Rhode Island State Briefing Book on low-level radioactive-waste management

International Nuclear Information System (INIS)

1981-07-01

The Rhode Island State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Rhode Island. The profile is the result of a survey of radioactive material licensees in Rhode Island. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment was developed through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the briefing book provides demographic and socioeconomic data and a discussion of relevant government agencies and activities, all of which may affect waste management practices in Rhode Island

RI State Profile. Rhode Island: New England Common Assessments Program (NCAP)

Science.gov (United States)

Center on Education Policy, 2010

2010-01-01

This paper provides information about Rhode Island's New England Common Assessments Program (NCAP), a comprehensive test. Its purpose is to measure each student's overall proficiency for graduation in the six core academic areas. In 2008, the Board of Regents in Rhode Island established new regulations for high school diplomas. Beginning with the…

Residential Energy Efficiency Potential: Rhode Island

Energy Technology Data Exchange (ETDEWEB)

Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-11-02

Energy used by Rhode Island single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

Radioactive fall-out from the Chernobyl disaster, and its aftermath in Central Europe

International Nuclear Information System (INIS)

Mueller-Broich, A.

1986-01-01

Radioactive fall-out originating from the disaster of the nuclear power station at Chernobyl in the Soviet Union was measured in Bavaria and other parts of Central Europe. Nuclide composition and spatial distribution of fall-out are presented and compared to radioactive debris from nuclear bomb tests. The uptake of radioactive material by plants and its passage into human food is discussed. The contribution of direct deposition, redistribution within plants and transfer from soil into plants is considered. Factors determining the paths of radioactive material into milk and meat are outlined. Safety precautions against excessive incorporation of radioactivity issued by the authorities are given. Irradiation of humans from external and internal fall-out is assessed. Nuclides composition is shown to be of major importance only for internal radiation. In view of the dominating abundance of radioiodine and radiocesium the differing physical and biochemical qualities of these nuclides are described in more detail. Finally, the resulting risk of cancer induction including leukemia is considered

Rhode Island crystalline repository project: Technical progress report, 1984-1986

International Nuclear Information System (INIS)

1986-01-01

A Nuclear Waste Fund established by the Nuclear Waste Policy Act of 1982 provided financial support to the State of Rhode Island for its participation in the high-level radioactive waste repository siting program. In 1984, the Office of the Governor set up a multidisciplinary Project Review Team consisting of staff from three State agencies and the University of Rhode Island. Members of the Review Team attended several meetings throughout the reporting period to voice their concerns about siting directly to the US Department of Energy (DOE). Written comments were also submitted on draft plans and reports. Many of Rhode Island's recommendations in these comments were later adopted. In May, 1986, Secretary of Energy John Herrington announced the suspension of the crystalline repository siting program. The remainder of the year was spent monitoring litigation challenging that decision and pending legislation. Administrative phase-down of the program was essentially complete by the close of the calendar year

Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Rhode Island

Energy Technology Data Exchange (ETDEWEB)

Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-02-15

The 2015 IECC provides cost-effective savings for residential buildings in Rhode Island. Moving to the 2015 IECC from the 2012 IECC base code is cost-effective for residential buildings in all climate zones in Rhode Island.

Tourism development and impacts: lessons from the Island of Rhodes, Greece

OpenAIRE

Pappas, Nikolaos; Tsartas, Paris

2009-01-01

During the post Second World War period, the island of Rhodes experienced significant changes at several levels of its economy, society, and environment, associated directly or indirectly with rapid tourism development. The tourism impacts are profound on both locals and visitors. The purpose of this paper is to examine the key informants’ perceptions in Rhodes toward tourism impacts. Moreover it correlates the respondents’ perceptions with the previous studies’ outcomes in the region. Finall...

Estimating the Economic Boost of Marriage Equality in Rhode Island

OpenAIRE

Kastanis, Angeliki; Badgett, Lee

2013-01-01

Extending marriage rights to same-sex couples in Rhode Island would bring an estimated $7 million to the state and local economy, including $5.5 million in additional wedding spending and $1.5 million in tourism expenditures made by out-of-town guests. Based on Rhode Island’s rates of 7 percent sales tax and 6 percent hotel and lodging tax, $530,000 in tax revenue will be generated for the state in the first three years same-sex couples may marry. The boost in travel spending will generate ap...

Rhode Island ITS/CVO business plan : final report

Science.gov (United States)

1998-01-01

The Rhode Island Intelligent Transportation Systems/Commercial Vehicle Operations (ITS/CVO) Institutional Issues Study completed July 1996, substantiated the need for enhanced efficiency and safety in commercial transportation systems and regulation....

Leaking Underground Tanks in Rhode Island; LUSTs12

Data.gov (United States)

University of Rhode Island Geospatial Extension Program — This dataset shows the location of storage tanks and associated piping used for petroleum and certain hazardous substances that have experienced leaks as determined...

76 FR 52656 - Rhode Island Department of Environmental Management; Notice of Preliminary Permit Application...

Science.gov (United States)

2011-08-23

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14211-000] Rhode Island Department of Environmental Management; Notice of Preliminary Permit Application Accepted for Filing and Soliciting Comments, Motions To Intervene, and Competing Applications On June 10, 2011, the Rhode Island Department of Environmental Management...

Lodging Update: Providence, Rhode Island

Directory of Open Access Journals (Sweden)

Ragel Roginsky

2013-04-01

Full Text Available Each quarter, Pinnacle Advisory Group prepares an analysis of the New England lodging industry, which provides a regional summary and then focuses in depth on a particular market. These reviews look at recent and proposed supply changes, factors affecting demand and growth rates, and the effects of interactions between such supply and demand trends. In this issue, the authors spotlight the lodging market in Providence, Rhode Island.

Many Rhodes: Travelling Scholarships and Imperial Citizenship in the British Academic World, 1880-1940

Science.gov (United States)

Pietsch, Tamson

2011-01-01

Since its Foundation in 1901, the Rhodes Scholarships scheme has been held up as the archetype of a programme designed to foster imperial citizens. However, though impressive in scale, Cecil Rhodes's foundation was not the first to bring colonial students to Britain. Over the course of the previous half-century, governments, universities and…

The timber resources of Rhode Island

Science.gov (United States)

Roland H. Ferguson; John R. McGuire; John R. McGuire

1957-01-01

This is a report on the first comprehensive survey ever made of the timber resources of Rhode Island. It shows, for the years 1952 and 1953, the area and condition of the forest land, the volume and quality of standing timber, the rates of timber growth and mortality, and the extent of timber cutting for forest products. The survey was made by the Forest Service as...

Preventing falls and fractures.

Science.gov (United States)

Ulfarsson, J; Robinson, B E

1994-11-01

One of four persons over age 65 in the community falls; those over age 75 in institutions fall more frequently. Falls, a complex phenomena suggesting present disease and predicting future disability, are caused by interactions between the environment and dynamic balance which is determined by the quality of sensory input, central processing, and motor responses. Clinical factors which predispose to falling often produce observable disturbances in gait and balance, making observation critical in assessment. Acute illness and drug therapy produce particularly preventable falls. Therapeutic exercise and environmental modification for safety are the clinical interventions most likely to successfully prevent fall-related injury.

[Central cervical cord syndrome: a case report on rehabilitation, with special references to accidental falls in the elderly].

Science.gov (United States)

Ina, G; Eto, F; Furuichi, T; Suzuki, H; Shibuya, K

1995-03-01

An 81-year-old man with Parkinson's disease was admitted to our hospital with impaired function of all extremities. Four weeks before his symptoms developed, he had tripped on the steps, fallen and bruised his jaw. Following this episode he experienced a few more falls inside his house. On examination his greatest weakness was in the hands and wrists. He was hyper-reflexic in all extremities and had bilateral Babinski's sign. He could not walk and needed physical assistance in most of his daily living activities. X-ray films of the cervical spine showed significant degenerative changes. The magnetic resonance images suggested central cervical cord damage at the level of the C6 vertebral body. After three months' rehabilitation treatment, he became able to walk with a cane and became independent in all the basic activities of daily living except for bathing. He never regained skillful function of his hands despite later levodopa treatment of Parkinson's disease. His clinical features were consistent with the central cervical cord syndrome, described by Schnneider and co-workers in 1954. This syndrome may occur as a result of hyperextension neck injury, occasionally associated with an accidental fall in the elderly with cervical spondylosis. Thirteen patients with cervical spinal cord injury above 65 of age were admitted to our department from 1983 to 1993. Six of them presented with the central cervical cord syndrome, and all patients had a history of accidental injuries related to falling.

Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.

Science.gov (United States)

Wylie, Matthew C; Baier, Rosa R; Gardner, Rebekah L

2014-10-01

Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience. We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice. The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P electronic health record introduction (P electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction. We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time. Copyright © 2014 Elsevier Inc. All rights reserved.

The Montessori Experiment in Rhode Island (1913-1940): Tracing Theory to Implementation over 25 Years

Science.gov (United States)

Zoll, Susan

2017-01-01

This article highlights archived documents pertaining to a 25-year experimental classroom implemented by Clara Craig, then supervisor of training at the Rhode Island Normal School. Craig is notable as she was the only participant in the first International Montessori Training Course in Rome, Italy, in 1913, to gain approval from the Rhode Island…

Feeding Dairy Cows to Increase Performance on Rhodes Grass Ley

International Nuclear Information System (INIS)

Irungu, K.R.G.; Mbugua, P.N.

1999-01-01

Majority of dairy farmers in Kenya produce milk from cows fed on roughage. The cow performance follows seasonal variability in quality and quantity of roughage. The objective of the current study was to increase cow performance and maintain productivity of a rhodes grass (chloris gayana) ley. Twenty-four Freisian cows in their second to third lactation were strip grazed on fertilized irrigated Rhodes grass at a stocking rate of 0.034 ha per cow. Four dietary groups of six cows were allocated to one of our diets. one group got no dairy meal while the other three groups were supplemented at a 1kg of dairy meal per 10, 5 and 2.5 kg of 4% fat corrected milk dairy. this amount to 0, 386, 750 and 1542 kg dairy meal (89.4%, DM, 93.7 OM, 16.8, CP and CF) during the lactation. during the 43 - week lactation, records on pasture nutrient yield, nutrient intake, milk yield, liveweight, reproduction and subsequent calf birth weight were collected. The Rhodes grass ley produced 20.7 (ranging from 16.7 to 28.7) t of dry matter (DM) per hectare and cows harvested 16.0 (12.0 to 24.0) t during the 43 weeks.The Rhodes grass contained 32.1, 87.7, 10.8, and 32.3% DM, organic matter (OM), crude protein (CP) and crude fiber (CF) respectively. Mean stubble of 4.7 (3.9 to 6.0) t DM per hectare was left at pasture. Feeding dairy meals significantly increased (P 0.05) affect batter fat content (3.78 to 3.96%). It maintained (P > 0.05) cow liveweight and increased (P < 0.05) calf birth weight from 32.7 to 37.2 kg. Feeding dairy meal did not affect oestrus cycling. Extreme supplementation, 1542 kg dairy meal, decreased (P < 0.05) fertility. Insemination per conception and calving interval increased (P < 0.05) from 1.5 to 3.5 and 522 days. The findings in the current study show that pasture yield can be increased by over 590% dry matter from 3.5 t obtained from natural pasture containing Kikuyu and Star grasses. The Rhodes grass yield can be increased to 232% of national average yield of 1300

Falls and fear of falling in vertigo and balance disorders: A controlled cross-sectional study.

Science.gov (United States)

Schlick, Cornelia; Schniepp, Roman; Loidl, Verena; Wuehr, Max; Hesselbarth, Kristin; Jahn, Klaus

2016-01-01

Vertigo and dizziness are among the most prevalent symptoms in neurologic disorders. Although many of these patients suffer from postural instability and gait disturbances, there is only limited data on their risk of falling. We conducted a controlled cross-sectional study at the tertiary care outpatient clinic of the German Center for Vertigo and Balance Disorders using a self-administered questionnaire to assess falls, fall-related injuries, and fear of falling. The recruitment period was 6 months. A total of 569 patients (mean age 59.6 ± 17.1 years, 55% females) and 100 healthy participants were included (response rate > 90%). Dizzy patients with central balance disorders (Parkinsonian, cerebellar, and brainstem oculomotor syndromes) had the highest fall rates (> 50% recurrent fallers, odds ratio > 10). The rate of recurrent fallers was 30% in bilateral vestibular failure and peripheral neuropathy (odds ratio > 5). Patients with functional dizziness (somatoform or phobic vertigo) were concerned about falling but did not fall more often than healthy controls (odds ratio 0.87). Falls are common in patients presenting to a dizziness unit. Those with central syndromes are at risk of recurrent and injurious falling. Fall rates and fear of falling should be assessed in balance disorders and used to guide the regimen of rehabilitation therapy. The identification of risk factors would help provide protective measures to these groups of patients.

Fall and winter survival of brook trout and brown trout in a north-central Pennsylvania watershed

Science.gov (United States)

Sweka, John A.; Davis, Lori A.; Wagner, Tyler

2017-01-01

Stream-dwelling salmonids that spawn in the fall generally experience their lowest survival during the fall and winter due to behavioral changes associated with spawning and energetic deficiencies during this time of year. We used data from Brook Trout Salvelinus fontinalis and Brown Trout Salmo trutta implanted with radio transmitters in tributaries of the Hunts Run watershed of north-central Pennsylvania to estimate survival from the fall into the winter seasons (September 2012–February 2013). We examined the effects that individual-level covariates (trout species, size, and movement rates) and stream-level covariates (individual stream and cumulative drainage area of a stream) have on survival. Brook Trout experienced significantly lower survival than Brown Trout, especially in the early fall during their peak spawning period. Besides a significant species effect, none of the other covariates examined influenced survival for either species. A difference in life history between these species, with Brook Trout having a shorter life expectancy than Brown Trout, is likely the primary reason for the lower survival of Brook Trout. However, Brook Trout also spawn earlier in the fall than Brown Trout and low flows during Brook Trout spawning may have resulted in a greater risk of predation for Brook Trout compared with Brown Trout, thereby also contributing to the observed differences in survival between these species. Our estimates of survival can aid parameterization of future population models for Brook Trout and Brown Trout through the spawning season and into winter.

76 FR 60850 - Rhode Island; Emergency and Related Determinations

Science.gov (United States)

2011-09-30

... Hurricane Irene beginning on August 26, 2011, and continuing, are of sufficient severity and magnitude to... State of Rhode Island have been designated as adversely affected by this declared emergency: Providence..., Disaster Unemployment Assistance (DUA); 97.046, Fire Management Assistance Grant; 97.048, Disaster Housing...

A Precipitation-Runoff Model for the Blackstone River Basin, Massachusetts and Rhode Island

Science.gov (United States)

Barbaro, Jeffrey R.; Zarriello, Phillip J.

2007-01-01

A Hydrological Simulation Program-FORTRAN (HSPF) precipitation-runoff model of the Blackstone River Basin was developed and calibrated to study the effects of changing land- and water-use patterns on water resources. The 474.5 mi2 Blackstone River Basin in southeastern Massachusetts and northern Rhode Island is experiencing rapid population and commercial growth throughout much of its area. This growth and the corresponding changes in land-use patterns are increasing stress on water resources and raising concerns about the future availability of water to meet residential and commercial needs. Increased withdrawals and wastewater-return flows also could adversely affect aquatic habitat, water quality, and the recreational value of the streams in the basin. The Blackstone River Basin was represented by 19 hydrologic response units (HRUs): 17 types of pervious areas (PERLNDs) established from combinations of surficial geology, land-use categories, and the distribution of public water and public sewer systems, and two types of impervious areas (IMPLNDs). Wetlands were combined with open water and simulated as stream reaches that receive runoff from surrounding pervious and impervious areas. This approach was taken to achieve greater flexibility in calibrating evapotranspiration losses from wetlands during the growing season. The basin was segmented into 50 reaches (RCHRES) to represent junctions at tributaries, major lakes and reservoirs, and drainage areas to streamflow-gaging stations. Climatological, streamflow, water-withdrawal, and wastewater-return data were collected during the study to develop the HSPF model. Climatological data collected at Worcester Regional Airport in Worcester, Massachusetts and T.F. Green Airport in Warwick, Rhode Island, were used for model calibration. A total of 15 streamflow-gaging stations were used in the calibration. Streamflow was measured at eight continuous-record streamflow-gaging stations that are part of the U.S. Geological

77 FR 68797 - Rhode Island; Emergency and Related Determinations

Science.gov (United States)

2012-11-16

... Hurricane Sandy beginning on October 26, 2012, and continuing, are of sufficient severity and magnitude to... emergency. The following areas of the State of Rhode Island have been designated as adversely affected by...; 97.048, Disaster Housing Assistance to Individuals and Households In Presidentially Declared Disaster...

The Rhodes Scholarship in the Current Era of Student Activism: What Do We Consider "Prestigious" and Who Benefits?

Science.gov (United States)

Adam, LeAnn

2016-01-01

Contemporary student activism has revealed deep feelings of alienation on college campuses, prompting strong reactions to current and historical racial injustice, including the history of Cecil Rhodes. Can advisors promote restorative justice by encouraging reflection upon privileges afforded to Rhodes scholars and their responsibility to address…

Electronic Out-fall Inspection Application - 12007

Energy Technology Data Exchange (ETDEWEB)

Weymouth, A Kent III; Pham, Minh; Messick, Chuck [Savannah River Nuclear Solutions, Aiken, South Carolina 29808 (United States)

2012-07-01

In early 2009 an exciting opportunity was presented to the Geographic Information Systems (GIS) team at the Savannah River Site (SRS). The SRS maintenance group was directed to maintain all Out-falls on Site, increasing their workload from 75 to 183 out-falls with no additional resources. The existing out-fall inspection system consisted of inspections performed manually and documented via paper trail. The inspections were closed out upon completion of activities and placed in file cabinets with no central location for tracking/trending maintenance activities. A platform for meeting new improvements required for documentation by the Department of Health and Environmental Control (DHEC) out-fall permits was needed to replace this current system that had been in place since the 1980's. This was accomplished by building a geographically aware electronic application that improved reliability of site out-fall maintenance and ensured consistent standards were maintained for environmental excellence and worker efficiency. Inspections are now performed via tablet and uploaded to a central point. Work orders are completed and closed either in the field using tablets (mobile application) or in their offices (via web portal) using PCs. And finally completed work orders are now stored in a central database allowing trending of maintenance activities. (authors)

The efficacy of fall-risk-increasing drug (FRID) withdrawal for the prevention of falls and fall-related complications: protocol for a systematic review and meta-analysis.

Science.gov (United States)

Lee, Justin Yusen; Holbrook, Anne

2017-02-20

Despite limited evidence of effectiveness, withdrawal (discontinuation or dose reduction) of high risk medications known as "fall-risk increasing drugs" (FRIDs) is typically conducted as a fall prevention strategy based on presumptive benefit. Our objective is to determine the efficacy of fall-risk increasing drugs (FRIDs) withdrawal on the prevention of falls and fall-related complications. We will search for all published and unpublished randomized controlled trials evaluating the effect of FRID withdrawal compared to usual care on the rate of falls, incidence of falls, fall-related injuries, fall-related fractures, fall-related hospitalizations, or adverse effects related to the intervention in adults aged 65 years or older. Electronic database searches will be conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. A grey literature search will be conducted including clinical trial registries and conference proceedings and abstracts. Two reviewers will independently perform in duplicate citation screening, full-text review, data abstraction, and risk of bias assessment. Conflicts will be resolved through team discussion or by a third reviewer if no consensus can be reached. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) criteria will be used to independently rate overall confidence in effect estimates for each outcome. Results will be synthesized descriptively, and a random effects meta-analysis will be conducted for each outcome if studies are deemed similar methodologically, clinically, and statistically. We will attempt to determine whether a FRID withdrawal strategy alone is effective at preventing falls in older adults. Our results will be used to optimize and focus fall prevention strategies and initiatives internationally with a goal of improving the health of older adults. PROSPERO CRD42016040203.

The Myth of the Citizen Soldier: Rhode Island Provincial Soldiers in the French and Indian War

Science.gov (United States)

2016-06-10

14 Revolution, is an excellent account of social, economic, and political factors in colonial America that influenced the concept of the citizen ...THE MYTH OF THE CITIZEN -SOLDIER: RHODE ISLAND PROVINCIAL SOLDIERS IN THE FRENCH AND INDIAN WAR A thesis presented to the...From - To) AUG 2015 – JUN 2016 4. TITLE AND SUBTITLE The Myth of the Citizen Soldier: Rhode Island Provincial Soldiers in the French and Indian War

Promoting Independence in Rhode Island: Weatherization Assistance Close-Up Fact Sheet

Energy Technology Data Exchange (ETDEWEB)

D& R International

2001-10-10

Rhode Island demonstrates its commitment to technology and efficiency through the Weatherization Program. Weatherization uses advanced technologies and techniques to reduce energy costs for low-income families by increasing the energy efficiency of their homes.

The efficacy of fall-risk-increasing drug (FRID withdrawal for the prevention of falls and fall-related complications: protocol for a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Justin Yusen Lee

2017-02-01

Full Text Available Abstract Background Despite limited evidence of effectiveness, withdrawal (discontinuation or dose reduction of high risk medications known as “fall-risk increasing drugs” (FRIDs is typically conducted as a fall prevention strategy based on presumptive benefit. Our objective is to determine the efficacy of fall-risk increasing drugs (FRIDs withdrawal on the prevention of falls and fall-related complications. Methods/design We will search for all published and unpublished randomized controlled trials evaluating the effect of FRID withdrawal compared to usual care on the rate of falls, incidence of falls, fall-related injuries, fall-related fractures, fall-related hospitalizations, or adverse effects related to the intervention in adults aged 65 years or older. Electronic database searches will be conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL, and CINAHL. A grey literature search will be conducted including clinical trial registries and conference proceedings and abstracts. Two reviewers will independently perform in duplicate citation screening, full-text review, data abstraction, and risk of bias assessment. Conflicts will be resolved through team discussion or by a third reviewer if no consensus can be reached. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE criteria will be used to independently rate overall confidence in effect estimates for each outcome. Results will be synthesized descriptively, and a random effects meta-analysis will be conducted for each outcome if studies are deemed similar methodologically, clinically, and statistically. Discussion We will attempt to determine whether a FRID withdrawal strategy alone is effective at preventing falls in older adults. Our results will be used to optimize and focus fall prevention strategies and initiatives internationally with a goal of improving the health of older adults. Systematic review registration PROSPERO CRD

Children's mental health and family functioning in Rhode Island.

Science.gov (United States)

Kim, Hyun Hanna K; Viner-Brown, Samara I; Garcia, Jorge

2007-02-01

Our objectives were to (a) estimate the prevalence of children's mental health problems, (b) assess family functioning, and (c) investigate the relationship between children's mental health and family functioning in Rhode Island. From the 2003 National Survey of Children's Health, Rhode Island data for children 6 to 17 years of age were used for the analyses (N = 1326). Two aspects of family functioning measures, parental stress and parental involvement, were constructed and were examined by children's mental health problems, as well as other child and family characteristics (child's age, gender, race/ethnicity, special needs, parent's education, income, employment, family structure, number of children, and mother's general and mental health). Bivariate analyses and multivariate logistic regression were used to investigate the relationship. Among Rhode Island children, nearly 1 (19.0%) in 5 had mental health problems, 1 (15.6%) in 6 lived with a highly stressed parent, and one third (32.7%) had parents with low involvement. Bivariate analyses showed that high parental stress and low parental involvement were higher among parents of children with mental health problems than parents of children without those problems (33.2% vs 11.0% and 41.0% vs 30.3%, respectively). In multivariate logistic regression, parents of children with mental health problems had nearly 4 times the odds of high stress compared with parents of children without those problems. When children's mental health problems were severe, the odds of high parental stress were elevated. However, children's mental health was not associated with parental involvement. Children's mental health was strongly associated with parental stress, but it was not associated with parental involvement. The findings indicate that when examining the mental health issues of children, parental mental health and stress must be considered.

Analysis of Human Trafficking Cases in Rhode Island, 2009-2013

Directory of Open Access Journals (Sweden)

Faith Skodmin

2016-06-01

Full Text Available This article is an analysis of law enforcement identified cases of human trafficking in Rhode Island from 2009 to 2013. Information was collected from police and court records, prosecutors’ press releases, and reports in the media. During this period, there was one case of forced labor of a domestic worker and six cases of domestic sex trafficking. Many of the characteristics of the Rhode Island cases were consistent with other human trafficking cases in the United States. Discussions of key findings include (a outcomes of a criminal case using a new human trafficking statute on fraud in foreign contracting and a civil suit, (b how online prostitution ads are used to market victims to sex buyers using ethnicity of the victims and age and social standing of the sex buyers, and (c how mothers of victims are involved in locating their daughters and making reports to the police that initiated investigations.

Rhode Island, Connecticut, New York, and New Jersey ESI: INVERT (Invertebrate Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for marine, estuarine, and terrestrial invertebrate species in coastal Rhode Island, Connecticut, New York,...

Influence of insemination time on fertility of Rhodes island white ...

African Journals Online (AJOL)

Influence of insemination time on fertility of Rhodes island white chicken (Gallus domestica) raised in northern guinea savannah zone of Nigeria. D Zahraddeen, ISR Butswat, KM Bello, AA Washik. Abstract. No Abstract. International Journal of Tropical Agriculture and Food Systems Vol. 1 (4) 2007: pp. 378-383. Full Text:.

Rhode Island, Connecticut, New York, and New Jersey ESI: INVERTPT (Invertebrate Points)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for rare terrestrial invertebrates in coastal Rhode Island, Connecticut, New York, and New Jersey. Vector...

REWSET: A prototype seismic and tsunami early warning system in Rhodes island, Greece

Science.gov (United States)

Papadopoulos, Gerasimos; Argyris, Ilias; Aggelou, Savvas; Karastathis, Vasilis

2014-05-01

Tsunami warning in near-field conditions is a critical issue in the Mediterranean Sea since the most important tsunami sources are situated within tsunami wave travel times starting from about five minutes. The project NEARTOWARN (2012-2013) supported by the EU-DG ECHO contributed substantially to the development of new tools for the near-field tsunami early warning in the Mediterranean. One of the main achievements is the development of a local warning system in the test-site of Rhodes island (Rhodes Early Warning System for Earthquakes and Tsunamis - REWSET). The system is composed by three main subsystems: (1) a network of eight seismic early warning devices installed in four different localities of the island, one in the civil protection, another in the Fire Brigade and another two in municipality buildings; (2) two radar-type (ultrasonic) tide-gauges installed in the eastern coastal zine of the island which was selected since research on the historical earthquake and tsunami activity has indicated that the most important, near-field tsunami sources are situated offshore to the east of Rhodes; (3) a crisis Geographic Management System (GMS), which is a web-based and GIS-based application incorporating a variety of thematic maps and other information types. The seismic early warning devices activate by strong (magnitude around 6 or more) earthquakes occurring at distances up to about 100 km from Rhodes, thus providing immediate mobilization of the civil protection. The tide-gauges transmit sea level data, while during the crisis the GMS supports decisions to be made by civil protection. In the near future it is planned the REWSET system to be integrated with national and international systems. REWSET is a prototype which certainly could be developed in other coastal areas of the Mediterranean and beyond.

Rhode Island, Connecticut, New York, and New Jersey ESI: FISH (Fish Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for marine, estuarine, and anadromous fish species in coastal Rhode Island, Connecticut, New York, and New...

"It's been a long road to acceptance": midwives in Rhode Island, 1970-2000.

Science.gov (United States)

Caron, Simone M

2014-01-01

A resurgence of midwifery came to Rhode Island in the 1970s. Midwives acted as modern health care professionals to conserve a traditional woman-centered birth, but the battle was long and arduous, from Dr. Ellen Stone attempting to eliminate midwives in the state in 1912 to doctors using the death of 2 home birth infants in the 1980s to undermine the growing presence of professional nurse-midwives in the state. Midwives prevailed when the state legislature passed measures in 1988 and 1990 increasing the power and authority of midwives, and when a federal grant in 1993 allowed the University of Rhode Island to open the first training program for nurse-midwives in the state.

"Into Your Hands His Life and Liberty...." A Collection of Significant Cases from the Rhode Island Courts. First Edition.

Science.gov (United States)

Leonard, Donald E.; Mattson, John O., Ed.

Six cases from Rhode Island court history are presented in this document. The cases, dating from the time of Roger Williams to the 1970s, examine religious freedom, personal freedom, treason, robbery, murder, and drug possession. Each case is summarized and questions are supplied to help students understand crime and punishment in Rhode Island. A…

2012 USACE Post Sandy Topographic LiDAR: Rhode Island and Massachusetts Coast

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This topographic elevation point data derived from multiple return light detection and ranging (LiDAR) represents 354.272 square miles of coastline for Rhode Island...

Rhode Island, Connecticut, New York, and New Jersey ESI: FISHL (Fish Lines)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for anadromous fish species in coastal Rhode Island, Connecticut, New York, and New Jersey. Vector arcs in...

Rhode Island, Connecticut, New York, and New Jersey ESI: NESTS (Nest Points)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for nesting birds in coastal Rhode Island, Connecticut, New York, and New Jersey. Vector points in this...

CTD data from Rhode Island Sound collected from R/V Hope Hudner in 2009-2010 in support of Rhode Island Ocean Special Area Management Plan (NODC Accession 0109929)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The dataset consists of 173 CTD casts in Rhode Island and Block Island Sounds obtained during 4 surveys. The surveys were performed during 22-24 September 2009, 7-8...

Semen bacterial flora of Rhode Island Breeder cocks in Zaria ...

African Journals Online (AJOL)

The semen used in this study was collected from 77 Rhode Island Breeder cocks reared in battery cages under intensive management from a private farm in Zaria, Kaduna State, Nigeria using the back massage procedure, 27 of the 77 semen samples (35.1%) contained bacterial isolates. None of the samples grew fungi.

Assessment of the risk of fall, related to visual stimulation, in patients with central vestibular disorders.

Science.gov (United States)

Suárez, H; Musé, P; Suárez, A; Arocena, M

2001-01-01

In order to assess the influence of visual stimulation in the triggering of imbalance and falls in the elderly population, the postural responses of 18 elderly patients with central vestibular disorders and clinical evidence of instability and falls were studied while receiving different types of visual stimuli. The stimulation conditions were: (i) no specific stimuli; (ii) smooth pursuit with pure sinusoids of 0.2 Hz as foveal stimulation; and (iii) optokinetic stimulation (OK) as retinal stimuli. Using a platform AMTI Accusway platform, the 95% confidence ellipse (CE) and sway velocity (SV) were evaluated with a scalogram using wavelets in order to assess the relationship between time and frequency in postural control. Velocity histograms were also constructed in order to observe the distribution of velocity values during the recording. A non-homogeneous postural behavior after visual stimulation was found among this population. In five of the patients the OK stimulation generated: (i) significantly higher average values of CE ( > 3.4+/-0.69 cm2); (ii) a significant increase in the average values of the SV ( > 3.89+/-1.15 cm/s) and a velocity histogram with a homogeneous distribution between 0 and 18 cm/s; and (iii) a scalogram with sway frequencies of up to 4 Hz distributed in both the X and Y directions (backwards and forwards and lateral) during visual stimulation with arbitrary units of energy density > 5. These three qualitative and quantitative aspects could be "markers" of visual dependence in the triggering of the mechanism of lack of equilibrium and hence falls in some elderly patients and should be considered in order to prevent falls and also to assist in the rehabilitation program of these patients.

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

Science.gov (United States)

Ted Hogg, Edward H; Michaelian, Michael

2015-05-01

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

The History of the Rhodes State College Dental Hygiene Program

Science.gov (United States)

Bowers, Denise E.

2012-01-01

The historiography of the Rhodes State College Dental Hygiene Program (Program) presents a historical journey of health care, as it relates to oral health, in the United States, in Ohio, and in Lima. This study bridges the gap between the history of higher education and the history of an academic program, dental hygiene. Prior to this study, there…

Contribution of chronic petroleum inputs to Narragansett Bay and Rhode Island Sound sediments

Energy Technology Data Exchange (ETDEWEB)

Van Vleet, E S; Quin, J G

1978-05-01

Sediment cores from Narragansett Bay and Rhode Island Sound have been analyzed for petroleum hydrocarbons and compared with a relatively unpolluted sediment core from the Gulf of Maine. The sediments were analyzed for unbound hydrocarbons, hydrocarbons bound or closely associated with humic substances, and residual hydrocarbons bound or closely associated with the clay mineral or kerogen matrix. Results indicated that in general 90-100% of the hydrocarbons were in the unbound form and could be easily extracted with organic solvents. The petroleum hydrocarbons decreased with depth at all stations. Biogenic hydrocarbons (nC/sub 25/, nC/sub 27/, nC/sub 29/, and nC/sub 31/) made up an increasingly greater percentage of the total with increasing depth. The hydrocarbons in the Narragansett Bay sediments and near surface Rhode Island Sound sediments strongly resembled the hydrocarbons previously reported for the Providence River and upper Narragansett Bay. These petroleum-like hydrocarbons were shown to be largely introduced to the river and bay through chronic inputs from a municipal wastewater treatment plant. These hydrocarbons then undergo sedimentation throughout the entire bay and into Rhode Island Sound. Preliminary calculations indicate that over 0.2 million t (tonne) of petroleum hydrocarbons may be transported to the marine environment annually from municipal treatment plants. Most of these hydrocarbons appear to accumulate in estuarine and coastal sediments.

Video Review: Better Places: The Hmong of Rhode Island a Generation Later

Directory of Open Access Journals (Sweden)

Chia Youyee Vang

2011-12-01

Full Text Available This article provides a review of Better Places: a documentary that follows up with Hmong families who were originally part of a film produced in the early 1980s about the resettlement experiences of Hmong refugees in Providence, Rhode Island.

Circumstantial Evidence of Possible Hot Spot Activity Outside Rhodes, Eastern Mediterranean Sea

OpenAIRE

Miliaresis, George

2014-01-01

Zouzias Dimitrios, St Seymour Karen, Miliaresis George, Vamvoukakis Costas (2008). Circumstantial Evidence of Possible Hot Spot Activity Outside Rhodes, Eastern Mediterranean Sea. 3rd International Conference on the Geology of the Tethys (8-11 January, 2008, South Valley University - Aswan). [Abstract in Program

Rhode Island, Connecticut, New York, and New Jersey ESI: HABITATS (Habitat and Plant Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for eelgrass, macroalgae, submerged aquatic vegetation, and rare terrestrial plants in coastal Rhode...

Consumer Behavior and Greenhouse Gas Emissions at the University of Rhode Island

Science.gov (United States)

2009-12-31

Of the 16,000 students at the University of Rhode Island, about 55% percent commute to campus. Between students, staff and faculty there could be up to 11,000 commuters at the University, most of which drive alone. A high volume of single-occupancy v...

Rhode Island, Connecticut, New York, and New Jersey ESI: REPTILES (Reptile and Amphibian Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for threatened/endangered sea turtles, diamondback terrapins, and rare reptiles/amphibians in coastal Rhode...

Evaluation of the impact of the 2012 Rhode Island health care worker influenza vaccination regulations: implementation process and vaccination coverage.

Science.gov (United States)

Kim, Hanna; Lindley, Megan C; Dube, Donna; Kalayil, Elizabeth J; Paiva, Kristi A; Raymond, Patricia

2015-01-01

In October 2012, the Rhode Island Department of Health (HEALTH) amended its health care worker (HCW) vaccination regulations to require all HCWs to receive annual influenza vaccination or wear a surgical mask during direct patient contact when influenza is widespread. Unvaccinated HCWs failing to wear a mask are subject to a fine and disciplinary action. To describe the implementation of the 2012 Rhode Island HCW influenza vaccination regulations and examine their impact on vaccination coverage. Two data sources were used: (1) a survey of all health care facilities subject to the HCW regulations and (2) HCW influenza vaccination coverage data reported to HEALTH by health care facilities. Descriptive statistics and paired t tests were performed using SAS Release 9.2. For the 2012-2013 influenza season, 271 inpatient and outpatient health care facilities in Rhode Island were subject to the HCW regulations. Increase in HCW influenza vaccination coverage. Of the 271 facilities, 117 facilities completed the survey (43.2%) and 160 facilities reported vaccination data to HEALTH (59.0%). Between the 2011-2012 and 2012-2013 influenza seasons, the proportion of facilities having a masking policy, as required by the revised regulations, increased from 9.4% to 94.0% (P employee HCWs in Rhode Island increased from 69.7% in the 2011-2012 influenza season to 87.2% in the 2012-2013 season. Rhode Island's experience demonstrates that statewide HCW influenza vaccination requirements incorporating mask wearing and moderate penalties for noncompliance can be effective in improving influenza vaccination coverage among HCWs.

School District Regionalization in Rhode Island: Relationship with Spending and Achievement

Science.gov (United States)

Masterson, Jason R.

2012-01-01

In Rhode Island, unless costs for education are controlled, taxpayers could face increased property taxes, increased sales tax on goods and services, and tax increases to existing fees to raise revenue (NEEP, 2010). Reducing the number of school districts was cited as the number two solution by the New England Economic Partnership in 2010 to…

Rhode Island, Connecticut, New York, and New Jersey ESI: M_MAMMAL (Marine Mammal Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for seals, whales, and dolphins in coastal Rhode Island, Connecticut, and the New York/New Jersey...

Social Vulnerability Index (SoVI) for Rhode Island based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Rhode Island census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Rhode Island, Connecticut, New York, and New Jersey ESI: HABPT (Habitat and Plant Points)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for rare terrestrial plants in coastal Rhode Island, Connecticut, New York, and New Jersey. Vector points...

Rhode Island, Connecticut, New York, and New Jersey ESI: HYDRO (Hydrography Lines and Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector lines and polygons representing coastal hydrography used in the creation of the Environmental Sensitivity Index (ESI) for Rhode Island,...

Social and Intel lectual Trends at Rhodes in the Early Sixties and ...

African Journals Online (AJOL)

canberry

When I arrived at Rhodes in 1962, the only graduates I had ever met were doctors .... expect me to fail at university, were aston ished at the end of my first year to find .... Irving was a socialist and a deter mined one, but his best friend was fellow.

Measuring the Influences That Affect Technological Literacy in Rhode Island High Schools

Science.gov (United States)

Walach, Michael

2015-01-01

This study sampled the current state of technological literacy in Rhode Island high schools using a new instrument, the Technological Literacy Assessment, which was developed for this study. Gender inequalities in technological literacy were discovered, and possible causes and solutions are presented. This study suggests possible next steps for…

Rhode Island, Connecticut, New York, and New Jersey ESI: T_MAMMAL (Terrestrial Mammal Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for small mammal species in coastal Rhode Island, Connecticut, New York, and New Jersey. Vector polygons in...

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

Science.gov (United States)

Blalock, Susan J; Gildner, Paula L; Jones, Jennifer L; Bowling, James M; Casteel, Carri H

2016-06-01

To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. Cross-sectional. Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Rhode Island, Connecticut, New York, and New Jersey ESI: M_MAMPT (Marine Mammal Points)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains sensitive biological resource data for seal haul-out sites in coastal Rhode Island, Connecticut, New York, and New Jersey. Vector points in...

Occurrence of the lessepsian species Portunus pelagicus (Crustacea and Apogon pharaonis (Pisces in the marine area of Rhodes Island

Directory of Open Access Journals (Sweden)

M. CORSINI-FOKA

2004-06-01

Full Text Available A large number of Red Sea species are colonizing the eastern Mediterranean Sea via the Suez Canal, mainly following the Anatolian coasts and spreading westwards. Portunus pelagicus is one of the most common Red Sea swimming crabs, first recorded in the Levantine Basin in 1898. Four specimens of P. pelagicus were collected in different marine areas of Rhodes Island from 1991 to 2000, while three specimens of the lessepsian fish Apogon pharaonis, first recorded in the Mediterranean in 1947, were caught during 2002 in the NW coast of Rhodes. The sub-tropical character of the marine area around Rhodes seems to facilitate the propagation of lessepsian species. These migrants have reached the island at different velocity and degree of establishment of their populations. The occurrence of the blue swimmer crab P. pelagicus and of the bullseye cardinal fish A. pharaonis increases the number of the decapod Crustacea and fish species of Red Sea origin observed in Greek waters.

Combined multibeam and bathymetry data from Rhode Island Sound and Block Island Sound: a regional perspective

Science.gov (United States)

Poppe, Lawrence J.; McMullen, Katherine Y.; Danforth, William W.; Blankenship, Mark R.; Clos, Andrew R.; Glomb, Kimberly A.; Lewit, Peter G.; Nadeau, Megan A.; Wood, Douglas A.; Parker, Castleton E.

2014-01-01

Detailed bathymetric maps of the sea floor in Rhode Island and Block Island Sounds are of great interest to the New York, Rhode Island, and Massachusetts research and management communities because of this area's ecological, recreational, and commercial importance. Geologically interpreted digital terrain models from individual surveys provide important benthic environmental information, yet many applications of this information require a geographically broader perspective. For example, individual surveys are of limited use for the planning and construction of cross-sound infrastructure, such as cables and pipelines, or for the testing of regional circulation models. To address this need, we integrated 14 contiguous multibeam bathymetric datasets that were produced by the National Oceanic and Atmospheric Administration during charting operations into one digital terrain model that covers much of Block Island Sound and extends eastward across Rhode Island Sound. The new dataset, which covers over 1244 square kilometers, is adjusted to mean lower low water, gridded to 4-meter resolution, and provided in Universal Transverse Mercator Zone 19, North American Datum of 1983 and geographic World Geodetic Survey of 1984 projections. This resolution is adequate for sea-floor feature and process interpretation but is small enough to be queried and manipulated with standard Geographic Information System programs and to allow for future growth. Natural features visible in the data include boulder lag deposits of winnowed Pleistocene strata, sand-wave fields, and scour depressions that reflect the strength of oscillating tidal currents and scour by storm-induced waves. Bedform asymmetry allows interpretations of net sediment transport. Anthropogenic features visible in the data include shipwrecks and dredged channels. Together the merged data reveal a larger, more continuous perspective of bathymetric topography than previously available, providing a fundamental framework for

Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

Science.gov (United States)

Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

2016-12-01

To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

Rhode Island hurricanes and tropical storms: A fifty-six year summary 1936-1991. Technical memo

International Nuclear Information System (INIS)

Vallee, D.R.

1993-03-01

The paper was compiled to provide a general overview of all tropical cyclone activity near Rhode Island since 1936. The year of 1936 is arbitrary, chosen mainly to include a 'not so well known' system prior to the well documented Great New England Hurricane of 1938. Thirty-one such storms have affected the state in the past 56 years, either making landfall along the coast of southern New England, or passing close enough over the offshore waters to spread tropical storm or hurricane force conditions into the area. The intensities of these systems have ranged from weak, disorganized tropical storms to full fledged major hurricanes. The one feature common to almost all of the storms was a rapid acceleration toward Rhode Island, which greatly reduced the time to prepare and evacuate

The Rhode Island "Washington": Meaning Making in Social Studies through Art History

Science.gov (United States)

Piro, Joseph M.

2005-01-01

The Rhode Island State House in Providence is an imposing structure. It is also an architecturally significant one. Built of white Georgia marble between 1895 and 1904, it has one of only four self-supporting marble covered domes found in the world. It was placed in the National Register of Historic Places in 1971. Looking around, one encounters…

City of Rhodes: residents' attitudes toward tourism impacts and development

OpenAIRE

Pappas, Nikolaos

2011-01-01

One of the most important issues of research in tourism is the exploration of residents' attitudes in local communities, since viable and sustainable tourism development can only be successful when it serves the actual needs and demands of the destination’s population, and any tourism evolution is directly dependant on locals’ acceptance and support. The purpose of this paper is to examine the host population perceptions in the city of Rhodes toward economic, social, and environmental tourism...

Surveillance of Travel-Related Mosquito-borne Illness in Rhode Island.

Science.gov (United States)

Alang, Neha; Glavis-Bloom, Justin; Alexander-Scott, Nicole; Mermel, Leonard A; Mileno, Maria D

2016-07-01

Malaria and Dengue are some of the common infections occurring in persons traveling to countries endemic for these infections. Chinkungunya virus infection is another illness that can occur in people who have travelled to areas endemic for chikungunya virus infection. Herein we report cases of malaria, dengue, and chikungunya in Newport Hospital, The Miriam Hospital and Rhode Island Hospital between January 1, 2010 and December 31, 2014. [Full article available at http://rimed.org/rimedicaljournal-2016-07.asp, free with no login].

Profiles of medicinal cannabis patients attending compassion centers in rhode island.

Science.gov (United States)

Zaller, Nickolas; Topletz, Ariel; Frater, Susan; Yates, Gail; Lally, Michelle

2015-01-01

Little is understood regarding medicinal marijuana dispensary users. We sought to characterize socio-demographics and reasons for medicinal marijuana use among medical cannabis dispensary patients in Rhode Island. Participants (n=200) were recruited from one of two Compassion Centers in Rhode Island and asked to participate in a short survey, which included assessment of pain interference using the Brief Pain Inventory (BPI). The majority of participants were male (73%), Caucasian (80%), college educated (68%), and had health insurance (89%). The most common reason for medicinal marijuana use was determined to be chronic pain management. Participants were more likely to have BPI pain interference scores of > 5 if they were older (OR: 1.36, 95% CI: 1.04-1.78) or reported using cannabis as a substitute for prescription medications (OR: 2.47, 95% CI: 1.23-4.95), and were less likely to have interference scores of >5 if they had higher income levels (OR: 0.53, 95% CI: 0.40-0.70) or reported having ever received treatment for an alcohol use disorder. One-fifth of participants had a history of a drug or alcohol use disorder. Most participants report that medicinal cannabis improves their pain symptomology, and are interested in alternative treatment options to opioid-based treatment regimens.

Legislative Districts, Rhode Island Senate Districts; risen07; State legislature district boundaries for the RI State Senate as determined in 2002 and revised in 2004 as designated in Rhode Island General Law 17-11. Corrected for renumbering of districts 9,12,24,and 32 in 2007, Published in 2007, 1:100000 (1in=8333ft) scale, Rhode Island and Providence Plantations.

Data.gov (United States)

NSGIC State | GIS Inventory — Legislative Districts dataset current as of 2007. Rhode Island Senate Districts; risen07; State legislature district boundaries for the RI State Senate as determined...

Numerical simulation of the 2002 Northern Rhodes Slide (Greece) and evaluation of the generated tsunami

Science.gov (United States)

Zaniboni, Filippo; Armigliato, Alberto; Pagnoni, Gianluca; Tinti, Stefano

2013-04-01

Small landslides are very common along the submarine margins, due to steep slopes and continuous material deposition that increment mass instability and supply collapse occurrences, even without earthquake triggering. This kind of events can have relevant consequences when occurring close to the coast, because they are characterized by sudden change of velocity and relevant speed achievement, reflecting into high tsunamigenic potential. This is the case for example of the slide of Rhodes Island (Greece), named Northern Rhodes Slide (NRS), where unusual 3-4 m waves were registered on 24 March 2002, provoking some damage in the coastal stretch of the city of Rhodes (Papadopoulos et al., 2007). The event was not associated with earthquake occurrence, and eyewitnesses supported the hypothesis of a non-seismic source for the tsunami, placed 1 km offshore. Subsequent marine geophysical surveys (Sakellariou et al., 2002) evidenced the presence of several detachment niches at about 300-400 m depth along the northern steep slope, one of which can be considered responsible of the observed tsunami, fitting with the previously mentioned supposition. In this work, that is carried out in the frame of the European funded project NearToWarn, we evaluated the tsunami effects due to the NRS by means of numerical modelling: after having reconstructed the sliding body basing on morphological assumptions (obtaining an esteemed volume of 33 million m3), we simulated the sliding motion through the in-house built code UBO-BLOCK1, adopting a Lagrangian approach and splitting the sliding mass into a "chain" of interacting blocks. This provides the complete dynamics of the landslide, including the shape changes that relevantly influence the tsunami generation. After the application of an intermediate code, accounting for the slide impulse filtering through the water depth, the tsunami propagation in the sea around the island of Rhodes and up to near coasts of Turkey was simulated via the

Silvicultural activities in Pringle Falls Experimental Forest, Central Oregon

Science.gov (United States)

Andrew Youngblood; Kim Johnson; Jim Schlaich; Boyd Wickman

2004-01-01

Pringle Falls Experimental Forest has been a center for research in ponderosa pine forests east of the crest of the Cascade Range since 1931. Long-term research facilities, sites, and future research opportunities are currently at risk from stand-replacement wildfire because of changes in stand structure resulting from past fire exclusion. At the same time, many of the...

Investing in Low-Wage Workers: Lessons from Family Child Care in Rhode Island

Science.gov (United States)

Roder, Anne; Seavey, Dorie

2006-01-01

While child care is one of the fastest growing occupations in the country, most employment in this field is precarious and low-wage. Investing in Low-Wage Workers profiles the Day Care Justice Co-op, a group of largely Latina and African American women living and working in some of Rhode Island's poorest communities. Determined to improve family…

Rhode Island Pension Reform: Implications and Opportunities for Education. Education Sector Policy Briefs

Science.gov (United States)

Herriot-Hatfield, Jennie; Monahan, Amy; Rosenberg, Sarah; Tucker, Bill

2011-01-01

On August 24, 2010, the state of Rhode Island received some outstanding news. Its yearlong, bipartisan effort to develop new policies to spur educational improvement was about to pay off. The state, along with eight others and the District of Columbia, was named a winner of the U.S. Department of Education's Race to the Top grant competition. The…

Estimated medical cost savings in Rhode Island by implementation of a primary seat belt law

Science.gov (United States)

2008-09-01

This report examines 2006 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Rhode Island if a primary seat belt law is implemented. The savin...

Preliminary results of a novel hay-hole fall prevention initiative.

Science.gov (United States)

Batra, Erich K; Gross, Brian W; Jammula, Shreya; Bradburn, Eric H; Baier, Ronald D; Reihart, Michael J; Murphy, Dennis; Moyer, Kay; Hess, Joseph; Lackmann, Susan; Miller, Jo Ann; Rogers, Frederick B

2018-02-01

Hay-hole falls are a prevalent source of trauma among Anabaptists-particularly Anabaptist youth. We sought to decrease hay-hole falls in South Central Pennsylvania through the development and distribution of all-weather hay-hole covers to members of the at-risk Anabaptist community. Following the creation of a rural trauma prevention syndicate, hay-hole cover prototypes co-designed and endorsed by the Pennsylvania Amish Safety Committee were developed and distributed throughout South Central Pennsylvania. Preintervention and postintervention surveys were distributed to recipients to gain an understanding of the hay-hole fall problem in this population, to provide insight into the acceptance of the cover within the community, and to determine the efficacy of the cover in preventing falls. A total of 231 hay-hole covers were distributed throughout eight rural trauma-prone counties in Pennsylvania. According to preintervention survey data, 52% of cover recipients reported at least one hay-hole fall on their property, with 46% reporting multiple falls (median fall rate, 1.00 [1.00-2.00] hay-hole falls per respondent). The median self-reported distance from hay-hole to ground floor was 10.0 (8.00-12.0) feet, and the median number of hay-holes present on-property was 3.00 (2.00-4.00) per respondent. Postintervention survey data found 98% compliance with hay-hole cover installation and no subsequent reported hay-hole falls. With the support of the Pennsylvania Amish Safety Committee, we developed a well-received hay-hole cover which could effectively reduce fall trauma across other rural communities in the United States. Epidemiological study, Level III.

76 FR 51383 - Commercial Leasing for Wind Power on the Outer Continental Shelf (OCS) Offshore Rhode Island and...

Science.gov (United States)

2011-08-18

... Rhode Island and Massachusetts recognizes the benefits of collaborating in the evaluation and potential... appropriate; (3) A preliminary schedule of proposed activities, including those leading to commercial...

Ecology of fall-migrating ducks in central Illinois: A radar perspective

Science.gov (United States)

O'Neal, Benjamin J.

Research from the last two decades has elucidated the importance of migration in the annual cycle of ducks, but many aspects of migration ecology remain poorly understood due to the difficulty of investigating movements that occur over large spatial scales, at substantial heights and at night. Weather surveillance radar (WSR) offers a unique tool for observing movements of birds aloft, but until now has been used primarily to address questions only relevant to broad taxonomic groups. Using thermal infrared imaging, portable radar, and natural history, I ground-truthed WSR echoes originating from a complex of wetlands in the central Illinois River valley to develop a technique for identifying and enumerating ducks as they emigrated from this important stopover area. With this technique, I quantified duck emigrations during 7 falls (1996, 1997, 2003, and 2005-2008). I used WSR-derived estimates of annual turnover in combination with aerial inventory estimates of duck use to estimate the average amount of time ducks spent at my study site during fall (stopover duration). The mean stopover duration estimate of 11 days (SD = 4 days) was much shorter than a historical estimate (28 days) that has been use for regional waterfowl conservation planning. I also regressed average annual stopover duration estimates against an index of annual foraging habitat quality and found a strong, positive relationship (r2 = 0.71), suggesting ducks assessed local habitat conditions and adjusted time spent at the site. Weather influences the timing of migration in many avian taxa, but this relationship is poorly understood for ducks. An evaluation of competing models including 15 years of data indicated following winds aloft, no precipitation, less cloud cover, decreasing temperatures, increasing barometric pressure and date best predicted emigration (R2 = 0.52). Based on this model, the odds of a duck emigration occurring when winds were following and precipitation was absent were 13.2 to

Collection and analysis of remotely sensed data from the Rhode River Estuary Watershed

Science.gov (United States)

Jenkins, D. W.; Williamson, F. S. L.

1973-01-01

The remote sensing study to survey the Rhode River watershed for spray irrigation with secondarily treated sewage is reported. The standardization of Autumn coloration changes with Munsell color chips is described along with the mapping of old field vegetation for the spray irrigation project. The interpretation and verification of salt marsh vegetation by remote sensing of the water shed is discussed.

77 FR 30551 - Commercial Renewable Energy Transmission on the Outer Continental Shelf (OCS) Offshore Rhode...

Science.gov (United States)

2012-05-23

... transmission grid on the Rhode Island mainland to Block Island. Deepwater Wind proposes to connect an onshore... Island LLC (Deepwater Wind) Transmission System (BITS) proposal submitted to the Bureau of Ocean Energy... electrical power from Deepwater Wind's proposed 30 megawatt (MW) offshore wind energy project located in...

33 CFR 165.121 - Safety and Security Zones: High Interest Vessels, Narragansett Bay, Rhode Island.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety and Security Zones: High... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY REGULATED NAVIGATION... Guard District § 165.121 Safety and Security Zones: High Interest Vessels, Narragansett Bay, Rhode...

The rise and fall of central dogmas.

Science.gov (United States)

Klein, George; Klein, Eva

2016-01-01

Stimulated by Francis Cricks "central dogma of molecular biology" open to criticism and rebuttal, five statements are formulated on current notions of tumor biology, inviting the criticism of the reader.

The rise and fall of the ridge

Energy Technology Data Exchange (ETDEWEB)

Sorensen, Paul [Brookhaven National Laboratory, Upton, NY 11973 (United States)

2011-04-01

Recent data from heavy ion collisions at RHIC show unexpectedly large near-angle correlations that broaden longitudinally with centrality. The amplitude of this ridge-like correlation rises rapidly with centrality, reaches a maximum, and then falls in the most central collisions. In this talk we explain how this behavior can be easily understood in a picture where final momentum-space correlations are driven by initial coordinate space density fluctuations. We propose {nu}{sub n}{sup 2}/{epsilon}{sub n,part}{sup 2} as a useful way to study these effects and explain what it tells us about the collision dynamics.

Violence Against Women: Injuries and Deaths in Rhode Island Yongwen Jiang, PhD; Deborah Debare, MMHS; Lynne-Marie Shea, BA; Samara Viner-Brown, MS.

Science.gov (United States)

Jiang, Yongwen; DeBare, Deborah; Shea, Lynne-Marie; Viner-Brown, Samara

2017-12-01

Violence against women is a public health issue. Monitoring assault-related injury and homicide death among women is imperative for understanding this public health issue. We used data from the 2014 Rhode Island emergency department (ED), hospital discharge (HD), and 2004-2014 Rhode Island violent death reporting system (RIVDRS) to provide a broad picture for violence against women injuries and deaths in Rhode Island. ED visit and HD data show that the majority of female assault injuries occurred among women aged 25-44, resided in the core cities, and had public insurance. RIVDRS data showed that over half of the homicides among women were aged 25-64; nearly two in five were non-Hispanic black or Hispanic. Precipitating circumstances include intimate partner violence, a preceding argument or a conflict, and precipitated by another crime. Evidence-informed interventions need to target high-risk populations and urban areas to effectively reduce violence against women. [Full article available at http://rimed.org/rimedicaljournal-2017-12.asp].

Analysis of Offshore Wind Energy Leasing Areas for the Rhode Island/Massachusetts Wind Energy Area

Energy Technology Data Exchange (ETDEWEB)

Musial, W.; Elliott, D.; Fields, J.; Parker, Z.; Scott, G.

2013-04-01

The National Renewable Energy Laboratory (NREL), under an interagency agreement with the Bureau of Ocean Energy Management (BOEM), is providing technical assistance to BOEM on the identification and delineation of offshore leasing areas for offshore wind energy development within the Atlantic Coast Wind Energy Areas (WEAs) established by BOEM in 2012. This report focuses on NREL's evaluation of BOEM's Rhode Island/Massachusetts (RIMA) WEA leasing areas. The objective of the NREL evaluation was to assess the proposed delineation of the two leasing areas and determine if the division is reasonable and technically sound. Additionally, the evaluation aimed to identify any deficiencies in the delineation. As part of the review, NREL performed the following tasks: 1. Performed a limited review of relevant literature and RIMA call nominations. 2. Executed a quantitative analysis and comparison of the two proposed leasing areas 3. Conducted interviews with University of Rhode Island (URI) staff involved with the URI Special Area Management Plan (SAMP) 4. Prepared this draft report summarizing the key findings.

The consumption of two or more fall risk-increasing drugs rather than polypharmacy is associated with falls.

Science.gov (United States)

Zia, Anam; Kamaruzzaman, Shahrul B; Tan, Maw P

2017-03-01

The presemt study aimed to determine the association between the risk of recurrent and injurious falls with polypharmacy, fall risk-increasing drugs (FRID) and FRID count among community-dwelling older adults. Participants (n = 202) were aged ≥65 years with two or more falls or one injurious fall in the past year, whereas controls (n = 156) included volunteers aged ≥65 years with no falls in the past year. A detailed medication history was obtained alongside demographic data. Polypharmacy was defined as "regular use of five or more prescription drugs." FRID were identified as cardiovascular agents, central nervous system drugs, analgesics and endocrine drugs; multiple FRID were defined as two or more FRID. Multiple logistic regression analyses were used to adjust for confounders. The use of non-steroidal anti-inflammatory drugs was independently associated with an increased risk of falls. Univariate analyses showed both polypharmacy (OR 2.23, 95% CI 1.39-3.56; P = 0.001) and the use of two or more FRID (OR 2.9, 95% CI 1.9-4.5; P = 0.0001) were significantly more likely amongst fallers. After adjustment for age, sex and comorbidities, blood pressure, and physical performance scores, polypharmacy was no longer associated with falls (OR 1.6, 95% CI 0.9-2.9; P = 0.102), whereas the consumption of two or more FRID remained a significant predictor for falls (OR 2.8, 95% CI 1.4-5.3; P = 0.001). Among high risk fallers, the use of two or more FRID was an independent risk factor for falls instead of polypharmacy. Our findings will inform clinical practice in terms of medication reviews among older adults at higher risk of falls. Future intervention studies will seek to confirm whether avoidance or withdrawal of multiple FRID reduces the risk of future falls. Geriatr Gerontol Int 2017; 17: 463-470. © 2016 Japan Geriatrics Society.

The Brave New World of GEC Evaluation: The Experience of the Rhode Island Geriatric Education Center

Science.gov (United States)

Filinson, Rachel; Clark, Phillip G.; Evans, Joann; Padula, Cynthia; Willey, Cynthia

2012-01-01

In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these…

Particle-bound metal transport after removal of a small dam in the Pawtuxet River, Rhode Island, USA

Science.gov (United States)

The Pawtuxet River in Rhode Island, USA, has a long history of industrial activity and pollutant discharges. Metal contamination of the river sediments is well documented and historically exceeded toxicity thresholds for a variety of organisms. The Pawtuxet River dam, a low-head ...

Adolescent suicide and health risk behaviors: Rhode Island's 2007 Youth Risk Behavior Survey.

Science.gov (United States)

Jiang, Yongwen; Perry, Donald K; Hesser, Jana E

2010-05-01

Suicide is the third-leading cause of death among high school students in the U.S. This study examined the relationships among indicators of depressed mood, suicidal thoughts, suicide attempts, and demographics and risk behaviors in Rhode Island high school students. Data from Rhode Island's 2007 Youth Risk Behavior Survey were utilized for this study. The statewide sample contained 2210 randomly selected public high school students. Data were analyzed in 2008 to model for each of five depressed mood/suicide indicators using multivariable logistic regression. By examining depressed mood and suicide indicators through a multivariable approach, the strongest predictors were identified, for multiple as well as specific suicide indicators. These predictors included being female, having low grades, speaking a language other than English at home, being lesbian/gay/bisexual/unsure of sexual orientation, not going to school as a result of feeling unsafe, having been a victim of forced sexual intercourse, being a current cigarette smoker, and having a self-perception of being overweight. The strength of associations between three factors (immigrant status, feeling unsafe, and having forced sex) and suicide indicators adds new information about potential predictors of suicidal behavior in adolescents. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Map Showing Geologic Terranes of the Hailey 1°x2° Quadrangle and the western part of the Idaho Falls 1°x2° Quadrangle, south-central Idaho

Data.gov (United States)

Department of the Interior — The paper version of Map Showing Geologic Terranes of the Hailey 1°x2° Quadrangle and the western part of the Idaho Falls 1°x2° Quadrangle, south-central Idaho was...

75 FR 57188 - Rhode Island: Final Authorization of State Hazardous Waste Management Program Revisions

Science.gov (United States)

2010-09-20

... implementation of the Land Disposal Restrictions (LDR) requirements in 40 CFR part 268 because Rhode Island has..., April 24, 2006 (other than LDR requirements): Rules 2.2 C, 2.2 C.4, 2.2 F, 2.2 G, 2.2 I, 2.2 J, 7.0 B.82...)), but Safe Food and Fertilizer disagrees with the EPA determinations and states that the ``use of...

How Will Teachers Fare in Rhode Island's New Hybrid Pension Plan? Public Pension Project Brief 4

Science.gov (United States)

Johnson, Richard W.; Butrica, Barbara A.; Haaga, Owen; Southgate, Benjamin G.

2014-01-01

Hybrid retirement plans that combine defined benefit pensions with 401(k) type, defined contribution accounts can play important roles in the reform of public-sector pensions. Summarizing results from our longer report ["How Will Rhode Island's New Hybrid Pension Plan Affect Teachers? A Report of the Public Pension Project" (2014)], this…

Collection and analysis of remotely sensed data from the Rhode River Estuary Watershed. [ecological parameters of Chesapeake Bay

Science.gov (United States)

Jenkins, D. W.

1972-01-01

NASA chose the watershed of Rhode River, a small sub-estuary of the Bay, as a representative test area for intensive studies of remote sensing, the results of which could be extrapolated to other estuarine watersheds around the Bay. A broad program of ecological research was already underway within the watershed, conducted by the Smithsonian Institution's Chesapeake Bay Center for Environmental Studies (CBCES) and cooperating universities. This research program offered a unique opportunity to explore potential applications for remote sensing techniques. This led to a joint NASA-CBCES project with two basic objectives: to evaluate remote sensing data for the interpretation of ecological parameters, and to provide essential data for ongoing research at the CBCES. A third objective, dependent upon realization of the first two, was to extrapolate photointerpretive expertise gained at the Rhode River watershed to other portions of the Chesapeake Bay.

Factors associated with developing a fear of falling in subjects with primary open-angle glaucoma.

Science.gov (United States)

Adachi, Sayaka; Yuki, Kenya; Awano-Tanabe, Sachiko; Ono, Takeshi; Shiba, Daisuke; Murata, Hiroshi; Asaoka, Ryo; Tsubota, Kazuo

2018-02-13

To investigate the relationship between clinical risk factors, including visual field (VF) defects and visual acuity, and a fear of falling, among patients with primary open-angle glaucoma (POAG). All participants answered the following question at a baseline ophthalmic examination: Are you afraid of falling? The same question was then answered every 12 months for 3 years. A binocular integrated visual field was calculated by merging a patient's monocular Humphrey field analyzer VFs, using the 'best sensitivity' method. The means of total deviation values in the whole, superior peripheral, superior central, inferior central, and inferior peripheral VFs were calculated. The relationship between these mean VF measurements, and various clinical factors, against patients' baseline fear of falling and future fear of falling was analyzed using multiple logistic regression. Among 392 POAG subjects, 342 patients (87.2%) responded to the fear of falling question at least twice in the 3 years study period. The optimal regression model for patients' baseline fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. The optimal regression equation for future fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. Defects in the inferior peripheral VF area are significantly related to the development of a fear of falling.

Pathogenesis and treatment of falls in elderly

Science.gov (United States)

Pasquetti, Pietro; Apicella, Lorenzo; Mangone, Giuseppe

2014-01-01

Summary Falls in the elderly are a public health problem. Consequences of falls are increased risk of hospitalization, which results in an increase in health care costs. It is estimated that 33% of individuals older than 65 years undergoes falls. Causes of falls can be distinguished in intrinsic and extrinsic predisposing conditions. The intrinsic causes can be divided into age-related physiological changes and pathological predisposing conditions. The age-related physiological changes are sight disorders, hearing disorders, alterations in the Central Nervous System, balance deficits, musculoskeletal alterations. The pathological conditions can be Neurological, Cardiovascular, Endocrine, Psychiatric, Iatrogenic. Extrinsic causes of falling are environmental factors such as obstacles, inadequate footwear. The treatment of falls must be multidimensional and multidisciplinary. The best instrument in evaluating elderly at risk is Comprehensive Geriatric Assessment (CGA). CGA allows better management resulting in reduced costs. The treatment should be primarily preventive acting on extrinsic causes; then treatment of chronic and acute diseases. Rehabilitation is fundamental, in order to improve residual capacity, motor skills, postural control, recovery of strength. There are two main types of exercises: aerobic and muscular strength training. Education of patient is a key-point, in particular through the Back School. In conclusion falls in the elderly are presented as a “geriatric syndrome”; through a multidimensional assessment, an integrated treatment and a rehabilitation program is possible to improve quality of life in elderly. PMID:25568657

Environmental management of mosquito-borne viruses in Rhode Island

Science.gov (United States)

Ginsberg, Howard S.; Gettman, Alan; Becker, Elisabeth; Bandyopadhyay, Ananda S.; LeBrun, Roger A.

2013-01-01

West Nile Virus (WNV) and Eastern Equine Encephalitis Virus (EEEV) are both primarily bird viruses, which can be transmitted by several mosquito species. Differences in larval habitats, flight, and biting patterns of the primary vector species result in substantial differences in epidemiology, with WNV more common, primarily occurring in urban areas, and EEEV relatively rare, typically occurring near swamp habitats. The complex transmission ecology of these viruses complicates prediction of disease outbreaks. The Rhode Island Department of Environmental Management (DEM) and Department of Health (DoH) provide prevention assistance to towns and maintain a mosquito surveillance program to identify potential disease risk. Responses to potential outbreaks follow a protocol based on surveillance results, assessment of human risk, and technical consultation.

Soil Survey Geographic (SSURGO) Soil Polygons for the State of Rhode Island: Bristol, Kent, Newport, Providence, and Washington Counties

Data.gov (United States)

University of Rhode Island Geospatial Extension Program — 2013 VERSION 6 Spatial: This data set is a digital soil survey and generally is the most detailed level of soil geographic data developed by the National Cooperative...

New Orleans on His Mind: A Rhode Island Choral Director Brings Katrina Victims Music--And Hope

Science.gov (United States)

Olson, Catherine Applefeld

2009-01-01

Westerly, Rhode Island, is a long way from New Orleans. But the physical distance has not stopped David DeAngelis, choral director at Westerly High School, from providing his students with one heck of a lesson: The opportunity to truly connect with others through music. Under DeAngelis' direction, Westerly's various vocal ensembles have held…

Soil Survey Geographic (SSURGO) Special Point Features for the State of Rhode Island: Bristol, Kent, Newport, Providence, and Washington Counties

Data.gov (United States)

University of Rhode Island Geospatial Extension Program — This data set is a digital soil survey and generally is the most detailed level of soil geographic data developed by the National Cooperative Soil Survey. The...

Soil Survey Geographic (SSURGO) Special Line Features for the State of Rhode Island: Bristol, Kent, Newport, Providence, and Washington County

Data.gov (United States)

University of Rhode Island Geospatial Extension Program — This data set is a digital soil survey and generally is the most detailed level of soil geographic data developed by the National Cooperative Soil Survey. The...

On the relationship between Indian monsoon withdrawal and Iran's fall precipitation onset

Science.gov (United States)

Babaeian, Iman; Rezazadeh, Parviz

2017-09-01

Indian monsoon is the most prominent of the world's monsoon systems which primarily affects synoptic patterns of India and adjacent countries such as Iran in interaction with large-scale weather systems. In this article, the relationship between the withdrawal date of the Indian monsoon and the onset of fall precipitation in Iran has been studied. Data included annual time series of withdrawal dates of the Indian monsoon prepared by the Indian Institute for Tropical Meteorology, and time series of the first date of 25 mm accumulated precipitation over Iran's synoptic weather stations in a 10-day period which is the basis for the cultivation date. Both time series were considered in Julian calendar with the starting date on August 1. The studied period is 1960-2014 which covers 55 years of data from 36 meteorological stations in Iran. By classifying the withdrawal dates of the Indian monsoon in three stages of late, normal, and early withdrawals, its relation with the onset of fall precipitation in western, southwestern, southern, eastern, central, and northern regions of Iran was studied. Results demonstrated that in four out of the six mentioned regions, the late withdrawal of the Indian monsoon postpones the onset of fall precipitation over Iran. No significant relation was found between the onset of fall precipitation in central region of Iran and the monsoon's withdrawal date. In the western, southwestern, southern, and eastern regions of Iran, the late monsoon delays the onset of fall's precipitation; while in the south Caspian Sea coastal area, it causes the early onset of autumnal precipitation. The lag in onset of fall precipitation in Iran which is coordinated with the late withdrawal of monsoon is accompanied with prolonged subtropical high settling over Iran's plateau that prevents the southward movement of polar jet frontal systems. Such conditions enhance northerly wind currents over the Caspian Sea which, in turn, increase the precipitation in Caspian

Falls following discharge after an in-hospital fall

Directory of Open Access Journals (Sweden)

Kessler Lori A

2009-12-01

Full Text Available Abstract Background Falls are among the most common adverse events reported in hospitalized patients. While there is a growing body of literature on fall prevention in the hospital, the data examining the fall rate and risk factors for falls in the immediate post-hospitalization period has not been well described. The objectives of the present study were to determine the fall rate of in-hospital fallers at home and to explore the risk factors for falls during the immediate post-hospitalization period. Methods We identified patients who sustained a fall on one of 16 medical/surgical nursing units during an inpatient admission to an urban community teaching hospital. After discharge, falls were ascertained using weekly telephone surveillance for 4 weeks post-discharge. Patients were followed until death, loss to follow up or end of study (four weeks. Time spent rehospitalized or institutionalized was censored in rate calculations. Results Of 95 hospitalized patients who fell during recruitment, 65 (68% met inclusion criteria and agreed to participate. These subjects contributed 1498 person-days to the study (mean duration of follow-up = 23 days. Seventy-five percent were African-American and 43% were women. Sixteen patients (25% had multiple falls during hospitalization and 23 patients (35% suffered a fall-related injury during hospitalization. Nineteen patients (29% experienced 38 falls at their homes, yielding a fall rate of 25.4/1,000 person-days (95% CI: 17.3-33.4. Twenty-three patients (35% were readmitted and 3(5% died. One patient experienced a hip fracture. In exploratory univariate analysis, persons who were likely to fall at home were those who sustained multiple falls in the hospital (p = 0.008. Conclusion Patients who fall during hospitalization, especially on more than one occasion, are at high risk for falling at home following hospital discharge. Interventions to reduce falls would be appropriate to test in this high-risk population.

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use - a qualitative study.

Science.gov (United States)

Bell, Hege Therese; Steinsbekk, Aslak; Granas, Anne Gerd

2017-09-01

The aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use. A qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation. The main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician's choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician. Elderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs.

Women's perspectives on falls and fall prevention during pregnancy.

Science.gov (United States)

Brewin, Dorothy; Naninni, Angela

2014-01-01

Falls are the leading cause of unintentional injury in women. During pregnancy, even a minor fall can result in adverse consequences. Evidence to inform effective and developmentally appropriate pregnancy fall prevention programs is lacking. Early research on pregnancy fall prevention suggests that exercise may reduce falls. However, acceptability and effectiveness of pregnancy fall prevention programs are untested. To better understand postpartum women's perspective and preferences on fall prevention strategies during pregnancy to formulate an intervention. Focus groups and individual interviews were conducted with 31 postpartum women using descriptive qualitative methodology. Discussion of falls during pregnancy and fall prevention strategies was guided by a focus group protocol and enhanced by 1- to 3-minute videos on proposed interventions. Focus groups were audio recorded, transcribed, and analyzed using NVivo 10 software. Emerging themes were environmental circumstances and physical changes of pregnancy leading to a fall, prevention strategies, barriers, safety concerns, and marketing a fall prevention program. Wet surfaces and inappropriate footwear commonly contributed to falls. Women preferred direct provider counseling and programs including yoga and Pilates. Fall prevention strategies tailored to pregnant women are needed. Perspectives of postpartum women support fall prevention through provider counseling and individual or supervised exercise programs.

Monte-Carlo RAY tracing simulation of a falling particle receiver in connection with a central receiver field

Energy Technology Data Exchange (ETDEWEB)

Alxneit, I [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

1999-08-01

The program RAY was developed to perform Monte-Carlo simulations of the flux distribution in solar reactors in connection with an arbitrary heliostat field. The code accounts for the shading of the incoming rays from the sun due to the reactor supporting tower as well as for full blocking and shading of the heliostats among themselves. A simplified falling particle reactor (FPR) was evaluated. A central receiver field was used with a total area of 311 m{sup 2} composed of 176 round, focusing heliostats. No attempt was undertaken to optimise either the geometry of the heliostat field nor the aiming strategy of the heliostats. The FPR was evaluated at two different geographic latitudes (-8.23W/47.542N; PSI and -8.23W/20.0N) and during the course of a day (May 30{sup th}). The incident power passing through the reactor aperture and the flux density distribution within the FPR was calculated. (author) 3 figs., 1 tab., 3 refs.

Continuous equilibrium scores: factoring in the time before a fall.

Science.gov (United States)

Wood, Scott J; Reschke, Millard F; Owen Black, F

2012-07-01

The equilibrium (EQ) score commonly used in computerized dynamic posturography is normalized between 0 and 100, with falls assigned a score of 0. The resulting mixed discrete-continuous distribution limits certain statistical analyses and treats all trials with falls equally. We propose a simple modification of the formula in which peak-to-peak sway data from trials with falls is scaled according the percent of the trial completed to derive a continuous equilibrium (cEQ) score. The cEQ scores for trials without falls remain unchanged from the original methodology. The cEQ factors in the time before a fall and results in a continuous variable retaining the central tendencies of the original EQ distribution. A random set of 5315 Sensory Organization Test trials were pooled that included 81 falls. A comparison of the original and cEQ distributions and their rank ordering demonstrated that trials with falls continue to constitute the lower range of scores with the cEQ methodology. The area under the receiver operating characteristic curve (0.997) demonstrates that the cEQ retained near-perfect discrimination between trials with and without falls. We conclude that the cEQ score provides the ability to discriminate between ballistic falls from falls that occur later in the trial. This approach of incorporating time and sway magnitude can be easily extended to enhance other balance tests that include fall data or incomplete trials. Copyright © 2012 Elsevier B.V. All rights reserved.

Streamflow, water quality, and constituent loads and yields, Scituate Reservoir drainage area, Rhode Island, water year 2013

Science.gov (United States)

Smith, Kirk P.

2015-01-01

Streamflow and concentrations of sodium and chloride estimated from records of specific conductance were used to calculate loads of sodium and chloride during water year (WY) 2013 (October 1, 2012, through September 30, 2013) for tributaries to the Scituate Reservoir, Rhode Island. Streamflow and water-quality data used in the study were collected by the U.S. Geological Survey (USGS) or the Providence Water Supply Board (PWSB) in the cooperative study. Streamflow was measured or estimated by the USGS following standard methods at 23 streamgages; 14 of these streamgages are equipped with instrumentation capable of continuously monitoring water level, specific conductance, and water temperature. Water-quality samples were collected at 37 sampling stations by the PWSB and at 14 continuous-record streamgages by the USGS during WY 2013 as part of a long-term sampling program; all stations are in the Scituate Reservoir drainage area. Water-quality data collected by the PWSB are summarized by using values of central tendency and are used, in combination with measured (or estimated) streamflows, to calculate loads and yields (loads per unit area) of selected water-quality constituents for WY 2013.

The Clinical Research Landscape in Rhode Island.

Science.gov (United States)

Mao, George; Ramratnam, Bharat

2017-01-06

To present an overview of clinical research activity and the state of medical research funding in Rhode Island. We utilized clinicaltrials.gov registry to profile clinical studies between 2011 to 2016. NIH RePORT and other federal databases were used to extract information on levels of federal funding. Previously published hospital financial reports were reviewed for data on hospital-specific total external research funding. During 2011-2016, 1651 clinical studies were registered in clinicaltrials.gov. Nearly a third of all clinical studies were in oncology (21%) and cardiovascular diseases (10%). Alzheimer's dementia, breast cancer, HIV, and hepatitis C accounted for nearly 17% of all clinical trials. Seventy-five percent (75%) of clinical trials in RI were conducted in hospitals affiliated with Lifespan or Care New England. Financial support for clinical trials largely came from industry (60%) with 23% being supported by the National Institutes of Health (NIH). The rest are funded by nonprofit organizations, charitable foundations, educational institutions, and unlisted concerns. [Full article available at http://rimed.org/rimedicaljournal-2017-01.asp].

Chronic interstitial lung disease in nylon flocking industry workers--Rhode Island, 1992-1996.

Science.gov (United States)

1997-09-26

Interstitial lung disease (ILD) occurs infrequently; some cases are attributed to sarcoidosis, pulmonary hemorrhage syndromes, connective tissue diseases, hypersensitivity pneumonitis, drugs, radiation, and mineral dusts (e.g., silica or asbestos). However, most cases of ILD are of uncertain classification or etiology. This report describes preliminary findings of the investigation in Rhode Island of an outbreak of ILD among workers involved in the manufacture of finely cut nylon (flock) and flocked fabric (used for upholstery, clothing, and automobiles); the findings provide evidence of a newly recognized occupational illness.

LIDAR Products, State of Rhode Island: LIDAR for the North East – ARRA and LiDAR for the North East Part II; LiDAR was collected in the Winter and Spring 2011 at a 1 meter or better nominal post spacing (1m GSD) for approximately 1,074 square miles of Rhode Island, whi, Published in 2012, 1:9600 (1in=800ft) scale, Rhode Island and Providence Plantations.

Data.gov (United States)

NSGIC State | GIS Inventory — LIDAR Products dataset current as of 2012. State of Rhode Island: LIDAR for the North East – ARRA and LiDAR for the North East Part II; LiDAR was collected in the...

How Will Rhode Island's New Hybrid Pension Plan Affect Teachers? A Report of the Public Pension Project

Science.gov (United States)

Johnson, Richard W.; Butrica, Barbara A.; Haaga, Owen; Southgate, Benjamin G.

2014-01-01

In 2011 Rhode Island replaced the stand-alone defined benefit pension plan it provided to state employees with a hybrid plan that reduced the defined benefit component and added a 401(k)-type, defined contribution component. Although controversial, the new hybrid plan will boost retirement incomes for most of the states public school teachers. Our…

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

Science.gov (United States)

Shimada, Hiroyuki; Suzukawa, Megumi; Ishizaki, Tatsuro; Kobayashi, Kumiko; Kim, Hunkyung; Suzuki, Takao

2011-08-12

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

Water-quality trends in the Scituate reservoir drainage area, Rhode Island, 1983-2012

Science.gov (United States)

Smith, Kirk P.

2015-01-01

The Scituate Reservoir is the primary source of drinking water for more than 60 percent of the population of Rhode Island. Water-quality and streamflow data collected at 37 surface-water monitoring stations in the Scituate Reservoir drainage area, Rhode Island, from October 2001 through September 2012, water years (WYs) 2002-12, were analyzed to determine water-quality conditions and constituent loads in the drainage area. Trends in water quality, including physical properties and concentrations of constituents, were investigated for the same period and for a longer period from October 1982 through September 2012 (WYs 1983-2012). Water samples were collected and analyzed by the Providence Water Supply Board, the agency that manages the Scituate Reservoir. Streamflow data were collected by the U.S. Geological Survey. Median values and other summary statistics for pH, color, turbidity, alkalinity, chloride, nitrite, nitrate, total coliform bacteria, Escherichia coli (E. coli), and orthophosphate were calculated for WYs 2003-12 for all 37 monitoring stations. Instantaneous loads and yields (loads per unit area) of total coliform bacteria and E. coli, chloride, nitrite, nitrate, and orthophosphate were calculated for all sampling dates during WYs 2003-12 for 23 monitoring stations with streamflow data. Values of physical properties and concentrations of constituents were compared with State and Federal water-quality standards and guidelines and were related to streamflow, land-use characteristics, varying classes of timber operations, and impervious surface areas.

The interactive systems framework applied to the strategic prevention framework: the Rhode Island experience.

Science.gov (United States)

Florin, Paul; Friend, Karen B; Buka, Stephen; Egan, Crystelle; Barovier, Linda; Amodei, Brenda

2012-12-01

The Interactive Systems Framework for Dissemination and Implementation (ISF) was introduced as a heuristic systems level model to help bridge the gap between research and practice (Wandersman et al., in Am J Commun Psychol 41:171-181, 2008). This model describes three interacting systems with distinct functions that (1) distill knowledge to develop innovations; (2) provide supportive training and technical assistance for dissemination to; (3) a prevention delivery system responsible for implementation in the field. The Strategic Prevention Framework (SPF) is a major prevention innovation launched by the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA). The SPF offers a structured, sequential, data-driven approach that explicitly targets environmental conditions in the community and aims for change in substance use and problems at the population level. This paper describes how the ISF was applied to the challenges of implementing the SPF in 14 Rhode Island communities, with a focus on the development of a new Training and Technical Assistance Resources Center to support SPF efforts. More specifically, we (1) describe each of the three ISF interacting systems as they evolved in Rhode Island; (2) articulate the lines of communication between the three systems; and (3) examine selected evaluation data to understand relationships between training and technical assistance and SPF implementation and outcomes.

Long-Term Ground-Water Levels and Transmissivity in the Blackstone River Basin, Northern Rhode Island

Science.gov (United States)

Eggleston, Jack R.; Church, Peter E.; Barbaro, Jeffrey R.

2007-01-01

Ground water provides about 7.7 million gallons per day, or 28 percent of total water use in the Rhode Island part of the Blackstone River Basin. Primary aquifers in the basin are stratified glacial deposits, composed mostly of sand and gravel along valley bottoms. The ground-water and surface-water system in the Blackstone River Basin is under stress due to population growth, out-of-basin water transfers, industrialization, and changing land-use patterns. Streamflow periodically drops below the Aquatic Base Flow standard, and ground-water withdrawals add to stress on aquatic habitat during low-flow periods. Existing hydrogeologic data were reviewed to examine historical water-level trends and to generate contour maps of water-table altitudes and transmissivity of the sand and gravel aquifer in the Blackstone River Basin in Rhode Island. On the basis of data from four long-term observation wells, water levels appear to have risen slightly in the study area during the past 55 years. Analysis of available data indicates that increased rainfall during the same period is a likely contributor to the water-level rise. Spatial patterns of transmissivity are shown over larger areas and have been refined on the basis of more detailed data coverage as compared to previous mapping studies.

Fibromyalgia is Associated with Impaired Balance and Falls

Science.gov (United States)

Jones, Kim D.; Horak, Fay B.; Winters, Kerri Stone; Morea, Jessica M.; Bennett, Robert M.

2010-01-01

Background/Objective The purpose of this study was to determine whether FM patients differ from matched healthy controls in clinical tests of balance ability and fall frequency. Methods 34 FM patients and 32 age matched controls were administered the Balance Evaluation-Systems Test (BESTest), rated their balance confidence with the Activities-Specific Balance Confidence Scale (ABC) and reported the number of falls in the last 6 months. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess FM severity. Results FM patients had significantly impaired balance in all components of the BESTest compared to controls. They also scored more poorly on balance confidence. Overall fibromyalgia severity (FIQ) correlated significantly with the BESTest, and the ABC scale. The BESTest and ABC correlated significantly with 6 commonly reported FM symptoms (excluding pain). FM patients reported a total of 37 falls over the last six-months compared to 6 falls in healthy controls. Conclusion Fibromyalgia is associated with balance problems and increased fall frequency. Patients were aware of their balance problems. These results suggest that FM may affect peripheral and/or central mechanisms of postural control. Further objective study is needed to identify the relative contributions of neural and musculoskeletal impairments to postural stability in FM, thus providing clinicians with exercise prescriptions that maximize postural stability. PMID:19125137

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

Directory of Open Access Journals (Sweden)

Shimada Hiroyuki

2011-08-01

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

Patient centered fall risk awareness perspectives: clinical correlates and fall risk

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Verghese, Joe

2016-01-01

Background While objective measures to assess risk of falls in older adults have been established; the value of patient self-reports in the context of falls is not known. Objectives To identify clinical correlates of patient centered fall risk awareness, and their validity for predicting falls. Design Prospective cohort study. Setting and Participants 316 non-demented and ambulatory community-dwelling older adults (mean age 78 years, 55% women). Measurements Fall risk awareness was assessed with a two-item questionnaire, which asked participants about overall likelihood and personal risk of falling over the next 12 months. Incident falls were recorded over study follow-up. Results Fifty-three participants (16.8%) responded positively to the first fall risk awareness question about being likely to have a fall in the next 12 months, and 100 (31.6%) reported being at personal risk of falling over the next 12 months. There was only fair correlation (kappa 0.370) between responses on the two questions. Prior falls and depressive symptoms were associated with positive responses on both fall risk awareness questions. Age and other established fall risk factors were not associated with responses on both fall risk awareness questions. The fall risk awareness questionnaire did not predict incident falls or injurious falls. Conclusion Fall risk awareness is low in older adults. While patient centered fall risk awareness is not predictive of falls, subjective risk perceptions should be considered when designing fall preventive strategies as they may influence participation and behaviors. PMID:27801936

NOAA Digital Oblique Imagery Collection for the Coasts of Main/New Hampshire, Massachusetts/Rhode Island/Connecticut, and Hudson River/Long Island /NY/NJ

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Project: NOAA Digital Orthophotography and Ancillary Oblique Imagery Collection for the Coasts of Main/New Hampshire, Massachusetts/Rhode Island/Connecticut, and...

Fall-related activity avoidance in relation to a history of falls or near falls, fear of falling and disease severity in people with Parkinson's disease.

Science.gov (United States)

Kader, Manzur; Iwarsson, Susanne; Odin, Per; Nilsson, Maria H

2016-06-02

There is limited knowledge concerning fall-related activity avoidance in people with Parkinson's disease (PD); such knowledge would be of importance for the development of more efficient PD-care and rehabilitation. This study aimed to examine how fall-related activity avoidance relates to a history of self-reported falls/near falls and fear of falling (FOF) as well as to disease severity in people with PD. Data were collected from 251 (61 % men) participants with PD; their median (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A self-administered postal survey preceded a home visit which included observations, clinical tests and interview-administered questionnaires. Fall-related activity avoidance was assessed using the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) as well as by using a dichotomous (Yes/No) question. Further dichotomous questions concerned: the presence of FOF and the history (past 6 months) of falls or near falls, followed by stating the number of incidents. Disease severity was assessed according to the Hoehn and Yahr (HY) stages. In the total sample (n = 251), 41 % of the participants reported fall-related activity avoidance; the median mSAFFE score was 22. In relation to a history of fall, the proportions of participants (p fall-related activity avoidance were: non-fallers (30 %), single fallers (50 %) and recurrent fallers, i.e. ≥ 2 falls (57 %). Among those that reported near falls (but no falls), 51 % (26 out of 51) reported fall-related activity avoidance. Of those that reported FOF, 70 % reported fall-related activity avoidance. Fall-related activity avoidance ranged from 24 % in the early PD-stage (HY I) to 74 % in the most severe stages (HY IV-V). Results indicate that fall-related activity avoidance may be related to a history of self-reported falls/near falls, FOF and disease severity in people with PD. Importantly, fall-related activity avoidance is

Mitigating fall risk: A community fall reduction program.

Science.gov (United States)

Reinoso, Humberto; McCaffrey, Ruth G; Taylor, David W M

One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening. Copyright © 2017 Elsevier Inc. All rights reserved.

Person-Centered Fall Risk Awareness Perspectives: Clinical Correlates and Fall Risk.

Science.gov (United States)

Verghese, Joe

2016-12-01

To identify clinical correlates of person-centered fall risk awareness and their validity for predicting falls. Prospective cohort study. Community. Ambulatory community-dwelling older adults without dementia (N = 316; mean age 78, 55% female). Fall risk awareness was assessed using a two-item questionnaire that asked participants about overall likelihood of someone in their age group having a fall and their own personal risk of falling over the next 12 months. Incident falls were recorded over study follow-up. Fifty-three participants (16.8%) responded positively to the first fall risk awareness question about being likely to have a fall in the next 12 months, and 100 (31.6%) reported being at personal risk of falling over the next 12 months. There was only fair correlation (κ = 0.370) between responses on the two questions. Prior falls and depressive symptoms were associated with positive responses on both fall risk awareness questions. Age and other established fall risk factors were not associated with responses on either fall risk awareness question. The fall risk awareness questionnaire did not predict incident falls or injurious falls. Fall risk awareness is low in older adults. Although person-centered fall risk awareness is not predictive of falls, subjective risk perceptions should be considered when designing fall preventive strategies because they may influence participation and behaviors. © 2016, Copyright the Author Journal compilation © 2016, The American Geriatrics Society.

Performance Results for Massachusetts and Rhode Island Deep Energy Retrofit Pilot Community

Energy Technology Data Exchange (ETDEWEB)

Gates, C. [Building Science Corporation, Somerville, MA (United States); Neuhauser, K. [Building Science Corporation, Somerville, MA (United States)

2014-03-01

Between December, 2009 and December, 2012, 42 deep energy retrofit (DER) projects were completed through a pilot program sponsored by National Grid and conducted in Massachusetts and Rhode Island. Thirty-seven of these projects were comprehensive retrofits while five were partial DERs, meaning that high performance retrofit was implemented for a single major enclosure component or a limited number of major enclosure components. Building Science Corporation developed a consistent "package" of measures in terms of the performance targeted for major building components. Based on the community experience, this DER package is expected to result in yearly source energy use near 110 MMBtu/year or approximately 40% below the Northeast regional average.

Falls and Fear of Falling After Stroke: A Case-Control Study.

Science.gov (United States)

Goh, Hui-Ting; Nadarajah, Mohanasuntharaam; Hamzah, Norhamizan Binti; Varadan, Parimalaganthi; Tan, Maw Pin

2016-12-01

Falls are common after stroke, with potentially serious consequences. Few investigations have included age-matched control participants to directly compare fall characteristics between older adults with and without stroke. Further, fear of falling, a significant psychological consequence of falls, has only been examined to a limited degree as a risk factor for future falls in a stroke population. To compare the fall history between older adults with and without a previous stroke and to identify the determinants of falls and fear of falling in older stroke survivors. Case-control observational study. Primary teaching hospital. Seventy-five patients with stroke (mean age ± standard deviation, 66 ± 7 years) and 50 age-matched control participants with no previous stroke were tested. Fall history, fear of falling, and physical, cognitive, and psychological function were assessed. A χ 2 test was performed to compare characteristics between groups, and logistic regression was performed to determine the risk factors for falls and fear of falling. Fall events in the past 12 months, Fall Efficacy Scale-International, Berg Balance Scale, Functional Ambulation Category, Fatigue Severity Scale, Montreal Cognitive Assessment, and Patient Healthy Questionnaire-9 were measured for all participants. Fugl-Meyer Motor Assessment was used to quantify severity of stroke motor impairments. Twenty-three patients and 13 control participants reported at least one fall in the past 12 months (P = .58). Nine participants with stroke had recurrent falls (≥2 falls) compared with none of the control participants (P falling than did nonstroke control participants (P falls in the nonstroke group, whereas falls in the stroke group were not significantly associated with any measured outcomes. Fear of falling in the stroke group was associated with functional ambulation level and balance. Functional ambulation level alone explained 22% of variance in fear of falling in the stroke group

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

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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 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.

Fall Down Detection Under Smart Home System.

Science.gov (United States)

Juang, Li-Hong; Wu, Ming-Ni

2015-10-01

Medical technology makes an inevitable trend for the elderly population, therefore the intelligent home care is an important direction for science and technology development, in particular, elderly in-home safety management issues become more and more important. In this research, a low of operation algorithm and using the triangular pattern rule are proposed, then can quickly detect fall-down movements of humanoid by the installation of a robot with camera vision at home that will be able to judge the fall-down movements of in-home elderly people in real time. In this paper, it will present a preliminary design and experimental results of fall-down movements from body posture that utilizes image pre-processing and three triangular-mass-central points to extract the characteristics. The result shows that the proposed method would adopt some characteristic value and the accuracy can reach up to 90 % for a single character posture. Furthermore the accuracy can be up to 100 % when a continuous-time sampling criterion and support vector machine (SVM) classifier are used.

Native Bee Diversity and Pollen Foraging Specificity in Cultivated Highbush Blueberry (Ericaceae: Vaccinium corymbosum) in Rhode Island.

Science.gov (United States)

Scott, Zachary; Ginsberg, Howard S; Alm, Steven R

2016-12-01

We identified 41 species of native bees from a total of 1,083 specimens collected at cultivated highbush blueberry plantings throughout Rhode Island in 2014 and 2015. Andrena spp., Bombus spp., and Xylocopa virginica (L.) were collected most often. Bombus griseocollis (DeGeer), B. impatiens Cresson, B. bimaculatus Cresson, B. perplexus Cresson, and Andrena vicina Smith collected the largest mean numbers of blueberry pollen tetrads. The largest mean percent blueberry pollen loads were carried by the miner bees Andrena bradleyi Viereck (91%), A. carolina Viereck (90%), and Colletes validus Cresson (87%). The largest mean total pollen grain loads were carried by B. griseocollis (549,844), B. impatiens (389,558), X. virginica (233,500), and B. bimaculatus (193,132). Xylocopa virginica was the fourth and fifth most commonly collected bee species in 2014 and 2015, respectively. They exhibit nectar robbing and females carried relatively low blueberry pollen loads (mean 33%). Overall, we found 10 species of bees to be the primary pollinators of blueberries in Rhode Island. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Fear of falling as seen in the Multidisciplinary falls consultation.

Science.gov (United States)

Gaxatte, C; Nguyen, T; Chourabi, F; Salleron, J; Pardessus, V; Delabrière, I; Thévenon, A; Puisieux, F

2011-06-01

Fear of falling may be as debilitating as the fall itself, leading to a restriction in activities and even a loss of autonomy. The main objective was to evaluate the prevalence of the fear of falling among elderly fallers. The secondary objectives were to determine the factors associated with the fear of falling and evaluate the impact of this fear on the activity "getting out of the house". Prospective study conducted between 1995 and 2006 in which fallers and patients at high risk for falling were seen at baseline by the multidisciplinary falls consultation team (including a geriatrician, a neurologist and a physical medicine and rehabilitation physician) and then, again 6 month later, by the same geriatrician. The fear of falling was evaluated with a yes/no question: "are you afraid of falling?". Out of 635 patients with a mean age of 80.6 years, 502 patients (78%) expressed a fear of falling. Patients with fear of falling were not older than those who did not report this fear, but the former were mostly women (Pfear of falling were not going out alone as much as the fearless group (31% vs 53%, Pfearful group admitted to avoiding going out because they were afraid of falling. The strong prevalence of the fear of falling observed in this population and its consequences in terms of restricted activities justifies systematically screening for it in fallers or patients at risk for falling. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Retrospective analysis of heavy metal contamination in Rhode Island based on old and new herbarium specimens.

Science.gov (United States)

Rudin, Sofia M; Murray, David W; Whitfeld, Timothy J S

2017-01-01

Herbarium specimens may provide a record of past environmental conditions, including heavy metal pollution. To explore this potential, we compared concentrations of copper, lead, and zinc in historical and new collections from four sites in Rhode Island, USA. We compared historical specimens (1846 to 1916) to congener specimens collected in 2015 at three former industrial sites in Providence, Rhode Island, and one nonindustrial site on Block Island. Leaf material was prepared by UltraWAVE SRC Microwave Digestion, and heavy metal concentrations were measured by inductively coupled plasma-atomic emission spectroscopy. Heavy metal concentrations in the historical and new specimens were measurable for all elements tested, and levels of copper and zinc were comparable in the historical and 2015 collections. By contrast, the concentration of lead declined at all sites over time. Significant variability in heavy metal concentration was observed between taxa, reflecting their varied potential for elemental accumulation. It seems clear that herbarium specimens can be used to evaluate past levels of pollution and assess local environmental changes. With careful sampling effort, these specimens can be a valuable part of environmental science research. Broadening the possible applications for herbarium collections in this way increases their relevance in an era of reduced funding for collections-based research.

APPARENT DIGESTIBILITY OF RHODE ISLAND RED HEN DIETS CONTAINING Leucaena leucocephala AND Moringa oleifera LEAF MEALS

Directory of Open Access Journals (Sweden)

Khaled Abouelezz Fouad Mohammed

2012-05-01

Full Text Available This study consisted of two trials aimed to evaluate the dietary digestibility by Rhode Island Red (RIR hens' fed on different levels of Leucaena leucocephala (LLM or Moringa oleifera (MOLM. In each experiment, thirty six Rhode Island Red hens at 36 weeks of age were randomly divided into four groups each of nine birds which were allocated in individual cages. The four groups were corresponded to four dietary treatments containing 0 (control, 5, 10 and 15 % of LLM (Exp 1 or MOLM (Exp 2. All groups received smashed diets containing similar metabolizable energy and crude protein (16% CP and 2900 kcal ME/kg diet, as fed basis. The hens were fed the experimental diets for six weeks and during the last four days, feed intake was individually recorded every day and excreta was totally collected twice daily and weighed individually. Considerable amounts of CP were found in LLM (23.61% DM and MOLM (19.76% DM. The dietary treatments had no significant effect on the intake of dry matter (DM, organic matter (OM, gross energy (GE, crude protein (CP or neutral detergent fiber (NDF in both experiments, while the acid detergent fibers (ADF consumption increased linearly (P

Falling and fall risk in adult patients with severe haemophilia.

Science.gov (United States)

Rehm, Hanna; Schmolders, Jan; Koob, Sebastian; Bornemann, Rahel; Goldmann, Georg; Oldenburg, Johannes; Pennekamp, Peter; Strauss, Andreas C

2017-05-10

The objective of this study was to define fall rates and to identify possible fall risk factors in adult patients with severe haemophilia. 147 patients with severe haemophilia A and B were evaluated using a standardized test battery consisting of demographic, medical and clinical variables and fall evaluation. 41 (27.9 %) patients reported a fall in the past 12 months, 22 (53.7 %) of them more than once. Young age, subjective gait insecurity and a higher number of artificial joints seem to be risk factors for falling. Falls seem to be a common phenomenon in patients with severe haemophilia. Fall risk screening and fall prevention should be implemented into daily practice.

The Forests of Southern New England, 2007: A report on the forest resources of Connecticut, Massachusetts, and Rhode Island

Science.gov (United States)

Brett J. Butler; Charles J. Barnett; Susan J. Crocker; Grant M. Domke; Dale Gormanson; William N. Hill; Cassandra M. Kurtz; Tonya Lister; Christopher Martin; Patrick D. Miles; Randall Morin; W. Keith Moser; Mark D. Nelson; Barbara O' Connell; Bruce Payton; Charles H. Perry; Ronald J. Piva; Rachel Riemann; Christopher W. Woodall

2011-01-01

This report summarizes the results of the fifth forest inventory of the forests of Southern New England, defined as Connecticut, Massachusetts, and Rhode Island, conducted by the U.S. Forest Service, Forest Inventory and analysis program. Information on forest attributes, ownership, land use change, carbon, timber products, forest health, and statistics and quality...

Overview of the Plio-Pleistocene geology of Rhodes, Greece. Lithology, calcareous nannofossil biostratigraphy, and sampling of the Kallithea Bay section

DEFF Research Database (Denmark)

Thomsen, Erik; Rasmussen, Tine Lander; Hastrup, Annette

2005-01-01

The Kallithea Bay section on the east coast of Rhodes represents an overall transgressive succession ranging from fluviatile and brackish water gravel at the base to deep-water marl at the top. The brackish water and near-shore deposits are assigned to the Kritika Formation, while the deep-water ...

Fiscal Year 1988 program report: Rhode Island Water Resources Center

International Nuclear Information System (INIS)

Poon, C.P.C.

1989-07-01

The State of Rhode Island is active in water resources planning, development, and management activities which include legislation, upgrading of wastewater treatment facilities, upgrading and implementing pretreatment programs, protecting watersheds and aquifers throughout the state. Current and anticipated state water problems are contamination and clean up of aquifers to protect the valuable groundwater resources; protection of watersheds by controlling non-point source pollution; development of pretreatment technologies; and deterioring groundwater quality from landfill leachate or drainage from septic tank leaching field. Seven projects were included covering the following subjects: (1) Radon and its nuclei parents in bedrocks; (2) Model for natural flushing of aquifer; (3) Microbial treatment of heavy metals; (4) Vegetative uptake of nitrate; (5) Microbial process in vegetative buffer strips; (6) Leachate characterization in landfills; and (7) Electrochemical treatment of heavy metals and cyanide

Magnitude of flood flows for selected annual exceedance probabilities in Rhode Island through 2010

Science.gov (United States)

Zarriello, Phillip J.; Ahearn, Elizabeth A.; Levin, Sara B.

2012-01-01

Heavy persistent rains from late February through March 2010 caused severe widespread flooding in Rhode Island that set or nearly set record flows and water levels at many long-term streamgages in the State. In response, the U.S. Geological Survey, in partnership with the Federal Emergency Management Agency, conducted a study to update estimates of flood magnitudes at streamgages and regional equations for estimating flood flows at ungaged locations. This report provides information needed for flood plain management, transportation infrastructure design, flood insurance studies, and other purposes that can help minimize future flood damages and risks. The magnitudes of floods were determined from the annual peak flows at 43 streamgages in Rhode Island (20 sites), Connecticut (14 sites), and Massachusetts (9 sites) using the standard Bulletin 17B log-Pearson type III method and a modification of this method called the expected moments algorithm (EMA) for 20-, 10-, 4-, 2-, 1-, 0.5-, and 0.2-percent annual exceedance probability (AEP) floods. Annual-peak flows were analyzed for the period of record through the 2010 water year; however, records were extended at 23 streamgages using the maintenance of variance extension (MOVE) procedure to best represent the longest period possible for determining the generalized skew and flood magnitudes. Generalized least square regression equations were developed from the flood quantiles computed at 41 streamgages (2 streamgages in Rhode Island with reported flood quantiles were not used in the regional regression because of regulation or redundancy) and their respective basin characteristics to estimate magnitude of floods at ungaged sites. Of 55 basin characteristics evaluated as potential explanatory variables, 3 were statistically significant—drainage area, stream density, and basin storage. The pseudo-coefficient of determination (pseudo-R2) indicates these three explanatory variables explain 95 to 96 percent of the variance

The falls and the fear of falling among elderly institutionalized

Directory of Open Access Journals (Sweden)

Patrícia Almeida

2013-06-01

Full Text Available In the present study it is intended to characterize the history of falls and to evaluate the fear to fall in aged institutionalized. The sample is composed for 113 institutionalized aged people, 32 men and 81 women with a average 82,96 ± 7,03 age of years. The data had been collected by means of a questionnaire and statistical analyzed (descriptive statistics, parametric tests - Test T and Anova - Test U-Mann Whitney, and Test of Kruskal-Wallis – and the Test of Tukey. The results point in the direction of that the women present a bigger number of falls (24.8% and greater fear to fall (Med=55. The falls had occurred in its majority in the context of the room of the institutions. It was verified that people who had at least a fall experience present greater fear to fall comparatively (Med=55 with that they had not the same had no incident of fall in period of time (Med=77. Our results come to strengthen the hypothesis of the changeable sex to be able to be considered a factor of fall risk. Aged that they present a history of falls seems to be more vulnerable to develop the fear to fall.

Archive of Geosample Data and Information from the University of Rhode Island (URI) Graduate School of Oceanography (GSO), Marine Geological Samples Laboratory (MGSL)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Marine Geological Samples Laboratory (MGSL) of the Graduate School of Oceanography (GSO), University of Rhode Island is a partner in the Index to Marine and...

On the wind power rejection in the islands of Crete and Rhodes

International Nuclear Information System (INIS)

Katsaprakakis, Dimitris Al.; Papadakis, Nikos; Christakis, Dimitris G.; Zervos, Arthouros

2007-01-01

Crete and Rhodes represent the two biggest isolated power systems in Greece. The energy production in both islands is based on thermal power plants. The annual wind energy rejection percentage is calculated for Crete and Rhodes in this paper. The rejected wind energy is defined as the electric energy produced by the wind turbines and not absorbed by the utility network, mainly due to power production system's stability and dynamic security reasons. A parametric calculation of the annual wind energy rejection percentage, in terms of the installed wind power, the power demand and the maximum allowed wind power instant penetration percentage, is accomplished. The methodology takes into account (i) the wind power penetration probability, restricted by the thermal generators technical minima and the maximum allowed wind power instant penetration percentage over the instant power demand; and (ii) the wind power production probability, derived by the islands' wind potential. The present paper indicates that isolated power systems which are based on thermal power plants have a limited wind power installation capacity - in order to achieve and maintain an adequate level of system stability. For a maximum wind power instant penetration percentage of 30% of the power demand, in order to ensure an annual wind energy rejection percentage less than 10%, the total installed wind power should not exceed the 40% of the mean annual power demand. The results of this paper are applicable to medium and great size isolated power systems, with particular features: (i) the power production is based on thermal power plants; (ii) the power demand exhibits intensive seasonal variations and is uncorrelated to the wind data; (iii) the mean annual power demand is greater than 10MW; and (iv) a high wind potential, presenting mean annual wind velocity values greater than 7.5ms-1, is recorded. (Author)

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

Science.gov (United States)

Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

Significant vestibular system impairment is common in a cohort of elderly patients referred for assessment of falls risk.

Science.gov (United States)

Jacobson, Gary P; McCaslin, Devin L; Grantham, Sarah L; Piker, Erin G

2008-01-01

Falls in elderly patients are associated with morbidity, mortality, and cost to the healthcare system. The development of falls risk assessment programs have represented a method of responding to what is known about injurious falls. The multidimensional assessments involve the comparison against normative data of a patient's performance on metrics known to influence the likelihood of future falls. The factors assessed usually include falls and medication history, measures of mentation, depression, orthostatic hypotension, simple or choice reaction time, gait stability, postural stability, and the integrity of the patient's vision, somesthetic, and vestibular senses. This investigation was conducted to measure the proportion of patients referred for falls risk assessment who have evidence of vestibular system impairment. Qualitative, retrospective review of data collected from 2003 to 2007. The cohort was 185 consecutive patients referred for multidimensional assessments of falls risk. Patients underwent quantitative assessments of peripheral and central vestibular system function consisting of electro- or videonystagmography (i.e., ENG/VNG), and sinusoidal harmonic acceleration testing. Results of these tests were compared to normative data. We found that 73% of the sample who underwent vestibular system assessment had quantitative evidence of either peripheral or central vestibular system impairment. Our results suggest that quantitative assessments of the vestibulo-ocular reflex should be conducted on patients who are evaluated for falls risk. These examinations should include at least caloric testing and, where available, rotational testing.

A piece of paper falling faster than free fall

International Nuclear Information System (INIS)

Vera, F; Rivera, R

2011-01-01

We report a simple experiment that clearly demonstrates a common error in the explanation of the classic experiment where a small piece of paper is put over a book and the system is let fall. This classic demonstration is used in introductory physics courses to show that after eliminating the friction force with the air, the piece of paper falls with acceleration g. To test if the paper falls behind the book in a nearly free fall motion or if it is dragged by the book, we designed a version of this experiment that includes a ball and a piece of paper over a book that is forced to fall using elastic cords. We recorded a video of our experiment using a high-speed video camera at 300 frames per second that shows that the book and the paper fall faster than the ball, which falls well behind the book with an acceleration approximately equal to g. Our experiment shows that the piece of paper is dragged behind the book and therefore the paper and book demonstration should not be used to show that all objects fall with acceleration g independently of their mass.

A piece of paper falling faster than free fall

Energy Technology Data Exchange (ETDEWEB)

Vera, F; Rivera, R, E-mail: fvera@ucv.cl [Instituto de Fisica, Pontificia Universidad Catolica de ValparaIso, Av. Universidad 330, Curauma, ValparaIso (Chile)

2011-09-15

We report a simple experiment that clearly demonstrates a common error in the explanation of the classic experiment where a small piece of paper is put over a book and the system is let fall. This classic demonstration is used in introductory physics courses to show that after eliminating the friction force with the air, the piece of paper falls with acceleration g. To test if the paper falls behind the book in a nearly free fall motion or if it is dragged by the book, we designed a version of this experiment that includes a ball and a piece of paper over a book that is forced to fall using elastic cords. We recorded a video of our experiment using a high-speed video camera at 300 frames per second that shows that the book and the paper fall faster than the ball, which falls well behind the book with an acceleration approximately equal to g. Our experiment shows that the piece of paper is dragged behind the book and therefore the paper and book demonstration should not be used to show that all objects fall with acceleration g independently of their mass.

First Report of Outbreaks of the Fall Armyworm Spodoptera frugiperda (J E Smith) (Lepidoptera, Noctuidae), a New Alien Invasive Pest in West and Central Africa.

Science.gov (United States)

Goergen, Georg; Kumar, P Lava; Sankung, Sagnia B; Togola, Abou; Tamò, Manuele

2016-01-01

The fall armyworm Spodoptera frugiperda is a prime noctuid pest of maize on the American continents where it has remained confined despite occasional interceptions by European quarantine services in recent years. The pest has currently become a new invasive species in West and Central Africa where outbreaks were recorded for the first time in early 2016. The presence of at least two distinct haplotypes within samples collected on maize in Nigeria and São Tomé suggests multiple introductions into the African continent. Implications of this new threat to the maize crop in tropical Africa are briefly discussed.

75 FR 65658 - Importer of Controlled Substances; Notice of Application

Science.gov (United States)

2010-10-26

..., and coca leaves. As explained in the Correction to Notice of Application pertaining to Rhodes... DEA to manufacture such basic classes of controlled substances listed in schedule I or II, which fall...

76 FR 35241 - Importer of Controlled Substances; Notice of Application

Science.gov (United States)

2011-06-16

..., and coca leaves. As explained in the Correction to Notice of Application pertaining to Rhodes... DEA to manufacture such basic classes of controlled substances listed in schedule I or II, which fall...

Retrospective analysis of heavy metal contamination in Rhode Island based on old and new herbarium specimens1

Science.gov (United States)

Rudin, Sofia M.; Murray, David W.; Whitfeld, Timothy J. S.

2017-01-01

Premise of the study: Herbarium specimens may provide a record of past environmental conditions, including heavy metal pollution. To explore this potential, we compared concentrations of copper, lead, and zinc in historical and new collections from four sites in Rhode Island, USA. Methods: We compared historical specimens (1846 to 1916) to congener specimens collected in 2015 at three former industrial sites in Providence, Rhode Island, and one nonindustrial site on Block Island. Leaf material was prepared by UltraWAVE SRC Microwave Digestion, and heavy metal concentrations were measured by inductively coupled plasma–atomic emission spectroscopy. Results: Heavy metal concentrations in the historical and new specimens were measurable for all elements tested, and levels of copper and zinc were comparable in the historical and 2015 collections. By contrast, the concentration of lead declined at all sites over time. Significant variability in heavy metal concentration was observed between taxa, reflecting their varied potential for elemental accumulation. Discussion: It seems clear that herbarium specimens can be used to evaluate past levels of pollution and assess local environmental changes. With careful sampling effort, these specimens can be a valuable part of environmental science research. Broadening the possible applications for herbarium collections in this way increases their relevance in an era of reduced funding for collections-based research. PMID:28090410

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

Science.gov (United States)

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.

Macroeconomic Stabilization When the Natural Real Interest Rate Is Falling

Science.gov (United States)

Buttet, Sebastien; Roy, Udayan

2015-01-01

The authors modify the Dynamic Aggregate Demand-Dynamic Aggregate Supply model in Mankiw's widely used intermediate macroeconomics textbook to discuss monetary policy when the natural real interest rate is falling over time. Their results highlight a new role for the central bank's inflation target as a tool of macroeconomic stabilization. They…

Attitudinal Factors and Personal Characteristics Influence Support for Shellfish Aquaculture in Rhode Island (US) Coastal Waters.

Science.gov (United States)

Dalton, Tracey M; Jin, Di

2018-05-01

This study explores public interests associated with shellfish aquaculture development in coastal waters of Rhode Island (US). Specifically, we examine (1) the levels of public support for (or opposition to) shellfish aquaculture development and (2) factors driving the levels of support, using survey data and ordinal logistic regressions. Results of the analysis identify several key attitudinal factors affecting individual's support for shellfish aquaculture in Rhode Island (RI). The level of support is positively associated with attitudes related to shellfish aquaculture's benefits to the local economy and its role as a nutritional food option, and negatively influenced by attitudes related to aquaculture farms' effects on aesthetic quality and their interference with other uses. Findings highlight that support for (or opposition to) aquaculture in RI is driven more by attitudes associated with social impacts than by those associated with environmental impacts. The level of support is also affected by personal characteristics related to an individual's participation in recreational activities. For instance, bicycle riders tend to be supportive of shellfish aquaculture while respondents who participate in sailing and birding are less supportive. By identifying the broader public's interests in shellfish aquaculture, findings from this study and others like it can be used to address public concerns, incorporate public perceptions and attitudes into permitting decisions, and develop outreach targeted at specific stakeholder groups.

Falling chains

OpenAIRE

Wong, Chun Wa; Yasui, Kosuke

2005-01-01

The one-dimensional fall of a folded chain with one end suspended from a rigid support and a chain falling from a resting heap on a table is studied. Because their Lagrangians contain no explicit time dependence, the falling chains are conservative systems. Their equations of motion are shown to contain a term that enforces energy conservation when masses are transferred between subchains. We show that Cayley's 1857 energy nonconserving solution for a chain falling from a resting heap is inco...

Pawtuxet River, Warwick, Rhode Island. Local Flood Damage Reduction Study. Detailed Project Report for Water Resources Development.

Science.gov (United States)

1982-06-01

Warwich (Belmont Park) Rhode Island. Cover Title Reads: Flood Damage Reduction IS. KEY WORDS (Ce൘.. asm towvee aide of mogoseem aid 1~110j IV MeMAw...cost of the premium paid by policy holders. The actual premium is less than the actuarial rate by the amount of the subsidy which represents one facet...coverage limits, therefore it was not necessary to calculate additional coverage premiums based on actuarial rates. The annual average subsidized

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

Science.gov (United States)

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.

Increasing fall risk awareness using wearables: A fall risk awareness protocol.

Science.gov (United States)

Danielsen, Asbjørn; Olofsen, Hans; Bremdal, Bernt Arild

2016-10-01

Each year about a third of elderly aged 65 or older experience a fall. Many of these falls may have been avoided if fall risk assessment and prevention tools where available in a daily living situation. We identify what kind of information is relevant for doing fall risk assessment and prevention using wearable sensors in a daily living environment by investigating current research, distinguishing between prospective and context-aware fall risk assessment and prevention. Based on our findings, we propose a fall risk awareness protocol as a fall prevention tool integrating both wearables and ambient sensing technology into a single platform. Copyright © 2016. Published by Elsevier Inc.

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

OpenAIRE

Shimada, Hiroyuki; Suzukawa, Megumi; Ishizaki, Tatsuro; Kobayashi, Kumiko; Kim, Hunkyung; Suzuki, Takao

2011-01-01

Abstract Background Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people. Methods The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotom...

Libraries, The locations and contact information for academic, private and public libraries in Rhode Island. The intention of this dataset was to provide an overview of data. Additional information pertinent to the state is also available from the RI Department of, Published in 2007, 1:4800 (1in=400ft) scale, Rhode Island and Providence Plantations.

Data.gov (United States)

NSGIC State | GIS Inventory — Libraries dataset current as of 2007. The locations and contact information for academic, private and public libraries in Rhode Island. The intention of this dataset...

Fall Protection Introduction, #33462

Energy Technology Data Exchange (ETDEWEB)

Chochoms, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-06-23

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

The clinical practice guideline for falls and fall risk

OpenAIRE

Vance, Jacqueline

2011-01-01

Falling is a significant cause of injury and death in frail older adults. Residents in long-term care (LTC) facilities fall for a variety of reasons and are more likely to endure injuries after a fall than those in the community The American Medical Directors Association (AMDA) Clinical Practice Guideline is written to give LTC staff an understanding of risk factors for falls and provide guidance for a systematic approach to patient assessment and selection of appropriate interventions. It is...

Prediction of falls and/or near falls in people with mild Parkinson's disease.

Directory of Open Access Journals (Sweden)

Beata Lindholm

Full Text Available To determine factors associated with future falls and/or near falls in people with mild PD.The study included 141 participants with PD. Mean (SD age and PD-duration were 68 (9.7 and 4 years (3.9, respectively. Their median (q1-q3 UPDRS III score was 13 (8-18. Those >80 years of age, requiring support in standing or unable to understand instructions were excluded. Self-administered questionnaires targeted freezing of gait, turning hesitations, walking difficulties in daily life, fatigue, fear of falling, independence in activities of daily living, dyskinesia, demographics, falls/near falls history, balance problems while dual tasking and pain. Clinical assessments addressed functional balance performance, retropulsion, comfortable gait speed, motor symptoms and cognition. All falls and near falls were subsequently registered in a diary during a six-month period. Risk factors for prospective falls and/or near falls were determined using logistic regression.Sixty-three participants (45% experienced ≥ 1 fall and/or near fall. Three factors were independent predictors of falls and/or near falls: fear of falling (OR = 1.032, p<0.001 history of near falls (OR = 3.475, p = 0.009 and retropulsion (OR = 2.813, p = 0.035. The strongest contributing factor was fear of falling, followed by a history of near falls and retropulsion.Fear of falling seems to be an important issue to address already in mild PD as well as asking about prior near falls.

Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients).

Science.gov (United States)

Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccolò, Marchionni; Andrea, Ungar

2013-01-01

To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65-101). Falls were defined "accidental" (fall explained by a definite accidental cause), "medical" (fall caused directly by a specific medical disease), "dementia-related" (fall in patients affected by moderate-severe dementia), and "unexplained" (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

Do Canes or Walkers Make Any Difference? NonUse and Fall Injuries.

Science.gov (United States)

Luz, Clare; Bush, Tamara; Shen, Xiaoxi

2017-04-01

Examine patterns of cane and walker use as related to falls and fall injuries. Among people who fall at home, most do not have an assistive device with them when they fall. Nonusers who fall sustain more severe injuries. This was a cross-sectional study using a self-administered written survey completed by 262 people aged 60 and older who were community dwelling, cognitively intact, and current cane/walker users with a history of falls. They were recruited through clinical practice sites, churches, and senior housing in central Michigan. Outcomes of interest included patterns of device use, reasons for nonuse, device use at time of fall, and fall-related injuries. Seventy-five percent of respondents who fell were not using their device at the time of fall despite stating that canes help prevent falls. Reasons for nonuse included believing it was not needed, forgetfulness, the device made them feel old, and inaccessibility. Perceived risk was not high enough to engage in self-protective behavior. However, nonuse led to a significantly higher proportion of falls resulting in surgery than among device users. Among respondents requiring surgery, 100% were nonusers. Most respondents never received a home safety evaluation (68%) and only 50% received training on proper device use. Providers must place increased emphasis on the importance of cane/walker use for injury prevention through patient education to promote personal relevance, proper fitting, and training. New strategies are needed to improve device acceptability and accessibility. © The Author 2015. 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.

Increase in Drug Overdose Deaths Involving Fentanyl-Rhode Island, January 2012-March 2014.

Science.gov (United States)

Mercado, Melissa C; Sumner, Steven A; Spelke, M Bridget; Bohm, Michele K; Sugerman, David E; Stanley, Christina

2018-03-01

This study identified sociodemographic, substance use, and multiple opioid prescriber and dispenser risk factors among drug overdose decedents in Rhode Island, in response to an increase in overdose deaths (ODs) involving fentanyl. This cross-sectional investigation comprised all ODs reviewed by Rhode Island's Office of the State Medical Examiners (OSME) during January 2012 to March 2014. Data for 536 decedents were abstracted from OSME's charts, death certificates, toxicology reports, and Prescription Monitoring Program (PMP) databases. Decedents whose cause of death involved illicit fentanyl (N = 69) were compared with decedents whose causes of death did not involve fentanyl (other drug decedents; N = 467). Illicit-fentanyl decedents were younger than other drug decedents (P = 0.005). While more other-drug decedents than illicit fentanyl decedents had postmortem toxicological evidence of consuming heroin (31.9% vs 19.8%, P < 0.001) and various pharmaceutical substances (P = 0.002-0.027), third party reports indicated more recent heroin use among illicit fentanyl decedents (62.3% vs 45.6%, P = 0.002). Approximately 35% of decedents filled an opioid prescription within 90 days of death; of these, one-third had a mean daily dosage greater than 100 morphine milligram equivalents (MME/day). Most decedents' opioid prescriptions were filled at one to two dispensers (83.9%) and written by one to two prescribers (75.8%). Notably, 29.2% of illicit fentanyl and 10.5% of other drug decedents filled prescriptions for buprenorphine, which is used to treat opioid use disorders. Illicit-fentanyl deaths frequently involved other illicit drugs (e.g., cocaine, heroin). The proportion of all decedents acquiring greater than 100 MME/day prescription dosages written and/or filled by few prescribers and dispensers is concerning. To protect patients, prescribers and dispensers should review PMP records and substance abuse history prior to providing opioids.

Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study.

Science.gov (United States)

Jørgensen, Vivien; Butler Forslund, Emelie; Opheim, Arve; Franzén, Erika; Wahman, Kerstin; Hultling, Claes; Seiger, Åke; Ståhle, Agneta; Stanghelle, Johan K; Roaldsen, Kirsti S

2017-04-01

What is the 1-year incidence of falls and injurious falls in a representative cohort of community-dwelling ambulatory individuals with chronic spinal cord injury? What are the predictors of recurrent falls (more than two/year) and injurious falls in this population? One-year longitudinal observational multi-centre study. A representative sample of 68 (of 73 included) community-dwelling ambulatory individuals with traumatic SCI attending regular follow-up programs at rehabilitation centres. Primary outcome measures were incidence and predictors of recurrent falls (more than two/year) and injurious falls reported every 2 weeks for 1year. A total of 48% of participants reported recurrent falls. Of the 272 reported falls, 41% were injurious. Serious injuries were experienced by 4% of participants, all of whom were women. Multivariate logistic regression analysis showed that recurrent falls in the previous year (OR=111, 95% CI=8.6 to 1425), fear of falling (OR=6.1, 95% CI=1.43 to 26) and longer time taken to walk 10m (OR=1.3, 95% CI=1.0 to 1.7) were predictors of recurrent falls. Fear of falling (OR=4.3, 95% CI=1.3 to 14) and recurrent falls in the previous year (OR=4.2, 95% CI=1.2 to 14) were predictors of injurious falls. Ambulatory individuals have a high risk of falling and of fall-related injuries. Fall history, fear of falling and walking speed could predict recurrent falls and injurious falls. Further studies with larger samples are needed to validate these findings. [Jørgensen V, Butler Forslund E, Opheim A, Franzén E, Wahman K, Hultling C, Seiger Å, Ståhle A, Stanghelle JK, Roaldsen KS (2017) Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study. Journal of Physiotherapy 63: 108-113]. Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients

Directory of Open Access Journals (Sweden)

Mussi Chiara

2013-01-01

Full Text Available To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82±7 years, range 65–101. Falls were defined “accidental” (fall explained by a definite accidental cause, “medical” (fall caused directly by a specific medical disease, “dementia-related” (fall in patients affected by moderate-severe dementia, and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause. According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

After the Fall: A Conflict Management Program to Foster Open Society

Science.gov (United States)

Shapiro, Daniel L.

2004-01-01

The fall of the Berlin Wall rocked the sociopolitical equilibrium of eastern and central Europe. Communism lost its grip over much of Europe. The USSR, Yugoslavia, and Czechoslovakia divided along ethnic, religious, and historical lines. Ethnopolitical tensions surfaced across the region, and in Yugoslavia, tensions combusted. Whereas democracy…

Associated Factors for Falls, Recurrent Falls, and Injurious Falls in Aged Men Living in Taiwan Veterans Homes

Directory of Open Access Journals (Sweden)

Yan-Chiou Ku

2013-06-01

Conclusion: This study demonstrated that the advanced age, depression status, stroke, gouty arthritis, and cataract are independent variables for predicting falls; depression is the only clinical factor capable of predicting the recurrent falls. These variables were potential targets for effective prevention of falls.

Central oxygen pipeline failure

African Journals Online (AJOL)

surgical intensive care unit (ICU), with two patients on full ventilation and ... uncertainty around the cause of the failure and the restoration, .... soon as its level also falls below three tons. Should ... (properly checked and closed prior to each anaesthetic). ... in use at the time of the central oxygen pipeline failure at Tygerberg.

Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study

Directory of Open Access Journals (Sweden)

Vivien Jørgensen

2017-04-01

Conclusion: Ambulatory individuals have a high risk of falling and of fall-related injuries. Fall history, fear of falling and walking speed could predict recurrent falls and injurious falls. Further studies with larger samples are needed to validate these findings. [Jørgensen V, Butler Forslund E, Opheim A, Franzén E, Wahman K, Hultling C, Seiger Å, Ståhle A, Stanghelle JK, Roaldsen KS (2017 Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study. Journal of Physiotherapy 63: 108–113

More Rhode Island Adults Have Dental Coverage After the Medicaid Expansion: Did More Adults Receive Dental Services? Did More Dentists Provide Services?

Science.gov (United States)

Zwetchkenbaum, Samuel; Oh, Junhie

2017-10-02

Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].

Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study.

Science.gov (United States)

Carroll, Jennifer J; Marshall, Brandon D L; Rich, Josiah D; Green, Traci C

2017-08-01

Illicit fentanyl use has become wide spread in the US, causing high rates of overdose deaths among people who use drugs. This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island. A mixed methods study was conducted via questionnaire with a convenience sample of 149 individuals using illicit opioids or misusing prescription opioids in Rhode Island between January and November 2016. Of these, 121 knew of fentanyl and reported known or suspected exposure to fentanyl in the past year. Semi-structured interviews were conducted with the first 47 participants. Study participants were predominantly male (64%) and white (61%). Demographic variables were similar across sample strata. Heroin was the most frequently reported drug of choice (72%). Self-reported exposure to illicit fentanyl in the past year was common (50.4%, n=61). In multivariate models, regular (at least weekly) heroin use was independently associated with known or suspected fentanyl exposure in the past year (adjusted prevalence ratio (APR)=4.07, 95% CI: 1.24-13.3, p=0.020). In interviews, users described fentanyl as unpleasant, potentially deadly, and to be avoided. Participants reporting fentanyl exposure routinely experienced or encountered non-fatal overdose. Heroin users reported limited ability to identify fentanyl in their drugs. Harm reduction strategies used to protect themselves from fentanyl exposure and overdose, included test hits, seeking prescription opioids in lieu of heroin, and seeking treatment with combination buprenorphine/naloxone. Participants were often unsuccessful in accessing structured treatment programs. Among illicit opioid users in Rhode Island, known or suspected fentanyl exposure is common, yet demand for fentanyl is low. Fentanyl-contaminated drugs are generating user interest in effective risk mitigation strategies, including treatment. Responses to the fentanyl epidemic should be informed by the perceptions and experiences of

Impact of Fall Prevention on Nurses and Care of Fall Risk Patients.

Science.gov (United States)

King, Barbara; Pecanac, Kristen; Krupp, Anna; Liebzeit, Daniel; Mahoney, Jane

2018-03-19

Falls are common events for hospitalized older adults, resulting in negative outcomes both for patients and hospitals. The Center for Medicare and Medicaid (CMS) has placed pressure on hospital administrators by identifying falls as a "never event", resulting in a zero falls goal for many hospitals. Staff nurses are responsible for providing direct care to patients and for meeting the hospital no falls goal. Little is known about the impact of "zero falls" on nurses, patients and the organization. A qualitative study, using Grounded Dimensional Analysis (GDA) was conducted to explore nurses' experiences with fall prevention in hospital settings and the impact of those experiences on how nurses provide care to fall risk patients. Twenty-seven registered nurses and certified nursing assistants participated in in-depth interviews. Open, axial and selective coding was used to analyze data. A conceptual model which illustrates the impact of intense messaging from nursing administration to prevent patient falls on nurses, actions nurses take to address the message and the consequences to nurses, older adult patients and to the organization was developed. Intense messaging from hospital administration to achieve zero falls resulted in nurses developing a fear of falls, protecting self and unit, and restricting fall risk patients as a way to stop messages and meet the hospital goal. Results of this study identify unintended consequences of fall prevention message on nurses and older adult patients. Further research is needed understand how nurse care for fall risk patients.

77 FR 63312 - Notice of Intent: Designation of an Ocean Dredged Material Disposal Site (ODMDS) in Eastern Long...

Science.gov (United States)

2012-10-16

... Material Disposal Site (ODMDS) in Eastern Long Island Sound; Connecticut, New York, and Rhode Island AGENCY... (ODMDS) to serve the eastern Long Island Sound region (Connecticut, New York, and Rhode Island). SUMMARY... Environmental Impact Statement that supported the designation of the Central and Western Long Island Sound...

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

Science.gov (United States)

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

Falls and falls efficacy: the role of sustained attention in older adults

LENUS (Irish Health Repository)

O'Halloran, Aisling M

2011-12-19

Abstract Background Previous evidence indicates that older people allocate more of their attentional resources toward their gait and that the attention-related changes that occur during aging increase the risk of falls. The aim of this study was to investigate whether performance and variability in sustained attention is associated with falls and falls efficacy in older adults. Methods 458 community-dwelling adults aged ≥ 60 years underwent a comprehensive geriatric assessment. Mean and variability of reaction time (RT), commission errors and omission errors were recorded during a fixed version of the Sustained Attention to Response Task (SART). RT variability was decomposed using the Fast Fourier Transform (FFT) procedure, to help characterise variability associated with the arousal and vigilance aspects of sustained attention. The number of self-reported falls in the previous twelve months, and falls efficacy (Modified Falls Efficacy Scale) were also recorded. Results Significant increases in the mean and variability of reaction time on the SART were significantly associated with both falls (p < 0.01) and reduced falls efficacy (p < 0.05) in older adults. An increase in omission errors was also associated with falls (p < 0.01) and reduced falls efficacy (p < 0.05). Upon controlling for age and gender affects, logistic regression modelling revealed that increasing variability associated with the vigilance (top-down) aspect of sustained attention was a retrospective predictor of falling (p < 0.01, OR = 1.14, 95% CI: 1.03 - 1.26) in the previous year and was weakly correlated with reduced falls efficacy in non-fallers (p = 0.07). Conclusions Greater variability in sustained attention is strongly correlated with retrospective falls and to a lesser degree with reduced falls efficacy. This cognitive measure may provide a novel and valuable biomarker for falls in older adults, potentially allowing for early detection and the implementation of preventative intervention

Sunn hemp as a ground cover to manage fall armyworm populations

Science.gov (United States)

Fall armyworm (FAW), Spodoptera frugiperda, is a serious pest of sweet corn in south Florida and a pest of other vegetable, row, and forage crops in the southeastern, mid-Atlantic, and central U.S. It is a migratory pest, moving north each season from overwintering areas in southern Texas and south...

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

Science.gov (United States)

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 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.

Natural Propagation and Habitat Improvement, Volume 1, Oregon, Supplement B, White River Falls Fish Passage, 1983 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1984-04-01

White River Falls are located in north central Oregon approximately 25 miles south of the City of The Dalles. The project site is characterized by a series of three natural waterfalls with a combined fall of 180 ft. In the watershed above the falls are some 120 miles of mainstem habitat and an undetermined amount of tributary stream habitat that could be opened to anadromous fish, if passage is provided around the falls. The purpose of this project is to determine feasibility of passage, select a passage scheme, and design and construct passage facilities. This report provides information on possible facilities that would pass adult anadromous fish over the White River Falls. 25 references, 29 figures, 12 tables. (ACR)

Siting high-level nuclear waste repositories: A progress report for Rhode Island

International Nuclear Information System (INIS)

Frohlich, R.K.; Vild, B.F.

1986-03-01

In this booklet, we will not try to argue the pros and cons of nuclear power or weapons production. We will focus instead on the issue of nuclear waste disposal. With the passage of the Nuclear Waste Policy Act (NWPA) of 1982, the US Congress and the President charged federal and state regulators with the responsibility of settling that issue by the end of this century - with extensive public involvement. This booklet, now in its second printing, is designed to explain the nature of ''high-level'' nuclear waste, the essential criteria for its safe and permanent disposal, and Rhode Island's participation in the federal repository program. It has been funded from a USDOE grant derived from a utility-financed Nuclear Waste Fund established under the NWPA. 17 refs., 10 figs., 2 tabs

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

Directory of Open Access Journals (Sweden)

Santosh K Verma

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

Southern African Linguistics and Applied Language Studies

African Journals Online (AJOL)

... (e.g. syntax, phonology, semantics) and applied (e.g. sociolinguistic topics, ... Articles in languages other than English are accompanied by an extended English ... language ecologies post #RhodesMustFall at the University of the Free State ...

The Association Between Fall Frequency, Injury Risk, and Characteristics of Falls in Older Residents of Long-Term Care: Do Recurrent Fallers Fall More Safely?

Science.gov (United States)

van Schooten, Kimberley S; Yang, Yijian; Feldman, Fabio; Leung, Ming; McKay, Heather; Sims-Gould, Joanie; Robinovitch, Stephen N

2018-05-09

Although a fall is a necessary prerequisite to a fall-related injury, previous studies suggest that frequent fallers are at lower injury risk for a given fall. We tested the hypotheses that differences in protective responses or the circumstances of falls underlie differences in injury risk with fall frequency. We analyzed video footage of 897 falls experienced by 220 long-term care residents (mean age 82 ± 9 years) to identify the cause of imbalance, activity leading to falling, direction of fall initiation, balance recovery and fall protective responses, and occurrence of impact to the head or hip. We further obtained injury information from the facilities' fall registration. We used generalized estimating equation models to examine the association between quartiles of fall frequency, injury risk, and fall characteristics. Residents with the highest fall frequency group (Q4; ≥5.6 falls/year) were less likely to sustain an injury per fall. They were less likely to fall during walking and more likely to fall during stand-to-sit transfers. Residents in the lowest fall frequency group (Q1; falls/year) were more likely to fall during walking, and walking was associated with an increased risk for injury. When compared to less frequent fallers, more frequent fallers had a lower risk for injury per fall. This appeared to be explained by differences in the circumstances of falls, and not by protective responses. Injury prevention strategies in long-term care should target both frequent and infrequent fallers, as the latter are more mobile and apt to sustain injury.

Falls in multiple sclerosis.

Science.gov (United States)

Matsuda, Patricia N; Shumway-Cook, Anne; Bamer, Alyssa M; Johnson, Shana L; Amtmann, Dagmar; Kraft, George H

2011-07-01

To examine incidence, associated factors, and health care provider (HCP) response to falls in persons with multiple sclerosis (MS). Cross-sectional retrospective design. Community setting. Four hundred seventy-four persons with MS. Mailed survey questionnaire examined incidence, risk factors, and HCP response to falls in persons with MS who were dwelling in the community. Univariate and multiple ordinal regression analysis identified variables associated with single and multiple falls. Falls, causes and perceived reasons for falls, and HCP response. A total of 265 participants (58.2%) reported one or more falls in the previous 6 months, and 58.5% of falls were medically injurious. Trips/slips while walking accounted for 48% of falls. Factors associated with falls included use of a cane or walker (odds ratio [OR] 2.62; 95% confidence interval [CI] 1.66-4.14), income falls; recommended strategies included safety strategies (53.2%), use of gait assistive devices (42.1%), exercise/balance training (22.2%), and home modifications (16.6%). Factors associated with falls in persons with MS are similar to those in other populations with neurologic diseases. Despite the high incidence of falls, fewer than 50% of people with MS receive information about prevention of falls from an HCP. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Exploring Older Adult ED Fall Patients' Understanding of Their Fall: A Qualitative Study.

Science.gov (United States)

Shankar, Kalpana N; Taylor, Devon; Rizzo, Caroline T; Liu, Shan W

2017-12-01

We sought to understand older patients' perspectives about their fall, fall risk factors, and attitude toward emergency department (ED) fall-prevention interventions. We conducted semistructured interviews between July 2015 and January 2016 of community-dwelling, nondemented patients in the ED, who presented with a fall to an urban, teaching hospital. Interviews were halted once we achieve thematic saturation with the data coded and categorized into themes. Of the 63 patients interviewed, patients blamed falls on the environment, accidents, a medical condition, or themselves. Three major themes were generated: (1) patients blamed falls on a multitude of things but never acknowledged a possible multifactorial rationale, (2) patients have variable level of concerns regarding their current fall and future fall risk, and (3) patients demonstrated a range of receptiveness to ED interventions aimed at preventing falls but provided little input as to what those interventions should be. Many older patients who fall do not understand their fall risk. However, based on the responses provided, older adults tend to be more receptive to intervention and more concerned about their future fall risk, making the ED an appropriate setting for intervention.

Nutrient, suspended sediment, and trace element loads in the Blackstone River Basin in Massachusetts and Rhode Island, 2007 to 2009

Science.gov (United States)

Zimmerman, Marc J.; Waldron, Marcus C.; DeSimone, Leslie A.

2015-01-01

Nutrients, suspended sediment, and trace element loads in the Blackstone River and selected tributaries were estimated from composite water-quality samples in order to better understand the distribution and sources of these constituents in the river basin. The flow-proportional composite water-quality samples were collected during sequential 2-week periods at six stations along the river’s main stem, at three stations on tributaries, and at four wastewater treatment plants in the Massachusetts segment of the basin from June 2007 to September 2009. Samples were collected at an additional station on the Blackstone River near the mouth in Pawtucket, Rhode Island, from September 2008 to September 2009. The flow-proportional composite samples were used to estimate average daily loads during the sampling periods; annual loads for water years 2008 and 2009 also were estimated for the monitoring station on the Blackstone River near the Massachusetts-Rhode Island border. The effects of hydrologic conditions and net attenuation of nitrogen were investigated for loads in the Massachusetts segment of the basin. Sediment resuspension and contaminant loading dynamics were evaluated in two Blackstone River impoundments, the former Rockdale Pond (a breached impoundment) and Rice City Pond.

Technical progress report: Rhode Island crystalline repository project, calendar year 1985

International Nuclear Information System (INIS)

Vild, B.F.

1985-01-01

A Nuclear Waste Fund established by the Nuclear Waste Policy Act of 1982 provides financial support to affected states to participate in the high-level radioactive waste repository siting program of the US Department of Energy. In Rhode Island, that function is performed by a multidisciplinary Project Review Team consisting of staff from three State agencies. Members of the Review Team attended several meetings in 1985 to voice their concerns directly to DOE. Written comments were also submitted on draft plans and reports. Among the issues raised were inconsistencies in the geologic and environmental data used to screen potential repository sites, the role of Monitored Retrievable Storage (MRS) in the repository program, and regulations regarding the transportation and storage of nuclear waste. The Review Team also began work on a public information booklet describing the repository program in nontechnical terms. That booklet will be distributed widely upon completion

Medication use and fall-risk assessment for falls in an acute care hospital.

Science.gov (United States)

Chiu, Ming-Huang; Lee, Hsin-Dai; Hwang, Hei-Fen; Wang, Shih-Chieh; Lin, Mau-Roung

2015-07-01

A nested case-control study was carried out to examine relationships of a fall-risk score and the use of single medications and polypharmacy with falls among hospitalized patients aged 50 years and older in Taiwan. There were 83 patients who experienced a fall during hospitalization in an acute-care hospital. Matched by age and sex, five control patients for each case were randomly selected from all other inpatients who had not experienced any fall at the time of the index fall. Patients who took tricyclic antidepressants, diuretics, and narcotics were 3.36-, 1.83- and 2.09-fold, respectively, more likely to experience a fall than their counterparts. Conversely, patients who took beta-blockers were 0.34-fold more likely than those who did not take them to experience a fall. Patients taking ≥6 medications were 3.08-fold more likely than those taking fewer medications to experience a fall, whereas those with anxiety were 4.72-fold more likely to experience a fall than those without. A high fall-risk score was not significantly associated with the occurrence of falls. Among older hospitalized patients, tricyclic antidepressants, diuretics, narcotics, and polypharmacy should be mindfully prescribed and reviewed on a regular basis. A fall-risk scale developed from community-dwelling older people might not accurately predict falls in hospitalized patients. Further research to validate the negative effect of beta-blocker use on falls is required. © 2014 Japan Geriatrics Society.

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

Science.gov (United States)

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

2014-11-01

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

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

Science.gov (United States)

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

2018-06-15

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

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

Science.gov (United States)

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

2016-01-01

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

Near-falls in people with Parkinson's disease: Circumstances, contributing factors and association with falling.

Science.gov (United States)

Gazibara, Tatjana; Kisic Tepavcevic, Darija; Svetel, Marina; Tomic, Aleksandra; Stankovic, Iva; Kostic, Vladimir S; Pekmezovic, Tatjana

2017-10-01

To describe circumstances of near-falls among persons with Parkinson's disease (PD), assess factors associated with near-falling and assess whether near-falls in the first 6 months are associated with falling in the latter 6 months over one year of follow-up. In the period August 2011-December 2012, 120 consecutive persons with PD, who denied having fallen in the past 6 months, were recruited at Clinical center of Serbia in Belgrade. Occurrence of falling and near-falls was followed for one year. A total of 31 persons with PD (25.8%) experienced near-falls, but did not fall. Of 42 fallers, 32 (76.2%) experienced near-falls. Tripping was the most common cause of near-falls among fallers, whereas postural instability was the most common in non-fallers. Regardless of falling experience, the most common manner to avoid fall was holding onto furniture or wall. After adjustment for multiple motor and non-motor PD features, more severe freezing of gait was associated with occurrence of near-falls over one year of follow-up (odds ratio [OR]=1.08, 95% confidence interval [CI] 1.01-1.16; p=0.043). Adjusted regression analysis did not show associations between near-falling in the first 6 months and falling in the latter 6 months of follow-up. Near-falls commonly occur in persons with PD. More severe freezing of gait appears to predispose near-falling. Fall prevention programs focusing on balance maintenance when experiencing freezing of gait could potentially be useful in reduction of near-falls. Copyright © 2017 Elsevier B.V. All rights reserved.

Geriatric fall-related injuries.

African Journals Online (AJOL)

Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

Prevalence and cost of imaging in inpatient falls: the rising cost of falling

Directory of Open Access Journals (Sweden)

Fields J

2015-06-01

Full Text Available Jessica Fields,1 Tahani Alturkistani,2 Neal Kumar,3 Arjun Kanuri,3 Deeb N Salem,1 Samson Munn,2 Deborah Blazey-Martin1 1Department of Medicine, Tufts Medical Center, Boston, MA, USA; 2Department of Radiology, Tufts Medical Center, Boston, MA, USA; 3Tufts University School of Medicine, Boston, MA, USA Objective: To quantify the type, prevalence, and cost of imaging following inpatient falls, identify factors associated with post-fall imaging, and determine correlates of positive versus negative imaging. Design: Single-center retrospective cohort study of inpatient falls. Data were collected from the hospital's adverse event reporting system, DrQuality. Age, sex, date, time, and location of fall, clinical service, Morse Fall Scale/fall protocol, admitting diagnosis, and fall-related imaging studies were reviewed. Cost included professional and facilities fees for each study. Setting: Four hundred and fifteen bed urban academic hospital over 3 years (2008–2010. Patients: All adult inpatient falls during the study period were included. Falls experienced by patients aged <18 years, outpatient and emergency patients, visitors to the hospital, and staff were excluded. Measurements and main results: Five hundred and thirty inpatient falls occurred during the study period, average patient age 60.7 years (range 20–98. More than half of falls were men (55% and patients considered at risk of falls (56%. Falls were evenly distributed across morning (33%, evening (34%, and night (33% shifts. Of 530 falls, 178 (34% patients were imaged with 262 studies. Twenty percent of patients imaged had at least one positive imaging study attributed to the fall and 82% of studies were negative. Total cost of imaging was $160,897, 63% ($100,700 from head computed tomography (CT. Conclusion: Inpatient falls affect patients of both sexes, all ages, occur at any time of day and lead to expensive imaging, mainly from head CTs. Further study should be targeted toward

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

Science.gov (United States)

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

The 3D Elevation Program: summary for Rhode Island

Science.gov (United States)

Carswell, William J.

2013-01-01

Elevation data are essential to a broad range of applications, including forest resources management, wildlife and habitat management, national security, recreation, and many others. For the State of Rhode Island, elevation data are critical for flood risk management, natural resources conservation, coastal zone management, sea level rise and subsidence, agriculture and precision farming, and other business uses. Today, high-quality light detection and ranging (lidar) data are the sources for creating elevation models and other elevation datasets. Federal, State, and local agencies work in partnership to (1) replace data, on a national basis, that are (on average) 30 years old and of lower quality and (2) provide coverage where publicly accessible data do not exist. A joint goal of State and Federal partners is to acquire consistent, statewide coverage to support existing and emerging applications enabled by lidar data. The new 3D Elevation Program (3DEP) initiative (Snyder, 2012a,b), managed by the U.S. Geological Survey (USGS), responds to the growing need for high-quality topographic data and a wide range of other three-dimensional representations of the Nation’s natural and constructed features.

Areas contributing recharge to production wells and effects of climate change on the groundwater system in the Chipuxet River and Chickasheen Brook Basins, Rhode Island

Science.gov (United States)

Friesz, Paul J.; Stone, Janet R.

2015-01-01

The Chipuxet River and Chickasheen Brook Basins in southern Rhode Island are an important water resource for public and domestic supply, irrigation, recreation, and aquatic habitat. The U.S. Geological Survey, in cooperation with the Rhode Island Department of Health, began a study in 2012 as part of an effort to protect the source of water to six large-capacity production wells that supply drinking water and to increase understanding of how climate change might affect the water resources in the basins. Soil-water-balance and groundwater-flow models were developed to delineate the areas contributing recharge to the wells and to quantify the hydrologic response to climate change. Surficial deposits of glacial origin ranging from a few feet to more than 200 feet thick overlie bedrock in the 24.4-square mile study area. These deposits comprise a complex and productive aquifer system.

Improving prediction of fall risk among nursing home residents using electronic medical records.

Science.gov (United States)

Marier, Allison; Olsho, Lauren E W; Rhodes, William; Spector, William D

2016-03-01

Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

First chelonian eggs and carapace fragments from the Pliocene of Rhodes, Greece

DEFF Research Database (Denmark)

Mueller-Töwe, Inken J.; Kjeldahl-Vallon, Tina A.; Milàn, Jesper

2011-01-01

Well-preserved fossil eggs and eggshell fragments from the Pliocene Apolakkia Formation of Rhodes (Greece) are described. The eggs were found in-situ in a clutch. They are sub-spherical with lengths of 53-60 mm and widths of about 40 mm. All eggs are diagenetically compressed and their original...... diameters are estimated at 45-50 mm. The eggshells are 0.3-0.5 mm thick, partly recrystallized, but widely still aragonitic. They consist of needle-like crystals that form individual shell units. A few pores are preserved between these shell units. This shell-structure allows assignment to chelonian eggs...... in the oofamily Testudoolithidae and the oogenus Testudolithus. The external morphology, microstructure and mineralogical composition of the eggshells show close resemblance to eggs of the extant tortoise Geochelone elephantopus. Together with a small association of turtle carapace fragments from the same...

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

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

2016-08-01

Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.

Meteorite falls in Africa

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Khiri, Fouad; Ibhi, Abderrahmane; Saint-Gerant, Thierry; Medjkane, Mohand; Ouknine, Lahcen

2017-10-01

The study of meteorites provides insight into the earliest history of our solar system. From 1800, about the year meteorites were first recognized as objects falling from the sky, until December 2014, 158 observed meteorite falls were recorded in Africa. Their collected mass ranges from 1.4 g to 175 kg with the 1-10 kg cases predominant. The average rate of African falls is low with only one fall recovery per 1.35-year time interval (or 0.023 per year per million km2). This African collection is dominated by ordinary chondrites (78%) just like in the worldwide falls. The seventeen achondrites include three Martian meteorite falls (Nakhla of Egypt, Tissint of Morocco and Zagami of Nigeria). Observed Iron meteorite falls are relatively rare and represent only 5%. The falls' rate in Africa is variable in time and in space. The number of falls continues to grow since 1860, 80% of which were recovered during the period between 1910 and 2014. Most of these documented meteorite falls have been recovered from North-Western Africa, Eastern Africa and Southern Africa. They are concentrated in countries which have a large surface area and a large population with a uniform distribution. Other factors are also favorable for observing and collecting meteorite falls across the African territory, such as: a genuine meteorite education, a semi-arid to arid climate (clear sky throughout the year most of the time), croplands or sparse grasslands and possible access to the fall location with a low percentage of forest cover and dense road network.

A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.

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Townsend, Ann B; Valle-Ortiz, Marisol; Sansweet, Tracy

2016-11-01

Emergency nurses did not perform falls risk assessments routinely on our ED patients; the instrument used was aimed at inpatients. We identified a need to revise fall assessment practices specific to our emergency department. The purpose of the performance improvement project was to reduce ED falls and evaluate the use of an ED-specific fall risk tool, the KINDER 1 Fall Risk Assessment. The plan was to establish fall risk assessment practices at point of ED entry and to decrease total falls. We retrospectively reviewed ED fall data for each quarter of 2013, which included risk assessments scores, the total number of falls, and the circumstances of each fall. Using Kotter's framework to guide a successful change process, we implemented the KINDER 1 to assess fall risk. During the first 4 weeks of the project, 937 patients (27%) were identified as high risk for falls using the KINDER 1. During the subsequent 3 quarters, the total number of falls decreased; reported falls without injuries dropped from 0.21 to 0.07 per 1000 patients, and falls with injuries were reduced from 0.21 to 0.0 per 1000 patients. The results of this project represented a valuable step toward achieving our goal to keep ED patients safe from injuries as a result of falls. The findings add to the body of nursing knowledge on the application of clinical-based performance improvement projects to improve patient outcomes and to provide data on the use of the KINDER 1 tool, which has not been extensively tested. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Fiscal Year 1987 program report: Rhode Island Water Resource Research Center

International Nuclear Information System (INIS)

Poon, P.C.

1988-07-01

The 1987 program objective was to conduct studies and research of value to the New England region as well as to assist in the solution of problems in the State of Rhode Island. Current and anticipated state and regional-water problems are contamination of surface and groundwater by natural radioactivity such as radon, by chemicals from industrial and agricultural activities, septic tank and leach field, improperly managed landfills and the lack of public awareness and public participation in water-quality protection and management. It was found in the 1987 program that an epithermal neutron-activation analysis was best suitable for measuring uranium and thorium of which radon is the decayed product. Lower U and Th were found in calc-alkalic and mafic volcanic rocks while higher concentrations were found in the alkalic and peraluminous rocks. A computer model using finite-element method to simulate fluid flows through fractured porous media was developed for predicting the extent of ground-water contamination in the State

Predictive value of stabilometry and fear of falling on falls in postmenopausal women.

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Hita-Contreras, F; Martínez-Amat, A; Lomas-Vega, R; Álvarez, P; Aránega, A; Martínez-López, E; Mendoza, N

2013-10-01

Falls are one of the leading causes of fractures and impaired quality of life in the elderly, and they are related to balance deficit and to fear of falls. The purpose of our study is to evaluate predictors of falls in the 50-65-year-old postmenopausal population. A prospective cohort study was conducted on 96 postmenopausal women. Fear of falling and postural stability were assessed by using the FES-I (Falls Efficacy Scale-International) and a force platform, respectively. Fall frequency was determined in the 12-month follow-up study period. Multivariate logistic regression was used to identify predictive factors of falls. Fear of falls, the FES-I scale and four stabilometric parameters, specifically under eyes-closed condition, were significantly higher in the group of fallers. The root mean square amplitude in the medial-lateral direction with eyes closed (RMSXec) (odds ratio 5.1, 95% confidence interval (CI) 1.6-15.5, p = 0.004) and FES-I (odds ratio 3.4, 95% CI 1.1-10.5, p = 0.026) were the best independent predictive factors of the risk of falling. RMSXec > 0.133 was the best predictive factor for falls in our group of 50-65-year-old postmenopausal women studied, and a FES-I score > 20 could predict falls in this population.

The effect of pramipexole therapy on balance disorder and fall risk in Parkinson's disease at early stage: clinical and posturographic assessment.

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

2012-01-01

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

Isolation and DNA barcode characterization of a permanent Telenomus (Hymenoptera: Platygastridae) population in Florida that targets fall armyworm (Lepidoptera: Noctuidae)

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Telenomus remus Nixon is a platygastrid egg parasite of the fall armyworm, Spodoptera frugiperda (J. E. Smith), with a history of use as an augmentative biological control agent in Central and South America. Efforts were made in 1975-1977 and again in 1988-1989 to introduce T. remus into the fall ar...

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

Science.gov (United States)

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).

Fall prevention modulates decisional saccadic behaviour in aging

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Olivier A. Coubard

2012-07-01

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

The brave new world of GEC evaluation: the experience of the Rhode Island Geriatric Education Center.

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Filinson, Rachel; Clark, Phillip G; Evans, Joann; Padula, Cynthia; Willey, Cynthia

2012-01-01

In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these efforts, and the modifications to assessment that ensued in response to the increased accountability requirements. The evaluation focused on RIGEC's series of continuing education, day-long workshops for health and social service professionals, the completion of all seven of which leads to a Certificate in Interdisciplinary Practice in Geriatrics.

Impact of Diabetic Complications on Balance and Falls: Contribution of the Vestibular System.

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D'Silva, Linda J; Lin, James; Staecker, Hinrich; Whitney, Susan L; Kluding, Patricia M

2016-03-01

Diabetes causes many complications, including retinopathy and peripheral neuropathy, which are well understood as contributing to gait instability and falls. A less understood complication of diabetes is the effect on the vestibular system. The vestibular system contributes significantly to balance in static and dynamic conditions by providing spatially orienting information. It is noteworthy that diabetes has been reported to affect vestibular function in both animal and clinical studies. Pathophysiological changes in peripheral and central vestibular structures due to diabetes have been noted. Vestibular dysfunction is associated with impaired balance and a higher risk of falls. As the prevalence of diabetes increases, so does the potential for falls due to diabetic complications. The purpose of this perspective article is to present evidence on the pathophysiology of diabetes-related complications and their influence on balance and falls, with specific attention to emerging evidence of vestibular dysfunction due to diabetes. Understanding this relationship may be useful for screening (by physical therapists) for possible vestibular dysfunction in people with diabetes and for further developing and testing the efficacy of interventions to reduce falls in this population. © 2016 American Physical Therapy Association.

iFall: an Android application for fall monitoring and response.

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Sposaro, Frank; Tyson, Gary

2009-01-01

Injuries due to falls are among the leading causes of hospitalization in elderly persons, often resulting in a rapid decline in quality of life or death. Rapid response can improve the patients outcome, but this is often lacking when the injured person lives alone and the nature of the injury complicates calling for help. This paper presents an alert system for fall detection using common commercially available electronic devices to both detect the fall and alert authorities. We use an Android-based smart phone with an integrated tri-axial accelerometer. Data from the accelerometer is evaluated with several threshold based algorithms and position data to determine a fall. The threshold is adaptive based on user provided parameters such as: height, weight, and level of activity. The algorithm adapts to unique movements that a phone experiences as opposed to similar systems which require users to mount accelerometers to their chest or trunk. If a fall is suspected a notification is raised requiring the user's response. If the user does not respond, the system alerts pre-specified social contacts with an informational message via SMS. If a contact responds the system commits an audible notification, automatically connects, and enables the speakerphone. If a social contact confirms a fall, an appropriate emergency service is alerted. Our system provides a realizable, cost effective solution to fall detection using a simple graphical interface while not overwhelming the user with uncomfortable sensors.

Native and alien ichthyofauna in coastal fishery of Rhodes (eastern Mediterranean (2002-2010

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Maria Corsini-Foka

2015-11-01

Full Text Available Rhodes Island (southeastern Aegean is located in a geographically crucial region subjected to biological invasions. Among the 108 alien species recorded, 30 are fish, all of Indo-Pacific/Red Sea origin introduced via Suez through Lessepsian migration (Corsini-Foka et al., 2015; Corsini-Foka and Kondylatos, In press; Kondylatos and Corsini-Foka, In press. In this oligotrophic area, fishery production is limited, due to the paucity of species of commercial interest and their low abundance, while adapted infrastructures for fish landing and marketing are absent. Coastal fishery has dominated during the last twenty years (ELSTAT, 2015. Within 2002-2010, the Hydrobiological Station of Rhodes conducted experimental boat seining surveys, using exclusively a professional 12m fishing boat, at 5-30 m depth, in the Gulf of Trianda (sandy mud, Posidonia meadows. The 94 carried out hauls (7-18 hauls/year, produced a total fish biomass of approximately 4400 Kg, recording 97 fish (86 native, 11 alien and 4 cephalopod species (3 native, 1 alien. Fish species ranged from 32 to 63/year, whereas aliens ranged from 5 to 8 species. Almost steadily present since 2002, were earlier colonizers such as Apogonichthyoides pharaonis, Siganus rivulatus, Siganus luridus, Stephanolepis diaspros and more recent ones as Pteragogus trispilus, Sphyraena chrysotaenia and Fistularia commersonii, while Lagocephalus sceleratus, firstly recorded in 2005, occurred regularly since 2007; the presence of Lagocephalus suezensis, Sphyraena flavicauda and Upeneus pori was scattered since their first records in 2004-2005. Alien fish commercially important are the Siganids, S. chrysotaenia and surprisingly F. commersonii. In terms of biomass per haul, alien fish ranged from 0 to 18.5 Kg, native from 1.5 to 182 Kg. Catches were dominated by Centracanthidae (Spicara spp. and Sparidae (Boops boops, sometimes by other native such as Oblada melanura, Diplodus spp., Chromis Chromis and others. The

Falls in institutions for older adults: characterization of fall occurrences and associated risk factors

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Cristina Rosa Soares Lavareda Baixinho

2015-12-01

Full Text Available Falls are the main accident for older adults, with consequences on functionality. Older adults impose restrictions or have restrictions imposed on their activities for fear of new falls. This prospective longitudinal study was conducted with 104 institutionalized older adults during six months with the following goals: to determine the prevalence of falls, to characterize the falls according to place, time, resulting injuries, supervision of the older adult, action performed at the time of the fall, and to relate the occurrence of the fall to the risk of falling, medical diagnoses, number of medications in use, type of medication, degree of dependency, age, and gender. The prevalence of falls was 37.5%, and they happened mostly in the bedroom, while walking after getting up from the bed. Those under risk in the Morse Fall Scale (p=0.034 and on sedatives (p=0.007 face a higher prevalence of falls. This study enables the possibility of making suggestions for practice, training and investigation.

The Neighborhood Environment: Perceived Fall Risk, Resources, and Strategies for Fall Prevention.

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Chippendale, Tracy; Boltz, Marie

2015-08-01

To explore the experience of older adults in their neighborhood in relation to perceived fall risk, fear of falling (FOF), and resources/strategies for fall prevention. Fourteen older adults, 65 years of age and older from 3 urban senior centers, participated in this qualitative study. The semistructured interview guidelines and background questionnaire were developed by the researchers based on the literature and an existing measure of walkability. Both tools were refined based on pilot interviews with seniors. Collaizzi's phenomenological method was used for data analysis. Five themes emerged from the data: (a) The built environment contributes to perceived fall risk and FOF, (b) personal strategies used to adapt to perceived neighborhood fall risks-behavioral approaches, (c) resources for physical activity and safety, (d) barriers to physical activity and exercise, and (e) neighborhood features as a motivator. Urban-dwelling seniors perceive that neighborhood features contribute to or mitigate fall risk and FOF. Behavioral strategies are used by seniors to prevent outdoor falls. The findings can help clinicians develop targeted fall prevention interventions for well elders and help urban planners to design and retrofit urban environments to reduce fall risk. © The Author 2014. 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.

Migratory patterns of the fall armyworm (Spodoptera frugiperda) in the western hemisphere

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Fall armyworm (FAW) is a serious pest of sweet corn in south Florida and a pest of other vegetable, row, and forage crops in the southeastern, mid-Atlantic, and central U.S. It is a migratory pest, moving north each season from overwintering areas in southern Texas and southern Florida. For the la...

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

Science.gov (United States)

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.

Effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults with risk of falls.

Science.gov (United States)

Lee, Hsuei-Chen; Chang, Ku-Chou; Tsauo, Jau-Yih; Hung, Jen-Wen; Huang, Yu-Ching; Lin, Sang-I

2013-04-01

To evaluate effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults. Multicenter randomized controlled trial. Three medical centers and adjacent community health centers. Community-dwelling older adults (N=616) who have fallen in the previous year or are at risk of falling. After baseline assessment, eligible subjects were randomly allocated into the intervention group (IG) or the control group (CG), stratified by the Physiological Profile Assessment (PPA) fall risk level. The IG received a 3-month multifactorial intervention program including 8 weeks of exercise training, health education, home hazards evaluation/modification, along with medication review and ophthalmology/other specialty consults. The CG received health education brochures, referrals, and recommendations without direct exercise intervention. Primary outcome was fall incidence within 1 year. Secondary outcomes were PPA battery (overall fall risk index, vision, muscular strength, reaction time, balance, and proprioception), Timed Up & Go (TUG) test, Taiwan version of the International Physical Activity Questionnaire, EuroQol-5D, Geriatric Depression Scale (GDS), and the Falls Efficacy Scale-International at 3 months after randomization. Participants were 76±7 years old and included low risk 25.6%, moderate risk 25.6%, and marked risk 48.7%. The cumulative 1-year fall incidence was 25.2% in the IG and 27.6% in the CG (hazard ratio=.90; 95% confidence interval, .66-1.23). The IG improved more favorably than the CG on overall PPA fall risk index, reaction time, postural sway with eyes open, TUG test, and GDS, especially for those with marked fall risk. The multifactorial fall prevention program with exercise intervention improved functional performance at 3 months for community-dwelling older adults with risk of falls, but did not reduce falls at 1-year follow-up. Fall incidence might have been decreased simultaneously in both

How Do Community-Dwelling Persons with Alzheimer Disease Fall Falls in the FINALEX Study

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Niko M. Perttila

2017-06-01

Full Text Available Background: People with dementia are at high risk for falls. However, little is known of the features causing falls in Alzheimer disease (AD. Our aim was to investigate how participants with AD fall. Methods: In the FINALEX (Finnish Alzheimer Disease Exercise Trial study, participants’ (n = 194 falls were followed up for 1 year by diaries kept by their spouses. Results: The most common reason for falls (n = 355 was stumbling (n = 61. Of the falls, 123 led to injuries, 50 to emergency department visits, and 13 to fractures. The participants without falls (n = 103 were younger and had milder dementia than those with 1 (n = 34 or ≥2 falls (n = 57. Participants with a Mini Mental State Examination score of around 10 points were most prone to fall. In adjusted regression models, good nutritional status, good physical functioning, and use of antihypertensive medication (incident rate ratio [IRR] 0.68, 95% confidence interval [CI] 0.54–0.85 protected against falls, whereas fall history (IRR 2.71, 95% CI 2.13–3.44, osteoarthritis, diabetes mellitus, chronic obstructive pulmonary disease, higher number of drugs, drugs with anticholinergic properties, psychotropics, and opioids (IRR 4.27, 95% CI 2.92–6.24 were risk factors for falls. Conclusions: Our study provides a detailed account on how and why people with AD fall, suggesting several risk and protective factors.

Dual-task and electrophysiological markers of executive cognitive processing in older adult gait and fall-risk

OpenAIRE

Walshe, Elizabeth A.; Patterson, Matthew R.; Commins, Se?n; Roche, Richard A. P.

2015-01-01

The role of cognition is becoming increasingly central to our understanding of the complexity of walking gait. In particular, higher-level executive functions are suggested to play a key role in gait and fall-risk, but the specific underlying neurocognitive processes remain unclear. Here, we report two experiments which investigated the cognitive and neural processes underlying older adult gait and falls. Experiment 1 employed a dual-task (DT) paradigm in young and older adults, to assess the...

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

Science.gov (United States)

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.

Fall Enrollment Report. 2014

Science.gov (United States)

Iowa Department of Education, 2014

2014-01-01

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

Character, mass, distribution, and origin of tephra-fall deposits of the 1989-1990 eruption of redoubt volcano, south-central Alaska

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Scott, W.E.; McGimsey, R.G.

1994-01-01

The 1989-1990 eruption of Redoubt Volcano spawned about 20 areally significant tephra-fall deposits between December 14, 1989 and April 26, 1990. Tephra plumes rose to altitudes of 7 to more than 10 km and were carried mainly northward and eastward by prevailing winds, where they substantially impacted air travel, commerce, and other activities. In comparison to notable eruptions of the recent past, the Redoubt events produced a modest amount of tephra-fall deposits - 6 ?? 107 to 5 ?? 1010 kg for individual events and a total volume (dense-rock equivalent) of about 3-5 ?? 107 m3 of andesite and dacite. Two contrasting tephra types were generated by these events. Pumiceous tephra-fall deposits of December 14 and 15 were followed on December 16 and all later events by fine-grained lithic-crystal tephra deposits, much of which fell as particle aggregates. The change in the character of the tephra-fall deposits reflects their fundamentally different modes of origin. The pumiceous deposits were produced by magmatically driven explosions. The finegrained lithic-crystal deposits were generated by two processes. Hydrovolcanic vent explosions generated tephrafall deposits of December 16 and 19. Such explosions continued as a tephra source, but apparently with diminishing importance, during events of January and February. Ash clouds of lithic pyroclastic flows generated by collapse of actively growing lava domes probably contributed to tephra-fall deposits of all events from January 2 to April 26, and were the sole source of tephra fall for at least the last 4 deposits. ?? 1994.

Students fall for Fall Meeting

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Smedley, Kara

2012-02-01

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

Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review.

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Lach, Helen W; Harrison, Barbara E; Phongphanngam, Sutthida

2017-05-01

Older adults with mild cognitive impairment (MCI) and early-stage dementia have an increased risk of falling, with risks to their health and quality of life. The purpose of the current integrative review was to evaluate evidence on fall risk and fall prevention in this population. Studies were included if they examined falls or fall risk factors in older adults with MCI or early-stage dementia, or reported interventions in this population; 40 studies met criteria. Evidence supports the increased risk of falls in individuals even in the early stages of dementia or MCI, and changes in gait, balance, and fear of falling that may be related to this increased fall risk. Interventions included exercise and multifactorial interventions that demonstrated some potential to reduce falls in this population. Few studies had strong designs to provide evidence for recommendations. Further study in this area is warranted. [Res Gerontol Nurs. 2017; 10(03):139-148.]. Copyright 2016, SLACK Incorporated.

The elderly recognizing themselves as vulnerable to falls in the concreteness of the femoral fracture.

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Carvalho, César Junior Aparecido de; Bocchi, Silvia Cristina Mangini

2017-04-01

understand the experience of the elderly with falls followed by femoral fracture and elaborate theoretical model of this process of lived experience. qualitative research with theoretical saturation through analysis of the ninth nondirected interview of elderly who underwent such experience. Interviews were recorded, transcribed, and analyzed according to Grounded Theory. three categories emerged (sub-processes): evaluating signs and symptoms of fracture after the fall; feeling sad and insecure with the new condition; and finding oneself susceptible to fractures. From realignment of these categories (sub-processes) we could abstract the central category (process), recognizing oneself as vulnerable to falls in the concreteness of the fracture. the theoretical model considering the Symbolic Interactionism signals the implementation of continued program for fall prevention, with teaching strategies that encourage the elderly to reflect on the concreteness of contexts in which there is risk of occurring injury to their health.

Exploring the relationship between fall risk-increasing drugs and fall-related fractures.

Science.gov (United States)

De Winter, Sabrina; Vanwynsberghe, Sarah; Foulon, Veerle; Dejaeger, Eddy; Flamaing, Johan; Sermon, An; Van der Linden, Lorenz; Spriet, Isabel

2016-04-01

Hospital admissions due to fall-related fractures are a major problem in the aging population. Several risk factors have been identified, including drug use. Most studies often retrieved prescription-only drugs from national databases. These are associated with some limitations as they do not always reliably reproduce the complete patient's active drug list. To evaluate the association between the number of FRIDs intake identified by a standardised medication reconciliation process and a fall-related fracture leading to a hospital admission in older adults. The first cohort has been recruited from one traumatology ward of a tertiary teaching hospital in Belgium and the second cohort has been recruited from 11 community pharmacies in Belgium. A prospective study with two individually matched cohorts was performed. Adult patients (≥75 years) admitted with an injury due to a fall were included in the first cohort (faller group). The second cohort consisted of patients who did not suffer from a fall within the last 6 months (non-faller group). Matching was performed for age, gender, place of residence and use of a walking aid. In both groups, clinical pharmacists and undergraduate pharmacy students obtained the medication history, using a standardised approach. A list of drugs considered to increase the risk of falling was created. It included cardiovascular drugs and drugs acting on the nervous system. A linear mixed model was used to compare the number of fall risk-increasing drugs between fallers and non-fallers. The number of fall risk-increasing drugs in a faller versus a non-faller group. Sixty-one patients were matched with 121 non-fallers. Patients received on average 3.1 ± 2.1 and 3.2 ± 1.8 fall risk-increasing drugs in the faller and in the non-faller group, respectively. The mean number of fall risk-increasing drugs was comparable in both groups (p = 0.844), even after adjusting for alcohol consumption, fear of falling, vision and foot problems (p = 0

Falls incidence underestimates the risk of fall-related injuries in older age groups : a comparison with the FARE (Falls risk by Exposure)

NARCIS (Netherlands)

Etman, Astrid; Wijlhuizen, Gert Jan; van Heuvelen, Marieke J. G.; Chorus, Astrid; Hopman-Rock, Marijke

Background: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE ( Falls risk by Exposure) is a

Falls incidence underestimates the risk of fall-related injuries in older age groups: a comparison with the FARE (Falls risk by Exposure)

NARCIS (Netherlands)

Etman, A.; Wijlhuizen, G.J.; van Heuvelen, M.J.G.; Chorus, A.M.J.; Hopman-Rock, M.

2012-01-01

Background: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE (Falls risk by Exposure) is a

Falls incidence underestimates the risk of fall-related injuries in older age groups: A comparison with the FARE (Falls risk by exposure)

NARCIS (Netherlands)

Etman, A.; Wijlhuizen, G.J.; Heuvelen, M.J.G. van; Chorus, A.; Hopman-Rock, M.

2012-01-01

Background: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE (Falls risk by Exposure) is a

Character, distribution, and ecological significance of storm wave-induced scour in Rhode Island Sound, USA

Science.gov (United States)

McMullen, Katherine Y.; Poppe, Lawrence J.; Parker, Castle E.

2015-01-01

Multibeam bathymetry, collected during NOAA hydrographic surveys in 2008 and 2009, is coupled with USGS data from sampling and photographic stations to map the seabed morphology and composition of Rhode Island Sound along the US Atlantic coast, and to provide information on sediment transport and benthic habitats. Patchworks of scour depressions cover large areas on seaward-facing slopes and bathymetric highs in the sound. These depressions average 0.5-0.8 m deep and occur in water depths reaching as much as 42 m. They have relatively steep well-defined sides and coarser-grained floors, and vary strongly in shape, size, and configuration. Some individual scour depressions have apparently expanded to combine with adjacent depressions, forming larger eroded areas that commonly contain outliers of the original seafloor sediments. Where cobbles and scattered boulders are present on the depression floors, the muddy Holocene sands have been completely removed and the winnowed relict Pleistocene deposits exposed. Low tidal-current velocities and the lack of obstacle marks suggest that bidirectional tidal currents alone are not capable of forming these features. These depressions are formed and maintained under high-energy shelf conditions owing to repetitive cyclic loading imposed by high-amplitude, long-period, storm-driven waves that reduce the effective shear strength of the sediment, cause resuspension, and expose the suspended sediments to erosion by wind-driven and tidal currents. Because epifauna dominate on gravel floors of the depressions and infauna are prevalent in the finer-grained Holocene deposits, it is concluded that the resultant close juxtaposition of silty sand-, sand-, and gravel-dependent communities promotes regional faunal complexity. These findings expand on earlier interpretations, documenting how storm wave-induced scour produces sorted bedforms that control much of the benthic geologic and biologic diversity in Rhode Island Sound.

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

Science.gov (United States)

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.

Association between obesity, risk of falls and fear of falling in older women

Directory of Open Access Journals (Sweden)

Silvia Gonçalves Ricci Neri

2017-11-01

Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n4p450   The aim of this cross-sectional study was to investigate the association between obesity, risk of falls and fear of falling in older women. Two hundred and twenty-six volunteers (68.05 ± 6.22 years, 68.06 ± 11.79 kg, 1.56 ± 0.06 m were classified as normal weight, overweight or obese, according to the body mass index. Risk of falls and fear of falling were evaluated using QuickScreen Clinical Falls Risk Assessment and Falls Efficiency Scale – International (FES-I, respectively. Comparisons between groups were conducted using Chi-square and ANOVA One-way tests. The significance level was set at p< 0.05. Obesity was associated with greater probability of falls (p< 0.001, which may be partly explained by decreased muscle strength (p< 0.001 and reaction time (p< 0.001. In addition, significant differences between groups was observed in FES-I score (p< 0.01, with obese women showing more pronounced fear of falling (30.10 ± 8.4 than normal weigh (25. 33 ± 7.11, p< 0.01 and overweight subjects (26.97 ± 7.05, p< 0.05. These findings corroborate previous evidence pointing obesity as a major risk factor for falls. Therefore, health professionals dealing with fall prevention should consider the effects of overweight.

Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults.

Science.gov (United States)

Taylor, Morag E; Delbaere, Kim; Lord, Stephen R; Mikolaizak, A Stefanie; Brodaty, Henry; Close, Jacqueline C T

2014-08-01

Older people with cognitive impairment have an elevated fall risk, with 60% falling annually. There is a lack of evidence for fall prevention in this population, in part due to limited understanding of risk factors. This study examined fall risk in older people with cognitive impairment with an emphasis on identifying explanatory and modifiable risk factors. One hundred and seventy-seven community-dwelling older people with mild-moderate cognitive impairment (Mini-Mental State Examination 11-23/Addenbrooke's Cognitive Examination-Revised Falls were recorded prospectively for 12 months with the assistance of carers. Of the 174 participants available to follow-up, 111 (64%) fell at least once and 71 (41%) at least twice. Higher fall rates were associated with slower reaction time, impaired balance (sway on floor and foam, semitandem, near-tandem, tandem stance), and reduced functional mobility (co-ordinated stability, timed up-and-go, steps needed to turn 180°, sit-to-stand, gait velocity). Higher fall rates were also associated with increased medication use (central nervous system, total number) and poorer performances in cognitive (Addenbrooke's Cognitive Examination-Revised: visuospatial domain, cube drawing; Trail-Making Test) and psychological (Geriatric Depression Scale, Goldberg Anxiety Scale, Falls Efficacy Scale-International) tests. Multivariate analysis identified increased sway on foam, co-ordinated stability score, and depressive symptoms to be significantly and independently associated with falls while controlling for age, years of education, and Addenbrooke's Cognitive Examination-Revised score. This study identified several risk factors of falls in older people with cognitive impairment, a number of which are potentially modifiable. Future research involving targeted interventions addressing medication use, balance, mood, and functional performance may prove useful for fall prevention in this population. © The Author 2013. Published by Oxford

New horizons in fall prevention.

Science.gov (United States)

Lord, Stephen R; Close, Jacqueline C T

2018-04-25

Falls pose a major threat to the well-being and quality of life of older people. Falls can result in fractures and other injuries, disability and fear and can trigger a decline in physical function and loss of autonomy. This article synthesises recent published findings on fall risk and mobility assessments and fall prevention interventions and considers how this field of research may evolve in the future. Fall risk topics include the utility of remote monitoring using wearable sensors and recent work investigating brain activation and gait adaptability. New approaches for exercise for fall prevention including dual-task training, cognitive-motor training with exergames and reactive step training are discussed. Additional fall prevention strategies considered include the prevention of falls in older people with dementia and Parkinson's disease, drugs for fall prevention and safe flooring for preventing fall-related injuries. The review discusses how these new initiatives and technologies have potential for effective fall prevention and improved quality of life. It concludes by emphasising the need for a continued focus on translation of evidence into practice including robust effectiveness evaluations of so that resources can be appropriately targeted into the future.

Masculinity and preventing falls: insights from the fall experiences of men aged 70 years and over.

Science.gov (United States)

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

2018-01-11

To explore men's fall experiences through the lens of masculine identities so as to assist health professionals better engage men in fall prevention programs. Twenty-five men, aged 70-93 years who had experienced a recent fall, participated in a qualitative semi-structured interview. Men's willingness to engage in fall prevention programs taking account of individual contexts and expressions of masculinity, were conceptualised using constant comparative methods. Men's willingness to engage in fall prevention programs was related to their perceptions of the preventability of falls; personal relevance of falls; and age, health, and capability as well as problem-solving styles to prevent falls. Fall prevention advice was rarely given when men accessed the health system at the time of a fall. Contrary to dominant expectations about masculine identity, many men acknowledged fall vulnerability indicating they would attend or consider attending, a fall prevention program. Health professionals can better engage men by providing consistent messages that falls can be prevented; tailoring advice, understanding men are at different stages in their awareness of fall risk and preferences for action; and by being aware of their own assumptions that can act as barriers to speaking with men about fall prevention. Implications for rehabilitation Men accessing the health system at the time of the fall, and during rehabilitation following a fall represent prime opportunities for health professionals to speak with men about preventing falls and make appropriate referrals to community programs. Tailored advice will take account of individual men's perceptions of preventability; personal relevance; perceptions of age, health and capability; and problem-solving styles.

Disability is an Independent Predictor of Falls and Recurrent Falls in People with Parkinson's Disease Without a History of Falls: A One-Year Prospective Study.

Science.gov (United States)

Almeida, Lorena R S; Sherrington, Catherine; Allen, Natalie E; Paul, Serene S; Valenca, Guilherme T; Oliveira-Filho, Jamary; Canning, Colleen G

2015-01-01

Predictors of falls in people with Parkinson's disease (PD) who have not previously fallen are yet to be identified. We aimed to identify predictors of all falls and recurrent falls in people with PD who had not fallen in the previous year and to explore the timing of falls in a 12-month follow-up period. Participants with PD (n = 130) were assessed by disease-specific, self-report and balance measures. Falls were recorded prospectively for 12 months. Univariate and multivariate analyses were performed. Kaplan-Meier survival analysis was used to investigate time to falling. Forty participants (31%) had ≥1 fall during follow-up and 21 (16%) had ≥2 falls. Disability, reduced balance confidence and greater concern about falling were associated with ≥1 fall in univariate analyses. Additionally, PD duration and severity, freezing of gait and impaired balance were associated with ≥2 falls (p Disability (Schwab and England scale, Odds Ratio [OR] = 0.56 per 10 points increase; 95% confidence interval [CI] 0.39-0.80; p = 0.002) was associated with ≥1 fall in the final multivariate model (area under the receiver operating characteristic curve [AUC] = 0.65; 95% CI 0.55-0.76; p = 0.005). Disability (Unified Parkinson's Disease Rating Scale activities of daily living, OR = 1.20; 95% CI 1.07-1.34; p = 0.001) and levodopa equivalent dose (OR = 1.11 per 100 mg increase; 95% CI 0.95-1.30; p = 0.19) were associated with ≥2 falls in the final multivariate model (AUC = 0.72; 95% CI 0.60-0.84; p = 0.001). Recurrent fallers experienced their first fall earlier than single fallers (p disability was the strongest single predictor of all falls and recurrent falls.

The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis

Directory of Open Access Journals (Sweden)

Faulkner Robert A

2007-07-01

Full Text Available Abstract Background Falling accounts for a significant number of hospital and long-term care admissions in older adults. Many adults with the combination of advancing age and functional decline associated with lower extremity osteoarthritis (OA, are at an even greater risk. The purpose of this study was to describe fall and near-fall history, location, circumstances and injuries from falls in a community-dwelling population of adults over aged 65 with hip OA and to determine the ability of the timed up and go test (TUG to classify fallers and near-fallers. Method A retrospective observational study of 106 older men and women with hip pain for six months or longer, meeting a clinical criteria for the presence of hip OA at one or both hips. An interview for fall and near-fall history and administration of the TUG were administered on one occasion. Results Forty-five percent of the sample had at least one fall in the past year, seventy-seven percent reported occasional or frequent near-falls. The majority of falls occurred during ambulation and ascending or descending steps. Forty percent experienced an injury from the fall. The TUG was not associated with history of falls, but was associated with near-falls. Higher TUG scores occurred for those who were older, less mobile, and with greater number of co-morbidities. Conclusion A high percentage of older adults with hip OA experience falls and near-falls which may be attributed to gait impairments related to hip OA. The TUG could be a useful screening instrument to predict those who have frequent near-falls, and thus might be useful in predicting risk of future falls in this population.

Diagnosis and Tests: Evaluating a Fall or Risk of Falling

Science.gov (United States)

... as a physical therapist, who can evaluate your fall risk. If your healthcare provider concludes that you are ... to check for things that can impact your fall risk, such as electrolyte balance and the possibility of ...

The rise and fall of the ridge in heavy ion collisions

Energy Technology Data Exchange (ETDEWEB)

Sorensen, P., E-mail: prsorensen@bnl.gov [Brookhaven National Laboratory, Physics Department, Upton, NY 11973 (United States); Bolliet, B. [ENS de Lyon, Lyon Cedex 07 (France); Mocsy, A. [Pratt Institute, Department of Math and Science, Brooklyn, NY 11205 (United States); Pandit, Y. [Kent State University, Physics Department, Kent, OH 44242 (United States); Pruthi, N. [Panjab University, Physics Department, Chandigarh 160014 (India)

2011-11-03

Recent data from heavy ion collisions at RHIC show unexpectedly large near-angle correlations that broaden longitudinally with increasing centrality. The amplitude of this ridge-like correlation rises rapidly, reaches a maximum, and then falls in the most central collisions. In this Letter we explain how this behavior can be uniquely explained by initial-state coordinate-space anisotropies converted into final-state momentum-space correlations. We propose v{sub n}{sup 2}/{epsilon}{sub n,part}{sup 2} as a useful way to study length scales and provide a prediction for the ridge in Pb + Pb collisions at {radical}(s{sub NN})=2.76 TeV.

Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study

NARCIS (Netherlands)

van der Velde, Nathalie; Stricker, Bruno H. Ch; Pols, Huib A. P.; van der Cammen, Tischa J. M.

2007-01-01

AIMS: Falling in older persons is a frequent and serious clinical problem. Several drugs have been associated with increased fall risk. The objective of this study was to identify differences in the incidence of falls after withdrawal (discontinuation or dose reduction) of fall-risk-increasing drugs

The design and development of a complex multifactorial falls assessment intervention for falls prevention: The Prevention of Falls Injury Trial (PreFIT).

Science.gov (United States)

Bruce, Julie; Ralhan, Shvaita; Sheridan, Ray; Westacott, Katharine; Withers, Emma; Finnegan, Susanne; Davison, John; Martin, Finbarr C; Lamb, Sarah E

2017-06-01

This paper describes the design and development of a complex multifactorial falls prevention (MFFP) intervention for implementation and testing within the framework of a large UK-based falls prevention randomised controlled trial (RCT). A complex intervention was developed for inclusion within the Prevention of Falls Injury Trial (PreFIT), a multicentre pragmatic RCT. PreFIT aims to compare the clinical and cost-effectiveness of three alternative primary care falls prevention interventions (advice, exercise and MFFP), on outcomes of fractures and falls. Community-dwelling adults, aged 70 years and older, were recruited from primary care in the National Health Service (NHS), England. Development of the PreFIT MFFP intervention was informed by the existing evidence base and clinical guidelines for the assessment and management of falls in older adults. After piloting and modification, the final MFFP intervention includes seven falls risk factors: a detailed falls history interview with consideration of 'red flags'; assessment of balance and gait; vision; medication screen; cardiac screen; feet and footwear screen and home environment assessment. This complex intervention has been fully manualised with clear, documented assessment and treatment pathways for each risk factor. Each risk factor is assessed in every trial participant referred for MFFP. Referral for assessment is based upon a screening survey to identify those with a history of falling or balance problems. Intervention delivery can be adapted to the local setting. This complex falls prevention intervention is currently being tested within the framework of a large clinical trial. This paper adheres to TIDieR and CONSORT recommendations for the comprehensive and explicit reporting of trial interventions. Results from the PreFIT study will be published in due course. The effectiveness and cost-effectiveness of the PreFIT MFFP intervention, compared to advice and exercise, on the prevention of falls and

High Falls Hydroelectric Plant feasibility study

Energy Technology Data Exchange (ETDEWEB)

Diezemann, Gustav A.

1979-07-01

This study was made in order to determine if re-activating the retired High Falls Hydro Station in New York would result in a more economical generation of some of the power required in the Central Hudson System than is being obtained with the oil-burning thermal plants. The findings show that the construction of a new plant is more economical than rehabilitation of the existing station. All new construction schemes are marginally unattractive at today's costs but are found to become profitable within a short period as alternative energy sources escalate in price. A new powerhouse with an installed capacity of 2390 kW proved most economical, and its construction is recommended.

Prevalence of Falls in an Urban Community-Dwelling Older Population of Cape Town, South Africa.

Science.gov (United States)

Zimba Kalula, S; Ferreira, M; Swingler, G; Badri, M; Aihie Sayer, A

2015-12-01

Falls are a major cause of disability and mortality in older adults. Studies on falls in this population have mainly been conducted in high income countries, and scant attention has been given to the problem in low and middle income countries, including South Africa. The aim of the study was to establish a rate for falls in older adults in South Africa. A cross-sectional survey with a 12-month follow-up survey. Three purposively selected suburbs of Cape Town: Plumstead, Wynberg Central and Gugulethu. Eight hundred and thirty seven randomly sampled ambulant community-dwelling subjects aged ≥ 65 years grouped according to ethnicity in three sub-samples: black Africans, coloureds (people of mixed ancestry) and whites. Data were collected on socio-demographic and health characteristics, and history of falls using a structured questionnaire and a protocol for physical assessments and measurements. Of the total baseline (n=837) and follow-up (n=632) survey participants, 76.5% and 77.2 % were females with a mean (S.D) age of 74 years (6.4) and 75 years (6.2), respectively. Rates of 26.4% and 21.9% for falls and of 11% and 6.3% for recurrent falls, respectively, were calculated at baseline and follow-up. Fall rates differed by ethnic sub-sample at baseline: whites 42 %, coloureds 34.4% and black Africans 6.4 % (p=0.0005). Rates of 236, 406 and 354 falls per 1000 person years were calculated for men, women and both genders, respectively. Recurrent falls were more common in women than in men. Falls are a significant problem in older adults in South Africa. Effective management of falls and falls prevention strategies for older people in South Africa, need to be developed and implemented.

Demographic tensions in Central America.

Science.gov (United States)

1986-08-01

This discussion of Central America focuses on the rapid growth of its population, its stagnating economy, and those countries that are socioeconomically advanced. Between 1950-85 the population of Central America tripled, from 9.1 million to 26. 4 million, due to marked mortality declines and the absence of off-setting fertility declines. The distribution of Central Americas's growing populations sets its population growth apart from that of other developing regions. Currently, almost half of all Central Americans live in cities. Although the average growth rate for Central American countries has fallen and is expected to drop further, the decline does not counterbalance the effect of the absolute rise in population numbers. The average annual growth rate of more than 3% annually in the 1960s fell to about 2.6% in recent years, but this decline is due primarily to socioeconomically advanced Costa Rica and Panama. Central America's age structure further complicates the population crisis. About 43% of Central Americans are under the age of 15. When the increasingly larger young population group enters it reproductive years, the potential for future growth (albeit the falling rate of population increase) is unparalleled. UN population projections show the region's population at 40 million by the year 2000. The 1973 oil crisis began a downward spiral for the buoyant post World War II Central American economy. Between 1950-79, real per capita income growth in Central America doubled, with Central American economies growing an average of 5.3% annually. By the early 1980s, overseas markets of the trade-dependent countries of Central America had dried up due to protectionism abroad and slumping basic commodity prices. These and other factors plunged Central America into its current economic malaise of falling real per capita income, rising unemployment, curtailed export led economic growth, and a rising cost of living. In general, economic growth in Central America

Falls in Parkinson's disease.

NARCIS (Netherlands)

Grimbergen, Y.A.M.; Munneke, M.; Bloem, B.R.

2004-01-01

PURPOSE OF REVIEW: To summarize the latest insights into the clinical significance, assessment, pathophysiology and treatment of falls in Parkinson's disease. RECENT FINDINGS: Recent studies have shown that falls are common in Parkinson's disease, even when compared with other fall-prone

Predicting Falls in People with Multiple Sclerosis: Fall History Is as Accurate as More Complex Measures

Directory of Open Access Journals (Sweden)

Michelle H. Cameron

2013-01-01

Full Text Available Background. Many people with MS fall, but the best method for identifying those at increased fall risk is not known. Objective. To compare how accurately fall history, questionnaires, and physical tests predict future falls and injurious falls in people with MS. Methods. 52 people with MS were asked if they had fallen in the past 2 months and the past year. Subjects were also assessed with the Activities-specific Balance Confidence, Falls Efficacy Scale-International, and Multiple Sclerosis Walking Scale-12 questionnaires, the Expanded Disability Status Scale, Timed 25-Foot Walk, and computerized dynamic posturography and recorded their falls daily for the following 6 months with calendars. The ability of baseline assessments to predict future falls was compared using receiver operator curves and logistic regression. Results. All tests individually provided similar fall prediction (area under the curve (AUC 0.60–0.75. A fall in the past year was the best predictor of falls (AUC 0.75, sensitivity 0.89, specificity 0.56 or injurious falls (AUC 0.69, sensitivity 0.96, specificity 0.41 in the following 6 months. Conclusion. Simply asking people with MS if they have fallen in the past year predicts future falls and injurious falls as well as more complex, expensive, or time-consuming approaches.

The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk?

Science.gov (United States)

Segev-Jacubovski, Orit; Herman, Talia; Yogev-Seligmann, Galit; Mirelman, Anat; Giladi, Nir; Hausdorff, Jeffrey M

2011-01-01

In this article, we briefly summarize the incidence and significant consequences of falls among older adults, the insufficient effectiveness of commonly used multifactorial interventions and the evidence linking falls and cognitive function. Recent pharmacologic and nonpharmacologic studies that evaluated the effects of cognitive therapy on fall risk are reviewed. The results of this article illustrate the potential utility of multiple, diverse forms of cognitive therapy for reducing fall risk. The article also indicates that large-scale, randomized controlled trials are warranted and that additional research is needed to better understand the pathophysiologic mechanisms underlying the interplay between human mobility, fall risk and cognitive function. Nonetheless, we suggest that multimodality interventions that combine motor and cognitive therapy should, eventually, be incorporated into clinical practice to enable older adults and patients to move safer and with a reduced fall risk. PMID:21721921

Rhode Island crystalline repository siting project: Technical progress report, Calendar year 1986

International Nuclear Information System (INIS)

Vild, B.

1987-01-01

A Nuclear Waste Fund established by the Nuclear Waste Policy Act of 1982 provides financial support to affected states to participate in the high-level radioactive waste repository siting program of the US Department of Energy. In Rhode Island, that function was performed by a multidisciplinary Project Review Team consisting of staff from three State agencies. Members of the Review Team attended several meetings in 1986 to discuss mutual concerns with Federal, State and Tribal officials. Comments were developed on DOE's Draft Area Recommendation Report. Members of the Review Team also testified at a public hearing in Providence on the Draft ARR, and developed and distributed a public information booklet. In May, Secretary of Energy John Herrington announced the suspension of the crystalline repository siting program. The remainder of the year was spent monitoring litigation challenging that decision and pending legislation. Administrative phase-down of the program was essentially complete by the close of the calendar year

Meanings of Falls and Prevention of Falls According to Rehabilitation Nurses: A Qualitative Descriptive Study.

Science.gov (United States)

Bok, Amy; Pierce, Linda L; Gies, Cheryl; Steiner, Victoria

2016-01-01

Guided by Friedemann's theoretical framework, this survey explored the meaning of a fall of an institutionalized older adult or fall prevention to rehabilitation registered nurses and whether the experience changed the nurse's practice. Qualitative, descriptive survey. A convenience sample of 742 rehabilitation nurses was asked to describe these experiences and the impact on their practice. Themes discovered related to the meaning of a fall include negative feelings (incongruence) and positive feelings (congruence). Themes related to the meaning of preventing a fall include positive feelings (congruence). Practice change themes emerged from both the experience of a fall and fall prevention. Practice change themes were drawn to Friedemann's (1995) process dimensions. Nurses' experiences and meanings of falls uncovered negative and positive feelings about these falls. New findings of this study were the positive feelings expressed by nurses, when there was no injury or when a fall was prevented. © 2015 Association of Rehabilitation Nurses.

Willingness of Rhode Island Dentists to Provide Limited Preventive Primary Care.

Science.gov (United States)

Dang, Catherine Tuyet Mai; Shield, Renee R; Giddon, Donald B

2016-07-01

In response to the shortage of primary care physicians and the need for greater intercollaboration among health professionals, dentists with sufficient medical and surgical training are an untapped resource to provide limited preventive primary care (LPPC), such as chairside screening for chronic diseases. The objective of this study was to determine attitudes of Rhode Island dentists toward becoming more involved in the overall health of their patients. Using a 5-point scale (1 being highest), a pretested survey was administered to 92 respondent RI dentists who were asked to indicate their willingness to become more involved in patients' overall health, and undergo additional training to provide LPPC. Their moderate level of willingness was offset by great concern for liability, with older dentists being significantly more willing to assume these additional responsibilities than younger dentists (pstomiatrist was still dentist first, but with no significant difference between the mean ranks of dentist and oral physician.[Full article available at http://rimed.org/rimedicaljournal-2016-07.asp, free with no login].

[Risk factors for falls and survival after falling in elderly people in a community].

Science.gov (United States)

Kato, Ryuichi; Takagi, Chika; Sakurai, Naoko; Hoshi, Tanji

2012-05-01

The purpose of this study was to assess the risk factors associated with falls and to examine the effects of falls on survival of elderly people in a community. A questionnaire survey was conducted in 16,462 urban elderly dwellers aged 65 years or more in City A in September 2001. A follow-up survey was carried out in September 2004. We analyzed the data of 8,285 subjects who answered both questionnaires and had not relocated by August 2007. Baseline assessments of health and functioning were carried out in 2001. Falls experienced during the 1-year period before September 2004 were recorded, and the deaths were recorded until August 2007. Statistical analysis was performed using a logistic regression model and Cox's proportional hazards analysis. A total of 6,420 subjects (3,127 men and 3,293 women) who had provided complete answers about their falls were included in the analyses. Of these, 27.8% of women and 16.4% of men had experienced falls, while 6.2% of women and 2.1% of men had experienced falls that caused fractures. We found that the likelihood of fall, with or without fracture development, was greater in women than in men (P falls tended to increase with age in both women and men. Risk factors associated with falls, in addition to age and gender, were pain (odds ratio [OR], 1.75), lack of instrumental activities of daily living (IADL; OR, 1.45), poor self-rated health status (OR, 1.42), and presence of disease (OR, 1.35). Risk factors associated with falls that caused fracture were pain (OR, 1.85) and lack of IADL (OR, 1.61). Cox's proportional hazards analysis showed a significant increase in mortality in both men and women who had experienced falls than in those who had not (hazard ratio [HR], 1.94, 1.43). Aging, pain and disease, lack of IADL, and poor self-rated health status were all significant risk factors for falls in elderly people, and a fall was related to subsequent mortality.

Geriatric fall-related injuries.

Science.gov (United States)

Hefny, Ashraf F; Abbas, Alaa K; Abu-Zidan, Fikri M

2016-06-01

Falls are the leading cause of geriatric injury. We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

Fall prevention walker during rehabilitation

Science.gov (United States)

Tee, Kian Sek; E, Chun Zhi; Saim, Hashim; Zakaria, Wan Nurshazwani Wan; Khialdin, Safinaz Binti Mohd; Isa, Hazlita; Awad, M. I.; Soon, Chin Fhong

2017-09-01

This paper proposes on the design of a walker for the prevention of falling among elderlies or patients during rehabilitation whenever they use a walker to assist them. Fall happens due to impaired balance or gait problem. The assistive device is designed by applying stability concept and an accelerometric fall detection system is included. The accelerometric fall detection system acts as an alerting device that acquires body accelerometric data and detect fall. Recorded accelerometric data could be useful for further assessment. Structural strength of the walker was verified via iterations of simulation using finite element analysis, before being fabricated. Experiments were conducted to identify the fall patterns using accelerometric data. The design process and detection of fall pattern demonstrates the design of a walker that could support the user without fail and alerts the helper, thus salvaging the users from injuries due to fall and unattended situation.

Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women.

Science.gov (United States)

Afrin, Nadia; Honkanen, Risto; Koivumaa-Honkanen, Heli; Lukkala, Pyry; Rikkonen, Toni; Sirola, Joonas; Williams, Lana J; Kröger, Heikki

2016-09-01

To ascertain whether the risk of falls of different types is related to morbidity (number of chronic medical conditions) among postmenopausal women. This cohort study uses data from a population-based prospective cohort study (OSTPRE). The study population consisted of 10,594 women aged 47-56 years living in Kuopio Province, Eastern Finland, in 1989, who responded to postal enquiries at both baseline and 5-year follow-up, in 1994. Morbidity (i.e. number of diagnosed chronic medical conditions) was reported in 1989 and falls in 1994. Falls were categorized as slip or nonslip, and 'frequent falls' was defined as two or more in a 12-month period. The risk (odds ratio (OR) with 95% CI) of a fall increased with the number of chronic medical conditions. The OR was 1.28 (1.17-1.40) for those with 1-2 conditions and 1.41 (1.24-1.60) for those with multimorbidity (≥3 conditions) compared with healthy respondents. Multimorbidity was associated with a greater risk of the woman experiencing frequent nonslip falls (OR=2.57; 2.01-3.29) than frequent slip falls (OR=1.46; 1.17-1.80). Adjusting with logistic regression for age, number of medications and smoking did not affect the risk estimates. Multimorbidity has a much smaller effect on slip than on nonslip falls in postmenopausal women. This should be taken into account when investigating the effects of multimorbidity on fall risk in varying weather conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2018-03-01

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

Perceived Fall Risk and Functional Decline: Gender Differences in Patient's Willingness to Discuss Fall Risk, Fall History, or to Have a Home Safety Evaluation.

Science.gov (United States)

Greenberg, Marna Rayl; Moore, Elizabeth C; Nguyen, Michael C; Stello, Brian; Goldberg, Arnold; Barraco, Robert D; Porter, Bernadette G; Kurt, Anita; Dusza, Stephen W; Kane, Bryan G

2016-06-01

The CDC reports that among older adults, falls are the leading cause of injury-related death and rates of fall-related fractures among older women are twice those of men. We set out to 1) determine patient perceptions (analyzed by gender) about their perceived fall risk compared to their actual risk for functional decline and death and 2) to report their comfort level in discussing their fall history or a home safety plan with their provider. Elders who presented to the Emergency Department (ED†) were surveyed. The survey included demographics, the Falls Efficacy Scale (FES) and the Vulnerable Elders Survey (VES); both validated surveys measuring fall concern and functional decline. Females had higher FES scores (mean 12.3, SD 5.9) than males (mean 9.7, SD 5.9 p = .007) in the 146 surveys analyzed. Females were more likely to report an increased fear of falling, and almost three times more likely to have a VES score of 3 or greater than males (OR = 2.86, 95% CI: 1.17-7.00, p = .02). A strong correlation was observed between FES and VES scores (r = 0.80, p fall risk with a provider; there was no difference between genders (p = .57). In this study, irrespective of gender, there appears to be a high association between subjects' perceived fall risk and risk for functional decline and death. The majority of patients are likely willing to discuss their fall risk with their provider. These findings may suggest a meaningful opportunity for fall risk mitigation in this setting.

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance.

Science.gov (United States)

Collado-Mateo, D; Gallego-Diaz, J M; Adsuar, J C; Domínguez-Muñoz, F J; Olivares, P R; Gusi, N

2015-01-01

To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance.

Falls in older people

NARCIS (Netherlands)

van Dieën, Jaap H.; Pijnappels, Mirjam

Falls are common incidents, which can have major con-sequences. For example, falls and the interrelated category of accidents being struck by or against objects account for more than 40% of injuries and 30% of injury costs in the USA (Corso et al., 2006). Especially among older adults, falls occur

[Fear of falling in a fall clinic for geriatric patients: a pilot study

NARCIS (Netherlands)

Dautzenberg, P.LJ.; Buurman, B.H.; Loonen, A.J.; Wouters, C.J.; Olde Rikkert, M.G.M.

2005-01-01

OBJECTIVE: In this pilot study we want to determine how often fear of falling occurs in geriatric patients visiting a fall clinic and to study the characteristics of fear of falling and its consequences. DESIGN: Retrospective study of patient's records. METHOD: A random sample of 100 medical records

Issues in Geriatric Care: Falls.

Science.gov (United States)

Patel, Dipesh; Ackermann, Richard J

2018-05-01

One in three older adults falls each year. There are approximately 2.5 million falls among older adults treated in emergency departments. Falls account for 87% of all fractures in this age group. The biggest risk factor for falling is a history of falls. Other risk factors include frailty, sedative and anticholinergic drugs, polypharmacy, and a variety of medical conditions. Current recommendations are that all patients age 65 years and older should be asked about falls each year. Patients also can be screened for fall risk with a variety of approaches including questionnaires and the Timed Up & Go test. For patients who have fallen or are at risk, care should focus on correcting reversible home environmental factors that predispose to falls, minimizing the use of drugs with sedating properties, addressing vision conditions, recommending physical exercise (including balance, strength, and gait training), and managing postural hypotension as well as foot conditions and footwear. In addition, vitamin D and calcium supplementation should be considered. For patients needing anticoagulation for medical reasons, an assessment must balance fall risk (and thus bleeding from a fall) versus the risk of discontinuing anticoagulation (eg, sustaining an embolic stroke from atrial fibrillation). Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Central Methysergide Prevents Renal Sympathoinhibition and Bradycardia during Hypotensive Hemorrhage

Science.gov (United States)

Veelken, Roland; Johnson, Kim; Scrogin, Karie E.

1998-01-01

Central methysergide prevents renal sympathoinhibition and bradycardia during hypotensive hemorrhage. Mean arterial pressure (MAP), heart rate (HR), and renal sympathetic nerve activity (RSNA) were measured in conscious rats during either hemorrhage or cardiopulmonary receptor stimulation with phenylbiguanide (PBG) after intracerebroventricular injection of the 5-HT1/5-HT2-receptor antagonist, methysergide (40 microg). Progressive hemorrhage caused an initial rise (109 +/- 33%) followed by a fall in RSNA (-60 +/- 7%) and a fall in HR (-126 +/- 7 beats/min). Methysergide delayed the hypotension and prevented both the sympathoinhibitory and bradycardic responses to hemorrhage. Systemic 5-HT3-receptor blockade did not influence responses to hemorrhage. The PBG infusion caused transient depressor(-25 +/- 6 mmHg), bradycardic (-176 +/- 40 beats/min), and renal sympathostimulatory (182 +/-47% baseline) responses that were not affected by central methysergide (-20 +/- 6 mmHg, -162 +/- 18 beats/min, 227 +/- 46% baseline). These data indicate that a central serotonergic receptor-mediated component contributes to the sympathoinhibitory and bradycardic responses to hypotensive hemorrhage in conscious rats. Furthermore, the same central 5-HT-receptor populations involved in reflex responses to hypotensive hemorrhage probably do not mediate the sympathoinhibitory response to cardiopulmonary chemosensitive 5-HT3 receptors.

Radioresistance in Central Asian tortoise

Energy Technology Data Exchange (ETDEWEB)

Turdyev, A.A.; Bogdanova-Berezovskaya, I.G.; Dvornikova, L.I.

Season-related studies were conducted on the phenomenal radioresistance of the Central Asian tortoise (Testudo horsfieldii), in order to obtain greater understanding of the factors that determine this physiological uniqueness. Test animals were exposed to gamma radiation from a Co-60 source with dosages ranging from 12.9 to 25.8 Cl/kg in the spring, summer, fall, and winter. Using Pearson's ..gamma..-distribution coefficient calculations of the mean lethal dose for the season yielded 16.33 Cl/kg for winter, 10.94 Cl/kg for spring, 7.1 Cl/kg for summer, and 19.71 Cl/kg for fall. The animals were thus seen to be most susceptible to radiation damage in the spring and summer. Correlation with histological and hematological studies showed that animals irradiated in spring and summer succumbed as a result of damage to the GI and the hematopoietic systems, whereas animals that died as a result of irradiation during the fall and winter season did so because of depletion of hepatic glycogen stores. 5 references, 1 figure.

Falls self-efficacy and falls incidence in community-dwelling older people: the mediating role of coping.

Science.gov (United States)

Loft, Christine C; Jones, Fergal W; Kneebone, Ian I

2017-11-08

A cognitive behavioral model predicts that coping responses mediate the relationship between falls related psychological concerns and falls incidence, in community-dwelling older people. If empirical support could be found for this pathway then interventions could be developed to reduce falls risk by targeting coping strategies. Therefore, this study aimed to begin the process of testing whether coping responses mediate the association between falls self-efficacy (a principal element of falls related psychological concerns) and falls incidence, in community-dwelling older people. In a cross-sectional design, 160 community-dwelling older people (31 male, 129 female; mean age 83.47 years) completed the Falls Efficacy Scale-International, the Revised-Ways of Coping Questionnaire, the Turning to Religion subscale of the COPE, and a falls questionnaire. Data were analyzed via mediation analysis using a bootstrapping approach. Lower falls self-efficacy was associated with higher falls incidence, and more self-controlling coping was found to be a partial mediator of this association, with a confidence interval for the indirect effect of (0.003, 0.021) and an effect size of κ 2 = 0.035. The association was not mediated by the other measured coping responses; namely, turning to religion, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem-solving, and positive reappraisal. Self-controlling coping may mediate the association between falls self-efficacy and falling. If longitudinal studies confirm this finding then coping could be targeted in interventions to reduce falls.

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance

Directory of Open Access Journals (Sweden)

D. Collado-Mateo

2015-01-01

Full Text Available Objective. To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. Methods. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Results. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. Conclusion. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance.

Fall risk assessment: retrospective analysis of Morse Fall Scale scores in Portuguese hospitalized adult patients.

Science.gov (United States)

Sardo, Pedro Miguel Garcez; Simões, Cláudia Sofia Oliveira; Alvarelhão, José Joaquim Marques; Simões, João Filipe Fernandes Lindo; Melo, Elsa Maria de Oliveira Pinheiro de

2016-08-01

The Morse Fall Scale is used in several care settings for fall risk assessment and supports the implementation of preventive nursing interventions. Our work aims to analyze the Morse Fall Scale scores of Portuguese hospitalized adult patients in association with their characteristics, diagnoses and length of stay. Retrospective cohort analysis of Morse Fall Scale scores of 8356 patients hospitalized during 2012. Data were associated to age, gender, type of admission, specialty units, length of stay, patient discharge, and ICD-9 diagnosis. Elderly patients, female, with emergency service admission, at medical units and/or with longer length of stays were more frequently included in the risk group for falls. ICD-9 diagnosis may also be an important risk factor. More than a half of hospitalized patients had "medium" to "high" risk of falling during the length of stay, which determines the implementation and maintenance of protocoled preventive nursing interventions throughout hospitalization. There are several fall risk factors not assessed by Morse Fall Scale. There were no statistical differences in Morse Fall Scale score between the first and the last assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

Snow deposition and melt under different vegetative covers in central New York

Science.gov (United States)

A. R. Eschner; D. R. Satterlund

1963-01-01

Two-thirds of the annual runoff from watersheds in the Allegheny Plateau of central New York comes from the snow-or snow and rain that falls in December through April. Although the amounts of precipitation in this period are fairly uniform from year to year, the proportion that falls as snow varies; so does the amount that accumulates on the ground, and its duration...

Pro-Active Fall-Risk Management is Mandatory to Sustain in Hospital-Fall Prevention in Older Patients--Validation of the LUCAS Fall-Risk Screening in 2,337 Patients.

Science.gov (United States)

Hoffmann, V S; Neumann, L; Golgert, S; von Renteln-Kruse, W

2015-12-01

Prevention of in-hospital falls contributes to improvement of patient safety. However, the identification of high-risk patients remains a challenge despite knowledge of fall-risk factors. Hence, objective was to prospectively validate the performance of the LUCAS (Longitudinal Urban Cohort Ageing Study) fall-risk screening, based on routine data (fall history, mobility, mental status) and applied by nurses. Observational study comparing two groups of patients who underwent different fall-risk screenings; the LUCAS screening (2010 - 2011) and the STRATIFY (St. Thomas's Risk Assessment Tool In Falling Elderly Inpatients) (2004 - 2006). Urban teaching hospital. Consecutively hospitalized patients (≥ 65 years old) were screened on admission; LUCAS n = 2,337, STRATIFY n = 4,735. The proportions of fallers were compared between the STRATIFY and the LUCAS time periods. The number of fallers expected was compared to that observed in the LUCAS time period. Standardized fall-incidence recording included case-note checks for unreported falls. Plausibility checks of fall-risk factors and logistic regression analysis for variable fall-risk factors were performed. The proportions of fallers during the two time periods were LUCAS n = 291/2,337 (12.5%) vs. STRATIFY n = 508/4,735 (10.7%). After adjustment for risk-factor prevalence, the proportion of fallers expected was 14.5% (334/2,337), the proportion observed was 12.5% (291/2,337) (p = 0.038). In-hospital fall prevention including systematic use of the LUCAS fall-risk screening reduced the proportion of fallers compared to that expected from the patients' fall-risk profile. Raw proportions of fallers are not suitable to evaluate fall prevention in hospital because of variable prevalence of patients' fall-risk factors over time. Continuous communication, education and training is needed to sustain in-hospital falls prevention.

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

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

2015-01-01

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

Affective Politics and Colonial Heritage

DEFF Research Database (Denmark)

Knudsen, Britta Timm; Andersen, Casper

2017-01-01

The article analyses the spatial entanglement of colonial heritage struggles through a study of the Rhodes Must Fall student movement at the University of Cape Town and the University of Oxford. We explore affective politics and the role heritage can play in the landscape of body politics. We aim...

Epidemiology of falls in older age.

Science.gov (United States)

Peel, Nancye May

2011-03-01

Worldwide, falls among older people are a public health concern because of their frequency and adverse consequences in terms of morbidity, mortality, and quality of life, as well as their impact on health system services and costs. This epidemiological review outlines the public health burden of falls and fall-related injuries and the impact of population aging. The magnitude of the problem is described in terms of the classification of falls and measurement of outcomes, including fall incidence rates across settings, sociodemographic determinants, international trends, and costs of falls and fall-related injuries. Finally, public health approaches to minimize falls risk and consequent demand on health care resources are suggested.

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

Science.gov (United States)

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

2018-04-01

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

Fall Prevention Hits Stumbling Blocks.

Science.gov (United States)

Huff, Charlotte

2018-03-01

Implementation of efforts to screen older people for fall risk-and to intervene before falls occur-have been scattershot at best. Ongoing studies of fall prevention called STRIDE (Strategies to Reduce Injuries and Develop Confidence in Elders) might change that. The studies look at whether clinicians can implement a fall-prevention program across rural, urban, and suburban treatment settings.

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

Science.gov (United States)

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

2012-01-01

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

[Impact of fall risk and fear of falling on mobility of independently living senior citizens transitioning to frailty: screening results concerning fall prevention in the community].

Science.gov (United States)

Anders, J; Dapp, U; Laub, S; von Renteln-Kruse, W

2007-08-01

There is a strong relation between mobility, walking safety and living independently in old age. People with walking problems suffer from fear of falling and tend to restrict their mobility and performance level in the community environment--even before falls occur. This study was planned to test the validity and prognostic value of a fall risk screening instrument ("Sturz-Risiko-Check") that has already shown its feasibility, acceptance and reliability, targeting independently living senior citizens. The study sample was recruited from a sheltered housing complex in Hamburg (with written consent). Persons with need of professional care ("Pflegestufe" in Germany) were excluded. The residents were asked to fill in the multidimensional questionnaire ("Sturz-Risiko- Check"). In a second step, a trained nurse asked the participants in a phone call about their competence in the instrumental activities of daily living (I-ADL mod. from Lawton, Brody 1969) and about their usual mobility performance level (e.g. frequency and distance of daily walks, use of public transport). According to the number and weight of self-reported risk factors for falling, three groups: "low fall risk", "medium fall risk" and "high fall risk" were classified. Finally, this classification was re-tested after one year, asking for falls and fall related injuries. A total of 112 senior citizens without need of personal care, living in a sheltered housing facility were asked to participate. Acceptance was high (76.1%). Self-reported data from 79 participants concerning falls, fall-risk, mobility and instrumental activities of daily living were included in the statistical analyses. Mean age was 78 (64 to 93) years and associated by a high percentage of women (75.9%) in this sample. The older participants reported 0 to 13 different factors (mean 5) related to a high risk of future falls. Most participants (78.5%) quit cycling because of fear of falling. There was a high incidence in the study sample

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

Science.gov (United States)

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

2017-07-01

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

Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy

Directory of Open Access Journals (Sweden)

Hudson Azevedo Pinheiro

Full Text Available Abstract Objective : To assess muscle mass, risk of falls and fear of falling in elderly adults with diabetic neuropathy (DNP. Methods : 50 elderly patients with diabetes mellitus (DM and diabetic neuropathy (NPD participated in this study. Risk of falling was assessed using the Berg Balance Scale (BBS. Fear of falling was assessed by means of the Falls Efficacy Scale-International (FES-I. Muscle mass was assessed by tetrapolar bioimpedance analysis (BIA and Janssen's equation. Subjects were divided into two groups: one with a history of falls in the six months before study enrollment (G1 and the other without history of falls (G2. Results : There were statistically significant differences between G1 and G2 regarding lean body mass (p < 0.05, risk of falls as measured by the BBS (p < 0.01, and fear of falling as measured by the FES-I (p < 0.01. In addition, there was a significant correlation between the BBS and BIA (r = 0.45 and p < 0.01, showing that the greater the lean body mass, the lower the risk of falling. Conclusions : We found an association between lean mass, risk of falls and fear of falling in elderly adults with DNP and a history of falls from own height.

New methods for fall risk prediction.

Science.gov (United States)

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

2014-09-01

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

East and Central African Journal of Pharmaceutical Sciences

African Journals Online (AJOL)

The East and Central African Journal of Pharmaceutical Sciences is dedicated to all aspects of Pharmaceutical Sciences research and is published in English. The scientific papers published in the Journal fall into three main categories: review papers, original research papers and short communications. Review papers in ...

First Aid: Falls

Science.gov (United States)

... Folleto de instructiones: Caídas (Falls) With all the running, climbing, and exploring kids do, it's no surprise that falls are common. Although many result in mild bumps, cuts, and bruises, some can cause serious injuries that need immediate medical attention. What to Do ...

Online Hookup Sites for Meeting Sexual Partners Among Men Who Have Sex with Men in Rhode Island, 2013: A Call for Public Health Action.

Science.gov (United States)

Chan, Philip A; Towey, Caitlin; Poceta, Joanna; Rose, Jennifer; Bertrand, Thomas; Kantor, Rami; Harvey, Julia; Santamaria, E Karina; Alexander-Scott, Nicole; Nunn, Amy

2016-01-01

Frequent use of websites and mobile telephone applications (apps) by men who have sex with men (MSM) to meet sexual partners, commonly referred to as "hookup" sites, make them ideal platforms for HIV prevention messaging. This Rhode Island case study demonstrated widespread use of hookup sites among MSM recently diagnosed with HIV. We present the advertising prices and corporate social responsibility (CSR) programs of the top five sites used by newly diagnosed HIV-positive MSM to meet sexual partners: Grindr, Adam4Adam, Manhunt, Scruff, and Craigslist. Craigslist offered universal free advertising. Scruff offered free online advertising to selected nonprofit organizations. Grindr and Manhunt offered reduced, but widely varying, pricing for nonprofit advertisers. More than half (60%, 26/43) of newly diagnosed MSM reported meeting sexual partners online in the 12 months prior to their diagnosis. Opportunities for public health agencies to promote HIV-related health messaging on these sites were limited. Partnering with hookup sites to reach high-risk MSM for HIV prevention and treatment messaging is an important public health opportunity for reducing disease transmission risks in Rhode Island and across the United States.

Forty Years of Excellence and Beyond. Proceedings of the Annual North East Association for Institutional Research (NEAIR) Conference (40th, Newport, Rhode Island, November 9-12, 2013)

Science.gov (United States)

Parker, Tiffany, Ed.

2013-01-01

The NEAIR 2013 Conference Proceedings is a compilation of papers presented at the Newport, Rhode Island, conference. Papers in this document include: (1) Aspiring to the Role of "Data Badass:" Some Thoughts on the Political Context of IR (Mark Freeman); (2) Data-Driven Internal Benchmarks and Successful Learning Outcomes (Mamta Saxena…

Circumstances of falls and falls-related injuries in a cohort of older patients following hospital discharge

Directory of Open Access Journals (Sweden)

Hill AM

2013-06-01

Full Text Available Anne-Marie Hill,1 Tammy Hoffmann,2,3 Terry P Haines4,51School of Physiotherapy, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, 2Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, 3School of Health and Rehabilitation Sciences, The University of Queensland, 4School of Primary Health Care, Monash University, Melbourne, VIC, 5Allied Health Research Unit, Kingston Centre, Southern Health, Clayton, VIC, AustraliaBackground: Older people are at increased risk of falls after hospital discharge. This study aimed to describe the circumstances of falls in the six months after hospital discharge and to identify factors associated with the time and location of these falls.Methods: Participants in this randomized controlled study comprised fallers (n = 138 who were part of a prospective observational cohort (n = 343 nested within a randomized controlled trial (n = 1206. The study tested patient education on falls prevention in hospital compared with usual care in older patients who were discharged from hospital and followed for six months after hospital discharge. The outcome measures were number of falls, falls-related injuries, and the circumstances of the falls, measured by use of a diary and a monthly telephone call to each participant.Results: Participants (mean age 80.3 ± 8.7 years reported 276 falls, of which 150 (54.3% were injurious. Of the 255 falls for which there were data available about circumstances, 190 (74.5% occurred indoors and 65 (25.5% occurred in the external home environment or wider community. The most frequent time reported for falls was the morning (between 6 am and 10 am when 79 (28.6% falls, including 49 (32.7% injurious falls, occurred. The most frequently reported location for falls (n = 80, 29.0%, including injurious falls (n = 42, 28.0%, was the bedroom. Factors associated with falling in the bedroom included

Prevention of falls in nursing homes: subgroup analyses of a randomized fall prevention trial.

Science.gov (United States)

Rapp, Kilian; Lamb, Sarah E; Büchele, Gisela; Lall, Ranjit; Lindemann, Ulrich; Becker, Clemens

2008-06-01

To evaluate the effectiveness of a multifactorial fall prevention program in prespecified subgroups of nursing home residents. Secondary analysis of a cluster-randomized, controlled trial. Six nursing homes in Germany. Seven hundred twenty-five long-stay residents; median age 86; 80% female. Staff and resident education on fall prevention, advice on environmental adaptations, recommendation to wear hip protectors, and progressive balance and resistance training. Time to first fall and the number of falls. Falls were assessed during the 12-month intervention period. Univariate regression analyses were performed, including a confirmatory test of interaction. The intervention was more effective in people with cognitive impairment (hazard ratio (HR)=0.49, 95% confidence interval (CI)=0.35-0.69) than in those who were cognitively intact (HR=0.91, 95% CI=0.68-1.22), in people with a prior history of falls (HR=0.47, 95% CI=0.33-0.67) than in those with no prior fall history (HR=0.77, 95% CI=0.58-1.01), in people with urinary incontinence (HR=0.59, 95% CI=0.45-0.77) than in those with no urinary incontinence (HR=0.98, 95% CI=0.68-1.42), and in people with no mood problems (incidence rate ratio (IRR)=0.41, 95% CI=0.27-0.61) than in those with mood problems (IRR=0.74, 95% CI=0.51-1.09). The effectiveness of a multifactorial fall prevention program differed between subgroups of nursing home residents. Cognitive impairment, a history of falls, urinary incontinence, and depressed mood were important in determining response.

Fall risk factors in Parkinson's disease.

Science.gov (United States)

Gray, P; Hildebrand, K

2000-08-01

Parkinson's disease (PD) is a neurodegenerative disorder characterized by tremor, rigidity, bradykinesia, gait disturbance, and postural instability. Patients with PD suffer frequent falls, yet little research has been done to identify risks specific to PD patients. The objective of this study was to identify the risk factors associated with falls for PD patients through the collection of demographic, environmental, and medical information as well as fall diaries completed during a 3-month period. Patients with a diagnosis of idiopathic PD, with and without falls, were included in the study provided they could stand and walk and had no other condition that could predispose them to falls. Of the 118 participants, 59% reported one or more falls. A total of 237 falls were reported. Duration and severity of PD symptoms, particularly freezing, involuntary movements, and walking and postural difficulties, were significantly associated with an increased risk of falls. Other factors associated with falls were postural hypotension and daily intake of alcohol. Forty percent of falls resulted in injury, but serious injury was rare. The findings have implications for reducing the risk of falls through patient education.

Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the Elderly Receiving Home Care Service.

Science.gov (United States)

Jeon, MiYang; Gu, Mee Ock; Yim, JongEun

2017-12-01

The purpose of this study was to provide information to develop a program to prevent repeated falls by analyzing the difference in gait, muscle strength, balance, and fear of falling according to their fall experience. The study subjects were 110 elderly individuals aged over 60 years who agreed to their participation in this research. The study participants were categorized into a repeated fall group (n = 40), a one-time fall group (n = 15), and a nonfall group (n = 46) of the elderly. Measurements of gait, muscle strength, balance, and fear of falling were taken in each group. With regard to gait, there were significant differences among three groups in gait cycle (F = 3.50, p = .034), speed (F = 13.06, p balance, the nonfall group had significantly greater results than the one-time fall group and repeated fall group in dynamic balance (F = 10.80, p balance (F = 8.20, p = .001). In the case of the fear of falling, the repeated fall group had significantly higher score than other two groups (F = 20.62, p fall risk factors to enhance gait and balance and lower body muscle strength and reduce the fear of falling to prevent repeated incidences of falls in this population. Copyright © 2017. Published by Elsevier B.V.

Force platform measurements as predictors of falls among older people - a review.

Science.gov (United States)

Piirtola, Maarit; Era, Pertti

2006-01-01

Poor postural balance is one of the major risk factors for falling. A great number of reports have analyzed the risk factors and predictors of falls but the results have for the most part been unclear and partly contradictory. Objective data on these matters are thus urgently needed. The force platform technique has widely been used as a tool to assess balance. However, the ability of force platform measures to predict falls remains unknown. The purpose of this systematic review was to extract and critically review the findings of prospective studies where force platform measurements have been used as predictors of falls among elderly populations. The study was done as a systematic literature review. PubMed, the Cochrane Central Register of Controlled Trials, and CINAHL databases from 1950 to April 2005 were used. The review includes prospective follow-up studies using the force platform as a tool to measure postural balance. Nine original prospective studies were included in the final analyses. In five studies fall-related outcomes were associated with some force platform measures and in the remaining four studies associations were not found. For the various parameters derived on the basis of the force platform data, the mean speed of the mediolateral (ML) movement of the center of pressure (COP) during normal standing with the eyes open and closed, the mean amplitude of the ML movement of the COP with the eyes open and closed, and the root-mean-square value of the ML displacement of COP were the indicators that showed significant associations with future falls. Measures related to dynamic posturography (moving platforms) were not predictive of falls. Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various

The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis.

Science.gov (United States)

Arnold, Cathy M; Busch, Angela J; Schachter, Candice L; Harrison, Liz; Olszynski, Wojciech

2005-07-01

Cross-sectional descriptive analysis investigating intrinsic fall risk factors in postmenopausal women with osteoporosis. To examine the relationships between history of recent falls and balance, pain, quality of life, function, posture, strength, and mobility. Women with osteoporosis who fall are at a high risk of fracture due to decreased bone strength. Identifying fall risk factors for older women with osteoporosis is a crucial step in decreasing the incidence of falls and fracture. METHOD AND MEASURES: Seventy-three women over 60 years of age with established osteoporosis participated in comprehensive testing of fall history, physical function, and quality of life. Significant correlations were found between a recent history of falls and degree of kyphosis (r = 0.29), fear of falls/emotional status (r = -0.27), and balance (r = -0.27). Degree of kyphosis and fear of falls/emotional status explained 20% of the variance of recent fall history using binary logistic regression. Women with an increased kyphosis were more likely to have had a recent fall (odds ratio [OR], 1.17; 95% CI, 1.03-1.34) and those with better emotional status and less fear of falling were less likely to have had a recent fall (OR, 0.61; 95% CI, 0.38-0.97). Increased thoracic kyphosis and fear of falling are 2 intrinsic factors associated with recent falls in women with osteoporosis. To design more effective interventions to decrease fall risk in this population, future prospective, longitudinal studies should monitor kyphosis, fear of falling, balance reactions, and other potential risk factors not identified in this study.

Prospective study of falls and risk factors for falls in adults with advanced cancer.

LENUS (Irish Health Repository)

Stone, Carol A

2012-06-10

Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

Community College Estimated Growth: Fall 2010

Science.gov (United States)

Phillippe, Kent; Mullin, Christopher M.

2011-01-01

A survey from the American Association of Community Colleges (AACC) found that enrollment growth in fall 2010 slowed its pace at community colleges, increasing 3.2% from the previous year. This contrasts with more dramatic increases in recent years: more than 11% between fall 2008 and fall 2009, and nearly 17% between fall 2007 and fall 2009,…

Stopover ecology of landbirds migrating along the middle Rio Grande in spring and fall

Science.gov (United States)

Wang Yong; Deborah M. Finch

2002-01-01

This research represents the first comprehensive summary of our study of stopover ecology of migratory landbirds in riparian habitats along the middle Rio Grande of central New Mexico. We report results from mist-netting operations conducted during spring and fall migration in 1994, 1995, and 1996. A total of 23,800 individuals of 146 species were captured during the...

Conversion, core redesign and upgrade of the Rhode Island Atomic Energy Commission Reactor

International Nuclear Information System (INIS)

DiMeglio, A.F.

1987-01-01

The 2 MW Rhode Island Atomic Energy Commission reactor is required to convert from the use of High Enriched Uranium (HEU) fuel to the use of Low Enriched Uranium (LEU) fuel using a standard LEU fuel plate which is thinner and contains more Uranium-235 than the current HEU plate. These differences, coupled with the fact that the conversion should be accomplished without serious degradation of reactor characteristics and capability, has resulted in core design studies and thermal hydraulic studies not only at the current 2 MW but also at the maximum power level of the reactor, 5 MW. In addition, during the course of its 23 years of operation, it has become clear that the main uses of the reactor are neutron scattering and neutron activation analysis. The requirement to convert to LEU presents an opportunity during the conversion to optimize the core for the utilization and to restudy the thermal hydraulics using modern techniques. This paper will present the preliminary conclusions of both aspects. (Author)

Intrinsic factors associated with pregnancy falls.

Science.gov (United States)

Wu, Xuefang; Yeoh, Han T

2014-10-01

Approximately 25% to 27% of women sustain a fall during pregnancy, and falls are associated with serious injuries and can affect pregnancy outcomes. The objective of the current study was to identify intrinsic factors associated with pregnancy that may contribute to women's increased risk of falls. A literature search (Medline and Pubmed) identified articles published between January 1980 and June 2013 that measured associations between pregnancy and fall risks, using an existing fall accident investigation framework. The results indicated that physiological, biomechanical, and psychological changes associated with pregnancy may influence the initiation, detection, and recovery phases of falls and increase the risk of falls in this population. Considering the logistic difficulties and ethnic concerns in recruiting pregnant women to participate in this investigation of fall risk factors, identification of these factors could establish effective fall prevention and intervention programs for pregnant women and improve birth outcomes. [Workplace Health Saf 2014;62(10):403-408.]. Copyright 2014, SLACK Incorporated.

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

Science.gov (United States)

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

2016-11-01

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

Preventing falls in hospital.

Science.gov (United States)

Pearce, Lynne

2017-02-27

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

National Uranium Resource Evaluation: Providence Quadrangle, Connecticut, Rhode Island, and Massachusetts

International Nuclear Information System (INIS)

Zollinger, R.C.; Blauvelt, R.P.; Chew, R.T. III.

1982-09-01

The Providence Quadrangle, Connecticut, Rhode Island, and Massachusetts, was evaluated to a depth of 1500 m to identify environments and delineate areas favorable for uranium deposits. Criteria for this evaluation were developed by the National Uranium Resource Evaluation program. Environments were recognized after literature research, surface and subsurface geologic reconnaissance, and examination of known uranium occurrences and aeroradioactivity anomalies. Environments favorable for authigenic uranium deposits were found in the Quincy and Cowesett Granites. An environment favorable for contact-metasomatic deposits is in and around the borders of the Narragansett Pier Granite where it intrudes the Pennsylvanian sediments of the Narragansett Basin. An environment favorable for authigenic deposits in metamorphic rocks is in a migmatite on the eastern edge of the Scituate Granite Gneiss batholith. Environments favorable for contact-metasomatic deposits occur at the contacts between many of the granitic rocks and metamorphic rocks of the Blackstone Series. Results of this study also indicate environments favorable for sandstone-type uranium deposits are present in the rocks of the Narragansett Basin. Environments unfavorable for uranium deposits in the quadrangle include all granites not classified as favorable and the metamorphic rocks of eastern Connecticut. Glacial deposits and Cretaceous-Tertiary sediments remain unevaluated

Preventing Falls in Older Persons.

Science.gov (United States)

Moncada, Lainie Van Voast; Mire, L Glen

2017-08-15

The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling older adults who are at increased risk of falls. Although the U.S. Preventive Services Task Force and American Academy of Family Physicians do not recommend routine multifactorial intervention to prevent falls in all community-dwelling older adults, they state that it may be appropriate in individual cases. The Centers for Disease Control and Prevention developed an algorithm to aid in the implementation of the American Geriatrics Society/British Geriatrics Society guideline. The algorithm suggests assessment and multifactorial intervention for those who have had two or more falls or one fall-related injury. Multifactorial interventions should include exercise, particularly balance, strength, and gait training; vitamin D supplementation with or without calcium; management of medications, especially psychoactive medications; home environment modification; and management of postural hypotension, vision problems, foot problems, and footwear. These interventions effectively decrease falls in the community, hospital, and nursing home settings. Fall prevention is reimbursed as part of the Medicare Annual Wellness Visit.

Spinal sagittal contour affecting falls: cut-off value of the lumbar spine for falls.

Science.gov (United States)

Ishikawa, Yoshinori; Miyakoshi, Naohisa; Kasukawa, Yuji; Hongo, Michio; Shimada, Yoichi

2013-06-01

Spinal deformities reportedly affect postural instability or falls. To prevent falls in clinical settings, the determination of a cut-off angle of spinal sagittal contour associated with increase risk for falls would be useful for screening for high-risk fallers. The purpose of this study was to calculate the spinal sagittal contour angle associated with increased risk for falls during medical checkups in community dwelling elders. The subjects comprised 213 patients (57 men, 156 women) with a mean age of 70.1 years (range, 55-85 years). The upright and flexion/extension thoracic kyphosis and lumbar lordosis angles, and the spinal inclination were evaluated with SpinalMouse(®). Postural instability was evaluated by stabilometry, using the total track length (LNG), enveloped areas (ENV), and track lengths in the lateral and anteroposterior directions (X LNG and Y LNG, respectively). The back extensor strength (BES) was measured using a strain-gauge dynamometer. The relationships among the parameters were analyzed statistically. Age, lumbar lordosis, spinal inclination, LNG, X LNG, Y LNG, and BES were significantly associated with falls (Pfalls about lumbar lordosis angles revealed that angles of 3° and less were significant for falls. The present findings suggest that increased age, spinal inclination, LNG, X LNG, Y LNG, and decreased BES and lumbar lordosis, are associated with falls. An angle of lumbar lordosis of 3° or less was associated with falls in these community-dwelling elders. Copyright © 2012 Elsevier B.V. All rights reserved.

Clinical and Community Strategies to Prevent Falls and Fall-Related Injuries Among Community-Dwelling Older Adults.

Science.gov (United States)

Taylor-Piliae, Ruth E; Peterson, Rachel; Mohler, Martha Jane

2017-09-01

Falls in older adults are the result of several risk factors across biological and behavioral aspects of the person, along with environmental factors. Falls can trigger a downward spiral in activities of daily living, independence, and overall health outcomes. Clinicians who care for older adults should screen them annually for falls. A multifactorial comprehensive clinical fall assessment coupled with tailored interventions can result in a dramatic public health impact, while improving older adult quality of life. For community-dwelling older adults, effective fall prevention has the potential to reduce serious fall-related injuries, emergency room visits, hospitalizations, institutionalization, and functional decline. Copyright © 2017 Elsevier Inc. All rights reserved.

Geothermal District Heating System City of Klamath Falls

Energy Technology Data Exchange (ETDEWEB)

Lienau, Paul J; Rafferty, Kevin

1991-12-01

between the Icelandic systems and the Klamath Falls design was that the Icelanders used an open-type system delivering geothermal fluids directly to the customers; whereas, the Klamath Falls type was a closed-system design employing a central heat exchanger.

Tectonic model for the Late Paleozoic of southeastern New England

Energy Technology Data Exchange (ETDEWEB)

Wintsch, R.P.; Sutter, J.F.

1986-07-01

Hornblende and biotite /sup 40/Ar//sup 39/Ar age spectra from rocks in south-central Connecticut help define a Permian-Triassic cooling curve for the area. Together with petrologic and structural information, a time-temperature-pressure-strain path is established. Similar data for the Narragansett basin in Rhode Island and Massachusetts allow correlation of the late Paleozoic histories of the two areas. Together, these data suggest that in the late Paleozoic, south-central New England was part of a fold-thrust belt, and the Narragansett basin was a retroarc foreland basin. NW-SE compression during the final assembly of Pangaea resulted in SE directed thrusting, causing the development of clastic wedges in adjacent Rhode Island and Massachusetts in the Late Carboniferous-Early Permian. A clockwise rotation of this deformation from NW to NNE led to northward underthrusting and concomitant uplift of both eastern Connecticut and Rhode Island in the Permian and Triassic.

Preventing Falls and Related Fractures

Science.gov (United States)

... slowed reflexes. Drinking alcoholic beverages also increases the risk of falling. Alcohol slows reflexes and response time; causes dizziness, sleepiness, or lightheadedness; alters balance; and encourages risky behaviors that can lead to falls. The Force and Direction of a Fall The ...

Virtual obstacle crossing: Reliability and differences in stroke survivors who prospectively experienced falls or no falls.

Science.gov (United States)

Punt, Michiel; Bruijn, Sjoerd M; Wittink, Harriet; van de Port, Ingrid G; Wubbels, Gijs; van Dieën, Jaap H

2017-10-01

Stroke survivors often fall during walking. To reduce fall risk, gait testing and training with avoidance of virtual obstacles is gaining popularity. However, it is unknown whether and how virtual obstacle crossing is associated with fall risk. The present study assessed whether obstacle crossing characteristics are reliable and assessed differences in stroke survivors who prospectively experienced falls or no falls. We recruited twenty-nine community dwelling chronic stroke survivors. Participants crossed five virtual obstacles with increasing lengths. After a break, the test was repeated to assess test-retest reliability. For each obstacle length and trial, we determined; success rate, leading limb preference, pre and post obstacle distance, margins of stability, toe clearance, and crossing step length and speed. Subsequently, fall incidence was monitored using a fall calendar and monthly phone calls over a six-month period. Test-retest reliability was poor, but improved with increasing obstacle-length. Twelve participants reported at least one fall. No association of fall incidence with any of the obstacle crossing characteristics was found. Given the absence of height of the virtual obstacles, obstacle avoidance may have been relatively easy, allowing participants to cross obstacles in multiple ways, increasing variability of crossing characteristics and reducing the association with fall risk. These finding cast some doubt on current protocols for testing and training of obstacle avoidance in stroke rehabilitation. Copyright © 2017 Elsevier B.V. All rights reserved.

Environmental Sensitivity Index (ESI) Atlas: Rhode Island, Connecticut, and the New York-New Jersey Metropolitan Area - Volume 1, Geographic Information Systems data and Volume 2, Maps in Portable Document Format (NODC Accession 0014792)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set comprises the Environmental Sensitivity Index (ESI) data for Rhode Island, Connecticut, and the New York - New Jersey Metropolitan Area from 1999 to...

Approach to Fall in Elderly Population

Directory of Open Access Journals (Sweden)

Mehmet Ilkin Naharci

2009-10-01

Full Text Available Falls are one of the geriatric syndromes which occur commonly and significantly increase morbidity and mortality rates in elderly. The incidence of falls increases with age. Falls usually occur when impairments in cognitive, behavioral, and executive function begin. The incidence of fall is between 30 and 40 percent of community-dwelling people and approximately 50 percent of individuals in the long-term care setting over the age of 65 years. Fracture (hip, arm, wrist, pelvis, head trauma or major lacerations, as defined serious wounding, occur 10-25% of elderly cases. Fall is overlooked in clinical examination due to various reasons; the patient never mentions the event to a doctor; there is no injury at the time of the fall; the doctor fails to ask the patient about a history of falls; or either doctor or patient erroneously believes that falls are an inevitable part of the aging process. Elderly give not usually any self-information about fall, for this reason, all older patients should be asked at least once per year about falls and should be assessed in terms of balance and gait disorders. There are many distinct causes for falls in old people. Falls in older individuals occur when a threat to the normal homeostatic mechanisms that maintain postural stability is superimposed on underlying age-related declines in balance, ambulation, and cardiovascular function. This factor may be an acute illness (eg, fever, water loss, arrhythmia, a new medication, an environmental stress (eg, unfamiliar surrounding, or an unsafe walking surface. The elderly person can not cope with happened additional stress. To prevent and decrease the frequency of falls, effective approaches are medical interventions, environmental modifications, education-exercise programs, and assisted device. Detection and amelioration of risk factors can significantly reduce the rate of future falls. The assessment of fall, causing mobility restriction, use of nursing home, and

Development and feasibility of falls prevention advice.

Science.gov (United States)

van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth

2011-10-01

This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.

Science.gov (United States)

Healey, Frances; Lowe, Derek; Darowski, Adam; Windsor, Julie; Treml, Jonathan; Byrne, Lisa; Husk, Janet; Phipps, Jill

2014-07-01

inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. : data on delivery of falls prevention processes were collected at baseline and for 18 months from nine FallSafe units and nine control units. Data on falls were collected from local risk management systems for 24 months, and data on under-reporting through staff surveys. : in FallSafe units, delivery of seven care bundle components significantly improved; most improvements were sustained after active project support was withdrawn. Twelve-month moving average of reported fall rates showed a consistent downward trend in FallSafe units but not controls. Significant reductions in reported fall rate were found in FallSafe units (adjusted rate ratio (ARR) 0.75, 95% confidence interval (CI) 0.68-0.84 P control units (ARR 0.91, 95% CI 0.81-1.03 P = 0.13). No significant changes in injurious fall rate were found in FallSafe units (ARR 0.86, 95% CI 0.71-1.03 P = 0.11), or controls (ARR 0.88, 95% CI 0.72-1.08 P = 0.13). In FallSafe units, staff certain falls had been reported increased from 60 to 77%. : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An outpatient multifactorial falls prevention intervention does not reduce falls in high-risk elderly Danes

DEFF Research Database (Denmark)

Vind, Ane B; Andersen, Hanne E; Pedersen, Kirsten D

2009-01-01

, mean age 74, 73.7%women, who had visited the emergency department or had been hospitalized due to a fall. INTERVENTION: Identification of general medical, cardiovascular, and physical risk factors for falls and individual intervention in the intervention group. Participants in the control group....... Followup exceeded 90.0%. A total of 422 falls were registered in the intervention group, 398 in the control group. Intention-to-treat analysis revealed no effect of the intervention on fall rates (relative risk=1.06, 95%confidence interval (CI)=0.75 -1.51), proportion with falls (odds ratio (OR)=1.20, 95......OBJECTIVES: To evaluate the effect of multifactorial fall prevention in community-dwelling people aged 65 and older in Denmark. DESIGN: Randomized, controlled clinical trial. SETTING: Geriatric outpatient clinic at Glostrup University Hospital. PARTICIPANTS: Three hundred ninety-two elderly people...

Investigation and hazard assessment of the 2003 and 2007 Staircase Falls rock falls, Yosemite National Park, California, USA

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G. F. Wieczorek

2008-05-01

Full Text Available Since 1857 more than 600 rock falls, rock slides, debris slides, and debris flows have been documented in Yosemite National Park, with rock falls in Yosemite Valley representing the majority of the events. On 26 December 2003, a rock fall originating from west of Glacier Point sent approximately 200 m³ of rock debris down a series of joint-controlled ledges to the floor of Yosemite Valley. The debris impacted talus near the base of Staircase Falls, producing fragments of flying rock that struck occupied cabins in Curry Village. Several years later on 9 June 2007, and again on 26 July 2007, smaller rock falls originated from the same source area. The 26 December 2003 event coincided with a severe winter storm and was likely triggered by precipitation and/or frost wedging, but the 9 June and 26 July 2007 events lack recognizable triggering mechanisms. We investigated the geologic and hydrologic factors contributing to the Staircase Falls rock falls, including bedrock lithology, weathering, joint spacing and orientations, and hydrologic processes affecting slope stability. We improved upon previous geomorphic assessment of rock-fall hazards, based on a shadow angle approach, by using STONE, a three-dimensional rock-fall simulation computer program. STONE produced simulated rock-fall runout patterns similar to the mapped extent of the 2003 and 2007 events, allowing us to simulate potential future rock falls from the Staircase Falls detachment area. Observations of recent rock falls, mapping of rock debris, and simulations of rock fall runouts beneath the Staircase Falls detachment area suggest that rock-fall hazard zones extend farther downslope than the extent previously defined by mapped surface talus deposits.

Investigation and hazard assessment of the 2003 and 2007 Staircase Falls rock falls, Yosemite National Park, California, USA

Science.gov (United States)

Wieczorek, G. F.; Stock, G. M.; Reichenbach, P.; Snyder, J. B.; Borchers, J. W.; Godt, J. W.

2008-05-01

Since 1857 more than 600 rock falls, rock slides, debris slides, and debris flows have been documented in Yosemite National Park, with rock falls in Yosemite Valley representing the majority of the events. On 26 December 2003, a rock fall originating from west of Glacier Point sent approximately 200 m3 of rock debris down a series of joint-controlled ledges to the floor of Yosemite Valley. The debris impacted talus near the base of Staircase Falls, producing fragments of flying rock that struck occupied cabins in Curry Village. Several years later on 9 June 2007, and again on 26 July 2007, smaller rock falls originated from the same source area. The 26 December 2003 event coincided with a severe winter storm and was likely triggered by precipitation and/or frost wedging, but the 9 June and 26 July 2007 events lack recognizable triggering mechanisms. We investigated the geologic and hydrologic factors contributing to the Staircase Falls rock falls, including bedrock lithology, weathering, joint spacing and orientations, and hydrologic processes affecting slope stability. We improved upon previous geomorphic assessment of rock-fall hazards, based on a shadow angle approach, by using STONE, a three-dimensional rock-fall simulation computer program. STONE produced simulated rock-fall runout patterns similar to the mapped extent of the 2003 and 2007 events, allowing us to simulate potential future rock falls from the Staircase Falls detachment area. Observations of recent rock falls, mapping of rock debris, and simulations of rock fall runouts beneath the Staircase Falls detachment area suggest that rock-fall hazard zones extend farther downslope than the extent previously defined by mapped surface talus deposits.

Fall prevention in nursing homes

DEFF Research Database (Denmark)

Andresen, Mette; Hauge, Johnny

2014-01-01

that the number of hospitalization after a fall injury will become an even greater task for the Danish hospitals, The aim of the study was to show if there is a relationship between physically frail elderly nursing home resident’s subjective evaluation of fall-risk and an objective evaluation of their balance....... Further, to suggest tools for fall prevention in nursing home settings on the basis of the results of this study and the literature. A quantitative method inspired by the survey method was used to give an overview of fall patterns, subjective and objective evaluations of fallrisk. Participants were 16...... physically frail elderly nursing home residents from three different nursing homes. Measures: a small staff-questionnaire about incidences and places where the participants had falling-episodes during a 12 month period, The Falls Effi cacy Scale Swedish version (FES(S)) and Berg Balance Scale (BBS) Results...

Falls: epidemiology, pathophysiology, and relationship to fracture.

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Berry, Sarah D; Miller, Ram R

2008-12-01

Falls are common in the elderly, and frequently result in injury and disability. Most falls result from an interaction between individual characteristics that increase an individual's propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, comorbidities such as osteoarthritis, visual impairment and dementia, psychotropic medications, and certain types of footwear. Fewer studies have focused on acute precipitating factors, but environmental and situational factors are clearly important to fall risk. Approximately 30% of falls result in an injury that requires medical attention, with fractures occurring in approximately 10%. In addition to the risk factors for falls, the fall descent, fall impact, and bone strength are all important determinants of whether a fall will result in a fracture. In recent years, numerous studies have been directed toward the development of effective fall and fall-related fracture prevention interventions.

Ground water input to coastal salt ponds of southern Rhode Island estimated using 226Ra as a tracer.

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Scott, M K; Moran, S B

2001-01-01

The naturally occurring radionuclide 226Ra (t1/2 = 1600 years) was used as a tracer to determine ground water input to Point Judith, Potter, Green Hill and Ninigret ponds in southern Rhode Island. Measurements of 226Ra activity were made in samples collected from salt ponds, pore waters, sediments, and local ground water wells during June-August, 1997. These results were combined with a simple box model to derive ground water input fluxes of 0.1-0.3 cm3 cm-2 d-1 (2-5 x 10(7) L d-1), which are comparable to previous estimates of ground water input to these ponds.

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

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

2017-05-01

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

Is a fall just a fall : correlates of falling in healthy older persons. The Health, Aging and Body Composition Study

NARCIS (Netherlands)

de Rekeneire, Nathalie; Visser, Marjolein; Peila, Rita; Nevitt, Michael C; Cauley, Jane A; Tylavsky, Frances A; Simonsick, Eleanor M; Harris, Tamara B

OBJECTIVES: To identify factors associated with falling in well-functioning older people. DESIGN: Cross-sectional analyses of report of falls over the past 12 months using baseline data from the Health, Aging and Body Composition Study. SETTING: Clinic examinations in Pittsburgh, Pennsylvania, or

Macrophthalmus graeffei A. Milne Edwards, 1873 (Crustacea: Brachyura: Macrophthalmidae: a new Indo-Pacific guest off Rhodes Island (SE Aegean Sea, Greece

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M.A. PANCUCCI-PAPADOPOULOU

2010-05-01

Full Text Available A new alien crab, the macrophthalmid Macrophthalmus graeffei, is reported from the eastern coastline of Rhodes Island. The species, of Indo-West Pacific origin, is known from muddy sediments up to about 80 m depth. In the Mediterranean, its presence has been observed along Levantine coasts as well as along the Turkish coast of the Aegean Sea.Macrophthalmus graeffei increases to twelve the number of alien brachyurans present in the Hellenic SE Aegean Sea, ten of them having Indo-Pacific origin.

The Association Between Body Adiposity Measures, Postural Balance, Fear of Falling, and Fall Risk in Older Community-Dwelling Women.

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Neri, Silvia Gonçalves Ricci; Gadelha, André Bonadias; de David, Ana Cristina; Ferreira, Aparecido Pimentel; Safons, Marisete Peralta; Tiedemann, Anne; Lima, Ricardo M

2017-12-07

Recent investigations demonstrate an association between obesity and the propensity of older adults to fall. The aim of this study was to investigate the association between body adiposity measures, postural balance, fear of falling, and risk of falls in older women. One hundred forty-seven volunteers took part in this cross-sectional study. Participants underwent body composition assessment using dual-energy x-ray absorptiometry and had body mass index, waist circumference (WC), and body adiposity index measured. Postural balance was assessed using a force platform, while fear of falling and risk of falls were, respectively, evaluated by the Falls Efficacy Scale-International and the QuickScreen Clinical Falls Risk Assessment. All adiposity measures were correlated to at least 1 postural stability parameter and to fear of falling (ρ= 0.163, P risk of falls (ρ= 0.325; P falling (28.04 vs 24.59; P = .002) and had a higher proportion of individuals with increased fall risk (72% vs 35%; P risk of falls in older women, which might be mediated by reduced postural balance and increased fear of falling. Among these indices, WC, an easy and low-cost assessment, demonstrated the strongest association with falls-related outcomes.

[Falls of older individuals: medical assessment].

Science.gov (United States)

De Breucker, S; Nkodo Mekongo, Y P; Ibebeke, B; Pepersack, T

2007-01-01

Falls are one of the most common problems that threaten the independence of older individuals. They usually occur when impairments in multiple domains compromise the compensatory ability of the individual, as is the case for many geriatric syndromes. A number of the physical conditions and environmental situations predispose to falls. The medical risk factors of falls are reviewed. Falls in older individuals are rarely due to a single cause. Mechanisms that maintain postural stability are altered with aging (balance, gait speed, cardiovascular function). Female gender, past history of a fall, cognitive impairment, lower extremity weakness, balance problems, psychotropic drug use, arthritis, history of stroke, orthostatic hypotension, dizziness, and anemia represent the most frequent causes of risk of falls. Physical examination should focus upon the above mentioned risk factors and also on the presence of orthostatic hypotension, visual acuity, hearing assessment, examination of the extremities for deformities or neuropathies, and carotid sinus hypersensitivity which contributes to falls in people with unexplained falls. In conclusion, assessment of older individual at risk of falls or who fall present medical specificities. However, these latter specificities should be included in a comprehensive assessment which focus on intrinsic and extrinsic factors. Interventional strategies including comprehensive and interdisciplinary assessment lead to effective prevention.

A Wavelet-Based Approach to Fall Detection

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Luca Palmerini

2015-05-01

Full Text Available Falls among older people are a widely documented public health problem. Automatic fall detection has recently gained huge importance because it could allow for the immediate communication of falls to medical assistance. The aim of this work is to present a novel wavelet-based approach to fall detection, focusing on the impact phase and using a dataset of real-world falls. Since recorded falls result in a non-stationary signal, a wavelet transform was chosen to examine fall patterns. The idea is to consider the average fall pattern as the “prototype fall”.In order to detect falls, every acceleration signal can be compared to this prototype through wavelet analysis. The similarity of the recorded signal with the prototype fall is a feature that can be used in order to determine the difference between falls and daily activities. The discriminative ability of this feature is evaluated on real-world data. It outperforms other features that are commonly used in fall detection studies, with an Area Under the Curve of 0.918. This result suggests that the proposed wavelet-based feature is promising and future studies could use this feature (in combination with others considering different fall phases in order to improve the performance of fall detection algorithms.

Childhood Falls With Occipital Impacts

NARCIS (Netherlands)

Atkinson, Norrell; van Rijn, Rick R.; Starling, Suzanne P.

2017-01-01

Falls are commonly reported in children who present with both accidental and inflicted brain injuries. Short falls rarely result in serious or life-threatening injuries. Our purpose is to describe a series of cases of short falls with occipital impact leading to subdural hemorrhage (SDH). We present

Predicting first fall in newly diagnosed Parkinson's disease: Insights from a fall-naïve cohort.

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Lord, Sue; Galna, Brook; Yarnall, Alison J; Coleman, Shirley; Burn, David; Rochester, Lynn

2016-12-01

Falls are common and associated with reduced independence and mortality in Parkinson's disease. Previous research has been conducted on falls-prevalent or advanced disease cohorts. This study identifies risk factors for first fall for 36 months in a newly diagnosed, falls-naïve cohort. A total of 121 consecutive Parkinson's disease patients were recruited. Falls data were collected prospectively during 36 months from diagnosis via monthly falls diaries and telephone follow-up for 117 participants. Assessment comprised a comprehensive battery of clinical, gait, and cognitive measures. Significant predictors were identified from decision-tree analysis and survival analysis with time to first fall during 36 months as the dependent variable. At baseline, 26 (22%) participants reported retrospective falls. At 36 months, the remaining cohort (n = 91) comprised 47 fallers (52%) and 30 (33%) nonfallers and 14 (15%) participants with incomplete diaries. Fallers presented with a significantly higher disease severity, poorer ability to stand on one leg, slower gait speed, increased stance time variability, and higher swing time asymmetry. Median time to first fall was 847 days. Gait speed, stance time, and Hoehn & Yahr III stage emerged as significant predictors of first fall, hazard ratio 3.44 (95% confidence interval [CI] 1.58 to 7.48), 3.31(95% CI 1.40 to 7.80), and 2.80 (95% CI 1.38 to 5.65), respectively. The hazard ratio for risk factors combined was 7.82 (CI 2.80 to 21.84). Interventions that target gait deficit and postural control in early Parkinson's disease may limit the potential for first fall. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Evaluating the fall risk among elderly population by choice step reaction test

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Wang D

2016-08-01

Full Text Available Donghai Wang,1 Jian Zhang,1 Yuliang Sun,2 Wenfei Zhu,2 Shiliu Tian,1 Yu Liu1 1Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai, People’s Republic of China; 2School of Physical Education, Shaanxi Normal University, Xian, People’s Republic of China Abstract: Falls during daily activities are often associated with injuries and physical disabilities, thereby affecting quality of life among elder adults. Balance control, which is crucial in avoiding falls, is composed of two elements: muscle strength and central nervous system (CNS control. A number of studies have reported that reduced muscle strength raises the risk of falling. However, to date there has been only limited research focused on the relationship between fall risk and the CNS. This study aimed to investigate the relationship between CNS and risk of falling among the elderly. A total of 140 elderly people (92 females and 48 males were divided into faller and nonfaller groups based on questionnaire responses concerning falls in their daily life. Participants undertook a choice step reaction test in which they were required to respond to random visual stimuli using foot movements as fast as possible in the left or right directions. Response time was quantified as premotor time (PMT and motor time (MT. In addition, the participants’ electromyography data were recorded during the choice step reaction test. A maximal isokinetic torque test was also performed. PMT was greater in the fallers than in the nonfallers group. There was a significant difference between fall status and direction on PMT. PMT of the left limb in nonfallers was faster than the right, but in fallers there was no difference between left and right limbs. A similar phenomenon was also observed for MT. There were significant differences between fallers and nonfallers in maximum isokinetic torque at knee and ankle joints. The correct rate of PMT was

Self-reported preclinical mobility limitation and fall history as predictors of future falls in older women: prospective cohort study

DEFF Research Database (Denmark)

Mänty, Minna Regina; Heinonen, A; Viljanen, A

2010-01-01

mobility limitation. Fall history was recalled for previous 12 months and dichotomized. The incidence of future falls over 12 months was followed up with fall calendars. RESULTS: During the fall follow-up, a total of 440 falls were reported by 201 participants. Among those with fall history, women...

Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy.

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Kim, Oksoo; Kim, Jung-Hee

2015-01-01

This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis. The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence. The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices. Stroke patients with fall experience and walking aids might be considered at increased risk of falling. Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients. © 2014 Association of Rehabilitation Nurses.

Civic Education Trends in Post-Communist Countries of Central and Eastern Europe. ERIC Digest.

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Hamot, Gregory E.

Developments during the decade and a half following the fall of communism in Central and Eastern Europe indicate broad advancement in civic education for democracy. This digest notes the rising trend in civic education competency in Central and Eastern Europe, describes an increasingly accepted and used framework for civic education, and…

Prevalence of falls in elderly women.

Science.gov (United States)

Vitor, Priscila Regina Rorato; de Oliveira, Ana Carolina Kovaleski; Kohler, Renan; Winter, Gabriele Regiane; Rodacki, Cintia; Krause, Maressa Priscila

2015-01-01

To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. The prevalence of falls in this sample was 32.4%. Among women fallers, 40% self-reported a high fear of falling. It is recommended that functional and resistance exercises are included in the preventive strategies for reducing risk factors for falls and its determinants in elderly women. Level of Evidence II, Prognostic-Prospective Study.

Ageing vision and falls: a review.

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Saftari, Liana Nafisa; Kwon, Oh-Sang

2018-04-23

Falls are the leading cause of accidental injury and death among older adults. One of three adults over the age of 65 years falls annually. As the size of elderly population increases, falls become a major concern for public health and there is a pressing need to understand the causes of falls thoroughly. While it is well documented that visual functions such as visual acuity, contrast sensitivity, and stereo acuity are correlated with fall risks, little attention has been paid to the relationship between falls and the ability of the visual system to perceive motion in the environment. The omission of visual motion perception in the literature is a critical gap because it is an essential function in maintaining balance. In the present article, we first review existing studies regarding visual risk factors for falls and the effect of ageing vision on falls. We then present a group of phenomena such as vection and sensory reweighting that provide information on how visual motion signals are used to maintain balance. We suggest that the current list of visual risk factors for falls should be elaborated by taking into account the relationship between visual motion perception and balance control.

Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls

NARCIS (Netherlands)

Mirjam Pijnappels; Sjoerd M. Bruijn; Kimberley M. Schooten; Jaap H. van Dieën; Dr. H.M. Wittink; Michiel Punt

2016-01-01

Background: Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model

Characteristics and adaptive strategies linked with falls in stroke survivors from analysis of laboratory-induced falls

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Honeycutt, Claire F.; Nevisipour, Masood; Grabiner, Mark D.

2016-01-01

Falls are the most common and expensive medical complication in stroke survivors. There is remarkably little information about what factors lead to a fall in stroke survivors. With few exceptions, the falls literature in stroke has focused on relating metrics of static balance and impairment to fall outcomes in the acute care setting or in community. While informative, these studies provide little information about what specific impairments in a stroke-survivor’s response to dynamic balance challenges lead to a fall. We identified the key kinematic characteristics of stroke survivors’ stepping responses following a balance disturbance that are associated with a fall following dynamic balance challenges. Stroke survivors were exposed to posteriorly-directed translations of a treadmill belt that elicited a stepping response. Kinematics were compared between successful and failed recovery attempts (i.e. a fall). We found that the ability to arrest and reverse trunk flexion and the ability to perform an appropriate initial compensatory step were the most critical response contributors to a successful recovery. We also identified 2 compensatory strategies utilized by stroke survivors to avoid a fall. Despite significant post-stroke functional impairments, the biomechanical causes of trip-related falls by stroke survivors appear to be similar to those of unimpaired older adults and lower extremity amputees. However, compensatory strategies (pivot, hopping) were observed. PMID:27614614

Falls and comorbidity

DEFF Research Database (Denmark)

Jørgensen, Terese Sara Høj; Hansen, Annette Højmann; Sahlberg, Marie

2014-01-01

AIMS: To compare nationwide time trends and mortality in hip and proximal humeral fractures; to explore associations between incidences of falls risk related comorbidities (FRICs) and incidence of fractures. METHODS: The study is a retrospective cohort study using nationwide Danish administrative....... CONCLUSIONS: The results suggest that the overall reduction in fractures can be explained by reduction in falls related comorbidity....

Home Improvements Prevent Falls

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... turn JavaScript on. Feature: Falls and Older Adults Home Improvements Prevent Falls Past Issues / Winter 2014 Table ... and ensure your safety. "Safe-ty-fy" Your Home Some Questions for Your Provider Will my medicines ...

Ambulatory fall-risk assessment: amount and quality of daily-life gait predict falls in older adults.

Science.gov (United States)

van Schooten, Kimberley S; Pijnappels, Mirjam; Rispens, Sietse M; Elders, Petra J M; Lips, Paul; van Dieën, Jaap H

2015-05-01

Ambulatory measurements of trunk accelerations can provide valuable information on the amount and quality of daily-life activities and contribute to the identification of individuals at risk of falls. We compared associations between retrospective and prospective falls with potential risk factors as measured by daily-life accelerometry. In addition, we investigated predictive value of these parameters for 6-month prospective falls. One week of trunk accelerometry (DynaPort MoveMonitor) was obtained in 169 older adults (mean age 75). The amount of daily activity and quality of gait were determined and validated questionnaires on fall-risk factors, grip strength, and trail making test were obtained. Six-month fall incidence was obtained retrospectively by recall and prospectively by fall diaries and monthly telephone contact. Among all participants, 35.5% had a history of ≥1 falls and 34.9% experienced ≥1 falls during 6-month follow-up. Logistic regressions showed that questionnaires, grip strength, and trail making test, as well as the amount and quality of gait, were significantly associated with falls. Significant associations differed between retrospective and prospective analyses although odds ratios indicated similar patterns. Predictive ability based on questionnaires, grip strength, and trail making test (area under the curve .68) improved substantially by accelerometry-derived parameters of the amount of gait (number of strides), gait quality (complexity, intensity, and smoothness), and their interactions (area under the curve .82). Daily-life accelerometry contributes substantially to the identification of individuals at risk of falls, and can predict falls in 6 months with good accuracy. © The Author 2015. 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.

Fall Prevention in a Primary Care Setting.

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Siegrist, Monika; Freiberger, Ellen; Geilhof, Barbara; Salb, Johannes; Hentschke, Christian; Landendoerfer, Peter; Linde, Klause; Halle, Martin; Blank, Wolfgang A

2016-05-27

Falls and fall-related injuries are common in community-dwelling elderly people. Effective multifactorial fall prevention programs in the primary care setting may be a promising approach to reduce the incidence rate of falls. In a cluster randomized trial in 33 general practices 378 people living independently and at high risk of falling (65 to 94 years old; 285 women) were allocated to either a 16 week exercise-based fall prevention program including muscle strengthening and challenging balance training exercises, combined with a 12 week home-based exercise program (222 participants), or to usual care (156 participants). The main outcome was number of falls over a period of 12 months. Secondary outcomes were the number of fall-related injuries, physical function (Timed-Up-and-Go-Test, TUG, Chair-Stand-Test, CST, modified Romberg Test), and fear of falling. In the intervention group (n=222 patients in 17 general practices) 291 falls occurred, compared to 367 falls in the usual care group (n=156 patients in 16 general practices). We observed a lower incidence rate for falls in the intervention group (incidence rate ratio/IRR: 0.54; 95% confidence interval (CI): [0.35; 0.84], p=0.007) and for fall-related injuries (IRR: 0.66; [0.42; 0.94], p=0.033). Additionally, patients in the intervention group showed significant improvements in secondary endpoints (TUG: -2.39 s, [-3.91; -0.87], p=0.014; mRomberg: 1.70 s, [0.35; 3.04], p=0.037; fear of falling: -2.28 points, [-3.87; -0.69], p=0.022) compared to usual care. A complex falls prevention program in a primary care setting was effective in reducing falls and fall-related injuries in community dwelling older adults at risk.

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

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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, pfall-related fractures (OR=6.84, 95%CI:5.45-8.58, pfall 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.

[Effects of a fall prevention program on falls in frail elders living at home in rural communities].

Science.gov (United States)

Yoo, Jae-Soon; Jeon, Mi Yang; Kim, Chul-Gyu

2013-10-01

This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.

Fall prevention in the elderly

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Ungar, Andrea; Rafanelli, Martina; Iacomelli, Iacopo; Brunetti, Maria Angela; Ceccofiglio, Alice; Tesi, Francesca; Marchionni, Niccolò

2013-01-01

Summary Falls are frequent in the elderly and affect mortality, morbidity, loss of functional capacity and institutionalization. In the older patient the incidence of falls can sometimes be underestimated, even in the absence of a clear cognitive impairment, because it is often difficult to reconstruct the dynamics. It is quite common that forms due to syncope are associated with retrograde amnesia and in 40 to 60% of the cases falls happen in the absence of witnesses. The pathogenesis of falls is often multifactorial, due to physiological age-related changes or more properly pathological factors, or due to the environment. The identification of risk factors is essential in the planning of preventive measures. Syncope is one of major causes of falls. About 20% of cardiovascular syncope in patients older than 70 appears as a fall and more than 20% of older people with Carotid Sinus Syndrome complain of falls as well as syncope. These data clearly state that older patients with history of falls should undergo a cardiovascular and neuroautonomic assessment besides the survey of other risk factors. Multifactorial assessment requires a synergy of various specialists. The geriatrician coordinates the multidisciplinary intervention in order to make the most effective evaluation of the risk of falling, searching for all predisposing factors, aiming towards a program of prevention. In clear pathological conditions it is possible to enact a specific treatment. Particular attention must indeed be paid to the re-evaluation of drug therapy, with dose adjustments or withdrawal especially for antihypertensive, diuretics and benzodiazepines. The Guidelines of the American Geriatrics Society recommend modification of environmental hazards, training paths, hip protectors and appropriate use of support tools (sticks, walkers), which can be effective elements of a multifactorial intervention program. Balance exercises are also recommended. In conclusion, an initial assessment

Fall prevention in the elderly.

Science.gov (United States)

Ungar, Andrea; Rafanelli, Martina; Iacomelli, Iacopo; Brunetti, Maria Angela; Ceccofiglio, Alice; Tesi, Francesca; Marchionni, Niccolò

2013-05-01

Falls are frequent in the elderly and affect mortality, morbidity, loss of functional capacity and institutionalization. In the older patient the incidence of falls can sometimes be underestimated, even in the absence of a clear cognitive impairment, because it is often difficult to reconstruct the dynamics. It is quite common that forms due to syncope are associated with retrograde amnesia and in 40 to 60% of the cases falls happen in the absence of witnesses. The pathogenesis of falls is often multifactorial, due to physiological age-related changes or more properly pathological factors, or due to the environment. The identification of risk factors is essential in the planning of preventive measures. Syncope is one of major causes of falls. About 20% of cardiovascular syncope in patients older than 70 appears as a fall and more than 20% of older people with Carotid Sinus Syndrome complain of falls as well as syncope. These data clearly state that older patients with history of falls should undergo a cardiovascular and neuroautonomic assessment besides the survey of other risk factors. Multifactorial assessment requires a synergy of various specialists. The geriatrician coordinates the multidisciplinary intervention in order to make the most effective evaluation of the risk of falling, searching for all predisposing factors, aiming towards a program of prevention. In clear pathological conditions it is possible to enact a specific treatment. Particular attention must indeed be paid to the re-evaluation of drug therapy, with dose adjustments or withdrawal especially for antihypertensive, diuretics and benzodiazepines. The Guidelines of the American Geriatrics Society recommend modification of environmental hazards, training paths, hip protectors and appropriate use of support tools (sticks, walkers), which can be effective elements of a multifactorial intervention program. Balance exercises are also recommended. In conclusion, an initial assessment, supported by a

Fall-Prone Older People's Attitudes towards the Use of Virtual Reality Technology for Fall Prevention.

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Dockx, Kim; Alcock, Lisa; Bekkers, Esther; Ginis, Pieter; Reelick, Miriam; Pelosin, Elisa; Lagravinese, Giovanna; Hausdorff, Jeffrey M; Mirelman, Anat; Rochester, Lynn; Nieuwboer, Alice

2017-01-01

Virtual reality (VR) technology is a relatively new rehabilitation tool that can deliver a combination of cognitive and motor training for fall prevention. The attitudes of older people to such training are currently unclear. This study aimed to investigate: (1) the attitudes of fall-prone older people towards fall prevention exercise with and without VR; (2) attitudinal changes after intervention with and without VR; and (3) user satisfaction following fall prevention exercise with and without VR. A total of 281 fall-prone older people were randomly assigned to an experimental group receiving treadmill training augmented by VR (TT+VR, n = 144) or a control group receiving treadmill training alone (TT, n = 137). Two questionnaires were used to measure (1) attitudes towards fall prevention exercise with and without VR (AQ); and (2) user satisfaction (USQ). AQ was evaluated at baseline and after intervention. USQ was measured after intervention only. The AQ revealed that most participants had positive attitudes towards fall prevention exercise at baseline (82.2%) and after intervention (80.6%; p = 0.144). In contrast, only 53.6% were enthusiastic about fall prevention exercise with VR at baseline. These attitudes positively changed after intervention (83.1%; p < 0.001), and 99.2% indicated that they enjoyed TT+VR. Correlation analyses showed that postintervention attitudes were strongly related to user satisfaction (USQ: r = 0.503; p < 0.001). Older people's attitudes towards fall prevention exercise with VR were positively influenced by their experience. From the perspective of the user, VR is an attractive training mode, and thus improving service provision for older people is important. © 2017 S. Karger AG, Basel.

Falls and patient safety for older adults.

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Aronovitch, Sharon A

2006-10-01

The risk of falling increases with age. Falls in the elderly have been found to raise mortality and morbidity rates and are a leading cause of premature admission to long-term care facilities. Attention to known intrinsic and extrinsic factors that predispose to falling is important in community dwelling and institutionalized older adults. New government guidelines for long-term care facilities have helped focus attention on the safety aspect of fall risk and information about the physical and psychological impact of falling is increasing. Implementation of fall prevention protocols, including the use of fall risk assessment tools, may help reduce the incidence of falls and resultant complications.

[Muscle and bone health as a risk factor of fall among the elderly. Kaigoyobou and prevention of falling].

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Obuchi, Shuichi

2008-06-01

Kaigoyobou, prevention of long-term care use, is a comprehensive approach, including physical, nutritional, and social, to maintain independent living in the elderly. Prevention of falling is one useful method of Kaigoyobou. From literature review, post-fall syndrome should be primarily eliminated in the elderly since falling rate of the elderly with the falling history reported significantly greater falling rate than the other community dwelling elderly. The ability to avoid falling when they trip or slip during walking may be the most important physical function needed to be intervened. In order to train elderly person successfully, nutritional intervention need to be considered into fall prevention program.

Older persons afraid of falling reduce physical activity to prevent outdoor falls

NARCIS (Netherlands)

Wijlhuizen, G.J.; Jong, R. de; Hopman-Rock, M.

2007-01-01

Objective.: The aim of this study was to test the assumption that the level of outdoor physical activity mediates the relationship between fear of falling and actual outdoor falls according to the Task Difficulty Homeostasis Theory. Method.: A prospective follow-up study of 10 months conducted in

Problems and fall risk determinants of quality of life in older adults with increased risk of falling.

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Lin, Sang-I; Chang, Ku-Chou; Lee, Hsuei-Chen; Yang, Yi-Ching; Tsauo, Jau-Yih

2015-05-01

Determine quality of life and its association with fall risk factors in older adults with increased risk of falling. A total of 597 community-dwelling Taiwanese older adults who were screened to have increased risk of falling participated in the present study. The fall risk factors included sociodemographics, physical and psychological function, Timed Up and Go, past fall/medical histories, fear of falling and medications. The Euro QOL EQ-5D was used to measure health-related quality of life. Pain/discomfort was the EQ-5D dimension most frequently reported to be impaired (35%), regardless of the level of fall risk or age groups, followed by mobility (25%). Hierarchical regression analysis showed that Geriatric Depression Scale, Mini-Mental State Examination, physiological function, up-and-go, fear of falling and psychotropic medication were independent predictors for total EQ-5D, explaining 68.37% of the variance. Logistic regression analysis showed that for the five EQ-5D dimensions, Geriatric Depression Scale and Up and Go time were the most common determinants. Pain/discomfort was the leading impairment, and greater Geriatric Depression Scale and longer up-and-go time were the main contributing factors in declines in quality of life in older adults with increased risk of falling. These factors are often modifiable, and their management might be considered a priority in falls prevention. © 2014 Japan Geriatrics Society.

An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls

Directory of Open Access Journals (Sweden)

Schuster Tibor

2011-02-01

Full Text Available Abstract Background Prevention of falls in the elderly is a public health target in many countries around the world. While a large number of trials have investigated the effectiveness of fall prevention programs, few focussed on interventions embedded in the general practice setting and its related network. In the Prevent Falls (PreFalls trial we aim to investigate the effectiveness of a pre-tested multi-modal intervention compared to usual care in this setting. Methods/Design PreFalls is a controlled multicenter prospective study with cluster-randomized allocation of about 40 general practices to an experimental or a control group. We aim to include 382 community dwelling persons aged 65 and older with an increased risk of falling. All participating general practitioners are trained to systematically assess the risk of falls using a set of validated tests. Patients from intervention practices are invited to participate in a 16-weeks exercise program with focus on fall prevention delivered by specifically trained local physiotherapists. Patients from practices allocated to the control group receive usual care. Main outcome measure is the number of falls per individual in the first 12 months (analysis by negative binomial regression. Secondary outcomes include falls in the second year, the proportion of participants falling in the first and the second year, falls associated with injury, risk of falls, fear of falling, physical activity and quality of life. Discussion Reducing falls in the elderly remains a major challenge. We believe that with its strong focus on a both systematic and realistic fall prevention strategy adapted to primary care setting PreFalls will be a valuable addition to the scientific literature in the field. Trial registration NCT01032252

The Role of the Humanities in Decolonising the Academy

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Prinsloo, Estelle H.

2016-01-01

This short paper argues that the #RhodesMustFall movement, which originated at the University of Cape Town, has brought renewed attention to the need to decolonise the academy in South Africa. It further argues that the Humanities are ideally placed to engage with the intellectual problems and questions presented by the decolonisation debate. Deep…

Free Falling in Stratified Fluids

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Lam, Try; Vincent, Lionel; Kanso, Eva

2017-11-01

Leaves falling in air and discs falling in water are examples of unsteady descents due to complex interaction between gravitational and aerodynamic forces. Understanding these descent modes is relevant to many branches of engineering and science such as estimating the behavior of re-entry space vehicles to studying biomechanics of seed dispersion. For regularly shaped objects falling in homogenous fluids, the motion is relatively well understood. However, less is known about how density stratification of the fluid medium affects the falling behavior. Here, we experimentally investigate the descent of discs in both pure water and in stable linearly stratified fluids for Froude numbers Fr 1 and Reynolds numbers Re between 1000 -2000. We found that stable stratification (1) enhances the radial dispersion of the disc at landing, (2) increases the descent time, (3) decreases the inclination (or nutation) angle, and (4) decreases the fluttering amplitude while falling. We conclude by commenting on how the corresponding information can be used as a predictive model for objects free falling in stratified fluids.

The neurobiology of falls.

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Fasano, Alfonso; Plotnik, Meir; Bove, Francesco; Berardelli, Alfredo

2012-12-01

Falling is a major clinical problem; especially, in elderly population as it often leads to fractures, immobilization, poor quality of life and life-span reduction. Given the growing body of evidences on the physiopathology of balance disorders in humans, in recent years the approach of research on falls has completely changed and new instruments and new definitions have been formulated. Among them, the definition of "idiopathic faller" (i.e. no overt cause for falling in a given subject) represented a milestone in building the "science of falling". This review deals with the new determinants of the neurobiology of falling: (1) the role of motor impairment and particularly of those "mild parkinsonian signs" frequently detectable in elderly subjects, (2) the role of executive and attentive resources when coping with obstacles, (3) the role of vascular lesions in "highest level gait disorder" (a condition tightly connected with senile gait, cautious gait and frailty), (4) the role of the failure of automaticity or inter-limbs coordination/symmetry during walking and such approach would definitely help the development of screening instrument for subjects at risk (still lacking in present days). This translational approach will lead to the development of specific therapeutic interventions.

Fall Prevention: Simple Tips to Prevent Falls

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... a gentle exercise that involves slow and graceful dance-like movements. Such activities reduce the risk of ... healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358 . Mayo Clinic Footer Legal Conditions and Terms ...

Falling from the Past. Geographies of exceptionalism in two novels by Jay McInerney

Directory of Open Access Journals (Sweden)

Fiorenzo Iuliano

2011-09-01

Full Text Available Celebrating the glamorous 1980s, Jay McInerney has described the fall of the ambitions and delusions of yuppies in New York City. The vibrant atmosphere of his debut novel (Bright Lights, Big City, 1984 comes to a sudden end in Brightness Falls (1987, where the 1987 stock market crash is prophesied and narrated in its consequences on the lives of a young, brilliant couple, Corrine and Russell Calloway. Almost twenty years later, in The Good Life (2006, McInerney takes up Russell’s and Corrine’s stories again, now in the aftermath of September 11. This article focuses on the symbolic economy of the US territory. The 1980s, as they have been represented in Brightness Falls, witnessed the boisterous celebration of New York City and its centrality in the imaginary geography of the USA. When New York apparently starts crumbling under the terrorist attacks, the protagonists of The Good Life ideally (and sometimes physically go back to their native places. In particular, one of the novel’s central characters, Luke McGavock, who starts an affair with Corrine while they are both volunteering at Ground Zero, returns to his native Tennessee, where is confronted with the memory of the Civil War. From this moment on, the novel starts tracing an implicit and highly thought-provoking parallel between the defeated nineteenth-century South and the synecdochic New York City at the turn of the twenty-first century, whose crash has engendered the dramatic need for the US to face the burden of its own history.

Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials.

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Mansfield, Avril; Wong, Jennifer S; Bryce, Jessica; Knorr, Svetlana; Patterson, Kara K

2015-05-01

Older adults and individuals with neurological conditions are at an increased risk for falls. Although physical exercise can prevent falls, certain types of exercise may be more effective. Perturbation-based balance training is a novel intervention involving repeated postural perturbations aiming to improve control of rapid balance reactions. The purpose of this study was to estimate the effect of perturbation-based balance training on falls in daily life. MEDLINE (1946-July 2014), EMBASE (1974-July 2014), PEDro (all dates), CENTRAL (1991-July 2014), and Google Scholar (all dates) were the data sources used in this study. Randomized controlled trials written in English were included if they focused on perturbation-based balance training among older adults or individuals with neurological conditions and collected falls data posttraining. Two investigators extracted data independently. Study authors were contacted to obtain missing information. A PEDro score was obtained for each study. Primary outcomes were proportion of participants who reported one or more falls (ie, number of "fallers") and the total number of falls. The risk ratio (proportion of fallers) and rate ratio (number of falls) were entered into the analysis. Eight studies involving 404 participants were included. Participants who completed perturbation-based balance training were less likely to report a fall (overall risk ratio=0.71; 95% confidence interval=0.52, 0.96; P=.02) and reported fewer falls than those in the control groups (overall rate ratio=0.54; 95% confidence interval=0.34, 0.85; P=.007). Study authors do not always identify that they have included perturbation training in their intervention; therefore, it is possible that some appropriate studies were not included. Study designs were heterogeneous, preventing subanalyses. Perturbation-based balance training appears to reduce fall risk among older adults and individuals with Parkinson disease. © 2015 American Physical Therapy Association.

Dance movement therapy and falls prevention.

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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.

Fall speed measurement and high-resolution multi-angle photography of hydrometeors in free fall

OpenAIRE

T. J. Garrett; C. Fallgatter; K. Shkurko; D. Howlett

2012-01-01

We describe here a new instrument for imaging hydrometeors in free fall. The Multi-Angle Snowflake Camera (MASC) captures high-resolution photographs of hydrometeors from three angles while simultaneously measuring their fall speed. Based on the stereoscopic photographs captured over the two months of continuous measurements obtained at a high altitude location within the Wasatch Front in Utah, we derive statistics for fall speed, hydrometeor size, shape, orientation and asp...

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

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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 performances on all functional tests predicted in-hospital falls and injurious falls (p 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.

Evaluation of the Frails' Fall Efficacy by Comparing Treatments (EFFECT) on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial.

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Kwok, Boon Chong; Mamun, Kaysar; Chandran, Manju; Wong, Chek Hooi

2011-06-18

Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contributes to avoidance of activities and functional decline. This randomised active-control trial is a comparison between the Nintendo WiiActive programme against standard gym-based rehabilitation of the older population. Eighty subjects aged above 60, fallers and non-fallers, will be recruited from the hospital outpatient clinic. The primary outcome measure is the Modified Falls Efficacy Scale and the secondary outcome measures are self-reported falls, quadriceps strength, walking agility, dynamic balance and quality of life assessments. The study is the first randomised control trial using the Nintendo Wii as a rehabilitation modality investigating a change in fall efficacy and self-reported falls. Longitudinally, the study will investigate if the interventions can successfully reduce falls and analyse the cost-effectiveness of the programme.

FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

Directory of Open Access Journals (Sweden)

Michaela Dingová

2017-03-01

Full Text Available Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged from data analysis: development of the fear of falling, feared consequences of falling, activities curtailment, fall prevention behavior and meaning of social support in daily life. The fear of falling was described as a negative experience, directly linked to fall consequences such as physical injury, incapacitation, loss of autonomy, fear of dependence and experience of humiliating conditions. To maintain a certain level of independence in daily life, the participants chose to avoid falls by activity curtailment, organizing their lives more carefully and getting support from others. Conclusion: All participants identified that they had discovered their fear of falling after experiencing falls. The fear of falling was associated with feared consequences of a potential fall and had an impact on their daily life. The participant also mentioned other contributors to their fear of falling, including ill health and aging. Keywords: Fear of falling, older adults, perceived consequences of falls, daily life.

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

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

2014-10-01

Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor's accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the

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

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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

A simple strategy for fall events detection

KAUST Repository

Harrou, Fouzi

2017-01-20

The paper concerns the detection of fall events based on human silhouette shape variations. The detection of fall events is addressed from the statistical point of view as an anomaly detection problem. Specifically, the paper investigates the multivariate exponentially weighted moving average (MEWMA) control chart to detect fall events. Towards this end, a set of ratios for five partial occupancy areas of the human body for each frame are collected and used as the input data to MEWMA chart. The MEWMA fall detection scheme has been successfully applied to two publicly available fall detection databases, the UR fall detection dataset (URFD) and the fall detection dataset (FDD). The monitoring strategy developed was able to provide early alert mechanisms in the event of fall situations.

Impact of falls and fear of falling on health-related quality of life in patients with Parkinson's disease

NARCIS (Netherlands)

Grimbergen, Y.A.M.; Schrag, A.; Mazibrada, G.; Borm, G.F.; Bloem, B.R.

2013-01-01

Postural instability, recurrent falls and fear of falling are common in advanced Parkinson's disease (PD). We examined the impact of fall frequency, fear of falling, balance confidence and objectively measured balance impairment (using Tinetti's Mobility Index) on health-related quality of life

[Influence of high fall-related self-efficacy on falls due to dissociation with ADL among elderly women in nursing homes].

Science.gov (United States)

Kato, Chikako; Ida, Kunio; Harada, Atsushi

2009-09-01

We examined the influence of high fall-related self-efficacy on falls due to dissociation with activities of daily living (ADL) among elderly women in nursing homes. We enrolled 72 female nursing home residents who were 70 years old or over and who scored 18 or higher on the Mini-Mental State Examination (MMSE). Subjects were classified into three groups based on the relationship between ADL and fall-related self-efficacy derived from a scattergram of the Functional Independence Measure (FIM) motor items and Falls Efficacy Scale (FES). The three groups were: group I which had low ADL and high fall-related self-efficacy (n=25); group II which had high ADL and low fall-related self-efficacy (n=30); and group III which had a correlation of ADL and fall-related self-efficacy in the 95% confidence interval (n=17). Then, we investigated the incidence of falls and the number of falls after 6 months in the three groups. The risk factor of falls was also investigated using multiple logistic regression analysis. The incidence and number of falls were significantly different in the three groups after 6 months. Moreover, the incidence of those falling was significantly different between group I and group III. The occurrence of falls was also significantly related with a past history of falls, FES, and group I which had low ADL and high fall-related self-efficacy. These findings suggest that the risk of falling increases in the presence of excessive fall-related self-efficacy dissociated from ADL.

An update on falls

NARCIS (Netherlands)

Bloem, B.R.; Steijns, J.A.G.; Smits-Engelsman, B.C.M.

2003-01-01

Purpose of review: Falls among elderly persons create immense social problems because of their association with physical decline, serious psychosocial consequences, negative impact on the quality of life, and markedly reduced survival. In addition, falls pose high costs to the public health service.

An update on falls.

NARCIS (Netherlands)

Bloem, B.R.; Steijns, J.A.G.; Smits-Engelsman, B.C.M.

2003-01-01

PURPOSE OF REVIEW: Falls among elderly persons create immense social problems because of their association with physical decline, serious psychosocial consequences, negative impact on the quality of life, and markedly reduced survival. In addition, falls pose high costs to the public health service.

The Inevitable Universe---Parker-Rhodes' peculiar mixture of ontology and physics

International Nuclear Information System (INIS)

Noyes, H.P.

1989-12-01

When asked to give a lecture on Parker-Rhodes' physics, I was somewhat non-plused. I almost replied ''What physics?'' --- a point of view that Frederick expresses himself more than once in the book he was working on when he died. But that would be unjust. Whatever his view, I assert that the discovery of the Combinational Hierarchy is one of the most important ''discoveries'' --- or whatever you want to call it --- in physics made in this century. His calculation of the proton-electron mass ratio is also a fantastic result that we are still trying to come to grips with. And his insight into early cosmology --- what he called a ''cold big bang'' --- which appeared in an early version of the Theory of Indistinguishables, also had merit. His early universe is a lot closer to my own views now than I realized when I first encountered it. We will mention other insights as I go along. But his views are so different from those of anyone I know or knew, that I have decided to let him speak for himself by reading passages from his manuscript The Inevitable Universe, or TIU, which was still unpublished at the time of his death, and add a few comments on them

Survival of falling robots

Science.gov (United States)

Cameron, Jonathan M.; Arkin, Ronald C.

1992-01-01

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

Survival of falling robots

Science.gov (United States)

Cameron, Jonathan M.; Arkin, Ronald C.

1992-02-01

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

Comparison of fall prediction by the Hessisch Oldendorf Fall Risk Scale and the Fall Risk Scale by Huhn in neurological rehabilitation: an observational study.

Science.gov (United States)

Hermann, Olena; Schmidt, Simone B; Boltzmann, Melanie; Rollnik, Jens D

2018-05-01

To calculate scale performance of the newly developed Hessisch Oldendorf Fall Risk Scale (HOSS) for classifying fallers and non-fallers in comparison with the Risk of Falling Scale by Huhn (FSH), a frequently used assessment tool. A prospective observational trail was conducted. The study was performed in a large specialized neurological rehabilitation facility. The study population ( n = 690) included neurological and neurosurgery patients during neurological rehabilitation with varying levels of disability. Around the half of the study patients were independent and dependent in the activities of daily living (ADL), respectively. Fall risk of each patient was assessed by HOSS and FSH within the first seven days after admission. Event of fall during rehabilitation was compared with HOSS and FSH scores as well as the according fall risk. Scale performance including sensitivity and specificity was calculated for both scales. A total of 107 (15.5%) patients experienced at least one fall. In general, fallers were characterized by an older age, a prolonged length of stay, and a lower Barthel Index (higher dependence in the ADL) on admission than non-fallers. The verification of fall prediction for both scales showed a sensitivity of 83% and a specificity of 64% for the HOSS scale, and a sensitivity of 98% with a specificity of 12% for the FSH scale, respectively. The HOSS shows an adequate sensitivity, a higher specificity and therefore a better scale performance than the FSH. Thus, the HOSS might be superior to existing assessments.

Fear of falling and gait parameters in older adults with and without fall history.

Science.gov (United States)

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

2017-12-01

Fear of falling (FOF) is associated with spatial and temporal gait parameters in older adults. FOF is prevalent among older adults, both those with and without fall history. It is still unclear whether the relationships between FOF and gait parameters are affected by fall history. The aim of the present study was to compare gait parameters by the presence of FOF and fall history. A total of 3575 older adults (mean age 71.7 years, 49.7% female) met the inclusion criteria for the present study. We assessed the presence of fall history and FOF by face-to-face interview, and gait parameters (gait speed, stride length, step rate, double support time and variation of stride length) at a comfortable speed using a computerized electronic walkway. Prevalences of fall history and FOF were as follows: non-fallers without FOF 52.6% (n = 1881); fallers without FOF 6.3% (n = 227); non-fallers with FOF 34.4% (n = 1229); and fallers with FOF 6.7% (n = 238). Analysis of covariance showed significant differences among the four groups in all gait variables even after adjusting for age, sex and number of medications used. It should be noted that non-fallers with FOF showed significantly slower gait speed, shorter stride length and longer double support time than did non-fallers without FOF (P fall history. The assessment of FOF might be helpful for better understanding of age-related changes in gait control. Geriatr Gerontol Int 2017; 17: 2455-2459. © 2017 Japan Geriatrics Society.

Fueling the fall migration of the monarch butterfly.

Science.gov (United States)

Brower, Lincoln P; Fink, Linda S; Walford, Peter

2006-12-01

Monarch butterflies in eastern North America accumulate lipids during their fall migration to central Mexico, and use them as their energy source during a 5 month overwintering period. When and where along their migratory journey the butterflies accumulate these lipids has implications for the importance of fall nectar sources in North America. We analyzed the lipid content of 765 summer breeding and fall migrant monarch butterflies collected at 1 nectaring site in central Virginia over 4 years (1998-2001), and compared them with 16 additional published and unpublished datasets from other sites, dating back to 1941. Virginia migrants store significantly more lipid than summer butterflies, and show significant intraseason and between-year variation. None of the Virginia samples, and none of the historical samples, with one exception, had lipid levels comparable with those found in migrants that had reached Texas and northern Mexico. This evidence suggests that upon reaching Texas, the butterflies undergo a behavioral shift and spend more time nectaring. The one exceptional sample led us to the discovery that monarchs that form roosts along their migratory routes have higher lipid contents than monarchs collected while nectaring at flowers. We propose that for much of their journey monarchs are opportunistic migrants, and the variation within and between samples reflects butterflies' individual experiences. The stored lipids appear to be of less importance as fuel for the butterflies' migration than for their survival during their overwintering period, in part because soaring on favorable winds reduces the energetic cost of flying. The conservation of nectar plants in Texas and northern Mexico is crucial to sustaining the monarch's migratory spectacle, and nectar abundance throughout eastern North America is also important. As generalists in their selection of nectar sources and nectaring habitats, monarchs are unlikely to be affected by small changes in plant

Does functional capacity, fall risk awareness and physical activity level predict falls in older adults in different age groups?

Science.gov (United States)

Moreira, Natália Boneti; Rodacki, Andre Luiz Felix; Pereira, Gléber; Bento, Paulo Cesar Barauce

2018-04-11

The aims of this study were to examine whether: i) functional capacity and physical activity level differ between fallers and non-fallers older adults, by controlling for fall risk awareness; ii) functional capacity, fall risk awareness and physical activity differ between fallers and non-fallers older adults, by controlling for age; iii) variables and which may predict falls in different age groups. 1826 older adults performed a series of functional tests and reported their fall episodes, fall risk awareness and physical activity level. The overall incidence of falls was high (40.2%), and falls risk awareness scores reduced with age. The older adults with greater falls risk awareness and non-fallers presented better scores in all functional tests and physical activity level (P age groups and differed between fallers and non-fallers, irrespective of age group (P age groups (odds ranging: 1.05-1.09). Handgrip strength and balance scores predicted falls until 79 years (OR = 1.04, 95%CI = 1.01-1.06). The physical activity level predicted falls up to 70 years (OR = 1.09, 95%CI = 1.06-1.12). Functional mobility was able to predict falls up to 80 years (OR = 1.06, 95%CI = 1.01-1.08). Therefore, according to age, functional capacity, physical activity level and falls risk awareness can be a predictor of falls in older adults. Copyright © 2018 Elsevier B.V. All rights reserved.

Sea-floor morphology and sedimentary environments in southern Narragansett Bay, Rhode Island

Science.gov (United States)

McMullen, Katherine Y.; Poppe, Lawrence J.; Blackwood, Dann S.; Nardi, Matthew J.; Andring, Matthew A.

2015-09-09

Multibeam echosounder data collected by the National Oceanic and Atmospheric Administration along with sediment samples and still and video photography of the sea floor collected by the U.S. Geological Survey were used to interpret sea-floor features and sedimentary environments in southern Narragansett Bay, Rhode Island, as part of a long-term effort to map the sea floor along the northeastern coast of the United States. Sea-floor features include rocky areas and scour depressions in high-energy environments characterized by erosion or nondeposition, and sand waves and megaripples in environments characterized by coarse-grained bedload transport. Two shipwrecks are also located in the study area. Much of the sea floor is relatively featureless within the resolution of the multibeam data; sedimentary environments in these areas are characterized by processes associated with sorting and reworking. This report releases bathymetric data from the multibeam echosounder, grain-size analyses of sediment samples, and photographs of the sea floor and interpretations of the sea-floor features and sedimentary environments. It provides base maps that can be used for resource management and studies of topics such as benthic ecology, contaminant inventories, and sediment transport.

Evaluation of the Frails' Fall Efficacy by Comparing Treatments (EFFECT on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial

Directory of Open Access Journals (Sweden)

Chandran Manju

2011-06-01

Full Text Available Abstract Background Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contributes to avoidance of activities and functional decline. Methods This randomised active-control trial is a comparison between the Nintendo WiiActive programme against standard gym-based rehabilitation of the older population. Eighty subjects aged above 60, fallers and non-fallers, will be recruited from the hospital outpatient clinic. The primary outcome measure is the Modified Falls Efficacy Scale and the secondary outcome measures are self-reported falls, quadriceps strength, walking agility, dynamic balance and quality of life assessments. Discussions The study is the first randomised control trial using the Nintendo Wii as a rehabilitation modality investigating a change in fall efficacy and self-reported falls. Longitudinally, the study will investigate if the interventions can successfully reduce falls and analyse the cost-effectiveness of the programme. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12610000576022

Body mass index, falls, and injurious falls among U.S. adults: Findings from the 2014 Behavioral Risk Factor Surveillance System.

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Ylitalo, Kelly R; Karvonen-Gutierrez, Carrie A

2016-10-01

Falls are an important health concern because they are associated with loss of independence and disability, particularly among women. We determined the age- and sex-specific prevalence of injurious falls among adults in the United States and examined the impact of obesity on fall risk. Self-reported falls, injurious falls, and health histories were obtained from 280,035 adults aged 45-79years in the 2014 Behavioral Risk Factor Surveillance System. Body mass index was categorized as underweight (fall in the previous 12months. Mid-life women 55-59years reported the highest prevalence of injurious falls (15.4%). Among mid-life women, overweight was associated with injurious falls (RR=1.17; 95% CI: 1.08, 1.28), but overweight was not associated with falling among other age-sex groups. Class II/III obesity was associated with injurious falls among all age-sex groups. After considering the mediators like health conditions (depression, cardiovascular disease, diabetes, arthritis) and behaviors (physical activity, sleep), the association of class II/III obesity and injurious fall risk persisted only among mid-life women (RR=1.23; 95% CI: 1.12, 1.36). Not only are mid-life women at high risk for falls, but the class II/III obesity is a risk factor for injurious falls. Targeting mid-life women for fall and injury prevention is an important aim for practitioners, particularly given unique correlates of falling for this group. Copyright © 2016 Elsevier Inc. All rights reserved.

“The balancing act”— Licensed practical nurse experiences of falls and fall prevention: a qualitative study

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Häggqvist Beatrice

2012-10-01

Full Text Available Abstract Background Falls are common in old age and may have serious consequences. There are many strategies to predict and prevent falls from occurring in long-term care and hospitals. The aim of this study was to describe licensed practical nurse experiences of predicting and preventing further falls when working with patients who had experienced a fall-related fracture. Licensed practical nurses are the main caretakers that work most closely with the patients. Methods A qualitative study of focus groups interviews and field observations was done. 15 licensed practical nurses from a rehabilitation ward and an acute ward in a hospital in northern Sweden were interviewed. Content was analyzed using qualitative content analysis. Results The result of the licensed practical nurse thoughts and experiences about risk of falling and fall prevention work is represented in one theme, “the balancing act”. The theme includes three categories: “the right to decide”, “the constant watch”, and “the ongoing negotiation” as well as nine subcategories. The analysis showed similarities and differences between rehabilitation and acute wards. At both wards it was a core strategy in the licensed practical nurse work to always be ready and to pay attention to patients’ appearance and behavior. At the rehabilitation ward, it was an explicit working task to judge the patients’ risk of falling and to be active to prevent falls. At the acute ward, the words “risk of falling” were not used and fall prevention were not discussed; instead the licensed practical nurses used for example “dizzy and pale”. The results also indicated differences in components that facilitate workplace learning and knowledge transfer. Conclusions Differences between the wards are most probably rooted in organizational differences. When it is expected by the leadership, licensed practical nurses can express patient risk of falling, share their observations with others

Evaluation of the Frails' Fall Efficacy by Comparing Treatments (EFFECT) on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial

OpenAIRE

Kwok, Boon Chong; Mamun, Kaysar; Chandran, Manju; Wong, Chek Hooi

2011-01-01

Abstract Background Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contri...

Falls and fractures in participants and excluded non-participants of a fall prevention exercise program for elderly women with a history of falls: 1-year follow-up study.

Science.gov (United States)

Kim, Hunkyung; Yoshida, Hideyo; Suzuki, Takao

2014-04-01

To evaluate the effectiveness of a strength and balance enhancing exercise intervention as a means of preventing falls in community-dwelling elderly Japanese women with a history of falls, while comparing functional fitness, fall and fracture rate in excluded subjects. A 1-year follow-up trial was carried out on 105 participants over the age of 70 years, who were randomly assigned to the exercise or education group, and also on 91 women excluded based on the exclusion criteria. The exercise group attended a 60-min exercise class twice a week for 3 months. Falls, injuries, fractures, and functional fitness assessments were measured at baseline, post-intervention and 1-year follow up. During the follow up, fall rates were 19.6% in the exercise group, 40.4% in the education group and 40.8% in excluded subjects (χ(2)  = 7.069, P = 0.029). Compared with the exercise group, the odds ratio (OR) for falls was greater in the education group (OR 2.78, 95% confidence interval (CI) 1.17-6.96) and excluded participants (OR 2.83, 95%CI 1.25-6.80). The OR for fractures was over fourfold greater in excluded participants (OR 4.30, 95% CI 1.02-9.70) than the exercise group. The exercise intervention for participants with fall history effectively decreased incidences of falls and fractures. However, fall and fracture rates in excluded people were high. Further research focusing on feasible countermeasures for falls in excluded people who are at high risk of fractures is required. © 2013 Japan Geriatrics Society.

Feed intake and utilization in sheep fed graded levels of dried moringa (Moringa stenopetala) leaf as a supplement to Rhodes grass hay.

Science.gov (United States)

Gebregiorgis, Feleke; Negesse, Tegene; Nurfeta, Ajebu

2012-03-01

The effects of feeding graded levels of dried moringa (Moringa stenopetala) leaf on intake, body weight gain (BWG), digestibility and nitrogen utilization were studied using male sheep (BW of 13.8 ± 0.12 kg). Six sheep were randomly allocated to each of the four treatment diets: Rhodes grass (Chloris gayana) hay offered ad libitum (T1), hay + 150 g moringa leaf (T2), hay + 300 g moringa leaf (T3), hay + 450 g moringa leaf (T4) were offered daily. A 7-day digestibility trial and an 84-day growth experiments were conducted. Dry matter (DM), organic matter (OM) and crude protein (CP) intakes increased (P moringa leaf in the diets. Sheep fed T2, T3 and T4 diets gained (P  0.05) among treatments. The digestibility of dietary CP increased (P moringa leaf, but there was no significant difference between T2 and T3 diets. The nitrogen (N) intake and urinary N excretion increased (P moringa leaf. The N retention was highest (P moringa leaf supplementation. The control group was in a negative N balance. Supplementing a basal diet of Rhodes grass hay with dried moringa leaves improved DM intake, BWG and N retention. It is concluded that M. stenopetala can serve as a protein supplement to low-quality grass during the dry season under smallholder sheep production system.

Falls from height: A retrospective analysis.

Science.gov (United States)

Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Güven, Taner; Gür, Ali; Gürbüz, Sükrü

2018-01-01

Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.

Fear of Falling in Older Adults: Comprehensive Review

Directory of Open Access Journals (Sweden)

Dukyoo Jung, PhD, RN

2008-12-01

Full Text Available Fear of falling has been reported in a high percentage of community-dwelling elderly who both do and don't have a history of falling. The aims of this review are to: (a elucidate the definition of fear of falling; (b clarify measurements of fear of falling based on its definition; and (c describe the risk factors for fear of falling. Despite the importance of the percentage and the consequences of fear of falling, its definition is still vague and warrants clarification. Based on a literature review, major fear of falling measurements involve the evaluation of fear of falling and use of a fall efficacy scale. Using a correct definition of fear of falling, nurses working close with older adults need to identify the different definitions of fear of falling and fall efficacy scale. In addition, nurses who work closely with older adults should encourage them to increase or maintain modifiable factors by maximizing their basic health status and enhancing their physical activity to decrease fear of falling.

Centrality behaviour of J/$\\psi$ production in NA50

CERN Document Server

Abreu, M C; Alexa, C; Arnaldi, R; Ataian, M R; Baglin, C; Baldit, A; Bedjidian, Marc; Beolè, S; Boldea, V; Bordalo, P; Borenstein, S R; Borges, G; Bussière, A; Capelli, L; Castor, J I; Castanier, C; Chaurand, B; Cheynis, B; Chiavassa, E; Cicalò, C; Claudino, T; Comets, M P; Constans, N; Constantinescu, S; Cortese, P; Cruz, J; De Marco, N; De Falco, A; Dellacasa, G; Devaux, A; Dita, S; Drapier, O; Espagnon, B; Fargeix, J; Force, P; Gallio, M; Gavrilov, Yu K; Gerschel, C; Giubellino, P; Golubeva, M B; Gonin, M; Grigorian, A A; Grigorian, S; Grossiord, J Y; Guber, F F; Guichard, A; Gulkanian, H R; Hakobyan, R S; Haroutunian, R; Idzik, M; Jouan, D; Karavitcheva, T L; Kluberg, L; Kurepin, A B; Le Bornec, Y; Lourenço, C; Macciotta, P; MacCormick, M; Marzari-Chiesa, A; Masera, M; Masoni, A; Monteno, M; Musso, A; Petiau, P; Piccotti, A; Pizzi, J R; Da Silva, W; Prino, F; Puddu, G; Quintans, C; Ramos, S; Ramello, L; Rato-Mendes, P; Riccati, L; Romana, A; Santos, H; Saturnini, P; Scalas, E; Scomparin, E; Serci, S; Shahoyan, R; Sigaudo, F; Silva, S; Sitta, M; Sonderegger, P; Tarrago, X; Topilskaya, N S; Usai, G L; Vercellin, Ermanno; Villatte, L; Willis, N

2002-01-01

The J/ psi production in 158 A GeV Pb-Pb interactions is studied, in the dimuon decay channel, as a function of centrality, as measured with the electromagnetic or with the very forward calorimeters. After a first sharp variation at midcentrality, both patterns continue to fall down and exhibit a curvature change at high centrality values. This trend excludes any conventional hadronic model and is in agreement with a deconfined quark gluon phase scenario. We report also preliminary results on the measured charged multiplicity, as given by a dedicated detector. (17 refs).

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

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

2018-01-01

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

Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.

Science.gov (United States)

Ishimoto, Yasuko; Wada, Taizo; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wenling; Hirosaki, Mayumi; Nakatsuka, Masahiro; Fujisawa, Michiko; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Otsuka, Kuniaki; Matsubayashi, Kozo

2012-10-01

The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk. The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers. FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons. © 2012 Japan Geriatrics Society.

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

Directory of Open Access Journals (Sweden)

Schwenk Michael

2012-04-01

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

A High-Resolution Reconstruction of Late-Holocene Relative Sea Level in Rhode Island, USA

Science.gov (United States)

Stearns, R. B.; Engelhart, S. E.; Kemp, A.; Cahill, N.; Halavik, B. T.; Corbett, D. R.; Brain, M.; Hill, T. D.

2017-12-01

Studies on the US Atlantic and Gulf coasts have utilized salt-marsh peats and the macro- and microfossils preserved within them to reconstruct high-resolution records of relative sea level (RSL). We followed this approach to investigate spatial and temporal RSL variability in southern New England, USA, by reconstructing 3,300 years of RSL change in lower Narragansett Bay, Rhode Island. After reconnaisance of lower Narragansett Bay salt marshes, we recovered a 3.4m core at Fox Hill Marsh on Conanicut Island. We enumerated foraminiferal assemblages at 3cm intervals throughout the length of the core and we assessed trends in δ13C at 5 cm resolution. We developed a composite chronology (average resolution of ±50 years for a 1 cm slice) using 30 AMS radiocarbon dates and historical chronological markers of known age (137Cs, heavy metals, Pb isotopes, pollen). We assessed core compaction (mechanical compression) by collecting compaction-free basal-peat samples and using a published decompaction model. We employed fossil foraminifera and bulk sediment δ13C to estimate paleomarsh elevation using a Bayesian transfer function trained by a previously-published regional modern foraminiferal dataset. We combined the proxy RSL reconstruction and local tide-gauge measurements from Newport, Rhode Island (1931 CE to present) and estimated past rates of RSL change using an Errors-in-Variables Integrated Gaussian Process (EIV-IGP) model. Both basal peats and the decompaction model suggest that our RSL record is not significantly compacted. RSL rose from -3.9 m at 1250 BCE reaching -0.4 m at 1850 CE (1 mm/yr). We removed a Glacial Isostatic Adjustment (GIA) contribution of 0.9 mm/yr based on a local GPS site to facilitate comparison to regional records. The detrended sea-level reconstruction shows multiple departures from stable sea level (0 mm/yr) over the last 3,300 years and agrees with prior reconstructions from the US Atlantic coast showing evidence for sea-level changes that

Work-related falls among union carpenters in Washington State before and after the Vertical Fall Arrest Standard.

Science.gov (United States)

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

2003-08-01

Washington State enacted a change in their fall standard for the construction industry in 1991, preceding the Safety Standard for Fall Protection in the Construction Industry promulgated by Federal OSHA in 1994. We evaluated changes in the rate of falls from elevations and measures of severity among a large cohort of union carpenters after the fall standard change in Washington State, taking into account the temporal trends in their overall injury rates. There was a significant decrease in the rate of falls from height after the standard went into effect, even after adjusting for the overall decrease in work-related injuries among this cohort. Much of the decrease was immediate, likely representing the publicity surrounding fatal falls and subsequent promulgation of the standard. The greatest decrease was seen between 3 and 3(1/2) years after the standard went into effect. There was a significant reduction in mean paid lost days per event after the standard change and there was a significant reduction in mean cost per fall when adjusting for age and the temporal trend for costs among non-fall injuries. Through the use of observational methods we have demonstrated significant effects of the Washington State Vertical Fall Arrest Standard among carpenters in the absence of a control or comparison group. Without controlling for the temporal trend in overall injury rates, the rate of decline in falls appeared significantly greater, but the more pronounced, but delayed, decline was not seen. The analyses demonstrate potential error in failing to account for temporal patterns or assuming that a decline after an intervention is related to the intervention. Copyright 2003 Wiley-Liss, Inc.

There is more to life than risk avoidance - elderly people's experiences of falls, fall-injuries and compliant flooring.

Science.gov (United States)

Gustavsson, Johanna; Jernbro, Carolina; Nilson, Finn

2018-12-01

Falls are the most common cause of injury in all ages and are especially difficult to prevent among residential care residents. Compliant flooring that absorbs energy generated within the fall, has been proposed as a measure to prevent fall-injury, however little is known regarding the implementation aspects in clinical settings. The aim of this study is to explore the experiences of falls, the risk of fall-injury, prevention in general and specifically compliant flooring as an injury preventative measure amongst frail elderly people living in a residential care facility with compliant flooring. Through this, generate a theory that further explains the underlying barriers of active prevention amongst elderly people. We used the grounded theory method and conducted semi-structured in-depth interviews with eight elderly people in residential care (data collected between February and December 2017). The identified categories were Falling as a part of life, Fearing the consequences and A wish to prevent falls and injuries. Through the results it was clear that There is more to life than risk avoidance, permeated the interviews, therefore forming the grounded theory. The interviewees viewed falls as something common and normal, and were uninterested in focusing on the risk of falls. Although they wanted to prevent falls, it was often difficult to integrate preventative measures into their everyday life. They embraced the idea of an injury-reducing compliant flooring, however their main interests lay elsewhere, preferring to focus on social interaction and issues concerning daily activities. The theory generated in this paper proposes explanations on the obstacles of implementing fall prevention measures in an elderly frail population. The findings give insights as to why interest and compliance for active fall prevention measures are low. We conclude that complaint flooring, from the perspective of the residents, can work well in residential care.

Falls: Epidemiology, Pathophysiology, and Relationship to Fracture

OpenAIRE

Berry, Sarah D.; Miller, Ram

2008-01-01

Falls are common in the elderly, and frequently result in injury, disability, and institutionalization. Although the causes of falls are complex, most falls result from an interaction between individual characteristics that increase an individual's propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, age-associated comorbidities such as osteoarthritis, visual impairment and d...

Determinants of Falls and Fear of Falling in Ambulatory Persons With Late Effects of Polio.

Science.gov (United States)

Brogårdh, Christina; Flansbjer, Ulla-Britt; Lexell, Jan

2017-05-01

Falls and fear of falling (FOF) are common in persons with late effects of polio, but there is limited knowledge of associated factors. To determine how knee muscle strength, dynamic balance, and gait performance (adjusted for gender, age, and body mass index) are associated with falls and FOF in persons with late effects of polio. A cross-sectional study. A university hospital outpatient clinic. Eighty-one ambulatory persons with verified late effects of polio (43 men; mean age 67 years). Number of falls the past year, Falls Efficacy Scale-International to assess FOF, a Biodex dynamometer to measure knee muscle strength, the Timed Up & Go test to assess dynamic balance, and the 6-Minute Walk test to assess gait performance. Univariate and multivariate logistic regression analyses were used for falls (categorical data) and linear regression analyses for FOF (continuous data) as dependent variables. Fifty-nine percent reported at least 1 fall during the past year, and 79% experienced FOF. Reduced knee muscle strength in the more affected limb and gait performance were determinants of falls. An increase of 10 Nm in knee flexor and knee extensor strength reduced the odds ratio between 0.70 and 0.83 (P = .01), and an increase of 100 m in 6-Minute Walk test reduced the odds ratio to 0.41 (P = .001). All factors were determinants of FOF; reduced knee muscle strength in the more and less affected limbs explained 17%-25% of the variance in FOF, dynamic balance 30%, and gait performance 41%. Gender, age, and body mass index only marginally influenced the results. Reduced gait performance, knee muscle strength, and dynamic balance are to a varying degree determinants of falls and FOF in ambulatory persons with late effects of polio. Future studies need to evaluate whether rehabilitation programs targeting these factors can reduce falls and FOF in this population. IV. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All

Evolving Privatization in Eastern and Central European Higher Education

Science.gov (United States)

Levy, Daniel

2014-01-01

With the fall of communism in 1989, Eastern and Central Europe would quickly become part of an already strong global tide of privatization in higher education. Nowhere else did private higher education rise so suddenly or strongly from virtual nonexistence to a major regional presence. A fresh database allows us to analyze the extent and…

Identifying nursing home residents at risk for falling.

Science.gov (United States)

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.

Developing a wintering waterfowl community baseline for environmental monitoring of Narragansett Bay, Rhode Island [version 3; referees: 1 approved, 2 approved with reservations

Directory of Open Access Journals (Sweden)

Betty J. Kreakie

2015-12-01

Full Text Available In 2004, the Atlantic Ecology Division of the US Environmental Protection Agency’s Office of Research and Development began an annual winter waterfowl survey of Rhode Island’s Narragansett Bay. Herein, we explore the survey data gathered from 2004 to 2011 in order to establish a benchmark understanding of our waterfowl communities and to establish a statistical framework for future environmental monitoring. The abundance and diversity of wintering waterfowl were relatively stable during the initial years of this survey, except in 2010 when there was a large spike in abundance and a reciprocal fall in diversity. There was no significant change in ranked abundance of most waterfowl species, with only Bufflehead (Bucephala albeola and Hooded Merganser (Lophodytes cucllatus showing a slight yet significant upward trend during the course of our survey period. Nonmetric multidimensional scaling (NMDS was used to examine the community structure of wintering waterfowl. The results of the NMDS indicate that there is a spatial structure to the waterfowl communities of Narragansett Bay and this structure has remained relatively stable since the survey began. Our NMDS analysis helps to solidify what is known anecdotally about the bay’s waterfowl ecology, and provides a formalized benchmark for long-term monitoring of Narragansett Bay’s waterfowl communities. Birds, including waterfowl, are preferred bioindicators and we propose using our multivariate approach to monitor the future health of the bay. While this research focuses on a specific area of New England, these methods can be easily applied to novel areas of concern and provide a straightforward nonparametric approach to community-level monitoring. The methods provide a statistic test to examine potential drivers of community turnover and well-suited visualization tools.

17 CFR 140.2 - Regional office-regional coordinators.

Science.gov (United States)

2010-04-01

..., Kentucky, Maine, Maryland, Massachusetts, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, and West Virginia. (b) The Central...

Intrinsic Risk Factors of Falls in Elderly

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Yasmin Amatullah

2016-09-01

Full Text Available Background: Falls are common geriatric problems. The risk factors of falls are the intrinsic and extrinsic risk factors. Studies on falls are scarcely conducted in Indonesia, especially in Bandung. Therefore, this study was conducted to identify the intrinsic risk factors of falls among elderly. Methods: A descriptive study was carried out from August to October 2013 at the Geriatric Clinic of Dr. Hasan Sadikin General Hospital Bandung. Fifty three participants were selected according to the inclusion and exclusion criteria using consecutive sampling. The determined variables in this study were classification of the risk of falls, demographic profile, history of falls, disease, and medications. After the selection, the participants were tested by Timed up-and-go test (TUGT. Moreover, an interview and analysis of medical records were carried out to discover the risk factors of falls. The collected data were analyzed and presented in the form of percentages shown in tables. Results: From 53 patients, women (35.66% were considered to have higher risk of fall than men (18.34%. The majority of patients (66% with the risk of fall were from the age group 60–74 years. The major diseases suffered by patients were hypertension, osteoarthritis and diabetes mellitus. Drugs that were widely used were antihypertensive drugs; analgesic and antipyretic drugs and antidiabetic drugs. Conclusions: There are various intrinsic risk factors of falls in elderly and each of the elderly has more than one intrinsic risk factor of falls.

Longitudinal association between habitual walking and fall occurrences among community-dwelling older adults: analyzing the different risks of falling.

Science.gov (United States)

Okubo, Yoshiro; Seino, Satoshi; Yabushita, Noriko; Osuka, Yosuke; Jung, Songee; Nemoto, Miyuki; Figueroa, Rafael; Tanaka, Kiyoji

2015-01-01

The purpose of this longitudinal study was to examine the association between habitual walking and multiple or injurious falls (falls) among community-dwelling older adults, by considering the relative risk of falling. A cohort of Japanese community-dwelling older adults (n=535) aged 60-91 years (73.1±6.6 year, 157 men and 378 women) who underwent community-based health check-ups from 2008 to 2012 were followed until 2013. Incidence rate of falls between walkers and non-walkers was compared separately by the number of risk factors (Groups R0, R1, R2, R3 and R4+). The Cox proportional hazard model was used to assess the association between habitual walking and falls separately by lower- (Rrisk groups. In Groups R0 and R1, the incidence of falls was lower in walkers than non-walkers; however, in Groups R2, R3, and R4+, the incidence of falls was higher in walkers. The Cox proportional hazard model showed that habitual walking was not significantly associated with falls (hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.48-1.62) among the lower risk group but that it was significantly associated with increased falls (HR: 1.89, 95% CI: 1.04-3.43) among the higher risk group. The significant interaction between habitual walking and higher risk of falling was found (Prisk factors for falling, caution is needed when recommending walking because walking can actually increase their risk of experiencing multiple or injurious falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Factors associated with recognition and prioritization for falling, and the effect on fall incidence in community dwelling older adults.

Science.gov (United States)

Jansen, Sofie; Schoe, Jolanda; van Rijn, Marjon; Abu-Hanna, Ameen; Moll van Charante, Eric P; van der Velde, Nathalie; de Rooij, Sophia E

2015-12-17

Recent trials have shown that multifactorial fall interventions vary in effectiveness, possibly due to lack of adherence to the interventions. The aim of this study was to examine what proportion of older adults recognize their falls risk and prioritize for fall-preventive care, and which factors are associated with this prioritization. Observational study within the intervention arm of a cluster randomized controlled trial (RCT) on the effect of preventive interventions for geriatric problems in older community-dwellers at risk of functional decline.  general practices in the Netherlands. Participants were community dwellers (70+) in whom falling was identified as a condition. A comprehensive geriatric assessment (CGA) was performed by a registered community care nurse. Participants were asked which of the identified conditions they recognized and prioritized for in a preventive care plan, and subsequent interventions were started. Multivariable logistic regression was performed to identify which factors were associated with this prioritization. Fall-incidence was measured during one-year follow-up. The RCT included 6668 participants, 3430 were in the intervention arm. Of those, 1209 were at risk of functional decline, of whom 936 underwent CGA. In 380 participants (41 %), falling was identified as a condition; 62 (16 %) recognized this and 37 (10 %) prioritized for it. Factors associated with prioritization for falls-prevention were: recurrent falls in the past year (OR 2.2 [95 % CI 1.1-4.4]), severe fear-of-falling (OR 2.7 [1.2-6.0]) and use of a walking aid (2.3 [1.1-5.0]). Sixty participants received a preventive intervention for falling; 29 had prioritized for falling. Incidence of falls was higher in the priority group than the non-priority group (67 % vs. 37 % respectively) during first six months of follow-up, but similar between groups after 12 months (40.7 % vs. 44.4 %). The proportion of community-dwellers at risk of falls that recognizes this

Dropping Knowledge Like Frozen Pumpkins: Successful Physics Outreach

Science.gov (United States)

Hook, E. A.

2011-12-01

The Society of Physics Students (SPS) is a professional organization specifically designed for college students. A main purpose of SPS is to develop college students into effective members of the physics community; one of the best ways to do this is by promoting science outreach. College students are in a prime position to engage the public in outreach to increase scientific literacy: they're easier for younger, school-age students to identify with, they can reach young adults in a unique way, and they're old enough to seriously engage the general public. SPS helps hundreds of college chapters across the country engage in outreach. One such chapter is at Rhodes College in Memphis, TN. The Rhodes College SPS chapter is active both in K12 schools and on its campus. Rhodes developed a position within its SPS structure to include an officer specifically related to handling outreach. For K12 schools this involved contacting teachers, organizing lessons, and holding training sessions for the college students preparing to teach the lessons. Rhodes SPS also focuses on campus outreach and trying to disabuse students of the notion that physics is stuffy, boring, and only for geniuses. Every fall, Rhodes SPS hosts an extremely popular annual Pumpkin Drop, as well as hosting demo shows, observatory open houses, and contests throughout the year for its students. One of the best received campus outreach programs is something called 'Stall Stories,' where SPS publishes a page flyer that goes in bathrooms around campus involving fun physics, a comic, and a list of SPS events. Rhodes SPS, like the national organization, has the goal of improving physics literacy among K12 students, college students, and the general public through effective outreach.

Prevalence of falls in elderly women

OpenAIRE

Vitor,Priscila Regina Rorato; Oliveira,Ana Carolina Kovaleski de; Kohler,Renan; Winter,Gabriele Regiane; Rodacki,Cintia; Krause,Maressa Priscila

2015-01-01

OBJECTIVE: To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. METHODS: Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. RES...

EFFECTS OF FEEDING Moringa stenopetala LEAF MEAL ON NUTRIENT INTAKE AND GROWTH PERFORMANCE OF RHODE ISLAND RED CHICKS UNDER TROPICAL CLIMATE

Directory of Open Access Journals (Sweden)

Aberra Melesse

2011-03-01

Full Text Available The effects of Moringa stenopetala leaf meal (MSLM on nutrient intake and weight gain (WG were evaluated. Forty unsexed Rhode Island Red chicks were randomly assigned to 4 treatment groups. The control diet (T1 (MSLM 0%, the experimental diets contained MSML at a rate of 2% (T2, 4% (T3, and 6% (T4 of the diets (as fed basis to replace 3%, 5.9% and 8.8% of the crude protein (CP of the control diet. Daily feed, dry matter and CP intake of the chicks fed MSLM diets were higher (p

Fear of Falling in Women with Fibromyalgia and Its Relation with Number of Falls and Balance Performance

OpenAIRE

Collado-Mateo, D.; Gallego-Diaz, J. M.; Adsuar, J. C.; Domínguez-Muñoz, F. J.; Olivares, P. R.; Gusi, N.

2015-01-01

Objective. To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. Methods. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb stre...

Aerial radiological survey of the area surrounding the UNC Recovery Systems Facility, Wood River Junction, Rhode Island

International Nuclear Information System (INIS)

Bluitt, C.M.

1981-05-01

An aerial radiological survey to measure terrestrial gamma radiation was carried out over the United Nuclear Corporation (UNC) Recovery Systems Facility located near Wood River Junction, Rhode Island. At the time of the survey (August 1979) materials were being processed at the facility. Gamma ray data were collected over a 3.28 km 2 area centered on the facility by flying north-south lines spaced 60 m apart. Processed data indicated that detected radioisotopes and their associated gamma ray exposure rates were consistent with those expected from normal background emitters, except directly over the UNC Facility. Average exposure rates 1 m above the ground, as calculated from the aerial data, are presented in the form of an isopleth map. No ground sample data were taken at the time of the aerial survey

[The rise and fall of an physician entrepreneur].

Science.gov (United States)

Dörnyei, Sándor

2002-01-01

In 1927 one of the most up-to-date and most beautiful sanatoriums of Central Europe was built on the hills of Buda by László Jakab MD (1875-1940), who at that time had already run - since 1909 - a successful health-resort, the rather popular and successful "Liget-Sanatorium": following a period of expansion and flourishing, his enterprise bankrupted. (The building itself was renewed after World War II - it served first as a hospital for tuberculosis patients and later as a university clinic for internal medicine.) This article tells the story of an entrepreneur physician, including his former and more successful attempts to run a health-care business, and gives detailed account of the rise and fall of private health-resort in prewar Hungary.

[Fall risk assessment in regular exercising elderly women].

Science.gov (United States)

Kikuchi, Reiko; Kozaki, Koichi; Kawashima, Yumiko; Iwata, Akiko; Hasegawa, Hiroshi; Igata, Akihiro; Toba, Kenji

2008-09-01

Fall prevention is important for elderly people to maintain their functional independence. We made a longitudinal fall-risk assessment using our "Fall-predicting score" of women who are 60 years or older and who exercised regularly. We sent "fall-predicting questionnaires" to 632 elderly women aged 60 years or older (mean 65.0+/-4.3), members of "Miishima gymnastics program", and asked about their fall history of falling in the past year in 2004 and 2005. We performed a logistic regression analysis to determine the future risk factor of falling in 2005. The number of people who fell was 134 (21.2%) in 2004 and 121 (19.1%) in 2005. The number of people who fell decreased in the seventh decade, but increased in the eighth decade, and members for 6-10 years showed most decreased fall rates. Logistic regression analysis revealed that age, falls in 2004, "tripping", "cannot squeeze a towel", and "walk steep slope around the house" were significant independent risk factors of "falls in 2005". Logistic regression analysis of non-fallers in 2004 showed that age and "tripping" were the significant independent risk factors of "falls in 2005", and the analysis of people who fell in 2004 showed that age, "tripping", "cannot squeeze a towel", "walk steep slope around the house", and "taking more than 5 medicines" were significant independent risk factors for falls in 2005. In regular exercising elderly women, exercise appears to prevent falls in people in the seventh decade and in the members of 6-10 years. Age, past history of falls, and fall-predicting questionnaire were important risk predictors of future falls.

Impaired perceived timing of falls in the elderly.

Science.gov (United States)

Lupo, Julian; Barnett-Cowan, Michael

2018-01-01

Falls are the leading cause of injury-related deaths and hospitalizations, with older adults at an increased risk. As humans age, physical changes and health conditions make falls more likely. While we know how the body reflexively responds to prevent injury during a fall, we know little about how people perceive the fall itself. We previously found that young adults required a fall to precede a comparison sound stimulus by approximately 44ms to perceive the two events as simultaneous. This may relate to common anecdotal reports suggesting that humans often describe distortions in their perception of time - time seems to slow down during a fall - with very little recollection of how and when the fall began. Here we examine whether fall perception changes with age. Young (19-25y) and older (61-72y) healthy adults made temporal order judgments identifying whether the onset of their fall or the onset of a comparison sound came first to measure the point of subjective simultaneity. Results show that fall perception is nearly twice as slow for older adults, where perturbation onset has to precede sound onset by ∼88ms to appear coincident, compared to younger adults (∼44ms). We suggest that such age-related differences in fall perception may relate to increased fall rates in older adults. We conclude that a better understanding of how younger versus older adults perceive falls may identify important factors for innovative fall prevention strategies and rehabilitative training exercises to improve fall awareness. Copyright © 2017 Elsevier B.V. All rights reserved.

Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

Directory of Open Access Journals (Sweden)

Elizabeth A Phelan

2016-09-01

Full Text Available A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ with a history of repeated falls or fall-related healthcare use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79±8 years; 68% were female, and 10% were non-white. They averaged 6 primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall risk factors varied from 24% (for home safety to 78% (for vitamin D. An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21% and home safety (24%. Use of a structured visit note template independently predicted assessment of fall risk factors (P=0.003. Geriatrics specialists were more likely to use a structured note template (p=.04 and perform more fall risk factor assessments (4.6 vs. 3.6, p=.007 than general internists. These results suggest opportunities for improving multifactorial fall risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

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

Science.gov (United States)

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

2017-03-01

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