persistent reduction in Treg (6.85% day 0, 5.4% day 2, 6.2% day 6) following in vivo allergen exposure. Furthermore, food-allergic infants had a significantly lower ratio of activated Treg:activated T cells (10.5 ± 0.77) at day 0 compared to food-sensitized (14.6 ± 1.24) and non-allergic subjects (16.2 ± 1.23). Our data suggest that the state of allergen sensitization is associated with depletion of Treg following allergen exposure. Impaired capacity to regenerate the Treg pool following allergen exposure may be an important factor that determines clinical allergy vs. sensitization without allergic reaction. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Psychotropic drug initiation or increased dosage and the acute risk of falls: a prospective cohort study of nursing home residents

PubMed Central

2013-01-01

Background Previous studies suggest that psychotropic drug changes may signal an acute period of time whereby a person is highly vulnerable to fall. It is unknown whether certain classes of psychotropic agents are less safe with respect to the acute risk of falls. Our purpose was to compare fall rates in the 7 days following a change of an antidepressant, antipsychotic, or benzodiazepine. We also identified specific times when residents are at high risk for falls with respect to a psychotropic drug change. Methods Residents in our one-year study included 851 long term care residents from two nursing home facilities in Boston, MA, U.S.A. (May 2010 - May 2011). Drug changes (i.e., new prescriptions or increased dose of a previously used drug) were ascertained using the computerized provider order entry system, whereas falls were ascertained by incident reports. Negative binomial regression was used to compare the rate of falls following a drug change between medication classes. Further, we calculated the rate of falls for each of the 7 days before and 7 days after a psychotropic drug change. Results Forty-eight percent of residents were prescribed a new prescription or increased dose of a psychotropic drug during the study. The rate of falls was similar in the 7 days following a change to a SSRI versus non-SSRI antidepressant (11.9 versus 14.4 falls/1,000 person years; p = 0.58), a typical versus an atypical antipsychotic (25.4 versus 17.1 falls/1,000 person years; p = 0.10), or a short versus long acting benzodiazepine (15.2 versus 13.9 falls/1,000 person years; p = 0.23). Fall risk was highest on day 4 before the drug change (19.0 falls/1,000 person days), on the day of the drug change through 2 days after the drug change (17.6-20.3 falls/1,000 person days), and 5-6 days after the drug change (17.6-19.0 falls/1,000 person days). Conclusions In the nursing home, risk of falls was similar following a psychotropic drug change of any class. We observed higher fall risk in the days before, but mostly after the drug change. We recommend that nursing home residents be closely monitored following a psychotropic drug change in an effort to reduce falls. PMID:23432790

75 FR 27359 - Meeting Notice for the John Day/Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

...] Meeting Notice for the John Day/Snake Resource Advisory Council AGENCY: Bureau of Land Management, Interior. ACTION: Meeting Notice for the John Day/Snake Resource Advisory Council. SUMMARY: Pursuant to the... Interior, Bureau of Land Management (BLM) John Day-Snake Resource Advisory Council (JDSRAC) will meet as...

75 FR 37461 - Notice of Public Meeting, John Day/Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

...] Notice of Public Meeting, John Day/Snake Resource Advisory Council AGENCY: Bureau of Land Management, Interior. ACTION: Meeting notice for the John Day/Snake Resource Advisory Council. SUMMARY: Pursuant to the... Interior, Bureau of Land Management (BLM) John Day-Snake Resource Advisory Council (JDSRAC) will meet as...

77 FR 23747 - Notice of Availability of the Proposed John Day Basin Resource Management Plan and Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-20

... on public lands, and expanded scientific knowledge and information pertaining to the conservation of... John Day/Snake Resource Advisory Council and with representatives of local, State, and other Federal... received from the public, John Day/Snake Resource Advisory Council, John Day Basin RMP Cooperating Agencies...

78 FR 64236 - Notice of Public Meeting for the John Day; Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

...] Notice of Public Meeting for the John Day; Snake Resource Advisory Council AGENCY: Bureau of Land... Interior, Bureau of Land Management (BLM), the John Day--Snake Resource Advisory Council (RAC) will meet as indicated below: DATES: The John Day--Snake RAC will hold a public meeting Thursday and Friday, November 14...

78 FR 76175 - Notice of Public Meeting for the John Day-Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

...] Notice of Public Meeting for the John Day-Snake Resource Advisory Council AGENCY: Bureau of Land... Interior, Bureau of Land Management (BLM), the John Day-Snake Resource Advisory Council (RAC) will meet as indicated below: DATES: The John Day-Snake RAC will hold a public meeting Thursday and Friday, January 9 and...

76 FR 20532 - Safety Zone; Boom Days, Niagara River, Niagara Falls, NY

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

...-AA00 Safety Zone; Boom Days, Niagara River, Niagara Falls, NY AGENCY: Coast Guard, DHS. ACTION..., Niagara Falls, NY for the Boom Days Fireworks. This zone is intended to restrict vessels from La Salle Marina and a portion of the Niagara River, Niagara Falls, NY during the Boom Days Fireworks on April 16...

Reduction in fluoride-induced genotoxicity in mouse bone marrow cells after substituting high fluoride-containing water with safe drinking water.

PubMed

Podder, Santosh; Chattopadhyay, Ansuman; Bhattacharya, Shelley

2011-10-01

Treatment of mice with 15 mg l(-1) sodium fluoride (NaF) for 30 days increased the number of cell death, chromosomal aberrations (CAs) and 'cells with chromatid breaks' (aberrant cells) compared with control. The present study was intended to determine whether the fluoride (F)-induced genotoxicity could be reduced by substituting high F-containing water after 30 days with safe drinking water, containing 0.1 mg F ions l(-1). A significant fall in percentage of CAs and aberrant cells after withdrawal of F-treatment following 30 days of safe water treatment in mice was observed which was highest after 90 days, although their levels still remained significantly high compared with the control group. This observation suggests that F-induced genotoxicity could be reduced by substituting high F-containing water with safe drinking water. Further study is warranted with different doses and extended treatment of safe water to determine whether the induced damages could be completely reduced or not. Copyright © 2011 John Wiley & Sons, Ltd.

Archeological Investigations in the Truscott Reservoir Area. King and Knox Counties, Texas,

DTIC Science & Technology

1978-06-01

Roy Dickinson, Mr. John A. Kay, Mr. Benton Ross, and the staff of the Texas Highway Department District Headquarters of Wichita Falls for...of the earliest settlers in King County was Isom Lynn, who came there in 1877 with friends, John and Aaron Lasater, from Jack County. The Lasaters...J. W. Williams, "Some Northwest Texas Trails after Butterfield," West Texas Historical Association Year Book 42 (1966), pp. 78-79. 23. John R

Navy Ship Names: Background for Congress

DTIC Science & Technology

2012-03-01

17, 1973. It is the only Naval vessel to date to have received a Papal blessing by Pope John Paul II in Naples, Italy, on September 4, 1981...received a Papal blessing by Pope John Paul II in Naples, Italy, on September 4, 1981. (9) The U.S.S. Capodanno was decommissioned on July 30, 1993...young officers and the esteemed ship from falling into Confederate hands. (13) In 1896, Congressman John F. ‘‘Honey Fitz ’’ Fitzgerald introduced

Navy Ship Names: Background for Congress

DTIC Science & Technology

2012-10-18

to have received a Papal blessing by Pope John Paul II in Naples, Italy, on September 4, 1981. (9) The U.S.S. Capodanno was decommissioned on July...It is the only Naval vessel to date to have received a Papal blessing by Pope John Paul II in Naples, Italy, on September 4, 1981...Island, preventing the young officers and the esteemed ship from falling into Confederate hands. (13) In 1896, Congressman John F. ‘‘Honey Fitz

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

PubMed

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

2016-10-07

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

The IVAIRE project--a randomized controlled study of the impact of ventilation on indoor air quality and the respiratory symptoms of asthmatic children in single family homes.

PubMed

Lajoie, P; Aubin, D; Gingras, V; Daigneault, P; Ducharme, F; Gauvin, D; Fugler, D; Leclerc, J-M; Won, D; Courteau, M; Gingras, S; Héroux, M-È; Yang, W; Schleibinger, H

2015-12-01

A randomized controlled trial was carried out to measure the impact of an intervention on ventilation, indoor air contaminants, and asthma symptoms of children. Eighty-three asthmatic children living in low-ventilated homes were followed over 2 years. Several environmental parameters were measured during the summer, fall, and winter. The children were randomized after Year 1 (43 Intervention; 40 Control). The intervention included the installation of either a Heat Recovery Ventilator (HRV) or Energy Recovery Ventilator (ERV). During the fall and winter seasons, there was a significant increase in the mean ventilation rate in the homes of the intervention group. A statistically significant reduction in mean formaldehyde, airborne mold spores, toluene, styrene, limonene, and α-pinene concentrations was observed in the intervention group. There was no significant group difference in change in the number of days with symptoms per 14 days. However, there was a significant decrease in the proportion of children who experienced any wheezing (≥1 episode) and those with ≥4 episodes in the 12-month period in the intervention group. This study indicates that improved ventilation reduces air contaminants and may prevent wheezing. Due to lack of power, a bigger study is needed. Positive findings from this study include the fact that, upon recruitment, most of the single family homes with asthmatic children were already equipped with a mechanical ventilation system and had relatively good indoor air quality. However, the 8-h indoor guideline for formaldehyde (50 μg/m3) was frequently exceeded and the ventilation rates were low in most of the homes, even those with a ventilation system. Both ERVs and HRVs were equally effective at increasing air exchange rates above 0.30 ACH and at preventing formaldehyde concentrations from exceeding the 50 μg/m3 guideline during the fall and winter seasons. Furthermore, the ERVs were effective at preventing excessively low relative humidities in the homes. Based on observed difference of risk, intervention to increase ventilation in five sample homes and children would prevent 1 home to exceed the indoor air long-term formaldehyde guideline and prevent 1 asthmatic child experiencing at least one episode of wheezing over a year. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Fall events in geriatric hospital in-patients. Results of prospective recording over a 3 year period].

PubMed

von Renteln-Kruse, W; Krause, T

2004-02-01

For a period of 3 consecutive years, all fall events were prospectively recorded in geriatric hospital in-patients by using a standardized protocol. The incidence was 9.1 fall events/1000 hospital days in 5946 patients, and 41.0/1000 hospital days in 1015 patients (17.0%) who actually had falls. The fall rate varied between 35.0-57.0/1000 hospital days according to the main diagnostic group. Fall events were more often recorded in men than women. Recurrent falls (> or =3 falls) which contributed 13% to the 1596 falls were recorded more frequently in male patients. The majority of fall events (73.5%) occurred in patient rooms, another 20% on the floor between the patient's bedroom and toilet/bath, or in the toilet/bath, respectively. The absolute numbers of falls during night and day were not different. However, there were different patterns in the time distribution of high fall frequencies according to the main diagnostic groups. Confusion and dehydration were recorded more frequently with fall events in patients 80 years and older, and more often in fall events during the night. Injuries due to falls which had to be treated were rare, and fall-related fractures were very rare. The average duration of in-hospital stay was longer for patients with than without falls.

Scholarship in Teaching and Learning: An Interview with John Mitterer

ERIC Educational Resources Information Center

Daniel, David B.

2009-01-01

John Mitterer earned his PhD in cognitive psychology from McMaster University. Like many teaching professors, his career took an unexpected turn early on when he was hired to teach introductory psychology at Brock University, near Niagara Falls, in Ontario, Canada. It was love at first lecture. He never left the course and now, as a full professor…

Rehospitalization after pediatric heart transplantation: Incidence, indications, and outcomes.

PubMed

Hollander, Seth A; McElhinney, Doff B; Almond, Christopher S; McDonald, Nancy; Chen, Sharon; Kaufman, Beth D; Bernstein, Daniel; Rosenthal, David N

2017-02-01

We report the patterns of rehospitalization after pediatric heart transplant (Htx) at a single center. Retrospective review of 107 consecutive pediatric Htx recipients between January 22, 2007, and August 28, 2014, who survived their initial transplant hospitalization. The frequency, duration, and indications for all hospitalizations between transplant hospitalization discharge and September 30, 2015, were analyzed. A total of 444 hospitalization episodes occurred in 90 of 107 (84%) patients. The median time to first rehospitalization was 59.5 (range 1-1526) days, and the median length of stay was 2.5 (range 0-81) days. There were an average of two hospitalizations per patient in the first year following transplant hospitalization, declining to about 0.8 per patient per year starting at 3 years post-transplant. Admissions for viral infections were most common, occurring in 93 of 386 (24%), followed by rule out sepsis in 61 of 386 (16%). Admissions for suspected or confirmed rejection were less frequent, accounting for 41 of 386 (11%) and 31 of 386 (8%) of all admissions, respectively. Survival to discharge after rehospitalization was 97%. Hospitalization is common after pediatric Htx, particularly in the first post-transplant year, with the most frequent indications for hospitalization being viral illness and rule out sepsis. After the first post-transplant year, the risk for readmission falls significantly but remains constant for several years. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Preoperative Falls Predict Postoperative Falls, Functional Decline, and Surgical Complications.

PubMed

Kronzer, Vanessa L; Jerry, Michelle R; Ben Abdallah, Arbi; Wildes, Troy S; Stark, Susan L; McKinnon, Sherry L; Helsten, Daniel L; Sharma, Anshuman; Avidan, Michael S

2016-10-01

Falls are common and linked to morbidity. Our objectives were to characterize postoperative falls, and determine whether preoperative falls independently predicted postoperative falls (primary outcome), functional dependence, quality of life, complications, and readmission. This prospective cohort study included 7982 unselected patients undergoing elective surgery. Data were collected from the medical record, a baseline survey, and follow-up surveys approximately 30days and one year after surgery. Fall rates (per 100 person-years) peaked at 175 (hospitalization), declined to 140 (30-day survey), and then to 97 (one-year survey). After controlling for confounders, a history of one, two, and ≥three preoperative falls predicted postoperative falls at 30days (adjusted odds ratios [aOR] 2.3, 3.6, 5.5) and one year (aOR 2.3, 3.4, 6.9). One, two, and ≥three falls predicted functional decline at 30days (aOR 1.2, 2.4, 2.4) and one year (aOR 1.3, 1.5, 3.2), along with in-hospital complications (aOR 1.2, 1.3, 2.0). Fall history predicted adverse outcomes better than commonly-used metrics, but did not predict quality of life deterioration or readmission. Falls are common after surgery, and preoperative falls herald postoperative falls and other adverse outcomes. A history of preoperative falls should be routinely ascertained. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Hourly rounding and patient falls: what factors boost success?

PubMed

Goldsack, Jennifer; Bergey, Meredith; Mascioli, Susan; Cunningham, Janet

2015-02-01

Falls are a persistent problem in all healthcare settings, with rates in acute care hospitals ranging from 1.3 to 8.9 falls per 1,000 inpatient days, about 30% resulting in serious injury. A 30-day prospective pilot study was conducted on two units with pre- and postimplementation evaluation to determine the impact of patient-centered proactive hourly rounding on patient falls as part of a Lean Six Sigma process improvement project. Nurse leaders and a staff champion from Unit 1 were involved in the process from the start of the implementation period, while Unit 2 was introduced to the project for training shortly before the intervention began. On Unit 1, where staff and leadership were engaged in the project from the outset, the 1-year baseline mean fall rate was 3.9 falls/1,000 patient days. The pilot period fall rate of 1.3 falls/1,000 patient days was significantly lower than the baseline fall rate (P = 0.006). On Unit 2, where there was no run-in period, the 1-year baseline mean fall rate was 2.6 falls/1,000 patient days, which fell, but not significantly, to 2.5 falls/1,000 patient days during the pilot period (P = 0.799). Engaging an interdisciplinary team, including leadership and unit champions, to complete a Lean Six Sigma process improvement project and implement a patient-centered proactive hourly rounding program was associated with a significant reduction in the fall rate in Unit 1. Implementation of the same program in Unit 2 without engaging leadership or front-line staff in program design did not impact its fall rate. The active involvement of leadership and front-line staff in program design and as unit champions during the project run-in period was critical to significantly reducing inpatient fall rates and call bell use in an adult medical unit.

The Infrastructure of Command Information Systems

DTIC Science & Technology

1991-11-01

Coordinator: Jan Prins RAs: Ed Biagioni (ONR fellow, FYgo-91) Quan Zhou SOFTLAB (infrastructure) Coordinator: Staff: Susanna Schwab (director of...engineer 2 Research Assistants: John Alspaugh * Murray Anderegg mp* Ron Azuma * Mike Bajura mp* David Becker Andrew Bell mp Ed Biagioni ...Jan Prins *Ed Biagioni (ONR fellow, FY90-91), *fall 90 *Dan Poirier *John A. Smith 3 CLOCS (ONR Fellow) Coordinator: RA: Donald F. Stanat *Mark Davis

No "Fear of Flying"? Worrals of the WAAF, Fiction, and Girls' Informal Wartime Education

ERIC Educational Resources Information Center

Spencer, Stephanie

2016-01-01

This article focuses on the series of 11 books about a young female pilot, "Worrals of the WAAF," by W.E. Johns, creator of Biggles. The Worrals books were published from 1941 when recruitment for the Women's Auxiliary Air Force was falling. Johns chose to ignore that the WAAF supported pilots through their work on the ground and did not…

Strategic Purpose of U.S. Military Foreign Humanitarian Assistance Operations

DTIC Science & Technology

2013-04-01

Observations—The El Salvador Case. U.S. Military Group, El Salvador Country Team, Fall, 2002, 4. 16...primarily 19 John D. Waghelstein, Military-To-Military Contacts: Personal Observations—The El Salvador Case. U.S. Military Group, El Salvador Country...Observations—The El Salvador Case. U.S. Military Group, El Salvador Country Team. Fall, 2002. Walt, Stephen M. "International Relations: One World, Many

76 FR 67206 - Notice of Public Meeting, John Day-Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLORV00000.L10200000.DD0000; HAG 12-0022] Notice of Public Meeting, John Day-Snake Resource Advisory Council AGENCY: Bureau of Land Management... (BLM) John Day-Snake Resource Advisory Council (RAC) will meet as indicated below: DATES: The meeting...

76 FR 78691 - Notice of Public Meeting, John Day-Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-19

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLORV00000.L10200000.DD0000; HAG 12-0056] Notice of Public Meeting, John Day-Snake Resource Advisory Council AGENCY: Bureau of Land Management... (BLM) John Day-Snake Resource Advisory Council (RAC) will meet as indicated below: DATES: The meeting...

Long continuous bridge deck evaluation : John Day River Bridge, Clatsop County, Bridge No. 1827B : final report.

DOT National Transportation Integrated Search

1995-06-01

The John Day River Bridge, near Astoria, Oregon was built with a continuous deck length of 1,105 ft. (340 m). The rationale for designing the John Day River Bridge with an unusually long continuous deck is in part based on the site's very mild climat...

1. Historic American Buildings Survey, Louis I. Schwartz, Photographer August, ...

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

1. Historic American Buildings Survey, Louis I. Schwartz, Photographer August, 1958 HOUSE AND ENVIRONMENT, FROM NORTHWEST. - John Falls Walker House, 344 East Bay Street, Charleston, Charleston County, SC

43 CFR 4.905 - What if a due date falls on a day the Department or relevant office is not open for business?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What if a due date falls on a day the... Appeals Concerning Federal Oil and Gas Royalties and Related Matters § 4.905 What if a due date falls on a day the Department or relevant office is not open for business? If a due date under this subpart falls...

43 CFR 4.905 - What if a due date falls on a day the Department or relevant office is not open for business?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false What if a due date falls on a day the... Appeals Concerning Federal Oil and Gas Royalties and Related Matters § 4.905 What if a due date falls on a day the Department or relevant office is not open for business? If a due date under this subpart falls...

43 CFR 4.905 - What if a due date falls on a day the Department or relevant office is not open for business?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false What if a due date falls on a day the... Appeals Concerning Federal Oil and Gas Royalties and Related Matters § 4.905 What if a due date falls on a day the Department or relevant office is not open for business? If a due date under this subpart falls...

43 CFR 4.905 - What if a due date falls on a day the Department or relevant office is not open for business?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false What if a due date falls on a day the... Appeals Concerning Federal Oil and Gas Royalties and Related Matters § 4.905 What if a due date falls on a day the Department or relevant office is not open for business? If a due date under this subpart falls...

43 CFR 4.905 - What if a due date falls on a day the Department or relevant office is not open for business?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true What if a due date falls on a day the... Appeals Concerning Federal Oil and Gas Royalties and Related Matters § 4.905 What if a due date falls on a day the Department or relevant office is not open for business? If a due date under this subpart falls...

Does acute care for the elderly (ACE) unit decrease the incidence of falls?

PubMed

Abdalla, Ahmed; Adhaduk, Mehul; Haddad, Raad A; Alnimer, Yanal; Ríos-Bedoya, Carlos F; Bachuwa, Ghassan

2017-11-11

To determine whether acute care for the elderly (ACE) units decrease the incidence of patient falls compared to general medical and surgical (GMS) units, a non-concurrent prospective study included individuals aged 65 and older admitted to ACE or GMS units over a 2-year span was done. There were 7069 admissions corresponded to 28,401 patient-days. A total of 149 falls were reported for an overall incidence rate (IR) of 5.2 falls per 1000 patient-days, 95% CI, 4.4/1000-6.1/1000 patient-days. The falls IR ratio for patients in ACE unit compared to those in non-ACE units after adjusting for age, sex, prescribed psychotropics and hypnotics, and Morse Fall Score was 0.27/1000 patient-days; 95% CI, 0.13-0.54; p < 0.001. So, an estimated 73% reduction in patient falls between ACE unit and non-ACE units. Hospitals may consider investing in ACE units to decrease the risk of falls and the associated medical and financial costs. Copyright © 2017 Elsevier Inc. All rights reserved.

NIH Research Leads to Cervical Cancer Vaccine

MedlinePlus

... Transmitted Diseases NIH Research Leads to Cervical Cancer Vaccine Past Issues / Fall 2008 Table of Contents For ... Douglas Lowy (left) and John Schiller developed the vaccine to prevent HPV infection in women, the cause ...

2005 Tri-Service Infrastructure Systems Conference and Exhibition. Volume 5, Track 5

DTIC Science & Technology

2005-08-04

Patrick O’Brien and David Biedenharn Watershed Approach to Stream Stability and Benefits Related to the Reduction of Nutrients, by John B. Smith A Lake ...J.B. Smith and Randall A. Wise Bluff Stabilization along Lake Michigan, using Active and Passive Dewatering Techniques, by Rennie Kaunda, Eileen...Sacred Falls, Oahsacred Falls, Oahu Section 227 Demonstration Project Track 4 Fern Ridge LakFern Ridge Lake Hydrologic Aspects of Operation during Failure

The Confederated Tribes of the Warm Springs Indian Reservation of Oregon John Day Basin Office : Watershed Restoration Projects : Annual Report, 2001.

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

Confederated Tribes of the Warm Springs Reservation of Oregon. John Day Basin Office.

The John Day River is the nation's second longest free-flowing river in the contiguous United States, which is entirely unsupplemented for it's runs of anadromous fish. Located in eastern Oregon, the John Day Basin drains over 8,000 square miles, is Oregon's fourth largest drainage basin, and the basin incorporates portions of eleven counties. Originating in the Strawberry Mountains near Prairie City, the mainstem John Day River flows 284 miles in a northwesterly direction entering the Columbia River approximately four miles upstream of the John Day dam. With wild runs of spring Chinook salmon, summer steelhead, westslope cutthroat, and redband andmore » bull trout, the John Day system is truly a basin with national significance. The Majority of the John Day Basin was ceded to the Federal government in 1855 by the Confederated Tribes of the Warm Springs Reservation of Oregon (Tribes). In 1997, the Tribes established an office in John Day to coordinate basin restoration projects, monitoring, planning, and other watershed restoration activities on private and public lands. Once established, the John Day Basin Office (JDBO) formed a partnership with the Grant Soil and Water Conservation District (GSWCD), also located in John Day, who subcontracts the majority of the construction implementation activities for these restoration projects from the JDBO. The GSWCD completes the landowner contact, preliminary planning, engineering design, permitting, construction contracting, and construction implementation phases of most projects. The JDBO completes the planning, grant solicitation/defense, environmental compliance, administrative contracting, monitoring, and reporting portion of the program. Most phases of project planning, implementation, and monitoring are coordinated with the private landowners and basin agencies, such as the Oregon Department of Fish and Wildlife and Oregon Water Resources Department. In 2001, the JDBO and GSWCD continued their successful partnership between the two agencies and basin landowners to implement an additional ten (10) watershed conservation projects. The project types include permanent lay flat diversions, pump stations, and return-flow cooling systems. Project costs in 2001 totaled $572,766.00 with $361,966.00 (67%) provided by the Bonneville Power Administration (BPA) and the remainder coming from other sources, such as the Bureau of Reclamation (BOR), Oregon Watershed Enhancement Board (OWEB), and individual landowners.« less

Assessment of landslide hazards in Kaluanui and Maakua gulches, Oahu, Hawaii, following the 9 May 1999 Sacred Falls landslide

USGS Publications Warehouse

Jibson, R.W.; Baum, R.L.

1999-01-01

One of the injured hikers later died of injuries received in the landslide. Governor Ben Cayetano of Hawaii ordered that the park be closed due to concern about continuing landslide hazard near the falls. Subsequently, Bill Meyer, District Chief for the U.S. Geological Survey (USGS) Water Resources Division in Honolulu contacted Tim Johns, Chair of the Board of Land and Natural Resources of the Hawaii Department of Land and Natural Resources (DLNR) and offered assistance in assessing slope stability in the park. Mr. Johns accepted the offer, and two landslide specialists from the USGS Geologic Hazards Team in Golden Colorado were sent to the site. On Friday, 14 May 1999, we visited the Sacred Falls landslide site with Glenn Bauer, Ed Sakoda, and Gary Moniz of DLNR. The ground investigation involved inspecting the impact area, estimating the volume of the deposit, and gathering data to help reconstruct the event. On Monday, 17 May 1999, we conducted an aerial reconnaissance of Kaluanui Gulch (Sacred Falls State Park) and Maakua Gulch in a commercial helicopter provided by DLNR. We inspected the source and path of movement of the Sacred Falls landslide of 9 May and reconnoitered the full length of both valleys to get an overview of ongoing landslide hazards there. This report gives our observations and conclusions about the Sacred Falls landslide, broadly assesses the ongoing hazard in the Kaluanui and Maakua Gulches, and suggests methods for more detailed assessment of landslide hazards here and along other trails in state parks on Oahu. Observations and conclusions in this report are based on a very brief investigation and thus are preliminary in nature.

Fall prevention in acute care hospitals: a randomized trial.

PubMed

Dykes, Patricia C; Carroll, Diane L; Hurley, Ann; Lipsitz, Stuart; Benoit, Angela; Chang, Frank; Meltzer, Seth; Tsurikova, Ruslana; Zuyov, Lyubov; Middleton, Blackford

2010-11-03

Falls cause injury and death for persons of all ages, but risk of falls increases markedly with age. Hospitalization further increases risk, yet no evidence exists to support short-stay hospital-based fall prevention strategies to reduce patient falls. To investigate whether a fall prevention tool kit (FPTK) using health information technology (HIT) decreases patient falls in hospitals. Cluster randomized study conducted January 1, 2009, through June 30, 2009, comparing patient fall rates in 4 urban US hospitals in units that received usual care (4 units and 5104 patients) or the intervention (4 units and 5160 patients). The FPTK integrated existing communication and workflow patterns into the HIT application. Based on a valid fall risk assessment scale completed by a nurse, the FPTK software tailored fall prevention interventions to address patients' specific determinants of fall risk. The FPTK produced bed posters composed of brief text with an accompanying icon, patient education handouts, and plans of care, all communicating patient-specific alerts to key stakeholders. The primary outcome was patient falls per 1000 patient-days adjusted for site and patient care unit. A secondary outcome was fall-related injuries. During the 6-month intervention period, the number of patients with falls differed between control (n = 87) and intervention (n = 67) units (P=.02). Site-adjusted fall rates were significantly higher in control units (4.18 [95% confidence interval {CI}, 3.45-5.06] per 1000 patient-days) than in intervention units (3.15 [95% CI, 2.54-3.90] per 1000 patient-days; P = .04). The FPTK was found to be particularly effective with patients aged 65 years or older (adjusted rate difference, 2.08 [95% CI, 0.61-3.56] per 1000 patient-days; P = .003). No significant effect was noted in fall-related injuries. The use of a fall prevention tool kit in hospital units compared with usual care significantly reduced rate of falls. clinicaltrials.gov Identifier: NCT00675935.

Fall Prevention in Acute Care Hospitals

PubMed Central

Dykes, Patricia C.; Carroll, Diane L.; Hurley, Ann; Lipsitz, Stuart; Benoit, Angela; Chang, Frank; Meltzer, Seth; Tsurikova, Ruslana; Zuyov, Lyubov; Middleton, Blackford

2011-01-01

Context Falls cause injury and death for persons of all ages, but risk of falls increases markedly with age. Hospitalization further increases risk, yet no evidence exists to support short-stay hospital-based fall prevention strategies to reduce patient falls. Objective To investigate whether a fall prevention tool kit (FPTK) using health information technology (HIT) decreases patient falls in hospitals. Design, Setting, and Patients Cluster randomized study conducted January 1, 2009, through June 30, 2009, comparing patient fall rates in 4 urban US hospitals in units that received usual care (4 units and 5104 patients) or the intervention (4 units and 5160 patients). Intervention The FPTK integrated existing communication and workflow patterns into the HIT application. Based on a valid fall risk assessment scale completed by a nurse, the FPTK software tailored fall prevention interventions to address patients’ specific determinants of fall risk. The FPTK produced bed posters composed of brief text with an accompanying icon, patient education handouts, and plans of care, all communicating patient-specific alerts to key stakeholders. Main Outcome Measures The primary outcome was patient falls per 1000 patient-days adjusted for site and patient care unit. A secondary outcome was fall-related injuries. Results During the 6-month intervention period, the number of patients with falls differed between control (n=87) and intervention (n=67) units (P=.02). Site-adjusted fall rates were significantly higher in control units (4.18 [95% confidence interval {CI}, 3.45-5.06] per 1000 patient-days) than in intervention units (3.15 [95% CI, 2.54-3.90] per 1000 patient-days; P=.04). The FPTK was found to be particularly effective with patients aged 65 years or older (adjusted rate difference, 2.08 [95% CI, 0.61-3.56] per 1000 patient-days; P=.003). No significant effect was noted in fall-related injuries. Conclusion The use of a fall prevention tool kit in hospital units compared with usual care significantly reduced rate of falls. PMID:21045097

26 CFR 301.7503-1 - Time for performance of acts where last day falls on Saturday, Sunday, or legal holiday.

Code of Federal Regulations, 2012 CFR

2012-04-01

... falls on Saturday, Sunday, or legal holiday. 301.7503-1 Section 301.7503-1 Internal Revenue INTERNAL... where last day falls on Saturday, Sunday, or legal holiday. (a) In general. Section 7503 provides that... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

26 CFR 301.7503-1 - Time for performance of acts where last day falls on Saturday, Sunday, or legal holiday.

Code of Federal Regulations, 2011 CFR

2011-04-01

... falls on Saturday, Sunday, or legal holiday. 301.7503-1 Section 301.7503-1 Internal Revenue INTERNAL... where last day falls on Saturday, Sunday, or legal holiday. (a) In general. Section 7503 provides that... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

26 CFR 301.7503-1 - Time for performance of acts where last day falls on Saturday, Sunday, or legal holiday.

Code of Federal Regulations, 2014 CFR

2014-04-01

... falls on Saturday, Sunday, or legal holiday. 301.7503-1 Section 301.7503-1 Internal Revenue INTERNAL... where last day falls on Saturday, Sunday, or legal holiday. (a) In general. Section 7503 provides that... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

26 CFR 301.7503-1 - Time for performance of acts where last day falls on Saturday, Sunday, or legal holiday.

Code of Federal Regulations, 2013 CFR

2013-04-01

... falls on Saturday, Sunday, or legal holiday. 301.7503-1 Section 301.7503-1 Internal Revenue INTERNAL... where last day falls on Saturday, Sunday, or legal holiday. (a) In general. Section 7503 provides that... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

26 CFR 301.7503-1 - Time for performance of acts where last day falls on Saturday, Sunday, or legal holiday.

Code of Federal Regulations, 2010 CFR

2010-04-01

... falls on Saturday, Sunday, or legal holiday. 301.7503-1 Section 301.7503-1 Internal Revenue INTERNAL... where last day falls on Saturday, Sunday, or legal holiday. (a) In general. Section 7503 provides that... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

Monitoring and Evaluation of Yearling Fall Chinook Salmon Released from Acclimation Facilities Upstream of Lower Granite Dam; 1998 Annual Report.

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

Rocklage, Stephen J.

The Nez Perce Tribe, in cooperation with the U.S. Fish and Wildlife Service and Washington Department of Fish and Wildlife, conducted monitoring and evaluation studies on Lyons Ferry Hatchery (Snake River stock) yearling fall chinook salmon that were acclimated and released at three Fall Chinook Acclimation Project sites upstream of Lower Granite Dam along with yearlings released on-station from Lyons Ferry Hatchery in 1998. The three fall chinook acclimation facilities are operated by the Nez Perce Tribe and located at Pittsburg Landing and Captain John Rapids on the Snake River and at Big Canyon Creek on the Clearwater River. Yearlingsmore » at the Big Canyon facility consisted of two size classes that are referred to in this report as 9.5 fish per pound (fpp) and 30 fpp. The Big Canyon 9.5 fpp were comparable to the yearlings at Pittsburg Landing, Captain John Rapids and Lyons Ferry Hatchery. A total of 9,942 yearlings were PIT tagged and released at Pittsburg Landing. PIT tagged yearlings had a mean fork length of 159.9 mm and mean condition factor of 1.19. Of the 9,942 PIT tagged fish released, a total of 6,836 unique tags were detected at mainstem Snake and Columbia River dams (Lower Granite, Little Goose, Lower Monumental and McNary). A total of 4,926 9.5 fpp and 2,532 30 fpp yearlings were PIT tagged and released at Big Canyon. PIT tagged 9.5 fpp yearlings had a mean fork length of 156.9 mm and mean condition factor of 1.13. PIT tagged 30 fpp yearlings had a mean fork length of 113.1 mm and mean condition factor of 1.18. Of the 4,926 PIT tagged 9.5 fpp yearlings released, a total of 3,042 unique tags were detected at mainstem Snake and Columbia River dams. Of the 2,532 PIT tagged 30 fpp yearlings released, a total of 1,130 unique tags were detected at mainstem Snake and Columbia River dams. A total of 1,253 yearlings were PIT tagged and released at Captain John Rapids. PIT tagged yearlings had a mean fork length of 147.5 mm and mean condition factor of 1.09. Of the 1,253 PIT tagged fish released, a total of 719 unique tags were detected at mainstem Snake and Columbia River dams. A total of 2,420 yearlings were PIT tagged and released at Lyons Ferry Hatchery. PIT tagged yearlings had a mean fork length of 159.0 mm and mean condition factor of 1.10. Of the 2,420 PIT tagged fish released, a total of 979 unique tags were detected at mainstem Snake and Columbia River dams (Lower Monumental and McNary). Median travel times, based on all detections, of PIT tagged fish released from Pittsburg Landing were 10.5 days to Lower Granite Dam, 21.7 days to McNary Dam and 29.8 days to Bonneville Dam. Median migration rates were 16.4 rkm/d to Lower Granite Dam, 18.3 rkm/d to McNary Dam and 18.9 rkm/d to Bonneville Dam. The median arrival dates were April 25 at Lower Granite Dam, May 6 at McNary Dam and May 14 at Bonneville Dam. The 90% passage dates were May 5 at Lower Granite Dam, May 20 at McNary Dam and May 25 at Bonneville Dam. Median travel times, based on all detections, of PIT tagged 9.5 fpp yearlings released from Big Canyon were 13.3 days to Lower Granite Dam, 26.0 days to McNary Dam and 30.8 days to Bonneville Dam. Median migration rates were 13.0 rkm/d to Lower Granite Dam, 15.3 rkm/d to McNary Dam and 18.3 rkm/d to Bonneville Dam. The median arrival dates were April 27 at Lower Granite Dam, May 11 at McNary Dam and May 15 at Bonneville Dam. The 90% passage dates were May 9 at Lower Granite Dam, May 24 at McNary Dam and May 25 at Bonneville Dam. Median travel times, based on all detections, of PIT tagged 30 fpp yearlings released from Big Canyon were 20.8 days to Lower Granite Dam, 37.6 days to McNary Dam and 43.5 days to Bonneville Dam. Median migration rates were 8.3 rkm/d to Lower Granite Dam, 10.6 rkm/d to McNary Dam and 12.9 rkm/d to Bonneville Dam. The median arrival dates were May 5 at Lower Granite Dam, May 23 at McNary Dam and May 28 at Bonneville Dam. The 90% passage dates were May 22 at Lower Granite Dam, May 31 at McNary Dam and June 5 at Bonneville Dam. Median arrival dates, based on all detections, of PIT tagged yearlings released from Captain John Rapids were April 26 at Lower Granite Dam, May 8 at McNary Dam and May 14 at Bonneville Dam. The 90% passage dates were May 8 at Lower Granite Dam, May 23 at McNary Dam and May 26 at Bonneville Dam. Median travel times, based on all detections, of PIT tagged fish released from Lyons Ferry Hatchery were 16.9 days to Lower Monumental Dam, 20.9 days to McNary Dam and 30.3 days to Bonneville Dam. Median migration rates were 1.7 rkm/d to Lower Monumental Dam, 7.0 rkm/d to McNary Dam and 12.6 rkm/d to Bonneville Dam. The median arrival dates were April 27 at Lower Monumental Dam, May 1 at McNary Dam and May 8 at Bonneville Dam. The 90% passage dates were May 13 at Lower Monumental Dam, May 16 at McNary Dam and May 24 at Bonneville Dam.« less

Geochemical map of the North Fork John Day River Roadless Area, Grant County, Oregon

USGS Publications Warehouse

Evans, James G.

1986-01-01

The North Fork John Day River Roadless Area comprised 21,210 acres in the Umatilla and Wallowa-Whitman National Forests, Grant County, Oregon, about 30 miles northwest of Baker, Oregon. The irregularly shaped area extends for about 1 mile on both sides of a 25-mile segment of the North Fork John Day River from Big Creek on the west to North Fork John Day Campground on the east. Most of the roadless area is in the northern half of the Desolation Butte 15-minute quadrangle. The eastern end of the area is in parts of the Granite and Trout Meadows 7½-minute quadrangles.

The Need for Speed. Hypersonic Aircraft and the Transformation of Long Range Airpower

DTIC Science & Technology

2005-06-01

lxxii Heppenheimer , Thomas A . “Origins of Hypersonic Propulsion: A Personal History.” Air Power History 47, no. 3 (Fall 2000), 14-27. Hicks, John W...early Aerospace plane research. 59 Thomas A . Heippenheimer, “Origins of Hypersonic Propulsion: A Personal History,” Air Power History 47, no. 3 (Fall...experiments with hypersonic engines. 65 Ibid. 66 Thomas A . Heippenheimer, 15. 67 Ibid., 17-18. Lockheed and General Applied Science Laboratories

27 CFR 70.306 - Time for performance of acts other than payment of tax or filing of any return when the last day...

Code of Federal Regulations, 2013 CFR

2013-04-01

... acts other than payment of tax or filing of any return when the last day falls on Saturday, Sunday, or... performance of acts other than payment of tax or filing of any return when the last day falls on Saturday... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

27 CFR 70.306 - Time for performance of acts other than payment of tax or filing of any return where last day...

Code of Federal Regulations, 2010 CFR

2010-04-01

... acts other than payment of tax or filing of any return where last day falls on Saturday, Sunday, or... performance of acts other than payment of tax or filing of any return where last day falls on Saturday, Sunday... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

27 CFR 70.306 - Time for performance of acts other than payment of tax or filing of any return when the last day...

Code of Federal Regulations, 2011 CFR

2011-04-01

... acts other than payment of tax or filing of any return when the last day falls on Saturday, Sunday, or... performance of acts other than payment of tax or filing of any return when the last day falls on Saturday... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

27 CFR 70.306 - Time for performance of acts other than payment of tax or filing of any return when the last day...

Code of Federal Regulations, 2012 CFR

2012-04-01

... acts other than payment of tax or filing of any return when the last day falls on Saturday, Sunday, or... performance of acts other than payment of tax or filing of any return when the last day falls on Saturday... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

27 CFR 70.306 - Time for performance of acts other than payment of tax or filing of any return when the last day...

Code of Federal Regulations, 2014 CFR

2014-04-01

... acts other than payment of tax or filing of any return when the last day falls on Saturday, Sunday, or... performance of acts other than payment of tax or filing of any return when the last day falls on Saturday... falls on a Saturday, Sunday, or legal holiday, such act shall be considered performed timely if...

Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study.

PubMed

Makino, Keitaro; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki

2018-04-01

Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence. Copyright © 2017 John Wiley & Sons, Ltd.

Impacts of the Columbia River hydroelectric system on main-stem habitats of fall chinook salmon

USGS Publications Warehouse

Dauble, D.D.; Hanrahan, T.P.; Geist, D.R.; Parsley, M.J.

2003-01-01

Salmonid habitats in main-stem reaches of the Columbia and Snake rivers have changed dramatically during the past 60 years because of hydroelectric development and operation. Only about 13% and 58% of riverine habitats in the Columbia and Snake rivers, respectively, remain. Most riverine habitat is found in the upper Snake River; however, it is upstream of Hells Canyon Dam and not accessible to anadromous salmonids. We determined that approximately 661 and 805 km of the Columbia and Snake rivers, respectively, were once used by fall chinook salmon Oncorhynchus tshawytscha for spawning. Fall chinook salmon currently use only about 85 km of the main-stem Columbia River and 163 km of the main-stem Snake River for spawning. We used a geomorphic model to identify three river reaches downstream of present migration barriers with high potential for restoration of riverine processes: the Columbia River upstream of John Day Dam, the Columbia-Snake-Yakima River confluence, and the lower Snake River upstream of Little Goose Dam. Our analysis substantiated the assertion that historic spawning areas for fall chinook salmon occurred primarily within wide alluvial floodplains, which were once common in the mainstem Columbia and Snake rivers. These areas possessed more unconsolidated sediment and more bars and islands and had lower water surface slopes than did less extensively used areas. Because flows in the main stem are now highly regulated, the predevelopment alluvial river ecosystem is not expected to be restored simply by operational modification of one or more dams. Establishing more normative flow regimes - specifically, sustained peak flows for scouring - is essential to restoring the functional characteristics of existing, altered habitats. Restoring production of fall chinook salmon to any of these reaches also requires that population genetics and viability of potential seed populations (i.e., from tributaries, tailrace spawning areas, and hatcheries) be considered.

Falls documentation in nursing homes: agreement between the minimum data set and chart abstractions of medical and nursing documentation.

PubMed

Hill-Westmoreland, Elizabeth E; Gruber-Baldini, Ann L

2005-02-01

To assess the agreement between falls as recorded in the Minimum Data Set (MDS) and fall events abstracted from chart documentation of elderly nursing home (NH) residents. Secondary analysis of data from a longitudinal panel study. Fifty-six randomly selected NHs in Maryland stratified by facility size and geographic region. Four hundred sixty-two NH residents, aged 65 and older, in NHs for 1 year. Falls were abstracted from resident charts and compared with MDS fall variables. Fall events data obtained from other sources of chart documentation were matched for the corresponding periods of 30 and 180 days before the 1-year MDS assessment date. For a 30-day period, concordance between the MDS and chart abstractions of falls occurred in 65% of cases, with a kappa coefficient of 0.29 (P<.001), indicating fair agreement. Concordance occurred between the sources for 75% of cases for a 180-day period, with a kappa of 0.50 (P<.001), indicating moderate agreement. During the 180-day period, chart abstractions showed that 49% of the sample fell, whereas the MDS revealed that only 28% fell. An analysis of residents whose falls the MDS missed indicated that these residents had significantly more activity of daily living impairment and significantly less unsteady gait and cane/walker use. The MDS underreported falls. Nurses completing MDS assessments must carefully review residents' medical records for falls documentation. Future studies should use caution when employing MDS data as the only indicator of falls.

Objective Assessment of Fall Risk in Parkinson's Disease Using a Body-Fixed Sensor Worn for 3 Days

PubMed Central

Weiss, Aner; Herman, Talia; Giladi, Nir; Hausdorff, Jeffrey M.

2014-01-01

Background Patients with Parkinson's disease (PD) suffer from a high fall risk. Previous approaches for evaluating fall risk are based on self-report or testing at a given time point and may, therefore, be insufficient to optimally capture fall risk. We tested, for the first time, whether metrics derived from 3 day continuous recordings are associated with fall risk in PD. Methods and Materials 107 patients (Hoehn & Yahr Stage: 2.6±0.7) wore a small, body-fixed sensor (3D accelerometer) on lower back for 3 days. Walking quantity (e.g., steps per 3-days) and quality (e.g., frequency-derived measures of gait variability) were determined. Subjects were classified as fallers or non-fallers based on fall history. Subjects were also followed for one year to evaluate predictors of the transition from non-faller to faller. Results The 3 day acceleration derived measures were significantly different in fallers and non-fallers and were significantly correlated with previously validated measures of fall risk. Walking quantity was similar in the two groups. In contrast, the fallers walked with higher step-to-step variability, e.g., anterior-posterior width of the dominant frequency was larger (p = 0.012) in the fallers (0.78±0.17 Hz) compared to the non-fallers (0.71±0.07 Hz). Among subjects who reported no falls in the year prior to testing, sensor-derived measures predicted the time to first fall (p = 0.0034), whereas many traditional measures did not. Cox regression analysis showed that anterior-posterior width was significantly (p = 0.0039) associated with time to fall during the follow-up period, even after adjusting for traditional measures. Conclusions/Significance These findings indicate that a body-fixed sensor worn continuously can evaluate fall risk in PD. This sensor-based approach was able to identify transition from non-faller to faller, whereas many traditional metrics were not successful. This approach may facilitate earlier detection of fall risk and may in the future, help reduce high costs associated with falls. PMID:24801889

Short-term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment with Antihypertensive Medication

PubMed Central

Shimbo, Daichi; Bowling, C. Barrett; Levitan, Emily B.; Deng, Luqin; Sim, John J.; Huang, Lei; Reynolds, Kristi; Muntner, Paul

2016-01-01

Background Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls following antihypertensive medication initiation and intensification. Methods and Results We examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90,127 Medicare beneficiaries who were ≥65 years old and had a serious fall injury between July 1, 2007 and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the prior year. Intensification was defined by the addition of a new antihypertensive class, and, separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy, respectively, within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days following antihypertensive medication initiation [odds ratio, OR, 1.36 (95% CI 1.19, 1.55)], adding a new class [OR 1.16 (95% CI 1.10, 1.23)], and titration [OR 1.13 (95% CI 1.08, 1.18)]. These associations were attenuated beyond 15 days. Conclusions Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults. PMID:27166208

Short-Term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment With Antihypertensive Medication.

PubMed

Shimbo, Daichi; Barrett Bowling, C; Levitan, Emily B; Deng, Luqin; Sim, John J; Huang, Lei; Reynolds, Kristi; Muntner, Paul

2016-05-01

Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls after antihypertensive medication initiation and intensification. We examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90 127 Medicare beneficiaries who were ≥65 years old and had a serious fall injury between July 1, 2007, and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the previous year. Intensification was defined by the addition of a new antihypertensive class, and separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days after antihypertensive medication initiation (odds ratio, 1.36 [95% confidence interval, 1.19-1.55]), adding a new class (odds ratio, 1.16 [95% confidence interval, 1.10-1.23]), and titration [odds ratio, 1.13 [95% confidence interval, 1.08-1.18]). These associations were attenuated beyond 15 days. Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults. © 2016 American Heart Association, Inc.

The Ram's Horn.

ERIC Educational Resources Information Center

Rassias, John A., Ed.; And Others

1983-01-01

The summer-fall and winter-spring numbers of the journal, "The Ram's Horn," contain these articles: "The Text as Dramatic Departure"; "The Dartmouth Language Outreach Approach to Spanish for Police Action"; "The Dartmouth Intensive Language Model (DILM) in Florida: John Rassias with High School Teachers";…

My Voice Heard: The Journey of a Young Man with a Cerebral Visual Impairment

ERIC Educational Resources Information Center

Macintyre-Beon, Catriona; Mitchell, Kate; Gallagher, Ian; Cockburn, Debbie; Dutton, Gordon N.; Bowman, Richard

2012-01-01

This longitudinal case study presents John's journey through childhood and adolescence, living with visual difficulties associated with a cerebral visual impairment. It highlights the day-to-day problems that John encountered, giving practical solutions and strategies that have enabled his dream of going to a university to be realized. John and…

Temporal association between hospitalization and rate of falls after discharge.

PubMed

Mahoney, J E; Palta, M; Johnson, J; Jalaluddin, M; Gray, S; Park, S; Sager, M

2000-10-09

Evidence suggests that acute illness and hospitalization may increase the risk for falls. To evaluate the rate of falls, and associated risk factors, for 90 days following hospital discharge. We consecutively enrolled 311 patients, aged 65 years and older, discharged from the hospital after an acute medical illness and receiving home-nursing services. Patients were assessed within 5 days of discharge for prehospital and current functioning by self-report, and balance, vision, cognition, and delirium by objective measures. Patients were followed up weekly for 13 weeks for falls, injuries, and health care use. The rate of falls was significantly higher in the first 2 weeks after hospitalization (8.0 per 1000 person-days) compared with 3 months later (1.7 per 1000 person-days) (P =.002). Fall-related injuries accounted for 15% of all hospitalizations in the first month after discharge. Independent prehospital risk factors significantly associated with falls included dependency in activities of daily living, use of a standard walker, 2 or more falls, and more hospitalizations in the year prior. Posthospital risk factors included use of a tertiary amine tricyclic antidepressant, probable delirium, and poorer balance, while use of a cane was protective. The rate of falls is substantially increased in the first month after medical hospitalization, and is an important cause of injury and morbidity. Posthospital risk factors may be potentially modifiable. Efforts to assess and modify risk factors should be integral to the hospital and posthospital care of older adults (those aged >/=65 years).

Using Multiple Metrics to Analyze Trends and Sensitivity of Climate Variability in New York City

NASA Astrophysics Data System (ADS)

Huang, J.; Towey, K.; Booth, J. F.; Baez, S. D.

2017-12-01

As the overall temperature of Earth continues to warm, changes in the Earth's climate are being observed through extreme weather events, such as heavy precipitation events and heat waves. This study examines the daily precipitation and temperature record of the greater New York City region during the 1979-2014 period. Daily station observations from three greater New York City airports: John F. Kennedy (JFK), LaGuardia (LGA) and Newark (EWR), are used in this study. Multiple statistical metrics are used in this study to analyze trends and variability in temperature and precipitation in the greater New York City region. The temperature climatology reveals a distinct seasonal cycle, while the precipitation climatology exhibits greater annual variability. Two types of thresholds are used to examine the variability of extreme events: extreme threshold and daily anomaly threshold. The extreme threshold indicates how the strength of the overall maximum is changing whereas the daily anomaly threshold indicates if the strength of the daily maximum is changing over time. We observed an increase in the frequency of anomalous daily precipitation events over the last 36 years, with the greatest frequency occurring in 2011. The most extreme precipitation events occur during the months of late summer through early fall, with approximately four expected extreme events occurring per year during the summer and fall. For temperature, the greatest frequency and variation in temperature anomalies occur during winter and spring. In addition, temperature variance is also analyzed to determine if there is greater day-to-day temperature variability today than in the past.

33 CFR 117.881 - John Day River.

Code of Federal Regulations, 2013 CFR

2013-07-01

... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Oregon § 117.881 John Day River. The draw of the... (Washington State Department of Fisheries and the Fish Commission of Oregon) for the Columbia River Fishery...

33 CFR 117.881 - John Day River.

Code of Federal Regulations, 2014 CFR

2014-07-01

... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Oregon § 117.881 John Day River. The draw of the... (Washington State Department of Fisheries and the Fish Commission of Oregon) for the Columbia River Fishery...

33 CFR 117.881 - John Day River.

Code of Federal Regulations, 2012 CFR

2012-07-01

... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Oregon § 117.881 John Day River. The draw of the... (Washington State Department of Fisheries and the Fish Commission of Oregon) for the Columbia River Fishery...

Geologic setting of the John Day Country, Grant County, Oregon

USGS Publications Warehouse

Thayer, Thomas P.

1977-01-01

One of the Pacific Northwest's most notable outdoor recreation areas, the "John Day Country" in northeastern Oregon, is named after a native Virginian who was a member of the Astor expedition to the mouth of the Columbia River in 1812. There is little factual information about John Day except that he was born in Culpeper County, Virginia, about 1770. It is known also that in 1810 this tall pioneer "with an elastic step as if he trod on springs" joined John Jacob Astor's overland expedition under Wilson Price Hunt to establish a vast fur-gathering network in the Western States based on a major trading post at the mouth of the Columbia River.

Lightning Injuries

MedlinePlus

... Prevent Falls (News) A Dangerous New Twist on Cyberbullying (News) Electrical Pulses May Ease Pain From 'Slipped' ... Falls News HealthDay A Dangerous New Twist on Cyberbullying News HealthDay Electrical Pulses May Ease Pain From ' ...

Internal Bleeding

MedlinePlus

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Lizard Bites

MedlinePlus

... Prevent Falls (News) A Dangerous New Twist on Cyberbullying (News) Electrical Pulses May Ease Pain From 'Slipped' ... Falls News HealthDay A Dangerous New Twist on Cyberbullying News HealthDay Electrical Pulses May Ease Pain From ' ...

Urethral Injuries

MedlinePlus

... Prevent Falls (News) A Dangerous New Twist on Cyberbullying (News) Electrical Pulses May Ease Pain From 'Slipped' ... Falls News HealthDay A Dangerous New Twist on Cyberbullying News HealthDay Electrical Pulses May Ease Pain From ' ...

Rib Fractures

MedlinePlus

... Prevent Falls (News) A Dangerous New Twist on Cyberbullying (News) Electrical Pulses May Ease Pain From 'Slipped' ... Falls News HealthDay A Dangerous New Twist on Cyberbullying News HealthDay Electrical Pulses May Ease Pain From ' ...

Ear Injury

MedlinePlus

... Prevent Falls (News) A Dangerous New Twist on Cyberbullying (News) Electrical Pulses May Ease Pain From 'Slipped' ... Falls News HealthDay A Dangerous New Twist on Cyberbullying News HealthDay Electrical Pulses May Ease Pain From ' ...

Aircraft Wake Vortex Core Size Measurements

DOT National Transportation Integrated Search

2003-06-23

We have examined data from three aircraft field tests designed, in part, to measure the size of the vortex cores generated by the aircraft. The field tests were performed between 1990 and 1997 at Idaho Falls, ID, Wallops Island, : VA, and John F. Ken...

9. Detail view, porch, from the southeast (Note the stonework's ...

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

9. Detail view, porch, from the southeast (Note the stonework's thick Portland cement mortar which was removed during the fall 2001 as part of stone conservation efforts). - John Bartram House & Garden, House, 54th Street & Lindbergh Boulevard, Philadelphia, Philadelphia County, PA

Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program.

PubMed

LaStayo, Paul; Marcus, Robin; Dibble, Leland; Wong, Bob; Pepper, Ginette

2017-07-17

Addressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period. Randomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis. The MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up <50% had experienced a fall or near fall. There were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival. NCT01080196 ; March 2, 2010 (retrospectively registered).

Pilot Testing Fall TIPS (Tailoring Interventions for Patient Safety): a Patient-Centered Fall Prevention Toolkit.

PubMed

Dykes, Patricia C; Duckworth, Megan; Cunningham, Stephanie; Dubois, Sasha; Driscoll, Melissa; Feliciano, Zinnia; Ferrazzi, Michael; Fevrin, Farah E; Lyons, Stephanie; Lindros, Mary Ellen; Monahan, Allison; Paley, Matthew M; Jean-Pierre, Saby; Scanlan, Maureen

2017-08-01

Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice. The Institute for Healthcare Improvement's Framework for Spread is the conceptual model for pilot implementation of Fall TIPS at Brigham and Women's Hospital (BWH; Boston) and Montefiore Medical Center (MMC; Bronx, New York). The key to translating the evidence into practice was engaging stakeholders by leveraging existing shared governance structures, identifying unit champions, holding training sessions for all staff, and implementing auditing to assess and provide feedback on protocol adherence and patient outcomes. BWH unit compliance with using Fall TIPS averaged 82%, the mean fall rate decreased from 3.28 to 2.80 falls per 1,000 patient-days from January through June 2015 versus 2016, and the mean fall with injury rate for these periods decreased from 1.00 to 0.54 per 1,000 patient-days. At MMC, compliance averaged 91%, but the mean fall rate increased marginally from 3.04 to 3.10, while the mean fall with injury rate decreased from 0.47 to 0.31 per 1,000 patient-days. Patient knowledge survey results show improvement in knowledge of the risks for falls and the ways to prevent falls. Engaging hospital and clinical leadership is critical in translating evidence-based care into clinical practice. Barriers to adoption of the protocol have been addressed and detailed to provide guidance for spread to other institutions. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Falls, a fear of falling and related factors in older adults with complex chronic disease.

PubMed

Lee, JuHee; Choi, MoonKi; Kim, Chang Oh

2017-12-01

To identify factors influencing falls and the fear of falling among older adults with chronic diseases in Korea. The fear of falling and falls in older adults are significant health problems towards which healthcare providers should direct their attention. Further investigation is needed to improve nursing practice specifically decreasing risk of falls and the fear of falling in Korea. Descriptive, cross-sectional survey. A convenience sample of 108 patients was recruited at the geriatric outpatient department of a tertiary hospital in Seoul, Korea. Demographic characteristics, comorbidities, medication use, fall history, level of physical activity, activities of daily living, mobility, muscle strength, and a fear of falling were investigated. Student's t tests, chi-square tests and multiple linear regressions were used in statistical analysis. Thirty-six participants (33.3%) among 108 subjects reported experiencing ≥1 falls in the past year. Marital status and the use of antipsychotics were associated with falls, while other factors were not significantly related to falls. Only benign prostatic hypertrophy and polypharmacy were significantly related to the fear of falling in the analysis of the relationships between chronic disease, medication use and fear of falling. In the regression model, the number of comorbidities, level of physical activity, activities of daily living and mobility were predictors of a fear of falling. Medication use was marginally significant, in the model. Increasing physical activity, functional fitness and physical independence is important to decrease the fear of falling, and to encourage active and healthy lives in older adults. The findings from this study provide evidence for the development of nursing interventions for older adults. We recommend early screening for a fear of falling and nursing interventions to decrease the fear of falling through enhancing physical activity level and function. © 2017 John Wiley & Sons Ltd.

Observations on the fulvous tree duck in Louisiana

USGS Publications Warehouse

Meanley, B.; Meanley, A.G.

1959-01-01

The Fulvous Tree Duck is a locally common breeding bird of the rice fields of southwestern Louisiana. Observations made in 1955, 1956 and 1957, showed that this species was probably most abundant in the vicinity of Mamou, Evangeline Parish, and Roanoke, Jefferson Davis Parish. Tree ducks arrive in the rice country as the rice is planted in the spring and usually depart following fall harvest. A few winter in the coastal marshes. The nesting period extends from late May well into August. Thirteen and 20 pairs were found nesting in two separate five-square-mile areas. All nests observed were in rice fields. Clutch size in several nests found by John J. Lynch averaged about 13 eggs. A clutch of 23 eggs was probably a dump nest. Several investigators have reported incubation periods varying from 24 to 26 days. Nests were constructed of rice or other plants that occurred in the rice fields; they usually had a canopy and ramp; none was lined with down. Renesting compensated for some first attempt losses. Depredations on rice plantings sometimes occurred in spring in water-planted rice fields. Favorite foods were seeds of grasses and sedges found in rice fields. Flocks totalling 3000 were occasionally seen in the fall on the Lacassine Wildlife Refuge.

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

PubMed

Stubbs, Kendra E; Sikes, Lindsay

2017-01-01

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

Nonfreezing Tissue Injuries

MedlinePlus

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Mobility measures differentiate falls risk status in persons with multiple sclerosis: An exploratory study.

PubMed

Sebastião, Emerson; Learmonth, Yvonne C; Motl, Robert W

2017-01-01

Falls are of great concern among persons with multiple sclerosis (MS). To examine differences in metrics of mobility, postural control, and cognition in persons with MS with distinct fall risk status; and to investigate predictors of fall risk group membership using discriminant analysis. Forty-seven persons with MS completed the Activities-Balance Confidence (ABC) Scale and underwent a battery of assessments of mobility, balance, and cognition. Participants further wore an accelerometer for 7 days as an assessment of steps/day. Participants were allocated into fall risk groups based on ABC scale scores (increased fall risk (IFR); and normal fall risk (NFR)). We examined univariate differences between groups using ANOVA, and discriminant function analysis (DFA) identified the significant multivariate predictors of FR status. After controlling for disability level, the IFR group had significantly (p < 0.05) worse scores on measures of mobility (i.e., MSWS-12, 6 MW, and steps/day) compared to the NFR group. DFA identified MSWS-12 and 6 MW scores as significant (p < 0.05) predictors of fall risk group membership. Those two variables collectively explained 55% of variance in fall risk grouping. The findings suggest that mobility should be the focus of rehabilitation programs in persons with MS, especially for those at IFR.

Fall-related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians.

PubMed

Lukaszyk, Caroline; Harvey, Lara A; Sherrington, Catherine; Close, Jacqueline Ct; Coombes, Julieann; Mitchell, Rebecca J; Moore, Robyn; Ivers, Rebecca

2017-07-03

To compare the socio-demographic characteristics and type of injury sustained, the use of hospital resources and rates of hospitalisation by injury type, and survival following fall injuries to older Aboriginal people and non-Indigenous Australian people hospitalised for fall-related injuries. Population-based retrospective cohort data linkage study. Setting, participants: New South Wales residents aged 50 years or more admitted to a public or private NSW hospital for a fall-related injury during 1 January 2003 - 31 December 2012. Proportions of patients with defined injury types, mean hospital length of stay (LOS), 30-day mortality, age-standardised hospitalisation rates and age-adjusted rate ratios, 28-day re-admission rates. There were 312 758 fall-related injury hospitalisations for 234 979 individuals; 2660 admissions (0.85%) were of Aboriginal people. The proportion of hospitalisations for fall-related fracture injuries was lower for Aboriginal than for non-Indigenous Australians (49% v 60% of fall-related hospitalisations; P < 0.001). The major injury type for Aboriginal patients was non-fracture injury to head or neck (19% of hospitalisations); for non-Indigenous patients it was hip fractures (18%). Age-adjusted LOS was lower for Aboriginal than for non-Indigenous patients (9.1 v 14.0 days; P < 0.001), as was 30-day mortality (2.9% v 4.2%; P < 0.001). For Aboriginal people, fall injury hospitalisations increased at an annual rate of 5.8% (95% CI, 4.0-7.7%; P < 0.001); for non-Indigenous patients, the mean annual increase was 2.5% (95% CI, 2.1-3.0; P < 0.001). The patterns of injury and outcomes of fall injury hospitalisations were different for older Aboriginal people and other older Australians, suggesting that different approaches are required to prevent and treat fall injuries.

Overview of Head Injuries

MedlinePlus

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Cerebral Contusions and Lacerations

MedlinePlus

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Proceedings of the Tri-Service Aeromedical Research Panel Fall Technical Meeting, 13-14 November 1984.

DTIC Science & Technology

1984-11-01

P t -.1 41 N a ( d AUTOMATED VISUAL FIELD TESTING Chris A. Johnson, Ph.D. and John L. Keltner , M.D. Department of Ophthalmology University...and D . R. Griffin. 1947. The change in refractive power of the human eye in dim and bright light. J. Opt. Soc. Am. 37:321-336. 2. Leibowitz, H. W. and...Dover, New York (1962). 3. Maddox, E. E. 1893. The Clinical Use of Prisms, pp. 83-92. John Wright and Sons, Bristol, England. 4. Cogan,

Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics

PubMed Central

Everhart, Damian; Schumacher, Jessica R.; Duncan, R. Paul; Hall, Allyson G.; Neff, Donna F.; Shorr, Ronald I.

2014-01-01

Background Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. Purpose The aim of this study was to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. Methodology/Approach We conducted a 54-month (July 2006–December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators® (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. Findings A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70, 95% CI [0.51, 0.94]) were significantly less likely to be categorized in the “consistently high” fall rate group. Practice Implications Over this 54-month period, hospitals were categorized into three groups based on long-term fall rates. Hospital-level factors differed among these three groups. This suggests that there may be hospitals in which “best practices” for fall prevention might be identified. In addition, administrators may be able to reduce fall rates by maintaining greater nurse staffing ratios as well as fostering an environment consistent with that of Magnet hospitals. PMID:24566249

Walking can be more effective than balance training in fall prevention among community-dwelling older adults.

PubMed

Okubo, Yoshiro; Osuka, Yosuke; Jung, Songee; Rafael, Figueroa; Tsujimoto, Takehiko; Aiba, Tatsuya; Kim, Teaho; Tanaka, Kiyoji

2016-01-01

To examine the effects of walking on falls among community-dwelling older adults while accounting for exposures. A total of 90 older adults, ranging in age from 65 to 79 years, were allocated into either the walking (brisk walking, n = 50) or the balance (balance and strength training, n = 40) group to participate in a 3-month supervised and 13-month unsupervised fall-prevention program held from 2012 to 2014 in Japan. Falls and trips that occurred during the 16-month period were monitored with a monthly fall calendar. The risk of falls and trips was evaluated by person-year, physically active person-day and person-step. The walking group showed a significant reduction in the fall risk when evaluated by the falls per physically active person-day (rate ratio 0.38, 95% confidence interval 0.19-0.77) and falls per person-step (rate ratio 0.47, 95% confidence interval 0.26-0.85) compared with the balance group. In contrast, the number of trips significantly increased with walking, even when evaluated as trips per physically active person-day (rate ratio 1.50, 95% confidence interval 1.12-2.00). The present findings suggest that walking among community-dwelling older adults can be more effective for fall prevention than balance training. However, because walking can induce more trips, walking should not be recommended for older adults who are susceptible to falling or frailty. © 2015 Japan Geriatrics Society.

Men's perspectives on fall risk and fall prevention following participation in a group-based programme conducted at Men's Sheds, Australia.

PubMed

Liddle, Jeannine L M; Lovarini, Meryl; Clemson, Lindy M; Jang, Haeyoung; Willis, Karen; Lord, Stephen R; Sherrington, Catherine

2017-05-01

Research on older men's views regarding fall prevention is limited. The purpose of this qualitative study was to explore the experiences and perspectives of older men regarding fall risk and prevention so that fall prevention programmes can better engage older men. Eleven men who had taken part in a group-based fall prevention programme called Stepping On conducted at Men's Sheds in Sydney, Australia, participated in semi-structured interviews during June and July 2015 which were audio-recorded and transcribed. Data were coded and analysed using constant comparative methods. Over-arching theoretical categories were developed into a conceptual framework linking programme context and content with effects of programme participation on men. Men's Sheds facilitated participation in the programme by being inclusive, male-friendly places, where Stepping On was programmed into regular activities and was conducted in an enjoyable, supportive atmosphere. Programme content challenged participants to think differently about themselves and their personal fall risk, and provided practical options to address fall risk. Two major themes were identified: adjusting the mindset where men adopted a more cautious mindset paying greater attention to potential fall risks, being careful, concentrating and slowing down; and changing the ways where men acted purposefully on environmental hazards at home and incorporated fall prevention exercises into their routine schedules. Practitioners can engage and support older men to address falls by better understanding men's perspectives on personal fall risk and motivations for action. © 2016 John Wiley & Sons Ltd.

Fractures of the Jaw and Midface

MedlinePlus

... Prevent Falls (News) A Dangerous New Twist on Cyberbullying (News) Electrical Pulses May Ease Pain From 'Slipped' ... Falls News HealthDay A Dangerous New Twist on Cyberbullying News HealthDay Electrical Pulses May Ease Pain From ' ...

Falling and fall risk factors in adults with haemophilia: an exploratory study.

PubMed

Sammels, M; Vandesande, J; Vlaeyen, E; Peerlinck, K; Milisen, K

2014-11-01

Falls are a particular risk in persons with haemophilia (PWH) because of damaged joints, high risk of bleeding, possible impact on the musculoskeletal system and functioning and costs associated with treatment for these fall-related injuries. In addition, fall risk increases with age and PWH are increasingly entering the over 65 age group. The aim of this study was to determine the occurrence of falls during the past year and to explore which fall risk factors are present in community-dwelling PWH. Dutch speaking community-dwelling adults were included from the age of 40 years with severe or moderate haemophilia A or B, independent in their mobility and registered at the University Hospitals Leuven. They were asked to come to the haemophilia centre; otherwise a telephone survey was conducted. Demographic and social variables, medical variables, fall evaluation and clinical variables were queried. From the 89 PWH, 74 (83.1%) participated in the study. Twenty-four (32.4%) fell in the past year, and 10 of them (41.7%) more than once with an average of four falls. Living conditions, physical activity, avoidance of winter sports due to fear of falling, orthopaedic status, urinary incontinence and mobility impairments are potential fall risk factors in adult PWH. This exploratory study indicates that PWH are attentive to falling since they are at higher risk for falls and because of the serious consequences it might have. Screening and fall prevention should be stimulated in the daily practice of haemophilia care. © 2014 John Wiley & Sons Ltd.

Technical Review of the CENWP Computational Fluid Dynamics Model of the John Day Dam Forebay

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

Rakowski, Cynthia L.; Serkowski, John A.; Richmond, Marshall C.

The US Army Corps of Engineers Portland District (CENWP) has developed a computational fluid dynamics (CFD) model of the John Day forebay on the Columbia River to aid in the development and design of alternatives to improve juvenile salmon passage at the John Day Project. At the request of CENWP, Pacific Northwest National Laboratory (PNNL) Hydrology Group has conducted a technical review of CENWP's CFD model run in CFD solver software, STAR-CD. PNNL has extensive experience developing and applying 3D CFD models run in STAR-CD for Columbia River hydroelectric projects. The John Day forebay model developed by CENWP is adequatelymore » configured and validated. The model is ready for use simulating forebay hydraulics for structural and operational alternatives. The approach and method are sound, however CENWP has identified some improvements that need to be made for future models and for modifications to this existing model.« less

Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study.

PubMed

Liu, Shan W; Sri-On, Jiraporn; Tirrell, Gregory Philip; Nickel, Christian; Bingisser, Roland

2016-08-01

Falls among older adults are a public health problem and are multifactorial. We sought to determine whether falls predict more serious conditions in older adult patients presenting to the emergency department (ED) with a "nonspecific complaint" (NSC). A secondary objective was to examine what factors predicted serious conditions among older adult patients with a fall. This study was a secondary analysis of a prospective delayed-type cross-sectional diagnostic study that included a 30-day follow-up. We included patients 65 years and older who presented to the ED from May 2007 and July 2011 with a NSC and had an Emergency Severity Index score of 2 or 3. We then compared the serious conditions among older adults who presented to the ED with a fall with those who did not fall in a cohort of patients with NSC. We had 1111 patients enrolled in our study; 518 (47%) of them had fallen. We found that 310 (60%) of elderly fall patients vs 349 (59%) of nonfall patients had a 30-day serious condition (P=.74). In multiple logistic regression analysis, falls did not predict serious conditions or 30-day mortality among all NSC patients. Among fall patients, male sex, diuretic use, and generalized weakness predicted serious conditions. Fall patients share many features with nonfall NSC patient. However, falls did not increase the risk of serious conditions. Falls in the elderly could be considered under the broader entity of NSC. Copyright © 2016 Elsevier Inc. All rights reserved.

Diversity in fall characteristics hampers effective prevention: the precipitants, the environment, the fall and the injury.

PubMed

Sanders, K M; Lim, K; Stuart, A L; Macleod, A; Scott, D; Nicholson, G C; Busija, L

2017-10-01

Falls among the elderly are common and characteristics may differ between injurious and non-injurious falls. Among 887 older Australian women followed for 1.6 years, 32% fell annually. Only 8.5% resulted in fracture and/or hospital admission. The characteristics of those falls are indistinguishable from those not coming to medical attention. The precipitants and environment of all falls occurring among a large cohort of older Caucasian women were categorised by injury status to determine if the characteristics differed between injurious and non-injurious falls. Among 887 Australian women (70+ years), falls were ascertained using monthly postcard calendars and a questionnaire was administered for each fall. Hospital admissions and fractures were independently confirmed. All falls were reported for a mean observation time of 577 (IQR 546-607) days per participant, equating to a total 1400 person-years. Thirty-two percent fell at least once per year. The most common features of a fall were that the faller was walking (61%) at home (61%) during the day (88%) and lost balance (32%). Only 12% of all falls occurred at night. Despite no difference in the type of injury between day and night, the likelihood of being hospitalised from a fall at night was 4.5 times greater than that of a daytime fall with adjustment for injury type and participant age (OR 4.5, 95% CI 2.1, 9.5; p < 0.001). Of all falls, approximately one third were associated with no injury to the faller (31%), one third reported a single injury (37%) and one third reported more than one injury (32%). In 95% of falls, the faller was not admitted to hospital. Only 5% of falls resulted in fracture(s). Our findings demonstrate the significant diversity of precipitants and environment where falls commonly occur among older community-dwelling women. Falls resulting in fracture and/or hospital admission collectively represent 8.5% of all falls and their characteristics are indistinguishable from falls not coming to medical attention and incurring no apparent cost to the health system.

The Confederated Tribes of the Warm Springs Indian Reservation of Oregon John Day Basin Office : Watershed Restoration Projects : Annual Report, 2000.

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

Confederated Tribes of the Warm Springs Reservation of Oregon. John Day Basin Office.

2001-03-01

The John Day is the second longest free-flowing river in the contiguous United States and the longest containing entirely unsupplemented runs of anadromous fish. Located in eastern Oregon, the basin drains over 8,000 square miles--Oregon's third largest drainage basin--and incorporates portions of eleven counties. Originating in the Strawberry Mountains near Prairie City, the John Day River flows 284 miles in a northwesterly direction, entering the Columbia River approximately four miles upstream of the John Day dam. With wild runs of spring Chinook salmon and summer steelhead, red band, westslope cutthroat, and redband trout, the John Day system is truly amore » basin with national significance. Most all of the entire John Day basin was ceded to the Federal government in 1855 by the Confederated Tribes of the Warm Springs Reservation of Oregon (Tribes). In 1997, the Tribes established an office in the Basin to coordinate restoration projects, monitoring, planning and other watershed activities on private and public lands. Using funding from the Bonneville Power Administration, Bureau of Reclamation, and others, the John Day Basin Office (JDBO) subcontracts the majority of its construction implementation activities with the Grant Soil and Water Conservation District (GSWCD), also located in the town of John Day. The GSWCD completes the landowner contact, preliminary planning, engineering design, permitting, construction contracting, and construction implementation phases of most projects. The JDBO completes the planning, grant solicitation/review, environmental compliance, administrative contracting, monitoring, and reporting portion of the program. Most phases of project planning, implementation, and monitoring are coordinated with the private landowners and basin agencies, such as the Oregon Department of Fish and Wildlife and Oregon Water Resources Department. In 2000, the JDBO and GSWCD proposed continuation of a successful partnership between the two agencies and basin landowners to implement an additional six watershed conservation projects funded by the BPA. The types of projects include permanent diversions, pump stations, and return-flow cooling systems. Project costs in 2000 totaled $533,196.00 with a total amount of $354,932.00 (67%) provided by the Bonneville Power Administration and the remainder coming from other sources such as the BOR, Oregon Watershed Enhancement Board, and individual landowners.« less

The Confederated Tribes of the Warm Springs Indian Reservation of Oregon John Day Basin Office: FY 1999 Watershed Restoration Projects : Annual Report 1999.

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

Robertson, Shawn W.

2001-03-01

The John Day River is the second longest free-flowing river in the contiguous United States and one of the few major subbasins in the Columbia River basin containing entirely unsupplemented runs of anadromous fish. Located in eastern Oregon, the basin drains over 8,000 square miles, the fourth largest drainage area in Oregon. With its beginning in the Strawberry Mountains near the town of Prairie City, the John Day flows 284 miles in a northwesterly direction, entering the Columbia River approximately four miles upstream of the John Day dam. With wild runs of spring chinook salmon and summer steelhead, red band,more » westslope cutthroat, and redband trout, the John Day system is truly one of national significance. The entire John Day basin was granted to the Federal government in 1855 by the Confederated Tribes of the Warm Springs Reservation of Oregon (Tribes). In 1997, the Tribes established an office in the basin to coordinate restoration projects, monitoring, planning and other watershed activities on private and public lands. Once established, the John Day Basin Office (JDBO) initiated contracting the majority of its construction implementation actions with the Grant Soil and Water Conservation District (GSWCD), also located in the town of John Day. The GSWCD completes the landowner contact, preliminary planning, engineering design, permitting, construction contracting, and construction implementation phases of the projects. The JDBO completes the planning, grant solicitation/defense, environmental compliance, administrative contracting, monitoring, and reporting portion of the program. Most phases of project planning, implementation, and monitoring are coordinated with the private landowners and basin agencies, such as the Oregon Department of Fish and Wildlife and Oregon Water Resources Department. In 1999, the JDBO and GSWCD proposed continuation of a successful partnership between the two agencies and basin landowners to implement an additional eleven (11) watershed conservation projects. The types of projects implemented included installation of infiltration galleries, permanent diversions, pumping stations, and irrigation efficiency upgrades. Project costs in 1999 totaled $284,514.00 with a total amount of $141,628.00 (50%) provided by the Bonneville Power Administration (BPA) and the remainder coming from other sources such as the Bureau of Reclamation (BOR), Confederated Tribes of Warm Springs, Oregon Watershed Enhancement Board, and individual landowners.« less

The Confederated Tribes of the Warm Springs Indian Reservation of Oregon John Day Basin Office : Watershed Restoration Projects : 2002 Annual Report.

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

Confederated Tribes of the Warm Springs Reservation of Oregon. John Day Basin Office.

The John Day is the nation's second longest free-flowing river in the contiguous United States and the longest containing entirely unsupplemented runs of anadromous fish. Located in eastern Oregon, the basin drains over 8,000 square miles, Oregon's fourth largest drainage basin, and incorporates portions of eleven counties. Originating in the Strawberry Mountains near Prairie City, the John Day River flows 284 miles in a northwesterly direction, entering the Columbia River approximately four miles upstream of the John Day dam. With wild runs of spring Chinook salmon and summer steelhead, westslope cutthroat, and redband and bull trout, the John Day systemmore » is truly a basin with national significance. The majority of the John Day basin was ceded to the Federal government in 1855 by the Confederated Tribes of the Warm Springs Reservation of Oregon (Tribes). In 1997, the Tribes established an office in the basin to coordinate restoration projects, monitoring, planning and other watershed activities on private and public lands. Once established, the John Day Basin Office (JDBO) formed a partnership with the Grant Soil and Water Conservation District (GSWCD), also located in the town of John Day, who contracts the majority of the construction implementation activities for these projects from the JDBO. The GSWCD completes the landowner contact, preliminary planning, engineering design, permitting, construction contracting, and construction implementation phases of most projects. The JDBO completes the planning, grant solicitation/defense, environmental compliance, administrative contracting, monitoring, and reporting portion of the program. Most phases of project planning, implementation, and monitoring are coordinated with the private landowners and basin agencies, such as the Oregon Department of Fish and Wildlife and Oregon Water Resources Department. In 2002, the JDBO and GSWCD proposed continuation of their successful partnership between the two agencies and basin landowners to implement an additional twelve (12) watershed conservation projects. The types of projects include off channel water developments, riparian fencing, juniper control, permanent diversions, pump stations, infiltration galleries and return-flow cooling systems. Project costs in 2002 totaled $423,198.00 with a total amount of $345,752.00 (81%) provided by the Bonneville Power Administration (BPA) and the remainder coming from other sources such as the Bureau of Reclamation (BOR), Oregon Watershed Enhancement Board, the U.S. Fish & Wildlife Service Partners in Wildlife Program and individual landowners.« less

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

Systematic review of fall risk screening tools for older patients in acute hospitals.

PubMed

Matarese, Maria; Ivziku, Dhurata; Bartolozzi, Francesco; Piredda, Michela; De Marinis, Maria Grazia

2015-06-01

To determine the most accurate fall risk screening tools for predicting falls among patients aged 65 years or older admitted to acute care hospitals. Falls represent a serious problem in older inpatients due to the potential physical, social, psychological and economic consequences. Older inpatients present with risk factors associated with age-related physiological and psychological changes as well as multiple morbidities. Thus, fall risk screening tools for older adults should include these specific risk factors. There are no published recommendations addressing what tools are appropriate for older hospitalized adults. Systematic review. MEDLINE, CINAHL and Cochrane electronic databases were searched between January 1981-April 2013. Only prospective validation studies reporting sensitivity and specificity values were included. Recommendations of the Cochrane Handbook of Diagnostic Test Accuracy Reviews have been followed. Three fall risk assessment tools were evaluated in seven articles. Due to the limited number of studies, meta-analysis was carried out only for the STRATIFY and Hendrich Fall Risk Model II. In the combined analysis, the Hendrich Fall Risk Model II demonstrated higher sensitivity than STRATIFY, while the STRATIFY showed higher specificity. In both tools, the Youden index showed low prognostic accuracy. The identified tools do not demonstrate predictive values as high as needed for identifying older inpatients at risk for falls. For this reason, no tool can be recommended for fall detection. More research is needed to evaluate fall risk screening tools for older inpatients. © 2014 John Wiley & Sons Ltd.

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…

Predicting falls using two instruments (the Hendrich Fall Risk Model and the Morse Fall Scale) in an acute care setting in Lebanon.

PubMed

Nassar, Nada; Helou, Nancy; Madi, Chantal

2014-06-01

To assess the predictive value of two instruments (the Morse Fall Scale (MFS) and the Heindrich II Fall Risk Model (HFRM)] in a Middle Eastern country (Lebanon) and to evaluate the factors that are related to falls. A prospective observational cross-sectional design was used. Falls and fall-related injuries in the acute care settings contribute a substantial health and economic burden on patients and organisations. Preventing falls is a priority for most healthcare organisations. While the risk of falling cannot be eliminated, it can be significantly reduced through accurate assessment of patients' risk of falling. Data from 1815 inpatients at the American University of Beirut Medical Center (AUBMC) in Lebanon were evaluated using two instruments to predict falls: the MFS and the HFRM. The incidence of falls was 2·7% in one year. The results indicate that while the instruments were significantly correlated, the HFRM was more sensitive in predicting falls than the MFS. The internal consistency of both scales was moderate, but inter-rater reliability was high. Patients using antiepileptic drugs and assistance devises had higher odds of falling. Although both instruments were easy to use in a Middle Eastern country, the HFRM rather than the MFS is recommended for inpatients in an acute care setting as it had higher sensitivity and specificity. It is recommended that while the HFRM had adequate sensitivity, it is not seamless, and as such, nurses should not rely entirely on it. Rather, nurses should use their expert clinical judgement, their ethical obligations and cultural considerations to implement a safer environment of care for the patient. © 2013 John Wiley & Sons Ltd.

Low-Impact Flooring: Does It Reduce Fall-Related Injuries?

PubMed

Hanger, H Carl

2017-07-01

To compare fall rates and injuries from falls on low-impact flooring (LIF) compared with a standard vinyl flooring. Prospective, observational, nonrandomized controlled study. Subacute Older Persons Health ward (N = 20 beds). Older inpatients. Three different types of LIF. All falls in the ward were prospectively monitored using incident reporting, noting location and consequences of each fall. Fall rates (per 1000 bed days) and injuries, were compared between bedroom falls on LIF against those occurring on standard vinyl flooring (controls). Over 31 months, there were 278 bedroom falls (from 178 fallers). The bedroom fall rate (falls per 1000 bed days occupied) did not differ between the LIF and control groups (median 15 [IQR 8-18] versus 17 [IQR 9-23], respectively; P = .47). However, fall-related injuries were significantly less frequent when they occurred on LIFs (22% of falls versus 34% of falls on control flooring; P = .02). Fractures occurred in 0.7% of falls in the LIF cohort versus 2.3% in the control cohort. Rolling resistance when moving heavier equipment, such as beds or hoists, was an issue for staff on LIF. LIF significantly reduced fall-related injuries compared with a standard vinyl flooring, whereas they did not alter the overall risk of falling. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Air and Space Power Joumal. Volume 25, Number 3, Fall 2011

DTIC Science & Technology

2011-01-01

Navarre, Florida Mr. Charles Tustin Kamps USAF Air Command and Staff College Dr. Tom Keaney Johns Hopkins University Col Merrick E. Krause , USAF, Retired...fighter pilots such as Wolfgang Falck, Hajo Herrmann, and Hans-Joachim Jabs. In this aspect, Heaton (a professor at the American Military University

Leading from the Middle: Enhancing Professional Practice through Peer Coaching

ERIC Educational Resources Information Center

Marchese, Joe

2012-01-01

In the fall of 2007--aware that the continuing professional development of teachers is paramount to quality education--John Baird, head of Westtown School (Pennsylvania), asked the faculty Professional Development Committee (PDC), consisting of faculty representatives from all three divisions of the school, to design a "professional growth…

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

ERIC Educational Resources Information Center

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

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

Chronicle of Higher Education. Volume 50, Number 29, March 26, 2004

ERIC Educational Resources Information Center

Chronicle of Higher Education, 2004

2004-01-01

"Chronicle of Higher Education" presents an abundant source of news and information for college and university faculty members and administrators. This March 26, 2004 issue of "Chronicle of Higher Education" includes the following articles: (1) "Going Over the Falls" (Brady, John N.); (2) "Lessons in Departmental…

Deaf-Blind Perspectives, Fall 1993-Spring 1994.

ERIC Educational Resources Information Center

Deaf-Blind Perspectives, 1994

1994-01-01

This document consists of the first three issues of a new newsletter concerning people who are deaf-blind. Issues present substantive articles, news on technical assistance in various areas, book reviews, and conference information. The following articles are included: (1) "Rationale for Editorial Policy on Terminology" (John W. Reiman),…

29 CFR 1917.41 - House falls.

Code of Federal Regulations, 2014 CFR

2014-07-01

... working with house fall blocks. (c) Designated employees shall inspect chains, links, shackles, swivels, blocks and other loose gear used in house fall operations before each day's use. Defective gear shall not...

29 CFR 1917.41 - House falls.

Code of Federal Regulations, 2010 CFR

2010-07-01

... working with house fall blocks. (c) Designated employees shall inspect chains, links, shackles, swivels, blocks and other loose gear used in house fall operations before each day's use. Defective gear shall not...

29 CFR 1917.41 - House falls.

Code of Federal Regulations, 2011 CFR

2011-07-01

... working with house fall blocks. (c) Designated employees shall inspect chains, links, shackles, swivels, blocks and other loose gear used in house fall operations before each day's use. Defective gear shall not...

29 CFR 1917.41 - House falls.

Code of Federal Regulations, 2012 CFR

2012-07-01

... working with house fall blocks. (c) Designated employees shall inspect chains, links, shackles, swivels, blocks and other loose gear used in house fall operations before each day's use. Defective gear shall not...

29 CFR 1917.41 - House falls.

Code of Federal Regulations, 2013 CFR

2013-07-01

... working with house fall blocks. (c) Designated employees shall inspect chains, links, shackles, swivels, blocks and other loose gear used in house fall operations before each day's use. Defective gear shall not...

John Day River Sub-Basin Fish Habitat Enhancement Project; 2008 Annual Report

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

Powell, Russ M.; Alley, Pamela D.; Goin Jr, Lonnie

Work undertaken in 2008 included: (1) Seven new fence projects were completed thereby protecting approximately 10.97 miles of streams with 16.34 miles of riparian fence; (2) Renewal of one expired lease was completed thereby continuing to protect 0.75 miles of stream with 1.0 mile of riparian fence. (3) Maintenance of all active project fences (106.54 miles), watergaps (78), spring developments (33) were checked and repairs performed; (3) Planted 1000 willow/red osier on Fox Creek/Henslee property; (4) Planted 2000 willows/red osier on Middle Fork John Day River/Coleman property; (5) Planted 1000 willow/red osier cuttings on Fox Creek/Johns property; (6) Since themore » initiation of the Fish Habitat Project in 1984 we have 126.86 miles of stream protected using 211.72 miles of fence protecting 5658 acres. The purpose of the John Day Fish Habitat Enhancement Program is to enhance production of indigenous wild stocks of spring Chinook and summer steelhead within the sub basin through habitat protection, enhancement and fish passage improvement. The John Day River system supports the largest remaining wild runs of spring chinook salmon and summer steelhead in Northeast Oregon.« less

Assessment of suspended-sediment transport, bedload, and dissolved oxygen during a short-term drawdown of Fall Creek Lake, Oregon, winter 2012-13

USGS Publications Warehouse

Schenk, Liam N.; Bragg, Heather M.

2014-01-01

The drawdown of Fall Creek Lake resulted in the net transport of approximately 50,300 tons of sediment from the lake during a 6-day drawdown operation, based on computed daily values of suspended-sediment load downstream of Fall Creek Dam and the two main tributaries to Fall Creek Lake. A suspended-sediment budget calculated for 72 days of the study period indicates that as a result of drawdown operations, there was approximately 16,300 tons of sediment deposition within the reaches of Fall Creek and the Middle Fork Willamette River between Fall Creek Dam and the streamgage on the Middle Fork Willamette River at Jasper, Oregon. Bedload samples collected at the station downstream of Fall Creek Dam during the drawdown were primarily composed of medium to fine sands and accounted for an average of 11 percent of the total instantaneous sediment load (also termed sediment discharge) during sample collection. Monitoring of dissolved oxygen at the station downstream of Fall Creek Dam showed an initial decrease in dissolved oxygen concurrent with the sediment release over the span of 5 hours, though the extent of dissolved oxygen depletion is unknown because of extreme and rapid fouling of the probe by the large amount of sediment in transport. Dissolved oxygen returned to background levels downstream of Fall Creek Dam on December 18, 2012, approximately 1 day after the end of the drawdown operation.

Testing the reliability of the Fall Risk Screening Tool in an elderly ambulatory population.

PubMed

Fielding, Susan J; McKay, Michael; Hyrkas, Kristiina

2013-11-01

To identify and test the reliability of a fall risk screening tool in an ambulatory outpatient clinic. The Fall Risk Screening Tool (Albert Lea Medical Center, MN, USA) was scripted for an interview format. Two interviewers separately screened a convenience sample of 111 patients (age ≥ 65 years) in an ambulatory outpatient clinic in a northeastern US city. The interviewers' scoring of fall risk categories was similar. There was good internal consistency (Cronbach's α = 0.834-0.889) and inter-rater reliability [intra-class correlation coefficients (ICC) = 0.824-0.881] for total, Risk Factor and Client's Health Status subscales. The Physical Environment scores indicated acceptable internal consistency (Cronbach's α = 0.742) and adequate reliability (ICC = 0.688). Two Physical Environment items (furniture and medical equipment condition) had low reliabilities [Kappa (K) = 0.323, P = 0.08; K = -0.078, P = 0.648), respectively. The scripted Fall Risk Screening Tool demonstrated good reliability in this sample. Rewording two Physical Environment items will be considered. A reliable instrument such as the scripted Fall Risk Screening Tool provides a standardised assessment for identifying high fall risk patients. This tool is especially useful because it assesses personal, behavioural and environmental factors specific to community-dwelling patients; the interview format also facilitates patient-provider interaction. © 2013 John Wiley & Sons Ltd.

Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care.

PubMed

Potter, Patricia; Allen, Kelly; Costantinou, Eileen; Klinkenberg, William Dean; Malen, Jill; Norris, Traci; O'Connor, Elizabeth; Roney, Wilhemina; Tymkew, Heidi Hahn; Wolf, Laurie

2017-08-01

Sensor technology that dynamically identifies hospitalized patients' fall risk and detects and alerts nurses of high-risk patients' early exits out of bed has potential for reducing fall rates and preventing patient harm. During Phase 1 (August 2014-January 2015) of a previously reported performance improvement project, an innovative depth sensor was evaluated on two inpatient medical units to study fall characteristics. In Phase 2 (April 2015-January 2016), a combined depth and bed sensor system designed to assign patient fall probability, detect patient bed exits, and subsequently prevent falls was evaluated. Fall detection depth sensors remained in place on two medicine units; bed sensors used to detect patient bed exits were added on only one of the medicine units. Fall rates and fall with injury rates were evaluated on both units. During Phase 2, the designated evaluation unit had 14 falls, for a fall rate of 2.22 per 1,000 patient-days-a 54.1% reduction compared with the Phase 1 fall rate. The difference in rates from Phase 1 to Phase 2 was statistically significant (z = 2.20; p = 0.0297). The comparison medicine unit had 30 falls-a fall rate of 4.69 per 1,000 patient-days, representing a 57.9% increase as compared with Phase 1. A fall detection sensor system affords a level of surveillance that standard fall alert systems do not have. Fall prevention remains a complex issue, but sensor technology is a viable fall prevention option. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Concordance with a STOPP (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions) Criterion in Nova Scotia, Canada: Benzodiazepine and Zoplicone Prescription Claims by Older Adults with Fall-related Hospitalizaions.

PubMed

Hill-Taylor, B; Sketris, I S; Gardner, D M; Thompson, K

2016-01-01

Optimization of prescribing in older adults is needed. The STOPP criteria provide a systematic way of identifying potentially inappropriate prescribing in this population. Previous research indicates poor concordance between benzodiazepine prescribing and STOPP. To determine the extent and predictors of benzodiazepine and zopiclone (BZD-Z) pharmacy dispensations in older adults with a history of a recent fall, in concordance with STOPP. Prescription claims data from the Nova Scotia Seniors' Phamacare Program were linked with fall-related injury data from the CIHI Discharge Abstract Database. Adults aged ≥ 66 years making a claim for a BZD-Z in the 100 days prior to fall-related hospitalization were identified. Their BZD-Z claims in the 100 days following discharge were also identified. Descriptive statistics, trend tests and logistical regression modelling were performed to examine predictors for continued use of BZD-Z post-fall. Over 5 years, from a pool of 8,271 older adults discharged following a fall-related hospitalization, 1,789 (21.6%) had made a claim for a BZD-Z in the 100 days prior to admission. Of these, 82% were women. Younger age and female sex were predictors of continuing BZD-Z dispensations post-fall. In the 100 days following discharge, 74.2% (n=1327) made a claim for at least one BZD-Z. BZD-Z use continued in 74% of patients following discharge from a fall-related hospitalization, representing limited concordance with the STOPP criterion. Such hospitalizations and follow-up care present an opportunity to address an ongoing modifiable risk factor.

Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial.

PubMed

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

2015-06-27

Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42-0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42-0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7-19], control 10 days [6-18]). Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. State Health Research Advisory Council, Department of Health, Government of Western Australia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lower likelihood of falling at age 90+ is associated with daily exercise a quarter of a century earlier: The 90+ Study.

PubMed

Paganini-Hill, Annlia; Greenia, Dana E; Perry, Shawna; Sajjadi, Seyed Ahmad; Kawas, Claudia H; Corrada, Maria M

2017-11-01

to explore the relationship between risk of falling at age 90+ and prior physical activity at age 60-70s. population-based cohort study (The 90+ Study). California retirement community. of 1596 cohort members, 1536 had both falls and prior activity data. Mean age = 94 years; 78% female; 99% Caucasian. time spent in active physical activity was self-reported in 1980s; medical history, medication, assistive devices, residence type, and falls (outcome) was collected in 2000s. Activity/fall relationships were assessed using logistic regression. falls were reported by 52% of participants, recurrent falls by 32%, and severe injury by 21% of fallers. In univariate analyses risk of falling at age 90+ was significantly related to medical history (heart disease, TIA/stroke, arthritis, vision disease, depression, dementia), medication use (hypnotics, anti-psychotics, anti-depressants), use of assistive devices (cane, walker, wheelchair), residence type (living with relatives, sheltered living), and source of information (self-report vs informant). Risks of falling and recurrent falls at age 90+ were 35-45% lower in those reporting 30+ minutes/day of active physical activity at age 60-70s compared with no activity. The odds ratio of falling was 0.65 (95% CI = 0.44-0.97) for 30-45 minutes/day and 0.64 (0.44-0.94) for 1+ hour/day adjusting for age, sex, medical history (stroke/TIA, vision disease, depression), use of assistive devices, and source of information. falls are extremely common among the oldest-old and a significant proportion lead to severe injury. This work is the first to show an association between exercise at age 60-70s and lower risk of falling at age 90+. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

Potential mechanisms for the association between fall birth and food allergy.

PubMed

Keet, C A; Matsui, E C; Savage, J H; Neuman-Sunshine, D L; Skripak, J; Peng, R D; Wood, R A

2012-06-01

Season of birth has been reported as a risk factor for food allergy, but the mechanisms by which it acts are unknown. Two populations were studied: 5862 children from the National Health and Nutrition Examination Survey (NHANES) III and 1514 well-characterized food allergic children from the Johns Hopkins Pediatric Allergy Clinic (JHPAC). Food allergy was defined as self-report of an acute reaction to a food (NHANES), or as milk, egg, and peanut allergy. Logistic regression compared fall or nonfall birth between (i) food allergic and nonallergic subjects in NHANES, adjusted for ethnicity, age, income, and sex, and (ii) JHPAC subjects and the general Maryland population. For NHANES, stratification by ethnicity and for JHPAC, eczema were examined. Fall birth was more common among food allergic subjects in both NHANES (OR, 1.91; 95% CI, 1.31-2.77) and JHPAC/Maryland (OR, 1.31; 95% CI, 1.18-1.47). Ethnicity interacted with season (OR, 2.34; 95% CI, 1.43-3.82 for Caucasians; OR, 1.19; 95% CI, 0.77-1.86 for non-Caucasians; P = 0.04 for interaction), as did eczema (OR, 1.47; 95% CI, 1.29-1.67 with eczema; OR, 1.00; 95% CI, 0.80-1.23 without eczema; P = 0.002 for interaction). Fall birth is associated with increased risk of food allergy, and this risk is greatest among those most likely to have seasonal variation in vitamin D during infancy (Caucasians) and those at risk for skin barrier dysfunction (subjects with a history of eczema), suggesting that vitamin D and the skin barrier may be implicated in seasonal associations with food allergy. © 2012 John Wiley & Sons A/S.

Air and Space Power Journal. Volume 25, Number 3, Fall 2011

DTIC Science & Technology

2011-01-01

Charles Tustin Kamps USAF Air Command and Staff College Dr. Tom Keaney Johns Hopkins University Col Merrick E. Krause , USAF, Retired Department of Homeland...conducted face-to-face interviews with many of the air war leaders and noble night-fighter pilots such as Wolfgang Falck, Hajo Herrmann, and Hans

The Uneducated Candidates

ERIC Educational Resources Information Center

Selingo, Jeffrey J.; Hebel, Sara

2008-01-01

During the three presidential debates this fall, both John McCain and Barack Obama opened by thanking their university hosts. If not for their locations, it's likely one would not have heard the words "college," "university," or "higher education" even uttered in the debates. Indeed, it wasn't until the final debate that Senator McCain mentioned…

Summary of the Fall 1978 Conference of the National Consortium on Testing; October 23-24, 1978.

ERIC Educational Resources Information Center

Scott, Laurie

Discussions at the National Consortium on Testing conference are summarized. Updates on recent and upcoming events are given by Jeff Schiller (National Institute of Education), Doug Whitney (American Council on Education), John Maxwell (National Council of Teachers of English), Dorianne Almann (National Science Teachers Association), Eric Gardner…

Anthrax in America: A Chronology and Analysis of the Fall 2001 Attacks

DTIC Science & Technology

2002-11-01

Glenville, CT, 55 miles west of Oxford. • Officials confirm that the anthrax spores in a letter received by Santiago, Chile pediatrician Antonio Barfi were...process of opening the Leahy letter after two weeks of planning and rehearsals. In charge is John Ezzell , a man described by the Weekend Australian as

New Directions for Administrator Preparation. UCEA Monograph Series.

ERIC Educational Resources Information Center

Wendel, Frederick C., Ed.; Bryant, Miles T., Ed.

This publication contains six selected papers from the 30th Anniversary Meeting of the University Council for Educational Administrators (UCEA) in the fall of 1987. The first article, by John A. Thompson discusses problems associated with implementing the agenda of the Holmes Group report in decentralizing the control of schools. Leslie, Snyder,…

Rejecting Dialogue for Perspective: Vygotsky's Zone of Proximal Development and John Calvin's Divine Pedagogy

ERIC Educational Resources Information Center

Horner, Jeffrey Michael

2017-01-01

James Estep's integration of Vygotsky's work on the Zone of Proximal Development into Christian education and pedagogy falls short of a distinctly evangelical form of integration. Using Ken Badley's schemata of Integration of Faith and Learning, this article distinguishes Estep's "paradigmatic" integration from a more thoroughgoing…

Research Matters/Flip the Script on Fate Control

ERIC Educational Resources Information Center

Goodwin, Bryan

2016-01-01

In this article, Bryan Goodwin reflects on a Johns Hopkins University study from 1966 that at that time sent shock waves across America. The report's sober conclusion was that: "Schools provide no opportunity at all" to bring impoverished and minority students up to the starting line. Rather, schools allow them to "fall farther…

Impacts of Military Training and Land Management on Threatened and Endangered Species in the Southeastern Fall Line Sandhills Communities

DTIC Science & Technology

2009-05-01

Fabaceae ). Florida Entomologist 87:398-400. Husch, B., C. I. Miller and T. W. Beers. 1982. Forest Mensuration. John Wiley and Sons, New York...Reproductive ecology of a federally endangered legume, Baptisia arachnifera, and its more widespread congener, B. lanceolata ( Fabaceae ). American Journal

Spatial Statistical Model and Optimal Survey Design for Rapid Geophysical Characterization of UXO Sites

DTIC Science & Technology

2003-07-01

4, Gnanadesikan , 1977). An entity whose measured features fall into one of the regions is classified accordingly. For the approaches we discuss here... Gnanadesikan , R. 1977. Methods for Statistical Data Analysis of Multivariate Observations. John Wiley & Sons, New York. Hassig, N. L., O’Brien, R. F

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

Eisses, A.; Kell, A.; Kent, G.

Amy Eisses, Annie M. Kell, Graham Kent, Neal W. Driscoll, Robert E. Karlin, Robert L. Baskin, John N. Louie, Kenneth D. Smith, Sathish Pullammanappallil, 2011, Marine and land active-source seismic investigation of geothermal potential, tectonic structure, and earthquake hazards in Pyramid Lake, Nevada: presented at American Geophysical Union Fall Meeting, San Francisco, Dec. 5-9, abstract NS14A-08.

The Hispanic Project for Architecture and Building Construction

ERIC Educational Resources Information Center

Dail, Edward; Mora, Jorge

2006-01-01

John Tyler Community College in Chester, Virginia, began a program in architecture and building construction in fall 2003 to meet the needs of the Hispanic community--a much neglected but rapidly growing segment of the regional population. After first hiring a Hispanic director (Mr. Jorge Mora), a program was developed that heavily involved the…

Schooling in Capitalism: Navigating the Bleak Pathways of Structural Fate

ERIC Educational Resources Information Center

Murray, Kevin; Liston, Daniel P.

2015-01-01

In this review essay Kevin Murray and Dan Liston examine three texts in what this symposium has deemed the recent resurgence in neo-Marxist accounts of schooling: David Blacker's "The Falling Rate of Learning and the Neoliberal Endgame," Mike Cole's "Marxism and Educational Theory," and John Marsh's "Class Dismissed."…

Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital.

PubMed

Flabeau, O; Laurendeau, G; Laksir, H; Castaings-Pelet, S; Harston, S; Bourdel-Marchasson, I

2013-02-01

Multidisciplinary interventions for fallers have provided conflicting results in part due to the diversity of fallers' profiles. to determine the characteristics of the subgroup of patients with a positive response to a multidisciplinary fall prevention program initiated in a geriatric day hospital. Prospective observational study in day hospital. Patients > 75 years referred for falls during the last 3 months benefited from a multidisciplinary assessment to record their characteristics at baseline and to tailor a risk-based multidisciplinary intervention for fall prevention. Patients free from falls at the 3rd or 6th month were compared to persistent fallers for baseline characteristics. Sixty-nine patients were assessed at baseline (mean age 85.2 y (SD=0.6)), 44 at the 3rd month and 21 at the 6th month. Baseline characteristics of the patients free from falls at the 3rd month were the lower number of previous non-serious falls (p=0.013), living in nursing home (p=0.045), a higher Berg balance score (p=0.02) and a better mental health-related quality of life (M HQol, p=0.045). On multivariate analysis restricted to home-dwelling patients, the positive predictive factors were less isolation at home (OR=0.028, 95%CI [0-0.813], p=0.037), a lower number of non-serious previous falls (OR= 0.526 [0.309- 0.894], p=0.018), a better M HQol (OR=1.205 [1.000-1.452], p=0.050) and a trend for younger age (OR= 0.662, [0.426-1.027], p=0.066). Being able to call upon a support person (familial or institutional) to apply advice and a less serious risk of falling may be preliminary conditions for success in a multidisciplinary intervention initiated in a day hospital.

Temporal Trends in Fall Rates with the Implementation of a Multifaceted Fall Prevention Program: Persistence Pays Off.

PubMed

Walsh, Catherine M; Liang, Li-Jung; Grogan, Tristan; Coles, Courtney; McNair, Norma; Nuckols, Teryl K

2018-02-01

Most fall prevention programs are only modestly effective, and their sustainability is unknown. An academic medical center implemented a series of fall prevention interventions from 2001 to 2014. The medical center's series of fall prevention interventions were as follows: reorganized the Falls Committee (2001), started flagging high-risk patients (2001), improved fall reporting (2002), increased scrutiny of falls (2005), instituted hourly nursing rounds (2006), reorganized leadership systems (2007), standardized fall prevention equipment (2008), adapted to a move to a new hospital building (2008), routinely investigated root causes (2009), mitigated fall risk during hourly nursing rounds (2009), educated patients about falls (2011), and taught nurses to think critically about risk (2012). To evaluate temporal trends in falls and injury falls, piecewise negative binomial regression with study unit-level random effects was used to analyze structured validated data sets available since 2003. From July 2003 through December 2014, the crude fall rate declined from 3.07 to 2.22 per 1,000 patient days, and injury falls declined from 0.77 to 0.65 per 1,000 patient days. Nonsignificant increases in falls occurred after nurses started rounding hourly and after the move to the new hospital. On the basis of regression models, significant declines occurred after nurses began to mitigate fall risk during hourly rounds (p = 0.009). Instituting incremental changes for more than a decade was associated with a meaningful (about 28%) and sustained decline in falls, although the rate of decline varied over time. Hospitals interested in reducing falls but concerned about competing clinical and financial priorities may find an incremental approach to be effective. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Fall Colors, Temperature, and Day Length

ERIC Educational Resources Information Center

Burton, Stephen; Miller, Heather; Roossinck, Carrie

2007-01-01

Along with the bright hues of orange, red, and yellow, the season of fall represents significant changes, such as day length and temperature. These changes provide excellent opportunities for students to use science process skills to examine how abiotic factors such as weather and temperature impact organisms. In this article, the authors describe…

STS-109 Mission Highlights Resource Tape

NASA Astrophysics Data System (ADS)

2002-05-01

This video, Part 1 of 4, shows the activities of the STS-109 crew (Scott Altman, Commander; Duane Carey, Pilot; John Grunsfeld, Payload Commander; Nancy Currie, James Newman, Richard Linnehan, Michael Massimino, Mission Specialists) during flight days 1 through 3. The activities from other flight days can be seen on 'STS 109 Mission Highlights Resource Tape' Part 2 of 4 (internal ID 2002137664), 'STS 109 Mission Highlights Resource Tape' Part 3 of 4 (internal ID 2002139471), and 'STS-109 Mission Highlights Resource Tape' Part 4 of 4 (internal ID 2002137577). The main activity recorded during flight day 1 is the liftoff of Columbia. Attention is given to suit-up, boarding, and pre-flight procedures. The pre-launch crew meal has no sound. The crew members often wave to the camera before liftoff. The jettisoning of the solid rocket boosters is shown, and the External Tank is seen as it falls to Earth, moving over African dunes in the background. There are liftoff replays, including one from inside the cockpit. The opening of the payload bay doors is seen from the rear of the shuttle's cockpit. The footage from flight day 2 shows the Flight Support System for bearthing the HST (Hubble Space Telescope). Crew preparations for the bearthing are shown. Flight day 3 shows the tracking of and approach to the HST by Columbia, including orbital maneuvers, the capture of the HST, and its lowering onto the Flight Support System. Many views of the HST are shown, including one which reveals an ocean and cloud background as the HST retracts a solar array.

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

PubMed

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

2010-11-01

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

Educators' emotion regulation strategies and their physiological indicators of chronic stress over 1 year.

PubMed

Katz, Deirdre A; Harris, Alexis; Abenavoli, Rachel; Greenberg, Mark T; Jennings, Patricia A

2018-04-01

Studies show teaching is a highly stressful profession and that chronic work stress is associated with adverse health outcomes. This study analysed physiological markers of stress and self-reported emotion regulation strategies in a group of middle school teachers over 1 year. Chronic physiological stress was assessed with diurnal cortisol measures at three time points over 1 year (fall, spring, fall). The aim of this longitudinal study was to investigate the changes in educators' physiological level of stress. Results indicate that compared to those in the fall, cortisol awakening responses were blunted in the spring. Further, this effect was ameliorated by the summer break. Additionally, self-reported use of the emotion regulation strategy reappraisal buffered the observed blunting that occurred in the spring. Copyright © 2017 John Wiley & Sons, Ltd.

The Little Schmidy Pediatric Hospital Fall Risk Assessment Index: A diagnostic accuracy study.

PubMed

Franck, Linda S; Gay, Caryl L; Cooper, Bruce; Ezrre, Suzanne; Murphy, Barbette; Chan, June Shu-Ling; Buick, Maureen; Meer, Carrie R

2017-03-01

Falls are among the most common potentially preventable adverse events. Current pediatric falls risk assessment methods have poor precision and accuracy. To evaluate an inpatient pediatric fall risk assessment index, known as the Little Schmidy, and describe characteristics of pediatric falls. Retrospective case control and descriptive study. The dataset included 114 reported falls and 151,678 Little Schmidy scores documented in medical records during the 5-year study period (2007-2011). Pediatric medical and surgical inpatient units of an academic medical center in the western United States. Pediatric hospital inpatients <25 years of age. Nurses used the 5-item, 7-point Little Schmidy to assess fall risk each day and night shift throughout the patient's hospitalization. Conditional fixed-effects logistic regressions were used to examine predictive relationships between Little Schmidy scores (at admission, highest prior to fall, and just prior to fall) and the patient's fall status (fell or not). The sensitivity and specificity of different cut-off scores were explored. Associations between Little Schmidy scores and patient and hospitalization factors were examined using multilevel mixed-effects logistic regression and multilevel mixed-effects ordinal logistic regression. Little Schmidy scores were significantly associated with pediatric falls (p<0.005). Maximal performance was achieved with a 4-item, 4-point, Little Schmidy index (LS4) using a cut-off score of 1 to indicate fall risk with sensitivity of 79% and specificity of 49%. Patients with an LS4 score ≥1 were 4 times more likely to fall before the next assessment than patients with a score of 0. LS4 scores indicative of fall risk were associated with age ≥5 years, neurological diagnosis, multiple hospitalizations, and night shift, but not with sex, length of hospital stay, or hospital unit. Of the 114 reported falls, 64% involved a male patient, nearly one third (32%) involved adolescents (13-17 years), most resulted in no (59%) or mild (36%) injury, and most (54%) were related to diagnosis or clinical characteristics. For 60% of the falls, fall precautions had been implemented prior to the fall. The revised 4-item Little Schmidy, the LS4, predicts pediatric falls when administered every day and night shift, but identifies most patients (65%) as being at risk for fall. Strategies for improving the accuracy and efficiency of the assessments are proposed. Further research is needed to develop more effective pediatric fall prevention strategies tailored to patient's age, diagnosis, and time of day. Copyright © 2017 Elsevier Ltd. All rights reserved.

78 FR 76175 - Notice of Public Meeting for the John Day-Snake Resource Advisory Council: Cancellation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

.... The meeting was cancelled. FOR FURTHER INFORMATION CONTACT: Lisa Clark, Public Affairs Specialist, BLM...] Notice of Public Meeting for the John Day--Snake Resource Advisory Council: Cancellation AGENCY: Bureau..., Oregon/Washington, published a document in the Federal Register on October 28, 2013, regarding a public...

76 FR 18777 - Notice of Public Meeting, John Day-Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

... Service Blue Mountain Plan revision; John Day Environmental Assessment (EA) and Permit System; Status..., 112 West 2nd Street, The Dalles, Oregon 97058. FOR FURTHER INFORMATION CONTACT: Mark Wilkening, Public Affairs Specialist, BLM Vale District Office, 100 Oregon Street, Vale, Oregon 97918, (541) 473-6218 or e...

77 FR 16257 - Notice of Public Meeting, John Day-Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... include: Blue Mountain Forest Plan, John Day Basin Final, Step-down BLM Vegetation Environmental Impact..., Oregon, on May 17, 2012. FOR FURTHER INFORMATION CONTACT: Mark Wilkening, Public Affairs Specialist, 100 Oregon Street, Vale, Oregon 97918, (541) 473-6218 or email [email protected] . Persons who use a...

75 FR 35832 - Notice of Public Tour and Meeting, Twin Falls District Resource Advisory Council, Idaho

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... of Public Tour and Meeting, Twin Falls District Resource Advisory Council, Idaho AGENCY: Bureau of... Land Management (BLM) Twin Falls District Resource Advisory Council (RAC) will attend a two-day tour and meeting as indicated below. DATES: July 20-21, 2010. The Twin Falls District RAC members will meet...

Effect of a Multidisciplinary Fall Risk Assessment on Falls Among Neurology Inpatients

PubMed Central

Hunderfund, Andrea N. Leep; Sweeney, Cynthia M.; Mandrekar, Jayawant N.; Johnson, LeAnn M.; Britton, Jeffrey W.

2011-01-01

OBJECTIVE: To evaluate whether the addition of a physician assessment of patient fall risk at admission would reduce inpatient falls on a tertiary hospital neurology inpatient unit. PATIENTS AND METHODS: A physician fall risk assessment was added to the existing risk assessment process (clinical nurse evaluation and Hendrich II Fall Risk Model score with specific fall prevention measures for patients at risk). An order to select either “Patient is” or “Patient is not at high risk of falls by physician assessment” was added to the physician electronic admission order set. Nurses and physicians were instructed to reach consensus when assessments differed. Full implementation occurred in second-quarter 2008. Preimplementation (January 1, 2006, to March 31, 2008) and postimplementation (April 1, 2008, to December 31, 2009) rates of falls were compared on the neurology inpatient unit and on 6 other medical units that did not receive intervention. RESULTS: The rate of falls during the 7 quarters after full implementation was significantly lower than that during the 9 preceding quarters (4.12 vs 5.69 falls per 1000 patient-days; P=.04), whereas the rate of falls on other medical units did not significantly change (2.99 vs 3.33 falls per 1000 patient-days; P=.24, Poisson test). The consensus risk assessment at admission correctly identified patients at risk for falls (14/325 at-risk patients fell vs 0/147 low-risk patients; P=.01, χ2 test), but the Hendrich II Fall Risk Model score, nurse, and physician assessments individually did not. CONCLUSION: A multidisciplinary approach to fall risk assessment is feasible, correctly identifies patients at risk, and was associated with a reduction in inpatient falls. PMID:21193651

Acetazolamide improves oxygenation in patients with respiratory failure and metabolic alkalosis.

PubMed

Gulsvik, Ragnhild; Skjørten, Ingunn; Undhjem, Kenneth; Holø, Lars; Frostad, Anne; Saure, Eirunn Waatevik; Lejlic, Vasvija; Humerfelt, Sjur; Hansen, Gunnar; Bruun Wyller, Torgeir

2013-10-01

Coexistent respiratory failure and metabolic alkalosis is a common finding. Acidotic diuretics cause a fall in pH that may stimulate respiration. The purpose of the study was to evaluate the effectiveness of short-term treatment with acetazolamide for combined respiratory failure and metabolic alkalosis. A randomised, placebo-controlled and double-blind parallel group trial where oral acetazolamide 250 mg three times a day for 5 days were administered to patients hospitalised for respiratory failure because of a pulmonary disease (Pa O2 ≤ 8 kPa and/or Pa CO2 ≥ 7 kPa) who had concurrent metabolic alkalosis [base excess (BE) ≥ 8 mmol/L]. Pa O2 after 5 days was the primary effect variable. Secondary effect variables were Pa CO2 , BE and pH on day 5, and the total number of days in hospital. Of 70 patients enrolled (35 in each group), data from 54 were analysed per protocol, while last observation carried forward was used for the remaining 16. During the 5-day treatment, Pa O2 increased on average 0.81 kPa in the placebo group and 1.41 kPa in the acetazolamide group. After adjustment for baseline skewness, the difference was statistically significant (adjusted mean difference 0.55 kPa, 95% confidence interval 0.03-1.06). Pa CO2 decreased in both groups, but the difference was not statistically significant. As expected, pH and BE decreased markedly in the acetazolamide group. Acetazolamide may constitute a useful adjuvant treatment mainly to be considered in selected patients with respiratory failure combined with prominent metabolic alkalosis or where non-invasive ventilation is insufficient or infeasible. © 2013 John Wiley & Sons Ltd.

Weather warnings predict fall-related injuries among older adults.

PubMed

Mondor, Luke; Charland, Katia; Verma, Aman; Buckeridge, David L

2015-05-01

weather predictions are a useful tool for informing public health planning and prevention strategies for non-injury health outcomes, but the association between winter weather warnings and fall-related injuries has not been assessed previously. to examine the association between fall-related injuries among older adults and government-issued winter weather warnings. using a dynamic cohort of individuals ≥65 years of age who lived in Montreal between 1998 and 2006, we identified all fall-related injuries from administrative data using a validated set of diagnostic and procedure codes. We compared rates of injuries on days with freezing rain or snowstorm warnings to rates observed on days without warnings. We also compared the incidence of injuries on winter days to non-winter days. All analyses were performed overall and stratified by age and sex. freezing rain alerts were associated with an increase in fall-related injuries (incidence rate ratio [IRR] = 1.20, 95% confidence interval [CI]: 1.08-1.32), particularly among males (IRR = 1.31, 95% CI: 1.10-1.56), and lower rates of injuries were associated with snowstorm alerts (IRR = 0.89, 95% CI: 0.80-0.99). The rate of fall-related injuries did not differ seasonally (IRR = 1.00, 95% CI: 0.97-1.03). official weather warnings are predictive of increases in fall-related injuries among older adults. Public health agencies should consider using these warnings to trigger initiation of injury prevention strategies in advance of inclement weather. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Several Bridges Too Far: A Commentary on Richard S. Prawat's "Dewey Meets the 'Mozart of Psychology' in Moscow: The Untold Story," in "American Educational Research Journal," Fall 2000.

ERIC Educational Resources Information Center

Gredler, Margaret E.; Shields, Carol

2003-01-01

Identifies problems with the portrayals by R. Prawat of the reform effort in post-Revolutionary Russia, the career of Lev Vygotsky, the hypothesized exchange of ideas between Vygotsky and John Dewey, and the theoretical views of Vygotsky. (SLD)

The Media Missionaries: American Support for Journalism Excellence and Press Freedom around the Globe

ERIC Educational Resources Information Center

Hume, Ellen

2004-01-01

This report maps the myriad American efforts to develop and support journalism around the globe with fellowships, exchanges, training, grants, loans, equipment, infrastructure, staff, conferences and other means. This study, commissioned in the fall of 2001 by the John S. and James L. Knight Foundation, tries to identify where money was spent and…

The Rise and Fall of Democracies in Third World Societies. Studies in Third World Societies. Publication Number Twenty-Seven.

ERIC Educational Resources Information Center

Sutlive, Vinson H. Ed.; And Others

Topics concerned with the experiments and problems of self-rule in Third World societies are presented in nine essays. The essays are: (1) "Democracy in Iran: The Untenable Dream" (John D. Stempel); (2) "Afghanistan's Struggle for National Liberation" (Hafizullah Emadi); (3) "Turkey's Experience with Political…

Sugar Beet Activities of the USDA-ARS East Lansing Conducted in Cooperation with Saginaw Valley Bean and Beet Farm During 2009

USDA-ARS?s Scientific Manuscript database

Two evaluation plots were planted at the Saginaw Valley Research & Extension Center in Frankenmuth, MI in 2009; one agronomic trial and one combined Cercospora evaluation trial. All trials were planted, following normal fall and spring tillage operations, with a USDA-ARS modified John Deere/Almaco ...

REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial

PubMed Central

Sahota, Opinder; Drummond, Avril; Kendrick, Denise; Grainge, Matthew J.; Vass, Catherine; Sach, Tracey; Gladman, John; Avis, Mark

2014-01-01

Background: falls in hospitals are a major problem and contribute to substantial healthcare burden. Advances in sensor technology afford innovative approaches to reducing falls in acute hospital care. However, whether these are clinically effective and cost effective in the UK setting has not been evaluated. Methods: pragmatic, parallel-arm, individual randomised controlled trial of bed and bedside chair pressure sensors using radio-pagers (intervention group) compared with standard care (control group) in elderly patients admitted to acute, general medical wards, in a large UK teaching hospital. Primary outcome measure number of in-patient bedside falls per 1,000 bed days. Results: 1,839 participants were randomised (918 to the intervention group and 921 to the control group). There were 85 bedside falls (65 fallers) in the intervention group, falls rate 8.71 per 1,000 bed days compared with 83 bedside falls (64 fallers) in the control group, falls rate 9.84 per 1,000 bed days (adjusted incidence rate ratio, 0.90; 95% confidence interval [CI], 0.66–1.22; P = 0.51). There was no significant difference between the two groups with respect to time to first bedside fall (adjusted hazard ratio (HR), 0.95; 95% CI: 0.67–1.34; P= 0.12). The mean cost per patient in the intervention group was £7199 compared with £6400 in the control group, mean difference in QALYs per patient, 0.0001 (95% CI: −0.0006–0.0004, P= 0.67). Conclusions: bed and bedside chair pressure sensors as a single intervention strategy do not reduce in-patient bedside falls, time to first bedside fall and are not cost-effective in elderly patients in acute, general medical wards in the UK. Trial registration: isrctn.org identifier: ISRCTN44972300. PMID:24141253

Older adult falls prevention behaviors 60 days post-discharge from an urban emergency department after treatment for a fall.

PubMed

Shankar, Kalpana Narayan; Treadway, Nicole J; Taylor, Alyssa A; Breaud, Alan H; Peterson, Elizabeth W; Howland, Jonathan

2017-12-01

Falls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury. We enrolled English speaking patients, aged ≥ 65 years, who presented to the ED of an urban level one trauma center with a fall or fall related injury and discharged home. During subjects' initial visits to the ED, we screened and enrolled patients, gathered patient demographics and provided them with a flyer for a Matter of Balance course. Sixty-days post enrollment, we conducted a phone follow-up interview to collect information on post-fall behaviors including information regarding the efforts to engage family and the primary care provider, enroll in a falls prevention program, assess patients' attitudes towards falling and experiences with any subsequent falls. Eighty-seven community-dwelling people between the ages of 65 and 90 were recruited, the majority (76%) being women. Seventy-one percent of subjects reported talking to their provider regarding the fall; 37% reported engaging in falls prevention activities. No subjects reported enrolling in a fall prevention program although two reported contacting falls program staff. Fourteen percent of subjects (n=12) reported a recurrent fall and 8% (7) reported returning to the ED after a recurrent fall. Findings indicate a low rate of initiating fall prevention behaviors following an ED visit for a fall-related injury among community-dwelling older adults, and highlight the ED visit as an important, but underutilized, opportunity to mobilize health care resources for people at high risk for subsequent falls.

Increased care demand and medical costs after falls in nursing homes: A Delphi study.

PubMed

Sterke, Carolyn Shanty; Panneman, Martien J; Erasmus, Vicki; Polinder, Suzanne; van Beeck, Ed F

2018-04-21

To estimate the increased care demand and medical costs caused by falls in nursing homes. There is compelling evidence that falls in nursing homes are preventable. However, proper implementation of evidence-based guidelines to prevent falls is often hindered by insufficient management support, staff time and funding. A three-round Delphi study. A panel of 41 experts, all working in nursing homes in the Netherlands, received three online questionnaires to estimate the extra hours of care needed during the first year after the fall. This was estimated for ten falls categories with different levels of injury severity, in three scenarios, that is a best-case, a typical-case and a worst-case scenario. We calculated the costs of falls by multiplying the mean amount of extra hours that the participants spent on the care for a resident after a fall with their hourly wages. In case of a noninjurious fall, the extra time spent on the faller is on average almost 5 hr, expressed in euros that add to € 193. The extra staff time and costs of falls increased with increasing severity of injury. In the case of a fracture of the lower limb, the extra staff time increased to 132 hr, expressed in euros that is € 4,604. In the worst-case scenario of a fracture of the lower limb, the extra staff time increased to 284 hr, expressed in euros that is € 10,170. Falls in nursing homes result in a great deal of extra staff time spent on care, with extra costs varying between € 193 for a noninjurious fall and € 10,170 for serious falls. This study could aid decision-making on investing in appropriate implementation of falls prevention interventions in nursing homes. © 2018 John Wiley & Sons Ltd.

Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up.

PubMed

Berggren, M; Stenvall, M; Olofsson, B; Gustafson, Y

2008-06-01

A randomized, controlled fall-prevention study including 199 patients operated on for femoral neck fracture reduced inpatient falls and injuries. No statistically significant effects of the intervention program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone old people. This study evaluates whether a postoperative multidisciplinary, multifactorial fall-prevention program performed by a geriatric team that reduced inpatient falls and injuries had any continuing effect after discharge. The intervention consisted of staff education, systematic assessment and treatment of fall risk factors and vitamin D and calcium supplementation. The randomized, controlled trial with a one-year follow-up at Umeå University Hospital, Sweden, included 199 patients operated on for femoral neck fracture, aged > or = 70 years. After one year 44 participants had fallen 138 times in the intervention group compared with 55 participants and 191 falls in the control group. The crude postoperative fall incidence was 4.16/1,000 days in the intervention group vs. 6.43/1,000 days in the control group. The incidence rate ratio was 0.64 (95% CI: 0.40-1.02, p = 0.063). Seven new fractures occurred in the intervention group and 11 in the control group. A team applying comprehensive geriatric assessment and rehabilitation, including prevention and treatment of fall-risk factors, reduced inpatient falls and injuries, but no statistically significant effects of the program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone elderly.

Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness.

PubMed

Basic, David; Hartwell, Tabitha J

2015-01-01

To examine the association between falls in hospital and new placement in a nursing home among older people hospitalized with acute illness. This prospective cohort study of 2,945 consecutive patients discharged alive from an acute geriatric medicine service used multivariate logistic regression to model the association between one or more falls and nursing home placement (primary analysis). Secondary analyses stratified falls by injury and occurrence of multiple falls. Demographic, medical, and frailty measures were considered in adjusted models. The mean age of all patients was 82.8±7.6 years and 94% were admitted through the emergency department. During a median length of stay (LOS) of 11 days, 257 (8.7%) patients had a fall. Of these, 66 (25.7%) sustained an injury and 53 (20.6%) had two or more falls. Compared with nonfallers, fallers were more likely to be placed in a nursing home (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.37-3.00), after adjustment for age, sex, frailty, and selected medical variables (including dementia and delirium). Patients without injury (OR: 1.83, 95% CI: 1.17-2.85) and those with injury (OR: 2.35, 95% CI: 1.15-4.77) were also more likely to be placed. Patients who fell had a longer LOS (median 19 days vs 10 days; P<0.001). This study of older people in acute care shows that falls in the hospital are significantly associated with new placement in a nursing home. Given the predominantly negative experiences and the financial costs associated with placement in a nursing home, fall prevention should be a high priority in older people hospitalized with acute illness.

Compliance Monitoring of Yearling Chinook Salmon and Juvenile Steelhead Survival and Passage at John Day Dam, Spring 2011

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

Skalski, J. R.; Townsend, Richard L.; Seaburg, Adam

2012-02-01

The study was designed to estimate dam passage survival at John Day Dam as stipulated by the 2008 Federal Columbia River Power System (FCRPS) Biological Opinion (BiOp) and to provide additional fish passage performance measures at that site as stipulated in the Columbia Basin Fish Accords.

Compliance Monitoring of Yearling Chinook Salmon and Juvenile Steelhead Survival and Passage at John Day Dam, Spring 2011

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

Skalski, J. R.; Townsend, Richard L.; Seaburg, Adam

The study was designed to estimate dam passage survival at John Day Dam as stipulated by the 2008 Federal Columbia River Power System (FCRPS) Biological Opinion (BiOp) and to provide additional fish passage performance measures at that site as stipulated in the Columbia Basin Fish Accords.

78 FR 42795 - Submission for OMB review; 30-Day Comment Request: Evaluation of the Brain Disorders in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-17

...; 30-Day Comment Request: Evaluation of the Brain Disorders in the Developing World Program of the John... Collection: Evaluation of the Brain Disorders in the Developing World Program of the John E. Fogarty... outcomes of the Brain Disorders in the Developing World extramural research program administered by the...

Revisit, Subsequent Hospitalization, Recurrent Fall, and Death Within 6 Months After a Fall Among Elderly Emergency Department Patients.

PubMed

Sri-On, Jiraporn; Tirrell, Gregory P; Bean, Jonathan F; Lipsitz, Lewis A; Liu, Shan W

2017-10-01

We seek to describe the risk during 6 months and specific risk factors for recurrent falls, emergency department (ED) revisits, subsequent hospitalizations, and death within 6 months after a fall-related ED presentation. This was a secondary analysis of a retrospective cohort of elderly fall patients who presented to the ED from one urban teaching hospital. We included patients aged 65 years and older who had an ED fall visit in 2012. We examined the frequency and risk factors of adverse events (composite of recurrent falls, ED revisits, subsequent hospitalization, and death, selected a priori) at 6 months. Our study included 350 older adults. Adverse events steadily increased, from 7.7% at 7 days, 21.4% at 30 days, and 50.3% at 6 months. Within 6 months, 22.6% of patients had at least one recurrent fall, 42.6% revisited the ED, 31.1% had subsequent hospitalizations, and 2.6% died. In multivariable logistic regression analysis, psychological or sedative drug use predicted recurrent falls, ED revisits, subsequent hospitalizations, and adverse events. More than half of fall patients had an adverse event within 6 months of presenting to the ED after a fall. The risk during 6 months of these adverse events increased with psychological or sedative drug use. Larger future studies should confirm this association and investigate methods to minimize recurrent falls through management of such medications. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Preventing falls in hospital.

PubMed

Pearce, Lynne

2017-01-04

Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 per day, according to the Royal College of Physicians (RCP).

STS-81 Flight Day 8

NASA Technical Reports Server (NTRS)

1997-01-01

On this eighth day of the STS-81 mission, the flight crew, Cmdr. Michael A. Baker, Pilot Brent W. Jett, Mission Specialists, John M. Grunsfeld, Marsha S. Ivins, Peter J.K. Wisoff, and John Blaha, bid farewell to Jerry Linenger and cosmonauts of Mir. Prior to hatch closure, the astronauts and cosmonauts conduct a formal farewell ceremony in the Mir Core Module. They then field questions from Russian and U.S. reporters in a joint news conference. Commander Mike Baker, Pilot Brent Jett and Mission Specialists Jeff Wisoff, John Grunsfeld, Marsha Ivins and John Blaha say goodbye to Mir 22 Commander Valery Korzun, Flight Engineer Alexander Kaleri and the newest Mir crewmember, astronaut Jerry Linenger. The hatches on the two spacecraft are closed.

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

PubMed

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

2017-09-04

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

Effectiveness of individualized fall prevention program in geriatric rehabilitation hospital setting: a cluster randomized trial.

PubMed

Aizen, Efraim; Lutsyk, Galina; Wainer, Lea; Carmeli, Sarit

2015-10-01

There is no conclusive evidence that hospital fall prevention programs can reduce the number of falls. We aimed to investigate the effect of a targeted individualized falls prevention program in a geriatric rehabilitation hospital. This was a two-stage cluster-controlled trial carried out in five geriatric rehabilitation wards. Participants were 752 patients with mean age 83.2 years. The intervention was a two-phase targeted intervention falls prevention program. The intervention included an assessment of patient's risk by a risk assessment tool and an individual management that includes medical, behavioral, cognitive and environmental modifications. Patients with moderate risk received additionally orientation guidance, and mobility restriction. Patients determined as high risk were additionally placed under permanent personal supervision. Outcome measures were falls during hospital stay. In both stages of the trial, intervention and control wards were almost similar at baseline for individual patient characteristics. Overall, 37 falls occurred during the study. No significant difference was found in fall rates during follow-up between intervention and control wards: 1.306 falls per 1000 bed days in the intervention groups and 1.763-1.826 falls per 1000 bed days in the control groups. The adjusted hazard ratio for falls in the intervention groups was 1.36 (95 % confidence interval 0.89-1.77) (P = 0.08) in the first stage and 1.27 (95 % confidence interval 0.92-1.67) (P = 0.12) in the second stage. These results suggest that in a geriatric rehabilitation hospital a targeted individualized intervention falls prevention program is not effective in reducing falls.

Preventing falls in hospital.

PubMed

Pearce, Lynne

2017-02-27

Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.

Non-invasive assessment of negative pressure wound therapy using high frequency diagnostic ultrasound: oedema reduction and new tissue accumulation.

PubMed

Young, Stephen R; Hampton, Sylvie; Martin, Robin

2013-08-01

Tissue oedema plays an important role in the pathology of chronic and traumatic wounds. Negative pressure wound therapy (NPWT) is thought to contribute to active oedema reduction, yet few studies have showed this effect. In this study, high frequency diagnostic ultrasound at 20 MHz with an axial resolution of 60 µm was used to assess the effect of NPWT at - 80 mmHg on pressure ulcers and the surrounding tissue. Wounds were monitored in four patients over a 3-month period during which changes in oedema and wound bed thickness (granulation tissue) were measured non-invasively. The results showed a rapid reduction of periwound tissue oedema in all patients with levels falling by a mean of 43% after 4 days of therapy. A 20% increase in the thickness of the wound bed was observed after 7 days due to new granulation tissue formation. Ultrasound scans through the in situ gauze NPWT filler also revealed the existence of macrodeformation in the tissue produced by the negative pressure. These preliminary studies suggest that non-invasive assessment using high frequency diagnostic ultrasound could be a valuable tool in clinical studies of NPWT. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Golden West College FACTS: Fall Enrollment Trends through 1999.

ERIC Educational Resources Information Center

Golden West Coll., Huntington Beach, CA. Research Office.

This report presents the fall enrollment trends through 1999 at California's Golden West College (GWC). This report contains charts and graphs of the following enrollment trend topics: (1) fall 1998 student enrollment snapshot, which includes counts and percentages by gender, time of day, age, educational goal, entrance level, high school…

Two-sample tests and one-way MANOVA for multivariate biomarker data with nondetects.

PubMed

Thulin, M

2016-09-10

Testing whether the mean vector of a multivariate set of biomarkers differs between several populations is an increasingly common problem in medical research. Biomarker data is often left censored because some measurements fall below the laboratory's detection limit. We investigate how such censoring affects multivariate two-sample and one-way multivariate analysis of variance tests. Type I error rates, power and robustness to increasing censoring are studied, under both normality and non-normality. Parametric tests are found to perform better than non-parametric alternatives, indicating that the current recommendations for analysis of censored multivariate data may have to be revised. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Mapping the Contours of Neoliberal Educational Restructuring: A Review of Recent Neo-Marxist Studies of Education and Racial Capitalist Considerations

ERIC Educational Resources Information Center

Pierce, Clayton

2015-01-01

In this article Clayton Pierce reviews three books representative of the recent neo-Marxist literature on education: David Blacker's "The Falling Rate of Learning and the Neoliberal Endgame," John Marsh's Class Dismissed: "Why We Cannot Teach or Learn Our Way out of Inequality," and Pauline Lipman's "The New Political…

HPC Insights, Fall 2011

DTIC Science & Technology

2011-01-01

Simulating Satellite Tracking Using Parallel Computing By Andrew Lindstrom ,University of Hawaii at Hilo — Mentors: Carl Holmberg, Maui High Performance...RDECOM) and his management team, RDECOM Deputy Director Gary Martin ; ARL Director John Miller; Communications- Electronics Research, Development...Saves Resources By Mike Knowles, ARL DSRC Site Lead, Lockheed Martin mode instead of full power down. The first phase of the EAS effort is an attempt

The Story Behind the Story: Falling out of the Tree of Life

ERIC Educational Resources Information Center

Sis, Peter

2004-01-01

In this article, the author shares some of the background material that did not make it into his biography of Charles Darwin, "The Tree of Life." Specifically, he discusses the important role that teachers played in Darwin's life, from his demanding father (Dr. Darwin) to zoologist Dr. Robert Grant and taxidermist John Edmonstone (a freed slave).

Estimates of recreational stream use in the White River drainage, Vermont

Treesearch

Ronald J. Glass; Gerald Walton; Herbert E. Echelberger; Herbert E. Echelberger

1992-01-01

An observation technique that incorporates Godified, stratified sampling was used to estimate in-stream recreation use in the White River Drainage in Vermont. Results were reported by season, day of week, time of day, kind of activity, and portion of stream. Summer had the highest use followed by spring and fall. Except in fall, weekends and holidays received...

Behavioral, semiochemical and androgen responses by male giant pandas to the olfactory sexual receptivity cues of females.

PubMed

Wilson, Abbey E; Sparks, Darrell L; Knott, Katrina K; Kouba, Andrew J; Willard, Scott; Brown, Ashli

2018-07-01

Male giant pandas identify female sexual receptivity through the detection of olfactory cues in estrous urine. However, it is yet unknown which specific days of the female estrous cycle may provoke male sexual-social responses and a physiological readiness to mate. We hypothesized that female urine from specific days of the estrous cycle will be positively associated with specific changes in male behaviors, urinary semiochemical production, and steroidogenic activity. Experimental simultaneous choice trials were conducted in captivity with four male giant pandas during the spring breeding season and during fall. Male interest was determined by a behavioral preference toward peri-estrual urine collected from a specific day of the estrous cycle encompassing proestrus (Day -13, Day -6, Day -3, Day -2), estrus (Day -1 and Day 0), and metestrus (Day four and Day nine) over that of anestrous urine. Provocation of male sexual motivation was examined by changes in urinary semiochemical composition and urinary androgen concentrations. During the spring, male investigative behaviors indicated a preference for Day -13, Day -3 and Day 0 urine over anestrous urine, while no significant preferences for estrous urine could be detected during fall. The relative abundance of only three compounds in male urine were significantly higher above baseline values after males were exposed to peri-estrual urine during spring; whereas 34 compounds significantly increased in the fall. Similarly, androgen concentrations increased above baseline in only two out of four males during spring, while all males had elevated androgen concentrations after exposure to Day -3 urine during the fall. Our results suggest that peri-estrual urine from Day -13, Day -3, and Day 0 elicited the greatest duration of male investigation, changes in the semiochemical profile, and elevations in androgen levels. These data suggest that managers should incorporate a combination of behavioral, semiochemical, and endocrinological assessment of males in the reproductive management of giant pandas to determine impending ovulation and pinpoint the best time for male-female introductions and artificial inseminations. Copyright © 2018 Elsevier Inc. All rights reserved.

Psychoactive Medications Increase the Risk of Falls and Fall-related Injuries in Hospitalized Patients With Cirrhosis.

PubMed

Tapper, Elliot B; Risech-Neyman, Yesenia; Sengupta, Neil

2015-09-01

Reducing or eliminating falls is a focus of patient safety programs as well as health policy. Falls are tied to hospital reimbursement. However, little is known about the risk of falls among hospitalized patients with cirrhosis or factors that affect risk of falling. We conducted a retrospective cohort study of inpatients with cirrhosis from 2010 to 2013 at a liver transplant center. Our primary aim was to determine the clinical factors associated with falls and fall-related injuries for patients with cirrhosis. Our secondary aim was to describe the rate ratio of falls and fall-related injuries among patients with cirrhosis compared with general medical inpatients. During the study period, there were 1749 admissions to the liver service; 55 (3.1%) resulted in falls. Patients who fell were more likely to have received benzodiazepines (50.9% vs 16.7%, P < .0001) and antipsychotic agents (30.9% vs 7.3%, P < .0001). After adjusting for hepatic encephalopathy, the respective odds of a fall after benzodiazepine or antipsychotic exposure were 6.59 (95% confidence interval [CI], 3.76-11.59) and 3.72 (95% CI, 1.90-7.06). The adjusted risk of a fall-related injury was also significantly associated with benzodiazepine and antipsychotic agents, with respective odds ratios of 3.45 (95% CI, 1.39-8.23) and 3.42 (95% CI, 1.09-8.99). Fall-related injuries occurred at a rate of 1.70/1000 patient-days for patients with cirrhosis vs 0.5/1000 patient-days for patients in the general medical service. Accordingly, the rate ratio for a fall-related injury among patients with cirrhosis was 3.37 (95% CI, 1.99-5.72; P < .0001). Psychoactive medications are associated with an increased adjusted risk of falls and fall-related injuries in hospitalized patients with cirrhosis. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Establishment of an appropriate fall prevention program: A community-based study.

PubMed

Otaka, Yohei; Morita, Mitsuo; Mimura, Toshio; Uzawa, Mitsuyoshi; Liu, Meigen

2017-07-01

To identify an appropriate community-based fall prevention program METHODS: We introduced two programs to 24 senior centers, "community salons," in a Japanese city, and carried out a prospective controlled trial between 2004 and 2005. Eight salons (185 participants aged 72.0 ± 7.1 years) received a single-visit program consisting of one multidisciplinary team visit that included fall risk assessment with feedback and a fall prevention lecture. A total of 16 salons (418 participants aged 73.6 ± 7.4 years) received a year-round comprehensive program, with visits carried out every 3 months. We compared the fall rates for 1 year between the two programs. Based on the results, we implemented a modified program until 2014 and examined the long-term consequences. In the prospective controlled trial, fall rates did not differ significantly between programs (P = 0.449). Instead, fall rates for both programs decreased significantly by 0.89 (95% CI 0.84-0.94) times each month. Therefore, we implemented a modified version of the single-visit program. By March 2014, the programs had been delivered to 1863 individuals, and the total number of attendees was 6622. The average attendance frequency per participant was 0.62 times per year. The majority (85.3%) of salons requested the program every year. Overall, the risk of falling (fall rates in the preceding year) decreased significantly as the number of program attendances increased (incident rate ratio = 0.89, 95% CI 0.85-0.92) irrespective of initial program types. The programs including fall risk assessment with feedback and a fall prevention lecture reduced falls when embedded into the community, and they were accepted well over the course of 10 years. Geriatr Gerontol Int 2017; 17: 1081-1089. © 2016 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

The Confederated Tribes of the Warm Springs Indian Reservation of Oregon John Day Basin Office : Watershed Restoration Projects : 2003 Annual Report.

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

Confederated Tribes of the Warm Springs Reservation of Oregon. John Day Basin Office.

The John Day is the nation's second longest free-flowing river in the contiguous United States and the longest containing entirely unsupplemented runs of anadromous fish. Located in eastern Oregon, the basin drains over 8,000 square miles, Oregon's fourth largest drainage basin, and incorporates portions of eleven counties. Originating in the Strawberry Mountains near Prairie City, the John Day River flows 284 miles in a northwesterly direction, entering the Columbia River approximately four miles upstream of the John Day dam. With wild runs of spring Chinook salmon and summer steelhead, westslope cutthroat, and redband and bull trout, the John Day systemmore » is truly a basin with national significance. The majority of the John Day basin was ceded to the Federal government in 1855 by the Confederated Tribes of the Warm Springs Reservation of Oregon (Tribes). In 1997, the Tribes established an office in the basin to coordinate restoration projects, monitoring, planning and other watershed activities on private and public lands. Once established, the John Day Basin Office (JDBO) formed a partnership with the Grant Soil and Water Conservation District (GSWCD), which contracts the majority of the construction implementation activities for these projects from the JDBO. The GSWCD completes the landowner contact, preliminary planning, engineering design, permitting, construction contracting, and construction implementation phases of most projects. The JDBO completes the planning, grant solicitation/defense, environmental compliance, administrative contracting, monitoring, and reporting portion of the program. Most phases of project planning, implementation, and monitoring are coordinated with the private landowners and basin agencies, such as the Oregon Department of Fish and Wildlife and Oregon Water Resources Department. In 2003, the JDBO and GSWCD proposed continuation of their successful partnership between the two agencies and basin landowners to implement an additional twelve (12) watershed conservation projects. The types of projects include off channel water developments, juniper control, permanent diversions, pump stations, and return-flow cooling systems. Due to funding issues and delays, permitting delays, fire closures and landowner contracting problems, 2 projects were canceled and 7 projects were rescheduled to the 2004 construction season. Project costs in 2003 totaled $115,554.00 with a total amount of $64,981.00 (56%) provided by the Bonneville Power Administration (BPA) and the remainder coming from other sources such as the Bureau of Reclamation (BOR), Oregon Watershed Enhancement Board, the U.S. Fish & Wildlife Service Partners in Wildlife Program and individual landowners.« less

John Day Watershed Restoration Projects, annual report 2003.

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

Brown, Linda

The John Day is the nation's second longest free-flowing river in the contiguous United States and the longest containing entirely unsupplemented runs of anadromous fish. Located in eastern Oregon, the basin drains over 8,000 square miles, Oregon's fourth largest drainage basin, and incorporates portions of eleven counties. Originating in the Strawberry Mountains near Prairie City, the John Day River flows 284 miles in a northwesterly direction, entering the Columbia River approximately four miles upstream of the John Day dam. With wild runs of spring Chinook salmon and summer steelhead, westslope cutthroat, and redband and bull trout, the John Day systemmore » is truly a basin with national significance. The majority of the John Day basin was ceded to the Federal government in 1855 by the Confederated Tribes of the Warm Springs Reservation of Oregon (Tribes). In 1997, the Tribes established an office in the basin to coordinate restoration projects, monitoring, planning and other watershed activities on private and public lands. Once established, the John Day Basin Office (JDBO) formed a partnership with the Grant Soil and Water Conservation District (GSWCD), which contracts the majority of the construction implementation activities for these projects from the JDBO. The GSWCD completes the landowner contact, preliminary planning, engineering design, permitting, construction contracting, and construction implementation phases of most projects. The JDBO completes the planning, grant solicitation/defense, environmental compliance, administrative contracting, monitoring, and reporting portion of the program. Most phases of project planning, implementation, and monitoring are coordinated with the private landowners and basin agencies, such as the Oregon Department of Fish and Wildlife and Oregon Water Resources Department. In 2003, the JDBO and GSWCD proposed continuation of their successful partnership between the two agencies and basin landowners to implement an additional twelve (12) watershed conservation projects. The types of projects include off channel water developments, juniper control, permanent diversions, pump stations, and return-flow cooling systems. Due to funding issues and delays, permitting delays, fire closures and landowner contracting problems, 2 projects were canceled and 7 projects were rescheduled to the 2004 construction season. Project costs in 2003 totaled $115,554.00 with a total amount of $64,981.00 (56%) provided by the Bonneville Power Administration (BPA) and the remainder coming from other sources such as the Bureau of Reclamation (BOR), Oregon Watershed Enhancement Board, the U.S. Fish & Wildlife Service Partners in Wildlife Program and individual landowners.« less

Geomorphology, active tectonics, and landscape evolution in the Mid-Atlantic region: Chapter

USGS Publications Warehouse

Pazzaglia, Frank J.; Carter, Mark W.; Berti, Claudio; Counts, Ronald C.; Hancock, Gregory S.; Harbor, David; Harrison, Richard W.; Heller, Matthew J.; Mahan, Shannon; Malenda, Helen; McKeon, Ryan; Nelson, Michelle S.; Prince, Phillip; Rittenour, Tammy M.; Spotilla, James; Whittecar, G. Richard

2015-01-01

In 2014, the geomorphology community marked the 125th birthday of one of its most influential papers, “The Rivers and Valleys of Pennsylvania” by William Morris Davis. Inspired by Davis’s work, the Appalachian landscape rapidly became fertile ground for the development and testing of several grand landscape evolution paradigms, culminating with John Hack’s dynamic equilibrium in 1960. As part of the 2015 GSA Annual Meeting, the Geomorphology, Active Tectonics, and Landscape Evolution field trip offers an excellent venue for exploring Appalachian geomorphology through the lens of the Appalachian landscape, leveraging exciting research by a new generation of process-oriented geomorphologists and geologic field mapping. Important geomorphologic scholarship has recently used the Appalachian landscape as the testing ground for ideas on long- and short-term erosion, dynamic topography, glacial-isostatic adjustments, active tectonics in an intraplate setting, river incision, periglacial processes, and soil-saprolite formation. This field trip explores a geologic and geomorphic transect of the mid-Atlantic margin, starting in the Blue Ridge of Virginia and proceeding to the east across the Piedmont to the Coastal Plain. The emphasis here will not only be on the geomorphology, but also the underlying geology that establishes the template and foundation upon which surface processes have etched out the familiar Appalachian landscape. The first day focuses on new and published work that highlights Cenozoic sedimentary deposits, soils, paleosols, and geomorphic markers (terraces and knickpoints) that are being used to reconstruct a late Cenozoic history of erosion, deposition, climate change, and active tectonics. The second day is similarly devoted to new and published work documenting the fluvial geomorphic response to active tectonics in the Central Virginia seismic zone (CVSZ), site of the 2011 M 5.8 Mineral earthquake and the integrated record of Appalachian erosion preserved on the Coastal Plain. The trip concludes on Day 3, joining the Kirk Bryan Field Trip at Great Falls, Virginia/ Maryland, to explore and discuss the dramatic processes of base-level fall, fluvial incision, and knickpoint retreat.

The Rise and Fall of Type Ia Supernova Light Curves in the SDSS-II Supernova Survey

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

Hayden, Brian T.; /Notre Dame U.; Garnavich, Peter M.

2010-01-01

We analyze the rise and fall times of Type Ia supernova (SN Ia) light curves discovered by the Sloan Digital Sky Survey-II (SDSS-II) Supernova Survey. From a set of 391 light curves k-corrected to the rest-frame B and V bands, we find a smaller dispersion in the rising portion of the light curve compared to the decline. This is in qualitative agreement with computer models which predict that variations in radioactive nickel yield have less impact on the rise than on the spread of the decline rates. The differences we find in the rise and fall properties suggest that amore » single 'stretch' correction to the light curve phase does not properly model the range of SN Ia light curve shapes. We select a subset of 105 light curves well observed in both rise and fall portions of the light curves and develop a '2-stretch' fit algorithm which estimates the rise and fall times independently. We find the average time from explosion to B-band peak brightness is 17.38 {+-} 0.17 days, but with a spread of rise times which range from 13 days to 23 days. Our average rise time is shorter than the 19.5 days found in previous studies; this reflects both the different light curve template used and the application of the 2-stretch algorithm. The SDSS-II supernova set and the local SNe Ia with well-observed early light curves show no significant differences in their average rise-time properties. We find that slow-declining events tend to have fast rise times, but that the distribution of rise minus fall time is broad and single peaked. This distribution is in contrast to the bimodality in this parameter that was first suggested by Strovink (2007) from an analysis of a small set of local SNe Ia. We divide the SDSS-II sample in half based on the rise minus fall value, t{sub r} - t{sub f} {approx}< 2 days and t{sub r} - t{sub f} > 2 days, to search for differences in their host galaxy properties and Hubble residuals; we find no difference in host galaxy properties or Hubble residuals in our sample.« less

The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

PubMed Central

2012-01-01

Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI) activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1) the fall risk assessment tool, 2) an intervention protocol to prevent in-patient falls, 3) specific environmental safety interventions, 4) staff education, and 5) multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331) in 2004 versus 1.53 falls per 1000 patient days (263/172325) in 2010, representing a significant decrease (p = 0.039). In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368), increasing to 97.6% in 2010 (10564/10828). The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective. PMID:22788785

Development of the Sydney Falls Risk Screening Tool in brain injury rehabilitation: A multisite prospective cohort study.

PubMed

McKechnie, Duncan; Fisher, Murray J; Pryor, Julie; Bonser, Melissa; Jesus, Jhoven De

2018-03-01

To develop a falls risk screening tool (FRST) sensitive to the traumatic brain injury rehabilitation population. Falls are the most frequently recorded patient safety incident within the hospital context. The inpatient traumatic brain injury rehabilitation population is one particular population that has been identified as at high risk of falls. However, no FRST has been developed for this patient population. Consequently in the traumatic brain injury rehabilitation population, there is the real possibility that nurses are using falls risk screening tools that have a poor clinical utility. Multisite prospective cohort study. Univariate and multiple logistic regression modelling techniques (backward elimination, elastic net and hierarchical) were used to examine each variable's association with patients who fell. The resulting FRST's clinical validity was examined. Of the 140 patients in the study, 41 (29%) fell. Through multiple logistic regression modelling, 11 variables were identified as predictors for falls. Using hierarchical logistic regression, five of these were identified for inclusion in the resulting falls risk screening tool: prescribed mobility aid (such as, wheelchair or frame), a fall since admission to hospital, impulsive behaviour, impaired orientation and bladder and/or bowel incontinence. The resulting FRST has good clinical validity (sensitivity = 0.9; specificity = 0.62; area under the curve = 0.87; Youden index = 0.54). The tool was significantly more accurate (p = .037 on DeLong test) in discriminating fallers from nonfallers than the Ontario Modified STRATIFY FRST. A FRST has been developed using a comprehensive statistical framework, and evidence has been provided of this tool's clinical validity. The developed tool, the Sydney Falls Risk Screening Tool, should be considered for use in brain injury rehabilitation populations. © 2017 John Wiley & Sons Ltd.

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

PubMed

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

2014-06-01

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

Epidural analgesia does not increase the rate of inpatient falls after major upper abdominal and thoracic surgery: a retrospective case-control study.

PubMed

Elsharydah, Ahmad; Williams, Tiffany M; Rosero, Eric B; Joshi, Girish P

2016-05-01

Postoperative epidural analgesia for major upper abdominal and thoracic surgery can provide significant benefits, including superior analgesia and reduced pulmonary dysfunction. Nevertheless, epidural analgesia may also be associated with decreased muscle strength, sympathetic tone, and proprioception that could possibly contribute to falls. The purpose of this retrospective case-control study was to search a large national database in order to investigate the possible relationship between postoperative epidural analgesia and the rate of inpatient falls. Data from the nationwide inpatient sample for 2007-2011 were queried for adult patients who underwent elective major upper abdominal and thoracic surgery. Multiple International Classification of Diseases, Ninth Revision, Clinical Modification codes for inpatient falls and accidents were combined into one binary variable. Univariate analyses were used for initial statistical analysis. Logistic regression analyses and McNemar's tests were subsequently used to investigate the association of epidural analgesia with inpatient falls in a 1:1 case-control propensity-matched sample after adjustment of patients' demographics, comorbidities, and hospital characteristics. Forty-two thousand six hundred fifty-eight thoracic and 54,974 upper abdominal surgical procedures were identified. The overall incidence of inpatient falls in the thoracic surgery group was 6.54% with an increasing trend over the study period from 4.95% in 2007 to 8.11% in 2011 (P < 0.001). Similarly, the overall incidence of inpatient falls in the upper abdominal surgery group was 5.30% with an increasing trend from 4.55% in 2007 to 6.07% in 2011 (P < 0.001). Postoperative epidural analgesia was not associated with an increased risk for postoperative inpatient falls in the thoracic surgery group (relative risk [RR], 1.18; 95% confidence interval [CI], 0.95 to 1.47; P = 0.144) and in the upper abdominal surgery group (RR, 0.84; 95% CI 0.64 to 1.09; P = 0.220). Inpatient falls compared with non-falls were associated with a longer median (interquartile range) length of hospital stay in both the thoracic surgery group (11 [7-17] days vs 9 [6-16] days, respectively; P < 0.001) and the upper abdominal surgery group (12 [7-20] days vs 10 [6-17] days, respectively; P < 0.001). Our study suggests that postoperative epidural analgesia for patients undergoing major upper abdominal and thoracic surgery is not associated with an increased risk of inpatient falls.

Fall from heights: does height really matter?

PubMed

Alizo, G; Sciarretta, J D; Gibson, S; Muertos, K; Romano, A; Davis, J; Pepe, A

2018-06-01

Fall from heights is high energy injuries and constitutes a fraction of all fall-related trauma evaluations while bearing an increase in morbidity and mortality. We hypothesize that despite advancements in trauma care, the overall survivability has not improved in this subset of trauma patients. All adult trauma patients treated after sustaining a fall from heights during a 40-month period were retrospectively reviewed. Admission demographics, clinical data, fall height (ft), injury patterns, ISS, GCS, length of stay, and mortality were reviewed. 116 patients sustained a fall from heights, 90.4% accidental. A mean age of 37± 14.7 years, 86% male, and a fall height of 19 ± 10 ft were encountered. Admission GCS was 13 ± 2 with ISS 10 ± 11. Overall LOS was 6.6 ± 14.9 days and an ICU LOS of 2.8 ± 8.9 days. Falls ≥ 25 ft.(16%) had lower GCS 10.4 ± 5.8, increased ISS 22.6 ± 13.8, a fall height 37.9 ± 13.1 ft and associated increased mortality (p < 0.001). Mortality was 5.2%, a mean distance fallen of 39 ± 22 ft. and an ISS of 31.5 ±16.5. Brain injury was the leading cause of death, 50% with open skull fractures. Level of height fallen is a good predictor of overall outcome and survival. Despite advances in trauma care, death rates remain unchanged. Safety awareness and injury prevention programs are needed to reduce the risk of high-level falls.

[Influence of traffic restriction on road and construction fugitive dust].

PubMed

Tian, Gang; Li, Gang; Qin, Jian-Ping; Fan, Shou-Bin; Huang, Yu-Hu; Nie, Lei

2009-05-15

By monitoring the road and construction dust fall continuously during the "Good Luck Beijing" sport events, the reduction of road and construction dust fall caused by traffic restriction was studied. The contribution rate of road and construction dust to particulate matter of Beijing atmosphere environment, and the emission ratio of it to total local PM10 emission were analyzed. The results show that the traffic restriction reduces road and construction dust fall significantly. The dust fall average value of ring roads was 0.27 g x (m2 x d)(-1) in the "traffic restriction" period, and the values were 0.81 and 0.59 g x (m2 x d)(-1) 1 month and 7 days before. The dust fall average value of major arterial and minor arterial was 0.21 g x (m2 x d)(-1) in the "traffic restriction" period, and the values were 0.54 and 0.58 g x (m2 x d)(-1) 1 month and 7 days before. The roads emission reduced 60%-70% compared with before traffic restriction. The dust fall average values of civil architecture and utility architecture were 0.61 and 1.06 g x (m2 x d)(-1) in the "traffic restriction" period, and the values were 1.15 and 1.55 g x (m2 x d)(-1) 20 days before. The construction dust reduced 30%-47% compared with 20 days before traffic restriction. Road and construction dust emission are the main source of atmosphere particulate matter in Beijing, and its contribution to ambient PM10 concentration is 21%-36%. PM10 emitted from roads and constructions account for 42%-72% and 30%-51% of local emission while the local PM10 account for 50% and 70% of the total emission.

Fall Leaf Portraits

ERIC Educational Resources Information Center

O'Hara, Cristina

2012-01-01

In this article, the author describes how students can create a stunning as well as economical mosaic utilizing fall's brilliantly colored leaves, preserved at their peak in color. Start by choosing a beautiful fall day to take students on a nature walk to collect a variety of leaves in different shapes, sizes, and colors. Focus on collecting a…

Influence of season of birth on growth and reproductive development of Brahman bulls.

PubMed

Tatman, Shawn R; Neuendorff, Don A; Wilson, Timothy W; Randel, Ronald D

2004-07-01

Seasonal effects on reproduction are more dramatic in Bos indicus than Bos taurus cattle. This experiment evaluated reproductive development of fall- (n=7) versus spring- (n = 10) born Brahman bulls to determine if season of birth affects reproductive development. Measurements of growth and reproductive development began after weaning and continued at bi-weekly intervals until each bull reached sexual maturity. Different stages of sexual development were classified according to characteristics of the ejaculate and included first sperm in the ejaculate, puberty (> 50 x 10(6) sperm/ejaculate), and sexual maturity (two ejaculates with > 500 = 10(6) sperm/ejaculate). Average daily increases in all measured traits were similar in fall- and spring-born bulls and there were no differences in age, body weight, scrotal circumference, or paired testis volume between groups at first sperm or puberty. However, fall-born bulls were older (P < 0.05) than spring-born bulls at sexual maturity (553 days versus 481 days, respectively) as the interval between puberty and sexual maturity was longer (P < 0.05) in fall- than in spring-born bulls (82 days versus 54 days, respectively). The prolonged interval between puberty and sexual maturity in fall-born calves coincided with a short photoperiod (winter) whereas the short interval between puberty and sexual maturity in spring-born calves coincided with a long photoperiod (summer). In conclusion, season of birth affected sexual development; photoperiod might be involved in regulating testicular function immediately after puberty in Brahman bulls.

Compliance Monitoring of Yearling and Subyearling Chinook Salmon and Juvenile Steelhead Survival and Passage at John Day Dam, 2012

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

Skalski, J. R.; Townsend, Richard L.; Seaburg, Adam

The purpose of this compliance study was to estimate dam passage survival of yearling and subyearling Chinook salmon and steelhead smolts at John Day Dam during the spring and summer outmigrations in 2012. Under the 2008 Federal Columbia River Power System (FCRPS) Biological Opinion (BiOp), dam passage survival should be greater than or equal to 0.96 for spring migrants and greater than or equal to 0.93 for summer migrants, estimated with a standard error (SE) less than or equal to 0.015. The study also estimated smolt passage survival from the forebay 2 km upstream of the dam to the tailracemore » 3 km downstream of the dam, as well as the forebay residence time, tailrace egress time, spill passage efficiency (SPE), and fish passage efficiency (FPE), as required in the Columbia Basin Fish Accords (Fish Accords). A virtual/paired-release design was used to estimate dam passage survival at John Day Dam. The approach included releases of smolts, tagged with acoustic micro-transmitters, above John Day Dam that contributed to the formation of a virtual release at the face of John Day Dam. A survival estimate from this release was adjusted by a paired release below John Day Dam. A total of 3376 yearling Chinook salmon, 5726 subyearling Chinook salmon, and 3239 steelhead smolts were used in the virtual releases. Sample sizes for the below-dam paired releases (R2 and R3, respectively) were 997 and 995 for yearling Chinook salmon smolts, 986 and 983 for subyearling Chinook salmon smolts, and 1000 and 1000 for steelhead smolts. The Juvenile Salmon Acoustic Telemetry System (JSATS) tags were manufactured by Advanced Telemetry Systems. Model SS300 tags, weighing 0.304 g in air, were surgically implanted in yearling and subyearling Chinook salmon, and Model SS130 tag, weighing 0.438 g in air, were surgically implanted in juvenile steelhead for this investigation. The intent of the spring study was to estimate dam passage survival during both 30% and 40% spill conditions. The two spill conditions were to be systematically performed in alternating 2-day test intervals over the course of the spring outmigration. High flow conditions in 2012 interrupted the spill study. Dam passage survival was therefore estimated season-wide regardless of spill conditions.« less

Columbia Plateau Basin and Fifteenmile Subbasin Water Rights Acquisitons; Oregon Water Trust Combined Work Plan, 2002-2003 Final Report.

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

Paulus, Fritz

2003-12-01

This is the Final Report submitted regarding Oregon Water Trust's Combined Work Plan for fiscal year 2003, with the contract period April 2002 to May 2003. Of this 12 month period, six month were spent concluding our work for the 2002 irrigation season and six months were spent preparing for the 2003 irrigation season. After this grant was completed, projects were finished with funding from the Columbia Basin Water Transactions Program. Many of the 2003 irrigation season successes began in the fall of 2002, when projects were researched and partnerships were developed. Trout Creek Ranch was one of the largemore » successes. During the 2003 irrigation season, 2.6 cfs was leased which led to a permanent instream transfer, protecting critical spawning habitat for summer steelhead in the Deschutes basin. Another success was the Walla Walla Lease Bank project. This project is an agreement between the OWT, the Walla Walla Irrigation District and 11 individual landowners. Through this single year lease, 7.9 cfs of water was legally protected in the Walla Walla River. The Vidando lease on Middle Fork John Day River was renewed for 2 more years, protecting 11.29 cfs. An innovative single year split-season lease was conducted with Voight on Standard Creek in the John Day basin to protect 4.93 cfs. Many other deals were conducted and the total was an impressive 50.43 cfs instream during 2003 and 9.39 cfs pending approval for the 2004 season. Included is a summary of the activities within the Fifteenmile subbasin and the Columbia Plateau basin by quarter and two tables. The summary of activities is broken down by objectives and quarters. The first summarizes the total cfs by type of lease or transfer. The second table lists all the projects by subbasin and provides project type, lease number, cfs, cost of acquisition, partners in the project and funding source.« less

Older adult falls at a metropolitan airport: 2009-2010.

PubMed

Howland, Jonathan; Bibi, Salma; English, James; Dyer, Sophia; Peterson, Elizabeth W

2012-04-01

We investigated falls at a metropolitan airport to determine fall incidence, identify potential causes of these falls, and suggest opportunities for mitigation. We used deidentified incident reports of all falls requiring EMS response that occurred at the airport during 2009 and 2010. On average, one fall occurred every 2.3days. Ninety-six percent (96%) of falls occurred in terminals. Of all falls, 44% occurred on escalators, making escalators the most common location. Seventy-two percent (72%) of fallers were females; 43% were ≥65years; 92% of all falls resulted in a documented injury; 37% of falls resulted in transport to hospital emergency departments. Escalator fall risks include carrying bags (due to changes in baggage fees), using cells phones, not using handrails, and compromised strength and balance. Diverting at-risk passengers to elevators could significantly reduce the overall falls. Interventions targeting escalator falls have the greatest promise for reducing falls at this airport. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

John Henry--The Steel Driving Man

ERIC Educational Resources Information Center

Murphy, David E.; Gulley, Laura L.

2005-01-01

The story of John Henry provided the setting for sixth-grade class to participate in a John Henry Day of mathematics experiments. The students collected data from experiments where students competed against machines and technology. The student analyzed the data by comparing two box plots, a box plot of human data, and a box plot of machine or…

Astronaut John Glenn dons space suit during preflight operations

NASA Technical Reports Server (NTRS)

1964-01-01

Astronaut John Glenn dons space suit during preflight operations at Cape Canaveral, February 20, 1962, the day he flew his Mercury-Atlas 6 spacecraft, Friendship 7, into orbital flight around the Earth.

Preliminary 3d depth migration of a network of 2d seismic lines for fault imaging at a Pyramid Lake, Nevada geothermal prospect

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

Frary, R.; Louie, J.; Pullammanappallil, S.

Roxanna Frary, John N. Louie, Sathish Pullammanappallil, Amy Eisses, 2011, Preliminary 3d depth migration of a network of 2d seismic lines for fault imaging at a Pyramid Lake, Nevada geothermal prospect: presented at American Geophysical Union Fall Meeting, San Francisco, Dec. 5-9, abstract T13G-07.

Black Males in the Green Mountains: Colorblindness and Cultural Competence in Vermont Public Schools. Black Studies and Critical Thinking. Volume 38

ERIC Educational Resources Information Center

Dunbar, Denise Helen

2013-01-01

Mention the state of Vermont and images of maple syrup, scenic mountains, and progressive politics come to mind. But in addition to skiing, farming, and fall foliage, there is also a startling history of racial and religious intolerance and bigotry. Burlington is known as the birthplace of John Dewey, whose enlightened views about education…

O'Hara Receives 2007 Harry H. Hess Medal

NASA Astrophysics Data System (ADS)

Niu, Yaoling; O'Hara, Michael John

2008-01-01

Michael John O'Hara was awarded the 2007 Harry H. Hess Medal at the AGU Fall Meeting Honors Ceremony, held on 12 December 2007 in San Francisco, Calif. The Harry H. Hess Medal recognizes ``outstanding achievements in research in the constitution and evolution of Earth and other planets.'' It is thus most appropriate that Mike O'Hara receive the 2007 Hess Medal of the American Geophysical Union.

Rejoinder to Craig A. Cunningham, David Granger, Jane Fowler Morse, Barbara Stengel, and Terri Wilson, "Dewey, Women, and Weirdoes"

ERIC Educational Resources Information Center

Fitzgerald, Terry

2010-01-01

It is good to see Cunningham et al. including F. Matthias Alexander in their list of positive influences in John Dewey's life. However, I believe Cunningham's essay, "Shared explorations of body-mind: the reciprocal influences of Dewey and F.M. Alexander", falls short in its acknowledgement of Alexander and in one important aspect is incorrect. In…

Reaching Each Student: National Challenge and Organizational Commitment. Addresses to the College Board National Forum, October 31-November 2, 1990, Boston, Massachusetts.

ERIC Educational Resources Information Center

College Board, New York, NY.

Four speakers addressed the College Board National Forum on "Reaching Each Student" in the Fall of 1990 in Boston, Massachusetts. John F. Akers, Chairman of the Board at International Business Machines in his speech "Reaching Each Student: A Business Perspective" challenged the College Board to work with American business to…

Symposium on the Physical Chemistry of Solar Energy Conversion, Indianapolis American Chemical Society Meetings, Fall 2013

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

Lian, Tianquan

2013-09-20

The Symposium on the Physical Chemistry of Solar Energy Conversion at the Fall ACS Meeting in Indianapolis, IN (Sept. 8-12) featured the following sessions (approx. 6 speakers per session): (1) Quantum Dots and Nanorods for Solar Energy Conversion (2 half-day sessions); (2) Artificial Photosynthesis: Water Oxidation; (3) Artificial Photosynthesis: Solar Fuels (2 half-day sessions); (4) Organic Solar Cells; (5) Novel Concepts for Solar Energy Conversion (2 half-day sessions); (6) Emerging Techniques for Solar Energy Conversion; (7) Interfacial Electron Transfer

Fall Enrollment Report 2009

ERIC Educational Resources Information Center

Iowa Department of Education, 2009

2009-01-01

This report summarizes fall enrollment in Iowa's community colleges. Every year Iowa's 15 community college districts submit data on students enrolled on the 10th day of the fall semester. Highlights include: (1) Enrollment grew at its fastest pace since 1975 to a record high of 100,736 students; (2) Year-to-year growth was 14.3 percent, which is…

Functional Performances on Admission Predict In-Hospital Falls, Injurious Falls, and Fractures in Older Patients: A Prospective Study.

PubMed

Hars, Mélany; Audet, Marie-Claude; Herrmann, François; De Chassey, Jean; Rizzoli, René; Reny, Jean-Luc; Gold, Gabriel; Ferrari, Serge; Trombetti, Andrea

2018-05-01

Falls are common among older inpatients and remain a great challenge for hospitals. Despite the relevance of physical impairments to falls, the prognostic value of performance-based functional measures for in-hospital falls and injurious falls remains unknown. This study aimed to determine the predictive ability and accuracy of various functional tests administered at or close to admission in a geriatric hospital to identify in-hospital fallers and injurious fallers. In this prospective study, conducted in a geriatric hospital in Geneva, Switzerland, 807 inpatients (mean age 85.0 years) were subjected to a battery of functional tests administered by physiotherapists within 3 days (interquartile range 1 to 6) of admission, including Short Physical Performance Battery (SPPB), simplified Tinetti, and Timed Up and Go tests. Patients were prospectively followed up for falls and injurious falls until discharge using mandatory standardized incident report forms and electronic patients' records. During a median length of hospital stay of 23 days (interquartile range 14 to 36), 329 falls occurred in 189 (23.4%) patients, including 161 injurious falls of which 24 were serious. In-hospital fallers displayed significantly poorer functional performances at admission on all tests compared with non-fallers (p < 0.001 for all). In multivariate analysis controlling for age, sex, previous falls, and fall as cause of admission, poorer functional performances on all functional tests predicted in-hospital falls and injurious falls (p < 0.001 for all). The SPPB only significantly predicted serious injurious falls (adjusted odds ratio [OR] = 0.76; 95% confidence interval [CI] 0.60-0.96) and fractures (adjusted OR = 0.76; 95% CI 0.59-0.98). In conclusion, poor functional performances, as assessed by SPPB, are independent predictors of in-hospital falls, injurious falls, and fractures in patients admitted to a geriatric hospital. These findings should help to design preventive strategies for in-hospital falls and support the adoption of objective performance-based functional measures into routine hospital practice. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.

2012 Diversity Day

NASA Image and Video Library

2012-10-31

John C. Stennis Space Center employees enjoyed 2012 Diversity Day activities Oct. 31. During the day, Stennis employees were able to visit exhibits highlighting different cultures and participate in a range of activities.

Burden of Proof in Bioethics.

PubMed

Koplin, Julian J; Selgelid, Michael J

2015-11-01

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.

Timing effects in health valuations.

PubMed

Leiter, Andrea M; Pruckner, Gerald J

2014-06-01

This paper analyzes the impact of external sources of information, conveyed by the frequency of risky events that vary across time, on the individual willingness to pay (WTP) for a reduction of mortality risk. We collected data from a contingent valuation (CV) exercise conducted in two waves (fall and winter) to examine whether individual WTP varied across periods that differed in the predominance of fatal accidents. Risk valuations were based on fatal snow avalanche accidents, that is, a type of risk with seasonal differences in occurrence. We found slightly lower but statistically significant mean WTP figures in the winter than in the fall sample because of time-varying individual risk attitudes and, therefore, recommend controlling for these factors in risk assessment CV surveys. Copyright © 2013 John Wiley & Sons, Ltd.

Change in serum lipids after acute coronary syndromes: secondary analysis of SPACE ROCKET study data and a comparative literature review.

PubMed

Barth, Julian H; Jackson, Beryl M; Farrin, Amanda J; Efthymiou, Maria; Worthy, Gillian; Copeland, Joanne; Bailey, Kristian M; Romaine, Simon P R; Balmforth, Anthony J; McCormack, Terry; Whitehead, Andrew; Flather, Marcus D; Nixon, Jane; Hall, Alistair S

2010-10-01

It has long been an accepted belief that serum cholesterol significantly falls after myocardial infarction and that a return to pre-event levels takes approximately 3 months. The magnitude and clinical significance of this fall has recently been challenged. In the Secondary Prevention of Acute Coronary Events-Reduction Of Cholesterol to Key European Targets (SPACE ROCKET) trial, we measured serum lipids of individuals on day 1 and between days 2 and 4 after acute myocardial infarction (AMI). Second, we performed a thorough literature review and compared all studies reporting data on absolute changes in lipids immediately after AMI, using weighted means. Of 1263 SPACE ROCKET participants, 128 had paired lipid measurements where both samples had been measured using identical methods at baseline and on days 2-4 after AMI. The mean lowering in total cholesterol between day 1 and day 2-4 was 0.71 mmol/L (95% CI 0.58-0.84; P < 0.0001) and in triglycerides was 0.10 mmol/L (-0.14-0.33; P = 0.405). A total of 25 papers showing absolute lipid changes post-AMI were identified. The combined data demonstrated a mean fall in total cholesterol of 9% to 11% from baseline over days 3-14 post-AMI, whereas for triglycerides, there was a rise of 18% from baseline to between day 9 and 12 weeks. After a secondary analysis of SPACE ROCKET data and a comparison of previously published data, we report a 10% fall in total cholesterol after AMI-a difference that is of high clinical significance. Consequently, measurement of serum lipids in patients with AMI should be performed within the first hours after presentation.

Lycra splinting garments for adults with intellectual disabilities who fall due to gait or balance issues: a feasibility study.

PubMed

Finlayson, J; Crockett, J; Shanmugam, S; Stansfield, B

2018-05-01

Adults with intellectual disabilities (IDs) experience high rates of falls and have high rates of gait or balance issues which contribute to falls. Lycra splinting garments (LSGs) have potential to improve gait or balance, but they have never before been tested with adults with IDs who fall due to gait or balance issues. The aim of this study was to test in adults with IDs, the feasibility of using LSGs to improve movement and function and reduce falls, whilst also exploring usability and likely compliance. A convenience sample of nine adults with IDs wore tailored LSGs over a 6-week assessment period. Laboratory-based foot clearance, balance, and gait measures were collected pre- and post-LSG-wear. Falls charts and questionnaires on usability and likely compliance were also completed. Seven participants experienced a reduction in falls during their six weeks of LSG wear; most notably in the group of five participants who wore lycra splinting socks, compared with only two in the group of four who wore lycra splinting shorts or leggings only. Lycra splinting socks are likely to bring about positive outcomes for adults with IDs who fall due to gait/balance issues on an individual case by case basis over time, but further research is required to test this hypothesis under randomised controlled trial conditions. Potential benefits of more intrusive LSGs are outweighed by reported problems with usability and compliance. © 2018 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disibilities and John Wiley & Sons Ltd.

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

PubMed Central

Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-01-01

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

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

PubMed

Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-11-01

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

Association between Antidepressants and Fall-Related Injuries among Long-Term Care Residents.

PubMed

Macri, Jennifer C; Iaboni, Andrea; Kirkham, Julia G; Maxwell, Colleen; Gill, Sudeep S; Vasudev, Akshya; Whitehead, Marlo; Seitz, Dallas P

2017-12-01

Antidepressants are associated with an increased risk of falls although little is known of the comparative risks of different types of antidepressants or individuals who are at greatest risk for falls. We examined the association between new use of antidepressants and fall-related injuries among older adults in long-term care (LTC). This was a matched, retrospective cohort study involving LTC residents in Ontario, Canada, from 2008 to 2014. New users of antidepressants were matched to non-users of antidepressants. The primary outcome was any fall resulting in an emergency department (ED) visit or hospitalization within 90 days after exposure. Secondary outcomes included hip fractures, wrist fractures, and falls reported in LTC. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval associated with antidepressants and outcomes. New users of any antidepressant had an increased risk of ED visits or hospitalization for falls within 90 days when compared with individuals not receiving antidepressants (5.2% versus 2.8%; adjusted OR: 1.9, 95% CI: 1.7-2.2). Antidepressants were also associated with an increased risk of all secondary outcomes. The increased risk of fall-related injuries was evident among selective-serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, trazodone, and across multiple patient subgroups. New use of antidepressants is associated with significantly increased risk of falls and fall-related injuries among LTC residents across different patient subgroups and antidepressant classes. The potential risk of fall-related outcomes should be carefully considered when initiating antidepressants among older adults in LTC. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Predictors and economic burden of serious workplace falls in health care.

PubMed

Alamgir, H; Ngan, K; Drebit, S; Guiyun Li, H; Keen, D

2011-06-01

To examine the demographic and workplace risk factors of serious falls and associated economic burden in Canadian health care workers. Fall injury data during 2005-2008 from a workplace health and safety surveillance system were linked with workers' compensation claims and payroll records. The costs for treatment and wage loss and days lost for accepted time-loss claims were calculated. Demographic and work-related factors were identified to distinguish the risk for more serious falls from less serious falls. Nine hundred and thirty-eight fall injury claims were captured among 48 519 full-time equivalent workers. Workers >60 years, part time or employed in the long-term care sector sustained a higher proportion of serious falls (>70%). Over 75% of falls were serious for care aides, facility support service workers and community health workers. In the multivariate analysis, the risk of serious falls remained higher for workers in the long-term care sector [odds ratio (OR) 1.71; P < 0.05] compared with those in acute care and for care aides (OR 1.72; P < 0.05), facility support service workers (OR 2.58; P < 0.01) and community health workers (OR 3.61; P < 0.001) compared with registered nurses (RNs). The median number of days lost was higher for females, long-term care workers, licensed practical nurses and care aides. Females, long-term care workers, RNs, licensed practical nurses, care aides and maintenance workers had the most costly falls. Reducing work-related serious fall injuries would be expected to bring about significant benefits in terms of reduced pain and suffering, improved workplace productivity, reduced absenteeism and reduced compensation costs.

Monitoring of Juvenile Yearling Chinook Salmon and Steelhead Survival and Passage at John Day Dam, Spring 2010

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

Weiland, Mark A.; Ploskey, Gene R.; Hughes, James S.

The purpose of this study was to compare dam passage survival, at two spill treatment levels, of yearling Chinook salmon and steelhead smolts at John Day Dam during spring 2010. The two treatments were 30% and 40% spill out of total project discharge. Under the 2008 Federal Columbia River Power System (FCRPS) Biological Opinion (BiOp), dam passage survival should be greater than or equal to 0.96 and estimated with a standard error (SE) less than or equal 0.015. The study also estimated forebay residence time, tailrace egress time, and spill passage efficiency (SPE), as required in the Columbia Basin Fishmore » Accords. However, by agreement among the stakeholders, this study was not an official BiOp compliance test because the long-term passage measures at John Day Dam have yet to be finalized and another year of spill-treatment testing was desired.« less

Do stock prices drive people crazy?

PubMed

Lin, Chung-Liang; Chen, Chin-Shyan; Liu, Tsai-Ching

2015-03-01

This is the first research to examine a potential relation between stock market volatility and mental disorders. Using data on daily incidences of mental disorders in Taiwan over 4000 days from 1998 through 2009 to assess the time-series relation between stock price movements and mental disorders, we observe that stock price fluctuation clearly affects the hospitalization of mental disorders. We find that during a 12-year follow-up period, a low stock price index, a daily fall in the stock price index and consecutive daily falls in the stock price index are all associated with greater of mental disorders hospitalizations. A 1000-point fall in the TAIEX (Taiwan Stock Exchange Capitalization Weighted Stock Index) increases the number of daily mental disorders hospitalizations by 4.71%. A 1% fall in the TAIEX in one single day increases daily hospitalizations for mental disorders by 0.36%. When the stock price index falls one consecutive day, it causes a daily increase of approximately 0.32% hospitalizations due to mental disorders on that day. Stock price index is found to be significant for both gender and all age groups. In addition, daily change is significant for both gender and middle-age groups, whereas accumulated change is significant for males and people aged 45-64. Stockholdings can help people accumulate wealth, but they can also increase mental disorders hospitalizations. In other words, stock price fluctuations do drive people crazy. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

An Integrative Review of Pediatric Fall Risk Assessment Tools.

PubMed

DiGerolamo, Kimberly; Davis, Katherine Finn

Patient fall prevention begins with accurate risk assessment. However, sustained improvements in prevention and quality of care include use of validated fall risk assessment tools (FRATs). The goal of FRATs is to identify patients at highest risk. Adult FRATs are often borrowed from to create tools for pediatric patients. Though factors associated with pediatric falls in the hospital setting are similar to those in adults, such as mobility, medication use, and cognitive impairment, adult FRATs and the factors associated with them do not adequately assess risk in children. Articles were limited to English language, ages 0-21years, and publish date 2006-2015. The search yielded 22 articles. Ten were excluded as the population was primarily adult or lacked discussion of a FRAT. Critical appraisal and findings were synthesized using the Johns Hopkins Nursing evidence appraisal system. Twelve articles relevant to fall prevention in the pediatric hospital setting that discussed fall risk assessment and use of a FRAT were reviewed. Comparison between and accuracy of FRATs is challenged when different classifications, definitions, risk stratification, and inclusion criteria are used. Though there are several pediatric FRATs published in the literature, none have been found to be reliable and valid across institutions and diverse populations. This integrative review highlights the importance of choosing a FRAT based on an institution's identified risk factors and validating the tool for one's own patient population as well as using the tool in conjunction with nursing clinical judgment to guide interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

A busy day has minimal effect on factors associated with falls in older people: An ecological randomised crossover trial.

PubMed

Sturnieks, Daina L; Yak, Sin Lin; Ratanapongleka, Mayna; Lord, Stephen R; Menant, Jasmine C

2018-06-01

Fatigue is a common complaint in older people. Laboratory-induced muscle fatigue has been found to affect physical functions in older populations but these protocols are rigorous and are unlikely to accurately reflect daily activities. This study used an ecological approach to determine the effects of a busy day on self-reported fatigue and fall-related measures of physical and cognitive function in older people. Fifty community-dwelling adult volunteers, aged 60-88 (mean 73) years participated in this randomised crossover trial. Participants undertook assessments of balance, strength, gait, mobility, cognitive function and self-reported fatigue, before and after a planned rest day and a planned busy day (randomly allocated) at least one week apart. Participants wore an activity monitor on both the rest and busy days. On average, participants undertook twice as many steps and 2.5 times more minutes of activity on the busy, compared with the rest day. Participants had a significant increase in self-reported fatigue on the afternoon of the busy day and no change on the rest day. Repeated measures ANOVAs found no significant day (rest/busy) × time (am/pm) interaction effects, except for the timed up and go test of mobility, resulting from relatively improved mobility performance over the rest day, compared with the busy day. This study showed few effects of a busy day on physical and cognitive performance tests associated with falls in older people. Copyright © 2018 Elsevier Inc. All rights reserved.

Falling Stars: Why Senior Military Leaders Fail

DTIC Science & Technology

2016-02-01

Will, for his endless patience and tireless parenting skills. I also greatly appreciate our daughter, Victoria, and our baby-on-the-way for making the...Michael Mulholland, Sean P. Mulholland, John F. Naughton, Richard F. Nesbitt, William T. Newell, Robert Newman , Robert B. Oliver, Daniel T. O’Reilly...Craven. “Leadership Styles and Cultural Intelligence.” Journal of Leadership, Accountability and Ethics 11, no. 3 (2014): 154- 165. Feaver, Peter D

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

PubMed

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

2016-04-27

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

An approach for sample size determination of average bioequivalence based on interval estimation.

PubMed

Chiang, Chieh; Hsiao, Chin-Fu

2017-03-30

In 1992, the US Food and Drug Administration declared that two drugs demonstrate average bioequivalence (ABE) if the log-transformed mean difference of pharmacokinetic responses lies in (-0.223, 0.223). The most widely used approach for assessing ABE is the two one-sided tests procedure. More specifically, ABE is concluded when a 100(1 - 2α) % confidence interval for mean difference falls within (-0.223, 0.223). As known, bioequivalent studies are usually conducted by crossover design. However, in the case that the half-life of a drug is long, a parallel design for the bioequivalent study may be preferred. In this study, a two-sided interval estimation - such as Satterthwaite's, Cochran-Cox's, or Howe's approximations - is used for assessing parallel ABE. We show that the asymptotic joint distribution of the lower and upper confidence limits is bivariate normal, and thus the sample size can be calculated based on the asymptotic power so that the confidence interval falls within (-0.223, 0.223). Simulation studies also show that the proposed method achieves sufficient empirical power. A real example is provided to illustrate the proposed method. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

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

PubMed

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

2012-01-01

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

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

MacVean, D.W.; Franzen, D.K.; Keefe, T.J.

To elucidate the role of air quality on the occurrence of pneumonia in feedlot cattle, the following environmental values were measured at a feedlot: suspended particulates in 5 particle-size fractions, relative humidity, air temperature, and barometric pressure. Pneumonia incidence data were classified by the number of days the cattle had been at the feedlot (days on feed). The concentration of airborne particles, range of temperature, days on feed, and season of the year were associated with incidence of pneumonia in cattle. Pneumonia incidence rates were greatest both within 15 days of arrival at the feedlot and during the fall samplingmore » periods. The incidence of pneumonia in the 16 to 30 days-on-feed group was closely associated with the concentration of particles 2.0 to 3.3 microns in diameter and the range of daily temperature when exposure occurred 15 days before the onset of disease in the fall and 10 days before in the spring.« less

Fall Risk Assessment Predicts Fall-Related Injury, Hip Fracture, and Head Injury in Older Adults.

PubMed

Nilsson, Martin; Eriksson, Joel; Larsson, Berit; Odén, Anders; Johansson, Helena; Lorentzon, Mattias

2016-11-01

To investigate the role of a fall risk assessment, using the Downton Fall Risk Index (DFRI), in predicting fall-related injury, fall-related head injury and hip fracture, and death, in a large cohort of older women and men residing in Sweden. Cross sectional observational study. Sweden. Older adults (mean age 82.4 ± 7.8) who had a fall risk assessment using the DFRI at baseline (N = 128,596). Information on all fall-related injuries, all fall-related head injuries and hip fractures, and all-cause mortality was collected from the Swedish Patient Register and Cause of Death Register. The predictive role of DFRI was calculated using Poisson regression models with age, sex, height, weight, and comorbidities as covariates, taking time to outcome or end of study into account. During a median follow-up of 253 days (interquartile range 90-402 days) (>80,000 patient-years), 15,299 participants had a fall-related injury, 2,864 a head injury, and 2,557 a hip fracture, and 23,307 died. High fall risk (DFRI ≥3) independently predicted fall-related injury (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.39-1.49), hip fracture (HR = 1.51, 95% CI =1.38-1.66), head injury (HR = 1.12, 95% CI = 1.03-1.22), and all-cause mortality (HR = 1.39, 95% CI = 1.35-1.43). DFRI more strongly predicted head injury (HR = 1.29, 95% CI = 1.21-1.36 vs HR = 1.08, 95% CI = 1.04-1.11) and hip fracture (HR = 1.41, 95% CI = 1.30-1.53 vs HR = 1.08, 95% CI = 1.05-1.11) in 70-year old men than in 90-year old women (P < .001). Fall risk assessment using DFRI independently predicts fall-related injury, fall-related head injury and hip fracture, and all-cause mortality in older men and women, indicating its clinical usefulness to identify individuals who would benefit from interventions. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

PubMed

Martinez, Maria Carmen; Iwamoto, Viviane Ernesto; Latorre, Maria do Rosário Dias de Oliveira; Noronha, Adriana Moreira; Oliveira, Ana Paula de Sousa; Cardoso, Carlos Eduardo Alves; Marques, Ifigenia Augusta Braga; Vendramim, Patrícia; Lopes, Paula Cristina; Sant'Ana, Thais Helena Saes de

2016-08-29

to perform the transcultural adaptation and content validity analysis of the Johns Hopkins Fall Risk Assessment Tool to assess both fall risk and fall-related injury risk for hospitalized elderly in Brazil. the transcultural adaptation consisted of translating the scale to Portuguese (Brazil), back-translating it into its language of origin, establishing a consensus version, and having an expert committee verify its transcultural equivalence. Content assessment was conducted by a committee of judges, ending with the calculation of the items and scales' content validity index. Nurses tested the tool. the scale's translated version went through two evaluation rounds by the judges, based on which, the items with unsatisfactory performance were changed. The content validity index for the items was ≥80.0% and the global index 97.1%. The experimental application showed the scale is user-friendly. the scale presents valid content for the assessment of fall risk and risk of fall-related injuries and is easy to use, with the potential to contribute to the proper identification of risks and the establishment of care actions. realizar a adaptação transcultural para uso no Brasil e a avaliação da validade de conteúdo da Johns Hopkins Fall Risk Assessment Tool para avaliação de risco de quedas e de danos por quedas em pacientes adultos hospitalizados. adaptação transcultural consistiu na tradução da escala para a língua portuguesa (Brasil), retrotradução para a língua de origem, versão de consenso e análise da equivalência transcultural por um comitê de especialistas. A avaliação do conteúdo foi realizada por meio de um comitê de juízes, finalizando com o cálculo do índice de validade de conteúdo dos itens e da escala. Foi realizada a aplicação experimental do instrumento por enfermeiros. a versão traduzida da escala passou por duas rodadas de avaliação pelos juízes, a partir das quais os itens com desempenho insatisfatório foram modificados. O índice de validade de conteúdo para itens foi ≥80,0% e o global foi 97,1%. A aplicação experimental mostrou que a escala é de fácil operacionalização. a escala demonstrou conteúdo válido para a avaliação de risco de quedas e de danos por quedas e ser de fácil operacionalização, podendo contribuir para a adequada identificação dos riscos e consequente direcionamento de ações assistenciais. realizar la adaptación transcultural para ser usada en Brasil y confirmar la validez de contenido de la Johns Hopkins Fall Risk Assessment Tool que evalúa riesgo de caídas y de daños por caídas en pacientes adultos mayores. adaptación transcultural que consistió en la traducción de la escala para el idioma portugués (Brasil); retrotraducción para el idioma de origen; y versión de consenso y análisis de la equivalencia transcultural por un comité de especialistas. La evaluación del contenido fue realizada por medio de un comité de jueces, siendo finalizado con el cálculo del índice de validez de contenido de los ítems y de la escala. Fue realizada la aplicación experimental del instrumento por enfermeros. la versión traducida de la escala pasó por dos vueltas de evaluación por los jueces, a partir de las cuales los ítems con desempeño insatisfactorio fueron modificados. El índice de validez de contenido para los ítems fue ≥80,0% y el global fue 97,1%. La aplicación experimental mostró que la escala es de fácil ejecución. la escala demostró tener un contenido válido para la evaluación de riesgo de caídas y de daños por caídas, y de ser de fácil ejecución; esta escala puede contribuir para la adecuada identificación de los riesgos y consecuentemente para la orientación de acciones asistenciales.

Geology and natural history of the San Francisco Bay area: A field-trip guidebook

USGS Publications Warehouse

Stoffer, Philip W.; Gordon, Leslie C.

2001-01-01

A National Association of Geoscience Teachers Far Western Section (NAGT-FWS) field conference is an ideal forum for learning about the geology and natural history of the San Francisco Bay area. We visit classic field sites, renew old friendships, and make new ones. This collection of papers includes field guides and road logs for all of the Bay-area trips held during the NAGT-FWS 2001 Fall Field Conference and supplemental chapters on other aspects of the area’s natural and human history. The trips touch on many aspects of the geology and natural hazards of the Bay area, especially urban problems associated with living on an active tectonic plate margin: earthquake faults, coastal erosion, landslides, and the utilization of land and natural resources. We hope this conference not only provides a two-day learning opportunity for conference participants but that students and educators will use this field guidebook for future teaching and research.Many thanks are due to the U.S. Geological Survey (USGS) and San José State University (SJSU) for cohosting the conference. We are grateful to each of the field trip leaders for preparing the trips and writing the accompanying guides. We especially appreciate the many hours put in by the guidebook reviewers, Robert I. Tilling (USGS) and Paula Messina (SJSU), and to the USGS Western Publications Group for editing, layout, and web posting. Additional guidebook contributions include articles by John Galloway, Scott Starratt, Page Mosier, and Susan Toussaint. During the conference guest speakers include Robert I. Tilling (USGS Volcano Hazards Team) and Ross Stein (USGS Earthquake Hazards Team). Workshops prepared for the conference include GIS in the classroom, using USGS data by John Vogel (USGS) and Paula Messina (SJSU), and The Best of BAESI (Bay Area Earth Science Institute), a teacher training organization under the direction of Ellen Metzger (SJSU) and Richard Sedlock (SJSU). The conference provides an opportunity to showcase USGS scientific and education resources with self-guided tours of the USGS Library, the Earth Science Information Center (ESIC), the Visitor Center, and various laboratories on the USGS campus and includes a half-day participatory tour of the USGS research vessel the R/V Polaris and the USGS Marine Facility at the Port of Redwood City under the direction of Cynthia L. Brown, Francis Parchaso, and Tara Schraga. Beyond the names mentioned above, a host of USGS and SJSU staff, SJSU students, and NAGT-FWS members contributed to the preparation and orchestration of the conference. We couldn’t have done it alone. Leslie C. Gordon (USGS), Philip W. Stoffer (USGS), and Deborah Harden (SJSU) NAGT-FWS 2001 Fall Field Conference Organizers.

Children's Rights, "die Antipadagogen," and the Paternalism of John Stuart Mill.

ERIC Educational Resources Information Center

Nordenbo, Sven Erik

1989-01-01

Examines how John Stuart Mill would have viewed present-day educational liberalists' claims that children should be included in Mill's principle of individual liberty. Concludes that educational liberalists cannot rightly claim Mill as spokesman for their views. (KO)

System-Wide Significance of Predation on Juvenile Salmonids in Columbia and Snake River Reservoirs : Annual Report 1992.

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

Petersen, James H.; Poe, Thomas P.

1993-12-01

Northern squawfish (Ptychocheilus oregonensis) predation on juvenile salmonids was characterized during 1992 at ten locations in the Columbia River below Bonneville Dam and at three locations in John Day Reservoir. During the spring and summer, 1,487 northern squawfish were collected in the lower Columbia River and 202 squawfish were sampled in John Day Reservoir. Gut content data, predator weight, and water temperature were used to compute a consumption index (CI) for northern squawfish, and overall diet was also described. In the Columbia River below Bonneville Dam, northern squawfish diet was primarily fish (spring 69%; summer 53%), most of which weremore » salmonids. Salmonids were also the primary diet component in the Bonneville Dam tailrace, John Day Dam forebay, and the McNary Dam tailrace. Crustaceans were the dominant diet item at the John Day mid-reservoir location, although sample sizes were small. About half of the non-salmonid preyfish were sculpins. The consumption index (CI) of northern squawfish was generally higher during summer than during spring. The highest CI`s were observed during summer in the tailrace boat restricted zones of Bonneville Dam (CI = 7.8) and McNary Dam (CI = 4.6). At locations below Bonneville Dam, CI`s were relatively low near Covert`s Landing and Rooster Rock, higher at four locations between Blue Lake and St. Helens, and low again at three downriver sites (Kalama, Ranier, and Jones Beach). Northern squawfish catches and CI`s were noticeably higher throughout the lower Columbia compared to mid-reservoir sites further upriver sampled during 1990--92. Predation may be especially intense in the free-flowing section of the Columbia River below Bonneville Dam. Smallmouth bass (Micropterus dolomieui; N = 198) ate mostly fish -- 25% salmonids, 29% sculpins, and 46% other fish. Highest catches of smallmouth bass were in the John Day Dam forebay.« less

Chest Drain Fall-Out Rate According to Suturing Practices: A Retrospective Direct Comparison.

PubMed

Asciak, Rachelle; Addala, Dinesh; Karimjee, Juzer; Rana, Maaz Suhail; Tsikrika, Stamatoula; Hassan, Maged Fayed; Mercer, Rachel Mary; Hallifax, Robert John; Wrightson, John Matthew; Psallidas, Ioannis; Benamore, Rachel; Rahman, Najib Mahboob

2018-06-14

Chest drains often become displaced and require replacement, adding unnecessary risks to patients. Simple measures such as suturing of the drain may reduce fall-out rates; however, there is no direct data to demonstrate this and no standardized recommended practice that is evidence based. The study aimed to analyze the rate of chest drain fall out according to suturing practice. Retrospective analysis of all chest drain insertions (radiology and pleural teams) in 2015-2016. Details of chest drain fall out were collected from patient electronic records. Drain "fall out" was pre-hoc defined as the drain tip becoming dislodged outside the pleural cavity unintentionally before a clinical decision was taken to remove the drain. A total of 369 chest drains were inserted: sutured (n = 106, 28.7%; 44 male [41.5%], median age 74 [interquartile range (IQR) 21] years), and unsutured (n = 263, 71.3%; 139 male [52.9%], median age 68 [IQR 21] years). Of the sutured drains, 7 (6.6%) fell out after a mean of 3.3 days (SD 2.6) compared to 39 (14.8%; p = 0.04) unsutured drains falling out after a mean of 2.7 days (SD 2.0; p = 0.8). Within the limits of this retrospective analysis, these results -suggest that suturing of drains is associated with lower fall-out rates. © 2018 S. Karger AG, Basel.

Influence of season and microclimate on fertility of dairy cows in a hot-arid environment

NASA Astrophysics Data System (ADS)

Ray, D. E.; Jassim, A. H.; Armstrong, D. V.; Wiersma, F.; Schuh, J. D.

1992-09-01

Records were obtained over a 3 year period from six Holstein dairy farms of 300 to 500 cows each in the Phoenix, Ariz. area. Dairies were selected on the basis of similar management practices, herd size, milk production and facilities (with the exception of cooling systems). Microclimatic modifications (two dairies each) were shade only (approximately 3.7 m2/cow), evaporative-cooled shades and low-pressure water foggers under the shades. Data were categorized by season of calving (spring, Feb. May; summer, June Sept.; and fall, Oct. Jan.). Traits evaluated were calving interval, days open and services/conception. Calving interval was shortest for cows calving in the spring (378 days), intermediate in fall (382 days) and longest in summer (396 days). Similar seasonal trends were observed for days open (103, 103 and 119 days, respectively) and services/conception (1.54, 1.81 and 1.93, respectively). All differences between spring and summer were significant ( P < 0.05). Calving interval and days open were less for evaporative-cooled groups (374 and 98 days, respectively), with no difference between shade only and foggers (391 and 392 days, 112 and 116 days, respectively). Services/conception were similar for all groups (1.72 to 1.79). A significant interaction between microclimate and season for services/conception could be interpreted as (i) smaller season differences for evaporative-cooled groups than for shade or foggers, or (ii) a change in the ranking of control and fogger groups during summer versus fall. Evaporative cooling was more effective than fogging for reducing the detrimental effects of seasonal high temperatures on fertility.

Clinical benefits of treatment with SQ house dust mite sublingual tablet in house dust mite allergic rhinitis.

PubMed

Demoly, P; Kleine-Tebbe, J; Rehm, D

2017-10-01

Treatment with SQ (standardised quality) house dust mite sublingual tablet for 1 year resulted in a decreased probability of having an allergic rhinitis (AR) exacerbation day (from 11% [placebo] to 5% [SQ house dust mite sublingual tablet]) and an increased probability of having a mild AR day (from 16% [placebo] to 34% [SQ house dust mite sublingual tablet]). © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

2012 Diversity Day

NASA Image and Video Library

2012-10-31

John C. Stennis Space Center employees enjoyed 2012 Diversity Day activities Oct. 31. The day's color-filled schedule included an employee talent showcase, a car/motorcycle show, Stennis 'Family Feud' contests, a cultural dress parade, food vendors and various cultural exhibits.

78 FR 6832 - Call for Nominations for the John Day-Snake Resource Advisory Council, Oregon/Washington

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-31

... advice and recommendations to the BLM on land use planning and management of the National System of... System sites like the Spring Basin and Badlands Wilderness Areas as well as the Lower Deschutes and John...

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); 18.7/1000 patient days (control). Conclusion This tailored education was received positively by older people, resulted in increased engagement in falls prevention strategies after discharge and is feasible to deliver to older hospital patients. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry; ACTRN12611000963921 on 8th November 2011. PMID:23717424

Out of Bounds. Transnational Sanctuary in Irregular Warfare

DTIC Science & Technology

2006-01-01

campaigns. Shortly after the Americans and their allies took Kabul in the fall of 2001 , the Taliban and al-Qaeda terrorists retreated to the mountainous...14 Small Wars Doctrine, 1915-1940 (Boulder, CO: Westview Press, 2001 ); Max Boot, The Savage Wars of Peace: Small Wars and the Rise of American Power...The Presidential Recordings: John F. Kennedy, The Great Crises, Volume Two (New York: W.W. Norton, 2001 ), 178-181. Americans and their allies would

Marine and land active-source seismic investigation of geothermal potential, tectonic structure, and earthquake hazards in Pyramid Lake, Nevada

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

Eisses, A.; Kell, A.; Kent, G.

Amy Eisses, Annie M. Kell, Graham Kent, Neal W. Driscoll, Robert E. Karlin, Robert L. Baskin, John N. Louie, Kenneth D. Smith, Sathish Pullammanappallil, 2011, Marine and land active-source seismic investigation of geothermal potential, tectonic structure, and earthquake hazards in Pyramid Lake, Nevada: presented at American Geophysical Union Fall Meeting, San Francisco, Dec. 5-9, abstract NS14A-08.

Review of the Environmental Protection Agency’s Common Sense Initiative (The National Shipbuilding Research Program)

DTIC Science & Technology

1996-03-01

Falls Church, VA 22042 Robert Yancey Jr., President Aahland Petroleum P.O. Box 391 Ashland KY 41114 ROSTER - PRINTING SECTOR SUBCOMMlTTEE, CSI Co...Regulatory Initiative Project Workgroup ChaiR: Rick Johns Statement of Project Objective: To explore auto specific concerns with the Title V...and Recycling Workgroup Chair: Rick Reibstein, Massachusetts OTA Solving the “Obscure Policy” Problem Statement of Project or Activity Objective: TO

Duped by the Frailty Myth: USMC Gender Based Physical Fitness Standards

DTIC Science & Technology

2012-05-07

REFERENCES TO THIS STUDY SHOULD INCLUDE THE FOREGOING STATEMENT. QUOTATION FROM, ABSTRACTION FROM, OR REPRODUCTION OF ALL OR ANY PART OF THIS DOCUMENT...hike’s conclusion. The hike was difficult, yet I completed it with all my gear without “falling out”. Never the less, even though the Marines who...for all Marines, regardless of gender. For work-out specific details, see Appendix A. vii Acknowledgements I would like to thank John

Transcribing and digitizing eighteenth- and nineteenth-century letters for a historical digital repository.

PubMed

Dunster, Emily S; Kipnis, Daniel G; Angelo, F Michael

2014-01-01

In fall 2011, the Scott Memorial Library purchased 53 letters belonging to an 1841 graduate of Jefferson Medical College, John Plimpton Green. The library staff transcribed and digitized the letters, creating an online collection in the university's institutional repository, Jefferson Digital Commons. This article will detail the process of transcribing and digitizing the collection along with sharing statistics and the benefits of this project to global researchers.

Flying Blind: The Rise, Fall, and Possible Resurrection of Science Policy Advice in the United States

DTIC Science & Technology

2004-12-01

Guillemin * Herbert A. Hauptman * Dudley R. Herschbach * Roald Hoffmann John P. Holdren * David H. Hubel * Jerome Karle Carl Kaysen * H. Gobind Khorana...Townes Frank von Hippel Robert A. Weinberg Myron Wegman * Steven Weinberg * Torsten N. Wiesel Alfred Yankauer Herbert F. York * Nobel Laureate Tara...Anderson * Kenneth J. Arrow * Julius Axelrod * David Baltimore * Baruj Benacerraf * Paul Berg * Hans A. Bethe * J. Michael Bishop * Nicolaas Bloembergen

Slipping through the cracks: A cross-sectional study examining older adult emergency department patient fall history, post-fall treatment and prevention.

PubMed

Goldberg, Elizabeth M; McCreedy, Ellen M; Gettel, Cameron J; Merchant, Roland C

2017-12-01

Falls are the leading cause of emergency department (ED) visits for fatal and non-fatal injuries among adults 65 years old and older. We aimed to better understand the fall history, risk for further falls, and actions taken to prevent further falls among this higher fall risk population. This cross-sectional study included older adults without cognitive impairment presenting to the Rhode Island Hospital ED from February to May 2017. Of the 76 participants, 35 self-reported no prior falls, and 41 self-reported at least one prior fall, of whom 20 fell on the day of ED presentation. Participants with vs. without self-reported prior falls were similar in age, gender, race, and substance use. Participants with prior falls scored lower on cognitive testing and had more comorbidities associated with falls. Only one quarter of those with prior falls reported making changes and few were evaluated by professionals to prevent future falls. This study highlights that older adult ED patients who sustain a fall are at higher risk for subsequent falls, and that greater fall prevention efforts are needed to protect this vulnerable group. [Full article available at http://rimed.org/rimedicaljournal-2017-12.asp].

Older Adult Falls: Effective Approaches to Prevention

PubMed Central

Dellinger, Ann

2017-01-01

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

Effects of season on sleep and skin temperature in the elderly

NASA Astrophysics Data System (ADS)

Okamoto-Mizuno, Kazue; Tsuzuki, Kazuyo

2010-07-01

The effects of season on sleep and skin temperature (Tsk) in 19 healthy, elderly volunteers were investigated. Measurements were obtained in summer, winter, and fall, and activity levels were monitored using a wrist actigraph system for five consecutive days. The temperature and humidity of the bedrooms of the subjects’ homes were measured continuously for five days. During actigraphic measurement, Tsk during sleep was measured for two nights. The bedroom temperature and humidity significantly increased in summer compared to winter and fall. In summer, the total sleep time decreased (mean ± SE min; summer, 350.8 ± 15.7; winter, 426.5 ± 14.2; fall, 403.2 ± 16.4) and wakefulness increased ( P < 0.003) compared to those in fall or winter. The sleep efficiency index that was derived from wrist actigraphy was significantly decreased ( P < 0.001) in summer (81.4 ± 2.9%) compared with winter (91.6 ± 1.3%) or fall (90.2 ± 1.2%). The forehead Tsk significantly increased, while the chest and thigh Tsks were decreased in summer compared to those in fall or winter. These results suggest that, in the elderly, sleep is disturbed in summer more than in other seasons, and that this disturbance is related to fluctuations in Tsk.

Tips to Help Parents Manage Their Child's Asthma Every Day

MedlinePlus

... to Help Parents Manage Their Child's Asthma Every Day Past Issues / Fall 2013 Table of Contents Asthma ... persistent asthma (for example, symptoms more than 2 days a week). Your health provider will help you ...

Entity Modeling and Immersive Decision Environments

DTIC Science & Technology

2011-09-01

Simulation Technologies (REST) Lerman, D. J. (2010). Correct Weather Modeling of non-Standard Days (10F- SIW -004). In Proceedings of 2010 Fall Simulation...Interoperability Workshop (Fall SIW ) SISO. Orlando, FL: SISO. Most flight simulators compute and fly in a weather environment that matches a

Standardized UXO Technology Demonstration Site Moguls Scoring Record Number 907 (Sky Research, Inc.)

DTIC Science & Technology

2008-08-01

day timeframe. 3.6 DEMONSTRATOR’S FIELD PERSONNEL Geophysicist: Craig Hyslop Geophysicist: John Jacobsen Geophysicist: Rob Mehl...Conover, John Wiley & Sons, 1980 , pages 144 through 151. APPENDIX F. ABBREVIATIONS F-1 (Page F-2 Blank) ADST = Aberdeen Data Services Team

Astronaut John Casper checks equipment to support medical testing

NASA Image and Video Library

1994-03-05

STS062-10-010 (4-18 March 1994) --- Astronaut John H. Casper, mission commander, takes stock of paraphenalia used to support medical testing onboard Columbia's middeck. Casper was poind by four other veteran astronauts for 14 days of variegated research in earth orbit.

Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.

PubMed

Ortolá, R; García-Esquinas, E; Galán, I; Guallar-Castillón, P; López-García, E; Banegas, J R; Rodríguez-Artalejo, F

2017-11-01

Falls are a major health problem in older adults, but their relationship with alcohol consumption in this population remains unclear. In a cohort with 2170 older adults followed up for 3.3 years, both moderate drinking and the Mediterranean drinking pattern were associated with a lower risk of falls and injurious falls. This study aims to examine the association between certain patterns of alcohol consumption, including the Mediterranean drinking pattern (MDP), and the risk of falls in older adults. A prospective cohort with 2170 community-dwelling individuals aged ≥60 years was recruited in Spain in 2008-2010 and followed up through 2012. At baseline, participants reported alcohol consumption and, at the end of follow-up, their falls during the previous year. The MDP was defined as moderate alcohol consumption (threshold between moderate and heavy intake was 40 g/day for men and 24 g/day for women) with preference for wine and drinking only with meals. Analyses were conducted with negative binomial or logistic regression, as appropriate, and adjusted for the main confounders. Compared with never drinkers, the number of falls was lower in moderate drinkers (incidence rate ratio (95% confidence interval), 0.79 (0.63-0.99)) and drinkers with MDP (0.73 (0.56-0.96)). Also, moderate drinkers and those with MDP showed a lower risk of ≥2 falls (odds ratio (95% confidence interval), 0.58 (0.38-0.88) and 0.56 (0.34-0.93), respectively) and of falls requiring medical care (0.67 (0.46-0.96) and 0.61 (0.39-0.96), respectively). Both moderate drinking and the MDP were associated with a lower risk of falls and injurious falls in older adults. However, sound advice on alcohol consumption should balance risks and benefits.

Spatiotemporal phenological changes in fall foliage peak coloration in deciduous forest and the responses to climatic variation

NASA Astrophysics Data System (ADS)

Xie, Y.; Wilson, A. M.

2017-12-01

Plant phenology studies typically focus on the beginning and end of the growing season in temperate forests. We know too little about fall foliage peak coloration, which is a bioindicator of plant response in autumn to environmental changes, an important visual cue in fall associated with animal activities, and a key element in fall foliage ecotourism. Spatiotemporal changes in timing of fall foliage peak coloration of temperate forests and the associated environmental controls are not well understood. In this study, we examined multiple color indices to estimate Land Surface Phenology (LSP) of fall foliage peak coloration of deciduous forest in the northeastern USA using Moderate Resolution Imaging Spectroradiometer (MODIS) daily imagery from 2000 to 2015. We used long term phenology ground observations to validate our estimated LSP, and found that Visible Atmospherically Resistant Index (VARI) and Plant Senescence Reflectance Index (PSRI) were good metrics to estimate peak and end of leaf coloration period of deciduous forest. During the past 16 years, the length of period with peak fall foliage color of deciduous forest at southern New England and northern Appalachian forests regions became longer (0.3 7.7 days), mainly driven by earlier peak coloration. Northern New England, southern Appalachian forests and Ozark and Ouachita mountains areas had shorter period (‒0.2 ‒9.2 days) mainly due to earlier end of leaf coloration. Changes in peak and end of leaf coloration not only were associated with changing temperature in spring and fall, but also to drought and heat in summer, and heavy precipitation in both summer and fall. The associations between leaf peak coloration phenology and climatic variations were not consistent among ecoregions. Our findings suggested divergent change patterns in fall foliage peak coloration phenology in deciduous forests, and improved our understanding in the environmental control on timing of fall foliage color change.

The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall.

PubMed

Stivala, Adam; Hartley, Greg

2014-01-01

Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.

Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT).

PubMed

Persson, Carina U; Kjellberg, Sigvar; Lernfelt, Bodil; Westerlind, Ellen; Cruce, Malin; Hansson, Per-Olof

2018-03-01

This study aimed to investigate incidence of falls and different baseline variables and their association with falling during hospitalization in a stroke unit among patients with acute stroke. Prospective observational study. A stroke unit at a university hospital. A consecutive sample of stroke patients, out of which 504 were included, while 101 declined participation. The patients were assessed a mean of 1.7 days after admission and 3.8 days after stroke onset. The primary end-point was any fall, from admission to the stroke unit to discharge. Factors associated with falling were analysed using univariable and multivariable Cox hazard regression analyses. Independent variables were related to function, activity and participation, as well as personal and environmental factors. In total, 65 patients (13%) fell at least once. Factors statistically significantly associated with falling in the multivariable analysis were male sex (hazard ratio (HR): 1.88, 95% confidence interval (CI): 1.13-3.14, P = 0.015), use of a walking aid (HR: 2.11, 95% CI: 1.24-3.60, P = 0.006) and postural control as assessed with the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS). No association was found with age, cognition or stroke severity, the HR for low SwePASS scores (⩽24) was 9.33 (95% CI: 2.19-39.78, P = 0.003) and for medium SwePASS scores (25-30) was 6.34 (95% CI: 1.46-27.51, P = 0.014), compared with high SwePASS scores (⩾31). Postural control, male sex and use of a walking aid are associated with falling during hospitalization after acute stroke.

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.

Mapping the Riverscape of the Middle Fork John Day River with Structure-from-Motion

NASA Astrophysics Data System (ADS)

Dietrich, J. T.

2014-12-01

Aerial photography has proven an efficient method to collect a wide range of continuous variables for large sections of rivers. These data include variables such as the planimetric shape, low-flow and bank-full widths, bathymetry, and sediment sizes. Mapping these variables in a continuous manner allows us to explore the heterogeneity of the river and build a more complete picture of the holistic riverscape. To explore a low-cost option for aerial photography and riverscape mapping, I used the combination of a piloted helicopter and an off-the-shelf digital SLR camera to collect aerial imagery for a 32 km segment of the Middle Fork John Day River in eastern Oregon. This imagery was processed with Structure-from-Motion (SfM) photogrammetry to produce high-resolution 10 cm orthophotos and digital surface models that were used to extract riverscape variables. The Middle Fork John Day River is an important spawning river for anadromous Chinnook and Steelhead and has been the focus of widespread restoration and conservation activities in response to the legacies of extensive grazing and mining activity. By mapping the riverscape of the Middle Fork John Day, I explored downstream relationships between several geomorphic variables with hyperscale analysis. These riverscape data also provided an opportunity to make a continuous map of habitat suitability for migrating adult Chinook. Both the geomorphic and habitat suitability analysis provide an important assessment of the natural variation in the river and the impact of human modification, both positive and negative.

Physical Activity in the Acute Ward Following Hip Fracture Surgery is Associated with Less Fear of Falling.

PubMed

Kronborg, Lise; Bandholm, Thomas; Palm, Henrik; Kehlet, Henrik; Kristensen, Morten Tange

2016-10-01

Early mobilization following hip fracture surgery reduces medical complications and mortality, but may increase the risk of falling. The aim was to objectively measure the physical activity (time spent upright) the first week after hip fracture surgery and relate it to functional performance and fear of falling at discharge. The 24-hr upright time was measured for a median of six days using a thigh-worn accelerometer in 37 patients (mean 80 years ± 8.4) and increased from median 13 (IQR 6-31) min to 46 (11-107) min at day 7. More upright time at discharge was associated with less fear of falling (r = -.48, p = .01, n = 27), which also was associated with fast gait speed (r = -.50, p = .02, n = 23) and a faster Timed Up and Go test time (r = .54, p < .01, n = 22), indicating a need for further studies on motivation and limitations for more physical activity following hip fracture surgery.

2012 Diversity Day

NASA Image and Video Library

2012-10-31

John C. Stennis Space Center employees enjoyed 2012 Diversity Day activities Oct. 31. During the day, Stennis employees were able to visit cultural exhibits and participate such events as an employee talent showcase, a car/motorcycle show, Stennis 'Family Feud' contests and a cultural dress parade.

Validation of a risk stratification tool for fall-related injury in a state-wide cohort.

PubMed

McCoy, Thomas H; Castro, Victor M; Cagan, Andrew; Roberson, Ashlee M; Perlis, Roy H

2017-02-06

A major preventable contributor to healthcare costs among older individuals is fall-related injury. We sought to validate a tool to stratify such risk based on readily available clinical data, including projected medication adverse effects, using state-wide medical claims data. Sociodemographic and clinical features were drawn from health claims paid in the state of Massachusetts for individuals aged 35-65 with a hospital admission for a period spanning January-December 2012. Previously developed logistic regression models of hospital readmission for fall-related injury were refit in a testing set including a randomly selected 70% of individuals, and examined in a training set comprised of the remaining 30%. Medications at admission were summarised based on reported adverse effect frequencies in published medication labelling. The Massachusetts health system. A total of 68 764 hospitalised individuals aged 35-65 years. Hospital readmission for fall-related injury defined by claims code. A total of 2052 individuals (3.0%) were hospitalised for fall-related injury within 90 days of discharge, and 3391 (4.9%) within 180 days. After recalibrating the model in a training data set comprised of 48 136 individuals (70%), model discrimination in the remaining 30% test set yielded an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI 0.72 to 0.76). AUCs were similar across age decades (0.71 to 0.78) and sex (0.72 male, 0.76 female), and across most common diagnostic categories other than psychiatry. For individuals in the highest risk quartile, 11.4% experienced fall within 180 days versus 1.2% in the lowest risk quartile; 57.6% of falls occurred in the highest risk quartile. This analysis of state-wide claims data demonstrates the feasibility of predicting fall-related injury requiring hospitalisation using readily available sociodemographic and clinical details. This translatable approach to stratification allows for identification of high-risk individuals in whom interventions are likely to be cost-effective. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Influence of season and microclimate on fertility of dairy cows in a hot-arid environment.

PubMed

Ray, D E; Jassim, A H; Armstrong, D V; Wiersma, F; Schuh, J D

1992-08-01

Records were obtained over a 3 year period from six Holstein dairy farms of 300 to 500 cows each in the Phoenix, Ariz. area. Dairies were selected on the basis of similar management practices, herd size, milk production and facilities (with the exception of cooling systems). Microclimatic modifications (two dairies each) were shade only (approximately 3.7 m2/cow), evaporative-cooled shades and low-pressure water foggers under the shades. Data were categorized by season of calving (spring, Feb.-May; summer, June-Sept.; and fall, Oct.-Jan.). Traits evaluated were calving interval, days open and services/conception. Calving interval was shortest for cows calving in the spring (378 days), intermediate in fall (382 days) and longest in summer (396 days). Similar seasonal trends were observed for days open (103, 103 and 119 days, respectively) and services/conception (1.54, 1.81 and 1.93, respectively). All differences between spring and summer were significant (P less than 0.05). Calving interval and days open were less for evaporative-cooled groups (374 and 98 days, respectively), with no difference between shade only and foggers (391 and 392 days, 112 and 116 days, respectively). Services/conception were similar for all groups (1.72 to 1.79). A significant interaction between microclimate and season for services/conception could be interpreted as (i) smaller season differences for evaporative-cooled groups than for shade or foggers, or (ii) a change in the ranking of control and fogger groups during summer versus fall. Evaporative cooling was more effective than fogging for reducing the detrimental effects of seasonal high temperatures on fertility.

75 FR 21977 - Earth Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... Day, 2010 By the President of the United States of America A Proclamation In the fall of 1969, Wisconsin Senator Gaylord Nelson announced plans for a national ``environmental teach- in''--one day, each year, of action and advocacy for the environment. His words rallied our Nation, and the first Earth Day...

NASA Earth Day 2014

NASA Image and Video Library

2014-04-22

Students listen intently while Astronaut John Mace Grunsfeld speaks at NASA's Earth Day event. The event took place at Union Station in Washington, DC on April 22, 2014. Photo Credit: (NASA/Aubrey Gemignani)

International Space Station (ISS)

NASA Image and Video Library

2007-06-15

Construction resumed on the International Space Station (ISS), as STS-117 astronauts and mission specialists Jim Reilly (on robotic arm), and John “Danny” Olivas joined forces with their colleagues inside the Shuttle and station, and controllers in Houston, to complete the delicate process of folding an older solar array, Port 6 (P6), so that it can be moved from its temporary location to its permanent home during an upcoming Fall scheduled Shuttle mission. The EVA lasted nearly 8 hours.

Rise and Fall of a Coalition: The Supreme War Council and Marshal Foch, 1917-1919

DTIC Science & Technology

2017-05-26

operations in the war and explained the origins of organizational change. They provided evidence of a growing awareness of differences to meet tactical...1993); James J. Cooke, Pershing and his Generals: Command and Staff in the AEF (Westport, CT: Praeger, Inc., 1997); Margaret Olwen Macmillan, Paris ...1917, General John Pershing, charged with overall command of American Forces in Europe, arrived in Paris . Pressure to incorporate the American’s into

Factors affecting fall down rates of dead aspen (Populus tremuloides) biomass following severe drought in west-central Canada.

PubMed

Ted Hogg, Edward H; Michaelian, Michael

2015-05-01

Increases in mortality of trembling aspen (Populus tremuloides Michx.) have been recorded across large areas of western North America following recent periods of exceptionally severe drought. The resultant increase in standing, dead tree biomass represents a significant potential source of carbon emissions to the atmosphere, but the timing of emissions is partially driven by dead-wood dynamics which include the fall down and breakage of dead aspen stems. The rate at which dead trees fall to the ground also strongly influences the period over which forest dieback episodes can be detected by aerial surveys or satellite remote sensing observations. Over a 12-year period (2000-2012), we monitored the annual status of 1010 aspen trees that died during and following a severe regional drought within 25 study areas across west-central Canada. Observations of stem fall down and breakage (snapping) were used to estimate woody biomass transfer from standing to downed dead wood as a function of years since tree death. For the region as a whole, we estimated that >80% of standing dead aspen biomass had fallen after 10 years. Overall, the rate of fall down was minimal during the year following stem death, but thereafter fall rates followed a negative exponential equation with k = 0.20 per year. However, there was high between-site variation in the rate of fall down (k = 0.08-0.37 per year). The analysis showed that fall down rates were positively correlated with stand age, site windiness, and the incidence of decay fungi (Phellinus tremulae (Bond.) Bond. and Boris.) and wood-boring insects. These factors are thus likely to influence the rate of carbon emissions from dead trees following periods of climate-related forest die-off episodes. © 2014 Her Majesty the Queen in Right of Canada Global Change Biology © 2014 John Wiley & Sons Ltd Reproduced with the permission of the Minister of Natural Resources Canada.

Survival, development, and growth of fall Chinook salmon embryos, alevin, and fry exposed to variable thermal and dissolved oxygen regimes

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

Geist, David R.; Abernethy, Cary S.; Hand, Kristine D.

2006-11-15

Some fall Chinook salmon (Oncorhynchus tshawytscha) initiate spawning in the Snake River downstream of Hells Canyon Dam at temperatures that exceed 13?C and at intergravel dissolved oxygen concentrations that are less than 8 mg O2/L. Although water temperature declines and dissolved oxygen increases soon after spawning, these temperature and dissolved oxygen levels do not meet the water quality standards established by the states of Oregon and Idaho for salmonid spawning. Our objective was to determine if temperatures from 13 to 17 C and dissolved oxygen levels from 4 to greater than 8 mg O2/L during the first 40 days ofmore » incubation followed by declining temperature and rising dissolved oxygen affected survival, development, and growth of Snake River fall Chinook salmon embryos, alevins, and fry. During the first 40 days of incubation, temperatures were adjusted downward approximately 0.2 C/day and oxygen was increased in increments of 2 mg O2/L to mimic the thermal and oxygen regime of the Snake River where these fish spawn. At 40 days post-fertilization, embryos were moved to a common exposure regime that followed the thermal and dissolved oxygen profile of the Snake River through emergence. Mortality of fall Chinook salmon embryos increased markedly at initial incubation temperatures equal to or greater than 17?C, and a rapid decline in survival occurred between 16.5 C and 17 C, with no significant difference in survival at temperatures less than or equal to 16.5 C. Initial dissolved oxygen levels as low as 4 mg O2/L over a range of initial temperatures from 15 to 16.5 C did not affect embryo survival to emergence. There were no significant differences across the range of initial temperature exposures for alevin and fry size at hatch and emergence. The number of days from fertilization to eyed egg, hatch, and emergence was highly related to temperature and dissolved oxygen; it took from 6 to 10 days longer to reach hatch at 4 mg O2/L than at saturation and up to 24 days longer to reach emergence. In contrast, within each dissolved oxygen treatment, it took about 20 days longer to reach hatch at 13 C than at 16.5 C (no data for 17 C) and up to 41 days longer to reach emergence. Overall, this study indicates that exposure to water temperatures up to 16.5 C will not have deleterious impacts on survival or growth from egg to emergence if temperatures decline at a rate of greater than or equal to 0.2 C/day following spawning. Although fall Chinook salmon survived low initial dissolved oxygen levels, the delay in emergence could have significant long-term effects on their survival. Thus, an exemption to the state water quality standards for temperature but not oxygen may be warranted in the Snake River where fall Chinook salmon spawn.« less

Acoustic Telemetry Evaluation of Juvenile Salmonid Passage and Survival at John Day Dam, 2011

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

Weiland, Mark A.; Woodley, Christa M.; Ploskey, Gene R.

This report presents survival, behavioral, and fish passage results for tagged yearling Chinook salmon and juvenile steelhead as part of a survival study conducted at John Day Dam during spring 2011. This study was designed to evaluate the passage and survival of yearling Chinook salmon and juvenile steelhead to assist managers in identifying dam operations for compliance testing as stipulated by the 2008 Federal Columbia River Power System Biological Opinion and the 2008 Columbia Basin Fish Accords. Survival estimates were based on a paired-release survival model.

The geomorphic response of rivers to dams: a short course.

Treesearch

M.J. Furniss; J. Guntle

2004-01-01

CD-ROMCourse AgendaDay 1: Tuesday, March 11, 20031:15 Forest Service line officer perspective: John Berry, Forest Supervisor, El Dorado National Forest, CA2:00 Power company perspective: John Esler, Portland General Electric, OR3:30 The spatial and geographical context of nonfederal hydropower dams on Forest...

3 CFR 9060 - Proclamation 9060 of November 21, 2013. Day of Remembrance for President John F. Kennedy

Code of Federal Regulations, 2014 CFR

2014-01-01

... celebrate his enduring imprint on American history. In his 3 years as President of the United States, John F... recognizing women's basic right to earn a living equal to their efforts, he signed the Equal Pay Act into law...

STS-57 external tank (ET) falls away from Endeavour, OV-105, after jettison

NASA Image and Video Library

1993-06-21

STS057-03-017 (21 June 1993) --- The external fuel tank falls toward Earth after being jettisoned from the Space Shuttle Endeavour as the spacecraft headed toward its ten-day stay in Earth orbit. A 35mm camera was used to record the ET jettison.

Spring and fall bloom evolutions estimated from 8 day composite satellite chlorophyll data in the East/Japan Sea

NASA Astrophysics Data System (ADS)

Kim, B.; Cho, Y.; Kim, S.; Kim, K.

2012-12-01

Bong-Guk Kim1, Yang-Ki Cho1, Sangil Kim2, Kwang-Yul, Kim1 1 School of Earth and Environmental Sciences, College of Natural Sciences, Seoul National University, Seoul, South Korea 2 College of Oceanic and Atmospheric Sciences, Oregon State University, Corvallis, Oregon, USA To understand the ocean carbon cycle, estimating the ocean biomass is necessary and it has been done by various methods. Satellite observation is one of beneficial methods to investigate ocean biomass. Satellite data enable us to monitor chlorophyll-a for wide area with high resolution and frequency. The East/Japan Sea, which called as 'miniature ocean' due to its rapid turnover circulation, is one of the most productive ocean. With the concerning global warming, a number of studies on temporal and spatial distribution of satellite chlorophyll in the East/Japan Sea have been processed. However, most of these studies have used monthly data set which can not resolve detail evolution of chlorophyll-a. In this study, detail evolutions of spring and fall bloom are investigated by the CSEOF (Cyclo-Stationary EOF) analysis of 8-day composite MODIS chlorophyll data from July 2002 to February 2012. For the CSEOF analysis, optimal interpolation (OI) method was applied to fill the blank data which is critical problem in satellite data. Spring bloom started at western Japanese coast on 57th day of the year. And it gradually moves eastern coast of Korean and then moves to northern Primorye coast. Spring bloom spreads entire the East/Japan Sea on 113th day of the year and then, it disappears from the southern East/Japan Sea. Spring bloom ends in the northern East/Japan Sea. In the case of fall bloom, it starts at Korean coast on 265th day of the year, and it moves to the north along the Korean coast by 329th day of the year. After that day, fall bloom ends near the northern coast of Korea on 353rd day of the year.

Sleep problems in cancer patients: prevalence and association with distress and pain.

PubMed

Sharma, Neelom; Hansen, Christian Holm; O'Connor, Mark; Thekkumpurath, Parvez; Walker, Jane; Kleiboer, Annet; Murray, Gordon; Espie, Colin; Storey, Dawn; Sharpe, Michael; Fleming, Leanne

2012-09-01

Although it is increasingly recognized that cancer patients often have sleep problems, we lack data on their prevalence and associations in representative clinical populations. We aimed to determine (i) the prevalence of sleep problems amongst outpatients of a cancer centre and (ii) the association with medical variables, emotional distress and pain. Secondary analysis of self-report and medical data on 2862 cancer centre outpatients. Sleep problems were identified using the sleep item from the Patient Health Questionnaire-9: 'Over the last two weeks, how often have you been bothered by trouble falling or staying asleep or sleeping too much?' scored on a four-point frequency scale. Emotional distress was measured using the Hospital Anxiety and Depression Scale and pain using the subscale of the European Organisation for Research and Treatment of Cancer Quality of Life Core 30 questionnaire. Medical data were obtained from the cancer centre clinical database. Sleep problems (bothered more than half the days during the previous 2 weeks) were reported by 30.2% (865/2862, 95% CI = 28.5 to 31.9) of the patients. They were common in both patients with active cancer (34.5%) and in cancer survivors (28.0%). There was only a modest association with cancer site and treatment status, but there was a strong association with pain (odds ratio = 2.7, 95% CI = 2.2 to 3.4) and emotional distress (odds ratio = 4.5, 95% CI = 3.7 to 5.6). Sleep problems are common in cancer outpatients and are strongly associated with pain and emotional distress. A combined approach to the management of sleep, pain and emotional distress is indicated. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Spring and fall phytoplankton blooms in a productive subarctic ecosystem, the eastern Bering Sea, during 1995-2011

NASA Astrophysics Data System (ADS)

Sigler, Michael F.; Stabeno, Phyllis J.; Eisner, Lisa B.; Napp, Jeffrey M.; Mueter, Franz J.

2014-11-01

The timing and magnitude of phytoplankton blooms in subarctic ecosystems often strongly influence the amount of energy that is transferred through subsequent trophic pathways. In the eastern Bering Sea, spring bloom timing has been linked to ice retreat timing and production of zooplankton and fish. A large part of the eastern Bering Sea shelf (~500 km wide) is ice-covered during winter and spring. Four oceanographic moorings have been deployed along the 70-m depth contour of the eastern Bering Sea shelf with the southern location occupied annually since 1995, the two northern locations since 2004 and the remaining location since 2001. Chlorophyll a fluorescence data from the four moorings provide 37 realizations of a spring bloom and 33 realizations of a fall bloom. We found that in the eastern Bering Sea: if ice was present after mid-March, spring bloom timing was related to ice retreat timing (p<0.001, df=1, 24); if ice was absent or retreated before mid-March, a spring bloom usually occurred in May or early June (average day 148, SE=3.5, n=11). A fall bloom also commonly occurred, usually in late September (average day 274, SE=4.2, n=33), and its timing was not significantly related to the timing of storms (p=0.88, df=1, 27) or fall water column overturn (p=0.49, df=1, 27). The magnitudes of the spring and fall blooms were correlated (p=0.011, df=28). The interval between the spring and fall blooms varied between four to six months depending on year and location. We present a hypothesis to explain how the large crustacean zooplankton taxa Calanus spp. likely respond to variation in the interval between blooms (spring to fall and fall to spring).

Investigation of Single versus Dual - Hot and Cold Building Water Systems.

DTIC Science & Technology

1981-10-15

S. Ramsey 2, Philip B. Shepherd JOHNS - MANVILLE SALES CORPORATION RESEARCH AND DEVELOPMENT CENTER KEN-CARYL RANCH DENVER, COLORADO 80217 15 October...Bruce DAAK 70-78-D-0002 Mark S. Ramsey Philip B. Shepherd 9PERFORMAING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMEN4T. PROJECT, TASK Johns - Manville Sales...0c NUMBER OF PIPE CCOLDOWN CYCLES FER DAY= 1.20 126 12/09/FC PAGE JOhNS - MANVILLE RESEARCH F DEVFLOPPENT CENTER ktlILDINC- HEATED WATER SUPPLY SYSTFM

Long term spatial and temporal trends in frost day indices in Kansas, USA

USDA-ARS?s Scientific Manuscript database

Frost day indices such as number of frost days (nFDs), frost free days (nFFDs), last spring freeze (LSF), first fall freeze (FFF), and growing-season length (GSL), were calculated using daily minimum air temperature (Tmin) values from 23 centennial weather stations spread across Kansas during four t...

Every Day Is Mathematical

ERIC Educational Resources Information Center

Barger, Rita H.; Jarrah, Adeeb M.

2012-01-01

March 14 is special because it is Pi Day. Mathematics is celebrated on that day because the date, 3-14, replicates the first three digits of pi. Pi-related songs, websites, trivia facts, and more are at the fingertips of interested teachers and students. Less celebrated, but still fairly well known, is National Metric Day, which falls on October…

Dizziness, but not falls rate, improves after routine cataract surgery: the role of refractive and spectacle changes.

PubMed

Supuk, Elvira; Alderson, Alison; Davey, Christopher J; Green, Clare; Litvin, Norman; Scally, Andrew J; Elliott, David B

2016-03-01

To determine whether dizziness and falls rates change due to routine cataract surgery and to determine the influence of spectacle type and refractive factors. Self-reported dizziness and falls were determined in 287 patients (mean age of 76.5 ± 6.3 years, 55% females) before and after routine cataract surgery for the first (81, 28%), second (109, 38%) and both eyes (97, 34%). Dizziness was determined using the short-form of the Dizziness Handicap Inventory. Six-month falls rates were determined using self-reported retrospective data. The number of patients with dizziness reduced significantly after cataract surgery (52% vs 38%; χ(2) = 19.14(,) p < 0.001), but the reduction in the number of patients who fell in the 6-months post surgery was not significant (23% vs 20%; χ(2) = 0.87, p = 0.35). Dizziness improved after first eye surgery (49% vs 33%, p = 0.01) and surgery on both eyes (58% vs 35%, p < 0.001), but not after second eye surgery (52% vs 45%, p = 0.68). Multivariate logistic regression analyses found significant links between post-operative falls and change in spectacle type (increased risk if switched into multifocal spectacles). Post-operative dizziness was associated with changes in best eye visual acuity and changes in oblique astigmatic correction. Dizziness is significantly reduced by first (or both) eye cataract surgery and this is linked with improvements in best eye visual acuity, although changes in oblique astigmatic correction increased dizziness. The lack of improvement in falls rate may be associated with switching into multifocal spectacle wear after surgery. © 2015 The Authors Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

Fall Risk is Not Black and White

PubMed Central

Kiely, Dan K.; Kim, Dae Hyun; Gross, Alden L.; Habtemariam, Daniel A.; Leveille, Suzanne G.; Li, Wenjun; Lipsitz, Lewis A.

2015-01-01

Objective To determine whether previously reported racial differences in fall rates between White and Black/African American is explained by differences in health status and neighborhood characteristics. Design Prospective cohort Setting Community Participants The study included 550 White and 116 Black older adults in the Greater Boston area (mean age: 78 years; 36% men) who were English-speaking, able to walk across a room, and without severe cognitive impairment. Measurements Falls were prospectively reported using monthly fall calendars. The location of each fall and fall-related injuries were asked during telephone interviews. At baseline, we assessed risk factors for falls, including sociodemographic characteristics, physiologic risk factors, physical activity, and community-level characteristics. Results Over the mean follow-up of 1,048 days, 1,539 falls occurred (incidence: 806/1,000 person-years). Whites were more likely than Blacks to experience any falls (867 versus 504 falls per 1,000 person-years; RR [95% CI]: 1.77 [1.33, 2.36]), outdoor falls (418 versus 178 falls per 1,000 person-years; 1.78 [1.08, 2.92]), indoor falls (434 versus 320 falls per 1,000 person-years; 1.44 [1.02, 2.05]), and injurious falls (367 versus 205 falls per 1,000 person-years; 1.79 [1.30, 2.46]). With exception of injurious falls, higher fall rates in Whites than Blacks were substantially attenuated with adjustment for risk factors and community-level characteristics: any fall (1.24 [0.81, 1.89]), outdoor fall (1.57 [0.86, 2.88]), indoor fall (1.08 [0.64, 1.81]), and injurious fall (1.77 [1.14, 2.74]). Conclusion Our findings suggest that the racial differences in fall rates may be largely due to confounding by individual-level and community-level characteristics. PMID:26855845

STS-81 Flight Day 7

NASA Technical Reports Server (NTRS)

1997-01-01

On this seventh first day of the STS-81 mission, the flight crew, Cmdr. Michael A. Baker, Pilot Brent W. Jett, Mission Specialists, John M. Grunsfeld, Marsha S. Ivins, Peter J.K. Wisoff, and John Blaha, and the cosmonauts of the Russian Space Station Mir continue to transfer hundreds of pounds of water, supplies, and logistical items to each other's spacecraft. More than 1,300 pounds of water have now been transferred from Atlantis to the Mir to resupply the Russian outpost, along with equipment that will be used by astronaut Jerry M. Linenger during his four-month research mission. A bioprocessing device and an experiment used to grow cartilage cells during astronaut John Blaha's four month stay on the Mir is also transferred to Atlantis for the trip back to Earth. Linenger spends most of the day collecting water samples from the Mir for analysis back on Earth and Blaha continues to exercise on a treadmill on the Mir to stay in shape for his return to Earth and a readaptation to gravity after four months of weightlessness.

Standardized UXO Technology Demonstration Site Open Field Scoring Record No. 905 (Sky Research, Inc.) EM61 MKII/Towed Array

DTIC Science & Technology

2008-09-01

day timeframe. 3.6 DEMONSTRATOR’S FIELD PERSONNEL Geophysicist: Craig Hyslop Geophysicist: John Jacobsen Geophysicist: Rob Mehl 3.7...Practical Nonparametric Statistics, W.J. Conover, John Wiley & Sons, 1980 , pages 144 through 151. F-1 (Page F-2 Blank) APPENDIX F

Astronaut John Grunsfeld uses camera to record ASTRO-2 payload

NASA Image and Video Library

1995-03-17

STS067-377-008 (2-18 March 1995) --- Astronaut John M. Grunsfeld, mission specialist, uses a handheld Hasselblad camera to record the Astro-2 payload. Orbiting Earth at 190 nautical miles, Grunsfeld joined four other NASA astronauts and two scientists for almost 17 days conducting research in support of the Astro-2 mission.

Training Needs in Gerontology. Hearings, Special Committee on Aging, United States Senate. Part 2.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

At the second day of hearings on training needs in gerontology the witnesses were Stephen Kurzman accompanied by Arthur S. Flemming, John Lapp, Gerald D. LaVeck; George Maddox; Elias Cohen; Wilma Donahue; Brin Hawkins with Lettie Graves and Yolanda Owens; and John B. Martin. (MS)

Dr. John Mather and the James Webb Space Telescope

NASA Image and Video Library

2017-12-08

Nobel Laureate and James Webb Space Telescope project scientist Dr. John Mather takes a selfie with the telescope. May 4, 2016 was a rare day for JWST, as it briefly faced the cleanroom observation window. The telescope was eventually rotated face-down in prep for the installation of the flight instruments. Credit: Meredith Gibb

Air and Space Power Journal. Volume 30, Number 3, Fall 2016

DTIC Science & Technology

2016-01-01

smarter ways to do business. —Gen Larry Spencer Former Air Force Vice-Chief of Staff General Spencer’s call to managerial arms is certainly one that our...weaknesses exploitable by an enemy. 20. James G. March and Herbert A. Simon, Organizations (New York: John Wiley and Sons, 1958), 140, 146. 21. Graham T...eight years,” said Gen Herbert “Hawk” Carlisle during a September 2015 talk at the Center for Strategic and International Studies in Washington

Relation of ground water to stream flow at Battle Creek, Mich.

USGS Publications Warehouse

Eddy, G.E.; Ferris, J.G.

1950-01-01

This is a summary of statements made by G.E. Eddy, State Geologist of Michigan, and J.G. Ferris, district engineer, Ground Water Branch, U.S. Geological Survey, Lansing, Mich., in a conference during the fall of 1949 with John Spoden, Chief of the Maintenance and Fold Control Division of the district office of the Corps of Engineers, Milwaukee, Wis. The conference related to the probably effect on ground-water conditions at Battle Creek of flood-control measures proposed by the Corps of Engineers.

Protection, Profit, or Privacy: Exploring Strategic Solutions for Integrating Unmanned Aerial Systems (UAS) and the Delicate Balance Between Commercial Opportunity and Public Safety

DTIC Science & Technology

2016-12-01

United States v. Knotts.9 Analysis of previous cases provides a starting point for discussion between government officials and the public they...authorized under this ordinance to deploy this technology. At the start of the legislative session in the fall of 2015, Senator John Kavanagh, a...2015, through April 30, 2016 (a span of approximately 15 months). The start date of this query is intended to correspond with the operational

Strategic Studies Quarterly, Volume 4, Number 3, Fall 2010

DTIC Science & Technology

2010-01-01

Story of the Aum Doomsday Cult, from the Subways of Tokyo to the Nuclear Arsenals of Russia (New York: Crown Publishers, 1996 ), 108-12. 32. Lt Col John...Attraction," Journal of Personality andSocial Psychology󈨊, no. 2 (February 1996 ). 26. As Siebold and Lindsay put it, "A central tenet of current [1999...Ralph M. Carney, eds., Out in Force: Sexual Orientation and the Miliuiry (Chicago: University of Chicago Press, 1996 ), 166. 29. Om Prakash, "The

Odontoid fracture following a fall in an elderly man.

PubMed

Pagnez, Maria Alice Mainenti; Elliott, James M

2011-12-01

The patient was a 79-year-old man with a chief complaint of neck pain after a fall. Three days following the fall, the patient was seen in the emergency department, where computed tomography imaging of the head and radiographs of the cervical spine were completed. The patient was subsequently referred to a physical therapist. Due to concern for a possible undetected cervical spine fracture, the patient was immediately referred to his physician. Magnetic resonance imaging demonstrated a type II fracture of the odontoid.

[Adrenalectomy after snowboard fall. A pheochromocytoma becomes clinically apparent in an unusual way].

PubMed

Gramann, T; Stamm, B; Buchmann, P

2007-04-01

A 33-year-old snowboarder fell and underwent radiological examination, which was suspicious for a vertebral body fracture. Accidentally we found a tumour of the left suprarenal gland. Two days after the fall, he developed a hypertensive crisis with peak blood pressure levels up to 280/120 mmHg. Further endocrinologic testing indicated a pheochromocytoma which was confirmed by post-operative histology. The fall is supposed to have activated the pheochromocytoma. The course of examinations and significance of the tumour are described.

A New National MODIS-Derived Phenology Data Set Every 16 Days, 2002 through 2006

NASA Astrophysics Data System (ADS)

Hargrove, W. W.; Spruce, J.; Gasser, G.; Hoffman, F. M.; Lee, D.

2008-12-01

A new national phenology data set has been developed, comprised of a series of seamless 231m national maps, every 16 days from 2001 through 2006. The data set was developed jointly by the Eastern Forest Environmental Threat Assessment Center (EFETAC) of the USDA Forest Service, and contractors of the NASA Stennis Space Center. The data are available now for dissemination and use. The first half of the National Phenology Data Set is the cumulative area under the NDVI curve since Jan 1, and increases monotonically every 16 days until the end of the year. These cumulative data values "latch" in the event of clouds or snow, remaining at the value when we last saw this cell. The second half is a set of diagnostic parameters fit to the annual NDVI function. The spring minimum, the 20% rise, the 80% rise, the leaf-on maximum, the 80% fall, the 20% fall, and the trailing fall minimum are determined for each map cell. For each parameter, we produce both a national map of the NDVI value, and a map of the day-of-year when that NDVI value was reached. Length of growing season, as the difference between the spring and fall 20% DOYs, and date of middle of growing season can be mapped as well. The new dataset has permitted the development of a set of national phonological ecoregions, and has also proven useful for mapping Gypsy Moth defoliation, simultaneously delineating the aftermath of three Gulf Coast hurricanes, and quantifying suburban/ex-urban development surrounding metro Atlanta.

The effects of St. John's wort extract and amitriptyline on autonomic responses of blood vessels and sweat glands in healthy volunteers.

PubMed

Siepmann, Martin; Kirch, Wilhelm; Krause, Stephanie; Joraschky, Peter; Mueck-Weymann, Michael

2004-02-01

St. John's wort extract is widely used and advertised as a "natural antidepressant" lacking autonomic side effects. This randomized, double-blind, placebo-controlled study compared the effects of St. John's wort extract on autonomic responses of blood vessels and sweat glands with those of amitriptyline and placebo. A randomized, double-blind, crossover study was performed in healthy male volunteers aged 22 to 31 years (25 +/- 3 years; mean +/- SD) years. Subjects orally received capsules with 255 to 285 mg St. John's wort extract (900 microg hypericin content), 25 mg amitriptyline, and placebo 3 times daily for periods of 14 days each with at least 14 days between. Vasoconstrictory response of cutaneous blood flow (VR) and skin conductance response (SR) following a single deep inspiration were employed as parameters of autonomic function. St. John's wort extract had no effect on VR and SR. In contrast, SR was diminished and the dilation phase of VR was prolonged following multiple dosing with amitriptyline (P < 0.05). Decreased electrodermal reactivity observed with amitriptyline reflects inhibition of acetylcholine at peripheral m3-cholinoreceptors, whereas prolongation of VR induced by the tricyclic drug may be due to sustained activation of central and/or peripheral sympathetic neurons.

The role of skeletal muscle contractile duration throughout the whole day: reducing sedentary time and promoting universal physical activity in all people.

PubMed

Hamilton, Marc T

2018-04-15

A shared goal of many researchers has been to discover how to improve health and prevent disease, through safely replacing a large amount of daily sedentary time with physical activity in everyone, regardless of age and current health status. This involves contrasting how different muscle contractile activity patterns regulate the underlying molecular and physiological responses impacting health-related processes. It also requires an equal attention to behavioural feasibility studies in extremely unfit and sedentary people. A sound scientific principle is that the body is constantly sensing and responding to changes in skeletal muscle metabolism induced by contractile activity. Because of that, the rapid time course of health-related responses to physical inactivity/activity patterns are caused in large part directly because of the variable amounts of muscle inactivity/activity throughout the day. However, traditional modes and doses of exercise fall far short of replacing most of the sedentary time in the modern lifestyle, because both the weekly frequency and the weekly duration of exercise time are an order of magnitude less than those for people sitting inactive. This can explain why high amounts of sedentary time produce distinct metabolic and cardiovascular responses through inactivity physiology that are not sufficiently prevented by low doses of exercise. For these reasons, we hypothesize that maintaining a high metabolic rate over the majority of the day, through safe and sustainable types of muscular activity, will be the optimal way to create a healthy active lifestyle over the whole lifespan. © 2017 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.

C.-E.A. Winslow Day: Proceedings of the June 3, 1977 Centenary Celebration

PubMed Central

Viseltear, Arthur J.

1977-01-01

Sponsored by Yale University, the City of New Haven, and the John B. Pierce Foundation, the C.-E.A. Winslow Day program consisted of speeches by Mr. Leonard Woodcock, President Emeritus, U.A.W., the Honorable Kenneth Gibson, Mayor of Newark, and Dr. Hector Acuña, Director, Pan American Health Organization; reminiscences of Ira Hiscock, Anna M.R. Lauder Professor Emeritus of Public Health, Mary Elizabeth Tennant, Associate Professor Emeritus of Nursing (Public Health), A. Pharo Gagge, Emeritus Fellow, John B. Pierce Foundation, and Mrs. Harriet Welch, Former President of the VNA of New Haven. The proceedings also included the presentation of gifts and the official C.-E.A. Winslow Day Proclamation. PMID:345631

The FIM instrument to identify patients at risk of falling in geriatric wards: a 10-year retrospective study.

PubMed

Petitpierre, Nicolas Julien; Trombetti, Andrea; Carroll, Iain; Michel, Jean-Pierre; Herrmann, François Richard

2010-05-01

the main objective was to evaluate if the admission functional independence measure (FIM) score could be used to predict the risk of falls in geriatric inpatients. a 10-year retrospective study was performed. the study was conducted in a 298-bed geriatric teaching hospital in Geneva, Switzerland. all patients discharged from the hospital from 1 January 1997 to 31 December 2006 were selected. measures used were FIM scores at admission using the FIM instrument and number of falls extracted from the institution's fall report forms. during the study period, there were 23,966 hospital stays. A total of 8,254 falls occurred. Of these, 7,995 falls were linked to 4,651 stays. Falls were recorded in 19.4% of hospital stays, with a mean incidence of 7.84 falls per 1,000 patients-days. Although there was a statistically significant relationship between total FIM score, its subscales, and the risk of falling, the sensitivity, specificity, positive predictive value and negative predictive value obtained with receiver operating characteristic curves were insufficient to permit fall prediction. This might be due in part to a non-linear relationship between FIM score and fall risk. in this study, the FIM instrument was found to be unable to predict risk of falls in general geriatric wards.

What Constitution Day Means and Why It Matters

ERIC Educational Resources Information Center

Jamieson, Kathleen Hall

2014-01-01

For almost three quarters of a century, advocates have worked to give comparable federal stature to September 17, the day on which we celebrate the anniversary of the 1787 signing of the U.S. Constitution by the nation's founders. As President John F. Kennedy noted in his 1961 Constitution Day proclamation, it is a day for…

Delimiting strategic zones for the development of fall armyworm (Lepidoptera: Noctuidae) on corn in the State of Florida

USDA-ARS?s Scientific Manuscript database

The fall armyworm, Spodoptera frugiperda (J. E. Smith), cannot survive prolonged periods of freezing temperatures, thereby limiting where it can overwinter in North America. Climate change is anticipated to reduce the frequency of freeze days in Florida over the decades, with the potential consequen...

A resolution designating September 23, 2014, as "National Falls Prevention Awareness Day" to raise awareness and encourage the prevention of falls among older adults.

THOMAS, 113th Congress

Sen. Nelson, Bill [D-FL

2014-09-18

Senate - 12/04/2014 Resolution agreed to in Senate without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Choosing cover crops for a fall grazing season

USDA-ARS?s Scientific Manuscript database

Forage brassicas are annuals that can be utilized as pasture during the spring, summer, and fall grazing seasons. They are quick maturing and can be grazed 60 to 120 days after planting. A 2-year study at the USDA-ARS PSWMRU showed that yield and total digestible nutrients of three brassica varietie...

The Annual Condition of Iowa's Community Colleges, 2012

ERIC Educational Resources Information Center

Bassis, Vladimir; Burroughs, Monte; Cooley, Tom; Farver, Kent; Vybiral, Amy

2013-01-01

Each fall, the Iowa Department of Education collects enrollment data from Iowa's community colleges on the tenth business day of the semester. The fall data pertain to the 2012-13 academic year (fiscal year 2013). This report is the only report on fiscal year 2013 until next year's "Annual Condition of Iowa's Community Colleges." Fall…

Vitamin D and muscle function.

PubMed

Dawson-Hughes, Bess

2017-10-01

Muscle weakness is a hallmark of severe vitamin D deficiency, but the effect of milder vitamin D deficiency or insufficiency on muscle mass and performance and risk of falling is uncertain. In this presentation, I review the evidence that vitamin D influences muscle mass and performance, balance, and risk of falling in older adults. Special consideration is given to the impact of both the starting 25-hydroxyvitamin D [25(OH)D] level and the dose administered on the clinical response to supplemental vitamin D in older men and women. Based on available evidence, older adults with serum 25(OH)D levels <40nmol/L appear most likely to improve their muscle performance with supplementation. The vitamin D dose range of 800-1000 IU per day has been effective in many studies; lower doses have generally been ineffective and several doses above this range have increased the risk of falls. In conclusion, older adults with serum 25(OH)D levels <40nmol/L are likely to have fewer falls if supplemented with 800-1000 IU per day of vitamin D. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

PubMed

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

2015-07-01

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

The spring migration of adult North American Ospreys

USGS Publications Warehouse

Martell, Mark S.; Bierregaard, Richard O.; Washburn, Brian E.; Elliott, John E.; Henny, Charles J.; Kennedy, Robert S.; MacLeod, Iain

2014-01-01

Most North American Ospreys (Pandion haliaetus) are migratory, breeding in northern latitudes and migrating long distances to and from their wintering grounds in the tropics. Although fall migration patterns of North American Ospreys have been described and studied, very little has been published about the spring migration of these birds. We used satellite telemetry to: (1) determine the characteristics (timing, duration, migratory routes) of spring migrations of Ospreys; (2) determine if differences in spring migration patterns existed between sexes and among three breeding populations (east coast, midwestern, and western); and (3) compare consecutive fall and spring migrations of individual Ospreys. The median dates for departure from the wintering grounds and arrival on the breeding grounds did not differ significantly between adult male and female Ospreys. Compared to their fall migrations, all male and all east coast Ospreys spent fewer days on migration, fewer days in stopover periods along the migration route, traveled shorter distances overall, and traveled farther (on average) each day during spring. In contrast, fall and spring migration characteristics of all female and western Ospreys were similar. Our findings suggest that, although sex and breeding location might influence the spring migration strategy used by individual Ospreys, both males and females minimize the time spent on migration to ensure a timely arrival on the breeding grounds to establish or defend a nesting territory.

Season-dependent effects of elevated temperature on stress biomarkers, energy metabolism and gamete development in mussels.

PubMed

Múgica, M; Sokolova, I M; Izagirre, U; Marigómez, I

2015-02-01

In coastal areas, sessile species can be severely affected by thermal stress associated to climate change. Presently, the effect of elevated temperature on metabolic, cellular and tissue-level responses of mussels was determined to assess whether the responses vary seasonally with seawater temperature and reproductive stage. Mussels were collected in fall, winter and summer, and (a) maintained at 16, 12, and 20 °C respectively or (b) subject to gradual temperature elevation for 8 days (+1 °C per day; from 16 to 24 °C in fall, from 12 to 20 °C in winter and from 20 to 28 °C in summer) and further maintained at 24 °C (fall), 20 °C (winter) and 28 °C (summer) for the following 6 days. Temperature elevation induced membrane destabilization, lysosomal enlargement, and reduced the aerobic scope in fall and summer whereas in winter no significant changes were found. Changes at tissue-level were only evident at 28 °C. Gamete development was impaired irrespective of season. Since the threshold of negative effects of warming was close to ambient temperatures in summer (24 °C or above) studied mussel populations would be vulnerable to the global climate change. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sleep and sleepiness: impact of entering or leaving shiftwork--a prospective study.

PubMed

Akerstedt, Torbjörn; Nordin, Maria; Alfredsson, Lars; Westerholm, Peter; Kecklund, Göran

2010-07-01

Very little is known about the effects on sleep and sleepiness of entering or exiting shiftwork. The present study used a longitudinal database (n = 3637). Participants completed a questionnaire on work hours, sleep, and work environment at the start and end of a 5-yr period. Changes in shift/day work status were related to change in a number of subjective sleep variables using logistic regression analysis. The analyses were adjusted for age, sex, and differences in socioeconomic status, work demands, work control, physical workload, marriage status, and number of children. In comparison with constant day work, entering shiftwork (with or without night shifts) from day work increased the risk of difficulties in falling asleep, and leaving shiftwork reduced this risk (odds ratio [OR] = 2.8 [confidence interval, CI = 1.8-4.5]). Also falling asleep at work showed a consistent pattern; an increased risk of falling asleep for those with shiftwork on both occasions, and for those with night work on both occasions. Also entering night work was associated with a strongly increased risk of falling asleep at work (OR = 2.9 [CI = 1.3-6.7]). These results suggest that entering and leaving shiftwork has a considerable impact on sleep and alertness. However, there is a need for large and more extended longitudinal studies to support our findings.

Focal muscle vibration as a possible intervention to prevent falls in elderly women: a pragmatic randomized controlled trial.

PubMed

Celletti, Claudia; Fattorini, Luigi; Camerota, Filippo; Ricciardi, Diego; La Torre, Giuseppe; Landi, Francesco; Filippi, Guido Maria

2015-12-01

Different and new approaches have been proposed to prevent the risk of falling of elderly people, particularly women. This study investigates the possibility that a new protocol based on the focal mechanical muscle vibration may reduce the risk of falling of elderly women. A pragmatic randomized controlled triple-blind trial with a 6-month follow-up after intervention randomized 350 women (mean age 73.4 years + 3.11), members of local senior citizen centers in Rome, into two groups: vibrated group (VG) and control group (CG). For VG participants a mechanical vibration (lasting 10 min) was focally applied on voluntary contracted quadriceps muscles, three times a day during three consecutive days. CG subjects received a placebo vibratory stimulation. Subjects were tested immediately before (T0) and 30 (T1) and 180 (T2) days after the intervention with the Performance-Oriented Mobility Assessment (POMA) test. All subjects were asked not to change their lifestyle during the study. CG underwent sham vibratory treatment. While CG did not show any statistically significant change of POMA at T1 and T2, VG revealed significant differences. At T2, ≈47% of the subjects who completed the study obtained the full score on the POMA test and ≈59% reached the full POMA score. The new protocol seems to be promising in reducing the risk of falling of elderly subjects.

Acoustic Telemetry Evaluation of Juvenile Salmonid Passage and Survival at John Day Dam with Emphasis on the Prototype Surface Flow Outlet, 2008

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

Weiland, Mark A.; Ploskey, Gene R.; Hughes, James S.

The main purpose of the study was to evaluate the performance of Top Spill Weirs installed at two spillbays at John Day Dam and evaluate the effectiveness of these surface flow outlets at attracting juvenile salmon away from the powerhouse and reducing turbine passage. The Juvenile Salmonid Acoustic Telemetry System (JSATS) was used to estimate survival of juvenile salmonids passing the dam and also for calculating performance metrics used to evaluate the efficiency and effectiveness of the dam at passing juvenile salmonids.

Acoustic Telemetry Evaluation of Juvenile Salmonid Passage and Survival at John Day Dam, 2010

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

Weiland, Mark A.; Woodley, Christa M.; Ploskey, Gene R.

This report presents survival, behavioral, and fish passage results for yearling and subyearling Chinook salmon smolts and juvenile steelhead tagged with JSATS acoustic micro-transmitters as part of a survival study conducted at John Day Dam during 2010. This study was designed to evaluate the passage and survival of yearling and subyearling Chinook salmon and juvenile steelhead to assist managers in identifying dam operations for compliance testing as stipulated by the 2008 Federal Columbia River Power System Biological Opinion and the 2008 Columbia Basin Fish Accords. Survival estimates were based on a single-release survival estimate model.

A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke.

PubMed

Foster, Emma J; Barlas, Raphae S; Wood, Adrian D; Bettencourt-Silva, Joao H; Clark, Allan B; Metcalf, Anthony K; Bowles, Kristian M; Potter, John F; Myint, Phyo K

2017-10-01

The risks of falls and fractures increase after stroke. Little is known about the prognostic significance of previous falls and fractures after stroke. This study examined whether having a history of either event is associated with poststroke mortality. We analyzed stroke register data collected prospectively between 2003 and 2015. Eight sex-specific models were analyzed, to which the following variables were incrementally added to examine their potential confounding effects: age, type of stroke, Oxfordshire Community Stroke Project classification, previous comorbidities, frailty as indicated by the prestroke modified Rankin Scale score, and acute illness parameters. Logistic regression was applied to investigate in-hospital and 30-day mortality, and Cox proportional-hazards models were applied to investigate longer-term outcomes of mortality. In total, 10,477 patients with stroke (86.1% ischemic) were included in the analysis. They were aged 77.7±11.9 years (mean±SD), and 52.2% were women. A history of falls was present in 8.6% of the men (n=430) and 20.2% of the women (n=1,105), while 3.8% (n=189) of the men and 12.9% of the women (n=706) had a history of both falls and fractures. Of the outcomes examined, a history of falls alone was associated with increased in-hospital mortality [odds ratio (OR)=1.33, 95% confidence interval (CI)=1.03-1.71] and 30-day mortality (OR=1.34, 95% CI=1.03-1.73) in women in the fully adjusted models. The Cox proportional-hazards models for longer-term outcomes and the history of falls and fractures combined showed no significant results. The history of falls is an important factor for acute stroke mortality in women. A previous history of falls may therefore be an important factor to consider in the short-term stroke prognosis, particularly in women. Copyright © 2017 Korean Neurological Association

The impact of snow on orthopaedic trauma referrals.

PubMed

Weston-Simons, John; Jack, Christopher M; Doctor, Cyrus; Brogan, Kit; Reed, Daniel; Ricketts, David

2012-07-01

Adverse weather has been shown to increase orthopaedic referrals and place strain on services. This retrospective study undertaken at a teaching hospital concerned referrals between April 2009 and April 2010 comparing days when snow fell to days when it did not. Referrals increased significantly on snow days (to 74.9 per day) in comparison to normal weather days (33.5 per day). During snow days there were significant increases in the number of distal radius and ankle fractures referred but not of fractured necks of femur. Complications during the snow fall period were related to procedures performed outside of the trauma unit with further difficulties related to a lack of operating equipment and implant availability. As a result of our study, we recommend that during periods of heavy snow fall orthopaedic and trauma units should place senior orthopaedic trainees in Accident and Emergency to review patients as a triage service, organise trauma lists related to surgeon specific expertise and avoid sending trauma patients outside the unit for operation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Care management service and falls prevention: a case-control study in a Chinese population.

PubMed

Leung, Angela Y M; Lou, Vivian W Q; Chan, Kin Sun; Yung, Alison; Chi, Iris

2010-04-01

This study evaluates the effect of a care management service (CMS) on falls in older adults. This is a retrospective case-control study with 78 CMS recipients as the case group who received CMS and another 312 community-dwelling frail elders as the control group.The groups were matched by age, gender, activity of daily living, cognitive impairment, and unsteady gait. Thus they were comparable in characteristics and frailty. Among the 390 participants, 89 older adults (23.0%) had falls in the 90 days prior to the survey. After controlling for the identified risk factors for falls, the odds ratio of CMS was 0.27 (95% confidence interval = 0.110-0.663, p < .01). These findings indicate that CMS recipients have a lower chance for falls compared to their counterparts. The two features of CMS (comprehensive assessment and multidisciplinary actions to reduce fall risks) are discussed.

Of lamp posts, keys, and fabled drunkards: A perspectival tale of 4 guidelines.

PubMed

Greenhalgh, Trisha

2018-04-15

Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time). Some evidence-based guidelines are reviewed and applied to the case. The clinical record described the cycle accident as a "fall." Initial assessment directed the clinicians' gaze to the obvious injuries, whose treatment was straightforward. On admission, the patient (aged 55 years at the time) was offered "falls prevention" via a guideline-based checklist. Several months later, neurological sequelae indicated possible damage to the cervical spine. But the NICE Guideline recommending cervical spine imaging in cases of high-impact trauma had not been considered-perhaps because the clinical narrative had been prematurely assigned to the script of "older person with fall." Furthermore, the author, who was (appropriately) treated with neurosurgery, was surprised at the response of clinical colleagues, based on application of an irrelevant section of a guideline, that her cervical discectomy was "nonevidence based." Nonsteroidal anti-inflammatory drugs for postoperative pain were indicated in this patient even though they were not recommended for the average patient. As Sir John Grimley Evans' warned, we should avoid using evidence-based guidelines in the manner of the fabled drunkard who searched under the lamp post for his key because that was where the light was, even though he knew he had lost his key somewhere else. © 2018 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

The effect of nurse manager turnover on patient fall and pressure ulcer rates.

PubMed

Warshawsky, Nora; Rayens, Mary Kay; Stefaniak, Karen; Rahman, Rana

2013-07-01

The purpose of this study was to explore the effects of nurse manager turnover on the occurrence of adverse events. Nurse managers create professional nurse practice environments to support the provision of quality patient outcomes. Inconsistent findings were reported in the literature testing the relationship between nurse managers and patient outcomes. All prior studies assumed stable nursing management. A longitudinal quasi-experimental study of 23 nursing units in two hospitals was used to determine whether unit characteristics, including nurse manager turnover, have an effect on patient falls or pressure ulcers. Statistical analyses included repeated measures and hierarchical modelling. Patients in medical/surgical units experienced more falls than in intensive care units (F1,11 = 15.9, P = 0.002). Patients in units with a nurse manager turnover [odds ratio: 3.16; 95% confidence interval: 1.49-6.70] and intensive care units (odds ratio: 2.70; 95% confidence interval: 1.33-5.49) were more likely to develop pressure ulcers. Nurse manager turnover and intensive care unit status were associated with more pressure ulcers. Medical/surgical unit status was associated with more falls. The study was limited by a small sample size. Nurse manager turnover may negatively impact patient outcomes. Stable nursing management, strategic interim management and long-term succession planning may reduce adverse patient events. © 2013 John Wiley & Sons Ltd.

Use of Risk Assessment Tool for Inpatient Traumatic Intracranial Hemorrhage after Falls in Acute Care Hospital Setting

PubMed Central

Toyabe, Shin-ichi

2012-01-01

Severe injuries such as intracranial hemorrhage (ICH) are the most serious problem after falls in hospital, but they have not been considered in risk assessment scores for falls. We tried to determine the risk factors for ICH after falls in 20,320 inpatients (696,364 patient-days) aged from 40 to 90 years who were admitted to a tertiary-care university hospital. Possible risk factors including STRATIFY risk score for falls and FRAX™ risk score for fractures were analyzed by univariate and multivariate analyses. Fallers accounted for 3.2% of the patients, and 5.0% of the fallers suffered major injuries, including peripheral bone fracture (59.6%) and ICH (23.4%). In addition to STRATIFY, FRAX™ was significantly associated not only with bone fractures but also ICH. Concomitant use of risk score for falls and risk score for fractures might be useful for the prediction of major injuries such as ICH after falls. PMID:22980233

The National Falls and Bone Health Audit: implications for UK emergency care.

PubMed

Banerjee, Jay; Benger, Jonathan; Treml, Jonathan; Martin, Finbarr C; Grant, Rob; Lowe, Derek; Potter, Jonathan; Husk, Janet

2012-10-01

The National Clinical Audit of Falls and Bone Health, coordinated by the Royal College of Physicians, assesses progress in implementing integrated falls services across the UK against national standards and enables benchmarking between service providers. Nationally, falls are a leading contributor towards mortality and morbidity in older people and account for 700,000 visits to emergency departments and 4 million annual bed days in England alone. Two rounds of national organisational audit in 2005 and 2008 and one national clinical audit in 2006 were carried out based on indicators developed by a multidisciplinary group. These showed that management of falls and bone health in older people remains suboptimal in emergency departments and minor injury units and opportunities are being missed in carrying out evidence-based risk assessment and management. Older people attending emergency departments in the UK following a fall are receiving a poor deal. There is an urgent need to ensure more effective assessment and management to prevent further falls and fractures.

Look Forward to Take a Hike Day This Spring | Poster

Cancer.gov

Are you looking forward to spring? Join Occupational Health Services (OHS) and the R&W Club Frederick for the next Take a Hike Day in April. At the fall event, about 30 employees walked or jogged the 1.3-mile course around the NCI at Frederick campus during their lunch hours. The event is designed to encourage employees to engage in physical activity, according to Sarah Hooper, manager of OHS. “It was so wonderful to see employees walking to wellness,” said Emily Burnett, a Werner H. Kirsten student intern in OHS who helped plan the fall event.

Using a Medical Intranet of Things System to Prevent Bed Falls in an Acute Care Hospital: A Pilot Study.

PubMed

Balaguera, Henri U; Wise, Diana; Ng, Chun Yin; Tso, Han-Wen; Chiang, Wan-Lin; Hutchinson, Aimee M; Galvin, Tracy; Hilborne, Lee; Hoffman, Cathy; Huang, Chi-Cheng; Wang, C Jason

2017-05-04

Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital. Patients 18 years and older with a Morse fall score of 45 or greater were recruited from a 35-bed medical-surgical ward in a 317-bed Massachusetts teaching hospital. Eligible patients were recruited between August 4, 2015 and July 31, 2016. Participants received a sensor pad placed between the top of their mattress and bed sheet. The sensor pad was positioned to monitor movement from patients' shoulders to their thighs. The SensableCare System was evaluated for monitoring patient movement and delivering timely alerts to nursing staff via mobile devices when there appeared to be a bed-exit attempt. Sensor pad data were collected automatically from the system. The primary outcomes included number of falls, time to turn off bed-exit alerts, and the number of attempted bed-exit events. Data on patient falls were collected by clinical research assistants and confirmed with the unit nurse manager. Explanatory variables included room locations (zones 1-3), day of the week, nursing shift, and Morse Fall Scale (ie, positive fall history, positive secondary diagnosis, positive ambulatory aid, weak impaired gait/transfer, positive IV/saline lock, mentally forgets limitations). We also assessed user experience via nurse focus groups. Qualitative data regarding staff interactions with the system were collected during two focus groups with 25 total nurses, each lasting approximately 1.5 hours. A total of 91 patients used the system for 234.0 patient-days and experienced no bed falls during the study period. On average, patients were assisted/returned to bed 46 seconds after the alert system was triggered. Response times were longer during the overnight nursing shift versus day shift (P=.005), but were independent of the patient's location on the unit. Focus groups revealed that nurses found the system integrated well into the clinical nursing workflow and the alerts were helpful in patient monitoring. A medical IoT system can be integrated into the existing nursing workflow and may reduce patient bed fall risk in acute care hospitals, a high priority but an elusive patient safety challenge. By using an alerting system that sends notifications directly to nurses' mobile devices, nurses can equally respond to unassisted bed-exit attempts wherever patients are located on the ward. Further study, including a fully powered randomized controlled trial, is needed to assess effectiveness across hospital settings. ©Henri U Balaguera, Diana Wise, Chun Yin Ng, Han-Wen Tso, Wan-Lin Chiang, Aimee M Hutchinson, Tracy Galvin, Lee Hilborne, Cathy Hoffman, Chi-Cheng Huang, C Jason Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.05.2017.

Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention--a randomised controlled trial.

PubMed

Davison, John; Bond, John; Dawson, Pamela; Steen, I Nicholas; Kenny, Rose Anne

2005-03-01

To determine the effectiveness of multifactorial intervention to prevent falls in cognitively intact older persons with recurrent falls. Randomised controlled trial of multifactorial (medical, physiotherapy and occupational therapy) post-fall assessment and intervention compared with conventional care. Accident & Emergency departments in a university teaching hospital and associated district general hospital. 313 cognitively intact men and women aged over 65 years presenting to Accident & Emergency with a fall or fall-related injury and at least one additional fall in the preceding year; 159 randomised to assessment and intervention and 154 to conventional care. primary outcome was the number of falls and fallers in 1 year after recruitment. Secondary outcomes included injury rates, fall-related hospital admissions, mortality and fear of falling. There were 36% fewer falls in the intervention group (relative risk 0.64, 95% confidence interval 0.46-0.90). The proportion of subjects continuing to fall (65% (94/144) compared with 68% (102/149) relative risk 0.95, 95% confidence interval 0.81-1.12), and the number of fall-related attendances and hospital admissions was not different between groups. Duration of hospital admission was reduced (mean difference admission duration 3.6 days, 95% confidence interval 0.1-7.6) and falls efficacy was better in the intervention group (mean difference in Activities Specific Balance Confidence Score of 7.5, 95% confidence interval 0.72-14.2). Multifactorial intervention is effective at reducing the fall burden in cognitively intact older persons with recurrent falls attending Accident & Emergency, but does not reduce the proportion of subjects still falling.

78 FR 19723 - Proposed Collection; 60-Day Comment Request; Evaluation of the Brain Disorders in the Developing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... Comment Request; Evaluation of the Brain Disorders in the Developing World Program of the John E. Fogarty...: Evaluation of the Brain Disorders in the Developing World Program of the John E. Fogarty International Center... Information Collection: This study seeks to evaluate the management, effectiveness, and outcomes of the Brain...

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

PubMed

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

2009-10-01

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

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

PubMed Central

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

2009-01-01

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

Fossil Flora of the John Day Basin, Oregon

USGS Publications Warehouse

Knowlton, Frank Hall

1902-01-01

For a number of years I have been gradually accumulating material for a thorough revision of the Tertiary floras of the Pacific slope. Fossil plants are known to occur at numerous points within this area, and their study and identification has already furnished valuable data bearing on the geological history of the region, and when still further exploited it is confidently expected that they will afford more exact data for the use of geologists. This investigation is progressing satisfactorily, and at no distant day it is hoped to have it in form for final publication. From time to time various members of the United States Geological Survey, as well as others not connected with this organization, have sent in small collections of fossil plants for determination. These have been studied and reported upon as fully as the condition of the problem permitted, so that the determinations could be immediately available to geologists, but with the reservation that none of the questions could be fully settled until all known material had been studied and properly correlated. The rich fossil plant deposits in the John Day Basin, as set forth more fully in the historical account which follows, have been known for a period of nearly fifty years, but their study has been carried on in a more or less desultory manner. There has also been considerable confusion as to the horizons whence these plants came. As various species of plants described originally from the John Day region were detected in various other localities in Oregon, and in surrounding areas, as central Washington, western Idaho, and northern California, it became more than ever apparent that a thorough study of all material obtainable from this type area would be necessary before any definite or satisfactory conclusions could be reached. The immediate incentive for this revision was furnished by the receipt of a considerable collection of plants, made by Dr. John C. Merriam in 1900 while he was in charge of an expedition into this region made under the auspices of the University of California. When these plants were submitted to me for study, it was thought possible to present their description, together with a revision of our knowledge of the previously known forms, within a space sufficiently small to permit the publication of the matter as an appendix to a paper on the general geology of the area, then in preparation by Dr. Merriam. But it soon became apparent that this could not be adequately done within the space available, and a short preliminary report was prepared for and published by Dr. Merriam. The results of a complete restudy of all available fossil plant material from the John Day Basin are now presented. I wish to record my great indebtedness to Dr. Merriam, who not only accompanied me at a considerable personal sacrifice on a trip through the region in 1901, but placed unreservedly at my disposal all material bearing in any way on the problem then in the paleontological museum of the University of California. To Dr. Arthur Hollick I am indebted for the loan of all material from the John Day region belonging to Columbia University, and now deposited in the New York Botanical Garden at Bronx Park. This material, together with the rich collections belonging to the United States National Museum, represents practically all now known to have come from the John Day Basin.

Late summer and fall use of stream margins by young-of year brown trout in a high-elevation stream

USGS Publications Warehouse

La Voie, W. J.; Hubert, W.A.

1997-01-01

We determined the relative abundance of young-of-year (YOY) brown trout (Salmo trutta) from late summer to fall during day and night in stream margin habitats of Douglas Creek, Wyoming. No significant differences in relative abundance were observed from August 14 through October 26. Few YOY brown trout were observed during the day over the entire sampling period, but significantly greater numbers were seen at night. Within stream margins, YOY brown trout of 36-75 mm total length primarily resided in concealment cover among interstices of cobbie during the day and emerged at night. Because no significant change in relative abundance was observed throughout the study period, we conclude that a shift to winter habitat did not occur up until three days prior to ice formation when the diurnal range in water temperature was 2.5-7.5??C.

Food habits of Juvenile American Shad and dynamics of zooplankton in the lower Columbia River

USGS Publications Warehouse

Haskell, C.A.; Tiffan, K.F.; Rondorf, D.W.

2006-01-01

As many as 2.4 million adult American shad annually pass John Day Dam, Columbia River to spawn upriver, yet food web interactions of juvenile shad rearing in John Day Reservoir are unexplored. We collected zooplankton and conducted mid-water trawls in McNary (June-July) and John Day reservoirs (August-November) from 1994 through 1996 during the outmigration of subyearling American shad and Chinook salmon. Juvenile American shad were abundant and represented over 98% of the trawl catch in late summer. The five major taxa collected in zooplankton tows were Bosmina longirostris, Daphnia, cyclopoid cope-pods, rotifers, and calanoid copepods. We evaluated total crustacean zooplankton abundance and Daphnia biomass in relation to water temperature, flow, depth, diel period, and cross-sectional location using multiple regression. Differences in zooplankton abundance were largely due to differences in water temperature and flow. Spatial variation in total zooplankton abundance was observed in McNary Reservoir, but not in John Day Reservoir. Juvenile American shad generally fed on numerically abundant prey, despite being less preferred than larger bodied zooplankton. A decrease in cladoceran abundance and size in August coupled with large percentages of Daphnia in juvenile American shad stomachs indicated heavy planktivory. Smaller juvenile American shad primarily fed on Daphnia in August, but switched to more evasive copepods as the mean size of fish increased and Daphnia abundance declined. Because Daphnia are particularly important prey items for subyearling Chinook salmon in mainstem reservoirs in mid to late summer, alterations in the cladoceran food base is of concern for the management of outmigrating salmonids and other Columbia River fishes. ?? 2006 by the Northwest Scientific Association. All rights reserved.

Water availability and flood hazards in the John Day Fossil Beds National Monument, Oregon

USGS Publications Warehouse

Frank, Frank J.; Oster, E.A.

1979-01-01

The rock formations of the John Day Fossil Beds National Monument area are aquifers that can be expected to yield less than 10 gallons of water per minute to wells. The most permeable of the geologic units is the alluvium that occurs at low elevations along the John Day River and most of the smaller streams. Wells in the alluvial deposits can be expected to yield adequate water supplies for recreational areas; also, wells completed in the underlying bedrock at depths ranging from 50 to 200 feet could yield as much as 10 gallons per minute. Pumping tests on two unused wells indicated yields of 8 gallons per minute and 2 gallons per minute. Nine of the ten springs measured in and near the monument area in late August of 1978 were flowing 0.2 to 30 gallons per minute. Only the Cant Ranch spring and the Johnny Kirk Spring near the Sheep Rock unit had flows exceeding 6 gallons per minute. Chemical analyses of selected constituents of the ground water indicated generally low concentrations of dissolved minerals. Although cloudbursts in the Painted Hills unit could generate a flood wave on the valley floors, flood danger can be reduced by locating recreational sites on high ground. The campground in Indian Canyon of the Clarno unit is vulnerable to cloudburst flooding. About 80 percent of the proposed campground on the John Day River in the Sheep Rock unit is above the estimated level of 1-percent chance flood (100-year flood) of the river. The 1-percent chance flood would extend about 120 feet from the riverbank into the upstream end of the campground. (USGS).

33 CFR 334.500 - St. Johns River, Atlantic Ocean, Sherman Creek; restricted areas and danger zone, Naval Station...

Code of Federal Regulations, 2014 CFR

2014-07-01

... north by Perimeter Road, and on the east by Mayport Road. (5) Danger zone. The danger zone shall... hours a day, seven days a week. Warning signs notifying individuals of the restricted area boundary and... will be in place 24 hours a day, seven days a week. Warning signs notifying individuals of the...

A resolution designating September 23, 2010, as "National Falls Prevention Awareness Day" to raise awareness and encourage the prevention of falls among older adults.

THOMAS, 111th Congress

Sen. Kohl, Herb [D-WI

2010-09-21

Senate - 09/21/2010 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

A resolution designating September 22, 2012, as "National Falls Prevention Awareness Day" to raise awareness and encourage the prevention of falls among older adults.

THOMAS, 112th Congress

Sen. Kohl, Herb [D-WI

2012-09-12

Senate - 09/12/2012 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

A resolution designating September 22, 2013, as "National Falls Prevention Awareness Day" to raise awareness and encourage the prevention of falls among older adults.

THOMAS, 113th Congress

Sen. Nelson, Bill [D-FL

2013-09-19

Senate - 09/19/2013 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

A resolution designating September 23, 2011, as "National Falls Prevention Awareness Day" to raise awareness and encourage the prevention of falls among older adults.

THOMAS, 112th Congress

Sen. Kohl, Herb [D-WI

2011-09-26

Senate - 09/26/2011 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Student Time Usage during Fall Reading Week

ERIC Educational Resources Information Center

Cramer, Ken; Pschibul, Rebecca

2017-01-01

The present study investigated the time usage and levels of perceived stress, academic workload, and recreation time for 177 students at the University of Windsor before, during, and after Fall Reading Week (FRW). Over a three-week span (at various times of the day), students received a message to their smartphone to complete a 20-second survey…

The Annual Condition of Iowa's Community Colleges, 2009

ERIC Educational Resources Information Center

Bassis, Vladimir; Farver, Kent; Schenk, Tom; Varner, Jeremy; Vybiral, Amy

2009-01-01

Each fall, the Iowa Department of Education collects enrollment data from Iowa's community colleges on the 10th business day of the semester. The fall data collection contains data on the 2009-10 academic year (fiscal year 2010). This report is the only report on fiscal year 2010 until next year's "Annual Condition of Iowa's Community…

Enrollment Data: Community Colleges--Day Division. Fall Semester, 1981.

ERIC Educational Resources Information Center

O'Connor, T.

This series of six tables provides fall 1981 data on enrollments in each of the 15 community colleges in Massachusetts and for the system as a whole. Table 1 presents information on the number of freshman, sophomore, and unclassified students who made requests for admission, were qualified applicants, and were notified of admission. In table 2,…

A Multicomponent Fall Prevention Strategy Reduces Falls at an Academic Medical Center.

PubMed

France, Dan; Slayton, Jenny; Moore, Sonya; Domenico, Henry; Matthews, Julia; Steaban, Robin L; Choma, Neesha

2017-09-01

While the reduction in fall rates has not kept pace with the reduction of other hospital-acquired conditions, patient safety research and quality improvement (QI) initiatives at the system and hospital levels have achieved positive results and provide insights into potentially effective risk reduction strategies. An academic medical center developed a QI-based multicomponent strategy for fall prevention and pilot tested it for six months in three high-risk units-the Neuroscience Acute Care Unit, the Myelosuppression/Stem Cell Transplant Unit, and the Acute Care for the Elderly Unit-before implementing and evaluating the strategy hospitalwide. The multicomponent fall strategy was evaluated using a pre-post study design. The main outcome measures were falls and falls with harm measured in events per 1,000 patient-days. Fall rates were monitored and compared for three classes of falls: (1) accidental, (2) anticipated physiologic, and (3) unanticipated physiologic. Statistical process control charts showed that the pilot units had achieved significant reductions in falls with harm during the last five months of data collection. Wald test and segmented regression analyses revealed significant improvements in pooled postintervention fall rates, stratified by fall type. The hospitalwide implementation of the program resulted in a 47% overall reduction in falls in the postintervention period. A fall prevention strategy that targeted the spectrum of risk factors produced measurable improvement in fall rates and rates of patient harm. Hospitals must continue developing, rigorously testing, and sharing their results and experiences in implementing and sustaining multicomponent fall prevention strategies. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke.

PubMed

Goljar, Nika; Globokar, Daniel; Puzić, Nataša; Kopitar, Natalija; Vrabič, Maja; Ivanovski, Matic; Vidmar, Gaj

2016-09-01

To evaluate effectiveness of fall-risk-assessment-based fall prevention for stroke rehabilitation inpatients. A consecutive series of 232 patients admitted for the first time to a subacute stroke-rehabilitation ward during 2010-2011 was studied in detail. The Assessment Sheet for Fall Prediction in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk upon admission. Association of ASFPSI score and patient characteristics with actual falls was statistically tested. Yearly incidence of falls per 1000 hospital days (HD) was retrospectively audited for the 2006-2014 period to evaluate effectiveness of fall-risk reduction measures. The observed incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the fallers fell during the first week after admission. ASFPSI score was not significantly associated with falls. Longer hospital stay, left body-side affected and non-extreme FIM score (55-101) were associated with higher odds of fall. Introduction of fall-risk reduction measures followed by compulsory fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006 to 2.8/1000 HD in 2011 and remaining at that level until 2014. The fall-risk-assessment-based measures appear to have led to decreasing falls risk among post-stroke rehabilitation inpatients classified as being at high risk of falls. The fall prevention programme as a whole was successful. Patients with non-extreme level of functional independence should receive enhanced fall prevention. Implications for Rehabilitation Recognising the fall risk upon the patient's admission is essential for preventing falls in rehabilitation wards. Assessing the fall risk is a team tasks and combines information from various sources. Assessing fall risk in stroke patients using the assessment sheet by Nakagawa et al. immediately upon admission systematically draws attention to the risk of falls in each individual patient.

Association between use of multiple psychoactive medicines and hospitalization for falls: retrospective analysis of a large healthcare claim database.

PubMed

Pratt, Nicole L; Ramsay, Emmae N; Kalisch Ellett, Lisa M; Nguyen, Tuan A; Barratt, John D; Roughead, Elizabeth E

2014-07-01

Little is known about the impact of taking multiple psychoactive medicines on the risk of hospitalization for falls. To identify the association between multiple psychoactive medicine use and hospitalization for falls. A retrospective cohort study was conducted between July 2011 and June 2012 in the Australian veteran population who had been dispensed at least one psychoactive medicine within the previous year. Psychoactive medicines with sedative properties included antipsychotics, anxiolytics, hypnotics, antidepressants, opioids, anti-epileptics, anti-Parkinson medicines and medicines for migraine. The associations between falls and the number of psychoactive medicines used or the number of doses were analysed in comparison with falls that occurred when no psychoactive medicine was used. The adjusted results showed a significantly increased risk of falls when patients were on one or more psychoactive medicines or were receiving 0.1-0.9 defined daily dose (DDD) or more per day. The incident rate ratios (IRRs) were 1.22 (95% confidence interval [CI] 1.08-1.38) for those on one psychoactive medicine, 1.70 (95% CI 1.45-1.99) for those on two, 1.96 (95% CI 1.58-2.43) for those on three or four, and 3.15 (95% CI 1.90-5.23) for those on five or more. A similar result was observed when the data were analysed by dose, with the highest risk being found for those taking three or more DDD per day (adjusted IRR 4.26, 95% CI 2.75-6.58). Increased numbers or increased doses of psychoactive medicines are associated with an increased risk of hospitalization for falls in older adults. Strategies to reduce the psychoactive medicine burden are likely to translate into significant health benefits.

Occupational fall injuries presenting to the emergency department.

PubMed

Son, Hyung Min; Kim, Sun Hyu; Shin, Sang Do; Ryoo, Hyun Wook; Ryu, Hyun Ho; Lee, Ji Ho

2014-04-01

This study was performed to evaluate occupational and fall injuries presenting to the ED, the risk factors associated with falls among all occupational injuries, and factors affecting prognosis. Data from ED-based Occupational Injury Surveillance System were analysed to investigate the occupational injuries. The 2147 occupational injury subjects were divided into two groups: fall (n = 213, 9.9%) and non-fall (n = 1934, 90.1%). Data including baseline and clinical characteristics were compared between the groups. The mean age was older in the fall group (46 vs 42 years old). The rate of construction site-related injury was 32% in the fall group and only 8% in the non-fall group. Injury occurrence during regular working hours (09.00 hours to 18.00 hours) was 70% in the fall group and 57% in the non-fall group. Injury severity using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS) was more severe in the fall group than in the non-fall group, and days away from work were longer in the fall group than the non-fall group. Older age, compared with an age <29 years old and presence in a construction area during regular working hours were factors associated with fall injuries. Factors affecting prolonged absence for work were older age, higher EMR-ISS, fall injury and poor workplace environmental conditions. Risk factors associated with fall-related occupational injuries include older age and being at a construction area during regular working hours. Falls among occupational injuries are more severe than other injuries and result in longer work loss. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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

PubMed

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

2018-01-01

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

Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

PubMed Central

2011-01-01

Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff. Results All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p < 0.01) for a single fall, 15.04 (p < 0.01) for recurrent falls, and 5.05 (p < 0.01) for fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status. Conclusion These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research. PMID:21838891

2010 Stennis Day of Service

NASA Image and Video Library

2010-01-12

Employees at NASA's John C. Stennis Space Center visit exhibits of volunteer organizations during their observance of Martin Luther King Jr. Day with a Day of Service on Jan. 12. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities. The day's focus was emphasized again and again - great things can happen when individuals work together toward a common goal.

2010 Stennis Day of Service

NASA Technical Reports Server (NTRS)

2010-01-01

Employees at NASA's John C. Stennis Space Center visit exhibits of volunteer organizations during their observance of Martin Luther King Jr. Day with a Day of Service on Jan. 12. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities. The day's focus was emphasized again and again - great things can happen when individuals work together toward a common goal.

Disabling occupational injury in the US construction industry, 1996.

PubMed

Courtney, Theodore K; Matz, Simon; Webster, Barbara S

2002-12-01

In 1996 the US construction industry comprised 5.4% of the annual US employment but accounted for 7.8% of nonfatal occupational injuries and illness and 9.7% of cases involving at least a day away from work. Information in the published literature on the disability arising from construction injuries is limited. The construction claims experience (n = 35,790) of a large workers' compensation insurer with national coverage was examined. The leading types and sources of disabling occupational morbidity in 1996 in the US construction industry were identified. Disability duration was calculated from indemnity payments data using previously published methods. The average disability duration for an injured construction worker was 46 days with a median of 0 days. The most frequently occurring conditions were low back pain (14.8%), foreign body eye injuries (8.5%), and finger lacerations (4.8%). Back pain also accounted for the greatest percentage of construction claim costs (21.3%) and disability days (25.5%). However, the conditions with the longest disability durations were sudden-onset injuries, including fractures of the ankle (median = 55 days), foot (42 days), and wrist (38 days). Same-level and elevated falls were the principal exposures for fractures of the wrist and ankle, whereas elevated falls and struck by incidents accounted for the majority of foot fractures. Manual materials handling activities were most often associated with low back pain disability. The results suggest that these most disabling injuries can be addressed by increasing primary prevention resources in slips and falls and exposures related to injuries of sudden-onset as well as in reducing manual materials handling and other exposures associated with more gradual-onset injuries.

Serving Young Learners: Exploring Junior Kindergarten

ERIC Educational Resources Information Center

Lawton, Stephen B.

2012-01-01

Full-day kindergarten programs did not survive the recession in some states, where districts reduced them to half-day programs in light of severe funding cuts. Now, with rising tax revenues and falling unemployment rates, the restoration of full-day kindergarten is back on the agenda. However, now that funds are available, is restoring full-day…

Variation in suicide occurrence by day and during major American holidays.

PubMed

Beauchamp, Gillian A; Ho, Mona L; Yin, Shan

2014-06-01

Due to temporal variations in completed suicides, it has been suggested that impulsivity and environmental factors may influence suicide. Our intent was to determine if particular days of the week, seasons, or holidays were associated with increased attempted and completed suicides by poisoning. All calls recorded in the National Poison Database System coded as "suspected suicide" from 2006 through 2010 were included. Exposures were evaluated by day, season, and holidays, and compared to control dates. There were 1,065,067 exposures (63% female) related to suicide attempts, with completions in 0.4% of cases. Sundays and Mondays for adults, and Mondays and Tuesdays for age < 19 years were the most common. Spring and fall had higher numbers of exposures than summer and winter. New Year's Day had a higher number of exposures, whereas Independence Day, Thanksgiving, and Christmas had fewer exposures. The beginning of the week, spring and fall, and New Year's Day were associated with higher numbers of ingestions with suicidal intent. This has implications for clinicians advising potential victims and providing emergency care for these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk Factors for Falls and Fall-Related Injuries in Adults 85 Years of Age and Older

PubMed Central

Grundstrom, Anna C.; Guse, Clare E.; Layde, Peter M.

2011-01-01

Background Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. Methods We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Results Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65–84 years of age. Conclusions Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. PMID:21862143

Risk factors for falls and fall-related injuries in adults 85 years of age and older.

PubMed

Grundstrom, Anna C; Guse, Clare E; Layde, Peter M

2012-01-01

Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65-84 years of age. Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A qualitative description of falls in a neuro-rehabilitation unit: the use of a standardised fall report including the International Classification of Functioning (ICF) to describe activities and environmental factors.

PubMed

Saverino, Alessia; Moriarty, Amy; Rantell, Khadija; Waller, Denise; Ayres, Rachael; Playford, Diane

2015-01-01

Falls are a recognised problem for people with long-term neurological conditions but less is known about fall risk in young adults. This study describes fallers' and falls' characteristics in adults less than 60 years old, in a neuro-rehabilitation unit. This single-centre, longitudinal, observational study included 114 consecutive admissions to a UK neuro-rehabilitation unit over 20 months. The demographic and clinical characteristics of eligible patients included age, sex, diagnosis, hospital length of stay and the Functional Independence Measure (FIM). Falls were recorded prospectively in a fall report, using the activities and environmental domains of the International Classification of Functioning (ICF). A total of 34 (30%) patients reported a fall, with 50% experiencing more than one fall. The majority of falls (60%) occurred during the first 2 weeks, during day-time (90%) and during mobile activities (70%). Overall, falls rate (95% confidence interval) was 1.33 (1.04 to 1.67) per 100 d of patient hospital stay. Factors associated with increased falls included becoming a walker during admission or being cognitively impaired. There were no serious fall-related injuries. The first 2 weeks of admission is a high risk time for fallers, in particular those who become walkers or are cognitively impaired. Prevention policies should be put in place based on fall characteristics. Implications for Rehabilitation The ICF is a valuable instrument for describing subject and environmental factors during a fall-event. Falls are frequent events but do not usually cause serious injuries during inpatient rehabilitation. There is an increased fall risk for subjects with cognitive impairments or those relearning how to walk.

Falls among union carpenters.

PubMed

Lipscomb, Hester J; Li, Leiming; Dement, John M

2003-08-01

Falls are a leading cause of morbidity and mortality in the construction trades. We identified a cohort of 16,215 active union carpenters, hours worked, and their workers' compensation claims for a 10-year period. The data on this well-defined cohort were used to describe their work-related falls; to define rates of injury and the associated costs; and to identify high-risk groups. Same level falls occurred at a rate of 1.8/200,000 hours worked; falls from elevations at a rate of 2.3/200,000 hours worked. These injuries resulted in direct payments of 0.30 dollars per hour of work or 2.40 dollars per 8-hr day. Mean costs per fall increased with increasing age. Age was not associated with risk of falls from elevations; younger carpenters had modestly reduced rates of falls from the same level. Rates of falls decreased with increasing time in the union. Carpenters whose usual work involved drywall installation or residential work were at highest risk. Falls are a significant public health risk for carpenters and they are responsible for a significant burden of work-related injury costs. While there is a need for prevention of falls from elevations--through training, enforcement of fall protection regulations, improved safety climate, or engineering changes--there is also the need to prevent falls from lower elevations. Differences in risk likely reflect varying exposures and safety practices in different areas of carpentry, as well as training, experience, and job assignments based on longevity in the union. Copyright 2003 Wiley-Liss, Inc.

Critical Materials Needs

DTIC Science & Technology

1975-08-11

Desulfurization of flue gases from electric power plants Arthur J. Coyle Walter E. Chapin John B. Day John T. Herridge Victor Levin James...45 High-Temperature Gas -Turbine Engines for Automotive Applications 60 Fuel Cel13 76 Lasers for Communications and Materials Processing 97...Relationship for a Regenerative Gas -Turbine Engine 61 Relative Raw Materials Cost 61 Proposed Milestone Chart ERDA/AAPS Ceramic Mate- rials and

KSC-02pp1751

NASA Image and Video Library

2002-11-10

KENNEDY SPACE CENTER, FLA. -- The Chickasaw Dance Troupe performs an Honor Dance for John Herrington's parents during the Native American Ceremony at the Rocket Garden in the KSC Visitor Complex. The ceremony was part of several days' activities commemorating John B. Herrington as the first tribally enrolled Native American astronaut to fly on a Shuttle mission. Herrington is a Mission Specialist on STS-113.

STS-95 Day 08 Highlights

NASA Technical Reports Server (NTRS)

1998-01-01

On this eighth day of the STS-95 mission, the flight crew, Cmdr. Curtis L. Brown, Pilot Steven W. Lindsey, Mission Specialists Scott E. Parazynski, Stephen K. Robinson, and Pedro Duque, and Payload Specialists Chiaki Mukai and John H. Glenn, continue to perform microgravity experiments. Specialist John Glenn completes a back-pain questionnaire as part of a study of how the muscle, intervertebral discs and bone marrow change due to microgravity. The results will then be compared with data provided by astronauts during previous missions. Glenn continues blood sample analysis and blood processing that are part of the Protein Turnover (PTO) experiment, which is studying the muscle loss that occurs during space flight.

STS-95 Day 02 Highlights

NASA Technical Reports Server (NTRS)

1998-01-01

On this second day of the STS-95 mission, the flight crew, Cmdr. Curtis L. Brown, Pilot Steven W. Lindsey, Mission Specialists Scott E. Parazynski, Stephen K. Robinson, and Pedro Duque, and Payload Specialists Chiaki Mukai and John H. Glenn, are seen preparing a glovebox device in the middeck area of Discovery, an enclosed research facility that will support numerous science investigations throughout the mission. Payload Specialist John Glenn, activates the Microgravity Encapsulation Process experiment (MEPS). This experiment will study the formation of capsules containing two kinds of anti-tumor drugs that could be delivered directly to solid tumors with applications for future chemotherapy treatments and the pharmaceutical industry.

Cost-effectiveness of vitamin D supplementation and exercise in preventing injurious falls among older home-dwelling women: findings from an RCT.

PubMed

Patil, R; Kolu, P; Raitanen, J; Valvanne, J; Kannus, P; Karinkanta, S; Sievänen, H; Uusi-Rasi, K

2016-01-01

This study assessed the cost-effectiveness of vitamin D supplementation and exercise, separately and combined, in preventing medically attended injurious falls among older home-dwelling Finnish women. Given a willingness to pay of €3,000 per injurious fall prevented, the exercise intervention had an 86 % probability of being cost-effective in this population. The costs of falling in older persons are high, both to the individual and to society. Both vitamin D and exercise have been suggested to reduce the risk of falls. This study assessed the cost-effectiveness of vitamin D supplementation and exercise, separately and combined, in preventing medically attended injurious falls among older Finnish women. Economic evaluation was based on the results of a previously published 2-year randomized controlled trial (RCT) where 409 community-dwelling women aged 70 to 80 years were recruited into four groups: (1) no exercise + placebo (D-Ex-), (2) no exercise + vitamin D 800 IU/day (D+Ex-), (3) exercise + placebo (D-Ex+), and (4) exercise + vitamin D 800 IU/day (D+Ex+). The outcomes were medically attended injurious falls and fall-related health care utilization costs over the intervention period, the latter evaluated from a societal perspective based on 2011 unit costs. Incremental cost-effectiveness ratios (ICER) were calculated for the number of injurious falls per person-year prevented and uncertainty estimated using bootstrapping. Incidence rate ratios (95 % CI) for medically attended injurious falls were lower in both Ex+ groups compared with D-Ex-: 0.46 (0.22 to 0.95) for D-Ex+, 0.38 (0.17 to 0.81) for D+Ex+. Step-wise calculation of ICERs resulted in exclusion of D+Ex- as more expensive and less effective. Recalculated ICERs were €221 for D-Ex-, €708 for D-Ex+, and €3,820 for D+Ex+; bootstrapping indicated 93 % probability that each injurious fall avoided by D-Ex+ per person year costs €708. At a willingness to pay €3,000 per injurious fall prevented, there was an 85.6 % chance of the exercise intervention being cost-effective in this population. Exercise was effective in reducing fall-related injuries among community-dwelling older women at a moderate cost. Vitamin D supplementation had marginal additional benefit. The results provide a firm basis for initiating feasible and cost-effective exercise interventions in this population.

Exploring the feasibility and acceptability of sensor monitoring of gait and falls in the homes of persons with multiple sclerosis.

PubMed

Newland, Pamela; Wagner, Joanne M; Salter, Amber; Thomas, Florian P; Skubic, Marjorie; Rantz, Marilyn

2016-09-01

Gait parameters variability and falls are problems for persons with MS and have not been adequately captured in the home. Our goal was to explore the feasibility and acceptability of monitoring of gait and falls in the homes of persons with MS over a period of 30 days. To test the feasibility of measuring gait and falls for 30days in the home of persons with MS, spatiotemporal gait parameters stride length, stride time, and gait speed were compared. A 3D infrared depth imaging system has been developed to objectively measure gait and falls in the home environment. Participants also completed a 16-foot GaitRite electronic pathway walk to validate spatiotemporal parameters of gait (gait speed (cm/s), stride length (cm), and gait cycle time(s)) during the timed 25 foot walking test (T25FWT). We also documented barriers to feasibility of installing the in-home sensors for these participants. The results of the study suggest that the Kinect sensor may be used as an alternative device to measure gait for persons with MS, depending on the desired accuracy level. Ultimately, using in-home sensors to analyze gait parameters in real time is feasible and could lead to better analysis of gait in persons with MS. Copyright © 2016 Elsevier B.V. All rights reserved.

FOREIGN LANGUAGE ENROLLMENTS IN SEVENTH-DAY ADVENTIST AND CATHOLIC PAROCHIAL SECONDARY SCHOOLS, FALL, 1959.

ERIC Educational Resources Information Center

Modern Language Association of America, New York, NY. Foreign Language Program Research Center.

THIS ENROLLMENT SURVEY OF FOREIGN LANGUAGE STUDY IN RELIGIOUS SECONDARY SCHOOLS IS THE COMPANION PIECE TO FIVE OTHERS CONDUCTED BY THE MODERN LANGUAGE ASSOCIATION IN THE FALL TERM OF 1959, THE TERM SELECTED AS THE NORM FOR FUTURE CALCULATIONS. THE INTRODUCTORY SURVEY OF THE GROSS NATIONAL PICTURE WITH AN ANALYSIS OF ATTRITION AMONG FOREIGN…

The effects of bedtime writing on difficulty falling asleep: A polysomnographic study comparing to-do lists and completed activity lists.

PubMed

Scullin, Michael K; Krueger, Madison L; Ballard, Hannah K; Pruett, Natalya; Bliwise, Donald L

2018-01-01

Bedtime worry, including worrying about incomplete future tasks, is a significant contributor to difficulty falling asleep. Previous research showed that writing about one's worries can help individuals fall asleep. We investigated whether the temporal focus of bedtime writing-writing a to-do list versus journaling about completed activities-affected sleep onset latency. Fifty-seven healthy young adults (18-30) completed a writing assignment for 5 min prior to overnight polysomnography recording in a controlled sleep laboratory. They were randomly assigned to write about tasks that they needed to remember to complete the next few days (to-do list) or about tasks they had completed the previous few days (completed list). Participants in the to-do list condition fell asleep significantly faster than those in the completed-list condition. The more specifically participants wrote their to-do list, the faster they subsequently fell asleep, whereas the opposite trend was observed when participants wrote about completed activities. Therefore, to facilitate falling asleep, individuals may derive benefit from writing a very specific to-do list for 5 min at bedtime rather than journaling about completed activities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

John Bell (1763-1820): brother artist and anatomist.

PubMed

Gardner-Thorpe, Christopher

2013-01-01

John Bell, brother-surgeon of Charles Bell, was, like Charles, an outstanding surgeon and a good artist. John was one of the few who illustrated his work with their own drawings in the days before audiovisual aids were available and without the benefit of reliable drawing aids, photography and computer-aided design. Charles, on the other hand, was the better artist and illustrated much of the normal anatomy of the nervous system. Each brother undertook extensive surgery of men who had been wounded in war; John Bell left us his engravings from the textbooks, more numerous perhaps than Charles, but Charles left us a series of oil paintings and watercolours in addition to the illustrations in his textbooks. © 2013 Elsevier B.V. All rights reserved.

Association between Sleep Duration and Injury from Falling among Older Adults: A Cross-Sectional Analysis of Korean Community Health Survey Data

PubMed Central

Noh, Jin-Won; Kim, Kyoung-Beom; Lee, Ju Hyun; Lee, Yejin; Lee, Byeong-Hui

2017-01-01

Purpose While sleeping problems increase with advancing age, there are inherent differences in sleep between males and females. Previous studies have shown inconsistent results of the relationship between sleep duration and risk of injury from falling. While controlling various sociodemographic and health-related factors, national representative data were used in order to analyze the association between sleep duration and injury from falling among older adults. Materials and Methods The data were obtained from the Korean Community Health Survey of 2011. A total of 55654 individuals aged 65 years and older participated in the study. Multivariable logistic regression analysis was conducted to identify the factors associated with injury from falling. Results After adjusting for covariates, such as age, sex, marital status, whether or not an individual is a recipient of benefits from the National Basic Livelihood Act, hypertension, diabetes mellitus, dyslipidemia, stress level, and self-rated health status, those who slept five hours or less per day [odds ratio (OR)=1.26; 95% confidence interval (CI)=1.18–1.34; p<0.001] or eight hours or more per day (OR=1.11; 95% CI=1.04–1.17; p=0.001) presented significantly higher ORs for injury from falling. A similar result was found when we conducted stratification by sex. Conclusion The current study supports that there is a relationship between short sleep duration and injury from falling and also identified a marginal risk of long sleep in older adults. Therefore, sleep management in older adults with inadequate sleep duration may be necessary. PMID:29047248

Injury to endoscopic personnel from tripping over exposed cords, wires, and tubing in the endoscopy suite: a preventable cause of potentially severe workplace injury.

PubMed

Cappell, Mitchell S

2010-04-01

BACKGROUND The endoscopy unit before remediation may be a high-risk area for slip and fall injuries due to a large number of exposed above-the-floor wires in the endoscopy rooms, dimmed lighting during endoscopic procedures, and staff inattention to obstacles due to preoccupation with the endoscopic patient. AIM To describe a novel, previously unappreciated workplace hazard to endoscopic personnel: Exposed wires in the endoscopy unit.METHODS This study is a retrospective review of 110,000 endoscopic procedures performed during the last 5 years at an academic, teaching hospital with a high-volume endoscopy unit. All significant orthopedic injuries to endoscopic personnel from slips, twists, and falls from tripping over exposed cords in the endoscopy unit were reviewed. The severity of injury was documented based on roentgenographic findings, number of days of missed work, number of days with a modified work schedule, and requirement for orthopedic surgery. The number of potentially exposed cords per endoscopy room was determined. RESULTS During the 5-year study period, three endoscopic personnel suffered significant orthopedic injuries from slips, twists, and falls from tripping over cords, wires, or tubing lying exposed over the floor in the endoscopy suite: The resulting injuries consisted of fourth and fifth metacarpal hand fractures due to a fall after tripping on oxygen tubing; a rib fracture due to tripping on electrical wires trailing from an endoscopy cart; and a grade II ankle sprain due to the foot becoming entangled in oxygen tubing. All injuries resulted in lost days of work [mean 9.3 +/- 11.0 (SD) days] and in additional days of restricted work (mean 41.7 +/- 31.8 days). One injury required orthopedic surgery. Hospital review revealed a mean of 35.3 +/- 7.5 cords, wires, or tubing per endoscopy procedure room, the majority of which were exposed above the floor before remediation (n = 10 rooms). Remediation of exposed wires included: bundling related wires together in a cable to reduce the number of independent wires, covering exposed wires on the floor with a nonslip heavy mat, and running wires from ceiling outlets to equipment high above ground (e.g. mounted endoscopy video monitors). CONCLUSIONS Tripping, slipping, and falling over exposed wires can cause significant injury to endoscopic personnel. This previously undescribed hazard should be preventable by simple remediation, and all endoscopic personnel, hospital architects, hospital administrators, and governmental regulators should be alerted to this potential hazard

Can volunteer companions prevent falls among inpatients? A feasibility study using a pre-post comparative design

PubMed Central

Giles, Lynne C; Bolch, Denise; Rouvray, Robyn; McErlean, Beth; Whitehead, Craig H; Phillips, Paddy A; Crotty, Maria

2006-01-01

Background Falls in hospital are frequent and their consequences place an increased burden on health services. We evaluated a falls prevention strategy consisting of the introduction of volunteers to 'sit' with patients identified as being at high risk of falling. Methods Two four bed 'safety bays' located on medical wards in two hospitals within southern Adelaide were used. Ward fall rates (expressed as falls per 1000 occupied bed days) were compared in the baseline period (February-May 2002) with the implementation period (February – May 2003) using incident rate ratios and 95% confidence intervals. The number of hours of volunteered time was also collected. Results No patient falls occurred on either site when volunteers were present. However, there was no significant impact on overall ward fall rates. In the baseline period, there were 70 falls in 4828 OBDs (14.5 falls per 1000 OBDs). During the implementation period, there were 82 falls in 5300 OBDs (15.5 falls per 1000 OBD). The IRR for falls in the implementation versus baseline period was 1.07 (95%CI 0.77 – 1.49; P = 0.346). Volunteers carried out care activities (e.g. cutting up food), provided company, and on occasions advocated on behalf of the patients. Volunteers donated 2345 hours, at an estimated value to the hospitals of almost $57,000. Conclusion Volunteers may play an important and cost-effective role in enhancing health care and can prevent falls in older hospital patients when they are present. Full implementation of this program would require the recruitment of adequate numbers of volunteers willing to sit with all patients considered at risk of falling in hospital. The challenge for future work in this area remains the sustainability of falls prevention strategies. PMID:16895609

Can volunteer companions prevent falls among inpatients? A feasibility study using a pre-post comparative design.

PubMed

Giles, Lynne C; Bolch, Denise; Rouvray, Robyn; McErlean, Beth; Whitehead, Craig H; Phillips, Paddy A; Crotty, Maria

2006-08-09

Falls in hospital are frequent and their consequences place an increased burden on health services. We evaluated a falls prevention strategy consisting of the introduction of volunteers to 'sit' with patients identified as being at high risk of falling. Two four bed 'safety bays' located on medical wards in two hospitals within southern Adelaide were used. Ward fall rates (expressed as falls per 1000 occupied bed days) were compared in the baseline period (February-May 2002) with the implementation period (February - May 2003) using incident rate ratios and 95% confidence intervals. The number of hours of volunteered time was also collected. No patient falls occurred on either site when volunteers were present. However, there was no significant impact on overall ward fall rates. In the baseline period, there were 70 falls in 4828 OBDs (14.5 falls per 1000 OBDs). During the implementation period, there were 82 falls in 5300 OBDs (15.5 falls per 1000 OBD). The IRR for falls in the implementation versus baseline period was 1.07 (95%CI 0.77 - 1.49; P = 0.346). Volunteers carried out care activities (e.g. cutting up food), provided company, and on occasions advocated on behalf of the patients. Volunteers donated 2345 hours, at an estimated value to the hospitals of almost $57,000. Volunteers may play an important and cost-effective role in enhancing health care and can prevent falls in older hospital patients when they are present. Full implementation of this program would require the recruitment of adequate numbers of volunteers willing to sit with all patients considered at risk of falling in hospital. The challenge for future work in this area remains the sustainability of falls prevention strategies.

An efficient multistage algorithm for full calibration of the hemodynamic model from BOLD signal responses.

PubMed

Zambri, Brian; Djellouli, Rabia; Laleg-Kirati, Taous-Meriem

2017-11-01

We propose a computational strategy that falls into the category of prediction/correction iterative-type approaches, for calibrating the hemodynamic model. The proposed method is used to estimate consecutively the values of the two sets of model parameters. Numerical results corresponding to both synthetic and real functional magnetic resonance imaging measurements for a single stimulus as well as for multiple stimuli are reported to highlight the capability of this computational methodology to fully calibrate the considered hemodynamic model. Copyright © 2017 John Wiley & Sons, Ltd.

Differential Equations Course Module for the Superior Student - Curriculum Development

DTIC Science & Technology

1987-04-01

13,14 25 Numerical 39 Explore 12 15 26 Project Lab 40 40 13 18 27 Explore 41 41 14 17 28 29 42 42 Table 3. Corresponding Lessons From Basic Math 245...for Math 245". USAFA/DFMS Letter, June 1986. Other Sources 12 . Cass, John R., MaJ, USAF. Assistant Professor of Mathematical Sciences, Department of...39 Exploration Work: 40 4.6 Convolution Integral Work: 1, 3, 12 41 GRADED REVIEW III REVIEW 42 Review/Critique 25 -’." .. ~ MATH 245A HANDOUT FALL

Dombeck Receives 2006 F. L. Scarf Award

NASA Astrophysics Data System (ADS)

2006-11-01

John Dombeck has been awarded the F. L. Scarf Award, which is given annually to a recent Ph.D. recipient for outstanding dissertation research that contributes directly to solar-planetary sciences. Dombeck's thesis is entitled ``Properties of Alfvén waves in the magnetotail below 9 RE and their relation to auroral acceleration and major geomagnetic storms.'' He will be formally presented with the award during the 2006 AGU Fall Meeting, which will be held 11-15 December in San Francisco, Calif., at the Space Physics and Aeronomy Section dinner.

Strategic Studies Quarterly. Volume 4, Number 3, Fall 2010

DTIC Science & Technology

2010-01-01

Tokyo to the Nuclear Arsenals of Russia (New York: Crown Publishers, 1996 ), 108–12. 32. Lt Col John Kane, USMC, has been of good help in tracking the...Psychology 70, no. 2 (February 1996 ). 26. As Siebold and Lindsay put it, “A central tenet of current [1999] personnel policy is that the Army can recruit 17...Military (Chicago: University of Chicago Press, 1996 ), 166. 29. Om Prakash, “The Efficacy of ‘Don’t Ask, Don’t Tell’,” Joint Force Quarterly 55 (4th

Fiber Supplements: Are They Safe to Take Every Day?

MedlinePlus

... be sure to drink plenty of fluids every day. With Michael F. Picco, M.D. Duyff RL. Carbs. In: American Dietetic Association Complete Food and Nutrition Guide. 4th ed. Hoboken, N.J.: John Wiley & Sons; 2012. Slavin JL. Position of ...

[Posture and gait disorders and the incidence of falling in patients with Parkinson].

PubMed

Cano-de la Cuerda, R; Macías-Jiménez, A I; Cuadrado-Pérez, M L; Miangolarra-Page, J C; Morales-Cabezas, M

Although falls are one of the main causes of morbidity and mortality in patients with Parkinson's disease, studies about its incidence and predicting factors are scarce. Our study involved 25 patients with PD (15 males and 10 females; age: 75.8 +/- 6.5 years). A closed survey was used to determine a retrospective record of falls during the last year. An analysis was performed to examine whether there was a relationship with Hoehn and Yahr staging, the score on the Up and Go scale or the Barthel index and with possible risk factors for falls. All the patients had suffered falls at some time over the last year (mean number of falls: 6.5 +/- 3.8). 56% of the falls happened during the phases of the day when patient mobility was at its highest. A significant correlation was found between the number of falls and the Hoehn and Yahr and the Up and Go scores. The number of falls was significantly higher in patients with loss of postural reflexes, the need for help in order to walk, and blockage and festination phenomena. No association was found with fear of falling, visual alterations or postural lateralisation. Association with the Barthel index and dependence for activities of daily living reached almost significant levels. Postural instability and disorders affecting gait appear to be the factors that give patients with PD a greater propensity to fall. Patients who present such alterations should be submitted to rehabilitation therapy aimed at preventing them from falling.

STS-29 Pilot Blaha with SE83-9 "Chix in Space" incubator on OV-103's middeck

NASA Image and Video Library

1989-03-16

STS029-01-001 (16 Marach 1989) --- Astronaut John E. Blaha, STS-29 pilot, checks an incubator on the mid deck of Earth-orbiting Discovery during Flight Day 4 activity. The incubator is part of a student involvement program experiment titled, "Chicken Embryo Development in Space." The student experimenter is John C. Vellinger. The experiment's sponsor is Kentucky Fried Chicken. This photographic frame was among NASA's third STS-29 photo release. Monday, March 20, 1989. Crewmembers were Astronauts Michael L. Coats, John E. Blaha, James F. Buchli, Robert C. Springer and James P. Bagian.

Rural Folklife Days: Resources for Teachers.

ERIC Educational Resources Information Center

Kay, Jon, Ed.; Beasley, Holly, Ed.; Hollingsworth, Teresa, Ed.; Smith, KC, Ed.

Rural Folklife Days is an annual celebration of customs and crafts that have been practiced every fall by generations of people in rural areas of north Florida. This packet is designed to help teachers prepare elementary students for Rural Folklife Days and to introduce them to traditional crafts and arts that are still practiced in parts of north…

Risk factors for unintentional injuries due to falls in children aged 0–6 years: a systematic review

PubMed Central

Khambalia, A; Joshi, P; Brussoni, M; Raina, P; Morrongiello, B; Macarthur, C

2006-01-01

Objective To identify risk factors for unintentional injuries due to falls in children aged 0–6 years. Design A systematic review of the literature. Methods Electronic databases from 1966 to March 2005 were comprehensively searched to identify empirical research that evaluated risk factors for unintentional injuries due to falls in children aged 0–6 years and included a comparison group. Results 14 studies met the inclusion criteria. Studies varied by the type of fall injury that was considered (ie, bunk bed, stairway, playground or infant walker) and with respect to the quality of evidence. In general, major risk factors for the incidence or severity of injuries due to falls in children included age of the child, sex, height of the fall, type of surface, mechanism (dropped, stairway or using a walker), setting (day care v home care) and socioeconomic status. Conclusion Despite a high burden, few controlled studies have examined the risk and protective factors for injuries due to falls in children aged 0–6 years. The only study to examine falls from a population health perspective suggests that age, sex and poverty are independent risk factors for injuries due to falls in children. PMID:17170185

John Moser’s search for small and “mitey” things

Treesearch

James Barnett; Stacy Blomquist

2013-01-01

In the basement of the Alexandria Forestry Center in Pineville works a scientist who many consider eccentric and few understand what he does, but most know that he works every work day and most weekends as a volunteer even though he retired from the Forest Service's Southern Research Station for nearly 25 years. The scientist, John Moser, has taken a path less...

Activities commemorating John B. Herrington as first Native American astronaut

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- Chickasaw Indian princesses seen here contributed to a pre-launch Native American ceremony at the Rocket Garden in the KSC Visitor Complex by leading a prayer. The ceremony was part of several days' activities commemorating John B. Herrington as the first tribally enrolled Native American astronaut to fly on a Shuttle mission. Herrington is a Mission Specialist on STS-113.

Efficacy of the Otago Exercise Programme to reduce falls in community-dwelling adults aged 65-80 years old when delivered as group or individual training.

PubMed

Albornos-Muñoz, Laura; Moreno-Casbas, María Teresa; Sánchez-Pablo, Clara; Bays-Moneo, Ana; Fernández-Domínguez, Juan Carlos; Rich-Ruiz, Manuel; Gea-Sánchez, Montserrat

2018-04-06

This study will compare how falls can be reduced in non-institutionalized older Spanish adults aged 65-80 years by providing group or individual exercise sessions using the Otago Exercise Programme. The Otago Exercise Programme is a progressive home-based exercise programme, where trained health professionals help people engage in strength, balance and endurance exercises. Its format is based on the evidence from four clinical trials. The benefits of the Otago Exercise Programme are the same for people who have and have not suffered falls and it can also be used for visually impaired people. A multicentre, simply blinded, randomized, non-inferiority clinical trial, with two arms-group training and individual training-that started in January 2017 and will continue until December 2019. Each study group has 364 subjects, who will take part in four individual or group sessions delivered mainly by nurses over an 8-week period, with a reinforcement session 6 months later. Data will be collected at baseline and after 6 and 12 months. The fall percentage will be the most relevant clinical variable and we will also consider safety, viability, compliance, economic analysis and therapeutic value. Approval and funding was granted in December 2016 for this 3-year study by the Spanish Health Research Fund (PI16CIII/00031). Older people from 65-80 years old tend to be more isolated and tackling worries about falls can improve social activities and independence. It has been shown that group training provides better adherence to exercise than individual training and this study will test that hypothesis for the Otago Exercise Programme. © 2018 John Wiley & Sons Ltd.

The interrater and test-retest reliability of the Home Falls and Accidents Screening Tool (HOME FAST) in Malaysia: Using raters with a range of professional backgrounds.

PubMed

Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin; Clemson, Lindy

2017-06-01

Falls can be a devastating issue for older people living in the community, including those living in Malaysia. Health professionals and community members have a responsibility to ensure that older people have a safe home environment to reduce the risk of falls. Using a standardised screening tool is beneficial to intervene early with this group. The Home Falls and Accidents Screening Tool (HOME FAST) should be considered for this purpose; however, its use in Malaysia has not been studied. Therefore, the aim of this study was to evaluate the interrater and test-retest reliability of the HOME FAST with multiple professionals in the Malaysian context. A cross-sectional design was used to evaluate interrater reliability where the HOME FAST was used simultaneously in the homes of older people by 2 raters and a prospective design was used to evaluate test-retest reliability with a separate group of older people at different times in their homes. Both studies took place in an urban area of Kuala Lumpur. Professionals from 9 professional backgrounds participated as raters in this study, and a group of 51 community older people were recruited for the interrater reliability study and another group of 30 for the test-retest reliability study. The overall agreement was moderate for interrater reliability and good for test-retest reliability. The HOME FAST was consistently rated by different professionals, and no bias was found among the multiple raters. The HOME FAST can be used with confidence by a variety of professionals across different settings. The HOME FAST can become a universal tool to screen for home hazards related to falls. © 2017 John Wiley & Sons, Ltd.

Effect of Fear of Falling on Turning Performance in Parkinson's Disease in the Lab and at Home.

PubMed

Haertner, Linda; Elshehabi, Morad; Zaunbrecher, Laura; Pham, Minh H; Maetzler, Corina; van Uem, Janet M T; Hobert, Markus A; Hucker, Svenja; Nussbaum, Susanne; Berg, Daniela; Liepelt-Scarfone, Inga; Maetzler, Walter

2018-01-01

Background: Parkinson's disease (PD) is a neurodegenerative movement disorder associated with gait and balance problems and a substantially increased risk of falling. Falls occur often during complex movements, such as turns. Both fear of falling (FOF) and previous falls are relevant risk factors for future falls. Based on recent studies indicating that lab-based and home assessment of similar movements show different results, we hypothesized that FOF and a positive fall history would influence the quantitative turning parameters differently in the laboratory and home. Methods: Fifty-five PD patients (43 underwent a standardized lab assessment; 40 were assessed over a mean of 12 days at home with approximately 10,000 turns per participant; and 28 contributed to both assessments) were classified regarding FOF and previous falls as "vigorous" (no FOF, negative fall history), "anxious" (FOF, negative fall history), "stoic" (no FOF, positive fall history) and "aware" (FOF, positive fall history). During the assessments, each participant wore a sensor on the lower back. Results: In the lab assessment, FOF was associated with a longer turning duration and lowered maximum and middle angular velocities of turns. In the home evaluations, a lack of FOF was associated with lowered maximum and average angular velocities of turns. Positive falls history was not significantly associated with turning parameters, neither in the lab nor in the home. Conclusion: FOF but not a positive fall history influences turning metrics in PD patients in both supervised and unsupervised environments, and this association is different between lab and home assessments. Our findings underline the relevance of comprehensive assessments including home-based data collection strategies for fall risk evaluation.

Assessment of reproductive effects in largemouth bass (Micropterus salmoides) exposed to bleached/unbleached kraft mill effluents

USGS Publications Warehouse

Sepulveda, M.S.; Ruessler, D.S.; Denslow, N.D.; Holm, S.E.; Schoeb, T.R.; Gross, T.S.

2001-01-01

This study evaluated the potential effects of different concentrations of bleached/unbleached kraft mill effluent (B/UKME) on several reproductive endpoints in adult largemouth bass (Micropterus salmoides). The kraft mill studied produces a 50/50 mix of bleached/unbleached market pulp with an estimated release of 36 million gal of efffluent/day. Bleaching sequences were C90d10EopHDp and CEHD for softwood (pines) and hardwoods (mainly tupelo, gums, magnolia, and water oaks), respectively. Bass were exposed to different effluent concentrations (0 [controls, exposed to well water], 10, 20, 40, or 80%) for either 28 or 56 days. At the end of each exposure period, fish were euthanized, gonads collected for histological evaluation and determination of gonadosomatic index (GSI), and plasma was analyzed for 17??-estradiol, 11-ketotestosterone, and vitellogenin (VTG). Largemouth bass exposed to B/UKME responded with changes at the biochemical level (decline in sex steroids in both sexes and VTG in females) that were usually translated into tissue/organ-level responses (declines in GSI in both sexes and in ovarian development in females). Although most of these responses occurred after exposing fish to 40% B/UKME concentrations or greater, some were observed after exposures to 20% B/UKME. These threshold concentrations fall within the 60% average yearly concentration of effluent that exists in the stream near the point of discharge (Rice Creek), but are above the <10% effluent concentration present in the St. Johns River. The chemical(s) responsible for such changes as well as their mode(s) of action remain unknown at this time.

Assessment of reproductive effects in largemouth bass (Micropterus salmoides) exposed to bleached/unbleached kraft mill effluents.

PubMed

Sepúlveda, M S; Ruessler, D S; Denslow, N D; Holm, S E; Schoeb, T R; Gross, T S

2001-11-01

This study evaluated the potential effects of different concentrations of bleached/unbleached kraft mill effluent (B/UKME) on several reproductive endpoints in adult largemouth bass (Micropterus salmoides). The kraft mill studied produces a 50/50 mix of bleached/unbleached market pulp with an estimated release of 36 million gal of effluent/day. Bleaching sequences were C90d10EopHDp and CEHD for softwood (pines) and hardwoods (mainly tupelo, gums, magnolia, and water oaks), respectively. Bass were exposed to different effluent concentrations (0 [controls, exposed to well water], 10, 20, 40, or 80%) for either 28 or 56 days. At the end of each exposure period, fish were euthanized, gonads collected for histological evaluation and determination of gonadosomatic index (GSI), and plasma was analyzed for 17beta-estradiol, 11-ketotestosterone, and vitellogenin (VTG). Largemouth bass exposed to B/UKME responded with changes at the biochemical level (decline in sex steroids in both sexes and VTG in females) that were usually translated into tissue/organ-level responses (declines in GSI in both sexes and in ovarian development in females). Although most of these responses occurred after exposing fish to 40% B/UKME concentrations or greater, some were observed after exposures to 20% B/UKME. These threshold concentrations fall within the 60% average yearly concentration of effluent that exists in the stream near the point of discharge (Rice Creek), but are above the <10% effluent concentration present in the St. Johns River. The chemical(s) responsible for such changes as well as their mode(s) of action remain unknown at this time.

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

PubMed Central

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

2012-01-01

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

Testing of a long-term fall detection system incorporated into a custom vest for the elderly.

PubMed

Bourke, Alan K; van de Ven, Pepijn W J; Chaya, Amy E; OLaighin, Gearóid M; Nelson, John

2008-01-01

A fall detection system and algorithm, incorporated into a custom designed garment has been developed. The developed fall detection system uses a tri-axial accelerometer to detect impacts and monitor posture. This sensor is attached to a custom designed vest, designed to be worn by the elderly person under clothing. The fall detection algorithm was developed and incorporates both impact and posture detection capability. The vest and fall algorithm was tested by two teams of 5 elderly subjects who wore the sensor system in turn for 2 week each and were monitored for 8 hours a day. The system previously achieved sensitivity of >90% and a specificity of >99%, using young healthy subjects performing falls and normal activities of daily living (ADL). In this study, over 833 hours of monitoring was performed over the course of the four weeks from the elderly subjects, during normal daily activity. In this time no actual falls were recorded, however the system registered a total of the 42 fall-alerts however only 9 were received at the care taker site. A fall detection system incorporated into a custom designed garment has been developed which will help reduce the incidence of the long-lie, when falls occur in the elderly population. However further development is required to reduce the number of false-positives and improve the transmission of messages.

2010 Stennis Day of Service

NASA Image and Video Library

2010-01-12

Rich Delgado, commanding officer of the Fleet Survey Team located at NASA's John C. Stennis Space Center, visits with Kertrina Watson Lewis, executive director of the HandsOn volunteer organization in New Orleans, during Day of Service activities Jan. 12. The Day of Service was part of the annual Martin Luther King Jr. Day observance at Stennis. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities.

2010 Stennis Day of Service

NASA Technical Reports Server (NTRS)

2010-01-01

Rich Delgado, commanding officer of the Fleet Survey Team located at NASA's John C. Stennis Space Center, visits with Kertrina Watson Lewis, executive director of the HandsOn volunteer organization in New Orleans, during Day of Service activities Jan. 12. The Day of Service was part of the annual Martin Luther King Jr. Day observance at Stennis. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities.

Falling PC Solitaire Cards: An Open-Inquiry Approach

ERIC Educational Resources Information Center

Gonzalez-Espada, Wilson J.

2012-01-01

Many of us have played the PC Solitaire game that comes as standard software in many computers. Although I am not a great player, occasionally I win a game or two. The game celebrates my accomplishment by pushing the cards forward, one at a time, falling gracefully in what appears to look like a parabolic path in a drag-free environment. One day,…

26 CFR 1.441-2 - Election of taxable year consisting of 52-53 weeks.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... For this purpose, a 52-53-week taxable year beginning on any of the days from June 25 to July 4... day of the week; and (iii) Ends always on— (A) Whatever date this same day of the week last occurs in a calendar month; or (B) Whatever date this same day of the week falls that is the nearest to the...

26 CFR 1.441-2 - Election of taxable year consisting of 52-53 weeks.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... For this purpose, a 52-53-week taxable year beginning on any of the days from June 25 to July 4... always on the same day of the week; and (iii) Ends always on— (A) Whatever date this same day of the week last occurs in a calendar month; or (B) Whatever date this same day of the week falls that is the...

Evaluation of dynamic balance among community-dwelling older adult fallers: a generalizability study of the limits of stability test.

PubMed

Clark, S; Rose, D J

2001-04-01

To establish reliability estimates of the 75% Limits of Stability Test (75% LOS test) when administered to community-dwelling older adults with a history of falls. Generalizability theory was used to estimate both the relative contribution of identified error sources to the total measurement error and generalizability coefficients. A random effects repeated-measures analysis of variance (ANOVA) was used to assess consistency of LOS test movement variables across both days and targets. A motor control research laboratory in a university setting. Fifty community-dwelling older adults with 2 or more falls in the previous year. Spatial and temporal measures of dynamic balance derived from the 75% LOS test included average movement velocity, maximum center of gravity (COG) excursion, end-point COG excursion, and directional control. Estimated generalizability coefficients for 2 testing days ranged from.58 to.87. Total variance in LOS test measures attributable to inconsistencies in day-to-day test performance (Day and Subject x Day facets) ranged from 2.5% to 8.4%. The ANOVA results indicated that no significant differences were observed in the LOS test variables across the 2 testing days. The 75% LOS test administered to older adult fallers on 2 consecutive days provides consistent and reliable measures of dynamic balance.

[Sleep structure instability in healthy men under conditions of 105-day isolation experiment "Mars-105"].

PubMed

Kovrov, G V; Posokhov, S I; Posokhov, S S; Zavalko, I M; Ponomareva, I P

2013-01-01

Night-to-night stability of falling asleep and duration of wakefulness in the sleep was studied in six healthy male subjects under conditions of 105-day isolation experiment "Mars-105". Polysomnography records were carried out in each subject during five nights taken in regular intervals within the experiment. Three subjects demonstrated high stability of falling asleep and wakefulness in sleep (group I), whereas in the remaining three subjects stability of these characteristics was low (group [I). Delta-sleep was shown to be deepened in subjects of group II (significant prevalence of stage 4 (47.3 min) over stage 3 (32.9 min)). In subjects of group I, the duration of stage 3 was 44.9 min and that of stage 4 was 26.6 min. We suggest that night-to-night instability of falling asleep and duration of wakefulness in sleep in combination with delta sleep is the special individual form of sleep adaptation to conditions of chronic isolation stress.

M.I.T./Canadian vestibular experiments on the Spacelab-1 mission: 3. Effects of prolonged weightlessness on a human otolith-spinal reflex

NASA Technical Reports Server (NTRS)

Watt, D. G.; Money, K. E.; Tomi, L. M.

1986-01-01

Reflex responses that depend on human otolith organ sensitivity were measured before, during and after a 10 day space flight. Otolith-spinal reflexes were elicited by means of sudden, unexpected falls. In weightlessness, "falls" were achieved using elastic cords running from a torso harness to the floor. Electromyographic (EMG) activity was recorded from gastrocnemius-soleus. The EMG response occurring in the first 100-120 ms of a fall, considered to be predominantly otolith-spinal in origin, decreased in amplitude immediately upon entering weightlessness, and continued to decline throughout the flight, especially during the first two mission days. The response returned to normal before the first post-flight testing session. The results suggest that information coming from the otolith organs is gradually ignored by the nervous system during prolonged space flight, although the possibility that otolith-spinal reflexes are decreased independent of other otolith output pathways cannot be ruled out.

M.I.T./Canadian vestibular experiments on the Spacelab-1 mission. III - Effects of prolonged weightlessness on a human otolith-spinal reflex

NASA Technical Reports Server (NTRS)

Watt, D. G. D.; Money, K. E.; Tomi, L. M.

1986-01-01

Reflex responses that depend on human otolith organ sensitivity were measured before, during and after a 10 day space flight. Otolith-spinal reflexes were elicited by means of sudden, unexpected falls. In weightlessness, 'falls' were achieved using elastic cords running from a torso harness to the floor. Electromyographic (EMG) activity was recorded from gastrocnemius-soleus. The EMG response occurring in the first 100-120 ms of a fall, considered to be predominantly otolith-spinal in origin, decreased in amplitude immediately upon entering weightlessness, and continued to decline throughout the flight, especially during the first two mission days. The response returned to normal before the first post-flight testing session. The results suggest that information coming from the otolith organs is gradually ignored by the nervous system during prolonged space flight, although the possibility that otolith-spinal reflexes are decreased independent of other otolith output pathways cannot by ruled out.

Biorack

NASA Image and Video Library

1997-01-12

STS081-E-05094 (12 Jan. 1997) --- Astronauts Peter J. K. (Jeff) Wisoff (left) and John M. Grunsfeld, mission specialists, deploy two Passive Thermal Conditioning Units (PTCU) onboard the SPACEHAB Double Module (DM) late on Day 1 of the mission. The two units had been transported by the pair through the tunnel connecting SPACEHAB and the mid-deck of crew cabin of the Space Shuttle Atlantis. They are joined by four other NASA astronauts for the almost ten-day mission. The crew is scheduled to dock with Russia's Mir Space Station and pick up John E. Blaha, NASA astronaut who has been serving as a cosmonaut guest researcher since September 1996. Jerry M. Linenger (out of frame) will replace Blaha onboard Mir.

The amount of television that infants and their parents watched influenced children's viewing habits when they got older.

PubMed

Chiu, Yu-Chan; Li, Yi-Fan; Wu, Wen-Chi; Chiang, Tung-Liang

2017-06-01

Excessive television (TV) exposure has negative impacts on a child's development, health and behaviour. This study examined the under-researched area of what impact infant and parental TV viewing during a child's infancy had on the child's later viewing habits. Data on 18 577 babies born in 2005 were collected from the Taiwan Birth Cohort Study, a prospective longitudinal study of a nationally representative cohort. Group-based trajectory analysis was conducted to identify childhood TV viewing trajectories at 18, 36 and 66 months of age. Multinomial logistic regression was used to examine the influence of parents' TV behaviour on their children's TV viewing trajectories. The percentage of children falling into the TV viewing trajectories that were identified were low (20%), increasing (46.5%) and high (33.5%). The child's TV viewing trajectory was significantly associated with the child's sex, parent's monthly household income, child's day care arrangements, maternal and paternal education, maternal and paternal TV viewing time and whether the child's TV viewing time was restricted. The amount of TV that children watched when they were older was associated with a range of factors, and the results particularly highlight the need to restrict child and parental viewing time in infancy. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Blood pressure and falls in community-dwelling people aged 60 years and older in the VHM&PP cohort.

PubMed

Klein, Diana; Nagel, Gabriele; Kleiner, Andrea; Ulmer, Hanno; Rehberger, Barbara; Concin, Hans; Rapp, Kilian

2013-05-21

Falls are one of the major health problems in old people. Different risk factors were identified but only few epidemiological studies analysed the influence of conventionally measured blood pressure on falls. The objective of our study was to investigate the relationship between systolic and diastolic blood pressure and falls. In 3,544 community-dwelling Austrian women and men aged 60 years and older, data on falls within the previous three months were collected by questionnaire. Blood pressure was measured by general practitioners within the Vorarlberg Health Monitoring and Prevention Programme (VHM&PP) 90 to 1095 days before the fall assessment. A multiple logistic regression analysis was conducted. The models were stratified by gender and adjusted by age, number of medical conditions and subjective feeling of illness. In total, 257 falls in 3,544 persons were reported. In women, high systolic and diastolic blood pressure was associated with a decreased risk of falls. An increase of systolic blood pressure by 10 mmHg and of diastolic blood pressure by 5 mmHg reduced the risk of falling by 9% (OR 0.91, 95% Cl 0.84-0.98) and 8% (OR 0.92, 95% Cl 0.85-0.99), respectively. In men, an increased risk of falls was observed in participants with low systolic or low diastolic blood pressure. Blood pressure was associated with the risk of falls. Hypertensive values decreased the risk in women and low blood pressure increased the risk in men.

Dual-stiffness flooring: can it reduce fracture rates associated with falls?

PubMed

Knoefel, Frank; Patrick, Louise; Taylor, Jodie; Goubran, Rafik

2013-04-01

Falls cause significant morbidity and mortality in long term care facilities. Dual-stiffness flooring (DSF) has previously shown promise in reducing such morbidity in experimental models. This study set out to measure the impact of SmartCell flooring on falls-related morbidity in a nursing home. All falls occurring at an Arizona nursing home between July 1, 2008, and December 31, 2010, were reviewed for age, sex, diagnosis of osteoporosis, number of medications, history of previous falls, type of flooring (normal vs DSF), time of day, type of injury, and resulting actions. Fall-related outcomes were compared across room types using chi-square and logistic regression methods. Eighty-two falls on the DSF were compared with 85 falls on the regular floor. There was a tendency for residents falling on DSF to have less bruising and abrasions, while having more redness and cuts. There were 2 fractures on regular flooring (2.4% fracture rate) and none on the DSF flooring (0% fracture rate). The fracture rate of 2.4% of falls on the regular floor is consistent with previous reports in the literature, whereas a 0% rate found on the DSF floor is a clinically significant improvement. This suggests that DSF may be a practical approach for institutions and consumers to reduce fall-related injuries. A larger scale controlled study to confirm these encouraging preliminary findings is warranted. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2014-01-01

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

Epidemiology of falls in older adults in Texas.

PubMed

Alamgir, Hasanat; Wong, Nicole J; Hu, Yueha; Yu, Mo; Marshall, Amanda; Yu, Shicheng

2015-02-01

The expected increase in the US older adult population implies an increased risk of fall-related injury among these individuals. We describe the epidemiology of fall morbidity among older adults in Texas, a large US state with a diverse population base. Texas Behavioral Risk Factor Surveillance System 2010 data were analyzed. The falls outcome was defined as falling: any fall in the past 3 months and a serious fall: a fall resulting in limited activities for at least 1 day or requiring medical attention. A total of 5996 subjects were included in this analysis; 17.6% (n = 1055) reported falling 1 to 5 times in the previous 3 months, and 361 (6%) experienced serious falls. Risk of falling had a significant positive association among respondents who rated their general health as fair to poor (relative risk [RR] 2.39, 95% confidence interval [CI] 1.55-3.68) and a negative association for those who reported regular physical activity (RR 0.59, 95% CI 0.42-0.82). A similar model examined the risk of serious falls and found statistically positive associations in respondents who reported fair or poor general health (RR 3.29, 95% CI 2.00-5.43). Negative associations were found for those who reported regular physical activity (RR 0.56, 95% CI 0.38-0.83) and for men (RR 0.62, 95% CI 0.39-0.98). No statistically significant correlations for either of the fall outcomes were found with residence, obesity, education, income, age, ethnicity, employment, marital status, diabetes mellitus, or cardiovascular disease. Interventions aimed at the prevention of falls should focus on maintaining and improving general health and promoting physical activity among older adults.

Trends in fall-related hospital admissions in older persons in the Netherlands.

PubMed

Hartholt, Klaas A; van der Velde, Nathalie; Looman, Caspar W N; van Lieshout, Esther M M; Panneman, Martien J M; van Beeck, Ed F; Patka, Peter; van der Cammen, Tischa J M

2010-05-24

Fall-related injuries, hospitalizations, and mortality among older persons represent a major public health problem. Owing to aging societies worldwide, a major impact on fall-related health care demand can be expected. We determined time trends in numbers and incidence of fall-related hospital admissions and in admission duration in older adults. Secular trend analysis of fall-related hospital admissions in the older Dutch population from 1981 through 2008, using the National Hospital Discharge Registry. All fall-related hospital admissions in persons 65 years or older were extracted from this database. Outcome measures were the numbers, and the age-specific and age-adjusted incidence rates (per 10,000 persons) of fall-related hospital admissions in each year of the study. From 1981 through 2008, fall-related hospital admissions increased by 137%. The annual age-adjusted incidence growth was 1.3% for men vs 0.7% for women (P < .001). The overall incidence rate increased from 87.7 to 141.2 per 10,000 persons (an increase of 61%). Age-specific incidence increased in all age groups, in both men and women, especially in the oldest old (>75 years). Although the incidence of fall-related hospital admissions increased, the total number of fall-related hospital days was reduced by 20% owing to a reduction in admission duration. In the Netherlands, numbers of fall-related hospital admissions among older persons increased drastically from 1981 through 2008. The increasing fall-related health care demand has been compensated for by a reduced admission duration. These figures demonstrate the need for implementation of falls prevention programs to control for increases of fall-related health care consumption.

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

PubMed Central

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

2014-01-01

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

The predictive value of fall assessment tools for patients admitted to hospice care.

PubMed

Patrick, Rebecca J; Slobodian, Dana; Debanne, Sara; Huang, Ying; Wellman, Charles

2017-09-01

Fall assessment tools are commonly used to evaluate the likelihood of fall. For patients found to be at high risk, patient-specific fall prevention interventions are implemented. The purposes of this study were to describe the population, evaluate and compare the efficacy of fall assessment tools, and suggest the best use for these tools in hospice. Data were downloaded from the electronic medical record for all patients who were admitted to and died in hospice care in 2013. Variables included demographic, clinical and initial fall assessment scores that had been computed on admission to hospice care, using our standard fall assessment tool. To facilitate comparison among three tools, additional fall assessment calculations were made for each patient using the Morse Fall Scale and MACH-10, two tools commonly used in a variety of healthcare settings. Data were available for 3446 hospice patients. Female patients were less likely to fall than males; Fallers lived longer than Nonfallers; and patients with a primary dementia diagnosis fell 10 days sooner than those with a primary non-dementia diagnosis. A comparison of three fall assessment tools revealed that no tool had a good positive predictive value, but each demonstrated a good negative predictive value. Fall assessment scores should not be used as the sole predictor of likelihood of fall, and are best used as a supplement to clinical judgement. Patients with a primary dementia diagnosis are likely to fall earlier in their hospice care than those with other primary diagnoses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Airway responsiveness to mannitol 24 h after allergen challenge in atopic asthmatics.

PubMed

Davis, B E; Amakye, D O; Cockcroft, D W

2015-06-01

Airway responsiveness to indirect stimuli correlates positively with airway inflammation. In atopic asthmatics, allergen inhalation is associated with an influx of inflammatory cells and increased responsiveness to the direct-acting stimuli methacholine at 3 and 24 h after exposure. We have shown mannitol responsiveness decreases 3 h after allergen inhalation. The current investigation assessed mannitol responsiveness 24 h after allergen challenge. Eleven mild atopic asthmatics completed allergen challenges on two separate occasions. In random order, methacholine or mannitol challenges were performed 24 h pre- and post-allergen challenge. Levels of fractional exhaled nitric oxide were also measured. Allergen challenge increased airway responsiveness to methacholine 24 h postchallenge; the geometric mean (95% CI) methacholine PC20 decreased from 5.9 mg/ml (1.8-19.4) to 2.2 mg/ml (0.81-5.89); P = 0.01. This coincided with a significant increase (P = 0.02) in FeNO levels. Conversely, allergen challenge decreased airway responsiveness to mannitol; geometric mean (95% CI) dose-response ratio was significantly higher after allergen exposure (57 mg/% FEV1 fall [27-121] to 147 mg/% FEV1 fall [57-379]; P = 0.03), and FeNO levels were not significantly increased (P = 0.054). Allergen-induced changes in airway responsiveness to direct and indirect stimuli are markedly different. The loss in responsiveness to mannitol is likely not explainable by a refractory state. The effect(s) of allergen exposure on airway responsiveness to indirect-acting stimuli require further investigation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Patterns of mandible fracture in children under 12 years in a district trauma center in India.

PubMed

Namdev, Ritu; Jindal, Ayushi; Bhargava, Smriti; Dutta, Samir; Singhal, Parul; Grewal, Priyanka

2016-02-01

This study aims to present the data of mandibular fracture among children in the age group of 0-12 years treated in a district trauma center in India. Sixty-two children younger than 12 years treated for mandibular fractures over two-and-a-half-year period were studied by age, gender, anatomic site, etiology, socioeconomic status, residing area, interval from trauma to reporting, and treatment performed. The cases were divided into three age groups, and the records of the patients were analyzed. The male to female ratio was 1.58:1. Common fall and fall from bike together was a cause for injury in 50% (31 patients), of total patients. Condylar fractures occurred in 25 patients (40.3%). Multiple fractures were seen in 13% of the patients. In 47 (75.8%) patients, associated injuries other than the mandibular fractures were also present. Most patients with mandibular fractures were treated by closed reduction (36 patients, 58%). Conservative treatment and open reduction were done in 18 (29%) and 8 (13%) patients, respectively. In addition to factors such as age, gender, etiology, anatomic site, and treatment of mandibular fracture, this study also reported statistics regarding other factors such as residing area, socioeconomic status, and interval from trauma to reporting in Indian patients. It is hoped that the data presented here will be valuable to the government agencies and healthcare professionals for planning treatment, recommending preventive measures and encouraging research in this area. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

40 CFR 124.20 - Computation of time.

Code of Federal Regulations, 2012 CFR

2012-07-01

... scheduled to begin on the occurrence of an act or event shall begin on the day after the act or event. (b) Any time period scheduled to begin before the occurrence of an act or event shall be computed so that the period ends on the day before the act or event. (c) If the final day of any time period falls on a...

40 CFR 124.20 - Computation of time.

Code of Federal Regulations, 2014 CFR

2014-07-01

... scheduled to begin on the occurrence of an act or event shall begin on the day after the act or event. (b) Any time period scheduled to begin before the occurrence of an act or event shall be computed so that the period ends on the day before the act or event. (c) If the final day of any time period falls on a...

40 CFR 124.20 - Computation of time.

Code of Federal Regulations, 2010 CFR

2010-07-01

... scheduled to begin on the occurrence of an act or event shall begin on the day after the act or event. (b) Any time period scheduled to begin before the occurrence of an act or event shall be computed so that the period ends on the day before the act or event. (c) If the final day of any time period falls on a...

40 CFR 124.20 - Computation of time.

Code of Federal Regulations, 2013 CFR

2013-07-01

... scheduled to begin on the occurrence of an act or event shall begin on the day after the act or event. (b) Any time period scheduled to begin before the occurrence of an act or event shall be computed so that the period ends on the day before the act or event. (c) If the final day of any time period falls on a...

40 CFR 124.20 - Computation of time.

Code of Federal Regulations, 2011 CFR

2011-07-01

... scheduled to begin on the occurrence of an act or event shall begin on the day after the act or event. (b) Any time period scheduled to begin before the occurrence of an act or event shall be computed so that the period ends on the day before the act or event. (c) If the final day of any time period falls on a...

5 CFR 610.406 - Holiday for employees on compressed work schedules.

Code of Federal Regulations, 2010 CFR

2010-01-01

... number of hours of the compressed work schedule on that day. (b) If a part-time employee is relieved or... of the compressed work schedule on that day. When a holiday falls on a nonworkday of a part-time... work schedules. (a) If a full-time employee is relieved or prevented from working on a day designated...

[Ascites and hematuria after falling in an alcoholic patient].

PubMed

Bürkner, A; Neuhaus, V; Schöb, O

2010-02-03

Isolated ruptures of the urinary bladder following minor traumas are a rare abdominal lesion. Diagnosis and treatment are a challenge to emergency physicians and surgeons. This case shows a 46-year-old patient admitted for a minor brain injury after falling during an episode of alcoholic intoxication. Ultrasound and CT scan of the abdomen showed intraabdominal fluid without a parenchymatous lesion. Also a hematuria was significant. The retrograde cystography showed intraabdominal contrast agent. The rupture of the urinary bladder was confirmed by laparoscopy and was intracorporal sutured in double layer technique. Without any postoperative complications the patient was discharged after 4 days. The retrograde cystography after 10 days showed no leckage and the urinary catheter could be removed.

Trauma caused by falling objects at construction sites.

PubMed

Atique, Sajid; Zarour, Ahmad; Siddiqui, Tariq; El-Menyar, Ayman; Maull, Kimball; Al Thani, Hassan; Latifi, Rifat

2012-09-01

Workplace-related injuries carry a significant health care challenge. The state of Qatar is developing rapidly, with much construction and an expanding industrial work force. This study aimed to assess the incidence and social impact of work-related injuries requiring hospitalization caused by falling objects at the construction sites. We performed a prospective study for all admissions, which resulted from falling objects between January 2008 and June 2010 at the only trauma center in the state of Qatar. Data were analyzed, and outcomes were described (mortality, length of hospital stay, and safety measures). Of the total injured patients (N = 4,302) admitted between January 2008 and June 2010, 185 (4%) had injuries caused purely by falling objects. Patients' mean age was 29 years, and 97% of the patients were men. All injuries occurred at construction sites. Most patients (86%) were brought by ambulance, and the reminder was brought by private vehicles. After initial evaluation and resuscitation, 120 patients (65%) were found to have a single-system injury, and 65 (35%) had multisystem injury. Operative interventions were required in 50% of the patients. Mean length of hospital stay varied from 6.5 days for single-system injuries to 19 days for multisystem injuries. Safety devices were used in 32 patients (17.3%). All of the 16 mortality cases (8.6%) were reported in multiple injuries. Traumatic injury caused by falling object represents a significant problem in a rapidly developing country. Many of these injuries could be prevented by following established safety guidelines. Epidemiologic study, level III.

Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty.

PubMed

Ravi, Bheeshma; Nan, Zhang; Schwartz, Adam J; Clarke, Henry D

2017-07-01

Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall. This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge. Of 2437 eligible TJA recipients, there were 226 (9.3%) patients who had a score ≥6. These patients were more likely to have an unplanned readmission (unadjusted odds ratio 2.84, 95% confidence interval 1.70-4.76, P < .0001), were more likely to have a length of stay >3 days (49.6% vs 36.6%, P = .0001), and were less likely to be sent home after discharge (20.8% vs 35.8%, P < .0001). The effect of a score ≥6 on readmission remained significant (adjusted odds ratio 2.44, 95% confidence interval 1.44-4.13, P = .0009) after controlling for age, paralysis, and the presence of a major psychiatric disorder. Increased Hendrich fall risk score after TJA is strongly associated with unplanned readmission. Application of this tool will allow hospitals to identify these patients and plan their discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

The influence of quarantine on reproductive cycling in wild-caught Baboons (Papio anubis).

PubMed

Liechty, Emma R; Wang, Diane Y; Chen, Emily; Chai, Daniel; Bell, Jason D; Bergin, Ingrid L

2015-12-01

Stress impacts nonhuman primate menstrual cycle length but the impact of quarantine is unknown. A retrospective analysis was performed on cycle data from 31 wild-caught baboons during and following quarantine. Cycling initiated in 94 days (19-181) and length normalized within 4-6 cycles. Quarantine significantly impacts menstrual cycle length. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Accelerating our Second Transformation. 2010 Annual Report

DTIC Science & Technology

2010-01-01

Practice,” by Robert Tremaine and Donna Seligman “Adaptation of Porter’s Five Forces Model to Risk Management,” by John Rice Defense AT&L Magazine The...Stan Rosen John Sarakatsannis Donna Seligman Marty Sherman Steve Skotte Woody Spring Robert Tremaine (Team Lead) Denise Wheaton Andy Zaleski Goal 4...DoD Acquisition Insight Days Conference Team Paul Brierley Bernadette Crumb Linda Perry Susan Shirey Matthew Snedeker Jonathan Specht Jeffrey Tkach

Activities commemorating John B. Herrington as first Native American astronaut

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- Chickasaw Tribal Elder Lee Frazier leads the dedication to the astronauts of STS-113 during the Native American Ceremony at the Rocket Garden in the KSC Visitor Complex. The ceremony was part of several days' activities commemorating John B. Herrington as the first tribally enrolled Native American astronaut to fly on a Shuttle mission. Herrington is a Mission Specialist on STS-113.

Astronaut John H. Casper, mission commander, has finished the final touches of suit donning and

NASA Technical Reports Server (NTRS)

1996-01-01

STS-77 TRAINING VIEW --- Astronaut John H. Casper, mission commander, has finished the final touches of suit donning and awaits the beginning of a training session for emergency bailout. All six crew members participated in the session, held in the Johnson Space Centers (JSC) Weightless Environment Training Facility (WET-F). The six astronauts will spend nine days aboard the Space Shuttle Endeavour next month.

Activities commemorating John B. Herrington as first Native American astronaut

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. - Chickasaw Indian princesses 'sign' the Lord's Prayer during a Native American Ceremony at the Rocket Garden in the KSC Visitor Complex. The princesses are Crystal Underwood, Julie Underwood and Tamela Alexander. The ceremony was part of several days' activities commemorating John B. Herrington as the first tribally enrolled Native American astronaut to fly on a Shuttle mission. Herrington is a Mission Specialist on STS-113.

Commercial Practices as Applied to Total Asset Visibility

DTIC Science & Technology

2003-12-01

Defense Technical Information Center 8725 John J. Kingman Road, Suite 0944 Ft. Belvoir, VA 22060-6218 DISCLAIMER This Technical Report is published...visibility," says John Coburn, retired four-star commanding general of the United States Army, materiel command, an operation that supports the Army...would still take an additional three days for maintenance personnel to get their hands on it). This outsourcing phenomenon is common at most Air Force

Successful hyperbaric oxygen therapy for refractory BK virus-associated hemorrhagic cystitis after cord blood transplantation.

PubMed

Hosokawa, K; Yamazaki, H; Nakamura, T; Yoroidaka, T; Imi, T; Shima, Y; Ohata, K; Takamatsu, H; Kotani, T; Kondo, Y; Takami, A; Nakao, S

2014-10-01

BK virus-associated hemorrhagic cystitis (BKV-HC) is a common and major cause of morbidity in recipients of allogeneic hematopoietic stem cell transplantation. A 32-year-old woman developed severe BKV-HC on day 24 after cord blood transplantation (CBT). Despite supportive therapies - such as hyperhydration, forced diuresis, and urinary catheterization - macroscopic hematuria and bladder irritation persisted for over a month. Hyperbaric oxygen (HBO) therapy at 2.1 atmospheres for 90 min per day was started on day 64 after CBT. Macroscopic hematuria resolved within a week, and microscopic hematuria was no longer detectable within 2 weeks. Hematuria did not recur after 11 sessions of HBO therapy, and no significant side effects were observed during or after treatment. HBO therapy could thus be useful in controlling refractory BKV-HC after CBT. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

STS-77 Flight Day 6

NASA Technical Reports Server (NTRS)

1996-01-01

On this sixth day of the STS-77 mission, the flight crew, Cmdr. John H. Casper, Pilot Curtis L. Brown, Jr., and Mission Specialists Andrew S.W. Thomas, Ph.D., Daniel W. Bursch, Mario Runco, Jr., and Marc Garneau, Ph.D., spend some time relaxing, then go back to working in the Spacehab module and preparing to revisit a small cylindrical satellite that they deployed on the mission's third day. Commander John Casper and Pilot Curt Brown monitor Endeavour's systems. Mission Specialist Mario Runco tests an attitude determination system using the GPS attitude and navigation experiment called GANE. The remaining crew members, Mission Specialists Andy Thomas, Dan Bursch and Marc Garneau monitor the health of experiments ongoing in the Spacehab and on the middeck of the orbiter. The crew also conduct a health check of the Aquatic Research Facility (ARF) which contains starfish, mussels and sea urchins.

Predation by Resident Fish on Juvenile Salmonids in John Day Reservoir: Final Report, 1983-1986: Volume 1, Final Report of Research.

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

Poe, Thomas P.; Rieman, Bruce E.

1988-07-01

In 1982 the NPPC included in its Fish and Wildlife Program a measure that called for studies ''... to investigate juvenile salmon and steelhead losses to predators while these fish are migrating through Columbia and Snake River reservoirs.'' In the same year the Bonneville Power Administration (BPA) funded ODFW and FWS to conduct collaborative studies to estimate the number of juvenile salmonids lost to predators in John Day Reservoir. Also included as study objectives were: (1) a description of the importance of predation losses relative to mortality at the dam and total reservoir mortality; (2) a description of how predationmore » losses might vary (spatially and temporally); and (3) recommendations of measures to control predation on smolts. We studied four species of predator: northern squawfish, walleye, smallmouth bass, and channel catfish. We selected John Day Reservoir as the study site because the following factors led us to believe if predation was a problem in any reservoir, it would be most obvious there because: (1) the reservoir is an important subyearling chinook rearing area; (2) passage and residualism of juvenile salmonids were considered a problem there; and (3) substantial populations of predators were known to reside in the reservoir. Individual reports were processed separately for the data base.« less

The recent fall in postperinatal mortality in New Zealand and the Safe Sleep programme.

PubMed

Mitchell, Edwin A; Cowan, Stephanie; Tipene-Leach, David

2016-11-01

Postneonatal mortality rates changed very little from 2000 until recently. There has been a decrease in mortality in New Zealand from 2009 to 2015. This study describes an infant Safe Sleep programme and postulates it is the cause for the recent decrease in deaths. The Safe Sleep programme involved as follows: a focus on preventing accidental suffocation, a 'blitz' approach to SUDI education, the targeted provision of portable infant Safe Sleep devices (ISSD) and the development of Safe Sleep policy across all district health boards (DHBs). Participation in the education 'blitz' by health professionals exceeded one in 23 live births, distribution of Safe Sleep leaflets exceeded two for every live birth, and over 16 500 ISSDs have been distributed to vulnerable infants. Postperinatal mortality fell 29% from 2009 to 2015 (2.8 to 2.0/1000 live births). The fall has been greatest for Māori and in regions with the most intensive programmes. The recent fall in postperinatal mortality has not happened by chance. It is likely that the components of end-stage prevention strategy, a focus on preventing accidental suffocation, the education 'blitz', the targeted supply of ISSDs and strengthened health policy, have all contributed to varying degrees. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Health Disparities by Income in Spain Before and After the Economic Crisis.

PubMed

Coveney, Max; García-Gómez, Pilar; Van Doorslaer, Eddy; Van Ourti, Tom

2016-11-01

Little is known about how health disparities by income change during times of economic crisis. We apply a decomposition method to unravel the contributions of income growth, income inequality and differential income mobility across socio-demographic groups to changes in health disparities by income in Spain using longitudinal data from the Survey of Income and Living Conditions for the period 2004-2012. We find a modest rise in health inequality by income in Spain in the 5 years of economic growth prior to the start of the crisis in 2008, but a sharp fall after 2008. The drop mainly derives from the fact that loss of employment and earnings has disproportionately affected the incomes of the younger and healthier groups rather than the (mainly stable pension) incomes of the groups over 65 years. This suggests that unequal distribution of income protection by age may reduce health inequality in the short run after an economic recession. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Effect of essential oil concentration on the pH of nutrient and Iso-sensitest broth.

PubMed

Hood, J R; Cavanagh, H M A; Wilkinson, J M

2004-11-01

The role of pH on the antimicrobial activity of essential oils has not been well studied. The effect of four essential oils: Backhousia citriodora, Melaleuca alternifolia, Lavandula angustifolia and Santalum spicatum (0.1% to 10%) on the pH of two commonly used media, nutrient broth and Iso-sensitest broth, was therefore undertaken. Small (less than 0.5 pH units) but statistically significant differences between the pH of the two media followed the addition of M. alternifolia, L. angustifolia and S. spicatum essential oil. In general the effect on pH was greatest at higher concentrations and the fall in pH was greatest in the nutrient broth. The addition of B. citriodora essential oil to nutrient broth resulted in a fall in pH from 7.29 +/- 0.02 (no oil) to 5.2 +/- 0.03 (10% oil). This effect was not observed in the Iso-sensitest broth. Copyright 2004 John Wiley & Sons, Ltd.

Computational Fluid Dynamics Modeling of the John Day Dam Tailrace

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

Rakowski, Cynthia L.; Perkins, William A.; Richmond, Marshall C.

US Army Corps of Engineers - Portland District required that a two-dimensional (2D) depth-averaged and a three-dimensional (3D) free-surface numerical models to be developed and validated for the John Day tailrace. These models were used to assess potential impact of a select group of structural and operational alternatives to tailrace flows aimed at improving fish survival at John Day Dam. The 2D model was used for the initial assessment of the alternatives in conjunction with a reduced-scale physical model of the John Day Project. A finer resolution 3D model was used to more accurately model the details of flow inmore » the stilling basin and near-project tailrace hydraulics. Three-dimensional model results were used as input to the Pacific Northwest National Laboratory particle tracking software, and particle paths and times to pass a downstream cross section were used to assess the relative differences in travel times resulting from project operations and structural scenarios for multiple total river flows. Streamlines and neutrally-buoyant particles were seeded in all turbine and spill bays with flows. For a Total River of 250 kcfs running with the Fish Passage Plan spill pattern and a spillwall, the mean residence times for all particles were little changed; however the tails of the distribution were truncated for both spillway and powerhouse release points, and, for the powerhouse releases, reduced the residence time for 75% of the particles to pass a downstream cross section from 45.5 minutes to 41.3 minutes. For a total river of 125 kcfs configured with the operations from the Fish Passage Plan for the temporary spillway weirs and for a proposed spillwall, the neutrally-buoyant particle tracking data showed that the river with a spillwall in place had the overall mean residence time increase; however, the residence time for 75% of the powerhouse-released particles to pass a downstream cross section was reduced from 102.4 min to 89 minutes.« less

Evaluation of Experimental Four-Day Week Class Schedule, January Through April 1974 at Lake City Community College.

ERIC Educational Resources Information Center

Hardman, Clark

Due to the energy disturbance during the fall and winter of 1973-74, Lake City Community College experimented with a 4-days-per-week schedule of classes. a student evaluation of the 4-day week was completed by 58 percent of the full-time students. Fifty-one percent of the total student sample preferred the 4-day week, and 30 percent preferred the…

Traumatic brain injuries from work accidents: a retrospective study.

PubMed

Salem, A M O; Jaumally, B A; Bayanzay, K; Khoury, K; Torkaman, A

2013-07-01

The United Arab Emirates is a rapidly developing country with recent expansion in construction and manufacturing. To investigate the occurrence and outcomes following occupational traumatic brain injury (TBI) requiring hospital admission. Records for all TBI cases admitted to an Abu Dhabi hospital between 2005 and 2009 were reviewed. Data on mechanisms of occupational injuries, Glasgow Coma Scale (GCS) on admission and Glasgow Outcome Scale (GOS) on follow-up, were analysed. Of 581 TBI cases reviewed, 56 (10%) cases were reported as occupational by either the patient or the informant accompanying the patient. All cases were male migrants, and 63% were aged 25-44. Falls accounted for 63% of cases, falling objects 34% and motor vehicle collisions 4%. Median GCS score was 13 for all cases. Median hospital stay was 7.5 days. Intensive care unit admission data were available in 47 cases, of which 34% (16) were admitted with a median stay of 5 days. GOS data were available in 95% (53) of cases, with good recovery in 81% cases, moderate-to-severe disability in 11% of cases and death in 8% (4) cases. Occupational TBI requiring hospitalization is most frequently due to falls and falling objects, with potentially grave consequences. This study further highlights the urgent need to implement preventative measures to improve construction worker safety.

Physical factors underlying the association between lower walking performance and falls in older people: a structural equation model.

PubMed

Shimada, Hiroyuki; Tiedemann, Anne; Lord, Stephen R; Suzukawa, Megumi; Makizako, Hyuma; Kobayashi, Kumiko; Suzuki, Takao

2011-01-01

The purpose of this study was to determine the interrelationships between lower limb muscle performance, balance, gait and falls in older people using structural equation modeling. Study participants were two hundred and thirteen people aged 65 years and older (mean age, 80.0 ± 7.1 years), who used day-care services in Japan. The outcome measures were the history of falls three months retrospectively and physical risk factors for falling, including performance in the chair stand test (CST), one-leg standing test (OLS), tandem walk test, 6m walking time, and the timed up-and-go (TUG) test. Thirty-nine (18.3%) of the 213 participants had fallen at least one or more times during the preceding 3 months. The fall group had significantly slower 6m walking speed and took significantly longer to undertake the TUG test than the non-fall group. In a structural equation model, performance in the CST contributed significantly to gait function, and low gait function was significantly and directly associated with falls in older people. This suggests that task-specific strength exercise as well as general mobility retraining should be important components of exercise programs designed to reduce falls in older people. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

2017 A Day of Remembrance

NASA Image and Video Library

2017-01-26

Apollo launch team member John Tribe addresses guests at Kennedy Space Center's Day of Remembrance ceremony. Held this year in the Center for Space Education at the Kennedy Space Center Visitor Complex in Florida, the annual event honors the contributions of all astronauts who lost their lives in the quest for space exploration.

76 FR 46321 - Notice of Public Meeting, John Day-Snake Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

..., Blue Mountains Forest Plan revision, BLM District's Vegetation EA stepdown, Wilderness Characteristics... Day-Snake and the Southeast Oregon RACs will be held at 1 Sunridge Lane, Baker City, Oregon, on... Campbell Street, Baker City, Oregon, on September 8, 2011. FOR FURTHER INFORMATION CONTACT: Mark Wilkening...

Predicting first fall in newly diagnosed Parkinson's disease: Insights from a fall-naïve cohort.

PubMed

Lord, Sue; Galna, Brook; Yarnall, Alison J; Coleman, Shirley; Burn, David; Rochester, Lynn

2016-12-01

Falls are common and associated with reduced independence and mortality in Parkinson's disease. Previous research has been conducted on falls-prevalent or advanced disease cohorts. This study identifies risk factors for first fall for 36 months in a newly diagnosed, falls-naïve cohort. A total of 121 consecutive Parkinson's disease patients were recruited. Falls data were collected prospectively during 36 months from diagnosis via monthly falls diaries and telephone follow-up for 117 participants. Assessment comprised a comprehensive battery of clinical, gait, and cognitive measures. Significant predictors were identified from decision-tree analysis and survival analysis with time to first fall during 36 months as the dependent variable. At baseline, 26 (22%) participants reported retrospective falls. At 36 months, the remaining cohort (n = 91) comprised 47 fallers (52%) and 30 (33%) nonfallers and 14 (15%) participants with incomplete diaries. Fallers presented with a significantly higher disease severity, poorer ability to stand on one leg, slower gait speed, increased stance time variability, and higher swing time asymmetry. Median time to first fall was 847 days. Gait speed, stance time, and Hoehn & Yahr III stage emerged as significant predictors of first fall, hazard ratio 3.44 (95% confidence interval [CI] 1.58 to 7.48), 3.31(95% CI 1.40 to 7.80), and 2.80 (95% CI 1.38 to 5.65), respectively. The hazard ratio for risk factors combined was 7.82 (CI 2.80 to 21.84). Interventions that target gait deficit and postural control in early Parkinson's disease may limit the potential for first fall. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Virtual Breakthrough Series, Part 2: Improving Fall Prevention Practices in the Veterans Health Administration.

PubMed

Zubkoff, Lisa; Neily, Julia; Quigley, Pat; Soncrant, Christina; Young-Xu, Yinong; Boar, Shoshana; Mills, Peter D

2016-11-01

The Veterans Health Administration (VHA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help prevent falls and fall-related injuries. This project enabled teams to expand program infrastructure, redesign improvement strategies, and enhance program evaluation. A VBTS collaborative involves prework, action, and continuous improvement. Actions included educational calls, monthly reports, coaching, and feedback. Evaluation included assessment of interventions, team capacity and infrastructure changes, and rates of falls and fall-related major injuries. Fifty-nine teams completed the project. The majority submitted monthly reports. The average number of interventions per team was 6.66 (range, 1-12; mode = 6). The most frequently implemented changes were staff education; post-fall huddles; data tracking; and classifying falls, handoff communication, and intentional rounding. On a program questionnaire aggregated average summary scores improved from 136.54 (baseline) to 58.26 (follow-up; range, 0-189; p < 0.0001). The mean aggregated fall-related major injury rate for participants decreased from 6.8 to 4.8 per 100,000 bed-days of care (p = 0.02), or 5 major injuries avoided per month. No statistically significant changes occurred for nonparticipants. The mean aggregated fall rate did not change significantly from baseline to follow-up for participants (p = 0.42) or nonparticipants (p = 0.21). Teams submitted reports and implemented changes resulting in decreased major injuries related to falls for participating units. Teams also made changes in their fall prevention programs such as classifying how they analyze falls and implementing injury reduction strategies. The approaches used show promise for reducing fall-related harm for inpatients, as well as assisting teams in implementing changes. Copyright 2016 The Joint Commission.

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

PubMed

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

2013-03-01

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

The effect of supervised Tai Chi intervention compared to a physiotherapy program on fall-related clinical outcomes: a randomized clinical trial.

PubMed

Tousignant, Michel; Corriveau, Hélène; Roy, Pierre-Michel; Desrosiers, Johanne; Dubuc, Nicole; Hébert, Réjean; Tremblay-Boudreault, Valérie; Beaudoin, Audrée-Jeanne

2012-01-01

To assess some fall-related clinical variables (balance, gait, fear of falling, functional autonomy, self-actualization and self-efficacy) that might explain the fact that supervised Tai Chi has a better impact on preventing falls compared to a conventional physiotherapy program. The participants (152 older adults over 65 who were admitted to a geriatric day hospital program) were randomly assigned to either a supervised Tai Chi group or the usual physiotherapy. The presence of the clinical variables related to falls was evaluated before the intervention (T1), immediately after (T2), and 12 months after the end of the intervention (T3). Both exercise programs significantly improved fall-related outcomes but only the Tai Chi intervention group decreased the incidence of falls. For both groups, most variables followed the same pattern, i.e. showed significant improvement with the intervention between T1 and T2, and followed by a statistically significant decrease at the T3 evaluation. However, self-efficacy was the only variable that improved solely with the Tai Chi intervention (p = 0.001). The impact of supervised Tai Chi on fall prevention can not be explained by a differential effect on balance, gait and fear of falling. It appeared to be related to an increase of general self-efficacy, a phenomenon which is not seen in the conventional physiotherapy program.

Bridging the gap between research and practice: review of a targeted hospital inpatient fall prevention programme.

PubMed

Barker, A; Kamar, J; Morton, A; Berlowitz, D

2009-12-01

Falls among older inpatients are frequent and have negative consequences. In this study, the effectiveness of a fall prevention programme in reducing falls and fall injuries in an acute hospital was studied. Retrospective audit. The Northern Hospital, an acute, metropolitan, hospital in Australia. A multi-factorial fall prevention programme that included establishment of a multidisciplinary committee, risk assessment of all patients on "high-risk" wards and targeted interventions for patients identified as high risk. Fall and fall injury rates per 1000 occupied bed-days were analysed using generalised additive models (GAM) and, because of the presence of autocorrelation, generalised additive mixed models (GAMM), respectively. During the 9-year observation of 271 095 patients, there were 2910 falls and 843 fall injuries. The GAM predicted rate of falls was stable in the 3 years after the programme was implemented, increased in 2006, then decreased between October 2006 and December 2007 from 4.13 (95% CI 3.65 to 4.67) to 2.83 (95% CI 2.24 to 3.59; p = 0.005). The GAMM predicted rate of fall injuries reduced from 1.66 (95% CI 1.24 to 2.21) to 0.61 (95% CI 0.43 to 0.88) after programme implementation (p<0.001). The falls rate varied throughout the observation period, and no significant change in the rate from preprogramme to postprogramme implementation was observed. The finding of no reduction in falls during the observation period may be explained by improved reporting throughout the observation period. The reduction in fall injuries was substantial and sustained. Identification of a local problem, use of a fall risk assessment to guide the delivery of simple interventions, integration of processes into daily clinical practice and creating systems that demand accountability of staff are factors that appear to have contributed to the programme's success.

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

9 CFR 381.38 - Overtime and holiday inspection service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Birthday, the third Monday in February; Memorial Day, the last Monday in May; Independence Day, July 4... above-listed holidays falls outside the basic workweek, the nearest workday within that week shall be... service. (a) The management of an official establishment, an importer, or an exporter shall reimburse the...

9 CFR 307.5 - Overtime and holiday inspection service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Birthday, the third Monday in February; Memorial Day, the last Monday in May; Independence Day, July 4... above-listed holidays falls outside the basic workweek, the nearest workday within that week shall...) The management of an official establishment, an importer, or an exporter shall reimburse the Program...

26 CFR 1.1252-1 - General rule for treatment of gain from disposition of farm land.

Code of Federal Regulations, 2010 CFR

2010-04-01

... is allowed in respect of the farm land disposed of for a taxable year every day of which falls within... subdivision is an amount equal to: (a) The aggregate of the deductions allowed, in any taxable year any day of...

New methods for regulating flowering time in short-day strawberry

USDA-ARS?s Scientific Manuscript database

Higher percentages of transplants of short-day cultivars 'Chandler', 'Carmine', 'Strawberry Festival', and 'Sweet Charlie' from runner tips plugged in early July rather than the standard time (early August) bloomed in the fall. Nearly 100% of the transplants produced in early July flowered in the f...

Potentiometric surface of the Floridan Aquifer and its use in management of water resources, St. Johns River Water Management District, Florida

USGS Publications Warehouse

Rodis, Harry George; Munch, D.A.

1983-01-01

The Floridan aquifer supplies most of the fresh groundwater for municipal, industrial, and agricultural uses within the 12,400 sq mi St. Johns River Water Management District. Because of the growing demand for water and the variation in rainfall, resource managers need timely information on short-term and long-term changes in the availability of fresh water. The purpose of this report is to explain potentiometric surface maps and their value in assessing the resource, particularly during drought conditions. The Floridan aquifer is recharged by rainfall falling directly on the outcrop of the aquifer, and, where the aquifer is overlain by the surficial aquifer with the water table above the potentiometric surface of the Floridan, by water infiltrating downward from the overlying surficial aquifer. Water is discharged by pumping and free-flowing wells, springflow, and upward leakage into overlying formations, streams, and lakes or into the ocean. Fluctuations in the potentiometric surface reflect net gains (recharge) or losses (discharge) of water stored in the aquifer. Net gains occur during the wet season (June through September) when recharge exceeds discharge and causes the potentiometric surface to rise in most places. Net losses in storage, and declines in the potentiometric surface, follow during the dry season (October through May) when discharge exceeds recharge. Seasonal changes in the potentiometric surface, based on a 2-yr average of water level measurements during May and September 1977, and May and September 1978, are illustrated. Two of the greater long-term declines in the potentiometric surface have occurred in the growing metropolitan areas of Jacksonville and Orlando-Winter Park, the two largest public suppliers of water in the Water Management District. Municipal pumpage increased in Jacksonville from 37 million gallons per day (mgd) in 1961 to 56 mgd in 1980. The increased pumpage and a deficiency in rainfall of 15.8 inches contributed to a decline in the potentiometric surface of as much as 15 ft. Orlando-Winter Park municipal pumpage increasing from 27 mgd in 1961 to 62 mgd in 1980. The periodic preparation of maps showing changes in the potentiometric surface of the aquifer provide the best base information for both short-term and long-term management of the water resources in the St. Johns River Water Management District. (Lantz-PTT)

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

PubMed

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

2001-10-01

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

Institutional Research, Fiscal Year 1977: Report on Publicity Activities. Research Monograph IV.

ERIC Educational Resources Information Center

South Oklahoma City Junior Coll., OK.

During the first week of December, a 10% random sample of day classes and a 10% sample of night classes at South Oklahoma City Junior College were given a questionnaire dealing with the publicity activities used prior to and during the fall 1976 enrollment period. A total of 314 students responded, 179 night and 135 day students. Day students were…

Stennis Space Center celebrates Diversity Day

NASA Technical Reports Server (NTRS)

2009-01-01

Kendall Mitchell of the Naval Oceanographic Office (right) learns about the culture of Bolivia from Narda Inchausty, president of the Foreign Born Wives Association in Slidell, La., during 2009 Diversity Day events at NASA's John Stennis Space Center. Stennis hosted Diversity Day activities for employees on Oct. 7. The day's events included cultural and agency exhibits, diversity-related performances, a trivia contest and a classic car and motorcycle show. It also featured the first-ever sitewide Stennis Employee Showcase.

Left to right, astronauts John H. Casper, mission commander, and Curtis L. Brown, Jr., pilot, get

NASA Technical Reports Server (NTRS)

1996-01-01

STS-77 TRAINING VIEW --- Left to right, astronauts John H. Casper, mission commander, and Curtis L. Brown, Jr., pilot, get help with the final touches of suit donning during emergency bailout training for STS-77 crew members in the Johnson Space Centers (JSC) Weightless Environment Training Facility (WET-F). Casper and Brown will join four other astronauts for nine days aboard the Space Shuttle Endeavour next month.

Laparoscopic appendectomy to remove a metallic foreign body in a wild Bornean orangutan (Pongo pygmaeus) undergoing rehabilitation.

PubMed

Llano Sanchez, Karmele; Handayani, Ayu B; Nelson, Christine L; Eng, Jaclyn W L; Prameswari, Wendi; Hicks, Nigel; Pizzi, Romain

2016-12-01

A laparoscopic appendectomy was performed in a wild orangutan (Pongo pygmaeus) undergoing rehabilitation, for a metal nail found on radiographs, using 3-mm instrumentation. Post-operative healing was rapid and uneventful, with return to the forest within 10 days. This is the first report of minimally invasive surgery in a wild orangutan. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

2017 Landsat Science Team Summer Meeting Summary

USGS Publications Warehouse

Crawford, Christopher J.; Loveland, Thomas R.; Wulder, Michael A.; Irons, James R.

2018-01-01

The summer meeting of the U.S. Geological Survey (USGS)-NASA Landsat Science Team (LST) was held June 11-13, 2017, at the USGS’s Earth Resources Observation and Science (EROS) Center near Sioux Falls, SD. This was the final meeting of the Second (2012-2017) LST.1 Frank Kelly [EROS—Center Director] welcomed the attendees and expressed his thanks to the LST members for their contributions. He then introduced video-recorded messages from South Dakota’s U.S. senators, John Thune and Mike Rounds, in which they acknowledged the efforts of the team in advancing the societal impacts of the Landsat Program.

Burden of allergy diets in Finnish day care reduced by change in practices.

PubMed

Erkkola, M; Saloheimo, T; Hauta-Alus, H; Kukkonen, A K; Virta, S; Kronberg-Kippilä, C; Vaara, E; Pelkonen, A S; Fogelholm, M; Mäkelä, M J

2016-10-01

Nonessential allergy diets in children with mild symptoms may harm the development of immunological tolerance and impose a burden on families and day care. We aimed to reduce the high prevalence of allergy diets in day care by reforming the practices for inquiring about need of special diets from parents. We developed a new special diet form and an information leaflet based on the new allergy guidelines. The new form was implemented into 40 Finnish day care centres in the capital region in 2013-2015. The questionnaires on practices concerning special diets in day care centres and allergy knowledge were collected from the personnel. After 2 years, the new special diet form was used by 64% of families with food-allergic children, and the prevalence of allergy diets in day care centres decreased by 43% to 4.3% (IQ range 3.05-5.96). A significant decrease was found in the prevalence of all basic (milk, grains, egg) and most other allergy diets (P for trend < 0.01). The new practice was well accepted by day care and kitchen personnel. Lack of updated allergy knowledge was noted among day care personnel. The burden of allergy diets in day care settings could be decreased by simple pragmatic changes based on current allergy guidelines. Old allergy attitudes persisted among day care personnel, indicating the need for continuous education. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Atlantic Flyway review: Piedmont-Coastal Plain, Region IV, Fall 2001: Robbins Nest, Laurel, MD (390-0765)

USGS Publications Warehouse

Robbins, Chandler S.

2002-01-01

I continue to band before and after work and all day on weekends on my two and a half acres along the Patuxent River gorge between highway 1-95 and the Laurel city limits. Our kids have long since flown the coop, so I have no one to run the station when I am out of town; thus, I miss some of the best flight days. The chief changes in habitat over the years have been replacement of pines by young deciduous growth, loss of dogwoods in the mature deciduous forest, and gradual replacement of lawn by shrubbery. To explore changes in fall migration patterns, I compared my banding totals for the first five years of systematic fall banding with those of the most recent five years. By coincidence the totals were nearly identical: 2175 birds in 1973-1977 and 2169 in 1997-2001. However, my net hour totals were vastly different: 9124 in the first five years compared with 26,284 for the current period. It took nearly 2.9 times the effort to catch the same number of birds I used to band. Next year, my 30th, I'll be checking to see which species I am losing and which are maintaining their numbers.I had 35 returns of a dozen species, but all were either summer, winter, or permanent residents. The oldest this time was only four years old, a Gray Catbird. Eleven transients repeated on a subsequent day. The one longest in residence was a Gray-cheeked Thrush that l captured 10 times in 17 days; it weighed 31.0 g when banded and reached a maximum of 51.7 g 13 days later.

Work-related falls among union carpenters in Washington State before and after the Vertical Fall Arrest Standard.

PubMed

Lipscomb, Hester J; Li, Leiming; Dement, John

2003-08-01

Washington State enacted a change in their fall standard for the construction industry in 1991, preceding the Safety Standard for Fall Protection in the Construction Industry promulgated by Federal OSHA in 1994. We evaluated changes in the rate of falls from elevations and measures of severity among a large cohort of union carpenters after the fall standard change in Washington State, taking into account the temporal trends in their overall injury rates. There was a significant decrease in the rate of falls from height after the standard went into effect, even after adjusting for the overall decrease in work-related injuries among this cohort. Much of the decrease was immediate, likely representing the publicity surrounding fatal falls and subsequent promulgation of the standard. The greatest decrease was seen between 3 and 3(1/2) years after the standard went into effect. There was a significant reduction in mean paid lost days per event after the standard change and there was a significant reduction in mean cost per fall when adjusting for age and the temporal trend for costs among non-fall injuries. Through the use of observational methods we have demonstrated significant effects of the Washington State Vertical Fall Arrest Standard among carpenters in the absence of a control or comparison group. Without controlling for the temporal trend in overall injury rates, the rate of decline in falls appeared significantly greater, but the more pronounced, but delayed, decline was not seen. The analyses demonstrate potential error in failing to account for temporal patterns or assuming that a decline after an intervention is related to the intervention. Copyright 2003 Wiley-Liss, Inc.

Use of ACE-inhibitors and falls in patients with Parkinson's disease.

PubMed

Laudisio, Alice; Lo Monaco, Maria Rita; Silveri, Maria Caterina; Bentivoglio, Anna Rita; Vetrano, Davide L; Pisciotta, Maria Stella; Brandi, Vincenzo; Bernabei, Roberto; Zuccalà, Giuseppe

2017-05-01

Falls represent a major concern in patients with Parkinson's disease (PD); however, currently acknowledged treatments for PD are not effective in reducing the risk of falling. The aim was to assess the association of use of ACE-inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) with falls among patients with PD. We analysed data of 194 elderly with PD attending a geriatric Day Hospital. Self-reported history of falls that occurred over the last year, as well as use of drugs, including ACEIs and angiotensin II receptor blockers (ARBs) were recorded. The association of the occurrence of any falls with use of ACEIs, and ARBs was assessed by logistic regression analysis. The association between the number of falls and use of ACEIs, and ARBs was assessed according to Poisson regression. In logistic regression, after adjusting for potential confounders, use of ACEIs was associated with a reduced probability of falling over the last year (OR=0.15, 95% CI=0.03-0.81; P=0.028). This association did not vary with blood pressure levels (P for the interaction term=0.528). Also, using Poisson regression, use of ACEIs predicted a reduced number of falls among participants who fell (PR=0.31; 95% CI=0.10-0.94; P=0.039). No association was found between use of ARBs and falls. Our results indicate that use of ACEIs might be independently associated with reduced probability, and a reduced number of falls among patients with PD. Dedicated studies are needed to define the single agents and dosages that might most effectively reduce the risk of falling in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Enhancing Home Health Mobile Phone App Usability Through General Smartphone Training: Usability and Learnability Case Study

PubMed Central

Harte, Richard; Hall, Tony; Glynn, Liam; Rodríguez-Molinero, Alejandro; Scharf, Thomas; ÓLaighin, Gearóid

2018-01-01

Background Each year, millions of older adults fall, with more than 1 out of 4 older people experiencing a fall annually, thereby causing a major social and economic impact. Falling once doubles one’s chances of falling again, making fall prediction an important aspect of preventative strategies. In this study, 22 older adults aged between 65 and 85 years were trained in the use of a smartphone-based fall prediction system. The system is designed to continuously assess fall risk by measuring various gait and balance parameters using a smart insole and smartphone, and is also designed to detect falls. The use case of the fall prediction system in question required the users to interact with the smartphone via an app for device syncing, data uploads, and checking system status. Objective The objective of this study was to observe the effect that basic smartphone training could have on the user experience of a group that is not technically proficient with smartphones when using a new connected health system. It was expected that even short rudimentary training could have a large effect on user experience and therefore increase the chances of the group accepting the new technology. Methods All participants received training on how to use the system smartphone app; half of the participants (training group) also received extra training on how to use basic functions of the smartphone, such as making calls and sending text messages, whereas the other half did not receive this extra training (no extra training group). Comparison of training group and no extra training group was carried out using metrics such as satisfaction rating, time taken to complete tasks, cues required to complete tasks, and errors made during tasks. Results The training group fared better in the first 3 days of using the system. There were significant recorded differences in number of cues required and errors committed between the two groups. By the fourth and fifth day of use, both groups were performing at the same level when using the system. Conclusions Supplementary basic smartphone training may be critical in trials where a smartphone app–based system for health intervention purposes is being introduced to a population that is not proficient with technology. This training could prevent early technology rejection and increase the engagement of older participants and their overall user experience with the system. PMID:29699969

Atmospheric conditions during the spring and fall transitions in the coastal ocean off western United States

NASA Technical Reports Server (NTRS)

Strub, P. Ted; James, Corinne

1988-01-01

Atmospheric events which force the spring and fall oceanic transitions in the coastal ocean off the west coast of North America were examined by analyzing the records of adjusted sea level (ASL), coastal wind stress, sea level atmospheric pressure (SLP), and 500-mbar heights for the years 1971-1975 and 1980-1983. The records cover periods of 91 days, centered on the dates of the spring and fall transitions as determined from coastal ASL data. It was found that the dominant mode of the ASL and coastal wind stress are similar around the times of both the spring and fall transitions, and that the time series for these modes are highly correlated with one another. Principal estimator patterns show the spatial patterns of SLP which force the ASL and coastal wind stress during the transitions.

A consideration of the availableness of MODIS data to assess a volcanic ash fall

NASA Astrophysics Data System (ADS)

Tomiyama, N.; Yonezawa, C.; Yamakoshi, T.

It is important to grasp the situation of the ash fall at short interval for a volcanic disaster-prevention. Clouds and volcanic smokes reduce the opportunities to observe a volcano by a satellite's optical sensor. Therefore it is preferable to use data of a sensor that is able to observe same area with high frequency. MODIS sees every point on the earth every 1-2 days and provides NDVI data with 250m spatial resolutions. The purpose of this study is to consider the availableness of MODIS data to assess the situation of the volcanic ash fall. The test site is Miyake-jima, one of the active volcanic island in Japan. It is verified that a rate of change of NDVI between before and after erruptions correlates with the amounts of ash fall.

Standardized Passiflora incarnata L. Extract Reverts the Analgesia Induced by Alcohol Withdrawal in Rats.

PubMed

Schunck, Rebeca Vargas Antunes; Macedo, Isabel Cristina; Laste, Gabriela; de Souza, Andressa; Valle, Marina Tuerlinckx Costa; Salomón, Janaína L O; Nunes, Ellen Almeida; Campos, Andreia Cristina Wildner; Gnoatto, Simone Cristina Baggio; Bergold, Ana Maria; Konrath, Eduardo L; Dallegrave, Eliane; Arbo, Marcelo Dutra; Torres, Iraci L S; Leal, Mirna Bainy

2017-08-01

Passiflora incarnata L. (Passifloraceae) has been traditionally used for treatment of anxiety, insomnia, drug addiction, mild infections, and pain. The aim of this study was to investigate the effect of a commercial extract of P. incarnata in the analgesia induced by alcohol withdrawal syndrome in rats. In addition, brain-derived neurotrophic factor and interleukin-10 levels were evaluated in prefrontal cortex, brainstem, and hippocampus. Male adult rats received by oral gavage: (1: water group) water for 19 days, 1 day interval and water (8 days); (2: P. incarnata group) water for 19 days, 1 day interval and P. incarnata 200 mg/kg (8 days); (3: alcohol withdrawal group) alcohol for 19 days, 1 day interval and water (8 days); and (4: P. incarnata in alcohol withdrawal) alcohol for 19 days, 1 day interval and P. incarnata 200 mg/kg (8 days). The tail-flick and hot plate tests were used as nociceptive response measures. Confirming previous study of our group, it was showed that alcohol-treated groups presented an increase in the nociceptive thresholds after alcohol withdrawal, which was reverted by P. incarnata, measured by the hot plate test. Besides, alcohol treatment increased brain-derived neurotrophic factor and interleukin-10 levels in prefrontal cortex, which was not reverted by P. incarnata. Considering these results, the P. incarnata treatment might be a potential therapy in the alcohol withdrawal syndrome. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

PubMed

Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

2017-11-01

New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed overall (mean, 0.03 [SE, 0.01] points on a 5-point scale; P = .03) and for communication timeliness (mean, 0.8 [SE, 0.03] points on a 5-point scale; P = .02). There was wide variation across facilities in intervention penetration. An intervention targeting gaps in staff communication and coordination did not improve the impact of a falls quality improvement program. New approaches to implementing evidence-based care for complex conditions in the nursing home are urgently needed. clinicaltrials.gov Identifier: NCT00636675.

Dragoon or Cavalryman, Major General John Buford in the American Civil War

DTIC Science & Technology

1994-06-03

the first day of the Battle of Gettysburg...Seminary Ridges on the first day of the Battle of Gettysburg. Several historians have presumed that the dismounted cavalry (or Dragoon) tactics used by...not in pitched battles that Buford excelled. His significant contributions were in the established roles of cavalry; performing reconnaissance

What's Happening in June?

ERIC Educational Resources Information Center

Toro, Leonor; And Others

Brief information is given on four June events celebrated by Puerto Ricans: Father's Day, the Feast of Saint John the Baptist (Puerto Rico's Partron Saint), the birthday of Francisco Oller Cestero (painter), and commemoration (on Father's Day) of Jean Baptiste Pointe Du Sable (first non-native American to settle in what is now known as Chicago).…

Energy Action Day

NASA Image and Video Library

2017-10-25

John Sherwin of the Florida Solar Energy Center in Cocoa speaks during the Energy Action Day employee event held in NASA Kennedy Space Center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

Simulated conditions of microgravity suppress progesterone production by luteal cells of the pregnant rat

NASA Technical Reports Server (NTRS)

Bhat, G. K.; Yang, H.; Sridaran, R.

2001-01-01

The purpose of this study was to assess whether simulated conditions of microgravity induce changes in the production of progesterone by luteal cells of the pregnant rat ovary using an in vitro model system. The microgravity environment was simulated using either a high aspect ratio vessel (HARV) bioreactor with free fall or a clinostat without free fall of cells. A mixed population of luteal cells isolated from the corpora lutea of day 8 pregnant rats was attached to cytodex microcarrier beads (cytodex 3). These anchorage dependent cells were placed in equal numbers in the HARV or a spinner flask control vessel in culture conditions. It was found that HARV significantly reduced the daily production of progesterone from day 1 through day 8 compared to controls. Scanning electron microscopy showed that cells attached to the microcarrier beads throughout the duration of the experiment in both types of culture vessels. Cells cultured in chamber slide flasks and placed in a clinostat yielded similar results when compared to those in the HARV. Also, when they were stained by Oil Red-O for lipid droplets, the clinostat flasks showed a larger number of stained cells compared to control flasks at 48 h. Further, the relative amount of Oil Red-O staining per milligram of protein was found to be higher in the clinostat than in the control cells at 48 h. It is speculated that the increase in the level of lipid content in cells subjected to simulated conditions of microgravity may be due to a disruption in cholesterol transport and/or lesions in the steroidogenic pathway leading to a fall in the synthesis of progesterone. Additionally, the fall in progesterone in simulated conditions of microgravity could be due to apoptosis of luteal cells.

Laboratory evaluation of transgenic Populus davidiana×Populus bolleana expressing Cry1Ac + SCK, Cry1Ah3, and Cry9Aa3 genes against gypsy moth and fall webworm.

PubMed

Ding, Liping; Chen, Yajuan; Wei, Xiaoli; Ni, Mi; Zhang, Jiewei; Wang, Hongzhi; Zhu, Zhen; Wei, Jianhua

2017-01-01

Transgenic poplar lines 'Shanxin' (Populus davidiana×Populus bolleana) were generated via Agrobacterium-mediated transformation. The transgenic lines carried the expression cassettes of Cry1Ac + SCK, Cry1Ah3, and Cry9Aa3, respectively. The expression levels of the exogenous insect resistance genes in the transgenic lines were determined by Q-PCR and Western blot. Leaves of the transgenic lines were used for insect feeding bioassays on first instar larvae of the gypsy moth (Lymantria dispar) and fall webworm (Hyphantria cunea). At 5 d of feeding, the mean mortalities of larvae feeding on Cry1Ac + SCK and Cry1Ah3 transgenic poplars leaves were 97% and 91%, while mortality on Cry9Aa3 transgenic lines was about 49%. All gypsy moth and fall webworm larvae were killed in 7-9 days after feeding on leaves from Cry1Ac + SCK or Cry1Ah3 transgenic poplars, while all the fall webworm larvae were killed in 11 days and about 80% of gypsy moth larvae were dead in 14 days after feeding on those from Cry9Aa3 transgenic lines. It was concluded that the transgenic lines of Cry1Ac + SCK and Cry1Ah3 were highly toxic to larvae of both insect species while lines with Cry9Aa3 had lower toxicity,and H. cunea larvae are more sensitive to the insecticidal proteins compared to L. dispar. Transgenic poplar lines toxic to L. dispar and H. cunea could be used to provide Lepidoptera pest resistance to selected strains of poplar trees.

The relationship between physical activity, and physical performance and psycho-cognitive functioning in older adults living in residential aged care facilities.

PubMed

Bootsman, Natalia J M; Skinner, Tina L; Lal, Ravin; Glindemann, Delma; Lagasca, Carmela; Peeters, G M E E Geeske

2018-02-01

Insight into modifiable factors related to falls risk in older adults living in residential aged care facilities (RACFs) is necessary to tailor preventive strategies for this high-risk population. Associations between physical activity (PA), physical performance and psycho-cognitive functioning have been understudied in aged care residents. This study investigated associations between PA, and both physical performance and psycho-cognitive functioning in older adults living in RACFs. Cross-sectional study. Forty-four residents aged 85±8years were recruited from four RACFs located in Southeast Queensland. PA was assessed as the average time spent walking in hours/day using activPAL3™. Physical performance tests included balance, gait speed, dual-task ability, reaction time, coordination, grip strength, and leg strength and power. Psycho-cognitive questionnaires included quality of life, balance confidence, fear of falling and cognitive functioning. Associations between PA and each outcome measure were analysed using linear or ordinal regression models. The average time spent walking was 0.5±0.4h/day. Higher levels of PA were significantly associated with better balance (compared with low PA, medium: B=1.6; high: B=1.3) and dual-task ability (OR=7.9 per 0.5h/day increase). No statistically significant associations were found between PA and the other physical and psycho-cognitive measures. More physically active residents scored higher on balance and dual-task ability, which are key predictors of falls risk. This suggests that physical activity programs targeting balance and dual-task ability could help prevent falls in aged care residents. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Greater deciduous shrub abundance extends tundra peak season and increases modeled net CO2 uptake.

PubMed

Sweet, Shannan K; Griffin, Kevin L; Steltzer, Heidi; Gough, Laura; Boelman, Natalie T

2015-06-01

Satellite studies of the terrestrial Arctic report increased summer greening and longer overall growing and peak seasons since the 1980s, which increases productivity and the period of carbon uptake. These trends are attributed to increasing air temperatures and reduced snow cover duration in spring and fall. Concurrently, deciduous shrubs are becoming increasingly abundant in tundra landscapes, which may also impact canopy phenology and productivity. Our aim was to determine the influence of greater deciduous shrub abundance on tundra canopy phenology and subsequent impacts on net ecosystem carbon exchange (NEE) during the growing and peak seasons in the arctic foothills region of Alaska. We compared deciduous shrub-dominated and evergreen/graminoid-dominated community-level canopy phenology throughout the growing season using the normalized difference vegetation index (NDVI). We used a tundra plant-community-specific leaf area index (LAI) model to estimate LAI throughout the green season and a tundra-specific NEE model to estimate the impact of greater deciduous shrub abundance and associated shifts in both leaf area and canopy phenology on tundra carbon flux. We found that deciduous shrub canopies reached the onset of peak greenness 13 days earlier and the onset of senescence 3 days earlier compared to evergreen/graminoid canopies, resulting in a 10-day extension of the peak season. The combined effect of the longer peak season and greater leaf area of deciduous shrub canopies almost tripled the modeled net carbon uptake of deciduous shrub communities compared to evergreen/graminoid communities, while the longer peak season alone resulted in 84% greater carbon uptake in deciduous shrub communities. These results suggest that greater deciduous shrub abundance increases carbon uptake not only due to greater leaf area, but also due to an extension of the period of peak greenness, which extends the period of maximum carbon uptake. © 2015 John Wiley & Sons Ltd.

Effect of season on reproductive behaviors and fertilization success in cavies (Cavia aperea).

PubMed

Hribal, Romy; Rübensam, Kathrin; Bernhardt, Sandra; Jewgenow, Katarina; Guenther, Anja

2018-04-05

Finding the optimal timing for breeding is crucial for small mammals to ensure survival and maximize lifetime reproductive success. Species living in temperate regions therefore often restrict breeding to seasons with favorable food and weather conditions. Although caviomorph rodents such as guinea pigs are described as non-seasonal breeders, a series of recent publications has shown seasonal adaptations in litter size, offspring birth mass and maternal investment. Here, we aim to test if seasonal patterns of litter size variation found in earlier studies, are mediated by seasonal differences in female estrus length, fertilization rate and mating behavior. The female estrus period was longer in fall compared to all other seasons (p < 0.001), frequently lasting 7-9 days while estrus in spring usually lasted less than 2 days. In fall, females mated later during estrus (p < 0.001), resulting in reduced fertilization rates (p < 0.001). Fertilization rate was well above 95% in summer while it dropped to less than 85% in fall and winter. While none of the male mating characteristics such as number and duration of copulations differed across seasons, the number of mating bouts was reduced in fall (p = 0.04). Finally, the developmental stages of flushed embryos were more diverse in spring and summer compared to fall and winter. These results suggest that seasonal differences in fertilization rate and quality of implanted embryos are mediated by female estrus length and timing and intensity of mating behavior. Together, these effects contribute to the observed differences in litter size across seasons. Copyright © 2018 Elsevier Inc. All rights reserved.

Fall Detection in Individuals With Lower Limb Amputations Using Mobile Phones: Machine Learning Enhances Robustness for Real-World Applications.

PubMed

Shawen, Nicholas; Lonini, Luca; Mummidisetty, Chaithanya Krishna; Shparii, Ilona; Albert, Mark V; Kording, Konrad; Jayaraman, Arun

2017-10-11

Automatically detecting falls with mobile phones provides an opportunity for rapid response to injuries and better knowledge of what precipitated the fall and its consequences. This is beneficial for populations that are prone to falling, such as people with lower limb amputations. Prior studies have focused on fall detection in able-bodied individuals using data from a laboratory setting. Such approaches may provide a limited ability to detect falls in amputees and in real-world scenarios. The aim was to develop a classifier that uses data from able-bodied individuals to detect falls in individuals with a lower limb amputation, while they freely carry the mobile phone in different locations and during free-living. We obtained 861 simulated indoor and outdoor falls from 10 young control (non-amputee) individuals and 6 individuals with a lower limb amputation. In addition, we recorded a broad database of activities of daily living, including data from three participants' free-living routines. Sensor readings (accelerometer and gyroscope) from a mobile phone were recorded as participants freely carried it in three common locations-on the waist, in a pocket, and in the hand. A set of 40 features were computed from the sensors data and four classifiers were trained and combined through stacking to detect falls. We compared the performance of two population-specific models, trained and tested on either able-bodied or amputee participants, with that of a model trained on able-bodied participants and tested on amputees. A simple threshold-based classifier was used to benchmark our machine-learning classifier. The accuracy of fall detection in amputees for a model trained on control individuals (sensitivity: mean 0.989, 1.96*standard error of the mean [SEM] 0.017; specificity: mean 0.968, SEM 0.025) was not statistically different (P=.69) from that of a model trained on the amputee population (sensitivity: mean 0.984, SEM 0.016; specificity: mean 0.965, SEM 0.022). Detection of falls in control individuals yielded similar results (sensitivity: mean 0.979, SEM 0.022; specificity: mean 0.991, SEM 0.012). A mean 2.2 (SD 1.7) false alarms per day were obtained when evaluating the model (vs mean 122.1, SD 166.1 based on thresholds) on data recorded as participants carried the phone during their daily routine for two or more days. Machine-learning classifiers outperformed the threshold-based one (P<.001). A mobile phone-based fall detection model can use data from non-amputee individuals to detect falls in individuals walking with a prosthesis. We successfully detected falls when the mobile phone was carried across multiple locations and without a predetermined orientation. Furthermore, the number of false alarms yielded by the model over a longer period of time was reasonably low. This moves the application of mobile phone-based fall detection systems closer to a real-world use case scenario. ©Nicholas Shawen, Luca Lonini, Chaithanya Krishna Mummidisetty, Ilona Shparii, Mark V Albert, Konrad Kording, Arun Jayaraman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 11.10.2017.

Impact of operational staging to improve patient throughput in an inner-city emergency department during the novel H1N1 influenza surge: a descriptive study.

PubMed

Waseem, Muhammad; McInerney, Joan E; Perales, Orlando; Leber, Mark

2012-01-01

A level 1 pediatric emergency department (ED) in a public hospital of South Bronx rapidly encountered a significant surge in ED patient census over several days as the novel H1N1 influenza outbreak occurred. Our aim was to identify ill patients with influenza-like illness and evaluate and treat them as expeditiously as possible without failing in our responsibility to treat all patients. We describe the ED response to the outbreak during 2009 H1N1-related visits. The objective of this study was to describe and compare pediatric ED visits during the fall 2009 H1N1 to that in the previous year. The department reorganized patient flow in the ED to maximize the understanding of where to best apportion our resources and to minimize walkout and return visit rates. We developed staging of the flow of patients. This included, but was not limited to, a rapid screening at pretriage stage, early registration before the formal triage, and expanding the service. We compared walkout rates during fall 2009 and fall 2008. Return visits for asthmatic patients within 7 days were also compared. Over a period of 48 days, 8841 patients visited the pediatric ED. The average number of visits during this outbreak was 184 per day (usual visits per day, 80-110). Overall ED visits increased by 93.6% (95% confidence interval [CI], 78.2%-109.6%; P < 0.001). Fifty-two patients tested positive for H1N1. The walkout rate was 2.9% (95% CI, 1.9%-4.0%) in 2009 compared with the walkout rate of 1.5% (95% CI, 1.0%-2.0%) in 2008. There were no statistically significant differences between walkouts (P = 0.06) and 7-day asthma revisits (P = 0.07) in 2008 and 2009 despite the almost doubling of the ED visits. Admission rates from 2009 did not significantly differ from 2008 (11.2% [990/8841] vs 10.2% [464/4560], P = 0.07). Staging of a surge volume allows ED administrators to maintain a strong control of a multipatient event to ensure an effective response and appropriate use of limited resources. The implementation of the reorganized measures during the fall 2009 H1N1-related surge in patient's visits resulted in improved patient flow without significant increase in walkout and 7-day asthma revisit rates. Our strategies accommodated the surge of patients in the ED.

THREE PLANETS ORBITING WOLF 1061

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

Wright, D. J.; Wittenmyer, R. A.; Tinney, C. G.

We use archival HARPS spectra to detect three planets orbiting the M3 dwarf Wolf 1061 (GJ 628). We detect a 1.36 M{sub ⊕} minimum-mass planet with an orbital period P = 4.888 days (Wolf 1061b), a 4.25 M{sub ⊕} minimum-mass planet with orbital period P = 17.867 days (Wolf 1061c), and a likely 5.21 M{sub ⊕} minimum-mass planet with orbital period P = 67.274 days (Wolf 1061d). All of the planets are of sufficiently low mass that they may be rocky in nature. The 17.867 day planet falls within the habitable zone for Wolf 1061 and the 67.274 day planetmore » falls just outside the outer boundary of the habitable zone. There are no signs of activity observed in the bisector spans, cross-correlation FWHMs, calcium H and K indices, NaD indices, or Hα indices near the planetary periods. We use custom methods to generate a cross-correlation template tailored to the star. The resulting velocities do not suffer the strong annual variation observed in the HARPS DRS velocities. This differential technique should deliver better exploitation of the archival HARPS data for the detection of planets at extremely low amplitudes.« less

Distress Tolerance Links Sleep Problems with Stress and Health in Homeless.

PubMed

Reitzel, Lorraine R; Short, Nicole A; Schmidt, Norman B; Garey, Lorra; Zvolensky, Michael J; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E; Businelle, Michael S

2017-11-01

We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.

Understanding drug interactions with St John's wort (Hypericum perforatum L.): impact of hyperforin content.

PubMed

Chrubasik-Hausmann, Sigrun; Vlachojannis, Julia; McLachlan, Andrew J

2018-02-07

The aim of this study was to review herb-drug interaction studies with St John's wort (Hypericum perforatum L.) with a focus on the hyperforin content of the extracts used in these studies. PUBMED was systematically searched to identify studies describing pharmacokinetic interactions involving St John's wort. Data on study design and the St John's wort extract or product were gathered to extract hyperforin content and daily dose used in interaction studies. This analysis demonstrates that significant herb-drug interactions (resulting in a substantial change in systemic exposure) with St John's wort products were associated with hyperforin daily dosage. Products that had a daily dose of <1 mg hyperforin were less likely to be associated with major interaction for drugs that were CYP3A4 or p-glycoprotein substrates. Although a risk of interactions cannot be excluded even for low-dose hyperforin St. John's wort extracts, the use of products that result in a dose of not more than 1 mg hyperforin per day is recommended to minimise the risk of interactions. This review highlights that the significance of herb-drug interactions with St John's wort is influenced by the nature of the herbal medicines product, particularly the hyperforin content. © 2018 Royal Pharmaceutical Society.

48 CFR 306.502 - Duties and responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... responsibilities. (a) Each OPDIV CA shall prepare an annual Competition Advocate Report (CAR), covering the prior... HHS CA not later than November 16 of each year or the next business day, if the due date falls on a non-business day. NIH's two CAs shall prepare and sign a joint report covering their respective areas...

48 CFR 306.502 - Duties and responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... responsibilities. (a) Each OPDIV CA shall prepare an annual Competition Advocate Report (CAR), covering the prior... HHS CA not later than November 16 of each year or the next business day, if the due date falls on a non-business day. NIH's two CAs shall prepare and sign a joint report covering their respective areas...

48 CFR 306.502 - Duties and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... responsibilities. (a) Each OPDIV CA shall prepare an annual Competition Advocate Report (CAR), covering the prior... HHS CA not later than November 16 of each year or the next business day, if the due date falls on a non-business day. NIH's two CAs shall prepare and sign a joint report covering their respective areas...

48 CFR 306.502 - Duties and responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... responsibilities. (a) Each OPDIV CA shall prepare an annual Competition Advocate Report (CAR), covering the prior... HHS CA not later than November 16 of each year or the next business day, if the due date falls on a non-business day. NIH's two CAs shall prepare and sign a joint report covering their respective areas...

48 CFR 306.502 - Duties and responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... responsibilities. (a) Each OPDIV CA shall prepare an annual Competition Advocate Report (CAR), covering the prior... HHS CA not later than November 16 of each year or the next business day, if the due date falls on a non-business day. NIH's two CAs shall prepare and sign a joint report covering their respective areas...

Knowing Where You're Going: Planning for Meaningful Course Closure

ERIC Educational Resources Information Center

Burgess-Van Aken, Barbara

2017-01-01

A literature review on approaches to a final course session reveals a dearth of attention to the issue. Options for last-day activities fall into three categories: professor-centered, activity-focused, and student-driven. Using the criterion that meaningful course closure calls for last-day activities that engage students in reflection not only…

An Analysis of Alternate Work Schedules in Selected Air Force Civil Engineering Squadrons.

DTIC Science & Technology

1982-09-01

find out if job satisfaction increased after implementation of the four-day workweek for the dissatisfied workers. Hodge and Tellier studied the...D. Tellier . "Employee Reactions to the Four-Day Week," California Management Review, Fall 1975, pp. 25-30. 27. Hull, C. Hadlai, and Norman H. Nie

Effects of Textbook and Teacher Definitions on Student Definitions of Psychology.

ERIC Educational Resources Information Center

Romer, Gail H.; Henley, Tracy B.

Two teachers gathered psychology definitions from 1,000 college students enrolled in introductory psychology classes on the first and last days of class during two successive fall terms at the University of Tennessee. A word analysis of first-day definitions suggested three major themes: behavior, mind/brain, and environment. These terms showed…

Historical Footage of John Glenn Friendship 7

NASA Technical Reports Server (NTRS)

1962-01-01

The Friendship mission launch on the 20th day of February marked the first time that an American attempts to orbit the Earth. Historical footage of John Glenn's suit up, ride out to the launch pad, countdown, liftoff, booster engine cutoff, and separation of the booster engine escape tower is shown. Views of the Earth, Glenn's manual control of the electrical fly-by wire system, and the recovery of the landing vehicle from the ocean are presented.

Comparison of fall prediction by the Hessisch Oldendorf Fall Risk Scale and the Fall Risk Scale by Huhn in neurological rehabilitation: an observational study.

PubMed

Hermann, Olena; Schmidt, Simone B; Boltzmann, Melanie; Rollnik, Jens D

2018-05-01

To calculate scale performance of the newly developed Hessisch Oldendorf Fall Risk Scale (HOSS) for classifying fallers and non-fallers in comparison with the Risk of Falling Scale by Huhn (FSH), a frequently used assessment tool. A prospective observational trail was conducted. The study was performed in a large specialized neurological rehabilitation facility. The study population ( n = 690) included neurological and neurosurgery patients during neurological rehabilitation with varying levels of disability. Around the half of the study patients were independent and dependent in the activities of daily living (ADL), respectively. Fall risk of each patient was assessed by HOSS and FSH within the first seven days after admission. Event of fall during rehabilitation was compared with HOSS and FSH scores as well as the according fall risk. Scale performance including sensitivity and specificity was calculated for both scales. A total of 107 (15.5%) patients experienced at least one fall. In general, fallers were characterized by an older age, a prolonged length of stay, and a lower Barthel Index (higher dependence in the ADL) on admission than non-fallers. The verification of fall prediction for both scales showed a sensitivity of 83% and a specificity of 64% for the HOSS scale, and a sensitivity of 98% with a specificity of 12% for the FSH scale, respectively. The HOSS shows an adequate sensitivity, a higher specificity and therefore a better scale performance than the FSH. Thus, the HOSS might be superior to existing assessments.

A retrospective review of fall risk factors in the bone marrow transplant inpatient service.

PubMed

Vela, Cory M; Grate, Lisa M; McBride, Ali; Devine, Steven; Andritsos, Leslie A

2018-06-01

Purpose The purpose of this study was to compare medications and potential risk factors between patients who experienced a fall during hospitalization compared to those who did not fall while admitted to the Blood and Marrow Transplant inpatient setting at The James Cancer Hospital. Secondary objectives included evaluation of transplant-related disease states and medications in the post-transplant setting that may lead to an increased risk of falls, post-fall variables, and number of tests ordered after a fall. Methods This retrospective, case-control study matched patients in a 2:1 ratio of nonfallers to fallers. Data from The Ohio State University Wexner Medical Center (OSUWMC) reported fall events and patient electronic medical records were utilized. A total of 168 adult Blood and Marrow Transplant inpatients with a hematological malignancy diagnosis were evaluated from 1 January 2010 to 30 September 2012. Results Univariable and multivariable conditional logistic regression models were used to assess the relationship between potential predictor variables of interest and falls. Variables that were found to be significant predictors of falls from the univariable models include age group, incontinence, benzodiazepines, corticosteroids, anticonvulsants and antidepressants, and number of days status-post transplant. When considered for a multivariable model age group, corticosteroids, and a cancer diagnosis of leukemia were significant in the final model. Conclusion Recent medication utilization such as benzodiazepines, anticonvulsants, corticosteroids, and antidepressants placed patients at a higher risk of experiencing a fall. Other significant factors identified from a multivariable analysis found were patients older than age 65, patients with recent corticosteroid administration and a cancer diagnosis of leukemia.

Ozone and daily mortality rate in 21 cities of East Asia: how does season modify the association?

PubMed

Chen, Renjie; Cai, Jing; Meng, Xia; Kim, Ho; Honda, Yasushi; Guo, Yue Leon; Samoli, Evangelia; Yang, Xin; Kan, Haidong

2014-10-01

Previous studies in East Asia have revealed that the short-term associations between tropospheric ozone and daily mortality rate were strongest in winter, which is opposite to the findings in North America and Western Europe. Therefore, we investigated the season-varying association between ozone and daily mortality rate in 21 cities of East Asia from 1979 to 2010. Time-series Poisson regression models were used to analyze the association between ozone and daily nonaccidental mortality rate in each city, testing for different temperature lags. The best-fitting model was obtained after adjustment for temperature in the previous 2 weeks. Bayesian hierarchical models were applied to pool the city-specific estimates. An interquartile-range increase of the moving average concentrations of same-day and previous-day ozone was associated with an increase of 1.44% (95% posterior interval (PI): 1.08%, 1.80%) in daily total mortality rate after adjustment for temperature in the previous 2 weeks. The corresponding increases were 0.62% (95% PI: 0.08%, 1.16%) in winter, 1.46% (95% PI: 0.89%, 2.03%) in spring, 1.60% (95% PI: 1.03%, 2.17%) in summer, and 1.12% (95% PI: 0.73%, 1.51%) in fall. We found significant associations between short-term exposure to ozone and higher mortality rate in East Asia that varied considerably from season to season with a significant trough in winter. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

PubMed

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

2012-06-01

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

Persistence and performance of esfenvalerate residues on broccoli.

PubMed

Antonious, George F

2002-01-01

The efficacy of esfenvalerate (84 g litre-1 EC; Asana XL) at 7.0 g AI ha-1 on broccoli was tested against the flea beetle, Phyllotreta cruciferae Goeze (Chrysomelidae: Coleoptera) and the imported cabbage worm, Pieris rapae L (Pieridae: Lepidoptera) under field conditions. Insect populations were monitored before and after treatment. Periodic sweep-net collections and examination of the leaves in treated and untreated broccoli plots revealed mean reductions of P cruciferae levels of nearly 98% 1 week post-application compared with untreated plots. The residual toxicity of esfenvalerate was also effective for 2 weeks in reducing population density of P rapae by 69% on broccoli leaves. The impact of esfenvalerate on feeding damage to broccoli leaves was established by counting the number of feeding holes made by P cruciferae on spring broccoli and P rapae on fall broccoli. As the leaf area ingested increased, a linear relationship was seen between the number of holes and number of insects. Results indicated that forage destruction by the two pests was significantly reduced by esfenvalerate application. Esfenvalerate was extracted from broccoli at 1 h and 1, 3, 7, 10, and 14 days post-application for residue analysis. Residues on spring broccoli were 12.2, 5.2 and 2.9 micrograms cm-2 on the leaves and 0.13, 0.05 and 0.02 microgram g-1 on the heads at 1 h, 1 and 3 days, respectively. Only trace levels (0.001 microgram g-1) were detected in/on the heads 14 days after spraying. On the basis of half-life (T1/2) values, persistence of esfenvalerate on spring broccoli leaves (T1/2 = 1 day) was shorter than on fall broccoli (T1/2 = 1.6 days). T1/2 values were 2.1 and 3.6 days on spring and fall broccoli heads, respectively. The implications of these residue levels on re-entry times into treated fields are discussed.

Incidence and outcome of injury in Ghana: a community-based survey.

PubMed Central

Mock, C. N.; Abantanga, F.; Cummings, P.; Koepsell, T. D.

1999-01-01

Injury is an increasingly significant health problem in most low-income countries. However, strategies for preventing injury have not been well addressed. The present study was carried out to measure the incidence and outcome of various mechanisms of injury in Ghana in order to provide data for use in developing priorities for injury prevention efforts. For this purpose, using two-stage cluster sampling and household interviews, we surveyed 21,105 persons living in 431 urban and rural sites. During the preceding year, 1609 injuries resulting in one or more days of loss of normal activity were reported. Injury-related mortality was slightly higher in the urban (83 per 100,000) than in the rural area (53 per 100,000). However, the burden of disability from nonfatal injuries, as assessed by disability days, was higher in the rural (4697 disability days per 1000 person-years) than in the urban area (2671 days per 1000 person-years). Based on incidence rates and disability times, the major types of injury in the urban area were transport-related injury and falls. In the rural area, agricultural injuries predominated, followed by falls and transport-related injury. In rural and urban areas combined, 73% of motor vehicle-related injuries involved commercial vehicles. In this and other similar developing-country settings, injury prevention efforts should focus on falls and on transport safety in both urban and rural areas, with special attention being paid to commercial vehicles. In rural areas, agricultural injuries contributed the largest burden of morbidity, and should be a priority for prevention efforts. PMID:10680242

The ET as it falls away from the orbiter after separation on STS-121

NASA Image and Video Library

2006-07-04

S121-E-05006 (4 July 2006) --- This picture of the STS-121 external tank was taken with a digital still camera by an astronaut only seconds after separation from the Space Shuttle Discovery on launch day. Engineers, managers and flight controllers have carefully studied this image and other frames from this series as well as a number of pictures showing the falling ET as photographed from umbilical well cameras.