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.

Validity of Caregivers’ Reports on Head Trauma Due to Falls in Young Children Aged Less than 2 Years

PubMed Central

Fujiwara, Takeo; Nagase, Hiroaki; Okuyama, Makiko; Hoshino, Takahiro; Aoki, Kazunori; Nagashima, Tastuya; Nakamura, Hajime

2010-01-01

Objective: The clinical presentations of head trauma due to falls among young children aged less than 2 years are controversial, particularly in Japan, as the history of trauma recounted by a caretaker is not always reliable. The purpose of this study was to assess the validity of caregiver’s reports on head trauma due to falls in young children aged less than 2 years in Japan. Methods: All patients <2 years of age presenting with head trauma resulting from a fall who were admitted to 3 children’s hospitals in Japan from January 2001 to December 2005 were retrospectively reviewed (N = 58). The clinical presentations were compared among groups categorized by the heights from which the patient fell (short (≤120 cm) or long (>120 cm)) and the surface on which the patient landed (carpet, tatami (Japanese mattress), hardwood floor, or concrete). Results: Patients who suffered short falls were more likely to present with subdural hemorrhage (SDH) than those who suffered long falls (74% and 40%, respectively, P = 0.027). More specifically, 62% of short falls showed SDH indicative of shaken baby syndrome (e.g. multilayer SDH). Neurological symptoms, cyanosis, and SDH were more commonly observed in patients who landed on carpeted or tatami surfaces than in those who landed on hardwood or concrete floors. Conclusions: Short falls and landing on soft surfaces resulted in the presentation of severer clinical symptoms than did long falls and landing on hard surfaces, suggesting that the validity of caretakers’ reports on infant or young children’s head trauma due to falls is low. Further research is warranted to investigate the cause of infant head trauma due to falls. PMID:23761991

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:…

Short stick exercises for fall prevention among older adults: a cluster randomized trial.

PubMed

Yokoi, Katsushi; Yoshimasu, Kouichi; Takemura, Shigeki; Fukumoto, Jin; Kurasawa, Shigeki; Miyashita, Kazuhisa

2015-01-01

To investigate the effects of short stick exercise (SSEs) on fall prevention and improvement of physical function in older adults. A cluster randomized trial was conducted in five residential care facilities. The intervention group (n = 51) practiced SSEs for six months, followed by routine care for six more months. The control group (n = 54) received ordinary care for 12 months. The primary outcome measure was the number of fallers, taking into account the time to first fall using the Kaplan-Meier method. The secondary outcome measures were physical and mental functions. The number of fallers was significantly lower in the intervention group (n = 6) than in the control group (n = 16) during the 12 months. The adjusted hazard ratio for a first fall in the intervention group compared with the control group was 0.15 (CI, 0.03 to 0.74, p = 0.02). The fall-free period was significantly longer in the intervention group than in controls (mean ± SD, 10.1 ± 3.0 versus 9.0 ± 4.1 months, p = 0.027). The functional reach and sit and reach tests were significantly improved at three and six months. The SSEs appeared effective for fall prevention and improvement of physical function in older adults. Implications for Rehabilitation The newly developed short stick exercises appear an effective means of reducing falls among older adults in residential care facilities. The short stick exercises seem to have an immediate effect on improving physical functions. Effects gained by performing the short stick exercises, such as static balance, flexibility and agility may last for six months. The short stick exercises were found to be easy for older adults to practice continuously in residential care facilities.

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.

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.

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.

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.

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…

Status of NASA Satellite, Field Observations, and Numerical Modeling Addressing the Impact of Urbanization on Short and Long Term Precipitation Variability

NASA Technical Reports Server (NTRS)

Shepherd, J. Marshall; Manyin, Michael; Burian, Steve; Garza, Carlos

2003-01-01

There is renewed interest in the impacts of urbanization on global change as witnessed by special sessions at the Fall AGU and Annual AMS meeting. A comprehensive satellite, modeling, and field campaign program is underway to assess the impact of urbanization on precipitation.

Dynamic stability of passive dynamic walking on an irregular surface.

PubMed

Su, Jimmy Li-Shin; Dingwell, Jonathan B

2007-12-01

Falls that occur during walking are a significant health problem. One of the greatest impediments to solve this problem is that there is no single obviously "correct" way to quantify walking stability. While many people use variability as a proxy for stability, measures of variability do not quantify how the locomotor system responds to perturbations. The purpose of this study was to determine how changes in walking surface variability affect changes in both locomotor variability and stability. We modified an irreducibly simple model of walking to apply random perturbations that simulated walking over an irregular surface. Because the model's global basin of attraction remained fixed, increasing the amplitude of the applied perturbations directly increased the risk of falling in the model. We generated ten simulations of 300 consecutive strides of walking at each of six perturbation amplitudes ranging from zero (i.e., a smooth continuous surface) up to the maximum level the model could tolerate without falling over. Orbital stability defines how a system responds to small (i.e., "local") perturbations from one cycle to the next and was quantified by calculating the maximum Floquet multipliers for the model. Local stability defines how a system responds to similar perturbations in real time and was quantified by calculating short-term and long-term local exponential rates of divergence for the model. As perturbation amplitudes increased, no changes were seen in orbital stability (r(2)=2.43%; p=0.280) or long-term local instability (r(2)=1.0%; p=0.441). These measures essentially reflected the fact that the model never actually "fell" during any of our simulations. Conversely, the variability of the walker's kinematics increased exponentially (r(2)>or=99.6%; p<0.001) and short-term local instability increased linearly (r(2)=88.1%; p<0.001). These measures thus predicted the increased risk of falling exhibited by the model. For all simulated conditions, the walker remained orbitally stable, while exhibiting substantial local instability. This was because very small initial perturbations diverged away from the limit cycle, while larger initial perturbations converged toward the limit cycle. These results provide insight into how these different proposed measures of walking stability are related to each other and to risk of falling.

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…

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.

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.

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.

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

Lidar method to estimate emission rates from extended sources

USDA-ARS?s Scientific Manuscript database

Currently, point measurements, often combined with models, are the primary means by which atmospheric emission rates are estimated from extended sources. However, these methods often fall short in their spatial and temporal resolution and accuracy. In recent years, lidar has emerged as a suitable to...

First order sea-level cycles and supercontinent break up

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

Heller, P.L.; Angevine, C.L.

1985-01-01

The authors have developed a model that successfully predicts the approximate magnitude and timing of long term sea-level change without relying on short term increases in global spreading rates. The model involves the following key assumptions. (1) Ocean basins have two types of area/age distributions; Pacific ocean basins are rimmed by subduction zones and have triangular distributions; and Atlantic ocean basins which open at constant rates, have no subduction, and so have rectangular distributions. (2) The total area of the global ocean is constant so that the Pacific basin must close as the Atlantic opens. These assumptions approximate modern globalmore » ocean basin conditions. The model begins with supercontinent break up. As the Atlantic begins to open, the mean age of the global ocean decreases, the mean depth of the sea floor shallows, and sea level, therefore, rises. Once the Atlantic occupies more than 8 to 10% of the global ocean area, the mean age and depth of the ocean floor increases resulting in a sea-level fall. The model can be applied to the mid-Cretaceous sea-level high stand which followed break up of Pangea by 80 to 100 Ma. Based on average Atlantic opening rates, sea level rises to a peak of 44 m at 80 Ma after opening began and then falls by 84 m to the present. Thus the model is capable of explaining approximately half of the total magnitude of the post-mid-Cretaceous eustatic fall without invoking short-term changes in global spreading rates. In addition, the model predicts the observed time lag between supercontinent break up and sea-level high stand for both Mesozoic as well as early Paleozoic time.« less

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.

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…

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...

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.

The Role of Diaspora in University-Industry Relationships in Globalised Knowledge Economy: The Case of Palestine

ERIC Educational Resources Information Center

Sharabati-Shahin, Mervat H. N.; Thiruchelvam, K.

2013-01-01

University-industry (U-I) linkage is not a new concept. Although there are models for such linkage that have been tested or used, they may remain unsuitable in certain countries and communities. With the unique situation of the Palestinians, the existing models may fall short of meeting the specific needs and targets of establishing such a…

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…

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…

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…

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.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-05-01

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

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…

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…

Supervisor's Manual: Great Falls Transition Project, a Cooperative Model for Least Restrictive Employment.

ERIC Educational Resources Information Center

White, Stephen; And Others

The manual is intended to provide employment supervisors with skills to enable them to motivate and provide any needed support to workers with disabilities. The material is organized into seven short sessions with most of the material consisting of basic principles for communicating and instructing persons with disabilities and case study problems…

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.

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.

A two-question tool to assess the risk of repeated falls in the elderly

PubMed Central

Gálvez-Barrón, César; Narvaiza, Leire; Miñarro, Antonio; Ruiz, Jorge; Valldosera, Esther; Gonzalo, Natalia; Ng, Thalia; Sanguino, María Jesús; Yuste, Antonio

2017-01-01

Introduction Older adults’ perception of their own risk of fall has never been included into screening tools. The goal of this study was to evaluate the predictive validity of questions on subjects’ self-perception of their own risk of fall. Methods This prospective study was conducted on a probabilistic sample of 772 Spanish community-dwelling older adults, who were followed-up for a one year period. At a baseline visit, subjects were asked about their recent history of falls (question 1: “Have you fallen in the last 6 months?”), as well as on their perception of their own risk of fall by using two questions (question 2: “Do you think you may fall in the next few months?” possible answers: yes/no; question 3: “What is the probability that you fall in the next few months?” possible answers: low/intermediate/high). The follow-up consisted of quarterly telephone calls, where the number of falls occurred in that period was recorded. Results A short questionnaire built with questions 1 and 3 showed 70% sensitivity (95% CI: 56%-84%), 72% specificity (95% CI: 68%-76%) and 0.74 area under the ROC curve (95% CI: 0.66–0.82) for prediction of repeated falls in the subsequent year. Conclusions The estimation of one’s own risk of fall has predictive validity for the occurrence of repeated falls in older adults. A short questionnaire including a question on perception of one’s own risk of fall and a question on the recent history of falls had good predictive validity. PMID:28489888

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.

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

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.

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.

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.

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.

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

Evaluation of one dimensional analytical models for vegetation canopies

NASA Technical Reports Server (NTRS)

Goel, Narendra S.; Kuusk, Andres

1992-01-01

The SAIL model for one-dimensional homogeneous vegetation canopies has been modified to include the specular reflectance and hot spot effects. This modified model and the Nilson-Kuusk model are evaluated by comparing the reflectances given by them against those given by a radiosity-based computer model, Diana, for a set of canopies, characterized by different leaf area index (LAI) and leaf angle distribution (LAD). It is shown that for homogeneous canopies, the analytical models are generally quite accurate in the visible region, but not in the infrared region. For architecturally realistic heterogeneous canopies of the type found in nature, these models fall short. These shortcomings are quantified.

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.

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.

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.

Seasonal analysis of the short-term effects of air pollution on daily mortality in Northeast Asia.

PubMed

Kim, Satbyul Estella; Honda, Yasushi; Hashizume, Masahiro; Kan, Haidong; Lim, Youn-Hee; Lee, Hyewon; Kim, Clara Tammy; Yi, Seung-Muk; Kim, Ho

2017-01-15

The constituents and concentrations of pollutants, individual exposures, and biologic responses to air pollution may vary by season and meteorological conditions. However, evidence regarding seasonality of the acute effects of air pollution on mortality is limited and inconsistent. Herein, we examined seasonal patterns in the short-term associations of particulate matter (PM) smaller than 10μm (PM 10 ) with daily mortality in 29 cities of three northeast Asian countries. Stratified time-series models were used to determine whether season altered the effect of PM 10 on mortality. This effect was first quantified within each season and at each location using a time-series model, after which city-specific estimates were pooled using a hierarchical Bayesian model. In all data sets, 3,675,348 non-accidental deaths were registered from 1993 to 2009. In Japan, a 10μg/m 3 increase in PM 10 was significantly associated with increases in non-accidental mortality of 0.44% (95% confidence interval [CI]: 0.03%, 0.8%) in spring and 0.42% (0.02%, 0.82%) in fall. In South Korea, a 10μg/m 3 increase in PM 10 was significantly associated with increases in non-accidental mortality of 0.51% (0.01%, 1.01%) in summer and 0.45% (0.03%, 0.87%) in fall, in cardiovascular disease mortality of 0.96% (0.29%, 1.63%) in fall, and in respiratory disease mortality of 1.57% (0.40%, 2.75%) in fall. In China, a 10μg/m 3 increase in PM 10 was associated with increases in non-accidental mortality of 0.33% (0.01%, 0.66%) in summer and 0.41% (0.09%, 0.73%) in winter, in cardiovascular disease mortality of 0.41% (0.08%, 0.74%) in spring and 0.33% (0.02%, 0.64%) in winter, and in respiratory diseases mortality of 0.78% (0.27%, 1.30%) in winter. Our analyses suggest that the acute effect of particulate air pollution could vary seasonally and geographically. Copyright © 2016 Elsevier B.V. All rights reserved.

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…

A mixed methods evaluation of yoga as a fall prevention strategy for older people in India.

PubMed

Keay, Lisa; Praveen, Devarsetty; Salam, Abdul; Rajasekhar, K V; Tiedemann, Anne; Thomas, Vimala; Jagnoor, Jagnoor; Sherrington, Cathie; Ivers, Rebecca Q

2018-01-01

Falls are an emerging public health issue in India, with the impact set to rise as the population ages. We sought to evaluate the acceptability, feasibility and likely impact of a yoga-based program aimed at improving balance and mobility for older residents in urban India. Fifty local residents aged 60 years and older were recruited from urban Hyderabad, Andhra Pradesh. They were invited to attend a 1-h yoga class, twice weekly for 3 months. Mixed methods were used to evaluate the acceptability and feasibility (qualitative) and likely impact (quantitative). Two focus groups and eight interviews with participants were conducted to evaluate the acceptability and feasibility of a yoga program. Thematic analysis was conducted in context of perceptions, barriers and benefits of yoga participation and fall ascertainment. Physical performance using the Short Physical Performance Battery, fear of falling, blood pressure and weight loss were measured before and after the program. The interviews and focus groups provided insights into the preferred format for classes, including session times, level of supervision and location. Improvements were seen in the Short Falls Efficacy Scale-International (Short FES-I (15.9 ± 4.0 vs 13.8 ± 2.1 s, p  = 0.002)), the number of steps taken in the timed 4-m walk (T4MW (9.0 ± 1.8 vs 8.6 ± 1.8, p  = 0.04)), Short FES-I scores (9.4 ± 2.9 vs 8.6 ± 2.9, p  = 0.02) and weight (63.8 ± 12.4 vs 62.1 ± 11.6, p  = 0.004) were lower. No changes were seen in standing balance, blood pressure or T4MW time. Yoga was well accepted and resulted in improved ability to rise from a chair, weight loss, increased step length and reduced fear of falling. These results provide impetus for further research evaluating yoga as a fall prevention strategy in India.

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.

Developing Qualified Logistics Readiness Officers (LROs) Within Air Combat Command (ACC): A Delphi Study

DTIC Science & Technology

2009-06-01

today face ( Lovewell , 2007). Although the model equips LROs with the understanding of most basic logistics processes, it falls short to deliver a...areas to the degree the operations tempo requires ( Lovewell , 2007). Due to recent changes in mission requirements and organizational re-structuring...the current CFETP appears to be outdated ( Lovewell , 2007). 6 Base-Level Training Guiding the officer to fulfill their training

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

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...

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.

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.

Multivariate Heteroscedasticity Models for Functional Brain Connectivity.

PubMed

Seiler, Christof; Holmes, Susan

2017-01-01

Functional brain connectivity is the co-occurrence of brain activity in different areas during resting and while doing tasks. The data of interest are multivariate timeseries measured simultaneously across brain parcels using resting-state fMRI (rfMRI). We analyze functional connectivity using two heteroscedasticity models. Our first model is low-dimensional and scales linearly in the number of brain parcels. Our second model scales quadratically. We apply both models to data from the Human Connectome Project (HCP) comparing connectivity between short and conventional sleepers. We find stronger functional connectivity in short than conventional sleepers in brain areas consistent with previous findings. This might be due to subjects falling asleep in the scanner. Consequently, we recommend the inclusion of average sleep duration as a covariate to remove unwanted variation in rfMRI studies. A power analysis using the HCP data shows that a sample size of 40 detects 50% of the connectivity at a false discovery rate of 20%. We provide implementations using R and the probabilistic programming language Stan.

Quality of life for children with life-limiting and life-threatening illnesses: description and evaluation of a regional, collaborative model for pediatric palliative care.

PubMed

Rogers, Susan K; Gomez, Carlos F; Carpenter, Philip; Farley, Jean; Holson, Debbie; Markowitz, Miriam; Rood, Brian; Smith, Karen; Nigra, Peter

2011-05-01

The care of children in the U.S. with life-limiting illnesses is inadequate. Misallocated resources, flawed assumptions and models of care, and a lack of appropriate professional education foster a costly, inefficient system that falls short of its true potential. This article details the evolution of a regional, shared approach to address these issues, the District of Columbia Pediatric Palliative Care Collaboration (DCPPCC), and includes its evolution, preliminary clinical results, and assessment of barriers encountered.

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.

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.

Solar Wind Driven Autoregression Model for Ionospheric Short Term Forecast (SWIF)

DTIC Science & Technology

2008-06-01

for GCAM; previous two months for TSAR). However the quality of the autoscaling software ( ARTIST ) performance determines largely the accuracy of...showing the SWIF synthesis. Figure 17: Athens Digisonde ionograms autoscaled with ARTIST4.0 (top) and with ARTIST4.5 (bottom) during fall quiet...intervals Figure 18: Athens Digisonde ionograms autoscaled with ARTIST4.0 (top) and with ARTIST4.5 (bottom) during summer quiet intervals Figure 19

Learning Shape Descriptions: Generating and Generalizing Models of Visual Objects.

DTIC Science & Technology

1985-09-01

Minsky , Marvin and Seymour Papert, [1969], Perceptrons, MIT Press, Cam- bridge, Ma. Mitchell, T. M., [1978], "Version spaces: A candidiate elimination...with respect to a suitable set of affine transformations. This is one area in which classic perceptrons fall short [ Minsky and Papert 19691. The third...Quillian, M. Ross, [1968], "Semantic Memory" (PhD Thesis), in Semantic Infor- mation Processing, M. Minsky (ed.), MIT Press, Cambridge MA. Schlesinger, G

The U.S. Trade Deficit: Causes, Consequences, and Policy Options

DTIC Science & Technology

2010-07-12

4 For further discussion of the standard model of open economy macroeconomics , see N. Gregory Mankiw , Principles of Economics...index.htm#bop. 7 For a fuller discussion of this analytical framework, see N. Gregory Mankiw , Principles of Economics (Fort Worth, TX: The Dryden Press...record 6.1% in 2006. The size of the U.S. trade deficit is ultimately rooted in macroeconomic conditions at home and abroad. U.S. saving falls short

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.

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.

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.

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.

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.

Normalization of cell responses in cat striate cortex

NASA Technical Reports Server (NTRS)

Heeger, D. J.

1992-01-01

Simple cells in the striate cortex have been depicted as half-wave-rectified linear operators. Complex cells have been depicted as energy mechanisms, constructed from the squared sum of the outputs of quadrature pairs of linear operators. However, the linear/energy model falls short of a complete explanation of striate cell responses. In this paper, a modified version of the linear/energy model is presented in which striate cells mutually inhibit one another, effectively normalizing their responses with respect to stimulus contrast. This paper reviews experimental measurements of striate cell responses, and shows that the new model explains a significantly larger body of physiological data.

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…

No correlation discerned between the periods of rise and dominance of simulated species in a model of biological evolution

NASA Astrophysics Data System (ADS)

Kuhnle, Alan

2009-11-01

In [1], Liow et al. discern a general feature of the occurrence trajectories of biological species: the periods of rise and fall of a typical species are about as long as the period of dominance. In this work, an individual-based model of biological evolution that was developed by Rikvold and Zia in [2] is investigated, but no analogous feature is observed in the simulated species populations. Instead, the periods of rise and fall of a simulated species cannot always be sensibly defined; when it does make sense to define these quantities, they are quite short and independent of the period of dominance. [4pt] [1] Liow, L. H., Skaug, H. J., Ergon, T., Schweder, T.: Global occurence trajectories of microfossils: Is the rise and persistence of species influenced by environmental volatility? Manuscript for Paleobiology, 5 Dec 2008 [0pt] [2] Rikvold, P.A., Zia, R.K.P.: Punctuated equilibria and 1/f noise in a biological coevolution model with individual-based dynamics. Physical Review E 68, 031913 (2003)

Quantum information erasure inside black holes

DOE PAGES

Lowe, David A.; Thorlacius, Larus

2015-12-15

An effective field theory for infalling observers in the vicinity of a quasi-static black hole is given in terms of a freely falling lattice discretization. The lattice model successfully reproduces the thermal spectrum of outgoing Hawking radiation, as was shown by Corley and Jacobson, but can also be used to model observations made by a typical low-energy observer who enters the black hole in free fall at a prescribed time. The explicit short distance cutoff ensures that, from the viewpoint of the infalling observer, any quantum information that entered the black hole more than a scrambling time earlier has beenmore » erased by the black hole singularity. Furthermore, this property, combined with the requirement that outside observers need at least of order the scrambling time to extract quantum information from the black hole, ensures that a typical infalling observer does not encounter drama upon crossing the black hole horizon in a theory where black hole information is preserved for asymptotic observers.« less

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.

Perceived Neighborhood Safety Is Associated with Poor Sleep Health among Gay, Bisexual, and Other Men Who Have Sex with Men in Paris, France.

PubMed

Duncan, Dustin T; Park, Su Hyun; Goedel, William C; Kreski, Noah T; Morganstein, Jace G; Hambrick, H Rhodes; Jean-Louis, Girardin; Chaix, Basile

2017-06-01

Recent studies have examined sleep health among men who have sex with men (MSM), but no studies have examined associations of neighborhood characteristics and sleep health among this population. The purpose of this study was to examine associations between perceived neighborhood safety and sleep health among a sample of MSM in Paris, France. We placed broadcast advertisements on a popular smartphone application for MSM in October 2016 to recruit users in the Paris (France) metropolitan area (n = 580). Users were directed to complete a web-based survey, including previously used items measuring perceptions of neighborhood safety, validated measures of sleep health, and socio-demographics. Modified Poisson models were used to estimate risk ratios (RRs) and 95% confidence intervals (CI) for the associations between perceived neighborhood safety and the following outcomes: (1) poor sleep quality, (2) short sleep duration, and (3) self-reported sleep problems. Poor sleep health was common in our sample; e.g., 30.1% reported poor sleep quality and 44.7% reported problems falling asleep. In multivariate regression models, perceived neighborhood safety was associated with poor sleep quality, short sleep duration, and having sleep problems. For example, reporting living in a neighborhood perceived as unsafe during the daytime (vs. safe) was associated with poor sleep quality (aRR, 1.60; 95% CI, 1.01, 2.52), short sleep duration (aRR, 1.92; 95% CI, 1.26, 2.94), problems falling asleep (aRR, 1.57; 95% CI, 1.17, 2.11), and problems staying awake in the daytime (aRR, 2.16; 95% CI, 1.05, 4.43). Interventions to increase neighborhood safety may improve sleep health among MSM.

Synchrotron Spectra of Short-Period Pulsars

NASA Astrophysics Data System (ADS)

Malov, I. F.

2001-02-01

A model with synchrotron radiation near the light cylinder is proposed to explain the observed spectra of short-period pulsars (P≤0.1 s). These spectra can be described if a power-law energy distribution of the emitting electrons with exponent γ=2 8 is assumed. For most pulsars, the peak frequency νm is below 10 MHz. The νm(γ) dependence is derived, and shows that the peak frequencies for pulsars with spectral indices α<1.5 may fall in the observable range. In particular, νm may be νm ˜ 100 MHz for PSR J0751 + 1807 and PSR J1640 + 2224. The observed radio spectrum of Geminga (PSR J0633 + 1746) can be described by a synchrotron model with a monoenergetic or Maxwellian distribution of relativistic electrons and a small angle β between the spin axis and magnetic moment (β ˜ 10°).

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...

A bio-inspired memory model for structural health monitoring

NASA Astrophysics Data System (ADS)

Zheng, Wei; Zhu, Yong

2009-04-01

Long-term structural health monitoring (SHM) systems need intelligent management of the monitoring data. By analogy with the way the human brain processes memories, we present a bio-inspired memory model (BIMM) that does not require prior knowledge of the structure parameters. The model contains three time-domain areas: a sensory memory area, a short-term memory area and a long-term memory area. First, the initial parameters of the structural state are specified to establish safety criteria. Then the large amount of monitoring data that falls within the safety limits is filtered while the data outside the safety limits are captured instantly in the sensory memory area. Second, disturbance signals are distinguished from danger signals in the short-term memory area. Finally, the stable data of the structural balance state are preserved in the long-term memory area. A strategy for priority scheduling via fuzzy c-means for the proposed model is then introduced. An experiment on bridge tower deformation demonstrates that the proposed model can be applied for real-time acquisition, limited-space storage and intelligent mining of the monitoring data in a long-term SHM system.

Hysteretic behavior of stage-discharge relationships in urban streams

NASA Astrophysics Data System (ADS)

Miller, A. J.; Lindner, G. A.

2009-12-01

Reliable stage-discharge relationships or rating curves are of critical importance for accurate calculation of streamflow and maintenance of long-term flow records. Urban streams offer particular challenges for the maintenance of accurate rating curves. It is often difficult or impossible to collect direct discharge measurements at high flows, many of which are generated by short-duration high-intensity summer thunderstorms, both because of dangerous conditions in the channel and also because the stream rises and falls so rapidly that field crews cannot reach sites in time and sometimes cannot make measurements rapidly enough to keep pace with changing water levels even when they are on site during a storm. Work in urban streams in the Baltimore metropolitan area has shown that projection of rating curves beyond the range of measured flows can lead to overestimation of flood peaks by as much as 100%, and these can only be corrected when adequate field data are available to support modeling efforts. Even moderate flows that are above safe wading depth and velocity may best be estimated using hydraulic models. Current research for NSF CNH project 0709659 includes the application of 2-d depth-averaged hydraulic models to match existing rating curves over a range of low to moderate flows and to extend rating curves for higher flows, based on field collection of high-water marks. Although it is generally assumed that stage-discharge relationships are single-valued, we find that modeling results in small urban streams often generate hysteretic relationships, with higher discharges on the rising limb of the hydrograph than on the falling limb. The difference between discharges for the same stage on the rising and falling limb can be on the order of 20-30% even for in-channel flows that are less than 1 m deep. As safety considerations dictate that it is preferable to make direct discharge measurements on the falling limb of the hydrograph, the higher direct measurements used in many rating curves probably have been collected on the falling limb and therefore may not capture the correct stage-discharge relationship for the rising limb. In some cases model results selected only from the falling limb are able to match the existing rating curve very closely. Although hysteresis may be explained with reference to the innate properties of the flood wave, other factors also lead to hysteretic behavior. Downstream constrictions and obstructions associated with urban infrastructure may cause substantial backwater effects, particularly during flood flows. Flood conditions at tributary confluences also can exert a controlling influence upstream. Based on our results we recommend that at some sites it is advisable to develop separate rating curves for the rising and falling limbs, and to develop a range of modeling scenarios for predicting the range of potential uncertainty.

On the Computational Power of Spiking Neural P Systems with Self-Organization.

PubMed

Wang, Xun; Song, Tao; Gong, Faming; Zheng, Pan

2016-06-10

Neural-like computing models are versatile computing mechanisms in the field of artificial intelligence. Spiking neural P systems (SN P systems for short) are one of the recently developed spiking neural network models inspired by the way neurons communicate. The communications among neurons are essentially achieved by spikes, i. e. short electrical pulses. In terms of motivation, SN P systems fall into the third generation of neural network models. In this study, a novel variant of SN P systems, namely SN P systems with self-organization, is introduced, and the computational power of the system is investigated and evaluated. It is proved that SN P systems with self-organization are capable of computing and accept the family of sets of Turing computable natural numbers. Moreover, with 87 neurons the system can compute any Turing computable recursive function, thus achieves Turing universality. These results demonstrate promising initiatives to solve an open problem arisen by Gh Păun.

On the Computational Power of Spiking Neural P Systems with Self-Organization

PubMed Central

Wang, Xun; Song, Tao; Gong, Faming; Zheng, Pan

2016-01-01

Neural-like computing models are versatile computing mechanisms in the field of artificial intelligence. Spiking neural P systems (SN P systems for short) are one of the recently developed spiking neural network models inspired by the way neurons communicate. The communications among neurons are essentially achieved by spikes, i. e. short electrical pulses. In terms of motivation, SN P systems fall into the third generation of neural network models. In this study, a novel variant of SN P systems, namely SN P systems with self-organization, is introduced, and the computational power of the system is investigated and evaluated. It is proved that SN P systems with self-organization are capable of computing and accept the family of sets of Turing computable natural numbers. Moreover, with 87 neurons the system can compute any Turing computable recursive function, thus achieves Turing universality. These results demonstrate promising initiatives to solve an open problem arisen by Gh Păun. PMID:27283843

Conserved intergenic sequences revealed by CTAG-profiling in Salmonella: thermodynamic modeling for function prediction

NASA Astrophysics Data System (ADS)

Tang, Le; Zhu, Songling; Mastriani, Emilio; Fang, Xin; Zhou, Yu-Jie; Li, Yong-Guo; Johnston, Randal N.; Guo, Zheng; Liu, Gui-Rong; Liu, Shu-Lin

2017-03-01

Highly conserved short sequences help identify functional genomic regions and facilitate genomic annotation. We used Salmonella as the model to search the genome for evolutionarily conserved regions and focused on the tetranucleotide sequence CTAG for its potentially important functions. In Salmonella, CTAG is highly conserved across the lineages and large numbers of CTAG-containing short sequences fall in intergenic regions, strongly indicating their biological importance. Computer modeling demonstrated stable stem-loop structures in some of the CTAG-containing intergenic regions, and substitution of a nucleotide of the CTAG sequence would radically rearrange the free energy and disrupt the structure. The postulated degeneration of CTAG takes distinct patterns among Salmonella lineages and provides novel information about genomic divergence and evolution of these bacterial pathogens. Comparison of the vertically and horizontally transmitted genomic segments showed different CTAG distribution landscapes, with the genome amelioration process to remove CTAG taking place inward from both terminals of the horizontally acquired segment.

On the Computational Power of Spiking Neural P Systems with Self-Organization

NASA Astrophysics Data System (ADS)

Wang, Xun; Song, Tao; Gong, Faming; Zheng, Pan

2016-06-01

Neural-like computing models are versatile computing mechanisms in the field of artificial intelligence. Spiking neural P systems (SN P systems for short) are one of the recently developed spiking neural network models inspired by the way neurons communicate. The communications among neurons are essentially achieved by spikes, i. e. short electrical pulses. In terms of motivation, SN P systems fall into the third generation of neural network models. In this study, a novel variant of SN P systems, namely SN P systems with self-organization, is introduced, and the computational power of the system is investigated and evaluated. It is proved that SN P systems with self-organization are capable of computing and accept the family of sets of Turing computable natural numbers. Moreover, with 87 neurons the system can compute any Turing computable recursive function, thus achieves Turing universality. These results demonstrate promising initiatives to solve an open problem arisen by Gh Păun.

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.;

Will high-resolution global ocean models benefit coupled predictions on short-range to climate timescales?

NASA Astrophysics Data System (ADS)

Hewitt, Helene T.; Bell, Michael J.; Chassignet, Eric P.; Czaja, Arnaud; Ferreira, David; Griffies, Stephen M.; Hyder, Pat; McClean, Julie L.; New, Adrian L.; Roberts, Malcolm J.

2017-12-01

As the importance of the ocean in the weather and climate system is increasingly recognised, operational systems are now moving towards coupled prediction not only for seasonal to climate timescales but also for short-range forecasts. A three-way tension exists between the allocation of computing resources to refine model resolution, the expansion of model complexity/capability, and the increase of ensemble size. Here we review evidence for the benefits of increased ocean resolution in global coupled models, where the ocean component explicitly represents transient mesoscale eddies and narrow boundary currents. We consider lessons learned from forced ocean/sea-ice simulations; from studies concerning the SST resolution required to impact atmospheric simulations; and from coupled predictions. Impacts of the mesoscale ocean in western boundary current regions on the large-scale atmospheric state have been identified. Understanding of air-sea feedback in western boundary currents is modifying our view of the dynamics in these key regions. It remains unclear whether variability associated with open ocean mesoscale eddies is equally important to the large-scale atmospheric state. We include a discussion of what processes can presently be parameterised in coupled models with coarse resolution non-eddying ocean models, and where parameterizations may fall short. We discuss the benefits of resolution and identify gaps in the current literature that leave important questions unanswered.

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

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

Sweet Spot Supersymmetry and Composite Messengers

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

Ibe, Masahiro; Kitano, Ryuichiro

2007-10-30

Sweet spot supersymmetry is a phenomenologically and cosmologically perfect framework to realize a supersymmetric world at short distance. We discuss a class of dynamical models of supersymmetry breaking and its mediation whose low-energy effective description falls into this framework. Hadron fields in the dynamical models play a role of the messengers of the supersymmetry breaking. As is always true in the models of the sweet spot supersymmetry, the messenger scale is predicted to be 10{sup 5} GeV {approx}< M{sub mess} {approx}< 10{sup 10} GeV. Various values of the effective number of messenger fields N{sub mess} are possible depending on themore » choice of the gauge group.« less

Detecting a Defective Casing Seal at the Top of a Bedrock Aquifer.

PubMed

Richard, Sandra K; Chesnaux, Romain; Rouleau, Alain

2016-03-01

An improperly sealed casing can produce a direct hydraulic connection between two or more originally isolated aquifers with important consequences regarding groundwater quantity and quality. A recent study by Richard et al. (2014) investigated a monitoring well installed in a fractured rock aquifer with a defective casing seal at the soil-bedrock interface. A hydraulic short circuit was detected that produced some leakage between the rock and the overlying deposits. A falling-head permeability test performed in this well showed that the usual method of data interpretation is not valid in this particular case due to the presence of a piezometric error. This error is the direct result of the preferential flow originating from the hydraulic short circuit and the subsequent re-equilibration of the piezometric levels of both aquifers in the vicinity of the inlet and the outlet of the defective seal. Numerical simulations of groundwater circulation around the well support the observed impact of the hydraulic short circuit on the results of the falling-head permeability test. These observations demonstrate that a properly designed falling-head permeability test may be useful in the detection of defective casing seals. © 2015, National Ground Water Association.

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

Adapting National Water Model Forecast Data to Local Hyper-Resolution H&H Models During Hurricane Irma

NASA Astrophysics Data System (ADS)

Singhofen, P.

2017-12-01

The National Water Model (NWM) is a remarkable undertaking. The foundation of the NWM is a 1 square kilometer grid which is used for near real-time modeling and flood forecasting of most rivers and streams in the contiguous United States. However, the NWM falls short in highly urbanized areas with complex drainage infrastructure. To overcome these shortcomings, the presenter proposes to leverage existing local hyper-resolution H&H models and adapt the NWM forcing data to them. Gridded near real-time rainfall, short range forecasts (18-hour) and medium range forecasts (10-day) during Hurricane Irma are applied to numerous detailed H&H models in highly urbanized areas of the State of Florida. Coastal and inland models are evaluated. Comparisons of near real-time rainfall data are made with observed gaged data and the ability to predict flooding in advance based on forecast data is evaluated. Preliminary findings indicate that the near real-time rainfall data is consistently and significantly lower than observed data. The forecast data is more promising. For example, the medium range forecast data provides 2 - 3 days advanced notice of peak flood conditions to a reasonable level of accuracy in most cases relative to both timing and magnitude. Short range forecast data provides about 12 - 14 hours advanced notice. Since these are hyper-resolution models, flood forecasts can be made at the street level, providing emergency response teams with valuable information for coordinating and dispatching limited resources.

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.

[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…

New methods for regulating flowering time in short-day strawberry

USDA-ARS?s Scientific Manuscript database

Higher percentages of transplants of short-day cultivars 'Chandler', 'Carmine', 'Strawberry Festival', and 'Sweet Charlie' from runner tips plugged in early July rather than the standard time (early August) bloomed in the fall. Nearly 100% of the transplants produced in early July flowered in the f...

Autoregressive-moving-average hidden Markov model for vision-based fall prediction-An application for walker robot.

PubMed

Taghvaei, Sajjad; Jahanandish, Mohammad Hasan; Kosuge, Kazuhiro

2017-01-01

Population aging of the societies requires providing the elderly with safe and dependable assistive technologies in daily life activities. Improving the fall detection algorithms can play a major role in achieving this goal. This article proposes a real-time fall prediction algorithm based on the acquired visual data of a user with walking assistive system from a depth sensor. In the lack of a coupled dynamic model of the human and the assistive walker a hybrid "system identification-machine learning" approach is used. An autoregressive-moving-average (ARMA) model is fitted on the time-series walking data to forecast the upcoming states, and a hidden Markov model (HMM) based classifier is built on the top of the ARMA model to predict falling in the upcoming time frames. The performance of the algorithm is evaluated through experiments with four subjects including an experienced physiotherapist while using a walker robot in five different falling scenarios; namely, fall forward, fall down, fall back, fall left, and fall right. The algorithm successfully predicts the fall with a rate of 84.72%.

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.

Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life.

PubMed

Trombetti, A; Reid, K F; Hars, M; Herrmann, F R; Pasha, E; Phillips, E M; Fielding, R A

2016-02-01

This 3-year longitudinal study among older adults showed that declining muscle mass, strength, power, and physical performance are independent contributing factors to increased fear of falling, while declines of muscle mass and physical performance contribute to deterioration of quality of life. Our findings reinforce the importance of preserving muscle health with advancing age. The age-associated loss of skeletal muscle quantity and function are critical determinants of independent physical functioning in later life. Longitudinal studies investigating how decrements in muscle components of sarcopenia impact fear of falling (FoF) and quality of life (QoL) in older adults are lacking. Twenty-six healthy older subjects (age, 74.1 ± 3.7; Short Physical Performance Battery (SPPB) score ≥10) and 22 mobility-limited older subjects (age, 77.2 ± 4.4; SPPB score ≤9) underwent evaluations of lower extremity muscle size and composition by computed tomography, strength and power, and physical performance at baseline and after 3-year follow-up. The Falls Efficacy Scale (FES) and Short Form-36 questionnaire (SF-36) were also administered at both timepoints to assess FoF and QoL, respectively. At 3-year follow-up, muscle cross-sectional area (CSA) (p < 0.013) and power decreased (p < 0.001), while intermuscular fat infiltration increased (p < 0.001). These decrements were accompanied with a longer time to complete 400 m by 22 ± 46 s (p < 0.002). Using linear mixed-effects regression models, declines of muscle CSA, strength and power, and SPPB score were associated with increased FES score (p < 0.05 for each model). Reduced physical component summary score of SF-36 over follow-up was independently associated with decreased SPPB score (p < 0.020), muscle CSA (p < 0.046), and increased 400 m walk time (p < 0.003). In older adults with and without mobility limitations, declining muscle mass, strength, power, and physical performance contribute independently to increase FoF, while declines of muscle mass and physical performance contribute to deterioration of QoL. These findings provide further rationale for developing interventions to improve aging muscle health.

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

Duality in Power-Law Localization in Disordered One-Dimensional Systems

NASA Astrophysics Data System (ADS)

Deng, X.; Kravtsov, V. E.; Shlyapnikov, G. V.; Santos, L.

2018-03-01

The transport of excitations between pinned particles in many physical systems may be mapped to single-particle models with power-law hopping, 1 /ra . For randomly spaced particles, these models present an effective peculiar disorder that leads to surprising localization properties. We show that in one-dimensional systems almost all eigenstates (except for a few states close to the ground state) are power-law localized for any value of a >0 . Moreover, we show that our model is an example of a new universality class of models with power-law hopping, characterized by a duality between systems with long-range hops (a <1 ) and short-range hops (a >1 ), in which the wave function amplitude falls off algebraically with the same power γ from the localization center.

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.

Comparative study of four physical performance measures as predictors of death, incident disability, and falls in unselected older persons: the insufficienza Cardiaca negli Anziani Residenti a Dicomano Study.

PubMed

Minneci, Cristina; Mello, Anna Maria; Mossello, Enrico; Baldasseroni, Samuele; Macchi, Loredana; Cipolletti, Stefano; Marchionni, Niccolò; Di Bari, Mauro

2015-01-01

To compare the ability of the Short Physical Performance Battery (SPPB), 4-m walk test (4mWT), 6-minute walk test (6MWT), and handgrip strength to predict mortality, incident disability, worsening mobility, and falls in older community dwellers. Cohort study. Population-based. Individuals aged 65 and older n = 561) without prevalent basic activity of daily living (ADL) disability participating. Separate logistic regression models were developed to predict incident ADL disability, worsening mobility, and falls in 3 years, and Cox regression models were used to assess 7-year risk of death as a function of the four tests, adjusting for covariates. Performance tests were reciprocally correlated at baseline. After 3 years, 33 (7.3%) of 453 participants reexamined were disabled in ADLs, 87 (20%) had worsening mobility, and 99 (22%) reported falls. Of the 561 baseline participants, 141 (25%) died over the 7 years. All measures predicted incident ADL disability, with adjusted odds ratios (ORs) per unit increase of 0.85 (95% confidence interval (CI) = 0.77-0.93) for handgrip strength, 0.08 (95% CI = 0.02-0.36) for 4mWT, 0.74 (95% CI = 0.61-0.89) for SPPB, and 0.993 (95% CI = 0.988-0.997) for 6MWT. Handgrip strength (OR = 0.88, 95% CI = 0.83-0.93), 4mWT (OR = 0.33, 95% CI = 0.11-0.94), and SPPB (OR = 0.81, 95%CI = 0.71-0.93) predicted worsening mobility. No measure predicted falls; only SPPB (hazard ratio (HR) = 0.92, 95% CI = 0.85-0.997) and 6MWT (HR = 0.997, 95% CI = 0.995-0.999) predicted death. Performance measures are independent predictors of relevant health outcomes, with the exception of falls. Because SPPB is easily applied and is the only measure predicting incident ADL disability, worsening mobility, and death, it is preferable to the other tests. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

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.

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…

Show the Data, Don't Conceal Them

ERIC Educational Resources Information Center

Drummond, Gordon B.; Vowler, Sarah L.

2011-01-01

Current standards of data presentation and analysis in biological journals often fall short of ideal. This is the first of a planned series of short articles, to be published in a number of journals, aiming to highlight the principles of clear data presentation and appropriate statistical analysis. This article considers the methods used to show…

Conceptualizing a Dynamic Fall Risk Model Including Intrinsic Risks and Exposures.

PubMed

Klenk, Jochen; Becker, Clemens; Palumbo, Pierpaolo; Schwickert, Lars; Rapp, Kilan; Helbostad, Jorunn L; Todd, Chris; Lord, Stephen R; Kerse, Ngaire

2017-11-01

Falls are a major cause of injury and disability in older people, leading to serious health and social consequences including fractures, poor quality of life, loss of independence, and institutionalization. To design and provide adequate prevention measures, accurate understanding and identification of person's individual fall risk is important. However, to date, the performance of fall risk models is weak compared with models estimating, for example, cardiovascular risk. This deficiency may result from 2 factors. First, current models consider risk factors to be stable for each person and not change over time, an assumption that does not reflect real-life experience. Second, current models do not consider the interplay of individual exposure including type of activity (eg, walking, undertaking transfers) and environmental risks (eg, lighting, floor conditions) in which activity is performed. Therefore, we posit a dynamic fall risk model consisting of intrinsic risk factors that vary over time and exposure (activity in context). eHealth sensor technology (eg, smartphones) begins to enable the continuous measurement of both the above factors. We illustrate our model with examples of real-world falls from the FARSEEING database. This dynamic framework for fall risk adds important aspects that may improve understanding of fall mechanisms, fall risk models, and the development of fall prevention interventions. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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.

Neighborhood Social Cohesion and Sleep Outcomes in the Native Hawaiian and Pacific Islander National Health Interview Survey.

PubMed

Young, Marielle C; Gerber, Monica W; Ash, Tayla; Horan, Christine M; Taveras, Elsie M

2018-05-16

Native Hawaiians and Pacific Islanders (NHPIs) have the lowest attainment of healthy sleep duration among all racial and ethnic groups in the United States. We examined associations of neighborhood social cohesion with sleep duration and quality. Cross-sectional analysis of 2,464 adults in the NHPI National Health Interview Survey (2014). Neighborhood social cohesion was categorized as a continuous and categorical variable into low (<12), medium (12-14) and high (>15) according to tertiles of the distribution of responses. We used multinomial logistic regression to examine the adjusted odds ratio of short and long sleep duration relative to intermediate sleep duration. We used binary logistic regression for dichotomous sleep quality outcomes. Sleep outcomes were modeled as categorical variables. 40% of the cohort reported short (<7 hours) sleep duration and only 4% reported long (>9 hours) duration. Mean (SE, range) social cohesion score was 12.4 units (0.11, 4-16) and 23% reported low social cohesion. In multivariable models, each 1 SD decrease in neighborhood social cohesion score was associated with higher odds of short sleep duration (OR: 1.14, 95% CI: 1.02, 1.29). Additionally, low social cohesion was associated with increased odds of short sleep duration (OR: 1.53, 95% CI: 1.10, 2.13). No associations between neighborhood social cohesion and having trouble falling or staying asleep and feeling well rested were found. Low neighborhood social cohesion is associated with short sleep duration in NHPIs.

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.

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

Adams, Marshall; Fortner, Allison M

On December 22, 2008, over 4 million cubic meters of fly ash slurry was released into the Emory River when a dike surrounding a solid waste containment area at the Tennessee Valley Authority's (TVA) Kingston Fossil Plant ruptured. One component of TVA's response to the spill is a biological monitoring program to assess short- and long-term ecological responses to the ash and associated chemicals, including studies on fish health and contaminant bioaccumulation. These studies were initiated in early Spring 2009 for the purposes of: (1) documenting the levels of fly ash-associated metals in various tissues of representative sentinel fish speciesmore » in the area of the fly ash spill, (2) determining if exposure to fly ash-associated metals causes short, intermediate, or long-term health effects on these sentinel fish species, (3) assessing if there are causal relationships between exposure to metals and health effects on fish, (4) evaluating, along with information from other ecological and physicochemical studies, the nature and route of contaminant transfer though food chains into higher level consumers, (5) providing important information for the Ecological Risk Assessment (ERA) for the Kingston fly ash project, and (6) serving as an important technology information transfer or model study focused on how to best evaluate the environmental effects of fly ash (and related environmental stressors), not only at the Kingston site, but also at sites on other aquatic systems where coal-fired generating stations are located. This report presents the results of the first two years of the fish health study. To date, fish health and bioaccumulation studies have been conducted from Spring 2009 though Fall 2011 and includes 6 seasonal studies: Spring 2009, Fall 2009, Spring 2010, Fall 2010, Spring 2011, and Fall 2011. Both the Spring and Fall studies have focused on 3-4 sentinel fish species that represent different feeding habits, behaviors, and home ranges. In addition to fish health and bioaccumulation, the Spring investigations also included reproductive integrity studies on the same fish used for bioaccumulation and fish health. In this report, results of the fish health studies from Spring 2009 through Fall 2010 are presented while an associated report will present the fish reproductive studies conducted during Spring 2009 and Spring 2010. A report on fish bioaccumulation was submitted to TVA in June 2011. The fish health study conducted in conjunction with the bioaccumulation and reproductive study is critical for assessing and evaluating possible causal relationships between contaminant exposure (bioaccumulation) and the response of fish to exposure as reflected by the various measurements of fish health.« less

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.

A quantum wave based compact modeling approach for the current in ultra-short DG MOSFETs suitable for rapid multi-scale simulations

NASA Astrophysics Data System (ADS)

Hosenfeld, Fabian; Horst, Fabian; Iñíguez, Benjamín; Lime, François; Kloes, Alexander

2017-11-01

Source-to-drain (SD) tunneling decreases the device performance in MOSFETs falling below the 10 nm channel length. Modeling quantum mechanical effects including SD tunneling has gained more importance specially for compact model developers. The non-equilibrium Green's function (NEGF) has become a state-of-the-art method for nano-scaled device simulation in the past years. In the sense of a multi-scale simulation approach it is necessary to bridge the gap between compact models with their fast and efficient calculation of the device current, and numerical device models which consider quantum effects of nano-scaled devices. In this work, an NEGF based analytical model for nano-scaled double-gate (DG) MOSFETs is introduced. The model consists of a closed-form potential solution of a classical compact model and a 1D NEGF formalism for calculating the device current, taking into account quantum mechanical effects. The potential calculation omits the iterative coupling and allows the straightforward current calculation. The model is based on a ballistic NEGF approach whereby backscattering effects are considered as second order effect in a closed-form. The accuracy and scalability of the non-iterative DG MOSFET model is inspected in comparison with numerical NanoMOS TCAD data for various channel lengths. With the help of this model investigations on short-channel and temperature effects are performed.

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…

Developing a multi-systemic fall prevention model, incorporating the physical environment, the care process and technology: a systematic review.

PubMed

Choi, Young-Seon; Lawler, Erin; Boenecke, Clayton A; Ponatoski, Edward R; Zimring, Craig M

2011-12-01

This paper reports a review that assessed the effectiveness and characteristics of fall prevention interventions implemented in hospitals. A multi-systemic fall prevention model that establishes a practical framework was developed from the evidence. Falls occur through complex interactions between patient-related and environmental risk factors, suggesting a need for multifaceted fall prevention approaches that address both factors. We searched Medline, CINAHL, PsycInfo and the Web of Science databases for references published between January 1990 and June 2009 and scrutinized secondary references from acquired papers. Due to the heterogeneity of interventions and populations, we conducted a quantitative systematic review without a meta-analysis and used a narrative summary to report findings. From the review, three distinct characteristics of fall prevention interventions emerged: (1) the physical environment, (2) the care process and culture and (3) technology. While clinically significant evidence shows the efficacy of environment-related interventions in reducing falls and fall-related injuries, the literature identified few hospitals that had introduced environment-related interventions in their multifaceted fall intervention strategies. Using the multi-systemic fall prevention model, hospitals should promote a practical strategy that benefits from the collective effects of the physical environment, the care process and culture and technology to prevent falls and fall-related injuries. By doing so, they can more effectively address the various risk factors for falling and therefore, prevent falls. Studies that test the proposed model need to be conducted to establish the efficacy of the model in practice. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

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.

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.

Influence of drought on salamander occupancy of isolated wetlands on the southeastern Coastal Plain of the United States

USGS Publications Warehouse

Walls, Susan C.; Barichivich, William J.; Brown, Mary E.; Scott, David E.; Hossack, Blake R.

2013-01-01

In the southeastern U.S., changes in temperature and precipitation over the last three decades have been the most dramatic in winter and spring seasons. Continuation of these trends could negatively impact pond-breeding amphibians, especially those that rely on winter and spring rains to fill seasonal wetlands, trigger breeding, and ensure reproductive success. From 2009 to 2012, we monitored Spring and Fall presence of aquatic stages (larval and paedomorphic, gilled adult) of a winter-breeding amphibian (the mole salamander, Ambystoma talpoideum) and used multi-season models to estimate occupancy, local colonization and extinction. Seasonal estimates of occupancy, corrected for imperfect detection, declined from 22.3 % of ponds in Spring 2009 to 9.9 % in Fall 2012. Our best supported model suggested that changes in occupancy were driven by increased rates of extinction that corresponded with drought-related drying of ponds. Based on uncertainty in climate change projections for the Southeast, we present a conceptual model of predicted changes in wetland hydroperiods across a landscape with projected decreases and increases in future precipitation. Such precipitation changes could alter wetland hydroperiods, facilitate extinctions of species adapted to short, intermediate or long hydroperiod environments and, ultimately, modify the composition of amphibian communities within freshwater wetland ecosystems.

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.

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

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.

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.

Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults.

PubMed

Jung, Dukyoo; Kang, Younhee; Kim, Mi Young; Ma, Rye-Won; Bhandari, Pratibha

2016-02-01

The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults. © The Author(s) 2014.

"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…

On the SCTC-OCTC Method for the Analysis and Design of Circuits

ERIC Educational Resources Information Center

Salvatori, S.; Conte, G.

2009-01-01

This paper discusses guidelines that emphasize the relevance of short-circuit- and open-circuit-time constant (SCTC and OCTC, respectively) methods in the analysis and design of electronic amplifiers. It is demonstrated that it is only necessary to grasp a few concepts in order to understand that the two short- and open-circuit cases fall into a…

Optimal fall indicators for slip induced falls on a cross-slope.

PubMed

Domone, Sarah; Lawrence, Daniel; Heller, Ben; Hendra, Tim; Mawson, Sue; Wheat, Jonathan

2016-08-01

Slip-induced falls are among the most common cause of major occupational injuries in the UK as well as being a major public health concern in the elderly population. This study aimed to determine the optimal fall indicators for fall detection models which could be used to reduce the detrimental consequences of falls. A total of 264 kinematic variables covering three-dimensional full body model translation and rotational measures were analysed during normal walking, successful recovery from slips and falls on a cross-slope. Large effect sizes were found for three kinematic variables which were able to distinguish falls from normal walking and successful recovery. Further work should consider other types of daily living activities as results show that the optimal kinematic fall indicators can vary considerably between movement types. Practitioner Summary: Fall detection models are used to minimise the adverse consequences of slip-induced falls, a major public health concern. Optimal fall indicators were derived from a comprehensive set of kinematic variables for slips on a cross-slope. Results suggest robust detection of falls is possible on a cross-slope but may be more difficult than level walking.

The IOD-ENSO precursory teleconnection over the tropical Indo-Pacific Ocean: dynamics and long-term trends under global warming

NASA Astrophysics Data System (ADS)

Yuan, Dongliang; Hu, Xiaoyue; Xu, Peng; Zhao, Xia; Masumoto, Yukio; Han, Weiqing

2018-01-01

The dynamics of the teleconnection between the Indian Ocean Dipole (IOD) in the tropical Indian Ocean and El Niño-Southern Oscillation (ENSO) in the tropical Pacific Ocean at the time lag of one year are investigated using lag correlations between the oceanic anomalies in the southeastern tropical Indian Ocean in fall and those in the tropical Indo-Pacific Ocean in the following winter-fall seasons in the observations and in high-resolution global ocean model simulations. The lag correlations suggest that the IOD-forced interannual transport anomalies of the Indonesian Throughflow generate thermocline anomalies in the western equatorial Pacific Ocean, which propagate to the east to induce ocean-atmosphere coupled evolution leading to ENSO. In comparison, lag correlations between the surface zonal wind anomalies over the western equatorial Pacific in fall and the Indo-Pacific oceanic anomalies at time lags longer than a season are all insignificant, suggesting the short memory of the atmospheric bridge. A linear continuously stratified model is used to investigate the dynamics of the oceanic connection between the tropical Indian and Pacific Oceans. The experiments suggest that interannual equatorial Kelvin waves from the Indian Ocean propagate into the equatorial Pacific Ocean through the Makassar Strait and the eastern Indonesian seas with a penetration rate of about 10%-15% depending on the baroclinic modes. The IOD-ENSO teleconnection is found to get stronger in the past century or so. Diagnoses of the CMIP5 model simulations suggest that the increased teleconnection is associated with decreased Indonesian Throughflow transports in the recent century, which is found sensitive to the global warming forcing.

Estimating severity of sideways fall using a generic multi linear regression model based on kinematic input variables.

PubMed

van der Zijden, A M; Groen, B E; Tanck, E; Nienhuis, B; Verdonschot, N; Weerdesteyn, V

2017-03-21

Many research groups have studied fall impact mechanics to understand how fall severity can be reduced to prevent hip fractures. Yet, direct impact force measurements with force plates are restricted to a very limited repertoire of experimental falls. The purpose of this study was to develop a generic model for estimating hip impact forces (i.e. fall severity) in in vivo sideways falls without the use of force plates. Twelve experienced judokas performed sideways Martial Arts (MA) and Block ('natural') falls on a force plate, both with and without a mat on top. Data were analyzed to determine the hip impact force and to derive 11 selected (subject-specific and kinematic) variables. Falls from kneeling height were used to perform a stepwise regression procedure to assess the effects of these input variables and build the model. The final model includes four input variables, involving one subject-specific measure and three kinematic variables: maximum upper body deceleration, body mass, shoulder angle at the instant of 'maximum impact' and maximum hip deceleration. The results showed that estimated and measured hip impact forces were linearly related (explained variances ranging from 46 to 63%). Hip impact forces of MA falls onto the mat from a standing position (3650±916N) estimated by the final model were comparable with measured values (3698±689N), even though these data were not used for training the model. In conclusion, a generic linear regression model was developed that enables the assessment of fall severity through kinematic measures of sideways falls, without using force plates. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2018-01-01

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

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.

Validation of Predictors of Fall Events in Hospitalized Patients With Cancer.

PubMed

Weed-Pfaff, Samantha H; Nutter, Benjamin; Bena, James F; Forney, Jennifer; Field, Rosemary; Szoka, Lynn; Karius, Diana; Akins, Patti; Colvin, Christina M; Albert, Nancy M

2016-10-01

A seven-item cancer-specific fall risk tool (Cleveland Clinic Capone-Albert [CC-CA] Fall Risk Score) was shown to have a strong concordance index for predicting falls; however, validation of the model is needed. The aims of this study were to validate that the CC-CA Fall Risk Score, made up of six factors, predicts falls in patients with cancer and to determine if the CC-CA Fall Risk Score performs better than the Morse Fall Tool. Using a prospective, comparative methodology, data were collected from electronic health records of patients hospitalized for cancer care in four hospitals. Risk factors from each tool were recorded, when applicable. Multivariable models were created to predict the probability of a fall. A concordance index for each fall tool was calculated. The CC-CA Fall Risk Score provided higher discrimination than the Morse Fall Tool in predicting fall events in patients hospitalized for cancer management.

Java PathFinder User Guide

NASA Technical Reports Server (NTRS)

Havelund, Klaus

1999-01-01

The JAVA PATHFINDER, JPF, is a translator from a subset of JAVA 1.0 to PROMELA, the programming language of the SPIN model checker. The purpose of JPF is to establish a framework for verification and debugging of JAVA programming based on model checking. The main goal is to automate program verification such that a programmer can apply it in the daily work without the need for a specialist to manually reformulate a program into a different notation in order to analyze the program. The system is especially suited for analyzing multi-threaded JAVA applications, where normal testing usually falls short. The system can find deadlocks and violations of boolean assertions stated by the programmer in a special assertion language. This document explains how to Use JPF.

"Staying safe" - a narrative review of falls prevention in people with Parkinson's - "PDSAFE".

PubMed

Hulbert, Sophia; Rochester, Lynn; Nieuwboer, Alice; Goodwin, Vicki; Fitton, Carolyn; Chivers-Seymour, Kim; Ashburn, Ann

2018-05-18

Parkinson's disease demonstrates a spectrum of motor and non-motor symptoms. Falling is common and disabling. Current medical management shows minimal impact to reduce falls or fall-related risk factors, such as deficits in gait, strength, and postural instability. Despite evidence supporting rehabilitation in reducing fall risk factors, the most appropriate intervention to reduce overall fall rate remains inconclusive. This article aims to 1) synthesise current evidence and conceptual models of falls rehabilitation in Parkinson's in a narrative review; and based on this evidence, 2) introduce the treatment protocol used in the falls prevention and multi-centre clinical trial "PDSAFE". Search of four bibliographic databases using the terms "Parkinson*" and "Fall*" combined with each of the following; "Rehab*, Balanc*, Strength*, Strateg*and Exercis*" and a framework for narrative review was followed. A total of 3557 papers were identified, 416 were selected for review. The majority report the impact of rehabilitation on isolated fall risk factors. Twelve directly measure the impact on overall fall rate. Results were used to construct a narrative review with conceptual discussion based on the "International Classification of Functioning", leading to presentation of the "PDSAFE" intervention protocol. Evidence suggests training single, fall risk factors may not affect overall fall rate. Combining with behavioural and strategy training in a functional, personalised multi-dimensional model, addressing all components of the "International Classification of Functioning" is likely to provide a greater influence on falls reduction. "PDSAFE" is a multi-dimensional, physiotherapist delivered, individually tailored, progressive, home-based programme. It is designed with a strong evidence-based approach and illustrates a model for the clinical delivery of the conceptual theory discussed. Implications for Rehabilitation Parkinson's disease demonstrates a spectrum of motor and non-motor symptoms, where falling is common and disabling. Current medical and surgical management have minimal impact on falls, rehabilitation of falls risk factors has strong evidence but the most appropriate intervention to reduce overall fall rate remains inconclusive. Addressing all components of the International Classification of Function in a multifactorial model when designing falls rehabilitation interventions may be more effective at reducing fall rates in people with Parkinson's than treating isolated risk factors. The clinical model for falls rehabilitation in people with Parkinson's should be multi-dimensional.

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

PubMed Central

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

2013-01-01

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

Accelerometer and Camera-Based Strategy for Improved Human Fall Detection.

PubMed

Zerrouki, Nabil; Harrou, Fouzi; Sun, Ying; Houacine, Amrane

2016-12-01

In this paper, we address the problem of detecting human falls using anomaly detection. Detection and classification of falls are based on accelerometric data and variations in human silhouette shape. First, we use the exponentially weighted moving average (EWMA) monitoring scheme to detect a potential fall in the accelerometric data. We used an EWMA to identify features that correspond with a particular type of fall allowing us to classify falls. Only features corresponding with detected falls were used in the classification phase. A benefit of using a subset of the original data to design classification models minimizes training time and simplifies models. Based on features corresponding to detected falls, we used the support vector machine (SVM) algorithm to distinguish between true falls and fall-like events. We apply this strategy to the publicly available fall detection databases from the university of Rzeszow's. Results indicated that our strategy accurately detected and classified fall events, suggesting its potential application to early alert mechanisms in the event of fall situations and its capability for classification of detected falls. Comparison of the classification results using the EWMA-based SVM classifier method with those achieved using three commonly used machine learning classifiers, neural network, K-nearest neighbor and naïve Bayes, proved our model superior.

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.

Archeological treasures protection based on early forest wildfire multi-band imaging detection system

NASA Astrophysics Data System (ADS)

Gouverneur, B.; Verstockt, S.; Pauwels, E.; Han, J.; de Zeeuw, P. M.; Vermeiren, J.

2012-10-01

Various visible and infrared cameras have been tested for the early detection of wildfires to protect archeological treasures. This analysis was possible thanks to the EU Firesense project (FP7-244088). Although visible cameras are low cost and give good results during daytime for smoke detection, they fall short under bad visibility conditions. In order to improve the fire detection probability and reduce the false alarms, several infrared bands are tested ranging from the NIR to the LWIR. The SWIR and the LWIR band are helpful to locate the fire through smoke if there is a direct Line Of Sight. The Emphasis is also put on the physical and the electro-optical system modeling for forest fire detection at short and longer ranges. The fusion in three bands (Visible, SWIR, LWIR) is discussed at the pixel level for image enhancement and for fire detection.

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.

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.

Rockfall hazard and risk assessment in the Yosemite Valley, California, USA

USGS Publications Warehouse

Guzzetti, F.; Reichenbach, P.; Wieczorek, G.F.

2003-01-01

Rock slides and rock falls are the most frequent types of slope movements in Yosemite National Park, California. In historical time (1857-2002) 392 rock falls and rock slides have been documented in the valley, and some of them have been mapped in detail. We present the results of an attempt to assess rock fall hazards in the Yosemite Valley. Spatial and temporal aspects of rock falls hazard are considered. A detailed inventory of slope movements covering the 145-year period from 1857 to 2002 is used to determine the frequency-volume statistics of rock falls and to estimate the annual frequency of rock falls, providing the temporal component of rock fall hazard. The extent of the areas potentially subject to rock fall hazards in the Yosemite Valley were obtained using STONE, a physically-based rock fall simulation computer program. The software computes 3-dimensional rock fall trajectories starting from a digital elevation model (DEM), the location of rock fall release points, and maps of the dynamic rolling friction coefficient and of the coefficients of normal and tangential energy restitution. For each DEM cell the software calculates the number of rock falls passing through the cell, the maximum rock fall velocity and the maximum flying height. For the Yosemite Valley, a DEM with a ground resolution of 10 ?? 10 m was prepared using topographic contour lines from the U.S. Geological Survey 1:24 000-scale maps. Rock fall release points were identified as DEM cells having a slope steeper than 60??, an assumption based on the location of historical rock falls. Maps of the normal and tangential energy restitution coefficients and of the rolling friction coefficient were produced from a surficial geologic map. The availability of historical rock falls mapped in detail allowed us to check the computer program performance and to calibrate the model parameters. Visual and statistical comparison of the model results with the mapped rock falls confirmed the accuracy of the model. The model results are compared with a previous map of rockfall talus and with a geomorphic assessment of rock fall hazard based on potential energy referred to as a shadow angle approach, recently completed for the Yosemite Valley. The model results are then used to identify the roads and trails more subject to rock fall hazard. Of the 166.5 km of roads and trails in the Yosemite Valley 31.2% were found to be potentially subject to rock fall hazard, of which 14% are subject to very high hazard. ?? European Geosciences Union 2003.

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.

Sea surface salinity and temperature-based predictive modeling of southwestern US winter precipitation: improvements, errors, and potential mechanisms

NASA Astrophysics Data System (ADS)

Liu, T.; Schmitt, R. W.; Li, L.

2017-12-01

Using 69 years of historical data from 1948-2017, we developed a method to globally search for sea surface salinity (SSS) and temperature (SST) predictors of regional terrestrial precipitation. We then applied this method to build an autumn (SON) SSS and SST-based 3-month lead predictive model of winter (DJF) precipitation in southwestern United States. We also find that SSS-only models perform better than SST-only models. We previously used an arbitrary correlation coefficient (r) threshold, |r| > 0.25, to define SSS and SST predictor polygons for best subset regression of southwestern US winter precipitation; from preliminary sensitivity tests, we find that |r| > 0.18 yields the best models. The observed below-average precipitation (0.69 mm/day) in winter 2015-2016 falls within the 95% confidence interval of the prediction model. However, the model underestimates the anomalous high precipitation (1.78 mm/day) in winter 2016-2017 by more than three-fold. Moisture transport mainly attributed to "pineapple express" atmospheric rivers (ARs) in winter 2016-2017 suggests that the model falls short on a sub-seasonal scale, in which case storms from ARs contribute a significant portion of seasonal terrestrial precipitation. Further, we identify a potential mechanism for long-range SSS and precipitation teleconnections: standing Rossby waves. The heat applied to the atmosphere from anomalous tropical rainfall can generate standing Rossby waves that propagate to higher latitudes. SSS anomalies may be indicative of anomalous tropical rainfall, and by extension, standing Rossby waves that provide the long-range teleconnections.

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.

Development of a Risk Assessment Tool to Predict Fall-Related Severe Injuries Occurring in a Hospital

PubMed Central

Toyabe, Shin-ichi

2014-01-01

Inpatient falls are the most common adverse events that occur in a hospital, and about 3 to 10% of falls result in serious injuries such as bone fractures and intracranial haemorrhages. We previously reported that bone fractures and intracranial haemorrhages were two major fall-related injuries and that risk assessment score for osteoporotic bone fracture was significantly associated not only with bone fractures after falls but also with intracranial haemorrhage after falls. Based on the results, we tried to establish a risk assessment tool for predicting fall-related severe injuries in a hospital. Possible risk factors related to fall-related serious injuries were extracted from data on inpatients that were admitted to a tertiary-care university hospital by using multivariate Cox’ s regression analysis and multiple logistic regression analysis. We found that fall risk score and fracture risk score were the two significant factors, and we constructed models to predict fall-related severe injuries incorporating these factors. When the prediction model was applied to another independent dataset, the constructed model could detect patients with fall-related severe injuries efficiently. The new assessment system could identify patients prone to severe injuries after falls in a reproducible fashion. PMID:25168984

Probabilistic short-term volcanic hazard in phases of unrest: A case study for tephra fallout

NASA Astrophysics Data System (ADS)

Selva, Jacopo; Costa, Antonio; Sandri, Laura; Macedonio, Giovanni; Marzocchi, Warner

2014-12-01

During volcanic crises, volcanologists estimate the impact of possible imminent eruptions usually through deterministic modeling of the effects of one or a few preestablished scenarios. Despite such an approach may bring an important information to the decision makers, the sole use of deterministic scenarios does not allow scientists to properly take into consideration all uncertainties, and it cannot be used to assess quantitatively the risk because the latter unavoidably requires a probabilistic approach. We present a model based on the concept of Bayesian event tree (hereinafter named BET_VH_ST, standing for Bayesian event tree for short-term volcanic hazard), for short-term near-real-time probabilistic volcanic hazard analysis formulated for any potential hazardous phenomenon accompanying an eruption. The specific goal of BET_VH_ST is to produce a quantitative assessment of the probability of exceedance of any potential level of intensity for a given volcanic hazard due to eruptions within restricted time windows (hours to days) in any area surrounding the volcano, accounting for all natural and epistemic uncertainties. BET_VH_ST properly assesses the conditional probability at each level of the event tree accounting for any relevant information derived from the monitoring system, theoretical models, and the past history of the volcano, propagating any relevant epistemic uncertainty underlying these assessments. As an application example of the model, we apply BET_VH_ST to assess short-term volcanic hazard related to tephra loading during Major Emergency Simulation Exercise, a major exercise at Mount Vesuvius that took place from 19 to 23 October 2006, consisting in a blind simulation of Vesuvius reactivation, from the early warning phase up to the final eruption, including the evacuation of a sample of about 2000 people from the area at risk. The results show that BET_VH_ST is able to produce short-term forecasts of the impact of tephra fall during a rapidly evolving crisis, accurately accounting for and propagating all uncertainties and enabling rational decision making under uncertainty.

Afterglows and Kilonovae Associated with Nearby Low-luminosity Short-duration Gamma-Ray Bursts: Application to GW170817/GRB 170817A

NASA Astrophysics Data System (ADS)

Xiao, Di; Liu, Liang-Duan; Dai, Zi-Gao; Wu, Xue-Feng

2017-12-01

Very recently, the gravitational-wave (GW) event GW170817 was discovered to be associated with the short gamma-ray burst (GRB) 170817A. Multi-wavelength follow-up observations were carried out, and X-ray, optical, and radio counterparts to GW170817 were detected. The observations undoubtedly indicate that GRB 170817A originates from a binary neutron star merger. However, the GRB falls into the low-luminosity class that could have a higher statistical occurrence rate and detection probability than the normal (high-luminosity) class. This implies the possibility that GRB 170817A is intrinsically powerful, but we are off-axis and only observe its side emission. In this Letter, we provide a timely modeling of the multi-wavelength afterglow emission from this GRB and the associated kilonova signal from the merger ejecta, under the assumption of a structured jet, a two-component jet, and an intrinsically less-energetic quasi-isotropic fireball, respectively. Comparing the afterglow properties with the multi-wavelength follow-up observations, we can distinguish between these three models. Furthermore, a few model parameters (e.g., the ejecta mass and velocity) can be constrained.

Testing the Predictive Validity of the Hendrich II Fall Risk Model.

PubMed

Jung, Hyesil; Park, Hyeoun-Ae

2018-03-01

Cumulative data on patient fall risk have been compiled in electronic medical records systems, and it is possible to test the validity of fall-risk assessment tools using these data between the times of admission and occurrence of a fall. The Hendrich II Fall Risk Model scores assessed during three time points of hospital stays were extracted and used for testing the predictive validity: (a) upon admission, (b) when the maximum fall-risk score from admission to falling or discharge, and (c) immediately before falling or discharge. Predictive validity was examined using seven predictive indicators. In addition, logistic regression analysis was used to identify factors that significantly affect the occurrence of a fall. Among the different time points, the maximum fall-risk score assessed between admission and falling or discharge showed the best predictive performance. Confusion or disorientation and having a poor ability to rise from a sitting position were significant risk factors for a fall.

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.

Predictive model for falling in Parkinson disease patients.

PubMed

Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Montesinos, Rosa; Castro-Suarez, Sheila; Cuenca-Alfaro, Jose; Cortijo, Patricia

2016-12-01

Falls are a common complication of advancing Parkinson's disease (PD). Although numerous risk factors are known, reliable predictors of future falls are still lacking. The aim of this study was to develop a multivariate model to predict falling in PD patients. Prospective cohort with forty-nine PD patients. The area under the receiver-operating characteristic curve (AUC) was calculated to evaluate predictive performance of the purposed multivariate model. The median of PD duration and UPDRS-III score in the cohort was 6 years and 24 points, respectively. Falls occurred in 18 PD patients (30%). Predictive factors for falling identified by univariate analysis were age, PD duration, physical activity, and scores of UPDRS motor, FOG, ACE, IFS, PFAQ and GDS ( p -value < 0.001), as well as fear of falling score ( p -value = 0.04). The final multivariate model (PD duration, FOG, ACE, and physical activity) showed an AUC = 0.9282 (correctly classified = 89.83%; sensitivity = 92.68%; specificity = 83.33%). This study showed that our multivariate model have a high performance to predict falling in a sample of PD patients.

Dynamic Blowout Risk Analysis Using Loss Functions.

PubMed

Abimbola, Majeed; Khan, Faisal

2018-02-01

Most risk analysis approaches are static; failing to capture evolving conditions. Blowout, the most feared accident during a drilling operation, is a complex and dynamic event. The traditional risk analysis methods are useful in the early design stage of drilling operation while falling short during evolving operational decision making. A new dynamic risk analysis approach is presented to capture evolving situations through dynamic probability and consequence models. The dynamic consequence models, the focus of this study, are developed in terms of loss functions. These models are subsequently integrated with the probability to estimate operational risk, providing a real-time risk analysis. The real-time evolving situation is considered dependent on the changing bottom-hole pressure as drilling progresses. The application of the methodology and models are demonstrated with a case study of an offshore drilling operation evolving to a blowout. © 2017 Society for Risk Analysis.

A multiloop generalization of the circle criterion for stability margin analysis

NASA Technical Reports Server (NTRS)

Safonov, M. G.; Athans, M.

1979-01-01

In order to provide a theoretical tool suited for characterizing the stability margins of multiloop feedback systems, multiloop input-output stability results generalizing the circle stability criterion are considered. Generalized conic sectors with 'centers' and 'radii' determined by linear dynamical operators are employed to specify the stability margins as a frequency dependent convex set of modeling errors (including nonlinearities, gain variations and phase variations) which the system must be able to tolerate in each feedback loop without instability. The resulting stability criterion gives sufficient conditions for closed loop stability in the presence of frequency dependent modeling errors, even when the modeling errors occur simultaneously in all loops. The stability conditions yield an easily interpreted scalar measure of the amount by which a multiloop system exceeds, or falls short of, its stability margin specifications.

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...

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.

Combining Motivational and Physical Intervention Components to Promote Fall-Reducing Physical Activity Among Community-Dwelling Older Adults: A Feasibility Study.

PubMed

McMahon, Siobhan Kathleen; Wyman, Jean F; Belyea, Michael J; Shearer, Nelma; Hekler, Eric B; Fleury, Julie

2016-11-01

To assess the feasibility of a new intervention, Ready~Steady, in terms of demand, acceptability, implementation, and limited efficacy. Randomized controlled trial; repeated measures. Two rural communities in Itasca County, Minnesota. Thirty participants were randomized to an intervention (n = 16) or attention-control (n = 14) group. Ready~Steady combined two components: (1) motivational (motivational support, social network support, empowering education), and (2) fall-reducing physical activities (PAs; guidance to practice leg-strengthening, balance, and flexibility activities and walking). Acceptability questionnaire and Indices of Procedural Consistency (investigator developed), Community Health Activity Model Program for Seniors Questionnaire (confirmed with accelerometry), Short Physical Performance Battery, Perceived Environmental Support Scale, Social Support for Exercise Questionnaire, Goal Attainment Scale, Index of Readiness, and Index of Self-Regulation. Descriptive statistics and a marginal approach to repeated-measures analysis of variance, using mixed-model procedures. Attrition was 7% and mean attendance was 7.2 of 8 sessions, participants evaluated Ready~Steady as acceptable, and implementation fidelity was good. The intervention group improved significantly more than the attention-control group in PA behavior, F 1,27 = 11.92, p = .002; fall risk (functional balance and strength), F 1,27 = 14.89, p = .001; support for exercise from friends, F 1,27 = 11.44, p = .002; and self-regulation, F 1,26 = 38.82, p < .005. The Ready~Steady intervention was feasible as evidenced by low attrition and good attendance and implementation, as well as positive effects on targeted outcomes and theoretical mechanisms of change. © 2016 by American Journal of Health Promotion, Inc.

The development of a fear of falling interdisciplinary intervention program

PubMed Central

Gomez, Fernando; Curcio, Carmen-Lucia

2007-01-01

Objective: To describe the development process of a protocol for a fear of falling interdisciplinary intervention program based on the main factors associated with fear of falling. Design/methods: The process of developing a protocol consisted of defining the target population, selecting the initial assessment components, adapting the intervention program based on findings about fear of falling and restriction of activities in this population. Settings: University-affiliated outpatient vertigo, dizziness and falls clinic in coffee-growers zone of Colombian Andes Mountains. Results: An intervention program was developed based on three main falling conceptual models. A medical intervention, based on a biomedical and pathophysiological model, a physiotherapeutic intervention based on a postural control model and a psychological intervention based on a biological-behavioral model. Conclusion: This interdisciplinary fear of falling intervention program developed is based on particular characteristics of target population, with differences in the inclusion criteria and the program intervention components; with emphasis on medical (recurrent falls and dizziness evaluation and management), psychological (cognitive-behavioral therapy) and physiotherapeutic (balance and transfers training) components. PMID:18225468

Modeling volcanic ash dispersal

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

Macedonio, Giovanni

2010-10-22

Explosive volcanic eruptions inject into the atmosphere large amounts of volcanic material (ash, blocks and lapilli). Blocks and larger lapilli follow ballistic and non-ballistic trajectories and fall rapidly close to the volcano. In contrast, very fine ashes can remain entrapped in the atmosphere for months to years, and may affect the global climate in the case of large eruptions. Particles having sizes between these two end-members remain airborne from hours to days and can cover wide areas downwind. Such volcanic fallout entails a serious threat to aircraft safety and can create many undesirable effects to the communities located around themore » volcano. The assessment of volcanic fallout hazard is an important scientific, economic, and political issue, especially in densely populated areas. From a scientific point of view, considerable progress has been made during the last two decades through the use of increasingly powerful computational models and capabilities. Nowadays, models are used to quantify hazard scenarios and/or to give short-term forecasts during emergency situations. This talk will be focused on the main aspects related to modeling volcanic ash dispersal and fallout with application to the well known problem created by the Eyjafjöll volcano in Iceland. Moreover, a short description of the main volcanic monitoring techniques is presented.« less

Modeling volcanic ash dispersal

ScienceCinema

Macedonio, Giovanni

2018-05-22

Explosive volcanic eruptions inject into the atmosphere large amounts of volcanic material (ash, blocks and lapilli). Blocks and larger lapilli follow ballistic and non-ballistic trajectories and fall rapidly close to the volcano. In contrast, very fine ashes can remain entrapped in the atmosphere for months to years, and may affect the global climate in the case of large eruptions. Particles having sizes between these two end-members remain airborne from hours to days and can cover wide areas downwind. Such volcanic fallout entails a serious threat to aircraft safety and can create many undesirable effects to the communities located around the volcano. The assessment of volcanic fallout hazard is an important scientific, economic, and political issue, especially in densely populated areas. From a scientific point of view, considerable progress has been made during the last two decades through the use of increasingly powerful computational models and capabilities. Nowadays, models are used to quantify hazard scenarios and/or to give short-term forecasts during emergency situations. This talk will be focused on the main aspects related to modeling volcanic ash dispersal and fallout with application to the well known problem created by the Eyjafjöll volcano in Iceland. Moreover, a short description of the main volcanic monitoring techniques is presented.

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

Gait dynamics to optimize fall risk assessment in geriatric patients admitted to an outpatient diagnostic clinic

PubMed Central

de Groot, Maartje H.; van Campen, Jos P.; Beijnen, Jos H.; Hortobágyi, Tibor; Vuillerme, Nicolas; Lamoth, Claudine C. J.

2017-01-01

Fall prediction in geriatric patients remains challenging because the increased fall risk involves multiple, interrelated factors caused by natural aging and/or pathology. Therefore, we used a multi-factorial statistical approach to model categories of modifiable fall risk factors among geriatric patients to identify fallers with highest sensitivity and specificity with a focus on gait performance. Patients (n = 61, age = 79; 41% fallers) underwent extensive screening in three categories: (1) patient characteristics (e.g., handgrip strength, medication use, osteoporosis-related factors) (2) cognitive function (global cognition, memory, executive function), and (3) gait performance (speed-related and dynamic outcomes assessed by tri-axial trunk accelerometry). Falls were registered prospectively (mean follow-up 8.6 months) and one year retrospectively. Principal Component Analysis (PCA) on 11 gait variables was performed to determine underlying gait properties. Three fall-classification models were then built using Partial Least Squares–Discriminant Analysis (PLS-DA), with separate and combined analyses of the fall risk factors. PCA identified ‘pace’, ‘variability’, and ‘coordination’ as key properties of gait. The best PLS-DA model produced a fall classification accuracy of AUC = 0.93. The specificity of the model using patient characteristics was 60% but reached 80% when cognitive and gait outcomes were added. The inclusion of cognition and gait dynamics in fall classification models reduced misclassification. We therefore recommend assessing geriatric patients’ fall risk using a multi-factorial approach that incorporates patient characteristics, cognition, and gait dynamics. PMID:28575126

Gait dynamics to optimize fall risk assessment in geriatric patients admitted to an outpatient diagnostic clinic.

PubMed

Kikkert, Lisette H J; de Groot, Maartje H; van Campen, Jos P; Beijnen, Jos H; Hortobágyi, Tibor; Vuillerme, Nicolas; Lamoth, Claudine C J

2017-01-01

Fall prediction in geriatric patients remains challenging because the increased fall risk involves multiple, interrelated factors caused by natural aging and/or pathology. Therefore, we used a multi-factorial statistical approach to model categories of modifiable fall risk factors among geriatric patients to identify fallers with highest sensitivity and specificity with a focus on gait performance. Patients (n = 61, age = 79; 41% fallers) underwent extensive screening in three categories: (1) patient characteristics (e.g., handgrip strength, medication use, osteoporosis-related factors) (2) cognitive function (global cognition, memory, executive function), and (3) gait performance (speed-related and dynamic outcomes assessed by tri-axial trunk accelerometry). Falls were registered prospectively (mean follow-up 8.6 months) and one year retrospectively. Principal Component Analysis (PCA) on 11 gait variables was performed to determine underlying gait properties. Three fall-classification models were then built using Partial Least Squares-Discriminant Analysis (PLS-DA), with separate and combined analyses of the fall risk factors. PCA identified 'pace', 'variability', and 'coordination' as key properties of gait. The best PLS-DA model produced a fall classification accuracy of AUC = 0.93. The specificity of the model using patient characteristics was 60% but reached 80% when cognitive and gait outcomes were added. The inclusion of cognition and gait dynamics in fall classification models reduced misclassification. We therefore recommend assessing geriatric patients' fall risk using a multi-factorial approach that incorporates patient characteristics, cognition, and gait dynamics.

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.

[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

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.

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.

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.

A comprehensive Network Security Risk Model for process control networks.

PubMed

Henry, Matthew H; Haimes, Yacov Y

2009-02-01

The risk of cyber attacks on process control networks (PCN) is receiving significant attention due to the potentially catastrophic extent to which PCN failures can damage the infrastructures and commodity flows that they support. Risk management addresses the coupled problems of (1) reducing the likelihood that cyber attacks would succeed in disrupting PCN operation and (2) reducing the severity of consequences in the event of PCN failure or manipulation. The Network Security Risk Model (NSRM) developed in this article provides a means of evaluating the efficacy of candidate risk management policies by modeling the baseline risk and assessing expectations of risk after the implementation of candidate measures. Where existing risk models fall short of providing adequate insight into the efficacy of candidate risk management policies due to shortcomings in their structure or formulation, the NSRM provides model structure and an associated modeling methodology that captures the relevant dynamics of cyber attacks on PCN for risk analysis. This article develops the NSRM in detail in the context of an illustrative example.

Determination of wind tunnel constraint effects by a unified pressure signature method. Part 2: Application to jet-in-crossflow

NASA Technical Reports Server (NTRS)

Hackett, J. E.; Sampath, S.; Phillips, C. G.

1981-01-01

The development of an improved jet-in-crossflow model for estimating wind tunnel blockage and angle-of-attack interference is described. Experiments showed that the simpler existing models fall seriously short of representing far-field flows properly. A new, vortex-source-doublet (VSD) model was therefore developed which employs curved trajectories and experimentally-based singularity strengths. The new model is consistent with existing and new experimental data and it predicts tunnel wall (i.e. far-field) pressures properly. It is implemented as a preprocessor to the wall-pressure-signature-based tunnel interference predictor. The supporting experiments and theoretical studies revealed some new results. Comparative flow field measurements with 1-inch "free-air" and 3-inch impinging jets showed that vortex penetration into the flow, in diameters, was almost unaltered until 'hard' impingement occurred. In modeling impinging cases, a 'plume redirection' term was introduced which is apparently absent in previous models. The effects of this term were found to be very significant.

Self-organization in the limb: a Turing mechanism for digit development.

PubMed

Cooper, Kimberly L

2015-06-01

The statistician George E. P. Box stated, 'Essentially all models are wrong, but some are useful.' (Box GEP, Draper NR: Empirical Model-Building and Response Surfaces. Wiley; 1987). Modeling biological processes is challenging for many of the reasons classically trained developmental biologists often resist the idea that black and white equations can explain the grayscale subtleties of living things. Although a simplified mathematical model of development will undoubtedly fall short of precision, a good model is exceedingly useful if it raises at least as many testable questions as it answers. Self-organizing Turing models that simulate the pattern of digits in the hand replicate events that have not yet been explained by classical approaches. The union of theory and experimentation has recently identified and validated the minimal components of a Turing network for digit pattern and triggered a cascade of questions that will undoubtedly be well-served by the continued merging of disciplines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Plasma plume diagnostics of low power stationary plasma thruster (SPT-20M8) with collisional radiative model

NASA Astrophysics Data System (ADS)

Uttamsing Rajput, Rajendrasing; Alona, Khaustova; Loyan, Andriy V.

2017-03-01

Electric propulsion offers higher specific impulse compared to the chemical propulsion systems. It reduces the overall propellant mass and enables high operational lifetimes. Scientific Technological Center of Space Power and Energy (STC SPE), KhAI is involved in designing, manufacturing and testing of stationary plasma thrusters (SPT). Efforts are made to perform plasma diagnostics with corona and collisional radiative models (C-R model), as expected corona model falls short below 4 eV because of the heavy particle collisions elimination, whereas the C-R model's applicability is confirmed. Several tests are performed to analyze the electron temperature at various operational parameters of thruster like discharge voltage and mass flow rate. SPT-20M8 far and near-field plumes diagnostics are performed. Feasibility of C-R model by comparing its result to optical emission spectroscopy (OES) to investigate the electron temperature is validated with the probe measurements within the 10% of discrepancy.

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.

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.

Population exposure to hazardous air quality due to the 2015 fires in Equatorial Asia.

PubMed

Crippa, P; Castruccio, S; Archer-Nicholls, S; Lebron, G B; Kuwata, M; Thota, A; Sumin, S; Butt, E; Wiedinmyer, C; Spracklen, D V

2016-11-16

Vegetation and peatland fires cause poor air quality and thousands of premature deaths across densely populated regions in Equatorial Asia. Strong El-Niño and positive Indian Ocean Dipole conditions are associated with an increase in the frequency and intensity of wildfires in Indonesia and Borneo, enhancing population exposure to hazardous concentrations of smoke and air pollutants. Here we investigate the impact on air quality and population exposure of wildfires in Equatorial Asia during Fall 2015, which were the largest over the past two decades. We performed high-resolution simulations using the Weather Research and Forecasting model with Chemistry based on a new fire emission product. The model captures the spatio-temporal variability of extreme pollution episodes relative to space- and ground-based observations and allows for identification of pollution sources and transport over Equatorial Asia. We calculate that high particulate matter concentrations from fires during Fall 2015 were responsible for persistent exposure of 69 million people to unhealthy air quality conditions. Short-term exposure to this pollution may have caused 11,880 (6,153-17,270) excess mortalities. Results from this research provide decision-relevant information to policy makers regarding the impact of land use changes and human driven deforestation on fire frequency and population exposure to degraded air quality.

Population exposure to hazardous air quality due to the 2015 fires in Equatorial Asia

PubMed Central

Crippa, P.; Castruccio, S.; Archer-Nicholls, S.; Lebron, G. B.; Kuwata, M.; Thota, A.; Sumin, S.; Butt, E.; Wiedinmyer, C.; Spracklen, D. V.

2016-01-01

Vegetation and peatland fires cause poor air quality and thousands of premature deaths across densely populated regions in Equatorial Asia. Strong El-Niño and positive Indian Ocean Dipole conditions are associated with an increase in the frequency and intensity of wildfires in Indonesia and Borneo, enhancing population exposure to hazardous concentrations of smoke and air pollutants. Here we investigate the impact on air quality and population exposure of wildfires in Equatorial Asia during Fall 2015, which were the largest over the past two decades. We performed high-resolution simulations using the Weather Research and Forecasting model with Chemistry based on a new fire emission product. The model captures the spatio-temporal variability of extreme pollution episodes relative to space- and ground-based observations and allows for identification of pollution sources and transport over Equatorial Asia. We calculate that high particulate matter concentrations from fires during Fall 2015 were responsible for persistent exposure of 69 million people to unhealthy air quality conditions. Short-term exposure to this pollution may have caused 11,880 (6,153–17,270) excess mortalities. Results from this research provide decision-relevant information to policy makers regarding the impact of land use changes and human driven deforestation on fire frequency and population exposure to degraded air quality. PMID:27848989

Circumpulsar Asteroids: Inferences from Nulling Statistics and High Energy Correlations

NASA Astrophysics Data System (ADS)

Shannon, Ryan; Cordes, J. M.

2006-12-01

We have proposed that some classes of radio pulsar variability are associated with the entry of neutral asteroidal material into the pulsar magnetosphere. The region surrounding neutron stars is polluted with supernova fall-back material, which collapses and condenses into an asteroid-bearing disk that is stable for millions of years. Over time, collisional and radiative processes cause the asteroids to migrate inward until they are heated to the point of ionization. For older and cooler pulsars, asteroids ionize within the large magnetospheres and inject a sufficient amount of charged particles to alter the electrodynamics of the gap regions and modulate emission processes. This extrinsic model unifies many observed phenomena of variability that occur on time scales that are disparate with the much shorter time scales associated with pulsars and their magnetospheres. One such type of variability is nulling, in which certain pulsars exhibit episodes of quiescence that for some objects may be as short as a few pulse periods, but, for others, is longer than days. Here, in the context of this model, we examine the nulling phenomenon. We analyze the relationship between in-falling material and the statistics of nulling. In addition, as motivation for further high energy observations, we consider the relationship between the nulling and other magnetospheric processes.

Wearable-Sensor-Based Classification Models of Faller Status in Older Adults.

PubMed

Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan

2016-01-01

Wearable sensors have potential for quantitative, gait-based, point-of-care fall risk assessment that can be easily and quickly implemented in clinical-care and older-adult living environments. This investigation generated models for wearable-sensor based fall-risk classification in older adults and identified the optimal sensor type, location, combination, and modelling method; for walking with and without a cognitive load task. A convenience sample of 100 older individuals (75.5 ± 6.7 years; 76 non-fallers, 24 fallers based on 6 month retrospective fall occurrence) walked 7.62 m under single-task and dual-task conditions while wearing pressure-sensing insoles and tri-axial accelerometers at the head, pelvis, and left and right shanks. Participants also completed the Activities-specific Balance Confidence scale, Community Health Activities Model Program for Seniors questionnaire, six minute walk test, and ranked their fear of falling. Fall risk classification models were assessed for all sensor combinations and three model types: multi-layer perceptron neural network, naïve Bayesian, and support vector machine. The best performing model was a multi-layer perceptron neural network with input parameters from pressure-sensing insoles and head, pelvis, and left shank accelerometers (accuracy = 84%, F1 score = 0.600, MCC score = 0.521). Head sensor-based models had the best performance of the single-sensor models for single-task gait assessment. Single-task gait assessment models outperformed models based on dual-task walking or clinical assessment data. Support vector machines and neural networks were the best modelling technique for fall risk classification. Fall risk classification models developed for point-of-care environments should be developed using support vector machines and neural networks, with a multi-sensor single-task gait assessment.

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

NASA Astrophysics Data System (ADS)

Abdallah, C.

2010-10-01

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

Predicting Falls and When to Intervene in Older People: A Multilevel Logistical Regression Model and Cost Analysis

PubMed Central

Smith, Matthew I.; de Lusignan, Simon; Mullett, David; Correa, Ana; Tickner, Jermaine; Jones, Simon

2016-01-01

Introduction Falls are the leading cause of injury in older people. Reducing falls could reduce financial pressures on health services. We carried out this research to develop a falls risk model, using routine primary care and hospital data to identify those at risk of falls, and apply a cost analysis to enable commissioners of health services to identify those in whom savings can be made through referral to a falls prevention service. Methods Multilevel logistical regression was performed on routinely collected general practice and hospital data from 74751 over 65’s, to produce a risk model for falls. Validation measures were carried out. A cost-analysis was performed to identify at which level of risk it would be cost-effective to refer patients to a falls prevention service. 95% confidence intervals were calculated using a Monte Carlo Model (MCM), allowing us to adjust for uncertainty in the estimates of these variables. Results A risk model for falls was produced with an area under the curve of the receiver operating characteristics curve of 0.87. The risk cut-off with the highest combination of sensitivity and specificity was at p = 0.07 (sensitivity of 81% and specificity of 78%). The risk cut-off at which savings outweigh costs was p = 0.27 and the risk cut-off with the maximum savings was p = 0.53, which would result in referral of 1.8% and 0.45% of the over 65’s population respectively. Above a risk cut-off of p = 0.27, costs do not exceed savings. Conclusions This model is the best performing falls predictive tool developed to date; it has been developed on a large UK city population; can be readily run from routine data; and can be implemented in a way that optimises the use of health service resources. Commissioners of health services should use this model to flag and refer patients at risk to their falls service and save resources. PMID:27448280

All the world’s a (clinical) stage: Rethinking bipolar disorder from a longitudinal perspective

PubMed Central

Frank, Ellen; Nimgaonkar, Vishwajit L.; Phillips, Mary L.; Kupfer, David J.

2014-01-01

Psychiatric disorders have traditionally been classified using a static, categorical approach. However, this approach falls short in facilitating understanding of the development, common comorbid diagnoses, prognosis, and treatment of these disorders. We propose a “staging” model of bipolar disorder that integrates genetic and neural information with mood and activity symptoms to describe how the disease progresses over time. From an early, asymptomatic, but “at risk” stage to severe, chronic illness, each stage is described with associated neuroimaging findings as well as strategies for mapping genetic risk factors. Integrating more biologic information relating to cardiovascular and endocrine systems, refining methodology for modeling dimensional approaches to disease, and developing outcome measures will all be crucial in examining the validity of this model. Ultimately, this approach should aid in developing targeted interventions for each group that will reduce the significant morbidity and mortality associated with bipolar disorder. PMID:25048003

Top-Down CO Emissions Based On IASI Observations and Hemispheric Constraints on OH Levels

NASA Astrophysics Data System (ADS)

Müller, J.-F.; Stavrakou, T.; Bauwens, M.; George, M.; Hurtmans, D.; Coheur, P.-F.; Clerbaux, C.; Sweeney, C.

2018-02-01

Assessments of carbon monoxide emissions through inverse modeling are dependent on the modeled abundance of the hydroxyl radical (OH) which controls both the primary sink of CO and its photochemical source through hydrocarbon oxidation. However, most chemistry transport models (CTMs) fall short of reproducing constraints on hemispherically averaged OH levels derived from methylchloroform (MCF) observations. Here we construct five different OH fields compatible with MCF-based analyses, and we prescribe those fields in a global CTM to infer CO fluxes based on Infrared Atmospheric Sounding Interferometer (IASI) CO columns. Each OH field leads to a different set of optimized emissions. Comparisons with independent data (surface, ground-based remotely sensed, aircraft) indicate that the inversion adopting the lowest average OH level in the Northern Hemisphere (7.8 × 105 molec cm-3, ˜18% lower than the best estimate based on MCF measurements) provides the best overall agreement with all tested observation data sets.

Models of sarcopenia: Short review.

PubMed

Palus, S; Springer, J I; Doehner, W; von Haehling, S; Anker, M; Anker, S D; Springer, J

2017-07-01

Approximately 40-50% of the population over 80years of age suffers from sarcopenia making this condition a major geriatric clinical disorder and a key challenge to healthy aging. The hallmark symptom of sarcopenia is the loss of muscle mass and strength without the loss of overall body weight. Sarcopenic patients are likely to have worse clinical outcomes and higher mortality compared to healthy individuals. This review will focus on animal models designed to study sarcopenia including hind-limb unloading, de-nervation, and immobilization by using casts or wire strategies, as well as using aged rodents. Currently there are no registered treatments for sarcopenia. Most sarcopenic individuals show signs of physical frailty, which leads to increases the prevalence of balance disorders, falls, fractures and pain. Therefore, is it essential to develop and use relevant animal models to further the research on sarcopenia therapy? Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed

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

2017-09-04

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

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.

Mass transfer characteristics during convective, microwave and combined microwave-convective drying of lemon slices.

PubMed

Sadeghi, Morteza; Mirzabeigi Kesbi, Omid; Mireei, Seyed Ahmad

2013-02-01

The investigation of drying kinetics and mass transfer phenomena is important for selecting optimum operating conditions, and obtaining a high quality dried product. Two analytical models, conventional solution of the diffusion equation and the Dincer and Dost model, were used to investigate mass transfer characteristics during combined microwave-convective drying of lemon slices. Air temperatures of 50, 55 and 60 °C, and specific microwave powers of 0.97 and 2.04 W g(-1) were the process variables. Kinetics curves for drying indicated one constant rate period followed by one falling rate period in convective and microwave drying methods, and only one falling rate period with the exception of a very short accelerating period at the beginning of microwave-convective treatments. Applying the conventional method, the effective moisture diffusivity varied from 2.4 × 10(-11) to 1.2 × 10(-9) m(2) s(-1). The Biot number, the moisture transfer coefficient, and the moisture diffusivity, respectively in the ranges of 0.2 to 3.0 (indicating simultaneous internal and external mass transfer control), 3.7 × 10(-8) to 4.3 × 10(-6) m s(-1), and 2.2 × 10(-10) to 4.2 × 10(-9) m(2) s(-1) were also determined using the Dincer and Dost model. The higher degree of prediction accuracy was achieved by using the Dincer and Dost model for all treatments. Therefore, this model could be applied as an effective tool for predicting mass transfer characteristics during the drying of lemon slices. Copyright © 2012 Society of Chemical Industry.

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

USGS Publications Warehouse

Sullivan, Annett B.; Rounds, Stewart A.

2016-09-09

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

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.

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.

Risk of fall-related injury in people with lower limb amputations: A prospective cohort study.

PubMed

Wong, Christopher Kevin; Chihuri, Stanford T; Li, Guohua

2016-01-01

To assess fall-related injury risk and risk factors in people with lower limb amputation. Prospective longitudinal cohort with follow-up every 6 months for up to 41 months. Community-dwelling adults with lower limb amputations of any etiology and level recruited from support groups and prosthetic clinics. Demographic and clinical characteristics were obtained by self-reported questionnaire and telephone or in-person follow-up. Fall-related injury incidence requiring medical care per person-month and adjusted hazard ratio of fall-related injury were calculated using multivariable proportional hazards regression modeling. A total of 41 subjects, with 782 follow-up person-months in total, had 11 fall-related injury incidents (14.1/1,000 person-months). During follow-up, 56.1% of subjects reported falling and 26.8% reported fall-related injury. Multivariable proportional hazard modeling showed that women were nearly 6 times more likely as men to experience fall-related injury and people of non-white race were 13 times more likely than people of white race to experience fall-related injury. The final predictive model also included vascular amputation and age. Risk of fall-related injury requiring medical care in people with lower limb amputation appears to be higher than in older adult inpatients. Intervention programs to prevent fall-related injury in people with lower limb amputation should target women and racial minorities.

Apollo: AN Automatic Procedure to Forecast Transport and Deposition of Tephra

NASA Astrophysics Data System (ADS)

Folch, A.; Costa, A.; Macedonio, G.

2007-05-01

Volcanic ash fallout represents a serious threat to communities around active volcanoes. Reliable short term predictions constitute a valuable support for to mitigate the effects of fallout on the surrounding area during an episode of crisis. We present a platform-independent automatic procedure aimed to daily forecast volcanic ash dispersal. The procedure builds on a series of programs and interfaces that allow an automatic data/results flow. Firstly the procedure downloads mesoscale meteorological forecasts for the region and period of interest, filters and converts data from its native format (typically GRIB format files), and sets up the CALMET diagnostic meteorological model to obtain hourly wind field and micro-meteorological variables on a finer mesh. Secondly a 1-D version of the buoyant plume equations assesses the distribution of mass along the eruptive column depending on the obtained wind field and on the conditions at the vent (granulometry, mass flow rate, etc.). All these data are used as input for the ash dispersion model(s). Any model able to face physical complexity and coupling processes with adequate solving times can be plugged into the system by means of an interface. Currently, the procedure contains the models HAZMAP, TEPHRA and FALL3D, the latter in both serial and parallel versions. Parallelization of FALL3D is done at two levels one for particle classes and one for spatial domain. The last step is to post-processes the model(s) outcomes to end up with homogeneous maps written on portable format files. Maps plot relevant quantities such as predicted ground load, expected deposit thickness or visual and flight safety concentration thresholds. Several applications are shown as examples.

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.

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.

Increased Urine Production Due to Leg Fluid Displacement Reduces Hours of Undisturbed Sleep.

PubMed

Kiba, Keisuke; Hirayama, Akihide; Yoshikawa, Motokiyo; Yamamoto, Yutaka; Torimoto, Kazumasa; Shimizu, Nobutaka; Tanaka, Nobumichi; Fujimoto, Kiyohide; Uemura, Hirotsugu

2017-07-03

To investigate whether or not the leg fluid displacement observed when moving from the standing to recumbent position at bedtime reduces the hours of undisturbed sleep (HUS). Men aged 50 years or older who were hospitalized for urological diseases were investigated. Body water evaluation was performed three times with a bioelectric impedance method: (i) 17:00, (ii) 30 min after (short-term), and (iii) waking up (long-term). A frequency volume chart was used to evaluate the status of nocturnal urine production, and the factors affecting HUS were investigated. A total of 50 patients (mean age: 68 years) were enrolled. Short-term changes in extracellular fluid (ECF in the legs showed a significant positive correlation with urine production per unit of time at the first nocturnal voiding (UFN/HUS) (r = 0.45, P = 0.01). In the comparison between patients who had <3 HUS vs. those who had ≥3 HUS, the <3 HUS group showed significantly greater short-term changes in leg fluid volume, night-time water intake (17:00-06:00), and UFN/HUS. Multivariate analysis to assess the risk factors for <3 HUS indicated UFN/HUS as a risk factor in the overall model, and short-term changes in leg ECF and night-time water intake as risk factors in the model that only considered factors before sleep. Nocturnal leg fluid displacement may increase urine production leading up to first voiding after going to bed, and consequently, induce early awakening after falling asleep. © 2017 John Wiley & Sons Australia, Ltd.

Improvement of Tidal Analysis Results by a Priori Rain Fall Modelling at the Vienna and Membach stations

NASA Astrophysics Data System (ADS)

Meurers, B.; van Camp, M.; Petermans, T.

2005-12-01

We investigate how far tidal analysis results can be improved when a rain fall admittance model is applied on the superconducting gravity (SG) data. For that purpose both Vienna and Membach data have been analysed with and without a priori rain fall correction. In Membach the residual drop for most events (80%) can be explained by the rain water load, while in Vienna only 50% of all events fit the model in detail. In the other cases the Newtonian effect of vertical air mass redistribution (vertical density variation without air pressure change), predominantly connected with high vertical convection activity, e.g. thunderstorms, plays an essential role: short-term atmospheric signals show up steep gravity residual decreases of a few nms-2 within 10 - 60 min, well correlated with outdoor air temperature in most cases. However, even in those cases the water load model is able to explain the dominating part of the residual drop especially during heavy rain fall. In Vienna more than 110 events have been detected over 10 years. 84% of them are associated with heavy rain starting at or up to 10 min later than the residual drop while the rest (16%) shows no or only little rainfall. The magnitude of the gravity drop depends on the total amount of rainfall accumulated during the meteorological event. Step like signals deteriorate the frequency spectrum estimates. This even holds for tidal analysis. As the drops are of physical origin, they should not be eliminated blindly but corrected using water load modeling constrained by high temporal resolution (1 min) rain data. 3D modeling of the water mass load due to a rain event is based on the following assumptions: (1) Rain water intrudes into the uppermost soil layer (close to the topography surface) and remains there at least until rain has stopped. This is justified for a period of some hours after the rainfall as evapotranspiration is not yet effective. (2) No run-off except of sealed areas or building roofs, where water can not intrude into the soil but will drain off into the sewage water system instead. (3) Rainfall is equal everywhere in the station surroundings. (4) No surface deformation due to the water mass load Correcting for rain fall effects reduces by about 10% the standard deviation of the residuals after tidal parameter adjustment. Amplitude factor changes are in the order of 10-3 or less, phase lags change by 10-3 to 10-2: statistically, these variations are not significant as they lie within the error bars. However, it is worth noting that the amplitude factors of tidal constituents with high amplitude (O1, P1, K1) and even Ψ1 and Φ1 show similar variations in Vienna and Membach. Generally the tidal parameter variation is less in the SD than in the D band.

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

Influence of neuromuscular noise and walking speed on fall risk and dynamic stability in a 3D dynamic walking model.

PubMed

Roos, Paulien E; Dingwell, Jonathan B

2013-06-21

Older adults and those with increased fall risk tend to walk slower. They may do this voluntarily to reduce their fall risk. However, both slower and faster walking speeds can predict increased risk of different types of falls. The mechanisms that contribute to fall risk across speeds are not well known. Faster walking requires greater forward propulsion, generated by larger muscle forces. However, greater muscle activation induces increased signal-dependent neuromuscular noise. These speed-related increases in neuromuscular noise may contribute to the increased fall risk observed at faster walking speeds. Using a 3D dynamic walking model, we systematically varied walking speed without and with physiologically-appropriate neuromuscular noise. We quantified how actual fall risk changed with gait speed, how neuromuscular noise affected speed-related changes in fall risk, and how well orbital and local dynamic stability measures predicted changes in fall risk across speeds. When we included physiologically-appropriate noise to the 'push-off' force in our model, fall risk increased with increasing walking speed. Changes in kinematic variability, orbital, and local dynamic stability did not predict these speed-related changes in fall risk. Thus, the increased neuromuscular variability that results from increased signal-dependent noise that is necessitated by the greater muscular force requirements of faster walking may contribute to the increased fall risk observed at faster walking speeds. The lower fall risk observed at slower speeds supports experimental evidence that slowing down can be an effective strategy to reduce fall risk. This may help explain the slower walking speeds observed in older adults and others. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influence of Neuromuscular Noise and Walking Speed on Fall Risk and Dynamic Stability in a 3D Dynamic Walking Model

PubMed Central

Roos, Paulien E.; Dingwell, Jonathan B.

2013-01-01

Older adults and those with increased fall risk tend to walk slower. They may do this voluntarily to reduce their fall risk. However, both slower and faster walking speeds can predict increased risk of different types of falls. The mechanisms that contribute to fall risk across speeds are not well known. Faster walking requires greater forward propulsion, generated by larger muscle forces. However, greater muscle activation induces increased signal-dependent neuromuscular noise. These speed-related increases in neuromuscular noise may contribute to the increased fall risk observed at faster walking speeds. Using a 3D dynamic walking model, we systematically varied walking speed without and with physiologically-appropriate neuromuscular noise. We quantified how actual fall risk changed with gait speed, how neuromuscular noise affected speed-related changes in fall risk, and how well orbital and local dynamic stability measures predicted changes in fall risk across speeds. When we included physiologically-appropriate noise to the ‘push-off’ force in our model, fall risk increased with increasing walking speed. Changes in kinematic variability, orbital, and local dynamic stability did not predict these speed-related changes in fall risk. Thus, the increased neuromuscular variability that results from increased signal-dependent noise that is necessitated by the greater muscular force requirements of faster walking may contribute to the increased fall risk observed at faster walking speeds. The lower fall risk observed at slower speeds supports experimental evidence that slowing down can be an effective strategy to reduce fall risk. This may help explain the slower walking speeds observed in older adults and others. PMID:23659911

Medication for Alzheimer's disease and associated fall hazard: a retrospective cohort study from the Alzheimer's Disease Neuroimaging Initiative.

PubMed

Epstein, Noam U; Guo, Rong; Farlow, Martin R; Singh, Jaswinder P; Fisher, Morris

2014-02-01

Falls are common in the elderly, especially in those with cognitive impairment. The elderly are often treated with several medications, which may have both beneficial and deleterious effects. The use and type of medication in Alzheimer's disease (AD) patients and association with falls is limited. We examined the association between falls and medication use in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Diagnosis, demographics, medication use, apolipoprotein E4 allele status and functional activity level at baseline were gathered for 810 participants enrolled in the ADNI, including healthy controls and subjects with mild cognitive impairment or Alzheimer's. Reports detailing adverse event falls were tabulated. Baseline characteristics were compared between subjects with and without one or more falls. Cox proportional hazards models were conducted to evaluate the association between subject characteristics and hazard of the first fall. Age (p < 0.0001), Functional Activities Questionnaire (p = 0.035), Beers List (p = 0.0477) and medications for treating cognitive symptoms of Alzheimer's (p = 0.0019) were associated with hazard of fall in the univariate model. In the final multivariate model, after adjusting for covariates, Alzheimer's medication use (p = 0.0005) was associated with hazard of fall. Medication was changed by the clinician after an adverse fall event in 9% of the falls. About 7% of the falls were reported as serious adverse events and 6% were reported to be severe. We found a significant association between the use of symptomatic medication treating cognitive symptoms in AD and hazard of fall after adjusting for age and Beers List medication use. Additional pharmacovigilance of the association between falls and Alzheimer's medication use is warranted.

Medication for Alzheimer’s Disease and Associated Fall Hazard: a Retrospective Cohort Study from the Alzheimer’s Disease Neuro-Imaging Initiative

PubMed Central

Epstein, Noam U.; Guo, Rong; Farlow, Martin R.; Singh, Jaswinder P.; Fisher, Morris

2014-01-01

Background Falls are common in the elderly, especially in those with cognitive impairment. The elderly are often treated with several medications which may have both beneficial and deleterious effects. The use and type of medication in Alzheimer’s patients and association with falls is limited. Objective We examined the association between falls and medication use in the Alzheimer’s Disease Neuro-Imaging Initiative (ADNI). Methods Diagnosis, demographics, medication use, apolipoprotein E4 allele status and functional activity level at baseline were gathered for 810 participants enrolled in ADNI including healthy controls and subjects with mild cognitive impairment or Alzheimer’s. Adverse event fall reports were tabulated. Baseline characteristics were compared between subjects with and without one or more falls. Cox proportional hazards models were conducted to evaluate the association between subject characteristics and hazard of first fall. Results Age (p<0.0001), functional activities questionnaire (p=0.035), Beers list (p=0.0477) and medications for treating cognitive symptoms of Alzheimer’s (p=0.0019) were associated with hazard of fall in the univariate model. In the final multivariate model, after adjusting for covariates, Alzheimer’s medication use (p=0.0005) was associated with hazard of fall. Medication was changed after an adverse fall event by the clinician in 9% of the falls. About 7% of the falls were reported as serious adverse events and 6% were reported to be severe. Conclusion We found a significant association between use of symptomatic medication treating cognitive symptoms in Alzheimer’s disease and hazard of fall after adjusting for age and Beers list medication use. Additional pharmaco-vigilance of the association between falls and Alzheimer’s medication use is warranted. PMID:24357133

Bayesian networks: a new method for the modeling of bibliographic knowledge: application to fall risk assessment in geriatric patients.

PubMed

Lalande, Laure; Bourguignon, Laurent; Carlier, Chloé; Ducher, Michel

2013-06-01

Falls in geriatry are associated with important morbidity, mortality and high healthcare costs. Because of the large number of variables related to the risk of falling, determining patients at risk is a difficult challenge. The aim of this work was to validate a tool to detect patients with high risk of fall using only bibliographic knowledge. Thirty articles corresponding to 160 studies were used to modelize fall risk. A retrospective case-control cohort including 288 patients (88 ± 7 years) and a prospective cohort including 106 patients (89 ± 6 years) from two geriatric hospitals were used to validate the performances of our model. We identified 26 variables associated with an increased risk of fall. These variables were split into illnesses, medications, and environment. The combination of the three associated scores gives a global fall score. The sensitivity and the specificity were 31.4, 81.6, 38.5, and 90 %, respectively, for the retrospective and the prospective cohort. The performances of the model are similar to results observed with already existing prediction tools using model adjustment to data from numerous cohort studies. This work demonstrates that knowledge from the literature can be synthesized with Bayesian networks.

Cost Effectiveness of Falls and Injury Prevention Strategies for Older Adults Living in Residential Aged Care Facilities.

PubMed

Church, Jody L; Haas, Marion R; Goodall, Stephen

2015-12-01

To evaluate the cost effectiveness of interventions designed to prevent falls and fall-related injuries among older people living in residential aged care facilities (RACFs) from an Australian health care perspective. A decision analytic Markov model was developed that stratified individuals according to their risk of falling and accounted for the risk of injury following a fall. The effectiveness of the interventions was derived from two Cochrane reviews of randomized controlled trials for falls/fall-related injury prevention in RACFs. Interventions were considered effective if they reduced the risk of falling or reduced the risk of injury following a fall. The interventions that were modelled included vitamin D supplementation, annual medication review, multifactorial intervention (a combination of risk assessment, medication review, vision assessment and exercise) and hip protectors. The cost effectiveness was calculated as the incremental cost relative to the incremental benefit, in which the benefit was estimated using quality-adjusted life-years (QALYs). Uncertainty was explored using univariate and probabilistic sensitivity analysis. Vitamin D supplementation and medication review both dominated 'no intervention', as these interventions were both more effective and cost saving (because of healthcare costs avoided). Hip protectors are dominated (less effective and more costly) by vitamin D and medication review. The incremental cost-effectiveness ratio (ICER) for medication review relative to vitamin D supplementation is AU$2442 per QALY gained, and the ICER for multifactorial intervention relative to medication review is AU$1,112,500 per QALY gained. The model is most sensitive to the fear of falling and the cost of the interventions. The model suggests that vitamin D supplementation and medication review are cost-effective interventions that reduce falls, provide health benefits and reduce health care costs in older adults living in RACFs.

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

Modeling spatial and temporal variations in temperature and salinity during stratification and overturn in Dexter Pit Lake, Tuscarora, Nevada, USA

USGS Publications Warehouse

Balistrieri, L.S.; Tempel, R.N.; Stillings, L.L.; Shevenell, L.A.

2006-01-01

This paper examines the seasonal cycling of temperature and salinity in Dexter pit lake in arid northern Nevada, and describes an approach for modeling the physical processes that operate in such systems. The pit lake contains about 596,200 m3 of dilute, near neutral (pHs 6.7-9) water. Profiles of temperature, conductivity, and selected element concentrations were measured almost monthly during 1999 and 2000. In winter (January-March), the pit lake was covered with ice and bottom water was warmer (5.3 ??C) with higher total dissolved solids (0.298 g/L) than overlying water (3.96 ??C and 0.241 g/L), suggesting inflow of warm (11.7 ??C) groundwater with a higher conductivity than the lake (657 versus 126-383 ??S/cm). Seasonal surface inflow due to spring snowmelt resulted in lower conductivity in the surface water (232-247 ??S/cm) relative to deeper water (315-318 ??S/cm). The pit lake was thermally stratified from late spring through early fall, and the water column turned over in late November (2000) or early December (1999). The pit lake is a mixture of inflowing surface water and groundwater that has subsequently been evapoconcentrated in the arid environment. Linear relationships between conductivity and major and some minor (B, Li, Sr, and U) ions indicate conservative mixing for these elements. Similar changes in the elevations of the pit lake surface and nearby groundwater wells during the year suggest that the pit lake is a flow-through system. This observation and geochemical information were used to configure an one-dimensional hydrodynamics model (Dynamic Reservoir Simulation Model or DYRESM) that predicts seasonal changes in temperature and salinity based on the interplay of physical processes, including heating and cooling (solar insolation, long and short wave radiation, latent, and sensible heat), hydrologic flow (inflow and outflow by surface and ground water, pumping, evaporation, and precipitation), and transfers of momentum (wind stirring, convective overturn, shear, and eddy diffusion). Inputs to the model include the size and shape of the lake, daily meteorological data (short wave radiation, long wave radiation or cloud cover, air temperature, vapor pressure, wind speed, and rainfall), rates for water inputs and outputs, the composition of inflowing water, and initial profiles of temperature and salinity. Predicted temperature profiles, which are influenced by seasonal changes in the magnitude of solar radiation, are in good agreement with observations and show the development of a strong thermocline in the summer, erosion of the thermocline during early fall, and turnover in late fall. Predicted salinity profiles are in reasonable agreement with observations and are affected by the hydrologic balance, particularly inflow of surface and groundwater and, to a lesser degree, evaporation. Defining the hydrodynamics model for Dexter pit lake is the first step in using a coupled physical - biogeochemical model (Dynamic Reservoir Simulation Model-Computational Aquatic Ecosystem Dynamics Model or DYRESM-CAEDYM) to predict the behavior of non-conservative elements (e.g., dissolved O2, Mn, and Fe) and their effect on water quality in this system. ?? 2006 Elsevier Ltd. All rights reserved.

Using latent class analysis to model prescription medications in the measurement of falling among a community elderly population

PubMed Central

2013-01-01

Background Falls among the elderly are a major public health concern. Therefore, the possibility of a modeling technique which could better estimate fall probability is both timely and needed. Using biomedical, pharmacological and demographic variables as predictors, latent class analysis (LCA) is demonstrated as a tool for the prediction of falls among community dwelling elderly. Methods Using a retrospective data-set a two-step LCA modeling approach was employed. First, we looked for the optimal number of latent classes for the seven medical indicators, along with the patients’ prescription medication and three covariates (age, gender, and number of medications). Second, the appropriate latent class structure, with the covariates, were modeled on the distal outcome (fall/no fall). The default estimator was maximum likelihood with robust standard errors. The Pearson chi-square, likelihood ratio chi-square, BIC, Lo-Mendell-Rubin Adjusted Likelihood Ratio test and the bootstrap likelihood ratio test were used for model comparisons. Results A review of the model fit indices with covariates shows that a six-class solution was preferred. The predictive probability for latent classes ranged from 84% to 97%. Entropy, a measure of classification accuracy, was good at 90%. Specific prescription medications were found to strongly influence group membership. Conclusions In conclusion the LCA method was effective at finding relevant subgroups within a heterogenous at-risk population for falling. This study demonstrated that LCA offers researchers a valuable tool to model medical data. PMID:23705639

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.

Gravity Modeling for Variable Fidelity Environments

NASA Technical Reports Server (NTRS)

Madden, Michael M.

2006-01-01

Aerospace simulations can model worlds, such as the Earth, with differing levels of fidelity. The simulation may represent the world as a plane, a sphere, an ellipsoid, or a high-order closed surface. The world may or may not rotate. The user may select lower fidelity models based on computational limits, a need for simplified analysis, or comparison to other data. However, the user will also wish to retain a close semblance of behavior to the real world. The effects of gravity on objects are an important component of modeling real-world behavior. Engineers generally equate the term gravity with the observed free-fall acceleration. However, free-fall acceleration is not equal to all observers. To observers on the sur-face of a rotating world, free-fall acceleration is the sum of gravitational attraction and the centrifugal acceleration due to the world's rotation. On the other hand, free-fall acceleration equals gravitational attraction to an observer in inertial space. Surface-observed simulations (e.g. aircraft), which use non-rotating world models, may choose to model observed free fall acceleration as the gravity term; such a model actually combines gravitational at-traction with centrifugal acceleration due to the Earth s rotation. However, this modeling choice invites confusion as one evolves the simulation to higher fidelity world models or adds inertial observers. Care must be taken to model gravity in concert with the world model to avoid denigrating the fidelity of modeling observed free fall. The paper will go into greater depth on gravity modeling and the physical disparities and synergies that arise when coupling specific gravity models with world models.

A break-even analysis of a community rehabilitation falls prevention service.

PubMed

Comans, Tracy; Brauer, Sandy; Haines, Terry

2009-06-01

To identify and compare the minimum number of clients that a multidisciplinary falls prevention service delivered through domiciliary or centre-based care needs to treat to allow the service to reach a 'break-even' point. A break-even analysis was undertaken for each of two models of care for a multidisciplinary community rehabilitation falls prevention service. The two models comprised either a centre-based group exercise and education program or a similar program delivered individually in the client's home. The service consisted of a physiotherapist, occupational therapist and therapy assistant. The participants were adults aged over 65 years who had experienced previous falls. Costs were based on the actual cost of running a community rehabilitation team located in Brisbane. Benefits were obtained by estimating the savings gained to society from the number of falls prevented by the program on the basis of the falls reduction rates obtained in similar multidisciplinary programs. It is estimated that a multi-disciplinary community falls prevention team would need to see 57 clients per year to make the service break-even using a centre-based model of care and 78 clients for a domiciliary-based model. The service this study was based on has the capability to see around 300 clients per year in a centre-based service or 200-250 clients per year in a home-based service. Based on the best available estimates of costs of falls, multidisciplinary falls prevention teams in the community targeting people at high risk of falls are worthwhile funding from a societal viewpoint.

A retrospective review of fall risk factors in the bone marrow transplant inpatient service.

PubMed

Vela, Cory M; Grate, Lisa M; McBride, Ali; Devine, Steven; Andritsos, Leslie A

2018-06-01

Purpose The purpose of this study was to compare medications and potential risk factors between patients who experienced a fall during hospitalization compared to those who did not fall while admitted to the Blood and Marrow Transplant inpatient setting at The James Cancer Hospital. Secondary objectives included evaluation of transplant-related disease states and medications in the post-transplant setting that may lead to an increased risk of falls, post-fall variables, and number of tests ordered after a fall. Methods This retrospective, case-control study matched patients in a 2:1 ratio of nonfallers to fallers. Data from The Ohio State University Wexner Medical Center (OSUWMC) reported fall events and patient electronic medical records were utilized. A total of 168 adult Blood and Marrow Transplant inpatients with a hematological malignancy diagnosis were evaluated from 1 January 2010 to 30 September 2012. Results Univariable and multivariable conditional logistic regression models were used to assess the relationship between potential predictor variables of interest and falls. Variables that were found to be significant predictors of falls from the univariable models include age group, incontinence, benzodiazepines, corticosteroids, anticonvulsants and antidepressants, and number of days status-post transplant. When considered for a multivariable model age group, corticosteroids, and a cancer diagnosis of leukemia were significant in the final model. Conclusion Recent medication utilization such as benzodiazepines, anticonvulsants, corticosteroids, and antidepressants placed patients at a higher risk of experiencing a fall. Other significant factors identified from a multivariable analysis found were patients older than age 65, patients with recent corticosteroid administration and a cancer diagnosis of leukemia.

Mobility predicts change in older adults' health-related quality of life: evidence from a Vancouver falls prevention prospective cohort study.

PubMed

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

2015-07-15

Older adults with mobility impairments are prone to reduced health related quality of life (HRQoL) is highly associated with mobility impairments. The consequences of falls have detrimental impact on mobility. Hence, ascertaining factors explaining variation among individuals' quality of life is critical for promoting healthy ageing, particularly among older fallers. Hence, the primary objective of our study was to identify key factors that explain variation in HRQoL among community dwelling older adults at risk of falls. We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 148 to 286 depending on the analysis). 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 also included the predictors by sex and predictor by sex by time interaction terms in order to investigate sex differences in the relations between the predictor variable and the outcome variable, the EQ-5D. Our primary analysis demonstrated a significant mobility (assessed using the Short Performance Physical Battery and the Timed Up and Go) by time interaction (p < 0.05) and mobility by time by sex interaction (p < 0.05). The sensitivity analyses demonstrated some heterogeneity of these findings using an imputed and a complete case analysis. Mobility may be an important predictor of changes in HRQoL over time. As such, mobility is a critical factor to target for future intervention strategies aimed at maintaining or improving HRQoL in late life.

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

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

Scaling Laws of Microactuators and Potential Applications of Electroactive Polymers in MEMS

NASA Technical Reports Server (NTRS)

Liu, Chang; Bar-Cohen, Y.

1999-01-01

Besides the scale factor that distinguishes the various species, fundamentally biological muscles changes little between species, indicating a highly optimized system. Electroactive polymer actuators offer the closest resemblance to biological muscles, however besides the large actuation displacement these materials are falling short with regards to the actuation force. As improved materials are emerging it is becoming necessary to address key issues such as the need for effective electromechanical modeling and guiding parameters in scaling the actuators. In this paper, we will review the scaling laws for three major actuation mechanisms that are of relevance to micro electromechanical systems: electrostatic actuation, magnetic actuation, thermal bimetallic actuation, and piezoelectric actuation.

[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.

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.

Alexander Hegedus Lightning Talk: Integrating Measurements to Optimize Space Weather Strategies

NASA Astrophysics Data System (ADS)

Hegedus, A. M.

2017-12-01

Alexander Hegedus is a PhD Candidate at the University of Michigan, and won an Outstanding Student Paper Award at the AGU 2016 Fall Meeting for his poster "Simulating 3D Spacecraft Constellations for Low Frequency Radio Imaging." In this short talk, Alex outlines his current research of analyzing data from both real and simulated instruments to answer Heliophysical questions. He then sketches out future plans to simulate science pipelines in a real-time data assimilation model that uses a Bayesian framework to integrate information from different instruments to determine the efficacy of future Space Weather Alert systems. MHD simulations made with Michigan's own Space Weather Model Framework will provide input to simulated instruments, acting as an Observing System Simulation Experiment to verify that a certain set of measurements can accurately predict different classes of Space Weather events.

Estimation of spectral kurtosis

NASA Astrophysics Data System (ADS)

Sutawanir

2017-03-01

Rolling bearings are the most important elements in rotating machinery. Bearing frequently fall out of service for various reasons: heavy loads, unsuitable lubrications, ineffective sealing. Bearing faults may cause a decrease in performance. Analysis of bearing vibration signals has attracted attention in the field of monitoring and fault diagnosis. Bearing vibration signals give rich information for early detection of bearing failures. Spectral kurtosis, SK, is a parameter in frequency domain indicating how the impulsiveness of a signal varies with frequency. Faults in rolling bearings give rise to a series of short impulse responses as the rolling elements strike faults, SK potentially useful for determining frequency bands dominated by bearing fault signals. SK can provide a measure of the distance of the analyzed bearings from a healthy one. SK provides additional information given by the power spectral density (psd). This paper aims to explore the estimation of spectral kurtosis using short time Fourier transform known as spectrogram. The estimation of SK is similar to the estimation of psd. The estimation falls in model-free estimation and plug-in estimator. Some numerical studies using simulations are discussed to support the methodology. Spectral kurtosis of some stationary signals are analytically obtained and used in simulation study. Kurtosis of time domain has been a popular tool for detecting non-normality. Spectral kurtosis is an extension of kurtosis in frequency domain. The relationship between time domain and frequency domain analysis is establish through power spectrum-autocovariance Fourier transform. Fourier transform is the main tool for estimation in frequency domain. The power spectral density is estimated through periodogram. In this paper, the short time Fourier transform of the spectral kurtosis is reviewed, a bearing fault (inner ring and outer ring) is simulated. The bearing response, power spectrum, and spectral kurtosis are plotted to visualize the pattern of each fault. Keywords: frequency domain Fourier transform, spectral kurtosis, bearing fault

Falls risk among a very old home-dwelling population

PubMed Central

Iinattiniemi, Sari; Jokelainen, Jari; Luukinen, Heikki

2009-01-01

Objective The aim of this prospective study was to examine risk factors of falling in a very old home-dwelling population. Design A prospective study of home-dwelling elderly people. Methods Baseline data were collected by home-nursing staff through postal questionnaires and clinical tests. Data on falls were recorded in telephone interviews every other month during a follow-up of 11 months constituting 494 person years (PY). Negative binomial modeling was used to assess fall risk. Setting General community. Subjects A population sample of home-dwelling subjects aged 85 years or older (n = 555). Main outcome measures Fall rate and risk factors of falls. Results Altogether 512 falls occurred in 273 (49%) subjects, incidence rate 1.03/PY. According to a multivariate model, history of recurrent falling, trouble with vision when moving, use of antipsychotic drug, and feelings of anxiety, nervousness, or fear were independent risk factors for subsequent falls. Conclusion Appropriate care of poor vision and feelings of anxiety, nervousness, or fear, and avoidance of use of antipsychotic drugs might be useful in the prevention of falls among the most elderly home-dwellers. PMID:19065453

A combined disease management and process modeling approach for assessing and improving care processes: a fall management case-study.

PubMed

Askari, Marjan; Westerhof, Richard; Eslami, Saied; Medlock, Stephanie; de Rooij, Sophia E; Abu-Hanna, Ameen

2013-10-01

To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. We identified essential disease management related concepts and mapped them into explicit questions meant to expose areas for improvement in the respective care processes. We applied the disease management oriented questions to a process model of a comprehensive real world fall prevention and treatment program covering primary and secondary care. We relied on interviews and observations to complete the process models, which were captured in UML activity diagrams. A preliminary evaluation of the usability of our approach by gauging the experience of the modeler and an external validator was conducted, and the usefulness of the method was evaluated by gathering feedback from stakeholders at an invitational conference of 75 attendees. The process model of the fall management program was organized around the clinical tasks of case finding, risk profiling, decision making, coordination and interventions. Applying the disease management questions to the process models exposed weaknesses in the process including: absence of program ownership, under-detection of falls in primary care, and lack of efficient communication among stakeholders due to missing awareness about other stakeholders' workflow. The modelers experienced the approach as usable and the attendees of the invitational conference found the analysis results to be valid. The proposed disease management view of process modeling was usable and useful for systematically identifying areas of improvement in a fall management program. Although specifically applied to fall management, we believe our case study is characteristic of various disease management settings, suggesting the wider applicability of the approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Testing a fall risk model for injection drug users.

PubMed

Pieper, Barbara; Templin, Thomas N; Goldberg, Allon

2012-01-01

Fall risk is a critical component of clinical assessment and has not been examined for persons who have injected illicit drugs and are aging. The aim of this study was to test and develop the Fall Risk Model for Injection Drug Users by examining the relationships among injection drug use, chronic venous insufficiency, lower extremity impairments (i.e., decreased ankle range of motion, reduced calf muscle endurance, and leg pain), age and other covariates, and the Tinetti balance and gait total score as a measure of fall risk. A cross-sectional comparative design was used with four crossed factors. Standardized instruments were used to assess the variables. Moderated multiple regression with linear and quadratic trends in age was used to examine the nature of the relationship between the Tinetti balance and gait total and age and the potential moderating role of injection drug use. A prespecified series of models was tested. Participants (n = 713) were men (46.9%) and women with a mean age of 46.26 years and primarily African American (61.7%) in methadone treatment centers. The fall risk of a 48-year-old leg injector was comparable with the fall risk of a 69-year-old who had not injected drugs. Variables were added to the model sequentially, resulting in some lost significance of some when they were explained by subsequent variables. Final significant variables in the model were employment status, number of comorbidities, ankle range of motion, leg pain, and calf muscle endurance. Fall risk was associated with route of drug use. Lower extremity impairments accounted for the effects of injection drug use and chronic venous insufficiency on risk for falls. Further understanding of fall risk in injection users is necessary as they age, attempt to work, and participate in activities.

Characteristics and fall experiences of older adults with and without fear of falling outdoors.

PubMed

Chippendale, Tracy; Lee, Chang Dae

2018-06-01

Using a theoretical model that combines an ecological perspective and Bandura's theory of self-efficacy as a guide, we sought to compare experiences and characteristics of community dwelling older adults with and without concern about falling outdoors. A survey of randomly selected community dwelling older adults across NYC (N = 120) was conducted using the outdoor falls questionnaire. Descriptive quantitative analyses of participant characteristics were conducted for all participants and for those with and without concern about falling outside. Conventional content analysis using two coders was employed to examine outdoor fall experiences for each group. A mixed methods matrix was used to integrate qualitative and quantitative findings. Some participant characteristics were more common among those with a concern about falling outside such as decreased functional status, female gender, and number of prior outdoor falls. As per descriptions of outdoor fall experiences, participants with concern were more likely to report a fall while climbing stairs or stepping up a curb, describe an intrinsic factor as a cause of their fall, use an injury prevention strategy during the fall, sustain a moderate to severe injury, seek medical attention, have had an ambulance called, require help to get up, and describe implementation of a behavioral change after the fall. Differences exist in participant characteristics and outdoor fall experiences of those with and without concern about falling outside. The proposed model can be used to understand fear of falling outdoors and can help to inform the target population and content of intervention programs.

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.

Facilitating political decisions using species distribution models to assess restoration measures in heavily modified estuaries.

PubMed

Heuner, Maike; Weber, Arnd; Schröder, Uwe; Kleinschmit, Birgit; Schröder, Boris

2016-09-15

The European Water Framework Directive requires a good ecological potential for heavily modified water bodies. This standard has not been reached for most large estuaries by 2015. Management plans for estuaries fall short in linking implementations between restoration measures and underlying spatial analyses. The distribution of emergent macrophytes - as an indicator of habitat quality - is here used to assess the ecological potential. Emergent macrophytes are capable of settling on gentle tidal flats where hydrodynamic stress is comparatively low. Analyzing their habitats based on spatial data, we set up species distribution models with 'elevation relative to mean high water', 'mean bank slope', and 'length of bottom friction' from shallow water up to the vegetation belt as key predictors representing hydrodynamic stress. Effects of restoration scenarios on habitats were assessed applying these models. Our findings endorse species distribution models as crucial spatial planning tools for implementing restoration measures in modified estuaries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Expansion of the Real-Time SPoRT-Land Information System for NOAA/National Weather Service Situational Awareness and Local Modeling Applications

NASA Technical Reports Server (NTRS)

Case, Jonathan L; White, Kristopher D.

2014-01-01

The NASA Short-term Prediction Research and Transition (SPoRT) Center in Huntsville, AL is running a real-time configuration of the Noah land surface model (LSM) within the NASA Land Information System (LIS) framework (hereafter referred to as the "SPoRT-LIS"). Output from the real-time SPoRT-LIS is used for (1) initializing land surface variables for local modeling applications, and (2) displaying in decision support systems for situational awareness and drought monitoring at select NOAA/National Weather Service (NWS) partner offices. The experimental CONUS run incorporates hourly quantitative precipitation estimation (QPE) from the National Severe Storms Laboratory Multi- Radar Multi-Sensor (MRMS) which will be transitioned into operations at the National Centers for Environmental Prediction (NCEP) in Fall 2014.This paper describes the current and experimental SPoRT-LIS configurations, and documents some of the limitations still remaining through the advent of MRMS precipitation analyses in the SPoRT-LIS land surface model (LSM) simulations.

Challenging Cosmic Ray Propagation with Antiprotons: Evidence for a "Fresh" Nuclei Component?

NASA Technical Reports Server (NTRS)

Moskalenko, Igor V.; Strong, Andrew W.; Mashnik, Stepan G.; Ormes, Jonathan F.

2002-01-01

Recent measurements of the cosmic ray (CR) antiproton flux have been shown to challenge existing CR propagation models. It was shown that the reacceleration models designed to match secondary to primary nuclei ratio (e.g., Boron/Carbon) produce too few antiprotons, while the traditional non-reacceleration models can reproduce the antiproton flux but fall short of explaining the low-energy decrease in the secondary to primary nuclei ratio. Matching both the secondary to primary nuclei ratio and antiproton flux requires artificial breaks in the diffusion coefficient and the primary injection spectrum suggesting the need for other approaches. In the present paper we discuss one possibility to overcome these difficulties. Using the measured antiproton flux to fix the diffusion coefficient, we show that the spectra of primary nuclei as measured in the heliosphere may contain a fresh local unprocessed component at low energies, thus decreasing the measured secondary to primary nuclei ratio. A model reproducing antiprotons, B/C ratio, and abundances up to Ni is presented.

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.

Parameterization of In-Cloud Aerosol Scavenging Due To Atmospheric Ionization: 2. Effects of Varying Particle Density

NASA Astrophysics Data System (ADS)

Zhang, Liang; Tinsley, Brian A.

2018-03-01

Simulations and parameterization of collision rate coefficients for aerosol particles with 3 μm radius droplets have been extended to a range of particle densities up to 2,000 kg m-3 for midtropospheric ( 5 km) conditions (540 hPa, -17°C). The increasing weight has no effect on collisions for particle radii less than 0.2 μm, but for greater radii the weight effect becomes significant and usually decreases the collision rate coefficient. When increasing size and density of particles make the fall speed of the particle relative to undisturbed air approach to that of the droplet, the effect of the particle falling away in the stagnation region ahead of the droplet becomes important, and the probability of frontside collisions can decrease to zero. Collisions on the rear side of the droplet can be enhanced as particle weight increases, and for this the weight effect tends to increase the rate coefficients. For charges on the droplet and for large particles with density ρ < 1,000 kg m-3 the predominant effect increases in rate coefficient due to the short-range attractive image electric force. With density ρ above about 1,000 kg m-3, the stagnation region prevents particles moving close to the droplet and reduces the effect of these short-range forces. Together with previous work, it is now possible to obtain collision rate coefficients for realistic combinations of droplet charge, particle charge, droplet radius, particle radius, particle density, and relative humidity in clouds. The parameterization allows rapid access to these values for use in cloud models.

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…

New Economic and Financial Indicators of Sustainability

ERIC Educational Resources Information Center

Pittman, James; Wilhelm, Kevin

2007-01-01

Financial accounting methods fall short of fully accounting for the relative sustainability of college and university operations. Management of social, environmental, and economic performance will be aided by changes to and new developments in financial accounting practices to complement other indicators of sustainability.

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

Nutrition, Balance and Fear of Falling as Predictors of Risk for Falls among Filipino Elderly in Nursing Homes: A Structural Equation Model (SEM)

ERIC Educational Resources Information Center

de Guzman, Allan B.; Ines, Joanna Louise C.; Inofinada, Nina Josefa A.; Ituralde, Nielson Louie J.; Janolo, John Robert E.; Jerezo, Jnyv L.; Jhun, Hyae Suk J.

2013-01-01

While a number of empirical studies have been conducted regarding risk for falls among the elderly, there is still a paucity of similar studies in a developing country like the Philippines. This study purports to test through Structural Equation Modeling (SEM) a model that shows the interaction between and among nutrition, balance, fear of…

Computer simulation of stair falls to investigate scenarios in child abuse.

PubMed

Bertocci, G E; Pierce, M C; Deemer, E; Aguel, F

2001-09-01

To demonstrate the usefulness of computer simulation techniques in the investigation of pediatric stair falls. Since stair falls are a common falsely reported injury scenario in child abuse, our specific aim was to investigate the influence of stair characteristics on injury biomechanics of pediatric stair falls by using a computer simulation model. Our long-term goal is to use knowledge of biomechanics to aid in distinguishing between accidents and abuse. A computer simulation model of a 3-year-old child falling down stairs was developed using commercially available simulation software. This model was used to investigate the influence that stair characteristics have on biomechanical measures associated with injury risk. Since femur fractures occur in unintentional and abuse scenarios, biomechanical measures were focused on the lower extremities. The number and slope of steps and stair surface friction and elasticity were found to affect biomechanical measures associated with injury risk. Computer simulation techniques are useful for investigating the biomechanics of stair falls. Using our simulation model, we determined that stair characteristics have an effect on potential for lower extremity injuries. Although absolute values of biomechanical measures should not be relied on in an unvalidated model such as this, relationships between accident-environment factors and biomechanical measures can be studied through simulation. Future efforts will focus on model validation.

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.

A failed model-based attempt to implement an evidence-based nursing guideline for fall prevention.

PubMed

Semin-Goossens, Astrid; van der Helm, Jelle M J; Bossuyt, Patrick M M

2003-01-01

An evidence-based nursing guideline had been locally developed in 1993 to reduce fall incidence rates, creating a 30% reduction. Implementation had failed though. Between 1999 and 2001 the guideline was updated. A multifaceted intervention was chosen based on a model for implementing change. The study was performed in 2 wards. All recommendations of Grol's 5-step implementation model were followed. The aim was a reduction of 30% in fall incidence within a year. Data on falls were extracted from nursing records and Incidence Report Forms (IRFs). In a pilot study an average of 9 falls per 1000 patients per day had been recorded in the department of internal medicine and 16 in the neurology ward. Given the desired reduction of 30%, the target averages were 6 and 11 falls respectively. During the intervention year the average incidences were 8 and 13 falls (95% CI: 6-11 and 10-15). There was a changeable pattern over time without any declining trend. The percentage filled in IRFs varied strongly, with an average of 52% in the department of internal medicine and 60% in the neurology department. There has been no durable decrease in monthly falls despite the use of a model-based procedure for implementing change. Neither did we observe any improvement in filling in IRFs. It can be questioned if the nurses themselves did experience patient falls to be troublesome enough. Investigating this is difficult though. Although the most successful strategy still appears to be changing attitudes of nurses in order to increase fall prevention, there is no clear strategy on how to create this successfully.

An Electronic Health Record Data-driven Model for Identifying Older Adults at Risk of Unintentional Falls

PubMed Central

Baus, Adam; Coben, Jeffrey; Zullig, Keith; Pollard, Cecil; Mullett, Charles; Taylor, Henry; Cochran, Jill; Jarrett, Traci; Long, Dustin

2017-01-01

Screening for risk of unintentional falls remains low in the primary care setting because of the time constraints of brief office visits. National studies suggest that physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time. Given prior success in developing methods for repurposing electronic health record data for the identification of fall risk, this study involves building a model in which electronic health record data could be applied for use in clinical decision support to bolster screening by proactively identifying patients for whom screening would be beneficial and targeting efforts specifically to those patients. The final model, consisting of priority and extended measures, demonstrates moderate discriminatory power, indicating that it could prove useful in a clinical setting for identifying patients at risk of falls. Focus group discussions reveal important contextual issues involving the use of fall-related data and provide direction for the development of health systems–level innovations for the use of electronic health record data for fall risk identification. PMID:29118679

Novel Hierarchical Fall Detection Algorithm Using a Multiphase Fall Model.

PubMed

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

2017-02-08

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

Novel Hierarchical Fall Detection Algorithm Using a Multiphase Fall Model

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-12-01

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

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

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.

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.

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.

A decision model to predict the risk of the first fall onset.

PubMed

Deschamps, Thibault; Le Goff, Camille G; Berrut, Gilles; Cornu, Christophe; Mignardot, Jean-Baptiste

2016-08-01

Miscellaneous features from various domains are accepted to be associated with the risk of falling in the elderly. However, only few studies have focused on establishing clinical tools to predict the risk of the first fall onset. A model that would objectively and easily evaluate the risk of a first fall occurrence in the coming year still needs to be built. We developed a model based on machine learning, which might help the medical staff predict the risk of the first fall onset in a one-year time window. Overall, 426 older adults who had never fallen were assessed on 73 variables, comprising medical, social and physical outcomes, at t0. Each fall was recorded at a prospective 1-year follow-up. A decision tree was built on a randomly selected training subset of the cohort (80% of the full-set) and validated on an independent test set. 82 participants experienced a first fall during the follow-up. The machine learning process independently extracted 13 powerful parameters and built a model showing 89% of accuracy for the overall classification with 83%-82% of true positive fallers and 96%-61% of true negative non-fallers (training set vs. independent test set). This study provides a pilot tool that could easily help the gerontologists refine the evaluation of the risk of the first fall onset and prioritize the effective prevention strategies. The study also offers a transparent framework for future, related investigation that would validate the clinical relevance of the established model by independently testing its accuracy on larger cohort. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Novel sensing technology in fall risk assessment in older adults: a systematic review.

PubMed

Sun, Ruopeng; Sosnoff, Jacob J

2018-01-16

Falls are a major health problem for older adults with significant physical and psychological consequences. A first step of successful fall prevention is to identify those at risk of falling. Recent advancement in sensing technology offers the possibility of objective, low-cost and easy-to-implement fall risk assessment. The objective of this systematic review is to assess the current state of sensing technology on providing objective fall risk assessment in older adults. A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Twenty-two studies out of 855 articles were systematically identified and included in this review. Pertinent methodological features (sensing technique, assessment activities, outcome variables, and fall discrimination/prediction models) were extracted from each article. Four major sensing technologies (inertial sensors, video/depth camera, pressure sensing platform and laser sensing) were reported to provide accurate fall risk diagnostic in older adults. Steady state walking, static/dynamic balance, and functional mobility were used as the assessment activity. A diverse range of diagnostic accuracy across studies (47.9% - 100%) were reported, due to variation in measured kinematic/kinetic parameters and modelling techniques. A wide range of sensor technologies have been utilized in fall risk assessment in older adults. Overall, these devices have the potential to provide an accurate, inexpensive, and easy-to-implement fall risk assessment. However, the variation in measured parameters, assessment tools, sensor sites, movement tasks, and modelling techniques, precludes a firm conclusion on their ability to predict future falls. Future work is needed to determine a clinical meaningful and easy to interpret fall risk diagnosis utilizing sensing technology. Additionally, the gap between functional evaluation and user experience to technology should be addressed.

Differing approaches to falls and fracture prevention between Australia and Colombia

PubMed Central

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

2013-01-01

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

Multiple sclerosis severity and concern about falling: Physical, cognitive and psychological mediating factors.

PubMed

van Vliet, Rob; Hoang, Phu; Lord, Stephen; Gandevia, Simon; Delbaere, Kim

2015-01-01

Concern about falling can have devastating physical and psychological consequences in people with multiple sclerosis (MS). However, little is known about physical and cognitive determinants for increased concern about falling inthis group. To investigate direct and indirect relationships between MS severity and concern about falling using structural equation modelling (SEM). Two hundred and ten community-dwelling people (21-73 years) with MS Disease Steps 0-5 completed several physical, cognitive and psychological assessments. Concern about falling was assessed using the Falls Efficacy Scale-International. Concern about falling was significantly associated with MS Disease Step and also balance, muscle strength, disability, previous falls, and executive functioning. SEM revealed a strong direct path between MS Disease Step and concern about falling (r = 0.31, p <  0.01), as well as indirect paths explained by impaired physical ability (r = 0.25, p <  0.01) and reduced cognitive function (r = 0.13, p <  0.01). The final model explained 51% of the variance of concern about falling in people with MS and had an excellent goodness-of-fit. The relationship between MS severity and increased concern about falling was primarily mediated by reduced physical ability (especially if this resulted in disability and falls) and less so by executive functioning. This suggests people with MS have a realistic appraisal of their concern about falling.

Changes in bone mineral density may predict the risk of fracture differently in older adults according to fall history.

PubMed

Berry, Sarah D; McLean, Robert R; Hannan, Marian T; Cupples, L Adrienne; Kiel, Douglas P

2014-12-01

To determine whether the association between change in bone mass density (BMD) over 4 years and risk of hip and nonvertebral fracture differs according to an individual's history of falls. Population-based cohort study. Framingham, Massachusetts. Individuals with two measures of BMD at the femoral neck (mean age 78.8; 310 male, 492 female). Cox proportional hazards models were used to estimate hazard ratios (HRs) for the association between percentage change in BMD (per sex-specific standard deviation) and risk of incident hip and nonvertebral fracture. Models were stratified based on history of falls (≥1 falls in the past year) and recurrent falls (≥2 falls) ascertained at the time of the second BMD test. Interactions were tested by including the term "fall history * change in BMD" in the models. Mean change in BMD was -0.6%/year; 27.8% of participants reported falls, and 10.8% reported recurrent falls. Seventy-six incident hip and 175 incident nonvertebral fractures occurred over a median follow-up of 9.0 years. There was no difference in the association between change in BMD and hip fracture according to history of falls (P for interaction = .57). The HR associated with change in BMD and nonvertebral fracture was 1.31 (95% confidence interval (CI) = 1.10-1.56) in participants without a history of falls and 0.95 (95% CI 0.70-1.28) in those with a fall (interaction P = .07). Results for recurrent fallers were similar. The effect of BMD loss on risk of nonvertebral fracture may be greater in persons without a history of falls. It is possible that change in BMD contributes less to fracture risk when a strong risk factor for fracture, such as falls, is present. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

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

NASA Astrophysics Data System (ADS)

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

2016-11-01

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

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.

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…

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

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

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.

The consciousness state space (CSS)—a unifying model for consciousness and self

PubMed Central

Berkovich-Ohana, Aviva; Glicksohn, Joseph

2014-01-01

Every experience, those we are aware of and those we are not, is embedded in a subjective timeline, is tinged with emotion, and inevitably evokes a certain sense of self. Here, we present a phenomenological model for consciousness and selfhood which relates time, awareness, and emotion within one framework. The consciousness state space (CSS) model is a theoretical one. It relies on a broad range of literature, hence has high explanatory and integrative strength, and helps in visualizing the relationship between different aspects of experience. Briefly, it is suggested that all phenomenological states fall into two categories of consciousness, core and extended (CC and EC, respectively). CC supports minimal selfhood that is short of temporal extension, its scope being the here and now. EC supports narrative selfhood, which involves personal identity and continuity across time, as well as memory, imagination and conceptual thought. The CSS is a phenomenological space, created by three dimensions: time, awareness and emotion. Each of the three dimensions is shown to have a dual phenomenological composition, falling within CC and EC. The neural spaces supporting each of these dimensions, as well as CC and EC, are laid out based on the neuroscientific literature. The CSS dynamics include two simultaneous trajectories, one in CC and one in EC, typically antagonistic in normal experiences. However, this characteristic behavior is altered in states in which a person experiences an altered sense of self. Two examples are laid out, flow and meditation. The CSS model creates a broad theoretical framework with explanatory and unificatory power. It constructs a detailed map of the consciousness and selfhood phenomenology, which offers constraints for the science of consciousness. We conclude by outlining several testable predictions raised by the CSS model. PMID:24808870

Terminal velocity of a shuttlecock in vertical fall

NASA Astrophysics Data System (ADS)

Peastrel, Mark; Lynch, Rosemary; Armenti, Angelo

1980-07-01

We have performed a straightforward vertical fall experiment for a case where the effects of air resistance are important and directly measurable. Using a commonly available badminton shuttlecock, a tape measure, and a millisecond timer, the times required for the shuttlecock to fall given distances (up to almost ten meters) were accurately measured. The experiment was performed in an open stairwell. The experimental data was compared to the predictions of several models. The best fit was obtained with the model which assumes a resistive force quadratic in the instantaneous speed of the falling object. This model was fitted to the experimental data enabling us to predict the terminal velocity of the shuttlecock (6.80 m/sec). The results indicate that, starting from rest, the vertically falling shuttlecock achieves 99% of its terminal velocity in 1.84 sec, after falling 9.2 m. The relative ease in collecting the data, as well as the excellent agreement with theory, make this an ideal experiment for use in physics courses at a variety of levels.

Early coordinated rehabilitation in acute phase after hip fracture - a model for increased patient participation.

PubMed

Asplin, Gillian; Carlsson, Gunnel; Zidén, Lena; Kjellby-Wendt, Gunilla

2017-10-17

Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients' perceived participation and subsequent effect on patients' function. A prospective, controlled, intervention performed in a CGC unit and compared with standard care. A total of 126 patients with hip fracture were recruited who were prior to fracture; community dwelling, mobile indoors and independent in personal care. Intervention Group (IG): 63 patients, mean age 82.0 years and Control Group (CG): 63 patients mean age 80.5 years. coordinated rehabilitation programme with early onset of patient participation and intensified occupational therapy and physiotherapy after hip fracture surgery. The primary outcome measure was self-reported patient participation at discharge. Secondary outcome measures were: TLS-BasicADL; Bergs Balance Scale (BBS); Falls Efficacy Scale FES(S); Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) at discharge and 1 month and ADL staircase for instrumental ADL at 1 month. At discharge a statistically significant greater number of patients in the IG reported higher levels of participation (p < 0.05) and independence in lower body hygiene (p < 0.05) and dressing (p < 0.001). There were however no statistically significant differences at discharge and 1 month between groups in functional balance and confidence, performance measures or risk for falls. This model of OT and PT coordinated inpatient rehabilitation had a positive effect on patients' perceived participation in their rehabilitation and ADL at discharge but did not appear to affect level of recovery or risk for future falls at 1 month. A large proportion of patients remained at risk for future falls at 1 month in both groups highlighting the need for continued rehabilitation after discharge. ClinicalTrials.gov Identifier: NCT03301584 (Retrospectively registered: 4 th October 2017).

Fall Detection in Individuals With Lower Limb Amputations Using Mobile Phones: Machine Learning Enhances Robustness for Real-World Applications.

PubMed

Shawen, Nicholas; Lonini, Luca; Mummidisetty, Chaithanya Krishna; Shparii, Ilona; Albert, Mark V; Kording, Konrad; Jayaraman, Arun

2017-10-11

Automatically detecting falls with mobile phones provides an opportunity for rapid response to injuries and better knowledge of what precipitated the fall and its consequences. This is beneficial for populations that are prone to falling, such as people with lower limb amputations. Prior studies have focused on fall detection in able-bodied individuals using data from a laboratory setting. Such approaches may provide a limited ability to detect falls in amputees and in real-world scenarios. The aim was to develop a classifier that uses data from able-bodied individuals to detect falls in individuals with a lower limb amputation, while they freely carry the mobile phone in different locations and during free-living. We obtained 861 simulated indoor and outdoor falls from 10 young control (non-amputee) individuals and 6 individuals with a lower limb amputation. In addition, we recorded a broad database of activities of daily living, including data from three participants' free-living routines. Sensor readings (accelerometer and gyroscope) from a mobile phone were recorded as participants freely carried it in three common locations-on the waist, in a pocket, and in the hand. A set of 40 features were computed from the sensors data and four classifiers were trained and combined through stacking to detect falls. We compared the performance of two population-specific models, trained and tested on either able-bodied or amputee participants, with that of a model trained on able-bodied participants and tested on amputees. A simple threshold-based classifier was used to benchmark our machine-learning classifier. The accuracy of fall detection in amputees for a model trained on control individuals (sensitivity: mean 0.989, 1.96*standard error of the mean [SEM] 0.017; specificity: mean 0.968, SEM 0.025) was not statistically different (P=.69) from that of a model trained on the amputee population (sensitivity: mean 0.984, SEM 0.016; specificity: mean 0.965, SEM 0.022). Detection of falls in control individuals yielded similar results (sensitivity: mean 0.979, SEM 0.022; specificity: mean 0.991, SEM 0.012). A mean 2.2 (SD 1.7) false alarms per day were obtained when evaluating the model (vs mean 122.1, SD 166.1 based on thresholds) on data recorded as participants carried the phone during their daily routine for two or more days. Machine-learning classifiers outperformed the threshold-based one (P<.001). A mobile phone-based fall detection model can use data from non-amputee individuals to detect falls in individuals walking with a prosthesis. We successfully detected falls when the mobile phone was carried across multiple locations and without a predetermined orientation. Furthermore, the number of false alarms yielded by the model over a longer period of time was reasonably low. This moves the application of mobile phone-based fall detection systems closer to a real-world use case scenario. ©Nicholas Shawen, Luca Lonini, Chaithanya Krishna Mummidisetty, Ilona Shparii, Mark V Albert, Konrad Kording, Arun Jayaraman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 11.10.2017.

Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.

PubMed

Masud, Tahir; Binkley, Neil; Boonen, Steven; Hannan, Marian T

2011-01-01

Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated into the FRAX® model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX® in individuals with a history of frequent falls. The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk in addition to bone directed therapy. Clinicians should recognize that patients with frequent falls are at higher fracture risk than currently estimated by FRAX® and include this in decision-making. However, quantitative adjustment of the FRAX® estimated risk based on falls history is not currently possible. In the long term, incorporation of falls as a risk factor in the FRAX® model would be ideal. Copyright © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

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

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

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

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.

Optimization and evaluation of the human fall detection system

NASA Astrophysics Data System (ADS)

Alzoubi, Hadeel; Ramzan, Naeem; Shahriar, Hasan; Alzubi, Raid; Gibson, Ryan; Amira, Abbes

2016-10-01

Falls are the most critical health problem for elderly people, which are often, cause significant injuries. To tackle a serious risk that made by the fall, we develop an automatic wearable fall detection system utilizing two devices (mobile phone and wireless sensor) based on three axes accelerometer signals. The goal of this study is to find an effective machine learning method that distinguish falls from activities of daily living (ADL) using only a single triaxial accelerometer. In addition, comparing the performance results for wearable sensor and mobile device data .The proposed model detects the fall by using seven different classifiers and the significant performance is demonstrated using accuracy, recall, precision and F-measure. Our model obtained accuracy over 99% on wearable device data and over 97% on mobile phone data.

Physical factors underlying the association between lower walking performance and falls in older people: a structural equation model.

PubMed

Shimada, Hiroyuki; Tiedemann, Anne; Lord, Stephen R; Suzukawa, Megumi; Makizako, Hyuma; Kobayashi, Kumiko; Suzuki, Takao

2011-01-01

The purpose of this study was to determine the interrelationships between lower limb muscle performance, balance, gait and falls in older people using structural equation modeling. Study participants were two hundred and thirteen people aged 65 years and older (mean age, 80.0 ± 7.1 years), who used day-care services in Japan. The outcome measures were the history of falls three months retrospectively and physical risk factors for falling, including performance in the chair stand test (CST), one-leg standing test (OLS), tandem walk test, 6m walking time, and the timed up-and-go (TUG) test. Thirty-nine (18.3%) of the 213 participants had fallen at least one or more times during the preceding 3 months. The fall group had significantly slower 6m walking speed and took significantly longer to undertake the TUG test than the non-fall group. In a structural equation model, performance in the CST contributed significantly to gait function, and low gait function was significantly and directly associated with falls in older people. This suggests that task-specific strength exercise as well as general mobility retraining should be important components of exercise programs designed to reduce falls in older people. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Factors associated with falling in early, treated Parkinson's disease: The NET-PD LS1 cohort.

PubMed

Chou, Kelvin L; Elm, Jordan J; Wielinski, Catherine L; Simon, David K; Aminoff, Michael J; Christine, Chadwick W; Liang, Grace S; Hauser, Robert A; Sudarsky, Lewis; Umeh, Chizoba C; Voss, Tiffini; Juncos, Jorge; Fang, John Y; Boyd, James T; Bodis-Wollner, Ivan; Mari, Zoltan; Morgan, John C; Wills, Anne-Marie; Lee, Stephen L; Parashos, Sotirios A

2017-06-15

Recognizing the factors associated with falling in Parkinson's disease (PD) would improve identification of at-risk individuals. To examine frequency of falling and baseline characteristics associated with falling in PD using the National Institute of Neurological Disorders and Stroke (NINDS) Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1) dataset. The LS-1 database included 1741 early treated PD subjects (median 4year follow-up). Baseline characteristics were tested for a univariate association with post-baseline falling during the trial. Significant variables were included in a multivariable logistic regression model. A separate analysis using a negative binomial model investigated baseline factors on fall rate. 728 subjects (42%) fell during the trial, including at baseline. A baseline history of falls was the factor most associated with post-baseline falling. Men had lower odds of post-baseline falling compared to women, but for men, the probability of a post-baseline fall increased with age such that after age 70, men and women had similar odds of falling. Other baseline factors associated with a post-baseline fall and increased fall rate included the Unified PD Rating Scale (UPDRS) Activities of Daily Living (ADL) score, total functional capacity (TFC), baseline ambulatory capacity score and dopamine agonist monotherapy. Falls are common in early treated PD. The biggest risk factor for falls in PD remains a history of falling. Measures of functional ability (UPDRS ADL, TFC) and ambulatory capacity are novel clinical risk factors needing further study. A significant age by sex interaction may help to explain why age has been an inconsistent risk factor for falls in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

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

PubMed Central

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

2011-01-01

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

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

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

Cathode fall model and current-voltage characteristics of field emission driven direct current microplasmas

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

Venkattraman, Ayyaswamy

2013-11-15

The post-breakdown characteristics of field emission driven microplasma are studied theoretically and numerically. A cathode fall model assuming a linearly varying electric field is used to obtain equations governing the operation of steady state field emission driven microplasmas. The results obtained from the model by solving these equations are compared with particle-in-cell with Monte Carlo collisions simulation results for parameters including the plasma potential, cathode fall thickness, ion number density in the cathode fall, and current density vs voltage curves. The model shows good overall agreement with the simulations but results in slightly overpredicted values for the plasma potential andmore » the cathode fall thickness attributed to the assumed electric field profile. The current density vs voltage curves obtained show an arc region characterized by negative slope as well as an abnormal glow discharge characterized by a positive slope in gaps as small as 10 μm operating at atmospheric pressure. The model also retrieves the traditional macroscale current vs voltage theory in the absence of field emission.« less

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.…

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.

Central Falls High School: First Year Transformation Report

ERIC Educational Resources Information Center

Burns, Amy; Whitney, Joye; Shah, Hardeek; Foley, Ellen; Dure, Elsa

2011-01-01

In January 2010, the Rhode Island Department of Education (RIDE) identified Central Falls High School (CFHS) as one of the state's persistently lowest-achieving schools. The Central Falls School District (CFSD) and the Central Falls Teachers Union (CFTU) considered the transformation model but could not come to an agreement initially around…

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.

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.

Associations between the five-factor model of personality and health behaviors among college students.

PubMed

Raynor, Douglas A; Levine, Heidi

2009-01-01

In fall 2006, the authors examined associations between the five-factor model of personality and several key health behaviors. 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. Highly conscientious individuals were more likely to wear seat belts, utilize alcohol-related harm reduction, exercise, get enough sleep, and consume fruits and vegetables. They were also less likely to smoke cigarettes, consume alcohol, and binge drink. Highly extraverted individuals were more likely to smoke cigarettes, consume alcohol, binge drink, and have multiple sexual partners, and they were less likely to engage in alcohol-related harm reduction, use condoms, and get enough sleep. These findings are supportive of a growing body of evidence indicating that conscientiousness and extraversion are robust concomitants of health behaviors among college students.

Power Hardware-in-the-Loop Testing of Multiple Photovoltaic Inverters' Volt-Var Control with Real-Time Grid Model

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

Chakraborty, Sudipta; Nelson, Austin; Hoke, Anderson

2016-12-12

Traditional testing methods fall short in evaluating interactions between multiple smart inverters providing advanced grid support functions due to the fact that such interactions largely depend on their placements on the electric distribution systems with impedances between them. Even though significant concerns have been raised by the utilities on the effects of such interactions, little effort has been made to evaluate them. In this paper, power hardware-in-the-loop (PHIL) based testing was utilized to evaluate autonomous volt-var operations of multiple smart photovoltaic (PV) inverters connected to a simple distribution feeder model. The results provided in this paper show that depending onmore » volt-var control (VVC) parameters and grid parameters, interaction between inverters and between the inverter and the grid is possible in some extreme cases with very high VVC slopes, fast response times and large VVC response delays.« less

Gmz: a Gml Compression Model for Webgis

NASA Astrophysics Data System (ADS)

Khandelwal, A.; Rajan, K. S.

2017-09-01

Geography markup language (GML) is an XML specification for expressing geographical features. Defined by Open Geospatial Consortium (OGC), it is widely used for storage and transmission of maps over the Internet. XML schemas provide the convenience to define custom features profiles in GML for specific needs as seen in widely popular cityGML, simple features profile, coverage, etc. Simple features profile (SFP) is a simpler subset of GML profile with support for point, line and polygon geometries. SFP has been constructed to make sure it covers most commonly used GML geometries. Web Feature Service (WFS) serves query results in SFP by default. But it falls short of being an ideal choice due to its high verbosity and size-heavy nature, which provides immense scope for compression. GMZ is a lossless compression model developed to work for SFP compliant GML files. Our experiments indicate GMZ achieves reasonably good compression ratios and can be useful in WebGIS based applications.

Uncomfortable realities: the challenge of creating real change in Europe's consolidating hospital sector.

PubMed

Jeurissen, Patrick; Duran, Antonio; Saltman, Richard B

2016-05-24

This article examines uncomfortable realities that the European hospital sector currently faces and the potential impact of wide-spread rationalization policies such as (hospital) payment reform and privatization. Review of relevant international literature. Based on the evidence we present, rationalization policies such as (hospital) payment reform and privatization will probably fall short in delivering better quality of care and lower growth in health expenses. Reasons can be sought in a mix of evidence on the effectiveness of these rationalization policies. Nevertheless, pressures for different business models will gradually continue to increase and it seems safe to assume that more value-added process business and facilitated network models will eventually emerge. The overall argument of this article holds important implications for future research: how can policymakers generate adequate leverage to introduce such changes without destroying necessary hospital capacity and the ability to produce quality healthcare.

A quantum probability perspective on borderline vagueness.

PubMed

Blutner, Reinhard; Pothos, Emmanuel M; Bruza, Peter

2013-10-01

The term "vagueness" describes a property of natural concepts, which normally have fuzzy boundaries, admit borderline cases, and are susceptible to Zeno's sorites paradox. We will discuss the psychology of vagueness, especially experiments investigating the judgment of borderline cases and contradictions. In the theoretical part, we will propose a probabilistic model that describes the quantitative characteristics of the experimental finding and extends Alxatib's and Pelletier's () theoretical analysis. The model is based on a Hopfield network for predicting truth values. Powerful as this classical perspective is, we show that it falls short of providing an adequate coverage of the relevant empirical results. In the final part, we will argue that a substantial modification of the analysis put forward by Alxatib and Pelletier and its probabilistic pendant is needed. The proposed modification replaces the standard notion of probabilities by quantum probabilities. The crucial phenomenon of borderline contradictions can be explained then as a quantum interference phenomenon. © 2013 Cognitive Science Society, Inc.

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

PubMed

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

2015-09-01

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

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.

Water Quantity and Water Quality Impacts of Intensive Woody Biomass Feedstock Production in the Southeastern US.

NASA Astrophysics Data System (ADS)

Bitew, M. M.; Jackson, C. R.; Vache, K. B.; Griffiths, N.; Starr, G.; McDonnell, J.; Rau, B.; Younger, S. E.; Fouts, K.

2016-12-01

Intensively managed loblolly pine is a candidate species for biofuel feedstock production in the southeastern Coastal Plain of the United States. However, the water quantity and quality effects of high intensity, short-rotation silviculture are largely unknown. Here we evaluate the potential hydrologic and water quality impacts of biofuel-induced land use changes based on model scenarios developed using existing forest BMPs and industry wide experiences. We quantified the effect of bio-energy production scenarios on each of water the balance components by applying an integrated physically based distributed watershed modeling system, and multi-objective assessment functions that accurately describes the flow regimes, water quality, and isotopic observations from three experimental headwater watersheds of Fourmile Creek at Savannah River Site, SC. The model incorporates optimized travel times of groundwater flowpaths and flow control processes in the riparian region allowing water quality analysis of groundwater dominated watershed systems. We compared five different short rotation pine management scenarios ranging from 35 year (low intensity) to 10 year (high intensity) rotations and a mixture of forestry and agriculture/pasture production practices. Simulation results, based on long-term climate records, revealed that complete conversion to short-rotation woody crops would have a negligible effect on water budget components; <2% decrease in streamflow, <1.5% increase in actual evapotranspiration, an average 0.5 m fall in the groundwater table, and no change in subsurface flow due to biofuel production. Simulation results of mixed 50% agriculture and pasture and 50% short-rotation woody crops showed the largest deviation in water budget components compared to the reference condition. Analysis of extreme stream flows showed that the largest effect was observed in the low intensity mixed land use scenario. The smallest effect was in the low intensity biomass production scenario with a 0.5% increase in a 100 year return event.

SNAP Participants' Eating Patterns over the Benefit Month: A Time Use Perspective.

PubMed

Hamrick, Karen S; Andrews, Margaret

2016-01-01

Individuals receiving monthly benefits through the U.S. Supplemental Nutrition Assistance Program (SNAP) often fall short of food at the end of the month and some report feelings of hunger. To investigate this situation, we used time diaries from the 2006-08 American Time Use Survey and Eating & Health Module to identify the timing of days where respondents reported no eating occurrences. Analysis includes descriptive statistics, a logit model, and a simulated benefit month. We found that SNAP participants were increasingly more likely than nonparticipants to report a day with no eating occurrences over the benefit issuance cycle. This supports the view that there is a monthly cycle in food consumption associated with the SNAP monthly benefit issuance policy.

Why Fix N2 in High N Supply Regions?

NASA Astrophysics Data System (ADS)

Landolfi, A.; Koeve, W.; Oschlies, A.

2016-02-01

Growing slowly, marine N2 fixers are expected to be competitive where nitrogen (N) supply falls short relative to that of phosphorus (P) with respect to the cellular N:P ratio (R) of non-fixing phytoplankton. Why do N2 fixers persist in the the oligotrophic North Atlantic where the ratio of nutrients supplied to the surface is elevated in N relative to the average R (16:1)? Combining resource competition theory and a global coupled ecosystem-circulation model we find a novel mechanism that can expand the ecological niche of N2 fixers also to regions where the nutrient supply is high in N relative to R, offering a new perspective on the environmental controls of marine N2-fixers.

SNAP Participants’ Eating Patterns over the Benefit Month: A Time Use Perspective

PubMed Central

2016-01-01

Individuals receiving monthly benefits through the U.S. Supplemental Nutrition Assistance Program (SNAP) often fall short of food at the end of the month and some report feelings of hunger. To investigate this situation, we used time diaries from the 2006–08 American Time Use Survey and Eating & Health Module to identify the timing of days where respondents reported no eating occurrences. Analysis includes descriptive statistics, a logit model, and a simulated benefit month. We found that SNAP participants were increasingly more likely than nonparticipants to report a day with no eating occurrences over the benefit issuance cycle. This supports the view that there is a monthly cycle in food consumption associated with the SNAP monthly benefit issuance policy. PMID:27410962

Identifying nursing home residents at risk for falling.

PubMed

Kiely, D K; Kiel, D P; Burrows, A B; Lipsitz, L A

1998-05-01

To develop a fall risk model that can be used to identify prospectively nursing home residents at risk for falling. The secondary objective was to determine whether the nursing home environment independently influenced the development of falls. A prospective study involving 1 year of follow-up. Two hundred seventy-two nursing homes in the state of Washington. A total of 18,855 residents who had a baseline assessment in 1991 and a follow-up assessment within the subsequent year. Baseline Minimum Data Set items that could be potential risk factors for falling were considered as independent variables. The dependent variable was whether the resident fell as reported at the follow-up assessment. We estimated the extrinsic risk attributable to particular nursing home environments by calculating the annual fall rate in each nursing home and grouping them into tertiles of fall risk according to these rates. Factors associated independently with falling were fall history, wandering behavior, use of a cane or walker, deterioration of activities of daily living performance, age greater than 87 years, unsteady gait, transfer independence, wheelchair independence, and male gender. Nursing home residents with a fall history were more than three times as likely to fall during the follow-up period than residents without a fall history. Residents in homes with the highest tertile of fall rates were more than twice as likely to fall compared with residents of homes in the lowest tertile, independent of resident-specific risk factors. Fall history was identified as the strongest risk factor associated with subsequent falls and accounted for the vast majority of the predictive strength of the model. We recommend that fall history be used as an initial screener for determining eligibility for fall intervention efforts. Studies are needed to determine the facility characteristics that contribute to fall risk, independent of resident-specific risk factors.

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)

"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.

Analysis of the free-fall behavior of liquid-metal drops in a gaseous atmosphere

NASA Technical Reports Server (NTRS)

Mccoy, J. Kevin; Markworth, Alan J.; Collings, E. W.; Brodkey, Robert S.

1987-01-01

The free-fall of a liquid-metal drop and heat transfer from the drop to its environment are described for both a gaseous atmosphere and vacuum. A simple model, in which the drop is assumed to fall rectilinearly with behavior like that of a rigid particle, is developed first, then possible causes of deviation from this behavior are discussed. The model is applied to describe solidification of drops in a drop tube. Possible future developments of the model are suggested.

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function.

PubMed

Sarter, Martin; Albin, Roger L; Kucinski, Aaron; Lustig, Cindy

2014-07-01

Falls are a major source of hospitalization, long-term institutionalization, and death in older adults and patients with Parkinson's disease (PD). Limited attentional resources are a major risk factor for falls. In this review, we specify cognitive-behavioral mechanisms that produce falls and map these mechanisms onto a model of multi-system degeneration. Results from PET studies in PD fallers and findings from a recently developed animal model support the hypothesis that falls result from interactions between loss of basal forebrain cholinergic projections to the cortex and striatal dopamine loss. Striatal dopamine loss produces inefficient, low-vigor gait, posture control, and movement. Cortical cholinergic deafferentation impairs a wide range of attentional processes, including monitoring of gait, posture and complex movements. Cholinergic cell loss reveals the full impact of striatal dopamine loss on motor performance, reflecting loss of compensatory attentional supervision of movement. Dysregulation of dorsomedial striatal circuitry is an essential, albeit not exclusive, mediator of falls in this dual-system model. Because cholinergic neuromodulatory activity influences cortical circuitry primarily via stimulation of α4β2* nicotinic acetylcholine receptors, and because agonists at these receptors are known to benefit attentional processes in animals and humans, treating PD fallers with such agonists, as an adjunct to dopaminergic treatment, is predicted to reduce falls. Falls are an informative behavioral endpoint to study attentional-motor integration by striatal circuitry. Copyright © 2014 Elsevier Inc. All rights reserved.

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

PubMed Central

Sarter, Martin; Albin, Roger L.; Kucinski, Aaron; Lustig, Cindy

2015-01-01

Falls are a major source of hospitalization, long-term institutionalization, and death in older adults and patients with Parkinson’s disease (PD). Limited attentional resources are a major risk factor for falls. In this review, we specify cognitive–behavioral mechanisms that produce falls and map these mechanisms onto a model of multi-system degeneration. Results from PET studies in PD fallers and findings from a recently developed animal model support the hypothesis that falls result from interactions between loss of basal forebrain cholinergic projections to the cortex and striatal dopamine loss. Striatal dopamine loss produces inefficient, low-vigor gait, posture control, and movement. Cortical cholinergic deafferentation impairs a wide range of attentional processes, including monitoring of gait, posture and complex movements. Cholinergic cell loss reveals the full impact of striatal dopamine loss on motor performance, reflecting loss of compensatory attentional supervision of movement. Dysregulation of dorsomedial striatal circuitry is an essential, albeit not exclusive, mediator of falls in this dual-system model. Because cholinergic neuromodulatory activity influences cortical circuitry primarily via stimulation of α4β2* nicotinic acetylcholine receptors, and because agonists at these receptors are known to benefit attentional processes in animals and humans, treating PD fallers with such agonists, as an adjunct to dopaminergic treatment, is predicted to reduce falls. Falls are an informative behavioral endpoint to study attentional–motor integration by striatal circuitry. PMID:24805070

Utilizing Weather RADAR for Rapid Location of Meteorite Falls and Space Debris Re-Entry

NASA Technical Reports Server (NTRS)

Fries, Marc D.

2016-01-01

This activity utilizes existing NOAA weather RADAR imagery to locate meteorite falls and space debris falls. The near-real-time availability and spatial accuracy of these data allow rapid recovery of material from both meteorite falls and space debris re-entry events. To date, at least 22 meteorite fall recoveries have benefitted from RADAR detection and fall modeling, and multiple debris re-entry events over the United States have been observed in unprecedented detail.

Effects of lesions to the left lateral prefrontal cortex on task-specific top-down biases and response strategies in blocked-cyclic naming.

PubMed

Belke, Eva

Anders, Riès, van Maanen and Alario put forward evidence accumulation modelling of object naming times as an alternative to neural network models of lexical retrieval. The authors exemplify their approach using data from the blocked-cyclic naming paradigm, requiring speakers to repeatedly name small sets of related or unrelated objects. The effects observed with this paradigm are understood reasonably well within the tradition of neural network modelling. However, implemented neural network models do not specify interfaces for task-specific top-down influences and response strategies that are likely to play a role in the blocked-cyclic naming paradigm, distinguishing it from continuous, non-cyclic manipulations of the naming context. I argue that the evidence accumulation approach falls short on this account as well, as it does not specify the potential contribution of task-specific top-down processes and strategic facilitation effects to the response time distributions. Future endeavours to model or fit data from blocked-cyclic naming experiments should strive to do so by simultaneously considering data from continuous context manipulations.

An Accretion Model for Anomalous X-Ray Pulsars

NASA Astrophysics Data System (ADS)

Chatterjee, Pinaki; Hernquist, Lars; Narayan, Ramesh

2000-05-01

We present a model for the anomalous X-ray pulsars (AXPs) in which the emission is powered by accretion from a fossil disk, established from matter falling back onto the neutron star following its birth. The time-dependent accretion drives the neutron star toward a ``tracking'' solution in which the rotation period of the star increases slowly, in tandem with the declining accretion rate. For appropriate choices of disk mass, neutron star magnetic field strength, and initial spin period, we demonstrate that a rapidly rotating neutron star can be spun down to periods characteristic of AXPs on timescales comparable to the estimated ages of these sources. In other cases, accretion onto the neutron star switches off after a short time and the star becomes an ordinary radio pulsar. Thus, in our picture, radio pulsars and AXPs are drawn from the same underlying population, in contrast to the situation in models involving neutron stars with ultrastrong magnetic fields, which require a new population of stars with very different properties.

Highly ionized atoms in cooling gas. [in model for cooling of hot Galactic corona

NASA Technical Reports Server (NTRS)

Edgar, Richard J.; Chevalier, Roger A.

1986-01-01

The ionization of low density gas cooling from a high temperature was calculated. The evolution during the cooling is assumed to be isochoric, isobaric, or a combination of these cases. The calculations are used to predict the column densities and ultraviolet line luminosities of highly ionized atoms in cooling gas. In a model for cooling of a hot galactic corona, it is shown that the observed value of N(N V) can be produced in the cooling gas, while the predicted value of N(Si IV) falls short of the observed value by a factor of about 5. The same model predicts fluxes of ultraviolet emission lines that are a factor of 10 lower than the claimed detections of Feldman, Bruna, and Henry. Predictions are made for ultraviolet lines in cooling flows in early-type galaxies and clusters of galaxies. It is shown that the column densities of interest vary over a fairly narrow range, while the emission line luminosities are simply proportional to the mass inflow rate.

Fundamental Scaling of Microplasmas and Tunable UV Light Generation.

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

Manginell, Ronald P.; Sillerud, Colin Halliday; Hopkins, Matthew M.

2016-11-01

The temporal evolution of spectral lines from microplasma devices (MD) was studied, including impurity transitions. Long-wavelength emission diminishes more rapidly than deep UV with decreasing pulse width and RF operation. Thus, switching from DC to short pulsed or RF operation, UV emissions can be suppressed, allowing for real-time tuning of the ionization energy of a microplasma photo-ionization source, which is useful for chemical and atomic physics. Scaling allows MD to operate near atmospheric pressure where excimer states are efficiently created and emit down to 65 nm; laser emissions fall off below 200 nm, making MD light sources attractive for deepmore » UV use. A first fully-kinetic three-dimensional model was developed that explicitly calculates electron-energy distribution function. This, and non-continuum effects, were studied with the model and how they are impacted by geometry and transient or DC operation. Finally, a global non-dimensional model was developed to help explain general trends MD physics.« less

Early axonal damage and progressive myelin pathology define the kinetics of CNS histopathology in a mouse model of multiple sclerosis.

PubMed

Recks, Mascha S; Stormanns, Eva R; Bader, Jonas; Arnhold, Stefan; Addicks, Klaus; Kuerten, Stefanie

2013-10-01

Studies of MS histopathology are largely dependent on suitable animal models. While light microscopic analysis gives an overview of tissue pathology, it falls short in evaluating detailed changes in nerve fiber morphology. The ultrastructural data presented here and obtained from studies of myelin oligodendrocyte glycoprotein (MOG):35-55-induced experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mice delineate that axonal damage and myelin pathology follow different kinetics in the disease course. While myelin pathology accumulated with disease progression, axonal damage coincided with the initial clinical disease symptoms and remained stable over time. This pattern applied both to irreversible axolysis and early axonal pathology. Notably, these histopathological patterns were reflected by the normal-appearing white matter (NAWM), suggesting that the NAWM is also in an active neurodegenerative state. The data underline the need for neuroprotection in MS and suggest the MOG model as a highly valuable tool for the assessment of different therapeutic strategies. Copyright © 2013 Elsevier Inc. All rights reserved.

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.

Learning in settings with partial feedback and the wavy recency effect of rare events.

PubMed

Plonsky, Ori; Erev, Ido

2017-03-01

Analyses of human learning reveal a discrepancy between the long- and the short-term effects of outcomes on subsequent choice. The long-term effect is simple: favorable outcomes increase the choice rate of an alternative whereas unfavorable outcomes decrease it. The short-term effects are more complex. Favorable outcomes can decrease the choice rate of the best option. This pattern violates the positive recency assumption that underlies the popular models of learning. The current research tries to clarify the implications of these results. Analysis of wide sets of learning experiments shows that rare positive outcomes have a wavy recency effect. The probability of risky choice after a successful outcome from risk-taking at trial t is initially (at t+1) relatively high, falls to a minimum at t+2, then increases for about 15 trials, and then decreases again. Rare negative outcomes trigger a wavy reaction when the feedback is complete, but not under partial feedback. The difference between the effects of rare positive and rare negative outcomes and between full and partial feedback settings can be described as a reflection of an interaction of an effort to discover patterns with two other features of human learning: surprise-triggers-change and the hot stove effect. A similarity-based descriptive model is shown to capture well all these interacting phenomena. In addition, the model outperforms the leading models in capturing the outcomes of data used in the 2010 Technion Prediction Tournament. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Sensitivity of a Riparian Large Woody Debris Recruitment Model to the Number of Contributing Banks and Tree Fall Pattern

Treesearch

Don C. Bragg; Jeffrey L. Kershner

2004-01-01

Riparian large woody debris (LWD) recruitment simulations have traditionally applied a random angle of tree fall from two well-forested stream banks. We used a riparian LWD recruitment model (CWD, version 1.4) to test the validity these assumptions. Both the number of contributing forest banks and predominant tree fall direction significantly influenced simulated...

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…

Identity, Intersectionality, and Mixed-Methods Approaches

ERIC Educational Resources Information Center

Harper, Casandra E.

2011-01-01

In this article, the author argues that current strategies to study and understand students' identities fall short of fully capturing their complexity. A multi-dimensional perspective and a mixed-methods approach can reveal nuance that is missed with current approaches. The author offers an illustration of how mixed-methods research can promote a…

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…

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…

Qualitative Analysis on Stage: Making the Research Process More Public.

ERIC Educational Resources Information Center

Anfara, Vincent A., Jr.; Brown, Kathleen M.

The increased use of qualitative research methods has spurred interest in developing formal standards for assessing its validity. These standards, however, fall short if they do not include public disclosure of methods as a criterion. The researcher must be accountable in documenting the actions associated with establishing internal validity…

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…

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.

Clinical and physiological assessments for elucidating falls risk in Parkinson's disease.

PubMed

Latt, Mark D; Lord, Stephen R; Morris, John G L; Fung, Victor S C

2009-07-15

The study aims were to devise (1) a fall risk screen for people with PD using routine clinical measures and (2) an explanatory (physiological) fall risk assessment for guiding fall prevention interventions. One hundred thirteen people with PD (age 66 +/- 95% CI 1.6 years) underwent clinical assessments and quantitative tests of sway, gait, strength, reaction time, and lower limb sensation. Participants were then followed up for 12 months to determine fall incidence. In the follow-up year, 51 participants (45%) fell one or more times whereas 62 participants (55%) did not fall. Multivariate analyses of routine clinical measures revealed that a fall in the past year, abnormal axial posture, cognitive impairment, and freezing of gait were independent risk factors for falls and predicted 38/51 fallers (75%) and 45/62 non-fallers (73%). A multivariate model combining clinical and physiological measures that elucidate the pathophysiology of falls identified abnormal posture, freezing of gait, frontal impairment, poor leaning balance, and leg weakness as independent risk factors. This model correctly classified 39/51 fallers (77%) and 51/62 non-fallers (82%). Patients with PD at risk of falls can be identified accurately with routine clinical assessments and quantitative physiological tests. Many of the risk factors identified are amenable to targeted intervention. 2009 Movement Disorder Society.

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

Nassar, Nada; Helou, Nancy; Madi, Chantal

2014-06-01

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

The numerical modelling of falling film thickness flow on horizontal tubes

NASA Astrophysics Data System (ADS)

Hassan, I. A.; Sadikin, A.; Isa, N. Mat

2017-04-01

This paper presents a computational modelling of water falling film flowing over horizontal tubes. The objective of this study is to use numerical predictions for comparing the film thickness along circumferential direction of tube on 2-D CFD models. The results are then validated with a theoretical result in previous literatures. A comprehensive design of 2-D models have been developed according to the real application and actual configuration of the falling film evaporator as well as previous experimental parameters. A computational modelling of the water falling film is presented with the aid of Ansys Fluent software. The Volume of Fluid (VOF) technique is adapted in this analysis since its capabilities of determining the film thickness on tubes surface is highly reliable. The numerical analysis is carried out under influence of ambient pressures at temperature of 27 °C. Three types of CFD numerical models were analyzed in this simulation with inter tube spacing of 30 mm, 20 mm and 10 mm respectively. The use of a numerical simulation tool on water falling film has resulted in a detailed investigation of film thickness. Based on the numerical simulated results, it is found that the average values of water film thickness for each model are 0.53 mm, 0.58 mm, and 0.63 mm.

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.

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

Segmental Dynamics of Forward Fall Arrests: System Identification Approach

PubMed Central

Kim, Kyu-Jung; Ashton-Miller, James A.

2009-01-01

Background Fall-related injuries are multifaceted problems, necessitating thorough biodynamic simulation to identify critical biomechanical factors. Methods A 2-degree-of-freedom discrete impact model was constructed through system identification and validation processes using the experimental data to understand dynamic interactions of various biomechanical parameters in bimanual forward fall arrests. Findings The bimodal reaction force response from the identified models had small identification errors for the first and second force peaks less than 3.5% and high coherence between the measured and identified model responses (R2=0.95). Model validation with separate experimental data also demonstrated excellent validation accuracy and coherence, less than 7% errors and R2=0.87, respectively. The first force peak was usually greater than the second force peak and strongly correlated with the impact velocity of the upper extremity, while the second force peak was associated with the impact velocity of the body. The impact velocity of the upper extremity relative to the body could be a major risk factor to fall-related injuries as observed from model simulations that a 75% faster arm movement relative to the falling speed of the body alone could double the first force peak from soft landing, thereby readily exceeding the fracture strength of the distal radius. Interpretation Considering that the time-critical nature of falling often calls for a fast arm movement, the use of the upper extremity in forward fall arrests is not biomechanically justified unless sufficient reaction time and coordinated protective motion of the upper extremity are available. PMID:19250726

Triaxial cosmological haloes and the disc of satellites

NASA Astrophysics Data System (ADS)

Bowden, A.; Evans, N. W.; Belokurov, V.

2013-10-01

We construct simple triaxial generalizations of Navarro-Frenk-White haloes. The models have elementary gravitational potentials, together with a density that is cusped like 1/r at small radii and falls off like 1/r3 at large radii. The ellipticity varies with radius in a manner that can be tailored to the user's specification. The closed periodic orbits in the planes perpendicular to the short and long axes of the model are well described by epicyclic theory, and can be used as building blocks for long-lived discs. As an application, we carry out the simulations of thin discs of satellites in triaxial dark halo potentials. This is motivated by the recent claims of an extended, thin disc of satellites around the M31 galaxy with a vertical rms scatter of ˜12 kpc and a radial extent of ˜300 kpc. We show that a thin satellite disc can persist over cosmological times if and only if it lies in the planes perpendicular to the long or short axis of a triaxial halo, or in the equatorial or polar planes of a spheroidal halo. In any other orientation, then the disc thickness doubles on ˜5 Gyr time-scales and so must have been born with an implausibly small vertical scaleheight.

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

PubMed

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

2009-11-14

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

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.

Bridging the gap between measurements and modelling: a cardiovascular functional avatar.

PubMed

Casas, Belén; Lantz, Jonas; Viola, Federica; Cedersund, Gunnar; Bolger, Ann F; Carlhäll, Carl-Johan; Karlsson, Matts; Ebbers, Tino

2017-07-24

Lumped parameter models of the cardiovascular system have the potential to assist researchers and clinicians to better understand cardiovascular function. The value of such models increases when they are subject specific. However, most approaches to personalize lumped parameter models have thus far required invasive measurements or fall short of being subject specific due to a lack of the necessary clinical data. Here, we propose an approach to personalize parameters in a model of the heart and the systemic circulation using exclusively non-invasive measurements. The personalized model is created using flow data from four-dimensional magnetic resonance imaging and cuff pressure measurements in the brachial artery. We term this personalized model the cardiovascular avatar. In our proof-of-concept study, we evaluated the capability of the avatar to reproduce pressures and flows in a group of eight healthy subjects. Both quantitatively and qualitatively, the model-based results agreed well with the pressure and flow measurements obtained in vivo for each subject. This non-invasive and personalized approach can synthesize medical data into clinically relevant indicators of cardiovascular function, and estimate hemodynamic variables that cannot be assessed directly from clinical measurements.

Optimism, Cynical Hostility, Falls, and Fractures: The Women's Health Initiative Observational Study (WHI-OS).

PubMed

Cauley, Jane A; Smagula, Stephen F; Hovey, Kathleen M; Wactawski-Wende, Jean; Andrews, Christopher A; Crandall, Carolyn J; LeBoff, Meryl S; Li, Wenjun; Coday, Mace; Sattari, Maryam; Tindle, Hilary A

2017-02-01

Traits of optimism and cynical hostility are features of personality that could influence the risk of falls and fractures by influencing risk-taking behaviors, health behaviors, or inflammation. To test the hypothesis that personality influences falls and fracture risk, we studied 87,342 women enrolled in WHI-OS. Optimism was assessed by the Life Orientation Test-Revised and cynical hostility, the cynicism subscale of the Cook-Medley questionnaire. Higher scores indicate greater optimism and hostility. Optimism and hostility were correlated at r = -0. 31, p < 0.001. Annual self-report of falling ≥2 times in the past year was modeled using repeated measures logistic regression. Cox proportional hazards models were used for the fracture outcomes. We examined the risk of falls and fractures across the quartiles (Q) of optimism and hostility with tests for trends; Q1 formed the referent group. The average follow-up for fractures was 11.4 years and for falls was 7.6 years. In multivariable (MV)-adjusted models, women with the highest optimism scores (Q4) were 11% less likely to report ≥2 falls in the past year (odds ratio [OR] = 0.89; 95% confidence intervals [CI] 0.85-0.90). Women in Q4 for hostility had a 12% higher risk of ≥2 falls (OR = 1.12; 95% CI 1.07-1.17). Higher optimism scores were also associated with a 10% lower risk of fractures, but this association was attenuated in MV models. Women with the greatest hostility (Q4) had a modest increased risk of any fracture (MV-adjusted hazard ratio = 1. 05; 95% CI 1.01-1.09), but there was no association with specific fracture sites. In conclusion, optimism was independently associated with a decreased risk of ≥2 falls, and hostility with an increased risk of ≥2 falls, independent of traditional risk factors. The magnitude of the association was similar to aging 5 years. Whether interventions aimed at attitudes could reduce fall risks remains to be determined. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

Modeling Outburst Flooding as a Turbulent Hydraulic Fracture Parallel to a Nearby Free Surface

NASA Astrophysics Data System (ADS)

Tsai, V. C.; Rice, J. R.

2009-12-01

Meltwater generated at the surface and base of glaciers and ice sheets is known to have a large impact on how ice masses behave dynamically, but much is still unknown about the physical processes responsible for how this meltwater drains out of the glacier. For example, little attention has been paid to short-timescale processes like turbulent hydraulic fracture, which is likely an important mechanism by which drainage channels initially form when water pressures are high. In recent work (Tsai and Rice [Fall AGU, 2008; JGR subm., 2009]), we have constructed a model of this turbulent hydraulic fracture process in which over-pressurized water is assumed to flow turbulently through a crack, leading to crack growth. However, one important limitation of this prior work is that it only strictly applies in the limit of short crack length 2L compared to glacier height H, whereas relevant observations of supraglacial lake drainage, jokulhlaups and sub-glacial lake-to-lake transport episodes do not fall in this regime. Here, we improve somewhat upon this model by explicitly accounting for a nearby free surface. We accomplish this by applying the approach of Erdogan et al. [Meth. Anal. Sol. Crack Prob., 1973] to numerically calculate elastic displacements consistent with crack pressure distribution for a crack near a free surface, and use these results as before to simultaneously satisfy the governing fluid, elastic and fracture equations. Our results are analogous to the zero fracture toughness results of Zhang et al. [Int. J. Numer. Anal. Meth. Geomech., 2005], but applied to the case of turbulent flow rather than laminar flow of a Newtonian viscous fluid. Our new results clarify the importance of the free surface and potentially explain discrepancies between our previous modeling results and observations of supraglacial lake drainage by Das et al. [Science, 2008]. However, the numerical challenges increase as 2L becomes comparable to or much larger than H. We hope to ultimately develop simpler analyses for that range which make use of (visco)elastic plate theory at positions along the uplifted ice sheet that are remote from the fracturing front. This approach may also be of interest for tidal interactions with the ice-shelf grounding line location.

Modeling Outburst Flooding as a Turbulent Hydraulic Fracture Parallel to a Nearby Free Surface

NASA Astrophysics Data System (ADS)

Tsai, Victor; Rice, James

2010-05-01

Meltwater generated at the surface and base of glaciers and ice sheets is known to have a large impact on how ice masses behave dynamically, but much is still unknown about the physical processes responsible for how this meltwater drains out of the glacier. For example, little attention has been paid to short-timescale processes like turbulent hydraulic fracture, which is likely an important mechanism by which drainage channels initially form when water pressures are high. In recent work (Tsai and Rice [Fall AGU, 2008; JGR subm., 2009]), we have constructed a model of this turbulent hydraulic fracture process in which over-pressurized water is assumed to flow turbulently through a crack, leading to crack growth. However, one important limitation of this prior work is that it only strictly applies in the limit of short crack length, 2L, compared to glacier height, H, whereas relevant observations of supraglacial lake drainage, jokulhlaups and sub-glacial lake-to-lake transport episodes do not fall in this regime. Here, we improve somewhat upon this model by explicitly accounting for a nearby free surface. We accomplish this by applying the approach of Erdogan et al. [Meth. Anal. Sol. Crack Prob., 1973] to numerically calculate elastic displacements consistent with crack pressure distribution for a crack near a free surface, and use these results as before to simultaneously satisfy the governing fluid, elastic and fracture equations. Our results are analogous to the zero fracture toughness results of Zhang et al. [Int. J. Numer. Anal. Meth. Geomech., 2005], but applied to the case of turbulent flow rather than laminar flow of a Newtonian viscous fluid. Our new results clarify the importance of the free surface and potentially explain discrepancies between our previous modeling results and observations of supraglacial lake drainage by Das et al. [Science, 2008]. However, the numerical challenges increase as 2L becomes comparable to or much larger than H. We hope to ultimately develop simpler analyses for that range which make use of (visco)elastic plate theory at positions along the uplifted ice sheet that are remote from the fracturing front. This approach may also be of interest for tidal interactions with the ice-shelf grounding line location.

Sideways fall-induced impact force and its effect on hip fracture risk: a review.

PubMed

Nasiri Sarvi, M; Luo, Y

2017-10-01

Osteoporotic hip fracture, mostly induced in falls among the elderly, is a major health burden over the world. The impact force applied to the hip is an important factor in determining the risk of hip fracture. However, biomechanical researches have yielded conflicting conclusions about whether the fall-induced impact force can be accurately predicted by the available models. It also has been debated whether or not the effect of impact force has been considered appropriately in hip fracture risk assessment tools. This study aimed to provide a state-of-the-art review of the available methods for predicting the impact force, investigate their strengths/limitations, and suggest further improvements in modeling of human body falling. We divided the effective parameters on impact force to two categories: (1) the parameters that can be determined subject-specifically and (2) the parameters that may significantly vary from fall to fall for an individual and cannot be considered subject-specifically. The parameters in the first category can be investigated in human body fall experiments. Video capture of real-life falls was reported as a valuable method to investigate the parameters in the second category that significantly affect the impact force and cannot be determined in human body fall experiments. The analysis of the gathered data revealed that there is a need to develop modified biomechanical models for more accurate prediction of the impact force and appropriately adopt them in hip fracture risk assessment tools in order to achieve a better precision in identifying high-risk patients. Graphical abstract Impact force to the hip induced in sideways falls is affected by many parameters and may remarkably vary from subject to subject.

Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial

PubMed Central

Ferrer, Assumpta; Formiga, Francesc; Sanz, Héctor; de Vries, Oscar J; Badia, Teresa; Pujol, Ramón

2014-01-01

Background The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. Methods A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat. Results Sixty-five (39.6%) subjects in the intervention group and 48 (29.3%) in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94–1.75). Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03–2.09) and that functional impairment (HR 1.42, 95% CI 0.97–2.12), previous falls (HR 1.09, 95% CI 0.74–1.60), and cognitive impairment (HR 1.08, 95% CI 0.72–1.60) had no effect on the assessment. Conclusion This multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study. PMID:24596458

Design a Learning-Oriented Fall Event Reporting System Based on Kirkpatrick Model.

PubMed

Zhou, Sicheng; Kang, Hong; Gong, Yang

2017-01-01

Patient fall has been a severe problem in healthcare facilities around the world due to its prevalence and cost. Routine fall prevention training programs are not as effective as expected. Using event reporting systems is the trend for reducing patient safety events such as falls, although some limitations of the systems exist at current stage. We summarized these limitations through literature review, and developed an improved web-based fall event reporting system. The Kirkpatrick model, widely used in the business area for training program evaluation, has been integrated during the design of our system. Different from traditional event reporting systems that only collect and store the reports, our system automatically annotates and analyzes the reported events, and provides users with timely knowledge support specific to the reported event. The paper illustrates the design of our system and how its features are intended to reduce patient falls by learning from previous errors.

Using Kettle Lake Records to Date and Interpret Holocene Ash Deposition in Upper Cook Inlet, Anchorage, AK

NASA Astrophysics Data System (ADS)

Werner, A.; Kathan, K. M.; Kaufman, D. S.; Hancock, J. R.; Waythomas, C. F.; Wallace, K. L.

2004-12-01

Fourteen sediment cores recovered from three kettle lakes (Goose, Little Campbell and Lorraine) near Anchorage, AK were used to document and date Holocene volcanic ash deposition in the upper Cook Inlet area. Small lakes (<0.5 km2) with small (<1.5 km2), low relief (<50 m), and well-vegetated drainage areas were selected in order to minimize ash remobilization by mass wasting and fluvial processes. The resulting stratigraphic records are interpreted as primary terpha-fall stratigraphies. Relative to the surrounding lacustrine sediments, the ash layers exhibit low organic-matter content (as determined by loss-on-ignition, LOI), high magnetic susceptibility (MS), increased density (X-radiographs), and bubble-wall glass shards. Some ash layers are up to 1 cm thick (macrotephra) consisting of pure glass, some occur as light bands, while others (microtephra) can only be located using non-visual techniques (MS, LOI and X-radiography). The thinnest microtephras observed occur either as discrete (1 mm) layers or diffuse laminations composed of tephra mixed with ambient lake sediment. Forty-five AMS C-14 dates on terrestrial macro fossils were used to constrain sedimentation-rate models for the cores, and to assign absolute ages to ash units. Comparison of inferred tephra ages corroborates our intra and inter basin stratigraphic correlations (+/- 200 yrs) based on physical and MS stratigraphy. Ten out of 12 macrotephras can be confidently correlated among all three lakes, whereas, two of the prominent tephras occur in one basin but not in the others. This suggests subtle differences in ash plume extents or differences in tephra preservation between lakes. A total of 24 Holocene ash units (12 macro and 12 micro) have been recognized and dated in the Anchorage area, suggesting an ash-fall frequency of about 2.4/1000 yrs. By comparison, historical records suggest more frequent ash-fall events (120/1000 yrs). Our data indicate that, either the ash layers are not consistently preserved in the kettle basins, or more likely, these records lack the resolution to differentiate closely spaced ash-fall events. Core top stratigraphies support the latter interpretation: The 10-12 historically observed ash-fall events are represented by two diffuse zones in the upper 15 cm of the cores. As such, ash records from small kettle lakes should be regarded as conservative statements of ash deposition. Further, ash plumes can have narrow geographic distributions and ash-fall thicknesses can change markedly over short distances. Therefore distal ash-fall stratigraphies underestimate eruption frequencies.

Discrimination of nonlinear frequency glides.

PubMed

Thyer, Nick; Mahar, Doug

2006-05-01

Discrimination thresholds for short duration nonlinear tone glides that differed in glide rate were measured in order to determine whether cues related to rate of frequency change alone were sufficient for discrimination. Thresholds for rising and falling nonlinear glides of 50-ms and 400-ms duration, spanning three frequency excursions (0.5, 1, and 2 ERBs) at three center frequencies (0.5, 2.0, and 6.0 kHz) were measured. Results showed that glide discrimination was possible when duration and initial and final frequencies were identical. Thresholds were of a different order to those found in previous studies using linear frequency glides where endpoint frequency or duration information is available as added cues. The pattern of results was suggestive of a mechanism sensitive to spectral changes in time. Thresholds increased as the rate of transition span increased, particularly above spans of 1 ERB. The Weber fraction associated with these changes was 0.6-0.7. Overall, the results were consistent with an excitation pattern model of nonlinear glide detection that has difficulty in tracking signals with rapid frequency changes that exceed the width of an auditory filter and are of short duration.

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

Classification of frailty and falls history using a combination of sensor-based mobility assessments.

PubMed

Greene, Barry R; Doheny, Emer P; Kenny, Rose A; Caulfield, Brian

2014-10-01

Frailty is an important geriatric syndrome strongly linked to falls risk as well as increased mortality and morbidity. Taken alone, falls are the most common cause of injury and hospitalization and one of the principal causes of death and disability in older adults worldwide. Reliable determination of older adults' frailty state in concert with their falls risk could lead to targeted intervention and improved quality of care. We report a mobile assessment platform employing inertial and pressure sensors to quantify the balance and mobility of older adults using three physical assessments (timed up and go (TUG), five times sit to stand (FTSS) and quiet standing balance). This study examines the utility of each individual assessment, and the novel combination of assessments, to screen for frailty and falls risk in older adults.Data were acquired from inertial and pressure sensors during TUG, FTSS and balance assessments using a touchscreen mobile device, from 124 community dwelling older adults (mean age 75.9 ± 6.6 years, 91 female). Participants were given a comprehensive geriatric assessment which included questions on falls and frailty. Methods based on support vector machines (SVM) were developed using sensor-derived features from each physical assessment to classify patients at risk of falls risk and frailty.In classifying falls history, combining sensor data from the TUG, Balance and FTSS tests to a single classifier model per gender yielded mean cross-validated classification accuracy of 87.58% (95% CI: 84.47-91.03%) for the male model and 78.11% (95% CI: 75.38-81.10%) for the female model. These results compared well or exceeded those for classifier models for each test taken individually. Similarly, when classifying frailty status, combining sensor data from the TUG, balance and FTSS tests to a single classifier model per gender, yielded mean cross-validated classification accuracy of 93.94% (95% CI: 91.16-96.51%) for the male model and 84.14% (95% CI: 82.11-86.33%) for the female model (mean 89.04%) which compared well or exceeded results for physical tests taken individually.Results suggest that the combination of these three tests, quantified using body-worn inertial sensors, could lead to improved methods for assessing frailty and falls risk.

Mobility of Undergraduate College Students Between Washington Colleges and Universities, Fall 1971.

ERIC Educational Resources Information Center

Winchester, E. Anne; Kenny, Eleanore

This study investigated the mobility of undergraduate college students between Washington colleges and universities fall, 1971. Data were taken from Table 1 of the Higher Education Enrollment Projection (HEEP) model report forms. HEEP data reports transfers on a fall to fall basis whereas this study has recorded transfers on a spring to fall…

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.

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

PubMed

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

2001-10-01

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

Modeling visual-based pitch, lift and speed control strategies in hoverflies

PubMed Central

Vercher, Jean-Louis

2018-01-01

To avoid crashing onto the floor, a free falling fly needs to trigger its wingbeats quickly and control the orientation of its thrust accurately and swiftly to stabilize its pitch and hence its speed. Behavioural data have suggested that the vertical optic flow produced by the fall and crossing the visual field plays a key role in this anti-crash response. Free fall behavior analyses have also suggested that flying insect may not rely on graviception to stabilize their flight. Based on these two assumptions, we have developed a model which accounts for hoverflies´ position and pitch orientation recorded in 3D with a fast stereo camera during experimental free falls. Our dynamic model shows that optic flow-based control combined with closed-loop control of the pitch suffice to stabilize the flight properly. In addition, our model sheds a new light on the visual-based feedback control of fly´s pitch, lift and thrust. Since graviceptive cues are possibly not used by flying insects, the use of a vertical reference to control the pitch is discussed, based on the results obtained on a complete dynamic model of a virtual fly falling in a textured corridor. This model would provide a useful tool for understanding more clearly how insects may or not estimate their absolute attitude. PMID:29361632

Preliminary Results of a U.S. Deep South Warm Season Deep Convective Initiation Modeling Experiment using NASA SPoRT Initialization Datasets for Operational National Weather Service Local Model Runs

NASA Technical Reports Server (NTRS)

Medlin, Jeffrey M.; Wood, Lance; Zavodsky, Brad; Case, Jon; Molthan, Andrew

2012-01-01

The initiation of deep convection during the warm season is a forecast challenge in the relative high instability and low wind shear environment of the U.S. Deep South. Despite improved knowledge of the character of well known mesoscale features such as local sea-, bay- and land-breezes, observations show the evolution of these features fall well short in fully describing the location of first initiates. A joint collaborative modeling effort among the NWS offices in Mobile, AL, and Houston, TX, and NASA s Short-term Prediction Research and Transition (SPoRT) Center was undertaken during the 2012 warm season to examine the impact of certain NASA produced products on the Weather Research and Forecasting Environmental Modeling System. The NASA products were: a 4-km Land Information System data, a 1-km sea surface temperature analysis, and a 4-km greenness vegetation fraction analysis. Similar domains were established over the southeast Texas and Alabama coastlines, each with a 9 km outer grid spacing and a 3 km inner nest spacing. The model was run at each NWS office once per day out to 24 hours from 0600 UTC, using the NCEP Global Forecast System for initial and boundary conditions. Control runs without the NASA products were made at the NASA SPoRT Center. The NCAR Model Evaluation Tools verification package was used to evaluate both the forecast timing and location of the first initiates, with a focus on the impacts of the NASA products on the model forecasts. Select case studies will be presented to highlight the influence of the products.

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.

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.

Bridging the gap between research and practice: review of a targeted hospital inpatient fall prevention programme.

PubMed

Barker, A; Kamar, J; Morton, A; Berlowitz, D

2009-12-01

Falls among older inpatients are frequent and have negative consequences. In this study, the effectiveness of a fall prevention programme in reducing falls and fall injuries in an acute hospital was studied. Retrospective audit. The Northern Hospital, an acute, metropolitan, hospital in Australia. A multi-factorial fall prevention programme that included establishment of a multidisciplinary committee, risk assessment of all patients on "high-risk" wards and targeted interventions for patients identified as high risk. Fall and fall injury rates per 1000 occupied bed-days were analysed using generalised additive models (GAM) and, because of the presence of autocorrelation, generalised additive mixed models (GAMM), respectively. During the 9-year observation of 271 095 patients, there were 2910 falls and 843 fall injuries. The GAM predicted rate of falls was stable in the 3 years after the programme was implemented, increased in 2006, then decreased between October 2006 and December 2007 from 4.13 (95% CI 3.65 to 4.67) to 2.83 (95% CI 2.24 to 3.59; p = 0.005). The GAMM predicted rate of fall injuries reduced from 1.66 (95% CI 1.24 to 2.21) to 0.61 (95% CI 0.43 to 0.88) after programme implementation (p<0.001). The falls rate varied throughout the observation period, and no significant change in the rate from preprogramme to postprogramme implementation was observed. The finding of no reduction in falls during the observation period may be explained by improved reporting throughout the observation period. The reduction in fall injuries was substantial and sustained. Identification of a local problem, use of a fall risk assessment to guide the delivery of simple interventions, integration of processes into daily clinical practice and creating systems that demand accountability of staff are factors that appear to have contributed to the programme's success.

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

PubMed

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

2015-06-01

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

A coarse wood dynamics model for the Western Cascades.

Treesearch

K. Mellen; A. Ager

2002-01-01

The Coarse Wood Dynamics Model (CWDM) analyzes the dynamics (fall, fragmentation, and decomposition) of Douglas-fir (Pseudotsuga menziesii) and western hemlock (Tsuga heterophylla) snags and down logs in forested ecosystems of the western Cascades of Oregon and Washington. The model predicts snag fall, height loss and decay,...

A Saturnian cam current system driven by asymmetric thermospheric heating

NASA Astrophysics Data System (ADS)

Smith, C. G. A.

2011-02-01

We show that asymmetric heating of Saturn's thermosphere can drive a current system consistent with the magnetospheric ‘cam’ proposed by Espinosa, Southwood & Dougherty. A geometrically simple heating distribution is imposed on the Northern hemisphere of a simplified three-dimensional global circulation model of Saturn's thermosphere. Currents driven by the resulting winds are calculated using a globally averaged ionosphere model. Using a simple assumption about how divergences in these currents close by flowing along dipolar field lines between the Northern and Southern hemispheres, we estimate the magnetic field perturbations in the equatorial plane and show that they are broadly consistent with the proposed cam fields, showing a roughly uniform field implying radial and azimuthal components in quadrature. We also identify a small longitudinal phase drift in the cam current with radial distance as a characteristic of a thermosphere-driven current system. However, at present our model does not produce magnetic field perturbations of the required magnitude, falling short by a factor of ˜100, a discrepancy that may be a consequence of an incomplete model of the ionospheric conductance.

Non-lambertian reflectance modeling and shape recovery of faces using tensor splines.

PubMed

Kumar, Ritwik; Barmpoutis, Angelos; Banerjee, Arunava; Vemuri, Baba C

2011-03-01

Modeling illumination effects and pose variations of a face is of fundamental importance in the field of facial image analysis. Most of the conventional techniques that simultaneously address both of these problems work with the Lambertian assumption and thus fall short of accurately capturing the complex intensity variation that the facial images exhibit or recovering their 3D shape in the presence of specularities and cast shadows. In this paper, we present a novel Tensor-Spline-based framework for facial image analysis. We show that, using this framework, the facial apparent BRDF field can be accurately estimated while seamlessly accounting for cast shadows and specularities. Further, using local neighborhood information, the same framework can be exploited to recover the 3D shape of the face (to handle pose variation). We quantitatively validate the accuracy of the Tensor Spline model using a more general model based on the mixture of single-lobed spherical functions. We demonstrate the effectiveness of our technique by presenting extensive experimental results for face relighting, 3D shape recovery, and face recognition using the Extended Yale B and CMU PIE benchmark data sets.

Cost-effectiveness of droxidopa in patients with neurogenic orthostatic hypotension: post-hoc economic analysis of Phase 3 clinical trial data.

PubMed

François, Clément; Hauser, Robert A; Aballéa, Samuel; Dorey, Julie; Kharitonova, Elizaveta; Hewitt, L Arthur

2016-01-01

Falls are associated with neurogenic orthostatic hypotension (nOH) and are an economic burden on the US healthcare system. Droxidopa is approved by the US FDA to treat symptomatic nOH. This study estimates the cost-effectiveness of droxidopa vs standard of care from a US payer perspective. A Markov model was used to predict numbers of falls and treatment responses using data from a randomized, double-blind trial of patients with Parkinson's disease and nOH who received optimized droxidopa therapy or placebo for 8 weeks. The severity of falls, utility values, and injury-related costs were derived from published studies. Model outcomes included number of falls, number of quality-adjusted life-years (QALYs), and direct costs. Incremental cost-effectiveness ratios (ICERs) were calculated. Outcomes were extrapolated over 12 months. Patients receiving droxidopa had fewer falls compared with those receiving standard of care and gained 0.33 QALYs/patient. Estimated droxidopa costs were $30,112, with estimated cost savings resulting from fall avoidance of $14,574 over 12 months. Droxidopa was cost-effective vs standard of care, with ICERs of $47,001/QALY gained, $24,866 per avoided fall with moderate/major injury, and $1559 per avoided fall with no/minor injury. The main drivers were fall probabilities and fear of fall-related inputs. A limitation of the current study is the reliance on falls data from a randomized controlled trial where the placebo group served as the proxy for standard of care. Data from a larger patient population, reflecting 'real-life' patient use and/or comparison with other agents used to treat nOH, would have been a useful complement, but these data were not available. Using Markov modeling, droxidopa appears to be a cost-effective option compared with standard of care in US clinical practice for the treatment of nOH.

A falls case summary: Application of the public health nursing intervention wheel.

PubMed

Leahy-Warren, Patricia; Day, Mary Rose; Philpott, Lloyd; Glavin, Kari; Gjevjon, Edith Roth; Steffenak, Anne Kjersti Myhrene; Nordhagen, Live S; Egge, Hilde; Healy, Elizabeth; Mulcahy, Helen

2018-04-20

The Public Health Intervention Wheel (PHIW) is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. Public health nurses (PHNs) provide care at the three levels of practice. Prevention of falls is a public health issue and the majority of falls happen at home. Therefore, prevention and management of falls in the community could benefit from a public health systems approach by PHNs underpinned by the PHIW. A hypothetical case is presented of a 78-year-old gentleman who had a fall which resulted in a fractured right acetabulum and surgery before being discharged home. The aim of this paper was to use a case summary to illustrate PHN practice in the context of the PHIW as applied to falls management and prevention. This paper focuses on fall incidence and PHN response in Ireland and Norway. The PHIW is described and relevant interventions from the PHIW are applied to PHN practice in managing the case. The PHIW model provides insight into the potential scope of public health nursing in falls, articulating PHN practice in the community. © 2018 Wiley Periodicals, Inc.

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.

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

A Model of Anode Sheath Potential Evolution in a Transverse Magnetic Field

NASA Astrophysics Data System (ADS)

Foster, John E.; Gallimore, Alec D.

1996-11-01

It has been conjectured that the growth in the magnitude of the anode fall voltage with changing transverse magnetic field is a function of the ratio of available transverse current to the discharge current. It has been postulated that at small values of this ratio, the anode fall voltage and thus the near-anode electric field increases in order to assure that the prescribed discharge is maintained.footnote H. Hugel, IEEE Tran. Plas. Sci., PS-8,4, 1980 In this present work, a model is presented which predicts the behavior of the anode fall voltage as a function of transverse magnetic field. The model attempts to explain why the anode fall voltage depends so strongly on this ratio. In addition, it is further shown that because of the current ratio's strong dependence on local electron number density, ultimately it is the changes in near-anode ionization processes with varying transverse magnetic field that control the anode fall voltage.

An In Vitro Model of the Horse Gut Microbiome Enables Identification of Lactate-Utilizing Bacteria That Differentially Respond to Starch Induction

PubMed Central

Biddle, Amy S.; Black, Samuel J.; Blanchard, Jeffrey L.

2013-01-01

Laminitis is a chronic, crippling disease triggered by the sudden influx of dietary starch. Starch reaches the hindgut resulting in enrichment of lactic acid bacteria, lactate accumulation, and acidification of the gut contents. Bacterial products enter the bloodstream and precipitate systemic inflammation. Hindgut lactate levels are normally low because specific bacterial groups convert lactate to short chain fatty acids. Why this mechanism fails when lactate levels rapidly rise, and why some hindgut communities can recover is unknown. Fecal samples from three adult horses eating identical diets provided bacterial communities for this in vitro study. Triplicate microcosms of fecal slurries were enriched with lactate and/or starch. Metabolic products (short chain fatty acids, headspace gases, and hydrogen sulfide) were measured and microbial community compositions determined using Illumina 16S rRNA sequencing over 12-hour intervals. We report that patterns of change in short chain fatty acid levels and pH in our in vitro system are similar to those seen in in vivo laminitis induction models. Community differences between microcosms with disparate abilities to clear excess lactate suggest profiles conferring resistance of starch-induction conditions. Where lactate levels recover following starch induction conditions, propionate and acetate levels rise correspondingly and taxa related to Megasphaera elsdenii reach levels exceeding 70% relative abundance. In lactate and control cultures, taxa related to Veillonella montpellierensis are enriched as lactate levels fall. Understanding these community differences and factors promoting the growth of specific lactate utilizing taxa may be useful to prevent acidosis under starch-induction conditions. PMID:24098591

An in vitro model of the horse gut microbiome enables identification of lactate-utilizing bacteria that differentially respond to starch induction.

PubMed

Biddle, Amy S; Black, Samuel J; Blanchard, Jeffrey L

2013-01-01

Laminitis is a chronic, crippling disease triggered by the sudden influx of dietary starch. Starch reaches the hindgut resulting in enrichment of lactic acid bacteria, lactate accumulation, and acidification of the gut contents. Bacterial products enter the bloodstream and precipitate systemic inflammation. Hindgut lactate levels are normally low because specific bacterial groups convert lactate to short chain fatty acids. Why this mechanism fails when lactate levels rapidly rise, and why some hindgut communities can recover is unknown. Fecal samples from three adult horses eating identical diets provided bacterial communities for this in vitro study. Triplicate microcosms of fecal slurries were enriched with lactate and/or starch. Metabolic products (short chain fatty acids, headspace gases, and hydrogen sulfide) were measured and microbial community compositions determined using Illumina 16S rRNA sequencing over 12-hour intervals. We report that patterns of change in short chain fatty acid levels and pH in our in vitro system are similar to those seen in in vivo laminitis induction models. Community differences between microcosms with disparate abilities to clear excess lactate suggest profiles conferring resistance of starch-induction conditions. Where lactate levels recover following starch induction conditions, propionate and acetate levels rise correspondingly and taxa related to Megasphaeraelsdenii reach levels exceeding 70% relative abundance. In lactate and control cultures, taxa related to Veillonellamontpellierensis are enriched as lactate levels fall. Understanding these community differences and factors promoting the growth of specific lactate utilizing taxa may be useful to prevent acidosis under starch-induction conditions.

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…

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…

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…

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…

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…

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…