Deep Learning to Predict Falls in Older Adults Based on Daily-Life Trunk Accelerometry.

PubMed

Nait Aicha, Ahmed; Englebienne, Gwenn; van Schooten, Kimberley S; Pijnappels, Mirjam; Kröse, Ben

2018-05-22

Early detection of high fall risk is an essential component of fall prevention in older adults. Wearable sensors can provide valuable insight into daily-life activities; biomechanical features extracted from such inertial data have been shown to be of added value for the assessment of fall risk. Body-worn sensors such as accelerometers can provide valuable insight into fall risk. Currently, biomechanical features derived from accelerometer data are used for the assessment of fall risk. Here, we studied whether deep learning methods from machine learning are suited to automatically derive features from raw accelerometer data that assess fall risk. We used an existing dataset of 296 older adults. We compared the performance of three deep learning model architectures (convolutional neural network (CNN), long short-term memory (LSTM) and a combination of these two (ConvLSTM)) to each other and to a baseline model with biomechanical features on the same dataset. The results show that the deep learning models in a single-task learning mode are strong in recognition of identity of the subject, but that these models only slightly outperform the baseline method on fall risk assessment. When using multi-task learning, with gender and age as auxiliary tasks, deep learning models perform better. We also found that preprocessing of the data resulted in the best performance (AUC = 0.75). We conclude that deep learning models, and in particular multi-task learning, effectively assess fall risk on the basis of wearable sensor data.

Deep Learning to Predict Falls in Older Adults Based on Daily-Life Trunk Accelerometry

PubMed Central

Englebienne, Gwenn; Pijnappels, Mirjam

2018-01-01

Early detection of high fall risk is an essential component of fall prevention in older adults. Wearable sensors can provide valuable insight into daily-life activities; biomechanical features extracted from such inertial data have been shown to be of added value for the assessment of fall risk. Body-worn sensors such as accelerometers can provide valuable insight into fall risk. Currently, biomechanical features derived from accelerometer data are used for the assessment of fall risk. Here, we studied whether deep learning methods from machine learning are suited to automatically derive features from raw accelerometer data that assess fall risk. We used an existing dataset of 296 older adults. We compared the performance of three deep learning model architectures (convolutional neural network (CNN), long short-term memory (LSTM) and a combination of these two (ConvLSTM)) to each other and to a baseline model with biomechanical features on the same dataset. The results show that the deep learning models in a single-task learning mode are strong in recognition of identity of the subject, but that these models only slightly outperform the baseline method on fall risk assessment. When using multi-task learning, with gender and age as auxiliary tasks, deep learning models perform better. We also found that preprocessing of the data resulted in the best performance (AUC = 0.75). We conclude that deep learning models, and in particular multi-task learning, effectively assess fall risk on the basis of wearable sensor data. PMID:29786659

Relationship between the use of benzodiazepines and falls in older adults: A systematic review.

PubMed

Díaz-Gutiérrez, Mª José; Martínez-Cengotitabengoa, Mónica; Sáez de Adana, Estíbaliz; Cano, Ana Isabel; Martínez-Cengotitabengoa, Maria Teresa; Besga, Ariadna; Segarra, Rafael; González-Pinto, Ana

2017-07-01

Falls in the elderly represent a major health problem. The etiology of falls is usually multifactorial. Special attention should be paid on benzodiazepines (BZDs) since they are widely used by older adults. A literature search of the PUBMED and EMBASE databases from January 2007 to February 2017 was conducted using the MeSH terms "benzodiazepines", "elderly" and "falls" or "accidental falls". The systematic review was performed according to PRISMA criteria. Of the 27 references selected for full reading from 235 found, 15 were eliminated and 12 papers were selected for systematic review. Exposure to BZDs was associated with a higher risk of falls in older adults, which is consistent with the results reported in the literature and previous reviews and meta-analyses. BZDs increase the risk of falling when used either as monotherapy or in combined therapies. It is preferable to use short-acting BZDs, to avoid cumulative effects over time predisposing to falls. A high proportion of falls in older adults are related to the use of BZDs. They should be prescribed to older patients in accordance with current clinical guidelines and reviewed over time. BZDs should be prescribed as a short-term therapy and progressively withdrawn. Short-acting BZDs should be the treatment of choice. Copyright © 2017 Elsevier B.V. All rights reserved.

Reliability and Validity of the Short Falls Efficacy Scale International in English, Mandarin, and Bahasa Malaysia in Malaysia.

PubMed

Tan, Maw Pin; Nalathamby, Nemala; Mat, Sumaiyah; Tan, Pey June; Kamaruzzaman, Shahrul Bahyah; Morgan, Karen

2018-01-01

While the prevalence of falls among Malaysian older adults is comparable to other older populations around the world, little is currently known about fear of falling in Malaysia. The Falls Efficacy Scale International (FES-I) and short FES-I scales to measure fear of falling have not yet been validated for use within the Malaysian population, and are currently not available in Bahasa Malaysia (BM). A total of 402 participants aged ≥63 years were recruited. The questionnaire was readministered to 149 participants, 4 to 8 weeks after the first administration to determine test-retest reliability. The original version of the 7-item short FES-I is available in English, while the Mandarin was adapted from the 16-item Mandarin FES-I. The BM version was translated according to protocol by four experts. The internal structure of the FES-I was examined by factor analysis. The 7-item short FES-I showed good internal reliability and test-retest reliability for English, Mandarin, and BM versions for Malaysia.

Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up.

PubMed

Arkkukangas, Marina; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

2017-02-27

In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency. A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization. A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups. In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

[Cost]effectiveness of withdrawal of fall-risk increasing drugs versus conservative treatment in older fallers: design of a multicenter randomized controlled trial (IMPROveFALL-study)

PubMed Central

2011-01-01

Background Fall incidents represent an increasing public health problem in aging societies worldwide. A major risk factor for falls is the use of fall-risk increasing drugs. The primary aim of the study is to compare the effect of a structured medication assessment including the withdrawal of fall-risk increasing drugs on the number of new falls versus 'care as usual' in older adults presenting at the Emergency Department after a fall. Methods/Design A prospective, multi-center, randomized controlled trial will be conducted in hospitals in the Netherlands. Persons aged ≥65 years who visit the Emergency Department due to a fall are invited to participate in this trial. All patients receive a full geriatric assessment at the research outpatient clinic. Patients are randomized between a structured medication assessment including withdrawal of fall-risk increasing drugs and 'care as usual'. A 3-monthly falls calendar is used for assessing the number of falls, fallers and associated injuries over a one-year follow-up period. Measurements will be at three, six, nine, and twelve months and include functional outcome, healthcare consumption, socio-demographic characteristics, and clinical information. After twelve months a second visit to the research outpatient clinic will be performed, and adherence to the new medication regimen in the intervention group will be measured. The primary outcome will be the incidence of new falls. Secondary outcome measurements are possible health effects of medication withdrawal, health-related quality of life (Short Form-12 and EuroQol-5D), costs, and cost-effectiveness of the intervention. Data will be analyzed using an intention-to-treat analysis. Discussion The successful completion of this trial will provide evidence on the effectiveness of withdrawal of fall-risk increasing drugs in older patients as a method for falls reduction. Trial Registration The trial is registered in the Netherlands Trial Register (NTR1593) PMID:21854643

Tai Chi for Risk of Falls. A Meta-analysis.

PubMed

Lomas-Vega, Rafael; Obrero-Gaitán, Esteban; Molina-Ortega, Francisco J; Del-Pino-Casado, Rafael

2017-09-01

To analyze the effectiveness of tai chi for falls prevention. Systematic review and meta-analysis. Pubmed, Scopus, CINHAL, and Physiotherapy Evidence Database (PEDro) were searched to May 26, 2016. Older adult population and at-risk adults. Randomized controlled trials analyzing the effect of tai chi versus other treatments on risk of falls. The incidence rate ratio (IRR) for falls incidence and hazard ratio (HR) for time to first fall. The search strategy identified 891 potentially eligible studies, of which 10 met the inclusion criteria. There was high-quality evidence of a medium protective effect for fall incidence over the short term (IRR = 0.57; 95% CI = 0.46, 0.70) and a small protective effect over the long term (IRR = 0.87; 95% CI = 0.77, 0.98). Regarding injurious falls, we found very low-quality evidence of a medium protective effect over the short term (IRR = 0.50; 95% CI = 0.33, 0.74) and a small effect over the long term (IRR = 0.72; 95% CI = 0.54, 0.95). There was no effect on time to first fall, with moderate quality of evidence (HR = 0.98; 95% CI = 0.69, 1.37). In at-risk adults and older adults, tai chi practice may reduce the rate of falls and injury-related falls over the short term (<12 months) by approximately 43% and 50%, respectively. Tai chi practice may not influence time to first fall in these populations. Due to the low quality of evidence, more studies investigating the effects of tai chi on injurious falls and time to first fall are required. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

17 CFR Appendix A to Part 190 - Bankruptcy Forms

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Attempt to estimate short-fall in customer segregated funds. a. If there is a substantial short-fall of customer segregated funds, the trustee should: i. Contact the DSRO and attempt to effectuate a transfer... transfer is highly unlikely. ii. If a bulk transfer cannot be effectuated, liquidate all customer commodity...

Associations between the Five-Factor Model of Personality and Health Behaviors among College Students

ERIC Educational Resources Information Center

Raynor, Douglas A.; Levine, Heidi

2009-01-01

Objective: In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. Methods: College students (N = 583) completed the American College Health Association-National College Health Assessment and the International Personality Item Pool Big Five short-form questionnaire. Results:…

Bridging the School-Home Divide in the Middle Grades: A Process for Strengthening School-Family Partnerships

ERIC Educational Resources Information Center

Kyzar, Kathleen; Jimerson, Jo Beth

2018-01-01

Evidence around adolescent learning and development is clear: School-family partnerships matter. However, traditional methods for engaging families that narrowly define who is involved and what constitutes involvement fall short of promoting optimal outcomes. Meaningful family engagement practices involve reciprocal, two-way interactions between…

Beyond Immanent and Transcendent Critique: Exploring Maul's Argument within the NRC (2001) Framework

ERIC Educational Resources Information Center

Duckor, Brent

2017-01-01

In Andrew Maul's focus paper "Rethinking Traditional Methods of Survey Validation'" published in this issue of "Measurement: Interdisciplinary Research and Perspectives," Maul contends that self-report measures may be particularly difficult to validate. He cautions that such techniques may fall short of providing the kinds of…

Whole-Grain Continuing Education for School Foodservice Personnel: Keeping Kids from Falling Short

ERIC Educational Resources Information Center

Roth-Yousey, Lori; Barno, Trina; Caskey, Mary; Asche, Kimberly; Reicks, Marla

2009-01-01

Objective: The purpose of this project was to develop and test whole-grain continuing education for school foodservice personnel. Methods: A continuing education program was developed to address planning, purchasing, preparing, and serving whole-grain food in schools. Participants completed a pre-post questionnaire to assess changes in knowledge,…

Mortality estimation from carcass searches using the R-package carcass – a tutorial

EPA Science Inventory

This article is a tutorial for the R-package carcass. It starts with a short overview of common methods used to estimate mortality based on carcass searches. Then, it guides step by step through a simple example. First, the proportion of animals that fall into the search area is ...

Chemocoding as an identification tool where morphological- and DNA-based methods fall short: Inga as a case study.

PubMed

Endara, María-José; Coley, Phyllis D; Wiggins, Natasha L; Forrister, Dale L; Younkin, Gordon C; Nicholls, James A; Pennington, R Toby; Dexter, Kyle G; Kidner, Catherine A; Stone, Graham N; Kursar, Thomas A

2018-04-01

The need for species identification and taxonomic discovery has led to the development of innovative technologies for large-scale plant identification. DNA barcoding has been useful, but fails to distinguish among many species in species-rich plant genera, particularly in tropical regions. Here, we show that chemical fingerprinting, or 'chemocoding', has great potential for plant identification in challenging tropical biomes. Using untargeted metabolomics in combination with multivariate analysis, we constructed species-level fingerprints, which we define as chemocoding. We evaluated the utility of chemocoding with species that were defined morphologically and subject to next-generation DNA sequencing in the diverse and recently radiated neotropical genus Inga (Leguminosae), both at single study sites and across broad geographic scales. Our results show that chemocoding is a robust method for distinguishing morphologically similar species at a single site and for identifying widespread species across continental-scale ranges. Given that species are the fundamental unit of analysis for conservation and biodiversity research, the development of accurate identification methods is essential. We suggest that chemocoding will be a valuable additional source of data for a quick identification of plants, especially for groups where other methods fall short. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

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

PubMed

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

2015-01-01

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

Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics.

PubMed

Seppala, Lotta J; Wermelink, Anne M A T; de Vries, Max; Ploegmakers, Kimberley J; van de Glind, Esther M M; Daams, Joost G; van der Velde, Nathalie

2018-04-01

Falls are a major public health problem in older adults. Earlier studies showed that psychotropic medication use increases the risk of falls. The aim of this study is to update the current knowledge by providing a comprehensive systematic review and meta-analysis on psychotropic medication use and falls in older adults. This study is a systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were "falls," "aged," "medication," and "causality." Studies were included that investigated psychotropics (antipsychotics, antidepressants, anxiolytics, sedatives, and hypnotics) as risk factors for falls in participants ≥60 years of age or participants with a mean age of ≥70 years. Meta-analyses were performed using generic inverse variance method pooling unadjusted and adjusted odds ratio (OR) estimates separately. In total, 248 studies met the inclusion criteria for qualitative synthesis. Meta-analyses using adjusted data showed the following pooled ORs: antipsychotics 1.54 [95% confidence interval (CI) 1.28-1.85], antidepressants 1.57 (95% Cl 1.43-1.74), tricyclic antidepressants 1.41 (95% CI 1.07-1.86), selective serotonin reuptake inhibitors 2.02 (95% CI 1.85-2.20), benzodiazepines 1.42 (95%, CI 1.22-1.65), long-acting benzodiazepines 1.81 (95%, CI 1.05-3.16), and short-acting benzodiazepines 1.27 (95%, CI 1.04-1.56) Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and healthcare setting. Antipsychotics, antidepressants, and benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Prescription bias could not be accounted for. Future studies need to address pharmacologic subgroups as fall risk may differ depending on specific medication properties. Precise and uniform classification of target medication (Anatomical Therapeutic Chemical Classification) is essential for valid comparisons between studies. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Soft-short management and remediation in 10-year-old NiCds in Geo orbit

NASA Technical Reports Server (NTRS)

Flordeliza, Nicanor A.; Bounds, Ronald W.

1996-01-01

After 10 years in Geo orbit, during the spring 1993 eclipse season, soft shorts occurred in cells of two of the three batteries on the F2R spacecraft On battery #1, the cell soft short turned suddenly into a hard short; the resulting sudden 1.2V fall in battery voltage and rise in temperature was observed via telemetry. On battery #3, the deleterious impact of its soft short increased day by day, manifesting itself as a drop in battery voltage part-way through each eclipse, causing high loading on the remaining good battery. This paper reports how by planned charge management, including applying (against-the-book) overcharge ratios (C/D) exceeding 1.75, the battery #3 cell soft short was 'built down' until the cell voltage fade ceased. The problem with the battery #3 soft-shorted cell was fought with partial success throughout the latter half of the fall 93 season, and the lessons learned were applied to alleviate the problem during the spring 94 and fall 94 eclipse seasons. The life of the spacecraft was successfully prolonged until it was retired in March 1995.

Struggles for Order and Control of School Behaviour: A Sketch for a Social Psychology

ERIC Educational Resources Information Center

Funnell, Robert

2009-01-01

Behaviour management is acknowledged as a leading psychological method to reduce classroom conflict by applying "rational choice" techniques. But it falls short in schools where poor academic results are reproduced, as is illustrated in an analysis of misbehaviour in an Australian rural school. It is argued that explanations of behaviour…

Statistics for Time-Series Spatial Data: Applying Survival Analysis to Study Land-Use Change

ERIC Educational Resources Information Center

Wang, Ninghua Nathan

2013-01-01

Traditional spatial analysis and data mining methods fall short of extracting temporal information from data. This inability makes their use difficult to study changes and the associated mechanisms of many geographic phenomena of interest, for example, land-use. On the other hand, the growing availability of land-change data over multiple time…

Gaming as an Educational Strategy to Enhance Clinical Judgment and Knowledge Retention

ERIC Educational Resources Information Center

Lane, Jodie

2011-01-01

Classroom lecture methods in nursing education are falling short of providing long-term retention of knowledge and do not enhance problem solving skills or clinical judgment at the bedside. This problem impacts the health care recipients because applied knowledge and an enhanced skill set can provide nurses with confident clinical judgment to…

Toward a New Approach to the Evaluation of a Digital Curriculum Using Learning Analytics

ERIC Educational Resources Information Center

Rangel, Virginia Snodgrass; Bell, Elizabeth R.; Monroy, Carlos; Whitaker, J. Reid

2015-01-01

Understanding how an educational intervention is implemented is essential to evaluating its effectiveness. With the increased use of digital tools in classrooms, however, traditional methods of measuring implementation fall short. Fortunately, there is a way to learn about the interactions that users have with digital tools that are embedded into…

School Gardens as a Strategy for Increasing Fruit and Vegetable Consumption

ERIC Educational Resources Information Center

Oxenham, Erin; King, Amber D.

2010-01-01

School gardens as a form of nutrition education have become widespread. It is well known that children fall short of the daily recommended intake of fruit and vegetables. School-garden based programs show promise as a method of hands-on learning that promotes and increases fruit and vegetable consumption among school-aged children. There is little…

Growing spearmint, thyme, oregano, and rosemary in Northern Wyoming using plastic tunnels

USDA-ARS?s Scientific Manuscript database

Growing perennial herbs in northern climate such as Northern Wyoming is a challenge. Due to short frost-free period, high wind, and inclement weather it is impossible to harvest any herbs twice a year (summer and late fall) without using any form of season extension methods. Hence, we set up an expe...

Investors’ risk attitudes and stock price fluctuation asymmetry

NASA Astrophysics Data System (ADS)

Zhang, Yu; Li, Honggang

2011-05-01

Price rise/fall asymmetry, which indicates enduring but modest rises and sudden short-term falls, is a ubiquitous phenomenon in stock markets throughout the world. Instead of the widely used time series method, we adopt inverse statistics from turbulence to analyze this asymmetry. To explore its underlying mechanism, we build a multi-agent model with two kinds of investors, which are specifically referred to as fundamentalists and chartists. Inspired by Kahneman and Tversky’s claim regarding peoples’ asymmetric psychological responses to the equivalent levels of gains and losses, we assume that investors take different risk attitudes to gains and losses and adopt different trading strategies. The simulation results of the model developed herein are consistent with empirical work, which may support our conjecture that investors’ asymmetric risk attitudes might be one origin of rise/fall asymmetry.

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.

Horizontal lifelines - review of regulations and simple design method considering anchorage rigidity.

PubMed

Galy, Bertrand; Lan, André

2018-03-01

Among the many occupational risks construction workers encounter every day falling from a height is the most dangerous. The objective of this article is to propose a simple analytical design method for horizontal lifelines (HLLs) that considers anchorage flexibility. The article presents a short review of the standards and regulations/acts/codes concerning HLLs in Canada the USA and Europe. A static analytical approach is proposed considering anchorage flexibility. The analytical results are compared with a series of 42 dynamic fall tests and a SAP2000 numerical model. The experimental results show that the analytical method is a little conservative and overestimates the line tension in most cases with a maximum of 17%. The static SAP2000 results show a maximum 2.1% difference with the analytical method. The analytical method is accurate enough to safely design HLLs and quick design abaci are provided to allow the engineer to make quick on-site verification if needed.

Home ownership and fall-related outcomes among older adults in South Korea.

PubMed

Do, Young Kyung; Kim, Cheong-Seok

2013-10-01

Many of the previously identified environmental risk factors for fall-related outcomes (e.g. flooring, stairs and steps, kitchen, and bathrooms) are amenable to change, but the extent of the changes on these home-related risk factors are conditional on home ownership of the elderly. This study aims to test whether lack of home ownership is associated with a higher risk of falls, and a higher likelihood of reporting fear of falling and activity limitations due to fear of falling among older adults in South Korea. Using data from the first two waves (2006 and 2008) of the Korean Longitudinal Study of Aging, the associations between home ownership variables and three fall-related outcomes were examined in two regression models. A logistic regression model of any falls in the past 2 years was estimated to examine whether older adults living in short-term rental homes based on monthly rent have an increased risk of falls. A probit model accounting for sample selection was estimated to examine whether the two related outcomes, fear of falling and limiting activities due to fear of falling, are associated with home ownership status. Compared with owned home, short-term rental home predicted a higher likelihood of incident of falls and activity limitation due to fear of falling. The study findings suggest that the lack of home ownership with unstable housing tenure is an important risk factor for fall-related outcomes among older adults in South Korea. © 2012 Japan Geriatrics Society.

Factors associated with short sleep duration in adolescents

PubMed Central

Felden, Érico Pereira Gomes; Filipin, Douglas; Barbosa, Diego Grasel; Andrade, Rubian Diego; Meyer, Carolina; Louzada, Fernando Mazilli

2016-01-01

Abstract Objective: This study aimed to investigate the prevalence and factors associated with short sleep duration in adolescents from Maravilha – Santa Catarina (SC), southern Brazil. Methods: The sample consisted of 516 adolescents aged 10–19 years of both genders. Issues associated with short sleep duration and difficulty falling asleep, chronotype, daytime sleepiness, physical activity, sedentary behavior and weight status were investigated. Results: The prevalence of short sleep duration (<8h on school days) was 53.6%. Adolescents aged 17–19 years showed a 2.05-fold (95%CI: 1.20–3.50) greater prevalence of short sleep duration than those aged 10–12 years. The ones studying in morning and evening shifts had a higher prevalence of short sleep duration compared to those in the afternoon shift. Older age and school shift were the main factors associated with short sleep duration. Conclusions: Adolescents from Maravilha showed high prevalence of short sleep duration, and older adolescents that studied in the morning and evening shifts showed reduced sleep. PMID:26559604

A Mixed-Methods Examination of Influences on the Shape and Malleability of Technological Pedagogical Content Knowledge (TPACK) in Graduate Teacher Education Students

ERIC Educational Resources Information Center

Sabo, Kent

2013-01-01

Concerted efforts have been made within teacher preparation programs to integrate teaching with technology into the curriculum. Unfortunately, these efforts continue to fall short as teachers' application of educational technology is unsophisticated and not well integrated. The most prevalent approaches to integrating technology tend to ignore…

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

PubMed

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

2015-01-01

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

Short-term risk of falling after cochlear implantation.

PubMed

Stevens, Madelyn N; Baudhuin, Jacqueline E; Hullar, Timothy E

2014-01-01

Cochlear implantation is a highly effective intervention for hearing loss, but insertion of an implant into the cochlea is often accompanied by loss of residual hearing function. Sometimes, postoperative testing also shows loss of function in the semicircular canals or otolith organs. The effect of this loss on equilibrium, particularly in the short term following surgery, and the risk of falling due to this loss is unknown. We prospectively measured balance in 16 consecutive adult cochlear implant patients before and 2 weeks after surgery. Subjects stood on a foam pad with eyes closed, feet together and arms at the side. The length of time over which this posture could be maintained was recorded up to a maximum value of 30 s indicating normal performance. Ten of 16 subjects reached a maximal time on preoperative testing. Nine of 16 subjects lost balance function after surgery. Four of the 10 subjects with normal preoperative balance function lost function. Subjects older than the age of 60 were more likely to lose balance function than younger subjects. We used previously published values relating balance performance on foam to risk of falling to calculate the fall risk among our subjects. The relative risk of falling increased after surgery by more than threefold in some patients. Imbalance after cochlear implantation may be much more common, particularly in the short term, than previously appreciated. This imbalance is accompanied by an increased risk of falling in many patients. Careful preoperative counseling before implantation and postoperative therapeutic intervention to improve comfort and reduce the chance of falling may be warranted, particularly in patients at a risk for injuries from falls (level of evidence: 2b). © 2014 S. Karger AG, Basel.

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

PubMed Central

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

2014-01-01

Introduction Falls and fall-related injuries are a serious cause of morbidity and cost to society. Foot problems and inappropriate footwear may increase the risk of falls; therefore podiatric interventions may play a role in reducing falls. Two Cochrane systematic reviews identified only one study of a podiatry intervention aimed to reduce falls, which was undertaken in Australia. The REFORM trial aims to evaluate the clinical and cost-effectiveness of a multifaceted podiatry intervention in reducing falls in people aged 65 years and over in a UK and Irish setting. Methods and analysis This multicentre, cohort randomised controlled trial will recruit 2600 participants from routine podiatry clinics in the UK and Ireland to the REFORM cohort. In order to detect a 10% point reduction in falls from 50% to 40%, with 80% power 890 participants will be randomised to receive routine podiatry care and a falls prevention leaflet or routine podiatry care, a falls prevention leaflet and a multifaceted podiatry intervention. The primary outcome is rate of falls (falls/person/time) over 12 months assessed by patient self-report falls diary. Secondary self-report outcome measures include: the proportion of single and multiple fallers and time to first fall over a 12-month period; Short Falls Efficacy Scale—International; fear of falling in the past 4 weeks; Frenchay Activities Index; fracture rate; Geriatric Depression Scale; EuroQoL-five dimensional scale 3-L; health service utilisation at 6 and 12 months. A qualitative study will examine the acceptability of the package of care to participants and podiatrists. Ethics and dissemination The trial has received a favourable opinion from the East of England—Cambridge East Research Ethics Committee and Galway Research Ethics Committee. The trial results will be published in peer-reviewed journals and at conference presentations. Trial registration number Current Controlled Trials ISRCTN68240461assigned 01/07/2011. PMID:25518875

Running functional sport vest and short for e-textile applications

NASA Astrophysics Data System (ADS)

Baskan, H.; Acikgoz, H.; Atakan, R.; Eryuruk, H.; Akalın, N.; Kose, H.; Li, Y.; Kursun Bahadir, S.; Kalaoglu, F.

2017-10-01

Sports garments with functional properties have become crucial as well as comfort properties since they improve the wearer performance. For this reason, sport vest and short having high elastic recovery with fall detection sensor, were designed and produced by using flat-bed knitting machine. Comfort properties of short and vest were tested with several test instruments and; tensile strength of elastomeric yarn, air permeability, moisture management, drape and objective handle (FAST tests) of garments were achieved. It was proved that short and vest samples have good comfort properties as a functional sport garment. It was also tested that fall-detection sensor can work efficiently by using a mobile phone application.

Biofidelic neck influences head kinematics of parietal and occipital impacts following short falls in infants.

PubMed

Sullivan, Sarah; Coats, Brittany; Margulies, Susan S

2015-09-01

Falls are a major cause of traumatic head injury in children. Understanding head kinematics during low height falls is essential for evaluating injury risk and designing mitigating strategies. Typically, these measurements are made with commercial anthropomorphic infant surrogates, but these surrogates are designed based on adult biomechanical data. In this study, we improve upon the state-of-the-art anthropomorphic testing devices by incorporating new infant cadaver neck bending and tensile data. We then measure head kinematics following head-first falls onto 4 impact surfaces from 3 fall heights with occipital and parietal head impact locations. The biofidelic skull compliance and neck properties of the improved infant surrogate significantly influenced the measured kinematic loads, decreasing the measured impact force and peak angular accelerations, lowering the expected injury risk. Occipital and parietal impacts exhibited distinct kinematic responses in primary head rotation direction and the magnitude of the rotational velocities and accelerations, with larger angular velocities as the head rebounded after occipital impacts. Further evaluations of injury risk due to short falls should take into account the impact surface and head impact location, in addition to the fall height. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biofidelic neck influences head kinematics of parietal and occipital impacts following short falls in infants

PubMed Central

Sullivan, Sarah; Coats, Brittany; Margulies, Susan S.

2015-01-01

Falls are a major cause of traumatic head injury in children. Understanding head kinematics during low height falls is essential for evaluating injury risk and designing mitigating strategies. Typically, these measurements are made with commercial anthropomorphic infant surrogates, but these surrogates are designed based on adult biomechanical data. In this study, we improve upon the state-of-the-art anthropomorphic testing devices by incorporating new infant cadaver neck bending and tensile data. We then measure head kinematics following head-first falls onto 4 impact surfaces from 3 fall heights with occipital and parietal head impact locations. The biofidelic skull compliance and neck properties of the improved infant surrogate significantly influenced the measured kinematic loads, decreasing the measured impact force and peak angular accelerations, lowering the expected injury risk. Occipital and parietal impacts exhibited distinct kinematic responses in primary head rotation direction and the magnitude of the rotational velocities and accelerations, with larger angular velocities as the head rebounded after occipital impacts. Further evaluations of injury risk due to short falls should take into account the impact surface and head impact location, in addition to the fall height. PMID:26072183

Assessment of head injury risk associated with feet-first free falls in 12-month-old children using an anthropomorphic test device.

PubMed

Thompson, Angela K; Bertocci, Gina; Pierce, Mary Clyde

2009-04-01

Short distance falls are a common false history provided in cases of child abuse. Falls are also a common occurrence in ambulating young children. The purpose of this study was to determine the risk of head injury in short distance feet-first free falls for a 12-month-old child. Feet-first free falls were simulated using an anthropomorphic test device. Three fall heights and five surfaces were tested to determine whether changing fall environment characteristics leads to differences in head injury risk outcomes. Linear head accelerations were measured and angular head accelerations in the anterior-posterior direction were determined. Head injury criteria values and impact durations were also determined for each fall. The mean peak linear head acceleration across all trials was 52.2g. HIC15 values were all below the injury assessment reference value. The mean peak angular head acceleration across all trials was 4,246 rad/s2. Impact durations ranged from 12.1 milliseconds to 27.8 milliseconds. In general, head accelerations were greater and impact durations were lower for surfaces with lower coefficients of restitution (a measure of resiliency). In falls onto wood and linoleum over concrete, the ground-based fall was associated with greater accelerations than the two higher fall heights. Results show that fall dynamics play an important role in head injury outcome measures. Different fall heights and impact surfaces led to differences in head injury risk, but the risk of severe head injury across all tested scenarios was low for a 12-month-old child in feet-first free falls.

Promoting Declines in the Prevalence of Late-Life Disability: Comparisons of Three Potentially High-Impact Interventions

PubMed Central

Freedman, Vicki A; Hodgson, Nancy; Lynn, Joanne; Spillman, Brenda C; Waidmann, Timothy; Wilkinson, Anne M; Wolf, Douglas A

2006-01-01

Although the prevalence of late-life disability has been declining, how best to promote further reductions remains unclear. This article develops and then demonstrates an approach for comparing the effects of interventions on the prevalence of late-life disability. We review evidence for three potentially high-impact strategies: physical activity, depression screening and treatment, and fall prevention. Because of the large population at risk for falling, the demonstrated efficacy of multi-component interventions in preventing falls, and the strong links between falls and disability, we conclude that, in the short run, multi-component fall-prevention efforts would likely have a higher impact than either physical activity or depression screening and treatment. However, longer-term comparisons cannot be made based on the current literature and may differ from short-run conclusions, since increases in longevity may temper the influences of these interventions on prevalence. Additional research is needed to evaluate longer-term outcomes of interventions, including effects on length and quality of life. PMID:16953808

Fall prevention in the young old using an exoskeleton human body posturizer: a randomized controlled trial.

PubMed

Verrusio, W; Gianturco, V; Cacciafesta, M; Marigliano, V; Troisi, G; Ripani, M

2017-04-01

Fall risk in elderly has been related with physical decline, low quality of life and reduced survival. To evaluate the impact of exoskeleton human body posturizer (HBP) on the fall risk in the elderly. 150 subjects (mean age 64.85; 79 M/71 F) with mild fall risk were randomized into two groups: 75 for group treated with human body posturizer (HBP group) and 75 for physical training without HBP group (exercise group). The effects of interventions were assessed by differences in tests related to balance and falls. Medically eligible patients were screened with Tinetti balance and Gait evaluation scale, short physical performance battery and numeric pain rating scale to determine fall risk in elderly people. In the HBP group there was a significant improvement in short physical performance battery, Tinetti scale and Pain Numeric rating scale with a significant reduction in fall risk (p < 0.05). In the exercise group we observed only minimal variations in the test scores. The results at the sixth and twelfth months show a twofold positive effect in the HBP group reducing fall risk and improving quality of life by reducing pain. The use of exoskeleton human body posturizer seems to be a new significant device for prevention of fall in elderly patients. Further research should be carried out to obtain more evidence on effects of robotic technology for fall prevention in the elderly.

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

PubMed

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

2016-07-01

Postural instability and falls are complex and disabling features of Parkinson's disease (PD) and respond poorly to anti-Parkinsonian medication. There is an imperative need to evaluate the effectiveness of exercise interventions in enhancing postural stability and decreasing falls in the PD population. The objectives of our study were to determine the effects of exercise training on the enhancement of balance and gait ability and reduction in falls for people with PD and to investigate potential factors contributing to the training effects on balance and gait ability of people with PD. We included 25 randomized control trials of a moderate methodological quality in our meta-analysis. The trials examined the effects of exercise training on balance and gait ability and falls against no intervention and placebo intervention. The results showed positive effects of exercise intervention on enhancing balance and gait performance (Hedges' g = 0.303 over the short-term in 24 studies and 0.419 over the long-term in 12 studies; P < .05) and reducing the fall rate (rate ratio = 0.485 over the short-term in 4 studies and 0.413 over the long-term in 5 studies; P < .05). The longest follow-up duration was 12 months. There was no evidence that training decreased the number of fallers over the short- or long-term (P > .05). The results of our metaregression and subgroup analysis showed that facility-based training produced greater training effects on improving PD participants' balance and gait ability (P < .05). The findings support the application of exercise training to improve balance and gait ability and prevent falls in people with PD. © The Author(s) 2015.

Fall risk in Chinese community-dwelling older adults: A physiological profile assessment study.

PubMed

Siong, Kar-Ho; Kwan, Marcella Mun-San; Lord, Stephen R; Lam, Andrew Kwok-Cheung; Tsang, William Wai-Nam; Cheong, Allen Ming-Yan

2016-02-01

The short-form Physiological Profile Assessment (PPA) is increasingly used in clinical practice for assessing fall risk in older people. However, a normative database is only available for Caucasian populations. The purpose of the present study was to develop a normative database for Hong Kong Chinese older people and examine the fall risk profile of this population. A total of 622 participants aged 60-95 years were recruited. Participants underwent the PPA (containing tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway), and composite fall risk scores were computed. Participants were then followed up for falls for 1 year. Quadriceps strength and lower limb proprioception scores were comparable with those reported for Caucasian populations. However, contrast sensitivity, simple reaction time and postural sway scores were relatively poor. The average composite fall risk score was 1.7 ± 1.5, showing a "moderate" fall risk when compared with the Caucasian norms. Despite the relatively poor physical performances and moderately high fall risk scores, the incidence of one plus falls in the 1-year follow-up period was just 16.4%, with just 2.6% reporting two plus falls. The area under the curve for composite fall risk scores in discriminating fallers from non-fallers was 0.53 (95% CI 0.45-0.60). Despite poorer performance in PPA tests, the incidence of prospective falls in a Hong Kong Chinese population was low. In consequence, the PPA could not discriminate well between fallers and non-fallers. The present study provided normality data for short-form PPA measures for older Chinese people as a reference for further studies. © 2015 Japan Geriatrics Society.

Can overestimation of walking ability increase the risk of falls in people in the subacute stage after stroke on their return home?

PubMed

Morone, G; Iosa, M; Pratesi, L; Paolucci, S

2014-03-01

Falls are common in patients who have had a stroke who return home after neurorehabilitation. Some studies have found that walking speed inversely correlates with the risk of falls. This study examined whether comparison between comfortable self-selected walking speed and maximum maintainable speed is informative with regard to the risk of falls in patients with stroke. A prospective cohort study was performed with 75 ambulant stroke patients. At discharge, the Barthel Index score and performance at the 10-m and 6-min walking tests were assessed. Number of falls was recorded by telephone interview every two months for one year. Regression analysis was performed to identify factors that were related to the risk of falls. Using forward multiple linear regression, only the ratio between walking speeds on the 6-min and 10-m tests was linked to the number of falls in the year after discharge (R=-0.451, p<0.001, OR=0.046). Patients who chose a walking speed for short distances that was not maintainable long term fell more frequently. A discrepancy between short and long-term walking speed can help in identifying subjects in the subacute stage after stroke with an increased risk of suffering a fall. Copyright © 2014 Elsevier B.V. All rights reserved.

Health care evaluation, utilitarianism and distortionary taxes.

PubMed

Calcott, P

2000-09-01

Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.

Bridging Literary and Philosophical Genres: Judgement, Reflection and Education in Camus' "The Fall"

ERIC Educational Resources Information Center

Roberts, Peter

2008-01-01

Both literature and philosophy, as genres of writing, can enable us to address important ontological, epistemological and ethical questions. One author who makes it possible for readers to bridge these two genres is Albert Camus. Nowhere is this more evident than in Camus' short novel, "The Fall". "The Fall", through the character and words of…

Race and fall risk: data from the National Health and Aging Trends Study (NHATS)

PubMed Central

Sun, Daniel Q.; Huang, Jin; Varadhan, Ravi; Agrawal, Yuri

2016-01-01

Objectives: the objective of this study was to explore whether race-based difference in fall risk may be mediated by environmental and physical performance risk factors. Methods: using data from a nationally representative longitudinal survey of 7,609 community-dwelling participants in the National Health and Aging Trends Study (NHATS), we evaluated whether racial differences in fall risk may be explained by physical performance level (measured by the Short Physical Performance Battery), mobility disability, physical activity level and likelihood of living alone. Multivariate Poisson regression and mediation models were used in analyses. Results: in whites and blacks, the annual incidence of ‘any fall’ was 33.8 and 27.1%, respectively, and the annual incidence of ‘recurrent falls’ was 15.5 and 12.3%, respectively. Compared with whites, blacks had relative risks of 0.7 (95% confidence interval 0.6–0.8) and 0.6 (0.5–0.8) for sustaining any fall and recurrent falls, respectively, in adjusted analyses. Blacks had poorer performance on the SPPB (P < 0.001), higher levels of mobility disability (P < 0.001), similar levels of physical activity (P = 0.19) and were equally likely to live alone relative to whites (P = 0.77). Mediation analysis revealed that these risk factors collectively acted as suppressors and none of these factors accounted for the racial differences in fall risk observed. Conclusions: relative to whites, blacks were at 30 and 40% decreased risk of sustaining any fall and recurrent falls, respectively. This difference in risk remains unexplained. PMID:26764401

Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors.

PubMed

Taylor-Piliae, Ruth E; Hoke, Tiffany M; Hepworth, Joseph T; Latt, L Daniel; Najafi, Bijan; Coull, Bruce M

2014-05-01

To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Single-blind, randomized controlled trial. General community. Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke. Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The influence of mechanical vibration on local and central balance control.

PubMed

Ehsani, Hossein; Mohler, Jane; Marlinski, Vladimir; Rashedi, Ehsan; Toosizadeh, Nima

2018-04-11

Fall prevention has an indispensable role in enhancing life expectancy and quality of life among older adults. The first step to prevent falls is to devise reliable methods to identify individuals at high fall risk. The purpose of the current study was to assess alterations in local postural muscle and central sensory balance control mechanisms due to low-frequency externally applied vibration among elders at high fall risk, in comparison with healthy controls, as a potential tool for assessing fall risk. Three groups of participants were recruited: healthy young (n = 10; age = 23 ± 2 years), healthy elders (n = 10; age = 73 ± 3 years), and elders at high fall risk (n = 10; age = 84 ± 9 years). Eyes-open and eyes-closed upright standing balance performance was measured with no vibration, 30 Hz, and 40 Hz vibration of Gastrocnemius muscles. When vibratory stimulation was applied, changes in local-control performance manifested significant differences among the groups (p < 0.01). On average between conditions, we observed 97% and 92% less change among high fall risk participants when compared to healthy young and older adults, respectively. On the other hand, vibration-induced changes in the central-control performance were not significant between groups (p ≥ 0.19). Results suggest that local-control deficits are responsible for balance behavior alterations among elders at high fall risk and healthy individuals. This observation may be attributable to deterioration of short-latency reflexive loop in elders at high fall risk. On the other hand, we could not ascribe the balance alterations to problems related to central nervous system performance or long-latency responses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study.

PubMed

Marcum, Zachary A; Perera, Subashan; Thorpe, Joshua M; Switzer, Galen E; Castle, Nicholas G; Strotmeyer, Elsa S; Simonsick, Eleanor M; Ayonayon, Hilsa N; Phillips, Caroline L; Rubin, Susan; Zucker-Levin, Audrey R; Bauer, Douglas C; Shorr, Ronald I; Kang, Yihuang; Gray, Shelly L; Hanlon, Joseph T

2016-07-01

Few studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture. To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63). Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls. © The Author(s) 2016.

Evaluation of Feature Extraction and Recognition for Activity Monitoring and Fall Detection Based on Wearable sEMG Sensors.

PubMed

Xi, Xugang; Tang, Minyan; Miran, Seyed M; Luo, Zhizeng

2017-05-27

As an essential subfield of context awareness, activity awareness, especially daily activity monitoring and fall detection, plays a significant role for elderly or frail people who need assistance in their daily activities. This study investigates the feature extraction and pattern recognition of surface electromyography (sEMG), with the purpose of determining the best features and classifiers of sEMG for daily living activities monitoring and fall detection. This is done by a serial of experiments. In the experiments, four channels of sEMG signal from wireless, wearable sensors located on lower limbs are recorded from three subjects while they perform seven activities of daily living (ADL). A simulated trip fall scenario is also considered with a custom-made device attached to the ankle. With this experimental setting, 15 feature extraction methods of sEMG, including time, frequency, time/frequency domain and entropy, are analyzed based on class separability and calculation complexity, and five classification methods, each with 15 features, are estimated with respect to the accuracy rate of recognition and calculation complexity for activity monitoring and fall detection. It is shown that a high accuracy rate of recognition and a minimal calculation time for daily activity monitoring and fall detection can be achieved in the current experimental setting. Specifically, the Wilson Amplitude (WAMP) feature performs the best, and the classifier Gaussian Kernel Support Vector Machine (GK-SVM) with Permutation Entropy (PE) or WAMP results in the highest accuracy for activity monitoring with recognition rates of 97.35% and 96.43%. For fall detection, the classifier Fuzzy Min-Max Neural Network (FMMNN) has the best sensitivity and specificity at the cost of the longest calculation time, while the classifier Gaussian Kernel Fisher Linear Discriminant Analysis (GK-FDA) with the feature WAMP guarantees a high sensitivity (98.70%) and specificity (98.59%) with a short calculation time (65.586 ms), making it a possible choice for pre-impact fall detection. The thorough quantitative comparison of the features and classifiers in this study supports the feasibility of a wireless, wearable sEMG sensor system for automatic activity monitoring and fall detection.

Evaluation of Feature Extraction and Recognition for Activity Monitoring and Fall Detection Based on Wearable sEMG Sensors

PubMed Central

Xi, Xugang; Tang, Minyan; Miran, Seyed M.; Luo, Zhizeng

2017-01-01

As an essential subfield of context awareness, activity awareness, especially daily activity monitoring and fall detection, plays a significant role for elderly or frail people who need assistance in their daily activities. This study investigates the feature extraction and pattern recognition of surface electromyography (sEMG), with the purpose of determining the best features and classifiers of sEMG for daily living activities monitoring and fall detection. This is done by a serial of experiments. In the experiments, four channels of sEMG signal from wireless, wearable sensors located on lower limbs are recorded from three subjects while they perform seven activities of daily living (ADL). A simulated trip fall scenario is also considered with a custom-made device attached to the ankle. With this experimental setting, 15 feature extraction methods of sEMG, including time, frequency, time/frequency domain and entropy, are analyzed based on class separability and calculation complexity, and five classification methods, each with 15 features, are estimated with respect to the accuracy rate of recognition and calculation complexity for activity monitoring and fall detection. It is shown that a high accuracy rate of recognition and a minimal calculation time for daily activity monitoring and fall detection can be achieved in the current experimental setting. Specifically, the Wilson Amplitude (WAMP) feature performs the best, and the classifier Gaussian Kernel Support Vector Machine (GK-SVM) with Permutation Entropy (PE) or WAMP results in the highest accuracy for activity monitoring with recognition rates of 97.35% and 96.43%. For fall detection, the classifier Fuzzy Min-Max Neural Network (FMMNN) has the best sensitivity and specificity at the cost of the longest calculation time, while the classifier Gaussian Kernel Fisher Linear Discriminant Analysis (GK-FDA) with the feature WAMP guarantees a high sensitivity (98.70%) and specificity (98.59%) with a short calculation time (65.586 ms), making it a possible choice for pre-impact fall detection. The thorough quantitative comparison of the features and classifiers in this study supports the feasibility of a wireless, wearable sEMG sensor system for automatic activity monitoring and fall detection. PMID:28555016

Utilizing Integrated Prediction Error Filter Analysis (INPEFA) to divide base-level cycle of fan-deltas: A case study of the Triassic Baikouquan Formation in Mabei Slope Area, Mahu Depression, Junggar Basin, China

NASA Astrophysics Data System (ADS)

Yuan, Rui; Zhu, Rui; Qu, Jianhua; Wu, Jun; You, Xincai; Sun, Yuqiu; Zhou, Yuanquan (Nancy)

2018-05-01

The Mahu Depression is an important hydrocarbon-bearing foreland sag located at the northwestern margin of the Junggar Basin, China. On the northern slope of the depression, large coarse-grained proximal fan-delta depositional systems developed in the Lower Triassic Baikouquan Formation (T1b). Some lithologic hydrocarbon reservoirs have been found in the conglomerates of the formation since recent years. However, the rapid vertical and horizontal lithology variations make it is difficult to divide the base-level cycle of the formation using the conventional methods. Spectral analysis technologies, such as Integrated Prediction Error Filter Analysis (INPEFA), provide another effective way to overcome this difficultly. In this paper, processed by INPEFA, conventional resistivity logs are utilized to study the base-level cycle of the fan-delta depositional systems. The negative trend of the INPEFA curve indicates the base-level fall semi-cycles, adversely, positive trend suggests the rise semi-cycles. Base-level cycles of Baikouquan Formation are divided in single and correlation wells. One long-term base-level rise semi-cycle, including three medium-term base-level cycles, is identified overall the Baikouquan Formation. The medium-term base-level cycles are characterized as rise semi-cycles mainly in the fan-delta plain, symmetric cycles in the fan-delta front and fall semi-cycles mainly in the pro-fan-delta. The short-term base-level rise semi-cycles most developed in the braided channels, sub-aqueous distributary channels and sheet sands. While, the interdistributary bays and pro-fan-delta mud indicate short-term base-level fall semi-cycles. Finally, based on the method of INPEFA, sequence filling model of Baikouquan formation is established.

Short- and Long-Term Effects of Balance Training on Physical Activity in Older Adults With Osteoporosis: A Randomized Controlled Trial

PubMed Central

Hagströmer, Maria; Hellénius, Mai-Lis; Ståhle, Agneta

2017-01-01

Background and Purpose: We have developed a 12-week balance training program for older adults shown to improve fall-related concerns, gait speed, balance performance, and physical function. We hypothesized that this balance training would also contribute to higher habitual physical activity (PA) levels and improved health-related quality of life (HRQoL). The primary aim was to evaluate short- and long-term effects of the balance training program on objectively measured habitual PA in older adults with osteoporosis. Secondary aims were to assess the effects of the balance training on HRQoL, and to study whether any effects on PA were associated with changes in HRQoL, gait speed, balance performance, fall-related concerns, and physical function. Methods: A randomized controlled trial with follow-up at 3, 9, and 15 months, including 91 participants with osteoporosis (75.6 ± 5.4 years), compared a balance training group (n = 61) with a control group (n = 30). The primary outcome was effect on habitual PA measured as steps/day, dichotomized into less than 5000 or 5000 or more steps/day. Physical activity was assessed with pedometers (Yamax) and accelerometers (Actigraph), HRQoL with the Short Form-36 (SF-36), gait with a GAITRite walkway, balance performance with Modified-Figure-Eight test and one-leg stance, fall-related concerns with Falls Efficacy Scale International, and physical function with the advanced lower extremity subscale of the questionnaire Late Life Function and Disability Instrument. Statistical methods used were multivariate logistic regression and logistic generalized estimating equation. Results: Sixty-eight participants completed the short-term follow-up at 3 months, and 53 participants completed the long-term follow-up at 15 months. Per-protocol analysis (n = 68) showed that the odds ratio for having a daily step count of 5000 or more at 3 months was 6.17 (95% confidence interval, 1.23-30.91), P = .027, for the intervention group compared with the control group. The longitudinal analysis (n = 91) showed that the odds ratio for having a daily step count of 5000 or more at 15 months was 2.02 (95% confidence interval, 0.88-4.64), P = .096, for the intervention group compared with the control group. The mental component sum of the SF-36 improved significantly from baseline to 3 months in the intervention group, and the physical component sum improved in both groups, but no statistically significant differences were found between groups. No associations were found between PA and changes in covariates. Discussion and Conclusions: The short-term evaluation showed that balance training increased habitual PA in community-dwelling older adults with osteoporosis. A significantly higher proportion of participants in the intervention group reached a level of 5000 or more steps/day, which is important for overall health. This effect was not associated with improvements in HRQoL, gait speed, balance performance, or fall-related concerns, and did not persist through the long-term follow-up. To accomplish a sustained PA change, a prolonged intervention or more support regarding habitual PA may be required, such as reinforcement with personalized behavior change counseling or PA on prescription. PMID:26859463

75 FR 33239 - Rangeland Allotment Management Planning on the Fall River West and Oglala Geographic Areas, Fall...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

...). Vegetation in the Analysis Area is characteristic of mixed-grass prairie and lesser amounts of ponderosa pine/juniper habitats. Short- grass species include blue grama, buffalograss, and upland sedges. Mid- grass...

Effect of Modified Otago Exercises on Postural Balance, Fear of Falling, and Fall Risk in Older Fallers With Knee Osteoarthritis and Impaired Gait and Balance: A Secondary Analysis.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Pey June; Ramli, Norlisah; Fadzli, Farhana; Rozalli, Faizatul Izza; Mazlan, Mazlina; Hill, Keith D; Tan, Maw Pin

2018-03-01

Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited. To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems. Randomized controlled trial. University of Malaya Medical Centre. Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds. Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated. Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months. Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found. Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

High-school seniors' college enrollment goals: Costs and benefits of ambitious expectations.

PubMed

Villarreal, Brandilynn J; Heckhausen, Jutta; Lessard, Jared; Greenberger, Ellen; Chen, Chuansheng

2015-12-01

High school students with high long-term educational expectations attain higher levels of education than those with lower expectations. Less studied is the role of students' short-term college enrollment expectations for the year after high school graduation. The purpose of the current study was to examine the costs and benefits of ambitious short-term expectations and the impact of falling short of these expectations on mental health, motivation, and educational outcomes. Over 1000 youth with expectations to attend college were surveyed during their senior year of high school, one year later, and four years later. Participants who did not achieve their short-term expectations had lower educational attainment four years later but were not less satisfied with their educational progress. The negative consequences of falling short of one's expectations were restricted to individuals with less ambitious short-term expectations. Thus, the benefits of ambitious short-term expectations for youth may outweigh the costs. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Fall rates of prescribed fire-killed ponderosa pine. Forest Service research paper

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

Harrington, M.G.

1996-05-01

Fall rates of prescribed fire-killed ponderosa pine were evaluated relative to tree and fire damage characteristics. High crown scorch and short survival time after fire injury were factors leading to a high probability of early tree fall. The role of chemical defense mechanisms is discussed. Results apply to prescribed-fire injured, second-growth ponderosa pine less than 16 inches diameter at breast height.

Seed fall in an oldgrowth northern hardwood forest

Treesearch

Raymond E. Graber; William B. Leak; William B. Leak

1992-01-01

Seed fall was measured for 11 years in a 200-year-old stand of sugar maple, yellow birch, and beech in New Hampshire. Yellow birch had 5 good seed years, sugar maple had 3, and beech had none. Viable seed fall of yellow birch began in August and continued through autumn and winter. Most of the viable sugar maple seed fell during a short period in October. Beech seed...

The free-fall mode experiment on LISA Pathfinder: first results

NASA Astrophysics Data System (ADS)

Giusteri, Roberta; LPF Collaboration

2017-05-01

The LISA Pathfinder space mission is testing the critical experimental challenge for LISA by measuring the differential acceleration between two free-falling test masses inside a single co-orbiting spacecraft at a level of sub-femto-g for frequencies down to 0.1mHz. In LPF it is necessary that one test mass (TM) is electrostatically forced to follow the orbit of the other TM. This force represents a noise source in differential acceleration at frequencies below 1mHz. The free-fall mode experiment has been performed in order to reduce this source of noise: the actuation is limited to short impulses on one TM, so that it is in free fall between two successive kicks, while the other TM is drag-free. The free-fall mode thus provides a different technique for measuring the differential TM acceleration without the added force noise and calibration issues introduced by the actuator. Data analysis challenge is related to the presence of the kicks: they represent a high-noise contribution and need to be removed, thus leaving short gaps in data. This article presents preliminary data of the LPF free-fall measurement campaign and describes the three data analysis techniques developed to mitigate the presence of gaps.

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

NASA Technical Reports Server (NTRS)

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

1975-01-01

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

AGU Cinema: Festival of short science films at Fall Meeting

NASA Astrophysics Data System (ADS)

Harned, Douglas A.

2012-11-01

New technologies have revolutionized the use of video as a means of science communication and have made it easier to create, distribute, and view. With video having become omnipresent in our culture, it sometime supplements or even replaces writing in many science and education applications. An inaugural science film festival sponsored by AGU at the 2012 Fall Meeting in San Francisco, Calif., in December will showcase short videos—30 minutes or less in length—developed to disseminate scientific results to various audiences and to enhance learning in the classroom. AGU Cinema will feature professionally produced, big budget films alongside low-budget videos aimed at niche audiences and made by amateurs. The latter category includes videos made by governmental agency scientists, educators, communications specialists within scientific organizations, and Fall Meeting oral and poster presenters.

Exercise for falls prevention in Parkinson disease

PubMed Central

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

2015-01-01

Objective: To determine whether falls can be prevented with minimally supervised exercise targeting potentially remediable fall risk factors, i.e., poor balance, reduced leg muscle strength, and freezing of gait, in people with Parkinson disease. Methods: Two hundred thirty-one people with Parkinson disease were randomized into exercise or usual-care control groups. Exercises were practiced for 40 to 60 minutes, 3 times weekly for 6 months. Primary outcomes were fall rates and proportion of fallers during the intervention period. Secondary outcomes were physical (balance, mobility, freezing of gait, habitual physical activity), psychological (fear of falling, affect), and quality-of-life measures. Results: There was no significant difference between groups in the rate of falls (incidence rate ratio [IRR] = 0.73, 95% confidence interval [CI] 0.45–1.17, p = 0.18) or proportion of fallers (p = 0.45). Preplanned subgroup analysis revealed a significant interaction for disease severity (p < 0.001). In the lower disease severity subgroup, there were fewer falls in the exercise group compared with controls (IRR = 0.31, 95% CI 0.15–0.62, p < 0.001), while in the higher disease severity subgroup, there was a trend toward more falls in the exercise group (IRR = 1.61, 95% CI 0.86–3.03, p = 0.13). Postintervention, the exercise group scored significantly (p < 0.05) better than controls on the Short Physical Performance Battery, sit-to-stand, fear of falling, affect, and quality of life, after adjusting for baseline performance. Conclusions: An exercise program targeting balance, leg strength, and freezing of gait did not reduce falls but improved physical and psychological health. Falls were reduced in people with milder disease but not in those with more severe Parkinson disease. Classification of evidence: This study provides Class III evidence that for patients with Parkinson disease, a minimally supervised exercise program does not reduce fall risk. This study lacked the precision to exclude a moderate reduction or modest increase in fall risk from exercise. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12608000303347). PMID:25552576

A method of evaluating effects of antecedent precipitation on duststorms and its application to Yuma, Arizona, 1981-1988

USGS Publications Warehouse

MacKinnon, D.J.; Elder, D.F.; Helm, P.J.; Tuesink, M.F.; Nist, C.A.

1990-01-01

Precipitation causes several short- and long-term effects on wind-induced surface erodibility and subsequent dust emission. Among the principal effects considered by this paper are soil moisture, soil crusts, and vegetation. A quantitative method is developed to assess these effects using differences between the potential and the actual amounts of dust emitted from dust sources as inferred from surface meteorological measurements obtained downwind from those sources. The results of this assessment must be interpreted with caution, however, when the size and location of dust sources are unknown. Using meteorological data recorded near Yuma, Arizona at the Yuma Marine Corps Air Station (YMCAS), the method is applied to calculate the potential and actual amounts of dust emitted from upwind dust sources during the spring and fall/winter seasons between January 1, 1981 and May 31, 1988. (Spring is considered to be the period between February 1 and May 31; fall/winter, between October 1 and January 31.) Because summer precipitation is intermittent and wind patterns are localized, summer meteorological data are not used to evaluate regional correlations between precipitation and dust storms. For the period between 1981 and 1988, a correlation of -0.60 was found between fall/winter precipitation and the actual amount of dust emitted from sources upwind of YMCAS during the following spring. A particularly strong reduction in dust emission was noted during the springs of 1983 and 1984 following the start of an 'El Nino event' in fall/winter 1982. Photographs taken at a geological and meteorological data-collection (Geomet) site, located in the natural desert 25 km southeast of YMCAS, show a correspondence between increased antecedent precipitation recorded at the site and increased vegetation. Whereas the annual precipitation totals at YMCAS and the Geomet site from the beginning of 1982 through 1984 are high, their seasonal totals, especially during the fall/winter seasons, are disparate. This fall/winter precipitation disparity may account for evidence suggesting that significant vegetation growth occurred at dust sources upwind of YMCAS by spring 1983, but that such growth did not occur at the Geomet site until fall/ winter of 1983. Spatial inhomogeneity in fall/winter precipitation probably contributed to the relatively low correlation (-0.60) between fall/winter precipitation recorded at YMCAS and the actual amount of dust emitted from upwind sources during the following spring. ?? 1990 Kluwer Academic Publishers.

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

PubMed Central

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

2015-01-01

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

The additional value of bioelectrical impedance analysis-derived muscle mass as a screening tool in geriatric assessment for fall prevention.

PubMed

Van Puyenbroeck, Karolien; Roelandts, Lieven; Van Deun, Thomas; Van Royen, Paul; Verhoeven, Veronique

2012-01-01

The decline in skeletal muscle in old age is a factor in the development of functional limitations. The objective of this study was to assess if there is a correlation between muscle mass based on bioelectrical impedance analysis (BIA) detection and the fall incidence in nursing home residents and to examine the risk factors for falling in nursing home residents. This prospective cohort study was part of a longitudinal study on nutritional issues in 52 nursing homes in Antwerp (Belgium) from October 2007 to April 2008. Two hundred and seventy-six people aged 65 years and older were included. Each subject was assessed with BIA, the timed get-up-and-go test, the Katz score, the Mini Nutritional Assessment - Short Form and the 36-Item Short Form Health Survey. The primary outcome parameter was fall incidence during the study. The prevalence of sarcopenia varied from 24.3 to 81.5% depending on which definition was used. No association was found between BIA-derived muscle mass and fall incidence. Logistic regression analysis showed that gait speed (odds ratio 1.029; p = 0.003) and mental health (odds ratio 0.981; p = 0.015) are significantly associated with fall incidence in nursing homes. A receiver operating characteristic curve showed that none of the BIA-derived muscle parameters are good predictors of the risk of falling. This study shows that there is no association between sarcopenia based on BIA and fall incidence and that BIA-derived muscle mass has no additional value in predicting fall incidents compared to the timed get-up-and-go test. Copyright © 2012 S. Karger AG, Basel.

Short Berg Balance Scale, BBS-9, as a predictor of fall risk among the aged: a prospective 12-month follow-up study.

PubMed

Hohtari-Kivimäki, Ulla; Salminen, Marika; Vahlberg, Tero; Kivelä, Sirkka-Liisa

2013-12-01

The aim of this study was to assess the adequacy of the short, 9-item Berg Balance Scale (BBS-9) to predict fall risk among the community-dwelling aged. The subjects (n = 519) were derived from the participants in a multifactorial fall prevention intervention conducted in Pori, Finland. Receiver operating characteristic (ROC) analysis was used to determine the cut-off score for BBS-9 (range 0-36) to classify aged people with a fall risk during a 12-month follow-up. Logistic regression was used to analyse the relationship of potential confounders with fall risk. The association between the cut-off score for BBS-9 and fall risk was tested using the Chi-square test. In determining the cut-off score of BBS-9 to classify fall risk, the highest sensitivity (0.51) and specificity (0.57) (when both presumed to be above 0.50) sum score was within the limit range 32 scores or below. The area under curve (AUC) was significantly better in the model adjusted for significant confounders (vision and the number of regularly used drugs) (AUC = 0.64) than in the unadjusted model (AUC = 0.57) (p = 0.045). Among patients who scored 32 or below in BBS-9 the incidence of multiple falls was 20.0 %, whereas among those who scored 33-36 it was 15.7 %. BBS-9 with the cut-off score of 32/33 together with data on vision and the number of regularly used drugs predicted moderately the risk of falling among the community-dwelling aged.

Use of a Short-Form Balance Confidence Scale to Predict Future Recurrent Falls in People With Parkinson Disease.

PubMed

Cole, Michael H; Rippey, Jodi; Naughton, Geraldine A; Silburn, Peter A

2016-01-01

To assess whether the 16-item Activities-specific Balance Confidence scale (ABC-16) and short-form 6-item Activities-specific Balance Confidence scale (ABC-6) could predict future recurrent falls in people with Parkinson disease (PD) and to validate the robustness of their predictive capacities. Twelve-month prospective cohort study. General community. People with idiopathic PD (N=79). Clinical tests were conducted to assess symptom severity, balance confidence, and medical history. Over the subsequent 12 months, participants recorded any falls on daily fall calendars, which they returned monthly by reply paid post. Logistic regression and receiver operating characteristic analyses estimated the sensitivities and specificities of the ABC-16 and ABC-6 for predicting future recurrent falls in this cohort, and "leave-one-out" validation was used to assess their robustness. Of the 79 patients who completed follow-up, 28 (35.4%) fell more than once during the 12-month period. Both the ABC-16 and ABC-6 were significant predictors of future recurrent falls, and moderate sensitivities (ABC-16: 75.0%; ABC-6: 71.4%) and specificities (ABC-16: 76.5%; ABC-6: 74.5%) were reported for each tool for a cutoff score of 77.5 and 65.8, respectively. The results have significant implications and demonstrate that the ABC-16 and ABC-6 independently identify patients with PD at risk of future recurrent falls. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Short-Term Study Abroad: Culture and the Path of Least Resistance

ERIC Educational Resources Information Center

Lemmons, Kelly

2015-01-01

American universities are decreasing the length of study abroad programs in an effort to send more students abroad. Recent publications find that "short-term" programs struggle to increase participants' cultural understanding. However, these research findings fail to offer an explanation as to why shorter programs are falling short. This…

Wind power prediction based on genetic neural network

NASA Astrophysics Data System (ADS)

Zhang, Suhan

2017-04-01

The scale of grid connected wind farms keeps increasing. To ensure the stability of power system operation, make a reasonable scheduling scheme and improve the competitiveness of wind farm in the electricity generation market, it's important to accurately forecast the short-term wind power. To reduce the influence of the nonlinear relationship between the disturbance factor and the wind power, the improved prediction model based on genetic algorithm and neural network method is established. To overcome the shortcomings of long training time of BP neural network and easy to fall into local minimum and improve the accuracy of the neural network, genetic algorithm is adopted to optimize the parameters and topology of neural network. The historical data is used as input to predict short-term wind power. The effectiveness and feasibility of the method is verified by the actual data of a certain wind farm as an example.

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial

PubMed Central

Merom, Dafna; Mathieu, Erin; Cerin, Ester; Morton, Rachael L.; Simpson, Judy M.; Anstey, Kaarin J.; Sherrington, Catherine; Lord, Stephen R.; Cumming, Robert G.

2016-01-01

Background The prevention of falls among older people is a major public health challenge. Exercises that challenge balance are recognized as an efficacious fall prevention strategy. Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults, two of the strongest risk factors for falls in older people, this study aimed to determine whether social dance is effective in i) reducing the number of falls and ii) improving physical and cognitive fall-related risk factors. Methods and Findings A parallel two-arm cluster randomized controlled trial was undertaken in 23 self-care retirement villages (clusters) around Sydney, Australia. Eligible villages had to have an appropriate hall for dancing, house at least 60 residents, and not be currently offering dance as a village activity. Retirement villages were randomised using a computer generated randomisation method, constrained using minimisation. Eligible participants had to be a resident of the village, be able to walk at least 50 m, and agree to undergo physical and cognitive testing without cognitive impairment. Residents of intervention villages (12 clusters) were offered twice weekly one-hour social dancing classes (folk or ballroom dancing) over 12 mo (80 h in total). Programs were standardized across villages and were delivered by eight dance teachers. Participants in the control villages (11 clusters) were advised to continue with their regular activities. Main outcomes: falls during the 12 mo trial and Trail Making Tests. Secondary outcomes: The Physiological Performance Assessment (i.e., postural sway, proprioception, reaction time, leg strength) and the Short Physical Performance Battery; health-related physical and mental quality of life from the Short-Form 12 (SF-12) Survey. Data on falls were obtained from 522 of 530 (98%) randomised participants (mean age 78 y, 85% women) and 424 (80%) attended the 12-mo reassessment, which was lower among folk dance participants (71%) than ballroom dancing (82%) or control participants (82%, p = 0.04). Mean attendance at dance classes was 51%. During the period, 444 falls were recorded; there was no significant difference in fall rates between the control group (0.80 per person-year) and the dance group (1.03 per person-year). Using negative binomial regression with robust standard errors the adjusted Incidence Rate Ratio (IRR) was 1.19 (95% CI: 95% CI = 0.83, 1.71). In exploratory post hoc subgroup analysis, the rate of falls was higher among dance participants with a history of multiple falls (IRR = 2.02, 95% CI: 1.15, 3.54, p = 0.23 for interaction) and with the folk dance intervention (IRR = 1.68, 95% CI: 1.03, 2.73). There were no significant between-group differences in executive function test (TMT-B = 2.8 s, 95% CI: −6.2, 11.8). Intention to treat (ITT) analysis revealed no between-group differences at 12-mo follow-up in the secondary outcome measures, with the exception of postural sway, favouring the control group. Exploratory post hoc analysis by study completers and style indicated that ballroom dancing participants apparently improved their gait speed by 0.07 m/s relative to control participants (95% CI: 0.00, 0.14, p = 0.05). Study limitations included allocation to style based on logistical considerations rather than at random; insufficient power to detect differential impacts of different dance styles and smaller overall effects; variation of measurement conditions across villages; and no assessment of more complex balance tasks, which may be more sensitive to changes brought about by dancing. Conclusions Social dancing did not prevent falls or their associated risk factors among these retirement villages' residents. Modified dance programmes that contain "training elements" to better approximate structured exercise programs, targeted at low and high-risk participants, warrant investigation. Trial Registration The Australian New Zealand Clinical Trials Registry ACTRN12612000889853 PMID:27575534

Effect of guided relaxation and imagery on falls self-efficacy: a randomized controlled trial.

PubMed

Kim, Bang Hyun; Newton, Roberta A; Sachs, Michael L; Glutting, Joseph J; Glanz, Karen

2012-06-01

To examine the effects of guided relaxation and imagery (GRI) on improvement in falls self-efficacy in older adults who report having a fear of falling. Randomized, controlled trial with allocation to GRI or guided relaxation with music of choice. General community. Ninety-one men and women aged 60 to 92. Participants were randomized to listen to a GRI audio compact disk (intervention group) or a guided relaxation audio compact disk and music of choice (control group) twice a week for 6 weeks for 10 minutes per session. Primary outcome measure was the Short Falls Efficacy Scale-International (FES-I). Secondary outcome measures were the Leisure Time Exercise Questionnaire (LTEQ) and the Timed Up and Go (TUG) mobility test. GRI participants reported greater improvements on the Short FES-I (P = .002) and LTEQ (P = .001) scores and shorter time on the TUG (P = .002) than the guided relaxation and music-of-choice group. GRI was more effective at increasing falls self-efficacy and self-reported leisure time exercise and reducing times on a simple mobility test than was guided relaxation with music of choice. GRI is an effective, simple, low-cost tool for older adults to improve falls self-efficacy and leisure time exercise behaviors. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

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

Short- and Long-Term Effects of Balance Training on Physical Activity in Older Adults With Osteoporosis: A Randomized Controlled Trial.

PubMed

Dohrn, Ing-Mari; Hagströmer, Maria; Hellénius, Mai-Lis; Ståhle, Agneta

We have developed a 12-week balance training program for older adults shown to improve fall-related concerns, gait speed, balance performance, and physical function. We hypothesized that this balance training would also contribute to higher habitual physical activity (PA) levels and improved health-related quality of life (HRQoL). The primary aim was to evaluate short- and long-term effects of the balance training program on objectively measured habitual PA in older adults with osteoporosis. Secondary aims were to assess the effects of the balance training on HRQoL, and to study whether any effects on PA were associated with changes in HRQoL, gait speed, balance performance, fall-related concerns, and physical function. A randomized controlled trial with follow-up at 3, 9, and 15 months, including 91 participants with osteoporosis (75.6 ± 5.4 years), compared a balance training group (n = 61) with a control group (n = 30). The primary outcome was effect on habitual PA measured as steps/day, dichotomized into less than 5000 or 5000 or more steps/day. Physical activity was assessed with pedometers (Yamax) and accelerometers (Actigraph), HRQoL with the Short Form-36 (SF-36), gait with a GAITRite walkway, balance performance with Modified-Figure-Eight test and one-leg stance, fall-related concerns with Falls Efficacy Scale International, and physical function with the advanced lower extremity subscale of the questionnaire Late Life Function and Disability Instrument. Statistical methods used were multivariate logistic regression and logistic generalized estimating equation. Sixty-eight participants completed the short-term follow-up at 3 months, and 53 participants completed the long-term follow-up at 15 months. Per-protocol analysis (n = 68) showed that the odds ratio for having a daily step count of 5000 or more at 3 months was 6.17 (95% confidence interval, 1.23-30.91), P = .027, for the intervention group compared with the control group. The longitudinal analysis (n = 91) showed that the odds ratio for having a daily step count of 5000 or more at 15 months was 2.02 (95% confidence interval, 0.88-4.64), P = .096, for the intervention group compared with the control group. The mental component sum of the SF-36 improved significantly from baseline to 3 months in the intervention group, and the physical component sum improved in both groups, but no statistically significant differences were found between groups. No associations were found between PA and changes in covariates. The short-term evaluation showed that balance training increased habitual PA in community-dwelling older adults with osteoporosis. A significantly higher proportion of participants in the intervention group reached a level of 5000 or more steps/day, which is important for overall health. This effect was not associated with improvements in HRQoL, gait speed, balance performance, or fall-related concerns, and did not persist through the long-term follow-up. To accomplish a sustained PA change, a prolonged intervention or more support regarding habitual PA may be required, such as reinforcement with personalized behavior change counseling or PA on prescription.

Utility of seasonal climate forecasts in management of winter-wheat grazing

USDA-ARS?s Scientific Manuscript database

Winter wheat in the southern Great Plains is a dual crop that produces livestock forage in the fall and winter and a grain crop in the spring. Forage production is highly dependent upon climatic variability, but stocking rate purchasing decisions must generally be made shortly after the fall planti...

Quality of life and fall risk in frail hospitalized elderly patients

PubMed

Öztürk, Zeynel Abidin; Özdemir, Sedat; Türkbeyler, İbrahim Halil; Demir, Zeynep

2017-11-13

Background/aim: Frailty is a complex, multifactorial, and important geriatric syndrome characterized by decline in physiological reserves and functional deficiency in multiple systems. The aim of the current study is to investigate the prevalence of frailty and to determine the correlation between quality of life (QoL) and falling risk in geriatric hospitalized patients. Materials and methods: A total of 420 patients, aged 65 years and above, were enrolled in the study. All participants were hospitalized at a university hospital in the internal medicine clinics. The Cardiovascular Health Study (CHS) frailty scale, Health-Related Quality of Life Short Form (SF-36) scale, and Hendrich II Fall Risk Model were administered to the patients. Demographic data of patients, number of chronic diseases, and information on used medication were also collected.Results: The median age of patients was 71.9 ± 6.3 years and 49.5% of the patients were female. By applying the CHS frailty scale, the proportion of frail patients was determined to be 65.5%. There were statistically significant differences among quality of life mean scores of robust, prefrail, and frail patients (P < 0.001). Frail patients had the lowest scores in all SF-36 subgroups. Eighty-three (19.8%) patients were in the low-risk group while 337 (80.2%) were high-risk according to the Hendrich II Fall Risk Model. The rate of patients with high falling risk and poor QoL reached a maximum in the frail group (96%).Conclusion: Frailty is an important geriatric syndrome in elderly hospitalized patients. Poor QoL and high falling risk are issues commonly experienced with frailty.

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

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

PubMed Central

Singh, Devinder KA; Pillai, Sharmila GK; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

2015-01-01

Background Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. Methods One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman’s rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Results Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=−0.33), and FRT (r=−0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). Conclusion The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments. PMID:26316727

Mineralogy, Petrology, Chronology, and Exposure History of the Chelyabinsk Meteorite and Parent Body

NASA Technical Reports Server (NTRS)

Righter, K.; Abell, P.; Agresti, D.; Berger, E. L.; Burton, A. S.; Delaney, J. S.; Fries, M. D.; Gibson, E. K.; Harrington, R.; Herzog, G. F.;

Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up

PubMed Central

Eggenberger, Patrick; Theill, Nathan; Holenstein, Stefan; Schumacher, Vera; de Bruin, Eling D

2015-01-01

Background About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive–physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Methods Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Results Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (−77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or trend). Conclusion Long-term multicomponent cognitive–physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning. PMID:26604719

Which Fall Ascertainment Method Captures Most Falls in Pre-Frail and Frail Seniors?

PubMed

Teister, Corina J; Chocano-Bedoya, Patricia O; Orav, Endel J; Dawson-Hughes, Bess; Meyer, Ursina; Meyer, Otto W; Freystaetter, Gregor; Gagesch, Michael; Rizzoli, Rene; Egli, Andreas; Theiler, Robert; Kanis, John A; Bischoff-Ferrari, Heike A

2018-06-15

There is no consensus on most reliable falls ascertainment method. Therefore, we investigated which method captures most falls among pre-frail and frail seniors from two randomized controlled trials conducted in Zurich, Switzerland, a 18-month trial (2009-2010) including 200 community-dwelling pre-frail seniors with a prior fall and a 12-month trial (2005-2008) including 173 frail seniors with acute hip fracture. Both included the same fall ascertainment methods: monthly active-asking, daily self-report diary, and a call-in hotline. We compared number of falls reported and estimated overall and positive percent agreement between methods. Pre-frail seniors reported 499 falls (rate = 2.5/year) and frail seniors reported 205 falls (rate = 1.4/year). Most falls were reported by active-asking: 81% of falls in pre-frail, and 78% in frail seniors. Among pre-frail seniors, diaries captured additional 19% falls, while hotline added none. Among frail seniors, hotline added 16% falls, while diaries added 6%. The positive percent agreement between active-asking and diary was 100% among pre-frail and 88% among frail seniors. While monthly active-asking captures most falls in both groups, this method alone missed 19% of falls in pre-frail and 22% in frail seniors. Thus, a combination of active-asking and diaries for pre-frail, and active-asking and the hotline for frail seniors is warranted.

Fall Risk Assessment and Early-Warning for Toddler Behaviors at Home

PubMed Central

Yang, Mau-Tsuen; Chuang, Min-Wen

2013-01-01

Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM) classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second. PMID:24335727

Epidemiologic features and intervention effect of fall injury among rural school-aged children in southwest China: a short-term cohort study.

PubMed

Shi, Xiuquan; Wang, Tao; Nie, Chan; Wang, Haiyan; Luo, Lirong; Qi, Yonghong; Jiang, Zhixia

2018-05-24

Falls are the top one type in all unintentional injuries. In this study, we aim to explore the epidemiological characteristics of falls and assess the intervention effect. Our research had interviewed 2854 rural children in southwest China. Then, we used School-Family-Individual (SFI) comprehensive education model to conduct an intervention among 1506 children and follow up them for one year. The changes in injury knowledge and incidence rate before and after intervention were compared. We found the fall injury was 37.32% (178/477) and ranked top one in the total injuries. After intervention, the children's fall-injuries-related knowledge was significantly increased by 15.29 percent (P < 0.001). While falls incidence significantly decreased after- intervention (6.24% vs. 3.93%; P < 0.001). From the results we concluded that the falls rate was high and was the prior reason of all injuries. SFI intervention model can effectively reduce the incidence of the fall injury.

Fall risk assessment and early-warning for toddler behaviors at home.

PubMed

Yang, Mau-Tsuen; Chuang, Min-Wen

2013-12-10

Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM) classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second.

Cost-utility of medication withdrawal in older fallers: results from the improving medication prescribing to reduce risk of FALLs (IMPROveFALL) trial.

PubMed

Polinder, Suzanne; Boyé, Nicole D A; Mattace-Raso, Francesco U S; Van der Velde, Nathalie; Hartholt, Klaas A; De Vries, Oscar J; Lips, Paul; Van der Cammen, Tischa J M; Patka, Peter; Van Beeck, Ed F; Van Lieshout, Esther M M

2016-11-04

The use of Fall-Risk-Increasing-Drugs (FRIDs) has been associated with increased risk of falls and associated injuries. This study investigates the effect of withdrawal of FRIDs versus 'care as usual' on health-related quality of life (HRQoL), costs, and cost-utility in community-dwelling older fallers. In a prospective multicenter randomized controlled trial FRIDs assessment combined with FRIDs-withdrawal or modification was compared with 'care as usual' in older persons, who visited the emergency department after experiencing a fall. For the calculation of costs the direct medical costs (intramural and extramural) and indirect costs (travel costs) were collected for a 12 month period. HRQoL was measured at baseline and at 12 months follow-up using the EuroQol-5D and Short Form-12 version 2. The change in EuroQol-5D and Short Form-12 scores over 12 months follow-up within the control and intervention groups was compared using the Wilcoxon Signed Rank test for continuous variables and the McNemar test for dichotomous variables. The change in scores between the control and intervention groups were compared using a two-way analysis of variance. We included 612 older persons who visited an emergency department because of a fall. The mean cost of the FRIDs intervention was €120 per patient. The total fall-related healthcare costs (without the intervention costs) did not differ significantly between the intervention group and the control group (€2204 versus €2285). However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant. Furthermore, the control group had a greater decline in EuroQol-5D utility score during the 12-months follow-up than the intervention group (p = 0.02). The change in the Short Form-12 Physical Component Summary and Mental Component Summary scores did not differ significantly between the two groups. Withdrawal of FRID's in older persons who visited an emergency department due to a fall, did not lead to reduction of total health-care costs. However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant in combination with less decline in HRQoL is an important result. The trial is registered in the Netherlands Trial Register ( NTR1593 - October 1 st 2008).

Undergraduate Training in the Epidemiology of Prostate Cancer with Focus on Genetics of Disease Progression and Quality of Life

DTIC Science & Technology

2015-10-01

surrounding the use of common chemotherapeutic regimens. Students met bimonthly to discuss journal articles and recent development in cancer therapy ...cafeteria, Student Union and offices; 7 3. Bare feet; 4. Short shorts; 5. Shorts, blue or other type jeans at major programs such as Musical Arts, Fall...dress. Bare feet. Shorts that reveal buttocks. Shorts, all types of jeans at programs dictating professional or formal attire, such as Musical Arts

Temporal selectivity by single neurons in the torus semicircularis of Batrachyla antartandica (Amphibia: Leptodactylidae).

PubMed

Penna, M; Lin, W Y; Feng, A S

2001-12-01

We investigated the response selectivities of single auditory neurons in the torus semicircularis of Batrachyla antartandica (a leptodactylid from southern Chile) to synthetic stimuli having diverse temporal structures. The advertisement call for this species is characterized by a long sequence of brief sound pulses having a dominant frequency of about 2000 Hz. We constructed five different series of synthetic stimuli in which the following acoustic parameters were systematically modified, one at a time: pulse rate, pulse duration, pulse rise time, pulse fall time, and train duration. The carrier frequency of these stimuli was fixed at the characteristic frequency of the units under study (n=44). Response patterns of TS units to these synthetic call variants revealed different degrees of selectivity for each of the temporal variables. A substantial number of neurons showed preference for pulse rates below 2 pulses s(-1), approximating the values found in natural advertisement calls. Tonic neurons generally showed preferences for long pulse durations, long rise and fall times, and long train durations. In contrast, phasic and phasic-burst neurons preferred stimuli with short duration, short rise and fall times and short train durations.

Role of photoperiod and melatonin in seasonal acclimatization of the djungarian hamster, Phodopus sungorus

NASA Astrophysics Data System (ADS)

Steinlechner, S.; Heldmaier, G.

1982-12-01

The Djungarian hamster, Phodopus sungorus, shows a clear annual cycle in some thermogenic parameters such as nonshivering thermogenesis (NST) and cold resistance. These seasonal changes were found to be basically controlled by natural changes in photoperiod. Further support for this view was obtained by exposing the hamsters to artificial long and short photoperiods. Implantation of melatonin during fall and winter results in an increased thermogenic capacity in both short and long day hamsters comparable to that shown by values of control hamsters exposed to short photoperiods during winter. This thermotropic action of melatonin and of short photoperiod could be found only in fall and winter whereas during spring and summer, melatonin, like photoperiod, had no influence on thermogenic capacities. These results show that the actions of melatonin and photoperiod vary with the season and that they depend upon the photoperiodic history of the hamsters. Our results further indicate that the pineal gland with its hormone melatonin is involved in mediation of photoperiodic control of seasonal acclimatization.

Association between Short Physical Performance Battery and falls in older people: the Progetto Veneto Anziani Study.

PubMed

Veronese, Nicola; Bolzetta, Francesco; Toffanello, Elena Debora; Zambon, Sabina; De Rui, Marina; Perissinotto, Egle; Coin, Alessandra; Corti, Maria-Chiara; Baggio, Giovannella; Crepaldi, Gaetano; Sergi, Giuseppe; Manzato, Enzo

2014-06-01

It is known that weakness in the lower limbs is associated with recurrent falls in old people. Among the tests routinely used to assess lower extremity strength, the Short Physical Performance Battery (SPPB) is one of those used most often, but its relationship with recurrent falls is poorly investigated. We aimed to determine if SPPB scores are related to recurrent falling in a sample of 2710 older-aged people, and to ascertain which test in the SPPB is most strongly associated with a higher rate of falls. In this cross-sectional study, we demonstrated that participants scoring 0-6 in the SPPB were more likely to be recurrent fallers than those scoring 10-12 (odds ratio [OR]=3.46, 95% confidence interval [CI] 2.04-5.88 in women; OR=3.82, 95% CI 1.77- 8.52, in men). SPPB scores of 7-9 were only associated with women being more likely to be recurrent fallers (OR=2.03, 95% CI 1.28-3.22). When the SPPB items were analyzed separately, even a lower score in gait speed for women was significantly associated with the presence of recurrent falls (OR=2.11; 95% CI 1.04-4.30), whereas in men only a significant increase in the time taken to complete the five timed chair stands test was associated with a higher rate of falls (OR=2.75; 95% CI 1.21-6.23). In conclusion, our study demonstrated that SPPB scores ≤6 are associated with a higher fall rate in old people of both genders; in females, even an SPPB score between 7 and 9 identifies subjects at a higher likelihood of being recurrent fallers. Among the single items of the SPPB, the most strongly associated with falls were gait speed in women and the five timed chair stands test in men.

Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study

PubMed Central

Bolzetta, Francesco; Toffanello, Elena Debora; Zambon, Sabina; De Rui, Marina; Perissinotto, Egle; Coin, Alessandra; Corti, Maria-Chiara; Baggio, Giovannella; Crepaldi, Gaetano; Sergi, Giuseppe; Manzato, Enzo

2014-01-01

Abstract It is known that weakness in the lower limbs is associated with recurrent falls in old people. Among the tests routinely used to assess lower extremity strength, the Short Physical Performance Battery (SPPB) is one of those used most often, but its relationship with recurrent falls is poorly investigated. We aimed to determine if SPPB scores are related to recurrent falling in a sample of 2710 older-aged people, and to ascertain which test in the SPPB is most strongly associated with a higher rate of falls. In this cross-sectional study, we demonstrated that participants scoring 0–6 in the SPPB were more likely to be recurrent fallers than those scoring 10–12 (odds ratio [OR]=3.46, 95% confidence interval [CI] 2.04–5.88 in women; OR=3.82, 95% CI 1.77– 8.52, in men). SPPB scores of 7–9 were only associated with women being more likely to be recurrent fallers (OR=2.03, 95% CI 1.28–3.22). When the SPPB items were analyzed separately, even a lower score in gait speed for women was significantly associated with the presence of recurrent falls (OR=2.11; 95% CI 1.04–4.30), whereas in men only a significant increase in the time taken to complete the five timed chair stands test was associated with a higher rate of falls (OR=2.75; 95% CI 1.21–6.23). In conclusion, our study demonstrated that SPPB scores ≤6 are associated with a higher fall rate in old people of both genders; in females, even an SPPB score between 7 and 9 identifies subjects at a higher likelihood of being recurrent fallers. Among the single items of the SPPB, the most strongly associated with falls were gait speed in women and the five timed chair stands test in men. PMID:24387140

Trunk kinematics and fall risk of older adults: translating biomechanical results to the clinic.

PubMed

Grabiner, Mark D; Donovan, Stephanie; Bareither, Mary Lou; Marone, Jane R; Hamstra-Wright, Karrie; Gatts, Strawberry; Troy, Karen L

2008-04-01

This paper reviews some of our experiences over nearly 15 years of trying to determine modifiable factors that contribute to the high incidence of fall by older adults. As part of our approach, we have subjected healthy young and older adults to very large postural disturbances during locomotion, in the form of trips and slips, to which rapid compensatory responses have been necessary to avoid falling. For both trips and slips, the ability to limit trunk motion has consistently discriminated older adults who fall from both younger adults and older adults who have been able to avoid falling. We have shown that the ability to limit trunk motion can be rapidly acquired, or learned, by older adults as a result of task-specific training. The learned motor skill has demonstrated short-term retention and has been shown to effectively decrease fall-risk due to trips. Collectively, we believe the works strongly suggests that the traditional exercise-based fall-prevention and whole-body, task-specific training can synergize to reduce falls and fall-related injury in older adults.

49 CFR 178.602 - Preparation of packagings and packages for testing.

Code of Federal Regulations, 2013 CFR

2013-10-01

...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant.... Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to...

49 CFR 178.602 - Preparation of packagings and packages for testing.

Code of Federal Regulations, 2010 CFR

2010-10-01

...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant.... Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to...

49 CFR 178.602 - Preparation of packagings and packages for testing.

Code of Federal Regulations, 2014 CFR

2014-10-01

...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant.... Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to...

49 CFR 178.602 - Preparation of packagings and packages for testing.

Code of Federal Regulations, 2011 CFR

2011-10-01

...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant.... Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to...

49 CFR 178.602 - Preparation of packagings and packages for testing.

Code of Federal Regulations, 2012 CFR

2012-10-01

...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant.... Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to...

Relationship Between Difficulties in Daily Activities and Falling: Loco-Check as a Self-Assessment of Fall Risk.

PubMed

Akahane, Manabu; Maeyashiki, Akie; Yoshihara, Shingo; Tanaka, Yasuhito; Imamura, Tomoaki

2016-06-20

People aged 65 years or older accounted for 25.1% of the Japanese population in 2013, and this characterizes the country as a "super-aging society." With increased aging, fall-related injuries are becoming important in Japan, because such injuries underlie the necessity for nursing care services. If people could evaluate their risk of falling using a simple self-check test, they would be able to take preventive measures such as exercise, muscle training, walking with a cane, or renovation of their surroundings to remove impediments. Loco-check is a checklist measure of early locomotive syndrome (circumstances in which elderly people need nursing care service or are at high risk of requiring the service within a short time), prepared by the Japanese Orthopaedic Association (JOA) in 2007, but it is unclear if there is any association between this measure and falls. To investigate the association between falls during the previous year and the 7 "loco-check" daily activity items and the total number of items endorsed, and sleep duration. We conducted an Internet panel survey. Subjects were 624 persons aged between 30 and 90 years. The general health condition of the participants, including their experience of falling, daily activities, and sleep duration, was investigated. A multivariate analysis was carried out using logistic regression to investigate the relationship between falls in the previous year and difficulties with specific daily activities and total number of difficulties (loco-check) endorsed, and sleep duration, adjusting for sex and age. One-fourth of participants (157 persons) experienced at least one fall during the previous year. Fall rate of females (94/312: 30.1%) was significantly higher than that of males (63/312: 20.2%). Fall rate of persons aged more than 65 years (80/242: 33.1%) was significantly higher than that of younger persons (77/382: 20.2%). Logistic regression analysis revealed that daily activities such as "impossibility of getting across the road at a crossing before the traffic light changes" are significantly related to falling. Logistic regression analysis also demonstrated a relationship between the number of items endorsed on loco-check and incidence of falling, wherein persons who endorsed 4 or more items appear to be at higher risk for falls. However, logistic regression found no significant relationship between sleep duration and falling. Our study demonstrated a relationship between the number of loco-check items endorsed and the incidence of falling in the previous year. Endorsement of 4 or more items appeared to signal a high risk for falls. The short self-administered checklist can be a valuable tool for assessing the risk of falling and for initiating preventive measures.

Predicting Geriatric Falls Following an Episode of Emergency Department Care: A Systematic Review

PubMed Central

Carpenter, Christopher R.; Avidan, Michael S.; Wildes, Tanya; Stark, Susan; Fowler, Susan A.; Lo, Alexander X.

2015-01-01

Background Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. Objectives This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor’s accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. Methods A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the projected benefits or harms of fall prevention interventions in the ED. Results A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. Conclusions This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk PMID:25293956

Obese frailty, physical performance deficits, and falls in older men with biochemical recurrence of prostate cancer on androgen deprivation therapy: a case-control study

PubMed Central

Bylow, Kathryn; Hemmerich, Joshua; Mohile, Supriya G.; Stadler, Walter M.; Sajid, Saleha; Dale, William

2010-01-01

Objectives Early androgen deprivation therapy (ADT) has no proven survival advantage in older men with biochemical recurrence (BCR) of prostate cancer (PCa), and it may contribute to geriatric frailty; we tested this hypothesis. Methods We conducted a case-control study of men aged 60+ with BCR on ADT (n=63) versus PCa survivors without recurrence (n=71). Frailty prevalence, “obese” frailty, Short Physical Performance Battery (SPPB) scores and falls were compared. An exploratory analysis of frailty biomarkers (CRP, ESR, hemoglobin, albumin, and total cholesterol) was performed. Summary statistics, univariate and multivariate regression analyses were conducted. Results More patients on ADT were obese (BMI >30; 46.2% vs. 20.6%; p=0.03). There were no statistical differences in SPPB (p=0.41) or frailty (p=0.20). Using a proposed “obese” frailty criteria, 8.7% in ADT group were frail and 56.5% were “prefrail”, compared with 2.9% and 48.8% of controls (p=0.02). Falls in the last year were higher in ADT group (14.3% vs. 2.8%; p=0.02). In analyses controlling for age, clinical characteristics, and comorbidities, the ADT group trended toward significance for “obese” frailty (p = 0.14) and falls (OR = 4.74, p = 0.11). Comorbidity significantly increased the likelihood of “obese” frailty (p=0.01) and falls (OR 2.02, p = 0.01). Conclusions Men with BCR on ADT are frailer using proposed modified “obese” frailty criteria. They may have lower performance status and more falls. A larger, prospective trial is necessary to establish a causal link between ADT use and progression of frailty and disability. PMID:21269665

[Medical sciences in the Byzantine-Ottoman area, from the emergence of Anatolian emirats to the Fall of Constantinople (end 13th -half 15th)].

PubMed

Balivet, M

1999-01-01

This article is a short analysis of the first activities of Medecine and Hospitals in the Turcoman and Ottoman Anatolia (end of XIIIth-middle of XVth). We also ask the question of relationships between Turkish and Byzantine Medical Sciences until the Fall of Constantinople.

Interest in Teaching Careers Rising; Technology and Nursing Careers Falling Sharply. 1987 Freshman Survey Report.

ERIC Educational Resources Information Center

Higher Education Research Inst., Inc., Los Angeles, CA.

According to the 22nd annual survey of entering freshmen in the United States, freshman interest in teaching careers has increased by more than two-thirds since 1982. However, this level of interest still falls short of the projected demand. The 1987 data also suggest potential problems with future supplies of certain technology and health care…

Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

PubMed Central

Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho

2016-01-01

Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls. PMID:26839487

Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors.

PubMed

Nam, Ki Yeun; Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

2016-02-01

Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls.

Maintenance Crisis vs Solutions.

ERIC Educational Resources Information Center

Haggard, Susie

Industrial maintenance in Northeast Georgia is facing an acute crisis. Contributing factors are economic development that is depleting the work force, aging of the population, downsizing of the military, and lack of technical school graduates. Solutions to the crisis fall into three categories: short-term, mid-term, and long-term. For short-term…

Management and treatment of splenic trauma in children.

PubMed

Arslan, Serkan; Guzel, Mahmut; Turan, Cuneyt; Doğanay, Selim; Kopru, Mehmet

2015-01-01

To assess types of splenic traumas, accompanying injuries, their management and results. We studied the reports of 90 patients (64 boys, 26 girls) who were treated for splenic injuries as a result of blunt abdominal trauma between 2005-2012. Age, sex, hospitalization time, mechanisms of traumas, accompanying injuries and management methods were recorded. Causes of trauma were falls from height (46 patients, 51%), pedestrian traffic accidents (17 patients, 19%), passenger traffic accidents (11 patients, 12%), bicycle accidents (10 patients, 11%) and falling objects from height (6 patients, 6.6%). Splenic injury alone was observed in 57 patients (63.3%) and other organ injuries together with splenic injury in 33 patients (36.7%). Splenectomy was performed in six patients (6.6%) due to hemodynamic instability and small intestine repair due to small intestine injury in one patient (1.1%). None of these patients died from their injuries. A large proportion of splenic injuries recover with conservative therapy. Some of the advantages of conservative therapy include short hospitalization time, less need for blood transfusion, and less morbidity and mortality. Falls from height and traffic accidents are important factors in etiology. The possibility of other organ injuries together with splenic injuries should be considered.

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

NASA Technical Reports Server (NTRS)

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

1975-01-01

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

Martial arts fall techniques reduce hip impact forces in naive subjects after a brief period of training.

PubMed

Weerdesteyn, V; Groen, B E; van Swigchem, R; Duysens, J

2008-04-01

Hip fractures are among the most serious consequences of falls in the elderly. Martial arts (MA) fall techniques may reduce hip fracture risk, as they are known to reduce hip impact forces by approximately 30% in experienced fallers. The purpose of this study was to investigate whether hip impact forces and velocities in MA falls would be smaller than in a 'natural' fall arrest strategy (Block) in young adults (without any prior experience) after a 30-min training session in sideways MA fall techniques. Ten subjects fell sideways from kneeling height. In order to identify experience-related differences, additional EMG data of both fall types were collected in inexperienced (n=10) and experienced fallers (n=5). Compared to Block falls, MA falls had significantly smaller hip impact forces (-17%) and velocities (-7%). EMG results revealed experience-related differences in the execution of the MA fall, indicative of less pronounced trunk rotation in the inexperienced fallers. This may explain their smaller reduction of impact forces compared to experienced fallers. In conclusion, the finding that a substantial reduction in impact forces can be achieved after a short training in MA techniques is very promising with respect to their use in interventions to prevent fall injuries.

On reducing hand impact force in forward falls: results of a brief intervention in young males.

PubMed

Lo, J; McCabe, G N; DeGoede, K M; Okuizumi, H; Ashton-Miller, J A

2003-10-01

To test the working hypotheses that after a brief (10 min) intervention, (a) young adults can volitionally reduce fall-related wrist impact forces, and (b) no difference in impact force would exist between intervention and control groups at 3-weeks or 3-months follow-up. The wrist is the most commonly fractured site in the body at any age, most often as a result of impact with the ground while arresting a forward fall.Methods. Twenty-nine healthy young male volunteers participated. A 3-month intervention group (n=10) performed five standardized forward falls before and after a 10-min instructional intervention aimed at reducing wrist impact forces during the baseline visit. They, along with a 3-month control group (n=11) who did not receive the intervention, were remeasured in five trials at 3-weeks and 3-months follow-up, without intervening practice. A baseline control group (n=8) performed the five trials, then repeated them at the baseline visit without receiving the intervention. Unilateral body segment kinematics and bilateral hand-ground impact forces were measured and the hypotheses were tested using repeated measures analysis of variance. At the baseline visit, a significant group-by-trial-block interaction was found (P=0.02): the 3-month intervention group reduced their average maximum impact forces by 18% from initial values (P=0.002); the baseline control group did not do so (0.5% increase, P=0.91). The 3-month intervention (20 falls) and control (15 falls) groups did not differ at the 3-month follow-up (P=0.62); however, when the groups were combined their maximum impact force had decreased significantly (8.9%, P=0.04) over that time. Healthy young males learned in 10 min to significantly reduce wrist impact forces in forward falls, but retention was poor at 3-weeks follow-up. Irrespective of group, however, after the 5 falls at 3-weeks subjects had taught themselves to reduce their impact forces at the 3-months follow-up. A brief educational intervention can significantly reduce forward fall-related impact forces in the short term. However, with or without the brief intervention, the experience of performing between 5-10 forward falls 3 weeks apart apparently resulted in decreased impact forces over the next 2 months, thereby reducing the risk of injury in these forward falls.

Highlights of 2012 Fall Meeting

NASA Astrophysics Data System (ADS)

Finn, Carol

2013-01-01

This past December the streets of San Francisco, Calif., surrounding the Moscone Center were awash with a sea of Earth and space scientists attending the 45th consecutive AGU Fall Meeting, eager to share and expand their knowledge "for the benefit of humanity." As it has for many years, attendance at AGU's Fall Meeting—the largest gathering of Earth and space scientists in the world—continued to increase, this year passing the 24,000 mark. Attendees at the meeting, which took place on 3-7 December 2012, hailed from 97 countries; nearly 7000 of them were students. News from the Fall Meeting was carried in newspapers and on Web sites around the world, and the social media sphere lit up with talk of AGU and the Fall Meeting. It's even reported that for a short time we were a trending topic on Twitter.

East Los Angeles College Student Profiles: Spring and Fall, 1979. Research Report 80-3.

ERIC Educational Resources Information Center

Sachs, Steven Mark

A study of the demographic make-up of the students enrolled during Spring and Fall 1979 was conducted by East Los Angeles College (ELAC) to determine how student demographics vary from semester to semester. The data, collected for students who had at least one active unit in either full- or short-term classes, profiled students by: sex; zipcode…

The predicaments of “dangerous safety”

PubMed Central

Feudtner, Chris

2000-01-01

Remedies are not useless because they fall short of their full scope. It is better to keep a man on the edge of a precipice, if you cannot pluck him away from it, than to let him fall over. And many diabetic patients are kept in this predicament of dangerous safety. Lectures on the Principles and Practice of Physic, 1836-1837 SirThomas Watson PMID:10903304

Fall Risk Assessment Through Automatic Combination of Clinical Fall Risk Factors and Body-Worn Sensor Data.

PubMed

Greene, Barry R; Redmond, Stephen J; Caulfield, Brian

2017-05-01

Falls are the leading global cause of accidental death and disability in older adults and are the most common cause of injury and hospitalization. Accurate, early identification of patients at risk of falling, could lead to timely intervention and a reduction in the incidence of fall-related injury and associated costs. We report a statistical method for fall risk assessment using standard clinical fall risk factors (N = 748). We also report a means of improving this method by automatically combining it, with a fall risk assessment algorithm based on inertial sensor data and the timed-up-and-go test. Furthermore, we provide validation data on the sensor-based fall risk assessment method using a statistically independent dataset. Results obtained using cross-validation on a sample of 292 community dwelling older adults suggest that a combined clinical and sensor-based approach yields a classification accuracy of 76.0%, compared to either 73.6% for sensor-based assessment alone, or 68.8% for clinical risk factors alone. Increasing the cohort size by adding an additional 130 subjects from a separate recruitment wave (N = 422), and applying the same model building and validation method, resulted in a decrease in classification performance (68.5% for combined classifier, 66.8% for sensor data alone, and 58.5% for clinical data alone). This suggests that heterogeneity between cohorts may be a major challenge when attempting to develop fall risk assessment algorithms which generalize well. Independent validation of the sensor-based fall risk assessment algorithm on an independent cohort of 22 community dwelling older adults yielded a classification accuracy of 72.7%. Results suggest that the present method compares well to previously reported sensor-based fall risk assessment methods in assessing falls risk. Implementation of objective fall risk assessment methods on a large scale has the potential to improve quality of care and lead to a reduction in associated hospital costs, due to fewer admissions and reduced injuries due to falling.

Strong Relation between Muscle Mass Determined by D3-creatine Dilution, Physical Performance and Incidence of Falls and Mobility Limitations in a Prospective Cohort of Older Men.

PubMed

Cawthon, Peggy M; Orwoll, Eric S; Peters, Katherine E; Ensrud, Kristine E; Cauley, Jane A; Kado, Deborah M; Stefanick, Marcia L; Shikany, James M; Strotmeyer, Elsa S; Glynn, Nancy W; Caserotti, Paolo; Shankaran, Mahalakshmi; Hellerstein, Marc; Cummings, Steven R; Evans, William J

2018-06-12

Direct assessment of skeletal muscle mass in older adults is clinically challenging. Relationships between lean mass and late-life outcomes have been inconsistent. The D3-creatine dilution method provides a direct assessment of muscle mass. Muscle mass was assessed by D3-creatine (D3Cr) dilution in 1,382 men (mean age, 84.2 yrs). Participants completed the Short Physical Performance Battery (SPPB); usual walking speed (6 meters); and DXA lean mass. Men self-reported mobility limitations (difficulty walking 2-3 blocks or climbing 10 steps); recurrent falls (2+); and serious injurious falls in the subsequent year. Across quartiles of D3Cr muscle mass/body mass, multivariate linear models calculated means for SPPB and gait speed; multivariate logistic models calculated odds ratios for incident mobility limitations or falls. Compared to men in the highest quartile, those in the lowest quartile of D3Cr muscle mass/body mass had slower gait speed (Q1: 1.04 vs Q4: 1.17 m/s); lower SPPB (Q1: 8.4 vs Q4: 10.4 points); greater likelihood of incident serious injurious falls (OR Q1 vs Q4: 2.49, 95% CI: 1.37, 4.54); prevalent mobility limitation (OR Q1 vs Q4,: 6.1, 95%CI: 3.7, 10.3) and incident mobility limitation (OR Q1 vs Q4: 2.15 95% CI: 1.42, 3.26); p for trend <.001 for all. Results for incident recurrent falls were in the similar direction (p=0.156). DXA lean mass had weaker associations with the outcomes. Unlike DXA lean mass, low D3Cr muscle mass/body mass is strongly related to physical performance, mobility and incident injurious falls in older me.

Factors influencing short-term outcomes for older patients accessing emergency departments after a fall: The role of fall dynamics.

PubMed

Trevisan, Caterina; Di Gregorio, Patrizia; Debiasi, Eugenio; Pedrotti, Martina; La Guardia, Mario; Manzato, Enzo; Sergi, Giuseppe; March, Albert

2017-10-01

While the relevance of falls in raising the risk of fractures, hospitalization and disability in older age is well recognized, the factors influencing the onset of fractures and the need for ward admission after a fall have yet to be fully elucidated. We investigated which factors and fall dynamics were mainly associated with fall-related injuries and hospitalization among elderly persons accessing the Emergency Department (ED) following a fall. The study involved 2144 older subjects who accessed the ED after a fall. Data on the fall´s nature and related injuries, ward admissions, history of falls, dementia, and medical therapies were examined for all patients. Considering dynamics, we distinguished accidental falls (due to interaction with environmental hazards while in motion) and falls from standing (secondary to syncope, lipothymia, drop attack, or vertigo). The overall prevalence of fractures in our population did not differ significantly with advancing age, though hip fractures were more common in the oldest, and upper limb fractures in the youngest patients. Falls from standing were associated with polypharmacy and with higher ward admission rate despite a lower fractures´ prevalence than accidental falls. The chances of fall-related fractures were more than fourfold as high for accidental dynamics (OR=4.05, 95%CI:3.10-5.29, p<0.0001). Ward admission was associated with polypharmacy, dementia, anticoagulants´ use and fall-related fractures (OR=6.84, 95%CI:5.45-8.58, p<0.0001), while it correlated inversely with accidental fall dynamics. Outcomes of falls in older age depend not only on any fall-related injuries, but also on factors such as polypharmacy, cognitive status and fall dynamics. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparison of Postural Recovery Following Short and Long Duration Spaceflights

NASA Technical Reports Server (NTRS)

Wood, S. J.; Fiedler, J.; Taylor, L. C.; Kozlovskaya, I.; Black, F. O.; Paloski, W. H.

2010-01-01

INTRODUCTION: Post-flight postural ataxia reflects adaptive changes to vestibulo-spinal reflexes and control strategies adopted for movement in weightlessness. Quantitative measures obtained during computerized dynamic posturography (CDP) from US and Russian programs provide insight into the effect of spaceflight duration in terms of both the initial decrements and recovery of postural stability. METHODS: CDP was obtained on 117 crewmembers following Shuttle flights lasting 4-17 days, and on 64 crewmembers following long-duration missions lasting 48-380 days. Although the number and timing of sessions varied, the goal was to characterize postural recovery pooling similar measures from different research and flight medicine programs. This report focuses on eyes closed, head erect conditions with either a fixed or sway-referenced base of support. A smaller subset of subjects repeated the sway-referenced condition while making pitch head movements (+/- 20deg at 0.33Hz). Equilibrium scores were derived from peak-to-peak anterior-posterior sway. Fall probability was modeled using Bayesian statistical methods to estimate parameters of a logit function. RESULTS: The standard Romberg condition was the least sensitive. Longer duration flights led to larger decrements in stability with sway-reference support during the first 1-2 days, although the timecourse of recovery was similar across flight duration with head erect. Head movements led to increased incidence of falls during the first week, with a significantly longer recovery following long duration flights. CONCLUSIONS: The diagnostic assessment of postural instability, and differences in the timecourse of postural recovery between short and long flight durations, are more pronounced during unstable support conditions requiring active head movements.

Measuring what matters to rare disease patients - reflections on the work by the IRDiRC taskforce on patient-centered outcome measures.

PubMed

Morel, Thomas; Cano, Stefan J

2017-11-02

Our ability to evaluate outcomes which genuinely reflect patients' unmet needs, hopes and concerns is of pivotal importance. However, much current clinical research and practice falls short of this objective by selecting outcome measures which do not capture patient value to the fullest. In this Opinion, we discuss Patient-Centered Outcomes Measures (PCOMs), which have the potential to systematically incorporate patient perspectives to measure those outcomes that matter most to patients. We argue for greater multi-stakeholder collaboration to develop PCOMs, with rare disease patients and families at the center. Beyond advancing the science of patient input, PCOMs are powerful tools to translate care or observed treatment benefit into an 'interpretable' measure of patient benefit, and thereby help demonstrate clinical effectiveness. We propose mixed methods psychometric research as the best route to deliver fit-for-purpose PCOMs in rare diseases, as this methodology brings together qualitative and quantitative research methods in tandem with the explicit aim to efficiently utilise data from small samples. And, whether one opts to develop a brand-new PCOM or to select or adapt an existing outcome measure for use in a rare disease, the anchors remain the same: patients, their daily experience of the rare disease, their preferences, core concepts and values. Ultimately, existing value frameworks, registries, and outcomes-based contracts largely fall short of consistently measuring the full range of outcomes that matter to patients. We argue that greater use of PCOMs in rare diseases would enable a fast track to Patient-Centered Care.

Balance Confidence Improves with Resistance or Agility training: Increase is not Correlated with Objective Changes in Fall Risk and Physical Abilities

PubMed Central

Liu-Ambrose, Teresa; Khan, Karim M; Eng, Janice J; Lord, SR; McKay, HA

2012-01-01

Background While the fear of falling is a common psychological consequence of falling, older adults who have not fallen also frequently report this fear. Fear of falling can lead to activity restriction that is self-imposed rather than due to actual physical impairments. Evidence suggests that exercise can significantly improve balance confidence, as measured by falls-related self-efficacy scales. However, there are no prospective reports that correlate change in balance confidence with changes in fall risk and physical abilities as induced by participating in a group-based exercise program. Objective The primary purpose of this prospective study was to examine the relationship between the change in balance confidence and the changes in fall risk and physical abilities in older women with confirmed low bone mass after 13 weeks of exercise participation. The secondary purpose of this study was to examine the relationship between the change in balance confidence and the change in physical activity level. Methods The sample comprised 98 women aged 75 to 85 years old women with low bone mass. Participants were randomly assigned to one of three groups: Resistance Training (n=32), Agility Training (n=34), and Stretching (sham) exercises (n=32). The 50-minute exercise classes for each study arm were held twice weekly at a local YMCA community centre. Results Both resistance training and agility training significantly improved balance confidence by 6% from baseline after 13 weeks. However, the change in balance confidence was only weakly correlated with improved general physical function and not significantly correlated with the changes in fall risk score, postural stability, gait speed, or physical activity level. As well, we observed balance confidence enhancement in the presence of increased fall risk or deterioration in physical abilities. Conclusions Two different types of exercise training improved balance confidence in older women with low bone mass. This change in balance confidence was significantly correlated with change in general physical function. Because of the observation of discordance between balance confidence change and changes in fall risk and physical abilities, those who design group-based exercise programs for community-dwelling older adults may wish to consider including an education component on factors that influence fear of falling. Objective changes in fall risk factors cannot be assumed to mirror change of fear of falling and physical abilities in older adults in the short-term. PMID:15477698

Bellevue Community College Community Impact Report, Fall 2002.

ERIC Educational Resources Information Center

Bellevue Community Coll., WA.

This document presents data pertaining to the impact of Bellevue Community College (BCC), Washington, on the surrounding community. The study examines both short- and long-term impacts of BCC on the larger community. Short-term impacts include the revenue and expenditures for which BCC is responsible, which for 2001-02 totaled $86,431,309. During…

Sex Role Stress and Job Burnout among Family Practice Physicians.

ERIC Educational Resources Information Center

Lemkau, Jeanne P.; And Others

1987-01-01

Explored relationships among sex role stress, gender, and job burnout in family practice physicians (N=67) in four residency programs. Results showed sexes agreed in describing ideal physician. Men saw themselves falling short on expressiveness; women saw themselves short on instrumentality and sensitivity. Sex role measures were most related to…

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.

Encoding of sound envelope transients in the auditory cortex of juvenile rats and adult rats.

PubMed

Lu, Qi; Jiang, Cuiping; Zhang, Jiping

2016-02-01

Accurate neural processing of time-varying sound amplitude and spectral information is vital for species-specific communication. During postnatal development, cortical processing of sound frequency undergoes progressive refinement; however, it is not clear whether cortical processing of sound envelope transients also undergoes age-related changes. We determined the dependence of neural response strength and first-spike latency on sound rise-fall time across sound levels in the primary auditory cortex (A1) of juvenile (P20-P30) rats and adult (8-10 weeks) rats. A1 neurons were categorized as "all-pass", "short-pass", or "mixed" ("all-pass" at high sound levels to "short-pass" at lower sound levels) based on the normalized response strength vs. rise-fall time functions across sound levels. The proportions of A1 neurons within each of the three categories in juvenile rats were similar to that in adult rats. In general, with increasing rise-fall time, the average response strength decreased and the average first-spike latency increased in A1 neurons of both groups. At a given sound level and rise-fall time, the average normalized neural response strength did not differ significantly between the two age groups. However, the A1 neurons in juvenile rats showed greater absolute response strength, longer first-spike latency compared to those in adult rats. In addition, at a constant sound level, the average first-spike latency of juvenile A1 neurons was more sensitive to changes in rise-fall time. Our results demonstrate the dependence of the responses of rat A1 neurons on sound rise-fall time, and suggest that the response latency exhibit some age-related changes in cortical representation of sound envelope rise time. Copyright © 2015 Elsevier Ltd. All rights reserved.

Recent slope failures in the Dolomites (Northeastern Italian Alps) in a context of climate change

NASA Astrophysics Data System (ADS)

Chiarle, Marta; Paranunzio, Roberta; Laio, Francesco; Nigrelli, Guido; Guzzetti, Fausto

2014-05-01

Climate change in the Greater Alpine Region is seriously affecting permafrost distribution, with relevant consequences on slope stability. In the Italian Alps, the number of failures from rockwalls at high elevation markedly increased in the last 20-30 years: the consistent temperature increase, which warmed twice than the global average, may have seriously influenced slope stability, in terms of glaciers retreat and permafrost degradation. Moreover, the growing number of tourists and activities in alpine regions (in particular in the Dolomites) made these areas particularly critical in relation to natural hazards. In this light, an integrated short-term geomorphological and climatic analysis was performed, in order to better comprehend the impact of main climate elements (especially temperature and precipitation) on slope failures in high mountain areas. In this contribution, we focus on three recent slope failures occurred at high elevation sites in the Dolomites (Northeastern Italian Alps), declared a UNESCO World Heritage Site in August 2009. We describe here three important rock falls occurred in the autumn 2013: 1) the Sorapiss rock fall, on 30 September 2013; 2) the Monte Civetta rock fall, on 16 November 2013; 3) the Monte Antelao rock fall, on 22 November 2013. The Monte Civetta rock fall damaged some climbing routes, while the other two landslides did not cause any damage or injury. Despite the limited volume involved, these three events represent an important warning sign in the context of ongoing climate change. Geomorphological information about the rock fall sites were combined with the climatic data acquired from the meteorological stations surrounding the slope failure areas. A short-term climatic analysis was performed, with the aim of understanding the role of the main climatic elements in the triggering of natural instability events in this area and in the Alps in general.

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

PubMed Central

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

2015-01-01

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

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

PubMed

Shieh, Wann-Yun; Huang, Ju-Chin

2012-09-01

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

Community Impact Report. Executive Summary, Fall 2000.

ERIC Educational Resources Information Center

Hodge, Valerie

This summary details Bellevue Community College's (BCC's) (Washington) short-term and long-term community impacts. Short-term community impacts include: (1) 34,994 students were educated and trained at BCC; (2) BCC employed over 2,272 people, 53% of whom lived in the BCC service area; (3) BCC total revenue was $62,966,226; (4) 28.6% of the total…

A modified method for MRF segmentation and bias correction of MR image with intensity inhomogeneity.

PubMed

Xie, Mei; Gao, Jingjing; Zhu, Chongjin; Zhou, Yan

2015-01-01

Markov random field (MRF) model is an effective method for brain tissue classification, which has been applied in MR image segmentation for decades. However, it falls short of the expected classification in MR images with intensity inhomogeneity for the bias field is not considered in the formulation. In this paper, we propose an interleaved method joining a modified MRF classification and bias field estimation in an energy minimization framework, whose initial estimation is based on k-means algorithm in view of prior information on MRI. The proposed method has a salient advantage of overcoming the misclassifications from the non-interleaved MRF classification for the MR image with intensity inhomogeneity. In contrast to other baseline methods, experimental results also have demonstrated the effectiveness and advantages of our algorithm via its applications in the real and the synthetic MR images.

Novel assay procedures for the measurement of α-amylase in weather-damaged wheat.

PubMed

Cornaggia, Claudio; Ivory, Ruth; Mangan, David; McCleary, Barry V

2016-01-30

The measurement of α-amylase (EC 3.2.1.1) in sprout-damaged grains is a crucial analysis yet a problematic one owing to the typically low α-amylase levels in ground wheat samples. A number of standardised methods such as the Falling Number method and the Ceralpha method exist which are routinely used for the assay of α-amylase. These methods, however, are either highly substrate-dependent or lack the required sensitivity to assess sprout damage. Novel colorimetric and fluorometric reagents have been prepared (Amylase HR, Amylase SD, BzCNPG7 reagent and BzMUG7 reagent) for the direct and specific assay of α-amylase activity in sprout-damaged wheat. Assays employing these reagents have been developed and optimised to include a decolourisation step using activated charcoal. When used in a convenient assay format, Amylase SD--containing EtNPG7 (II) as the colorimetric substrate and α-glucosidase as the ancillary enzyme--was found to be an excellent reagent for the assessment of sprout damage in wheat with incubation times as short as 5 min. The assay using Amylase SD is completely specific for α-amylase. The use of the Amylase SD assay represents a sensitive and valid alternative to the traditionally used Falling Number values for the assessment of sprout damage in wheat samples. © 2015 Society of Chemical Industry.

Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial.

PubMed

Merom, Dafna; Mathieu, Erin; Cerin, Ester; Morton, Rachael L; Simpson, Judy M; Rissel, Chris; Anstey, Kaarin J; Sherrington, Catherine; Lord, Stephen R; Cumming, Robert G

2016-08-01

The prevention of falls among older people is a major public health challenge. Exercises that challenge balance are recognized as an efficacious fall prevention strategy. Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults, two of the strongest risk factors for falls in older people, this study aimed to determine whether social dance is effective in i) reducing the number of falls and ii) improving physical and cognitive fall-related risk factors. A parallel two-arm cluster randomized controlled trial was undertaken in 23 self-care retirement villages (clusters) around Sydney, Australia. Eligible villages had to have an appropriate hall for dancing, house at least 60 residents, and not be currently offering dance as a village activity. Retirement villages were randomised using a computer generated randomisation method, constrained using minimisation. Eligible participants had to be a resident of the village, be able to walk at least 50 m, and agree to undergo physical and cognitive testing without cognitive impairment. Residents of intervention villages (12 clusters) were offered twice weekly one-hour social dancing classes (folk or ballroom dancing) over 12 mo (80 h in total). Programs were standardized across villages and were delivered by eight dance teachers. Participants in the control villages (11 clusters) were advised to continue with their regular activities. falls during the 12 mo trial and Trail Making Tests. The Physiological Performance Assessment (i.e., postural sway, proprioception, reaction time, leg strength) and the Short Physical Performance Battery; health-related physical and mental quality of life from the Short-Form 12 (SF-12) Survey. Data on falls were obtained from 522 of 530 (98%) randomised participants (mean age 78 y, 85% women) and 424 (80%) attended the 12-mo reassessment, which was lower among folk dance participants (71%) than ballroom dancing (82%) or control participants (82%, p = 0.04). Mean attendance at dance classes was 51%. During the period, 444 falls were recorded; there was no significant difference in fall rates between the control group (0.80 per person-year) and the dance group (1.03 per person-year). Using negative binomial regression with robust standard errors the adjusted Incidence Rate Ratio (IRR) was 1.19 (95% CI: 95% CI = 0.83, 1.71). In exploratory post hoc subgroup analysis, the rate of falls was higher among dance participants with a history of multiple falls (IRR = 2.02, 95% CI: 1.15, 3.54, p = 0.23 for interaction) and with the folk dance intervention (IRR = 1.68, 95% CI: 1.03, 2.73). There were no significant between-group differences in executive function test (TMT-B = 2.8 s, 95% CI: -6.2, 11.8). Intention to treat (ITT) analysis revealed no between-group differences at 12-mo follow-up in the secondary outcome measures, with the exception of postural sway, favouring the control group. Exploratory post hoc analysis by study completers and style indicated that ballroom dancing participants apparently improved their gait speed by 0.07 m/s relative to control participants (95% CI: 0.00, 0.14, p = 0.05). Study limitations included allocation to style based on logistical considerations rather than at random; insufficient power to detect differential impacts of different dance styles and smaller overall effects; variation of measurement conditions across villages; and no assessment of more complex balance tasks, which may be more sensitive to changes brought about by dancing. Social dancing did not prevent falls or their associated risk factors among these retirement villages' residents. Modified dance programmes that contain "training elements" to better approximate structured exercise programs, targeted at low and high-risk participants, warrant investigation. The Australian New Zealand Clinical Trials Registry ACTRN12612000889853.

Feasibility study of short-term effects of chiropractic manipulation on older adults with impaired balance

PubMed Central

Hawk, Cheryl; Pfefer, Mark T.; Strunk, Richard; Ramcharan, Michael; Uhl, Nathan

2007-01-01

Abstract Objective The purpose of this study was to collect preliminary information on the effects of chiropractic spinal manipulation on reducing risk of falls in older adults with impaired balance, as assessed by the Berg Balance Scale (BBS). This information is necessary to develop a line of investigation into the role of chiropractic care on reduction of fall risk in this population. Methods Randomized, 2-group pretest/posttest design feasibility study with a target sample size of 10 (5 per group), conducted within the outpatient health center of a chiropractic college. Inclusion criteria were as follows: aged 60 years or older, able to stand on one leg <5 seconds, and able to attend all sessions. Patients were assigned to chiropractic care (CMT) or supervised exercise (EX) and scheduled for 2 visits per week for 8 weeks. Results A total of 26 people responded to recruitment; and 11 were enrolled: 6 in the CMT and 5 in the EX group. Two patients dropped out at the baseline visit when they were assigned to the EX group. One CMT patient dropped out in the seventh week because of a fall at home resulting in a leg fracture. All remaining patients were compliant with treatment protocols. Five of 6 CMT patients and 4 of 5 EX patients had baseline BBS scores <45, indicating increased risk of falls. At visit 16, 2 CMT and 1 of the 3 remaining EX patients had BBS scores <45. One mild and transient adverse event was noted. Conclusion Further investigation of the possible role of chiropractic care in reducing fall risk in this population appears feasible. PMID:19674706

Dynamic malaria hotspots in an open cohort in western Kenya.

PubMed

Platt, Alyssa; Obala, Andrew A; MacIntyre, Charlie; Otsyula, Barasa; Meara, Wendy Prudhomme O'

2018-01-12

Malaria hotspots, defined as areas where transmission intensity exceeds the average level, become more pronounced as transmission declines. Targeting hotspots may accelerate reductions in transmission and could be pivotal for malaria elimination. Determinants of hotspot location, particularly of their movement, are poorly understood. We used spatial statistical methods to identify foci of incidence of self-reported malaria in a large census population of 64,000 people, in 8,290 compounds over a 2.5-year study period. Regression models examine stability of hotspots and identify static and dynamic correlates with their location. Hotspot location changed over short time-periods, rarely recurring in the same area. Hotspots identified in spring versus fall season differed in their stability. Households located in a hotspot in the fall were more likely to be located in a hotspot the following fall (RR = 1.77, 95% CI: 1.66-1.89), but the opposite was true for compounds in spring hotspots (RR = 0.15, 95% CI: 0.08-0.28). Location within a hotspot was related to environmental and static household characteristics such as distance to roads or rivers. Human migration into a household was correlated with risk of hotspot membership, but the direction of the association differed based on the origin of the migration event.

Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

PubMed Central

2012-01-01

Background The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs) on fall prevention. Methods An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls". Results The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes. Conclusions No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review. PMID:22510239

In vitro regeneration of Basella alba L

NASA Technical Reports Server (NTRS)

Edney, Norris Allen; Rizvi, Muhammad A.; Rizvi, Narjis F.

1989-01-01

Basella alba L. is a tropical vine used as a vegetable in some Asian and African countries. It has potential as a nontraditional crop for small family farms. A short day plant, it blooms during the fall, provided the temperatures are mild. In the southeastern U.S., the short days of fall are associated with subfreezing temperatures, and plants are killed before blooming. Attempts were made to regenerate the plant using tissue culture techniques. Several trials were conducted with different media, hormones, and explants. It was found that nodal segments on Gamborg medium regenerated shoots. Interaction studies of auxins and cytokinins indicated that its endogeneous auxin content might be high because callus proliferated in almost all treatments and roots initiated even when the medium was not supplemented with an auxin.

"Neither Can They Die Any More; for They Are Equal Unto the Angels": Secular Epiphanies in David Almond's "Counting Stars"

ERIC Educational Resources Information Center

Grace, Deborah

2014-01-01

Written before the successful publication of Skellig (1998), David Almond's short story collection, "Counting Stars," has attracted less critical attention than his more famous novels. Falling between fiction and autobiography, the earlier short stories are more firmly grounded in realism than the novels, which feature elements of…

Vacation Study Abroad, 1995/96: The Complete Guide to Summer and Short-Term Study. 45th Edition.

ERIC Educational Resources Information Center

Steen, Sara J., Ed.

This directory provides information on summer programs abroad from 1 week to several months in length and short courses of varying lengths in the fall, winter, or spring. Approximately 60 percent of the programs are sponsored by U.S. accredited colleges and universities; the others are offered by foreign universities, language schools, and other…

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

History of falls, gait, balance, and fall risks in older cancer survivors living in the community.

PubMed

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A "faller" was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher's exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594-29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling.

History of falls, gait, balance, and fall risks in older cancer survivors living in the community

PubMed Central

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A “faller” was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher’s exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594–29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling. PMID:26425079

a Modeling Method of Fluttering Leaves Based on Point Cloud

NASA Astrophysics Data System (ADS)

Tang, J.; Wang, Y.; Zhao, Y.; Hao, W.; Ning, X.; Lv, K.; Shi, Z.; Zhao, M.

2017-09-01

Leaves falling gently or fluttering are common phenomenon in nature scenes. The authenticity of leaves falling plays an important part in the dynamic modeling of natural scenes. The leaves falling model has a widely applications in the field of animation and virtual reality. We propose a novel modeling method of fluttering leaves based on point cloud in this paper. According to the shape, the weight of leaves and the wind speed, three basic trajectories of leaves falling are defined, which are the rotation falling, the roll falling and the screw roll falling. At the same time, a parallel algorithm based on OpenMP is implemented to satisfy the needs of real-time in practical applications. Experimental results demonstrate that the proposed method is amenable to the incorporation of a variety of desirable effects.

Cognitive Behavioral Therapy, Mindfulness, and Hypnosis as Treatment Methods for Generalized Anxiety Disorder.

PubMed

Daitch, Carolyn

2018-07-01

Individuals suffering from generalized anxiety disorder (GAD) experience a broad range of physical, emotional, and cognitive distress. A hallmark of GAD is anxiety around making decisions. Many clinicians notice improvements in patients through specific modalities, such as mindfulness, hypnosis, and cognitive behavioral therapy (CBT); however, these individual methods sometimes fall short. Clinicians and researchers alike note that it can be more effective to combine these three methods into an integrative treatment protocol. This article demonstrates the efficacy of an integrative model through the case study of a client who suffers from GAD and acute fear of decision making. Competent use of mindfulness, hypnosis, and CBT helps the client build the skills necessary to self-soothe, diminish worry, access resources, and enhance hope for the future. Through the article, clinicians interested in integrated treatment models will gain insight into how to apply these methods.

Imaging voltage in neurons

PubMed Central

Peterka, Darcy S.; Takahashi, Hiroto; Yuste, Rafael

2011-01-01

In the last decades, imaging membrane potential has become a fruitful approach to study neural circuits, especially in invertebrate preparations with large, resilient neurons. At the same time, particularly in mammalian preparations, voltage imaging methods suffer from poor signal to noise and secondary side effects, and they fall short of providing single-cell resolution when imaging of the activity of neuronal populations. As an introduction to these techniques, we briefly review different voltage imaging methods (including organic fluorophores, SHG chromophores, genetic indicators, hybrid, nanoparticles and intrinsic approaches), and illustrate some of their applications to neuronal biophysics and mammalian circuit analysis. We discuss their mechanisms of voltage sensitivity, from reorientation, electrochromic or electro-optical phenomena, to interaction among chromophores or membrane scattering, and highlight their advantages and shortcomings, commenting on the outlook for development of novel voltage imaging methods. PMID:21220095

The Association Between Fall History and Physical Performance Tests in the Community-Dwelling Elderly: A Cross-Sectional Analysis.

PubMed

Kim, Jin Chul; Chon, Jinmann; Kim, Hee Sang; Lee, Jong Ha; Yoo, Seung Don; Kim, Dong Hwan; Lee, Seung Ah; Han, Yoo Jin; Lee, Hyun Seok; Lee, Bae Youl; Soh, Yun Soo; Won, Chang Won

2017-04-01

To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.

Transient features in nanosecond pulsed electric fields differentially modulate mitochondria and viability.

PubMed

Beebe, Stephen J; Chen, Yeong-Jer; Sain, Nova M; Schoenbach, Karl H; Xiao, Shu

2012-01-01

It is hypothesized that high frequency components of nanosecond pulsed electric fields (nsPEFs), determined by transient pulse features, are important for maximizing electric field interactions with intracellular structures. For monopolar square wave pulses, these transient features are determined by the rapid rise and fall of the pulsed electric fields. To determine effects on mitochondria membranes and plasma membranes, N1-S1 hepatocellular carcinoma cells were exposed to single 600 ns pulses with varying electric fields (0-80 kV/cm) and short (15 ns) or long (150 ns) rise and fall times. Plasma membrane effects were evaluated using Fluo-4 to determine calcium influx, the only measurable source of increases in intracellular calcium. Mitochondria membrane effects were evaluated using tetramethylrhodamine ethyl ester (TMRE) to determine mitochondria membrane potentials (ΔΨm). Single pulses with short rise and fall times caused electric field-dependent increases in calcium influx, dissipation of ΔΨm and cell death. Pulses with long rise and fall times exhibited electric field-dependent increases in calcium influx, but diminished effects on dissipation of ΔΨm and viability. Results indicate that high frequency components have significant differential impact on mitochondria membranes, which determines cell death, but lesser variances on plasma membranes, which allows calcium influxes, a primary determinant for dissipation of ΔΨm and cell death.

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.

Are the spring and fall blooms on the Scotian Shelf related to short-term physical events?

NASA Astrophysics Data System (ADS)

Greenan, B. J. W.; Petrie, B. D.; Harrison, W. G.; Oakey, N. S.

2004-03-01

Physical, chemical and biological data from the Scotian Shelf indicate that short-term physical events affect the dynamics of spring and fall blooms. This is based on results from a three-week mooring deployment measuring currents, temperature, salinity and fluorescence in October 2000, combined with biweekly sampling of temperature, salinity, nutrients and chlorophyll throughout the year at this mooring site. A wind-driven upwelling event in mid-October shows temperature, salinity and density iso-surfaces rising by approximately 20 m. During this event, a bloom with peak chlorophyll concentrations of about 2.5 mg m -3 began as nutrients are brought into the upper part of the water column. Gradient Richardson Numbers ( Ri), a proxy for vertical mixing, are estimated for the mooring period in 2 m vertical bins using SeaHorse CTD data and nearby ADCP current measurements. These data indicate that vertical mixing may have played a complementary role to the upwelling in bringing nutrients into the euphotic zone. A trend of decreasing Ri in the ocean mixed layer with increasing surface wind stress is suggested. It appears that this short-term physical event is a primary factor in initiating the fall bloom on the inner Scotian Shelf in 2000. In April of that year, the termination of the spring bloom coincided with a downwelling event suggesting that it played a role in determining the duration of the bloom. SeaWiFS ocean color satellite provided a spatial context for chlorophyll observations, however, the lack of temporal resolution due to poor atmospheric conditions means that these data provide limited information on short-term chlorophyll variability.

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

The elimination half-life of benzodiazepines and fall risk: two prospective observational studies.

PubMed

de Vries, Oscar J; Peeters, Geeske; Elders, Petra; Sonnenberg, Caroline; Muller, Majon; Deeg, Dorly J H; Lips, Paul

2013-11-01

the STOPP criteria advise against the use of long-acting benzodiazepines (LBs). to study whether LBs are associated with a higher fall risk than short-acting benzodiazepines (SBs) (elimination half-life ≤ 10 h). we used base-line data and prospective fall follow-up from the Longitudinal Aging Study Amsterdam, a longitudinal cohort study including 1,509 community-dwelling older persons (Study 1) and from a separate fall prevention study with 564 older persons after a fall (Study 2). Time to the first fall after inclusion and number of falls in the first year after inclusion were the primary endpoints. both in Study 1 and Study 2 the use of SBs was associated with time to the first fall, hazard ratio (HR) 1.62 (95% CI: 1.03-2.56) and HR 1.64 (95% CI: 1.19-2.26),respectively. LBs were not significantly associated with time to first fall, HR 1.40 (0.85-2.31) and HR 1.08 (0.72-1.62). In both studies, the use of SBs was also associated with number of falls, odds ratio (OR) 1.28 (95% CI: 1.01-1.61) and OR 1.37 (95% CI: 1.10-1.70). LBs were not significantly associated with number of falls, OR 1.23 (0.96-1.57) and 1.10 (0.82-1.48). the use of SBs is not associated with a lower fall risk compared with LBs. The use of both SBs and LBs by old persons should be strongly discouraged.

Dance movement therapy and falls prevention.

PubMed

Veronese, Nicola; Maggi, Stefania; Schofield, Patricia; Stubbs, Brendon

2017-08-01

Falls are a leading cause of morbidity, healthcare use and mortality. Dance is a popular form of physical activity among older people and previous research has suggested that it may improve various health outcomes in this population, including balance, gait and muscle performance. A systematic review of the potential benefits of dance on falls and fear of falling is lacking. Thus, we conducted a systematic review considering all randomized controls trials (RCTs) investigating if dance can reduce falls and improve fear of falling in older adults. Major databases were searched from inception until 1 March 2017 and a total of 10 RCTs were identified, which included a total of 680 people (n=356 dance, n=324 control). Overall, the mean age of the samples was 69.4 years, and 75.2% were female. Across four RCTs, dance therapy reduced falls versus usual care in only one study. Dance therapy improved fear of falling in two out of three included RCTs. There were no serious adverse events reported in the RCTs. In summary, we found a paucity of studies investigating the effect of dance on falls and fear of falling and the evidence base is preliminary and equivocal. Given the heterogeneity of the included samples and interventions, in addition to the short-term follow-up, no firm conclusions can be drawn. However, dance appears to be safe and, given its popularity and demonstrated benefits on other health/wellbeing outcomes in older adults, it is important that future research considers its potential benefits on falls/fear of falling in older age. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed Central

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

2014-01-01

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

Compensation of hospital-based physicians.

PubMed Central

Steinwald, B

1983-01-01

This study is concerned with methods of compensating hospital-based physicians (HBPs) in five medical specialties: anesthesiology, pathology, radiology, cardiology, and emergency medicine. Data on 2232 nonfederal, short-term general hospitals came from a mail questionnaire survey conducted in Fall 1979. The data indicate that numerous compensation methods exist but these methods, without much loss of precision, can be reduced to salary, percentage of department revenue, and fee-for-service. When HBPs are compensated by salary or percentage methods, most patient billing is conducted by the hospital. In contrast, most fee-for-service HBPs bill their patients directly. Determinants of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods is sensitive to a number of hospital characteristics and attributes of both the hospital and physicians' services markets. The empirical findings are discussed in light of past conceptual and empirical research on physician compensation, and current policy issues in the health services sector. PMID:6841112

Perceptions of Speaking Ability: An Explanation for Stage Fright.

ERIC Educational Resources Information Center

Ayres, Joe

1986-01-01

Argues that stage fright is a function of the speaker's perception that ability falls short of audience expectation. Discusses the implications of this theory for future investigations and interventions. (MS)

Challenge of COPD: Getting Tested

MedlinePlus

... please turn JavaScript on. Feature: The Challenge of COPD Getting Tested Past Issues / Fall 2014 Table of Contents Getting Tested Everyone at risk for COPD who has cough, sputum production, or shortness of ...

Wolf predation risk associated with white-tailed deer movements

USGS Publications Warehouse

Nelson, M.E.; Mech, L.D.

1991-01-01

The survival of 159 yearling and adult deer (Odocoileus virginianus) was monitored by telemetry during 282 spring and 219 fall individual migrations to winter deeryards in northeastern Minnesota. A disproportionate number of deer were killed by wolves (Canis lupus) during fall migration relative to the short time they spent migrating, but not during spring migration. Predation was also significantly greater for male and female yearlings and adult females outside deeryards during winter. Survival of 79 yearlings dispersing from natal ranges was high (1.00). It appears that changing climatic conditions combined with unfamiliar terrain and undetermined factors predispose migratory deer to wolf predation during fall. These findings support an earlier hypothesis that winter yarding is an antipredator strategy.

Fall Risk Assessment Tools for Elderly Living in the Community: Can We Do Better?

PubMed

Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Chiari, Lorenzo

2015-01-01

Falls are a common, serious threat to the health and self-confidence of the elderly. Assessment of fall risk is an important aspect of effective fall prevention programs. In order to test whether it is possible to outperform current prognostic tools for falls, we analyzed 1010 variables pertaining to mobility collected from 976 elderly subjects (InCHIANTI study). We trained and validated a data-driven model that issues probabilistic predictions about future falls. We benchmarked the model against other fall risk indicators: history of falls, gait speed, Short Physical Performance Battery (Guralnik et al. 1994), and the literature-based fall risk assessment tool FRAT-up (Cattelani et al. 2015). Parsimony in the number of variables included in a tool is often considered a proxy for ease of administration. We studied how constraints on the number of variables affect predictive accuracy. The proposed model and FRAT-up both attained the same discriminative ability; the area under the Receiver Operating Characteristic (ROC) curve (AUC) for multiple falls was 0.71. They outperformed the other risk scores, which reported AUCs for multiple falls between 0.64 and 0.65. Thus, it appears that both data-driven and literature-based approaches are better at estimating fall risk than commonly used fall risk indicators. The accuracy-parsimony analysis revealed that tools with a small number of predictors (~1-5) were suboptimal. Increasing the number of variables improved the predictive accuracy, reaching a plateau at ~20-30, which we can consider as the best trade-off between accuracy and parsimony. Obtaining the values of these ~20-30 variables does not compromise usability, since they are usually available in comprehensive geriatric assessments.

Detecting Single-Nucleotides by Tunneling Current Measurements at Sub-MHz Temporal Resolution.

PubMed

Morikawa, Takanori; Yokota, Kazumichi; Tanimoto, Sachie; Tsutsui, Makusu; Taniguchi, Masateru

2017-04-18

Label-free detection of single-nucleotides was performed by fast tunneling current measurements in a polar solvent at 1 MHz sampling rate using SiO₂-protected Au nanoprobes. Short current spikes were observed, suggestive of trapping/detrapping of individual nucleotides between the nanoelectrodes. The fall and rise features of the electrical signatures indicated signal retardation by capacitance effects with a time constant of about 10 microseconds. The high temporal resolution revealed current fluctuations, reflecting the molecular conformation degrees of freedom in the electrode gap. The method presented in this work may enable direct characterizations of dynamic changes in single-molecule conformations in an electrode gap in liquid.

Genetic engineering applied to agriculture has a long row to hoe.

PubMed

Miller, Henry I

2018-01-02

In spite of the lack of scientific justification for skepticism about crops modified with molecular techniques of genetic engineering, they have been the most scrutinized agricultural products in human history. The assumption that "genetically engineered" or "genetically modified" is a meaningful - and dangerous - classification has led to excessive and dilatory regulation. The modern molecular techniques are an extension, or refinement, of older, less precise, less predictable methods of genetic modification, but as long as today's activists and regulators remain convinced that so called "GMOs" represent a distinct and dangerous category of research and products, genetic engineering will fall short of its potential.

42 CFR 417.598 - Annual enrollment reconciliation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.598 Annual enrollment reconciliation. CMS... conducts this reconciliation as necessary to ensure that the payments made do not exceed or fall short of...

40 CFR 85.535 - Liability, recordkeeping, and end of year reporting.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., if we learn that your actions fall short of full compliance with applicable requirements we may... calendar year intermediate age conversions, outside useful life conversions, and the same conversion model...

Chloral Hydrate

MedlinePlus

Chloral hydrate, a sedative, is used in the short-term treatment of insomnia (to help you fall asleep and ... Chloral hydrate comes as a capsule and liquid to take by mouth and as a suppository to insert rectally. ...

Delirium Research: Where Am I?

MedlinePlus

... facility, he experienced shortness of breath and acute lower-extremity edema that resulted in a series of hospital ... had a serious fall and sustained multiple hip fractures that required emergency hip replacement surgery to repair. ...

Short-pulse controlled optical switch using external cavity based single mode Fabry-Pérot laser diode.

PubMed

Nakarmi, Bikash; Hoai, Tran Quoc; Won, Yong-Hyub; Zhang, Xuping

2014-06-30

We propose and demonstrate a novel scheme for short pulse controlled all-optical switch using external cavity based single mode Fabry- Pérot laser diode (SMFP-LD). The proposed scheme consists of control unit and switching unit as two essential blocks. The basic principle of the proposed scheme is the optical bistability property of SMFP-LD for the control unit and the suppression of the dominant beam of SMFP-LD with injection locking for the switching unit. We also present the analysis of hysteresis width and rising/falling time with change in wavelength detuning which helps to find the optimum wavelength detuning value and power of light beams at different stages of the proposed scheme that gives wide input dynamic power range, high ON/OFF contrast ratio, and low rising/falling time. Input data of 10 Gb/s Non Return to Zero (NRZ) signal is switched at output ports depending upon the control signal generated by the control unit, which comprises of optical SR latch. Output waveforms, clear eye diagrams with extinction ratio of about 11 dB, rising/falling time of about 30 ps and 40 ps, and bit error rate (BER) are measured to validate proposed scheme. No noise floor is observed at output ports up to BER of 10-(12) and the maximum power penalty recorded is about 1.7 dB at a BER of 10-(9) which shows good performance of the proposed short pulse controlled optical switch using SMFP-LDs.

Femur loading in feet-first fall experiments using an anthropomorphic test device.

PubMed

Thompson, Angela; Bertocci, Gina; Smalley, Craig

2018-03-31

Femur fractures are a common orthopedic injury in young children. Falls account for a large portion of accidental femur fractures in young children, but there is also a high prevalence of femur fractures in child abuse, with falls often provided as false histories. Objective information regarding fracture potential in short distance fall scenarios may aid in assessing whether a child's injuries are the result of abuse or an accidental fall. Knowledge of femur loading is the first step towards understanding likelihood of fracture in a fall. Characterize femur loading during feet-first free falls using a surrogate representing a 12-month-old child. The femur and hip joint of a surrogate representing a 12-month-old were modified to improve biofidelity and measure femur loading; 6-axis load cells were integrated into the proximal and distal femur. Femur modification was based upon CT imaging of cadaveric femurs in children 10-14 months of age. Using the modified 12-month-old surrogate, feet-first free falls from 69 cm and 119 cm heights onto padded carpet and linoleum were conducted to assess fall dynamics and determine femur loading. Femur compression, bending moment, shear and torsional moment were measured for each fall. Fall dynamics differed across fall heights, but did not substantially differ by impact surface type. Significant differences were found in all loading conditions across fall heights, while only compression and bending loads differed between carpet and linoleum surfaces. Maximum compression, bending, torsion and shear occurred in 119 cm falls and were 572 N, 23 N-m, 11 N-m and 281 N, respectively. Fall dynamics play an important role in the biomechanical assessment of falls. Fall height was found to influence both fall dynamics and femur loading, while impact surface affected only compression and bending in feet-first falls; fall dynamics did not differ across carpet and linoleum. Improved pediatric thresholds are necessary to predict likelihood of fracture, but morphologically accurate representation of the lower extremity, along with accurate characterization of loading in falls are a crucial first step. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Progressive Resistance and Balance Training for Falls Prevention in Long-Term Residential Aged Care: A Cluster Randomized Trial of the Sunbeam Program.

PubMed

Hewitt, Jennifer; Goodall, Stephen; Clemson, Lindy; Henwood, Timothy; Refshauge, Kathryn

2018-04-01

Falls prevention is an international priority, and residents of long-term aged care fall approximately 3 times more often than community dwellers. There is a relative scarcity of published trials in this setting. Our objective was to undertake a randomized controlled trial to test the effect of published best practice exercise in long-term residential aged care. The trial was designed to determine if combined high level balance and moderate intensity progressive resistance training (the Sunbeam Program) is effective in reducing the rate of falls in residents of aged care facilities. A cluster randomized controlled trial of 16 residential aged care facilities and 221 participants was conducted. The broad inclusion criterion was permanent residents of aged care. Exclusions were diagnosed terminal illness, no medical clearance, permanent bed- or wheelchair-bound status, advanced Parkinson's disease, or insufficient cognition to participate in group exercise. Assessments were taken at baseline, after intervention, and at 12 months. Randomization was performed by computer-generated sequence to receive either the Sunbeam program or usual care. A cluster refers to an aged care facility. The program consisted of individually prescribed progressive resistance training plus balance exercise performed in a group setting for 50 hours over a 25-week period, followed by a maintenance period for 6 months. The primary outcome measure was the rate of falls (number of falls and days followed up). Secondary outcomes included physical performance (Short Physical Performance Battery), quality of life (36-item Short-Form Health Survey), functional mobility (University of Alabama Life Space Assessment), fear of falling (Falls Efficacy Scale International), and cognition (Addenbrooke's Cognitive Evaluation-revised). The rate of falls was reduced by 55% in the exercise group (incidence rate ratio = 0.45, 95% confidence interval 0.17-0.74); an improvement was also seen in physical performance (P = .02). There were no serious adverse events. The Sunbeam Program significantly reduced the rate of falls and improved physical performance in residents of aged care. This finding is important as prior work in this setting has returned inconsistent outcomes, resulting in best practice guidelines being cautious about recommending exercise in this setting. This work provides an opportunity to improve clinical practice and health outcomes for long-term care residents. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Properties of Thermal Staircases Off the Northeast Coast of South America, Spring and Fall 1985

DTIC Science & Technology

1989-06-15

Figures 15 + I and 16 aire accepted, then on may conclude that the stair- Lij15, FALL cases arise at and shortly aller the confluence (at diflerent U...Space Center, MS 39529-5004 11. Supplementary Notes. *Formerly Naval Ocean Research and Development Activity **Continued on the next page 1 12a...south (180-360 m) and deepest in the northwest (420-650 m), occurring on the average between the 8 degrea and 13 degree C isotherms. Typically, each

1990 Fall Meeting Report

NASA Astrophysics Data System (ADS)

Chapman, David S.

The AGU 1990 Fall Meeting, held in San Francisco December 3-7, continued the steady growth trend for the western meeting set over the last decade. About 5200 members registered for the meeting and 3836 papers were given. The scientific kickoff to the meeting was provided by a Union session on initial results of the current Magellan mission to Venus. The mission was also the focus of a public lecture and short film on highlights of the mission and an extensive Union poster session.

Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.

PubMed

Ellmers, Toby J; Paraskevopoulos, Ioannis Th; Williams, A Mark; Young, William R

2018-03-22

Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.

Testing the Stability of 2-D Recursive QP, NSHP and General Digital Filters of Second Order

NASA Astrophysics Data System (ADS)

Rathinam, Ananthanarayanan; Ramesh, Rengaswamy; Reddy, P. Subbarami; Ramaswami, Ramaswamy

Several methods for testing stability of first quadrant quarter-plane two dimensional (2-D) recursive digital filters have been suggested in 1970's and 80's. Though Jury's row and column algorithms, row and column concatenation stability tests have been considered as highly efficient mapping methods. They still fall short of accuracy as they need infinite number of steps to conclude about the exact stability of the filters and also the computational time required is enormous. In this paper, we present procedurally very simple algebraic method requiring only two steps when applied to the second order 2-D quarter - plane filter. We extend the same method to the second order Non-Symmetric Half-plane (NSHP) filters. Enough examples are given for both these types of filters as well as some lower order general recursive 2-D digital filters. We applied our method to barely stable or barely unstable filter examples available in the literature and got the same decisions thus showing that our method is accurate enough.

Symplocin A, a Linear Peptide from the Bahamian Cyanobacterium Symploca sp. Configurational Analysis of N,N-Dimethylamino Acids by Chiral-Phase HPLC of Naphthacyl Esters†

PubMed Central

Molinski, Tadeusz F.; Reynolds, Kirk A.; Morinaka, Brandon I.

2012-01-01

The absolute stereostructures of the components of symplocin A (3), a new N,N-dimethyl-terminated peptide from the Bahamian cyanobacterium, Symploca sp., were assigned from spectroscopic analysis, including MS and 2D NMR and Marfey’s analysis. The complete absolute configuration of symplocin A, including the unexpected D-configurations of the terminal N,N-dimethylisoleucine and valic acid residues, were assigned by chiral-phase HPLC of the corresponding 2-naphthacyl esters, a highly sensitive, complementary strategy for assignment of N-blocked peptide residues where Marfey’s method is ineffectual, or other methods fall short. Symplocin A exhibited potent activity as an inhibitor of cathepsin E (IC50 300 pM). PMID:22360587

Phenotypic mapping of metabolic profiles using self-organizing maps of high-dimensional mass spectrometry data.

PubMed

Goodwin, Cody R; Sherrod, Stacy D; Marasco, Christina C; Bachmann, Brian O; Schramm-Sapyta, Nicole; Wikswo, John P; McLean, John A

2014-07-01

A metabolic system is composed of inherently interconnected metabolic precursors, intermediates, and products. The analysis of untargeted metabolomics data has conventionally been performed through the use of comparative statistics or multivariate statistical analysis-based approaches; however, each falls short in representing the related nature of metabolic perturbations. Herein, we describe a complementary method for the analysis of large metabolite inventories using a data-driven approach based upon a self-organizing map algorithm. This workflow allows for the unsupervised clustering, and subsequent prioritization of, correlated features through Gestalt comparisons of metabolic heat maps. We describe this methodology in detail, including a comparison to conventional metabolomics approaches, and demonstrate the application of this method to the analysis of the metabolic repercussions of prolonged cocaine exposure in rat sera profiles.

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

NASA Astrophysics Data System (ADS)

Dindar, Cigdem; Kiran, Erdogan

2002-10-01

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

Using Dynamic Walking Models to Identify Factors that Contribute to Increased Risk of Falling in Older Adults

PubMed Central

Roos, Paulien E.; Dingwell, Jonathan B.

2013-01-01

Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of falling and to target those factors that influence fall risk most. PMID:24120280

Using dynamic walking models to identify factors that contribute to increased risk of falling in older adults.

PubMed

Roos, Paulien E; Dingwell, Jonathan B

2013-10-01

Falls are common in older adults. The most common cause of falls is tripping while walking. Simulation studies demonstrated that older adults may be restricted by lower limb strength and movement speed to regain balance after a trip. This review examines how modeling approaches can be used to determine how different measures predict actual fall risk and what some of the causal mechanisms of fall risk are. Although increased gait variability predicts increased fall risk experimentally, it is not clear which variability measures could best be used, or what magnitude of change corresponded with increased fall risk. With a simulation study we showed that the increase in fall risk with a certain increase in gait variability was greatly influenced by the initial level of variability. Gait variability can therefore not easily be used to predict fall risk. We therefore explored other measures that may be related to fall risk and investigated the relationship between stability measures such as Floquet multipliers and local divergence exponents and actual fall risk in a dynamic walking model. We demonstrated that short-term local divergence exponents were a good early predictor for fall risk. Neuronal noise increases with age. It has however not been fully understood if increased neuronal noise would cause an increased fall risk. With our dynamic walking model we showed that increased neuronal noise caused increased fall risk. Although people who are at increased risk of falling reduce their walking speed it had been questioned whether this slower speed would actually cause a reduced fall risk. With our model we demonstrated that a reduced walking speed caused a reduction in fall risk. This may be due to the decreased kinematic variability as a result of the reduced signal-dependent noise of the smaller muscle forces that are required for slower. These insights may be used in the development of fall prevention programs in order to better identify those at increased risk of falling and to target those factors that influence fall risk most. Copyright © 2013 Elsevier B.V. All rights reserved.

Mobility Is a Key Predictor of Change in Well-Being Among Older Adults Who Experience Falls: Evidence From the Vancouver Falls Prevention Clinic Cohort.

PubMed

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

2015-09-01

To determine the factors that predict change in well-being over time in older men and women presenting to the falls prevention clinic. Prospective cohort study. Falls prevention clinic. Community-dwelling older adults who were referred to the clinic after sustaining a fall (between N=244 and N=255, depending on the analysis). Not applicable. The ICEpop CAPability measure for Older people, a measure of well-being or quality of life, was administered at baseline, 6 months, and 12 months. We constructed linear mixed models to determine whether baseline predictor variables were related to baseline well-being and/or changes in well-being over time. In addition, we included interactions with sex to investigate the difference between men and women. Baseline predictors included 2 measures of mobility--Short Performance Physical Battery and timed Up and Go test--and a measure of global cognitive function--Montreal Cognitive Assessment. All 3 predictors were associated with well-being at baseline (P<.05). Furthermore, both the Short Performance Physical Battery and the timed Up and Go test interacted with sex (P<.05) to predict changes in well-being over time. Follow-up analyses suggested that better mobility was protective against decline in well-being in men but was generally unrelated to changes in well-being in women. We found that 2 valid and reliable measures of mobility interacted with sex to predict changes in well-being over time. This is a critical research area to develop in order to appropriately tailor future intervention strategies targeting well-being in older fallers, a population at high risk of functional decline. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

New methods for fall risk prediction.

PubMed

Ejupi, Andreas; Lord, Stephen R; Delbaere, Kim

2014-09-01

Accidental falls are the leading cause of injury-related death and hospitalization in old age, with over one-third of the older adults experiencing at least one fall or more each year. Because of limited healthcare resources, regular objective fall risk assessments are not possible in the community on a large scale. New methods for fall prediction are necessary to identify and monitor those older people at high risk of falling who would benefit from participating in falls prevention programmes. Technological advances have enabled less expensive ways to quantify physical fall risk in clinical practice and in the homes of older people. Recently, several studies have demonstrated that sensor-based fall risk assessments of postural sway, functional mobility, stepping and walking can discriminate between fallers and nonfallers. Recent research has used low-cost, portable and objective measuring instruments to assess fall risk in older people. Future use of these technologies holds promise for assessing fall risk accurately in an unobtrusive manner in clinical and daily life settings.

Historical rock falls in Yosemite National Park, California (1857-2011)

USGS Publications Warehouse

Stock, Greg M.; Collins, Brian D.; Santaniello, David J.; Zimmer, Valerie L.; Wieczorek, Gerald F.; Snyder, James B.

2013-01-01

Inventories of rock falls and other types of landslides are valuable tools for improving understanding of these events. For example, detailed information on rock falls is critical for identifying mechanisms that trigger rock falls, for quantifying the susceptibility of different cliffs to rock falls, and for developing magnitude-frequency relations. Further, inventories can assist in quantifying the relative hazard and risk posed by these events over both short and long time scales. This report describes and presents the accompanying rock fall inventory database for Yosemite National Park, California. The inventory database documents 925 events spanning the period 1857–2011. Rock falls, rock slides, and other forms of slope movement represent a serious natural hazard in Yosemite National Park. Rock-fall hazard and risk are particularly relevant in Yosemite Valley, where glacially steepened granitic cliffs approach 1 km in height and where the majority of the approximately 4 million yearly visitors to the park congregate. In addition to damaging roads, trails, and other facilities, rock falls and other slope movement events have killed 15 people and injured at least 85 people in the park since the first documented rock fall in 1857. The accompanying report describes each of the organizational categories in the database, including event location, type of slope movement, date, volume, relative size, probable trigger, impact to humans, narrative description, references, and environmental conditions. The inventory database itself is contained in a Microsoft Excel spreadsheet (Yosemite_rock_fall_database_1857-2011.xlsx). Narrative descriptions of events are contained in the database, but are also provided in a more readable Adobe portable document format (pdf) file (Yosemite_rock_fall_database_narratives_1857-2011.pdf) available for download separate from the database.

Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial.

PubMed

Smulders, Ellen; Weerdesteyn, Vivian; Groen, Brenda E; Duysens, Jacques; Eijsbouts, Agnes; Laan, Roland; van Lankveld, Wim

2010-11-01

To evaluate the efficacy of the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis and a fall history in a randomized controlled trial. Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength. A decrease in the number of falls therefore is expected to be particularly beneficial for these persons. Randomized controlled trial. Hospital. Persons with osteoporosis and a fall history (N=96; mean ± SD age, 71.0±4.7y; 90 women). After baseline assessment, participants were randomly assigned to the exercise (n=50; participated in the NFPP for persons with osteoporosis [5.5wk]) or control group (n=46; usual care). Primary outcome measure was fall rate, measured by using monthly fall calendars for 1 year. Secondary outcomes were balance confidence (Activity-specific Balance Confidence Scale), quality of life (QOL; Quality of Life Questionnaire of the European Foundation for Osteoporosis), and activity level (LASA Physical Activity Questionnaire, pedometer), assessed posttreatment subsequent to the program and after 1 year of follow-up. The fall rate in the exercise group was 39% lower than for the control group (.72 vs 1.18 falls/person-year; risk ratio, .61; 95% confidence interval, .40-.94). Balance confidence in the exercise group increased by 13.9% (P=.001). No group differences were observed in QOL and activity levels. The NFPP for persons with osteoporosis was effective in decreasing the number of falls and improving balance confidence. Therefore, it is a valuable new tool to improve mobility and independence of persons with osteoporosis. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Watershed Planning within a Quantitative Scenario Analysis Framework.

PubMed

Merriam, Eric R; Petty, J Todd; Strager, Michael P

2016-07-24

There is a critical need for tools and methodologies capable of managing aquatic systems within heavily impacted watersheds. Current efforts often fall short as a result of an inability to quantify and predict complex cumulative effects of current and future land use scenarios at relevant spatial scales. The goal of this manuscript is to provide methods for conducting a targeted watershed assessment that enables resource managers to produce landscape-based cumulative effects models for use within a scenario analysis management framework. Sites are first selected for inclusion within the watershed assessment by identifying sites that fall along independent gradients and combinations of known stressors. Field and laboratory techniques are then used to obtain data on the physical, chemical, and biological effects of multiple land use activities. Multiple linear regression analysis is then used to produce landscape-based cumulative effects models for predicting aquatic conditions. Lastly, methods for incorporating cumulative effects models within a scenario analysis framework for guiding management and regulatory decisions (e.g., permitting and mitigation) within actively developing watersheds are discussed and demonstrated for 2 sub-watersheds within the mountaintop mining region of central Appalachia. The watershed assessment and management approach provided herein enables resource managers to facilitate economic and development activity while protecting aquatic resources and producing opportunity for net ecological benefits through targeted remediation.

The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol.

PubMed

Fuchs, Tomasz; Pomorski, Michał; Grobelak, Krzysztof; Zimmer, Mariusz

2015-07-01

To evaluate values of foetal T/QRS ratios in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol using non-invasive methods with transabdominal electrodes. The study group consisted of 451 Caucasian women (63 preterm pregnancies and 327 healthy controls) whose pregnancies ranged from 28 to 37 gestational weeks. Foetal electrocardiograms were recorded and T/QRS ratios were calculated by KOMPOREL software (ITAM, Zabrze, Poland). The first recording was performed 30 min after the start of fenoterol infusion and the second 2 days after finishing tocolysis. T/QRS ratio variables were calculated. One-way analysis of variance was carried out. Significantly higher mean values of the T/QRS ratio were observed in pregnancies during tocolytic treatment in comparison to controls and pregnancies after tocolysis (P=0.0158 and P=0.0071, respectively). The T/QRS ratio values fall again shortly after finishing intravenous tocolysis. The T/QRS ratio is one of the methods used for non-invasive foetal distress assessment that can be used in antepartum foetal monitoring in complicated pregnancies. Raised values of the T/QRS ratio in the foetus during tocolysis with fenoterol and next its fall to values observed in physiological pregnancies may indicate transient worsening of fetal well-being, however, additional research is required.

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study

PubMed Central

Fleming, Jane; Matthews, Fiona E; Brayne, Carol

2008-01-01

Background The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Methods Design: Re-survey of over-90-year-olds in a longitudinal cohort study – cross-sectional interview and intensive 12-month follow-up. Participants and setting: 90 women and 20 men participating in a population-based cohort (aged 91–105 years, in care-homes and community-dwelling) recruited from representative general practices in Cambridge, UK Measurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. Results 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%), as were fall rates (1.6 and 2.8 falls/person-year respectively). Repeated falls in the past year were more highly predictive of falls during the following year – IRR 4.7, 95% CI 2.6–8.7 – than just one – IRR 3.6, 95% CI 2.0–6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Conclusion Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions of people who fell were reported by retrospective and prospective methods covering two consecutive years. Recall methods may underestimate numbers of repeated falls and the extent of recurrent falling. Professionals caring for people of advanced age can easily ask routinely whether someone has fallen at all, or more than once, in the past year to identify those at high risk of subsequent falls. PMID:18366645

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.

Fall of the Integrated Planning System

DTIC Science & Technology

2012-05-17

operations planning processes. Any service planner can lead the implementation of JOPP because he is familiar with the process and the products . The...discontinued the use of IPS. One can ask, why was IPS withdrawn so soon after its implementation ? This monograph explores the reasons behind the short...IPS raises the question, why was IPS withdrawn so soon after its implementation . This monograph explores the reasons behind the short lifespan of the

Phosphate and Calcium Control in Short Frequent Hemodialysis with the NxStage System One Cycler: Mass Balance Studies and Comparison with Standard Thrice-Weekly Bicarbonate Dialysis.

PubMed

Brunati, Chiara Carla Maria; Gervasi, Francesca; Casati, Costanza; Querques, Maria Luisa; Montoli, Alberto; Colussi, Giacomo

2018-01-01

Short frequent dialysis with NxStage System One cycler (NSO) has become increasingly popular as home hemodialysis prescription. Short dialysis sessions with NSO might not allow adequate phosphate (P) removal. Single-session and weekly balances of P and calcium (Ca) were compared in 14 patients treated with NSO (6 sessions/week) and in 14 patients on standard bicarbonate dialysis (BHD). NSO and BHD showed similar plasma P fall, with end-dialysis plasma P slightly lower in BHD (2.2 ± 0.5 vs. 2.7 ± 0.8 mg/dL, p < 0.02). Single-session P removal was lower in NSO, but weekly removal was higher (3,488 ± 1,181 mg vs. 2,634 ± 878, p < 0.003). Plasma Ca increase was lower in NSO, with similar PTH fall. Ca balance varied according to start plasma Ca, dialysate to blood Ca gradient and net ultrafiltration. short, frequent home hemodialysis with NSO, on a 6/week-based prescription, allows higher weekly P removal than BHD. With the dialysate Ca concentration in use (6 mg/dL), total plasma Ca and iCa concentration increase is lower in NSO. © 2018 S. Karger AG, Basel.

Predicting geriatric falls following an episode of emergency department care: a systematic review.

PubMed

Carpenter, Christopher R; Avidan, Michael S; Wildes, Tanya; Stark, Susan; Fowler, Susan A; Lo, Alexander X

2014-10-01

Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor's accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the projected benefits or harms of fall prevention interventions in the ED. A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk. © 2014 by the Society for Academic Emergency Medicine.

Comparison of seven fall risk assessment tools in community-dwelling Korean older women.

PubMed

Kim, Taekyoung; Xiong, Shuping

2017-03-01

This study aimed to compare seven widely used fall risk assessment tools in terms of validity and practicality, and to provide a guideline for choosing appropriate fall risk assessment tools for elderly Koreans. Sixty community-dwelling Korean older women (30 fallers and 30 matched non-fallers) were evaluated. Performance measures of all tools were compared between the faller and non-faller groups through two sample t-tests. Receiver Operating Characteristic curves were generated with odds ratios for discriminant analysis. Results showed that four tools had significant discriminative power, and the shortened version of Falls Efficacy Scale (SFES) showed excellent discriminant validity, followed by Berg Balance Scale (BBS) with acceptable discriminant validity. The Mini Balance Evaluation System Test and Timed Up and Go, however, had limited discriminant validities. In terms of practicality, SFES was also excellent. These findings suggest that SFES is the most suitable tool for assessing the fall risks of community-dwelling Korean older women, followed by BBS. Practitioner Summary: There is no general guideline on which fall risk assessment tools are suitable for community-dwelling Korean older women. This study compared seven widely used assessment tools in terms of validity and practicality. Results suggested that the short Falls Efficacy Scale is the most suitable tool, followed by Berg Balance Scale.

The Ottaviano eruption of Somma-Vesuvio (8000 y B.P.): a magmatic alternating fall and flow-forming eruption

NASA Astrophysics Data System (ADS)

Rolandi, G.; Maraffi, S.; Petrosino, P.; Lirer, L.

1993-11-01

The Ottaviano eruption occurred in the late neolithic (8000 y B.P.). 2.40 km 3 of phonolitic pyroclastic material (0.61 km 3 DRE) were emplaced as pyroclastic flow, surge and fall deposits. The eruption began with a fall phase, with a model column height of 14 km, producing a pumice fall deposit (LA). This phase ended with short-lived weak explosive activity, giving rise to a fine-grained deposit (L1), passing to pumice fall deposits as the result of an increasing column height and mass discharge rate. The subsequent two fall phases (producing LB and LC deposits), had model column heights of 20 and 22 km with eruption rates of 2.5 × 10 7 and 2.81 × 10 7 kg/s, respectively. These phases ended with the deposition of ash layers (L2 and L3), related to a decreasing, pulsing explosive activity. The values of dynamic parameters calculated for the eruption classify it as a sub-plinian event. Each fall phase was characterized by variations in the eruptive intensity, and several pyroclastic flows were emplaced (F1 to F3). Alternating pumice and ash fall beds record the waning of the eruption. Finally, owing to the collapse of a eruptive column of low gas content, the last pyroclastic flow (F4) was emplaced.

Complex proximal deposition during the Plinian eruptions of 1912 at Novarupta, Alaska

USGS Publications Warehouse

Houghton, Bruce F.; Wilson, C.J.N.; Fierstein, J.; Hildreth, W.

2004-01-01

Proximal (<3 km) deposits from episodes II and III of the 60-h-long Novarupta 1912 eruption exhibit a very complex stratigraphy, the result of at least four transport regimes and diverse depositional mechanisms. They contrast with the relatively simple stratigraphy (and inferred emplacement mechanisms) for the previously documented, better known, medial-distal fall deposits and the Valley of Ten Thousand Smokes ignimbrite. The proximal products include alternations and mixtures of both locally and regionally dispersed fall ejecta, and numerous thin complex deposits of pyroclastic density currents (PDCs) with no regional analogs. The locally dispersed component of the fall deposits forms sector-confined wedges of material whose thicknesses halve radially from and concentrically about the vent over distances of 100-300 m (cf. several kilometers for the medial-distal fall deposits). This locally dispersed fall material (and many of the associated PDC deposits) is rich in andesitic and banded pumices and richer in shallow-derived wall-rock lithics in comparison with the coeval medial fall units of almost entirely dacitic composition. There are no marked contrasts in grain size in the near-vent deposits, however, between locally and widely dispersed beds, and all samples of the proximal fall deposits plot as a simple continuation of grain size trends for medial-distal samples. Associated PDC deposits form a spectrum of facies from fines-poor, avalanched beds through thin-bedded, landscape-mantling beds to channelized lobes of pumice-block-rich ignimbrite. The origins of the Novarupta near-vent deposits are considered within a spectrum of four transport regimes: (1) sustained buoyant plume, (2) fountaining with co-current flow, (3) fountaining with counter-current flow, and (4) direct lateral ejection. The Novarupta deposits suggest a model where buoyant, stable, regime-1 plumes characterized most of episodes II and III, but were accompanied by transient and variable partitioning of clasts into the other three regimes. Only one short period of vent blockage and cessation of the Plinian plume occurred, separating episodes II and III, which was followed by a single PDC interpreted as an overpressured "blast" involving direct lateral ejection. In contrast, regimes 2 and 3 were reflected by spasmodic sedimentation from the margins of the jet and perhaps lower plume, which were being strongly affected by short-lived instabilities. These instabilities in turn are inferred to be associated with heterogeneities in the mixture of gas and pyroclasts emerging from the vent. Of the parameters that control explosive eruptive behavior, only such sudden and asymmetrical changes in the particle concentration could operate on time scales sufficiently short to explain the rapid changes in the proximal 1912 products. ?? Springer-Verlag 2003.

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.

Development of a protocol for improving the clinical utility of posturography as a fall-risk screening tool.

PubMed

Bigelow, Kimberly Edginton; Berme, Necip

2011-02-01

The usefulness of posturography in the clinical screening of older adults for fall risk has been limited by a lack of standardization in testing methodology and data reporting. This study determines which testing condition and postural sway measures best differentiate recurrent fallers and nonrecurrent fallers. One hundred and fifty older adults were categorized based on their fall status in the past year. Participants performed four quiet-standing tasks, eyes open and eyes closed in both comfortable and narrow stance, for 60 seconds while standing on a force-measuring platform. Traditional and fractal measures were calculated from the center of pressure data. Logistic regression was performed to determine the model for each condition that best discriminated between recurrent fallers and nonrecurrent fallers. The eyes closed comfortable stance condition, with its associated model, best differentiated recurrent fallers and nonrecurrent fallers. Medial-lateral sway velocity, anterior-posterior short-term α-scaling exponent, medial-lateral short-term α-scaling exponent, mean frequency, body mass index, and age were included in this model. Sensitivity of the model was 75%, and specificity was 94%. This resulting model demonstrates potential to differentiate recurrent fallers and nonrecurrent fallers in an eyes closed comfortable stance condition. The inclusion of traditional sway parameters, fractal measures, and personal characteristics in this model demonstrates the importance of considering multiple descriptions of postural stability together rather than using only a single measure to establish fall risk.

A new high intensity and short-pulse molecular beam valve

NASA Astrophysics Data System (ADS)

Yan, B.; Claus, P. F. H.; van Oorschot, B. G. M.; Gerritsen, L.; Eppink, A. T. J. B.; van de Meerakker, S. Y. T.; Parker, D. H.

2013-02-01

In this paper, we report on the design and performance of a new home-built pulsed gas valve, which we refer to as the Nijmegen Pulsed Valve (NPV). The main output characteristics include a short pulse width (as short as 20 μs) combined with operating rates up to 30 Hz. The operation principle of the NPV is based on the Lorentz force created by a pulsed current passing through an aluminum strip located within a magnetic field, which opens the nozzle periodically. The amplitude of displacement of the opening mechanism is sufficient to allow the use of nozzles with up to 1.0 mm diameter. To investigate the performance of the valve, several characterizations were performed with different experimental methods. First, a fast ionization gauge was used to measure the beam intensity of the free jet emanating from the NPV. We compare free jets from the NPV with those from several other pulsed valves in current use in our laboratory. Results showed that a high intensity and short pulse-length beam could be generated by the new valve. Second, the NPV was tested in combination with a skimmer, where resonance enhanced multiphoton ionization combined with velocity map imaging was used to show that the NPV was able to produce a pulsed molecular beam with short pulse duration (˜20 μs using 0.1% NO/He at 6 bars) and low rotational temperature (˜1 K using 0.5% NO/Ar at 6 bars). Third, a novel two-point pump-probe method was employed which we label double delay scan. This method allows a full kinematic characterization of the molecular beam, including accurate speed ratios at different temporal positions. It was found that the speed ratio was maximum (S = 50 using 0.1% NO/He at 3 bars) at the peak position of the molecular beam and decreased when it was on the leading or falling edge.

Patterns of perspectives on fall-prevention beliefs by community-dwelling older adults: a Q method investigation.

PubMed

Chen, Shueh-Fen; Huang, Su-Fei; Lu, Li-Ting; Wang, Mei-Chuen; Liao, Jung-Yu; Guo, Jong-Long

2016-07-07

Falling has high incidence and reoccurrence rates and is an essential factor contributing to accidental injury or death for older adults. Enhancing the participation of community-dwelling older adults in fall-prevention programs is crucial. Understanding fall-prevention beliefs will be beneficial for developing a community-based fall-prevention program. The aim of the present study was to identify the distinct types of subjective views on the fall-prevention beliefs of community-dwelling older adults aged 80 years and older by applying the Q method. The Q method was adopted to investigate the pattern of perception on fall-prevention beliefs. Forty-two older adults aged 80 - 92 years from a community care center in Northern Taiwan were recruited and requested to complete a Q-sorting. A series of Q-sorts was performed by the participants to rank 30 statements into a normal distribution Q-sort grid. The Q-sorts were subjected to principal component analysis by using PQMethod software Version 2.35. Four statistically independent perspectives were derived from the analysis and reflected distinct viewpoints on beliefs related to fall prevention. Participants in the Considerate perspective believed that health problems caused by falling were serious and fall prevention could decrease the burden they place on their family. Participants in the Promising perspective believed that existing health problems could cause a fall and that fall prevention contributed to their well-being. Participants in the Adaptable perspective perceived low barriers to execute fall prevention and displayed self-confidence and independence in preventing falls. Participants in the Ignorance perspective believed that they could not prevent falls and perceived barriers to fall prevention. By combining theoretical constructs and the Q methodology approach, this study identified four distinct perspectives on fall prevention among community-dwelling older adults. Critical reflection on older adult personal perspectives and interpretations of the required responsive approach is a key element for appropriating fall-prevention support.

Fall incidence in Germany: results of two population-based studies, and comparison of retrospective and prospective falls data collection methods.

PubMed

Rapp, Kilian; Freiberger, Ellen; Todd, Chris; Klenk, Jochen; Becker, Clemens; Denkinger, Michael; Scheidt-Nave, Christa; Fuchs, Judith

2014-09-20

Fall incidence differs considerably between studies and countries. Reasons may be differences between study samples or different assessment methods. The aim was to derive estimates of fall incidence from two population-based studies among older community-living people in Germany and compare retrospective and prospective falls data collection methods. Data were derived from the 2008-11 wave of the German health interview and examination survey for adults (DEGS1), and the Activity and Function of the Elderly in Ulm study (ActiFE-Ulm). Data collection took place in community facilities (DEGS1) or participants' homes (ActiFE-Ulm). Participation rates were 42% (newly recruited) and 64% (panel component) in DEGS1 and 19.8% in ActiFE-Ulm. Self-report retrospective fall data covering the previous 12 month period in DEGS1 and ActiFE-Ulm were collected, but only ActiFE-Ulm used prospective 12 month fall calendars. The incidence of 'any fall' and 'recurrent falls' were calculated for both methods. Fall rates increased with age in men but not women. The ActiFE-Ulm prospectively assessed incidence (95% confidence interval) in women and men aged 65- < 90 years were 38.7 (36.9-40.5) and 29.7 (28.1-31.3) fallers/year and 13.7 (12.5-14.9) and 10.9 (9.9-12.0) recurrent fallers/year, respectively. Retrospective and prospective fall incidence in ActiFE-Ulm did not differ.The retrospectively assessed incidence of 'any fall' among persons 65- < 80 years were significantly lower in DEGS1 than ActiFE-Ulm (women: 25.7% (22.4-29.2) versus 37.4% (34.8-39.9); men: 16.3% (13.6-19.3) versus 28.9% (26.6-31.1). Retrospective incidence estimates of recurrent falls were similar in both studies for women (10.4% (8.3-12.9) versus 10.2% (8.5-11.8)) and men (6.1% (4.3-8.5) versus 8.4% (7.1-9.8)). Both studies were population-based, but retrospective self-reported fall incidence differed between studies. Study design influences retrospective reported fall incidence considerably. Costly collection of prospective data gives similar rates to the cheaper retrospective report method.

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.

Review of fall detection techniques: A data availability perspective.

PubMed

Khan, Shehroz S; Hoey, Jesse

2017-01-01

A fall is an abnormal activity that occurs rarely; however, missing to identify falls can have serious health and safety implications on an individual. Due to the rarity of occurrence of falls, there may be insufficient or no training data available for them. Therefore, standard supervised machine learning methods may not be directly applied to handle this problem. In this paper, we present a taxonomy for the study of fall detection from the perspective of availability of fall data. The proposed taxonomy is independent of the type of sensors used and specific feature extraction/selection methods. The taxonomy identifies different categories of classification methods for the study of fall detection based on the availability of their data during training the classifiers. Then, we present a comprehensive literature review within those categories and identify the approach of treating a fall as an abnormal activity to be a plausible research direction. We conclude our paper by discussing several open research problems in the field and pointers for future research. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

A vision-based fall detection algorithm of human in indoor environment

NASA Astrophysics Data System (ADS)

Liu, Hao; Guo, Yongcai

2017-02-01

Elderly care becomes more and more prominent in China as the population is aging fast and the number of aging population is large. Falls, as one of the biggest challenges in elderly guardianship system, have a serious impact on both physical health and mental health of the aged. Based on feature descriptors, such as aspect ratio of human silhouette, velocity of mass center, moving distance of head and angle of the ultimate posture, a novel vision-based fall detection method was proposed in this paper. A fast median method of background modeling with three frames was also suggested. Compared with the conventional bounding box and ellipse method, the novel fall detection technique is not only applicable for recognizing the fall behaviors end of lying down but also suitable for detecting the fall behaviors end of kneeling down and sitting down. In addition, numerous experiment results showed that the method had a good performance in recognition accuracy on the premise of not adding the cost of time.

The Thrifty Food Plan is not thrifty when labor cost is considered.

PubMed

Davis, George C; You, Wen

2010-04-01

Recent research has shown that the typical Supplemental Food Assistance Program (SNAP) family falls short in meeting the Thrifty Food Plan (TFP) nutritional guidelines that underlie the SNAP even when they typically have sufficient monetary resources to eat a healthful diet (i.e. to follow the TFP recommendations). However, the TFP does not consider labor cost. This study uses a basic labor economics technique to value labor in a home food production scenario that is required to reach the TFP nutrition and budget targets and calculates the total cost (inclusive of labor) associated with the TFP. This TFP consistent total cost is then compared, using several metrics, with the total cost associated with actual choices made by those families sharing the same profiles as current SNAP participants. Once labor is included, we find the TFP is not very thrifty and the mean household falls short of the TFP guidelines even with adequate monetary resources.

Age-related changes in gait adaptability in response to unpredictable obstacles and stepping targets.

PubMed

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

2016-05-01

A large proportion of falls in older people occur when walking. Limitations in gait adaptability might contribute to tripping; a frequently reported cause of falls in this group. To evaluate age-related changes in gait adaptability in response to obstacles or stepping targets presented at short notice, i.e.: approximately two steps ahead. Fifty older adults (aged 74±7 years; 34 females) and 21 young adults (aged 26±4 years; 12 females) completed 3 usual gait speed (baseline) trials. They then completed the following randomly presented gait adaptability trials: obstacle avoidance, short stepping target, long stepping target and no target/obstacle (3 trials of each). Compared with the young, the older adults slowed significantly in no target/obstacle trials compared with the baseline trials. They took more steps and spent more time in double support while approaching the obstacle and stepping targets, demonstrated poorer stepping accuracy and made more stepping errors (failed to hit the stepping targets/avoid the obstacle). The older adults also reduced velocity of the two preceding steps and shortened the previous step in the long stepping target condition and in the obstacle avoidance condition. Compared with their younger counterparts, the older adults exhibited a more conservative adaptation strategy characterised by slow, short and multiple steps with longer time in double support. Even so, they demonstrated poorer stepping accuracy and made more stepping errors. This reduced gait adaptability may place older adults at increased risk of falling when negotiating unexpected hazards. Copyright © 2016 Elsevier B.V. All rights reserved.

The Marangoni convection induced by acetone desorption from the falling soap film

NASA Astrophysics Data System (ADS)

Sha, Yong; Li, Zhangyun; Wang, Yongyi; Huang, Jiali

2012-05-01

By means of the falling soap film tunnel and the Schlieren optical method, the Marangoni convection were observed directly in the immediate interfacial neighborhood during the desorption process of acetone from the falling soap film. Moreover, the hydraulic characteristics of the falling soap film tunnel, the acetone concentration, the surface tension of the soap liquid and the mass transfer has been investigated in details through the experimental or theoretical method.

Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls

PubMed Central

Maben, Jill; Murrells, Trevor; Griffiths, Peter

2016-01-01

Objectives A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. Methods A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people’s wards. Move to 100% single room accommodation compared to ‘steady state’ and ‘new build’ control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Results Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people’s ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people’s ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. Conclusion For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. PMID:26811373

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

PubMed Central

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

2016-01-01

Introduction Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education. Methods and analysis This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach. Ethics and dissemination Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences. Trial registration number NCT02603523, Pre-results. PMID:28039296

Integration of Fall Prevention into State Policy in Connecticut

ERIC Educational Resources Information Center

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

2013-01-01

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

Falling short of universal access to reproductive health: unintended pregnancy and contraceptive use among Mexican women with HIV.

PubMed

Kendall, Tamil

2013-01-01

A favourable context for women with HIV to prevent unintended pregnancy is a cornerstone of reproductive rights and will contribute to achieving universal access to reproductive health, a Millennium Development Goal target. This analysis explores the reproductive trajectories of Mexican women with HIV post-diagnosis and their access to reproductive counselling and use of contraceptives. In-depth interviews and short surveys were conducted with women of reproductive age living with HIV. Results indicate that sexual and reproductive health counselling in HIV care focuses on the male condom and does not routinely address reproductive desires or provide information about or access to other contraceptive methods. Unintended pregnancies result from inconsistent condom use and condom breakage. Women experienced discriminatory denial of and pressure to accept particular contraceptive methods because of their HIV status. Mexican women with HIV are not enjoying their constitutionally guaranteed right to freely choose the number and spacing of their children. Mexico's commitment to reproductive rights and the Popular Health Insurance offer policy and financial frameworks for providing family planning services in public HIV clinics. To ensure respectful implementation, rights-based training for HIV healthcare providers and careful monitoring and evaluation will be needed.

An analysis of the relationship between bodily injury severity and fall height in victims of fatal falls from height.

PubMed

Teresiński, Grzegorz; Milaszkiewicz, Anna; Cywka, Tomasz

2016-01-01

Aim of the study: One of the basic issues discussed in forensic literature regarding falls from a height is determination of fall heights and differentiation between suicidal and accidental falls. The aim of the study was to verify the usefulness of the available methods for the purposes of forensic expertises. Material and methods: The study encompassed fatalities of falls from a height whose autopsies were performed in the Department of Forensic Medicine in Lublin. Results: Similarly to other authors, the severity of injuries was assessed using the Abbreviated Injury Scale (AIS) and injury severity score (ISS). The study findings demonstrated a statistically significant correlation between the fall height and the severity of injuries according to ISS and a statistically significant difference in fall heights between the groups of accidents and suicides.

Fighting the Fire in Our Own House: How Poor Decisions are Smoldering Within the U.S. Fire Service

DTIC Science & Technology

Additionally, a second recommendation suggests incorporating an anonymous near-miss reporting system to identify workplace incidents that fall short of an accident, but nonetheless contain pertinent educational information.

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

NASA Astrophysics Data System (ADS)

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

2005-10-01

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

Semmes-Weinstein Monofilament Examination for Predicting Physical Performance and the Risk of Falls in Older People: Results of the Pro.V.A. Longitudinal Study.

PubMed

Carrer, Pamela; Trevisan, Caterina; Curreri, Chiara; Giantin, Valter; Maggi, Stefania; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

2018-01-01

To investigate whether the Semmes-Weinstein monofilament examination (SWME) was associated with, and could predict, measures of physical performance and the risk of fall in older people. Prospective study. Community. Older participants (N=2826) enrolled in the Progetto Veneto Anziani (Pro.V.A.) study and a subsample of persons (n=1885) who did not report falls at baseline for longitudinal analyses. Not applicable. Falls reported in the year preceding the assessment and Short Physical Performance Battery (SPPB) were recorded at baseline and again after 4.4 years. At baseline, 830 participants (29.4%) had experienced falls in the previous year, with a higher prevalence of falls in those positive at SWME than in those negative at SWME (35.8% vs 28.0%; P=.001). Using logistic regression, participants positive at SWME had a (significant) 66% higher risk of presenting worse SPPB score (95% confidence interval, 1.51-1.83) and between 25% and 32% higher risks of having experienced ≥1 fall or recurrent falls than did those negative at SWME. The incidence of falls at follow-up was higher in the positive SWME group than in the negative SWME group (42.2% vs 30.7%; P=.001), and multinomial logistic regression showed that the former had a 13% higher risk of decline in SPPB scores (95% confidence interval, 1.03-1.25), particularly for gait and balance; 48% higher risk of having had 1 fall; and 77% higher risk of recurrent falls. At both baseline and follow-up, the larger the extension of neuropathy (negative SWME vs unilateral impairment in positive SWME vs bilateral impairment in positive SWME), the greater its negative effect on falls and physical performance. SMWE was associated with, and could predict, lower extremity physical performance and falls in older people. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study.

PubMed

Fleming, Jane; Matthews, Fiona E; Brayne, Carol

2008-03-17

The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Re-survey of over-90-year-olds in a longitudinal cohort study - cross-sectional interview and intensive 12-month follow-up. 90 women and 20 men participating in a population-based cohort (aged 91-105 years, in care-homes and community-dwelling) recruited from representative general practices in Cambridge, UKMeasurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%), as were fall rates (1.6 and 2.8 falls/person-year respectively). Repeated falls in the past year were more highly predictive of falls during the following year - IRR 4.7, 95% CI 2.6-8.7 - than just one - IRR 3.6, 95% CI 2.0-6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions of people who fell were reported by retrospective and prospective methods covering two consecutive years. Recall methods may underestimate numbers of repeated falls and the extent of recurrent falling. Professionals caring for people of advanced age can easily ask routinely whether someone has fallen at all, or more than once, in the past year to identify those at high risk of subsequent falls.

Fracture toughness of CIP-HIP (cold isostatic pressed - hot isostatic pressed) beryllium at elevated temperatures. Final report, 13 May 1980-13 February 1981

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

Barker, L.M.; Jones, A.H.

1986-04-01

The fracture toughness of CIP-HIP (cold isostatic pressed-hot isostatic pressed) beryllium was determined using the short-bar fracture-toughness (K/sub IcSB/) method. The K/sub IcSB/ value measured was 10.96 MPa x the square root of m at room temperature. This falls well within the expected range of 9 to 12 MPa x the square root of m as observed from previous fracture toughness measurements of beryllium. Toughness increased rapidly between 400 F and 500 F reaching a value of 16.7 MPa x the square root of m at 500 F.

Mortality estimation from carcass searches using the R-package carcass: a tutorial

USGS Publications Warehouse

Korner-Nievergelt, Fränzi; Behr, Oliver; Brinkmann, Robert; Etterson, Matthew A.; Huso, Manuela M. P.; Dalthorp, Daniel; Korner-Nievergelt, Pius; Roth, Tobias; Niermann, Ivo

2015-01-01

This article is a tutorial for the R-package carcass. It starts with a short overview of common methods used to estimate mortality based on carcass searches. Then, it guides step by step through a simple example. First, the proportion of animals that fall into the search area is estimated. Second, carcass persistence time is estimated based on experimental data. Third, searcher efficiency is estimated. Fourth, these three estimated parameters are combined to obtain the probability that an animal killed is found by an observer. Finally, this probability is used together with the observed number of carcasses found to obtain an estimate for the total number of killed animals together with a credible interval.

COVER (cover of vaccination evaluated rapidly): description of the England and Wales scheme.

PubMed

Begg, N T; Gill, O N; White, J M

1989-03-01

The COVER scheme, a method for the rapid evaluation of vaccine coverage in England and Wales, is described. The primary aim of the scheme is to improve cover by providing health district vaccination programme coordinators with relevant timely information. Quarterly data were obtained from, analysed and promptly fed back to, 126 health districts on cohorts of children who had recently attained the target ages for receiving the selected sentinel vaccines; 18 months for third diphtheria and third pertussis and 2 years for measles. Although the data suggested that vaccination cover is improving, national performance still falls well short of 90%, the 1990 target set by the World Health Organisation for countries in Europe.

Direct-to-consumer advertising in black and white: racial differences in placement patterns of print advertisements for health products and messages.

PubMed

Crawley, LaVera M; Hisaw, Lisa; Illes, Judy

2009-01-01

If direct-to-consumer advertising (DTCA) increases consumer participation in healthcare, then it may provide a useful strategy for addressing health disparities, in part, where patient-level barriers have contributed to such disparities. However, this presumes equitable access to DTCA. Using mixed methods, we explored advertisement patterns in matched African American and general audience magazines across a range of genres and ad types. Results suggest no significant differences in ad frequencies by race. However other meaningful categorical and qualitative differences were found, suggesting that advertisers may fall short in maximizing DTCA as an adjunctive strategy for empowering populations at risk for health disparities.

Associations between a patient reported outcome (PRO) measure of sarcopenia and falls, functional status, and physical performance in older patients with cancer

PubMed Central

Gewandter, Jennifer S.; Dale, William; Magnuson, Allison; Pandya, Chintan; Heckler, Charles E.; Lemelman, Tatyana; Roussel, Breton; Ifthikhar, Rafa; Dolan, James; Noyes, Katia; Mohile, Supriya G.

2015-01-01

Objective In older patients with cancer, we aimed to investigate associations between a patient-reported outcome measure for sarcopenia (SarcoPRO) and the Short Physical Performance Battery (SPPB), self-reported falls, and limitations in instrumental activities of daily living (IADLs). Materials and Methods Assessments were conducted as part of the initial evaluation of older, often frail, patients with cancer seen in the Specialized Oncology Care and Research in the Elderly (SOCARE) clinic. Univariate associations were evaluated using Spearman’s correlation and Wilcoxon sign ranked tests. Logistic regressions were used to identify associations of clinical factors and SarcoPRO scores or SPPB scores with falls and IADL limitations. Results In total, 174 older patients with cancer were evaluated. A moderate correlation was found between the SarcoPRO and the SPPB (ρ = 0.62). After adjusting for multiple clinical factors, neither the SarcoPRO nor the SPPB were associated with falls. In contrast, both higher SarcoPRO (i.e., worse) and lower SPPB (i.e., worse) scores were associated with limitations in IADLs (Odds ratio for one unit change in predictor: SarcoPRO: 1.06, p<0.0001; SPPB: 0.71, p = 0.003, respectively). Models using the SarcoPRO and SPPB explained similar amounts of variability in association with IADL limitations (AUC: 0.88 vs 0.87, respectively). Conclusions The SarcoPRO was moderately associated with the SPPB, an objective measure of physical performance, and was associated with limitations in IADLs. Thus, older patients with cancer who present with IADL limitations should be screened for sarcopenia. The SarcoPRO shows promise as a measure for screening as well as outcome assessment for research on sarcopenia. PMID:26365897

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

PubMed

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

2014-12-17

Falls and fall-related injuries are a serious cause of morbidity and cost to society. Foot problems and inappropriate footwear may increase the risk of falls; therefore podiatric interventions may play a role in reducing falls. Two Cochrane systematic reviews identified only one study of a podiatry intervention aimed to reduce falls, which was undertaken in Australia. The REFORM trial aims to evaluate the clinical and cost-effectiveness of a multifaceted podiatry intervention in reducing falls in people aged 65 years and over in a UK and Irish setting. This multicentre, cohort randomised controlled trial will recruit 2600 participants from routine podiatry clinics in the UK and Ireland to the REFORM cohort. In order to detect a 10% point reduction in falls from 50% to 40%, with 80% power 890 participants will be randomised to receive routine podiatry care and a falls prevention leaflet or routine podiatry care, a falls prevention leaflet and a multifaceted podiatry intervention. The primary outcome is rate of falls (falls/person/time) over 12 months assessed by patient self-report falls diary. Secondary self-report outcome measures include: the proportion of single and multiple fallers and time to first fall over a 12-month period; Short Falls Efficacy Scale-International; fear of falling in the past 4 weeks; Frenchay Activities Index; fracture rate; Geriatric Depression Scale; EuroQoL-five dimensional scale 3-L; health service utilisation at 6 and 12 months. A qualitative study will examine the acceptability of the package of care to participants and podiatrists. The trial has received a favourable opinion from the East of England-Cambridge East Research Ethics Committee and Galway Research Ethics Committee. The trial results will be published in peer-reviewed journals and at conference presentations. Current Controlled Trials ISRCTN68240461 assigned 01/07/2011. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A study of using smartphone to detect and identify construction workers' near-miss falls based on ANN

NASA Astrophysics Data System (ADS)

Zhang, Mingyuan; Cao, Tianzhuo; Zhao, Xuefeng

2018-03-01

As an effective fall accident preventive method, insight into near-miss falls provides an efficient solution to find out the causes of fall accidents, classify the type of near-miss falls and control the potential hazards. In this context, the paper proposes a method to detect and identify near-miss falls that occur when a worker walks in a workplace based on artificial neural network (ANN). The energy variation generated by workers who meet with near-miss falls is measured by sensors embedded in smart phone. Two experiments were designed to train the algorithm to identify various types of near-miss falls and test the recognition accuracy, respectively. At last, a test was conducted by workers wearing smart phones as they walked around a simulated construction workplace. The motion data was collected, processed and inputted to the trained ANN to detect and identify near-miss falls. Thresholds were obtained to measure the relationship between near-miss falls and fall accidents in a quantitate way. This approach, which integrates smart phone and ANN, will help detect near-miss fall events, identify hazardous elements and vulnerable workers, providing opportunities to eliminate dangerous conditions in a construction site or to alert possible victims that need to change their behavior before the occurrence of a fall accident.

Comparisons of Modeled and Observed Reflectivities and Fall Speeds for Snowfall of Varied Riming Degree During Winter Storms on Long Island, New York

NASA Technical Reports Server (NTRS)

Molthan, Andrew L.; Colle, Brian A.; Yuter, Sandra E.; Stark, David

2016-01-01

Derived radar reflectivity and fall speed for four Weather Research and Forecasting model bulk microphysical parameterizations (BMPs) run at 1.33 km grid spacing are compared with ground-based, vertically-pointing Ku-band radar, scanning S- band radar, and in situ measurements at Stony Brook, NY. Simulations were partitioned into periods of observed riming degree as determined manually using a stereo microscope and camera during nine winter storms. Simulations were examined to determine whether the selected BMPs captured the effects of varying riming intensities, provided a reasonable match to the vertical structure of radar reflectivity or fall speed, and whether they produced reasonable surface fall speed distributions. Schemes assuming non spherical mass-diameter relationships yielded reflectivity distributions closer to observed values. All four schemes examined in this study provided a better match to the observed, vertical structure of reflectivity during moderate riming than light riming periods. The comparison of observed and simulated snow fall speeds had mixed results. One BMP produced episodes of excessive cloud water at times, resulting in fall speeds that were too large. However, most schemes had frequent periods of little or no cloud water during moderate riming periods and thus underpredicted the snow fall speeds at lower levels. Short, 1-4 hour periods with relatively steady snow conditions were used to compare BMP and observed size and fall speed distributions. These limited data suggest the examined BMPs underpredict fall speeds of cold-type snow habits and underrepresent aggregates larger than 4 mm diameter.

Dynamic Parameters of Balance Which Correlate to Elderly Persons with a History of Falls

PubMed Central

Muir, Jesse W.; Kiel, Douglas P.; Hannan, Marian; Magaziner, Jay; Rubin, Clinton T.

2013-01-01

Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; p<0.05), while three measures of balance were significantly worse in fallers as compared to older persons with no recent fall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement). Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score (“B-score”) algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly “non-fallers” had a B-score of 0.334, compared to 0.645 for those with a fall history (p<0.001). A weighted amalgam of postural sway elements may identify individuals at greatest risk of falling, allowing interventions to target those with greatest need of attention. PMID:23940592

A small-area study of environmental risk assessment of outdoor falls.

PubMed

Lai, Poh-Chin; Wong, Wing-Cheung; Low, Chien-Tat; Wong, Martin; Chan, Ming-Houng

2011-12-01

Falls in public places are an issue of great health concern especially for the elderly. Falls among the elderly is also a major health burden in many countries. This study describes a spatial approach to assess environmental causes of outdoor falls using a small urban community in Hong Kong as an example. The method involves collecting data on fall occurrences and mapping their geographic positions to examine circumstances and environmental evidence that contribute to falls. High risk locations or hot spots of falls are identified on the bases of spatial proximity and concentration of falls within a threshold distance by means of kernel smoothing and standard deviational ellipses. This method of geographic aggregation of individual fall incidents for a small-area study yields hot spots of manageable sizes. The spatial clustering approach is effective in two ways. Firstly, it allows visualisation and isolation of fall hot spots to draw focus. Secondly and especially under conditions of resource decline, policy makers are able to target specific locations to examine the underlying causal mechanisms and strategise effective response and preventive measures based on the types of environmental risk factors identified.

Cross-Sectional and Longitudinal Risk Factors for Falls, Fear of Falling, and Falls Efficacy in a Cohort of Middle-Aged African Americans

ERIC Educational Resources Information Center

Anderson, Elena M.; Wolinsky, Fredric D.; Miller, J. Phillip; Wilson, Margaret-Mary G.; Malmstrom, Theodore K.; Miller, Douglas K.

2006-01-01

Purpose: The purpose of this study is to cross-sectionally and longitudinally identify risk factors for falls, fear of falling, and falls efficacy in late-middle-aged African Americans. Design and Methods: We performed in-home assessments on a probability sample of 998 African Americans and conducted two annual follow-up interviews. Multiple…

Usability testing of a Falls Prevention Tool Kit for an inpatient acute care setting.

PubMed

Goldsmith, Denise; Zuyev, Lyubov; Benoit, Angie; Chang, Frank Y; Horsky, Jan; Dykes, Patricia

2009-01-01

Efforts to prevent falls in the hospital setting involves identifying patients at risk of falling and implementing fall prevention strategies. This poster describes the method and results of Performance Usability Testing on a web-based Fall Prevention Tool Kit (FPTK) developed as part of a research study, (Falls TIPS-Tailoring Interventions for Patient Safety) funded by The Robert Wood Johnson Foundation.

Relationship between fear of falling and outcomes of an inpatient geriatric rehabilitation population--fear of the fear of falling.

PubMed

Denkinger, Michael D; Igl, Wilmar; Lukas, Albert; Bader, Anne; Bailer, Stefanie; Franke, Sebastian; Denkinger, Claudia M; Nikolaus, Thorsten; Jamour, Michael

2010-04-01

To examine the effects of various risk factors on three functional outcomes during rehabilitation. Geriatric inpatient rehabilitation unit. Observational longitudinal study. One hundred sixty-one geriatric rehabilitation inpatients (men, women), mean age 82, who were capable of walking at baseline. Functional status was assessed weekly between admission and discharge and at a follow-up 4 months later at home using the function component of the Short Form-Late Life Function and Disability Instrument, the Barthel Index, and Habitual Gait Speed. Various risk factors, such as falls-related self-efficacy (Falls Efficacy Scale-International), were measured. Associations between predictors and functional status at discharge and follow-up were analyzed using linear regression models and bivariate plots. Fear of falling predicted functioning across all outcomes except for habitual gait speed at discharge and follow-up. Visual comparison of functional trajectories between subgroups confirmed these findings, with different levels of fear of falling across time in linear plots. Thus, superior ability of this measure to discriminate between functional status at baseline across all outcomes and to discriminate between functional change especially with regard to the performance-based outcome was demonstrated. Falls-related self-efficacy is the only parameter that significantly predicts rehabilitation outcome at discharge and follow-up across all outcomes. Therefore, it should be routinely assessed in future studies in (geriatric) rehabilitation and considered to be an important treatment goal.

Race and fall risk: data from the National Health and Aging Trends Study (NHATS).

PubMed

Sun, Daniel Q; Huang, Jin; Varadhan, Ravi; Agrawal, Yuri

2016-01-01

the objective of this study was to explore whether race-based difference in fall risk may be mediated by environmental and physical performance risk factors. using data from a nationally representative longitudinal survey of 7,609 community-dwelling participants in the National Health and Aging Trends Study (NHATS), we evaluated whether racial differences in fall risk may be explained by physical performance level (measured by the Short Physical Performance Battery), mobility disability, physical activity level and likelihood of living alone. Multivariate Poisson regression and mediation models were used in analyses. in whites and blacks, the annual incidence of 'any fall' was 33.8 and 27.1%, respectively, and the annual incidence of 'recurrent falls' was 15.5 and 12.3%, respectively. Compared with whites, blacks had relative risks of 0.7 (95% confidence interval 0.6-0.8) and 0.6 (0.5-0.8) for sustaining any fall and recurrent falls, respectively, in adjusted analyses. Blacks had poorer performance on the SPPB (P < 0.001), higher levels of mobility disability (P < 0.001), similar levels of physical activity (P = 0.19) and were equally likely to live alone relative to whites (P = 0.77). Mediation analysis revealed that these risk factors collectively acted as suppressors and none of these factors accounted for the racial differences in fall risk observed. relative to whites, blacks were at 30 and 40% decreased risk of sustaining any fall and recurrent falls, respectively. This difference in risk remains unexplained. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The TSX Gives a Short Course in Health Economics: It's the Prices, Stupid!

PubMed Central

Evans, Robert G.

2010-01-01

The fall in Shoppers Drug Mart shares last April 8 gave a crystal-clear demonstration of the link between health expenditures and health incomes. Reacting (finally) to the excessive retail prices of generic drugs, the Ontario government effectively halved the rate of reimbursement of ingredient costs and banned the “professional allowances” (kickbacks) paid to pharmacies by generic manufacturers. Taxpayers and private payers will save hundreds of millions of dollars, and pharmacy revenues will fall by an equivalent amount. Patients will still get their drugs, with no loss of quantity, quality or even convenience; no one's health is threatened. But investor profits will fall. There are similar savings opportunities throughout the health system. Health costs are primarily a political, not an economic, problem. PMID:22043220

Evaluation of an Outpatient Rehabilitative Program to Address Mobility Limitations Among Older Adults

PubMed Central

Brown, Lorna G.; Ni, Meng; Schmidt, Catherine T.; Bean, Jonathan F.

2017-01-01

Abstract Live Long Walk Strong is a clinical demonstration program for community-dwelling older patients. It was designed to be consistent with current fall prevention guidelines and reimbursed under the Medicare model. Patients were screened within primary care and referred to a physiatrist followed by systematic assessment and treatment within an outpatient rehabilitative care setting. The treatment included behavioral modification, fall prevention education, community/home exercise integration, and exercise targeting strength, power, flexibility, balance, and endurance. Treatment duration and frequency varied with each patient based on baseline presentation, clinical judgment, and patient preference. Program feasibility and preliminary effectiveness were evaluated by assessing participation and changes in physical performance, respectively. There were 266 patients referred to the program, and 147 were willing to participate. Of these, 116 patients completed all scheduled visits (10.8 ± 3.9 visits). The noncompleters (n = 31) had a higher rate of falls in the previous 6 months and lower baseline Short Physical Performance Battery composite score. At the completion of care, the adjusted mean change in Short Physical Performance Battery was 1.66 units, surpassing a large clinically meaningful threshold (1 unit). The Live Long Walk Strong program appears to be feasible to implement and demonstrates preliminary effectiveness in enhancing mobility among older adults. PMID:28079616

Fall-Back Disks in Long and Short GRBS

NASA Technical Reports Server (NTRS)

Cannizo, John K.; Troja, E.; Gehrels, N.

2011-01-01

We present numerical time-dependent calculations for fall-back disks relevant for GRBs in which the disk of material surrounding the black hole (BH) powering the GRB jet modulates the mass flow, and hence the strength of the jet. Given the initial existence of a small mass appr oximately less than 10(exp -4) M(solar) near the progenitor with a circularization radius approximately 10(exp 10) - 10(exp 11) cm, an una voidable consequence will be the formation of an "external disk" whose outer edge continually moves to larger radii due to angular momentum transport and lack of a confining torque. For long GRBs, if the mass distribution in the initial fall-back disk traces the progenitor envelope, then a radius approximates 10(exp 11) cm gives a time scale app roximately 10(exp 4) s for the X-ray plateau. For late times t > 10(exp 7) s a steepening due to a cooling front in the disk may have obser vational support in GRB 060729. For short GRBs, one expects most of t he mass initially to lie at small radii < 10(exp 8) cm; however the presence of even a trace amount approximately 10(exp -9) M(solar) of hi gh angular material can give a brief plateau in the light curve.

Postflight Quiet Stance Stability of Astronauts Following Recovery From a Simulated Fall

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Kofman, I. S.; Fisher, E. A.; Cerisano, J. M.; Lawrence, E. L.; Peters, B. T.; Harm, D. L.; Kulecz, W.; Mulavara, A. P.; Fiedler, M. J.;

Multi-Angle Snowflake Camera Instrument Handbook

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

Stuefer, Martin; Bailey, J.

2016-07-01

The Multi-Angle Snowflake Camera (MASC) takes 9- to 37-micron resolution stereographic photographs of free-falling hydrometers from three angles, while simultaneously measuring their fall speed. Information about hydrometeor size, shape orientation, and aspect ratio is derived from MASC photographs. The instrument consists of three commercial cameras separated by angles of 36º. Each camera field of view is aligned to have a common single focus point about 10 cm distant from the cameras. Two near-infrared emitter pairs are aligned with the camera’s field of view within a 10-angular ring and detect hydrometeor passage, with the lower emitters configured to trigger the MASCmore » cameras. The sensitive IR motion sensors are designed to filter out slow variations in ambient light. Fall speed is derived from successive triggers along the fall path. The camera exposure times are extremely short, in the range of 1/25,000th of a second, enabling the MASC to capture snowflake sizes ranging from 30 micrometers to 3 cm.« less

[German adaptation of the "Activities-Specific Balance Confidence (ABC) scale" for the assessment of falls-related self-efficacy].

PubMed

Schott, Nadja

2008-12-01

The present study investigates the psychometric properties and the factorial structure of the German adaptation of the Activities-Specific Balance Confidence (ABC) scale (Powell & Myers, 1995) for the evaluation of falls-related self-efficacy in community-dwelling older adults. The German adaptation of the ABC using a forward-backward procedure was administered to 113 older adults (age 68.9+/-8.5 years). The following internationally accepted instruments were used for validation: The Short Form Health Survey SF 36, the Geriatric Depression Scale (GDS), the Trail Making Test and the Letter Number Sequencing Test, and motor tests (balance, strength, mobility). The internal consistency (0.91-0.95) as well as the test-retest reliability of the subscales was excellent (0.94-0.98). The correlation coefficients with the validation instruments ranged between 0.33 and 0.58. Significant differences in the ABC-D scores were found in older adults with and without falls. Older adults with a recent fall history scored lower on the ABC-D than older adults without a recent fall history. To conclude, the German version of the ABC has properties analogous to the original English version and is apparently useful in assessing falls-related self-efficacy.

Monte Carlo calculated TG-60 dosimetry parameters for the {beta}{sup -} emitter {sup 153}Sm brachytherapy source

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

Sadeghi, Mahdi; Taghdiri, Fatemeh; Hamed Hosseini, S.

Purpose: The formalism recommended by Task Group 60 (TG-60) of the American Association of Physicists in Medicine (AAPM) is applicable for {beta} sources. Radioactive biocompatible and biodegradable {sup 153}Sm glass seed without encapsulation is a {beta}{sup -} emitter radionuclide with a short half-life and delivers a high dose rate to the tumor in the millimeter range. This study presents the results of Monte Carlo calculations of the dosimetric parameters for the {sup 153}Sm brachytherapy source. Methods: Version 5 of the (MCNP) Monte Carlo radiation transport code was used to calculate two-dimensional dose distributions around the source. The dosimetric parameters ofmore » AAPM TG-60 recommendations including the reference dose rate, the radial dose function, the anisotropy function, and the one-dimensional anisotropy function were obtained. Results: The dose rate value at the reference point was estimated to be 9.21{+-}0.6 cGy h{sup -1} {mu}Ci{sup -1}. Due to the low energy beta emitted from {sup 153}Sm sources, the dose fall-off profile is sharper than the other beta emitter sources. The calculated dosimetric parameters in this study are compared to several beta and photon emitting seeds. Conclusions: The results show the advantage of the {sup 153}Sm source in comparison with the other sources because of the rapid dose fall-off of beta ray and high dose rate at the short distances of the seed. The results would be helpful in the development of the radioactive implants using {sup 153}Sm seeds for the brachytherapy treatment.« less

Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: a randomized controlled trial.

PubMed

Freiberger, Ellen; Häberle, Lothar; Spirduso, Waneen W; Zijlstra, G A Rixt

2012-03-01

To determine the long-term effects of three strength and balance exercise interventions on physical performance, fall-related psychological outcomes, and falls in older people. A single-blinded, four-group, randomized controlled trial. Community, Germany. Community-dwelling adults aged 70 to 90 who had fallen in the past 6 months or reported fear of falling. After baseline assessment, 280 participants were randomly assigned to the control group (CG; no intervention; n = 80) or one of three strength and balance exercise interventions (the strength and balance group (SBG; strength and balance only; n = 63), the fitness group (FG; strength and balance plus endurance training; n = 64), or the multifaceted group (MG; strength and balance plus fall risk education; n = 73). The interventions consisted of 32 one-hour group sessions in 16 weeks. Data on physical performance, fall-related psychological outcomes, and falls were collected for 24 months. Mixed-effects regression analyses showed improved short- and long-term (12 and 24 months, respectively) physical performance for the SBG and FG, particularly regarding mobility, balance, and walking speed (P < .05). The improvements in physical performance outcomes were most prominent in the FG. Fall-related psychological outcomes, number of falls, and injurious falls were not significantly different from in the control group. Training focusing on strength, balance, and endurance can enhance physical performance for up to 24 months in community-dwelling older adults. These findings did not translate to improved fall-related psychological outcomes or reduced incidence of falls. This demonstrates the need for a different approach (e.g., regarding intervention dose and components) to gain intervention benefits in the multiple domains that contribute to independence and well-being in older adults. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Older Adults' Perspectives on Home Exercise after Falls Rehabilitation: Understanding the Importance of Promoting Healthy, Active Ageing

ERIC Educational Resources Information Center

Hawley, Helen

2009-01-01

Objective To explore what might encourage older people to exercise at home after falls rehabilitation. Design: Qualitative research methods were used based on a grounded theory approach, to provide insights into older adults' experiences following a fall, of both rehabilitation and home exercise. Setting: Community dwellings. Method: Nine…

Drought-induced changes in Amazon forest structure from repeat airborne lidar

NASA Astrophysics Data System (ADS)

Morton, D. C.; Leitold, V.; Longo, M.; Keller, M.; dos-Santos, M. N.; Scaranello, M. A., Sr.

2017-12-01

Drought events in tropical forests, including the 2015-2016 El Niño, may reduce net primary productivity and increase canopy tree mortality, thereby altering the short and long-term net carbon balance of tropical forests. Given the broad extent of drought impacts, forest inventory plots or eddy flux towers may not capture regional variability in forest response to drought. Here, we analyzed repeat airborne lidar data to evaluate canopy turnover from branch and tree fall before (2013-2014) and during (2014-2016) the recent El Niño drought in the eastern and central Brazilian Amazon. Coincident field surveys for a 16-ha subset of the lidar coverage provided complementary information to classify turnover areas by mechanism (branch, multiple branch, tree fall, multiple tree fall) and estimate the total coarse woody debris volume from canopy and understory tree mortality. Annualized rates of canopy turnover increased by 50%, on average, during the drought period in both intact and fragmented forests near Santarém, Pará. Turnover increased uniformly across all size classes, and there was limited evidence that taller trees contributed a greater proportion of turnover events in any size class in 2014-2016 compared to 2013-2014. This short-term increase in canopy turnover differs from findings in multi-year rainfall exclusion experiments that large trees were more sensitive to drought impacts. Field measurements confirmed the separability of the smallest (single branch) and largest damage classes (multiple tree falls), but single tree and multiple branch fall events generated similar coarse woody debris production and lidar-derived changes in canopy volume. Large-scale sampling possible with repeat airborne lidar data also captured strong local and regional gradients in canopy turnover. Differences in slope partially explained the north-south gradient in canopy turnover dynamics near Santarém, with larger increases in turnover on flatter terrain. Regional variability in canopy turnover in response to drought conditions highlights the need for a mechanistic representation of branch and tree fall dynamics in ecosystem models to resolve changes in net carbon balance from the increase in coarse woody debris production and reorganization of canopy light environments during drought years.

EEG-based emergency braking intention prediction for brain-controlled driving considering one electrode falling-off.

PubMed

Huikang Wang; Luzheng Bi; Teng Teng

2017-07-01

This paper proposes a novel method of electroencephalography (EEG)-based driver emergency braking intention detection system for brain-controlled driving considering one electrode falling-off. First, whether one electrode falls off is discriminated based on EEG potentials. Then, the missing signals are estimated by using the signals collected from other channels based on multivariate linear regression. Finally, a linear decoder is applied to classify driver intentions. Experimental results show that the falling-off discrimination accuracy is 99.63% on average and the correlation coefficient and root mean squared error (RMSE) between the estimated and experimental data are 0.90 and 11.43 μV, respectively, on average. Given one electrode falls off, the system accuracy of the proposed intention prediction method is significantly higher than that of the original method (95.12% VS 79.11%) and is close to that (95.95%) of the original system under normal situations (i. e., no electrode falling-off).

Physical activity level and fall risk among community-dwelling older adults.

PubMed

Low, Sok Teng; Balaraman, Thirumalaya

2017-07-01

[Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

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

PubMed Central

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

2013-01-01

Problem Falls from heights account for 64% of residential construction worker fatalities and 20% of missed work days. We hypothesized that worker safety would improve with foremen training in fall prevention and safety communication. Method Training priorities identified through foreman and apprentice focus groups and surveys were integrated into an 8-hour training. We piloted the training with ten foremen employed by a residential builder. Carpenter trainers contrasted proper methods to protect workers from falls with methods observed at the foremen’s worksites. Trainers presented methods to deliver toolbox talks and safety messages. Results from worksite observational audits (n=29) and foremen/crewmember surveys (n=97) administered before and after training were compared. Results We found that inexperienced workers are exposed to many fall hazards that they are often not prepared to negotiate. Fall protection is used inconsistently and worksite mentorship is often inadequate. Foremen feel pressured to meet productivity demands and some are unsure of the fall protection requirements. After the training, the frequency of daily mentoring and toolbox talks increased, and these talks became more interactive and focused on hazardous daily work tasks. Foremen observed their worksites for fall hazards more often. We observed increased compliance with fall protection and decreased unsafe behaviors during worksite audits. Discussion Designing the training to meet both foremen’s and crewmembers’ needs ensured the training was learner-centered and contextually-relevant. This pilot suggests that training residential foremen can increase use of fall protection, improve safety behaviors, and enhance on-the-job training and safety communication at their worksites. Impact on Industry Construction workers’ training should target safety communication and mentoring skills with workers who will lead work crews. Interventions at multiple levels are necessary to increase safety compliance in residential construction and decrease falls from heights. PMID:23398712

The Emergence of Postculturalism.

ERIC Educational Resources Information Center

Nucci, Larry; Neblo, Michael A.

1998-01-01

Argues that Baumrind's (1998) postculturalist stance reflects the direction of developmental psychology research, but her efforts to construct a complementary ethical theory fall short. Argues that her position suffers from internal contradictions and that her project can be salvaged by accommodation with elements of communicative discourse theory…

Gold Standard Tests

DTIC Science & Technology

2001-06-01

important issues need to be understood. Caloric Irrigation: Irrigation of both ears with water of 30 and 44 degree Celsius is the standard Anamnesis ... anamnesis , falls short. In the usual because there are many factors which may clinical situation, a vestibular deficit is suspected if influence the final

Putting on the green

EPA Science Inventory

The green chemistry movement is scrutinized for marks of tangible success in this short perspective. Beginning with the easily identified harm of the Union Carbide Bhopal, India disaster and the concerns of Love Canal site in Niagara Falls, NY the public can begin to more easily ...

Coughing Wheezing Shortness of Breath Tightness in Chest

MedlinePlus

... National Asthma Education and Prevention Program National Heart, Lung, and Blood Institute; National Institutes of Health; Public Health Service; U.S. Department of Health and Human Services www.nhlbi.nih.gov Fall 2006 Issue: Volume 1 Number 1 Page inside back cover

Review of fall risk assessment in geriatric populations using inertial sensors

PubMed Central

2013-01-01

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

Randomized Controlled Trial Comparing Tailoring Methods of Multimedia-Based Fall Prevention Education for Community-Dwelling Older Adults

PubMed Central

Schepens, Stacey L.; Panzer, Victoria; Goldberg, Allon

2012-01-01

OBJECTIVE We attempted to determine whether multimedia fall prevention education using different instructional strategies increases older adults’ knowledge of fall threats and their fall prevention behaviors. METHOD Fifty-three community-dwelling older adults were randomized to two educational groups or a control group. Multimedia-based educational interventions to increase fall threats knowledge and encourage fall prevention behaviors had two tailoring strategies: (1) improve content realism for individual learners (authenticity group) and (2) highlight program goals and benefits while using participants’ content selections (motivation group). Knowledge was measured at baseline and 1-mo follow-up. Participants recorded prevention behaviors for 1 mo. RESULTS Intervention group participants showed greater knowledge gains and posttest knowledge than did control group participants. The motivation group engaged in more prevention behaviors over 1 mo than did the other groups. CONCLUSION Tailoring fall prevention education by addressing authenticity and motivation successfully improved fall threats knowledge. Combining motivational strategies with multimedia education increased the effectiveness of the intervention in encouraging fall prevention behaviors. PMID:22214115

Why Do Patients in Acute Care Hospitals Fall? Can Falls Be Prevented?

PubMed Central

Dykes, Patricia C.; Carroll, Diane L.; Hurley, Ann C.; Benoit, Angela; Middleton, Blackford

2011-01-01

Objective Obtain the views of nurses and assistants as to why patients in acute care hospitals fall. Background Despite a large quantitative evidence base for guiding fall risk assessment and not needing highly technical, scarce, or expensive equipment to prevent falls, falls are serious problems in hospitals. Methods Basic content analysis methods were used to interpret descriptive data from 4 focus groups with nurses (n = 23) and 4 with assistants (n = 19). A 2-person consensus approach was used for analysis. Results Positive and negative components of 6 concepts—patient report, information access, signage, environment, teamwork, and involving patient/family—formed 2 core categories: knowledge/communication and capability/actions that are facilitators or barriers, respectively, to preventing falls. Conclusion Two conditions are required to reduce patient falls. A patient care plan including current and accurate fall risk status with associated tailored and feasible interventions needs to be easily and immediately accessible to all stakeholders (entire healthcare team, patients, and family). Second, stakeholders must use that information plus their own knowledge and skills and patient and hospital resources to carry out the plan. PMID:19509605

A multidisciplinary approach to trace Asian dust storms from source to sink

NASA Astrophysics Data System (ADS)

Yan, Yan; Sun, Youbin; Ma, Long; Long, Xin

2015-03-01

Tracing the source of dust storm (DS) in mega-cities of northern China currently suffers ambiguities from different approaches including source-sink proxy comparison, air mass back trajectory modeling, and satellite image monitoring. By integrating advantages of all three methods, we present a multidisciplinary approach to trace the provenance of dust fall in Xi'an during the spring season (March to May) of 2012. We collected daily dust fall to calculate dust flux variation, and detected eight DS events with remarkable high flux values based on meteorological comparison and extreme detection algorithm. By combining MODIS images and accompanying real-time air mass back trajectories, we attribute four of them as natural DS events and the other four as anthropogenic DS events, suggesting the importance of natural and anthropogenic processes in supplying long-range transported dust. The primary sources of these DS events were constrained to three possible areas, including the northern Chinese deserts, Taklimakan desert, and Gurbantunggut desert. Proxy comparisons based upon the quartz crystallinity index and oxygen isotope further confirmed the source-to-sink linkage between the natural DS events in Xi'an and the dust emissions from the northern Chinese deserts. The integration of geochemical and meteorological tracing approaches favors the dominant contribution of short-distance transportation of modern dust fall on the Chinese Loess Plateau. Our study shows that the multidisciplinary approach could permit a better source identification of modern dust and should be applied properly for tracing the provenance fluctuations of geological dust deposits.

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

PubMed

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

2015-01-01

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

Uphill falling of old-growth Douglas-fir.

Treesearch

Douglas L. Hunt; John W. Henley

1981-01-01

Five timber sales were made in old-growth Douglas-fir with matched cutting units. On one unit of each sale uphill falling by either hydraulic jacks or tree-pulling machine was required; on the other unit free falling was required. Logging equipment and methods were the same in each unit. Uphill falling produced a larger volume of timber at less cost than free falling...

Does interactive instruction in introductory physics impact long-term outcomes for students?

NASA Astrophysics Data System (ADS)

Gordon, Vernita

Early college classroom experiences contribute greatly to students leaving STEM majors. Peer instruction is a research-based pedagogy in which students, in small groups in the classroom, discuss concepts and work short problems. A single study at Harvard found that taking peer-instruction introductory physics also increases persistence in science majors. To what degree, if at all, peer instruction helps retention and performance for STEM majors at large public institutions (like University of Texas, Austin) is not known. Here I describe the results of a retrospective pilot study comparing outcomes for students who took different sections of the same calculus-based introductory mechanics course in Fall 2012 and Fall 2014. Compared with traditional lecture sections, peer-instruction sections had a 50% lower drop rate, a 40% / 55% higher rate of enrollment in the 2nd/ 3rd courses in the sequence, and, for the Fall 2012 cohort, a 74% / 165% higher rate of graduating from UT Austin / the UT Austin College of Natural Sciences by Fall 2015. I will discuss weaknesses of this retrospective pilot study and present plans for an intentionally-designed study to be implemented beginning Fall 2017.

Novel use of the Wii Balance Board to prospectively predict falls in community-dwelling older adults.

PubMed

Kwok, Boon-Chong; Clark, Ross A; Pua, Yong-Hao

2015-06-01

The Wii Balance Board has received increasing attention as a balance measurement tool; however its ability to prospectively predict falls is unknown. This exploratory study investigated the use of the Wii Balance Board and other clinical-based measures for prospectively predicting falls among community-dwelling older adults. Seventy-three community-dwelling men and women, aged 60-85years were followed-up over a year for falls. Standing balance was indexed by sway velocities measured using the Wii Balance Board interfaced with a laptop. Clinical-based measures included Short Physical Performance Battery, gait speed and Timed-Up-and-Go test. Multivariable regression analyses were used to assess the ability of the Wii Balance Board measure to complement the TUG test in fall screening. Individually, the study found Wii Balance Board anteroposterior (odds ratio 1.98, 95% CI 1.16 to 3.40, P=0.01) and mediolateral (odds ratio 2.80, 95% CI 1.10 to 7.13, p=0.03) sway velocity measures predictive of prospective falls. However, when each velocity measure was adjusted with body mass index and Timed-Up-and-Go, only anteroposterior sway velocity was predictive of prospective falls (odds ratio 2.21, 95% CI 1.18 to 4.14). A faster anteroposterior velocity was associated with increased odds of falling. Area-under-the-curves for Wii Balance Board sway velocities were 0.67 and 0.71 for anteroposterior and mediolateral respectively. The Wii Balance Board-derived anteroposterior sway velocity measure could complement existing clinical-based measures in predicting future falls among community-dwelling older adults. Australian New Zealand Clinical Trials Registry number: ACTRN12610001099011. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cognitive and Physical Function in Relation to the Risk of Injurious Falls in Older Adults: A Population-Based Study.

PubMed

Welmer, Anna-Karin; Rizzuto, Debora; Laukka, Erika J; Johnell, Kristina; Fratiglioni, Laura

2017-05-01

We aimed to quantify the independent effect of cognitive and physical deficits on the risk of injurious falls, to verify whether this risk is modified by global cognitive impairment, and to explore whether risk varies by follow-up time. Data on 2,495 participants (≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) study were analyzed using flexible parametric survival models. Two cognitive domains (processing speed and executive function) were assessed with standard tests. Physical function tests included balance (one-leg-stands), walking speed, chair stands, and grip strength. Global cognition was assessed using the Mini-Mental State Examination. A total of 167 people experienced an injurious fall over 3 years of follow-up, 310 over 5 years, and 571 over 10 years. Each standard deviation worse balance, slower walking speed, and longer chair stand time increased the risk of injurious falls over 3 years by 43%, 38%, and 23%, respectively (p < .05). Each standard deviation worse processing speed and executive function was significantly associated with 10% increased risk of injurious falls over 10 years (p < .05). In stratified analyses, deficits in physical functioning were associated with injurious falls only in people with cognitive impairment, whereas deficits in processing speed and executive function were associated with injurious falls only in people without cognitive impairment. Deficits in specific cognitive domains, such as processing speed and executive function, appear to predict injurious falls in the long term. Deficits in physical function predict falls in the short term, especially in people with global cognitive impairment. © The Author 2016. 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.

Mobility limitations and fear of falling in non-English speaking older Mexican-Americans.

PubMed

James, Eric G; Conatser, Phillip; Karabulut, Murat; Leveille, Suzanne G; Hausdorff, Jeffrey M; Cote, Sarah; Tucker, Katherine L; Barton, Bruce; Bean, Jonathan F; Al Snih, Soham; Markides, Kyriakos S

2017-10-01

To determine whether older Mexican-Americans who cannot speak and/or understand spoken English have higher rates of mobility limitations or fear of falling than their English-speaking counterparts. We conducted a cross-sectional analysis of 1169 community-dwelling Mexican-Americans aged 72-96 years from the 2000-2001 wave of the Hispanic Established Population for the Epidemiological Study of the Elderly. Mobility limitations were defined as having a Short Physical Performance Battery score ≤9, and fear of falling by participant report of being somewhat, fairly, or very afraid of falling. We determined the rates and odds ratios, for having mobility limitations and fear of falling as a function of English ability in those who were 72-96, <80, and ≥80 years of age. Among participants who were unable to speak and/or understand spoken English 85.7% had mobility limitations and 61.6% were afraid of falling, compared to 77.6% and 57.5%, respectively, of English speakers. Before adjusting for covariates, participants who did not speak and/or understand spoken English were more likely to have mobility limitations (odds ratio: 1.7; 95% CI: 1.3-2.4) but not fear of falling, compared to English speakers. Among those aged ≥80 years, but not those <80 years, who did not speak or understand English were more likely to have mobility limitations (odds ratio: 4.8; 95% CI:2.0-11.5) and fear of falling (odds ratio: 2.0; 95% CI:1.3-3.1). Older Mexican-Americans who do not speak or understand spoken English have a higher rate of mobility limitations and fear of falling than their English-speaking counterparts.

Rapid Geriatric Assessment of Hip Fracture.

PubMed

Zanker, Jesse; Duque, Gustavo

2017-08-01

A comprehensive geriatric assessment, combined with a battery of imaging and blood tests, should be able to identify those hip fracture patients who are at higher risk of short- and long-term complications. This comprehensive assessment should be followed by the implementation of a comprehensive multidimensional care plan aimed to prevent negative outcomes in the postoperative period (short and long term), thus assuring a safe and prompt functional recovery while also preventing future falls and fractures. Copyright © 2017 Elsevier Inc. All rights reserved.

Influence of He-Ne laser radiation on biogenic amines content and cytochemical parameters of polymorphonuclear leukocytes in short-term stress

NASA Astrophysics Data System (ADS)

Brill, Gregory E.; Dobrovolsky, Gennady A.; Romanova, Tatyana P.; Porozova, Svetlana G.; Brill, Alexander G.

1997-06-01

In experiments on white male rats short-term immobilization- sound stress was modelled. Decrease of glycogen content and myeloperoxidase activity, increase of lysosomal cationic proteins level and NBT-test parameters as well as fall of adrenaline, dopamine and 5-hydroxytryptamine amount in polymorphonuclear leukocytes were observed. Preliminary transcutaneous He-Ne laser irradiation modified metabolic reaction of leukocytes to stress and prevented stress- induced decrease of biogenic amines content in cells.

Determining the Viscosity of Liquids Using an Extended Falling Ball Method

ERIC Educational Resources Information Center

Houari, Ahmed

2011-01-01

In this article, I will extend the falling ball method to measure the viscosity of liquids regardless of the degree of their viscosity. For this, I will show that one can obtain a measurement of the terminal velocity of a falling spherical ball in a viscous liquid by solving numerically the equation of motion which describes the dynamics of the…

Context-Sensitive Ethics in School Psychology

ERIC Educational Resources Information Center

Lasser, Jon; Klose, Laurie McGarry; Robillard, Rachel

2013-01-01

Ethical codes and licensing rules provide foundational guidance for practicing school psychologists, but these sources fall short in their capacity to facilitate effective decision-making. When faced with ethical dilemmas, school psychologists can turn to decision-making models, but step-wise decision trees frequently lack the situation…

Falling Short in HR Management

ERIC Educational Resources Information Center

Bastian, Jim

2009-01-01

A school district's strategic objectives typically include improving education outcomes of students, reducing costs, improving customer service and increasing productivity. While the language, emphasis and order will vary, it is difficult to imagine a district that does not strategically focus on these or related objectives. Most districts perform…

Climate Science: Tropical Expansion by Ocean Swing

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

Lu, Jian

The tropical belt has become wider over the past decades, but climate models fall short of capturing the full rate of the expansion. The latest analysis of the climate simulations suggests that a long-term swing of the Pacific Decadal Oscillation is the main missing cause.

Delaying flowering in short-day strawberry transplants with photoselective nets

USDA-ARS?s Scientific Manuscript database

The effect of growing transplants under photoselective netting on subsequent field performance of strawberry plants was tested. In August, 'Strawberry Festival' strawberry plug plants were grown under red or blue ChromatiNet and without shade netting (control) in a glasshouse. Fall flowering respo...

Hey Look at Me!

ERIC Educational Resources Information Center

Uslander, Arlene S.

1979-01-01

This article discusses the child who never manages to succeed, who always falls short of his/her personal or academic goals. Consideration is given to causes of failure in the child's over- or under-expectations of self and to the behavior problems that can result from continuous frustration. (SJL)

How Scientists Can Become Entrepreneurs

PubMed Central

Thon, Jonathan N.; Karlsson, Sven

2017-01-01

Translating basic research discoveries through entrepreneurship must be scientist driven and institutionally supported to be successful (not the other way around). Here, we describe why scientists should engage in entrepreneurship, where institutional support for scientist-founders falls short, and how these challenges can be overcome. PMID:28385393

Gender Representation on Journal Editorial Boards in the Mathematical Sciences.

PubMed

Topaz, Chad M; Sen, Shilad

2016-01-01

We study gender representation on the editorial boards of 435 journals in the mathematical sciences. Women are known to comprise approximately 15% of tenure-stream faculty positions in doctoral-granting mathematical sciences departments in the United States. Compared to this group, we find that 8.9% of the 13067 editorships in our study are held by women. We describe group variations within the editorships by identifying specific journals, subfields, publishers, and countries that significantly exceed or fall short of this average. To enable our study, we develop a semi-automated method for inferring gender that has an estimated accuracy of 97.5%. Our findings provide the first measure of gender distribution on editorial boards in the mathematical sciences, offer insights that suggest future studies in the mathematical sciences, and introduce new methods that enable large-scale studies of gender distribution in other fields.

Gender Representation on Journal Editorial Boards in the Mathematical Sciences

PubMed Central

2016-01-01

We study gender representation on the editorial boards of 435 journals in the mathematical sciences. Women are known to comprise approximately 15% of tenure-stream faculty positions in doctoral-granting mathematical sciences departments in the United States. Compared to this group, we find that 8.9% of the 13067 editorships in our study are held by women. We describe group variations within the editorships by identifying specific journals, subfields, publishers, and countries that significantly exceed or fall short of this average. To enable our study, we develop a semi-automated method for inferring gender that has an estimated accuracy of 97.5%. Our findings provide the first measure of gender distribution on editorial boards in the mathematical sciences, offer insights that suggest future studies in the mathematical sciences, and introduce new methods that enable large-scale studies of gender distribution in other fields. PMID:27536970

The Complexity of Standing Postural Sway Associates with Future Falls in Community-Dwelling Older Adults: The MOBILIZE Boston Study.

PubMed

Zhou, Junhong; Habtemariam, Daniel; Iloputaife, Ikechukwu; Lipsitz, Lewis A; Manor, Brad

2017-06-07

Standing postural control is complex, meaning that it is dependent upon numerous inputs interacting across multiple temporal-spatial scales. Diminished physiologic complexity of postural sway has been linked to reduced ability to adapt to stressors. We hypothesized that older adults with lower postural sway complexity would experience more falls in the future. 738 adults aged ≥70 years completed the Short Physical Performance Battery test (SPPB) test and assessments of single and dual-task standing postural control. Postural sway complexity was quantified using multiscale entropy. Falls were subsequently tracked for 48 months. Negative binomial regression demonstrated that older adults with lower postural sway complexity in both single and dual-task conditions had higher future fall rate (incident rate ratio (IRR) = 0.98, p = 0.02, 95% Confidence Limits (CL) = 0.96-0.99). Notably, participants in the lowest quintile of complexity during dual-task standing suffered 48% more falls during the four-year follow-up as compared to those in the highest quintile (IRR = 1.48, p = 0.01, 95% CL = 1.09-1.99). Conversely, traditional postural sway metrics or SPPB performance did not associate with future falls. As compared to traditional metrics, the degree of multi-scale complexity contained within standing postural sway-particularly during dual task conditions- appears to be a better predictor of future falls in older adults.

Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: study protocol for a randomised trial.

PubMed

Spink, Martin J; Menz, Hylton B; Lord, Stephen R

2008-11-25

Falls in older people are a major public health problem, with at least one in three people aged over 65 years falling each year. There is increasing evidence that foot problems and inappropriate footwear increase the risk of falls, however no studies have been undertaken to determine whether modifying these risk factors decreases the risk of falling. This article describes the design of a randomised trial to evaluate the efficacy of a multifaceted podiatry intervention to reduce foot pain, improve balance, and reduce falls in older people. Three hundred community-dwelling men and women aged 65 years and over with current foot pain and an increased risk of falling will be randomly allocated to a control or intervention group. The "usual cae" control group will receive routine podiatry (i.e. nail care and callus debridement). The intervention group will receive usual care plus a multifaceted podiatry intervention consisting of: (i) prefabricated insoles customised to accommodate plantar lesions; (ii) footwear advice and assistance with the purchase of new footwear if current footwear is inappropriate; (iii) a home-based exercise program to strengthen foot and ankle muscles; and (iv) a falls prevention education booklet. Primary outcome measures will be the number of fallers, number of multiple fallers and the falls rate recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the Medical Outcomes Study Short Form 12 (SF-12), the Manchester Foot Pain and Disability Index, the Falls Efficacy Scale International, and a series of balance and functional tests. Data will be analysed using the intention to treat principle. This study is the first randomised trial to evaluate the efficacy of podiatry in improving balance and preventing falls. The trial has been pragmatically designed to ensure that the findings can be generalised to clinical practice. If found to be effective, the multifaceted podiatry intervention will be a unique addition to common falls prevention strategies already in use. Australian New Zealand Clinical Trials Registry: ACTRN12608000065392.

Exercise for falls prevention in Parkinson disease: a randomized controlled trial.

PubMed

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

2015-01-20

To determine whether falls can be prevented with minimally supervised exercise targeting potentially remediable fall risk factors, i.e., poor balance, reduced leg muscle strength, and freezing of gait, in people with Parkinson disease. Two hundred thirty-one people with Parkinson disease were randomized into exercise or usual-care control groups. Exercises were practiced for 40 to 60 minutes, 3 times weekly for 6 months. Primary outcomes were fall rates and proportion of fallers during the intervention period. Secondary outcomes were physical (balance, mobility, freezing of gait, habitual physical activity), psychological (fear of falling, affect), and quality-of-life measures. There was no significant difference between groups in the rate of falls (incidence rate ratio [IRR] = 0.73, 95% confidence interval [CI] 0.45-1.17, p = 0.18) or proportion of fallers (p = 0.45). Preplanned subgroup analysis revealed a significant interaction for disease severity (p < 0.001). In the lower disease severity subgroup, there were fewer falls in the exercise group compared with controls (IRR = 0.31, 95% CI 0.15-0.62, p < 0.001), while in the higher disease severity subgroup, there was a trend toward more falls in the exercise group (IRR = 1.61, 95% CI 0.86-3.03, p = 0.13). Postintervention, the exercise group scored significantly (p < 0.05) better than controls on the Short Physical Performance Battery, sit-to-stand, fear of falling, affect, and quality of life, after adjusting for baseline performance. An exercise program targeting balance, leg strength, and freezing of gait did not reduce falls but improved physical and psychological health. Falls were reduced in people with milder disease but not in those with more severe Parkinson disease. This study provides Class III evidence that for patients with Parkinson disease, a minimally supervised exercise program does not reduce fall risk. This study lacked the precision to exclude a moderate reduction or modest increase in fall risk from exercise. Australian New Zealand Clinical Trials Registry (ACTRN12608000303347). © 2014 American Academy of Neurology.

Fate and agricultural consequences of leachable elements added to the environment from the 2011 Cordón Caulle tephra fall

NASA Astrophysics Data System (ADS)

Stewart, Carol; Craig, Heather M.; Gaw, Sally; Wilson, Thomas; Villarosa, Gustavo; Outes, Valeria; Cronin, Shane; Oze, Christopher

2016-11-01

The June 2011 eruption of Cordón Caulle volcano, Chile, dispersed tephra over 350,000 km2, including productive agricultural land. This resulted in the death of nearly one million livestock. Two distinct environments were affected: a proximal temperate Andean setting, and the semi-arid Argentine steppe farther from the volcano. The purpose of this study was to better understand the fate and agricultural consequences of leachable elements added to the environment by this large silicic tephra fall. Tephra, soil and surface water samples across the depositional area were collected both immediately after the eruption (tephra and water) and nine months afterwards (tephra, soil and water). Tephra samples were analysed following a new hazard assessment protocol developed by the International Volcanic Health Hazard Network (IVHHN). Water-extractable element concentrations in freshly-collected tephra were very low to low compared to other eruptions, and showed no trends with distance from the volcano. Surface water analyses suggested short-term changes to water composition due to the release of elements from tephra. No effect on the fertility of soils underlying tephra was apparent after nine months. Water-extractable fluorine (F) in freshly-collected tephra ranged from 12 to 167 mg/kg, with a median value of 67 mg/kg. Based on parallels with the 11-12 October 1995 eruption of Ruapehu volcano, New Zealand, we conclude that F toxicity was a possible contributing factor to the large-scale livestock deaths as well as to chronic fluorosis widely reported in wild deer populations across the Cordón Caulle tephra depositional area. Finally, we recommend that effective response to widespread tephra fall over agricultural areas should include: (1) rapid, statistically representative field sampling of tephra, soils, surface water supplies and forage crops; (2) analysis using appropriate and reliable laboratory methods; (3) modelling both short and long-term impacts on the ecosystem, especially for elements that may generate chronic hazard; (4) timely dissemination of results to agricultural agencies; (5) longitudinal sampling and monitoring to adapt impact models; and (6) developing reliable animal fatality diagnoses through autopsies and chemical analysis.

Key challenges in future Li-battery research.

PubMed

Tarascon, J-M

2010-07-28

Batteries are a major technological challenge in this new century as they are a key method to make more efficient use of energy. Although today's Li-ion technology has conquered the portable electronic markets and is still improving, it falls short of meeting the demands dictated by the powering of both hybrid electric vehicles and electric vehicles or by the storage of renewable energies (wind, solar). There is room for optimism as long as we pursue paradigm shifts while keeping in mind the concept of materials sustainability. Some of these concepts, relying on new ways to prepare electrode materials via eco-efficient processes, on the use of organic rather than inorganic materials or new chemistries will be discussed. Achieving these concepts will require the inputs of multiple disciplines.

Eye gaze tracking using correlation filters

NASA Astrophysics Data System (ADS)

Karakaya, Mahmut; Bolme, David; Boehnen, Chris

2014-03-01

In this paper, we studied a method for eye gaze tracking that provide gaze estimation from a standard webcam with a zoom lens and reduce the setup and calibration requirements for new users. Specifically, we have developed a gaze estimation method based on the relative locations of points on the top of the eyelid and eye corners. Gaze estimation method in this paper is based on the distances between top point of the eyelid and eye corner detected by the correlation filters. Advanced correlation filters were found to provide facial landmark detections that are accurate enough to determine the subjects gaze direction up to angle of approximately 4-5 degrees although calibration errors often produce a larger overall shift in the estimates. This is approximately a circle of diameter 2 inches for a screen that is arm's length from the subject. At this accuracy it is possible to figure out what regions of text or images the subject is looking but it falls short of being able to determine which word the subject has looked at.

Sarcomere length dependence of rat skinned cardiac myocyte mechanical properties: dependence on myosin heavy chain

PubMed Central

Korte, F Steven; McDonald, Kerry S

2007-01-01

The effects of sarcomere length (SL) on sarcomeric loaded shortening velocity, power output and rates of force development were examined in rat skinned cardiac myocytes that contained either α-myosin heavy chain (α-MyHC) or β-MyHC at 12 ± 1°C. When SL was decreased from 2.3 μm to 2.0 μm submaximal isometric force decreased ∼40% in both α-MyHC and β-MyHC myocytes while peak absolute power output decreased 55% in α-MyHC myocytes and 70% in β-MyHC myocytes. After normalization for the fall in force, peak power output decreased about twice as much in β-MyHC as in α-MyHC myocytes (41%versus 20%). To determine whether the fall in normalized power was due to the lower force levels, [Ca2+] was increased at short SL to match force at long SL. Surprisingly, this led to a 32% greater peak normalized power output at short SL compared to long SL in α-MyHC myocytes, whereas in β-MyHC myocytes peak normalized power output remained depressed at short SL. The role that interfilament spacing plays in determining SL dependence of power was tested by myocyte compression at short SL. Addition of 2% dextran at short SL decreased myocyte width and increased force to levels obtained at long SL, and increased peak normalized power output to values greater than at long SL in both α-MyHC and β-MyHC myocytes. The rate constant of force development (ktr) was also measured and was not different between long and short SL at the same [Ca2+] in α-MyHC myocytes but was greater at short SL in β-MyHC myocytes. At short SL with matched force by either dextran or [Ca2+], ktr was greater than at long SL in both α-MyHC and β-MyHC myocytes. Overall, these results are consistent with the idea that an intrinsic length component increases loaded crossbridge cycling rates at short SL and β-MyHC myocytes exhibit a greater sarcomere length dependence of power output. PMID:17347271

Fall detection in homes of older adults using the Microsoft Kinect.

PubMed

Stone, Erik E; Skubic, Marjorie

2015-01-01

A method for detecting falls in the homes of older adults using the Microsoft Kinect and a two-stage fall detection system is presented. The first stage of the detection system characterizes a person's vertical state in individual depth image frames, and then segments on ground events from the vertical state time series obtained by tracking the person over time. The second stage uses an ensemble of decision trees to compute a confidence that a fall preceded on a ground event. Evaluation was conducted in the actual homes of older adults, using a combined nine years of continuous data collected in 13 apartments. The dataset includes 454 falls, 445 falls performed by trained stunt actors and nine naturally occurring resident falls. The extensive data collection allows for characterization of system performance under real-world conditions to a degree that has not been shown in other studies. Cross validation results are included for standing, sitting, and lying down positions, near (within 4 m) versus far fall locations, and occluded versus not occluded fallers. The method is compared against five state-of-the-art fall detection algorithms and significantly better results are achieved.

Habitat use and movement patterns by adult saugers from fall to summer in an unimpounded small-river system

USGS Publications Warehouse

Kuhn, K.M.; Hubert, W.A.; Johnson, K.; Oberlie, D.; Dufek, D.

2008-01-01

The Little Wind River drainage in Wyoming is a relatively small unimpounded river system inhabited by native saugers Sander canadensis. Radio telemetry was used to assess habitat use and movement patterns by adult saugers in the river system from fall through early summer. Fifty-four adult saugers were captured during fall 2004, surgically implanted with radio transmitters, and tracked through mid-July 2005. Tagged saugers selected large and deep pools. Such pools were abundant throughout the Little Wind River system and led to saugers being widely dispersed from fall to early spring. During fall, winter, and early spring, tagged saugers remained sedentary and moved short distances among pools in close proximity to each other. Longer movements by tagged saugers occurred from mid-spring to early summer, and were associated with both upstream and downstream movements to and from two river segments believed to be used for spawning. During early summer, most saugers returned to locations where they had been tagged the previous fall and had spent the winter. Our results provide evidence that preservation of the sauger fishery in the Wind River system will depend on maintaining fish passage throughout the portion of the watershed inhabited by saugers and preserving natural fluvial processes that maintain large and deep pools. ?? Copyright by the American Fisheries Society 2008.

CAN STABILITY REALLY PREDICT AN IMPENDING SLIP-RELATED FALL AMONG OLDER ADULTS?

PubMed Central

Yang, Feng; Pai, Yi-Chung

2015-01-01

The primary purpose of this study was to systematically evaluate and compare the predictive power of falls for a battery of stability indices, obtained during normal walking among community-dwelling older adults. One hundred and eighty seven community-dwelling older adults participated in the study. After walking regularly for 20 strides on a walkway, participants were subjected to an unannounced slip during gait under the protection of a safety harness. Full body kinematics and kinetics were monitored during walking using a motion capture system synchronized with force plates. Stability variables, including feasible-stability-region measurement, margin of stability, the maximum Floquet multiplier, the Lyapunov exponents (short- and long-term), and the variability of gait parameters (including the step length, step width, and step time) were calculated for each subject. Accuracy of predicting slip outcome (fall vs. recovery) was examined for each stability variable using logistic regression. Results showed that the feasible-stability-region measurement predicted fall incidence among these subjects with the highest accuracy (68.4%). Except for the step width (with an accuracy of 60.2%), no other stability variables could differentiate fallers from those who did not fall for the sample studied in this study. The findings from the present study could provide guidance to identify individuals at increased risk of falling using the feasible-stability-region measurement or variability of the step width. PMID:25458148

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

PubMed

Elledge, Julie

2017-12-01

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

LETTER TO EDITOR REGARDING "ARSENIC CHALLENGES FOR WATER UTILITIES"

EPA Science Inventory

The two part series on "Arsenic Challenges for Water Utilities" have provided useful information for the many small water utilities faced with arsenic problems. Part II states that treatment options fall into six major categories and then proceeds to provide a short summary on e...

The Standardized Childhood.

ERIC Educational Resources Information Center

Johnson, Christopher

1981-01-01

Mass media, including television and advertising, has created a popular culture in which adolescents and children are taught the need to gain material gratification and group membership through a superficial attempt at fitting themselves into a preconceived mold. Those who fall short of the effort develop feelings of inferiority and may become…

Financing Human Capital.

ERIC Educational Resources Information Center

Juffras, Jason; Sawhill, Isabel V.

This paper examines the government's role in financing human capital investments. It first examines why private investments in education, training, and other forms of human capital are likely to fall short of socially desirable levels. It then reviews past trends in public support for human resource investments. Finally, it discusses current…

Compensation Chemistry

ERIC Educational Resources Information Center

Roady, Celia

2008-01-01

Congress, the news media, and the Internal Revenue Service (IRS) continue to cast a wary eye on the compensation of nonprofit leaders. Hence, any college or university board that falls short of IRS expectations in its procedures for setting the president's compensation is putting the president, other senior officials, and board members at…

Comparing Science Achievement Constructs: Targeted and Achieved

ERIC Educational Resources Information Center

Ferrara, Steve; Duncan, Teresa

2011-01-01

This article illustrates how test specifications based solely on academic content standards, without attention to other cognitive skills and item response demands, can fall short of their targeted constructs. First, the authors inductively describe the science achievement construct represented by a statewide sixth-grade science proficiency test.…

I-STEM Ed Exemplar: Implementation of the PIRPOSAL Model

ERIC Educational Resources Information Center

Wells, John G.

2016-01-01

The opening pages of the first PIRPOSAL (Problem Identification, Ideation, Research, Potential Solutions, Optimization, Solution Evaluation, Alterations, and Learned Outcomes) article make the case that the instructional models currently used in K-12 Science, Technology, Engineering, and Mathematics (STEM) Education fall short of conveying their…

49 CFR 178.960 - Preparation of Large Packagings for testing.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., including inner packagings. All closures must be installed using proper techniques and torques. (b) For the...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ± 5 percent relative humidity without significant...

49 CFR 178.960 - Preparation of Large Packagings for testing.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., including inner packagings. All closures must be installed using proper techniques and torques. (b) For the...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ± 5 percent relative humidity without significant...

49 CFR 178.960 - Preparation of Large Packagings for testing.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., including inner packagings. All closures must be installed using proper techniques and torques. (b) For the...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant...

49 CFR 178.960 - Preparation of Large Packagings for testing.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., including inner packagings. All closures must be installed using proper techniques and torques. (b) For the...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant...

49 CFR 178.960 - Preparation of Large Packagings for testing.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., including inner packagings. All closures must be installed using proper techniques and torques. (b) For the...). Average values should fall within these limits. Short-term fluctuations and measurement limitations may cause individual measurements to vary by up to ±5 percent relative humidity without significant...

Higher Education in California

ERIC Educational Resources Information Center

Public Policy Institute of California, 2016

2016-01-01

Higher education enhances Californians' lives and contributes to the state's economic growth. But population and education trends suggest that California is facing a large shortfall of college graduates. Addressing this short­fall will require strong gains for groups that have been historically under­represented in higher education. Substantial…

A 9-Week Jaques-Dalcroze Eurhythmics Intervention Improves Single and Dual-Task Gait Speed in Community-Dwelling Older People.

PubMed

Ferguson-Stegall, Lisa; Vang, Mandy; Wolfe, Anthony S; Thomsen, Kathy M

2017-09-01

Falls are a major public health concern among older adults, and most occur while walking, especially under dualtask conditions. Jaques-Dalcroze eurhythmics (JDE) is a music-based movement training program that emphasizes multitask coordinated movement. A previous 6-mo JDE study in older people demonstrated improved gait and balance; however, the effects of short-term JDE interventions on fall risk-related outcomes are largely unknown. We conducted a preliminary investigation on whether a 9-week JDE intervention improved gait and stability in a community-dwelling older cohort, hypothesizing that improvements would occur in all outcome measures. Nine participants (78.9 ± 12.3 y) completed the supervised JDE intervention (once/week for 60 min). Gait speed was determined by the 6-m timed walk test (6MTW); dual-task gait speed was determined by another 6MTW while counting backward from 50 aloud; and coordinated stability was assessed using a Swaymeter-like device. Gait speed (0.92 ± 0.11 vs 1.04 ± 0.12 m/sec, P = .04) and dual-task gait speed (0.77 ± 0.09 vs 0.92 ± 0.11 m/sec, P = .0005) significantly improved. This novel intervention is an effective short-term physical activity option for those that plan physical activity or fall-risk reduction programs for the older people.

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

PubMed

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

2015-08-01

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

Classification of older adults with/without a fall history using machine learning methods.

PubMed

Lin Zhang; Ou Ma; Fabre, Jennifer M; Wood, Robert H; Garcia, Stephanie U; Ivey, Kayla M; McCann, Evan D

2015-01-01

Falling is a serious problem in an aged society such that assessment of the risk of falls for individuals is imperative for the research and practice of falls prevention. This paper introduces an application of several machine learning methods for training a classifier which is capable of classifying individual older adults into a high risk group and a low risk group (distinguished by whether or not the members of the group have a recent history of falls). Using a 3D motion capture system, significant gait features related to falls risk are extracted. By training these features, classification hypotheses are obtained based on machine learning techniques (K Nearest-neighbour, Naive Bayes, Logistic Regression, Neural Network, and Support Vector Machine). Training and test accuracies with sensitivity and specificity of each of these techniques are assessed. The feature adjustment and tuning of the machine learning algorithms are discussed. The outcome of the study will benefit the prediction and prevention of falls.

Risk of falls in patients with ankylosing spondylitis.

PubMed

Dursun, Nigar; Sarkaya, Selda; Ozdolap, Senay; Dursun, Erbil; Zateri, Coskun; Altan, Lale; Birtane, Murat; Akgun, Kenan; Revzani, Aylin; Aktas, İlknur; Tastekin, Nurettin; Celiker, Reyhan

2015-03-01

Risk of vertebral fractures is increased in patients with ankylosing spondylitis (AS). The underlying mechanisms for the elevated fracture risk might be associated with bone and fall-related risks. The aims of this study were to evaluate the risk of falls and to determine the factors that increase the risk of falls in AS patients. Eighty-nine women, 217 men, a total of 306 AS patients with a mean age of 40.1 ± 11.5 years from 9 different centers in Turkey were included in the study. Patients were questioned regarding history of falls within the last 1 year. Their demographics, disease characteristics including Bath AS Disease Activity Index, Bath AS Metrology Index (BASMI), Bath AS Functional Index (BASFI), and risk factors for falls were recorded. The Short Physical Performance Battery (SPPB) test was used for evaluation of static and dynamic balance. Erythrocyte sedimentation rate, C-reactive protein, and 25-hydroxyvitamin D levels were measured. Forty of 306 patients reported at least 1 fall in the recent 1 year. The patients with history of falls had higher mean age and longer disease duration than did nonfallers (P = 0.001). In addition, these patients' BASMI and BASFI values were higher than those of nonfallers (P = 0.002; P = 0.000, respectively). We found that the patients with history of falls had lower SPPB scores (P = 0.000). We also found that the number of falls increased with longer disease duration and older age (R = 0.117 [P = 0.041] and R = 0.160 [P = 0.005]). Our results show that decreased SPPB scores were associated with increased number of falls (R = 0.183, P = 0.006). Statistically significant correlations were found between number of falls and AS-related lost job (R = 0.140, P = 0.014), fear of falling (R = 0.316, P = 0.000), hip involvement (R = 0.112, P = 0.05), BASMI (R =0.234, P = 0.000), and BASFI (R = 0.244, P = 0.000). Assessment of pain, stiffness, fatigue, and lower-extremity involvement as well as asking for a history of falls will highlight those at high risk for further falls. In addition to the general exercise program adopted for all patients, we suggest that a balance rehabilitation program should be valuable for the patients with risk factors for fall. Exercise may improve fear of falling and BASFI and BASMI scores. However, further study is needed to investigate these hypotheses. We believe that clinicians should train and support the patients via reducing fear of falls and maintaining good posture and functional capacity.

The pitch of short-duration fundamental frequency glissandos.

PubMed

d'Alessandro, C; Rosset, S; Rossi, J P

1998-10-01

Pitch perception for short-duration fundamental frequency (F0) glissandos was studied. In the first part, new measurements using the method of adjustment are reported. Stimuli were F0 glissandos centered at 220 Hz. The parameters under study were: F0 glissando extents (0, 0.8, 1.5, 3, 6, and 12 semitones, i.e., 0, 10.17, 18.74, 38.17, 76.63, and 155.56 Hz), F0 glissando durations (50, 100, 200, and 300 ms), F0 glissando directions (rising or falling), and the extremity of F0 glissandos matched (beginning or end). In the second part, the main results are discussed: (1) perception seems to correspond to an average of the frequencies present in the vicinity of the extremity matched; (2) the higher extremities of the glissando seem more important; (3) adjustments at the end are closer to the extremities than adjustments at the beginning. In the third part, numerical models accounting for the experimental data are proposed: a time-average model and a weighted time-average model. Optimal parameters for these models are derived. The weighted time-average model achieves a 94% accurate prediction rate for the experimental data. The numerical model is successful in predicting the pitch of short-duration F0 glissandos.

[Pigmentosum retinis and tubulo-interstitial nephronophtisis in Sensenbrenner syndrome: a case report].

PubMed

Costet, C; Betis, F; Bérard, E; Tsimaratos, M; Sigaudy, S; Antignac, C; Gastaud, P

2000-02-01

Sensenbrenner syndrome or cranio-ectodermal dysplasia is an extremely rare autosomal recessive condition (12 cases reported in literature). Our observation shows the possibility of both ocular and renal involvement associated with cranio-ectodermal abnormalities. and method:We report the case of a girl who presented a typical cranio-ectodermal syndrome with dolicocephaly, short thorax, short limbs, short fingers and teeth abnormalities. At five years, she was found to have pigmentosum retinitis with amblyopy and moderate hyperopia. A chronic renal failure with uncontrollable hypertension underwent a cadaveric-donor transplantation at the age of six years. Two years later, the pigmentosum retinitis was stable. The kidney histology revealed a tubulo-interstitial nephronophtisis. The molecular analysis of the NPH 1 locus, which was associated with nephronophtisis, was negative. Our observation and two recent publications have in common ocular and renal abnormalities associated with cranio-ectodermal dysplasia. The underlying genetic defect would involve not only morphogenesis but also development and maturation of organs as eye and kidney. Sensenbrenner syndrome would thus be similar to certain disorders affecting the eye, kidney, skeleton and ectodermal structures such as the EEM, Senior-Loken, Mainzer-Saldino, and Jeune syndromes. The retinal dystrophy falls within the spectrum of clinical and genetic forms of pigmentosum retinitis. Our observation would confirm possible links between Sensenbrenner syndrome and oculorenal syndromes.

Effects of short-term active video game play on community adults: under International Classification of Functioning, Disability and Health consideration.

PubMed

Tseng, Wei-Che; Hsieh, Ru-Lan

2013-06-01

The effects of active video game play on healthy individuals remain uncertain. A person's functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning, Disability, and Health (ICF). The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF. Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited. Over 2 weeks, each adult participated in six sessions of active video game play lasting 20 minutes each. Participants were assessed before and after the intervention. Variables were collected using sources related to the ICF components, including the Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Biodex Stability System, chair- rising time, Frenchay Activity Index, Rivermead Mobility Index, Chronic Pain Grade Questionnaire, Work Ability Index, and World Health Organization Quality of Life-Brief Version. Compared to baseline data, significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted. There was no significant change in the other variables measured. Short-term, active video game play reduces fall risks and ameliorates disabilities in community adults.

An Energy-Efficient Multi-Tier Architecture for Fall Detection Using Smartphones.

PubMed

Guvensan, M Amac; Kansiz, A Oguz; Camgoz, N Cihan; Turkmen, H Irem; Yavuz, A Gokhan; Karsligil, M Elif

2017-06-23

Automatic detection of fall events is vital to providing fast medical assistance to the causality, particularly when the injury causes loss of consciousness. Optimization of the energy consumption of mobile applications, especially those which run 24/7 in the background, is essential for longer use of smartphones. In order to improve energy-efficiency without compromising on the fall detection performance, we propose a novel 3-tier architecture that combines simple thresholding methods with machine learning algorithms. The proposed method is implemented on a mobile application, called uSurvive, for Android smartphones. It runs as a background service and monitors the activities of a person in daily life and automatically sends a notification to the appropriate authorities and/or user defined contacts when it detects a fall. The performance of the proposed method was evaluated in terms of fall detection performance and energy consumption. Real life performance tests conducted on two different models of smartphone demonstrate that our 3-tier architecture with feature reduction could save up to 62% of energy compared to machine learning only solutions. In addition to this energy saving, the hybrid method has a 93% of accuracy, which is superior to thresholding methods and better than machine learning only solutions.

Development of a Fall-Risk Self-Assessment for Community-Dwelling Seniors

PubMed Central

Vivrette, Rebecca L.; Rubenstein, Laurence Z.; Martin, Jennifer L.; Josephson, Karen R.; Kramer, B. Josea

2012-01-01

Objective To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors. Methods Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials. Results Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers. Implications An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them. PMID:21285473

Effects of cell volume changes on membrane ionic permeabilities and sodium transport in frog skin (Rana ridibunda).

PubMed

Costa, P M; Fernandes, P L; Ferreira, H G; Ferreira, K T; Giraldez, F

1987-12-01

1. Membrane potential and conductances and short-circuit current were continuously measured with microelectrodes and conventional electrophysiological techniques in a stripped preparation of frog skin epithelium. The effects of the removal of chloride or sodium ions and the concentration or dilution of the serosal (inner) bathing solution were studied. 2. Chloride- or sodium-free solutions produced a cell depolarization of about 30 mV in parallel with a fall in the short-circuit current. Mucosal and serosal membrane conductances both decreased and the sodium permeability of the mucosal barrier was calculated to fall to about one-half its value in standard Ringer solution. The observed decrease in the short-circuit current is probably related to the combined effect of the decrease in sodium permeability and the decrease in the driving force across the mucosal membrane. 3. The removal of chloride or sodium ions reduced the depolarization caused by serosal perfusion with high-potassium solutions (50 mM-KCl). The ratio of the change in cell membrane potential under short-circuit conditions to the change in the potassium equilibrium potential (delta Ec(s.c.)/delta EK), was 0.59 in standard Ringer solution and 0.26 and 0.24 after the removal of chloride or sodium respectively. The depolarizing effect of barium-containing solutions (2 mM-BaCl2) was also markedly reduced in chloride- or sodium-free solutions, suggesting a decrease of the potassium selectivity of the serosal membrane in these conditions. 4. Increasing the osmolality of the serosal bathing solution produced similar effects, i.e. cell depolarization, fall in the short-circuit current and membrane conductances and reduction of the depolarizing effect of high-potassium and barium solutions. On the contrary, dilution of the serosal bath produced the opposite effects, consistent with an increase in the serosal permeability to potassium. 5. The effects of chloride- or sodium-free solutions were reversed by the dilution of the serosal bath. Cells repolarized when exposed to low-osmolality solutions after being in the absence of serosal chloride or sodium. The repolarization ran in parallel with the restoration of the short-circuit current and the potassium selectivity of the serosal membrane. 6. The results show that the effects produced by the removal of sodium or chloride ions from the serosal bathing solution are most probably mediated by a reduction in cell volume. Cell volume changes would lead to changes in the serosal membrane selectivity to potassium and thus to changes in cell membrane potential and sodium transport.(ABSTRACT TRUNCATED AT 400 WORDS)

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

NASA Astrophysics Data System (ADS)

Ghasemi, Ebrahim; Ataei, Mohammad; Shahriar, Kourosh

2017-03-01

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

"Are Your Clients Having Fun?" The Implications of Respondents' Preferences for the Delivery of Group Exercise Programs for Falls Prevention.

PubMed

McPhate, Lucy; Simek, Emily M; Haines, Terry P; Hill, Keith D; Finch, Caroline F; Day, Lesley

2016-01-01

Group exercise has been shown to be effective in preventing falls; however, adherence to these interventions is often poor. Older adults' preferences for how these programs can be delivered are unknown. To identify older people's preferences for how group exercise programs for falls prevention can be delivered. A two-wave, cross-sectional, state-wide telephone survey was undertaken. Respondents were community-dwelling men and women aged 70+ in Victoria, Australia. Open-ended questions were asked to elicit information regarding respondent preferences of the program, which were analyzed using a framework approach. Ninety-seven respondents completed the follow-up survey. The results indicate that older adults most frequently report the short-term advantages and disadvantages when describing their preferences for group exercise, such as enjoyment, social interaction, and leader qualities. Longer-term advantages such as falls prevention were described less frequently. This study indicates the importance of interpersonal skills, and that the opportunity for social interaction should not be overlooked as a positive feature of a group exercise program.

Risk assessment of fall-related occupational accidents in the workplace

PubMed Central

Tsukada, Tsukimi; Sakakibara, Hisataka

2016-01-01

Objectives: This study aimed to examine effective assessment methods of falls in the workplace. Methods: There were 436 employees (305 males and 131 females) of electrical appliance manufacturers included in this study. In 2014, a baseline survey was conducted using the fall scores questionnaire and the self-check risk assessment of falls and other accidents in the workplace (physical function measurement and questionnaire). In 2015, the occurrence of falls in the past year was investigated. Multivariate logistic regression analyses were performed to examine factors relevant to falls. Results: In total, 62 subjects (14.2%) fell during the year, including those who fell during off-hours. The occurrence of falls during that one year was only associated with having experienced falls during the past year in the baseline survey (odds ratio [OR] 5.0; 95% confidence interval [CI] 2.5-9.7). Falls during that year were also related to the inability to walk 1 km continuously (OR 0.1; 95% CI 0.1-0.6), tripping sometimes (OR 4.0; 95% CI 1.6-9.9), step height differences at home (OR 3.0; 95% CI 1.3-6.8), and working in the production section (OR 0.2; 95% CI 0.1-0.5). Measurements of physical functions, such as muscle strength, balance, and agility, were not different between subjects who fell and those who did not. Conclusions: Our results showed that the questionnaire assessing falls during the past year could be useful to assess the risk of falls in the workplace. Annual checks for falls may contribute to fall prevention programs in the workplace. PMID:27725487

Plunging into the pool of death: Imagining a dangerous outcome influences distance perception

PubMed Central

Stefanucci, Jeanine K.; Gagnon, Kyle T.; Tompkins, Christopher L.; Bullock, Kendall E.

2012-01-01

The current studies examined whether manipulating the imagined consequences of falling would influence the perception of height, distance, and size. In Experiment 1, height and size perception were measured when participants stood at a short height (.89 m) or a medium height (1.91 m) above either an empty pool or a pool filled with a bed of nails. Participants who viewed the bed of nails and imagined falling into it estimated both the height as taller and the size of the bed of nails as larger than participants who imagined falling into an empty pool. In a second experiment, participants overestimated the horizontal ground distance to and across the bed of nails after being told to imagine jumping over it. Overall, these experiments suggest that costs associated with imagined actions can influence the perception of both vertical and horizontal extents that are not inherently dangerous. PMID:22611659

Passive in-home measurement of stride-to-stride gait variability comparing vision and Kinect sensing.

PubMed

Stone, Erik E; Skubic, Marjorie

2011-01-01

We present an analysis of measuring stride-to-stride gait variability passively, in a home setting using two vision based monitoring techniques: anonymized video data from a system of two web-cameras, and depth imagery from a single Microsoft Kinect. Millions of older adults fall every year. The ability to assess the fall risk of elderly individuals is essential to allowing them to continue living safely in independent settings as they age. Studies have shown that measures of stride-to-stride gait variability are predictive of falls in older adults. For this analysis, a set of participants were asked to perform a number of short walks while being monitored by the two vision based systems, along with a marker based Vicon motion capture system for ground truth. Measures of stride-to-stride gait variability were computed using each of the systems and compared against those obtained from the Vicon.

Self-discipline outdoes IQ in predicting academic performance of adolescents.

PubMed

Duckworth, Angela L; Seligman, Martin E P

2005-12-01

In a longitudinal study of 140 eighth-grade students, self-discipline measured by self-report, parent report, teacher report, and monetary choice questionnaires in the fall predicted final grades, school attendance, standardized achievement-test scores, and selection into a competitive high school program the following spring. In a replication with 164 eighth graders, a behavioral delay-of-gratification task, a questionnaire on study habits, and a group-administered IQ test were added. Self-discipline measured in the fall accounted for more than twice as much variance as IQ in final grades, high school selection, school attendance, hours spent doing homework, hours spent watching television (inversely), and the time of day students began their homework. The effect of self-discipline on final grades held even when controlling for first-marking-period grades, achievement-test scores, and measured IQ. These findings suggest a major reason for students falling short of their intellectual potential: their failure to exercise self-discipline.

Vehicle accidents related to sleep: a review.

PubMed

Horne, J; Reyner, L

1999-05-01

Falling asleep while driving accounts for a considerable proportion of vehicle accidents under monotonous driving conditions. Many of these accidents are related to work--for example, drivers of lorries, goods vehicles, and company cars. Time of day (circadian) effects are profound, with sleepiness being particularly evident during night shift work, and driving home afterwards. Circadian factors are as important in determining driver sleepiness as is the duration of the drive, but only duration of the drive is built into legislation protecting professional drivers. Older drivers are also vulnerable to sleepiness in the mid-afternoon. Possible pathological causes of driver sleepiness are discussed, but there is little evidence that this factor contributes greatly to the accident statistics. Sleep does not occur spontaneously without warning. Drivers falling asleep are unlikely to recollect having done so, but will be aware of the precursory state of increasing sleepiness; probably reaching a state of fighting off sleep before an accident. Self awareness of sleepiness is a better method for alerting the driver than automatic sleepiness detectors in the vehicle. None of these have been proved to be reliable and most have shortcomings. Putative counter measures to sleepiness, adopted during continued driving (cold air, use of car radio) are only effective for a short time. The only safe counter measure to driver sleepiness, particularly when the driver reaches the stage of fighting sleep, is to stop driving, and--for example, take a 30 minute break encompassing a short (< 15 minute) nap or coffee (about 150 mg caffeine), which are very effective particularly if taken together. Exercise is of little use. More education of employers and employees is needed about planning journeys, the dangers of driving while sleepy, and driving at vulnerable times of the day.

Estimates of price and income elasticity in Greece. Greek debt crisis transforming cigarettes into a luxury good: an econometric approach

PubMed Central

Tarantilis, Filippos; Athanasakis, Kostas; Zavras, Dimitris; Vozikis, Athanassios; Kyriopoulos, Ioannis

2015-01-01

Objective During the past decades, smoking prevalence in Greece was estimated to be near or over 40%. Following a sharp fall in cigarette consumption, as shown in current data, our objective is to assess smokers’ sensitivity to cigarette price and consumer income changes as well as to project health benefits of an additional tax increase. Methods Cigarette consumption was considered as the dependent variable, with Weighted Average Price as a proxy for cigarette price, gross domestic product as a proxy for consumers’ income and dummy variables reflecting smoking restrictions and antismoking campaigns. Values were computed to natural logarithms and regression was performed. Then, four scenarios of tax increase were distinguished in order to calculate potential health benefits. Results Short-run price elasticity is estimated at −0.441 and short-run income elasticity is estimated at 1.040. Antismoking campaigns were found to have a statistically significant impact on consumption. Results indicate that, depending on the level of tax increase, annual per capita consumption could fall by at least 209.83 cigarettes; tax revenue could rise by more than €0.74 billion, while smokers could be reduced by up to 530 568 and at least 465 smoking-related deaths could be averted. Conclusions Price elasticity estimates are similar to previous studies in Greece, while income elasticity estimates are far greater. With cigarettes regarded as a luxury good, a great opportunity is presented for decisionmakers to counter smoking. Increased taxation, along with focused antismoking campaigns, law reinforcement (to ensure compliance with smoking bans) and intensive control for smuggling could invoke a massive blow to the tobacco epidemic in Greece. PMID:25564137

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.

Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership.

PubMed

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

2013-01-01

The impact of falls in older adults presents a significant public health burden. Fall risk is not well-described in Latino populations nor have fall prevention programs considered the needs of this population. The objectives of this study were to develop a needs assessment of falls in older adult Latinos at a community center (CC), determine fall prevention barriers and strengths in this population, determine the level of interest in various fall prevention methods, and provide medical students an opportunity for participation in a culturally diverse community project. A cross-sectional survey was conducted with a convenience sample of older adult program participants. The survey was developed in collaboration with both partners. CC participants were approached by the interviewer and asked to participate. They were read the survey in their preferred language and their answers were recorded. Data were analyzed using descriptive statistics. We conducted 103 interviews. We found that 54% of participants had fallen in the last year, and of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. Of all respondents, 52% had 5 or more of the 10 surveyed risk factors for falling; 4% had no risk factors. Of all respondents, 75% were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (78% and 65%, respectively). Older adult Latinos in this selected population frequently fall and are worried about falling. Risk factors are prevalent. A fall prevention program is warranted and should include exercise classes and a connection with local primary care providers. A partnership between an academic organization and a CC is an ideal collaboration for the future development of prevention program.

Identifying Home Care Clinicians’ Information Needs for Managing Fall Risks

PubMed Central

Alhuwail, Dari

2016-01-01

Summary Objectives To help manage the risk of falls in home care, this study aimed to (i) identify home care clinicians’ information needs and how they manage missing or inaccurate data, (ii) identify problems that impact effectiveness and efficiency associated with retaining, exchanging, or processing information about fall risks in existing workflows and currently adopted health information technology (IT) solutions, and (iii) offer informatics-based recommendations to improve fall risk management interventions. Methods A case study was carried out in a single not-for-profit suburban Medicare-certified home health agency with three branches. Qualitative data were collected over a six month period through observations, semi-structured interviews, and focus groups. The Framework method was used for analysis. Maximum variation sampling was adopted to recruit a diverse sample of clinicians. Results Overall, the information needs for fall risk management were categorized into physiological, care delivery, educational, social, environmental, and administrative domains. Examples include a brief fall-related patient history, weight-bearing status, medications that affect balance, availability of caregivers at home, and the influence of patients’ cultures on fall management interventions. The unavailability and inaccuracy of critical information related to fall risks can delay necessary therapeutic services aimed at reducing patients’ risk for falling and thereby jeopardizing their safety. Currently adopted IT solutions did not adequately accommodate data related to fall risk management. Conclusion The results highlight the essential information for fall risk management in home care. Home care workflows and health IT solutions must effectively and efficiently retain, exchange, and process information necessary for fall risk management. Interoperability and integration of the various health IT solutions to make data sharing accessible to all clinicians is critical for fall risk management. Findings from this study can help home health agencies better understand their information needs to manage fall risks. PMID:27437035

Mobile Learning and Student Retention

ERIC Educational Resources Information Center

Fozdar, Bharat Inder; Kumar, Lalita S.

2007-01-01

Student retention in open and distance learning (ODL) is comparatively poor to traditional education and, in some contexts, embarrassingly low. Literature on the subject of student retention in ODL indicates that even when interventions are designed and undertaken to improve student retention, they tend to fall short. Moreover, this area has not…

Contextualized Teacher-Training and Racial/Ethnic Tensions in U.S. Schools

ERIC Educational Resources Information Center

Guinn, Cameron S.

2017-01-01

Public school teachers are required to have specialized training to appropriately address discipline problems and foster positive school culture. Despite good intentions, many teacher-training initiatives fall short of creating an unbiased school atmosphere. This study used data collected by the National Center for Educational Statistics through…

Disrupting Racialized Institutional Scripts: Toward Parent-Teacher Transformative Agency for Educational Justice

ERIC Educational Resources Information Center

Ishimaru, Ann M.; Takahashi, Sola

2017-01-01

Partnerships between teachers and parents from nondominant communities hold promise for reducing race- and class-based educational disparities, but the ways families and teachers work together often fall short of delivering systemic change. Racialized institutional scripts provide "taken-for-granted" norms, expectations, and assumptions…

Renewable Energy for Rural Sustainability in Developing Countries

ERIC Educational Resources Information Center

Alazraque-Cherni, Judith

2008-01-01

This article establishes the benefits of applying renewable energy and analyzes the main difficulties that have stood in the way of more widely successful renewable energy for rural areas in the developing world and discusses why outcomes from these technologies fall short. Although there is substantial recognition of technological, economic,…

Mr Cameron's Three Million Apprenticeships

ERIC Educational Resources Information Center

Allen, Martin

2015-01-01

In the 2015 general election campaign David Cameron celebrated the success of apprenticeships during the Coalition and promised another 3 million. This article argues that the "reinvention" of apprenticeships has neither created real skills nor provided real alternatives for young people and that the UK schemes fall far short of those in…

Capabilities and Contributions of Unwed Fathers

ERIC Educational Resources Information Center

Lerman, Robert I.

2010-01-01

Young, minority, and poorly educated fathers in fragile families have little capacity to support their children financially and are hard-pressed to maintain stability in raising those children. In this article, Robert Lerman examines the capabilities and contributions of unwed fathers, how their capabilities and contributions fall short of those…

Standing Up for Diversity: Lesbian Mothers' Suggestions for Teachers

ERIC Educational Resources Information Center

Bower, Laura A.

2008-01-01

Increased diversity within student populations has led to concerns for meeting the needs of all learners. Traditionally, education has defined diversity in terms of students' ethnicity, language, and academic abilities. In today's environment, however, multicultural efforts fall short if they do not also include sexual orientation and family…

Education Statistics Quarterly, Fall 2002.

ERIC Educational Resources Information Center

Dillow, Sally, Ed.

2003-01-01

This publication provides a comprehensive overview of work done across all parts of the National Center for Education Statistics (NCES). Each issue contains short publications, summaries, and descriptions that cover all NCES publications and data products released in a 3-month period. Each issue also contains a message from the NCES on a timely…

Education Statistics Quarterly, Fall 2001.

ERIC Educational Resources Information Center

Dillow, Sally, Ed.

2001-01-01

The publication gives a comprehensive overview of work done across all parts of the National Center for Education Statistics (NCES). Each issue contains short publications, summaries, and descriptions that cover all NCES publications, data products, and funding opportunities developed over a 3-month period. Each issue also contains a message from…

Urban-Rural Flows of Physicians

ERIC Educational Resources Information Center

Ricketts, Thomas C.; Randolph, Randy

2007-01-01

Context: Physician supply is anticipated to fall short of national requirements over the next 20 years. Rural areas are likely to lose relatively more physicians. Policy makers must know how to anticipate what changes in distribution are likely to happen to better target policies. Purpose: To determine whether there was a significant flow of…

Personality Types as an Indicator of Online Student Success and Retention

ERIC Educational Resources Information Center

Meredith, Ben P.

2011-01-01

With online education courses within public institutions realizing lower than average retention and success rates for students, current retention practices and models are falling woefully short of providing workable, viable answers to keeping students and helping them be successful without lowering academic standards. While a relationship between…

On Conceptual Analysis as the Primary Qualitative Approach to Statistics Education Research in Psychology

ERIC Educational Resources Information Center

Petocz, Agnes; Newbery, Glenn

2010-01-01

Statistics education in psychology often falls disappointingly short of its goals. The increasing use of qualitative approaches in statistics education research has extended and enriched our understanding of statistical cognition processes, and thus facilitated improvements in statistical education and practices. Yet conceptual analysis, a…

Online Plagiarism Training Falls Short in Biology Classrooms

ERIC Educational Resources Information Center

Holt, Emily A.; Fagerheim, Britt; Durham, Susan

2014-01-01

Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework…

To Practice What One Preaches: Deepening Civic Education

ERIC Educational Resources Information Center

Bain-Selbo, Eric; Markham, Paul

2012-01-01

American democracy is in disarray. While many colleges and universities have responded to the democracy crisis, their efforts are falling short. This article reviews the current situation of civic education in higher education, explores its promise and current shortcomings, and provides a radical proposal for deepening civic education and…

Influence of Culture on Curriculum Development in Ghana: An Undervalued Factor?

ERIC Educational Resources Information Center

Gervedink Nijhuis, Chantal J.; Pieters, Jules M.; Voogt, Joke M.

2013-01-01

Curriculum implementation often falls short because of a lack of cultural understanding by curriculum developers and aid organizations. This paper describes a single-case study of a professional development programme for polytechnic Heads of Department in Ghana, which aimed at identifying how curriculum development activities were sensitive to…

Role Socialization Theory: The Sociopolitical Realities of Teaching Physical Education

ERIC Educational Resources Information Center

Richards, K. Andrew R.

2015-01-01

Much has been learned about the socialization of physical education (PE) teachers using occupational socialization theory (OST). However, important to understanding any socialization process is explaining how the roles that individuals play are socially constructed and contextually bound. OST falls short of providing a comprehensive overview of…

Genetic and environmental limitations on crop responses to elevated [CO2

USDA-ARS?s Scientific Manuscript database

While the future crop growing environment is likely to be warmer and with more variable water availability, the stimulation of C3 photosynthesis by elevated CO2 concentration provides a potential benefit of global climate change. However, experimental field studies suggest that C3 crops fall short o...

Mentoring--Is It Failing Women?

ERIC Educational Resources Information Center

Ghosh, Rajashi

2015-01-01

Mentoring programs are gaining traction as human resource development initiatives that can support women to advance in their careers in organizations. However, some of these programs are falling short of delivering on this promise due to particular inherent flaws. This case study considers the following three potential flaws of formal mentoring…

Building Leadership Capacity in the Involving Network State

ERIC Educational Resources Information Center

Pedersen, Dorthe; Tangkjaer, Christian

2013-01-01

New partnerships, cross-organisational collaborations and co-creation, digitalisation, involvement of citizens, public design and innovation stand out as new and emerging solutions in welfare delivery. However, New Public Management (NPM) seems to represent a historical repertoire of perspectives and tools that falls short of dealing with public…

Contributions to an Understanding of the Music and Movement Connection.

ERIC Educational Resources Information Center

Young, Susan

1996-01-01

Describes alternative conceptions to the connection between music and movement by relating aspects of recent research on infant-caregiver interaction to musical development. Claims that existing explanations seem to fall short of providing an explanation adequate for the immediate, expressive, and integrated nature of this bond. (MOK)

Revisiting Interpretation of Canonical Correlation Analysis: A Tutorial and Demonstration of Canonical Commonality Analysis

ERIC Educational Resources Information Center

Nimon, Kim; Henson, Robin K.; Gates, Michael S.

2010-01-01

In the face of multicollinearity, researchers face challenges interpreting canonical correlation analysis (CCA) results. Although standardized function and structure coefficients provide insight into the canonical variates produced, they fall short when researchers want to fully report canonical effects. This article revisits the interpretation of…

Service Delivery to Southern Black Population in Rural Areas.

ERIC Educational Resources Information Center

Pinnock, Theo J.

Planning for viable rural communities must seek elements inherent in a well-kept American home: lights, water, telephone, employment of the household head, children in school, access to transportation, sufficient food, clothing, health care, recreation, etc. If a community falls short in these necessities, the "needs gap" is where…

Science and Mathematics Teachers' Experiences, Needs, and Expectations regarding Professional Development

ERIC Educational Resources Information Center

Chval, Kathryn; Abell, Sandra; Pareja, Enrique; Musikul, Kusalin; Ritzka, Gerard

2008-01-01

High quality teachers are essential to improving the teaching and learning of mathematics and science, necessitating effective professional development (PD) and learning environments for teachers. However, many PD programs for science and mathematics teachers fall short because they fail to consider teacher background, experience, knowledge,…

EFFECTS OF HEAVY METALS IN SEDIMENTS OF THE MACROINVERTEBRATE COMMUNITY IN THE SHORT CREEK/EMPIRE LAKE AQUATIC SYSTEM, CHEROKEE COUNTY, KANSAS: A RECOMMENDATION FOR SITE-SPECIFIC CRITERIA.

EPA Science Inventory

The study uses statistical analysis techniques to determine the effects of four heavy metals (cadmium, lead, manganese, and zinc) on the macroinvertebrate community using the data collected in the fall 1987.

Reinstate the Draft? Target Report No. 15.

ERIC Educational Resources Information Center

Orleans, Bill, Comp.

Position papers collected by the United States Student Association (USSA) outlining objections to the reimposition of a selective service draft are presented. The USSA believes that a draft is unnecessary because: total active military strength is maintained even when voluntary enlistment falls short of its goal; it would increase military costs;…

Professional Learning Orientations: Patterns of Dissonance and Alignment between Teachers' Values and Practices

ERIC Educational Resources Information Center

Pedder, David; Opfer, V. Darleen

2013-01-01

Through its positive influence on teachers' classroom practices and their students' learning, effective professional learning of teachers is an important condition for school improvement. However, the Teaching and Learning International Survey reports that teachers' professional development in most countries falls short of meeting the needs of…

How Scientists Can Become Entrepreneurs.

PubMed

Thon, Jonathan N; Karlsson, Sven

2017-05-01

Translating basic research discoveries through entrepreneurship must be scientist driven and institutionally supported to be successful (not the other way around). Here, we describe why scientists should engage in entrepreneurship, where institutional support for scientist-founders falls short, and how these challenges can be overcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

State Policies and Planning to Increase Attainment, Quality, and Productivity

ERIC Educational Resources Information Center

Lingenfelter, Paul E.

2007-01-01

This article examines why state planning and policy for higher education are increasingly focused on increasing educational attainment, quality, and the productivity of the system. It presents four "stories" which illustrate initiatives to improve attainment, quality, and productivity, but fall far short of exhausting the available material.

An investigation of local and regional sources of fine particulate matter in the Ostrava,the Czech Republic

EPA Science Inventory

Despite efforts to reduce air pollutants, particularly in the coal power plant and industrial sectors, the Ostrava region of the Czech Republic continues to experience episodes of high pollutant concentrations, especially during the fall and winter seasons. A short-term investig...

Polysynchronous: Dialogic Construction of Time in Online Learning

ERIC Educational Resources Information Center

Oztok, Murat; Wilton, Lesley; Zingaro, Daniel; Mackinnon, Kim; Makos, Alexandra; Phirangee, Krystle; Brett, Clare; Hewitt, Jim

2014-01-01

Online learning has been conceptualized for decades as being delivered in one of two modes: synchronous or asynchronous. Technological determinism falls short in describing the role that the individuals' psychological, social and pedagogical factors play in their perception, experience and understanding of time online. This article explores…

Home-Grown Courses. Tech Talk.

ERIC Educational Resources Information Center

Klajnscek, Rich

1999-01-01

Home-built adventure-education courses exhibit refreshing creativity but almost always fall short of their potential due to inadequate construction techniques and materials. A ropes course inspector for the adventure education industry discusses the most common mistakes made in home-built ropes courses and how to prevent or fix them. (TD)

Cultural Assumptions against Sustainability: An International Survey

ERIC Educational Resources Information Center

Gambini, Barbara

2006-01-01

Despite the great progress in increasing public awareness of and attention to the issue of sustainability, the measures taken so far fall dramatically short of halting deleterious cycles. This apparent deficiency can be ascribed to two main factors: insufficient efforts to finding viable and visible alternatives and the failure to thoroughly…

The Seven Silos of Accountability in Higher Education: Systematizing Multiple Logics and Fields

ERIC Educational Resources Information Center

Brown, Joshua Travis

2017-01-01

Higher education accountability is a field characterized by complexity. Prior frameworks grounded in psychometrics, economics, and history fall short in explaining the persistence and composition of its complexity. This article employs organizational theory to identify the multiple conflicting approaches of higher education accountability and…

Soil Carbon Budget During Establishment of Short Rotation Woody Crops

NASA Astrophysics Data System (ADS)

Coleman, M. D.

2003-12-01

Carbon budgets were monitored following forest harvest and during re-establishment of short rotation woody crops. Soil CO2 efflux was monitored using infared gas analyzer methods, fine root production was estimated with minirhizotrons, above ground litter inputs were trapped, coarse root inputs were estimated with developed allometric relationships, and soil carbon pools were measured in loblolly pine and cottonwood plantations. Our carbon budget allows evaluation of errors, as well as quantifying pools and fluxes in developing stands during non-steady-state conditions. Soil CO2 efflux was larger than the combined inputs from aboveground litter fall and root production. Fine-root production increased during stand development; however, mortality was not yet equivalent to production, showing the belowground carbon budget was not yet in equilibrium and root carbon standing crop was accruing. Belowground production was greater in cottonwood than pine, but the level of pine soil CO2 efflux was equal to or greater than that of cottonwood, indicating heterotrophic respiration was higher for pine. Comparison of unaccounted efflux with soil organic carbon changes provides verification of loss or accrual.

The Team Climate Inventory as a Measure of Primary Care Teams' Processes: Validation of the French Version

PubMed Central

Beaulieu, Marie-Dominique; Dragieva, Nataliya; Del Grande, Claudio; Dawson, Jeremy; Haggerty, Jeannie L.; Barnsley, Jan; Hogg, William E.; Tousignant, Pierre; West, Michael A.

2014-01-01

Purpose: Evaluate the psychometric properties of the French version of the short 19-item Team Climate Inventory (TCI) and explore the contributions of individual and organizational characteristics to perceived team effectiveness. Method: The TCI was completed by 471 of the 618 (76.2%) healthcare professionals and administrative staff working in a random sample of 37 primary care practices in the province of Quebec. Results: Exploratory factor analysis confirmed the original four-factor model. Cronbach's alphas were excellent (from 0.88 to 0.93). Latent class analysis revealed three-class response structure. Respondents in practices with professional governance had a higher probability of belonging to the “High TCI” class than did practices with community governance (36.7% vs. 19.1%). Administrative staff tended to fall into the “Suboptimal TCI” class more frequently than did physicians (36.5% vs. 19.0%). Conclusion: Results confirm the validity of our French version of the short TCI. The association between professional governance and better team climate merits further exploration. PMID:24726073

Sleep problems, short sleep and a combination of both increase the risk of depressive symptoms in older people: a 6-year follow-up investigation from the English Longitudinal Study of Ageing.

PubMed

Jackowska, Marta; Poole, Lydia

2017-09-01

This study investigated whether sleep problems, sleep duration and a combination of short or long sleep with sleep problems were predictive of depressive symptoms six years later. Participants were 4545 men and women aged 50 years or older from the English Longitudinal Study of Ageing. Sleep problems were indexed through self-report enquiring about the most frequent insomnia symptoms including difficulties falling asleep, waking up several times a night and waking up in the morning feeling tired. Sleep duration was ascertained by asking about average sleep in the weeknight. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. Sleep problems were predictive of elevated depressive symptoms at follow-up (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.19-1.56). When explored separately, waking up in the morning feeling tired (OR = 1.71, 95% CI = 1.24-2.37) followed by difficulties falling asleep (OR = 1.49, 95% CI = 1.06-2.11) were also predictors of future depressive symptoms. Compared to optimal duration, short (OR = 1.90, 95% CI = 1.34-2.71) but not long sleep hours were also linked to elevated depressive symptoms. Participants reporting short sleep hours combined with high sleep problems also had an elevated risk of depressive symptoms six years later (OR = 1.85, 95% CI = 1.15-3.00). Long sleep combined with high sleep problems was not predictive of depressive symptoms. Short and disturbed sleep and their combination increase the risk of future depressive symptoms in older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

A complex baleen whale call recorded in the Mariana Trench Marine National Monument.

PubMed

Nieukirk, Sharon L; Fregosi, Selene; Mellinger, David K; Klinck, Holger

2016-09-01

In fall 2014 and spring 2015, passive acoustic data were collected via autonomous gliders east of Guam in an area that included the Mariana Trench Marine National Monument. A short (2-4 s), complex sound was recorded that features a ∼38 Hz moan with both harmonics and amplitude modulation, followed by broad-frequency metallic-sounding sweeps up to 7.5 kHz. This sound was recorded regularly during both fall and spring surveys. Aurally, the sound is quite unusual and most resembles the minke whale "Star Wars" call. It is likely this sound is biological and produced by a baleen whale.

[Some impressions of child and adolescent psychiatric management in Berlin after the fall of the wall].

PubMed

Fegert, J M; Geiken, G; Lenz, K

1992-12-01

The fall of the Berlin wall caused a sudden increase in migration from East-Germany to West-Berlin. In our sample we compared 155 Berlin elementary school children to 17 children from East-Germany now living in Berlin and 25 immigrant children most oft them coming from Turkey and Poland. Although many authors expected short-term disorders of adaptation, we found a constancy of psychiatric diagnosis in the migration group. We noticed important differences particularly in the new psychosocial situation of the former East German mothers, with many single-mother-families, where the mothers now were often unemployed.

Fine structure of acoustic signals caused by a drop falling onto the surface of water

NASA Astrophysics Data System (ADS)

Chashechkin, Yu. D.; Prokhorov, V. E.

2015-08-01

The temporal structure of sound radiation upon a drop falling onto a free liquid surface is investigated experimentally by high-resolution high-speed videorecording synchronized with a broad-band measurement of the acoustic pressure. Groups of short and relatively prolonged sound packets with frequency filling from 2 to 50 kHz and the corresponding flow patterns including the simultaneous formation of resonating bubbles and their interaction processes with an originating cavern are isolated. The temporal dependence of the determining parameter, i.e., the Weber number, which is stably reproduced in a series of experiments by a power function with a fractional index, is constructed.

Systematic Review of Falls in Older Adults with Cancer

PubMed Central

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

2014-01-01

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

Unsupervised machine-learning method for improving the performance of ambulatory fall-detection systems

PubMed Central

2012-01-01

Background Falls can cause trauma, disability and death among older people. Ambulatory accelerometer devices are currently capable of detecting falls in a controlled environment. However, research suggests that most current approaches can tend to have insufficient sensitivity and specificity in non-laboratory environments, in part because impacts can be experienced as part of ordinary daily living activities. Method We used a waist-worn wireless tri-axial accelerometer combined with digital signal processing, clustering and neural network classifiers. The method includes the application of Discrete Wavelet Transform, Regrouping Particle Swarm Optimization, Gaussian Distribution of Clustered Knowledge and an ensemble of classifiers including a multilayer perceptron and Augmented Radial Basis Function (ARBF) neural networks. Results Preliminary testing with 8 healthy individuals in a home environment yields 98.6% sensitivity to falls and 99.6% specificity for routine Activities of Daily Living (ADL) data. Single ARB and MLP classifiers were compared with a combined classifier. The combined classifier offers the greatest sensitivity, with a slight reduction in specificity for routine ADL and an increased specificity for exercise activities. In preliminary tests, the approach achieves 100% sensitivity on in-group falls, 97.65% on out-group falls, 99.33% specificity on routine ADL, and 96.59% specificity on exercise ADL. Conclusion The pre-processing and feature-extraction steps appear to simplify the signal while successfully extracting the essential features that are required to characterize a fall. The results suggest this combination of classifiers can perform better than MLP alone. Preliminary testing suggests these methods may be useful for researchers who are attempting to improve the performance of ambulatory fall-detection systems. PMID:22336100

Risk of falls in older people during fast-walking--the TASCOG study.

PubMed

Callisaya, M L; Blizzard, L; McGinley, J L; Srikanth, V K

2012-07-01

To investigate the relationship between fast-walking and falls in older people. Individuals aged 60-86 years were randomly selected from the electoral roll (n=176). Gait speed, step length, cadence and a walk ratio were recorded during preferred- and fast-walking using an instrumented walkway. Falls were recorded prospectively over 12 months. Log multinomial regression was used to estimate the relative risk of single and multiple falls associated with gait variables during fast-walking and change between preferred- and fast-walking. Covariates included age, sex, mood, physical activity, sensorimotor and cognitive measures. The risk of multiple falls was increased for those with a smaller walk ratio (shorter steps, faster cadence) during fast-walking (RR 0.92, CI 0.87, 0.97) and greater reduction in the walk ratio (smaller increase in step length, larger increase in cadence) when changing to fast-walking (RR 0.73, CI 0.63, 0.85). These gait patterns were associated with poorer physiological and cognitive function (p<0.05). A higher risk of multiple falls was also seen for those in the fastest quarter of gait speed (p=0.01) at fast-walking. A trend for better reaction time, balance, memory and physical activity for higher categories of gait speed was stronger for fallers than non-fallers (p<0.05). Tests of fast-walking may be useful in identifying older individuals at risk of multiple falls. There may be two distinct groups at risk--the frail person with short shuffling steps, and the healthy person exposed to greater risk. Copyright © 2012 Elsevier B.V. All rights reserved.

Improving Fall Detection Using an On-Wrist Wearable Accelerometer

PubMed Central

Chira, Camelia; González, Víctor M.; de la Cal, Enrique

2018-01-01

Fall detection is a very important challenge that affects both elderly people and the carers. Improvements in fall detection would reduce the aid response time. This research focuses on a method for fall detection with a sensor placed on the wrist. Falls are detected using a published threshold-based solution, although a study on threshold tuning has been carried out. The feature extraction is extended in order to balance the dataset for the minority class. Alternative models have been analyzed to reduce the computational constraints so the solution can be embedded in smart-phones or smart wristbands. Several published datasets have been used in the Materials and Methods section. Although these datasets do not include data from real falls of elderly people, a complete comparison study of fall-related datasets shows statistical differences between the simulated falls and real falls from participants suffering from impairment diseases. Given the obtained results, the rule-based systems represent a promising research line as they perform similarly to neural networks, but with a reduced computational cost. Furthermore, support vector machines performed with a high specificity. However, further research to validate the proposal in real on-line scenarios is needed. Furthermore, a slight improvement should be made to reduce the number of false alarms. PMID:29701721

Lidar-Based Rock-Fall Hazard Characterization of Cliffs

USGS Publications Warehouse

Collins, Brian D.; Greg M.Stock,

2017-01-01

Rock falls from cliffs and other steep slopes present numerous challenges for detailed geological characterization. In steep terrain, rock-fall source areas are both dangerous and difficult to access, severely limiting the ability to make detailed structural and volumetric measurements necessary for hazard assessment. Airborne and terrestrial lidar survey methods can provide high-resolution data needed for volumetric, structural, and deformation analyses of rock falls, potentially making these analyses straightforward and routine. However, specific methods to collect, process, and analyze lidar data of steep cliffs are needed to maximize analytical accuracy and efficiency. This paper presents observations showing how lidar data sets should be collected, filtered, registered, and georeferenced to tailor their use in rock fall characterization. Additional observations concerning surface model construction, volumetric calculations, and deformation analysis are also provided.

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

PubMed

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

2013-02-01

Falls from heights account for 64% of residential construction worker fatalities and 20% of missed work days. We hypothesized that worker safety would improve with foremen training in fall prevention and safety communication. Training priorities identified through foreman and apprentice focus groups and surveys were integrated into an 8-hour training. We piloted the training with ten foremen employed by a residential builder. Carpenter trainers contrasted proper methods to protect workers from falls with methods observed at the foremen's worksites. Trainers presented methods to deliver toolbox talks and safety messages. Results from worksite observational audits (n=29) and foremen/crewmember surveys (n=97) administered before and after training were compared. We found that inexperienced workers are exposed to many fall hazards that they are often not prepared to negotiate. Fall protection is used inconsistently and worksite mentorship is often inadequate. Foremen feel pressured to meet productivity demands and some are unsure of the fall protection requirements. After the training, the frequency of daily mentoring and toolbox talks increased, and these talks became more interactive and focused on hazardous daily work tasks. Foremen observed their worksites for fall hazards more often. We observed increased compliance with fall protection and decreased unsafe behaviors during worksite audits. Designing the training to meet both foremen's and crewmembers' needs ensured the training was learner-centered and contextually-relevant. This pilot suggests that training residential foremen can increase use of fall protection, improve safety behaviors, and enhance on-the-job training and safety communication at their worksites. Construction workers' training should target safety communication and mentoring skills with workers who will lead work crews. Interventions at multiple levels are necessary to increase safety compliance in residential construction and decrease falls from heights. Copyright © 2013 Elsevier Ltd. All rights reserved.

Bursts of seizures in long-term recordings of human focal epilepsy

PubMed Central

Karoly, Philippa J.; Nurse, Ewan S.; Freestone, Dean R.; Ung, Hoameng; Cook, Mark J.; Boston, Ray

2017-01-01

Summary Objective We report on temporally clustered seizures detected from continuous long-term ambulatory human electroencephalographic data. The objective was to investigate short-term seizure clustering, which we have termed bursting, and consider implications for patient care, seizure prediction, and evaluating therapies. Methods Chronic ambulatory intracranial EEG data collected for the purpose of seizure prediction were annotated to identify seizure events. A detection algorithm was used to identify bursts of events. Burst events were compared to non-burst events to evaluate event dispersion, duration and dynamics. Results Bursts of seizures were present in six of fifteen patients, and detections were consistent over long term monitoring (> 2 years). Seizures within bursts are highly overdispersed compared to non-burst seizures. There was a complicated relationship between bursts and clinical seizures, although bursts were associated with multi-modal distributions of seizure duration, and poorer predictive outcomes. For three subjects, bursts demonstrated distinctive pre-ictal dynamics compared to clinical seizures. Significance We have previously hypothesized that there are distinct physiological pathways underlying short and long duration seizures. Here we show that burst seizures fall almost exclusively within the short population of seizure durations; however, a short duration was not sufficient to induce or imply bursting. We can therefore conclude that in addition to distinct mechanisms underlying seizure duration, there are separate factors regulating bursts of seizures. We show that bursts were a robust phenomenon in our patient cohort, which were consistent with overdispersed seizure rates, suggesting long-memory dynamics. PMID:28084639

Liquid oxygen dicting cleaned by falling film method

NASA Technical Reports Server (NTRS)

Paul, H. I.

1967-01-01

Principle of a vertical falling film is used to clean contaminated large diameter and length liquid oxygen /LOX/ cylindrical ducting. The cleaning cycle is performed by flowing trichloroethylene in a falling film down a vertically mounted duct for approximately one hour.

Beryllium-7 as a tracer of short-term sediment deposition and resuspension in the Fox River Wisconsin

USGS Publications Warehouse

Fitzgerald, S.A.; Klump, J.V.; Swarzenski, P.W.; Mackenzie, R.A.; Richards, K.D.

2001-01-01

Short-term (???monthly) sediment deposition and resuspension rates of surficial bed sediments in two PCB-laden impoundments on the Fox River, WI, were determined in the summer and fall of 1998 using 7Be, a naturally occurring radioisotope produced in the atmosphere. Decay-corrected activities and inventories of 7Be were measured in bed sediment and in suspended particles. Beryilium-7 activities generally decreased with depth in the top 5-10 cm of sediments and ranged from undetectable to ???0.9 pCi cm-3. Inventories of 7Be, calculated from the sum of activities from all depths, ranged from 0.87 to 3.74 pCi cm-2, and the values covaried between sites likely reflecting a common atmospheric input signal. Activities of 7Be did not correlate directly with rainfall. Partitioning the 7Be flux into "new" and "residual" components indicated that net deposition was occurring most of the time during the summer. Net erosion, however, was observed at the upstream site from the final collection in the fall. This erosion event was estimated to have removed 0.10 g (cm of sediment)-2, corresponding to ???0.5 cm of sediment depth, and ???6-10 kg of polychlorinated biphenyls (PCBs) over the whole deposit. Short-term accumulation rates were up to ???130 times higher than the long-term rates calculated from 137Cs profiles, suggesting an extremely dynamic sediment transport environment, even within an impounded river system.Short-term (approximately monthly) sediment deposition and resuspension rates of surficial bed sediments in two PCB-laden impoundments on the Fox River, WI, were determined in the summer and fall of 1998 using 7Be, a naturally occurring radioisotope produced in the atmosphere. Decay-corrected activities and inventories of 7Be were measured in bed sediment and in suspended particles. Beryllium-7 activities generally decreased with depth in the top 5-10 cm of sediments and ranged from undetectable to approximately 0.9 pCi cm-3. Inventories of 7Be, calculated from the sum of activities from all depths, ranged from 0.87 to 3.74 pCi cm-2, and the values covaried between sites likely reflecting a common atmospheric input signal. Activities of 7Be did not correlate directly with rainfall. Partitioning the 7Be flux into `new' and `residual' components indicated that net deposition was occurring most of the time during the summer. Net erosion, however, was observed at the upstream site from the final collection in the fall. This erosion event was estimated to have removed 0.10 g (cm of sediment)-2, corresponding to approximately 0.5 cm of sediment depth, and approximately 6-10 kg of polychlorinated biphenyls (PCBs) over the whole deposit. Short-term accumulation rates were up to approximately 130 times higher than the long-term rates calculated from 137Cs profiles, suggesting an extremely dynamic sediment transport environment, even within an impounded river system.

Heat transfer coefficients for staggered arrays of short pin fins

NASA Technical Reports Server (NTRS)

Vanfossen, G. J.

1981-01-01

Short pin fins are often used to increase that heat transfer to the coolant in the trailing edge of a turbine blade. Due primarily to limits of casting technology, it is not possible to manufacture pins of optimum length for heat transfer purposes in the trailing edge region. In many cases the pins are so short that they actually decrease the total heat transfer surface area compared to a plain wall. A heat transfer data base for these short pins is not available in the literature. Heat transfer coefficients on pin and endwall surfaces were measured for several staggered arrays of short pin fins. The measured Nusselt numbers when plotted versus Reynolds numbers were found to fall on a single curve for all surfaces tested. The heat transfer coefficients for the short pin fins (length to diameter ratios of 1/2 and 2) were found to be about a factor of two lower than data from the literature for longer pin arrays (length to diameter ratios of about 8).

Discovery of the short gamma-ray burst GRB 050709.

PubMed

Villasenor, J S; Lamb, D Q; Ricker, G R; Atteia, J-L; Kawai, N; Butler, N; Nakagawa, Y; Jernigan, J G; Boer, M; Crew, G B; Donaghy, T Q; Doty, J; Fenimore, E E; Galassi, M; Graziani, C; Hurley, K; Levine, A; Martel, F; Matsuoka, M; Olive, J-F; Prigozhin, G; Sakamoto, T; Shirasaki, Y; Suzuki, M; Tamagawa, T; Vanderspek, R; Woosley, S E; Yoshida, A; Braga, J; Manchanda, R; Pizzichini, G; Takagishi, K; Yamauchi, M

2005-10-06

Gamma-ray bursts (GRBs) fall into two classes: short-hard and long-soft bursts. The latter are now known to have X-ray and optical afterglows, to occur at cosmological distances in star-forming galaxies, and to be associated with the explosion of massive stars. In contrast, the distance scale, the energy scale and the progenitors of the short bursts have remained a mystery. Here we report the discovery of a short-hard burst whose accurate localization has led to follow-up observations that have identified the X-ray afterglow and (for the first time) the optical afterglow of a short-hard burst; this in turn led to the identification of the host galaxy of the burst as a late-type galaxy at z = 0.16 (ref. 10). These results show that at least some short-hard bursts occur at cosmological distances in the outskirts of galaxies, and are likely to be caused by the merging of compact binaries.

Geohazard reconnaissance mapping for potential rock boulder fall using low altitude UAV photogrammetry

NASA Astrophysics Data System (ADS)

Sharan Kumar, N.; Ashraf Mohamad Ismail, Mohd; Sukor, Nur Sabahiah Abdul; Cheang, William

2018-05-01

This paper discusses potential applications of unmanned aerial vehicles (UAVs) for evaluation of risk immediately with photos and 3-dimensional digital element. Aerial photography using UAV ready to give a powerful technique for potential rock boulder fall recognition. High-resolution outputs from this method give the chance to evaluate the site for potential rock boulder falls spatially. The utilization of UAV to capture the aerial photos is a quick, reliable, and cost-effective technique contrasted with terrestrial laser scanning method. Reconnaissance of potential rock boulder susceptible to fall is very crucial during the geotechnical investigation. This process is essential in the view of the rock fall hazards nearby site before the beginning of any preliminary work. Photogrammetric applications have empowered the automated way to deal with identification of rock boulder susceptible to fall by recognizing the location, size, and position. A developing examination of the utilization of digital photogrammetry gives numerous many benefits for civil engineering application. These advancements have made important contributions to our capabilities to create the geohazard map on potential rock boulder fall.

Multi-site Stochastic Simulation of Daily Streamflow with Markov Chain and KNN Algorithm

NASA Astrophysics Data System (ADS)

Mathai, J.; Mujumdar, P.

2017-12-01

A key focus of this study is to develop a method which is physically consistent with the hydrologic processes that can capture short-term characteristics of daily hydrograph as well as the correlation of streamflow in temporal and spatial domains. In complex water resource systems, flow fluctuations at small time intervals require that discretisation be done at small time scales such as daily scales. Also, simultaneous generation of synthetic flows at different sites in the same basin are required. We propose a method to equip water managers with a streamflow generator within a stochastic streamflow simulation framework. The motivation for the proposed method is to generate sequences that extend beyond the variability represented in the historical record of streamflow time series. The method has two steps: In step 1, daily flow is generated independently at each station by a two-state Markov chain, with rising limb increments randomly sampled from a Gamma distribution and the falling limb modelled as exponential recession and in step 2, the streamflow generated in step 1 is input to a nonparametric K-nearest neighbor (KNN) time series bootstrap resampler. The KNN model, being data driven, does not require assumptions on the dependence structure of the time series. A major limitation of KNN based streamflow generators is that they do not produce new values, but merely reshuffle the historical data to generate realistic streamflow sequences. However, daily flow generated using the Markov chain approach is capable of generating a rich variety of streamflow sequences. Furthermore, the rising and falling limbs of daily hydrograph represent different physical processes, and hence they need to be modelled individually. Thus, our method combines the strengths of the two approaches. We show the utility of the method and improvement over the traditional KNN by simulating daily streamflow sequences at 7 locations in the Godavari River basin in India.

Systems and Methods for Imaging of Falling Objects

NASA Technical Reports Server (NTRS)

Fallgatter, Cale (Inventor); Garrett, Tim (Inventor)

2014-01-01

Imaging of falling objects is described. Multiple images of a falling object can be captured substantially simultaneously using multiple cameras located at multiple angles around the falling object. An epipolar geometry of the captured images can be determined. The images can be rectified to parallelize epipolar lines of the epipolar geometry. Correspondence points between the images can be identified. At least a portion of the falling object can be digitally reconstructed using the identified correspondence points to create a digital reconstruction.

Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss

PubMed Central

Lacerda, Clara Fonseca; Silva, Luciana Oliveira e; de Tavares Canto, Roberto Sérgio; Cheik, Nadia Carla

2012-01-01

Summary Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS) and Functional Capacity (CF) and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. Conclusion: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss. PMID:25991930

An Energy-Efficient Multi-Tier Architecture for Fall Detection on Smartphones

PubMed Central

Guvensan, M. Amac; Kansiz, A. Oguz; Camgoz, N. Cihan; Turkmen, H. Irem; Yavuz, A. Gokhan; Karsligil, M. Elif

2017-01-01

Automatic detection of fall events is vital to providing fast medical assistance to the causality, particularly when the injury causes loss of consciousness. Optimization of the energy consumption of mobile applications, especially those which run 24/7 in the background, is essential for longer use of smartphones. In order to improve energy-efficiency without compromising on the fall detection performance, we propose a novel 3-tier architecture that combines simple thresholding methods with machine learning algorithms. The proposed method is implemented on a mobile application, called uSurvive, for Android smartphones. It runs as a background service and monitors the activities of a person in daily life and automatically sends a notification to the appropriate authorities and/or user defined contacts when it detects a fall. The performance of the proposed method was evaluated in terms of fall detection performance and energy consumption. Real life performance tests conducted on two different models of smartphone demonstrate that our 3-tier architecture with feature reduction could save up to 62% of energy compared to machine learning only solutions. In addition to this energy saving, the hybrid method has a 93% of accuracy, which is superior to thresholding methods and better than machine learning only solutions. PMID:28644378

Gait characteristics, balance performance and falls in ambulant adults with cerebral palsy: An observational study.

PubMed

Morgan, P; Murphy, A; Opheim, A; McGinley, J

2016-07-01

The relationship between spatiotemporal gait parameters, balance performance and falls history was investigated in ambulant adults with cerebral palsy (CP). Participants completed a single assessment of gait using an instrumented walkway at preferred and fast speeds, balance testing (Balance Evaluation Systems Test; BESTest), and reported falls history. Seventeen ambulatory adults with CP, mean age 37 years, participated. Gait speed was typically slow at both preferred and fast speeds (mean 0.97 and 1.21m/s, respectively), with short stride length and high cadence relative to speed. There was a significant, large positive relationship between preferred gait speed and BESTest total score (ρ=0.573; p<0.05) and fast gait speed and BESTest total score (ρ=0.647, p<0.01). The stride lengths of fallers at both preferred and fast speeds differed significantly from non-fallers (p=0.032 and p=0.025, respectively), with those with a prior history of falls taking shorter strides. Faster gait speed was associated with better performance on tests of anticipatory and postural response components of the BESTest, suggesting potential therapeutic training targets to address either gait speed or balance performance. Future exploration of the implications of slow walking speed and reduced stride length on falls and community engagement, and the potential prognostic value of stride length on identifying falls risk is recommended. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

In-hospital paediatric accidents: an integrative review of the literature.

PubMed

Da Rin Della Mora, R; Bagnasco, A; Sasso, L

2012-12-01

Paediatric hospitals can be perceived by children, parents, health professionals as 'safe' places, but accidents do occur. To review publications relating to in-hospital paediatric accidents and highlight the state-of-the-science concerning this issue especially in relation to falls, and the evolution of research addressing this issue. Integrative review of papers published before March 2011 on accidents and falls occurred in hospitalized children. Electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature and Cochrane Library databases) and further hand searching through references were searched. The inclusion criteria were articles involving observational, quasi-experimental or experimental studies in English or Italian. Exclusion criteria were articles addressing the outcomes of falls caused by suspect violence on children. Thirteen studies in English were included. Of the 13 studies conducted between 1963 and 2010, 10 had been conducted in the last 5 years; 10 in the USA. The studies were divided into two categories: contextualization and prevention of the 'accident' or 'fall' phenomenon (10 studies), and fall risk assessment (three studies). The most frequent type of design was observational explorative/descriptive. Several areas of investigation were explored (hazardous environment, children's characteristics correlated to accidents/falls, characteristics of the accidents/falls and their outcomes, paediatric fall risk factors and risk assessment tools, fall risk prevention programmes, parents' perceptions of accident/fall risks, etc.). No comparable methods were used to investigate the contextualization and prevention of the 'accident' and 'fall' phenomena; proposed fall risk assessment tools were not evaluated for their reliability and validity. Consensus would be needed around the approach to accidents in terms of: the definition of 'accident' and 'fall'; 'fall-related injury' and respective classifications; the frequency and rate calculation methods; the tools used to assess the risk of falls; and evidence-based practice aimed at preventing them. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program.

PubMed

Renfro, Mindy; Bainbridge, Donna B; Smith, Matthew Lee

2016-01-01

Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. Despite the limited number of participants ( n  = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more participants in diverse geographic regions with longer lengths of participation and follow-up.

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

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Discrete size optimization of steel trusses using a refined big bang-big crunch algorithm

NASA Astrophysics Data System (ADS)

Hasançebi, O.; Kazemzadeh Azad, S.

2014-01-01

This article presents a methodology that provides a method for design optimization of steel truss structures based on a refined big bang-big crunch (BB-BC) algorithm. It is shown that a standard formulation of the BB-BC algorithm occasionally falls short of producing acceptable solutions to problems from discrete size optimum design of steel trusses. A reformulation of the algorithm is proposed and implemented for design optimization of various discrete truss structures according to American Institute of Steel Construction Allowable Stress Design (AISC-ASD) specifications. Furthermore, the performance of the proposed BB-BC algorithm is compared to its standard version as well as other well-known metaheuristic techniques. The numerical results confirm the efficiency of the proposed algorithm in practical design optimization of truss structures.

A Method for Estimating Meteorite Fall Mass from Weather Radar Data

NASA Technical Reports Server (NTRS)

Laird, C.; Fries, M.; Matson, R.

2017-01-01

Techniques such as weather RADAR, seismometers, and all-sky cameras allow new insights concerning the physics of meteorite fall dynamics and fragmentation during "dark flight", the period of time between the end of the meteor's luminous flight and the concluding impact on the Earth's surface. Understanding dark flight dynamics enables us to rapidly analyze the characteristics of new meteorite falls. This analysis will provide essential information to meteorite hunters to optimize recovery, increasing the frequency and total mass of scientifically important freshly-fallen meteorites available to the scientific community. We have developed a mathematical method to estimate meteorite fall mass using reflectivity data as recorded by National Oceanic and Atmospheric Administration (NOAA) Next Generation RADAR (NEXRAD) stations. This study analyzed eleven official and one unofficial meteorite falls in the United States and Canada to achieve this purpose.

Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up.

PubMed

Eggenberger, Patrick; Theill, Nathan; Holenstein, Stefan; Schumacher, Vera; de Bruin, Eling D

2015-01-01

About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive-physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (-77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or trend). Long-term multicomponent cognitive-physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning.

FALL-BACK DISKS IN LONG AND SHORT GAMMA-RAY BURSTS

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

Cannizzo, J. K.; Troja, E.; Gehrels, N., E-mail: John.K.Cannizzo@nasa.gov

2011-06-10

We present time-dependent numerical calculations for fall-back disks relevant to gamma-ray bursts (GRBs) in which the disk of material surrounding the black hole powering the GRB jet modulates the mass flow and hence the strength of the jet. Given the initial existence of a small mass {approx}< 10{sup -4} M{sub sun} near the progenitor with a circularization radius {approx}10{sup 10}-10{sup 11} cm, an unavoidable consequence will be the formation of an 'external disk' whose outer edge continually moves to larger radii due to angular momentum transport and lack of a confining torque. For long GRBs, if the mass distribution inmore » the initial fall-back disk traces the progenitor envelope, then a radius {approx}10{sup 11} cm gives a timescale {approx}10{sup 4} s for the X-ray plateau. For late times t > 10{sup 7} s a steepening due to a cooling front in the disk may have observational support in GRB 060729. For short GRBs, one expects most of the mass initially to lie at small radii <10{sup 8} cm; however, the presence of even a trace amount {approx}10{sup -9} M{sub sun} of high angular material can give a brief plateau in the light curve. By studying the plateaus in the X-ray decay of GRBs, which can last up to {approx}10{sup 4} s after the prompt emission, Dainotti et al. find an apparent inverse relation between the X-ray luminosity at the end of the plateau and the duration of the plateau. We show that this relation may simply represent the fact that one is biased against detecting faint plateaus and therefore preferentially sampling the more energetic GRBs. If, however, there were a standard reservoir in fall-back mass, our model could reproduce the inverse X-ray luminosity-duration relation. We emphasize that we do not address the very steep, initial decays immediately following the prompt emission, which have been modeled by Lindner et al. as fall back of the progenitor core, and may entail the accretion of {approx}> 1 M{sub sun}.« less

Changing American Education. Recapturing the Past or Inventing the Future?

ERIC Educational Resources Information Center

Borman, Kathryn M., Ed.; Greenman, Nancy P., Ed.

This book examines the nature of comprehensive, large scale historical and social changes that contextualize educational reform, and it amplifies the meaning of lessons learned by those who have assisted in change efforts. It also examines how the rhetoric of educational change may fall short of the reality, as translated to processes and…

Measuring Instructional Interactions in Kindergarten Mathematics Classrooms through a Direct Observation System

ERIC Educational Resources Information Center

Doabler, Christian T.

2010-01-01

There is convincing evidence that many students struggle to learn mathematics proficiently. One plausible contributor to the low math achievement is the quantity and quality of learning opportunities provided in classrooms. These opportunities may fall short of addressing the learning needs of students, especially those at risk for failure in…

ANALYSIS OF COMPONENTS OF PARTICULATE MATTER (PM2.5) FOR AN EXPOSURE ASSESSMENT STUDY OF TWO SENSITIVE COHORTS IN ATLANTA, GA

EPA Science Inventory

Introduction
An exposure assessment study was conducted in Atlanta, GA during fall 1999 and spring 2000 to examine the short-term effects of exposure to particulate matter and gaseous air pollutants on heart rate variability (HRV). Characterization of particulate matter (PM...

Assessment in Higher Education: Drivers, Barriers and Directions for Change in the UK

ERIC Educational Resources Information Center

Medland, Emma

2016-01-01

Assessment is fundamental to student learning and achievement. However, whilst research consistently emphasises the role of assessment in supporting the development of the learner, the reality of assessment processes and practices in higher education is frequently indicated to fall someway short. This article aims to contribute to a shared…

State of Our Schools: America's K-12 Facilities 2016

ERIC Educational Resources Information Center

Filardo, Mary

2016-01-01

School facilities have a direct impact on student learning, student and staff health, and school finances. But too many students attend school facilities that fall short of providing 21st century learning environments because essential maintenance and capital improvements are underfunded. In this report, the author compiled and analyzed the best…

"Why Does Rain Fall?": Children Prefer to Learn from an Informant Who Uses Noncircular Explanations

ERIC Educational Resources Information Center

Corriveau, Kathleen H.; Kurkul, Katelyn E.

2014-01-01

These two studies explored 3- and 5-year-olds' evaluation of noncircular and circular explanations, and their use of such explanations to determine informant credibility. Although 5-year-olds demonstrated a selective preference for noncircular over circular explanations (Experiment 1: Long Explanations; Experiment 2: Short Explanations),…

Promoting Multicultural Competence: Diversity Training for Transition Professionals

ERIC Educational Resources Information Center

Lichtenstein, David; Lindstrom, Lauren; Povenmire-Kirk, Tiana

2008-01-01

As post-school outcomes for diverse students with disabilities continue to fall short of those of their majority-culture peers, there is an increasingly urgent need to increase multicultural competence among transition professionals. This study used a pre-/post-test measure to assess changes in multicultural competence for a statewide group of…

Mathematics in the K-8 Classroom and Library

ERIC Educational Resources Information Center

McKinney, Sueanne; Hinton, KaaVonia

2010-01-01

Two experts on education offer a rich and diverse selection of children's literature and teaching strategies for the K-8 mathematics classroom. To date, a vast majority of classrooms continue to fall short in the implementation and direction of NCTM Principles and Standards for School Mathematics (PSSM), in part because most of these classrooms…

Eight Conditions Influencing the Implementation of Educational Rights.

ERIC Educational Resources Information Center

Thomas, R. Murray

The extent to which claims to educational rights are actually fulfilled in a society depends on a variety of conditions. There are eight conditions that can contribute to a society's falling short in the implementation of those rights. The conditions include: (1) complacency--failure to take steps toward ensuring that the right is honored in…

A Short Course in Communication for Prison Personnel & Offenders. Final Report.

ERIC Educational Resources Information Center

Brandes, Paul D.; Frazier, Michael

The communication course presented in this document was developed as it was being offered at correctional centers throughout North Carolina from the fall of 1971 through the spring of 1976. The document contains 12 "encounters," or lessons, each of which discusses behavioral objectives, physical facilities, general advice, the time…

The Teacher as a Service Professional

ERIC Educational Resources Information Center

Myers, Donald A.

2008-01-01

The belief that teachers are professionals has become so pervasive during the past one third century that it is increasingly viewed as a fact. This article reviews the 13 characteristics of a profession advanced by sociologists of occupations, and it provides evidence that teachers fall far short of achieving them. However, it is noteworthy that…

Discrepancies Confer Vulnerability to Depressive Symptoms: A Three-Wave Longitudinal Study

ERIC Educational Resources Information Center

Sherry, Simon B.; Mackinnon, Sean P.; Macneil, Matthew A.; Fitzpatrick, Skye

2013-01-01

Discrepancies (i.e., a subjective sense of falling short of one's own standards) are a key part of the perfectionism construct. Theory suggests discrepancies confer vulnerability to depressive symptoms. Since most research in this area is cross-sectional, longitudinal research is needed to disentangle directionality of relationships and to permit…

A Model of Public Scholarship That Integrates Professional Skills into Graduate Education

ERIC Educational Resources Information Center

Knudson, Kandace M.; Gutstein, Joyce; Evans, Emily R.

2011-01-01

Graduate students education is falling short of what the twenty-first century demands from its next generation of leaders; indeed, many educational leaders and scholars have called for graduate education to include richer, more relevant experiences (Stanton & Wagner, 2006; Stewart, 2010; Walker, Jones, Bueschel, & Hutchings, 2008). At the…

Beyond Rhetoric: A Recipe for Civil Society Action on Literacy

ERIC Educational Resources Information Center

Tanvir, Mohammad Muntasim

2007-01-01

On the eve of CONFINTEA VI, discussion and debates on promoting literacy is being revived. However, in most cases, the discussion limits itself to the definitional nuances of literacy and falls short of critiquing the global policy making inertia that violates the human rights obligations to the millions of adults remaining illiterate. This…

A case for conserving imperiled plants by ecological area

Treesearch

Tony Povilitis

2001-01-01

Imperiled plants are sometimes protected as endangered or threatened species at state and national levels. However, politically based geographic units fall short for conservation purposes. For example, only 19 percent of plant species considered imperiled in the San Juan region of Colorado and New Mexico appeared on recent state or federal endangered species lists....

Psychologists and Families of the Severely Mentally Ill: The Role of Family Consultation.

ERIC Educational Resources Information Center

Bernheim, Kayla F.

1989-01-01

The needs of families of the mentally ill are being newly evaluated. While family burden remains a real concomitant of mental disorders, assistance from mental health professionals often falls short of family needs. Family consultation seeks to address these serious family problems. Issues for graduate psychology education are discussed. (AF)

The Wisconsin-Spencer Doctoral Research Program: An Evaluation

ERIC Educational Resources Information Center

Leonard, Mary; Fennema, Elizabeth

2008-01-01

Background/Context: At a time when educational research is recognized as capable of improving teaching and learning, it is under attack for falling short of this promise. Part of the solution lies in improving the preparation of educational researchers. Toward this goal, the UW-Madison School of Education (SOE) participated with the Spencer…

Use of Double-Loop Learning to Combat Advanced Persistent Threat: Multiple Case Studies

ERIC Educational Resources Information Center

Lamb, Christopher J.

2013-01-01

The Advanced Persistent Threat (APT) presents an ever present and more growing threat to organizations across the globe. Traditional Information Technology (IT) incident response falls short in effectively addressing this threat. This researcher investigated the use of single-loop and double-loop learning in two organizations with internal…

Factors Influencing Success of Conditionally Admitted Students in Graduate TESOL Programs

ERIC Educational Resources Information Center

Micek, Timothy A.; Kim, Soonhyang; Weinstein, Daniel A.

2012-01-01

Many graduate TESOL programs grapple with whether to admit applicants who fall short of meeting established admission criteria yet who show promise as future TESOL professionals. This study examined key characteristics affecting the success of candidates admitted conditionally to graduate TESOL programs. Participants were 21 students who had been…

Faculty Beliefs and Practices about Writing Initiatives as Classroom Strategies and Institutional Objectives

ERIC Educational Resources Information Center

Kreiger, Joan

2013-01-01

Employers consistently rank "writing skills" as a desired quality of college graduates; however studies show that students' writing skills often fall short of the mark (AAC& U, 2008; Charting the Future, 2006). Writing Across the Curriculum (WAC) initiatives are one way universities attempt to improve student writing and promote…

Viewpoint: The History Manifesto and the History of Science. Editor's Introduction.

PubMed

Cohen, H Floris

2016-06-01

This "Viewpoint" section takes up the question of what, if anything, historians of science can learn from The History Manifesto, initially published in the fall of 2014. One summary, two essay reviews, and nine short comments are followed by remarks by the authors of the manifesto, Jo Guldi and David Armitage.

Proposing a Knowledge Base for Teaching Academic Content to English Language Learners: Disciplinary Linguistic Knowledge

ERIC Educational Resources Information Center

Turkan, Sultan; De Oliveira, Luciana C.; Lee, Okhee; Phelps, Geoffrey

2014-01-01

Background/Context: The current research on teacher knowledge and teacher accountability falls short on information about what teacher knowledge base could guide preparation and accountability of the mainstream teachers for meeting the academic needs of ELLs. Most recently, research on specialized knowledge for teaching has offered ways to…

Focus. Volume 26, Number 2, Fall 2009

ERIC Educational Resources Information Center

Caspar, Emma, Ed.

2009-01-01

The purpose of "Focus" is to provide coverage of poverty-related research, events, and issues, and to acquaint a large audience with the work of the Institute for Research on Poverty by means of short essays on selected pieces of research. This issue contains the following articles: (1) Changing poverty and changing antipoverty policies…

Alternative Organization of Speech Perception Deficits in Children

ERIC Educational Resources Information Center

Gosy, Maria

2007-01-01

Children's first-language perception base takes shape gradually from birth onwards. Empirical research has confirmed that children may continue to fall short of age-based expectations in their speech perception. The purpose of this study was to assess the contribution of various perception processes in both reading and learning disabled children.…

Poverty, Disability, and Employment: Global Perspectives from the National Centre for Promotion of Employment for Disabled People

ERIC Educational Resources Information Center

Abidi, Javed; Sharma, Dorodi

2014-01-01

The worldwide problems of disability, poverty, and unemployment stem out of the interaction of multiple factors including social stigma, stereotypes, lack of access to physical infrastructure, information, and enabling environments. Given this, a singular approach toward tackling these interrelated issues falls short. This article attempts to…

Evidence Summary for H&R Block College Financial Aid Application Assistance. Top Tier Evidence Initiative

ERIC Educational Resources Information Center

Coalition for Evidence-Based Policy, 2012

2012-01-01

U.S. social programs, set up to address important problems, often fall short by funding specific models/strategies ("interventions") that are not effective. When evaluated in scientifically-rigorous studies, social interventions in K-12 education, job training, crime prevention, and other areas are frequently found ineffective or…

New Way to Break Down Barriers to Higher Education: Build "Financial Capabilities"

ERIC Educational Resources Information Center

Savage, Sarah; Graves, Erin M.

2015-01-01

Community colleges have traditionally responded to the financial needs of their students by removing or minimizing financial barriers to attending. Efforts to make community college tuition free fit with this philosophy, but where efforts to minimize or remove financial barriers to attending community college fall short is in empowering students…

Promoting Physical Activity for Students with Autism Spectrum Disorder: Barriers, Benefits, and Strategies for Success

ERIC Educational Resources Information Center

Menear, Kristi S.; Neumeier, William H.

2015-01-01

Many students with autism spectrum disorder (ASD) fall short of the recommended physical activity levels and experience challenges in physical activity and physical education settings. This article reviews factors that can improve the physical activity statistics of students with ASD, outlines the researched benefits of physical activity for…

Barriers to Career Success for Minority Researchers in the Behavioral Sciences

ERIC Educational Resources Information Center

Kameny, Rebecca R.; DeRosier, Melissa E.; Taylor, Lorraine C.; McMillen, Janey Sturtz; Knowles, Meagan M.; Pifer, Kimberly

2014-01-01

The United States falls short in the diversity of its scientific workforce. While the underrepresentation of minority researchers in the behavioral sciences has been a concern for several decades, policy and training initiatives have been only marginally successful in increasing their number. Diversity plays a critical role in our nation's…

A Phenomenological Examination of Perceived Skills and Concepts Necessary for Teaching Scientific Thinking

ERIC Educational Resources Information Center

Kapetanis, Ana Cristina

2011-01-01

The use of high stakes testing to improve educational outcomes falls short in many settings. Proposals for improvement include providing more opportunities for students to extend their thinking, gaining experience in the social nature of science, and learning how to interpret, explain, and justify results. This phenomenological qualitative project…

Factors Influencing the Quality of EHR Performance: An Exploratory Qualitative Study

ERIC Educational Resources Information Center

Rhodes, Harry B.

2016-01-01

A significant amount of evidence existed in support of the positive effect on the quality of healthcare that resulted from transitioning to electronic health information systems, equally compelling evidence suggests that the development process for electronic health information systems falls short of achieving its potential. The objective of this…

What Types of Students' Effort Are Rewarded with High Marks?

ERIC Educational Resources Information Center

Kelly, Sean

2008-01-01

This analysis of data from the Partnership for Literacy Study investigates the relationship among achievement, effort, and grades. Certainly, grades reward achievement, the mastery of material by students. Research has also suggested that grades are used to reward students for exerting effort to learn material, even if students fall short of…

Recommending Peers for Learning: Matching on Dissimilarity in Interpretations to Provoke Breakdown

ERIC Educational Resources Information Center

Rajagopal, Kamakshi; van Bruggen, Jan M.; Sloep, Peter B.

2017-01-01

People recommenders are a widespread feature of social networking sites and educational social learning platforms alike. However, when these systems are used to extend learners' Personal Learning Networks, they often fall short of providing recommendations of learning value to their users. This paper proposes a design of a people recommender based…

Child and Family Development Research. OPRE Report 2014-89

ERIC Educational Resources Information Center

Administration for Children & Families, 2014

2014-01-01

This catalog provides short descriptions of major Division of Child and Family Development (DCFD) projects from Fiscal Year 2014. Multiple projects are described in the areas of child care, Head Start/Early Head Start, child welfare promotion, and the recognition of cultural diversity. An additional section features projects that fall into more…

"Educate to Innovate": How the Obama Plan for STEM Education Falls Short. Backgrounder. No. 2504

ERIC Educational Resources Information Center

Burke, Lindsey M.; McNeill, Jena Baker

2011-01-01

President Obama's Educate to Innovate initiative has provided billions in additional federal funding for science, technology, engineering, and mathematics (STEM) education programs across the country. The Administration's recognition of the importance of STEM education-- for global competitiveness as well as for national security--is good and…

Management Education and Transformational Learning: The Integration of Mindfulness in an MBA Course

ERIC Educational Resources Information Center

Kuechler, William; Stedham, Yvonne

2018-01-01

Most management classes are taught by modified traditional techniques in which the acquisition of facts and rote skills is primary. However, traditional pedagogies fall short when the desired result is not inculcating knowledge about a subject, but rather constructively altering worldviews and behaviors. Leadership, ethics, strategic management,…

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…

Non-destructive detection of diapause in males of the western tarnished plant bug

USDA-ARS?s Scientific Manuscript database

Southern populations of the western tarnished plant bug, Lygus hesperus Knight, survive the late-fall and early-winter in adult diapause. Because this diapause is short, it is not clear how it integrates with other survival tactics to ensure overwintering survival of the population. Reports of exten...

Developing Leaders through Service at the University of Wisconsin-Whitewater

ERIC Educational Resources Information Center

Collet-Klingenberg, Lana L.; Hribar, Kelsy E.; Fenwick, Delaney K.

2015-01-01

First year learning community (LC) freshmen entering as education majors participated in year-long activities related to service learning and leadership development. Activities included fall cohort classes with shared content, a common read, and a spring seminar that included leadership learning, fund raising, and a short-term service project in…

Evidence Summary for New York City's Small Schools of Choice. Top Tier Evidence Initiative

ERIC Educational Resources Information Center

Coalition for Evidence-Based Policy, 2015

2015-01-01

U.S. social programs, set up to address important problems, often fall short by funding specific models/strategies ("interventions") that are not effective. When evaluated in scientifically-rigorous studies, social interventions in K-12 education, job training, crime prevention, and other areas are frequently found ineffective or…

Systemic Approach to Building 21st Century Schools: Experiences in the Aloha State

ERIC Educational Resources Information Center

Bingler, Steven B.; Kaneko, William M.; Oshima, Alan M.

2011-01-01

School districts throughout the country are suffering from aging schools, repair and maintenance backlogs, and budget short-falls. The result is insufficient government resources to ensure that students are provided adequate classrooms and facilities to enhance learning and student achievement. In Hawaii, the repair and maintenance backlog for…

Drama as a Tool in Interpretation: Practitioner Perceptions of Its Strengths & Limitations

ERIC Educational Resources Information Center

Adcock, Lynne; Ballantyne, Roy

2007-01-01

Although environmental and heritage interpretation aims to connect humans with their natural and cultural heritage, and has the potential to contribute to a vision of sustainable living, it often falls short of engaging and inspiring its audiences. Some interpreters advocate the use of artistic approaches to create more affective…

Reconciling (Seemingly) Discrepant Findings: Implications for Practice and Future Research

ERIC Educational Resources Information Center

Bowman, Nicholas A.; Herzog, Serge

2011-01-01

Decades of research in survey methodology and psychology have yielded important insights about how to create effective and valid survey instruments. As Porter (in press) has argued convincingly, college student surveys often fall well short of these standards by placing unrealistic demands on students' memory and by assuming that students readily…

An Examination of Superintendent Salaries and Compensation Packages in Kentucky

ERIC Educational Resources Information Center

Carroll, Lisa M.

2014-01-01

The salaries and compensation packages of women in the United States fall short of those to men holding similar employment positions. This study will look specifically at the salaries and compensation packages of current Kentucky school superintendents and investigate whether or not there exists discrepencies among them along gender lines. The…

An Analysis and Evaluation of Research in Cognition and Learning among Older Adults.

ERIC Educational Resources Information Center

Wass, Hannelore; Olejnik, Stephen F.

1983-01-01

Reviews research literature to determine implications for educational programs for elderly persons. Showed that, in general, researchers fall far short of providing useful information to practitioners in this field. Suggested that laboratory research on cognition and learning must be followed by research conducted in the actual educational…

Reframing Retention Strategy: A Focus on Promise

ERIC Educational Resources Information Center

Kalsbeek, David H.

2013-01-01

At every college and university, students enroll with expectations and aspirations about the kind of experience and the kind of outcomes that the institution delivers. When those expectations are met and exceeded, students are satisfied and likely to remain committed to their college choice. When their experience falls short of their expectations,…

Reaching Out: Best Practices for Educating Mexican-Origin Children and Youth.

ERIC Educational Resources Information Center

Romo, Harriett D.

School systems in the United States are not serving Latino students well, especially those from low-income families. This book examines difficulties encountered by Mexican-origin students--one of the fastest growing minority groups--and describes why some schools fall short and how others have improved student outcomes. The focus throughout the…

Criteria for Evaluating Interventions

ERIC Educational Resources Information Center

Miles, T. R.

2007-01-01

By common consent there is a "gold standard" in reference to which the efficacy of medical interventions needs to be evaluated. It is suggested in this paper that in educational research achievement of this gold standard is rarely possible. It does not follow, however, that research that falls short of this standard is therefore valueless; there…

Education Pipeline. Forum Focus. Volume 2, Issue 4, September-October 2004

ERIC Educational Resources Information Center

Yohalem, Nicole; Joselowsky, Francine; Allen, Lili

2004-01-01

While the nation's public systems continue to fall short of delivering equitable educational supports to children and youth, youth workers have spent the last several decades insulating and, in some cases, patching the leaks in the "education pipeline"--a term describing the route students follow from early childhood through…

Stewards of the Word: Employing Oral Examinations in Required Theology Courses

ERIC Educational Resources Information Center

Crist, Joan Frances; Robinson, Kirk

2015-01-01

College graduates are falling short in oral communication skills, yet these skills are important for employment and for effective civic engagement. Catholic colleges and universities are well suited to revive sustained attention to the development and assessment of oral communication skills in today's higher education context. We can do this by…

Teachers Developing Exemplary Inquiry Practices: Three Longitudinal Case Studies

ERIC Educational Resources Information Center

Sweetman, Sara Berry

2013-01-01

If students are to be successful in the ever-changing scientific world they need to be taught how to think critically, to manipulate materials, and to gather evidence to build knowledge. Most teachers fall short in providing students the inquiry instruction described in the Next Generation Science Frameworks (National Research Council, 2011). This…

Changing Our Minds: The Struggle To Generate a Humanistic Neuroscience Language through Metaphors from Quantum Physics.

ERIC Educational Resources Information Center

Liston, Delores D.

While the physiological explanations from neuroscience help explain the mechanisms of learning, they fall short of explaining the sociocultural and phenomenological factors that determine a stressful versus a challenging interpretation of experience. For this reason, neuroscience seems less than useful to classroom teachers. A major obstacle in…

California System Development: Peat Marwick Study Pegs Shortcomings

ERIC Educational Resources Information Center

Savage, Noel

1975-01-01

A recent study says that the state hasn't been giving public library systems enough money, that system development has lacked coordination and system planning falls far short of the mark, that interlibrary loan and reference service take too much time and are too costly, and that system personnel need more training. (Author/PF)

A Critical Policy Analysis of Texas' "Closing the Gaps 2015"

ERIC Educational Resources Information Center

Mansfield, Katherine Cumings; Thackik, Stefani Leigh

2016-01-01

This critical policy analysis uses critical race theory to provide a counter narrative to the P-16 initiative in Texas known as "Closing the Gaps 2015". Findings indicate that while these reforms aim to increase educational access and achievement for people of color, they fall short of addressing systemic inequities such as enduring…

Impact Measures for a Marketing Intervention Strategy at a Two-Year College.

ERIC Educational Resources Information Center

Donsky, Aaron P.; And Others

In fall 1983, Dutchess Community College (DCC), Poughkeepsie, New York, implemented a strategic planning process which ultimately resulted in the development of short- and long-range marketing plans. The initial marketing approach began in spring 1985 and was directed toward a pilot project to affect summer 1985 enrollments utilizing a market…

From Personal to Social: Learning Environments that Work

ERIC Educational Resources Information Center

Camacho, Mar; Guilana, Sonia

2011-01-01

VLE (Virtual Learning Environments) are rapidly falling short to meet the demands of a networked society. Web 2.0 and social networks are proving to offer a more personalized, open environment for students to learn formally as they are already doing informally. With the irruption of social media into society, and therefore, education, many voices…

Moral Education: The Missing Link to Science, Technology and Society Programs.

ERIC Educational Resources Information Center

Zeidler, Dana Lewis

Progressive approaches to science education incorporate a social dimension based on an interdisciplinary curriculum. The importance of such an approach has been recognized by educators and many science-techonology-society (STS) programs have been developed as a response to this social need. However, such programs may fall short of their mark…

Towards a truer multicultural science education: how whiteness impacts science education

NASA Astrophysics Data System (ADS)

Le, Paul T.; Matias, Cheryl E.

2018-03-01

The hope for multicultural, culturally competent, and diverse perspectives in science education falls short if theoretical considerations of whiteness are not entertained. Since whiteness is characterized as a hegemonic racial dominance that has become so natural it is almost invisible, this paper identifies how whiteness operates in science education such that it falls short of its goal for cultural diversity. Because literature in science education has yet to fully entertain whiteness ideology, this paper offers one of the first theoretical postulations. Drawing from the fields of education, legal studies, and sociology, this paper employs critical whiteness studies as both a theoretical lens and an analytic tool to re-interpret how whiteness might impact science education. Doing so allows the field to reconsider benign, routine, or normative practices and protocol that may influence how future scientists of Color experience the field. In sum, we seek to have the field consider the theoretical frames of whiteness and how it might influence how we engage in science education such that our hope for diversity never fully materializes.

The Significance of Macrocephaly or Enlarging Head Circumference in Infants With the Triad

PubMed Central

Miller, David; Barnes, Patrick; Miller, Marvin

2015-01-01

Abstract Infants with the triad (neurologic dysfunction, subdural hematoma [SDH], and retinal hemorrhage) are often diagnosed as victims of shaken baby syndrome. Medical conditions/predisposing factors to developing the triad are often dismissed: short falls, birth-related SDH that enlarges, macrocephaly, sinus/cortical vein thrombosis, and others. Six infants with the triad are described in which child abuse was diagnosed, but parents denied wrongdoing. All 6 had either macrocephaly or enlarging head circumference, which suggested medical explanations. Three infants incurred short falls, 1 had a difficult delivery in which there was likely a rebleed of a birth-related SDH, 1 had a spontaneous SDH associated with increased extra-axial fluid spaces, and 1 had a sinus thrombosis. Following legal proceedings, all 6 infants were returned to their parents, and there has been no child maltreatment in follow-up, suggesting child abuse never happened. The results indicate that alternative medical explanations for causing the triad should be considered and that macrocephaly or an enlarging head circumference raises the possibility of a medical explanation. PMID:25893912

Short-Term Memory for Space and Time Flexibly Recruit Complementary Sensory-Biased Frontal Lobe Attention Networks.

PubMed

Michalka, Samantha W; Kong, Lingqiang; Rosen, Maya L; Shinn-Cunningham, Barbara G; Somers, David C

2015-08-19

The frontal lobes control wide-ranging cognitive functions; however, functional subdivisions of human frontal cortex are only coarsely mapped. Here, functional magnetic resonance imaging reveals two distinct visual-biased attention regions in lateral frontal cortex, superior precentral sulcus (sPCS) and inferior precentral sulcus (iPCS), anatomically interdigitated with two auditory-biased attention regions, transverse gyrus intersecting precentral sulcus (tgPCS) and caudal inferior frontal sulcus (cIFS). Intrinsic functional connectivity analysis demonstrates that sPCS and iPCS fall within a broad visual-attention network, while tgPCS and cIFS fall within a broad auditory-attention network. Interestingly, we observe that spatial and temporal short-term memory (STM), respectively, recruit visual and auditory attention networks in the frontal lobe, independent of sensory modality. These findings not only demonstrate that both sensory modality and information domain influence frontal lobe functional organization, they also demonstrate that spatial processing co-localizes with visual processing and that temporal processing co-localizes with auditory processing in lateral frontal cortex. Copyright © 2015 Elsevier Inc. All rights reserved.

Local Stability of the Trunk in Patients with Degenerative Cerebellar Ataxia During Walking.

PubMed

Chini, Giorgia; Ranavolo, Alberto; Draicchio, Francesco; Casali, Carlo; Conte, Carmela; Martino, Giovanni; Leonardi, Luca; Padua, Luca; Coppola, Gianluca; Pierelli, Francesco; Serrao, Mariano

2017-02-01

This study aims to evaluate trunk local stability in a group of patients with degenerative primary cerebellar ataxia and to correlate it with spatio-temporal parameters, clinical variables, and history of falls. Sixteen patients affected by degenerative cerebellar ataxia and 16 gender- and age-matched healthy adults were studied by means of an inertial sensor to measure trunk kinematics and spatio-temporal parameters during over-ground walking. Trunk local dynamic stability was quantified by the maximum Lyapunov exponent with short data series of the acceleration data. According to this index, low values indicate more stable trunk dynamics, while high values denote less stable trunk dynamics. Disease severity was assessed by means of International Cooperative Ataxia Rating Scale (ICARS) according to which higher values correspond to more severe disease, while lower values correspond to less severe disease.Patients displayed a higher short-term maximum Lyapunov exponent than controls in all three spatial planes, which was correlated with the age, onset of the disease, and history of falls. Furthermore, the maximum Lyapunov exponent was negatively correlated with ICARS balance, ICARS posture, and ICARS total scores.These findings indicate that trunk local stability during gait is lower in patients with cerebellar degenerative ataxia than that in healthy controls and that this may increase the risk of falls. Local dynamic stability of the trunk seems to be an important aspect in patients with ataxia and could be a useful tool in the evaluation of rehabilitative and pharmacological treatment outcomes.

Soil Nutrient Responses to Disturbance in a Northern Temperate Forest: The Influence of an Ice Storm Manipulation Experiment on Belowground Biogeochemical Cycling

NASA Astrophysics Data System (ADS)

Weitzman, J. N.; Groffman, P.

2017-12-01

Temperate forest ecosystems are increasingly impacted by human-induced changes in climate, which have the ability to alter the prevalence, severity, and extent of extreme weather events. Ice storms, an example of such extreme events, tend to be rarer and often occur as localized events, making them difficult to predict. As such, their impacts on ecosystem structure and functioning are poorly understood. We utilized a field manipulation experiment that effectively simulated natural ice storms of varying intensities to mechanistically understand the short-term nitrogen (N) responses to such extreme weather events. Net N mineralization and nitrification were quantified for both the organic and mineral soil horizons via 30-day in situ incubations of intact soil cores, while gross N transformations were measured in short-term laboratory incubations using the 15N pool dilution technique. Net C mineralization and N and C microbial biomass were also measured on disturbed soil cores via the chloroform fumigation incubation method. All microbial transformation measurements were carried out in the fall of the pre-treatment year (2015), and the spring and fall of the post-treatment years (2016 and 2017). We found that the availability of inorganic N to the microbial community did not significantly change immediately following the simulated ice storms. Over longer time-scales, however, we expect that N loss (mineralization, nitrification, denitrification) and conservation (immobilization) processes will be controlled more by the flow and availability of labile C from newly decaying fine and coarse woody debris that was dropped immediately following the ice storm. We hypothesize that the forested ecosystem is now in a state of N oligotrophy, and thus less likely to show any N response to disturbance in the short-term. This suggests that recovery of the forest over the long-term may be slower than that observed following a natural ice storm event that took place in 1998 in the same forest, when N transformations appeared to change more in response to disturbance (i.e. there seemed to be a decrease in plant uptake of inorganic N in response to canopy loss).

Soil Nutrient Responses to Disturbance in a Northern Temperate Forest: The Influence of an Ice Storm Manipulation Experiment on Belowground Biogeochemical Cycling

NASA Astrophysics Data System (ADS)

Wiley, E.; King, C.; Richardson, A. D.; Landhäusser, S.

2016-12-01

Temperate forest ecosystems are increasingly impacted by human-induced changes in climate, which have the ability to alter the prevalence, severity, and extent of extreme weather events. Ice storms, an example of such extreme events, tend to be rarer and often occur as localized events, making them difficult to predict. As such, their impacts on ecosystem structure and functioning are poorly understood. We utilized a field manipulation experiment that effectively simulated natural ice storms of varying intensities to mechanistically understand the short-term nitrogen (N) responses to such extreme weather events. Net N mineralization and nitrification were quantified for both the organic and mineral soil horizons via 30-day in situ incubations of intact soil cores, while gross N transformations were measured in short-term laboratory incubations using the 15N pool dilution technique. Net C mineralization and N and C microbial biomass were also measured on disturbed soil cores via the chloroform fumigation incubation method. All microbial transformation measurements were carried out in the fall of the pre-treatment year (2015), and the spring and fall of the post-treatment years (2016 and 2017). We found that the availability of inorganic N to the microbial community did not significantly change immediately following the simulated ice storms. Over longer time-scales, however, we expect that N loss (mineralization, nitrification, denitrification) and conservation (immobilization) processes will be controlled more by the flow and availability of labile C from newly decaying fine and coarse woody debris that was dropped immediately following the ice storm. We hypothesize that the forested ecosystem is now in a state of N oligotrophy, and thus less likely to show any N response to disturbance in the short-term. This suggests that recovery of the forest over the long-term may be slower than that observed following a natural ice storm event that took place in 1998 in the same forest, when N transformations appeared to change more in response to disturbance (i.e. there seemed to be a decrease in plant uptake of inorganic N in response to canopy loss).

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance

PubMed Central

Collado-Mateo, D.; Gallego-Diaz, J. M.; Adsuar, J. C.; Domínguez-Muñoz, F. J.; Olivares, P. R.; Gusi, N.

2015-01-01

Objective. To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. Methods. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Results. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. Conclusion. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance. PMID:26618173

Medical Student Teaching and Recruiting: 50 Years of Balancing Two Educational Aims.

PubMed

Schneider, Benjamin N; Chessman, Alexander; Toffler, William; Handler, Lara; Steiner, Beat; Biagioli, Frances Emily

2017-04-01

Family medicine (FM) undergraduate medical educators have had two distinct missions, to increase the knowledge, skills, and attitudes of all students while also striving to attract students to the field of family medicine. A five decade literature search was conducted gathering FM curricular innovations and the parallel trends in FM medical student interest. Student interest in FM had a rapid first-decade rise to 14%, a second 1990's surge, followed by a drop to the current plateau of 8-9%. This falls far short of the 30-50% generalist benchmark needed to fill the country's health care needs. Curricular innovations fall into three periods: Charismatic Leaders & Clinical Exposures (1965-1978), Creation of Clerkships of FM (1979-1998) and Curricular Innovations (1998-present). There is good evidence that having a required third-year clerkship positively impacts student interest in the field, however there is little research regarding the recruitment impact of specific clerkship curricula. Other tools associated with student interest include programming geared towards primary care or rural training and extracurricular opportunities such as FM Interest Groups. Strategic plans to improve the primary care work force should focus funding and legislative efforts on effective methods such as: establishing and maintaining FM clerkships, admitting students with rural and underserved backgrounds or primary care interest, developing longitudinal primary care tracks, and supporting extracurricular FM activities. Rigorous research is needed to assess how best to utilize limited educational resources to ensure that all students graduate with a core set of FM competence as well as an increased FM matriculation. Strategic plans to improve the primary care work force should focus funding and legislative efforts on effective methods such as: establishing and maintaining FM clerkships, admitting students with rural and underserved backgrounds or primary care interest, developing longitudinal primary care tracks, and supporting extracurricular FM activities. Rigorous research is needed to assess how best to utilize limited educational resources to ensure that all students graduate with a core set of FM competence as well as an increased FM matriculation. st in FM had a rapid first-decade rise to 14%, a second 1990's surge, followed by a drop to the current plateau of 8-9%. This falls far short of the 30-50% generalist benchmark needed to fill the country's healthcare needs. Curricular innovations fall into three periods: Charismatic Leaders & Clinical Exposures (1965-1978), Creation of Clerkships of FM (1979-1998) and Curricular Innovations (1998 - present). There is good evidence that having a required third-year clerkship positively impacts student interest in the field, however there is little research regarding the recruitment impact of specific clerkship curricula. Other tools associated with student interest include programming geared towards primary care or rural training and extracurricular opportunities such as FM Interest Groups. Strategic plans to improve the primary care work force should focus funding and legislative efforts on effective methods such as: establishing and maintaining FM clerkships, admitting students with rural and underserved backgrounds or primary care interest, developing longitudinal primary care tracks, and supporting extracurricular FM activities. Rigorous research is needed to assess how best to utilize limited educational resources to ensure that all students graduate with a core set of FM competence as well as an increased FM matriculation.

Prevalence of falls in elderly women

PubMed Central

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

2015-01-01

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

Building better healthcare facilities through evidence-based design: breaking new ground at Vancouver Island Health Authority.

PubMed

Waldner, Howard; Johnson, Bart; Sadler, Blair

2012-01-01

Many of today's healthcare facilities were constructed at least 50 years ago, and a growing number have outlived their useful lives. Despite renovations and renewals, they often fall short of providing an appropriate care setting. Clinicians and staff develop a mixture of compromises and workarounds simply to make things function. Evidence-based design principles are often absent from new healthcare facilities, perhaps because of lack of awareness of the principles or because implementing them may fall foul of short-term and short-sighted budgetary decisions. In planning a new healthcare facility in 2008, the executive team at Vancouver Island Health Authority decided to adopt the evidence-based design approach. They conducted site visits to newly constructed hospitals across North America and beyond, to determine best practices in terms of design and construction. These engagements resulted in the implementation of 102 evidence-based design principles and attributes in Victoria's Royal Jubilee hospital, a 500-bed Patient Care Centre. This $350M project was completed on time and on budget, showing that using evidence need not result in delays or higher costs. To date, the results of the evidence-based design are promising, with accolades coming from patients, staff and clinical partners, and a number of immediate and practical benefits for patients, families and care teams alike. Copyright © 2012 Longwoods Publishing.

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

PubMed

1987-04-01

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

Distribution and timing of thick transient air-fall deposits in Electris: Implications for the nature of the upland plains

NASA Technical Reports Server (NTRS)

Grant, J. A.; Schultz, P. H.

1987-01-01

A large area in the Electris region of Mars is (or once was) covered by an unconformable and etched deposit. Although interpreted as lava filling volcano-tectonic depressions or fluvial deposits filling large degraded craters, more recent work has shown the deposit is more likely the result of air-fall deposition. Crater densities on both the surface of the deposit and on exhumed, underlying ridged plains indicate that the deposit was emplaced and eroded over a relatively short time. These crater statistics also demonstate that the relative age of the Electris deposit is similar to those obtained for other unconformable deposits, thereby suggesting they may be related.

Comparison of real-life accidental falls in older people with experimental falls in middle-aged test subjects.

PubMed

Kangas, M; Vikman, I; Nyberg, L; Korpelainen, R; Lindblom, J; Jämsä, T

2012-03-01

Falling is a common accident among older people. Automatic fall detectors are one method of improving security. However, in most cases, fall detectors are designed and tested with data from experimental falls in younger people. This study is one of the first to provide fall-related acceleration data obtained from real-life falls. Wireless sensors were used to collect acceleration data during a six-month test period in older people. Data from five events representing forward falls, a sideways fall, a backwards fall, and a fall out of bed were collected and compared with experimental falls performed by middle-aged test subjects. The signals from real-life falls had similar features to those from intentional falls. Real-life forward, sideways and backward falls all showed a pre impact phase and an impact phase that were in keeping with the model that was based on experimental falls. In addition, the fall out of bed had a similar acceleration profile as the experimental falls of the same type. However, there were differences in the parameters that were used for the detection of the fall phases. The beginning of the fall was detected in all of the real-life falls starting from a standing posture, whereas the high pre impact velocity was not. In some real-life falls, multiple impacts suggested protective actions. In conclusion, this study demonstrated similarities between real-life falls of older people and experimental falls of middle-aged subjects. However, some fall characteristics detected from experimental falls were not detectable in acceleration signals from corresponding heterogeneous real-life falls. Copyright © 2011 Elsevier B.V. All rights reserved.

Older people's experiences of therapeutic exercise as part of a falls prevention service: survey findings from England, Wales and Northern Ireland.

PubMed

Buttery, Amanda K; Husk, Janet; Lowe, Derek; Treml, Jonathan; Vasilakis, Naomi; Riglin, Jackie

2014-05-01

falling, and fear of falling, significantly affect older people and their lifestyle resulting in loss of confidence, restriction of activity and deteriorating quality of life. Multi-factorial assessment and active participation in an evidence-based exercise programme are key interventions to prevent and manage falls. to examine older people's experiences of therapeutic exercise as part of a falls prevention service in NHS Trusts in England, Wales and Northern Ireland. a cross-sectional survey targeted patients and staff members delivering exercise interventions for reducing falls. A multi-disciplinary group including patient and staff representatives developed a 20-item patient questionnaire and a 12-item staff questionnaire that were distributed to 94 NHS Trusts (113 participating sites within the NHS Trusts) in October 2011. response was 57% for the patient sample and 88% for the staff sample. The median (IQR) age of patients was 82 (77-86) years. 72% were women. Two-thirds reported attending group-based therapeutic exercise classes generally of short duration (80% <12 weeks) and low intensity (85% one class per week) at hospitals and community venues. Balance and strength exercises were prescribed; 68% reported using resistance equipment such as ankle weights and/or exercise band. Only 52% reported exercises were made more difficult as they improved. However, patient satisfaction levels were high (95% satisfied or very satisfied). Patients and staff reported limited availability of strength and balance follow-up classes. despite high levels of patient satisfaction therapeutic exercise provision was limited and implementation of evidence-based exercise interventions by healthcare providers is incomplete and varies widely. Patients and staff wanted greater availability of long-term exercise services for falls prevention.

How Accurately Can Your Wrist Device Recognize Daily Activities and Detect Falls?

PubMed Central

Gjoreski, Martin; Gjoreski, Hristijan; Luštrek, Mitja; Gams, Matjaž

2016-01-01

Although wearable accelerometers can successfully recognize activities and detect falls, their adoption in real life is low because users do not want to wear additional devices. A possible solution is an accelerometer inside a wrist device/smartwatch. However, wrist placement might perform poorly in terms of accuracy due to frequent random movements of the hand. In this paper we perform a thorough, large-scale evaluation of methods for activity recognition and fall detection on four datasets. On the first two we showed that the left wrist performs better compared to the dominant right one, and also better compared to the elbow and the chest, but worse compared to the ankle, knee and belt. On the third (Opportunity) dataset, our method outperformed the related work, indicating that our feature-preprocessing creates better input data. And finally, on a real-life unlabeled dataset the recognized activities captured the subject’s daily rhythm and activities. Our fall-detection method detected all of the fast falls and minimized the false positives, achieving 85% accuracy on the first dataset. Because the other datasets did not contain fall events, only false positives were evaluated, resulting in 9 for the second, 1 for the third and 15 for the real-life dataset (57 days data). PMID:27258282

Evaluation of function, performance, and preference as transfemoral amputees transition from mechanical to microprocessor control of the prosthetic knee.

PubMed

Hafner, Brian J; Willingham, Laura L; Buell, Noelle C; Allyn, Katheryn J; Smith, Douglas G

2007-02-01

To evaluate differences in function, performance, and preference between mechanical and microprocessor prosthetic knee control technologies. A-B-A-B reversal design. Home, community, and laboratory environments. Twenty-one unilateral, transfemoral amputees. Mechanical control prosthetic knee versus microprocessor control prosthetic knee (Otto Bock C-Leg). Stair rating, hill rating and time, obstacle course time, divided attention task accuracy and time, Amputee Mobility Predictor score, step activity, Prosthesis Evaluation Questionnaire score, Medical Outcomes Study 36-Item Short-Form Health Survey score, self-reported frequency of stumbles and falls, and self-reported concentration required for ambulation. Stair descent score, hill descent time, and hill sound-side step length showed significant (P<.01) improvement with the C-Leg. Users reported a significant (P<.05) decrease in frequency of stumbles and falls, frustration with falling, and difficulty in multitasking while using the microprocessor knee. Subject satisfaction with the C-Leg was significantly (P<.001) greater than the mechanical control prosthesis. The study population showed improved performance when negotiating stairs and hills, reduced frequency of stumbling and falling, and a preference for the microprocessor control C-Leg as compared with the mechanical control prosthetic knee.

Factors inducing falling in schizophrenia patients

PubMed Central

Tsuji, Yoko; Akezaki, Yoshiteru; Mori, Kohei; Yuri, Yoshimi; Katsumura, Hitomi; Hara, Tomihiro; Usui, Yuki; Fujino, Yoritaka; Nomura, Takuo; Hirao, Fumio

2017-01-01

[Purpose] The purpose of this study is to investigate the factors causing falling among patients with schizophrenia hospitalized in psychiatric hospitals. [Subjects and Methods] The study subjects were divided into either those having experienced a fall within the past one year (Fall group, 12 patients) and those not having experienced a fall (Non-fall group, 7 patients), and we examined differences between the two groups. Assessment items measured included muscle strength, balance ability, flexibility, body composition assessment, Global Assessment of Functioning scale (GAF), the antipsychotic drug intake, and Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS). [Results] As a result, significant differences were observed in regard to One leg standing time with eyes open, Time Up and Go Test (TUGT), and DIEPSS Sialorrhea between the Fall group and the Non-fall group. [Conclusion] These results suggest that a decrease in balance ability was significantly correlated with falling in schizophrenia patients. PMID:28356628

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

PubMed Central

2013-01-01

Background With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Methods/Design Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale – International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version ('3 times 3’) that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period. Discussion It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose–response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention. Trial registration ClinicalTrials.gov Identifier: NCT01906034 PMID:24106864

Worldwide Weather Radar Imagery May Allow Substantial Increase in Meteorite Fall Recovery

NASA Technical Reports Server (NTRS)

Fries, Marc; Matson, Robert; Schaefer, Jacob; Fries, Jeffery; Hankey, Mike; Anderson, Lindsay

2014-01-01

Weather radar imagery is a valuable new technique for the rapid recovery of meteorite falls, to include falls which would not otherwise be recovered (e.g. Battle Mountain). Weather radar imagery reveals about one new meteorite fall per year (18 falls since 1998), using weather radars in the United States alone. However, an additional 75 other nations operate weather radar networks according to the UN World Meteorological Organization (WMO). If the imagery of those radars were analyzed, the current rate of meteorite falls could be improved considerably, to as much as 3.6 times the current recovery rate based on comparison of total radar areal coverage. Recently, the addition of weather radar imagery, seismometry and internet-based aggregation of eyewitness reports has improved the speed and accuracy of fresh meteorite fall recovery [e.g. 1,2]. This was demonstrated recently with the radar-enabled recovery of the Sutter's Mill fall [3]. Arguably, the meteorites recovered via these methods are of special scientific value as they are relatively unweathered, fresh falls. To illustrate this, a recent SAO/NASA ADS search using the keyword "meteorite" shows that all 50 of the top search results included at least one named meteorite recovered from a meteorite fall. This is true even though only 1260 named meteorite falls are recorded among the >49,000 individual falls recorded in the Meteoritical Society online database. The US NEXRAD system used thus far to locate meteorite falls covers most of the United States' surface area. Using a WMO map of the world's weather radars, we estimate that the total coverage of the other 75 national weather radar networks equals about 3.6x NEXRAD's coverage area. There are two findings to draw from this calculation: 1) For the past 16 years during which 18 falls are seen in US radar data, there should be an additional 65 meteorite falls recorded in worldwide radar imagery. Also: 2) if all of the world's radar data could be analyzed, the rate of recovery of fresh meteorite falls can increase by as much as 3.6x the current rate. The authors' experience to date indicates that the most effective course of action would be to have local meteorite research groups (outside of the US) form research consortia and develop a working relationship with their nation's weather bureau for access to data. These research consortia could utilize the same, proven methods used for US NEXRAD imagery, internet eyewitness report aggregation, seismometry analysis, etc. to locate meteorite falls. The consortia could then recover and analyze meteorite falls and enrich their own research efforts. It would be beneficial to conduct a global program to coordinate the development of methods and data tools, as well as to coordinate meteorite sample sharing and research. Perhaps an institution such as the Meteoritical Society could lead such an effort.

3D-resolved fluorescence and phosphorescence lifetime imaging using temporal focusing wide-field two-photon excitation

PubMed Central

Choi, Heejin; Tzeranis, Dimitrios S.; Cha, Jae Won; Clémenceau, Philippe; de Jong, Sander J. G.; van Geest, Lambertus K.; Moon, Joong Ho; Yannas, Ioannis V.; So, Peter T. C.

2012-01-01

Fluorescence and phosphorescence lifetime imaging are powerful techniques for studying intracellular protein interactions and for diagnosing tissue pathophysiology. While lifetime-resolved microscopy has long been in the repertoire of the biophotonics community, current implementations fall short in terms of simultaneously providing 3D resolution, high throughput, and good tissue penetration. This report describes a new highly efficient lifetime-resolved imaging method that combines temporal focusing wide-field multiphoton excitation and simultaneous acquisition of lifetime information in frequency domain using a nanosecond gated imager from a 3D-resolved plane. This approach is scalable allowing fast volumetric imaging limited only by the available laser peak power. The accuracy and performance of the proposed method is demonstrated in several imaging studies important for understanding peripheral nerve regeneration processes. Most importantly, the parallelism of this approach may enhance the imaging speed of long lifetime processes such as phosphorescence by several orders of magnitude. PMID:23187477

Bio-, Magneto- and event-stratigraphy across the K-T boundary

NASA Technical Reports Server (NTRS)

Preisinger, A.; Stradner, H.; Mauritsch, H. J.

1988-01-01

Determining the time and the time structure of rare events in geology can be accomplished by applying three different and independent stratigraphic methods: Biostratigraphy, magneto-stratigraphy and event-stratigraphy. The optimal time resolution of the two former methods is about 1000 years, while by means of event-stratigraphy a resolution of approximately one year can be achieved. For biostratigraphy across the Cretaceous-Tertiary (K-T) boundary micro- and nannofossils have been found best suited. The qualitative and quantitative analyses of minerals and trace elements across the K-T boundary show anomalies on a millimeter scale and permit conclusions regarding the time structure of the K-T event itself. The results of the analyses find a most consistent explanation by the assumption of an extraterrestrial impact. The main portion of the material rain from the atmosphere evidently was deposited within a short time. The long-time components consist of the finest portion of the material rain from the atmosphere and the transported and redeposited fall-out.

A new simple technique for improving the random properties of chaos-based cryptosystems

NASA Astrophysics Data System (ADS)

Garcia-Bosque, M.; Pérez-Resa, A.; Sánchez-Azqueta, C.; Celma, S.

2018-03-01

A new technique for improving the security of chaos-based stream ciphers has been proposed and tested experimentally. This technique manages to improve the randomness properties of the generated keystream by preventing the system to fall into short period cycles due to digitation. In order to test this technique, a stream cipher based on a Skew Tent Map algorithm has been implemented on a Virtex 7 FPGA. The randomness of the keystream generated by this system has been compared to the randomness of the keystream generated by the same system with the proposed randomness-enhancement technique. By subjecting both keystreams to the National Institute of Standards and Technology (NIST) tests, we have proved that our method can considerably improve the randomness of the generated keystreams. In order to incorporate our randomness-enhancement technique, only 41 extra slices have been needed, proving that, apart from effective, this method is also efficient in terms of area and hardware resources.

Comparative systems biology between human and animal models based on next-generation sequencing methods.

PubMed

Zhao, Yu-Qi; Li, Gong-Hua; Huang, Jing-Fei

2013-04-01

Animal models provide myriad benefits to both experimental and clinical research. Unfortunately, in many situations, they fall short of expected results or provide contradictory results. In part, this can be the result of traditional molecular biological approaches that are relatively inefficient in elucidating underlying molecular mechanism. To improve the efficacy of animal models, a technological breakthrough is required. The growing availability and application of the high-throughput methods make systematic comparisons between human and animal models easier to perform. In the present study, we introduce the concept of the comparative systems biology, which we define as "comparisons of biological systems in different states or species used to achieve an integrated understanding of life forms with all their characteristic complexity of interactions at multiple levels". Furthermore, we discuss the applications of RNA-seq and ChIP-seq technologies to comparative systems biology between human and animal models and assess the potential applications for this approach in the future studies.

Eye Gaze Tracking using Correlation Filters

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

Karakaya, Mahmut; Boehnen, Chris Bensing; Bolme, David S

In this paper, we studied a method for eye gaze tracking that provide gaze estimation from a standard webcam with a zoom lens and reduce the setup and calibration requirements for new users. Specifically, we have developed a gaze estimation method based on the relative locations of points on the top of the eyelid and eye corners. Gaze estimation method in this paper is based on the distances between top point of the eyelid and eye corner detected by the correlation filters. Advanced correlation filters were found to provide facial landmark detections that are accurate enough to determine the subjectsmore » gaze direction up to angle of approximately 4-5 degrees although calibration errors often produce a larger overall shift in the estimates. This is approximately a circle of diameter 2 inches for a screen that is arm s length from the subject. At this accuracy it is possible to figure out what regions of text or images the subject is looking but it falls short of being able to determine which word the subject has looked at.« less

It is always on your mind: experiences and perceptions of falling of older people and their carers and the potential of a mobile falls detection device.

PubMed

Williams, Veronika; Victor, Christina R; McCrindle, Rachel

2013-01-01

Background. Falls and fear of falling present a major risk to older people as both can affect their quality of life and independence. Mobile assistive technologies (AT) fall detection devices may maximise the potential for older people to live independently for as long as possible within their own homes by facilitating early detection of falls. Aims. To explore the experiences and perceptions of older people and their carers as to the potential of a mobile falls detection AT device. Methods. Nine focus groups with 47 participants including both older people with a range of health conditions and their carers. Interviews were audio recorded, transcribed verbatim, and thematically analysed. Results. Four key themes were identified relating to participants' experiences and perceptions of falling and the potential impact of a mobile falls detector: cause of falling, falling as everyday vulnerability, the environmental context of falling, and regaining confidence and independence by having a mobile falls detector. Conclusion. The perceived benefits of a mobile falls detector may differ between older people and their carers. The experience of falling has to be taken into account when designing mobile assistive technology devices as these may influence perceptions of such devices and how older people utilise them.

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

PubMed Central

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

2011-01-01

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

Critical analysis of submerged membrane sequencing batch reactor operating conditions.

PubMed

McAdam, Ewan; Judd, Simon J; Gildemeister, René; Drews, Anja; Kraume, Matthias

2005-10-01

To evaluate the Submerged Membrane Sequencing Batch Reactor process, several short-term studies were conducted to define critical flux, membrane aeration and intermittent filtration operation. Critical flux trials indicated that as mixed liquor suspended solids increased in concentration so would the propensity for membrane fouling. Consequently in order to characterise the impact of biomass concentration increase (that develops during permeate withdrawal) upon submerged microfiltration operation, two longer term studies were conducted, one with a falling hydraulic head and another with a continuous hydraulic head (as in membrane bio-reactors). Trans membrane pressure data was used to predict the maximum possible operating periods at 10 and 62 days for the falling hydraulic head and continuous hydraulic head respectively. Further analysis revealed that falling hydraulic head operation would require 21% more aeration to maintain a consistent crossflow velocity than continuous operation and would rely on pumping for full permeate withdrawal 80% earlier. This study concluded that further optimisation would be required to make this technology technically and economically viable.

"I Don't Know Why I'm Learning This": Preservice English Teachers' Engagement in a Language Development Course

ERIC Educational Resources Information Center

Ramanayake, Selena; Williams, Cheri

2017-01-01

Despite the increase of English learners in the U.S. and of standards for linguistically responsive teaching practices, teacher education programs often fall short of preparing preservice teachers to teach diverse learners. In this case study, specifically designed to improve a pedagogical course on English language development, the researchers…

A Case Study on Moving Philosophically Diverse Funders to Common Priorities. Education Funders Research Initiative

ERIC Educational Resources Information Center

Hilliard, Thomas J.

2015-01-01

Collaboration is a recurring theme among philanthropic funders and their grantees. Most funders have engaged in collaboration at some level. A few collaborations achieve outstanding success and are lionized in case studies. Others break up without conclusion or fall short of their original mission and are tactfully forgotten. One standard…

49 CFR 26.47 - Can recipients be penalized for failing to meet overall goals?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Can recipients be penalized for failing to meet... Goals, Good Faith Efforts, and Counting § 26.47 Can recipients be penalized for failing to meet overall... rule, because your DBE participation falls short of your overall goal, unless you have failed to...

Managerial Action and Sensemaking in E-Learning Implementation in Brazilian Business Schools

ERIC Educational Resources Information Center

de Freitas, Angilberto Sabino; Bandeira-de-Mello, Rodrigo

2012-01-01

The existing literature on e-learning implementation is either descriptive or normative and falls short on explaining how managers act in introducing and disseminating e-learning projects in school settings. In this paper, we follow a symbolic approach in order to offer a grounded model for explaining how managerial framing of the introduction of…

Transfer Student Success: Latinx Students Overcoming Challenges at Two- and Four-Year Institutions towards Baccalaureate Degree Attainment

ERIC Educational Resources Information Center

Byrd, Ajani M.

2017-01-01

As the largest post-secondary educational system, community colleges enroll nearly 35% of all college students (American Association for Community Colleges, 2014). However, the vast majority of students attending two-year institutions aspiring to vertically transfer (from community college to four-year institution), fall short of their academic…

Teachers: New and Old, Judged Chiefly on Same Standards

ERIC Educational Resources Information Center

Keller, Bess

2005-01-01

This article describes the work Colorado has done to meet the "highly qualified teaching" requirements of the federal No Child Left Behind Act. Colorado's standard is devoid of the loopholes that have drawn criticism to other states' policies, many of which, observers have suggested, fall short of both the letter and the spirit of the…

Growing trees where trees grow best: short-term research sheds light on long-term productivity.

Treesearch

Jonathan Thompson

2008-01-01

In 1999, the Fall River Long-Term Site Productivity study began in coastal Washington to investigate how intensive management practices affect soil processes and forest productivity. By comparing conventional harvests to more intensive wood removal treatments, researchers are answering long-standing questions about how residual organic matter influences future growth....

Riparian ecotone: A functional definition and delineation for resource assessment

Treesearch

E. S Verry; C. A Dolloff; M. E. Manning

2004-01-01

We propose a geomorphic basis for defining riparian areas using the term: riparian ecotone, discuss how past definitions fall short, and illustrate how a linked sequence of definition, delineation, and riparian sampling are used to accurately assess riparian resources on the ground. Our riparian ecotone is based on the width of the valley (its floodprone area width)...

Developing a Practical Forecasting Screener for Domestic Violence Incidents

ERIC Educational Resources Information Center

Berk, Richard A.; He, Yan; Sorenson, Susan B.

2005-01-01

In this article, the authors report on the development of a short screening tool that deputies in the Los Angeles Sheriff's Department could use in the field to help forecast domestic violence incidents in particular households. The data come from more than 500 households to which sheriff's deputies were dispatched in fall 2003. Information on…

Understanding Environmental Literacy in America and Making It a Reality: Three-Year Report 2002/2003/2004

ERIC Educational Resources Information Center

National Environmental Education & Training Foundation, 2005

2005-01-01

Research by the National Environmental Education & Training Foundation (NEETF) and Roper Public Affairs at NOP World tells that the average 12th grader (and by extension, the average adult) still falls far short of what would be considered "environmentally literate" by anyone's definition. Seemingly elementary questions elude most of…

Is South Korea a Case of High-Stakes Testing Gone Too Far? Information Capsule. Volume 1107

ERIC Educational Resources Information Center

Blazer, Christie

2012-01-01

South Korea's students consistently outperform their counterparts in almost every country in reading and math. Experts have concluded, however, that the South Korean education system has produced students who score well on tests, but fall short on creativity and innovative thinking. They blame these shortcomings on schools' emphasis on rote…

Identifying Areas of Tension in the Field of Technology-Enhanced Learning: Results of an International Delphi Study

ERIC Educational Resources Information Center

Plesch, Christine; Kaendler, Celia; Rummel, Nikol; Wiedmann, Michael; Spada, Hans

2013-01-01

Despite steady progress in research in technology-enhanced learning (TEL), the translation of research findings and technology into educational practices falls short of expectations. We present five Areas of Tension which were identified and evaluated in an international Delphi study on TEL. These tensions might impede a more comprehensive…

Strategies for Institutional Transformation: A Multi-Case Study of the Chief Diversity Officer Position

ERIC Educational Resources Information Center

Leon, Raul Alejandro

2010-01-01

This study is concerned with the fact that many colleges and universities have adopted strategic diversity plans, but many still fall short of reaping the benefits that diversity brings to the college environment (Milem, Chang, & Antonio, 2005). Today, several colleges and universities have developed a chief diversity officer (CDO) position to…

Impact Evaluation of the National Writing Project's College-Ready Writing Project in High Poverty Rural Districts

ERIC Educational Resources Information Center

Gallagher, H. Alix; Arshan, Nicole; Woodworth, Katrina

2016-01-01

Writing is an essential skill for participating in modern American society. Although it is crucial to careers and civic engagement, student writing falls far short of national expectations (College Board, 2004; NCES, 2012; Persky, Daane, & Jin, 2003). The Common Core State Standards (CCSS) seek to increase the rigor of writing instruction…

Evidence Summary for First-Grade Classroom Prevention Program (Good Behavior Game Plus Enhanced Academic Curriculum). Top Tier Evidence Initiative

ERIC Educational Resources Information Center

Coalition for Evidence-Based Policy, 2010

2010-01-01

U.S. social programs, set up to address important problems, often fall short by funding specific models/strategies ("interventions") that are not effective. When evaluated in scientifically-rigorous studies, social interventions in K-12 education, job training, crime prevention, and other areas are frequently found ineffective or…

Optimal and Most Exact Confidence Intervals for Person Parameters in Item Response Theory Models

ERIC Educational Resources Information Center

Doebler, Anna; Doebler, Philipp; Holling, Heinz

2013-01-01

The common way to calculate confidence intervals for item response theory models is to assume that the standardized maximum likelihood estimator for the person parameter [theta] is normally distributed. However, this approximation is often inadequate for short and medium test lengths. As a result, the coverage probabilities fall below the given…

Focus. Volume 26, Number 1, Summer-Fall 2008

ERIC Educational Resources Information Center

Caspar, Emma, Ed.

2008-01-01

The purpose of "Focus" is to provide coverage of poverty-related research, events, and issues, and to acquaint a large audience with the work of the Institute for Research on Poverty by means of short essays on selected pieces of research. This issue contains the following articles: (1) The new global labor market (Richard B. Freeman);…

Cracking the Code of Effective Learning through Management of Learning Experiences

ERIC Educational Resources Information Center

Al-Fuqaha, Isam Najib

2016-01-01

This article is an attempt to explore why the efforts of universities fall short of accomplishing their objectives, and fail to improve the caliber of their graduates, as large numbers of them are unable to encounter real-life problems. It also probes the relations between four independent demographic variables (gender, age, experience, and…

Revamping the Teacher Evaluation Process. Education Policy Brief. Volume 9, Number 4, Fall 2011

ERIC Educational Resources Information Center

Whiteman, Rodney S.; Shi, Dingjing; Plucker, Jonathan A.

2011-01-01

This policy brief explores Senate Enrolled Act 001 (SEA 1), specifically the provisions for how teachers must be evaluated. After a short summary of SEA 1 and its direct changes to evaluation policies and practices, the brief reviews literature in teacher evaluation and highlights important issues for school corporations to consider when selecting…

E-Learning Change Management: Challenges and Opportunities

ERIC Educational Resources Information Center

Parlakkilic, Alaattin

2013-01-01

The role of e-learning technologies entirely depends on the acceptance and execution of required-change in the thinking and behaviour of the users of institutions. The research are constantly reporting that many e-learning projects are falling short of their objectives due to many reasons but on the top is the user resistance to change according…

Your Guide to Meebo Options: Virtual Reference Summer Meltdown and Fall Shakeout

ERIC Educational Resources Information Center

Breitbach, William

2012-01-01

Competition in the virtual reference market got really hot this past summer. Recent developments in virtual reference offerings suggest the market is much more dynamic than most people would have imagined a short time ago. With Google's acquisition of Meebo and its subsequent decision to shut down the chat widget service, many libraries scrambled…

Flowering and seed dispersal of dwarfmistletoe (Arceuthobium campylopodum in California

Treesearch

Robert F. Scharpf

1965-01-01

Under the short growing season of the Sierra Nevada, both flowering and seed dispersal of Arceuthobium campylopodum occurred earlier in the fall and dispersal extended for a shorter duration than at lower elevations and along the coast of California. Also in years of above normal surrmer temperatures, flowering and seed dispersal occurred earlier in...

Minding the Achievement Gap One Classroom at a Time

ERIC Educational Resources Information Center

Pollock, Jane E.; Ford, Sharon; Black, Margaret M.

2012-01-01

Do teachers have the power to close achievement gaps? Here's a book that boldly claims they do and lays out a blueprint for how to do something now to help students who are falling short of standards. Regardless of the student population you need to address--English language learners, special education, or just the unmotivated and hard to…

A Voice Onset Time Analysis of Apical Stop Production in 3-Year-Olds

ERIC Educational Resources Information Center

Gilbert, John H. V.

1977-01-01

This paper reports data for voice onset time (VOT) for /d/ and /t/, from six children at average age 3;0. Values for /d/ clearly achieve the short voicing lag category of adults, reported previously. Values for /t/, however, are much more varied, although falling within the category long voicing lag. (CHK)

Not Just "a Book on the Wall": Pedagogical Work, Museums and Representing the Sporting Past

ERIC Educational Resources Information Center

Phillips, Murray G.; Tinning, Richard

2011-01-01

Historians often evaluate sport exhibitions as simply transplantations from the pages of books to the walls of a museum. Not surprisingly, on this basis many sport exhibitions fall short of the criteria demanded by historians. This paper specifically explores this issue by examining the exhibition, "Between the Flags", that traveled…

Teachers as Absurd Heroes: Camus' Sisyphus and the Promise of Rebellion

ERIC Educational Resources Information Center

Gordon, Mordechai

2016-01-01

Inspired by Camus' portrayal of Sisyphus, this essay examines the act of teaching as an absurd profession, one that faces numerous obstacles and challenges and continually falls short of its intended goals. I begin my analysis by demonstrating that Camus' understanding of the absurd was heavily influenced by Nietzsche's conception of nihilism. I…

Monitoring the Quality of School Buildings in Belgium's Flemish Community

ERIC Educational Resources Information Center

Leemans, Geert

2009-01-01

In the course of 2008, the Flemish Agency for Infrastructure in Education (AGIOn) evaluated the quality of school buildings in Flanders using a monitoring system based on international experience. The results showed that most school buildings satisfy the basic requirements of habitability and safety, but they often fall short when it comes to the…

Commentary on Social Skills Training Curricula for Individuals with ASD: Social Interaction, Authenticity, and Stigma

ERIC Educational Resources Information Center

Bottema-Beutel, Kristen; Park, Haerin; Kim, So Yoon

2018-01-01

By teaching social rules thought to be necessary for social competence, social skills training (SST) curricula aim to improve indicators of well-being for individuals with autism spectrum disorder (ASD), such as the attainment of meaningful friendships. However, several recent meta-analyses indicate that SST curricula may fall short of these…

Using Performance-Based Funding to Incentivize Change. Occasional Paper. RTI Press Publication OP-0020-1501

ERIC Educational Resources Information Center

Klein, Steven G.

2015-01-01

Performance-based funding is a resource distribution strategy used in education to reward service providers for the outcomes they achieve. Institutions that produce above-average results earn additional financing, while those that fall short may face funding reductions and may be targeted for technical assistance to address their performance…

A Brief History of Non-Euclidean Geometry

ERIC Educational Resources Information Center

Marshall, Daniel; Scott, Paul

2004-01-01

Around 300 BC, Euclid wrote "The Elements", a major treatise on the geometry of the time, and what would be considered "geometry" for many years after. Arguably "The Elements" is the second most read book of the western world, falling short only to The Bible. In his book, Euclid states five postulates of geometry which he uses as the foundation…

Where Focus on the Family Falls Short on Character Development.

ERIC Educational Resources Information Center

Berman, Sheldon H.

1995-01-01

Linda Page's article ("A Conservative Christian View on Values," this issue) mistakenly argues that the source of this country's moral crisis lies in a 30-year history of moral relativism in schools promoted by the values-clarification movement. Page unfairly blames educators for the growth in crime and violence and the decline of moral…

Vacation Study Abroad, 1991: An IIE Guide to Study Abroad.

ERIC Educational Resources Information Center

Steen, Sara J., Ed.; Battle, Ed, Ed.

This directory provides information on summer higher education programs ranging from 1 week to several months, and on short courses of varying lengths in the fall, winter, and spring that take place in countries other than the United States. An introductory section describes the organization of the listings, which provide program sponsor and name,…

Understanding "The Other" through Art: Fostering Narrative Imagination in Elementary Students

ERIC Educational Resources Information Center

Kim, Jeong-Hee; Wiehe-Beck, Anna

2016-01-01

Teachers in many countries live the language of standards although it is confined to uniformity and standardization. In the United States, for example, teachers teach to what is now called the Common Core State Standards that focus on students' college and career readiness while falling short of developing good judgment and wisdom. In this…