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Sample records for fall premigratory period

  1. Roosting behavior of premigratory Dunlins (Calidris alpina)

    Science.gov (United States)

    Handel, Colleen M.; Gill, Robert E.

    1992-01-01

    We studied roosting behavior of Dunlins (Calidris alpina) during late summer along the coast of the Yukon-Kuskokwim Delta, Alaska, in relation to tidal cycle, time of day, time of season, and occurrence of predators. Within Angyoyaravak Bay, peak populations of 70,000-100,000 Dunlins occur each year. The major diurnal roost sites were adjacent to intertidal feeding areas, provided an unobstructed view of predators, and were close to shallow waters used for bathing. At one site studied intensively, roosting flocks formed at high water consistently during the day but rarely at night. On about 75% of the days, Dunlins also came to the roost at dawn and dusk when the tide was low. The size of the roosting flock, the length of time birds spent at the roost site, and behavior at the roost site were highly variable throughout the season and significantly affected by both tide level and time of day. Roosting behavior changed significantly between early and late August, as Dunlins underwent heavy wing and body molt, and began premigratory fattening. The reaction of Dunlins to potential predators, the formation of roosting flocks in response to light cues, and seasonal changes in social behavior at the roost site suggested that communal roosting behavior may be related not only to the risk of predation but also to behavior during migration.

  2. Premigratory fat metabolism in hummingbirds: A rumsfeldian approach

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    Raul K. SUAREZ

    2013-06-01

    Full Text Available Hummingbird migration is a remarkable feat, given the small body sizes of migratory species, their high metabolic rates during flight and the long distances traveled using fat to fuel the effort. Equally remarkable is the ability of premigratory hummingbirds in the wild to accumulate fat, synthesized from sugar, at rates as high as 10% of body mass per day. This paper summarizes, using Rumsfeldian terminology, “known knowns” concerning the energetics of hummingbird migration and premigratory fattening. Energy metabolism during hover-feeding on floral nectar is fueled directly by dietary sugar through the pathway recently named the “sugar oxidation cascade”. However, flight without feeding for more than a few minutes requires shifting to fat as a fuel. It is proposed that behavior and metabolic fuel choice are coadapted to maximize the rate of fat deposition during premigratory fattening. The hummingbird liver appears to possess extraordinarily high capacities for fatty acid synthesis. The analysis of “known knowns” leads to identification of “known unknowns”, e.g., the fates of dietary glucose and fructose, the regulation of fat metabolism and metabolic interactions between liver and adipose tissue. The history of science behooves recognition of “unknown unknowns” that, when discovered serendipitously, might shed new light on fundamental mechanisms as well as human pathological conditions [Current Zoology 59 (3: 371–380, 2013].

  3. Early life events carry over to influence pre-migratory condition in a free-living songbird.

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    Greg W Mitchell

    Full Text Available Conditions experienced during development can have long-term consequences for individual success. In migratory songbirds, the proximate mechanisms linking early life events and survival are not well understood because tracking individuals across stages of the annual cycle can be extremely challenging. In this paper, we first use a 13 year dataset to demonstrate a positive relationship between 1(st year survival and nestling mass in migratory Savannah sparrows (Passerculus sandwichensis. We also use a brood manipulation experiment to show that nestlings from smaller broods have higher mass in the nest relative to individuals from larger broods. Having established these relationships, we then use three years of field data involving multiple captures of individuals throughout the pre-migratory period and a multi-level path model to examine the hypothesis that conditions during development limit survival during migration by affecting an individual's ability to accumulate sufficient lean tissue and fat mass prior to migration. We found a positive relationship between fat mass during the pre-migratory period (Sept-Oct and nestling mass and a negative indirect relationship between pre-migratory fat mass and fledging date. Our results provide the first evidence that conditions during development limit survival during migration through their effect on fat stores. These results are particularly important given recent evidence showing that body condition of songbirds at fledging is affected by climate change and anthropogenic changes to landscape structure.

  4. Crestospheres: Long-Term Maintenance of Multipotent, Premigratory Neural Crest Stem Cells

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    Laura Kerosuo

    2015-10-01

    Full Text Available Premigratory neural crest cells comprise a transient, embryonic population that arises within the CNS, but subsequently migrates away and differentiates into many derivatives. Previously, premigratory neural crest could not be maintained in a multipotent, adhesive state without spontaneous differentiation. Here, we report conditions that enable maintenance of neuroepithelial “crestospheres” that self-renew and retain multipotency for weeks. Moreover, under differentiation conditions, these cells can form multiple derivatives in vitro and in vivo after transplantation into chick embryos. Similarly, human embryonic stem cells directed to a neural crest fate can be maintained as crestospheres and subsequently differentiated into several derivatives. By devising conditions that maintain the premigratory state in vitro, these results demonstrate that neuroepithelial neural crest precursors are capable of long-term self-renewal. This approach will help uncover mechanisms underlying their developmental potential, differentiation and, together with the induced pluripotent stem cell techniques, the pathology of human neurocristopathies.

  5. Falls

    Science.gov (United States)

    ... falling off furniture or down the stairs. Older children may fall off playground equipment. For elderly people, falls can be especially serious. They are at higher risk of falling. They are also more likely to ...

  6. Pre-Migratory Movements by Juvenile Burrowing Owls in a Patchy Landscape

    Directory of Open Access Journals (Sweden)

    L. Danielle. Todd

    2007-12-01

    Full Text Available Dispersal is a fundamental aspect of population dynamics, and can have direct implications on processes such as the colonization of habitat patches. Pre-migratory movements, landscape fragmentation, and body condition have all been hypothesized as key factors influencing dispersal in birds, but little direct evidence exists to support these ideas. We used radio-telemetry and supplementary feeding to test if body condition or landscape pattern influenced pre-migratory movements of juvenile Burrowing Owls (Athene cunicularia in a fragmented landscape. We categorized grassland patches as either large (≥95 ha or small and isolated (≤58 ha and ≥1.5 km to next nearest grassland patch, and young owls were either provided supplemental food as nestlings or not. Owlets receiving supplemental food and residing in large grassland patches moved a greater maximum distance from their nest than similarly fed owlets residing in small patches (large = 1605 ± 443 m; small = 373 ± 148 m. In contrast, non-supplemented owlets from large and small patches did not differ in their maximum distance moved from the nest (large = 745 ± 307 m; small 555 ± 286 m. Only two of 32 individuals from small patches moved >800 m, whereas ten of 23 owlets from large patches moved >800 m. In addition, owlets from large patches continued to move farther and farther from their nest before migration, whereas owlets in small, isolated patches ultimately moved

  7. Hydraulic Characteristics of the Lower Snake River During Periods of Juvenile Fall Chinook Migration

    Energy Technology Data Exchange (ETDEWEB)

    Cook, Chris B.; Dibrani, Berhon; Richmond, Marshall C.; Bleich, Matthew D.; Titzler, P. Scott; Fu, Tao

    2006-01-30

    This report documents a four-year study to assess hydraulic conditions in the lower Snake River. The work was conducted for the Bonneville Power Administration, U.S. Department of Energy, by the Pacific Northwest National Laboratory. Cold water released from the Dworshak Reservoir hypolimnion during mid- to late-summer months cools the Clearwater River far below equilibrium temperature. The volume of released cold water augments the Clearwater River, and the combined total discharge is on the order of the Snake River discharge when the two rivers meet at their confluence near the upstream edge of Lower Granite Reservoir. With typical temperature differences between the Clearwater and Snake rivers of 10°C or more during July and August, the density difference between the two rivers during summer flow augmentation periods is sufficient to stratify Lower Granite Reservoir as well as the other three reservoirs downstream. Because cooling of the river is desirable for migrating juvenile fall Chinook salmon (Oncorhynchus tshawytscha) during this same time period, the amount of mixing and cold water entrained into Lower Granite Reservoir’s epilimnion at the Clearwater/Snake River confluence is of key biological importance to juvenile fall Chinook salmon. Data collected during this project indicates the three reservoirs downstream of Lower Granite also stratify as direct result of flow augmentation from Dworshak Reservoir. These four lower Snake reservoirs are also heavily influenced by wind forcing at the water’s surface, and during periods of low river discharge, often behave like a two-layer lake. During these periods of stratification, lower river discharge, and wind forcing, the water in the upper layer of the reservoir is held in place or moves slightly upstream. This upper layer is also exposed to surface heating and may warm up to temperatures close to equilibrium temperature. The depth of this upper warm layer and its direction of travel may also be of key

  8. Alterations in tissue aerobic capacity may play a role in premigratory fattening in shorebirds.

    Science.gov (United States)

    Selman, Colin; Evans, Peter R

    2005-03-22

    Migratory shorebirds show regulated seasonal increases in body mass (BM) even in captivity, consisting primarily, but not exclusively, of fat. We examined whether captive red knot (Calidris canutus) exhibited seasonal alterations in mitochondrial volume (liver, pectoral muscle) and/or succinate dehydrogenase (SDH) activity (liver, pectoral muscle, heart, small intestine) during three distinct life-cycle stages: stable BM, spring peak in BM, and as BM rapidly declined after the spring peak. Mitochondrial volume in liver and pectoral muscle and SDH activity in liver and heart did not alter with life-cycle stage. However, red knot undergoing premigratory fattening exhibited significantly lower pectoral muscle SDH activity in concert with significantly elevated activity in the small intestine compared with the other two time-points, suggesting that tissue metabolic rate alters with life-cycle stage. The increased intestinal SDH activity may indicate an elevation in energy assimilation at a time when intestine hypertrophy occurs, thus maximizing BM increase prior to putative migration. The concomitant decrease in pectoral muscle activity may act to reduce overall metabolic rate, or at least help counter the elevation in intestinal mass-specific metabolic rate. Both tissues hypertrophy prior to migration in wild red knot, but hypertrophy of the intestine precedes that of pectoral muscle. Indeed, it appears that the intestinal mass undergoes atrophy by the time pectoral muscle hypertrophy occurs in wild red knot. Thus, physiological adjustments in tissue metabolism may be an important factor in the life-history strategies of migrating shorebirds.

  9. Numerical and Experimental Study of the Rotational Behaviour of Flat Plates Falling Freely with Periodic Oscillating Motion

    DEFF Research Database (Denmark)

    Hærvig, Jakob; Jensen, Anna Lyhne; Pedersen, Marie Cecilie

    2017-01-01

    -dimensional flow with Reynolds number Re ≈ 10,000 and non-dimensional moment of inertia I* = 0.115. To validate the free fall trajectory obtained by computational fluid dynamics, video recordings are used. Based on the validated free fall computational fluid dynamics simulation, the instantaneous fluid forces......When a flat plate falls freely in periodic oscillating motion regime, unsteady fluid forces create additional lift force contributions due to the rotational behaviour. Computational fluid dynamics is used to simulate the free fall behaviour of a flat plate with aspect ratio β = 20 falling in two...... and torques on the plate are obtained. The validated simulations show significant deviations in per-pendicular and tangential force coefficients at the same angle of attack depending on the trajectory history of the plate. At low angles of attack below 5 deg, the tangential force differs significantly...

  10. Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Luciana Regina Ferreira da Mata

    Full Text Available ABSTRACT Objective: to assess the factors associated with the risk of fall in patients undergoing surgical procedures. Method: quantitative and cross-sectional study carried out with 257 adult patients in a hospital in the state of Minas Gerais, Brazil. Data were collected using the sociodemographic and clinical questionnaire, the Morse Fall Scale, and the Quality of Recovery Score. Data were submitted to descriptive statistical analysis and multinomial logistic regression. The level of significance was set at 0.05. Results: 35.4% of patients had high risk of falls, 38.9% had moderate risk and 25.7% had low risk. The mean value in the surgical recovery scale was 175.37 points and no patient presented poor surgical recovery. Regarding the results of the bivariate analysis, it was found that age (p<0.001, SAH (p<0.001 and diabetes (p=0.017 were positively associated with high risk of fall, whereas cancer (p=0.004 was positively associated with moderate risk of fall. Surgical recovery (p=0,008 was inversely associated with high risk of fall. Conclusion: the results of this study allowed the identification of five factors associated with the risk of fall in adults in the postoperative hospital stay. These findings may support the planning of nursing actions aimed at preventing the risk of fall in the postoperative period.

  11. Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.

    Science.gov (United States)

    Mata, Luciana Regina Ferreira da; Azevedo, Cissa; Policarpo, Aryanne Gabrielle; Moraes, Juliano Teixeira

    2017-06-08

    to assess the factors associated with the risk of fall in patients undergoing surgical procedures. quantitative and cross-sectional study carried out with 257 adult patients in a hospital in the state of Minas Gerais, Brazil. Data were collected using the sociodemographic and clinical questionnaire, the Morse Fall Scale, and the Quality of Recovery Score. Data were submitted to descriptive statistical analysis and multinomial logistic regression. The level of significance was set at 0.05. 35.4% of patients had high risk of falls, 38.9% had moderate risk and 25.7% had low risk. The mean value in the surgical recovery scale was 175.37 points and no patient presented poor surgical recovery. Regarding the results of the bivariate analysis, it was found that age (prisk of fall, whereas cancer (p=0.004) was positively associated with moderate risk of fall. Surgical recovery (p=0,008) was inversely associated with high risk of fall. the results of this study allowed the identification of five factors associated with the risk of fall in adults in the postoperative hospital stay. These findings may support the planning of nursing actions aimed at preventing the risk of fall in the postoperative period. evaluar los factores asociados al riesgo de caída en pacientes sometidos a procedimientos quirúrgicos. estudio cuantitativo, transversal, realizado en 257 pacientes adultos en un hospital de Minas Gerais, Brasil. La recolección de datos se realizó por medio de un cuestionario sociodemográfico y clínico, Morse Fall Scale Quality of Recovery Score. Los datos fueron sometidos al análisis estadístico descriptivo y regresión logística multinomial. El nivel de significación adoptado fue de 0,05. 35,4% de los pacientes presentaron elevado riesgo de caídas, 38,9% moderado riesgo y 25,7% bajo riesgo. La escala de recuperación quirúrgica indicó valor promedio de 175,37 puntos y ningún paciente presentó recuperación quirúrgica precaria. En relación a los resultados

  12. High-frequency Quasi-periodic Light Variations from Arc-shaped Gas Clouds Falling onto a Black Hole

    Science.gov (United States)

    Moriyama, Kotaro; Mineshige, Shin; Takahashi, Hiroyuki R.

    2017-11-01

    We investigate the dynamical and radiative properties of arc-shaped gas clouds falling onto a stellar-mass black hole based on the three-dimensional general relativistic radiation-magnetohydrodynamics (3D-GRRMHD) simulation data. Assuming that the gas clouds radiate mainly due to the free-free emission and/or optically thick, inverse Compton scattering, we calculate how the emissivity distributions develop with time. We find that (1) gas clouds, each of which has a ring-like or arc shape, are intermittently formed, and that (2) they slowly fall onto the black hole, keeping nearly the Keplerian orbital velocity. These features support the dynamical properties of the gas clouds assumed in the spin measurement method proposed by Moriyama & Mineshige, but the radius of the inner edge of the accretion disk is larger than that of the marginally stable orbit (ISCO). Next, we examine how each gas cloud is observed by a distant observer by calculating the photon trajectories in the black hole spacetime. The luminosity of the accretion flow exhibits significant time variations on different timescales, reflecting the time evolution of the gas density distributions. The relatively slow variations on the time durations of 0.08-0.10 s is due to the formation and fall of gas clouds, while quasi-periodic flux peaks with short time intervals (0.01 s) are due to the quasi-periodic enhancement of light from the non-axisymmetric arc-shaped clouds through the beaming effect. This may account for the high-frequency quasi-periodic oscillations (HF QPOs) observed in black hole binaries. The observational implications and future issues are briefly discussed.

  13. The rise and fall of periodic 'drumbeat' seismicity at Tungurahua volcano, Ecuador

    Science.gov (United States)

    Bell, Andrew F.; Hernandez, Stephen; Gaunt, H. Elizabeth; Mothes, Patricia; Ruiz, Mario; Sierra, Daniel; Aguaiza, Santiago

    2017-10-01

    Highly periodic 'drumbeat' long period (LP) earthquakes have been described from several andesitic and dacitic volcanoes, commonly accompanying incremental ascent and effusion of viscous magma. However, the processes controlling the occurrence and characteristics of drumbeat, and LP earthquakes more generally, remain contested. Here we use new quantitative tools to describe the emergence, evolution, and degradation of drumbeat LP seismicity at the andesitic Tungurahua volcano, Ecuador, in April 2015. The signals were recorded during an episode of minor explosive activity and ash emission, without lava effusion, and are the first to be reported at Tungurahua during the ongoing 17 yrs of eruption. Following four days of high levels of continuous and 'pulsed' tremor, highly-periodic LP earthquakes first appear on 10 April. Over the next four days, inter-event times and event amplitudes evolve through a series of step-wise transitions between stable behaviors, each involving a decrease in the degree of periodicity. Families of similar waveforms persist before, during, and after drumbeat activity, but the activity levels of different families change coincidentally with transitions in event rate, amplitude, and periodicity. A complex micro-seismicity 'initiation' sequence shows pulse-like and stepwise changes in inter-event times and amplitudes in the hours preceding the onset of drumbeat activity that indicate a partial de-coupling between event size and rate. The observations increase the phenomenology of drumbeat LP earthquakes, and suggest that at Tungurahua they result from gas flux and rapid depressurization controlled by shear failure of the margins of the ascending magma column.

  14. Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study.

    Science.gov (United States)

    Almegbel, Faisal Yousef; Alotaibi, Ibrahim Muthyib; Alhusain, Faisal Ahmed; Masuadi, Emad M; Al Sulami, Salma Lafyan; Aloushan, Amairah Fahad; Almuqbil, Bashayer Ibrahim

    2018-01-10

    Approximately 28% to 35% of people aged 65 and over fall each year. The consequent injuries of falls are considered a major public health problem. Falls account for more than half of injury-related hospitalisations among old people. The aim of this study was to measure a 1-year period prevalence of falling among old people in Riyadh, Saudi Arabia. In addition, this study described the most common risk factors and consequent injuries of falls. A cross-sectional survey was carried out in Riyadh, using a convenient sampling. The targeted population were Saudi citizens who were 60 years or above. Over a 6-month period, 1182 individuals were sampled (545 men and 637 women). The 1-year prevalence of falling among old Saudis (>=60 years) was 49.9%. Our results show that 74% of the participants who experienced falls had postfall injuries. Old participants who were uneducated and those with middle school certification were associated with falls (adjusted OR (aOR) 1.72; 95% CI 1.15 to 2.56, aOR 1.81; 95% CI 1.15 to 2.85, respectively). Those who live in rented houses had a higher risk of falls. Interestingly, having a caregiver was significantly associated with more falls (aOR 1.39; 95% CI 1.08 to 1.79). However, not using any medications was significantly related to fewer falls. In addition, old individuals using walking aids were more likely to fall than those who did not. Participants who mentioned 'not having stressors were associated with less frequent falls (aOR 0.62; 95% CI 0.39 to 0.97). Cerebrovascular accidents were strongly associated with falls with an estimated OR of 2.75 (95% CI 1.18 to 6.43). Moreover, osteoporosis, poor vision and back pain were found to be predictors for falls among the elderly. 49.9% of elderly Saudis had experienced one or more falls during a 12-month period. Several preventable risk factors could be addressed by routine geriatric assessment. Research on the impact of these risk factors is needed. © Article author(s) (or their

  15. Hydraulic Characteristics of the Lower Snake River during Periods of Juvenile Fall Chinook Salmon Migration, 2002-2006 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Cook, C.; Dibrani, B.; Richmond, M.; Bleich, M.; Titzler, P..; Fu, T. [Pacific Northwest National Laboratory

    2006-01-01

    This report documents a four-year study to assess hydraulic conditions in the lower Snake River. The work was conducted for the Bonneville Power Administration, U.S. Department of Energy, by the Pacific Northwest National Laboratory. Cold water released from the Dworshak Reservoir hypolimnion during mid- to late-summer months cools the Clearwater River far below equilibrium temperature. The volume of released cold water augments the Clearwater River, and the combined total discharge is on the order of the Snake River discharge when the two rivers meet at their confluence near the upstream edge of Lower Granite Reservoir. With typical temperature differences between the Clearwater and Snake rivers of 10 C or more during July and August, the density difference between the two rivers during summer flow augmentation periods is sufficient to stratify Lower Granite Reservoir as well as the other three reservoirs downstream. Because cooling of the river is desirable for migrating juvenile fall Chinook salmon (Oncorhynchus tshawytscha) during this same time period, the amount of mixing and cold water entrained into Lower Granite Reservoir's epilimnion at the Clearwater/Snake River confluence is of key biological importance. Data collected during this project indicates the three reservoirs downstream of Lower Granite also stratify as direct result of flow augmentation from Dworshak Reservoir. These four reservoirs are also heavily influenced by wind forcing at the water's surface and during periods of low river discharge often behave like a two-layer lake. During these periods of stratification, lower river discharge, and wind forcing, the water in the upper layer of the reservoir is held in place or moves slightly upstream. This upper layer is also exposed to surface heating and may warm up to temperatures close to equilibrium temperature. The thickness (depth) of this upper warm layer and its direction of travel may be of key biological importance to juvenile

  16. Future migratory behaviour predicted from premigratory levels of gill Na+/K(+-)ATPase activity in individual wild brown trout ( Salmo trutta )

    DEFF Research Database (Denmark)

    Nielsen, C.; Aarestrup, Kim; Norum, U.

    2004-01-01

    The relationship between premigratory gill Na+/K(+-)ATPase activity, determined at two dates during spring, and future migratory behaviour was investigated using non-lethal gill biopsies and PIT-tagging in wild brown trout (Salmo trutta) from two tributaries. No significant relationship between...... future migrants or residents. The maximum percentage of correct predictions of future migratory behaviour in mainstream fish was observed at threshold probabilities between approximately 0.15 and 0.45 (corresponding to threshold gill Na+/K+-ATPase activities between 2.7 and 3.7 mumol ADP mg(-1) protein h...

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

    NARCIS (Netherlands)

    Weerdesteijn, V.G.M.; Groen, B.E.; Swigchem, R. van; Duysens, J.E.J.

    2008-01-01

    Hip fractures are among the most serious consequences of falls in the elderly. Martial arts (MA) fall techniques may reduce hip fracture risk, as they are known to reduce hip impact forces by approximately 30% in experienced fallers. The purpose of this study was to investigate whether hip impact

  18. Periods of constant and falling-rate for infrared drying of carrot slices Períodos de secagem constante e decrescente de fatias de cenoura por infravermelho

    OpenAIRE

    Fernando M. Botelho; Paulo C. Corrêa; André. L. D. Goneli; Márcio A. Martins; Felipe E. A. Magalhães; Sílvia C. Campos

    2011-01-01

    The aim of this work was to study the infrared drying process of carrot slices and to determine coefficients related to the heat and mass transfer of the process. Fresh carrots were used, dried until constant weight in a dryer with infrared heating source. Different models were utilized to fit the experimental data of constant and falling drying rate periods. It was verified that the coefficients of heat and mass transfer, during the constant drying rate, significantly increased with temperat...

  19. Pre-migratory congregations of Red-crowned (Grus japonensis, White-naped (G. vipio and Hooded (G. monacha cranes in the Muraviovka Park for Sustainable Land Use in 1992

    Directory of Open Access Journals (Sweden)

    P. I. Gorlov

    2017-05-01

    Full Text Available The autumn pre-migratory concentrations of Red-crowned, White-naped and Hooded Cranes were studied in the Muraviovka Park for Sustainable Land Use and Environmentla Education (Tambov District, Amur Region, Russian Federation during 23.08–29.09.1992. We counted 292 Hooded Cranes, 34 White-naped Cranes, and 17 Red-crowned Cranes during the study period. We also marked specific differences in the behaviour of the birds connected with their readiness for migration. The Hooded Cranes showed the greatest readiness for migration. We observed mutual flights, overnight stays, and feeding of adult birds and family groups in their flocks. This was not the same in the flocks of White-naped Cranes. However, the average number of birds in the flocks of White-naped Cranes had increased by the end of our observations due to new families joining the general flock. The family parties of the Red-crowned Crane and adult birds without young individuals stayed apart from each other and from other crane species during the whole observation period. We registered the autumn departure of Hooded Cranes in late September, the migratory departure of White-naped Cranes in the middle of October, and the Red-crowned Cranes left the area in the first half of November. The breeding period for all crane species starts at the same time: the third decade of April – the beginning of May. The young of the studied crane species differ significantly in the period of time before fledging: Hooded Cranes – 55–60 days, White-naped Cranes – 65–70 days, and Red-crowned Cranes – 70–75 days because of their specific differences in the ratio of size to weight (1 : 1.3 : 1.7. Thus, the time difference between the Hooded and Red-crowned Cranes is about 2–3 weeks. We suggest that this is the main reason that determines the differences between these species in the timing of the the start of autumn migration.

  20. Observations of long-period waves in the nearshore waters of central west coast of India during the fall inter-monsoon period

    Digital Repository Service at National Institute of Oceanography (India)

    Amrutha, M.M; SanilKumar, V.; Jesbin, G.

    . It is observed that the high waves (significant wave height >4 m) generated in an area bounded by 40–60°S and 20–40°E in the south Indian Ocean reached the measurement locations in 5–6 days and resulted in the long-period waves. Relatively high percentage of long...

  1. Study of the contamination of live-stock during periods of radio-active fall-out (1963)

    International Nuclear Information System (INIS)

    Michon, G.; Jeanmaire, L.

    1963-01-01

    The authors have tried, during the radioactive period corresponding, to the nuclear tests of the autumn 1961, to follow under natural conditions the contamination of a herd of cattle made up 9 cows and 7 calves. The observations concern I 131 , which was studied in particular, and the mixture of fission products. As far as the excretion of iodine in milk is concerned, the equilibrium is established slowly and the amount found in the milk is about 1 per cent of the daily intake. This figure is lower than those based on experimental studies (given in the literature). For the mixture of products, only a small number of elements is metabolised. The fraction found in 1 kilo of liver is about 5 x 10 -5 of the amount of Zr-Nb taker up per day, and about 4 x 10 -4 of the daily intake of Ru. These elements are not found afterwards in muscle. (authors) [fr

  2. Periods of constant and falling-rate for infrared drying of carrot slices Períodos de secagem constante e decrescente de fatias de cenoura por infravermelho

    Directory of Open Access Journals (Sweden)

    Fernando M. Botelho

    2011-08-01

    Full Text Available The aim of this work was to study the infrared drying process of carrot slices and to determine coefficients related to the heat and mass transfer of the process. Fresh carrots were used, dried until constant weight in a dryer with infrared heating source. Different models were utilized to fit the experimental data of constant and falling drying rate periods. It was verified that the coefficients of heat and mass transfer, during the constant drying rate, significantly increased with temperature on rise. The Diffusion Approximation, Two Terms, Midili and Verna models satisfactory represented the falling period of drying rate of carrot slices. The effective diffusion coefficient increased with temperature and this relationship can be represented by the Arrhenius equation, obtaining activation energy to the drying process of 29.092 kJ mol-1.Com este trabalho objetivou-se estudar o processo de secagem por infravermelho das fatias de cenoura e determinar alguns coeficientes referentes à transferência de calor e massa do processo. Utilizaram-se cenouras frescas, secadas até massa constante em um secador com fonte de aquecimento por infravermelho. Aos dados experimentais se ajustaram diferentes modelos para os períodos de taxa de secagem constante e decrescentes. Verificou-se que os coeficientes transferência de calor e massa, referentes ao período de secagem constante, aumentaram significativamente com o aumento da temperatura e que os modelos Aproximação da Difusão, Dois Termos, Midili e Verna representaram satisfatoriamente o período de secagem decrescente das fatias de cenoura. O coeficiente de difusão efetivo aumentou com a temperatura e esta relação pode ser representada pela Equação de Arrhenius, obtendo-se uma energia de ativação para o processo de secagem de 29,092 kJ mol-1.

  3. Effects of time of weaning, supplement, and sire breed of calf during the fall grazing period on cow and calf performance.

    Science.gov (United States)

    Short, R E; Grings, E E; MacNeil, M D; Heitschmidt, R K; Haferkamp, M R; Adams, D C

    1996-07-01

    A 4-yr experiment was conducted to determine effects of protein supplementation, age at weaning, and calf sire breed on cow and calf performance during fall grazing. Each year 48 pregnant, crossbred cows nursing steer calves (mean calving date = April 8) were assigned to a 2 x 2 x 2 factorial experiment replicated in three native range pastures. Treatment factors were: 1) no supplement (NS) or an individually fed supplement (S, 3 kg of a 34% protein supplement fed to cows every 3rd d); 2) calves weaned at the beginning (W, mid to late September) or at the end (NW, mid to late December) of the trial each year; or 3) calves sired by Hereford or Charolais bulls. Data were adjusted for cow size (initial hip height and initial and final weights and condition scores) by analyses of covariance using principal component coefficients as covariates. Change in cow weight and condition score were increased by S and W (P Forage intake was decreased (P intake (forage+supplement) was not affected by S but was decreased by W (P effects of treatments were observed the next spring in cow weight, condition score, and birth weight (NW decreased birth weight by 2 kg, P effects by the next fall on weaning weights or pregnancy rates. Milk yield decreased during the experimental period, and S maintained higher milk production in late lactation (P Calf ADG was increased by S and Charolais sires (P effects of feeding a 34% protein supplement to cows were to increase calf gains and improve persistency of lactation and efficiency; 2) delaying weaning decreased cow weight and condition score; 3) effects of weaning age and protein supplementation were highly dependent on forage and environmental conditions in any given year; and 4) whatever effects existed in a given year did not carry over to effects on next year's production as measured by pregnancy rates and weaning weights.

  4. Future migratory behaviour predicted from premigratory levels of gill Na+/K+-ATPase activity in individual wild brown trout (Salmo trutta)

    DEFF Research Database (Denmark)

    Nielsen, Christian; Aarestrup, Kim; Nørum, Ulrik

    2004-01-01

    The relationship between premigratory gill Na+/K+-ATPase activity, determined at two dates during spring, and future migratory behaviour was investigated using non-lethal gill biopsies and PIT-tagging in wild brown trout (Salmo trutta) from two tributaries. No significant relationship between...... future migrants or residents. The maximum percentage of correct predictions of future migratory behaviour in mainstream fish was observed at threshold probabilities between approximately 0.15 and 0.45 (corresponding to threshold gill Na+/K+-ATPase activities between 2.7 and 3.7 micromol ADP mg-1 protein...

  5. Meteorite falls in Africa

    Science.gov (United States)

    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.

  6. Review of perioperative falls

    Science.gov (United States)

    Kronzer, V. L.; Wildes, T. M.; Stark, S. L.; Avidan, M. S.

    2016-01-01

    Falls are a known public health problem, and there is increasing recognition of the importance of perioperative falls for risk prediction and quality assessment. Our objective was to review existing literature regarding the occurrence, injuries, and risk factors of preoperative and postoperative falls. A systematized search of PubMed entries between 1947 and November 2015 produced 24 articles that met inclusion criteria. Most studied orthopaedic surgery patients older than 65 yr. Four were rated ‘good’ quality. Interrater reliability for the quality assessment was moderate (κ = 0.77). In the 3–12 months before surgery, the proportion of preoperative patients who fell ranged from 24 to 48%. Injuries were common (70%). The rate of postoperative falls ranged from 0.8 to 16.3 per 1000 person-days, with a gradual decline in the months after surgery. Injuries from postoperative falls occurred in 10–70% of fallers, and 5–20% experienced a severe injury. Risk factors were not well studied. Prospective studies reported a higher percentage of falls and fall-related injuries than retrospective studies, suggesting that there may be underdetection of falls and injuries with retrospective studies. Perioperative falls were more common than falls reported in the general community, even up to 12 months after surgery. Surgery-related falls may therefore occur beyond the hospitalization period. Future studies should use a prospective design, validated definitions, and broader populations to study perioperative falls. In particular, investigations of risk factors and follow-up after hospitalization are needed. Registry number: PROSPERO registration number CRD42015029971. PMID:27956670

  7. Falls among union carpenters.

    Science.gov (United States)

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

    2003-08-01

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

  8. Fluxes of ozone and Biogenic Volatile Organic Compounds in a mixed Mediterranean forest over a transition period between summer and fall

    Science.gov (United States)

    Fares, S.; Schnitzhofer, R.; Hansel, A.; Petersson, F.; Matteucci, G.; Scarascia Mugnozza, G.; Jiang, X.; Guenther, A. B.; Loreto, F.

    2012-12-01

    Mediterranean plant ecosystems are exposed to abiotic stressors that may be exacerbated by climate change dynamics. Moreover, plants need now to cope with increasing anthropogenic pressures, often associated with expanding impacts of urbanization. Anthropogenic stressors include harmful gases (e.g. ozone,) that are transported from anthropogenic pollution sources to the vegetation. They may alter ecophysiology and compromise metabolism of Mediterranean plants. A disproportionate number of Mediterranean ecosystems, many dominated by forest trees, are being transformed into "urban or pre-urban forests". This is in particular the case for Castelporziano Estate, a 6,000 ha Mediterranean forest located just 25 km from Rome downtown at the coast of the Mediterranean Sea. In September 2011 an intensive field campaign was performed in Castelporziano to investigate ozone deposition and biogenic emissions of volatile organic compounds (BVOC) from a mixed Mediterranean forest, mainly composed by Quercus suber, Quercus ilex, Pinus pinea. Measurements were performed at canopy level with fast real-time instruments (a fast ozone analyzer and a Proton Transfer Reaction-Time of Flight Mass Spectrometer) that allowed eddy covariant flux measurements of ozone and BVOC. In the transitional period from a warm and dry summer to a wet and moderately cool fall we typically observed tropospheric ozone volume mixing ratios (VMR) of 60 ppb at around noon, with high deposition fluxes (up to -10 nmol m-2 s-1) into the forest canopy. Canopy models were used to to calculate that up to 90% of ozone uptake can be attributed to non-stomatal sinks, suggesting that chemical reactions between ozone and reactive BVOC may have played an important role. The concentrations of reactive isoprenoids (e.g. sesquiterpenes) were indeed observed to decrease during the central hours of the day, in coincidence with increased ozone concentrations. Concentrations and fluxes of isoprenoid

  9. Preventing falls

    Science.gov (United States)

    ... more difficult to stand up or keep your balance are a common cause of falls. Balance problems can also cause falls. When you walk, ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

  10. 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.

  11. Drought, epidemic disease, and the fall of classic period cultures in Mesoamerica (AD 750-950). Hemorrhagic fevers as a cause of massive population loss.

    Science.gov (United States)

    Acuna-Soto, Rodolfo; Stahle, David W; Therrell, Matthew D; Gomez Chavez, Sergio; Cleaveland, Malcolm K

    2005-01-01

    The classical period in Mexico (AD 250-750) was an era of splendor. The city of Teotihuacan was one of the largest and most sophisticated human conglomerates of the pre-industrial world. The Mayan civilization in southeastern Mexico and the Yucatan peninsula reached an impressive degree of development at the same time. This time of prosperity came to an end during the Terminal Classic Period (AD 750-950) a time of massive population loss throughout Mesoamerica. A second episode of massive depopulation in the same area was experienced during the sixteenth century when, in less than one century, between 80% and 90% of the entire indigenous population was lost. The 16th century depopulation of Mexico constitutes one of the worst demographic catastrophes in human history. Although newly imported European and African diseases caused high mortality among the native population, the major 16th century population losses were caused by a series of epidemics of a hemorrhagic fever called Cocoliztli, a highly lethal disease unknown to both Aztec and European physicians during the colonial era. The cocoliztli epidemics occurred during the 16th century megadrought, when severe drought extended at times from central Mexico to the boreal forest of Canada, and from the Pacific to the Atlantic coast. The collapse of the cultures of the Classic Period seems also to have occurred during a time of severe drought. Tree ring and lake sediment records indicate that some of the most severe and prolonged droughts to impact North America-Mesoamerica in the past 1000-4000 years occurred between AD 650 and 1000, particularly during the 8th and 9th centuries, a period of time that coincides with the Terminal Classic Period. Based on the similarities of the climatic (severe drought) and demographic (massive population loss) events in Mesoamerica during the sixteenth century, we propose that drought-associated epidemics of hemorrhagic fever may have contributed to the massive population loss

  12. Students fall for Fall Meeting

    Science.gov (United States)

    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.

  13. 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...

  14. Observations of the lesser kestrel (Falco naumanni in Bulgaria during the period of post-breeding dispersal

    Directory of Open Access Journals (Sweden)

    Daskalova Girgina

    2016-12-01

    Full Text Available The lesser kestrel (Falco naumanni was considered extinct as a breeding species in Bulgaria, but recently a small breeding colony was found again in the south-eastern part of the country. Seven recent observations of flocks or solitary birds of the species in Bulgaria during the post-breeding period are presented and commented here. It is shown that the territory of the country is a regular area for post-breeding dispersal and pre-migratory feeding of lesser kestrels. The origin of these is not known, but most probably birds from the populations of the European part of Turkey, Greece, Republic of Macedonia and Albania are involved.

  15. 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.

  16. Falls: epidemiology and strategies for prevention.

    Science.gov (United States)

    Mosenthal, A C; Livingston, D H; Elcavage, J; Merritt, S; Stucker, S

    1995-05-01

    Injury secondary to falls is a largely preventable public health problem. The records of 356 patients admitted following a fall to a level I trauma center over a 32-month period were reviewed to determine the epidemiology and to define possible prevention strategies. Falls constituted 9% of total trauma admissions during this time period and had a mortality of 11% (38 of 356). Two hundred ninety-seven falls were accidental, 36 were due to violent criminal behavior, 16 were from suicide attempts, and 7 were from house fires. Sixty-one children under the age of 13 fell; only one died. Falls out of windows accounted for 36% of these falls with over three-quarters of children falling from three stories or less. Elderly patients (age more than 64 years) accounted for only 44 (14%) of falls but over 50% of the deaths. This mortality rate occurred despite the fact that the majority of these falls were from relatively low heights. There were 224 adult falls (ages 18 to 64 years); 36% were occupation-related, and most were by construction workers, roofers, or painters. The remaining adult fall victims had a high rate of unemployment and alcohol and drug use. This study identified several groups where risk factors for falling permit targeted prevention strategies. A large percentage of children who fell were preschool males who fell from windows and this may be related to the lack of window guard legislation in our area.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Modeling a falling slinky

    Science.gov (United States)

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

    2012-12-01

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

  18. Evaluation of the falls telephone: an automated system for enduring assessment of falls.

    Science.gov (United States)

    van der Marck, Marjolein A; Overeem, Sebastiaan; Klok, Philomène C M; Bloem, Bastiaan R; Munneke, Marten

    2011-02-01

    To evaluate the reliability and user experiences of an automated telephone system to monitor falls during a prolonged period of time. Prospective cohort study. Four neurological outpatient clinics in the Netherlands. One hundred nineteen community-dwelling people with Parkinson's disease without dementia, because falls are common in this population. Clinical and demographic data were obtained. The Falls Telephone is a computerized telephone system through which participants can enter the number of falls during a particular period. During a follow-up of 1 to 40 weekly calls, 2,465 calls were made. In total, 173 no-fall entries and 115 fall entries were verified using personal telephone interviews. User experiences were evaluated in 90 of the 119 participants using structured telephone interviews. All no-fall entries and 78% of fall entries were confirmed to be correct. Sensitivity to detect falls was 100%, and specificity was 87%. Users regarded the Falls Telephone as a convenient tool to monitor falls. The Falls Telephone is a convenient and reliable instrument to monitor falls. The automated system has high specificity, obviating the need for time-consuming personal follow-up calls in the majority of nonfallers. As such, the Falls Telephone lends itself well to data collection in large trials with prolonged follow-up in participants with Parkinson's disease. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  19. [Characteristics of falls among free living elders].

    Science.gov (United States)

    González, G; Marín, P P; Pereira, G

    2001-09-01

    Falls by older adults are a frequent problem among ambulatory patients in primary care. To describe the prevalence and features of falls among elders consulting to an ambulatory Geriatric Clinic. Persons aged 60 years or more were surveyed about the number of falls in the preceding six months, the characteristics and consequences of each falls. Biopsychosocial characteristics were recorded and the Tinetti gait and balance test was performed in all patients reporting falls. In 104 (18.2%) of 571 clinical consultations, one or more falls were reported. Among patients who fell and provided complete data (n = 95), 64% reported one fall and 36% reported two or more, totaling 156 falls to analyze. The mean age of the patients with falls was 71.8 +/- 6.8 years. The functional and cognitive status was normal in 73 and 71.6% of cases respectively and 38% carried out periodical physical activity. Fifty seven percent of falls occurred outside of home, and an extrinsic factor was a precipitating cause in 55% of the falls. A post-fall syndrome appeared in 21% of cases and 2.6% resulted in fractures. Falling two or more times versus one time during the last six months was statistically associated with an age over 75, an absence of periodic physical activity, functional impairments, three or more chronic diseases, neurological diseases and with living alone, among other variables. Falls among elders occur mainly outside of home, in subjects older than 75 years old, functionally dependent and with an important involvement of extrinsic factors. Physical activity, as well as the control of environmental risks, could be protective factors against recurrent falls.

  20. 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.

  1. 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.

  2. 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.

  3. Home Improvements Prevent Falls

    Science.gov (United States)

    ... 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 ...

  4. 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

  5. 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

  6. Peralta Facts: Fall 1983.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    Data were collected in fall 1983 to provide a profile of the student population of the Peralta Community College District (PCCD). The data revealed: (1) total student enrollment declined by 12% from fall 1982 (N=38,976) to fall 1983 (N=34,183); (2) 57% of the students whose sex was identified were women; (3) minorities constituted 58% of the…

  7. Fall Prevention: Simple Tips to Prevent Falls

    Science.gov (United States)

    ... bars for the shower or tub A sturdy plastic seat for the shower or tub — plus a ... healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358 . Mayo Clinic Footer Legal Conditions and Terms ...

  8. Road and Street Centerlines, Average Freeway/Arterial/Low Speed Arterial Travel Speeds - Spring and Fall 2010 Data collected during PM Peak period (4:30 - 6:30pm) and AM Peak Period (7 - 9am) on selected roadways - GPS travel speeds at 1,000 ft interval, Published in 2010, 1:2400 (1in=200ft) scale, Baltimore Metropolitan Council.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Road and Street Centerlines dataset current as of 2010. Average Freeway/Arterial/Low Speed Arterial Travel Speeds - Spring and Fall 2010 Data collected during PM...

  9. Falls aren't us: state of the science.

    Science.gov (United States)

    Cozart, Huberta-Corazon T; Cesario, Sandra K

    2009-01-01

    This article reviews the scientific health and medical literature on accidental falls and fall prevention modalities specifically directed to the hospitalized elderly population over a 15-year period. Electronic searches of databases include CINAHL, Cochrane Library, Dissertation Abstracts, ERIC, MEDLINE, MeSH, PubMed PEDro, Ulrich's, and Web of Science. Key words and controlled subject headings used include accidental falls, fall prevention, fall risk factors, hospitalized elderly, fall incidence and rates, and environmental and patient safety. Boolean operators were utilized. Search limits include English languages, human subjects, older adult population, clinical trials, and meta-analyses. Wide array and multitude of papers were accessed. Analyses of the various documents from classical seminal works to the current technological studies were performed. Fall prevention modalities may facilitate achievement of the ninth goal of The Joint Commission namely, to "reduce the risk of patient harm resulting form falls" and achievement of Healthy People 2010 15th goal namely, to "reduce death from falls."

  10. 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.

  11. 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

  12. Slow Processing Speed Predicts Falls in Older Adults With a Falls History: 1-Year Prospective Cohort Study.

    Science.gov (United States)

    Davis, Jennifer C; Best, John R; Khan, Karim M; Dian, Larry; Lord, Stephen; Delbaere, Kim; Hsu, Chun Liang; Cheung, Winnie; Chan, Wency; Liu-Ambrose, Teresa

    2017-05-01

    A previous fall is a strong predictor of future falls. Recent epidemiologic data suggest that deficits in processing speed predict future injurious falls. Our primary objective was to determine a parsimonious predictive model of future falls among older adults who experienced ≥1 fall in the past 12 months based on the following categories: counts of (1) total, (2) indoor, (3) outdoor or (4) non-injurious falls; (5) one mild or severe injury fall (yes vs no); (6) an injurious instead of a non-injurious fall; and (7) an outdoor instead of an indoor fall. 12-month prospective cohort study. Vancouver Falls Prevention Clinic, Canada (www.fallsclinic.ca). Two-hundred and eighty-eight community-dwelling older adults aged ≥70 years with a history of ≥1 fall resulting in medical attention in the previous 12 months. We employed principal component analysis to reduce the baseline predictor variables to a smaller set of five factors (i.e., processing speed, working memory, emotional functioning, physical functioning and body composition/fall risk profile). Second, we used the extracted five factors as predictors in regression models predicting the incidence of falls over a 12-month prospective observation period. We conducted regression analyses for the seven falls-related categories (defined above). Among older adults with a falls history, processing speed was the most consistent predictor of future falls; poorer processing speed predicted a greater number of total, indoor, outdoor, and non-injurious falls, and a greater likelihood of experiencing at least one mild or severe injurious fall (all P values factor, a trainable factor, was independently associated with the most costly type of falls-injurious falls. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  13. 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....

  14. Fall Leaf Portraits

    Science.gov (United States)

    O'Hara, Cristina

    2012-01-01

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

  15. Chair Lift Falls and Injuries in Children.

    Science.gov (United States)

    Glissmeyer, Eric W; Metzger, Ryan R; Bolte, Robert

    2018-02-01

    The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014. There were 443 cases of hospitalized ski and snowboarding injuries during the study period. Twenty-nine cases (7%) fell from height while riding a chair lift. Children falling from chair lifts were more likely to be younger (6.9 years vs 12.1, P chair lift falls with a significant injury (abbreviated injury scale, ≥3) was lower extremity (4/29, all femur fractures). Patient age discriminated chair lift falls well (area under the receiver operating characteristic curve, 0.87) with age of 7 years and below predicting chair lift fall with a sensitivity of 76% and a specificity of 91%. Injuries requiring hospitalization after falls from chair lifts occur at regulated facilities and are more common in younger female children when compared with other ski and snowboarding injuries. Interventions for reducing falls from chair lifts may be most effective applied to children 7 years and younger.

  16. Falls prevention for the elderly

    Directory of Open Access Journals (Sweden)

    Dagmar Lühmann

    2012-04-01

    Full Text Available Background: An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention.Research questions: The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years, living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Methods: Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT, the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed.Results: Out of 12,000 references retrieved by literature searches, 184 meet the

  17. Falls prevention for the elderly.

    Science.gov (United States)

    Balzer, Katrin; Bremer, Martina; Schramm, Susanne; Lühmann, Dagmar; Raspe, Heiner

    2012-01-01

    An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention. The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years), living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT), the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed. Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, to a variable degree the validity of their

  18. Hourly rounding and patient falls: what factors boost success?

    Science.gov (United States)

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

    2015-02-01

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

  19. 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.

  20. The variability of meteoroid falling

    Science.gov (United States)

    Velasco Herrera, V. M.; Cordero, G.

    2016-10-01

    We analysed a historical catalogue of meteoroid falling during the last 400 years. We report here for the first time the synchronization between observed meteors and solar barycentric parameters in 19.6 and 13.2 years periodicities using a new multiple cross wavelet. The group of moderated number of meteors is distributed around the positive phase of the solar barycentric periodicity of 13.2 years. While the group of severe number of meteors are distributed on the positive phase of the solar barycentric periodicity of 19.6 years. These periodicities could be associated with Jupiter periodicities. So understanding the modulation of meteoroid falling is important for determining the falling patterns of these objects and for knowing when it is more likely to expect the entry of one of these objects into the Earth's atmosphere, because bodies falling onto the Earth can cause damage from minor impacts to mass-extinctions events. One of the most extreme events was the formation of the Chicxulub impact crater 65,000,000 years ago that caused one of the five major mass extinctions in the last 500,000,000 years. During the 20th and 21st centuries, a series of events demonstrated the importance of collisions between planets and small bodies (comets and asteroids), which included our own planet. In the case of the Earth, we can cite three examples: Tunguska, Curuça and Chelyabinsk. These events invite us to think that perhaps the occurrence of this phenomenon might be more common than we realize, but the lack of communication or people in the area where they happened prevents us from having a complete record. Modern man has not witnessed the impact of large asteroids or comets on our planet, but it has been observed on other planetary bodies. The most spectacular of these events was the collision of fragments of the comet Shoemaker-Levy 9 with Jupiter in 1994. The total energy of the 21 impacts on Jupiter's atmosphere was estimated as the equivalent of tens of millions of

  1. Catapults fall short

    Science.gov (United States)

    Gibson, Marcus

    2018-01-01

    In reply to the news story "UK Catapults fall short, claims review of technology centres", which describes an independent review that criticized the management of the UK's network of technology innovation centres.

  2. Fall Bottom Trawl Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The standardized NEFSC Fall Bottom Trawl Survey was initiated in 1963 and covered an area from Hudson Canyon, NY to Nova Scotia, Canada. Throughout the years,...

  3. Reducing the risk of baby falls in maternity units.

    Science.gov (United States)

    Janiszewski, Helen

    During a 12-month period there were 17 baby falls on the maternity wards at Nottingham University Hospitals Trust; two of the babies who fell were injured. By collecting information about the baby falls and how they happened, we were able to compile a guideline for both preventing and managing baby falls. This formed part of the trust's patient safety programme. We then piloted and implemented risk-prevention strategies for baby falls. These involved a risk assessment to identify women needing closer observation and the installation of bedside cots. These strategies brought about a marked reduction of baby falls and are now being established across all the maternity units across the trust.

  4. The neurobiology of falls.

    Science.gov (United States)

    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.

  5. 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.

  6. I see falling stars

    CERN Document Server

    Orr, Tamra B

    2015-01-01

    "Young children are naturally curious about the world around them. I See Falling Stars offers answers to their most compelling questions about meteors. Age-appropriate explanations and appealing photos encourage readers to continue their quest for knowledge. Additional text features and search tools, including a glossary and an index, help students locate information and learn new words."-- Provided by publisher.

  7. Fall Back Equilibrium

    NARCIS (Netherlands)

    Kleppe, J.; Borm, P.E.M.; Hendrickx, R.L.P.

    2008-01-01

    Fall back equilibrium is a refinement of the Nash equilibrium concept. In the underly- ing thought experiment each player faces the possibility that, after all players decided on their action, his chosen action turns out to be blocked. Therefore, each player has to decide beforehand on a back-up

  8. Fall 1982 Retention Study.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    In fall 1982, a study was conducted in the Peralta Community College District (PCCD) using withdrawal and grade distribution data to analyze student retention patterns. Successful retention rates were based on the percentage of students who received a passing grade, while total retention rates were based on the percentage of students who received…

  9. Fall 1984 Retention Study.

    Science.gov (United States)

    Peralta Community Coll. District, Oakland, CA. Office of Research, Planning and Development.

    A study was conducted of the retention patterns of students enrolled in the Peralta Community College District (PCCD) in fall 1984 using college reports on withdrawals and grade distributions. The study focused on successful retention (i.e., all students who received a passing grade) and on total retention (i.e., all students who received any…

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

    Science.gov (United States)

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

    2016-09-01

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

  11. Inpatient falls in older adults: a cohort study of antihypertensive prescribing pre- and post-fall.

    Science.gov (United States)

    Omer, H M R B; Hodson, J; Pontefract, S K; Martin, U

    2018-02-23

    Falls are common during hospital admissions and may occur more frequently in patients who are taking antihypertensive medications, particularly in the context of normal to low blood pressure. The review and adjustment of these medications is an essential aspect of the post-fall assessment and should take place as soon as possible after the fall. Our aim was to investigate whether appropriate post-fall adjustments of antihypertensive medications are routinely made in a large National Health Service (NHS) Trust. Inpatient records over an eight-month period were captured from an electronic prescribing system to identify older adults (≥80 years old) with normal/low blood pressures (fall as these patients were considered to be at high risk of further falls. Prescribed antihypertensive medication on admission was then compared with the post-fall (within 24 h after the fall) and discharge prescriptions. A total of 146 patients were included in the analysis. Of those, 120 patients (82%) were taking the same number of antihypertensive medications in the 24 h after the fall as they were before; only 19 patients (13%) had a reduction in the number of medications and seven patients (5%) had an increase in medications during that period. Only 9% of the antihypertensive classes assessed were either stopped or reduced in dose immediately post-fall. In addition, 11 new antihypertensives were prescribed at this time. At discharge, half of the patients (n = 73) remained on the same number of antihypertensive medication as on admission, 51 patients (35%) were on fewer antihypertensives and 22 (15%) were on more. Additionally, no changes were made to individual antihypertensives in 49% of prescriptions; 34% were stopped or reduced in dose but 38 new agents were started by the time of discharge. Angiotensin converting enzyme inhibitors and angiotensin II receptor blockers (ACEi/ARB) were the class of medications most commonly stopped or reduced (51%). Antihypertensive

  12. Incidence of falls and preventive actions in a University Hospital.

    Science.gov (United States)

    Luzia, Melissa de Freitas; Cassola, Talita Portela; Suzuki, Lyliam Midori; Dias, Vera Lucia Mendes; Pinho, Leandro Barbosa de; Lucena, Amália de Fátima

    2018-01-01

    Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

  13. 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 ...

  14. 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.

  15. Development of fall foliage color in sugar maple

    Science.gov (United States)

    Abby K. Van den Berg; John R. Donnelly; Paula F. Murakami; Paul G. Schaberg

    2001-01-01

    Fall foliage development is important to tourism and culture in the Northeast. However, few data exist on the control of the timing and brilliance of fall color. In this study, leaf tissue from 16 sugar maples (Acer saccharum) was collected periodically from June 30 through October 27, 1999 and analyzed for foliar nutrient, moisture and carbohydrate...

  16. 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...

  17. Urban fall traps

    Directory of Open Access Journals (Sweden)

    Vera Lucia de Almeida Valsecchi

    2007-06-01

    Full Text Available Objectives: To evaluate the repercussion of falls in the elderly peoplewho live in the city of São Paulo and address - though synthetically- some questions regarding the city and its relation to aging and thequality of life of the elderly. Methods: This is a qualitative study. As fordata collection, “in-depth individual interviews” were applied. Selectionof subjects was guided by a procedure named as “network”. Results:Ten interviews were performed, nine with elderly individuals who werevictims of falls and one with a public authority representative. Dataresulting from interviews confirmed that significant changes occurin live of the elderly, who are victims of what has been called “urbantraps”, and that, by extrapolating mobility and dependence contexts,invade feelings, emotions and desires. The inappropriate environmentprovided by the city of São Paulo is confirmed by absence of adequateurban planning and lack of commitment of public authorities. It alsorevealed that the particular way of being old and living an elderlylife, in addition to right to citizenship, is reflected by major or lesserdifficulties imposed to the elderly to fight for their rights and have theirpublic space respected. Conclusion: The city of São Paulo is not anideal locus for an older person to live in. To the traps that are found inpublic places one can add those that are found in private places andthat contribute to the hard experience of falls among the elderly, anexperience that is sometimes fatal. In Brazil, the attention is basicallyfocused on the consequences of falls and not on prevention, by meansof urban planning that should meet the needs of the most vulnerablegroups - the physically disabled and the elderly.

  18. The falling slinky

    OpenAIRE

    Unruh, W. G.

    2011-01-01

    The slinky, released from rest hanging under its own weight, falls in a peculiar manner. The bottom stays at rest until a wave hits it from above. Two cases - one unphysical one where the slinky is able to pass through itself, and the other where the coils of the slinky collide creating a shock wave travelling down the slinky are analysed. In the former case, the bottom begins to move much later than in the latter.

  19. The Resource. Fall 2001

    Science.gov (United States)

    2001-01-01

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

  20. Fall Prevention in Apprentice Carpenters

    Science.gov (United States)

    Kaskutas, Vicki; Dale, Ann Marie; Lipscomb, Hester; Gaal, John; Fuchs, Mark; Evanoff, Bradley; Faucette, Julia; Gillen, Marion; Deych, Elena

    2013-01-01

    Objectives Falls from heights are a leading cause of mortality and morbidity in the construction industry, especially among inexperienced workers. We surveyed apprentice carpenters to identify individual and organizational factors associated with falls from heights. Methods We developed a 72-item fall prevention survey with multiple domains including fall experience, fall prevention knowledge, risk perceptions, confidence in ability to prevent falls, training experience, and perceptions of the safety climate and crew safety behaviors. We administered the questionnaire to apprentice carpenters in this cross-sectional study. Results Of the 1,025 respondents, 51% knew someone who had fallen from height at work and 16% had personally fallen in the past year, with ladders accounting for most of the falls. Despite participation in school-based and on-the-job training, fall prevention knowledge was poor. Ladders were perceived as low risk and ladder training was rare. Apprentices reported high levels of unsafe fall-related behaviors on their work crews. Apprentices working residential construction were more likely to fall than those working commercial construction, as were apprentices working on crews with fewer senior carpenters to provide mentorship, and those reporting more unsafe behaviors among fellow workers. Conclusions Despite participation in a formal apprenticeship program, many apprentices work at heights without adequate preparation and subsequently experience falls. Apprenticeship programs can improve the timing and content of fall prevention training. This study suggests that organizational changes in building practices, mentorship, and safety culture must also occur in order to decrease worker falls from heights. PMID:19953214

  1. 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.

  2. 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.

  3. The role of population in tracking meteorite falls in Africa

    Science.gov (United States)

    Khiri, F.; Ibhi, A.; Saint-Gerant, T.; Medjkane, M.; Ouknine, L.

    2016-01-01

    The 158 African meteorite falls recorded during the period 1801 to 2014, account for more than 12.3% of all meteorite falls known from the world. Their rate is variable in time and in space. The number of falls continues to grow since 1860. They are concentrated in countries which exhibit large population (mainly rural population) with an uniform distribution. Generally, the number of falls follows the increase of the population density (coefficient of correlation r = 0.98). The colonial phenomenon, the education of population in this field, the population lifestyle and the rural exodus, are also factors among others which could explain the variability of the recovery of meteorite falls in Africa. In this note, we try by a statistical study, to examine the role of the African population in tracking meteorite falls on this continent.

  4. 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.

  5. Modeling a falling slinky

    OpenAIRE

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

    2012-01-01

    A slinky is an example of a tension spring: in an unstretched state a slinky is collapsed, with turns touching, and a finite tension is required to separate the turns from this state. If a slinky is suspended from its top and stretched under gravity and then released, the bottom of the slinky does not begin to fall until the top section of the slinky, which collapses turn by turn from the top, collides with the bottom. The total collapse time t_c (typically ~0.3 s for real slinkies) correspon...

  6. Falls and cerebellar ataxia

    Directory of Open Access Journals (Sweden)

    I. V. Damulin

    2015-01-01

    Full Text Available The paper considers the main causes of falls. Whatever their cause is, falls may lead to severe maladjustment in everyday life. In nearly 1 out of 10 cases, they are accompanied by severe injuries, including fractures (most commonly those of the proximal femur and humerus, hands, pelvic bones, and vertebrae, subdural hematoma, and severe soft tissue and head injuries. This process is emphasized to be multifactorial. Particular emphasis is laid on the involvement of the cerebellum and its associations, which may be accompanied by falls. This is clinically manifested mainly by gait disorders. Walking is a result of an interaction of three related functions (locomotion, maintenance of balance and adaptive reactions. In addition to synergies related to locomotion and balance maintenance, standing at rest and walking are influenced bythe following factors: postural and environmental information (proprioceptive, vestibular, and visual, the capacity to interpret and integrate this information, the ability of the musculoskeletal system to make movements, and the capability to optimally modulate these movements in view of the specific situation and the ability to choose and adapt synergy in terms of external factors and the capacities and purposes of an individual. The clinical signs of damage to the cerebellum and its associations are considered in detail. These structures are emphasized to be involved not only in movements, but also in cognitive functions. The major symptoms that permit cerebellar dysfunction to be diagnosed are given. Symptoms in cerebellar injuries are generally most pronounced when suddenly changing the direction of movements or attempting to start walking immediately after a dramatic rise. The magnitude of ataxia also increases in a patient who tries to decrease the step size. Falling tendencies or bending to one side (in other symptoms characteristic of cerebellar diseases suggest injury of the corresponding

  7. Falling Liquid Films

    CERN Document Server

    Kalliadasis, S; Scheid, B

    2012-01-01

    This research monograph gives a detailed review of the state-of-the-art theoretical methodologies for the analysis of dissipative wave dynamics and pattern formation on the surface of a film falling down a planar, inclined substrate. This prototype is an open-flow hydrodynamic instability representing an excellent paradigm for the study of complexity in active nonlinear media with energy supply, dissipation and dispersion. Whenever possible, the link between theory and experiments is illustrated and the development of order-of-magnitude estimates and scaling arguments is used to facilitate the

  8. 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.

  9. 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

  10. 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.

  11. Evaluation of the falls telephone: an automated system for enduring assessment of falls

    NARCIS (Netherlands)

    Marck, M.A. van der; Overeem, S.; Klok, P.C.; Bloem, B.R.; Munneke, M.

    2011-01-01

    OBJECTIVES: To evaluate the reliability and user experiences of an automated telephone system to monitor falls during a prolonged period of time. DESIGN: Prospective cohort study. SETTING: Four neurological outpatient clinics in the Netherlands. PARTICIPANTS: One hundred nineteen community-dwelling

  12. 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.

  13. Fall-related hospitalization in people with Parkinson's disease.

    Science.gov (United States)

    Paul, S S; Harvey, L; Canning, C G; Boufous, S; Lord, S R; Close, J C T; Sherrington, C

    2017-03-01

    Falls are common in people with Parkinson's disease (PD) but few data exist on fall-related hospitalizations in this group. This population-based study compared fall-related hospital admissions, injury rates and consequences in people with and without PD, and determined whether PD was an independent predictor of fall-related hospital length of stay. This was a retrospective study using probabilistic linkage of hospital data in people aged ≥65 years hospitalized for a fall between 1 July 2005 and 31 December 2013 in New South Wales, Australia. Rates of hospital admissions and injuries per person admitted over the study period were compared between people with and without PD using Poisson or negative binomial regression. Multilevel linear modelling was used to analyse length of stay by clustering individuals and adjusting for possible confounders. There were 342 265 fall-related hospital admissions in people aged ≥65 years during the study period, of which 8487 (2.5%) were for people with PD. Sixty-seven per cent of fall-related PD admissions were associated with injury and 35% were associated with fracture. People with PD had higher rate ratios for fall admissions (1.63, 95% confidence interval 1.59-1.67) and injury (1.47, 95% confidence interval 1.43-1.51) and longer median length of stay [9 (interquartile range 1-27) vs. 6 (interquartile range 1-20) days in people without PD; P hospitalizations for falls and fall injuries for older people with PD, which may be used to monitor the effect of fall prevention programmes. © 2017 EAN.

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

    Science.gov (United States)

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

    2015-01-01

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

  15. Macrobenthic community structure of coastal Arabian Sea during the fall intermonsoon

    Digital Repository Service at National Institute of Oceanography (India)

    Ingole, B.S.; Gaonkar, U.V.; Deshmukh, A.; Mukherjee, I.; Sivadas, S.K.; Gophane, A.

    In the Arabian Sea, organic matter produced during the upwelling period reaches the seafloor by the end of the monsoon and during the fall intermonsoon period (FIM) Studies on the benthic community is lacking during this period Therefore, we predict...

  16. Falls in nursing home residents receiving pharmacotherapy for anemia

    Directory of Open Access Journals (Sweden)

    Reardon G

    2012-10-01

    Full Text Available Gregory Reardon,1 Naushira Pandya,2 Robert A Bailey31Informagenics, LLC and The Ohio State University College of Pharmacy, Columbus, OH, USA; 2Department of Geriatrics, Nova Southeastern University College of Osteopathic Medicine, Ft Lauderdale, FL, USA; 3Janssen Scientific Affairs, LLC, Horsham, PA, USAPurpose: Falls are common among nursing home residents and have potentially severe consequences, including fracture and other trauma. Recent evidence suggests anemia may be independently related to these falls. This study explores the relationship between the use of anemia-related pharmacotherapies and falls among nursing home residents.Methods: Forty nursing homes in the United States provided data for analysis. All incidents of falls over the 6-month post-index follow-up period were used to identify the outcomes of falls (≥1 fall and recurrent falls (>1 fall. Logistic regression was used to analyze the relationship between falls and recurrent falls with each of the anemia pharmacotherapies after adjusting for potential confounders.Results: A total of 632 residents were eligible for analysis. More than half (57% of residents were identified as anemic (hemoglobin < 12 g/dL females, or <13 g/dL males. Of anemic residents, 50% had been treated with one or more therapies (14% used vitamin B12, 10% folic acid, 38% iron, 0.3% darbepoetin alfa [DARB], and 1.3% epoetin alfa [EPO]. Rates of falls/recurrent falls were 33%/18% for those receiving vitamin B12, 40%/16% for folic acid, 27%/14% for iron, 38%/8% for DARB, 18%/2% for EPO, and 22%/11% for those receiving no therapy. In the adjusted models, use of EPO or DARB was associated with significantly lower odds of recurrent falls (odds ratio = 0.06; P = 0.001. Other significant covariates included psychoactive medication use, age 75–84 years, age 85+ years, worsened balance score, and chronic kidney disease (P < 0.05 for all.Conclusion: Only half of the anemic residents were found to be using anemia

  17. Fall prevention in acute care hospitals: a randomized trial.

    Science.gov (United States)

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

    2010-11-03

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

  18. The characteristics of falls in an inpatient traumatic brain injury rehabilitation setting.

    Science.gov (United States)

    McKechnie, Duncan; Fisher, Murray J; Pryor, Julie

    2016-01-01

    To describe the nature of falls in an inpatient traumatic brain injury rehabilitation setting. Falls are the most frequently recorded patient safety incident in the inpatient context. However, higher rates of falls are reported in rehabilitation settings compared to acute care settings. In the rehabilitation setting, patients with a traumatic brain injury have been identified as at a high risk of falling. However to date, research into the nature of falls involving this patient population is limited. Five-year retrospective cohort study design. Falls data from an inpatient traumatic brain injury rehabilitation unit were retrieved from the NSW Ministry of Health Incident Information Management System and patient clinical notes; nursing shift data were retrieved from the local rostering system. The fall rate was 5·18 per 1000 patient bed days. Over a 24-hour period falls (n = 103) occurred in a trimodal pattern. The median fall free period after admission was 14 days and 22% of traumatic brain injury patients had at least one fall. 53% of falls occurred in the patient's bedroom and 57% were attributed to loss of balance. At time of fall, 93% of fallers had impaired mobility and 85% required assistance for transfers. Falls within inpatient traumatic brain injury rehabilitation are a significant and complex clinical issue. While many patients continued to be at risk of falling several months after admission, a repeat faller's first fall occurred earlier in their admission than a single faller's. Generic falls prevention measures are insufficient for preventing falls in the brain injury rehabilitation population. Falls prevention initiatives should target times of high patient activity and situations where there is decreased nursing capacity to observe patients. Rehabilitation clinicians need to be mindful that a patient's risk of falling is not static and in fact, may increase over time. © 2015 John Wiley & Sons Ltd.

  19. Falls in hospitalized geriatric psychiatry patients: high incidence, but only a few fractures.

    Science.gov (United States)

    Oepen, Dennis; Fleiner, Tim; Oliva Y Hausmann, Andrés; Zank, Susanne; Zijlstra, Wiebren; Haeussermann, Peter

    2018-01-01

    Fall rates from 3.2 to 17.1 falls per 1,000 hospital days in geriatric psychiatry facilities have been reported to date. Up to 5% of the falls result in severe injuries, but data concerning medical consequences are scare. This brief report presents a retrospective analysis of one year fall protocols from a geriatric psychiatry department focusing on consequences of falls. Fall-induced injuries were rated in four categories: no injuries, mild injuries (contusions, hematomas, abrasions), moderate injuries (lacerations, dislocations), and severe injuries (fractures, cerebral hemorrhages). In total, 510 falls were registered during the study period, indicating a fall rate of 17.7 falls per 1,000 hospital days. Overall, 375 falls (73.5%) resulted in no injuries, 67 (13.1%) resulted in mild injuries, 59 (11.6%) resulted in moderate injuries, and only 9 (1.8%) falls led to severe injuries (fractures and cerebral hemorrhages). These results indicate a quite high fall rate in our sample of hospitalized geriatric psychiatry patients with only a relatively small number of severe injuries resulting from the falls. These results raise the question about the use of physical restraints and the use of bedrails in geriatric patients to prevent falls as the medical implications of falls may be less problematic than previously thought.

  20. Premigratory and migratory neural crest cells are multipotent in vivo

    NARCIS (Netherlands)

    Baggiolini, Arianna; Varum, Sandra; Mateos, José María; Bettosini, Damiano; John, Nessy; Bonalli, Mario; Ziegler, Urs; Dimou, Leda; Clevers, Hans; Furrer, Reinhard; Sommer, Lukas

    2015-01-01

    The neural crest (NC) is an embryonic stem/progenitor cell population that generates a diverse array of cell lineages, including peripheral neurons, myelinating Schwann cells, and melanocytes, among others. However, there is a long-standing controversy as to whether this broad developmental

  1. 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.

  2. [Falls mortality trends in México, 1979-2010].

    Science.gov (United States)

    Celis-de la Rosa, Alfredo de Jesús; Méndez-Magaña, Ana; Orozco-Valerio, María; Baez-Baez, Guadalupe Laura; Dávalos-Guzmán, Julio César

    2013-01-01

    To analyze the mortality trend by accidental falls in Mexico, from 1979 to 2010. We used official mortality data in México. Variables included were mortality cause, place of lesion, age, sex, year of mortality registration, size of the town of occurrence, state, occupation, workplace falls. During that period, 124,509 deaths by accidental and intentional falls were registered; of these 77.03% were men. From 1989 (3.20 per 100,000) to 2010 (1.99 per 100,000), the mortality trend was falling (β = -0.053/ 100,000, p ≤ 0.001). In the majority of states, we found a decreased between 1993-1997 and 2006 to 2010, except in Aguascalientes, Puebla, Baja California Sur, Durango and Nuevo León. This is the first study in México that showed the descending trend of mortality in accidental falls in the last two decades.

  3. Painful shoulder post fall.

    Science.gov (United States)

    Mayne, Alistair Iw; Jariwala, Arpit

    2018-03-03

    CLINICAL INTRODUCTION: A 32-year-old man presented to the ED after a heavy fall on his left shoulder. He presented the following day with pain and gross limitation of movement in the left shoulder. There was no history of previous injury to the left shoulder. This was his non-dominant limb and he worked in a manual occupation. He was neurovascularly intact. His initial radiographs are shown in figures 1 and 2.emermed;emermed-2017-207003v1/F1F1F1Figure 1Anteroposterior radiograph (AP) radiograph of left shoulder.emermed;emermed-2017-207003v1/F2F2F2Figure 2Lateral radiograph of left shoulder.  QUESTION: Management options:Anterior shoulder dislocation - closed reductionAnterior shoulder dislocation - CT scanPosterior shoulder dislocation - closed reductionPosterior shoulder dislocation - CT scan. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Fall Meeting Hydrology Highlights

    Science.gov (United States)

    Bales, Roger

    The AGU 1992 Fall Meeting in San Francisco offered the full range of subjects represented by the Hydrology Section's technical committees. The total number of papers was double the number of just 4 years ago. Sessions were well attended. The following highlights were prepared from material written by session organizers.There were 3 full days of papers on snow, ice, and permafrost. One highlight was the special session on new developments in glacier mass-balance studies, which was organized to compare existing methods and examine new techniques for assessing changes in ice mass of the polar ice sheets and alpine glaciers. Current methods for assessing mass change of the ice sheets include satellite laser altimetry to detect surface-elevation changes, surface-based control volume methods to determine net ice flux in a region, and ice-shelf melting and iceberg calving to determine mass loss from the ice sheet. Using these techniques, it is difficult to tell whether the ice sheet is gaining or losing mass. Methods that use drainage basin inputs/outputs indicate a net mass increase, whereas methods that emphasize oceanographic estimates of ice-shelf melting suggest a net mass decrease and estimates based on satellite altimetry are equivocal.

  5. Falling into Salvation in Cioran

    Directory of Open Access Journals (Sweden)

    Joseph Acquisto

    2014-01-01

    Full Text Available While, at first glance, there seems to be very little room in the thought of E.M. Cioran for the notion of salvation, a closer look reveals that Cioran returns constantly to the vocabulary and the concept of redemption. This article teases out Cioran’s complex use of the topos of salvation throughout his works, with special emphasis on his middle period. I begin by tracing Cioran’s notion of humanity’s fall into time and language, from which he claims there can be no salvation in the traditional Christian sense. Nonetheless, he retains the concept, claiming at various points that there is a kind of salvation to be found in suicide, music, silence, and skepticism. Ultimately, however, each of these provides only false salvation, since the only permanent solution to the problem of existence for Cioran would be either to cease to exist or to lose our human nature in exchange for a plant-like life. Since this is impossible, we are left with our human means of seeking deliverance. While Cioran generally condemns human attempts at creation or procreation, he takes a different approach to the act of writing. In his reflections on writing we see that salvation for Cioran is always temporary, provisional, and threatened by our next bout of lucidity, but at the same time, eternally renewable with each new act of writing.

  6. Falls risk assessment begins with hello: lessons learned from the use of one home health agency's fall risk tool.

    Science.gov (United States)

    Flemming, Patricia J; Ramsay, Katherine

    2012-10-01

    Identifying older adults at risk for falls is a challenge all home healthcare agencies (HHAs) face. The process of assessing for falls risk begins with the initial home visit. One HHA affiliated with an academic medical center describes its experience in development and use of a Falls Risk Assessment (FRA) tool over a 10-year period. The FRA tool has been modified since initial development to clarify elements of the tool based on research and to reflect changes in the Outcome and Assessment Information Set (OASIS) document. The primary purpose of this article is to share a validated falls risk assessment tool to facilitate identification of fall-related risk factors in the homebound population. A secondary purpose is to share lessons learned by the HHA during the 10 years using the FRA.

  7. Results of falling barrier analyses

    International Nuclear Information System (INIS)

    Fox, G.L.

    1994-01-01

    This document assesses the consequences if the isolation barrier plate is dropped and falls over on the fuel stored in the water-filled K-East basin. The water slows the rate of fall and some canister bending is expected but only a few rods, if any, would get crushed. The basin criticality calculations will not be affected

  8. Highly Challenging Balance Program Reduces Fall Rate in Parkinson Disease

    Science.gov (United States)

    Sparrow, David; DeAngelis, Tamara R.; Hendron, Kathryn; Thomas, Cathi A.; Saint-Hilaire, Marie; Ellis, Terry

    2015-01-01

    Background and Purpose There is a paucity of effective treatment options to reduce falls in Parkinson’s disease (PD). Although a variety of rehabilitative approaches have been shown to improve balance, evidence of a reduction in falls has been mixed. Prior balance trials suggest that programs with highly challenging exercises had superior outcomes. We investigated the effects of a theoretically driven, progressive, highly challenging group exercise program on fall rate, balance, and fear of falling. Methods Twenty-three subjects with PD participated in this randomized cross-over trial. Subjects were randomly allocated to 3 months of active balance exercises or usual care followed by the reverse. During the active condition, subjects participated in a progressive, highly challenging group exercise program twice weekly for 90 minutes. Outcomes included a change in fall rate over the 3-month active period and differences in balance (Mini-BESTest), and fear of falling (Falls Efficacy Scale-International (FES-I)) between active and usual care conditions. Results: The effect of time on falls was significant (regression coefficient = −0.015 per day, p<0.001). The estimated rate ratio comparing incidence rates at time points one month apart was 0.632 (95% CI 0.524 to 0.763). Thus, there was an estimated 37% decline in fall rate per month (95% CI 24% to 48%). Improvements were also observed on the Mini-BESTest (p=0.037) and FES-I (p=0.059). Discussion and Conclusions The results of this study show that a theoretically based, highly challenging, and progressive exercise program was effective in reducing falls, improving balance, and reducing fear of falling in PD. PMID:26655100

  9. First Fall-Related Injuries Requiring Hospitalization Increase the Risk of Recurrent Injurious Falls: A Nationwide Cohort Study in Taiwan.

    Science.gov (United States)

    Lam, Carlos; Kang, Jiunn-Horng; Lin, Hsiao-Yu; Huang, Hung-Chang; Wu, Chia-Chieh; Chen, Ping-Ling

    2016-01-01

    Recurrent falls not only have risk factors different from those of single falls but also have less favorable outcomes. The aim of our study was to determine the association between the injury characteristics of a first fall and the likelihood of recurrent injurious falls in a cohort of hospitalized patients. We designed a nationwide retrospective cohort study and selected hospitalized patients who had injurious falls between 2001 and 2010. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of recurrent injurious falls requiring hospitalization in the following year on the basis of the patients' demographic characteristics, comorbidities, and the characteristics of injuries from the first injurious fall requiring hospitalization. Among the 504 512 patients hospitalized for injurious falls, 19 442 experienced recurrent injurious falls requiring hospitalization. The 1-year incidence of recurrent injurious falls requiring hospitalization was 3.85%. The incidence density was the highest within the 3-month period after the first injurious fall. The risk of recurrent injurious falls among patients aged 40 to 64, 65 to 74, and ≥ 75 years increased progressively (HR: 2.11, 95% confidence interval [CI]: 1.90-2.34; HR: 2.80, 95% CI: 2.51-3.11; and HR: 3.80, 95% CI: 3.42-4.23, respectively). The length of hospitalization (LOH) ≥ 15 or ≥ 31 days (HR: 1.39, 95% CI: 1.30-1.48; and HR: 1.59, 95% CI: 1.43-1.77, respectively) and injury to the head (HR: 1.59, 95% CI: 1.53-1.65) or spine (HR: 1.66, 95% CI: 1.59-1.74) were also found to be major risk factors. Our findings show that the LOH and head and spine injuries are associated with an increased risk of recurrent injurious falls leading to hospitalization. The risk of recurrent injurious falls requiring hospitalization increased significantly among adults older than 40 years. We suggest further research on the effects of injury characteristics associated with the first injurious fall requiring

  10. First Fall-Related Injuries Requiring Hospitalization Increase the Risk of Recurrent Injurious Falls: A Nationwide Cohort Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Carlos Lam

    Full Text Available Recurrent falls not only have risk factors different from those of single falls but also have less favorable outcomes. The aim of our study was to determine the association between the injury characteristics of a first fall and the likelihood of recurrent injurious falls in a cohort of hospitalized patients.We designed a nationwide retrospective cohort study and selected hospitalized patients who had injurious falls between 2001 and 2010. Cox proportional hazards models were used to estimate the hazard ratios (HRs of recurrent injurious falls requiring hospitalization in the following year on the basis of the patients' demographic characteristics, comorbidities, and the characteristics of injuries from the first injurious fall requiring hospitalization.Among the 504 512 patients hospitalized for injurious falls, 19 442 experienced recurrent injurious falls requiring hospitalization. The 1-year incidence of recurrent injurious falls requiring hospitalization was 3.85%. The incidence density was the highest within the 3-month period after the first injurious fall. The risk of recurrent injurious falls among patients aged 40 to 64, 65 to 74, and ≥ 75 years increased progressively (HR: 2.11, 95% confidence interval [CI]: 1.90-2.34; HR: 2.80, 95% CI: 2.51-3.11; and HR: 3.80, 95% CI: 3.42-4.23, respectively. The length of hospitalization (LOH ≥ 15 or ≥ 31 days (HR: 1.39, 95% CI: 1.30-1.48; and HR: 1.59, 95% CI: 1.43-1.77, respectively and injury to the head (HR: 1.59, 95% CI: 1.53-1.65 or spine (HR: 1.66, 95% CI: 1.59-1.74 were also found to be major risk factors.Our findings show that the LOH and head and spine injuries are associated with an increased risk of recurrent injurious falls leading to hospitalization. The risk of recurrent injurious falls requiring hospitalization increased significantly among adults older than 40 years. We suggest further research on the effects of injury characteristics associated with the first injurious fall

  11. Benign Paroxysmal Positional Vertigo: Management and Its Impact on Falls.

    Science.gov (United States)

    Jumani, Kiran; Powell, Jason

    2017-08-01

    Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness in the elderly. This has been identified as a risk factor in falls. Falls are the leading cause of disability and the leading cause of death from injury among people over 75 in the UK. We assessed the effect of BPPV treatment on falls in an elderly population by retrospectively reviewing one unit's experience of BPPV management over an 8-year period from June 2008 to June 2016. We specifically assessed patients who were referred for the primary reason of falls and were aged over 65 years. These patients were evaluated and treated with particle repositioning maneuvers if their positional tests were positive. The frequency of falls prior to their visit and at 6-month clinic follow-up were reviewed. The total number of falls in the cohort reduced significantly ( P < .0001) after the procedure, from 128 to 46 falls (64% reduction). Associated comorbidities were also evaluated in this group. A prompt and effective treatment of BPPV is prudent to prevent devastating falls in older people in our communities.

  12. Risk Factors for Falls among Hospitalized Trauma Patients.

    Science.gov (United States)

    Brown, Carlos V R; Ali, Sadia; Fairley, Romeo; Lai, Bryan K; Arthrell, Justin; Walker, Melinda; Tips, Gaylen

    2013-05-01

    Inpatient falls lead to an injury in 30 per cent of cases and serious injury in 5 per cent. Increasing staffing and implementing fall prevention programs can be expensive and require a significant use of resources. We hypothesized that trauma patients have unique risk factors to sustain a fall while hospitalized. This is a retrospective cohort study from 2005 to 2010 of all trauma patients admitted to an urban Level I trauma center. Patients who fell while hospitalized were compared with patients who did not fall to identify risk factors for sustaining an inpatient fall. There were 16,540 trauma patients admitted during the study period and 128 (0.8%) fell while hospitalized. Independent risk factors for a trauma patient to fall while hospitalized included older age (odds ratio [OR], 1.02 [1.01 to 1.03], P hospitalized sustained an injury in 17 per cent of cases and a serious injury in 5 per cent. Inpatient falls in hospitalized trauma patients are uncommon. Risk factors include older age, male gender, blunt mechanism, lower Glasgow Coma Score, and the need for intensive care unit admission or mechanical ventilation. Trauma patients with these risk factors may require higher staffing ratios and should be enrolled in a formal fall prevention program.

  13. Executive Control Deficits as a Prodrome to Falls in Healthy Older Adults: A Prospective Study Linking Thinking, Walking, and Falling

    Science.gov (United States)

    Herman, Talia; Mirelman, Anat; Giladi, Nir; Schweiger, Avraham

    2010-01-01

    Background. Executive function (EF) deficits may increase fall risk, even among older adults with no overt cognitive impairment. Indeed, the effects of dual tasking (DT) on gait, a challenge to executive control, are more exaggerated in persons with a history of falls. Prospective evidence is, however, lacking. Methods. We prospectively evaluated whether EF predicts falls over a 2-year period among 262 community-living, healthy, and well-functioning older adults, focusing on the 201 who reported no falls during the previous year. At baseline, participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains. Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions. Results. The 262 participants (mean age: 76.3 ± 4.3 years, 60.3% women) had intact cognitive function on testing, a low comorbidity index, and good mobility. The EF index predicted future falls. Among those who reported no previous falls, participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up, and they were more likely to transition from nonfaller to faller sooner. DT gait variability also predicted future falls and multiple falls, whereas other measures of cognitive function, gait, and mobility did not. Conclusions. Among healthy older adults, individuals with poorer EF are more prone to falls. Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that demands multitasking. Optimal screening, early detection, and treatment of falls should, apparently, also target this cognitive domain. PMID:20484336

  14. 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.

  15. Executive control deficits as a prodrome to falls in healthy older adults: a prospective study linking thinking, walking, and falling.

    Science.gov (United States)

    Herman, Talia; Mirelman, Anat; Giladi, Nir; Schweiger, Avraham; Hausdorff, Jeffrey M

    2010-10-01

    Executive function (EF) deficits may increase fall risk, even among older adults with no overt cognitive impairment. Indeed, the effects of dual tasking (DT) on gait, a challenge to executive control, are more exaggerated in persons with a history of falls. Prospective evidence is, however, lacking. We prospectively evaluated whether EF predicts falls over a 2-year period among 262 community-living, healthy, and well-functioning older adults, focusing on the 201 who reported no falls during the previous year. At baseline, participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains. Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions. The 262 participants (mean age: 76.3 ± 4.3 years, 60.3% women) had intact cognitive function on testing, a low comorbidity index, and good mobility. The EF index predicted future falls. Among those who reported no previous falls, participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up, and they were more likely to transition from nonfaller to faller sooner. DT gait variability also predicted future falls and multiple falls, whereas other measures of cognitive function, gait, and mobility did not. Among healthy older adults, individuals with poorer EF are more prone to falls. Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that demands multitasking. Optimal screening, early detection, and treatment of falls should, apparently, also target this cognitive domain.

  16. Seed fall in an oldgrowth northern hardwood forest

    Science.gov (United States)

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

    1992-01-01

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

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

    Science.gov (United States)

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

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

  18. Period Cramps

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Period Cramps KidsHealth / For Kids / Period Cramps Print en español ... a girl who gets them. What Are Period Cramps? Lots of girls experience cramps before or during ...

  19. Cowlitz Falls fish passage

    International Nuclear Information System (INIS)

    1995-09-01

    The upper Cowlitz was once home to native salmon and steelhead. But the combined impacts of overharvest, farming, logging and road building hammered fish runs. And in the 1960s, a pair of hydroelectric dams blocked the migration path of ocean-returning and ocean-going fish. The lower Cowlitz still supports hatchery runs of chinook, coho and steelhead. But some 200 river miles in the upper river basin--much of it prime spawning and rearing habitat--have been virtually cut off from the ocean for over 26 years. Now the idea is to trap-and-haul salmon and steelhead both ways and bypass previously impassable obstacles in the path of anadromous fish. The plan can be summarized, for the sake of explanation, in three steps: (1) trap and haul adult fish--collect ocean-returning adult fish at the lowermost Cowlitz dam, and truck them upstream; (2) reseed--release the ripe adults above the uppermost dam, and let them spawn naturally, at the same time, supplement these runs with hatchery born fry that are reared and imprinted in ponds and net pens in the watershed; (3) trap and haul smolts--collection the new generation of young fish as they arrive at the uppermost Cowlitz dam, truck them past the three dams, and release them to continue their downstream migration to the sea. The critical part of any fish-collection system is the method of fish attraction. Scientists have to find the best combination of attraction system and screens that will guide young fish to the right spot, away from the turbine intakes. In the spring of 1994 a test was made of a prototype system of baffles and slots on the upriver face of the Cowlitz Falls Dam. The prototype worked at 90% efficiency in early tests, and it worked without the kind of expensive screening devices that have been installed on other dams. Now that the success of the attraction system has been verified, Harza engineers and consultants will design and build the appropriate collection part of the system

  20. Exercises to help prevent falls

    Science.gov (United States)

    ... slowly and easily. DO NOT hold your breath. Balance Exercises You can do some balance exercises during ... fall prevention in the elderly: what about agility? Sports Med . 2016;46:143-149. PMID: 26395115 www. ...

  1. Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients.

    Science.gov (United States)

    Atay, Selma; Vurur, Sevda; Erdugan, Necla

    Patient falls and fall-related injuries are an important problem for patients, relatives, caregivers, and the health system at large. This study aims to identify opinions of nurses about the risk of falling among patients staying in hospitals. This study uses a qualitative descriptive design and employs a semistructured interview method to identify the opinions and experiences of nurses about patient falls. This study evaluated the opinions of a total of 12 staff nurses. It was found that nurses consider patients in the postoperative period to be most prone to falls. They think that most falls take place during transfers and that the medical diagnosis of the patient plays a crucial role in fall incidents. The most important problem associated with patient falls was symptoms of traumatic brain injury. According to the participating nurses, the risk of fall for every patient should be evaluated upon admission. Measures that the nurses take against patient falls include raising the bed's side rails and securing the bed brakes. The findings of this research suggest that in-service training programs about the evaluation of the risk of falling should be organized for nurses. Guidelines should be developed for patients with different levels of risk of falling. It is suggested that nurses should be in charge of training patients who are conscious, their relatives, and caregiver personnel. The training of nurses and caregivers helps to prevent the falls of inpatients.

  2. Falls: epidemiology, pathophysiology, and relationship to fracture.

    Science.gov (United States)

    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.

  3. Free Falling in Stratified Fluids

    Science.gov (United States)

    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.

  4. Functional neural correlates of reduced physiological falls risk.

    Science.gov (United States)

    Nagamatsu, Lindsay S; Hsu, Chun Liang; Handy, Todd C; Liu-Ambrose, Teresa

    2011-08-16

    It is currently unclear whether the function of brain regions associated with executive cognitive processing are independently associated with reduced physiological falls risk. If these are related, it would suggest that the development of interventions targeted at improving executive neurocognitive function would be an effective new approach for reducing physiological falls risk in seniors. We performed a secondary analysis of 73 community-dwelling senior women aged 65 to 75 years old who participated in a 12-month randomized controlled trial of resistance training. Functional MRI data were acquired while participants performed a modified Eriksen Flanker Task - a task of selective attention and conflict resolution. Brain volumes were obtained using MRI. Falls risk was assessed using the Physiological Profile Assessment (PPA). After accounting for baseline age, experimental group, baseline PPA score, and total baseline white matter brain volume, baseline activation in the left frontal orbital cortex extending towards the insula was negatively associated with reduced physiological falls risk over the 12-month period. In contrast, baseline activation in the paracingulate gyrus extending towards the anterior cingulate gyrus was positively associated with reduced physiological falls risk. Baseline activation levels of brain regions underlying response inhibition and selective attention were independently associated with reduced physiological falls risk. This suggests that falls prevention strategies may be facilitated by incorporating intervention components - such as aerobic exercise - that are specifically designed to induce neurocognitive plasticity. ClinicalTrials.gov Identifier: NCT00426881.

  5. Falls and patient safety for older adults.

    Science.gov (United States)

    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.

  6. 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.

  7. Fall prevention in the elderly

    Science.gov (United States)

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

    2013-01-01

    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

  8. Problem Periods

    Science.gov (United States)

    ... during your menstrual cycle Premenstrual syndrome (PMS) Problem periods Getting enough sleep Looking and feeling your best Fighting germs Your sexuality What are STDs and STIs? Seeing the doctor Quizzes Links to more information on girls' bodies girlshealth glossary girlshealth.gov home http://www.girlshealth.gov/ Home ... Problem periods It’s common to have ...

  9. Historiske perioder

    DEFF Research Database (Denmark)

    2017-01-01

    For at forstå fortiden og fortællingerne om den, må vi skabe en form for orden og systematik. Her spiller inddelingen af fortiden i historiske perioder en afgørende rolle – og historiske perioder er da også et kompetencemål efter 6. klasse. Videoen diskuterer forskellige principper...... for periodisering. Kronologi og sammenhænge hænger naturligt sammen med historiske perioder. Videoen handler også om forståelser og brug af synkrone og diakrone sammenhænge i faget....

  10. [Home falls in infants before walking acquisition].

    Science.gov (United States)

    Claudet, I; Gurrera, E; Honorat, R; Rekhroukh, H; Casasoprana, A; Grouteau, E

    2013-05-01

    Minor head trauma is frequent among infants and leads to numerous visits to emergency departments for neurological assessment to evaluate the value of cerebral CT scan with the risk for traumatic brain injuries (TBI). To analyze the epidemiological characteristics of nonwalking infants admitted after falling at home and to analyze associated factors for skull fractures and TBI. Between January 2007 and December 2011, all children aged 9 months or younger and admitted after a home fall to the pediatric emergency unit of a tertiary children's hospital were included. The data collected were age, sex, weight and height, body mass index; geographic origin, referral or direct admission, mode of transportation; month, day and time of admission; causes of the fall, alleged fall height, presence of an eyewitness, type of landing surface; Glasgow Coma Scale (GCS) score, application of the head trauma protocol, location and type of injuries, cerebral CT scan results, length of hospital stay, progression, and neglect or abuse situations. DESCRIPTIVE ANALYSIS: within the study period, 1910 infants were included. Fifty-four percent of children were aged less than 6 months with a slight male prevalence (52%). Falls from parental bed and infant carriers accounted for the most frequent fall circumstances. GCS score on admission was equal to 14 or 15 in 99% of cases. A cerebral CT scan was performed in 34% of children and detected 104 skull fractures and 55 TBI. Infants aged less than 1 month had the highest rate of TBI (8.5%). Eleven percent of patients were hospitalized. A situation of abuse was identified in 51 infants (3%). UNIVARIATE ANALYSIS: Male children and infants aged less than 3 months had a higher risk of skull fractures (P = 0.03 and P = 0.0003, respectively). In the TBI group, children were younger (3.8 ± 2.6 months versus 5.4 ± 2.5 months, P falling from a height greater than 90 cm (OR 3.1 [1.7-5.6], P = 0.0002). Before walking acquisition, children are

  11. Catching a Falling Star

    Science.gov (United States)

    2004-07-01

    . Comets are another important source of meteoroids and perhaps the most spectacular. After many visits near the Sun, a comet "dirty-snowball" nucleus of ice and dust decays and fragments, leaving a trail of meteoroids along its orbit. Some "meteoroid streams" cross the earth's orbit and when our planet passes through them, some of these particles will enter the atmosphere. The outcome is a meteor shower - the most famous being the "Perseids" in the month of August [2] and the "Leonids" in November. Thus, although meteors are referred to as "shooting" or "falling stars" in many languages, they are of a very different nature. More information The research presented in this paper is published in the journal Meteoritics and Planetary Science, Vol. 39, Nr. 4, p. 1, 2004 ("Spectroscopic anatomy of a meteor trail cross section with the ESO Very Large Telescope", by P. Jenniskens et al.). Notes [1] The team is composed of Peter Jenniskens (SETI Institute, USA), Emmanuël Jehin (ESO), Remi Cabanac (Pontificia Universidad Catolica de Chile), Christophe Laux (Ecole Centrale de Paris, France), and Iain Boyd (University of Michigan, USA). [2] The maximum of the Perseids is expected on August 12 after sunset and should be easily seen.

  12. Two-Year Trajectory of Fall Risk in People With Parkinson Disease: A Latent Class Analysis.

    Science.gov (United States)

    Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

    2016-03-01

    To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson disease (PD). Latent class analysis, specifically growth mixture modeling (GMM), of longitudinal fall risk trajectories. Assessments were conducted at 1 of 4 universities. Community-dwelling participants with PD of a longitudinal cohort study who attended at least 2 of 5 assessments over a 2-year follow-up period (N=230). Not applicable. Fall risk trajectory (low, medium, or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6 monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. The GMM optimally grouped participants into 3 fall risk trajectories that closely mirrored baseline fall risk status (P=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium fall risk trajectories (Pfall risk (posterior probability fall risk trajectories over 2 years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Falls and gait disturbances in Huntington's disease.

    NARCIS (Netherlands)

    Grimbergen, Y.A.M.; Knol, M.J.; Bloem, B.R.; Kremer, B.P.; Roos, R.A.C.; Munneke, M.

    2008-01-01

    Falls are common in patients with Huntington's disease, but the incidence, falling circumstances and contributing factors have never been examined. We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were

  14. Falling: should one blame the heart?

    NARCIS (Netherlands)

    Jansen, S.

    2015-01-01

    Approximately 30% of people aged 65 and older suffer a fall each year; one in five of these falls will lead to significant injury. As the world’s ageing population increases, healthcare costs associated with falls are only expected to rise. It is estimated that over a third of falls may be

  15. Bistability of flight states for heavy falling plates

    Science.gov (United States)

    Lau, Edwin; Huang, Wei-Xi

    2017-11-01

    Interactions of falling flat plates in two-dimensional flows is presented through direct numerical simulation and immersed boundary method. The transition from steady falling to tumbling flight for heavy plates is presented. At steep angles of release, the plates undergo a period of amplitude increasing fluttering motion before developing to tumble. For the same fluid-solid system of Reynolds number Re and moment of inertia I*, shallow angles of release develop to a state of steady falling after a period of diminishing fluttering amplitude. Simulations further construct a mapping of this bistable region. Relationships among Re, I*, and the critical angles of release separating the two flight states are also provided. The inclusion of this finding on the mapping of flight states suggests fluttering motion as a transitional state before the onset of tumble. National Natural Science Foundation of China or NSFC (Grant No. 11322221).

  16. Induction period

    International Nuclear Information System (INIS)

    Land, C.E.; Tokunaga, M.

    1984-01-01

    Induction period is the temporal aspect of the excess cancer risk that follows an exposure to ionizing radiation. Operationally, it can be thought of as the time from an exposure of brief duration to the diagnosis of any resultant cancer. Whereas the magnitude of excess risk can be described by a single number, such as the average yearly excess risk over some fixed time interval after exposure, the temporal distribution requires a histogram or a curve, that is, an array or continuum of numbers. The study of induction period involves a search for a simple way of describing the temporal distribution of risk, that is, a way of describing a continuum by using only one or two numbers. In other words, the goal is to describe induction period probabilistically, using a parametric model with a few parameters

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

    Science.gov (United States)

    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

  18. 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...

  19. Falls from heights in and around the city of Batman.

    Science.gov (United States)

    Al, Behçet; Yildirim, Cuma; Coban, Sacid

    2009-03-01

    We evaluated the demographic data, mortality rates, fall causes, and post-mortem findings of individuals who fell from heights. Five hundred thirty-eight patients who sustained injuries after an accidental fall from heights were entered into the study. Our cases were collected prospectively in Batman over a seven- month period. The mean age was 12.4+/-3.22 years (3 months-98 years); 56.5% of patients were under 6 years old and 83.5% were under 20 years old. The mean fall height was 3.2+/-2.4 m. The mortality rate was 2.2%, and was highest among the patients who fell from flat-roofed houses. The most common injuries were to the head, and 100% of those who died had a head injury. Six patients were followed because of abdominal bleeding and 141 patients due to extremity fractures; 6.7% of patients were operated on and 83.8% of patients were treated in the emergency department. The results of this study were at variance with literature data with respect to the following: falls from heights were most common in the 0-5 years of age group. Craniocerebral trauma is the most common injury in fatal falls. Males had a higher rate of falls from height than females.

  20. PERIODIC BEHAVIORS

    NARCIS (Netherlands)

    Napp, Diego; Put, Marius van der; Shankar, Shiva

    2010-01-01

    This paper studies behaviors that are defined on a torus, or equivalently, behaviors defined in spaces of periodic functions, and establishes their basic properties analogous to classical results of Malgrange, Palamodov, Oberst et al. for behaviors on R(n). These properties-in particular the

  1. Periodical Economics

    OpenAIRE

    King, Andrew

    2016-01-01

    This is the first overview of the economics of nineteenth-century periodicals and newspapers. While media economics is an established field in business studies, the chapter redefines economics by looking at value systems including capitalist ones but no confined to them. Original case studies are offered as models for research into the economics of nineteenth-century print culture.

  2. 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.

  3. Nuclear fall-out shelter

    International Nuclear Information System (INIS)

    Lowery, R.J.

    1981-01-01

    An underground nuclear fall-out shelter has a plastics shell which, apart from service and access openings, is waterproof and provided, if desired, with a concrete roof. The shelter has an access opening, an air system, lighting, water storage, sanitation and sewage facilities. (author)

  4. NOVA Fall 2000 Teacher's Guide.

    Science.gov (United States)

    Ransick, Kristina; Rosene, Dale; Sammons, Fran Lyons; Sammons, James

    This teacher's guide complements six programs that aired on the Public Broadcasting System (PBS) in the fall of 2000. Programs include: (1) "Lincoln's Secret Weapon"; (2) "Hitler's Lost Sub"; (3) "Runaway Universe"; (4) "Garden of Eden"; (5) "Dying to Be Thin"; and (6) "Japan's Secret…

  5. Fall prevention in older persons

    African Journals Online (AJOL)

    psychotropic medications, an exercise programme to improve balance and strength, and home modifications. Early studies of multifactorial interventions, such as those by Tinetti et al. in the US and Close et al. in the UK,[7,10] showed that they could reduce falls risk by 30 - 40%. More recent studies, however, have tended to ...

  6. The Fall of a Sparrow

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 2; Issue 1. The Fall of a Sparrow The Life of Sálim Ali. Kartik Shanker. Book Review Volume 2 Issue 1 January 1997 pp 74-76. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/002/01/0074-0076 ...

  7. Trapping fall armyworm in Africa

    Science.gov (United States)

    Fall armyworm, Spodoptera frugiperda, is a noctuid pest of row and vegetable crops throughout the Americas. It has recently invaded Africa and has been identified from almost all sub-Saharan countries. There is a strong expectation of significant damage to African maize crop yield and a high likel...

  8. Falling-sphere radioactive viscometry

    International Nuclear Information System (INIS)

    Souza, R. de.

    1987-01-01

    In this work the falling sphere viscometric method was studies experimentally using a sphere tagged with 198 Au radiosotopo, the objective being the demosntration of the advantages of this technique in relation to the traditional method. The utilisation of the falling radioactive sphere permits the point-point monitoring of sphere position as a function of count rate. The fall tube wall and end effects were determined by this technique. Tests were performed with spheres of different diameters in four tubes. The application of this technique demosntrated the wall and end effects in sphere speed. The case of sphere fall in the steady slow regime allowed the determination of the terminal velocity, showing the increase of botton end effect as the sphere approaches the tube base. In the case the transient slow regime, the sphere was initially in a state of respose near the top surface. The data obtained show the influence of the free surface and wall on the sphere acceleration. These experimental data were applied to the Basset equation on order to verify the behaviour of the terms in this equation. (author) [pt

  9. Perception of the postural vertical and falls in older people.

    Science.gov (United States)

    Menant, Jasmine C; St George, Rebecca J; Fitzpatrick, Richard C; Lord, Stephen R

    2012-01-01

    Research on the relationship between vestibular function and falls in older people is sparse. The perception of the postural vertical (PPV) provides an indicator measure of vestibular (otolith) function in the absence of visual input and diminished somatosensory feedback. This study examined whether impaired PPV is associated with falls in this group. One hundred and ninety-five people aged 70 plus years stood blindfolded on a motorised platform that could be tilted in the roll plane and attempted to adjust it so that their bodies were aligned to the vertical. Somatosensory feedback was minimised as the base and vertical support surfaces on the tilting platform were covered in thick soft foam rubber. PPV error from true vertical and PPV variability (°) were calculated. Participants also underwent an assessment of distal tactile sensitivity and the physiological profile assessment (PPA); fallers were defined as those who had one or more falls during a prospective 12-month follow-up period. Eighty-eight participants (45%) reported falling in the follow-up year. Increased PPV error and variability were correlated with increased lateral sway in a condition of absent visual input and reduced foot somatosensory feedback (eyes closed/foam; r range = 0.16-0.20, p fall risk scores (r range = 0.22-0.26, p falls after adjusting for the composite PPA scores, age and gender [adjusted RR = 1.42 (1.01-1.98)]. Older people with increased PPV variability are at increased risk of falls. These findings indicate that assessment of PPV may augment fall risk assessments in older people. Copyright © 2012 S. Karger AG, Basel.

  10. Brain activation in high-functioning older adults and falls

    Science.gov (United States)

    Wang, Cuiling; Ayers, Emmeline; Izzetoglu, Meltem; Holtzer, Roee

    2017-01-01

    Objective: To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults. Method: We examined166 older persons (mean age 75 years, 51% women) enrolled in a prospective aging study. High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians. The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor (walking at normal pace) and cognitive (reciting alternate letters of the alphabet) single tasks and a dual-task condition (walking while reciting alternate letters of the alphabet). Incident falls were prospectively assessed over a 50-month study period. Results: Over a mean follow-up of 33.9 ± 11.9 months, 116 falls occurred. Higher levels of prefrontal cortical activation during the dual-task walking condition predicted falls (hazard ratio adjusted for age, sex, education, medical illnesses and general mental status 1.32, 95% confidence interval 1.03–1.70). Neither behavioral outcomes (velocity or letter rate) on the dual task nor brain activation patterns on the single tasks (normal walk or talk alone) predicted falls in this high-functioning sample. The results remained robust after accounting for multiple confounders and for cognitive status, slow gait, previous falls, and frailty. Conclusions: Prefrontal brain activity levels while performing a cognitively demanding walking condition predicted falls in high-functioning seniors. These findings implicate neurobiological processes early in the pathogenesis of falls. PMID:27927937

  11. Longitudinal Evaluation of Johns Hopkins Fall Risk Assessment Tool and Nurses' Experience.

    Science.gov (United States)

    Hur, Eun Young; Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

    The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) is relatively new in Korea, and it has not been fully evaluated. This study revealed that the JHFRAT had good predictive validity throughout the hospitalization period. However, 2 items (fall history and elimination patterns) on the tool were not determinants of falls in this population. Interestingly, the nurses indicated those 2 items were the most difficult items to assess and needed further training to develop the assessment skills.

  12. 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.

  13. Falls among Adult Patients Hospitalized in the United States: Prevalence and Trends

    Science.gov (United States)

    Bouldin, Erin D.; Andresen, Elena M.; Dunton, Nancy E.; Simon, Michael; Waters, Teresa M.; Liu, Minzhao; Daniels, Michael J.; Mion, Lorraine C.; Shorr, Ronald I.

    2012-01-01

    Objectives The purpose of this study was to provide normative data on fall prevalence in US hospitals by unit type and to determine the 27-month secular trend in falls prior to the implementation of the Centers for Medicare and Medicaid Service (CMS) rule which does not reimburse hospitals for care related to injury resulting from hospital falls. Methods We used data from the National Database of Nursing Quality Indicators (NDNQI) collected between July 1, 2006 and September 30, 2008 to estimate prevalence and secular trends of falls occurring in adult medical, medical-surgical and surgical nursing units. More than 88 million patient days (pd) of observation were contributed from 6,100 medical, surgical, and medical-surgical nursing units in 1,263 hospitals across the United States. Results A total of 315,817 falls occurred (rate=3.56 falls/1,000 pd) during the study period, of which 82,332 (26.1%) resulted in an injury (rate=0.93/1,000 pd). Both total fall and injurious fall rates were highest in medical units (fall rate=4.03/1,000 pd; injurious fall rate=1.08/1,000 pd) and lowest in surgery units (fall rate=2.76/1,000 pd; injurious fall rate=0.67/1,000 pd). Falls (0.4% decrease/quarter, pfalls (1% decrease per quarter, pfall and injurious fall prevalence varied by nursing unit type in US hospitals. Over the 27 month study, there was a small, but statistically significant, decrease in falls (pfalls (p<0.0001). PMID:23143749

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

    Science.gov (United States)

    Hartholt, Klaas A; Boyé, Nicole D A; Van der Velde, Nathalie; Van Lieshout, Esther M M; Polinder, Suzanne; De Vries, Oscar J; Kerver, Albert J H; Ziere, Gijsbertus; Bruijninckx, Milko M M; De Vries, Mark R; Mattace-Raso, Francesco U S; Uitterlinden, André G; Van Beeck, Ed F; Lips, Paul; Patka, Peter; Van der Cammen, Tischa J M

    2011-08-21

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

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

    Directory of Open Access Journals (Sweden)

    Mattace-Raso Francesco US

    2011-08-01

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

  16. Watch Out for Falling Plasma

    Science.gov (United States)

    Kohler, Susanna

    2016-12-01

    The path taken by the falling fragment in the June 2011 event. [Adapted from Petralia et al. 2016]Sometimes plasma emitted from the Sun doesnt escape into space, but instead comes crashing back down to the solar surface. What can observations and models of this process tell us about how the plasma falls and the local conditions on the Sun?Fallback from a FlareOn 7 June 2011, an M-class flare erupted from the solar surface. As the Solar Dynamics Observatorys Atmospheric Imaging Assembly looked on, plasma fragments from the flare arced away from the Sun and then fell back to the surface.Some fragments fell back where the Suns magnetic field was weak, returning directly to the surface. But others fell within active regions, where they crashed into the Suns magnetic field lines, brightening the channels and funneling along them through the dense corona and back to the Suns surface.The authors model of the falling blobs at several different times in their simulation. The blobs get disrupted when they encounter the field lines, and are then funneled along the channels to the solar surface. [Adapted from Petralia et al. 2016]This sort of flare and fall-back event is a common occurrence with the Sun, and SDOs observations of the June 2011 event present an excellent opportunity to understand the process better. A team of scientists led by Antonino Petralia (University of Palermo, Italy and INAF-OAPA) modeled this event in an effort to learn more about how the falling plasma interacts with strong magnetic fields above the solar surface.Magnetic Fields as GuidesPetralia and collaborators used three-dimensional magnetohydrodynamical modeling to attempt to reproduce the observations of this event. They simulated blobs of plasma as they fall back to the solar surface and interact with magnetic field lines over a range of different conditions.The team found that only simulations that assume a relatively strong magnetic field resulted in the blobs funneling along a channel to the

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

    Science.gov (United States)

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

    2017-01-01

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

  18. The correlation between white matter hyperintensity and balance disorder and fall risk: An observational, prospective cohort study

    Directory of Open Access Journals (Sweden)

    Dong-Chao Shen

    2016-09-01

    Full Text Available Objective: The presence of an association between white matter hyperintensity (WMH and the risk of falls in older people is uncertain, with little supporting prospective evidence available at present. We aimed to determine whether WMH was associated with dysfunctions of balance and gait, and other sensorimotor factors leading to falls, and the independent factors related to falls in older Chinese people. The protective effect of exercise against falls was also addressed. Methods: In a representative sample of hospital-based individuals aged 50 years and older in China, the patients' history of falls, magnetic resonance imaging data, scores on the 9-item Berg Balance Scale (BBS-9 test and timed up-and-go test (TUGT, and sensorimotor measures of computerized dynamic posturography (CDP were analyzed. Incident falls were recorded prospectively over a 12-month period. Using regression modeling, the association between the risk of falls and baseline WMH was estimated. Results: Only individuals with severe WMH were at an increased risk of falls, and CDP was more sensitive than BBS-9 in detecting WMH-related balance and gait dysfunction. However, WMH was not an independent predictor of falls. Taller height and overweight or obese body habitus were identified as novel protective factors for falls. Female, fall history, and increased TUGT score were identified as independent risk factors for falls in older Chinese people. Conclusion: Although WMH was associated with an increased risk of falls, it was not an independent predictor. Keywords: White matter hyperintensity, Balance disorder, Gait disorder, Fall risk

  19. Youth Attitude Tracking Study. Volume 2. Fall 1976.

    Science.gov (United States)

    1976-01-01

    youth as coming from rela- tively modest socio-economic backgrounds. Periods of high unemployment affect the less-educated, less-skilled, and less...FRD-fl143 187 YOUTH ATTITUDE TRACKING STUDY VOLUME 2 FALL 1976(U) 1/2 MARKET FACTS INC CHICAGO IL J T HEISLER JAN 76 H390 UNCLASSIFIED ___ F/G 5/9 NL...PRACTS ag e 8 Analytic Comment. I MARKET FAOTS YOUTH ATTITUDE TRACKING STUDY -. FALL 1976 e4.? .2 L A Report Prepared for: . The Department of Defense p’V

  20. Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls.

    Science.gov (United States)

    Phelan, Elizabeth A; Aerts, Sally; Dowler, David; Eckstrom, Elizabeth; Casey, Colleen M

    2016-01-01

    A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79 ± 8 years; 68% were female, and 10% were non-white. They averaged six primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall-risk factors varied from 24% (for home safety) to 78% (for vitamin D). An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21%) and home safety (24%). Use of a structured visit note template independently predicted assessment of fall-risk factors (p = 0.003). Geriatrics specialists were more likely to use a structured note template (p = 0.04) and perform more fall-risk factor assessments (4.6 vs. 3.6, p = 0.007) than general internists. These results suggest opportunities for improving multifactorial fall-risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

  1. Sensorbased fall detection and fall prediction of senior citizens in their domestic environment

    OpenAIRE

    Feldwieser, Florian

    2015-01-01

    Introduction: Falls in old age are associated with a reduction of autonomy and mobility and are one the main threads to the health of older adults. Physical and mental consequences of falls are a large financial burden to the healthcare system. Automatic fall detection devices could call of medical help in case of a fall and fall prevention programmers could specifically address the deficits of persons at risk of falling. Currently it is difficult and expensive to correctly identify perso...

  2. Falling Magnets and Electromagnetic Braking

    Science.gov (United States)

    Culbreath, Christopher; Palffy-Muhoray, Peter

    2009-03-01

    The slow fall of a rare earth magnet through a copper pipe is a striking example of electromagnetic braking; this remarkable phenomenon has been the subject of a number of scientific paper s [1, 2]. In a pipe having radius R and wall thickness D, the terminal velocity of the falling magnet is proportional to (R̂4)/D. It is interesting to ask what happens in the limit as D becomes very large. We report our experimental observations and theoretical predictions of the dependence of the terminal velocity on pipe radius R for large D. [1] Y. Levin, F.L. da Silveira, and F.B. Rizzato, ``Electromagnetic braking: A simple quantitative model''. American Journal of Physics, 74(9): p. 815-817 (2006). [2] J.A. Pelesko, M. Cesky, and S. Huertas, Lenz's law and dimensional analysis. American Journal of Physics, 3(1): p. 37-39. 2005.

  3. 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.

  4. 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.

  5. Fall TIP: validation of icons to communicate fall risk status and tailored interventions to prevent patient falls.

    Science.gov (United States)

    Hurley, Ann C; Dykes, Patricia C; Carroll, Diane L; Dykes, John S; Middleton, Blackford

    2009-01-01

    This paper reports on the development and validation of a set of icons designed to communicate fall risk status and tailored interventions to prevent patient falls in hospitals. The icons will populate a fall prevention toolkit to provide actionable alerts to nurses, nursing assistants, and other interdisciplinary health care team members and educational materials for patients and families in acute hospital settings.

  6. 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.

  7. Periodic paralysis.

    Science.gov (United States)

    Fialho, Doreen; Griggs, Robert C; Matthews, Emma

    2018-01-01

    The periodic paralyses are a group of skeletal muscle channelopathies characterizeed by intermittent attacks of muscle weakness often associated with altered serum potassium levels. The underlying genetic defects include mutations in genes encoding the skeletal muscle calcium channel Ca v 1.1, sodium channel Na v 1.4, and potassium channels K ir 2.1, K ir 3.4, and possibly K ir 2.6. Our increasing knowledge of how mutant channels affect muscle excitability has resulted in better understanding of many clinical phenomena which have been known for decades and sheds light on some of the factors that trigger attacks. Insights into the pathophysiology are also leading to new therapeutic approaches. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Nationwide time trends and risk factors for in-hospital falls-related major injuries

    DEFF Research Database (Denmark)

    Jørgensen, Terese Sara Høj; Hansen, A. H.; Sahlberg, M

    2015-01-01

    BACKGROUND: Accidental falls during hospitalisation have a range of complications and more information is needed to improve prevention. We investigated patterns of in-hospital fall-related major injuries in the period 2000-2012 and the association between chronic conditions and in-hospital fall......-related major injuries. METHODS: Using administrative databases, patients aged 65+ years with in-hospital falls causing fractures or head injuries with need for surgery or intensive observation were identified as cases and were individually matched with five controls. Joinpoint regression was used to examine...

  9. Chaotic Dynamics of Falling Disks: from Maxwell to Bar Tricks.

    Science.gov (United States)

    Field, Stuart

    1998-03-01

    Understanding the motion of flat objects falling in a viscous medium dates back to at least Newton and Maxwell, and is relevant to problems in meteorology, sedimentology, aerospace and chemical engineering, and nori/disks/pub.html>bar wagering strategies. Recent theoretical studies have emphasized the role played by deterministic chaos. Here we nori/falling.html>report(S. B. Field, M. Klaus, M. G. Moore, and F. Nori, Nature 388), 252 (1997) experimental observations and theoretical analysis of the dynamics of disks falling in water/glycerol mixtures. We find four distinct types of motion, and map out a ``phase diagram'' in the appropriate variables. The apparently complex behavior of the disks can be reduced to a series of one-dimensional maps which display a discontinuity at the crossover from periodic and chaotic motion. This discontinuity leads to an unusual intermittency transition between the two behaviors, which has not previously been observed experimentally in any system.

  10. 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.

  11. Path tortuosity in everyday movements of elderly persons increases fall prediction beyond knowledge of fall history, medication use, and standardized gait and balance assessments.

    Science.gov (United States)

    Kearns, William D; Fozard, James L; Becker, Marion; Jasiewicz, Jan M; Craighead, Jeffrey D; Holtsclaw, Lori; Dion, Charles

    2012-09-01

    We hypothesized that variability in voluntary movement paths of assisted living facility (ALF) residents would be greater in the week preceding a fall compared with residents who did not fall. Prospective, observational study using telesurveillance technology. Two ALFs. The sample consisted of 69 older ALF residents (53 female) aged 76.9 (SD ± 11.9 years). Daytime movement in ALF common use areas was automatically tracked using a commercially available ultra-wideband radio real-time location sensor network with a spatial resolution of approximately 20 cm. Movement path variability (tortuosity) was gauged using fractal dimension (fractal D). A logistic regression was performed predicting movement related falls from fractal D, presence of a fall in the prior year, psychoactive medication use, and movement path length. Fallers and non-fallers were also compared on activities of daily living requiring supervision or assistance, performance on standardized static and dynamic balance, and stride velocity assessments gathered at the start of a 1-year fall observation period. Fall risk due to cognitive deficit was assessed by the Mini Mental Status Examination (MMSE), and by clinical dementia diagnoses from participant's activities of daily living health record. Logistic regression analysis revealed odds of falling increased 2.548 (P = .021) for every 0.1 increase in fractal D, and having a fall in the prior year increased odds of falling by 7.36 (P = .006). There was a trend for longer movement paths to reduce the odds of falling (OR .976 P = .08) but it was not significant. Number of psychoactive medications did not contribute significantly to fall prediction in the model. Fallers had more variable stride-to-stride velocities and required more activities of daily living assistance. High fractal D levels can be detected using commercially available telesurveillance technologies and offers a new tool for health services administrators seeking to reduce falls at their

  12. Falls from ladders: age matters more than height.

    Science.gov (United States)

    Con, Jorge; Friese, Randall S; Long, Dustin M; Zangbar, Bardiya; O'Keeffe, Terence; Joseph, Bellal; Rhee, Peter; Tang, Andrew L

    2014-10-01

    Falls from ladders account for a significant number of hospital visits. However, the epidemiology, injury pattern, and how age affects such falls are poorly described in the literature. Patients ≥18 y who suffered falls from ladders over a 5½-y period were identified in our trauma registry. Dividing patients into three age groups (18-45, 46-65, and >66 y), we compared demographic characteristics, clinical data, and outcomes including injury pattern and mortality. The odds ratios (ORs) were calculated with the group 18-45 y as reference; group means were compared with one-way analysis of variance. Of 27,155 trauma patients, 340 (1.3%) had suffered falls from ladders. The average age was 55 y, with a male predominance of 89.3%. Average fall height was 9.8 ft, and mean Injury Severity Score was 10.6. Increasing age was associated with a decrease in the mean fall height (P 66 y: OR, 5.3; confidence interval [CI], 2.5-11.5). In univariate analysis, patients in the >66-y age group were more likely to sustain traumatic brain injuries (OR, 3.4; CI, 1.5-7.8) and truncal injuries (OR, 3.6; CI, 1.9-7.0) and less likely to sustain hand and/or forearm fractures (OR, 0.3; CI, 0.1-0.9). Older people are particularly vulnerable after falling from ladders. Although they fell from lower heights, the elderly sustained different and more severe injury patterns. Ladder safety education should be particularly tailored at the elderly. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Vind, Ane B; Andersen, Hanne E; Pedersen, Kirsten D; Jørgensen, Torben; Schwarz, Peter

    2009-06-01

    To evaluate the effect of multifactorial fall prevention in community-dwelling people aged 65 and older in Denmark. Randomized, controlled clinical trial. Geriatric outpatient clinic at Glostrup University Hospital. Three hundred ninety-two elderly people, mean age 74, 73.7%women, who had visited the emergency department or had been hospitalized due to a fall. Identification of general medical, cardiovascular, and physical risk factors for falls and individual intervention in the intervention group. Participants in the control group received usual care. Falls were registered prospectively in falls diaries, with monthly telephone calls for collection of data. Outcomes were fall rates and proportion of participants with falls, frequent falls, and injurious falls in 12 months. Groups were comparable at baseline. 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% CI 0.81-1.79), frequent falls (OR=0.97, 95% CI=0.60-1.56), or injurious falls (OR=0.97, 95% CI=0.57-1.62). A program of multifactorial fall prevention aimed at elderly Danish people experiencing at least one injurious fall was not effective in preventing further falls.

  14. Determinants of falls in community-dwelling elderly: hierarchical analysis.

    Science.gov (United States)

    Brito, Thais Alves; Coqueiro, Raildo da Silva; Fernandes, Marcos Henrique; de Jesus, Cleber Souza

    2014-01-01

    To analyze the fall-related factors in community-dwelling elderly. Epidemiologic cross-sectional population-based household study with hierarchical interrelationships among the potential risk factors. The sample was made up of noninstitutionalized individuals over age 60, who were resident of a city in Brazil's Northeast Region. The dependent variable was fall occurrence in the last 12 months; independent variables were sociodemographic, behavioral, health, and functional status factors. Multivariate hierarchical Poisson regression analysis was used based on a proposed theoretic model. Three hundred and sixteen (89.0%) elderly participated of the survey, average age 74.2 years; the majority was female, with limited literacy and had low-medium family income. The fall prevalence was of 25.8%; occurrence was related to depression symptoms (PR = 1.55) and balance limitation (PR = 1.56). The high fall prevalence among elderly necessitates the identification of fall-related factors for action planning prevention programs with this group. © 2014 Wiley Periodicals, Inc.

  15. Hospital falls: development of a predictive model for clinical practice.

    Science.gov (United States)

    Hendrich, A; Nyhuis, A; Kippenbrock, T; Soja, M E

    1995-08-01

    A retrospective case-control study related to falls was conducted at an 1,120-bed acute care tertiary hospital. The case (fall) sample consisted of 102 falls and 236 control (nonfall) charts during a 1-month period. An instrument developed by Hendrich (1988) was modified for use in the study. Demographic data and risk factors were recorded. Descriptive statistics included risk factor percentages for each sample and the corresponding univariate relative risks. Logistic regression was used to develop a multivariate risk factor model with seven risk factors. The significant risk factors were recent history of falls, depression, altered elimination patterns, dizziness or vertigo, primary cancer diagnosis, confusion, and altered mobility. The adjusted relative risks were converted to risk points to be used to assess a patient's level of fall risk. Within the data set, a sensitivity of 77% (79 of 102) and specificity of 72% (169 of 236) were calculated. The model was cross-validated in a 1987 data set with a sensitivity of 83% (59 of 71) and specificity of 66% (106 of 161).

  16. 29 CFR 1926.760 - Fall protection.

    Science.gov (United States)

    2010-07-01

    ..., safety net systems, personal fall arrest systems, positioning device systems or fall restraint systems... feet (27.4 m) wide and 90 (27.4 m) feet deep from any leading edge. The CDZ shall be marked by the use... protection equipment. (1) Guardrail systems, safety net systems, personal fall arrest systems, positioning...

  17. Epidemiology of Falls in Older Age

    Science.gov (United States)

    Peel, Nancye May

    2011-01-01

    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…

  18. 29 CFR 1917.41 - House falls.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false House falls. 1917.41 Section 1917.41 Labor Regulations...) MARINE TERMINALS Cargo Handling Gear and Equipment § 1917.41 House falls. (a) Span beams shall be secured... working with house fall blocks. (c) Designated employees shall inspect chains, links, shackles, swivels...

  19. Falls, faints, fits and funny turns.

    NARCIS (Netherlands)

    Thijs, R.D.; Bloem, B.R.; Dijk, J.G. van

    2009-01-01

    In this practically oriented review, we will outline the clinical approach of patients with falls due to an impairment or loss of consciousness. Following a set of definitions, we describe the salient clinical features of disorders leading to such falls. Among falls caused by true loss of

  20. Promoting adoption of fall prevention measures among Latino workers and residential contractors: formative research findings.

    Science.gov (United States)

    Teran, Suzanne; Blecker, Hillary; Scruggs, Kelsie; García Hernández, Javier; Rahke, Barbara

    2015-08-01

    Falls from heights remain a concern in construction, particularly for foreign-born Latino construction workers employed by small residential contractors. The social ecological model provides a framework to assess the individual and contextual factors influencing the risk for falls. Five focus groups and thirteen in-depth interviews with workers, small residential contractors, and key informants were conducted in 2012 in San Francisco and Philadelphia. Data were analyzed with qualitative methods. Economic conditions in residential construction, coupled with a lack of enforcement and vulnerabilities of the foreign-born workforce, are principal contributors to risk for falls. Small contractors perceive strong economic disincentives for implementation of fall protection and foreign-born Latino workers experience a variety of social, cultural and occupational pressures impeding its use. Increased adoption of fall protection cannot be accomplished solely by targeting Latino construction workers. Research is needed on incentives to influence contractor behavior and facilitate adoption of fall protection measures. © 2015 Wiley Periodicals, Inc.

  1. Falls in Swedish hurdle and steeplechase racing and the condition of the track surface

    DEFF Research Database (Denmark)

    Gottlieb-Vedi, M.; Pipper, Christian Bressen

    2015-01-01

    Falls in National Hunt races is a tragic part of the sport. The present study focuses on the relation between racing track conditions and the number of falls in Swedish jump racing. The assumption was that more horses fell on heavy or soft going than on good or firm going. Results from all jump...... races at Täby Racecourse (1992-2001) were recorded. Parameters registered were: type and number of races, racing surface and condition, total time to finish the race, number of starting horses and number of falls. In this period 212 races, corresponding to 1,556 horse starts, were registered. Falls were...... registered in 42 races and in total 61 horses fell. The fall frequency on horse level was significantly higher in steeplechases than in hurdle races (odds ratio =3.69; 95% confidence interval (CI) = 1.99-6.85). For the steeplechases recorded in this study, significantly more falls were seen in long distance...

  2. Falls in residential carpentry and drywall installation: findings from active injury surveillance with union carpenters.

    Science.gov (United States)

    Lipscomb, Hester J; Dement, John M; Nolan, James; Patterson, Dennis; Li, Leiming; Cameron, Wilfred

    2003-08-01

    Active injury surveillance was conducted with a large, unionized workforce of residential and drywall carpenters over a 3-year period. Injured carpenters were interviewed by trained carpenter investigators and sites were visited where falls occurred. Qualitative information was collected on exposures, risk perception, training, and mentoring. Falls accounted for 20% of injuries. Same-level falls were often related to weather, carrying objects-sometimes with an obstructed view-housekeeping, terrain of the lot, and speed of work. Falls from height occurred from a variety of work surfaces and involved ladders, scaffolding, roofs, work on other unsecured surfaces, unprotected openings, speed, and weather conditions. Recognized fall protection strategies, such as guardrails, toe boards, tying off to appropriate anchors, and guarding openings, would have prevented many of these falls; these practices were not the norm on many sites.

  3. Risks, consequences, and prevention of falls of older people in oral healthcare centers.

    Science.gov (United States)

    de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

    2017-03-01

    One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  4. 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.

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

    Science.gov (United States)

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

    2017-03-01

    Falls are among the most common potentially preventable adverse events. Current pediatric falls risk assessment methods have poor precision and accuracy. To evaluate an inpatient pediatric fall risk assessment index, known as the Little Schmidy, and describe characteristics of pediatric falls. Retrospective case control and descriptive study. The dataset included 114 reported falls and 151,678 Little Schmidy scores documented in medical records during the 5-year study period (2007-2011). Pediatric medical and surgical inpatient units of an academic medical center in the western United States. Pediatric hospital inpatients fall risk each day and night shift throughout the patient's hospitalization. Conditional fixed-effects logistic regressions were used to examine predictive relationships between Little Schmidy scores (at admission, highest prior to fall, and just prior to fall) and the patient's fall status (fell or not). The sensitivity and specificity of different cut-off scores were explored. Associations between Little Schmidy scores and patient and hospitalization factors were examined using multilevel mixed-effects logistic regression and multilevel mixed-effects ordinal logistic regression. Little Schmidy scores were significantly associated with pediatric falls (pfall risk with sensitivity of 79% and specificity of 49%. Patients with an LS4 score ≥1 were 4 times more likely to fall before the next assessment than patients with a score of 0. LS4 scores indicative of fall risk were associated with age ≥5 years, neurological diagnosis, multiple hospitalizations, and night shift, but not with sex, length of hospital stay, or hospital unit. Of the 114 reported falls, 64% involved a male patient, nearly one third (32%) involved adolescents (13-17 years), most resulted in no (59%) or mild (36%) injury, and most (54%) were related to diagnosis or clinical characteristics. For 60% of the falls, fall precautions had been implemented prior to the fall. The

  6. Measuring fall risk and predicting who will fall: clinimetric properties of four fall risk assessment tools for residential aged care.

    Science.gov (United States)

    Barker, Anna L; Nitz, Jennifer C; Low Choy, Nancy L; Haines, Terry

    2009-08-01

    The purpose of this prospective cohort study was to describe the clinimetric evaluation of four fall risk assessment tools (FRATs) recommended in best practice guidelines for use in residential aged care (RAC). Eighty-seven residents, mean age 81.59 years (SD +/-10.69), participated. The Falls Assessment Risk and Management Tool (FARAM), Peninsula Health Fall Risk Assessment Tool (PHFRAT), Queensland Fall Risk Assessment Tool (QFRAT), and Melbourne Fall Risk Assessment Tool (MFRAT) were completed at baseline, and 2 and 4 months, and falls occurring in the 6 months after the baseline assessment were recorded. Interrater agreement (kappa), predictive accuracy (survival analysis and Youden Index), and fit to the Rasch model were examined. Twelve-month fall history formed the predictive accuracy reference. Interrater risk classification agreement was high for the PHFRAT (small ka, Cyrillic = .84) and FARAM (small ka, Cyrillic = .81), and low for the QFRAT (small ka, Cyrillic = .51) and MFRAT (small ka, Cyrillic = .21). Survival analysis identified that 43%-66% of risk factors on each tool had no (p > .10) association with falls. No tool had higher predictive accuracy (Youden index) than the question, "has the resident fallen in past 12 months?" (p > .05). All tools did not exhibit fit to the Rasch model, invalidating summing of risk factor scores to provide an overall risk score. The studied tools have poor clinimetric properties, casting doubt about their usefulness for identifying fall risk factors for those most at risk for falling and measuring fall risk in RAC.

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

    Directory of Open Access Journals (Sweden)

    Alejandro Rodríguez-Molinero

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

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

    Science.gov (United States)

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

    2017-01-01

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

  9. 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

  10. Fall-risk Screening Test: A Prospective Study on Predictors for Falls in Community Dwelling Elderly

    NARCIS (Netherlands)

    Tromp, A.M.; Pluijm, S.M.F.; Smit, J.H.; Deeg, D.J.H.; Bouter, L.M.; Lips, P.T.A.M.

    2001-01-01

    This large prospective cohort study was undertaken to construct a fall-risk model for elderly. The emphasis of the study rests on easily measurable predictors for any falls and recurrent falls. The occurrence of falls among 1285 community-dwelling elderly aged 65 years and over was followed during 1

  11. 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.

  12. [New fall prediction score for the prevention of fall fractures in the elderly].

    Science.gov (United States)

    Komuro, Hajime; Miyazaki, Hiroaki

    2014-10-01

    Elderly fracture is a critical public health issue for older adults, and falls risk assessment is an expected competency for medical worker. The prevention from fall fracture is one of the important items of medical safety, and although fall assessment is carried out, it is not much effective. One of the reasons is that there is not the simple and easy tool of the fall prediction. The aim of this study was to design an innovative method of falls risk assessment using standing ability of the elderly. We devised new fall assessment score (Mimamori score) that scored lifting assistance movement. We incorporate it in real duties after 2011, inflect for the fall prevention.

  13. Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms.

    Science.gov (United States)

    Cuttler, Sasha J; Barr-Walker, Jill; Cuttler, Lauren

    2017-01-01

    Inpatient falls and subsequent injuries are among the most common hospital-acquired conditions with few effective prevention methods. To evaluate the effectiveness of patient education videos and fall prevention visual signalling icons when added to bed exit alarms in improving acutely hospitalised medical-surgical inpatient fall and injury rates. Performance improvement study with historic control. Four medical-surgical units in one US public acute care hospital. Adult medical-surgical inpatients units. A 4 min video was shown to patients by trained volunteers. Icons of individual patient risk factors and interventions were placed at patients' bedsides. Beds with integrated three-mode sensitivity exit alarms were activated for confused patients at risk of falling. The main outcome measure is the incident rate per 1000 patient days (PDs) for patient falls, falls with any injury and falls with serious injury. The incident rate ratio (IRR) for each measure compared January 2009-September 2010 (baseline) with the follow-up period of January 2015-December 2015 (intervention). Falls decreased 20% from 4.78 to 3.80 per 1000 PDs (IRR 0.80, 95% CI 0.66 to 0.96); falls with any injury decreased 40% from 1.01 to 0.61 per 1000 PDs (IRR 0.60, 95% CI 0.38 to 0.94); and falls with serious injury 85% from 0.159 to 0.023 per 1000 PDs (IRR 0.15, 95% CI 0.01 to 0.85). Icons were not fully implemented. The first known significant reduction of falls, falls with injury and falls with serious injury among medical-surgical inpatients was achieved. Patient education and continued use of bed exit alarms were associated with large decreases in injury. Icons require further testing. Multicentre randomised controlled trials are needed to confirm the effectiveness of icons and video interventions and exit alarms.

  14. Factors associated with falls during hospitalization in an older adult population.

    Science.gov (United States)

    Titler, Marita G; Shever, Leah L; Kanak, Mary F; Picone, Debra M; Qin, Rui

    2011-01-01

    Falls of hospitalized older adults are of concern for patients, family members, third-party payers, and caregivers. Falls are the most common safety incident among hospitalized patients with fall rates from 2.9-13 per 1,000 patient days. Little effectiveness research has been conducted on nursing interventions and other variables associated with falls of older adults during hospitalization. The purpose of this exploratory outcomes effectiveness study was to examine variables associated with falls during hospitalization of older adults. An effectiveness research model composed of patient characteristics, clinical conditions, nursing unit characteristics, medical, pharmacy, and nursing interventions was tested using generalized estimating equations (GEE) analysis. The sample consisted of 10,187 hospitalizations of 7,851 patients, aged 60 or older, admitted for acute care services over a 4-year period. Those included in the sample either had received the Nursing Interventions Classification (NIC) intervention of Fall Prevention (defined as "instituting special precautions with patient at risk for injury from falling" [Dochterman & Bulechek, 2004, p. 363]) or were at risk for falling as defined by a fall risk assessment scale. Data were obtained retrospectively from 9 clinical and administrative data repositories from 1 tertiary care hospital. Variables that were positively associated with falls, after controlling for other variables in the model, included several medical and nursing treatments; several types of medications including antidepressants, benzodiazepines, antipsychotic, and psychotropic agents; and several types of nursing treatments including restraints and neurologic monitoring (at low use rates of falls included registered nurse (RN) skill mix, pressure ulcer care, pain management, and tube care. The study demonstrates the importance of conducting interdisciplinary effectiveness research that includes nursing care. Most of the variables associated with

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

    Science.gov (United States)

    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.

  16. 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.

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

    Science.gov (United States)

    2011-01-01

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

  18. Fatal falls among older construction workers.

    Science.gov (United States)

    Dong, Xiuwen Sue; Wang, Xuanwen; Daw, Christina

    2012-06-01

    This study examines recent trends and patterns in fall fatalities in the U.S. construction industry to determine whether fatal falls among older workers are different from younger workers in this industry. Falls are the leading cause of fatalities in the U.S. construction industry. Given the increasingly aging workforce in construction, it is important to assess the risk of falls among older construction workers. Fatality data were obtained from the Census of Fatal Occupational Injuries for the years 1992 through 2008. Denominators for death rates were estimated from the Current Population Survey. Stratified and multivariate analyses were performed to examine whether there are differences in fatal falls between older workers (> or = 55 years) and younger workers (16-54 years). Fatal falls in nonconstruction industries were excluded from this study. Older workers had higher rates of fatal falls than younger workers; results were significant in 11 of 14 construction occupations. Regression analysis indicated that older decedents had a higher likelihood that work-related death was caused by a fall, after controlling for major demographic and employment factors (odds ratio = 1.50, confidence interval [1.30, 1.72]). Falls from roofs accounted for one third of construction fatal falls, but falls from ladders caused a larger proportion of deadly falls in older decedents than in younger decedents. Older workers have a higher likelihood of dying from a fall. Roofs and ladders are particularly risky for older construction workers. As the construction workforce ages, there is an urgent need to enhance fall prevention efforts, provide work accommodations, and match work capabilities to job duties.

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

    Science.gov (United States)

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

    2014-09-20

    Fall incidence differs considerably between studies and countries. Reasons may be differences between study samples or different assessment methods. The aim was to derive estimates of fall incidence from two population-based studies among older community-living people in Germany and compare retrospective and prospective falls data collection methods. Data were derived from the 2008-11 wave of the German health interview and examination survey for adults (DEGS1), and the Activity and Function of the Elderly in Ulm study (ActiFE-Ulm). Data collection took place in community facilities (DEGS1) or participants' homes (ActiFE-Ulm). Participation rates were 42% (newly recruited) and 64% (panel component) in DEGS1 and 19.8% in ActiFE-Ulm. Self-report retrospective fall data covering the previous 12 month period in DEGS1 and ActiFE-Ulm were collected, but only ActiFE-Ulm used prospective 12 month fall calendars. The incidence of 'any fall' and 'recurrent falls' were calculated for both methods. Fall rates increased with age in men but not women. The ActiFE-Ulm prospectively assessed incidence (95% confidence interval) in women and men aged 65- collection of prospective data gives similar rates to the cheaper retrospective report method.

  20. [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.

  1. 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.

  2. Characteristics of Falls Among Institutionalized Elderly People

    Directory of Open Access Journals (Sweden)

    Ahmad Ali Akbari Kamrani

    2007-01-01

    Full Text Available Objectives: Falls by elderly people area frequent cause of morbidity and mortality, especially in institutionalized elders. to describe the features of falls among institutionalized elderly people. Methods & Materials: characteristics of falls in the preceding six months (March 2006 - September 2006 that occurred among elder lies (aged over 60years with normal physical function and cognitive status, who lived at Kahrizak Institute, along term nursing home in Tehran, were surveyed and analyzed. Results: The mean age of the patients with falls was 76.9 yrs. These numbers of falls had occurred among 29 elders that 48.3% were women and 51.7% were men. 57.6% off alls were simple and elders could standup immediately independently. 42.4% of falls needed to help for standup, 2 elder person (2.6% had sever consequence of fall and had fractures. (Skull fracture, head trauma & hip fracture 30.3% of falls occurred in yard, 28.9% at room, 18.4%inhallway, 14.5% at WC, .3.9%at bathroom, and 3.9% at lunch saloon. Analysis of the time of falls showed: 45.3% of falls occurred at 7bl2 am, 13.2% at the lunch time (12bI4, 17% at 14b19, 11.3%at night (19b4 am, and 13.2% at 4b7 am. Conclusion: falls among elder lies occur mainly outside of room. And occur at the time of maximum activities, for example at morning; also falls have been happened more in subjects older, and occasionally result in sever injury such as head trauma, skull fracture, femur and pelvis fracture and cause more mortality and morbidity. Control of environmental risk factors could be protective factors against falls.

  3. Fall risk factors in older people with dementia or cognitive impairment: a systematic review.

    Science.gov (United States)

    Härlein, Jürgen; Dassen, Theo; Halfens, Ruud J G; Heinze, Cornelia

    2009-05-01

    This paper is a report of a review conducted to identify and summarize specific risk factors for falls in older people with dementia or cognitive impairments as documented by prospective or case-control studies. People with dementia have a doubled to threefold risk for falls, but the reasons for this have not yet been fully explained. Several integrative literature reviews discuss possible specific fall risk factors. However, there is lack of a systematic evaluation of studies. The CINAHL, PubMed, EMBASE and PsychInfo databases were searched for the period between 1980 and May 2007. A systematic review was conducted. Cohort or case-control studies published in English or German were included if they investigated risk factors for falls or fall-related injuries in a sample consisting of participants with dementia or cognitive impairment. Two reviewers independently assessed study quality. Six prospective studies were included in the review. These differed concerning samples, settings, follow-up periods and examined variables. Therefore, meta-analysis was not possible. Eight categories of risk factors emerged: disease-specific motor impairments, impaired vision, type and severity of dementia, behavioural disturbances, functional impairments, fall history, neuroleptics and low bone mineral density. There is lack of sound studies examining fall risk factors in cognitively impaired elders. Well-known risk factors such as motor impairment show particular characteristics in people with dementia. In addition, behavioural disturbances contribute to their high risk for falls. Further prospective studies are needed.

  4. Understanding the relationship between walking aids and falls in older adults: a prospective cohort study.

    Science.gov (United States)

    Roman de Mettelinge, Tine; Cambier, Dirk

    2015-01-01

    A substantial proportion of older adults living in residential aged care facilities are use wheelchairs or walk with aids. The relationship between using walking aids and falling is somewhat inconsistent and poorly understood. To investigate the use of walking aids as a risk factor for future falls among older adults living in residential aged care facilities and to identify spatiotemporal gait parameters that mediate the potential relationship between walking aids and falling. Forty-three older adults (22 using walking aids and 21 not using walking aids) living in residential aged care facilities were enrolled in this study. Fall history, fear of falling, and the use of psychotropic agents were registered. Spatiotemporal gait (GAITRite®), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Individuals using walking aids were older (P = .012), had a greater fear of falling (P = .017), and demonstrated a more conservative gait pattern compared with those not using walking aids. They walked slower (P fall ("fallers"). Univariate logistic regression identified using walking aids as a risk factor for future falls (odds ratio, 3.98; 95% confidence interval, 1.10-14.37; P = .035). A lower cadence, increased stance percentage, decreased swing percentage, increased age, and greater psychotropic drug intake were mediators that reduced the odds ratio of the relationship between using walking aids and faller status the most. Using walking aids is a risk factor for future falls among the older population living in residential settings. A substantial proportion of the relationship between walking aids and future falls could be explained by an altered spatiotemporal gait pattern, increased age, and psychotropic drug intake. This finding supports the aim of extensive training periods and appropriate instructions on the

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

    OpenAIRE

    Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccol?, 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 ...

  6. Internship Progress Summary: Fall 2016

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ralph S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Valencia, Matthew John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-13

    This fall I had the opportunity to work at Los Alamos National Laboratory for the Technology Applications engineering group. I assisted two main projects during my appointment, both related to the Lab’s mission statement: “To solve national security challenges through scientific excellence.” My first project, a thermal source transfer unit, involved skills such as mechanical design, heat transfer simulation, and design analysis. The goal was to create a container that could protect a heat source and regulate its temperature during transit. I generated several designs, performed heat transfer simulations, and chose a design for prototyping. The second project was a soil drying unit for use in post blast sample analysis. To ensure fast and accurate sample processing, agents in the field wanted a system that could process wet dirt and turn it into dry powder. We designed a system of commercially available parts, and we tested the systems to determine the best methods and processes.

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

    Science.gov (United States)

    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.

  8. 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

    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......, 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...... received usual care. MEASUREMENTS: Falls were registered prospectively in falls diaries, with monthly telephone calls for collection of data. Outcomes were fall rates and proportion of participants with falls, frequent falls, and injurious falls in 12 months. RESULTS: Groups were comparable at baseline...

  9. Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment.

    Science.gov (United States)

    Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Park, Hyuntae; Yoshida, Daisuke; Uemura, Kazuki; Tsutsumimoto, Kota; Liu-Ambrose, Teresa; Suzuki, Takao

    2013-08-05

    The risk of falling is associated with cognitive dysfunction. Older adults with mild cognitive impairment (MCI) exhibit an accelerated reduction of brain volume, and face an increased risk of falling. The current study examined the relationship between baseline physical performance, baseline gray matter volume and falls during a 12-month follow-up period among community-dwelling older adults with MCI. Forty-two older adults with MCI (75.6 years, 43% women) underwent structural magnetic resonance imaging and baseline physical performance assessment, including knee-extension strength, one-legged standing time, and walking speed with normal pace. 'Fallers' were defined as people who had one or more falls during the 12-month follow-up period. Of the 42 participants, 26.2% (n = 11) experienced at least one fall during the 12-month follow-up period. Fallers exhibited slower walking speed and shorter one-legged standing time compared with non-fallers (both p falls during the 12-month follow-up after adjusting for age, sex, body mass index, and history of falling in the past year at baseline. Voxel-based morphometry was used to examine differences in baseline gray matter volume between fallers and non-fallers, revealing that fallers exhibited a significantly greater reduction in the bilateral middle frontal gyrus and superior frontal gyrus. Poor balance predicts falls over 12 months, and baseline lower gray matter densities in the middle frontal gyrus and superior frontal gyrus were associated with falls in older adults with MCI. Maintaining physical function, especially balance, and brain structural changes through many sorts of prevention strategies in the early stage of cognitive decline may contribute to decreasing the risk of falls in older adults with MCI.

  10. 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.

  11. 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.

  12. Predicting Falls in Parkinson Disease: What Is the Value of Instrumented Testing in OFF Medication State?

    Directory of Open Access Journals (Sweden)

    Martina Hoskovcová

    Full Text Available Falls are a common complication of advancing Parkinson's disease (PD. Although numerous risk factors are known, reliable predictors of future falls are still lacking. The objective of this prospective study was to investigate clinical and instrumented tests of balance and gait in both OFF and ON medication states and to verify their utility in the prediction of future falls in PD patients.Forty-five patients with idiopathic PD were examined in defined OFF and ON medication states within one examination day including PD-specific clinical tests, instrumented Timed Up and Go test (iTUG and computerized dynamic posturography. The same gait and balance tests were performed in 22 control subjects of comparable age and sex. Participants were then followed-up for 6 months using monthly fall diaries and phone calls.During the follow-up period, 27/45 PD patients and 4/22 control subjects fell one or more times. Previous falls, fear of falling, more severe motor impairment in the OFF state, higher PD stage, more pronounced depressive symptoms, higher daily levodopa dose and stride time variability in the OFF state were significant risk factors for future falls in PD patients. Increased stride time variability in the OFF state in combination with faster walking cadence appears to be the most significant predictor of future falls, superior to clinical predictors.Incorporating instrumented gait measures into the baseline assessment battery as well as accounting for both OFF and ON medication states might improve future fall prediction in PD patients. However, instrumented testing in the OFF state is not routinely performed in clinical practice and has not been used in the development of fall prevention programs in PD. New assessment methods for daylong monitoring of gait, balance and falls are thus required to more effectively address the risk of falling in PD patients.

  13. [Incidence of falls and fractures in disabled elderly people utilizing long-term care insurance].

    Science.gov (United States)

    Suzukawa, Megumi; Shimada, Hiroyuki; Makizako, Hyuma; Watanabe, Shuichiro; Suzuki, Takao

    2009-07-01

    To investigate the incidence of falls and fall-related fractures in disabled elderly people utilizing long-term care insurance, and influence of gender, age, disabled level is examined. Subjects were 8,335 elderly people (mean age, 82.2+/-7.4 years). Falls and fractures were investigated retrospectively for the one year study period either via a self-report questionnaire, or via care workers and/or family members when the subjects had cognitive impairments. The care workers gave are a free description about for the fall that had occurred when using the facilities. Men showed significantly higher rate of falls (26.8%) than women (24.6%). In women, there was a significant difference in fall rates between the severely disabled group (26.4%) and the moderately disabled group (23.5%). Women showed a significantly higher rate of fractures (12.2%) than that of men (4.5%). In relationship between fall-related fractures and potential correlates, there was a significant relation between women and the fall-related fractures [OR 2.5, 95%CI 1.7-3.6]. The severely disabled group showed a significantly higher rate of falls in the toilet, on the other hand, the moderately disabled group showed significantly higher rate of falls during exercise and recreation or standing. The rate of falls in women was lower than men in this study population. The result may be affected by the lower proportion of women in the moderately disabled group compared with men. Only gender was significantly associated with the incidence of fall-related fractures in disabled elderly people.

  14. 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.

  15. IDENTIFYING ROOF FALL PREDICTORS USING FUZZY CLASSIFICATION

    International Nuclear Information System (INIS)

    Bertoncini, C. A.; Hinders, M. K.

    2010-01-01

    Microseismic monitoring involves placing geophones on the rock surfaces of a mine to record seismic activity. Classification of microseismic mine data can be used to predict seismic events in a mine to mitigate mining hazards, such as roof falls, where properly bolting and bracing the roof is often an insufficient method of preventing weak roofs from destabilizing. In this study, six months of recorded acoustic waveforms from microseismic monitoring in a Pennsylvania limestone mine were analyzed using classification techniques to predict roof falls. Fuzzy classification using features selected for computational ease was applied on the mine data. Both large roof fall events could be predicted using a Roof Fall Index (RFI) metric calculated from the results of the fuzzy classification. RFI was successfully used to resolve the two significant roof fall events and predicted both events by at least 15 hours before visual signs of the roof falls were evident.

  16. Dance movement therapy and falls prevention

    OpenAIRE

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

    2017-01-01

    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 red...

  17. The Fall 2000 and Fall 2001 SOHO-Ulysses Quadratures

    Science.gov (United States)

    Suess, S. T.; Poletto, G.; Rose, M. Franklin (Technical Monitor)

    2001-01-01

    SOHO-Ulysses quadrature occurs when the SOHO-Sun-Ulysses included angle is 90 degrees. It is only at such times that the same plasma leaving the Sun in the direction of Ulysses can first be remotely analyzed with SOHO instruments and then later be sampled in situ by Ulysses instruments. The quadratures in December 2000 and 2001 are of special significance because Ulysses will be near the south and north heliographic poles, respectively, and the solar cycle will be near sunspot maximum. Quadrature geometry is sometimes confusing and observations are influenced by solar rotation. The Fall 2000 and 2001 quadratures are more complex than usual because Ulysses is not in a true polar orbit and the orbital speed of Ulysses about the Sun is becoming comparable to the speed of SOHO about the Sun. In 2000 Ulysses will always be slightly behind the pole but will appear to hang over the pole for over two months because it is moving around the Sun in the same direction as SOHO. In 2001 Ulysses will be slightly in front of the pole so that its footpoint will be directly observable. Detailed plots will be shown of the relative positions of SOHO and Ulysses will their relative positions. In neither case is true quadrature actually achieved, but this works to the observers advantage in 2001.

  18. 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...

  19. 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

  20. Fall risk and function in older women after gynecologic surgery.

    Science.gov (United States)

    Miller, Karen L; Richter, Holly E; Graybill, Charles S; Neumayer, Leigh A

    2017-11-01

    To examine change in balance-related fall risk and daily functional abilities in the first 2 post-operative weeks and up to 6 weeks after gynecologic surgery. Prospective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre- and post-operatively daily for 1 week and twice the second week. Physical performance balance and functional mobility were measured pre- and 1 week post-operatively using the Tinetti Fall Risk Scale, Timed Up and Go, and 6-Minute Walk test. Measures were repeated 6 weeks after surgery. Non-parametric tests for paired data were used comparing scores baseline to post-operative (POD) 7 and to POD 42. Median age was 72 years (range 65-88). Fall risk was elevated during the first 2 post-operative weeks, greatest on the median discharge day, POD 2 (pgynecologic surgery, older women's fall risk is highest on POD 2 and remains elevated from baseline for 2 weeks. Functional limitations in the early home recovery period include the anticipated (bathing, cooking, etc.) and some unanticipated (medication management) ones. This information may help with post-operative discharge planning. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  1. ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial.

    Science.gov (United States)

    Gschwind, Yves J; Eichberg, Sabine; Ejupi, Andreas; de Rosario, Helios; Kroll, Michael; Marston, Hannah R; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Aal, Konstantin; Vaziri, Daryoush; Woodbury, Ashley; Fink, Dennis; Delbaere, Kim

    2015-01-01

    Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people's homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors. A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes. The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052). The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway

  2. Identifying characteristics and outcomes that are associated with fall-related fatalities: multi-year retrospective summary of fall deaths in older adults from 2005-2012.

    Science.gov (United States)

    Deprey, Sara M; Biedrzycki, Lynda; Klenz, Kristine

    2017-12-01

    Fall-related deaths continue to be the leading cause of accidental deaths in the older adult (65+ year) population. However, many fall-related fatalities are unspecified and little is known about the fall characteristics and personal demographics at the time of the fall. Therefore, this report describes the characteristics, circumstances and injuries of falls that resulted in older adult deaths in one U.S. County and explores the variables associated with fatal injuries from falls. This is a continued retrospective analysis of 841older adults whose underlying cause of death was due to a fall over an 8-year period (2005-2012). Demographics and logistic regression of fall characteristics and injuries were analyzed. Falls that led to death most often occurred when walking in one's own home. Most of the residents in this study were community-dwellers who had previous comorbidities taking an average of six medications prior to their fall. Survival after a fall was on average 31 days. The two most common injuries after a fatal fall were hip fractures (54%), and head injuries (21%). A logistic regression identified two variables associated with hip fracture, advancing age (OR = 1.05, 95% confidence interval [CI] = 1.02-1.08) and diagnosis of a prior neurological condition (OR = 2.1, 95% CI = 1.4-3.1). Variables associated with head injuries included younger age (OR = .91, 95% CI = .89-.94), male gender (OR = 2.5, 95% CI = 1.7-3.8), prescribed anticoagulants (OR = 2.4, 95% CI = 1.5-3.9) and negative musculoskeletal comorbidity (OR = 1.9. 95% CI = 1.1-3.0). Hip fractures and head injuries were the most common injury after a fall that led to death in older adults greater than 65 years. There are opposing risk factors for older adults who incur a hip fracture compared to a head injury. Thus, health professionals will need to individualize prevention efforts to reduce fall fatalities.

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

    Science.gov (United States)

    Perttila, Niko M; Öhman, Hannareeta; Strandberg, Timo E; Kautiainen, Hannu; Raivio, Minna; Laakkonen, Marja-Liisa; Savikko, Niina; Tilvis, Reijo S; Pitkala, Kaisu H

    2017-01-01

    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. 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. 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. Our study provides a detailed account on how and why people with AD fall, suggesting several risk and protective factors.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Leisure-Time Physical Activity, Falls, and Fall Injuries in Middle-Aged Adults.

    Science.gov (United States)

    Caban-Martinez, Alberto J; Courtney, Theodore K; Chang, Wen-Ruey; Lombardi, David A; Huang, Yueng-Hsiang; Brennan, Melanye J; Perry, Melissa J; Katz, Jeffrey N; Christiani, David C; Verma, Santosh K

    2015-12-01

    Although exercise and strength training have been shown to be protective against falls in older adults (aged 65 years and older), evidence for the role of leisure-time physical activity (LTPA) in the prevention of falls and resulting injuries in middle-aged adults (aged 45-64 years) is lacking. In the present study, we investigate the association between self-reported engagement in LTPA and the frequency of falls and fall-related injuries among middle-aged and older adults, while controlling for key sociodemographic and health characteristics. Nationally representative data from the 2010 U.S. Behavioral Risk Factor Surveillance Survey were analyzed in April 2014 to examine the number of adults aged ≥45 years who self-reported their fall experience in the previous 3 months and any injuries that resulted from those falls. We then evaluated the association between LTPA and self-reported falls and injuries across three age strata (45-54, 55-64, and ≥65 years). The two main self-reported outcome measures were (1) frequency of falls in the 3 months prior to the survey interview date and (2) the number of injuries resulting from these falls. Prevalence ratios (PRs) and 95% CIs were calculated using Poisson regression models with robust SEs. Of 340,680 survey participants aged ≥45 years, 70.7% reported engaging in LTPA, and 17% reported one or more falls. Among those reporting a fall within 3 months, 25.6% experienced one injurious fall (fall resulting in an injury) and 8.4% reported two or more injurious falls. Controlling for sociodemographic and health characteristics, among adults aged 45-54 years, those who engaged in LTPA were significantly less likely to report one fall (PR=0.90, 95% CI=0.81, 0.99); two or more falls (PR=0.84, 95% CI=0.77, 0.93); one injurious fall (PR=0.88, 95% CI=0.78, 0.99); and two or more injurious falls (PR=0.69, 95% CI=0.58, 0.83) than those who did not exercise. A similar protective effect of LTPA on reporting falls and injuries was

  6. 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

  7. Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff's global judgement and fall history in evaluating fall risk in residential care facilities.

    Science.gov (United States)

    Nordin, Ellinor; Lindelöf, Nina; Rosendahl, Erik; Jensen, Jane; Lundin-Olsson, Lillemor

    2008-07-01

    to evaluate and compare the prognostic validity relative to falls of the Timed Up-and-Go test (TUG), a modified Get-Up-and-Go test (GUG-m), staff's judgement of global rating of fall risk (GLORF) and fall history among frail older people. cohort study, 6-month prospective follow-up for falls. 183 frail persons living in residential care facilities in Sweden, mean age 84 years, 73% women. the occurrence of falls during the follow-up period were compared to the following assessments at baseline: the TUG at normal speed; the GUG-m, a rating of fall risk scored from 1 (no risk) to 5 (very high risk); the GLORF, staff's rating of fall risk as 'high' or 'low'; a history of falls in the previous 6 months. These assessment tools were evaluated using sensitivity, specificity and positive and negative likelihood ratios (LR(+) to rule in and LR(-) to rule out a high fall risk). 53% of the participants fell at least once. Various cut-off values of the TUG (12, 15, 20, 25, 30, 35, 40 s) and the GUG-m showed LR(+) between 0.9 and 2.6 and LR(-) between 0.1 and 1.0. The GLORF showed an LR(+) of 2.8 and an LR(-) of 0.6 and fall history showed an LR(+) of 2.4 and an LR(-) of 0.6. in this population of frail older people, staff judgement of their residents' fall risk as well as previous falls both appear superior to the performance-based measures TUG and GUG-m in ruling in a high fall risk. A TUG score of less than 15 s gives guidance in ruling out a high fall risk but insufficient information in ruling in such a risk. The grading of fall risk by GUG-m appears of very limited value.

  8. Determinants of hospital fall rate trajectory groups: a longitudinal assessment of nurse staffing and organizational characteristics.

    Science.gov (United States)

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

    2014-01-01

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

  9. Dance movement therapy and falls prevention.

    Science.gov (United States)

    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.

  10. Supervision of young children with fall injuries.

    Science.gov (United States)

    Castro, Yessenia; Powell, Elizabeth C; Sheehan, Karen M

    2010-10-01

    Specific information about the supervision of young children with injuries related to falls is limited. In this study, we describe the supervision and physical environment of falls resulting in medical care in the emergency department. We enrolled a convenience sample of 108 children younger than 7 years with fall injuries. The average age was 3 years, and 56% were male. Seventy-six (70%) were a fall from a height including 16 that involved stairs. Among caretakers in a nongroup setting (n = 95), most (61%) were supervising more than one child. The attention to the child was holding or playing with the child (13%), observing (45%), usually constantly, or listening for the child (19%); 9% reported no supervision at the time of the fall. Thirty-two percent stated they were touching or within reach of the child. Of falls indoors (n = 56), the supervisor was in the same room as the child for more than half of cases. There was no association between the number of children supervised and fall type (height vs. same level). When compared with those with same level falls, children with falls from a height were more often supervised with listening or no supervision (vs. observation, holding, or playing with the child) χ², p = 0.004. Many children were supervised at the time of their fall. Most caretakers had visual contact, and up to a third were touching or within reach of the child. The strategies used in these apparently low-risk situations were insufficient to prevent the falls we report.

  11. The Periodical Use/Survey at Fitchburg State College Library.

    Science.gov (United States)

    Ouellette, Janice A.; Anttila, Faith E.

    This narrative description summarizes the planning and implementation of a periodical use survey conducted during fall 1985 and spring 1986 to determine who uses the Fitchburg State College Library periodical holdings and which periodicals are used. Relevant literature is discussed, the purpose of the survey is explained, and survey procedures are…

  12. Klamath Falls geothermal field, Oregon

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.J.; Culver, G.; Lund, J.W.

    1989-09-01

    Klamath Falls, Oregon, is located in a Known Geothermal Resource Area which has been used by residents, principally to obtain geothermal fluids for space heating, at least since the turn of the century. Over 500 shallow-depth wells ranging from 90 to 2,000 ft (27 to 610 m) in depth are used to heat (35 MWt) over 600 structures. This utilization includes the heating of homes, apartments, schools, commercial buildings, hospital, county jail, YMCA, and swimming pools by individual wells and three district heating systems. Geothermal well temperatures range from 100 to 230{degree}F (38 to 110{degree}C) and the most common practice is to use downhole heat exchangers with city water as the circulating fluid. Larger facilities and district heating systems use lineshaft vertical turbine pumps and plate heat exchangers. Well water chemistry indicates approximately 800 ppM dissolved solids, with sodium sulfate having the highest concentration. Some scaling and corrosion does occur on the downhole heat exchangers (black iron pipe) and on heating systems where the geo-fluid is used directly. 73 refs., 49 figs., 6 tabs.

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

    Science.gov (United States)

    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.

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

    OpenAIRE

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

    2013-01-01

    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 de...

  15. Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

    Science.gov (United States)

    Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

    2017-11-01

    New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed

  16. Fall prevention strategy in an emergency department.

    Science.gov (United States)

    Muray, Mwali; Bélanger, Charles H; Razmak, Jamil

    2018-02-12

    Purpose The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services. Design/methodology/approach The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ 2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables. Findings In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool. Originality/value Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

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

    Science.gov (United States)

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

    2006-01-01

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

  18. Osteosarcopenic obesity and fall prevention strategies.

    Science.gov (United States)

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

    2015-02-01

    Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal women's balance, leading to a decreased risk of falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Preclinical Alzheimer disease and risk of falls.

    Science.gov (United States)

    Stark, Susan L; Roe, Catherine M; Grant, Elizabeth A; Hollingsworth, Holly; Benzinger, Tammie L; Fagan, Anne M; Buckles, Virginia D; Morris, John C

    2013-07-30

    We determined the rate of falls among cognitively normal, community-dwelling older adults, some of whom had presumptive preclinical Alzheimer disease (AD) as detected by in vivo imaging of fibrillar amyloid plaques using Pittsburgh compound B (PiB) and PET and/or by assays of CSF to identify Aβ₄₂, tau, and phosphorylated tau. We conducted a 12-month prospective cohort study to examine the cumulative incidence of falls. Participants were evaluated clinically and underwent PiB PET imaging and lumbar puncture. Falls were reported monthly using an individualized calendar journal returned by mail. A Cox proportional hazards model was used to test whether time to first fall was associated with each biomarker and the ratio of CSF tau/Aβ₄₂ and CSF phosphorylated tau/Aβ₄₂, after adjustment for common fall risk factors. The sample (n = 125) was predominately female (62.4%) and white (96%) with a mean age of 74.4 years. When controlled for ability to perform activities of daily living, higher levels of PiB retention (hazard ratio = 2.95 [95% confidence interval 1.01-6.45], p = 0.05) and of CSF biomarker ratios (p fall. Presumptive preclinical AD is a risk factor for falls in older adults. This study suggests that subtle noncognitive changes that predispose older adults to falls are associated with AD and may precede detectable cognitive changes.

  20. The Latino Experience in Central Falls

    Science.gov (United States)

    Holland, William R.

    2011-01-01

    Central Falls is, by far, the poorest community in Rhode Island. More than 40 percent of the children under 18 live in poverty, and 40 percent of that group live in severe poverty. At Central Falls High School, low-income Latino students have fallen behind their white counterparts, with shockingly low graduation, poor literacy, and low…

  1. Risk factors for falls of older citizens

    NARCIS (Netherlands)

    Boelens, C.; Hekman, E. E. G.; Verkerke, G. J.

    2013-01-01

    OBJECTIVE: Fall prevention is a major issue in the ageing society. This study provides an overview of all risk factors for falls of older citizens. METHOD: A literature search was conducted to retrieve studies of the past 25 years. All participants from the studies lived in the community or

  2. Playful home training for falls prevention

    DEFF Research Database (Denmark)

    Jessen, Jari Due; Lund, Henrik Hautop

    2015-01-01

    Falling is a big issue among elderly, and prevention of falling is of big importance both for the individual and for society at large. In this paper we present a pilot study with fun exergaming equipment in private homes. The initial findings in the small pilot study suggests that this kind of tr...

  3. Nurses' Job Satisfaction and Patient Falls

    Directory of Open Access Journals (Sweden)

    Cecilia D. Alvarez, DNP, RN

    2007-09-01

    Results and Conclusion: No significant relationship was found between overall nurses' job satisfaction and patient fall rate. MD–RN interactions (r = .65 and decision-making (r = .57 were the job satisfaction subscales that showed a significant positive correlation with patient fall rate (p < .05. Recommendations for future research are provided.

  4. Falls and stumbles in myotonic dystrophy.

    Science.gov (United States)

    Wiles, C M; Busse, M E; Sampson, C M; Rogers, M T; Fenton-May, J; van Deursen, R

    2006-03-01

    To investigate falls and risk factors in patients with myotonic dystrophy type 1 (DM1) compared with healthy volunteers. 13 sequential patients with DM1 from different kindreds were compared with 12 healthy volunteers. All subjects were evaluated using the Rivermead Mobility Index, Performance Oriented Mobility Assessment, and modified Activities Specific Balance Confidence scale. Measures of lower limb muscle strength, gait speed, and 7-day ambulatory activity monitoring were recorded. Subjects returned a weekly card detailing stumbles and falls. 11 of 13 patients (mean age 46.5 years, seven female) had 127 stumbles and 34 falls over the 13 weeks, compared with 10 of 12 healthy subjects (34.4 years, seven female) who had 26 stumbles and three falls. Patients were less active than healthy subjects but had more falls and stumbles per 5000 right steps taken (mean (SD) events, 0.21 (0.29) v 0.02 (0.02), p = 0.007). Patients who fell (n = 6) had on average a lower Rivermead Mobility score, slower self selected gait speed, and higher depression scores than those who did not. DM1 patients stumble or fall about 10 times more often than healthy volunteers. Routine inquiry about falls and stumbles is justified. A study of multidisciplinary intervention to reduce the risk of falls seems warranted.

  5. Free Fall and the Equivalence Principle Revisited

    Science.gov (United States)

    Pendrill, Ann-Marie

    2017-01-01

    Free fall is commonly discussed as an example of the equivalence principle, in the context of a homogeneous gravitational field, which is a reasonable approximation for small test masses falling moderate distances. Newton's law of gravity provides a generalisation to larger distances, and also brings in an inhomogeneity in the gravitational field.…

  6. How Fast Does a Building Fall?

    Science.gov (United States)

    Denny, Mark

    2010-01-01

    In this paper, the time required for a tower block to collapse is calculated. The tower collapses progressively, with one floor falling onto the floor below, causing it to fall. The rate of collapse is found to be not much slower than freefall. The calculation is an engaging and relevant application of Newton's laws, suitable for undergraduate…

  7. Falls and Fall Injuries Among Adults Aged ≥65 Years - United States, 2014.

    Science.gov (United States)

    Bergen, Gwen; Stevens, Mark R; Burns, Elizabeth R

    2016-09-23

    Falls are the leading cause of fatal and nonfatal injuries among adults aged ≥65 years (older adults). During 2014, approximately 27,000 older adults died because of falls; 2.8 million were treated in emergency departments for fall-related injuries, and approximately 800,000 of these patients were subsequently hospitalized.* To estimate the numbers, percentages, and rates of falls and fall injuries among older adults by selected characteristics and state, CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey. In 2014, 28.7% of older adults reported falling; the estimated 29.0 million falls resulted in 7.0 million injuries. Known effective strategies for reducing the number of older adult falls include a multifactorial clinical approach (e.g., gait and balance assessment, strength and balance exercises, and medication review). Health care providers can play an important role in fall prevention by screening older adults for fall risk, reviewing and managing medications linked to falls, and recommending vitamin D supplements to improve bone, muscle, and nerve health and reduce the risk for falls.

  8. Risk Factors for Falls and Fall-related Fractures in the Elderly

    NARCIS (Netherlands)

    G. Ziere (Gijsbertus)

    2007-01-01

    textabstractFalls are among the most common and serious problems facing older persons and are associated with considerable morbidity and mortality. They often lead to reduced functioning and nursing home admissions. The incidence of falls as well as the severity of fall-related complications rises

  9. 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

  10. 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.

  11. 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.

  12. [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

  13. Two-year trajectory of fall risk in people with Parkinson’s disease: a latent class analysis

    Science.gov (United States)

    Paul, Serene S; Thackeray, Anne; Duncan, Ryan P; Cavanaugh, James T; Ellis, Theresa D; Earhart, Gammon M; Ford, Matthew P; Foreman, K Bo; Dibble, Leland E

    2015-01-01

    Objective To examine fall risk trajectories occurring naturally in a sample of individuals with early to middle stage Parkinson’s disease (PD). Design Latent class analysis, specifically growth mixture modeling (GMM) of longitudinal fall risk trajectories. Setting Not applicable. Participants 230 community-dwelling PD participants of a longitudinal cohort study who attended at least two of five assessments over a two year period. Interventions Not applicable. Main Outcome Measures Fall risk trajectory (low, medium or high risk) and stability of fall risk trajectory (stable or fluctuating). Fall risk was determined at 6-monthly intervals using a simple clinical tool based on fall history, freezing of gait, and gait speed. Results The GMM optimally grouped participants into three fall risk trajectories that closely mirrored baseline fall risk status (p=.001). The high fall risk trajectory was most common (42.6%) and included participants with longer and more severe disease and with higher postural instability and gait disability (PIGD) scores than the low and medium risk trajectories (pfall risk (posterior probability fall risk trajectories over two years. Further investigation is required to determine whether interventions to improve gait and balance may improve fall risk trajectories in people with PD. PMID:26606871

  14. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial.

    Science.gov (United States)

    Barker, Anna L; Morello, Renata T; Wolfe, Rory; Brand, Caroline A; Haines, Terry P; Hill, Keith D; Brauer, Sandra G; Botti, Mari; Cumming, Robert G; Livingston, Patricia M; Sherrington, Catherine; Zavarsek, Silva; Lindley, Richard I; Kamar, Jeannette

    2016-01-26

    To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. Cluster randomised controlled trial. Six Australian hospitals. All patients admitted to 24 acute wards during the trial period. Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: "falls alert" sign, supervision of patients in the bathroom, ensuring patients' walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients' characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; Pcontrol wards. Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. Australian New Zealand Clinical Trials Registry ACTRN12611000332921. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Individual housing-based socioeconomic status predicts risk of accidental falls among adults.

    Science.gov (United States)

    Ryu, Euijung; Juhn, Young J; Wheeler, Philip H; Hathcock, Matthew A; Wi, Chung-Il; Olson, Janet E; Cerhan, James R; Takahashi, Paul Y

    2017-07-01

    Accidental falls are a major public health concern among people of all ages. Little is known about whether an individual-level housing-based socioeconomic status measure is associated with the risk of accidental falls. Among 12,286 Mayo Clinic Biobank participants residing in Olmsted County, Minnesota, subjects who experienced accidental falls between the biobank enrollment and September 2014 were identified using ICD-9 codes evaluated at emergency departments. HOUSES (HOUsing-based Index of SocioEconomic Status), a socioeconomic status measure based on individual housing features, was also calculated. Cox regression models were utilized to assess the association of the HOUSES (in quartiles) with accidental fall risk. Seven hundred eleven (5.8%) participants had at least one emergency room visit due to an accidental fall during the study period. Subjects with higher HOUSES were less likely to experience falls in a dose-response manner (hazard ratio: 0.58; 95% confidence interval: 0.44-0.76 for comparing the highest to the lowest quartile). In addition, the HOUSES was positively associated with better health behaviors, social support, and functional status. The HOUSES is inversely associated with accidental fall risk requiring emergency care in a dose-response manner. The HOUSES may capture falls-related risk factors through housing features and socioeconomic status-related psychosocial factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Describing Older Adults' Awareness of Fall Risk Using Situation Awareness Research Techniques: A Pilot Study.

    Science.gov (United States)

    Azzarello, Jo; Hall, Beth

    2016-07-01

    The purpose of the current study was to evaluate efficacy of techniques adapted from situation awareness research for describing how older adults perceive and understand fall risk factors in the context of daily routine. Eleven older adults watched a video of an older woman performing daily activities. Thirteen intrinsic, extrinsic, and behavioral fall risks were embedded throughout the scenario. The video was periodically frozen/blanked from view while participants answered questions about their understanding of the situation and associated story elements. Participants perceived a variety of fall risk factors but did not necessarily interpret them as indicating fall risk. Many fall risks held non-fall meaning for participants (e.g., newspapers on the floor meant the woman liked to read). Although four participants readily identified a fall risk situation, seven did not until they were explicitly asked to consider safety. Study techniques were effective for describing situation awareness of fall risk and several suggestions for improvement are described. [Res Gerontol Nurs. 2016; 9(4):161-166.]. Copyright 2016, SLACK Incorporated.

  19. Nutritional status and associations with falls, balance, mobility and functionality during hospital admission.

    Science.gov (United States)

    Vivanti, A; Ward, N; Haines, T

    2011-05-01

    To explore associations between nutritional status, falls and selected falls risk factors amongst older hospitalized people. Lengths of stay amongst fallers and the malnourished were assessed. An observational longitudinal cohort study. Geriatric Assessment and Rehabilitation Unit (GARU) of a tertiary teaching hospital. Admissions to the GARU during a six-month period were included. Associations between nutritional status and falls during hospitalization, reported preadmission history of falls, functional status, balance and mobility during GARU admission were analysed. Associations between nutritional status or experiencing a hospital fall and length of stay were also examined. Malnutrition prevalence was 39% (75/194, 95% CI 32-46%) with odds of falling during admission being 1.49 (95%CI: 0.81, 2.75), polder (polder people assessed as malnourished. Considering the results, a larger study concerning nutritional status, functionality and falls in the hospitalized population is warranted. The influence of nutritional status upon a person's physical functioning should be considered more broadly in falls research.

  20. The epidemiology of slips, trips, and falls in a helicopter manufacturing plant.

    Science.gov (United States)

    Amandus, Harlan; Bell, Jennifer; Tiesman, Hope; Biddle, Elyce

    2012-06-01

    The purpose of this evaluation was to evaluate the causes and costs of slips, trips, and falls (STFs) in a helicopter manufacturing plant. STFs are a significant portion of the total industry injury burden. For this study, 4,070 helicopter plant workers who were employed from January 1, 2004, through February 28, 2008, were enrolled. Company records on workers' compensation claims, occupational health first report of injury, and payroll records on hours worked were collected. Cause and source of all injuries, including STFs, were coded for analysis. During the 4-year study period, there were 2,378 injuries and 226 STFs (46 falls [20%] to a lower level, 117 [52%] falls on the same level, 41 [18%] from loss of balance without a fall, and 22 [10%] from other events). Of the 226 STFs, 123 falls to the same level were caused by slippery substances (52), objects on floor (43), and surface hazards (28), and they cost $1,543,946. Falls to lower levels primarily involved access to stands to and from aircraft and falling off large machines. More than half of the STF injury claims likely could have been prevented by housekeeping and maintenance, and this cost saving could reasonably offset a considerable portion of the cost of prevention. Training and stand modifications could be considered to prevent falls from elevation from stands, machines, and aircraft. Recommendations for STF prevention are discussed.

  1. The financial implications of falls in older people for an acute hospital.

    LENUS (Irish Health Repository)

    Cotter, P E

    2012-02-03

    BACKGROUND: Falls are a common occurrence in older people and frequently lead to hospital admission. There is a current lack of cohesive fall prevention strategies in the Republic of Ireland. AIM: To demonstrate the cost of fall-related admissions to an acute hospital. METHODS: A review of Hospital Inpatient Enquiry (HIPE) data and medical case notes was performed for all fall-related admissions over a one-year period. The cost of fall-related admissions was calculated. In addition a detailed cost analysis was performed to determine the true cost of a hip fracture admission. RESULTS: There were 810 fall-related admissions, resulting in 8,300 acute bed days, and 6,220 rehabilitation bed days, costing euros 10.3 million. Fall-related readmissions resulted in 650 bed-days, bringing the total cost to euros 10.8 million. A typical hip fracture incident admission episode costs euros 14,300. CONCLUSION: Fall-related admissions of olderpeople are a significant financial burden to the health service.

  2. Fall Risk Assessment By Measuring Determinants Of Gait

    OpenAIRE

    Zhang, Xiaoyue

    2013-01-01

    Fall accidents are one of the most serious problems leading to unintentional injuries and fatalities among older adults. However, it is difficult to assess individuals' fall risk and to determine who are at risk of falls and in need of fall interventions. Therefore, this study was motivated by a need to provide a cogent fall risk assessment strategy that may be conducive to various wireless platforms. It aimed at developing a fall risk assessment method for evaluating individuals' fall risk b...

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

    OpenAIRE

    Rodr?guez-Molinero, Alejandro; G?lvez-Barr?n, C?sar; Narvaiza, Leire; Mi?arro, Antonio; Ruiz, Jorge; Valldosera, Esther; Gonzalo, Natalia; Ng, Thalia; Sanguino, Mar?a Jes?s; Yuste, Antonio

    2017-01-01

    Introduction Older adults' perception of their own risk of fall has never been included into screening tools. The goal of this study was to evaluate the predictive validity of questions on subjects' self-perception of their own risk of fall. Methods This prospective study was conducted on a probabilistic sample of 772 Spanish community-dwelling older adults, who were followed-up for a one year period. At a baseline visit, subjects were asked about their recent history of falls (question 1: 'H...

  4. 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

  5. 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

  6. Falls and fall injuries among adults with arthritis--United States, 2012.

    Science.gov (United States)

    Barbour, Kamil E; Stevens, Judy A; Helmick, Charles G; Luo, Yao-Hua; Murphy, Louise B; Hootman, Jennifer M; Theis, Kristina; Anderson, Lynda A; Baker, Nancy A; Sugerman, David E

    2014-05-02

    Falls are the leading cause of injury-related morbidity and mortality among older adults, with more than one in three older adults falling each year, resulting in direct medical costs of nearly $30 billion. Some of the major consequences of falls among older adults are hip fractures, brain injuries, decline in functional abilities, and reductions in social and physical activities. Although the burden of falls among older adults is well-documented, research suggests that falls and fall injuries are also common among middle-aged adults. One risk factor for falling is poor neuromuscular function (i.e., gait speed and balance), which is common among persons with arthritis. In the United States, the prevalence of arthritis is highest among middle-aged adults (aged 45-64 years) (30.2%) and older adults (aged ≥65 years) (49.7%), and these populations account for 52% of U.S. adults. Moreover, arthritis is the most common cause of disability. To examine the prevalence of falls among middle-aged and older adults with arthritis in different states/territories, CDC analyzed data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) to assess the state-specific prevalence of having fallen and having experienced a fall injury in the past 12 months among adults aged ≥45 years with and without doctor-diagnosed arthritis. This report summarizes the results of that analysis, which found that for all 50 states and the District of Columbia (DC), the prevalence of any fall (one or more), two or more falls, and fall injuries in the past 12 months was significantly higher among adults with arthritis compared with those without arthritis. The prevalence of falls and fall injuries is high among adults with arthritis but can be addressed through greater dissemination of arthritis management and fall prevention programs in clinical and community practice.

  7. Neuropsychological Mechanisms for Falls in Older Adults

    Directory of Open Access Journals (Sweden)

    Yu eLiu

    2014-04-01

    Full Text Available Falls, a common cause of injury among older adults, have become increasingly prevalent. As the world’s population ages, the increase in – and the prevalence of – falls among older people makes this a serious and compelling societal and healthcare issue. Physical weakness is a critical predictor in falling. While considerable research has examined this relationship, comprehensive reviews of neuropsychological predictors of falls have been lacking. In this paper, we examine and discuss current studies of the neuropsychological predictors of falls in older adults, as related to sporting and non-sporting contexts. By integrating the existing evidence, we propose that brain aging is an important precursor of the increased risk of falls in older adults. Brain aging disrupts the neural integrity of motor outputs and reduces neuropsychological abilities. Older adults may shift from unconscious movement control to more conscious or attentive motor control. Increased understanding of the causes of falls will afford opportunities to reduce their incidence, reduce consequent injuries, improve overall well-being and quality of life, and possibly to prolong life.

  8. Fall Prevention for Older Adults Receiving Home Healthcare.

    Science.gov (United States)

    Bamgbade, Sarah; Dearmon, Valorie

    2016-02-01

    Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

  9. 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

    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.

  10. 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

  11. Collective Fall Protection for Construction Workers

    Directory of Open Access Journals (Sweden)

    Sulowski, A. C.

    2014-03-01

    Full Text Available Construction safety regulations require protection of workers against falls from elevations. The collective fall protection systems, in most cases, allow workers to move freely without wearing individual fall protection gear. The collective systems which prevent falls are preferred over the fall arrest systems. The latter are employed only if prevention of falls is not feasible. Arresting a fall always carries with it a residual risk of injury to the fall victim. The collective fall arrest systems are employed primarily during construction of electricity or telecomm towers. The aim of this paper has been a review of the collective FPS employed in the construction industry.Las normas de seguridad en la construcción requieren de protección para los trabajadores contra las caídas desde altura. Los Sistemas de Protección contra Caídas (FPS, por sus siglas en inglés colectivos, en la mayoría de los casos, permiten que los trabajadores se muevan libremente sin usar un equipo de protección contra caídas individual. Los sistemas colectivos de prevención de caídas son preferibles a los sistemas de detención de caídas, estos últimos se emplean sólo si la prevención de las caídas no es factible. La detención de una caída siempre lleva consigo un riesgo residual de lesiones en la víctima accidentada. Los sistemas colectivos de detención de caídas se emplean principalmente en la construcción de torres de electricidad o telecomunicaciones. El objetivo de este trabajo ha sido la revisión de los sistemas colectivos de protección contra caídas empleados en la industria de la construcción.

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

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    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.

  13. 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.

  14. 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 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 .

  15. 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

    2017-10-12

    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 yrs) 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. © 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.

  16. Effectiveness of simple balancing training program in elderly patients with history of frequent falls

    Directory of Open Access Journals (Sweden)

    Kuptniratsaikul V

    2011-05-01

    Full Text Available Vilai Kuptniratsaikul1, Rungnirand Praditsuwan2, Prasert Assantachai3, Teerada Ploypetch1, Suthipol Udompunturak4, Julaporn Pooliam41Department of Rehabilitation Medicine, 2Department of Medicine, 3Department of Preventive Medicine, 4Office for Research and Development, Siriraj Hospital, Mahidol University, ThailandObjective: To study the effectiveness of simply-performed balancing exercises in fall prevention.Design: Pre- and post-trial.Setting: University hospital from January 2009 to May 2010.Participants: Elderly with falls in the previous year.Intervention: Simple balancing exercise was performed at home every day and was recorded in the booklet.Measurements: New falling events and a battery of balancing abilities including the Timed Up and Go Test (TUGT, chair stand, functional reach, and Berg balance scale-short form were evaluated at baseline, 3-, 6-, 9-, and 12-month periods. Fear of falling and quality of life scores were assessed at baseline and 12-month periods.Results: 146 subjects were recruited, 116 female (79.5% with a mean age of 67.1 years. At the end of the study, 49% of participants had not fallen. All of the balancing abilities were compared between frequent and infrequent fallers and were significantly improved (P < 0.001 except for functional reach in the frequent fall group. Most subjects (72%–79% complied well with the exercise program. However, compliance had no effect on balancing abilities. About 36.4% of participants had adverse events from exercise, of which knee pain was the top ranked. The quality of life and the fall efficacy scores increased significantly at the end of the study. Factors affecting falling were compliance with exercise (adjusted odds ratio [OR]: 2.55, 95% confidence intervals [CI]: 1.04, 6.30 and a history of falling ≥3 times in the previous year (adjusted OR: 3.76, 95% CI: 1.18, 11.98.Conclusion: Performing simply-designed balancing exercises, at least 3 days per week, can increase

  17. The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis.

    Science.gov (United States)

    Arnold, Cathy M; Faulkner, Robert A

    2010-07-01

    To evaluate the effect of aquatic exercise and education on fall risk factors in older adults with hip osteoarthritis (OA). Seventy-nine adults, 65 years of age or older with hip OA and at least 1 fall risk factor, were randomly assigned to 1 of 3 groups: aquatics and education (AE; aquatic exercise twice a wk with once-a-wk group education), aquatics only (A; 2 wk aquatic exercise) and control (C; usual activity). Balance, falls efficacy, dual-task function, functional performance (chair stands), and walking performance were measured pre- and postintervention or control period. There was a significant improvement in fall risk factors (full-factorial MANCOVA, baseline values as covariates; p = .038); AE improved in falls efficacy compared with C and in functional performance compared with A and C. The combination of aquatic exercise and education was effective in improving fall risk factors in older adults with arthritis.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Medication as a risk factor for falls in older women in Brazil

    Directory of Open Access Journals (Sweden)

    Rozenfeld Suely

    2003-01-01

    Full Text Available OBJECTIVE: To assess the prevalence of falls and their association with the use of medications among elderly women in the city of Rio de Janeiro, Brazil. Falls among the elderly are likely to gain additional public health importance in Brazil and many other developing countries given the rapid growth of the elderly populations in those nations. METHODS: A cross-sectional study was carried out with women who were participating in the educational, cultural, and medical care activities of the Open University of the Third Age (OUTA, a group that works to promote the welfare of elderly people in the city of Rio de Janeiro. The women in the study were all 60 years old or older, were able to walk, had no cognitive impairment, and were living in the community (rather than living in a facility exclusively for older persons. A questionnaire was used that asked about falls within the 12 months prior to the interview, medications used in the previous 15 days, current and past health problems, and demographic characteristics. Women who were interviewed face-to-face also had their blood pressure checked. Two outcome variables were defined: (1 "fallers," who had suffered one or more falls (contrasted with "nonfallers" and (2 "recurrent fallers," who had had two or more falls (contrasted with those who had had one or no falls, called "nonrecurrent fallers". RESULTS: A total of 634 women were interviewed face-to-face at the OUTA facilities. Among these in-person interviewees, 23.3% reported one fall in the previous year, and 14.0% reported two or more falls in that period. Considering both prescribed drugs and over-the-counter drugs, only 9.1% of these women were not using any medications, 52.7% were using 1 to 4 medications, 34.4% were using 5 to 10, and 3.8% were using 11 to 17 medications. In comparison to nonusers, users of diuretics who also suffered from musculoskeletal disease were 1.6 times as likely to report having suffered a single fall in the

  20. Comparing the Incidence of Falls/Fractures in Parkinson's Disease Patients in the US Population.

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    Linda Kalilani

    Full Text Available Patients with Parkinson's disease (PD may experience falls and/or fractures as a result of disease symptoms. There are limited data available from long-term studies estimating the incidence of falls/fractures in patients with PD. The objective was to compare the incidence rate of falls/fractures in PD patients with non-PD patients in a US population. This was a retrospective study using a US-based claims database (Truven Health MarketScan® that compared the incidence rate of falls/fractures in PD subjects with non-PD subjects. The study period included the 12 months prior to index date (defined as earliest PD diagnosis [International Classification of Diseases, Ninth Revision, Clinical Modification code 332.0] and a postindex period to the end of data availability. Fractures were defined by inpatient/outpatient claims as a principal or secondary diagnosis and accompanying procedure codes during the postindex period. Incidence rates and 95% CIs for falls/fractures were calculated as the number of events per 10,000 person-years of follow-up using negative binomial or Poisson regression models. Twenty-eight thousand two hundred and eighty PD subjects were matched to non-PD subjects for the analysis (mean [SD] age, 71.4 [11.8] years; 53% male. A higher incidence rate (adjusted for comorbidities and medications of all fall/fracture cases and by fall and fracture types was observed for PD subjects versus non-PD subjects; the overall adjusted incidence rate ratio comparing PD to non-PD subjects was 2.05; 95% CI, 1.88-2.24. The incidence rate of falls/fractures was significantly higher in subjects with PD compared with non-PD subjects in a US population.

  1. 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.

  2. Speak Up: Reduce Your Risk of Falling

    Science.gov (United States)

    ... cause weakness, sleepiness, confusion or dizziness • Slippery or wet floors or stairs • Obstructed pathways • Darkness How to ... help. Take extra precautions in the hospital or nursing home Many falls occur when patients or residents ...

  3. Older Adults' Perceptions of Fall Detection Devices.

    Science.gov (United States)

    Chaudhuri, Shomir; Kneale, Laura; Le, Thai; Phelan, Elizabeth; Rosenberg, Dori; Thompson, Hilaire; Demiris, George

    2017-08-01

    A third of adults over the age of 65 are estimated to fall at least once a year. Perhaps as dangerous as the fall itself is the time spent after a fall if the person is unable to move. Although there are many devices available to detect when a person has fallen, little is known about the opinions of older adults regarding these fall detection devices (FDDs). We conducted five focus groups with 27 older adults. Transcripts from sessions were coded to generate themes that captured participants' perceptions. Themes were identified that related to two topics of interest: (a) personal influences on the participants' desire to have a FDD, including perceived need, participant values, and cost, and (b) participant recommendations regarding specific features and functionalities of these devices such as automation, wearable versus non-wearable devices, and device customization. Together, these themes suggest ways in which FDDs may be improved so that they are suitable for their intended population.

  4. Siena, 1794: History's Most Consequential Meteorite Fall

    Science.gov (United States)

    Marvin, U. B.

    1995-09-01

    In the mythos of meteoritics, the fall of stones at L'Aigle in Normandy at 1 p. m. on April 26, 1803, is commonly regarded as the event that turned skeptics into believers and opened the way for the new science. A strong case can be made, however, that the fall of stones at Siena at 7:00 p.m. on June 16, 1794, established the authenticity of meteorite falls and set in motion the reexaminations of entrenched beliefs that led to the founding of the new science. The Siena fall was heralded by the appearance of an extraordinarily high, dark cloud emitting smoke, sparks like rockets, and bolts of unusually slow-moving red lightning. With a tremendous explosion a shower of stones, ranging in weight from a few milligrams to 3 kg, fell southeast of Siena. This was the first meteorite fall to occur in the vicinity of a sizeable European city and the first to be witnessed by so many people, including English visitors, that the fall of the stones from the sky could not be denied. It also was the first fall to be seriously investigated by scholars, at several universities in Italy, who collected eye-witness reports and specimens and formulated hypotheses of origin. Their task was greatly complicated by the timing of the fall which occurred 18 hours after Mt. Vesuvius sprang into full eruption. Some believed that the two events were entirely coincidental; others thought that the stones either were ejecta from the volcano (which lay about 320 km to the southeast of Siena) or had consolidated in the fiery masses of dust and ash expelled by the mountain. No explanations seemed entirely satisfactory, but, in an age when the very possibility of falling stones had been decisively ruled out by savants of the Enlightenment, the well-observed fall at Siena opened a new dialog on this subject. The Siena fall occurred only two months after the publication in Riga and Leipzig of Ernst F. F. Chladni's book On the Origin of Ironmasses in which he concluded from historical records that

  5. Effect of free fall on higher plants.

    Science.gov (United States)

    Gordon, S. A.

    1973-01-01

    The influence of exposure to the free-fall state on the orientation, morphogenesis, physiology, and radiation response of higher plants is briefly summarized. It is proposed that the duration of the space-flight experiments has been to brief to permit meaningful effects of free fall on general biochemistry, growth, and development to appear. However, two types of significant effect did occur. The first is on differential growth - i.e., tropism and epinasty - resulting from the absence of a normal geostimulus. For these phenomena it is suggested that ground-based experiments with the clinostat would suffice to mimic the effect of the free-fall state. The second is an apparent interaction between the radiation response and some flight condition, yielding an enhanced microspore abortion, a disturbed spindle function, and a stunting of stamen hairs. It is suggested that this apparent interaction may be derived from a shift in the rhythm of the cell cycle, induced by the free fall.

  6. Falls Among Older Adults: An Overview

    Science.gov (United States)

    ... your feet. Vision problems Foot pain or poor footwear Home hazards or dangers such as broken or ... Can Do to Prevent Falls brochure Check for Safety brochure Postural Hypotension brochure Chair Rise Exercise Related ...

  7. Escaping and Falling into Poverty in India Today.

    Science.gov (United States)

    Thorat, Amit; Vanneman, Reeve; Desai, Sonalde; Dubey, Amaresh

    2017-05-01

    The study examines the dynamic nature of movements into and out of poverty over a period when poverty has fallen substantially in India. The analysis identifies people who escaped poverty and those who fell into it over the period 2005 to 2012. The analysis identifies people who escaped poverty and those who fell into it over the period 2005 to 2012. Using panel data from the India Human Development Survey for 2005 and 2012, we find that the risks of marginalized communities such as Dalits and Adivasis of falling into or remaining in poverty were higher than those for more privileged groups. Some, but not all of these higher risks are explained by educational, financial, and social disadvantages of these groups in 2005. Results from a logistic regression show that some factors that help people escape poverty differ from those that push people into it and that the strength of their effects varies.

  8. 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

  9. 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

  10. 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

  11. Quantifying Temperature Effects on Fall Chinook Salmon

    Energy Technology Data Exchange (ETDEWEB)

    Jager, Yetta [ORNL

    2011-11-01

    The motivation for this study was to recommend relationships for use in a model of San Joaquin fall Chinook salmon. This report reviews literature pertaining to relationships between water temperature and fall Chinook salmon. The report is organized into three sections that deal with temperature effects on development and timing of freshwater life stages, temperature effects on incubation survival for eggs and alevin, and temperature effects on juvenile survival. Recommendations are made for modeling temperature influences for all three life stages.

  12. The effects of proprioceptive neuromuscular facilitation integration pattern exercise program on the fall efficacy and gait ability of the elders with experienced fall.

    Science.gov (United States)

    Song, Hyun-Seung; Park, Seong-Doo; Kim, Jin-Young

    2014-08-01

    The purpose of this study is to investigate the effect of exercising program utilizing proprioceptive neuromuscular facilitation integration pattern (PIP), which is effective in improvement of the physical function, on the fall efficacy and gait ability of the elders who experienced injuries from falls. Also, this study aims to investigate he applicability of exercise program as methods for fall reoccurrence prevention and physical functions enhancement. The subjects of the study were 30 elders in the local community with experience of injuries from falls. The period of the study was 4 weeks with 12 exercise sessions. The subjects were randomly allocated to 2 groups where 15 elders were allocated to PIP and the rest 15 elders were allocated to general exercise (GE) group. Fall efficacy scale (FES) and GAITRite were used for the measurements in this study. Paired t-test was used to analyze the differences within the group while independent t-test was used to analyze the difference between two groups. In the comparison of measurements before and after exercise program, FES, velocity, cadence, and stride length were shown to be significantly increased in both PIP group and GE group. Also, in the comparison between two groups after the exercise program, the measurements of FES, cadence, stride length, and step length in PIP group were shown to be significantly increased compared to the GE group. Therefore, the PNF combined pattern is judged to be applicable to as methods for fall reoccurrence prevention and physical functions enhancement of the elders with experience of being fallen.

  13. Evidence-Based Practice Guideline: Fall Prevention for Older Adults.

    Science.gov (United States)

    Kruschke, Cheryl; Butcher, Howard K

    2017-11-01

    Falls are a major cause of injury and death annually for millions of individuals 65 and older. Older adults are at risk for falls for a variety of reasons regardless of where they live. Falls are defined as any sudden drop from one surface to a lower surface. The purpose of this fall prevention evidence-based practice guideline is to describe strategies that can identify individuals at risk for falls. A 10-step protocol including screening for falls, comprehensive fall assessment, gait and balance screening when necessary, and an individualized fall intervention program addressing specific fall risks is presented. Reassessing fall risk and fall prevention programs will ensure a proactive approach to reducing falls in the aging population. [Journal of Gerontological Nursing, 43(11), 15-21.]. Copyright 2017, SLACK Incorporated.

  14. Falls and depression in older people.

    Science.gov (United States)

    Turcu, Alin; Toubin, Sandrine; Mourey, France; D'Athis, Philippe; Manckoundia, Patrick; Pfitzenmeyer, Pierre

    2004-01-01

    Depression is one of the most common risk factors for falls, but links between falls and depression are still unclear. Few studies have examined the relationship between depression and gait alteration, which may increase the risk of fall. This study aims to assess a possible relationship between depression, postural and gait abnormalities, and falls. We conducted a 1-year prospective study on patients >/=70 years who were admitted to a geriatric unit for 'spontaneous' unexplained falls. Patients were tested for depression using the 30-item Geriatric Depression Scale (GDS). Their motor performances were assessed using the Mini Motor Test (MMT), which is an easy direct-observation test, validated in France, for assessment of frail old people who present with severe postural and gait impairment. This scale is composed of 4 categories of items: (1) abilities in bed; (2) quality of the sitting position; (3) abilities in the standing position, and (4) quality of gait. Sixty-nine patients were included. Depression was found in 46 patients (66.7%). The MMT score was higher in the non-depressed fallers (NDF) group (GDS 10; p predispose to falls. In clinical practice, more attention should be given to old fallers concerning diagnosis and treatment of associated depression. Copyright 2004 S. Karger AG, Basel

  15. Elderly outpatient profile and predictors of falls.

    Science.gov (United States)

    Gomes, Grace Angélica de Oliveira; Cintra, Fernanda Aparecida; Batista, Fernanda Sotelo; Neri, Anita Liberalesso; Guariento, Maria Elena; Sousa, Maria da Luz Rosario de; D'Elboux, Maria José

    2013-01-01

    CONTEXT AND OBJECTIVES Falls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects. DESIGN AND SETTING Cross-sectional descriptive study forming part of the project "Quality of Life of Frail Elderly People", carried out in Campinas, Brazil. METHODS The subjects were 145 elderly individuals (76.3 ± 7.8 years old), of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out. RESULTS Cluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found. CONCLUSIONS The results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  16. Ammonia emissions from deciduous forest after leaf fall

    DEFF Research Database (Denmark)

    Hansen, Kristina; Sørensen, Lise Lotte; Hertel, Ole

    2013-01-01

    The understanding of biochemical feedback mechanisms in the climate system is lacking knowledge in relation to bi-directional ammonia (NH3) exchange between natural ecosystems and the atmosphere. We therefore study the atmospheric NH3 fluxes during a 25-day period during autumn 2010 (21 October...... leaf fall, the magnitude and temporal structure of the measured NH3 emission fluxes could be adequately reproduced with the bi-directional resistance model; it suggested the forest ground layer (soil and litter) to be the main contributing component to the NH3 emissions. The modelled concentration from...

  17. 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

  18. 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...

  19. Quantitative trunk sway and prediction of incident falls in older adults.

    Science.gov (United States)

    Mahoney, Jeannette R; Oh-Park, Mooyeon; Ayers, Emmeline; Verghese, Joe

    2017-10-01

    Poor balance and balance impairments are major predictors of falls. The purpose of the current study was to determine the clinical validity of baseline quantitative static trunk sway measurements in predicting incident falls in a cohort of 287 community-dwelling non-demented older Americans (mean age 76.14±6.82years; 54% female). Trunk sway was measured using the SwayStar™ device, and quantified as angular displacement in degrees in anterior-posterior (pitch) and medio-lateral (roll) planes. Over a one-year follow-up period, 66 elders (23%) reported incident falls. Anterior-posterior angular displacement was a strong predictor of incident falls in older adults in Cox proportional hazards models (hazard ratio adjusted for age, gender, education, RBANS total score, medical comorbidities, geriatric depression scale score, sensory impairments, gait speed, and history of fall in the past 1year ((aHR)=1.59; p=0.033) whereas, angular displacement in the medio-lateral plane was not predictive of falls (aHR=1.35; p=0.276). Our results reveal the significance of quantitative trunk sway, specifically anterior-posterior angular displacement, in predicting incident falls in older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Dysmenorrhea: Painful Periods

    Science.gov (United States)

    ... Search FAQs Dysmenorrhea: Painful Periods Page Navigation ▼ ACOG Pregnancy Book Dysmenorrhea: Painful Periods Patient Education FAQs Dysmenorrhea: Painful Periods Patient Education Pamphlets - Spanish ...

  1. 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.

  2. 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.

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

    Science.gov (United States)

    2009-07-06

    falls could be attributed to weakness or gait disorders; six in patients using assisted devices; two falls related to syncope or seizures; and two...multidisciplinary staff leading initiatives to facilitate innovative, patient - centered approaches to make Hopkins the safest place to receive patient care...Report 3. DATES COVERED (From July 2008 to Jan 2009 To) 4. TITLE AND SUBTITLE Patient Falls Risk Assessment, Neurology Clinic, Johns Hopkins

  4. Above, Beyond, and Over the Side rails: Evaluating the New Memorial Emergency Department Fall-Risk-Assessment Tool.

    Science.gov (United States)

    Scott, Robin A; Oman, Kathleen S; Flarity, Kathleen; Comer, Jennifer L

    2018-03-06

    Patient falls are a significant issue in hospitalized patients and financially costly to hospitals. The Joint Commission requires that patients be assessed for fall risk and interventions in place to mitigate the risk of falls. It is imperative to have a patient population/setting specific fall risk assessment tool to identify patients at risk for falling. The purpose of this study was to evaluate the reliability and validity of the 2013 Memorial ED Fall Risk Assessment tool (MEDFRAT) specifically designed for the ED population. A two-phase prospective design was used for this study. Phase one determined the interrater reliability of the MEDFRAT. Phase two assessed the validity of the MEDFRAT in an emergency department (ED) within a 600-bed academic/teaching institution; Level II Trauma Center with >100,000 annual patient visits. The Memorial ED Fall Risk Assessment Tool was validated in this ED setting. The tool demonstrated positive interrater reliability (k=0.701) and when implemented with a falls prevention strategy and staff education demonstrated a 48% decrease in ED fall rate (0.57 falls/1000 patient visits) post implementation during the study period. The MEDFRAT, an evidenced based ED-specific fall risk tool was implemented on the basis of the risk factors consistently identified in the literature: prior fall history, impaired mobility, altered mental status, altered elimination, and the use of sedative medication. The Memorial ED Fall Risk Assessment Tool demonstrated to be a valid tool for this hospital system. Copyright © 2018 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  5. Cost-effectiveness analysis of screening for risk of in-hospital falls using physiotherapist clinical judgement.

    Science.gov (United States)

    Haines, Terry; Kuys, Suzanne S; Morrison, Greg; Clarke, Jane; Bew, Paul

    2009-04-01

    Screening hospital patients for falls risk is now a contentious component of geriatric care despite its widespread clinical use. The economic implications of using a falls risk screening approach to deliver an effective falls prevention intervention have not previously been examined. This was a multicenter prospective longitudinal cohort and incremental cost-effectiveness analysis. One thousand one hundred twenty-three geriatric inpatients from 17 rehabilitation units across Australia. Physiotherapist accuracy in predicting patient who will fall was captured with the question "Will this patient experience one or more falls during their rehabilitation period?" Falls were measured using hospital incident reporting systems. The multicenter longitudinal cohort was undertaken to establish the predictive accuracy of physiotherapist clinical judgement. This data was used in the incremental cost-effectiveness analysis where estimates of the cost of falls and effectiveness of an intervention program were taken from previous research. The accuracy of physiotherapist clinical judgement in predicting falls was high relative to previous research (sensitivity = 0.61, specificity = 0.82, Youden index = 0.43). Selectively providing patient falls-prevention education using physiotherapist clinical judgement would reduce falls [2.2 (SD: 0.19) fallers per 100 inpatients reduction] and reduce resources spent on trying to prevent and treat injuries from in-hospital falls [$2704 AUD (SD: $432) per 100 inpatients reduction] compared with doing nothing. However, there was greater uncertainty as to whether the patient education intervention modeled should be provided selectively or universally. Preventing in-hospital falls using a targeted falls prevention intervention approach utilizing physiotherapist clinical judgement was more cost-effective than a "no intervention" approach.

  6. The Correlation Between Rates of Falling, Balance, Quality of Life and Fear of Falling in Patients With Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Hamid Azadeh

    2018-04-01

    Conclusion The findings of the present study demonstrated the correlation between balance, physical dimensions of quality of life and fear of falling in patients with stroke; however, the rate of falling has no association with fear of falling.

  7. 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

    and fall history may offer one possibility for inexpensive fall-risk evaluation in clinical practice. INTRODUCTION: We studied if self-reported preclinical mobility limitation predicts future falls in older women with and without fall history. METHODS: The study population consisted of 428 community...... with preclinical mobility limitation had almost 4-fold (incidence rate ratios 3.77; 95% CI 1.02-13.92) and those with manifest mobility limitation almost 15-fold (14.66; 2.72-79.00) adjusted risk for future falls compared to those with no mobility limitation and no previous falls. Among women without fall history......, preclinical and manifest mobility limitation did not predict future falls nor did fall history without mobility limitation. CONCLUSIONS: Already, early signs of mobility decline with history of falls increase the risk of further falls and should be considered as indications for fall prevention interventions....

  8. The Frequency of Falling Elderly and Evaluation of the Behavioral Factors Related to Preventing the Falls

    OpenAIRE

    DURU, Pınar; ÖRSAL, Özlem; ÜNSAL, Alaettin; BALCI ALPARSLAN, Güler

    2015-01-01

    Present study was carried out to determine the frequency of fall in people over the age of 60 years and to evaluate the awareness of and behaviors related to the prevention of fall among elderly people. A total of 724 individuals including 164 elderly people from nursing homes and 560 elderly people living at their home were included in the study group. The “Falls Behavioral Scale for Older People” was used to evaluate the presence or absence of protective behaviors from falls. The frequency ...

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

    Science.gov (United States)

    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.

  10. 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.

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

    OpenAIRE

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

    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 could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke s...

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

    OpenAIRE

    Punt, Michiel; Bruijn, Sjoerd M.; van Schooten, Kimberley S.; Pijnappels, Mirjam; van de Port, Ingrid G.; Wittink, Harriet; van Die?n, Jaap H.

    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 could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke su...

  13. A Method for Estimating Meteorite Fall Mass from Weather Radar Data

    Science.gov (United States)

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

    2017-01-01

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

  14. Same-level fall injuries in US workplaces by age group, gender, and industry.

    Science.gov (United States)

    Scott, Kenneth A; Fisher, Gwenith G; Barón, Anna E; Tompa, Emile; Stallones, Lorann; DiGuiseppi, Carolyn

    2018-02-01

    As the workforce ages, occupational injuries from falls on the same level will increase. Some industries may be more affected than others. We conducted a cross-sectional study using data from the Bureau of Labor Statistics to estimate same-level fall injury incidence rates by age group, gender, and industry for four sectors: 1) healthcare and social assistance; 2) manufacturing; 3) retail; and 4) transportation and warehousing. We calculated rate ratios and rate differences by age group and gender. Same-level fall injury incidence rates increase with age in all four sectors. However, patterns of rate ratios and rate differences vary by age group, gender, and industry. Younger workers, men, and manufacturing workers generally have lower rates. Variation in incidence rates suggests there are unrealized opportunities to prevent same-level fall injuries. Interventions should be evaluated for their effectiveness at reducing injuries, avoiding gender- or age-discrimination and improving work ability. © 2017 Wiley Periodicals, Inc.

  15. Assessment of risk for falls in elderly

    Directory of Open Access Journals (Sweden)

    Stanetić Kosana

    2014-01-01

    Full Text Available Introduction: Elderly persons have higher risk for falls, compared to younger population. Although no single risk factor causes all falls, a great deal of risk factors to which an individual is exposed, i.e. osteoporosis, lack of physical activity, impaired vision, usage of drugs, living settings etc, can be treated. Objective: To investigate the risk for falls in elderly patients treated in Family medicine teaching center (ECPM, Primary Health Care Center Banja Luka. Method: This prospective study was conducted in June 2012. The study included 150 patients aged 65 years and older. Patients were chosen randomly. In study were included patients who have visited their family doctors on every of Mondays in June 2012. The Tinetti Gait and Balance Instrument was used to asses the risk for falls. Patients were examined to asses gait and balance according to Tinetti questionnaire, and supplementary questionnaire was created to record data about age, sex, chronic diseases and drugs that patients take. Results: The study included 91 (60.7% female and 59 (39.3% male patients. The average age of patients was 74.71 years. 77 (51.3% were aged 65 to 75 years and 73 (48.7% were more than 75 years old. Results of Tinetti Gait and Balance Instrument showed that the risk for falls was high in 55 (36.7%, moderate in 31 (20.7% and low in 64 (42.7% patients. Conclusion: Approximately, one third of investigated patients had high risk for falls, what indicates that family doctors should be more involved in fall prevention in elderly and in constant educating of older adults and their families.

  16. Pediatric falls from buildings: defining the burden of injury in Hawai'i.

    Science.gov (United States)

    Sarkar, Joy; Wolfe, Stacey Q; Speck, Cora; Woods, Elizabeth; Lustik, Michael B; Edwards, Kurt D; Edwards, Mary J

    2014-05-01

    Falls from buildings, including houses, are an important cause of childhood injury in the United States; however, no study has previously examined the impact of this problem in Hawai'i. The objective of this study is to categorize the demographics and injury circumstances of pediatric falls from buildings in Hawai'i and compare to other US cities. Patients age 10 and under who were injured in nonfatal accidental falls from buildings in Hawai'i between 2005 and 2011 were identified retrospectively from a statewide repository of hospital billing data. The Hawai'i death certificate database was searched separately for deaths in children age 10 and under due to falls from buildings, with data available from 1991 through 2011. Data was reviewed for demographics, circumstances surrounding the injury, and level of hospital treatment. During the 7-year period for nonfatal injuries, 416 fall-related injuries were identified in children age 10 and younger. Of these, 86 required hospitalization. The rate of nonfatal injury in Hawai'i County was twice that of Honolulu and Maui Counties, and three times that of Kaua'i County. There were 9 fatal falls over a 21-year period. The population based incidence for nonfatal injuries was three-fold higher than that reported in the city of Dallas. The rate of hospitalizations following building falls was more than twice as high as the national average, and that of New York City, but similar to that of California. Strategies for education and environmental modification are reviewed, which may be helpful in reducing the incidence of pediatric falls from buildings in Hawai'i.

  17. Implementing a Pediatric Fall Prevention Policy and Program.

    Science.gov (United States)

    Murray, Elizabeth; Vess, Joy; Edlund, Barbara J

    2016-01-01

    Preventing patient falls begins with an accurate assessment of a patient's risk of falling followed by the initiation and continued evaluation of a fall prevention program based on patient-specific identified risks. Children have a normal tendency to fall based on developmental growth, and each child is different in physical and cognitive abilities. Falls may occur both in and out of the hospital setting. Prevention programs that have revealed the most favorable restuls include the use of a validated fall risk assessment tool. The Humpty Dumpty fall Scale is a screening tool specifically developed for pediatric patients to assess risk for fall. This project developed a pediatric fall prevention policy and implemented an inpatient pediatric fall prevention program. Pediatric staff contributed to the development of this policy and program by providing feedback, support, and cooperation, which was instrumental in the success of this program resulting in no falls after implementation.

  18. Considerations on comprehensive risk assessment and mitigation planning of volcanic ash-fall

    International Nuclear Information System (INIS)

    Toshida, Kiyoshi

    2010-01-01

    Volcanic ash-fall is inevitable hazard throughout Japan, and causes wide range of effects due to its physical and chemical properties. Nuclear power plants in Japan face the necessity to assess the risk from volcanic ash-fall. Risk assessment of the volcanic ash-fall should include engineering solution and mitigation planning as well as the ash-fall hazard. This report points out the characteristics for reducing the various effects of volcanic ash-fall as follows. Large-scale eruptions produce prominent volcanic ash-falls that can approach power plants at a great distance. Aftermath hazards of ash-fall events, such as remobilization of fine ash particles and generation of lahars, require further assessments. The kind and extent of damages becomes greater whenever ash is wet. Wet ash requires separate assessments in contrast to dry ash. The mitigation and recovery measures at power plants involve quick cleanup operations of volcanic ash. Those operations should be prepared through comprehensive risk assessment, and by cooperation with authorities, during pre-eruption repose period. The comprehensive assessment for volcanic ash-fall hazards, however, has yet to be conducted. Development of risk communication method may result in increased implementation mitigation planning. Numerical analysis of the ash-fall hazards provides quantitative data on particle motions that can be used in the risk assessment. In order to implement the quantitative assessment method, the verification on the effect of ambient air condition to the altitude of volcanic ash cloud is necessary. We need to develop a three-dimensional model of volcanic ash cloud, and calculate motions of ash clouds under multiple conditions of ambient air. (author)

  19. Brain white matter hyperintensities, executive dysfunction, instability, and falls in older people: a prospective cohort study.

    Science.gov (United States)

    Zheng, Jacqueline J J; Lord, Stephen R; Close, Jacqueline C T; Sachdev, Perminder S; Wen, Wei; Brodaty, Henry; Delbaere, Kim

    2012-10-01

    White matter hyperintensities (WMHs) are associated with fall risk factors in older people including reduced cognitive functioning and impaired balance and gait. This prospective study investigated relationships between WMHs, sensorimotor performance, executive functioning, and falls in a large sample of community-living older people. Two hundred and eighty-seven community-dwelling people aged 70-90 years, underwent structural magnetic resonance imaging and assessments of executive function (Trail-Making Tests), sensorimotor performance (Physiological Profile Assessment), and prospective monitoring of falls. Total WMH volume was quantified using an automated method. Fallers were defined as people who had at least one injurious or two noninjurious falls during the 12-month follow-up period. Participants with severe WMH burden (WMH volumes as a percentage of intracranial volume in the fourth quartile) performed poorly in the Trail-Making Test and Physiological Profile Assessment (p falls during the 12-month follow-up (relative risk = 1.63, 95% confidence interval 1.11-2.40). The association between WMHs and falls was little changed after adjusting for Trail-Making Test and Physiological Profile Assessment scores, age, sex, education, and a range of cardiovascular risk factors (relative risk = 1.55, 95% confidence interval 1.06-2.26). Greater WMH burden predicts falls over 12 months, and the association between greater burden of WMHs and falls appears to be independent of reduced executive function and sensorimotor performance. Strategies to reduce the development and progression of WMHs may contribute to future falls prevention in older people.

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

    Science.gov (United States)

    Stone, Carol A; Lawlor, Peter G; Savva, George M; Bennett, Kathleen; Kenny, Rose Anne

    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. Patients admitted consecutively to community and inpatient palliative care services with metastatic or locoregionally advanced cancer who were mobile without assistance were recruited. Risk-factor assessment was conducted on initial encounter. Patients underwent follow-up via weekly telephone contact for 6 months or until time of fall or death. Relationship between covariates and time to fall was examined using hazard ratios (HRs) derived from univariate and multivariate Cox proportional hazards models. Of 185 participants (52.4% men; mean age 68 ± standard deviation of 12.6 years), 50.3% fell; 35 (53%) of 66 participants age falls occurred in the community; 42% resulted in injury. Median time to fall was 96 days (95% CI, 64.66 to 127.34). Primary brain tumor or brain metastasis (HR 2.5; P = .002), number of falls in the preceding 3 months (HR, 1.27; P = .005), severity of depression (HR, 1.12; P = .012), benzodiazepine dose (HR, 1.05; P = .004), and cancer-related pain (HR, 1.96; P = .024) were independently associated with time to fall in multivariate analysis. Fifty percent of adults with advanced cancer, regardless of age, will experience a fall associated with high risk of physical injury. There is a compelling need to assess the efficacy of assessment and management of modifiable fall risk factors in patients with advanced cancer.

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

    Science.gov (United States)

    Punt, Michiel; Bruijn, Sjoerd M; van Schooten, Kimberley S; Pijnappels, Mirjam; van de Port, Ingrid G; Wittink, Harriet; van Dieën, Jaap H

    2016-07-27

    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 could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke survivors, or if modifications are needed, either in the cut-off values of such models, or in the gait characteristics of interest. This study investigated gait characteristics by assessing accelerations of the lower back measured during seven consecutive days in 31 non fall-prone stroke survivors, 25 fall-prone stroke survivors, 20 neurologically intact fall-prone older adults and 30 non fall-prone older adults. We created a binary logistic regression model to assess the ability of predicting falls for each gait characteristic. We included health status and the interaction between health status (stroke survivors versus older adults) and gait characteristic in the model. We found four significant interactions between gait characteristics and health status. Furthermore we found another four gait characteristics that had similar predictive capacity in both stroke survivors and older adults. The interactions between gait characteristics and health status indicate that gait characteristics are differently associated with fall history between stroke survivors and older adults. Thus specific models are needed to predict fall risk in stroke survivors.

  2. Accidents due to falls from roof slabs.

    Science.gov (United States)

    Rudelli, Bruno Alves; Silva, Marcelo Valerio Alabarce da; Akkari, Miguel; Santili, Claudio

    2013-01-01

    CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. METHODS Data were collected from 29 cases of falls from roof slabs involving children and adolescents between October 2008 and October 2009. RESULTS Cases involving males were more prevalent, accounting for 84%. The predominant age group was schoolchildren (7 to 12 years old; 44%). Leisure activities were most frequently being practiced on the roof slab at the time of the fall (86%), and flying a kite was the most prevalent game (37.9%). In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places.

  3. Accidents due to falls from roof slabs

    Directory of Open Access Journals (Sweden)

    Bruno Alves Rudelli

    Full Text Available CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. METHODS Data were collected from 29 cases of falls from roof slabs involving children and adolescents between October 2008 and October 2009. RESULTS Cases involving males were more prevalent, accounting for 84%. The predominant age group was schoolchildren (7 to 12 years old; 44%. Leisure activities were most frequently being practiced on the roof slab at the time of the fall (86%, and flying a kite was the most prevalent game (37.9%. In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places.

  4. Elderly outpatient profile and predictors of falls

    Directory of Open Access Journals (Sweden)

    Grace Angélica de Oliveira Gomes

    Full Text Available CONTEXT AND OBJECTIVESFalls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects.DESIGN AND SETTINGCross-sectional descriptive study forming part of the project “Quality of Life of Frail Elderly People”, carried out in Campinas, Brazil.METHODSThe subjects were 145 elderly individuals (76.3 ± 7.8 years old, of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out.RESULTSCluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found.CONCLUSIONSThe results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

  5. Detection and Prevention of Seniors Falls

    Directory of Open Access Journals (Sweden)

    Lubomír MACKŮ

    2016-11-01

    Full Text Available The paper deals with the issue of seniors’ security and safety, namely the security problems related to falls of independently living elderly citizens. The number of elderly people is growing very fast worldwide and very often they live unattended in their house or flat. In case of accidently falling down, they are often unable help themselves and stay on the floor for hours or even longer. This may lead even to the death if no help comes. Various possibilities of their fall detection are studied. We analyze the historical development, current capabilities and efficiency of different approaches and methods. We address the willingness and ability of seniors to actively use technology, detection limits, privacy, personal data security and other important factors. In addition, we discuss the challenges, current shortcomings, issues and trends in fall detection or operation reliability in real-life conditions. The main future goal would be to maintain the personal privacy and security of irrelevant information in modern fall detection systems.

  6. Stick balancing, falls and Dragon-Kings

    Science.gov (United States)

    Cabrera, J. L.; Milton, J. G.

    2012-05-01

    The extent to which the occurrence of falls, the dominant feature of human attempts to balance a stick at their fingertip, can be predicted is examined in the context of the "Dragon-King" hypothesis. For skilled stick balancers, fluctuations in the controlled variable, namely the vertical displacement angle θ, exhibit power law behaviors. When stick balancing is made less stable by either decreasing the length of the stick or by requiring the subject to balance the stick on the surface of a table tennis racket, systematic departures from the power law behaviors are observed in the range of large θ. This observation raises the possibility that the presence of departures from the power law in the large length scale region, possibly Dragon-Kings, may identify situations in which the occurrence of a fall is more imminent. However, whether or not Dragon-Kings are observed, there is a Weibull-type survival function for stick falling. The possibility that increased risk of falling can, at least to some extent, be predicted from fluctuations in the controlled variable before the event occurs has important implications for the development of preventative strategies for the management of phenomena ranging from earthquakes to epileptic seizures to falls in the elderly.

  7. Older people's perception of and coping with falling, and their motivation for fall-prevention programmes

    DEFF Research Database (Denmark)

    Høst, Dorte; Hendriksen, Carsten; Borup, Ina

    2011-01-01

    This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes.......This study aims to investigate older people's perceptions of and coping with falls, and what motivates them to join such programmes....

  8. Martial arts fall techniques decrease the impact forces at the hip during sideways falling.

    NARCIS (Netherlands)

    Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.E.J.

    2007-01-01

    Falls to the side and those with impact on the hip are risky for hip fractures in the elderly. A previous study has indicated that martial arts (MA) fall techniques can reduce hip impact force, but the underlying mechanism is unknown. Furthermore, the high impact forces at the hand used to break the

  9. The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre-post implementation study in the U.S.

    Science.gov (United States)

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

    2016-08-01

    Falls are a major public health problem internationally. Many hospitals have implemented fall risk assessment tools, but few have implemented interventions to mitigate patient-specific fall risks. Little research has been done to examine the effect of implementing evidence-based fall prevention interventions to mitigate patient-specific fall risk factors in hospitalized adults. To evaluate the impact of implementing, in 3 U.S. hospitals, evidence-based fall prevention interventions targeted to patient-specific fall risk factors (Targeted Risk Factor Fall Prevention Bundle). Fall rates, fall injury rates, types of fall injuries and adoption of the Targeted Risk Factor Fall Prevention Bundle were compared prior to and following implementation. A prospective pre-post implementation cohort design. Thirteen adult medical-surgical units from three community hospitals in the Midwest region of the U.S. Nurses who were employed at least 20hours/week, provided direct patient care, and licensed as an RN (n=157 pre; 140 post); and medical records of patients 21years of age or older, who received care on the study unit for more than 24hours during the designated data collection period (n=390 pre and post). A multi-faceted Translating Research Into Practice Intervention was used to implement the Targeted Risk Factor Fall Prevention Bundle composed of evidence-based fall prevention interventions designed to mitigate patient-specific fall risks. Dependent variables (fall rates, fall injury rates, fall injury type, use of Targeted Risk Factor Fall Prevention Bundle) were collected at baseline, and following completion of the 15month implementation phase. Nurse questionnaires included the Stage of Adoption Scale, and the Use of Research Findings in Practice Scale to measure adoption of evidence-based fall prevention practices. A Medical Record Abstract Form was used to abstract data about use of targeted risk-specific fall prevention interventions. Number of falls, and number and

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

    Science.gov (United States)

    Xie, Y.; Wilson, A. M.

    2017-12-01

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

  11. Elderly fall detection using SIFT hybrid features

    Science.gov (United States)

    Wang, Xiaoxiao; Gao, Chao; Guo, Yongcai

    2015-10-01

    With the tendency of aging society, countries all over the world are dealing with the demographic change. Fall had been proven to be of the highest fatality rate among the elderly. To realize the elderly fall detection, the proposed algorithm used the hybrid feature. Based on the rate of centroid change, the algorithm adopted VEI to offer the posture feature, this combined motion feature with posture feature. The algorithm also took advantage of SIFT descriptor of VEI(V-SIFT) to show more details of behaviors with occlusion. An improved motion detection method was proposed to improve the accuracy of front-view motion detection. The experimental results on CASIA database and self-built database showed that the proposed approach has high efficiency and strong robustness which effectively improved the accuracy of fall detection.

  12. Falls study: Proprioception, postural stability, and slips.

    Science.gov (United States)

    Sohn, Jeehoon; Kim, Sukwon

    2015-01-01

    The present study evaluated effects of exercise training on the proprioception sensitivity, postural stability, and the likelihood of slip-induced falls. Eighteen older adults (6 in balance, 6 in weight, and 6 in control groups) participated in this study. Three groups met three times per week over the course of eight weeks. Ankle and knee proprioception sensitivities and postural stability were measured. Slip-induced events were introduced for all participants before and after training. The results indicated that, overall, strength and postural stability were improved only in the training group, although proprioception sensitivity was improved in all groups. Training for older adults resulted in decreased likelihood of slip-induced falls. The study suggested that proprioception can be improved by simply being active, however, the results suggested that training would aid older adults in reducing the likelihood of slip-induced falls.

  13. Electrostatic demonstration of free-fall weightlessness

    Science.gov (United States)

    Balukovic, Jasmina; Slisko, Josip; Corona Cruz, Adrian

    2015-05-01

    The phenomena of free-fall weightlessness have been demonstrated to students for many years in a number of different ways. The essential basis of all these demonstrations is the fact that in free-falling, gravitationally accelerated systems, the weight force and weight-related forces (for example, friction and hydrostatic forces) disappear. In this article, an original electrostatic demonstration of weightlessness is presented. A charged balloon fixed at the opening of a plastic container cannot lift a light styrofoam sphere sitting on the bottom when the container is at rest. However, while the system is in free-fall, the sphere becomes weightless and the charged balloon is able to lift it electrostatically.

  14. Maxillofacial Trauma Following Road Accidents and Falls.

    Science.gov (United States)

    Einy, Shmuel; Abdel Rahman, Nura; Siman-Tov, Maya; Aizenbud, Dror; Peleg, Kobi

    2016-06-01

    Motor vehicle accidents (MVA) and falls are major causes of maxillofacial injuries posing real challenges for the medical staff. To describe the demographic and injury characteristics, as well as the treatment procedures of casualties diagnosed with maxillofacial injuries. The investigators implemented a multicenter retrospective study composed of hospitalized maxillofacial trauma patients recorded in the Israel Trauma Registry for 2000 to 2011. The predictor variable was mechanism of injury and the outcome variable was type of injury, severity, and hospital resources utilization. Descriptive and bivariate statistics with P values was set at 0.05. The study included 11,592 reported hospitalized maxillofacial trauma patients (39.4% of them were MVA, 33.5% were falls), with a male predominance of a 3:1 ratio. The high-risk age groups were the first 3 decades of life in both etiologies, while age groups above 75 years were also frequent in falls. Severity of maxillofacial injuries, multiple injuries, admission to intensive care units, hospitalization for more than 15 days, inpatient mortality, and rehabilitation after discharge was significantly higher in MVA compared with falls. Conversely, maxillofacial surgeries were performed slightly more among patients injured in falls (34.1% and 31.1% respectively), as tongue and mouth are more prone targets in falls, compared with zygoma, maxilla, mandible, and teeth in MVA. The results of this study suggest that the etiologies present an entire separate pattern of trauma. A better understanding and proper identification of their high-risk groups should lead to appropriate prevention programs and treatment protocols.

  15. Nocturia Is Associated with Slipping and Falling.

    Directory of Open Access Journals (Sweden)

    So Young Kim

    Full Text Available Several reports have demonstrated associations between falls and nocturia in the elderly. However, little information is available regarding other age groups. This study evaluated the relationship between the frequency of nocturia and falls in men using a large, population-based survey in Korea, and the results were adjusted for various confounding factors. Data from a 2011 Korean community health survey (KCHS were retrieved for 92,660 men aged 19 to 103 years. Information regarding the history of slips or falls in the past year was collected. The frequency of nocturia was classified as 0, 1, 2, 3, 4, and ≥ 5 instances a night. Walking during the day, education, income, body mass index (BMI, smoking, alcohol consumption, sleep time, stress level and medical histories of hypertension, diabetes mellitus, hyperlipidemia, cerebral stroke, angina or myocardial infarction, arthritis, and osteoporosis were adjusted using multiple logistic regression analysis with complex sampling. A subgroup analysis was conducted for young (19-30 years, middle-aged (31-60 years, and elderly individuals (61+ years. Approximately 14.6% of the men had a history of falls. Their mean age was 42.9 years, which was significantly higher than that of the non-faller group (P < 0.001. An increased frequency of nocturia was associated with increased adjusted odds ratio (AOR for falls (AOR for 1 instance of nocturia/night = 1.41 [95% confidence interval, 1.33-1.50]; AOR for 2 instances = 1.41 [1.33-1.50]; AOR for 3 instances = 2.00 [1.75-2.28]; AOR for 4 instances = 2.12 [1.73-2.61]; AOR for ≥ 5 instances = 2.02 [1.74-2.36], P < 0.001. In the subgroup analysis, the AORs for falls significantly increased in all age groups as the frequency of nocturia increased.

  16. Retrospective analysis of free-fall fractures with regard to height and cause of fall.

    Science.gov (United States)

    Petaros, Anja; Slaus, Mario; Coklo, Miran; Sosa, Ivan; Cengija, Morana; Bosnar, Alan

    2013-03-10

    Free-fall fractures represent a specific form of blunt force trauma that can be hard to interpret because of the numerous factors that affect it. The aim of this study is to focus on skeletal injury patterns resulting from free-falls and to analyse the relationship between specific skeletal fractures, and the height and cause (accidental vs. suicidal) of the fall. A total of 179 autopsy reports of fatal free-falls from known heights were analysed at the Department of Forensic Medicine and Criminalistics, in Rijeka, Croatia. The location, type and frequency of fractures, as well as the number and distribution of fractured regions were analysed with regard to height and cause of fall. Height was found to be the major factor influencing fracture patterns in free-falls. In our sample, the frequencies of thoracic fractures, fractures to the extremities and those to the pelvis increased with height. Head fractures show no such relationship. However, types of fractures recorded in different anatomical regions, including the cranium, differ between height groups suggesting different injury mechanisms in each. Victims of falls generally sustained fractures in more than one body region, and the number of injured regions correlates significantly with height. Although no statistical difference was found in the number of fractured regions or frequency of fractures between accidental fallers and suicidal jumpers, jumpers showed a significantly higher number of bilateral extremity fractures when compared to victims of accidental falls. Logistic regression analyses also demonstrate a significant relationship between lower extremity fractures, and the cause of the fall. Our results highlight the need for further investigations of the influence that behaviour and height have in free-fall fractures. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Relapse of polymyalgia rheumatica after a fall.

    Science.gov (United States)

    Manzo, Ciro; Natale, Maria

    2017-01-01

    Approximately half of PMR patients have a relapse with a necessity to increase GC dosages. The role of external factors in inducing PMR relapse have been poorly investigated. We present a case-series of five PMR patients in remission with low doses of glucocorticosteroids (GC), who presented with relapse immediately after a fall. The assessment of PMR relapse was made using PMR-AS by Leeb and Bird, and a score > 9.35 was consistent with diagnosis of relapse. Gender, age, and cumulative dose of GC at the time of the fall were compared between the group of these five patients and a group of 41 PMR patients who had no PMR relapse after a fall: using the Fischer's exact test a significant difference was pointed out when the p-value was < 0.05. In our five PMR patients, the sharp worsening of clinical manifestations was always accompanied by a significant rise of the inflammatory indices and the increase of GC dosage (almost always 10 mg/day of prednisone) prompted a fast return (seven days as average) to the previous clinical and laboratory features. All other potentially responsible factors were excluded. Several months (6-10 months on average) after the fall, none of these five patients had a new relapse. No significant differences were found when we compared age, sex, and the cumulative dose of GC at the time of the fall between the group of patients with PMR relapse and the group of patients without. The possibility of PMR relapse being realised immediately after a fall should be kept in mind in daily practice, especially when typical manifestations reappear immediately after a fall and other diagnostic hypotheses have been carefully excluded. The lack of important data (genetic factors, hormonal dosages, serum levels of IL-6 and/or serum soluble IL-6 receptor) in our case-series represented important limits for clarifying the nature of our observations and should be included in any subsequent study design on this argument. If our monocentric data are confirmed by

  18. Seismic isolation of two dimensional periodic foundations

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Y.; Mo, Y. L., E-mail: yilungmo@central.uh.edu [University of Houston, Houston, Texas 77004 (United States); Laskar, A. [Indian Institute of Technology Bombay, Powai, Mumbai (India); Cheng, Z.; Shi, Z. [Beijing Jiaotong University, Beijing (China); Menq, F. [University of Texas, Austin, Texas 78712 (United States); Tang, Y. [Argonne National Laboratory, Argonne, Illinois 60439 (United States)

    2014-07-28

    Phononic crystal is now used to control acoustic waves. When the crystal goes to a larger scale, it is called periodic structure. The band gaps of the periodic structure can be reduced to range from 0.5 Hz to 50 Hz. Therefore, the periodic structure has potential applications in seismic wave reflection. In civil engineering, the periodic structure can be served as the foundation of upper structure. This type of foundation consisting of periodic structure is called periodic foundation. When the frequency of seismic waves falls into the band gaps of the periodic foundation, the seismic wave can be blocked. Field experiments of a scaled two dimensional (2D) periodic foundation with an upper structure were conducted to verify the band gap effects. Test results showed the 2D periodic foundation can effectively reduce the response of the upper structure for excitations with frequencies within the frequency band gaps. When the experimental and the finite element analysis results are compared, they agree well with each other, indicating that 2D periodic foundation is a feasible way of reducing seismic vibrations.

  19. 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.

  20. Biomedical engineering for healthy ageing. Predictive tools for falls

    OpenAIRE

    Palumbo, Pierpaolo

    2015-01-01

    Falls are common and burdensome accidents among the elderly. About one third of the population aged 65 years or more experience at least one fall each year. Fall risk assessment is believed to be beneficial for fall prevention. This thesis is about prognostic tools for falls for community-dwelling older adults. We provide an overview of the state of the art. We then take different approaches: we propose a theoretical probabilistic model to investigate some properties of prognostic tools fo...

  1. Absent menstrual periods - secondary

    Science.gov (United States)

    Amenorrhea - secondary; No periods - secondary; Absent periods - secondary; Absent menses - secondary; Absence of periods - secondary ... Secondary amenorrhea can occur due to natural changes in the body. For example, the most common cause of secondary ...

  2. Fall-risk screening test : a prospective study on predictors for falls in community-dwelling elderly

    NARCIS (Netherlands)

    Tromp, A M; Pluijm, S M; Smit, J H; Deeg, D J; Bouter, L M; Lips, P

    This large prospective cohort study was undertaken to construct a fall-risk model for elderly. The emphasis of the study rests on easily measurable predictors for any falls and recurrent falls. The occurrence of falls among 1285 community-dwelling elderly aged 65 years and over was followed during 1

  3. Fear of falling and falls in people with Parkinson's disease treated with deep brain stimulation in the subthalamic nuclei.

    Science.gov (United States)

    Nilsson, M H; Rehncrona, S; Jarnlo, G-B

    2011-06-01

    No previous study prospectively investigated the effects of subthalamic deep brain stimulation on fear of falling (FOF) and falls. The aim was to prospectively explore whether FOF and fall rate were affected after STN stimulation in people with Parkinson's disease (PD). Twenty participants (mean age: 65, SD 6.4) were included. Falls and near falls were recorded (fall diary) during 3 months before and 1 year after surgery. FOF was evaluated using the Falls-Efficacy Scale, Swedish version, FES(S), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE). After surgery, the FES(S) scores of complex activities improved (P=0.026), i.e. median 34 (q1-q3, 26-50) vs 43 (32-55). SAFFE scores also improved (P=0.007): median 25 (22-30) versus 22 (18-27). The rate of near falls decreased (P=0.014). Nine participants reported no near falls. For the remaining ten participants, the median near fall rate decreased from 6 (3-17) to 2 (1-8). The rate of falls showed no significant (P>0.3) difference. After surgery, fewer activities were avoided owing to the risk of falling, and fall-related self-efficacy had improved during complex activities. The rate of near falls decreased. The results cannot support any change in fall rate. © 2010 John Wiley & Sons A/S.

  4. Health-related quality of life, handgrip strength and falls during detraining in elderly habitual exercisers.

    Science.gov (United States)

    Esain, Izaro; Rodriguez-Larrad, Ana; Bidaurrazaga-Letona, Iraia; Gil, Susana María

    2017-11-21

    The effects of regular exercise on physical functioning and health-related quality of life (HRQOL) have been thoroughly studied. In contrast, little is known about the changes which occur following cessation of activity (detraining). Here, we have investigated the effect of a 3 month detraining period on HRQOL and on handgrip strength in elderly people who had regularly exercised, and examined the association of these variables with falls. Thirty-eight women and 11 men (mean age, 75.5±5.7 years) took part in a supervised physical exercise program for 9 months, followed by a 3 month detraining period. Participants completed the SF-36 HRQOL questionnaire at the beginning of detraining (baseline) and 3 months later. Handgrip strength and number of falls were also recorded. Participants had been exercising for 12.1±8.7 years. After the detraining period, we found a significant (p detraining period, 18.4% participants had a fall incident. HRQOL declined in both fallers and non-fallers during detraining. Interestingly, fallers already had at baseline significantly lower values in physical functioning (p detraining period, particularly in women. In contrast, strength of the upper limb was not affected by the detraining. The prior lower HRQOL values of those who will subsequently fall suggest that this criterion should be studied as a candidate risk factor for falls. Efforts should be made to encourage the elderly to continue with exercise activities and/or to shorten holiday break periods, in order to maintain their quality of life. The protocol was registered as a clinical trial in the ANZCTR (trial ID: ACTRN12617000716369 ).

  5. Falls and comorbid conditions among community dwelling Arkansas older adults from a population-based survey.

    Science.gov (United States)

    George, Masil; Azhar, Gohar; Kilmer, Greta; Miller, Sabra; Bynum, LaTonya; Balamurugan, Appathurai

    2014-12-01

    The prevalence of self-reported falls and associated comorbid conditions among community dwelling Arkansas older adults (ages 65 years and older) was estimated using data from the 2010 Behavioral Risk Factor Surveillance System survey. 1,653 Arkansas older adults were surveyed. Eighteen percent of them had sustained a fall at least once in the past three months prior to the survey period. After adjusting for age, general health, coronary heart disease, diabetes status and quality rest or sleep in a multinomial logistic regression, we found that older adults with visual impairment (OR = 1.47; 95% CI: 1.02, 2.12), and those who use special equipment (OR = 2.85; 95% CI: 1.94, 4.19) were more likely to have sustained a fall. An integrated multidisciplinary approach in caring for older adults is imperative for preventing falls and fall-related injuries. This can also reduce-fall-related hospitalizations and potentially result in substantial cost savings as well as improve the quality of life of older Arkansans.

  6. Using a laser measurement system for monitoring morphological changes on the Strug rock fall, Slovenia

    Directory of Open Access Journals (Sweden)

    M. Mikoš

    2005-01-01

    Full Text Available A medium-ranged high performance handheld reflectorless laser measurement system, was used for a morphological survey on the Strug rock fall in W Slovenia in the period from August 2003 to August 2004. The purpose was to evaluate its potential for monitoring ground surface changes in rock fall source areas and to help evaluating morphological changes by measuring distance from fixed points. In the area, 21 fixed geodetic points have been established. Altogether, seven measurement sets with more than 5500 points have been gathered in the rock fall area. Choosing a point cloud with a density of less than 1 point per 10m2 on a very rough rock fall surface failed to be a good solution. The changes on larger areas were shown by displacements of selected significantly large-sized rock blocks with a volume of several m3. Because only smaller changes were observed between the single field series, the rock fall surface generally remained unchanged. Local surface changes of the order of 1 m or more, were clearly shown by measurements in the selected referenced cross sections. The usage of these cross sections gave a possibility to evaluate volumetric changes on the surface. The laser measurement system provided a good replacement for the classical terrestrial geodetic survey equipment, especially when performing remote monitoring of morphological changes in rock fall hazard zones, however, the case is different when fixed points are to be measured precisely.

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

    Directory of Open Access Journals (Sweden)

    Francesco Barban

    2017-02-01

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

  8. Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury?

    Directory of Open Access Journals (Sweden)

    Fabio Roccia

    2014-12-01

    Full Text Available Objectives: In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall. Material and Methods: Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF, loss of consciousness (LOCF, stairs (SAF, and height (HF. Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS, facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed. Results: This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]. In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5% followed by LOCF (157; 28.2%, HF (55; 9.9%, and SAF (30; 5.4%. The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF. Conclusions: This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.

  9. A wavelet-based approach to fall detection.

    Science.gov (United States)

    Palmerini, Luca; Bagalà, Fabio; Zanetti, Andrea; Klenk, Jochen; Becker, Clemens; Cappello, Angelo

    2015-05-20

    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.

  10. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  11. Montana Advanced Biofuels Great Falls Approval

    Science.gov (United States)

    This November 20, 2015 letter from EPA approves the petition from Montana Advanced Biofuels, LLC, Great Falls facility, regarding ethanol produced through a dry mill process, qualifying under the Clean Air Act for advanced biofuel (D-code 5) and renewable

  12. Anode Fall Formation in a Hall Thruster

    International Nuclear Information System (INIS)

    Dorf, Leonid A.; Raitses, Yevgeny F.; Smirnov, Artem N.; Fisch, Nathaniel J.

    2004-01-01

    As was reported in our previous work, accurate, nondisturbing near-anode measurements of the plasma density, electron temperature, and plasma potential performed with biased and emissive probes allowed the first experimental identification of both electron-repelling (negative anode fall) and electron-attracting (positive anode fall) anode sheaths in Hall thrusters. An interesting new phenomenon revealed by the probe measurements is that the anode fall changes from positive to negative upon removal of the dielectric coating, which appears on the anode surface during the course of Hall thruster operation. As reported in the present work, energy dispersion spectroscopy analysis of the chemical composition of the anode dielectric coating indicates that the coating layer consists essentially of an oxide of the anode material (stainless steel). However, it is still unclear how oxygen gets into the thruster channel. Most importantly, possible mechanisms of anode fall formation in a Hall thruster with a clean and a coated anodes are analyzed in this work; practical implication of understanding the general structure of the electron-attracting anode sheath in the case of a coated anode is also discussed

  13. Engineering and Technician Enrollments--Fall 1969.

    Science.gov (United States)

    Engineers Joint Council, New York, NY. Engineering Manpower Commission.

    Engineering and technician enrollments for Fall 1969 are reported for associate and bachelor's degree programs in engineering technology and industrial technology, and for engineering degrees at the bachelor's, master's, and doctor's levels. Statistical tables were produced by a computer analysis of data from 269 engineering schools and 558 other…

  14. A new view on falling aprons

    NARCIS (Netherlands)

    Verhagen, H.J.; Van der Hoeven, M.; Thiel, B.

    2003-01-01

    In a flume of BallastHam Dredging a falling apron model has been constructed and loaded by current. The tests have been done with different rock sizes, different layer thickness of the top storage of the apron and two different gradings. In summary it was found that for both the narrow graded rock

  15. Artists Paint ... Fall: Grades K-1

    Science.gov (United States)

    Herberholz, Barbara

    2012-01-01

    Artists often paint the different seasonal activities people engage in and the way the world looks as changes take place. The weather for each of the four seasons is different. Farmers plant crops and gardens in the spring and harvest their crops in the fall, just like "The Harvesters" by Pieter Bruegel the Elder. To begin, children will observe…

  16. Protect the Ones You Love From Falls

    Centers for Disease Control (CDC) Podcasts

    2008-12-10

    This podcast, developed as part of the Protect the Ones You Love initiative, discusses steps parents can take to help protect their children from falls, one of the leading causes of child injury.  Created: 12/10/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 12/10/2008.

  17. Milestones in gait, balance, and falling

    NARCIS (Netherlands)

    Nutt, J.G.; Horak, F.B.; Bloem, B.R.

    2011-01-01

    Gait, balance, and falls have become increasingly common topics of published articles in the Movement Disorders journal since its launch in 1986. This growth represents an increasing awareness of the importance of mobility to patients' quality of life. New methods have become available that allow

  18. [Subdural hygroma after falling down a staircase

    NARCIS (Netherlands)

    Wel, M.C. van der; Lammers, G.J.; Buchem, M.A. van; Olde Rikkert, M.G.M.; Bloem, B.R.

    2007-01-01

    An 80-year-old man was admitted because of head trauma following a fall down a staircase. Initial CT-imaging of the brain showed only global atrophy, but repeated CT-imaging 4 days later revealed a subdural hygroma. Because of the discrepancy between the radiological deterioration and the unchanged

  19. Water supply impacts of nuclear fall

    International Nuclear Information System (INIS)

    Hobbs, B.F.; Luo, Y.; Maciejowski, M.E.; Chester, C.V.

    1989-01-01

    “Nuclear winter,” more properly called “nuclear fall,” could be caused by injection of large amounts of dust into the atmosphere. Besides causing a decrease in temperature, it could be accompanied by “nuclear drought,” a catastrophic decrease in precipitation. Dry land agriculture would then be impossible, and municipal, industrial, and irrigation water supplies would be diminished. It has been argued that nuclear winter/fall poses a much greater threat to human survival than do fall out or the direct impacts of a conflict. However, this does not appear to be true, at least for the U.S. Even under the unprecedented drought that could result from nuclear fall, water supplies would be available for many essential activities. For the most part, ground water supplies would be relatively invulnerable to nuclear drought, and adequate surface supplies would be available for potable uses. This assumes that conveyance facilities and power supplies survive a conflict largely intact or can be repaired

  20. The Pteridophyta of the Kundalila Falls, Zambia

    Directory of Open Access Journals (Sweden)

    Jan Koraś

    2015-01-01

    Full Text Available 40 species of Pteridophyta occur at the Kundalila Falls, near Serenje in the Central Province of Zambia. Many of them have disjunct geographical distributions. Hygrophilous plant communities of wet rocks and evergreen fringing forests, in which these species grow, seem to represent a relict vegetation type.

  1. Student Time Usage during Fall Reading Week

    Science.gov (United States)

    Cramer, Ken; Pschibul, Rebecca

    2017-01-01

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

  2. Have a Safe and Healthy Fall

    Centers for Disease Control (CDC) Podcasts

    2010-10-14

    Fall is a great time to try new and healthy activities with your parents! Have a food tasting or a leaf raking contest! Whatever your plans, make sure to have fun and be safe!  Created: 10/14/2010 by CDC Office of Women’s Health.   Date Released: 10/14/2010.

  3. 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.

  4. The rise and fall of tourism for poverty reduction within SNV Netherlands Development Organisation

    NARCIS (Netherlands)

    Hummel, J.A.

    2015-01-01

    Although development organizations have been involved in tourism for poverty reduction for more than 30 years, their role remains contested. In my study, I examined the rise and fall of tourism within SNV Netherlands Development Organisation in the period 1993–2013. Here, I show how and why

  5. The rise and fall of tourism for poverty reduction within SNV Netherlands Development Organisation

    NARCIS (Netherlands)

    Hummel, J.A.

    2015-01-01

    Although development organizations have been involved in tourism for poverty reduction for more than 30 years, their role remains contested. In my study, I examined the rise and fall of tourism within SNV Netherlands Development Organisation in the period 1993–2013. Here, I show how and why

  6. Evaluation of the Cosmetology Program at Caldwell Community College and Technical Institute--Fall, 1981.

    Science.gov (United States)

    Pipes, V. David

    In fall 1981, the cosmetology program at Caldwell Community College and Technical Institute (CCC&TI) was evaluated as part of a process to create a model for the periodic evaluation of all occupational programs at the school. In addition to collecting information for planning and program improvement, the study sought to assess the achievement of…

  7. Moral and physical gangrene in the novel: The wound , By Malick Fall

    African Journals Online (AJOL)

    This second figurative representation of Africa's ills prevalent during that period, will be analysed, with reference to the novel The Wound (1967) by the Senegalese writer Malick Fall. It is characterised by manifold and complex forms of symbolism. Indeed, in addition to presenting visual and clinical authenticity, other levels ...

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

    Science.gov (United States)

    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.

  9. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study.

    Science.gov (United States)

    Moreira, Bruno S; Sampaio, Rosana F; Kirkwood, Renata N

    2015-01-01

    Falling is a common but devastating and costly problem of aging. There is no consensus in the literature on whether the spatial and temporal gait parameters could identify elderly people at risk of recurrent falls. To determine whether spatiotemporal gait parameters could predict recurrent falls in elderly women. One hundred and forty-eight elderly women (65-85 years) participated in this study. Seven spatiotemporal gait parameters were collected with the GAITRite(r) system. Falls were recorded prospectively during 12 months through biweekly phone contacts. Elderly women who reported two or more falls throughout the follow-up period were considered as recurrent fallers. Principal component analysis (PCA) and discriminant analysis followed by biplot graph interpretation were applied to the gait parameters. After 12 months, 23 elderly women fell twice or more and comprised the recurrent fallers group and 110 with one or no falls comprised the non-recurrent fallers group. PCA resulted in three components that explained 88.3% of data variance. Discriminant analysis showed that none of the components could significantly discriminate the groups. However, visual inspection of the biplot showed a trend towards group separation in relation to gait velocity and stance time. PC1 represented gait rhythm and showed that recurrent fallers tend to walk with lower velocity and cadence and increased stance time in relation to non-recurrent fallers. The analyzed spatiotemporal gait parameters failed to predict recurrent falls in this sample. The PCA-biplot technique highlighted important trends or red flags that should be considered when evaluating recurrent falls in elderly females.

  10. Spatiotemporal gait parameters and recurrent falls in community-dwelling elderly women: a prospective study

    Directory of Open Access Journals (Sweden)

    Bruno S. Moreira

    2015-02-01

    Full Text Available BACKGROUND: Falling is a common but devastating and costly problem of aging. There is no consensus in the literature on whether the spatial and temporal gait parameters could identify elderly people at risk of recurrent falls. OBJECTIVE: To determine whether spatiotemporal gait parameters could predict recurrent falls in elderly women. METHOD: One hundred and forty-eight elderly women (65-85 years participated in this study. Seven spatiotemporal gait parameters were collected with the GAITRite(r system. Falls were recorded prospectively during 12 months through biweekly phone contacts. Elderly women who reported two or more falls throughout the follow-up period were considered as recurrent fallers. Principal component analysis (PCA and discriminant analysis followed by biplot graph interpretation were applied to the gait parameters. RESULTS: After 12 months, 23 elderly women fell twice or more and comprised the recurrent fallers group and 110 with one or no falls comprised the non-recurrent fallers group. PCA resulted in three components that explained 88.3% of data variance. Discriminant analysis showed that none of the components could significantly discriminate the groups. However, visual inspection of the biplot showed a trend towards group separation in relation to gait velocity and stance time. PC1 represented gait rhythm and showed that recurrent fallers tend to walk with lower velocity and cadence and increased stance time in relation to non-recurrent fallers. CONCLUSIONS: The analyzed spatiotemporal gait parameters failed to predict recurrent falls in this sample. The PCA-biplot technique highlighted important trends or red flags that should be considered when evaluating recurrent falls in elderly females.

  11. Tile Drainage Nitrate Losses and Corn Yield Response to Fall and Spring Nitrogen Management.

    Science.gov (United States)

    Pittelkow, Cameron M; Clover, Matthew W; Hoeft, Robert G; Nafziger, Emerson D; Warren, Jeffery J; Gonzini, Lisa C; Greer, Kristin D

    2017-09-01

    Nitrogen (N) management strategies that maintain high crop productivity with reduced water quality impacts are needed for tile-drained landscapes of the US Midwest. The objectives of this study were to determine the effect of N application rate, timing, and fall nitrapyrin addition on tile drainage nitrate losses, corn ( L.) yield, N recovery efficiency, and postharvest soil nitrate content over 3 yr in a corn-soybean [ (L.) Merr.] rotation. In addition to an unfertilized control, the following eight N treatments were applied as anhydrous ammonia in a replicated, field-scale experiment with both corn and soybean phases present each year in Illinois: fall and spring applications of 78, 156, and 234 kg N ha, fall application of 156 kg N ha + nitrapyrin, and sidedress (V5-V6) application of 156 kg N ha. Across the 3-yr study period, increases in flow-weighted NO concentrations were found with increasing N rate for fall and spring N applications, whereas N load results were variable. At the same N rate, spring vs. fall N applications reduced flow-weighted NO concentrations only in the corn-soybean-corn rotation. Fall nitrapyrin and sidedress N treatments did not decrease flo8w-weighted NO concentrations in either rotation compared with fall and spring N applications, respectively, or increase corn yield, crop N uptake, or N recovery efficiency in any year. This study indicates that compared with fall N application, spring and sidedress N applications (for corn-soybean-corn) and sidedress N applications (for soybean-corn-soybean) reduced 3-yr mean flow-weighted NO concentrations while maintaining yields. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  12. The dual task effect on gait in adults with intellectual disabilities: is it predictive for falls?

    Science.gov (United States)

    Oppewal, Alyt; Hilgenkamp, Thessa I M

    2017-09-03

    Falling is an important health issue in adults with intellectual disabilities. Their cognitive and motor limitations may result in difficulties with dual tasking (walking and talking), which increases fall risk. Therefore, we assessed the dual task effect on gait in adults with intellectual disabilities, if this dual task effect is predictive for falls, and if this is more predictive than regular walking. Gait characteristics of 31 adults with intellectual disabilities without Down syndrome were assessed with the GAITRite at comfortable speed and during dual tasking (conversation). Falls were collected over a three-month follow-up period. During dual tasking, participants walked slower, with a lower cadence, increased stride time, and shorter stride lengths. They spend less time in swing and single support phase than at comfortable speed. Also swing and single support time became more variable. The dual task effect and walking at comfortable speed were not predictive for falls, although medium effect sizes were found. Dual tasking affects gait in adults with intellectual disabilities. This is an important finding for safe community participation, and must be considered while interacting with adults with intellectual disabilities during daily activities. Possible negative consequences of distractors should be kept in mind. More research is needed to better understand the predictive value of gait for falls. Implications for Rehabilitation Having a conversation while walking affects the gait pattern of adults with intellectual disabilities, possible negative consequences of distractors should be kept in mind. The dual task effect on the width of the gait pattern and stride time variability had the largest effect sizes with future falls, this potential relationship should be kept in mind in clinical practice. The dual task effect on gait is important to consider with regard to safe community participation. Future studies are needed to better understand the predictive

  13. Brain activation in high-functioning older adults and falls: Prospective cohort study.

    Science.gov (United States)

    Verghese, Joe; Wang, Cuiling; Ayers, Emmeline; Izzetoglu, Meltem; Holtzer, Roee

    2017-01-10

    To determine whether brain activity over the prefrontal cortex measured in real time during walking predicts falls in high-functioning older adults. We examined166 older persons (mean age 75 years, 51% women) enrolled in a prospective aging study. High-functioning status defined as the absence of dementia or disability with normal gait diagnosed by study clinicians. The magnitude of task-related changes in oxygenated hemoglobin levels over the prefrontal cortex was measured with functional near-infrared spectroscopy during motor (walking at normal pace) and cognitive (reciting alternate letters of the alphabet) single tasks and a dual-task condition (walking while reciting alternate letters of the alphabet). Incident falls were prospectively assessed over a 50-month study period. Over a mean follow-up of 33.9 ± 11.9 months, 116 falls occurred. Higher levels of prefrontal cortical activation during the dual-task walking condition predicted falls (hazard ratio adjusted for age, sex, education, medical illnesses and general mental status 1.32, 95% confidence interval 1.03-1.70). Neither behavioral outcomes (velocity or letter rate) on the dual task nor brain activation patterns on the single tasks (normal walk or talk alone) predicted falls in this high-functioning sample. The results remained robust after accounting for multiple confounders and for cognitive status, slow gait, previous falls, and frailty. Prefrontal brain activity levels while performing a cognitively demanding walking condition predicted falls in high-functioning seniors. These findings implicate neurobiological processes early in the pathogenesis of falls. © 2016 American Academy of Neurology.

  14. Falls and fallers in traumatic brain injury (TBI) rehabilitation settings: an integrative review.

    Science.gov (United States)

    McKechnie, Duncan; Pryor, Julie; Fisher, Murray J

    2015-01-01

    To critically appraise the research literature on the nature of falls and fallers in traumatic brain injury (TBI) rehabilitation settings. An integrative review of the literature using thematic analysis was undertaken. Papers identified via a systematic search strategy were independently appraised by two reviewers. A data extraction instrument was developed to record results and to aid identification of themes in the literature. Critical Appraisal Skills Programme instruments were utilised to conduct a methodological critique of the papers included. Thirteen studies were identified as having between 4% and 100% TBI patients in their study cohorts. From these papers, up to 71% of falls took place in a patient's bedroom occurring in peaks and troughs over a 24-h period. With some divergent results, nine themes were identified describing faller characteristics including: (1) functional mobility impairments; (2) dizziness; (3) bladder and bowel dysfunction; (4) certain medications and number of medications prescribed; (5) executive functioning; (6) patient age; (7) fear of falling; (8) coma length following TBI; and (9) Functional Independence Measure (FIM™) total score, subscale scores and particular individual items. Being a multifactorial phenomenon, falls are a complex clinical issue. Despite the heterogeneity of diagnosis related groups (DRGs) in the included studies, TBI patients were identified as a high falls risk patient population in several studies. Implications for Rehabilitation Due to multisystem impairments, falls in the traumatic brain injury (TBI) rehabilitation context are a multifactorial and significant clinical issue. When interpreting and generalising results from research into falls, clinicians need to be mindful that falls and faller characteristics may be dependent on study setting and patient population. There is need for context specific research into faller characteristics following a TBI; particularly in relation to post-traumatic amnesia.

  15. Fear of falling after brain injury.

    Science.gov (United States)

    Collicutt McGrath, Joanna

    2008-07-01

    To investigate the prevalence and nature of fear of falling in a sample of people with severe acquired brain injury. A descriptive study. A regional inpatient neurological rehabilitation unit. One hundred and five adults with acquired brain injury of mixed aetiology. All 105 participants were rated by observers who were asked to judge the degree to which fear behaviour interfered with rehabilitation therapy (activity limitation). Eighty-two participants also rated themselves. They were asked to report the degree of distress caused by fear. Both participants and observers were asked to describe the focus of any reported fear. Two stepwise logistic regression analyses were carried out to identify variables that predicted fear giving rise to significant activity limitation and fear giving rise to significant subjective distress. Self and observer rating scales designed and constructed specifically for the study. Raters reported significant fear-related activity limitation in 12-15% of participants. Significant fear-related subjective distress was reported by 40% of participants. Fear of falling, fear of physical harm and fear of not making sufficient rehabilitation progress dominated the reports of both observers and participants. The variables predicting significant activity limitation were premorbid alcohol misuse, low functional ability and the occurrence of a fall since onset. The variables predicting significant subjective distress were poor motor coordination and organization, and good verbal comprehension. Fear of falling is a clinically significant phenomenon in younger adults recovering from severe acquired brain injury. Fear sufficient to cause high degrees of subjective distress was often not evident to observers. Proactive questioning about fear of falling is therefore advisable when working clinically with this group.

  16. 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

  17. [Functional impairment, fear of falling and body composition in institutionalized elderly].

    Science.gov (United States)

    São Romão Preto, Leonel; Nogueiro Santos, Ana Luisa; Mendes, Maria Eugénia; Pinto Novo, André; Pimentel, Maria Helena

    2015-01-01

    To analyze changes in the aging process of institutionalized elderly over a 24 months period, including physical condition, fear of falling, and body composition. A longitudinal, analytic and prospective study was implemented in 3 residential care homes for seniors. Data were collected using a socio-demographic and clinical questionnaire, the Rikli and Jones Senior Fitness Test, handgrip dynamometry and bioelectric impedance. The Portuguese version of the Falls Efficacy Scale was used for measure fear of falling. Fifty-one institutionalized elderly (82.5 ± 7.4 years) were included. In the 24 months analysis period, functional decline was observed (Pdecrease of self-efficacy to prevent falling, and falls prevalence was 42.1%. Results suggest a functional decrease, mainly in variables related with strength and muscular control of arms and legs, agility/dynamic balance and flexibility. Data don't highlight significant changes in body composition, however, tend to a muscle mass and bone mineral mass reduction. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  18. Do the risks and consequences of hospitalized fall injuries among older adults in California vary by type of fall?

    Science.gov (United States)

    Ellis, A A; Trent, R B

    2001-11-01

    Research on fall injuries in older persons generally does not examine different types of falls separately. (The main types are same level, from one level to another, and on or from stairs and steps.) There is no a priori reason to believe that various types of falls have similar demographic risk factors and consequences. Therefore, we examined patterns in types of falls, place of falls, and consequences of fall injuries as Californians move through their later decades. We analyzed all computerized patient discharge records for all adults 20 years and over hospitalized with a fall as the principal external cause of injury in California nonfederal acute care hospitals, from 1995 through 1997 (N = 242,166). Older-adult age groups were compared with all younger adults. Place of fall, hospital charges, and disposition at discharge were analyzed by type of fall. The three main types of fall injury increase with age, but each type shows variation by age and sex. Women have the highest rates for the main types but not for the less common types. Hospitalized falls vary by place of fall. Mean hospital charges ($17,086) vary by type of fall, with falls from one level to another having the largest mean hospital charge ($19,632). Disposition at discharge does not vary by type of fall. We found significant variation in demographic factors, place of fall, and mean hospital charges for falling by type of fall, suggesting that future research should focus on individual types of falls rather than on aggregated falls.

  19. Sensor-derived physical activity parameters can predict future falls in people with dementia.

    Science.gov (United States)

    Schwenk, Michael; Hauer, Klaus; Zieschang, Tania; Englert, Stefan; Mohler, Jane; Najafi, Bijan

    2014-01-01

    There is a need for simple clinical tools that can objectively assess the fall risk in people with dementia. Wearable sensors seem to have the potential for fall prediction; however, there has been limited work performed in this important area. To explore the validity of sensor-derived physical activity (PA) parameters for predicting future falls in people with dementia. To compare sensor-based fall risk assessment with conventional fall risk measures. This was a cohort study of people with confirmed dementia discharged from a geriatric rehabilitation ward. PA was quantified using 24-hour motion-sensor monitoring at the beginning of the study. PA parameters (percentage of walking, standing, sitting, and lying; duration of single walking, standing, and sitting bouts) were extracted using specific algorithms. Conventional assessment included performance-based tests (Timed Up and Go Test, Performance-Oriented Mobility Assessment, 5-chair stand) and questionnaires (cognition, ADL status, fear of falling, depression, previous faller). Outcome measures were fallers (at least one fall in the 3-month follow-up period) versus non-fallers. 77 people were included in the study (age 81.8 ± 6.3; community-dwelling 88%, institutionalized 12%). Surprisingly, fallers and non-fallers did not differ on any conventional assessment (p = 0.069-0.991), except for 'previous faller' (p = 0.006). Interestingly, several PA parameters discriminated between the groups. The 'walking bout average duration', 'longest walking bout duration' and 'walking bout duration variability' were lower in fallers, compared to non-fallers (p = 0.008-0.027). The 'standing bout average duration' was higher in fallers (p = 0.050). Two variables, 'walking bout average duration' [odds ratio (OR) 0.79, p = 0.012] and 'previous faller' (OR 4.44, p = 0.007) were identified as independent predictors for falls. The OR for a 'walking bout average duration' risk and may have higher diagnostic accuracy in persons with

  20. Mild anemia and the risk of falls in older adults from nursing homes and the community.

    Science.gov (United States)

    Dharmarajan, T S; Norkus, Edward P

    2004-01-01

    The objectives of this study were to determine if a relationship exists between a history of falls and anemia in older adults and to compare the findings by place of residence. The authors conducted a retrospective and observational study. One hundred forty-five adults (60-97 years of age) from nursing homes and the community hospitalized for hip fracture over a 2-year period were included in this study. Laboratory values (hemoglobin [Hb], hematocrit [Hct]), medical history, and demographics were measured. Falls occurred similarly in both nursing home patients and community patients (19% vs. 17%, P=0.785). Nursing home and community patients also had similar Hb (P=0.0899), Hct (P=0.1929), and rates of anemia (P=0.187). Nursing home residents were older (P=0.0188) and had lower serum albumin levels (P=0.0007) than community patients. When the two groups were combined, falls were more common in anemic individuals (30% vs. 13%; P=0.028). Furthermore, those with a history of falls were older (P=0.0447), had lower Hb (P=0.0257) and Hct levels (P=0.0310). After controlling for age, gender, place of residence, and arthritis in a logistic regression model, anemia predicted a threefold increased risk of falls (P=0.041), and a 45% decreased risk of falls was predicted for every 1.0-g/dL increase in Hb (P=0.005). Falls risk increased 7% per year of age (P=0.040), whereas musculoskeletal disease increased the falls risk 3.2-fold, both increases being independent of Hb levels or anemia. Finally, falls were not associated with gender or other comorbidity, nor did these variables alter the falls risk attributed to low Hb or anemia. These findings suggest a new and potentially important link between anemia and the risk of falls in patients sustaining hip fractures from both nursing homes and the community. Further studies will help determine if this risk is modified or eliminated with treatment of anemia and if the relationship applies to larger samples of older adults in

  1. Probabilistic approach to rock fall hazard assessment: potential of historical data analysis

    Directory of Open Access Journals (Sweden)

    C. Dussauge-Peisser

    2002-01-01

    Full Text Available We study the rock fall volume distribution for three rock fall inventories and we fit the observed data by a power-law distribution, which has recently been proposed to describe landslide and rock fall volume distributions, and is also observed for many other natural phenomena, such as volcanic eruptions or earthquakes. We use these statistical distributions of past events to estimate rock fall occurrence rates on the studied areas. It is an alternative to deterministic approaches, which have not proved successful in predicting individual rock falls. The first one concerns calcareous cliffs around Grenoble, French Alps, from 1935 to 1995. The second data set is gathered during the 1912–1992 time window in Yosemite Valley, USA, in granite cliffs. The third one covers the 1954–1976 period in the Arly gorges, French Alps, with metamorphic and sedimentary rocks. For the three data sets, we find a good agreement between the observed volume distributions and a fit by a power-law distribution for volumes larger than 50 m3 , or 20 m3 for the Arly gorges. We obtain similar values of the b exponent close to 0.45 for the 3 data sets. In agreement with previous studies, this suggests, that the b value is not dependant on the geological settings. Regarding the rate of rock fall activity, determined as the number of rock fall events with volume larger than 1 m3 per year, we find a large variability from one site to the other. The rock fall activity, as part of a local erosion rate, is thus spatially dependent. We discuss the implications of these observations for the rock fall hazard evaluation. First, assuming that the volume distributions are temporally stable, a complete rock fall inventory allows for the prediction of recurrence rates for future events of a given volume in the range of the observed historical data. Second, assuming that the observed volume distribution follows a power-law distribution without cutoff at small or large scales, we can

  2. Probabilistic approach to rock fall hazard assessment: potential of historical data analysis

    Science.gov (United States)

    Dussauge-Peisser, C.; Helmstetter, A.; Grasso, J.-R.; Hantz, D.; Desvarreux, P.; Jeannin, M.; Giraud, A.

    We study the rock fall volume distribution for three rock fall inventories and we fit the observed data by a power-law distribution, which has recently been proposed to describe landslide and rock fall volume distributions, and is also observed for many other natural phenomena, such as volcanic eruptions or earthquakes. We use these statistical distributions of past events to estimate rock fall occurrence rates on the studied areas. It is an alternative to deterministic approaches, which have not proved successful in predicting individual rock falls. The first one concerns calcareous cliffs around Grenoble, French Alps, from 1935 to 1995. The second data set is gathered during the 1912-1992 time window in Yosemite Valley, USA, in granite cliffs. The third one covers the 1954-1976 period in the Arly gorges, French Alps, with metamorphic and sedimentary rocks. For the three data sets, we find a good agreement between the observed volume distributions and a fit by a power-law distribution for volumes larger than 50 m3 , or 20 m3 for the Arly gorges. We obtain similar values of the b exponent close to 0.45 for the 3 data sets. In agreement with previous studies, this suggests, that the b value is not dependant on the geological settings. Regarding the rate of rock fall activity, determined as the number of rock fall events with volume larger than 1 m3 per year, we find a large variability from one site to the other. The rock fall activity, as part of a local erosion rate, is thus spatially dependent. We discuss the implications of these observations for the rock fall hazard evaluation. First, assuming that the volume distributions are temporally stable, a complete rock fall inventory allows for the prediction of recurrence rates for future events of a given volume in the range of the observed historical data. Second, assuming that the observed volume distribution follows a power-law distribution without cutoff at small or large scales, we can extrapolate these

  3. A Wavelet-Based Approach to Fall Detection

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Mindy Renfro

    2016-12-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  6. Inability to Perform the Repeated Chair Stand Task Predicts Fall-related Injury in Older Primary Care Patients.

    Science.gov (United States)

    Shea, Cristina A; Ward, Rachel E; Welch, Sarah A; Kiely, Dan K; Goldstein, Richard; Bean, Jonathan F

    2018-01-03

    To examine whether the chair stand component of the Short Physical Performance Battery (SPPB) predicts fall-related injury among older adult primary care patients. 2-year longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 years screened to be at risk for mobility decline. The three components of the SPPB (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for two years. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across SPPB scores, adjusting for age, gender, race, Digit Symbol Substitution Test score, and fall history. Participants were 68% female and 83% white, with a mean age of 76.6 (SD=7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (HR [hazard ratio]=2.11, 95% CI=1.23-3.62, p=0.01). Total SPPB score, gait component score, and balance component score were not predictive of fall-related injury. Inability to perform the repeated chair stand task was associated with increased hazard of an injurious fall over 2 years among a cohort of older adult primary care patients.

  7. Elderly fall risk prediction using static posturography.

    Directory of Open Access Journals (Sweden)

    Jennifer Howcroft

    Full Text Available Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP and medial-lateral (ML center of pressure (CoP motion; AP and ML CoP root mean square distance from mean (RMS; and AP, ML, and vector sum magnitude (VSM CoP velocity were calculated. Romberg Quotients (RQ were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24, prospective all fallers (42, prospective fallers (22 single, 6 multiple, and prospective non-fallers (47. Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for

  8. Elderly fall risk prediction using static posturography.

    Science.gov (United States)

    Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan; McIlroy, William E

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older

  9. How to manage recurrent falls in clinical practice: guidelines of the French Society of Geriatrics and Gerontology.

    Science.gov (United States)

    Beauchet, Olivier; Dubost, V; Revel Delhom, C; Berrut, G; Belmin, J

    2011-01-01

    Health care professionals need a simple and pragmatic clinical approach for the management of recurrent fallers in clinical routine. To develop clinical practice recommendations with the aim to assist health care professionals, especially in primary care in the management of recurrent falls. A systematic English and French review was conducted using Medline, Embase, Pascal and Cochrane literature. Search included systematic reviews, meta-analyses, controlled trials, cohort studies, case-control studies and transversal studies published until July 31, 2008. The following Medical Subject Heading (MeSH) terms were used: "aged OR aged, 80 and over", "frail elderly", "Accidental Fall", "Mental Recall", and "Recurrent falls". The guidelines were elaborated according the Haute Autorite de Sante methods by a multidisciplinary working group comprising experts and practitioners. A fall is an event that results in a person coming to rest inadvertently on the ground or floor or other lower level and should be considered as a recurrent event as soon as a subject reported at least two falls in a 12-month period. Recurrent falls impose a prompt and appropriate management with the first aim to systematically evaluate the severity of falls. The evaluation of fall severity should be based on a standardized questionnaire and physical examination. It is recommended not to perform cerebral imaging in the absence of specific indication based on the clinical examination and to reevaluate the subject within a week after the fall. Prior to any intervention and after an evaluation of signs of severity, it is recommended to systematically assess the risk factors for falls. This evaluation should be based on the use of validated and standardized tests. The education of recurrent fallers and their care givers is required in order to implement appropriate intervention. In the event of a gait and/or balance disorders, it is recommended to prescribe physiotherapy. A regular physical activity

  10. Fall prevention among children in the presence of caregivers in a paediatric ward: a best practice implementation.

    Science.gov (United States)

    Lee, Yee Ling Geraldine; Yip, Wai Kin; Goh, Beng Wah; Chiam, En Ping Jeannie; Ng, Hui Ping Chermaine

    2013-03-01

    This study aims to reduce the incidence of falls in paediatric inpatients aged 3 and below by implementing fall prevention strategies. The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programmes were used for this project. The project was carried out in three phases over a 4-month period from March to June 2011. A fall prevention poster was introduced during the implementation phase, and pre- and post-implementation audits were carried out in a 43-bed acute care paediatric ward in Singapore, with a sample size of 30. The audit result of Criterion 1, evaluating the effectiveness of the fall prevention measures, improved by 13%, to 93%. Criterion 2, measuring nurses' compliance in the regular reinforcement of safety, improved significantly by 27%, to 40%. However, Criterion 3, which measured nurses' compliance in identifying patients at high risk of falls by placing a green identification wrist tag on such patients, decreased by 23%, to 50%. A multi-language poster on fall prevention was strategically positioned at the foot of all the cots. The poster served as an effective reminder and communication method between nurses and caregivers and also among caregivers of the child. Caregivers' increased awareness and knowledge of fall prevention contributed to a 50% decrease in fall incidence of patients aged 3 and below in the presence of a caregiver from January to June 2011, as compared with the incidence rate in 2010. This project has shown that fall incidents can be reduced when caregivers' awareness of fall prevention measures in the hospital setting were to be improved. The poster on fall prevention has increased caregivers' awareness and reduced inpatient falls in the acute care setting. The pre- and post-implementation audits showed that the presence of a poster on fall prevention to remind parents/caregivers to raise and securely lock the cot rails at all times was effective in reducing the number of

  11. Completion and return of fall diaries varies with participants' level of education, first language, and baseline fall risk.

    Science.gov (United States)

    Perry, Laura; Kendrick, Denise; Morris, Richard; Dinan, Susie; Masud, Tahir; Skelton, Dawn; Iliffe, Steve

    2012-02-01

    Consensus guidelines recommend the use of prospective fall diaries in studies of fall rates. We sought to determine the characteristics associated with return and successful completion of a falls diary and whether characteristics such as gender, education level, native language, income, and falls risk influenced self-reported fall rates. Two hundred and seventy people aged 65 years and older participating in a randomized controlled trial evaluating two exercise programmes. Fall diaries were collected for 6 months, then evaluated for correct completion and falls reported. An increasing risk of falls was associated with a reducing odds of returning diaries (odds ratio for a one unit increase in Falls Risk Assessment Tool score 0.71, 95% confidence interval 0.53-0.96). Native English speakers were more likely to complete more than half the diaries correctly (odds ratio 2.63, 95% confidence interval 1.20-5.75). Problems arise in the correct completion of falls diaries among those for whom English is not their first language. Diaries may underreport the rate of falls as those at higher risk were less likely to return diaries but more likely to report falls. Careful consideration should be given to the analysis of falls diaries as missing data are unlikely to be missing completely at random. We recommend additional training in the use of falls diaries for these groups or the utilization of simpler instruments.

  12. Fall Meeting abstract submission inspires science poetry

    Science.gov (United States)

    Balcerak, Ernie

    2011-08-01

    When the 4 August deadline for submitting Fall Meeting abstracts passed, AGU had received more than 20,000 abstracts, a record-breaking number. The submission process had an unexpected by-product: It inspired some scientists to write haiku on Twitter. (Haiku is a form of Japanese poetry typically having three lines, the first with five syllables, the second with seven, and the third with five.) The following are examples of the haiku tweets, with the hashtag #AGU11AbstractHaiku. (For those who want to keep updated about the Fall Meeting on Twitter, the hashtag is #AGU11.) For more information about the meeting, including registration and housing, visit http://sites.agu.org/fallmeeting/.

  13. Cardiovascular assessment of falls in older people.

    Science.gov (United States)

    Tan, Maw Pin; Kenny, Rose Anne

    2006-01-01

    Falls in older people can be caused by underlying cardiovascular disorders, either because of balance instability in persons with background gait and balance disorders, or because of amnesia for loss of consciousness during unwitnessed syncope. Pertinent investigations include a detailed history, 12-lead electrocardiography, lying and standing blood pressure, carotid sinus massage (CSM), head-up tilt, cardiac electrophysiological tests, and ambulatory blood pressure and heart rate monitoring, which includes external and internal cardiac monitoring. The presence of structural heart disease predicts an underlying cardiac cause. Conversely, the absence of either indicates that neurally mediated etiology is likely. CSM and tilt-table testing should be considered in patients with unexplained and recurrent falls. Holter monitoring over 24 hours has a low diagnostic yield. Early use of an implantable loop recorder may be more cost-effective. A dedicated investigation unit increases the likelihood of achieving positive diagnoses and significantly reduces hospital stay and health expenditure.

  14. Gold Veins near Great Falls, Maryland

    Science.gov (United States)

    Reed, John Calvin; Reed, John C.

    1969-01-01

    Small deposits of native gold are present along an anastomosing system of quartz veins and shear zones just east of Great Falls, Montgomery County, Md. The deposits were discovered in 1861 and were worked sporadically until 1951, yielding more than 5,000 ounces of gold. The vein system and the principal veins within it strike a few degrees west of north, at an appreciable angle to foliation and fold axial planes in enclosing rocks of the Wissahickon Formation of late Precambrian (?) age. The veins cut granitic rocks of Devonian or pre-Devonian age and may be as young as Triassic. Further development of the deposits is unlikely under present economic conditions because of their generally low gold content and because much of the vein system lies on park property, but study of the Great Falls vein system may be useful in the search for similar deposits elsewhere in the Appalachian Piedmont.

  15. Nuclear blast and fall-out shelter

    International Nuclear Information System (INIS)

    Daroga, N.D.

    1984-01-01

    A nuclear blast and fall-out shelter is described with automatically controlled oxygen supply means, air reconditioning means to remove CO and CO 2 , a hand operated pump for introducing external air if required, an over-pressure outlet valve, and means for automatically measuring the proportion of CO and CO 2 in the air in the shelter and giving an alarm signal in case of danger. (author)

  16. An alternative model of free fall

    Science.gov (United States)

    Lattery, Mark

    2018-03-01

    In Two World Systems (Galileo 1632/1661 Dialogues Concerning Two New Sciences (New York: Prometheus)), Galileo attempted to unify terrestrial and celestial motions using the Aristotelian principle of circularity. The result was a model of free fall that correctly predicts the linear increase of the velocity of an object released from rest near the surface of the Earth. This historical episode provides an opportunity to communicate the nature of science to students.

  17. Cardiovascular Assessment of Falls in Older People

    OpenAIRE

    Tan, Maw Pin; Kenny, Rose Anne

    2006-01-01

    Falls in older people can be caused by underlying cardiovascular disorders, either because of balance instability in persons with background gait and balance disorders, or because of amnesia for loss of consciousness during unwitnessed syncope. Pertinent investigations include a detailed history, 12-lead electrocardiography, lying and standing blood pressure, carotid sinus massage (CSM), head-up tilt, cardiac electrophysiological tests, and ambulatory blood pressure and heart rate monitoring,...

  18. Elderly fall risk prediction using static posturography

    OpenAIRE

    Howcroft, Jennifer; Lemaire, Edward D.; Kofman, Jonathan; McIlroy, William E.

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed w...

  19. Youth Attitude Tracking Study II, Fall 1983.

    Science.gov (United States)

    1983-01-01

    considered along with civilian employment. The notion expressed in - econometric research is that when youth unemployment in the civilian sector is high...young people will find military Service relatively more attractive. Conversely, when youth unemployment is low, young people are more likely to . join...AD-Ri5@ 428 YOUTH ATTITUDE TRACKING STUDY II FALL 1983(U) RESEARCH 1/4 TRIANGLE INST RESEARCH TRIANGLE PARK NC M E MARSDEN 1983 DA98-83-C-8172

  20. 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.

  1. 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.

  2. Free fall and the equivalence principle revisited

    Science.gov (United States)

    Pendrill, Ann-Marie

    2017-11-01

    Free fall is commonly discussed as an example of the equivalence principle, in the context of a homogeneous gravitational field, which is a reasonable approximation for small test masses falling moderate distances. Newton’s law of gravity provides a generalisation to larger distances, and also brings in an inhomogeneity in the gravitational field. In addition, Newton’s third law of action and reaction causes the Earth to accelerate towards the falling object, bringing in a mass dependence in the time required for an object to reach ground—in spite of the equivalence between inertial and gravitational mass. These aspects are rarely discussed in textbooks when the motion of everyday objects are discussed. Although these effects are extremely small, it may still be important for teachers to make assumptions and approximations explicit, to be aware of small corrections, and also to be prepared to estimate their size. Even if the corrections are not part of regular teaching, some students may reflect on them, and their questions deserve to be taken seriously.

  3. A dynamic evidential network for fall detection.

    Science.gov (United States)

    Aguilar, Paulo Armando Cavalcante; Boudy, Jerome; Istrate, Dan; Dorizzi, Bernadette; Mota, Joao Cesar Moura

    2014-07-01

    This study is part of the development of a remote home healthcare monitoring application designed to detect distress situations through several types of sensors. The multisensor fusion can provide more accurate and reliable information compared to information provided by each sensor separately. Furthermore, data from multiple heterogeneous sensors present in the remote home healthcare monitoring systems have different degrees of imperfection and trust. Among the multisensor fusion methods, Dempster-Shafer theory (DST) is currently considered the most appropriate for representing and processing the imperfect information. Based on a graphical representation of the DST called evidential networks, a structure of heterogeneous data fusion from multiple sensors for fall detection has been proposed. The evidential networks, implemented on our remote medical monitoring platform, are also proposed in this paper to maximize the performance of automatic fall detection and thus make the system more reliable. However, the presence of noise, the variability of recorded signals by the sensors, and the failing or unreliable sensors may thwart the evidential networks performance. In addition, the sensors signals nonstationary nature may degrade the experimental conditions. To compensate the nonstationary effect, the time evolution is considered by introducing the dynamic evidential network which was evaluated by the simulated fall scenarios corresponding to various use cases.

  4. Falling through the black hole horizon

    International Nuclear Information System (INIS)

    Brustein, Ram; Medved, A.J.M.

    2015-01-01

    We consider the fate of a small classical object, a “stick”, as it falls through the horizon of a large black hole (BH). Classically, the equivalence principle dictates that the stick is affected by small tidal forces, and Hawking’s quantum-mechanical model of BH evaporation makes essentially the same prediction. If, on the other hand, the BH horizon is surrounded by a “firewall”, the stick will be consumed as it falls through. We have recently extended Hawking’s model by taking into account the quantum fluctuations of the geometry and the classical back-reaction of the emitted particles. Here, we calculate the strain exerted on the falling stick for our model. The strain depends on the near-horizon state of the Hawking pairs. We find that, after the Page time when the state of the pairs deviates significantly from maximal entanglement (as required by unitarity), the induced strain in our semiclassical model is still parametrically small. This is because the number of the disentangled pairs is parametrically smaller than the BH entropy. A firewall does, however, appear if the number of disentangled pairs near the horizon is of order of the BH entropy, as implicitly assumed in previous discussions in the literature.

  5. Relativistic theory of the falling retroreflector gravimeter

    Science.gov (United States)

    Ashby, Neil

    2018-02-01

    We develop a relativistic treatment of interference between light reflected from a falling cube retroreflector in the vertical arm of an interferometer, and light in a reference beam in the horizontal arm. Coordinates that are nearly Minkowskian, attached to the falling cube, are used to describe the propagation of light within the cube. Relativistic effects such as the dependence of the coordinate speed of light on gravitational potential, propagation of light along null geodesics, relativity of simultaneity, and Lorentz contraction of the moving cube, are accounted for. The calculation is carried to first order in the gradient of the acceleration of gravity. Analysis of data from a falling cube gravimeter shows that the propagation time of light within the cube itself causes a significant reduction in the value of the acceleration of gravity obtained from measurements, compared to assuming reflection occurs at the face. An expression for the correction to g is derived and found to agree with experiment. Depending on the instrument, the correction can be several microgals, comparable to commonly applied corrections such as those due to polar motion and earth tides. The controversial ‘speed of light’ correction is discussed. Work of the US government, not subject to copyright.

  6. Hospitalisations due to falls in older persons.

    LENUS (Irish Health Repository)

    Carey, D

    2005-06-01

    This paper describes hospitalisations due to falls among people aged 65 years and over resident in the Eastern Region of Ireland. Of the 2,029 hospitalisations recorded for 2002, 78% were female and 68% were aged 75 years and over. Fractures accounted for 1,697 or 84% of cases with nearly half of them (841) sustained to the hip. Females were more likely to have a limb fracture whereas males were more likely to have a head injury. The total inpatient costs of the 2,029 hospitalisations were estimated at 10.6 million euros. Hip fractures were the costliest injuries as they accounted for 7.4 million euros (70%) of inpatient costs. There are also substantial additional costs implications for hip fractures as they constituted the majority (56%) of cases transferred to nursing\\/convalescent homes or long-stay health facilities. In keeping with an ageing population, the problem of injuries in older people is likely to increase over time and as falls are the dominant cause of those injuries, all acute and long-stay health facilities need to develop and implement fall prevention strategies for older people.

  7. Albeni Falls Wildlife Mitigation : Annual Report 2002.

    Energy Technology Data Exchange (ETDEWEB)

    Terra-Berns, Mary

    2003-01-01

    The Albeni Falls Interagency Work Group continued to actively engage in implementing wildlife mitigation actions in 2002. Regular Work Group meetings were held to discuss budget concerns affecting the Albeni Falls Wildlife Mitigation Program, to present potential acquisition projects, and to discuss and evaluate other issues affecting the Work Group and Project. Work Group members protected 1,386.29 acres of wildlife habitat in 2002. To date, the Albeni Falls project has protected approximately 5,914.31 acres of wildlife habitat. About 21% of the total wildlife habitat lost has been mitigated. Administrative activities have increased as more properties are purchased and continue to center on restoration, operation and maintenance, and monitoring. In 2001, Work Group members focused on development of a monitoring and evaluation program as well as completion of site-specific management plans. This year the Work Group began implementation of the monitoring and evaluation program performing population and plant surveys, data evaluation and storage, and map development as well as developing management plans. Assuming that the current BPA budget restrictions will be lifted in the near future, the Work Group expects to increase mitigation properties this coming year with several potential projects.

  8. Exercise and fall prevention self-management to reduce mobility-related disability and falls after fall-related lower limb fracture in older people: protocol for the RESTORE (Recovery Exercises and STepping On afteR fracturE) randomised controlled trial.

    Science.gov (United States)

    Sherrington, Catherine; Fairhall, Nicola; Kirkham, Catherine; Clemson, Lindy; Howard, Kirsten; Vogler, Constance; Close, Jacqueline C T; Moseley, Anne M; Cameron, Ian D; Mak, Jenson; Sonnabend, David; Lord, Stephen R

    2016-02-02

    Lasting disability and further falls are common and costly problems in older people following fall-related lower limb and pelvic fractures. Exercise interventions can improve mobility after fracture and reduce falls in older people, however the optimal approach to rehabilitation after fall-related lower limb and pelvic fracture is unclear. This randomised controlled trial aims to evaluate the effects of an exercise and fall prevention self-management intervention on mobility-related disability and falls in older people following fall-related lower limb or pelvic fracture. Cost-effectiveness of the intervention will also be investigated. A randomised controlled trial with concealed allocation, assessor blinding for physical performance tests and intention-to-treat analysis will be conducted. Three hundred and fifty people aged 60 years and over with a fall-related lower limb or pelvic fracture, who are living at home or in a low care residential aged care facility and have completed active rehabilitation, will be recruited. Participants will be randomised to receive a 12-month intervention or usual care. The intervention group will receive ten home visits from a physiotherapist to prescribe an individualised exercise program with motivational interviewing, plus fall prevention education through individualised advice from the physiotherapist or attendance at the group based "Stepping On" program (seven two-hour group sessions). Participants will be followed for a 12-month period. Primary outcome measures will be mobility-related disability and falls. Secondary outcomes will include measures of balance and mobility, falls risk, physical activity, walking aid use, frailty, pain, nutrition, falls efficacy, mood, positive and negative affect, quality of life, assistance required, hospital readmission, and health-system and community-service contact. This study will determine the effect and cost-effectiveness of this exercise self management intervention on mobility

  9. 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.

  10. The Ways to Prevent Economy Fall in the Current Conditions

    Directory of Open Access Journals (Sweden)

    Bozhko Valeriy P.

    2017-04-01

    Full Text Available Statistical data as to the situation of the contemporary economy were considered. Declines in the indicators of economic development for practically all directions have been specified. Particular attention has been paid to the influence of economic situation on the living standards of population. A detailed analysis of magnitude of the minimum wage in the the European Union Member States has been carried out, on results of which it is concluded that, in order to enlarge it, it would be necessary to create an enabling environment for business together with and drastic actions to counter corruption. Comparative data on the dynamics of development of industry and agriculture in the period of 2008-2016 have been provided. Use of re-innovation as an effective way of developing the economy has been substantiated, and the basic ways to prevent economy fall have been formulated.

  11. Modeling rises and falls in money addicted social hierarchies

    International Nuclear Information System (INIS)

    Dybiec, Bartłomiej; Mitarai, Namiko; Sneppen, Kim

    2014-01-01

    The emergence of large communities is inherently associated with the creation of social structures. Connections between individuals are indispensable for cooperative action of agents building social groups. Moreover, social groups usually evolve and their structure changes over time. Consequently, an underlying network connecting individuals is not static, reflecting an ongoing adaptation to new conditions. The evolution of social connections is influenced by the relative position (hierarchy) of individuals building the system as well as by the availability of resources. We explore this aspect of human ambition by modeling the interplay of social networking and an uneven distribution of external resources. The model naturally generates social hierarchies. Remarkably, this social structure exhibits a rise-and-fall behavior. A well pronounced quasi-periodic dynamics, which is closely associated with the dissipation of resources that are needed to sustain the social links, is revealed. (paper)

  12. [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.

  13. Modeling rises and falls in money addicted social hierarchies

    Science.gov (United States)

    Dybiec, Bartłomiej; Mitarai, Namiko; Sneppen, Kim

    2014-08-01

    The emergence of large communities is inherently associated with the creation of social structures. Connections between individuals are indispensable for cooperative action of agents building social groups. Moreover, social groups usually evolve and their structure changes over time. Consequently, an underlying network connecting individuals is not static, reflecting an ongoing adaptation to new conditions. The evolution of social connections is influenced by the relative position (hierarchy) of individuals building the system as well as by the availability of resources. We explore this aspect of human ambition by modeling the interplay of social networking and an uneven distribution of external resources. The model naturally generates social hierarchies. Remarkably, this social structure exhibits a rise-and-fall behavior. A well pronounced quasi-periodic dynamics, which is closely associated with the dissipation of resources that are needed to sustain the social links, is revealed.

  14. Fall of the İldenizids Atabeys of Azerbaijan

    Directory of Open Access Journals (Sweden)

    Hüseyin KAYHAN

    2017-04-01

    Full Text Available The Atabey of Azerbaijan founded by Atabey Ildeniz was established from within the Iraqi Seljuk Sultanate and it could be considered as this sultanate’s successor. This state filled in the vacuum formed in Western Iran and Caucasia after the fall of the Seljuk Empire. Atabey Ö� zbek, the last ruler of this state, could not rule the country as successfully as his predecessors did. Alongside his own personal insufficiencies, the inner strife in the region that never ended also contributed greatly for Atabey Ö� zbek’s failure. Despite everything, he managed to keep his country undivided, but the new political situation brought by the Mongol invasion also affected his state as happened to the other states. Following Atabey Ö� zbek’s death in the year 1225, this period came to an end and the entire Middle East fell under Mongol rule.

  15. Thyrotoxic periodic paralysis

    Science.gov (United States)

    ... have a family history of periodic paralysis or thyroid disorders. Emergency symptoms include: Difficulty breathing, speaking, or swallowing ... Prevention Genetic counseling may be advised. Treating the thyroid disorder prevents attacks of weakness. Alternative Names Periodic paralysis - ...

  16. Your First Period

    Science.gov (United States)

    ... on your abdomen or lower back. What is amenorrhea? Amenorrhea means not having a period. It is normal ... or less often than every 45 days. Glossary Amenorrhea: The absence of menstrual periods. Egg: The female ...

  17. Use of fall risk increasing drugs in residents of retirement villages: a pilot study of long term care and retirement home residents in Ontario, Canada.

    Science.gov (United States)

    Rojas-Fernandez, Carlos; Dadfar, Farzan; Wong, Andrea; Brown, Susan G

    2015-10-14

    Falls continue to be a problem for older people in long-term care (LTC) and retirement home (RH) settings and are associated with significant morbidity and health care use. Fall-risk increasing drugs (FRIDs) are known to increase fall risk and represent modifiable risk factors. There are limited data regarding the use of FRIDs in contemporary LTC and RH settings, and it has not been well documented to what extent medication regimens are reviewed and modified for those who have sustained falls. The objective of this study is to characterize medication related fall risk factors in LTC and RH residents and on-going use of medications known to increase fall risk. Retrospective chart review of residents aged >65 who sustained one or more falls living in LTC or RH settings. 105 residents who fell one or more times during 2009-2010 were identified with a mean age of 89 years, a mean of nine scheduled medications and seven diagnoses, and 83% were women. Residents in LTC were ostensibly at higher risk for falls relative to those in RH settings as suggested by higher proportion of residents with multiple falls, multiple comorbidities, comorbidities that increase fall risk and visual impairment. Post fall injuries were sustained by 42% of residents, and residents in RH sustained more injuries relative to LTC residents (47 vs 34%). Use of FRIDs such as benzodiazepines, antipsychotic, antidepressant and various antihypertensive drugs was common in the present sample. No medication regimen changes were noted in the 6-month post fall period. The present study documented common use FRIDs by LTC and RH residents with multiple falls. These potentially modifiable falls risk factors are not being adequately addressed in contemporary practice, demonstrating that there is much room for improvement with regards to the safe and appropriate use of medications in LTC and RH residents.

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

    Science.gov (United States)

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

    2015-08-01

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

  19. Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial.

    Science.gov (United States)

    Fahlström, Gunilla; Kamwendo, Kitty; Forsberg, Jenny; Bodin, Lennart

    2017-08-29

    Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention. © 2017

  20. 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.

  1. INTEGRATING PILATES EXERCISE INTO AN EXERCISE PROGRAM FOR 65+ YEAR-OLD WOMEN TO REDUCE FALLS

    Directory of Open Access Journals (Sweden)

    Gonul Babayigit Irez

    2011-03-01

    Full Text Available The purpose of this study was to determine if Pilates exercise could improve dynamic balance, flexibility, reaction time and muscle strength in order to reduce the number of falls among older women. 60 female volunteers over the age of 65 from a residential home in Ankara participated in this study. Participants joined a 12-week series of 1-hour Pilates sessions three times per week. Dynamic balance, flexibility, reaction time and muscle strength were measured before and after the program. The number of falls before and during the 12-week period was also recorded. Dynamic balance, flexibility, reaction time and muscle strength improved (p < 0. 05 in the exercise group when compared to the non-exercise group. In conclusion, Pilates exercises are effective in improving dynamic balance, flexibility, reaction time, and muscle strength as well as decreasing the propensity to fall in older women.

  2. Preventing falls in residential construction: Effectiveness of engaging partners for a national social marketing campaign.

    Science.gov (United States)

    Macario, Everly; Hannon, Sandra Wills; Baker, Robin; Branche, Christine M; Trahan, Christina

    2015-08-01

    Falls are the leading cause of fatalities in construction. The Safety Pays, Falls Cost campaign aims to prevent falls in residential construction. A critical component of our social marketing approach was to involve 70 partners in reaching target audiences. We assessed partner engagement April 2012-August 2013 through: (1) baseline partnership quality interviews (eight partners); (2) pre-/post-partner "market" readiness in-depth interviews (three partners); (3) a pre-/post- (29/31 partners) online partner engagement survey; and (4) standardized metrics to measure partner activity. We found a high level of interest and engagement that increased with the addition of prompting to action through regular communication and new resources from organizers and formation of local partnerships that were able to tailor their activities to their own communities or regions. It is feasible to leverage government-labor-management partnerships that enjoy trust among target audiences to widely disseminate campaign materials and messages. © 2015 Wiley Periodicals, Inc.

  3. Book Reviews in Periodicals.

    Science.gov (United States)

    Ettelt, Harold J.

    All recent issues of periodicals found which contain indexed book reviews are listed in this compilation from Drake Memorial Library at the New York State University at Brockport. The periodicals are listed by 29 subject headings in this informal guide designed to be used at Drake Library. The number of reviews in the periodical in a recent year…

  4. The Periodic Pyramid

    Science.gov (United States)

    Hennigan, Jennifer N.; Grubbs, W. Tandy

    2013-01-01

    The chemical elements present in the modern periodic table are arranged in terms of atomic numbers and chemical periodicity. Periodicity arises from quantum mechanical limitations on how many electrons can occupy various shells and subshells of an atom. The shell model of the atom predicts that a maximum of 2, 8, 18, and 32 electrons can occupy…

  5. P270: Factors associated with fall rate in psychogeriatric residents

    NARCIS (Netherlands)

    Kosse, N.M.; de Groot, Maartje H; Hortobágyi, T.; Lamoth, C.J.C.

    2014-01-01

    Introduction: Falls in psychogeriatric residents represent a costly but unresolved safety issue. Identifying fall risk factors and their inter-relationship may help to individualize prevention programs and increase the effectiveness. Therefore, we aimed to examine the relationship between patient

  6. Skin-contact sensor for automatic fall detection.

    Science.gov (United States)

    Narasimhan, Ravi

    2012-01-01

    This paper describes an adhesive sensor system worn on the skin that automatically detects human falls. The sensor, which consists of a tri-axial accelerometer, a microcon-troller and a Bluetooth Low Energy transceiver, can be worn anywhere on a subject's torso and in any orientation. In order to distinguish easily between falls and activities of daily living (ADL), a possible fall is detected only if an impact is detected and if the subject is horizontal shortly afterwards. As an additional criterion to reduce false positives, a fall is confirmed if the user activity level several seconds after a possible fall is below a threshold. Intentional falls onto a gymnastics mat were performed by 10 volunteers (total of 297 falls); ADL were performed by 15 elderly volunteers (total of 315 ADL). The fall detection algorithm provided a sensitivity of 99% and a specificity of 100%.

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

    Science.gov (United States)

    ... feet. Repeat five times. How Can I Prevent Broken Bones if I Fall? Sometimes you cannot prevent ... Falls and Fractures (NIA) Caídas y fracturas (NIA) Home Bone Basics Osteoporosis Osteogenesis Imperfecta Paget’s Disease of ...

  8. Increased prevalence of fall risk factors in older people following hip fracture.

    Science.gov (United States)

    Sherrington, C; Lord, S R

    1998-01-01

    Many people who suffer a hip fracture do not achieve full functional recovery. Simple tests of physical function such as quadriceps strength and postural sway may provide insight into why this population is at increased risk of experiencing further falls and fractures and assist in developing rehabilitation strategies for preventing falls. To determine whether impairments in a range of physiological measures and specific medical conditions are more prevalent in people who have suffered a fall-related hip fracture than in a matched sample of community-dwelling people without a history of falls. This case-control study involved 88 older people. The hip fracture group comprised 44 persons aged 64-94 years, assessed on average 7 months following a fall-related hip fracture. An age- and sex-matched control group (older persons who had not fallen in a 12-month period before recruitment) was drawn randomly from community samples. Compared with the control group, the hip fracture group had markedly reduced quadriceps strength and increased body sway when tested on firm and compliant (foam rubber) surfaces. Patients in the hip fracture group also had higher prevalence rates of poor vision, arthritis and stroke, were taking more medications, were less physically active and perceived themselves to be at greater risk of falling than the control group. No significant differences were apparent for cardiovascular conditions, subjective health status and psychoactive medication use between the groups. Multivariate analyses identified quadriceps strength and body sway on the compliant surface as the most important variables for distinguishing between the hip fracture and no hip fracture groups. These two variables correctly classified 92% of the cases, with equal sensitivity and specificity. The findings identify an increased prevalence of certain physical fall risk factors among older persons who have suffered a hip fracture. Decreased quadriceps strength and increased postural

  9. Evaluation of falls risk in community-dwelling older adults using body-worn sensors.

    Science.gov (United States)

    Greene, Barry R; Doheny, Emer P; Walsh, Cathal; Cunningham, Clodagh; Crosby, Lisa; Kenny, Rose A

    2012-01-01

    Falls are the most common cause of injury and hospitalization and one of the principal causes of death and disability in older adults worldwide. This study aimed to determine if a method based on body-worn sensor data can prospectively predict falls in community-dwelling older adults, and to compare its falls prediction performance to two standard methods on the same data set. Data were acquired using body-worn sensors, mounted on the left and right shanks, from 226 community-dwelling older adults (mean age 71.5 ± 6.7 years, 164 female) to quantify gait and lower limb movement while performing the 'Timed Up and Go' (TUG) test in a geriatric research clinic. Participants were contacted by telephone 2 years following their initial assessment to determine if they had fallen. These outcome data were used to create statistical models to predict falls. Results obtained through cross-validation yielded a mean classification accuracy of 79.69% (mean 95% CI: 77.09-82.34) in prospectively identifying participants that fell during the follow-up period. Results were significantly (p falls risk estimation using two standard measures of falls risk (manually timed TUG and the Berg balance score, which yielded mean classification accuracies of 59.43% (95% CI: 58.07-60.84) and 64.30% (95% CI: 62.56-66.09), respectively). Results suggest that the quantification of movement during the TUG test using body-worn sensors could lead to a robust method for assessing future falls risk. Copyright © 2012 S. Karger AG, Basel.

  10. 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

  11. 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.

  12. Polypharmacy including falls risk-increasing medications and subsequent falls in community-dwelling middle-aged and older adults.

    Science.gov (United States)

    Richardson, Kathryn; Bennett, Kathleen; Kenny, Rose Anne

    2015-01-01

    polypharmacy is an important risk factor for falls, but recent studies suggest only when including medications associated with increasing the risk of falls. a prospective, population-based cohort study. 6,666 adults aged ≥50 years from The Irish Longitudinal study on Ageing. participants reported regular medication use at baseline. Any subsequent falls, any injurious falls and the number of falls were reported 2 years later. The association between polypharmacy (>4 medications) or fall risk-increasing medications and subsequent falls or injurious falls was assessed using modified Poisson regression. The association with the number of falls was assessed using negative binomial regression. during follow-up, 231 falls per 1,000 person-years were reported. Polypharmacy including antidepressants was associated with a greater risk of any fall (adjusted relative risk (aRR) 1.28, 95% CI 1.06-1.54), of injurious falls (aRR 1.51, 95% CI 1.10-2.07) and a greater number of falls (adjusted incident rate ratio (aIRR) 1.60, 95% CI 1.19-2.15), but antidepressant use without polypharmacy and polypharmacy without antidepressants were not. The use of benzodiazepines was associated with injurious falls when coupled with polypharmacy (aRR 1.40, 95% CI 1.04-1.87), but was associated with a greater number of falls (aIRR 1.32, 95% CI 1.05-1.65), independent of polypharmacy. Other medications assessed, including antihypertensives, diuretics and antipsychotics, were not associated with outcomes. in middle-aged and older adults, polypharmacy, including antidepressant or benzodiazepine use, was associated with injurious falls and a greater number of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    Science.gov (United States)

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

    2012-06-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. 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.

  15. 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.

  16. Premigratory and migratory neural crest cells are multipotent in vivo

    NARCIS (Netherlands)

    Baggiolini, Arianna; Varum, Sandra; Mateos, José María; Bettosini, Damiano; John, Nessy; Bonalli, Mario; Ziegler, Urs; Dimou, Leda; Clevers, Hans; Furrer, Reinhard; Sommer, Lukas

    2015-01-01

    The neural crest (NC) is an embryonic stem/progenitor cell population that generates a diverse array of cell lineages, including peripheral neurons, myelinating Schwann cells, and melanocytes, among others. However, there is a long-standing controversy as to whether this broad developmental

  17. Pre-migratory differentiation of wild brown trout into migrant and resident individuals

    DEFF Research Database (Denmark)

    Nielsen, C.; Aarestrup, Kim; Norum, U.

    2003-01-01

    sites in April by electrofishing and eventually caught in downstream smolt traps ('migrants') placed in the main river or by electrofishing ('residents') on the initial sites in June. Upon each capture, smolt appearance and body size were evaluated, and a non-lethal gill biopsy was taken and used for Na...... a smolt-like appearance before the onset of migration and had higher rate of change of gill Na+,K+-ATPase activity than fish remaining residents. The rate of change of gill Na+,K+-ATPase activity was independent of the distance migrated to the trap (3-28 km). Thus in bimodal wild brown trout populations...

  18. Three dimensional periodic foundations for base seismic isolation

    International Nuclear Information System (INIS)

    Yan, Y; Mo, Y L; Cheng, Z; Shi, Z; Menq, F; Tang, Y

    2015-01-01

    Based on the concept of phononic crystals, periodic foundations made of periodic materials are investigated in this paper. The periodic foundations can provide low frequency band gaps, which cover the main frequency ranges of seismic waves. Therefore, the periodic foundations are able to protect the upper structures during earthquake events. In this paper, the basic theory of three dimensional periodic foundations is studied and the finite element method was used to conduct the sensitivity study. A simplified three-dimensional periodic foundation with a superstructure was tested in the field and the feasibility of three dimensional periodic foundations was proved. The test results showed that the response of the upper structure with the three dimensional periodic foundation was reduced under excitation waves with the main frequency falling in the attenuation zones. The finite element analysis results are consistent with the experimental data, indicating that three dimensional periodic foundations are a feasible way of reducing seismic vibrations. (paper)

  19. Fall risk assessment among older adults with mild Alzheimer disease.

    Science.gov (United States)

    Ryan, John J; McCloy, Constance; Rundquist, Peter; Srinivasan, Visalakshi; Laird, Rosemary

    2011-01-01

    Older adults with Alzheimer disease (AD) fall more than twice as often as those without dementia, yet few studies have assessed fall risk in this population. The purpose of the study was to determine whether a fall assessment, the Physical Performance Test 7-item (PPT 7-item), could accurately identify subjects with history of falls in a group of community-dwelling elders with mild AD. An additional purpose was to determine whether the PPT 7-item, a cognitive screen, and/or nonperformance data could predict falling in this population. Forty-three community-dwelling elders diagnosed with mild AD completed the fall risk assessment. In addition, the following data were collected: Mini-Mental State Examination (MMSE) score, age, gender, education, gait aid use, number of falls in the past 6 months, and history of fall-related injury. There was a significant difference in the PPT 7-item total score between subjects with history of falls and subjects without history of falls (z = -2.04, P = .042), with items related to turning (z = -2.56, P = .01) and walking (z = -2.89, P = .004) accounting for most of the difference. However, only gait aid usage predicted falling (45.8% of the variance). While the PPT 7-item was able to detect differences in mobility between subjects with history of falls and subjects without history of falls in subjects with mild AD, total PPT 7-item score did not predict falling. Gait aid usage was more strongly related to falling in these subjects. Early detection of fall risk in individuals with mild AD is important to prevent injuries and moderate costs of care.

  20. Uphill falling of old-growth Douglas-fir.

    Science.gov (United States)

    Douglas L. Hunt; John W. Henley

    1981-01-01

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

  1. Sensory-Challenge Balance Exercises Improve Multisensory Reweighting in Fall-Prone Older Adults.

    Science.gov (United States)

    Allison, Leslie K; Kiemel, Tim; Jeka, John J

    2018-04-01

    Multisensory reweighting (MSR) deficits in older adults contribute to fall risk. Sensory-challenge balance exercises may have value for addressing the MSR deficits in fall-prone older adults. The purpose of this study was to examine the effect of sensory-challenge balance exercises on MSR and clinical balance measures in fall-prone older adults. We used a quasi-experimental, repeated-measures, within-subjects design. Older adults with a history of falls underwent an 8-week baseline (control) period. This was followed by an 8-week intervention period that included 16 sensory-challenge balance exercise sessions performed with computerized balance training equipment. Measurements, taken twice before and once after intervention, included laboratory measures of MSR (center of mass gain and phase, position, and velocity variability) and clinical tests (Activities-specific Balance Confidence Scale, Berg Balance Scale, Sensory Organization Test, Limits of Stability test, and lower extremity strength and range of motion). Twenty adults 70 years of age and older with a history of falls completed all 16 sessions. Significant improvements were observed in laboratory-based MSR measures of touch gain (P = 0.006) and phase (P = 0.05), Berg Balance Scale (P = 0.002), Sensory Organization Test (P = 0.002), Limits of Stability Test (P = 0.001), and lower extremity strength scores (P = 0.005). Mean values of vision gain increased more than those for touch gain, but did not reach significance. A balance exercise program specifically targeting multisensory integration mechanisms improved MSR, balance, and lower extremity strength in this mechanistic study. These valuable findings provide the scientific rationale for sensory-challenge balance exercise to improve perception of body position and motion in space and potential reduction in fall risk.

  2. Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults.

    Science.gov (United States)

    Carty, Christopher P; Cronin, Neil J; Nicholson, Deanne; Lichtwark, Glen A; Mills, Peter M; Kerr, Graham; Cresswell, Andrew G; Barrett, Rod S

    2015-01-01

    a fall occurs when an individual experiences a loss of balance from which they are unable to recover. Assessment of balance recovery ability in older adults may therefore help to identify individuals at risk of falls. The purpose of this 12-month prospective study was to assess whether the ability to recover from a forward loss of balance with a single step across a range of lean magnitudes was predictive of falls. two hundred and one community-dwelling older adults, aged 65-90 years, underwent baseline testing of sensori-motor function and balance recovery ability followed by 12-month prospective falls evaluation. Balance recovery ability was defined by whether participants required either single or multiple steps to recover from forward loss of balance from three lean magnitudes, as well as the maximum lean magnitude participants could recover from with a single step. forty-four (22%) participants experienced one or more falls during the follow-up period. Maximal recoverable lean magnitude and use of multiple steps to recover at the 15% body weight (BW) and 25%BW lean magnitudes significantly predicted a future fall (odds ratios 1.08-1.26). The Physiological Profile Assessment, an established tool that assesses variety of sensori-motor aspects of falls risk, was also predictive of falls (Odds ratios 1.22 and 1.27, respectively), whereas age, sex, postural sway and timed up and go were not predictive. reactive stepping behaviour in response to forward loss of balance and physiological profile assessment are independent predictors of a future fall in community-dwelling older adults. Exercise interventions designed to improve reactive stepping behaviour may protect against future falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Understanding the relationship between type 2 diabetes mellitus and falls in older adults: a prospective cohort study.

    Science.gov (United States)

    Roman de Mettelinge, Tine; Cambier, Dirk; Calders, Patrick; Van Den Noortgate, Nele; Delbaere, Kim

    2013-01-01

    Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls ("fallers"). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21-4.15, p = 0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes.

  5. Understanding the relationship between type 2 diabetes mellitus and falls in older adults: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Tine Roman de Mettelinge

    Full Text Available BACKGROUND: Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. METHODS: 199 older adults (104 with diabetes and 95 healthy controls underwent a medical screening. Gait (GAITRite®, balance (AccuGait® force plate, grip strength (Jamar®, and cognitive status (Mini-Mental State Examination and Clock Drawing Test were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. RESULTS: Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls reported at least one injurious fall or two non-injurious falls ("fallers". Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21-4.15, p = 0.010. Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. CONCLUSIONS: Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes.

  6. Ablation effect indicated by impedance fall is correlated with contact force level during ablation for atrial fibrillation.

    Science.gov (United States)

    De Bortoli, Alessandro; Sun, Li-Zhi; Solheim, Eivind; Hoff, Per Ivar; Schuster, Peter; Ohm, Ole-Jørgen; Chen, Jian

    2013-11-01

    Previous studies have validated the use of impedance fall as a measure of the effects of ablation. We investigated whether catheter-to-tissue contact force correlated with impedance fall during atrial fibrillation ablation. A total of 394 ablation points from 35 patients who underwent atrial fibrillation ablation were selected and analyzed in terms of the presence of stable catheter contact in non-ablated areas in the left atrium. A fixed power output (30 W) was applied for 60 seconds. Contact force, impedance fall, and force-direction angle were retrieved and exported for off-line analysis. Qualified points were divided into 5 groups according to the level of contact force (1-5 g, 6-10 g, 11-15 g, 16-20 g, and >20 g). An acute impedance fall was observed in the first 10 seconds followed by a plateau in group I and by a further fall in the other groups. Group V showed a rise in impedance during the last 20 seconds of ablation. Levels of impedance fall at each time point were significantly different among all the groups (Pcontact force and maximum impedance fall (rho = 0.54, Pangle of 0-30° had significantly lower contact force and maximum impedance fall than those with angles of 30-60° and 60-135° (Pcontact force correlates with impedance fall during 60 seconds of ablation. Contact force exceeding 5 g produces greater impedance fall, which probably indicates adequate lesion formation. A contact force greater than 20 g may lead to late tissue overheating. © 2013 Wiley Periodicals, Inc.

  7. Underreporting of Fall Injuries of Older Adults: Implications for Wellness Visit Fall Risk Screening.

    Science.gov (United States)

    Hoffman, Geoffrey J; Ha, Jinkyung; Alexander, Neil B; Langa, Kenneth M; Tinetti, Mary; Min, Lillian C

    2018-04-17

    To compare the accuracy of and factors affecting the accuracy of self-reported fall-related injuries (SFRIs) with those of administratively obtained FRIs (AFRIs). Retrospective observational study SETTING: United States PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 65 and older (N=47,215). We used 24-month self-report recall data from 2000-2012 Health and Retirement Study data to identify SFRIs and linked inpatient, outpatient, and ambulatory Medicare data to identify AFRIs. Sensitivity and specificity were assessed, with AFRIs defined using the University of California at Los Angeles/RAND algorithm as the criterion standard. Logistic regression models were used to identify sociodemographic and health predictors of sensitivity. Overall sensitivity and specificity were 28% and 92%. Sensitivity was greater for the oldest adults (38%), women (34%), those with more functional limitations (47%), and those with a prior fall (38%). In adjusted results, several participant factors (being female, being white, poor functional status, depression, prior falls) were modestly associated with better sensitivity and specificity. Injury severity (requiring hospital care) most substantively improved SFRI sensitivity (73%). An overwhelming 72% of individuals who received Medicare-reimbursed health care for FRIs failed to report a fall injury when asked. Future efforts to address underreporting in primary care of nonwhite and healthier older adults are critical to improve preventive efforts. Redesigned questions-for example, that address stigma of attributing injury to falling-may improve sensitivity. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

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

    Science.gov (United States)

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

    2010-07-01

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

  9. Prediction of falls using a risk assessment tool in the acute care setting

    Directory of Open Access Journals (Sweden)

    Ferko Nicole

    2004-01-01

    Full Text Available Abstract Background The British STRATIFY tool was previously developed to predict falls in hospital. Although the tool has several strengths, certain limitations exist which may not allow generalizability to a Canadian setting. Thus, we tested the STRATIFY tool with some modification and re-weighting of items in Canadian hospitals. Methods This was a prospective validation cohort study in four acute care medical units of two teaching hospitals in Hamilton, Ontario. In total, 620 patients over the age of 65 years admitted during a 6-month period. Five patient characteristics found to be risk factors for falls in the British STRATIFY study were tested for predictive validity. The characteristics included history of falls, mental impairment, visual impairment, toileting, and dependency in transfers and mobility. Multivariate logistic regression was used to obtain optimal weights for the construction of a risk score. A receiver-operating characteristic curve was generated to show sensitivities and specificities for predicting falls based on different threshold scores for considering patients at high risk. Results Inter-rater reliability for the weighted risk score indicated very good agreement (inter-class correlation coefficient = 0.78. History of falls, mental impairment, toileting difficulties, and dependency in transfer / mobility significantly predicted fallers. In the multivariate model, mental status was a significant predictor (P Conclusion Good predictive validity for identifying fallers was achieved in a Canadian setting using a simple-to-obtain risk score that can easily be incorporated into practice.

  10. Incidence and characteristics of accidental falls in hospitalizations.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Inagaki, Yuko; Suzuki, Yusuke; Ando, Kei; Nishida, Yoshihiro; Nagao, Yoshimasa; Ishiguro, Naoki

    2017-08-01

    Aging of the patient population has led to increased occurrence of accidental falls in acute care settings. The aim of this study is to survey the annual occurrence of falls in a university hospital, and to examine procedures to prevent fall. A total of 49,059 inpatients were admitted to our hospital from April 2015 to March 2016. A fall assessment scale was developed to estimate the risk of fall at admission. Data on falls were obtained from the hospital incident reporting system. There were fall-related incidents in 826 patients (1.7%). Most falls occurred in hospital rooms (67%). Adverse events occurred in 101 patients who fell (12%) and were significantly more frequent in patients aged ≥80 years old and in those wearing slippers. The incidence of falls was also significantly higher in patients in the highest risk group. These results support the validity of the risk assessment scale for predicting accidental falls in an acute treatment setting. The findings also clarify the demographic and environmental factors and consequences associated with fall. These results of the study could provide important information for designing effective interventions to prevent fall in elderly patients.

  11. Hyponatremia as a fall predictor in a geriatric trauma population.

    Science.gov (United States)

    Rittenhouse, Katelyn J; To, Tuc; Rogers, Amelia; Wu, Daniel; Horst, Michael; Edavettal, Mathew; Miller, Jo Ann; Rogers, Frederick B

    2015-01-01

    Approximately one in three older adults fall each year, resulting in a significant proportion of geriatric traumatic injuries. In a hospital with a focus on geriatric fall prevention, we sought to characterize this population to develop targeted interventions. As mild hyponatremia, defined as a serum sodium falls, unsteadiness and attention deficits, we hypothesized that hyponatremia is associated with falls in our geriatric trauma population. Gender, age, pre-existing conditions (cardiac disease, diabetes, hematologic disorder, liver disease, malignancy, musculoskeletal disorder, neurological disorder, obesity, psychiatric disorder, pulmonary disease, renal disease, thyroid disease), mechanism of injury and admitting serum sodium level were queried for all geriatric trauma admissions from 2008 to 2011. Mechanism of injury was coded as falls admissions and non-falls admissions. Admitting serum sodium levels were coded as hyponatremic (falls admissions and 293 (12.4%) patients who were hyponatremic. Gender, age, neurological disorder, hematologic disorder, and hyponatremia were found to be significant predictors of falls in both univariate and multivariable analyses. Hyponatremic patients are significantly more likely to be admitted for a fall than non-hyponatremic patients, when adjusting for age, neurological disorder, and hematologic disorder. Consequently, hyponatremia identification and management should be an integral part of any geriatric trauma fall prevention programme. Additionally, if hyponatremia is found during a geriatric fall workup, it should be corrected prior to discharge and closely monitored by a primary care physician to prevent recurrent episodes of falls. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Falls among pregnant women in Enugu, Southeast Nigeria | Okeke ...

    African Journals Online (AJOL)

    Background: Falls during pregnancy are major public health issues and a common cause of maternal injury during pregnancy. There is paucity of data on prevalence and risk factors of falls during pregnancy in African population including Nigeria. Objective: To determine the prevalence and risk factors associated with falls ...

  13. Geriatric fall-related injuries | Hefny | African Health Sciences

    African Journals Online (AJOL)

    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). Conclusion: 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 ...

  14. The Falling Chain of Hopkins, Tait, Steele and Cayley

    Science.gov (United States)

    Wong, Chun Wa; Youn, Seo Ho; Yasui, Kosuke

    2007-01-01

    A uniform, flexible and frictionless chain falling link by link from a heap by the edge of a table falls with an acceleration g/3 if the motion is nonconservative, but g/2 if the motion is conservative, g being the acceleration due to gravity. Unable to construct such a falling chain, we use instead higher-dimensional versions of it. A home…

  15. The Association of Cardiovascular Disorders and Falls : A Systematic Review

    NARCIS (Netherlands)

    Jansen, Sofie; Bhangu, Jaspreet; de Rooij, Sophia; Daams, Joost; Kenny, Rose Anne; van der Velde, Nathalie

    2016-01-01

    Objective: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care. Design: Systematic review. Data

  16. The Pendulum: From Constrained Fall to the Concept of Potential

    Science.gov (United States)

    Bevilacqua, Fabio; Falomo, Lidia; Fregonese, Lucio; Giannetto, Enrico; Giudice, Franco; Mascheretti, Paolo

    2006-01-01

    Kuhn underlined the relevance of Galileo's gestalt switch in the interpretation of a swinging body from constrained fall to time metre. But the new interpretation did not eliminate the older one. The constrained fall, both in the motion of pendulums and along inclined planes, led Galileo to the law of free fall. Experimenting with physical…

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Comparison of temporal and kinetic walking parameters among young people and falling and non-falling elderly persons

    OpenAIRE

    Briani,Ronaldo Valdir; Taborda,Bianca; Martines,Érica Caroline Carvalho; Aragão,Fernando Amâncio

    2015-01-01

    Objective : Comparison of the biomechanical parameters (spatiotemporal and kinetic) during walking of young people, falling, and non-falling elderly persons. Methods : A cross-sectional study was performed of 29 individuals divided into three groups: young persons (n=10); falling elderly individuals (n=7) and non-falling individuals (n=12). Gait analysis was performed based on the recording of three walking gait cycles along an 8 meter platform, which was attached to a force plate with a rec...

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. Nonlinear periodic space-charge waves in plasma

    International Nuclear Information System (INIS)

    Kovalev, V. A.

    2009-01-01

    A solution is obtained in the form of coupled nonlinear periodic space-charge waves propagating in a magnetoactive plasma. The wave spectrum in the vicinity of the critical point, where the number of harmonics increases substantially, is found to fall with harmonic number as ∝ s -1/3 . Periodic space-charge waves are invoked to explain the zebra pattern in the radio emission from solar flares.

  2. Characteristics of outdoor falls among older people: a qualitative study.

    Science.gov (United States)

    Nyman, Samuel R; Ballinger, Claire; Phillips, Judith E; Newton, Rita

    2013-11-18

    Falls are a major threat to older people's health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people's experiences of outdoor falls to develop understanding of how they may be prevented. We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses. Forty-four adults aged 65 - 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week. This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people.

  3. Analysis of falls that caused serious events in hospitalized patients.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Inagaki, Yuko; Suzuki, Yusuke; Nishida, Yoshihiro; Nagao, Yoshimasa; Ishiguro, Naoki

    2017-12-01

    Falls are common adverse events for hospitalized elderly patients that can cause fracture, which decreases activities of daily living, and other injuries that can be fatal. The purpose of the present study was to investigate serious events due to fall, and to consider measures for fall prevention. Incidents of fall were obtained from a database of 163 558 inpatients at Nagoya University Hospital, Nagoya, Aichi, Japan, from April 2012 to March 2016. The risk of fall was evaluated using a fall assessment score sheet at admission and during hospitalization, based on which patients were divided into risk grades 1, 2 and 3. A fall that led to fracture or a life-threatening injury was defined as a serious event. Fall occurred in 3099 patients for 4 years (1.89%). Most patients that fell (45%) were in the highest (grade 3) risk category. Serious events associated with fall occurred in 36 of the 3099 patients (1.2%), and the overall incidence of serious events was 0.22%. These events included fracture in 24 patients, intracranial injury in 10 patients and others in two patients. Finally, one patient died. Serious events occurred significantly more frequently after falls in patients wearing slippers compared with other footwear (P < 0.01). The incidences of serious events and fall were significantly higher in patients with a higher risk of fall (P < 0.05). The present results support the validity of our risk assessment scale for fall, but it should be recognized that fall can also occur in a patient with a low predicted risk of fall. Geriatr Gerontol Int 2017; 17: 2403-2406. © 2017 Japan Geriatrics Society.

  4. Physical Design Factors Contributing to Patient Falls.

    Science.gov (United States)

    Pati, Debajyoti; Valipoor, Shabboo; Cloutier, Aimee; Yang, James; Freier, Patricia; Harvey, Thomas E; Lee, Jaehoon

    2017-02-03

    The aim of this study was to identify physical design elements that contribute to potential falls in patient rooms. An exploratory, physical simulation-based approach was adopted for the study. Twenty-seven subjects, older than 70 years (11 male and 16 female subjects), conducted scripted tasks in a mockup of a patient bathroom and clinician zone. Activities were captured using motion-capture technology and video recording. After biomechanical data processing, video clips associated with potential fall moments were extracted and then examined and coded by a group of registered nurses and health care designers. Exploratory analyses of the coded data were conducted followed by a series of multivariate analyses using regression models. In multivariate models with all personal, environmental, and postural variables, only the postural variables demonstrated statistical significance-turning, grabbing, pushing, and pulling in the bathroom and pushing and pulling in the clinician zone. The physical elements/attributes associated with the offending postures include bathroom configuration, intravenous pole, door, toilet seat height, flush, grab bars, over-bed table, and patient chair. Postural changes, during interactions with the physical environment, constitute the source of most fall events. Physical design must include simultaneous examination of postural changes in day-to-day activities in patient rooms and bathrooms. Among discussed testable recommendations in the article, the followings design strategies should be considered: (a) designing bathrooms to reduce turning as much as possible and (b) designing to avoid motions that involve 2 or more of the offending postures, such as turning and grabbing or grabbing and pulling, and so on.

  5. The rise and fall of food minerals.

    Science.gov (United States)

    Reeves, John

    2011-01-01

    Climax fertility developed in early times with higher plants and animals developing to use this high standard of mineral nutrition. This climax fertility is built on carbon fixed from the air by plants. This carbon provides the energy to soil micro-organisms. Both those dependant on soil organic matter and those that draw energy and minerals directly from the plant. These micro-organisms increase plant mineral content and provide other life compounds. Agricultural activity has broken this climax fertility leading to a fall in food chain minerals.

  6. Traumatic Lung Herniation following Skateboard Fall

    Directory of Open Access Journals (Sweden)

    Dafney L. Davare

    2016-01-01

    Full Text Available Lung herniation (LH is a rare clinical entity involving the protrusion of lung outside the thoracic cage. It has a variety of etiologies and clinical presentations, making diagnosis difficult. We present a case of a 20-year-old male who reported pleuritic pain after falling from a skateboard. Evaluation through computed tomography (CT scanning of the chest revealed an anterior lung hernia associated with rib fractures. This case emphasizes the need for clinicians to include lung herniation in the differential diagnosis of patients with trauma and inexplicable or persistent pulmonary issues.

  7. Comparison of the Validity of Four Fall-Related Psychological Measures in a Community-Based Falls Risk Screening

    Science.gov (United States)

    Moore, Delilah S.; Ellis, Rebecca; Kosma, Maria; Fabre, Jennifer M.; McCarter, Kevin S.; Wood, Robert H.

    2011-01-01

    We examined the measurement properties of fall-related psychological instruments with a sample of 133 older adults (M age = 74.4 years, SD = 9.4). Measures included the Comprehensive Falls Risk Screening Instrument, Falls-efficacy Scale-International (FES-I), Activities-specific Balance Confidence (ABC), modified Survey of Activities and Fear of…

  8. 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.

  9. Factors associated with recognition and prioritization for falling, and the effect on fall incidence in community dwelling older adults

    NARCIS (Netherlands)

    Jansen, Sofie; Schoe, Jolanda; van Rijn, Marjon; Abu-Hanna, Ameen; Moll van Charante, Eric P.; van der Velde, Nathalie; de Rooij, Sophia E.

    2015-01-01

    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

  10. Factors associated with recognition and prioritization for falling, and the effect on fall incidence in community dwelling older adults

    NARCIS (Netherlands)

    Jansen, Sofie; Schoe, Jolanda; van Rijn, Marjon; Abu-Hanna, Ameen; van Charante, Eric P. Moll; van der Velde, Nathalie; de Rooij, Sophia E.

    2015-01-01

    Background: 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

  11. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    NARCIS (Netherlands)

    Zijden, A.M. van der; Groen, B.E.; Tanck, E.J.M.; Nienhuis, B.; Verdonschot, N.J.J.; Weerdesteijn, V.G.M.

    2012-01-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force).

  12. 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.

  13. Middle Helladic Period

    DEFF Research Database (Denmark)

    Sarri, Kalliopi

    1999-01-01

    administration, e.g. the administrative buildings and the sealing of products, were abandoned. The economic decline of the Middle Bronze Age affected the social stratification as well. The changes in social stratification appear in a series of completely new burial customs which show the prevalence of social......The Middle Bronze Age on Mainland Greece is also known as the Middle Helladic period. The chronological framework of this period extends from the beginnings of the second millenium - roughly 1900 - until 1550 BC, that is until the beginnings of the Mycenaean period. The Middle Helladic period...... is considered as the dark period of the cultural decline. The remains of the material culture reveal a clear retrogression while the information available on the social stratification and economy are so few and problematic in interpretation that this period is considered as the "Middle Age of Greek Prehistory...

  14. Falls in the community: state of the science

    Directory of Open Access Journals (Sweden)

    Hester AL

    2013-06-01

    Full Text Available Amy L Hester,1 Feifei Wei2 1Clinical Informatics and Innovation, 2Department of Biostatistics, Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, USA Abstract: Falls and fall-related injuries among older community-dwelling adults continue to be a major health concern in the US. Falls are the leading cause of disability and trauma-related death in persons over 65 years of age. This article discusses current approaches in community fall management and challenges with these approaches, and offers some insight for community providers regarding this issue. Keywords: community falls, patient care planning, risk assessment, aged

  15. Home Camera-Based Fall Detection System for the Elderly

    Directory of Open Access Journals (Sweden)

    Koldo de Miguel

    2017-12-01

    Full Text Available Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

  16. Home Camera-Based Fall Detection System for the Elderly.

    Science.gov (United States)

    de Miguel, Koldo; Brunete, Alberto; Hernando, Miguel; Gambao, Ernesto

    2017-12-09

    Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow) as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

  17. Fear of falling in patients with hip fractures: prevalence and related psychological factors.

    Science.gov (United States)

    Visschedijk, Jan; van Balen, Romke; Hertogh, Cees; Achterberg, Wilco

    2013-03-01

    To determine the prevalence of fear of falling (FoF) in patients after a hip fracture, to investigate the relation with time after fracture, and to assess associations between FoF and other psychological factors. Cross-sectional study performed between September 2010 and March 2011 in elderly patients after a hip fracture. Ten postacute geriatric rehabilitation wards in Dutch nursing homes. A total of 100 patients aged ≥65 years with a hip fracture admitted to a geriatric rehabilitation ward. FoF and related concepts such as falls-related self-efficacy, depression, and anxiety were measured by means of self-assessment instruments. Of all patients, 36% had a little FoF and 27% had quite a bit or very much FoF. Scores on the Falls Efficacy Scale-International were 30.6 in the first 4 weeks after hip fracture, 35.6 in the second 4 weeks, and 29.4 in the period ≥8 weeks after fracture. In these 3 periods, the prevalence rates of FoF were 62%, 68%, and 59%, respectively. Significant correlations were found between FoF and anxiety (P falls-related self-efficacy. During rehabilitation, FoF is greatest in the second 4 weeks after hip fracture. More studies are needed to explore the determinants of FoF and develop interventions to reduce FoF and improve outcome after rehabilitation. Copyright © 2013. Published by Elsevier Inc.

  18. Paths of stable configurations resulting from the interaction of two disks falling in tandem

    Science.gov (United States)

    Brosse, N.; Ern, P.

    2011-07-01

    We investigate the interaction of two identical disks falling in tandem in a fluid at rest, at Reynolds numbers Re varying between 80 and 300. Wake visualization with fluorescent dyes was used to capture the interaction process: the trailing body accelerates until it catches up with the leading body. Thick disks (χ=diameter/thickness=3) then lose their initial wakes, separate laterally and eventually fall side by side. In contrast, the wakes of thinner disks (χ⩾6) merge into a single wake and the bodies continue their fall together, adopting a Y-configuration. The paths associated with this stable configuration were investigated in detail by three-dimensional trajectography. Three regimes were identified. At the lowest Re the Y-configuration falls along a rectilinear non-vertical path, but at higher Re the centre of gravity of the pair describes a periodic path contained in a plane slightly tilted relative to the vertical, and the orientations of the bodies exhibit planar in-phase oscillations. In both cases, the two bodies behave like a single rigid body. When Re is further increased, the configuration becomes flexible, the relative distance and relative inclination of the bodies fluctuate in time and the inclined periodic motion becomes irregular.

  19. [Scientific periodicals: quality criteria].

    Science.gov (United States)

    Ferreira, Maria Cecilia Gonzaga; Krzyzanowski, Rosaly Favero

    2003-05-01

    This paper presents a historical literature review on the evaluation of periodicals and the methodology employed for their evaluation. It emphasizes the attention that should be given to the contents of the periodicals and their format based on technical standards in order to reach a global quality of the publications. This paper includes a summary of the most important aspects of the technical standards for periodicals and scientific articles.

  20. Biomass production and nutrient cycling in Eucalyptus short rotation energy forests in New Zealand: II. Litter fall and nutrient return

    Energy Technology Data Exchange (ETDEWEB)

    Guo, L.B.; Sims, R.E.H. [Institute of Technology and Engineering, Massey University, Private Bag 11222, Palmerston North (New Zealand); Horne, D.J. [Institute of Natural Resources, Massey University, Private Bag 11222, Palmerston North (New Zealand)

    2006-05-15

    Litter fall and nutrient return via the litter fall were measured during the first 3-yr rotation of three Eucalyptus short rotation forest species (E. botryoides, E. globulus and E. ovata) irrigated with meatworks effluent compared with no irrigation. Up to 13.4 oven-dry t/ha/yr of annual litter fall was recorded with nutrient returns of up to 159kgN/ha/yr, 9kgP/ha/yr, 28kgK/ha/yr, 125kgCa/ha/yr, 22kgMg/ha/yr, and 32kgMn/ha/yr. Effluent irrigation increased the litter fall and the return of some nutrients. More litter fall with higher nutrient return was found under E. globulus than under the other two species. However, the amounts of litter fall and nutrient return were highly dependent on the degree of biomass production and nutrient uptake. During the 3-yr period, up to 20% of the total above ground biomass produced was in the form of litter, and via the litter fall, up to 24% of the total N uptake was returned to the soil surface. (author)

  1. Associations between obesity and overweight and fall risk, health status and quality of life in older people.

    Science.gov (United States)

    Mitchell, Rebecca J; Lord, Stephen R; Harvey, Lara A; Close, Jacqueline C T

    2014-02-01

    To determine whether overweight and obese individuals have higher reported fall and fall injury risk than individuals of healthy weight, and to examine the influence of BMI on health, quality of life and lifestyle characteristics of fallers. A representative sample of community-based individuals aged 65 years and older in New South Wales was surveyed regarding their history of falls, height, weight, lifestyle and general health within a 12-month period. Obese individuals had a 31% higher risk of having fallen, but no higher risk of a fall-related injury compared to healthy-weight individuals. Obese fallers also had a 57% higher risk of believing nothing could be done to prevent falls; a 41% higher risk of using four or more medications; a 30% higher risk of experiencing moderate or extreme pain or discomfort; were 26% less likely have walked for two or more hours in the last week; and were less likely to think they were doing enough physical activity. Older obese individuals have an increased risk of falls and obese fallers have a higher prevalence of pain and inactivity than fallers of a healthy weight. A decrease in sedentary lifestyle and regular weight-bearing exercise may reduce fall risk in older obese individuals. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

  2. Painful menstrual periods

    Science.gov (United States)

    Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps ... related activities for a few days during each menstrual cycle. Painful menstruation is the leading cause of ...

  3. 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.

  4. Social and psychologic factors related to falls among the elderly.

    Science.gov (United States)

    Mossey, J M

    1985-08-01

    Studies on falls are reviewed. Little information exists on which social or psychologic factors predispose an older person to fall or to sustain a fall-related injury. Risk of falling appears to be greater among females, the cognitively impaired, and those who use hypnotics, tranquilizers, and diuretics. The potential significance of depression and senile dementia of the Alzheimer's type on the risk of falling is explored. It is suggested that because of the associated impaired judgment, distraction, and psychomotor retardation, the presence of either clinical condition may increase an individual's risk of falling. In the final section of the article, directions for future research are discussed. Development of a systematic research program is suggested including epidemiologic studies of all falls and of medically treated falls. Such studies should be multidisciplinary and include assessment of social and psychologic factors as well as physical and functional health status, ambulatory function, perceptual acuity, and the circumstances surrounding the fall. The psychologic consequences of falling, particularly in the absence of a serious fall-related injury, is identified as an important research area.

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

    Science.gov (United States)

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

    2016-02-01

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

  6. A Palliative Approach to Falls in Advanced Dementia.

    Science.gov (United States)

    Iaboni, Andrea; Van Ooteghem, Karen; Marcil, Meghan N; Cockburn, Amy; Flint, Alastair J; Grossman, Daphna; Keren, Ron

    2017-12-11

    Falls are viewed as a preventable cause of injury, functional loss, and death in older adults with dementia, and have been used as a marker of quality of care in long-term care facilities. Despite intensive intervention around fall prevention in these settings, falls and injury remain frequent, particularly among residents in the advanced stages of dementia. In this clinical review, we consider the common challenges and pitfalls in both the management of falls and the provision of palliative care in advanced dementia. We then describe a palliative approach to falls in advanced dementia that involves identifying individuals who would benefit from this care approach, framing falls and loss of mobility as a quality of life issue, and devising an individualized symptom assessment and management plan. A palliative approach can lead to recognition and acceptance that recurrent falls are often symptomatic of advanced dementia, and that not all falls are preventable. We conclude that falls in the advanced stage of dementia can be sentinel events indicating the need for a palliative approach to care. Rather than replace falls prevention activities, a palliative approach to falls prompts us to select dementia stage-appropriate interventions with a focus on symptom management, comfort, and dignity. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Risk Factors Related to Caregivers in Hospitalized Children's Falls.

    Science.gov (United States)

    Almis, Habip; Bucak, Ibrahim Hakan; Konca, Capan; Turgut, Mehmet

    This study aimed to evaluate the risk factors for falls in hospitalized children in relation to their caregivers. This was a case control study to evaluate the risk factors for falls in hospitalized children in relation to their caregivers. The children included in our study were at the hospital between June 2014 and June 2015. Demographic data of patients, caregivers, some habits; education level; and number of siblings were recorded. The data of 117 patients were evaluated, and there were 39 patients with a fall event and 78 patients who did not experience a fall. The mean age for the fall group and the non-fall group were 14.71±9.36 and 15.62±10.65months, respectively. The mean age for the caregivers of the fall group and the non-fall group were 29.33±5.89 and 29.53±5.56years, respectively. There was a statistically significant difference in fall risk related to the caregivers' education level (pfalls, by multivariate logistic regression, showed that low educational level of caregivers (OR=0.361; CI=0.196-0.665; pfalls. The data obtained in our study have shown that caregivers play a key role in fall events in hospitalized children. Nurses and other health workers should consider children's caregivers educational level and habits for prevention of hospitalized children falls. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. A multifactorial falls risk prediction model for hospitalized older adults.

    Science.gov (United States)

    GholamHosseini, Hamid; Baig, Mirza Mansoor; Connolly, Martin J; Lindén, Maria

    2014-01-01

    Ageing population worldwide has grown fast with more cases of chronic illnesses and co-morbidity, involving higher healthcare costs. Falls are one of the leading causes of unintentional injury-related deaths in older adults. The aim of this study was to develop a robust multifactorial model toward the falls risk prediction. The proposed model employs real-time vital signs, motion data, falls history and muscle strength. Moreover, it identifies high-risk individuals for the development falls in their activity of daily living (ADL). The falls risk prediction model has been tested at a controlled-environment in hospital with 30 patients and compared with the results from the Morse fall scale. The simulated results show the proposed algorithm achieved an accuracy of 98%, sensitivity of 96% and specificity of 100% among a total of 80 intentional falls and 40 ADLs. The ultimate aim of this study is to extend the application to elderly home care and monitoring.

  9. Disposable falling sensors to monitor atmospheric parameters

    Science.gov (United States)

    Bertoldo, S.; Lucianaz, C.; Allegretti, M.; Perona, G.

    2016-10-01

    Detailed studies and researches about clouds and precipitations characterization are considered to play a key role in weather and strong events prediction. Most monitoring instruments perform indirect monitoring operation, sensing the parameters from a remote position and not being directly inside the phenomenon. A feasibility analysis of a set of disposable sensors is presented. The very light sensors are planned to be dropped by a plane or a UAV (Unmanned Aerial Vehicle) in the atmosphere and are designed to dynamically behave as very light particles similar to raindrops in their fluctuations and falling through the atmosphere. In order to realize sensing probes with a similar fluid-dynamic behavior of drops, the weight, the size and the surface properties of the probes should be carefully designed. An estimated size of the order of many centimeters and a total weight of less than 15 g is needed. Consequently particular attention has to be paid in designing electronic boards and in the choice of integrated measurement sensors as well as the transmitter. Minimum power consumption should be also guaranteed, in order to assure the proper working during the fluctuating and falling time. Sensors installed on the sensing probe will measure different atmospheric parameters (e.g. humidity, temperature, pressure, acceleration) with a sampling interval of the order of some milliseconds. All data are then sent to a receiver located on the ground and can then be stored and post processed for further analysis.

  10. Validation and inter-rater reliability of a three item falls risk screening tool

    Directory of Open Access Journals (Sweden)

    Catherine Maree Said

    2017-11-01

    Full Text Available Abstract Background Falls screening tools are routinely used in hospital settings and the psychometric properties of tools should be examined in the setting in which they are used. The aim of this study was to explore the concurrent and predictive validity of the Austin Health Falls Risk Screening Tool (AHFRST, compared with The Northern Hospital Modified St Thomas’s Risk Assessment Tool (TNH-STRATIFY, and the inter-rater reliability of the AHFRST. Methods A research physiotherapist used the AHFRST and TNH-STRATIFY to classify 130 participants admitted to Austin Health (five acute wards, n = 115 two subacute wards n = 15; median length of stay 6 days IQR 3–12 as ‘High’ or ‘Low’ falls risk. The AHFRST was also completed by nursing staff on patient admission. Falls data was collected from the hospital incident reporting system. Results Six falls occurred during the study period (fall rate of 4.6 falls per 1000 bed days. There was substantial agreement between the AHFRST and the TNH-STRATIFY (Kappa = 0.68, 95% CI 0.52–0.78. Both tools had poor predictive validity, with low specificity (AHFRST 46.0%, 95% CI 37.0–55.1; TNH-STRATIFY 34.7%, 95% CI 26.4–43.7 and positive predictive values (AHFRST 5.6%, 95% CI 1.6–13.8; TNH-STRATIFY 6.9%, 95% CI 2.6–14.4. The AHFRST showed moderate inter-rater reliability (Kappa = 0.54, 95% CI = 0.36–0.67, p < 0.001 although 18 patients did not have the AHFRST completed by nursing staff. Conclusions There was an acceptable level of agreement between the 3 item AHFRST classification of falls risk and the longer, 9 item TNH-STRATIFY classification. However, both tools demonstrated limited predictive validity in the Austin Health population. The results highlight the importance of evaluating the validity of falls screening tools, and the clinical utility of these tools should be reconsidered.

  11. Development and evaluation of an automated fall risk assessment system.

    Science.gov (United States)

    Lee, Ju Young; Jin, Yinji; Piao, Jinshi; Lee, Sun-Mi

    2016-04-01

    Fall risk assessment is the first step toward prevention, and a risk assessment tool with high validity should be used. This study aimed to develop and validate an automated fall risk assessment system (Auto-FallRAS) to assess fall risks based on electronic medical records (EMRs) without additional data collected or entered by nurses. This study was conducted in a 1335-bed university hospital in Seoul, South Korea. The Auto-FallRAS was developed using 4211 fall-related clinical data extracted from EMRs. Participants included fall patients and non-fall patients (868 and 3472 for the development study; 752 and 3008 for the validation study; and 58 and 232 for validation after clinical application, respectively). The system was evaluated for predictive validity and concurrent validity. The final 10 predictors were included in the logistic regression model for the risk-scoring algorithm. The results of the Auto-FallRAS were shown as high/moderate/low risk on the EMR screen. The predictive validity analyzed after clinical application of the Auto-FallRAS was as follows: sensitivity = 0.95, NPV = 0.97 and Youden index = 0.44. The validity of the Morse Fall Scale assessed by nurses was as follows: sensitivity = 0.68, NPV = 0.88 and Youden index = 0.28. This study found that the Auto-FallRAS results were better than were the nurses' predictions. The advantage of the Auto-FallRAS is that it automatically analyzes information and shows patients' fall risk assessment results without requiring additional time from nurses. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  12. Falls in the nursing home: are they preventable?

    Science.gov (United States)

    Vu, Man Quang; Weintraub, Nancy; Rubenstein, Laurence Z

    2004-01-01

    Falls are prevalent in elderly patients residing in nursing homes, with approximately 1.5 falls occurring per nursing home bed-years. Although most are benign and injury-free, 10% to 25% result in hospital admission and/or fractures. Primary care providers for nursing home residents must therefore aim to reduce both the fall rate as well as the rate of fall-related morbidity in the long-term care setting. Interventions have been demonstrated to be successful in reducing falls in community-dwelling elderly patients. However, less evidence supports the efficacy of fall prevention in nursing home residents. The authors conducted a Medline search using the key words Falls and Nursing Homes. Several studies examined the efficacy of multifaceted intervention programs on reducing falls in nursing homes with varied results. Components of these intervention programs include: environmental assessment, assistive device evaluation and modification, medication changes, gait assessment and training, staff education, exercise programs, hip protector use, and blood pressure evaluation. Current literature supports the use of environmental assessment and intervention in reducing falls in nursing homes, and demonstrates an association between certain medications and falls. However, there are no studies that examine the effect of medication adjustments on fall rates. Also, the literature does not strongly suggest that exercise programs are effective in fall reduction. Although not effective in reducing fall rates, the use of hip protectors appears to result in less fall-related morbidity. More studies must be done to clarify the effects of high-risk medication reduction, the optimal nature and intensity of exercise programs, and patient targeting criteria to maximize the effectiveness of nursing home fall prevention programs. Based on the current literature, an effective multifaceted fall prevention program for nursing home residents should include risk factor assessment and

  13. Systematic Review of Falls in Older Adults with Cancer

    Science.gov (United States)

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

    2014-01-01

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

  14. 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

  15. 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.

  16. Second Period Access Report

    DEFF Research Database (Denmark)

    Maisondieu, Christophe; Giebhardt, Jochen; Tetu, Amelie

    The work described in this publication has received support from the European Community - Research Infrastructure Action under the FP7 “Capacities” Specific Programme through grant agreement number 262552, MaRINET. Project Periodic Report. 2nd Period: October 2012 – March 2014 inclusive....