Why AGU is important in Eastern Europe and should increase its role even more?

Science.gov (United States)

Mocanu, V.

2007-12-01

After the fall of the ex-communist system about twenty years ago, the East European countries faced a significant, multilateral challenge in all aspects of their economical, financial, military, scientific and especially educational and professional life. They had a pretty robust tradition in classic education and research, but had to prepare their young generation and specialists for a hard competition for grad-, post grad- and professional level competing with colleagues from other parts of the world. They had to restructure their systems and re-discovered the professional societies. AGU represented a certain model of efficiency on handling various aspects of geoscientific activities: integration of geophysics with other related disciplines like atmospheric sciences, hydrology and hydrogeology, volcanism, geochemistry etc., from deep Earth to the intergalactic space. Close cooperation with other boundary sciences, regular and very well organized meetings dedicated more to Solid earth (AGU Fall Meeting) or Near-Surface Geophysics (AGU Spring Meetings), its very close cooperation with the sister societies from Europe, other North, Central and South American countries as well as the Far East and Australia, permanent opening towards a strong international cooperation with all countries and societies world- wide, very active interest in education and career orientation, strong publication policy represented a certain attraction and a very tempting model for the East European countries. Their very quick development has to be joined by transformation of their higher education and research system in such a way that they become more and more competitive with other countries worldwide. They have to develop their own system so that it attracts more and more youngsters to remain/return home and contribute to the advance of their home countries and, in close partnerships with other developed and developing countries, with the guidance of the professional societies like AGU

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

Science.gov (United States)

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

2017-12-01

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

Research in rock deformation: Report of the Second Rock Deformation Colloquium, 1989 AGU Spring Meeting

Science.gov (United States)

Green, Harry

In response to the considerable interest expressed at the first Rock Deformation Colloquium held at the Fall 1988 AGU meeting in San Francisco, a second dinner meeting was held on Monday evening, May 8, 1989, at the Omni Hotel in Baltimore. The principal business items were a report by Steve Kirby (U.S. Geological Survey, Menlo Park, Calif.) concerning the meeting the previous day of the rock deformation steering committee and an after dinner presentation by Steve Freiman of the National Institute of Standards and Technology in Gaithersburg, Md., entitled “The Environmental Effects on Subcritical Crack Growth.” Kirby reported that a technical committee for rock deformation has been established within the Tectonophysics Section of AGU; the steering committee will attempt to establish constructive working relations with allied societies and disciplines, such as ceramics, metallurgy, materials science, structural geology, and surface science. Brian Evans of the Massachusetts Institute of Technology in Cambridge, Terry Tullis of Brown University in Providence, R.I., and Harry Green of the University of California at Davis agreed to be a subcommittee to propose a name for the technical committee, for discussion at the next steering committee meeting to be held before the 1989 Fall AGU meeting. Green also agreed to investigate the possibility of convening a special session at the Fall Meeting on the nature and mechanism of deep-focus earthquakes. (The session is Deep Slab Deformation and Faulting, T21B and T22A, organized by Harry and Ken Creager of the University of Washington, Seattle; it will be all day on Tuesday, December 5.)

Märt Agu: "Isa vari käib mul kogu aeg kannul" / Märt Agu ; interv. Aigi Viira

Index Scriptorium Estoniae

Agu, Märt

2006-01-01

1. okt. tähistas oma 30-aastast sünnipäeva ja oma ellukutsuja Mait Agu 55-sünniaastapäeva Tallinna Ülikooli koreograafiaosakond. Sel puhul esitati Estonias Mait Agu tantsulavastus "Kodalased ja kaasaegsed", mille seadis uuesti lavale Märt Agu oma isa loodud koreograafia põhjal

New software system to improve AGU membership management

Science.gov (United States)

McEntee, Chris

2012-06-01

Almost 2 years ago, AGU began investigating how it could more efficiently manage member and customer records as well as support processes that currently run on multiple systems. I am pleased to announce that on 25 June, as the result of intense efforts, AGU will migrate to a new database software system that will house the majority of AGU operations. AGU staff will have more tools at their disposal to assist members, and members will have more intuitive and user-friendly options when using the online interface to update their profiles or make purchases. I am particularly excited about this major improvement to our infrastructure because it better positions AGU to achieve goals in its strategic plan.

Fostering Diversity in the Earth and Space Sciences: The Role of AGU

Science.gov (United States)

Snow, J. T.; Johnson, R. M.; Hall, F. R.

2002-12-01

In May 2002, AGU's Committee on Education and Human Resources (CEHR) approved a new Diversity Plan, developed in collaboration with the CEHR Subcommittee on Diversity. Efforts to develop a diversity plan for AGU were motivated by the recognition that the present Earth and space science community poorly represents the true diversity of our society. Failure to recruit a diverse scientific workforce in an era of rapidly shifting demographics could have severe impact on the health of our profession. The traditional base of Earth and space scientists in the US (white males) has been shrinking during the past two decades, but women, racial and ethnic minorities, and persons with disabilities are not compensating for this loss. The potential ramifications of this situation - for investigators seeking to fill classes and recruit graduate students, for institutions looking to replace faculty and researchers, and for the larger community seeking continued public support of research funding - could be crippling. AGU's new Diversity Plan proposes a long-term strategy for addressing the lack of diversity in the Earth and space sciences with the ultimate vision of reflecting diversity in all of AGU's activities and programs. Four key goals have been identified: 1) Educate and involve the AGU membership in diversity issues; 2) Enhance and foster the participation of Earth and space scientists, educators and students from underrepresented groups in AGU activities; 3) Increase the visibility of the Earth and space sciences and foster awareness of career opportunities in these fields for underrepresented populations; and 4) Promote changes in the academic culture that both remove barriers and disincentives for increasing diversity in the student and faculty populations and reward member faculty wishing to pursue these goals. A detailed implementation plan that utilizes all of AGU's resources is currently under development in CEHR. Supportive participation by AGU members and

The AGU Hydrology Student Subcommittee (H3S) - fostering the Fall Meeting experience for young hydrologists

Science.gov (United States)

Claes, N.; Beria, H.; Brown, M. R. M.; Kumar, A.; Goodwell, A. E.; Preziosi-Ribero, A.; Morris, C. K.; Cheng, F. Y.; Gootman, K. S.; Welsh, M.; Khatami, S.; Knoben, W.

2017-12-01

The AGU Hydrology Section Student Subcommittee (H3S), the student body of the AGU hydrology section, caters to the needs of students and early career scientists whose research interests contain a hydrological component. The past two years, H3S organized a Student and Early Career Scientist conference addressing both the technical and research needs of young hydrologists. Over the past several years, H3S organized pop-up sessions in Water Sciences and Social Dimensions of Geosciences which allowed young hydrologists to share and learn from their collective experiences. Social events like the early career social mixer, co-organized with CUAHSI, led to increased networking opportunities among peers. Continuous social media engagement led to a general dialogue within the community over varied issues including research productivity, gender equality, etc. Ice-breaker events between junior and senior academics encouraged young hydrologists to talk with their academic crushes and continuously seek out mentorship opportunities. Collating our past experiences, we ponder over our accomplishments, failures, and opportunities to improve representation of early career hydrologists within the community.

AGU Public Affairs: How to Get Involved in Science Policy

Science.gov (United States)

Landau, E. A.; Hankin, E. R.; Uhlenbrock, K. M.

2012-12-01

AGU Public Affairs offers many ways for its members to get involved in science policy at different levels of participation, whether you would love to spend a year working as a resident science expert in a congressional office in Washington, D.C., or would rather simply receive email alerts about Earth and space science policy news. How you can get involved: Sign up for AGU Science Policy Alerts to receive the most relevant Earth and space science policy information delivered to your email inbox. Participate in one of AGU's Congressional Visits Days to speak with your legislators about important science issues. Attend the next AGU Science Policy Conference in spring 2013. Participate in events happening on Capitol Hill, and watch video of past events. Learn about AGU Embassy Lectures, where countries come together to discuss important Earth and space science topics. Learn how you can comment on AGU Position Statements. Apply to be an AGU Congressional Science Fellow, where you can work in a congressional office for one year and serve as a resident science expert, or to be an AGU Public Affairs Intern, where you can work in the field of science policy for three months. The AGU Public Affairs Team will highlight ways members can be involved as well as provide information on how the team is working to shape policy and inform society about the excitement of AGU science.

Inaugural AGU Science Policy Conference

Science.gov (United States)

Uhlenbrock, Kristan

2012-01-01

AGU will present its inaugural Science Policy Conference, 30 April to 3 May 2012, at the Ronald Reagan Building and International Trade Center, located in downtown Washington, D. C. This conference will bring together leading scientists, policy makers, industry professionals, press, and other stakeholders to discuss natural hazards, natural resources, oceans, and Arctic science and the role these sciences play in serving communities. To bridge the science and policy fields, AGU plans to host this conference every 2 years and focus on the applications of Earth and space sciences to serve local and national communities. "Our nation faces a myriad of challenges such as the sustainability of our natural resources, current and future energy needs, and the ability to mitigate and adapt to natural and manmade hazards," said Michael McPhaden, president of AGU. "It is essential that policies to address these challenges be built on a solid foundation of credible scientific knowledge."

AGU's Updated Scientific Integrity and Professional Ethics Policy

Science.gov (United States)

McPhaden, M. J.

2017-12-01

AGU'S mission is to promote discovery in Earth and space science for the benefit of humanity. This mission can only be accomplished if all those engaged in the scientific enterprise uphold the highest standards of scientific integrity and professional ethics. AGU's Scientific Integrity and Professional Ethics Policy provides a set of principles and guidelines for AGU members, staff, volunteers, contractors, and non-members participating in AGU sponsored programs and activities. The policy has recently been updated to include a new code of conduct that broadens the definition of scientific misconduct to include discrimination, harassment, and bullying. This presentation provides the context for what motivated the updated policy, an outline of the policy itself, and a discussion of how it is being communicated and applied.

Tantsuime: märjaks nutetud Märt Agu saab 8000 uut sõpra / Märt Agu ; intervjueerinud Rein Sikk

Index Scriptorium Estoniae

Agu, Märt, 1980-

2011-01-01

11. Noorte tantsupeo "Maa ja ilm" üldjuht ja Tallinna Tantsuakadeemia kunstiline juht Märt Agu Tallinna lauluväljakul toimuvast tantsupeost, ülevaatustest, eesti meeste rahvatantsust, oma isast Mait Agust, tema tantsust "Põhjamaa", tantsuõpetaja elukutsest, eesti tantsust, Tallinna Tantsuakadeemiast. Andmeid Märt Agu loomingu kohta

Public affairs events at Fall Meeting

Science.gov (United States)

Uhlenbrock, Kristan

2012-02-01

AGU's Public Affairs team presented two workshop luncheons and hosted 17 oral and poster sessions at the 2011 Fall Meeting. Topics ranged from defining the importance of the geosciences, to climate change science for communities and institutions. The workshop luncheon "How to Be a Congressional Science Fellow or Mass Media Fellow" was a well-attended event with more than 115 participants. The luncheon provided the opportunity for audience members to ask fellow scientists about their experiences working either in Congress or as a reporter for a news organization. For scientists looking to expand their expertise outside the academic environment, these AGU fellowships are fantastic opportunities.

New AGU Executive Director Outlines Goals and Priorities

Science.gov (United States)

Showstack, Randy

2010-04-01

When Christine W. McEntee takes the helm at AGU as the new executive director on 30 August, she will bring with her a number of key qualities: more than 25 years of successful association leadership and management experience, a passion for the Earth and space sciences to benefit humanity, a commitment to working to ensure the planet's sustainability, a respect for AGU's distinguished legacy, and the desire and ability to help AGU grow to a higher level of effectiveness. “I have always liked to work in professional associations that are solid and strong and want to go to their next level of excellence—that is where my sweet spot is in being an association executive—and that is what AGU wants to do. So I am very excited about that: a match with what I really enjoy and get passionate about doing in an area that I really care about,” McEntee told Eos in an in-depth interview.

Why publish with AGU?

Science.gov (United States)

Graedel, T. E.

The most visible activity of the American Geophysical Union is its publication of scientific journals. There are eight of these: Journal of Geophysical Research—Space Physics (JGR I), Journal of Geophysical Research—Solid Earth (JGR II), Journal of Geophysical Research—Oceans and Atmospheres (JGR III), Radio Science (RS), Water Resources Research (WRR), Geophysical Research Letters (GRL), Reviews of Geophysics and Space Physics (RGSP), and the newest, Tectonics.AGU's journals have established solid reputations for scientific excellence over the years. Reputation is not sufficient to sustain a high quality journal, however, since other factors enter into an author's decision on where to publish his or her work. In this article the characteristics of AGU's journals are compared with those of its competitors, with the aim of furnishing guidance to prospective authors and a better understanding of the value of the products to purchasers.

AGU honored for Antarctic book

Science.gov (United States)

AGU has won an honorable mention award at the Fifteenth Annual Awards Program for Excellence in Professional and Scholarly Publishing sponsored by the Association of American Publishers for the book Volcanoes of the Antarctic Plate and Southern Oceans. The book is part of AGU's Antarctic Research Series, an outgrowth of research done during the International Geophysical Year that was begun in 1963 with a grant from the National Science Foundation. The award was presented at the AAP Annual Awards Dinner on February 6 at the Ritz-Carlton Hotel in Washington, D.C. The award consists of a medallion and a plate on which the names of the publisher, title, and authors are engraved.

Ensuring Integrity in AGU Publications and Compliance With Dual Publication Policy

Science.gov (United States)

Kumar, Praveen; Calais, Eric

2011-03-01

To ensure the highest standards for publication, AGU has begun screening manuscript submissions using CrossCheck (http://www.crossref.org/crosscheck.html) for possible verbatim use of previously published material. Water Resources Research and Geophysical Research Letters have tested this technology since summer 2010. It has proven very useful in ensuring the highest integrity in publication standards and compliance with the AGU dual publication policy (http://www.agu.org/pubs/authors/policies/dualpub_policy.shtml). According to Barbara Major, assistant director of journals, other AGU journals will adopt this screening process in the near future.

AGU hydrology publication outlets

Science.gov (United States)

Freeze, R. Allan

In recent months I have been approached on several occasions by members of the hydrology community who asked me which of the various AGU journals and publishing outlets would be most suitable for a particular paper or article that they have prepared.Water Resources Research (WRR) is the primary AGU outlet for research papers in hydrology. It is an interdisciplinary journal that integrates research in the social and natural sciences of water. The editors of WRR invite original contributions in the physical, chemical and biological sciences and also in the social and policy sciences, including economics, systems analysis, sociology, and law. The editor for the physical sciences side of the journal is Donald R. Nielson, LAWR Veihmeyer Hall, University of California Davis, Davis, CA 95616. The editor for the policy sciences side of the journal is Ronald G. Cummings, Department of Economics, University of New Mexico, Albuquerque, NM 87131

Transcriptomic profile of aguR deletion mutant of Lactococcus lactis subsp. cremoris CECT 8666

Science.gov (United States)

del Rio, Beatriz; Linares, Daniel M.; Redruello, Begoña; Martin, Maria Cruz; Fernandez, Maria; de Jong, Anne; Kuipers, Oscar P.; Ladero, Victor; Alvarez, Miguel A.

2015-01-01

Lactococcus lactis subsp. cremoris CECT 8666 (formerly GE2-14) is a dairy strain that catabolizes agmatine (a decarboxylated derivative of arginine) into the biogenic amine putrescine by the agmatine deiminase (AGDI) pathway [1]. The AGDI cluster of L. lactis is composed by five genes aguR, aguB, aguD, aguA and aguC. The last four genes are responsible for the deamination of agmatine to putrescine and are co-transcribed as a single policistronic mRNA forming the catabolic operon aguBDAC[1]. aguR encodes a transmembrane protein that functions as a one-component signal transduction system that senses the agmatine concentration of the medium and accordingly regulates the transcription of aguBDAC[2], which is also transcriptionally regulated by carbon catabolic repression (CCR) via glucose, but not by other sugars such as lactose and galactose [1], [3]. Here we report the transcriptional profiling of the aguR gene deletion mutant (L. lactis subsp. cremoris CECT 8666 ∆aguR) [2] compared to the wild type strain, both grown in M17 medium with galactose as carbon source and supplemented with agmatine. The transcriptional profiling data of AguR-regulated genes were deposited in the Gene Expression Omnibus (GEO) database under accession no. GSE59514. PMID:26697381

Transcriptomic profile of aguR deletion mutant of Lactococcus lactis subsp. cremoris CECT 8666

Directory of Open Access Journals (Sweden)

Beatriz del Rio

2015-12-01

Full Text Available Lactococcus lactis subsp. cremoris CECT 8666 (formerly GE2-14 is a dairy strain that catabolizes agmatine (a decarboxylated derivative of arginine into the biogenic amine putrescine by the agmatine deiminase (AGDI pathway [1]. The AGDI cluster of L. lactis is composed by five genes aguR, aguB, aguD, aguA and aguC. The last four genes are responsible for the deamination of agmatine to putrescine and are co-transcribed as a single policistronic mRNA forming the catabolic operon aguBDAC [1]. aguR encodes a transmembrane protein that functions as a one-component signal transduction system that senses the agmatine concentration of the medium and accordingly regulates the transcription of aguBDAC [2], which is also transcriptionally regulated by carbon catabolic repression (CCR via glucose, but not by other sugars such as lactose and galactose [1,3]. Here we report the transcriptional profiling of the aguR gene deletion mutant (L. lactis subsp. cremoris CECT 8666 ∆aguR [2] compared to the wild type strain, both grown in M17 medium with galactose as carbon source and supplemented with agmatine. The transcriptional profiling data of AguR-regulated genes were deposited in the Gene Expression Omnibus (GEO database under accession no. GSE59514.

7 years of MacGyver sessions at EGU and AGU: what happened?

Science.gov (United States)

Hut, Rolf; Selker, John; Weijs, Steven; Luxemburg, Wim; Wickert, Andy; Blume, Theresa; Bamburger, Jan; Stoof, Cathelijne; Tauro, Flavia

2016-04-01

The session that this poster is in, the: "Self-made sensors and unintended use of measurement equipment", also known as the "MacGyver-session" has had 7 years of scientists contributing their self made devices, hacks and solutions with the hydrological community. In 2009, the first session was held at the AGU fall meeting and since 2011 a session is also organised at the EGU General Assembly. On this poster, and in the accompanying review paper, we will present an overview of the work presented in the last 7 years, cataloging the work of the inventive scientists who have contributed to these successful, and above all: fun, sessions.

AGU education and public outreach programs: Empowering future Earth and space scientists

Science.gov (United States)

Adamec, Bethany; Asher, Pranoti

2011-10-01

The staff and leadership of AGU are committed to fostering excellence in Earth and space science education. While AGU's Strategic Plan does not specifically highlight primary or secondary education among its objectives, outreach in this area plays a significant role in developing and nurturing the next generation of Earth and space scientists. Several educational goals along with specific strategies will help AGU meet its goal related to workforce or talent pool development. Particular emphasis is being placed on building partnerships and collaborations that will increase the effectiveness of AGU's outreach efforts related to education.

MO-FG-BRA-07: Theranostic Gadolinium-Based AGuIX Nanoparticles for MRI-Guided Radiation Therapy

International Nuclear Information System (INIS)

Detappe, A; Rottmann, J; Kunjachan, S; Berbeco, R; Tillement, O

2015-01-01

Purpose: AGuIX are gadolinium-based nanoparticles, initially developed for MRI, that have a potential role in radiation therapy as a radiosensitizer. Our goal is to demonstrate that these nanoparticles can both be used as an MRI contrast agent, as well as to obtain local dose enhancement in a pancreatic tumor when delivered in combination with an external beam irradiation. Methods: We performed in vitro cell uptake and radiosensitization studies of a pancreatic cancer cell line in a low energy (220kVp) beam, a standard clinical 6MV beam (STD) and a flattening filter free clinical 6MV beam (FFF). After injection of 40mM of nanoparticles, a biodistribution study was performed in vivo on mice with subcutaneous xenograft pancreatic tumors. In vivo radiation therapy studies were performed at the time point of maximum tumor uptake. Results: The concentration of AGuIX nanoparticles in Panc-1 pancreatic cancer cells, determined in vitro by MRI and ICPMS, peaks after 30 minutes with 0.3% of the initial concentration (5mg/g). Clonogenic assays show a significant effect (p<0.05) when the AGuIX are coupled with MV photon irradiation (DEF20%=1.31). Similar AGuIX tumor uptake is found in vivo by both MRI and ICPMS 30 minutes after intravenous injection. For long term survival studies, the choice of the radiation dose is determined with 5 control groups (3mice/group) irradiated with 0, 5, 10, 15, and 20Gy. Afterwards, 4 groups (8mice/group) are used to evaluate the effect of the nanoparticles. A Logrank test is performed as a statistical test to evaluate the effect of the nanoparticles. Conclusion: The combination of the MRI contrast and radiosensitization properties of gadolinium nanoparticles reveals a strong potential for usage with MRI-guided radiation therapy

Major Changes in AGU Publication Fees

Science.gov (United States)

Cook, Bill

2010-12-01

Effective with any manuscript submitted after 31 December 2010, AGU is eliminating color charges in all formats. At the same time that we eliminate color charges, we are simplifying publication fees. Articles published in Journal of Geophysical Research; Geochemistry, Geophysics, Geosystems; and Radio Science will each have a flat fee of $1000, and Geophysical Research Letters (GRL) articles will each have a flat fee of $500. These prices represent a small drop from the average cost currently paid by authors. We will retain the excess page charges for full articles longer than 13 pages (including Water Resources Research) and 4 pages for letters, comments, and replies. This simplification means we can streamline the “calculator” authors must use when submitting manuscripts to AGU.

Regulation of the alpha-glucuronidase-encoding gene ( aguA) from Aspergillus niger.

Science.gov (United States)

de Vries, R P; van de Vondervoort, P J I; Hendriks, L; van de Belt, M; Visser, J

2002-09-01

The alpha-glucuronidase gene aguA from Aspergillus niger was cloned and characterised. Analysis of the promoter region of aguA revealed the presence of four putative binding sites for the major carbon catabolite repressor protein CREA and one putative binding site for the transcriptional activator XLNR. In addition, a sequence motif was detected which differed only in the last nucleotide from the XLNR consensus site. A construct in which part of the aguA coding region was deleted still resulted in production of a stable mRNA upon transformation of A. niger. The putative XLNR binding sites and two of the putative CREA binding sites were mutated individually in this construct and the effects on expression were examined in A. niger transformants. Northern analysis of the transformants revealed that the consensus XLNR site is not actually functional in the aguA promoter, whereas the sequence that diverges from the consensus at a single position is functional. This indicates that XLNR is also able to bind to the sequence GGCTAG, and the XLNR binding site consensus should therefore be changed to GGCTAR. Both CREA sites are functional, indicating that CREA has a strong influence on aguA expression. A detailed expression analysis of aguA in four genetic backgrounds revealed a second regulatory system involved in activation of aguA gene expression. This system responds to the presence of glucuronic and galacturonic acids, and is not dependent on XLNR.

1990 Fall Meeting Report

Science.gov (United States)

Chapman, David S.

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

Exploration Station Brings AGU Science to Children and Parents

Science.gov (United States)

Cooper, Paul

2008-08-01

More than 20 families from the Fort Lauderdale, Fla., area attended AGU's pilot family science event, ``Exploration Station,'' held on 26 May as part of the 2008 Joint Assembly. During the event-which was organized by AGU's education staff, the Association for Astronomy Education, and the Solar Physics Division of the American Astronomical Association-children and parents had the opportunity to discuss science with researchers and to get involved with many hands-on activities.

AGU Webinars: Leveraging 21st Century Technology to Level the Playing Field

Science.gov (United States)

Janick, N. G.; Harwell, D. E.; Hankin, E. R.; Asher, P. M.; Marasco, L.

2017-12-01

AGU Webinars offer weekly insights into topics in the Earth and space sciences presented by scientists and other experts every Thursday at 2:00 pm ET. Its monthly Professional Development series emphasizes essential soft skills, connections to experiential and learning opportunities, jobs outside of academia, and other career resources. Additional topics focus on science communication, science policy, special topics for Earth and space science department heads and chairs, technical highlights from AGU Meetings and Publications, among others. By offering these live sessions and recordings free of charge to all participants, AGU is removing barriers to entry and encouraging diversity in the global talent pool of Earth and space scientists. This presentation will look at the first year of the AGU Webinars program and explore its future goals and how we can achieve them together.

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

Science.gov (United States)

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

2018-04-11

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

AGU Pathfinder: Career and Professional Development Resources for Earth and Space Scientists

Science.gov (United States)

Harwell, D. E.; Asher, P. M.; Hankin, E. R.; Janick, N. G.; Marasco, L.

2017-12-01

The American Geophysical Union (AGU) is committed to inspiring and educating present and future generations of diverse, innovative, and creative Earth and space scientists. To meet our commitment, AGU provides career and educational resources, webinars, mentoring, and support for students and professionals at each level of development to reduce barriers to achievement and to promote professional advancement. AGU is also working with other organizations and educational institutions to collaborate on projects benefiting the greater geoscience community. The presentation will include an overview of current Pathfinder efforts, collaborative efforts, and an appeal for additional partnerships.

Lanzerotti to Head New AGU Journal on Space Weather

Science.gov (United States)

Lifland, Jonathan

Louis J. Lanzerotti has been named editor of a new AGU online publication devoted to the emerging field of near-Earth space conditions and their effects on technical systems. Space Weather: The International Journal of Research and Applications, will be the first journal dedicated solely to the subject, and will include peer-reviewed research, as well as news, features, and opinion articles. A quarterly magazine digest will also be published from the online edition and distributed free of charge to space weather professionals. Lanzerotti, a longtime AGU member who was elected an AGU Fellow in 1985, is currently a consulting physicist at Lucent Technologies Bell Laboratories, and a distinguished research professor at the New Jersey Institute of Technology. He also serves on the governing board of the American Institute of Physics. He is author or co-author of more than 500 publications, including many related to space weather and its effects on communications.

Regulation of the alpha-glucuronidase-encoding gene (aguA) from Aspergillus niger

NARCIS (Netherlands)

Vries, de R.P.; Vondervoort, van de P.J.I.; Hendriks, L.; Belt, van de M.; Visser, J.

2002-01-01

The !-glucuronidase gene aguA from Aspergillus niger was cloned and characterised. Analysis of the promoter region of aguA revealed the presence of four putative binding sites for the major carbon catabolite repressor protein CREA and one putative binding site for the transcriptional activator XLNR.

Lin Receives 2010 Natural Hazards Focus Group Award for Graduate Research

Science.gov (United States)

2010-11-01

Ning Lin has been awarded the Natural Hazards Focus Group Award for Graduate Research, given annually to a recent Ph.D. recipient for outstanding contributions to natural hazards research. Lin's thesis is entitled “Multi-hazard risk analysis related to hurricanes.” She is scheduled to present an invited talk in the Extreme Natural Events: Modeling, Prediction, and Mitigation session (NH20) during the 2010 AGU Fall Meeting, held 13-17 December in San Francisco, Calif. Lin will be formally presented with the award at the Natural Hazards focus group reception on 14 December 2010.

AguR, a Transmembrane Transcription Activator of the Putrescine Biosynthesis Operon in Lactococcus lactis, Acts in Response to the Agmatine Concentration.

Science.gov (United States)

Linares, Daniel M; Del Rio, Beatriz; Redruello, Begoña; Ladero, Victor; Martin, M Cruz; de Jong, Anne; Kuipers, Oscar P; Fernandez, Maria; Alvarez, Miguel A

2015-09-01

Dairy industry fermentative processes mostly use Lactococcus lactis as a starter. However, some dairy L. lactis strains produce putrescine, a biogenic amine that raises food safety and spoilage concerns, via the agmatine deiminase (AGDI) pathway. The enzymatic activities responsible for putrescine biosynthesis in this bacterium are encoded by the AGDI gene cluster. The role of the catabolic genes aguB, aguD, aguA, and aguC has been studied, but knowledge regarding the role of aguR (the first gene in the cluster) remains limited. In the present work, aguR was found to be a very low level constitutively expressed gene that is essential for putrescine biosynthesis and is transcribed independently of the polycistronic mRNA encoding the catabolic genes (aguBDAC). In response to agmatine, AguR acts as a transcriptional activator of the aguB promoter (PaguB), which drives the transcription of the aguBDAC operon. Inverted sequences required for PaguB activity were identified by deletion analysis. Further work indicated that AguR is a transmembrane protein which might function as a one-component signal transduction system that senses the agmatine concentration of the medium and, accordingly, regulates the transcription of the aguBDAC operon through a C-terminal cytoplasmic DNA-binding domain typically found in LuxR-like proteins. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Growing and Supporting the Student and Early Career Pipeline in Earth and Space Sciences - A Spotlight on New AGU Initiatives

Science.gov (United States)

Hankin, E. R.; Williams, B. M.; Asher, P. M.; Furukawa, H.; Holm Adamec, B.; Lee, M.; Cooper, P.

2015-12-01

The American Geophysical Union (AGU) is home to more than 60,000 scientists from 139 countries. Included in this membership are approximately 20,000 (34%) student and early career members. Many well-established programs within AGU provide a dynamic forum for Earth and Space scientists to advance research, collaborate across disciplines, and communicate the importance and impact of science to society regardless of career stage—programs such as AGU publications, scientific meetings and conferences, honors and recognition, and other educational and scientific forums. Additionally, many AGU program initiatives focusing specifically on supporting student and early career scientists and the global talent pool pipeline ones are actively underway. These include both new and long-standing programs. This presentation will describe (1) the overall demographics and needs in Earth and Space sciences, and (2) AGU's coordinated series of programs designed to help attract, retain and support student and early career scientists—with an emphasis on new programmatic activities and initiatives targeting improved diversity. Included in this presentation are a description of the AGU BrightSTaRS Program, the AGU Berkner Program for international students, a newly established AGU Student & Early Career Conference, the AGU Virtual Poster Showcase initiative, the AGU Meeting Mentor program, and GeoLEAD—an umbrella program being jointly built by a coalition of societies to help address Earth and space sciences talent pool needs.

AGU Committee on Education and Human Resources Sub-Committee on Diversity Program for the term 2004-2006

Science.gov (United States)

Alexander, C. J.; Hiza, M.; Jenkins, G.; Karsten, J.; Molina, L.; Pyrtle, A.; Runyon, C.

2004-12-01

The American Geophysical Union (AGU) founded the Diversity Subcommittee in 2000 to address what the AGU felt were important issues for the future of the geoscience community. A recent AGU statement of commitment and concern about issues of diversity reads, in part: It is essential that new strategies for educating, recruiting, and retaining geoscientists from currently under-represented populations be developed (a) for individual investigators seeking students to fill classes or work in their research programs; (b) for institutions looking to replace faculty and researchers; (c) for the larger community looking to the public for continued research funding, and (d) for the future US membership of AGU. In an effort to fulfill its charge, the majority of the 2004-2006 sub-committee's activities will be directed towards: (1) Education of the AGU Membership, including the sub-committee itself, on the salient issues of Diversity; (2) Mentoring and supporting minority students in the pipeline of Earth and Space Science education as well as minority faculty seeking to establish successful collaborations; (3) Establishing a mechanism for quantitative assessment of (a) the AGU demographics, (b) member knowledge, and (c) success of programs in the area of Diversity; (4) Conducting the first ever Chapman Conference on the needs of investigators with disabilities (July, 2005); (5) Partnering with other agencies and societies to build bridges; (6) Creating mechanisms for marketing the Earth and Space sciences to minority audiences; (7) Nurturing of minority members already in the AGU; promoting these members for honors and awards within AGU. Details, goals, and milestones of this program will be presented.

Transcriptomic profile of aguR deletion mutant of Lactococcus lactis subsp. cremoris CECT 8666

NARCIS (Netherlands)

Del Rio, Beatriz; Linares, Daniel M; Redruello, Begoña; Martin, Maria Cruz; Fernandez, Maria; de Jong, Anne; Kuipers, Oscar P; Ladero, Victor; Alvarez, Miguel A

2015-01-01

Lactococcus lactis subsp. cremoris CECT 8666 (formerly GE2-14) is a dairy strain that catabolizes agmatine (a decarboxylated derivative of arginine) into the biogenic amine putrescine by the agmatine deiminase (AGDI) pathway [1]. The AGDI cluster of L. lactis is composed by five genes aguR, aguB,

AGU, Science and Engagement with the Energy Industry

Science.gov (United States)

Leinen, M.; Davidson, E. A.

2016-12-01

The relationship between science and society evolves over time and the social, political, and economic factors shaping this relationship are complex. When problems facing society become more challenging, the public, NGOs, and policy makers call for science to more directly inform solutions, to assure accountability for the use of funds and to address conflicts of interest. But when policy solutions for such challenges require significant economic and societal tradeoffs, discussion of the science can become polarized and politicized. When this occurs, AGU's policies that uphold the highest standards of scientific integrity, address conflicts of interests and promote independence for members are even more important. These policies are implemented through processes for: a) control of science presented at meeting and in publications; b) requirements for data cited in publications to be publicly accessible, and c) an organizational support policy that prohibits sponsors from influencing science presented in AGU programs. The private sector wields vast influence on human behavior and governmental policy through commerce and lobbying. These actions can be controversial when the profit motive appears incongruent with other societal opinions of what is in the public interest. Climate change is an example of this tension, where the economic exploitation of fossil fuels has complex effects on food and energy security as well as on the environment. Nonetheless, the AGU Board unanimously agreed that given our mission to advance science to create a more sustainable earth, engagement of the private sector rather than disengagement is the best way to influence decision makers on all sides because we believe that the private sector needs to be part of any solutions. We plan to use our convening power and scientific authority to bring together diverse views on climate change solutions from the private, NGO, policy, decision-maker and scientific sectors to begin a substantial

The AGU Data Management Maturity Model Initiative

Science.gov (United States)

Bates, J. J.

2015-12-01

In September 2014, the AGU Board of Directors approved two initiatives to help the Earth and space sciences community address the growing challenges accompanying the increasing size and complexity of data. These initiatives are: 1) Data Science Credentialing: development of a continuing education and professional certification program to help scientists in their careers and to meet growing responsibilities and requirements around data science; and 2) Data Management Maturity (DMM) Model: development and implementation of a data management maturity model to assess process maturity against best practices, and to identify opportunities in organizational data management processes. Each of these has been organized within AGU as an Editorial Board and both Boards have held kick off meetings. The DMM model Editorial Board will recommend strategies for adapting and deploying a DMM model to the Earth and space sciences create guidance documents to assist in its implementation, and provide input on a pilot appraisal process. This presentation will provide an overview of progress to date in the DMM model Editorial Board and plans for work to be done over the upcoming year.

Bridging Science and Policy: The AGU Science Policy Conference

Science.gov (United States)

Hankin, E. R.; Uhlenbrock, K.; Landau, E. A.

2013-12-01

In recent years, science has become inextricably linked to the political process. As such, it is more important now than ever for science to forge a better relationship with politics, for the health of both science and society. To help meet this need, the American Geophysical Union (AGU) strives to engage its members, shape policy, and inform society about the excitement of Earth and space science and its role in developing solutions for the sustainability of the planet. In June 2013, AGU held its second annual Science Policy Conference in Washington, D.C. The goal of the conference is to provide a new forum for diverse discussions and viewpoints on the challenges and opportunities of science policy, with a focus on applications of Earth and space science that serve local, national, and international communities. The meeting brought together more than 300 scientists, policy makers, industry professionals, members of the press, and other stakeholders to discuss the topics concerning the Arctic, climate change, oceans, energy, technology and infrastructure, and natural hazards science as they relate to challenges impacting society. Sessions such as 'The Water-Energy Nexus,' 'Potential for Megadisasters,' 'The Changing Ocean and Impacts on Human Health,' and 'Drowning and Drought: Agricultural Impacts of Climate Change' are examples of some of the intriguing and timely science policy issues addressed at the conference. The findings from the conference were used to develop a summary report. The report highlights key facts and figures to be used as a resource in discussions with policy makers and other stakeholders regarding the conference topics. This presentation will discuss the goals and outcomes of the conference and how the event represents one of the many ways AGU is approaching its 'Science and Society' priority objective as part of the Union's strategic plan; namely by increasing the effectiveness and recognition of AGU among policy makers as an authoritative

How Science and Hollywood Can Work Together Is Focus of Fall Meeting Panel

Science.gov (United States)

Showstack, Randy

2011-01-01

Jon Amiel, director of the 2003 science fiction blockbuster movie The Core, told a room packed with geophysicists at the recent AGU Fall Meeting that he had a confession to make. The confession had nothing to do with what he called the “preposterous premises” of the movie, including that humans could start or stop the spinning of Earth's core. Rather, he told the crowd at the Tuesday evening presentation “Science and the Cinema: AGU Sciences Meet Hollywood” about his recurring dream of being on stage wearing nothing but a skimpy T-shirt. “This dream now has come true. Here I am, I'm talking to a whole room of geophysicists about The Core. I've never felt like the T-shirt was this short,” he said.

Improving Diversity and Educational Outreach at the K-14 level: A Call to Action for the AGU Membership

Science.gov (United States)

Hall, F. R.; Johnson, R.

2002-12-01

In 2002, the Subcommittee on Diversity (SD) of the Committee on Education and Human Resources (CEHR) submitted a Diversity Plan to the leadership of AGU. This plan outlines specific programs and goals that AGU can follow to help improve diversity in the Earth and space sciences. Diversity issues are key components to improve the human resource potential in the geosciences. As women are the majority population, and racial and ethnic minorities are experiencing the largest growing segment of the United States population, it is within our best interest to actively recruit and retain these populations into our dynamic fields of study. The SD recognizes that the strength of the AGU lies within its membership. Composed of some of the brightest and talented scientists in the world, the AGU members are leaders and pioneers in our understanding of the Earth System. Yet, many, if not most, people within underrepresented communities are not aware of the relevance that the Earth and space sciences play in their lives. In this discussion, we will discuss the importance of the AGU membership in the Diversity Plan. In addition, we will outline specific things that AGU members can do to improve access of US students and citizenry to Earth and space science education. These steps require that AGU members become active advocates in the public, especially at the K-14 level.

Videos, tweet-ups, and training unite scientist communicators at Fall Meeting

Science.gov (United States)

Adams, Mary Catherine; Ramsayer, Kate

2012-02-01

AGU's public information office held several events at the 2011 Fall Meeting designed to train, recognize, and reward member scientists who communicate with, or want to communicate with, nonscience audiences. On Sunday, about 90 researchers gathered at the Marriott Marquis hotel for an all-day science communications training event covering topics including journalism from the insider's perspective, storytelling, and using humor to share science. On Wednesday a communications panel focusing specifically on climate science shared tips on communicating with audiences via TV and the Web, among other outlets. At a social media soiree Monday evening, geobloggers, Facebook fans, Twitter followers, and others met in person and talked about how to share news and research across the many platforms of the Internet. Later in the week, bloggers from AGU's blogosphere and other sites met for lunch to discuss the online Earth and space science community.

Staircase falls: High-risk groups and injury characteristics in 464 patients

NARCIS (Netherlands)

Boele van Hensbroek, P.; Mulder, S.; Luitse, J. S. K.; van Ooijen, M. R.; Goslings, J. C.

2009-01-01

Introduction: Few data are available about the epidemiology and injury characteristics in staircase falls. The available literature mainly concerns children and autopsy studies. Objective: To describe the epidemiology and injury characteristics of staircase falls, and to identify high-risk groups

Scientific Integrity and Professional Ethics at AGU - The Establishment and Evolution of an Ethics Program at a Large Scientific Society

Science.gov (United States)

McPhaden, Michael; Leinen, Margaret; McEntee, Christine; Townsend, Randy; Williams, Billy

2016-04-01

The American Geophysical Union, a scientific society of 62,000 members worldwide, has established a set of scientific integrity and professional ethics guidelines for the actions of its members, for the governance of the union in its internal activities, and for the operations and participation in its publications and scientific meetings. This presentation will provide an overview of the Ethics program at AGU, highlighting the reasons for its establishment, the process of dealing ethical breaches, the number and types of cases considered, how AGU helps educate its members on Ethics issues, and the rapidly evolving efforts at AGU to address issues related to the emerging field of GeoEthics. The presentation will also cover the most recent AGU Ethics program focus on the role for AGU and other scientific societies in addressing sexual harassment, and AGU's work to provide additional program strength in this area.

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

AGU candidates for office, 1998”2000, Union officers

Science.gov (United States)

Marcia K. McNutt. AGU member since 1976, Director of the Monterey Bay Aquarium Research Institute. Major areas of interest are lithospheric tectonics and mantle geodynamics. B.A. in physics (Phi Beta Kappa, summa cum laude), 1973, Colorado College; Ph.D. in Earth science, 1978, Scripps Institution of Oceanography. Researcher at U.S. Geological Survey, Menlo Park, 1979-1982semi Professor at Massachusetts Institute of Technology, 1982-1997. Member of American Association for the Advancement of Science. Authored 74 publications, 45 in AGU journals. Most important publications include The Superswell and mantle dynamics beneath the South Pacific, Science, 248, 969-975,1990semi Marine geodynamics: depth-age revisited, Rev. Geophys., U.S. National Report Supplement, 413-418,1995 Mapping the descent of Indian and Eurasian plates beneath the Tibetan plateau from gravity anomalies, J. Geophys. plume theory to explain multiple episodes of stress-triggered volcanism in the Austral Islands, Nature, in press, 1997. Awarded Macelwane Medal, 1988; Doctor of Science (honoris causa), Colorado College, 1988; NSF Visiting Professorship for Women, Lamont-Doherty Earth Observatory, 1989-1990semi Griswold Professor of Geophysics, MIT, 1991-1997 Outstanding Alumni Award, The Blake Schools, Minneapolis, 1993; Capital Science Lecturer, Carnegie Institution, 1995; Phi Beta Kappa Visiting Scholar, 1996-1997 MIT School of Science Graduate Teaching Prize, 1996. AGU service as Associate Editor and Guest Editor of Journal of Geophysical Research-Solid Earth, member of Program, Budget and Finance, and Audit and Legal Affairs committeessemi; chair of Publications and Macelwane committees, and President of the Tectonophysics Section.

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.

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

Science.gov (United States)

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

2017-05-01

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

The Updated AGU Ethics Policy: Supporting Inclusive and Diverse Field and Lab Environments within the Geosciences.

Science.gov (United States)

Williams, B. M.; McPhaden, M. J.; Gundersen, L. C.

2017-12-01

The American Geophysical Union (AGU), a scientific society of >60,000 members worldwide, has established a set of scientific integrity and professional ethics guidelines for the actions of its members, for the governance of the union in its internal activities, and for the operations and participation in its publications and scientific meetings. More recently AGU has undertaken actions to help address the issue of harassment in the sciences and other work climate issues; and, where applied more broadly as a code of standard behavior, will help address tangential issues of diversity and inclusion. This presentation will highlight the proposed policy changes and additional resources now in place, as they apply to field and lab environments. Progress to date and remaining challenges of this effort will be discussed, including AGU's work to provide additional program strength in the areas of Ethics, Diversity and Inclusion.

AGU and Wiley-Blackwell to partner on publication of journals and books

Science.gov (United States)

McEntee, Chris

2012-07-01

AGU has signed a memorandum of understanding (MOU) with Wiley-Blackwell to partner in journal and book publishing. The agreement, effective 1 January 2013, is a significant step forward in transforming AGU publishing consistent with our strategic plan goal of scientific leadership and collaboration. Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, Inc. Family-owned and publicly traded on the New York Stock Exchange, the company is strong in every major academic and professional field and partners with many of the world's leading societies. Wiley-Blackwell, a leader in developing models for open access and providing developing nations with access to science, publishes nearly 1500 peer-reviewed journals and more than 1500 new books annually. The company publishes approximately 700 society titles.

Scientific Integrity and Professional Ethics at AGU - Strategies and Actions to Impact Sexual Harassment in Science and other Work Climate Issues

Science.gov (United States)

McPhaden, Michael; Davidson, Eric; McEntee, Christine; Williams, Billy

2017-04-01

The American Geophysical Union (AGU), a scientific society of 62,000 members worldwide, has established a set of scientific integrity and professional ethics guidelines for the actions of its members, for the governance of the union in its internal activities, and for the operations and participation in its publications and scientific meetings. More recently AGU has undertaken strategies and actions to help address the issue of harassment in the sciences and other work climate issues. This presentation will provide an overview of the role of scientific societies in helping to address these important issues, as well as specific strategies and actions underway at AGU and other societies. Progress to date and remaining challenges of this effort will be discussed, including AGU's work to provide additional program strength in this area.

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.

Extended abstracts Fall 2012 automorphisms of free groups

CERN Document Server

Lustig, Martin; Ventura, Enric

2014-01-01

This volume features seventeen extended conference abstracts corresponding to selected talks given by participants at the CRM research program “Automorphisms of Free Groups: Algorithms, Geometry and Dynamics”, which took place at the Centre de Recerca Matemàtica in Barcelona in fall 2012. Most of them are short articles giving preliminary presentations of new results not yet published in regular research journals. The articles are the result from a direct collaboration among active researchers in the area after working in a dynamic and productive atmosphere. The book is intended for established researchers in the area of Group Theory, as well as for PhD and postdoc students who wish to learn more about the latest advances in this active area of research.

[comment t[Comment on] “What is AGU's proper role in society?”] AGU's role in society: Duty to the public

Science.gov (United States)

Wilshire, Howard

Bravo to William Kaula and Don Anderson for their forthright opinion, “What Is AGU's Proper Role in Society?” (Eos, April 9, 1991). In hearing preliminaries about Mission to Planet Earth at the Geological Society of America's meeting in Phoenix in 1987, I was turned off by what seemed to me to be endless self-serving proposals to probe the Earth “with our steely knives,” but with hardly a mention of how we could use the information to assist the nation in making rational decisions about the future human occupancy of Earth. I concur with Kaula and Anderson that it is not only the duty of individual scientists to speak out on controversial issues of public concern, but also the duty of professional societies to influence the public policy decision-making process in areas where our special expertise is relevant.It does not matter that opinions within the professional societies differ. Opinions within the nation differ, too. But to take no position at all because of these differences of opinion is dereliction of our duty to the public that supports us. AGU already has a mechanism for presenting a Union-endorsed position on public issues (which could serve as a model for other professional societies whose best effort is to hide under the bed). This mechanism needs to be used more aggressively so that our expert knowledge (both of facts and hypotheses) is brought to bear on matters of critical human concern.

Evaluation of a gadolinium-based nanoparticle (AGuIX) for contrast-enhanced MRI of the liver in a rat model of hepatic colorectal cancer metastases at 9.4 tesla

Energy Technology Data Exchange (ETDEWEB)

Fries, P.; Morr, D.; Mueller, A.; Massmann, A.; Seidel, R.; Schneider, G.; Buecker, A. [Saarland University Medical Center, Homburg (Germany). Clinic of Diagnostic and Interventional Radiology; Lux, F.; Tillement, O. [Universite Claude Bernard, Lyon (France). Laboratoire de Physico-Chimie des Materiaux Luminescents; Schaefer, T. [Saarland University Medical Center, Homburg (Germany). Dept. of General, Visceral and Pediatric Surgery; Menger, M.D. [Saarland University Medical Center, Homburg (Germany). Inst. for Clinical and Experimental Surgery

2015-12-15

The aim of this study was to compare a Gd-based nanoparticle (AGuIX) with a standard extracellular Gd-based contrast agent (Gd-DOTA) for MRI at 9.4 T in rats with hepatic colorectal cancer metastases. 12 rats with hepatic metastases were subjected to MRI using a 9.4 T animal scanner. T1w self-gated FLASH sequences (TR/TE=45/2.5 ms, alpha = 45 , TA=1: 23 min, FOV=5.12 x 5.12 cm{sup 2}, matrix = 256 x 256) were acquired before and at 10 time points after contrast injection. Each animal received 0.1 mmol/kg BW Gd-DOTA i.v. 2 days later AGuIX was applied at 0.01 mmol/kg BW (representing equal Gd doses). The SNR of normal liver (SNRliver), hyper- and hypoenhancing parts of tumors (SNRtumor, hyperenh/SNRtumor, hypoenhanc), erector spinae muscle (SNRmuscle), CNR and lesion enhancement (LE) were calculated based on ROI measurements. Mean SNRliver (Gd-DOTA: 14.6 ± 0.7; AGuIX: 28.2 ± 2.6, p < 0.001), SNRtumor, hyperenhanc (Gd-DOTA: 18.6 ± 1.2; AGuIX: 29.6 ± 2.8, p < 0.001), SNRtumor, hypoenhanc (Gd-DOTA: 12.0 ± 0.7; AGuIX: 15.4 ± 0.7, p < 0.001), SNRmuscle (Gd-DOTA: 12.3 ± 0.3; AGuIX: 14.0 ± 0.7, p < 0.001), mean CNR (Gd-DOTA: -2.5 ± 0.2; AGuIX: -7.5 ± 1.0, p < 0.001) and LE (Gd-DOTA: 3.8 ± 0.7; AGuIX: 14.9 ± 2.8, p=0.001) were significantly higher using AGuIX. Regardless of the larger molecular size, AGuIX demonstrates an early peak enhancement followed by a continuous washout. AGuIX provides better enhancement at 9.4 T compared to Gd-DOTA for equal doses of applied Gd. This is based on the molecule structure and the subsequent increased interaction with protons leading to a higher relaxivity. AGuIX potentially ameliorates the conspicuity of focal liver lesions and may improve the sensitivity in diagnostic imaging of malignant hepatic tumors.

Evaluation of a gadolinium-based nanoparticle (AGuIX) for contrast-enhanced MRI of the liver in a rat model of hepatic colorectal cancer metastases at 9.4 tesla

International Nuclear Information System (INIS)

Fries, P.; Morr, D.; Mueller, A.; Massmann, A.; Seidel, R.; Schneider, G.; Buecker, A.; Lux, F.; Tillement, O.; Schaefer, T.; Menger, M.D.

2015-01-01

The aim of this study was to compare a Gd-based nanoparticle (AGuIX) with a standard extracellular Gd-based contrast agent (Gd-DOTA) for MRI at 9.4 T in rats with hepatic colorectal cancer metastases. 12 rats with hepatic metastases were subjected to MRI using a 9.4 T animal scanner. T1w self-gated FLASH sequences (TR/TE=45/2.5 ms, alpha = 45 , TA=1: 23 min, FOV=5.12 x 5.12 cm 2 , matrix = 256 x 256) were acquired before and at 10 time points after contrast injection. Each animal received 0.1 mmol/kg BW Gd-DOTA i.v. 2 days later AGuIX was applied at 0.01 mmol/kg BW (representing equal Gd doses). The SNR of normal liver (SNRliver), hyper- and hypoenhancing parts of tumors (SNRtumor, hyperenh/SNRtumor, hypoenhanc), erector spinae muscle (SNRmuscle), CNR and lesion enhancement (LE) were calculated based on ROI measurements. Mean SNRliver (Gd-DOTA: 14.6 ± 0.7; AGuIX: 28.2 ± 2.6, p < 0.001), SNRtumor, hyperenhanc (Gd-DOTA: 18.6 ± 1.2; AGuIX: 29.6 ± 2.8, p < 0.001), SNRtumor, hypoenhanc (Gd-DOTA: 12.0 ± 0.7; AGuIX: 15.4 ± 0.7, p < 0.001), SNRmuscle (Gd-DOTA: 12.3 ± 0.3; AGuIX: 14.0 ± 0.7, p < 0.001), mean CNR (Gd-DOTA: -2.5 ± 0.2; AGuIX: -7.5 ± 1.0, p < 0.001) and LE (Gd-DOTA: 3.8 ± 0.7; AGuIX: 14.9 ± 2.8, p=0.001) were significantly higher using AGuIX. Regardless of the larger molecular size, AGuIX demonstrates an early peak enhancement followed by a continuous washout. AGuIX provides better enhancement at 9.4 T compared to Gd-DOTA for equal doses of applied Gd. This is based on the molecule structure and the subsequent increased interaction with protons leading to a higher relaxivity. AGuIX potentially ameliorates the conspicuity of focal liver lesions and may improve the sensitivity in diagnostic imaging of malignant hepatic tumors.

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

Science.gov (United States)

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

2016-12-01

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

Charting a path forward: building AGU's capacity to help foster scientist-decision maker engagement

Science.gov (United States)

Vano, J. A.; Behar, D. H.; Mote, P.; Ferguson, D. B.; Pandya, R.

2016-12-01

Most research proposals, papers, and presentation abstracts begin with the motivation that the new science presented will benefit society. Behind this, beyond making good on the promises to get funding, is a sincere effort to contribute our knowledge and talent to build a better (safer, sustainable, more resilient) world. For this to happen, however, the science needs to be connected to people in communities who make decisions. While this happens in a variety of ways, often for research to be most useful to society, engagement with decision makers should occur at the beginning and throughout the research process. Increasingly this is being recognized as important, as evidenced by the growing number of boundary organizations (e.g., U.S. Department of the Interior's Climate Science Centers, NOAA's Regional Integrated Sciences and Assessment programs). Even within AGU, in recent years there has been a number of new activities and networks that suggest a growing community of practice for those doing work at the science-society interface (e.g., The Thriving Earth Exchange, the Water and Society Technical Committee in the Hydrology Section). In this presentation, we highlight what these activities are and share insights from those involved. We evaluate trends (e.g., have the number of abstracts on this topic increased?) and present responses from AGU members to questions on where this community of practice should go next (e.g., What is the most important task the AGU community should do to improve decision maker-scientist engagement?). The goal of this presentation is to promote a conversation about how the AGU community can be better prepared to foster engagement with decision makers that will lead to more actionable science. This will help us ensure our science is useful to society, fulfilling our motivations, and arguably responsibilities, both individually and as a community. It will also serve to prepare new scientists for a broader range of careers beyond

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

NARCIS (Netherlands)

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

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

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

NARCIS (Netherlands)

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

2012-01-01

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

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

NARCIS (Netherlands)

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

2012-01-01

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

Reply to Comments on “AGU Statement: Investigation of Scientists and Officials in L'Aquila, Italy, Is Unfounded”

Science.gov (United States)

McPhaden, Michael

2010-10-01

It is critical to recognize the benefits and limitations of scientific knowledge, particularly when it comes to predicting hazards. I agree with G. J. Wasserburg that AGU should help scientists communicate their work accurately and understandably so it can provide the greatest value to society. This objective is explicit in AGU's new strategic plan (http://www.agu.org/about/strategic_plan.shtml) and is consistent with our vision of both advancing and communicating Earth and space science to ensure a sustainable future. We as a community have an obligation to increase the role of science in informing policy to mitigate the impacts of natural disasters. Such efforts require an open exchange of ideas and information and a clear understanding of the limitations of our knowledge. In response to Flavio Dobran, I agree that scientists are not above the law and, like all citizens, must be held accountable for their actions. However, laws and lawmakers must also recognize what science can and cannot do. We cannot yet reliably predict precisely when earthquakes will occur.

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

Science.gov (United States)

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

2011-08-12

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

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.

Expression of the Agmatine Deiminase Pathway in Enterococcus faecalis Is Activated by the AguR Regulator and Repressed by CcpA and PTSMan Systems

Science.gov (United States)

Blancato, Víctor S.; Magni, Christian

2013-01-01

Although the agmatine deiminase system (AgDI) has been investigated in Enterococcus faecalis, little information is available with respect to its gene regulation. In this study we demonstrate that the presence of exogenous agmatine induces the expression of agu genes in this bacterium. In contrast to the homologous and extensively characterized AgDI system of S. mutants, the aguBDAC operon in E. faecalis is not induced in response to low pH. In spite of this, agmatine catabolism in this bacterium contributes by neutralizing the external medium while enhancing bacterial growth. Our results indicate that carbon catabolic repression (CCR) operates on the AgDI system via a mechanism that involves interaction of CcpA and P-Ser-HPr with a cre site found in an unusual position considering the aguB promoter (55 nt upstream the +1 position). In addition, we found that components of the mannose phosphotransferase (PTSMan) system also contributed to CCR in E. faecalis since a complete relief of the PTS-sugars repressive effect was observed only in a PTSMan and CcpA double defective strain. Our gene context analysis revealed that aguR is present in oral and gastrointestinal microorganisms. Thus, regulation of the aguBDAC operon in E. faecalis seems to have evolved to obtain energy and resist low pH conditions in order to persist and colonize gastrointestinal niches. PMID:24155893

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

Fear of falling as seen in the Multidisciplinary falls consultation.

Science.gov (United States)

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

2011-06-01

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

CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study.

Science.gov (United States)

Carling, Anna; Forsberg, Anette; Gunnarsson, Martin; Nilsagård, Ylva

2017-09-01

Imbalance leading to falls is common in people with multiple sclerosis (PwMS). To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5). A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up. Post-intervention, the exercise group showed statistically significant improvement ( p = 0.015) in BBS and borderline significant improvement in MS Walking Scale ( p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before ( p balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.

Expression of the agmatine deiminase pathway in Enterococcus faecalis is activated by the AguR regulator and repressed by CcpA and PTS(Man systems.

Directory of Open Access Journals (Sweden)

Cristian Suárez

Full Text Available Although the agmatine deiminase system (AgDI has been investigated in Enterococcus faecalis, little information is available with respect to its gene regulation. In this study we demonstrate that the presence of exogenous agmatine induces the expression of agu genes in this bacterium. In contrast to the homologous and extensively characterized AgDI system of S. mutants, the aguBDAC operon in E. faecalis is not induced in response to low pH. In spite of this, agmatine catabolism in this bacterium contributes by neutralizing the external medium while enhancing bacterial growth. Our results indicate that carbon catabolic repression (CCR operates on the AgDI system via a mechanism that involves interaction of CcpA and P-Ser-HPr with a cre site found in an unusual position considering the aguB promoter (55 nt upstream the +1 position. In addition, we found that components of the mannose phosphotransferase (PTS(Man system also contributed to CCR in E. faecalis since a complete relief of the PTS-sugars repressive effect was observed only in a PTS(Man and CcpA double defective strain. Our gene context analysis revealed that aguR is present in oral and gastrointestinal microorganisms. Thus, regulation of the aguBDAC operon in E. faecalis seems to have evolved to obtain energy and resist low pH conditions in order to persist and colonize gastrointestinal niches.

Fall risk awareness and safety precautions taken by older community-dwelling women and men--a qualitative study using focus group discussions.

Directory of Open Access Journals (Sweden)

Petra Pohl

Full Text Available Daily life requires frequent estimations of the risk of falling and the ability to avoid a fall. The objective of this study was to explore older women's and men's understanding of fall risk and their experiences with safety precautions taken to prevent falls.A qualitative study with focus group discussions was conducted. Eighteen community-dwelling people [10 women and 8 men] with and without a history of falls were purposively recruited. Participants were divided into two groups, and each group met four times. A participatory and appreciative action and reflection approach was used to guide the discussions. All discussions were audio recorded and transcribed verbatim. Data were analysed by qualitative content analysis, and categories were determined inductively.Three categories describing the process of becoming aware of fall risks in everyday life were identified: 1] Facing various feelings, 2] Recognizing one's fall risk, and 3] Taking precautions. Each category comprised several subcategories. The comprehensive theme derived from the categories was "Safety precautions through fall risk awareness". Three strategies of ignoring [continuing a risky activity], gaining insight [realizing the danger in a certain situation], and anticipating [thinking ahead and acting in advance] were related to all choices of actions and could fluctuate in the same person in different contexts.The fall risk awareness process might be initiated for various reasons and can involve different feelings and precautions as well as different strategies. This finding highlights that there are many possible channels to reach older people with information about fall risk and fall prevention, including the media and their peers. The findings offer a deeper understanding of older peoples' conceptualizations about fall risk awareness and make an important contribution to the development and implementation of fall prevention programmes.

Seed fall and regeneration from a group selection cut . . . first year results

Science.gov (United States)

Philip M. McDonald

1966-01-01

To approximate a group selection cut at the Challenge Experimental Forest, 48 small openings of three sizes—30, 60, and 90 feet in diameter—were logged in 1963. One aim was to create conditions of light and soil moisture that would favor establishment and growth of Douglas-fir, sugar pine, and white fir over ponderosa pine. Seed fall and first-year...

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

Science.gov (United States)

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

2013-10-01

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

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

Science.gov (United States)

Kato, Chikako; Ida, Kunio; Harada, Atsushi

2009-09-01

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

An 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...

Millist eriala soovitate keskkoolilõpetajatele edasiõppimiseks? / Karmel Eikner, Reet Hääl, Agu Laanemets, Jaanus Laugus

Index Scriptorium Estoniae

2010-01-01

Küsimusele vastavad ettevõtja, Powered by Karmeli brändijuht Karmel Eikner, MTÜ Eesti Liisingühingute Liidu tegevdirektor Reet Hääl, OÜ Kvintessents juhatuse liige Agu Laanemets ja OÜ Uus Maa Kinnisvaragrupi juhatuse esimees Jaanus Laugus

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.

Effects of a health promotion and fall prevention program in elderly individuals participating in interaction groups

Directory of Open Access Journals (Sweden)

Lays Cavallero Pagliosa

Full Text Available Introduction Falls in elderly people are an increasing public health problem resulting in high costs to health services. Thus, it is essential to invest in the development of actions and programs focused on decreasing such risks. Objective To verify the effects of a program of health promotion and prevention of falls in relation to balance and functional abilities in elderly people participating in interaction groups in Caxias do Sul City, RS State. Materials and methods For this purpose, 14 elderly people were selected for assessment and reassessment through the following instruments: the Barthel Index, Timed Up and Go Test (TUG, Berg Balance Scale (BBS, and a questionnaire to characterize the sample. Over the course of 2 months, group activities were conducted in a multi-sensory and proprioceptive circuit with a frequency of 2 times per week, totaling 14 meetings. Results The average age of participants was about 72 years old, mostly women (78.6%; 64.3% of them had experienced falls, and 92.9% had already practiced physical activities. After the intervention, there was an average increase of 9.14 points in the BBS (p = 0.000 and an average reduction of 4.4 seconds in gait speed on the TUG test (p = 0.000. Conclusion The application of the proposed program resulted in increasing balance and gait performance of the elderly, reducing the risk of falls.

Falls and fractures in participants and excluded non-participants of a fall prevention exercise program for elderly women with a history of falls: 1-year follow-up study.

Science.gov (United States)

Kim, Hunkyung; Yoshida, Hideyo; Suzuki, Takao

2014-04-01

To evaluate the effectiveness of a strength and balance enhancing exercise intervention as a means of preventing falls in community-dwelling elderly Japanese women with a history of falls, while comparing functional fitness, fall and fracture rate in excluded subjects. A 1-year follow-up trial was carried out on 105 participants over the age of 70 years, who were randomly assigned to the exercise or education group, and also on 91 women excluded based on the exclusion criteria. The exercise group attended a 60-min exercise class twice a week for 3 months. Falls, injuries, fractures, and functional fitness assessments were measured at baseline, post-intervention and 1-year follow up. During the follow up, fall rates were 19.6% in the exercise group, 40.4% in the education group and 40.8% in excluded subjects (χ(2)  = 7.069, P = 0.029). Compared with the exercise group, the odds ratio (OR) for falls was greater in the education group (OR 2.78, 95% confidence interval (CI) 1.17-6.96) and excluded participants (OR 2.83, 95%CI 1.25-6.80). The OR for fractures was over fourfold greater in excluded participants (OR 4.30, 95% CI 1.02-9.70) than the exercise group. The exercise intervention for participants with fall history effectively decreased incidences of falls and fractures. However, fall and fracture rates in excluded people were high. Further research focusing on feasible countermeasures for falls in excluded people who are at high risk of fractures is required. © 2013 Japan Geriatrics Society.

Group fitness activities for the elderly: an innovative approach to reduce falls and injuries.

Science.gov (United States)

Bianco, Antonino; Patti, Antonino; Bellafiore, Marianna; Battaglia, Giuseppe; Sahin, Fatma Nese; Paoli, Antonio; Cataldo, Maria Concetta; Mammina, Caterina; Palma, Antonio

2014-04-01

The aim of this study was to examine the opportunity to adopt, for the elderly, already validated function ability tests to better understand how to prevent falls and injuries and to better plan group fitness activities like ballroom dance classes (e.g., Valzer, Polka, Mazurka). A cross-sectional study was conducted. The Berg Balance Scale (BBS) and the Barthel Index (BI) were administered and the occurrence of falls during the previous 2 years was evaluated by anamnesis. One hundred and twenty-two elderly subjects living in Palermo city participated to the study. According to the anamnesis, subjects were divided into two groups: experimental group (EG) and control group (CG). The EG consisted of 75 subjects attending classes of ballroom dancing (73.0 ± 5.6 years 26.1 ± 3.9 BMI), while the CG included 47 volunteers (74.3 ± 5.4 years, 26.8 ± 4.4 BMI). A threshold of 70 % for both scales (BBS-70 and BI-70 %) was set, according to the aims of the study. STATISTICA software was adopted to perform an unpaired t test. A P value lower than 0.05 was considered to be statistically relevant. The BI and BBS of CG were 76.7 ± 33.08 and 30.9 ± 14.9, respectively, while the BI and BBS of EG were 98.1 ± 6.9 and 50.5 ± 54. In EG the BBS-70 % showed 96.0 % of cases compared to 27.6 % of the CG. The BI showed a similar trend to BBS. In EG the BI-70 % showed 98.6 % of cases, while the BI-70 % of CG showed 70.2 % of cases. Moreover, only 36.0 % of EG reported falls previously, while CG reported 53.2 % of falls during the same period of time. The BBS seems to be a valid and reliable tool able to be adopted also by professionals of the ballroom dancing sector (e.g., Valzer, Polka and Mazurka classes). Instructors may evaluate the functional ability of their attendees through BBS to easily obtain more information and better plan ballroom dance classes. Moreover, we highlight that these conclusions need to be supported by other studies with different

An Ai Chi-based aquatic group improves balance and reduces falls in community-dwelling adults: A pilot observational cohort study.

Science.gov (United States)

Skinner, Elizabeth H; Dinh, Tammy; Hewitt, Melissa; Piper, Ross; Thwaites, Claire

2016-11-01

Falls are associated with morbidity, loss of independence, and mortality. While land-based group exercise and Tai Chi programs reduce the risk of falls, aquatic therapy may allow patients to complete balance exercises with less pain and fear of falling; however, limited data exist. The objective of the study was to pilot the implementation of an aquatic group based on Ai Chi principles (Aquabalance) and to evaluate the safety, intervention acceptability, and intervention effect sizes. Pilot observational cohort study. Forty-two outpatients underwent a single 45-minute weekly group aquatic Ai Chi-based session for eight weeks (Aquabalance). Safety was monitored using organizational reporting systems. Patient attendance, satisfaction, and self-reported falls were also recorded. Balance measures included the Timed Up and Go (TUG) test, the Four Square Step Test (FSST), and the unilateral Step Tests. Forty-two patients completed the program. It was feasible to deliver Aquabalance, as evidenced by the median (IQR) attendance rate of 8.0 (7.8, 8.0) out of 8. No adverse events occurred and participants reported high satisfaction levels. Improvements were noted on the TUG, 10-meter walk test, the Functional Reach Test, the FSST, and the unilateral step tests (p falls risk reduced from 38% to 21%. The study was limited by its small sample size, single-center nature, and the absence of a control group. Aquabalance was safe, well-attended, and acceptable to participants. A randomized controlled assessor-blinded trial is required.

Collaborative leadership and the implementation of community-based fall prevention initiatives: a multiple case study of public health practice within community groups.

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Markle-Reid, Maureen; Dykeman, Cathy; Ploeg, Jenny; Kelly Stradiotto, Caralyn; Andrews, Angela; Bonomo, Susan; Orr-Shaw, Sarah; Salker, Niyati

2017-02-16

Falls among community-dwelling older adults are a serious public health concern. While evidence-based fall prevention strategies are available, their effective implementation requires broad cross-sector coordination that is beyond the capacity of any single institution or organization. Community groups comprised of diverse stakeholders that include public health, care providers from the public and private sectors and citizen volunteers are working to deliver locally-based fall prevention. These groups are examples of collective impact and are important venues for public health professionals (PHPs) to deliver their mandate to work collaboratively towards achieving improved health outcomes. This study explores the process of community-based group work directed towards fall prevention, and it focuses particular attention on the collaborative leadership practices of PHPs, in order to advance understanding of the competencies required for collective impact. Four community groups, located in Ontario, Canada, were studied using an exploratory, retrospective, multiple case study design. The criteria for inclusion were presence of a PHP, a diverse membership and the completion of an initiative that fit within the scope of the World Health Organization Fall Prevention Model. Data were collected using interviews (n = 26), focus groups (n = 4), and documents. Cross-case synthesis was conducted by a collaborative team of researchers. The community groups differed by membership, the role of the PHP and the type of fall prevention initiatives. Seven practice themes emerged: (1) tailoring to address context; (2) making connections; (3) enabling communication; (4) shaping a vision; (5) skill-building to mobilize and take action; (6) orchestrating people and projects; and (7) contributing information and experience. The value of recognized leadership competencies was underscored and the vital role of institutional supports was highlighted. To align stakeholders working

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

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

2018-05-09

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

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

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

2013-04-01

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

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

Science.gov (United States)

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

2007-08-01

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

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

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

2013-10-01

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

Longitudinal association between habitual walking and fall occurrences among community-dwelling older adults: analyzing the different risks of falling.

Science.gov (United States)

Okubo, Yoshiro; Seino, Satoshi; Yabushita, Noriko; Osuka, Yosuke; Jung, Songee; Nemoto, Miyuki; Figueroa, Rafael; Tanaka, Kiyoji

2015-01-01

The purpose of this longitudinal study was to examine the association between habitual walking and multiple or injurious falls (falls) among community-dwelling older adults, by considering the relative risk of falling. A cohort of Japanese community-dwelling older adults (n=535) aged 60-91 years (73.1±6.6 year, 157 men and 378 women) who underwent community-based health check-ups from 2008 to 2012 were followed until 2013. Incidence rate of falls between walkers and non-walkers was compared separately by the number of risk factors (Groups R0, R1, R2, R3 and R4+). The Cox proportional hazard model was used to assess the association between habitual walking and falls separately by lower- (Rrisk groups. In Groups R0 and R1, the incidence of falls was lower in walkers than non-walkers; however, in Groups R2, R3, and R4+, the incidence of falls was higher in walkers. The Cox proportional hazard model showed that habitual walking was not significantly associated with falls (hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.48-1.62) among the lower risk group but that it was significantly associated with increased falls (HR: 1.89, 95% CI: 1.04-3.43) among the higher risk group. The significant interaction between habitual walking and higher risk of falling was found (Prisk factors for falling, caution is needed when recommending walking because walking can actually increase their risk of experiencing multiple or injurious falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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.

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

Science.gov (United States)

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

2016-01-01

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

The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly.

Science.gov (United States)

1987-04-01

Although falls among the elderly carry high costs to individuals and society, the prevention of falls in later life has not received adequate attention from health care professionals. The prevalence of falls appears to involve roughly one-third of persons aged 65 and over, and the risk of falling and suffering serious injury increases substantially up to the eighth decade of life. The proportion of falls which result in fracture is low, but the absolute number of older people who suffer fractures is high and places heavy demands on health care systems. Even falls which result in no physical injury often have serious social and psychological consequences for the elderly, including loss of confidence and restrictions in mobility, and high proportions of older people report fears of falling. There is a need to provide accurate information about the causes and prevention of falls in later life. Falls are not part of the normal aging process. Rather, they are due to underlying physical illnesses, medications, and environmental hazards, often in interaction. This report provides an overview of the elderly population at risk of falling and suffering serious injury, some of the reasons older people fall, and the methods to prevent falls which have been developed in both community and institutional settings. In addition, it suggests some of the practical steps which can be taken by health and social care professionals and by older people and their families in order to prevent falls. Empirical knowledge about the causes of falls by the elderly and the most effective methods of prevention remains limited. Major barriers to research have been the lack of a clear definition of a fall and the fact that falls are not included in medical diagnostic indices. It is recommended that falls be recorded as a disease entity in Index Medicus and in the International Classification of Diseases Xth Revision. To facilitate future comparisons of research findings on falls, a definition of a

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

Directory of Open Access Journals (Sweden)

Silvia Gonçalves Ricci Neri

2017-11-01

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

Fall Prevention in a Primary Care Setting.

Science.gov (United States)

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

2016-05-27

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

aguA, the gene encoding an extracellular alpha-glucuronidase from Aspergillus tubingensis, is specifically induced on xylose and not on glucuronic acid.

Science.gov (United States)

de Vries, R P; Poulsen, C H; Madrid, S; Visser, J

1998-01-01

An extracellular alpha-glucuronidase was purified and characterized from a commercial Aspergillus preparation and from culture filtrate of Aspergillus tubingensis. The enzyme has a molecular mass of 107 kDa as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 112 kDa as determined by mass spectrometry, has a determined pI just below 5.2, and is stable at pH 6.0 for prolonged times. The pH optimum for the enzyme is between 4.5 and 6.0, and the temperature optimum is 70 degrees C. The alpha-glucuronidase is active mainly on small substituted xylo-oligomers but is also able to release a small amount of 4-O-methylglucuronic acid from birchwood xylan. The enzyme acts synergistically with endoxylanases and beta-xylosidase in the hydrolysis of xylan. The enzyme is N glycosylated and contains 14 putative N-glycosylation sites. The gene encoding this alpha-glucuronidase (aguA) was cloned from A. tubingensis. It consists of an open reading frame of 2,523 bp and contains no introns. The gene codes for a protein of 841 amino acids, containing a eukaryotic signal sequence of 20 amino acids. The mature protein has a predicted molecular mass of 91,790 Da and a calculated pI of 5.13. Multiple copies of the gene were introduced in A. tubingensis, and expression was studied in a highly overproducing transformant. The aguA gene was expressed on xylose, xylobiose, and xylan, similarly to genes encoding endoxylanases, suggesting a coordinate regulation of expression of xylanases and alpha-glucuronidase. Glucuronic acid did not induce the expression of aguA and also did not modulate the expression on xylose. Addition of glucose prevented expression of aguA on xylan but only reduced the expression on xylose.

aguA, the Gene Encoding an Extracellular α-Glucuronidase from Aspergillus tubingensis, Is Specifically Induced on Xylose and Not on Glucuronic Acid

Science.gov (United States)

de Vries, Ronald P.; Poulsen, Charlotte H.; Madrid, Susan; Visser, Jaap

1998-01-01

An extracellular α-glucuronidase was purified and characterized from a commercial Aspergillus preparation and from culture filtrate of Aspergillus tubingensis. The enzyme has a molecular mass of 107 kDa as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 112 kDa as determined by mass spectrometry, has a determined pI just below 5.2, and is stable at pH 6.0 for prolonged times. The pH optimum for the enzyme is between 4.5 and 6.0, and the temperature optimum is 70°C. The α-glucuronidase is active mainly on small substituted xylo-oligomers but is also able to release a small amount of 4-O-methylglucuronic acid from birchwood xylan. The enzyme acts synergistically with endoxylanases and β-xylosidase in the hydrolysis of xylan. The enzyme is N glycosylated and contains 14 putative N-glycosylation sites. The gene encoding this α-glucuronidase (aguA) was cloned from A. tubingensis. It consists of an open reading frame of 2,523 bp and contains no introns. The gene codes for a protein of 841 amino acids, containing a eukaryotic signal sequence of 20 amino acids. The mature protein has a predicted molecular mass of 91,790 Da and a calculated pI of 5.13. Multiple copies of the gene were introduced in A. tubingensis, and expression was studied in a highly overproducing transformant. The aguA gene was expressed on xylose, xylobiose, and xylan, similarly to genes encoding endoxylanases, suggesting a coordinate regulation of expression of xylanases and α-glucuronidase. Glucuronic acid did not induce the expression of aguA and also did not modulate the expression on xylose. Addition of glucose prevented expression of aguA on xylan but only reduced the expression on xylose. PMID:9440512

A community-based Falls Management Exercise Programme (FaME) improves balance, walking speed and reduced fear of falling.

Science.gov (United States)

Yeung, Pui Yee; Chan, Wayne; Woo, Jean

2015-04-01

Although effective community falls prevention programmes for the older persons have been described, challenges remain in translating proven interventions into daily practice. To evaluate the efficacy, feasibility and acceptability of a falls prevention programme that can be integrated into daily activities in a group of community-dwelling older adults with risk of falling. A cohort study with intervention and comparison groups was designed to evaluate a 36-week group-based falls prevention exercise programme (FaME) in the community setting. Participants were aged 60 years or older, had fallen in the past 12 months, had fear of falling with avoidance of activities or had deficits in balance control. Primary outcome measures included assessment of balance control and mobility; secondary outcome measures included level of physical activity, assessment of fear of falling and health-related quality of life. There were 48 and 51 participants in the intervention and comparison groups, respectively. There were improvements in measurements of balance, walking speed and self-efficacy. The drop out rate was low (14.6% and 3.9% from the intervention and comparison groups, respectively). Overall compliance in the intervention group was 79%. Factors that motivated continued participation include the regular and long-term nature of the programme helping to reinforce their exercise habits, the simplicity of movements and friendliness of the group. The FaME programme improves balance, walking speed and reduces fear of falling. It could be widely promoted and integrated into regular health and social activities in community settings.

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.

AGuIX, a theranostic nano-particle to improve image-guided radiation therapy: a proof of concept in pancreatic cancer

International Nuclear Information System (INIS)

Detappe, Alexandre

2017-01-01

Previous studies demonstrated AGuIX ability to act as an efficient radiosensitizer under the presence of preclinical radiations or monoenergetic radiation beams for multiple cancer models. The preclinical irradiation (220 kV) has been shown effective in activating high atomic number (Z) nanoparticles. The energy peak is close to the k-edge of the different high-Z elements used (50.2 keV for the gadolinium), leading to a strong photoelectric effect. Auger electrons generation and biological effects occur afterwards creating a local dose enhancement. However, clinical treatments use a higher energy beam (≥6 MV). At these energy ranges, the photoelectric probability is less important, decreasing the direct interaction of the nanoparticles with the incoming photons. We performed a proof of concept on a pancreatic tumor model, known for its low survival rates, with preclinical and clinical radiation beams to evaluate the efficacy of the AGuIX. To increase the efficacy of the clinical radiation beam without modifying the nanoparticle structure in order to obtain a dose enhancement close to the one observed with the preclinical beam, we evaluated key clinical beam parameters to understand and increase the mechanisms of interaction between the incident photons and the high-Z nanoparticles. Hence, we evaluated analytically the impact of the radiation beam under different conditions of irradiation, confirming the potential of the AGuIX with a preclinical beam, and finally shown their significant efficacy under a clinical setup. This study is the first to evaluate the potential of a high-Z nanoparticle to act as radiosensitizer following low dose intravenous injections. (author)

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

Directory of Open Access Journals (Sweden)

Mussi Chiara

2013-01-01

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

Body mass index, falls, and injurious falls among U.S. adults: Findings from the 2014 Behavioral Risk Factor Surveillance System.

Science.gov (United States)

Ylitalo, Kelly R; Karvonen-Gutierrez, Carrie A

2016-10-01

Falls are an important health concern because they are associated with loss of independence and disability, particularly among women. We determined the age- and sex-specific prevalence of injurious falls among adults in the United States and examined the impact of obesity on fall risk. Self-reported falls, injurious falls, and health histories were obtained from 280,035 adults aged 45-79years in the 2014 Behavioral Risk Factor Surveillance System. Body mass index was categorized as underweight (fall in the previous 12months. Mid-life women 55-59years reported the highest prevalence of injurious falls (15.4%). Among mid-life women, overweight was associated with injurious falls (RR=1.17; 95% CI: 1.08, 1.28), but overweight was not associated with falling among other age-sex groups. Class II/III obesity was associated with injurious falls among all age-sex groups. After considering the mediators like health conditions (depression, cardiovascular disease, diabetes, arthritis) and behaviors (physical activity, sleep), the association of class II/III obesity and injurious fall risk persisted only among mid-life women (RR=1.23; 95% CI: 1.12, 1.36). Not only are mid-life women at high risk for falls, but the class II/III obesity is a risk factor for injurious falls. Targeting mid-life women for fall and injury prevention is an important aim for practitioners, particularly given unique correlates of falling for this group. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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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 (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for 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

Active lifestyle all your life : a multifactorial group-based falls-prevention programme

OpenAIRE

Johansson, Erika

2015-01-01

Internationally, gerontology focuses on an emerging paradigm of healthy ageing where the goal is to extend the senior years in absence of morbidity by improving human health. A major threat to healthy ageing is accidental falls, as falls are the second-leading cause of unintentional injury or deaths worldwide. For the individual who falls, it is crucial to be able to continue living an active, independent life in one’s senior years. Additionally social engagement, valued activities, as well a...

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

Science.gov (United States)

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

2018-06-15

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

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

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

2013-01-01

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

Poster: A modern Python interface for the Generic Mapping Tools

OpenAIRE

Uieda, Leonardo; Wessel, Paul

2017-01-01

Poster presentation at the AGU Fall Meeting 2017.Abstract: IN51B-0018Inkscape source files for the poster and a Jupyter notebook with the demo are on the Github repository: github.com/leouieda/agu2017 The demo notebook can be run online using the MyBinder service: agu2017demo.gmtpython.xyzAbstractFigures generated by The Generic Mapping Tools (GMT) are present in countless publications across the Earth sciences. The command-line interface of GMT lends the tool its flexibility bu...

Special awards lighten up SPR banquet

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Zwickl, Ron; Baker, Dan; Reiff, Pat

On December 8, 1982, Marcia Neugebauer, then president of the Solar and Planetary Relationships section, held the “First Occasional Awards Ceremony” in conjunction with the annual dinner banquet at the Fall AGU meeting. These awards were an attempt to add a little humor to our usually somber gatherings. This year we reincarnated Neugebauer's successful concept and presented a number of new and novel awards to our fellow scientists at the Fall AGU SPR dinner. Summarized for your enjoyment are the categories and the official winners, as announced at the December 6 banquet.

Intensive exercise reduces the fear of additional falls in elderly people: findings from the Korea falls prevention study.

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Oh, Dong Hyun; Park, Ji Eun; Lee, Eon Sook; Oh, Sang Woo; Cho, Sung Il; Jang, Soong Nang; Baik, Hyun Wook

2012-12-01

Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p falling, more participants in the EG than in the CG responded "not at all" or "a little." The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.

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.

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

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

2010-11-01

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

Space station astronauts discuss life in space during AGU interview

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Showstack, Randy

2012-07-01

Just one day after China's Shenzhou-9 capsule, carrying three Chinese astronauts, docked with the Tiangong-1 space lab on 18 June, Donald Pettit, a NASA astronaut on the International Space Station (ISS), said it is “a step in the right direction” that more people are in space. “Before they launched, there were six people in space,” he said, referring to those on ISS, “and there are 7 billion people on Earth.” The astronauts were “like one in a billion. Now there are nine people in space,” Pettit said during a 19 June interview that he and two other astronauts onboard ISS had with AGU. Pettit continued, “So the gradient of human beings going into space is moving in the right direction. We need to change these numbers so that more and more human beings can call space their home so we can expand off of planet Earth and move out into our solar system.”

Falls from height: A retrospective analysis.

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Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Güven, Taner; Gür, Ali; Gürbüz, Sükrü

2018-01-01

Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.

[Preliminary results of a community fall prevention programme: Precan study (falls prevention in La Ribera)].

Science.gov (United States)

Pérez-Ros, Pilar; Martínez-Arnau, Francisco; Tormos Miñana, Immaculada; López Aracil, Aranzazu; Oltra Sanchis, M Carmen; Pechene Mera, Leidy E; Tarazona-Santabalbina, Francisco José

2014-01-01

To evaluate the results of a fall prevention programme designed to be applied to the elderly living in the community. The sample consisted of 249 participants ≥70 years of age, who were randomly assigned to one of three groups. The monthly intervention group (GIM): instructions on fall prevention and healthy exercises to improve physical function and balance at beginning of the study, and a monthly theoretical and practical refresher session. The quarterly intervention group (GIT), with the same beginning intervention and a refresher session every three months. The control group (GC), the same beginning intervention but no refresher sessions. The mean age of the sample was 74.47 years (SD 5.33), with 64% women. The incidence of falls was reduced from 0.64 per patient year in the previous year to 0.39 in the post-intervention year in GIM, from 0.49 to 0.47 in GIT, and in the GC it remained at 0.47 before and twelve months after, but with no significant differences in the reduction between groups (P=.062). At the end of the study there was a decrease in Rizzo scale of 0.72 points (95% CI: 0.57-0.88, Pfalls. Further studies are required to continue research into the incidence of falls in the elderly living in the community. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

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

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

2017-01-01

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

Sarcopenia and falls in community-dwelling elderly subjects in Japan: Defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People.

Science.gov (United States)

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Tamaki, Junko

2014-01-01

This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. Subjects who did not have any of these deficiencies were classified as "normal." We then administered a questionnaire assessing age, sex, household status, chronic illness, lifestyle-related habits, and fall. This study showed the prevalence of fall was 16.9% and 21.3% in men and women, respectively, while that of sarcopenia was 13.4% and 14.9% in men and women, respectively. In men and women, the prevalence of sarcopenia was higher among those who had fallen. A logistic regression analysis using age, body fat, current drinker status, and physical inactivity for men, and age, body fat, smoking, and diabetes for women as covariate variables revealed that sarcopenia was significantly associated with a history of fall. The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effects of a randomized controlled recurrent fall prevention program on risk factors for falls in frail elderly living at home in rural communities.

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Jeon, Mi Yang; Jeong, HyeonCheol; Petrofsky, Jerrold; Lee, Haneul; Yim, JongEun

2014-11-14

Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program--31 subjects in the experimental group and 31 subjects in the control group. When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (pbalance. This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history.

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

Science.gov (United States)

Chippendale, Tracy; Lee, Chang Dae

2018-06-01

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

Effects of vertical and side-alternating vibration training on fall risk factors and bone turnover in older people at risk of falls.

Science.gov (United States)

Corrie, Heather; Brooke-Wavell, Katherine; Mansfield, Neil J; Cowley, Alison; Morris, Robert; Masud, Tahir

2015-01-01

whole-body vibration training may improve neuromuscular function, falls risk and bone density, but previous studies have had conflicting findings. this study aimed to evaluate the influence of vertical vibration (VV) and side-alternating vibration (SV) on musculoskeletal health in older people at risk of falls. single-blind, randomised, controlled trial comparing vibration training to sham vibration (Sham) in addition to usual care. participants were 61 older people (37 women and 24 men), aged 80.2 + 6.5 years, referred to an outpatient falls prevention service. participants were randomly assigned to VV, SV or Sham in addition to the usual falls prevention programme. Participants were requested to attend three vibration sessions per week for 12 weeks, with sessions increasing to six, 1 min bouts of vibration. Falls risk factors and neuromuscular tests were assessed, and blood samples collected for determination of bone turnover, at baseline and following the intervention. chair stand time, timed-up-and-go time, fear of falling, NEADL index and postural sway with eyes open improved in the Sham group. There were significantly greater gains in leg power in the VV than in the Sham group and in bone formation in SV and VV compared with the Sham group. Conversely, body sway improved less in the VV than in the Sham group. Changes in falls risk factors did not differ between the groups. whole-body vibration increased leg power and bone formation, but it did not provide any additional benefits to balance or fall risk factors beyond a falls prevention programme in older people at risk 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.

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...

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

Directory of Open Access Journals (Sweden)

Schuster Tibor

2011-02-01

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

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.

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

Science.gov (United States)

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

2015-12-17

Recent trials have shown that multifactorial fall interventions vary in effectiveness, possibly due to lack of adherence to the interventions. The aim of this study was to examine what proportion of older adults recognize their falls risk and prioritize for fall-preventive care, and which factors are associated with this prioritization. Observational study within the intervention arm of a cluster randomized controlled trial (RCT) on the effect of preventive interventions for geriatric problems in older community-dwellers at risk of functional decline.  general practices in the Netherlands. Participants were community dwellers (70+) in whom falling was identified as a condition. A comprehensive geriatric assessment (CGA) was performed by a registered community care nurse. Participants were asked which of the identified conditions they recognized and prioritized for in a preventive care plan, and subsequent interventions were started. Multivariable logistic regression was performed to identify which factors were associated with this prioritization. Fall-incidence was measured during one-year follow-up. The RCT included 6668 participants, 3430 were in the intervention arm. Of those, 1209 were at risk of functional decline, of whom 936 underwent CGA. In 380 participants (41 %), falling was identified as a condition; 62 (16 %) recognized this and 37 (10 %) prioritized for it. Factors associated with prioritization for falls-prevention were: recurrent falls in the past year (OR 2.2 [95 % CI 1.1-4.4]), severe fear-of-falling (OR 2.7 [1.2-6.0]) and use of a walking aid (2.3 [1.1-5.0]). Sixty participants received a preventive intervention for falling; 29 had prioritized for falling. Incidence of falls was higher in the priority group than the non-priority group (67 % vs. 37 % respectively) during first six months of follow-up, but similar between groups after 12 months (40.7 % vs. 44.4 %). The proportion of community-dwellers at risk of falls that recognizes this

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.

The impact of care recipient falls on caregivers.

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Dow, Briony; Meyer, Claudia; Moore, Kirsten J; Hill, Keith D

2013-05-01

This study sought to explore the impact of care recipient falls on caregivers. Ninety-six community-dwelling caregiver-care recipient dyads participated in a 12-month prospective study. Falls and other accidents and service use were recorded. Dyads were assessed at baseline and after each fall. Assessment included the Zarit Burden Interview and a post-accident survey developed for the present study. Focus groups were then conducted to further explore the impact of falls on caregivers. Fifty-four care recipients (56%) experienced falls within the 12 months of the study. There was a significant increase in caregiver burden after the first fall (Zarit Burden Interview score increased from 24.2±14.2 to 27.6±14.5, Precipient alone. However, there was no increase in the number of services used. Focus group discussions highlighted the need for constant vigilance of the care recipient, a lack of knowledge about support services and concerns related to utilising respite care. Falls among care recipients have a significant impact on carers, including an increased fear of falling, prompting the need for even closer vigilance. WHAT IS KNOWN ABOUT THE TOPIC? Falls are a significant problem for older people as one in three older people fall each year and injurious falls are the leading cause of injury-related hospitalisation in older people. In Australia falls cost the economy over $500 million per year. WHAT DOES THIS PAPER ADD? This paper adds a unique perspective to the falls literature, that of the older person's carer. Falls are a significant problem for community-dwelling carers of older people, contributing to carer burden and impeding the carer's ability to undertake activities of daily living because of the perceived need for constant vigilance to prevent the person they care for from falling. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners should ensure that carers are aware of evidence-based falls-prevention practices and services, such as group and

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

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

2016-01-01

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

Risks of falls in subjects with multiple sclerosis.

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Cattaneo, Davide; De Nuzzo, Carmela; Fascia, Teresa; Macalli, Marco; Pisoni, Ivana; Cardini, Roldano

2002-06-01

To quantify fall risk among patients with multiple sclerosis (MS) and to report the importance of variables associated with falls. Retrospective case-control study design with a 2-group sample of convenience. A hospital and home settings in Italy. A convenience sample of 50 people with MS divided into 2 groups according to their reports of falls. Not applicable. Subjects were assessed with questionnaires for cognitive ability and were measured on their ability to maintain balance, to walk, and to perform daily life activities. Data regarding patients' strength, spasticity, and transfer skills impairment were also collected. No statistical differences were found between groups of fallers and nonfallers using variables pertaining to years after onset, age, gender, and Mini-Mental State Examination. Near statistically significant differences were found in activities of daily living and transfer skills (Pfall status: balance, ability to walk, and use of a cane (Pcane differed between fallers and nonfallers groups and the incidence of those variables can be used as a predictive model to quantify fall risk in patients suffering from MS. These findings emphasize the multifactorial nature of falls in this patient population. Assessment of different aspects of motor impairment and the accurate determination of factors contributing to falls are necessary for individual patient management and therapy and for the development of a prevention program for falls. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Fall with and without fracture in elderly: what's different?

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Kantayaporn, Choochat

2012-10-01

Falling fracture was one of the health problems in elderly. This presentation aimed to identify the factors of fall that caused fractures. The retrospective case-control study was designed. Samples were all who experienced fall within 1 year in Lamphun. Factors included age, gender underlying diseases, chronic drugs used, history of parent fragility fracture, age of menopause, steroid used, body mass index, visual acuity and time up and go test were studied. Multivariate regression analysis was used. 336 cases of fractures in 1,244 cases of fall were found. Significant factors of falling fracture group that were different from fall without fracture group included age, female gender, menopause before age of 45 and visual impairment. Visual impairment was the other key factor rather than osteoporosis that caused fall with fracture. The author suggested that falling fracture prevention programs should be included correction of visual impairment other than osteoporosis treatment.

The effects of eyeball exercise on balance ability and falls efficacy of the elderly who have experienced a fall: A single-blind, randomized controlled trial.

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Park, Jin-Hyuck

The purpose of this study was to investigate the effects of eyeball exercise on balance and fall efficacy of the elderly who have experienced a fall. Subjects were randomly assigned to the eyeball exercise group (n=30) or functional exercise group (n=31). All subjects received 30 sessions for 10 weeks. To identify the effects on balance, static and dynamic balance were measured using the center of pressure (CoP) measurement equipment and Timed Up and Go Test (TUGT) respectively. Fall efficacy was evaluated using the modified efficacy scale (MFES). The outcome measurements were performed before and after the 10 weeks training period. After 10 weeks, static balance, dynamic balance, and fall efficacy were significantly improved in both groups. Also, there were significant differences in the outcome measures between both groups (peyeball exercise is beneficial to improve the fall efficacy as well as the balance of the elderly compared with functional exercise. Eyeball exercise would be useful to improve balance and fall efficacy of the elderly who have experienced a fall. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.

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Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years ( P fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P falls (OR =2.55; 95% CI =1.05-6.19; P =0.039), age (OR =1.14; 95% CI =1.05-1.23; P =0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P =0.034). Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

Issues in Geriatric Care: Falls.

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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.

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

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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.

Selection of useful items for fall risk screening for community dwelling Japanese elderly from the perspective of fall experience, physical function, and age level differences.

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Demura, Shinichi; Yamada, Takayoshi; Uchiyama, Masanobu; Sugiura, Hiroki; Hamazaki, Hiroshi

2011-01-01

This study aimed to examine useful items for screening the fall risk of community dwelling elderly from various perspectives, including fall experience, physical function level, and age level difference. 968 independently living elderly persons over the age of 60 (age: 70.0 ± 7.0) responded to 80 fall risk items representing 7 factors (physical function, fall history, using devices, fear of falling and inactivity, dosing, disease and disability, and environment) and an ADL questionnaire. The high fall risk response rate was calculated for each item and tested for statistical significance among age groups and those with and without fall experience. Cramer's V was calculated to examine the relationship between each item and the ADL. In addition, we selected items with significant differences in the high fall risk response rates between the faller and the non-faller groups, a significant relationship with ADL, and a significant difference among age groups. A total of 40 useful items were selected from each fall risk factor (decrease in physical function: 21 items, fall history: 2 items, device usage: 3 items, fear of falling and inactivity: 5 items, dosing: 0 items, disease and disability: 8 items, and environment: 1 item). Selected items can comprehensively and properly assess the fall risk of the healthy elderly as compared with existing questionnaires. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults.

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Hill, Anne-Marie; Etherton-Beer, Christopher; McPhail, Steven M; Morris, Meg E; Flicker, Leon; Shorr, Ronald; Bulsara, Max; Lee, Den-Ching; Francis-Coad, Jacqueline; Waldron, Nicholas; Boudville, Amanda; Haines, Terry

2017-02-02

Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care. The 'Back to My Best' study is a multisite, single blind, parallel-group randomised controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participant's length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months. Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research

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

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

2015-01-20

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

Ageing vision and falls: a review.

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Saftari, Liana Nafisa; Kwon, Oh-Sang

2018-04-23

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

Stratigraphy and correlation of the Manitou Falls formation, the Athabasca Group

International Nuclear Information System (INIS)

Iida, Yoshimasa; Ikeda, Koki; Tsuruta, Tadahiko; Yamada, Yasuo; Ito, Hiroaki; Goto, Junichi

1996-01-01

Manitou Falls formation is the thick strata of Proterozoic era that spread widely in the uranium deposit zone in Northern Saskatchewan, Canada (Athabasca basin). In order to study in detail underground geological structure by trial boring, it is necessary to distinguish and compare strata by dividing them into the units as small as possible. The Manitou Falls formation is composed of only sandstone and conglomerate, and it does not have simply identified, continuous strata like tuff and coal layers. In the Christie Lake B district located in Eastern Athabasca basin, the division of strata was carried out by utilizing the data of the changes in the volume ratio of conglomerate layer and maximum pebble size and natural radioactivity logging and based on the careful comparison among trial bores. As the result, this formation was divided into the units of 9 strata. As one of the methods of identifying each unit, the comparison of the power spectra of natural radioactivity logging data was attempted. By this means, it was found that the features in the periodicity of stratum accumulation are useful for identifying strata. The outline of the Manitou Falls formation, the location of the investigated district, the basic data for stratigraphy division, the stratigraphy division in Christie Lake B district and the results are reported. (K.I.)

Al Gore attends Fall Meeting session on Earth observing satellite

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Richman, Barbara T.

2011-12-01

Former U.S. vice president Al Gore, making unscheduled remarks at an AGU Fall Meeting session, said, "The reason you see so many pictures" of the Deep Space Climate Observatory (DSCOVR) satellite at this session is "that it already has been built." However, "because one of its primary missions was to help document global warming, it was canceled. So for those who are interested in struggling against political influence," Gore said, "the benefits have been documented well here." Gore made his comments after the third oral presentation at the 8 December session entitled "Earth Observations From the L1 (Lagrangian Point No. 1)," which focused on the capabilities of and progress on refurbishing DSCOVR. The satellite, formerly called Triana, had been proposed by Gore in 1998 to collect climate data. Although Triana was built, it was never launched: Congress mandated that before the satellite could be sent into space the National Academies of Science needed to confirm that the science it would be doing was worthwhile. By the time the scientific validation was complete, the satellite "was no longer compatible with the space shuttle manifest," Robert C. Smith, program manager for strategic integration at the NASA Goddard Space Flight Center, told Eos.

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.

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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.

Albeni Falls Wildlife Mitigation : Annual Report 2002.

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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.

The effects of plantar perception training on balance and falls efficacy of the elderly with a history of falls: A single-blind, randomized controlled trial.

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Park, Jin-Hyuck

2018-03-28

The purpose of this study was to identify the effects of plantar perception training using a hardness discrimination task on balance and falls efficacy of the elderly who have experienced a fall. Sixty-two elderly persons 65 years of age or older were randomly allocated to the experimental group (n = 31) or the control group (n = 31). The experimental group performed a hardness discrimination task using five different levels of hardness of sponge mats, while the control group performed the same task except that they were not asked to discriminate hardness levels of sponge mats. All subjects performed 10 sessions for two weeks. Outcome measures were conducted using center of pressure (CoP) sway in the standing position, the Timed Up and Go (TUG) test, and falls efficacy scale (FES) to measure balance and falls efficacy. There were no significant differences in general characteristics between both groups (p > .05). After 10 sessions, plantar perception was significantly improved in the experimental group (F = 101.18, p falls efficacy as well as balance of the elderly. Copyright © 2018 Elsevier B.V. All rights reserved.

Yoga's effect on falls in rural, older adults.

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Hamrick, Irene; Mross, Paul; Christopher, Nate; Smith, Paul D

2017-12-01

Unintentional falls affect 30% of people over age 65 years. Yoga has been shown to improve balance. We designed this study to examine if yoga reduces falls. We conducted 16 sessions of Hatha yoga over 8 weeks. Participants were randomly assigned to practice 10min of yoga daily at home in addition to 5-min relaxation exercises or relaxation exercises only (control group). Of the 38 participants completing the intervention, 15 participants reported a total of 27 falls in the 6-months before the study, compared to 13 participants sustaining 14 falls in the 6 months from the start of the study (pBalance Scale (53-54 out of 56, p=0.002), the Functional Gait Assessment (22.9-25.8 out of 30 points, pBalance Confidence Scale, increased in the yoga home-exercise group (88%-93%, p=0.037) compared to 90% unchanged from pre-intervention in the home relaxation-only group. Yoga classes reduce self-reported falls and improve balance measures. The addition of home yoga exercises did not enhance benefit over relaxation exercise only. Copyright © 2017 Elsevier Ltd. All rights reserved.

Elderly outpatient profile and predictors of falls.

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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.

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

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Grzegorz Teresiński

2017-03-01

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

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

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

2015-05-01

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

Falls following discharge after an in-hospital fall

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Kessler Lori A

2009-12-01

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

An Occupational Therapy Fall Reduction Home Visit Program for Community-Dwelling Older Adults in Hong Kong After an Emergency Department Visit for a Fall.

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Chu, Mary Man-Lai; Fong, Kenneth Nai-Kuen; Lit, Albert Chau-Hung; Rainer, Timothy Hudson; Cheng, Stella Wai-Chee; Au, Frederick Lap-Yan; Fung, Henry Kwok-Kwong; Wong, Chit-Ming; Tong, Hon-Kuan

2017-02-01

To investigate the effects of an occupational therapy fall reduction home visit program for older adults admitted to the emergency department (ED) for a fall and discharged directly home. Single-blind, multicenter, randomized, controlled trial. EDs in three acute care hospitals in Hong Kong. Individuals aged 65 and older who had fallen (N = 311). After screening for eligibility, 204 consenting individuals were randomly assigned to an intervention group (IG) and received a single home visit from an occupational therapist (OT) within 2 weeks after discharge from the hospital or a control group (CG) and received a well-wishing visit from a research assistant not trained in fall prevention. Both groups were followed for 12 months through telephone calls made every 2 weeks by blinded assessors with a focus on the frequency of falls. Another blinded assessor followed up on their status with telephone calls 4, 8, and 12 months after ED discharge. Prospective fall records on hospital admissions were retrieved from electronic databases; 198 individuals were followed for 1 year on an intention-to-treat basis. The percentage of fallers over 1 year was 13.7% in the IG (n = 95) and 20.4% in the CG (n = 103). There were significant differences in the number of fallers (P = .03) and the number of falls (P = .02) between the two groups over 6 months. Significant differences were found in survival analysis for first fall at 6 months (log-rank test 5.052, P = .02) but not 9 or 12 months. One OT visit after a fall was more effective than a well-wishing visit at reducing future falls at 6 months. A booster OT visit at 6 months is suggested. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Comparison of different strategies of referral to a fall clinic: how to achieve an optimal casemix?

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Schoon, Y; Hoogsteen-Ossewaarde, M E; Scheffer, A C; Van Rooij, F J M; Rikkert, M G M Olde; De Rooij, S E

2011-02-01

OBJECTIVE To study the potential differences in patient characteristics between two referral methods to a fall clinic, specifically: case-finding of patients admitted to an emergency department because of a fall, compared to direct referral to the fall clinic via the general practitioner. Cross-sectional study. Fall clinics in two university teaching hospitals in the Netherlands. Three hundred community-dwelling older people aged 65 years or over currently attending the fall clinics in Nijmegen (Group 1, n=154) and in Amsterdam (Group 2, n=146). Patients were referred by a general practitioner (Group 1) or were selected using the Carefall Triage Instrument (CTI) after visiting the emergency department (Group 2). In all patients, modifiable risk factors for recurrent falls were assessed. Group 1 had less modifiable risk factors for falling (a mean of 4 (SD 1.6) vs. a mean of 5 (SD 1.5) in Group 2, p < 0.001). Compared to Group 2, Group 1 had more prevalent " recurrent falling (≥ 2 falls)" (p=0.001) and "assisted living in homes for the aged" (p=0.037). "Fear of falling", "mobility and balance problems", "home hazards" and "osteoporosis" were significantly less prevalent in Group 1. This study suggests that patients referred to a multidisciplinary fall prevention clinic by their general practitioner have a different risk profile than those selected by case finding using the CTI. These differences have consequences for the reach of secondary care for fall-preventive interventions and will probably influence the effectiveness and efficiency of a fall prevention program.

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.

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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

Elderly outpatient profile and predictors of falls

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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.

Developing an audit checklist to assess outdoor falls risk.

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Curl, Angela; Thompson, Catharine Ward; Aspinall, Peter; Ormerod, Marcus

2016-06-01

Falls by older people (aged 65+) are linked to disability and a decrease in mobility, presenting a challenge to active ageing. As such, older fallers represent a vulnerable road user group. Despite this there is little research into the causes and prevention of outdoor falls. This paper develops an understanding of environmental factors causing falls or fear of falling using a walk-along interview approach with recent fallers to explore how older people navigate the outdoor environment and which aspects of it they perceived facilitate or hinder their ability to go outdoors and fear of falling. While there are a number of audit checklists focused on assessing the indoor environment for risk or fear of falls, nothing exists for the outdoor environment. Many existing street audit tools are focused on general environmental qualities and have not been designed with an older population in mind. We present a checklist that assesses aspects of the environment most likely to encourage or hinder those who are at risk of falling outdoors, developed through accounting for the experiences and navigational strategies of elderly individuals. The audit checklist can assist occupational therapists and urban planners, designers and managers in working to reduce the occurrence of outdoor falls among this vulnerable user group.

ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial.

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

2014-08-20

Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission's Seventh Framework Program (FP7) project 'iStoppFalls' an Information and Communication Technology (ICT) based system has been developed to regularly assess a person's risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people. This international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars. We hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise training may have a positive impact on quality of

Policy Statements Issued by Scientific Societies: Why Less can be More

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Folger, P. F.

2001-12-01

The results of hydrological research are increasingly important to decision-makers grappling with problems as diverse as global climate change, non-point source pollution, extreme weather events, and damage from flooding. In some cases scientific aspects of these problems are interwoven with economic, political and social disputes, and policy makers often seek the consensus scientific opinion to help shape the debate. Policy or position statements issued by scientific societies like AGU can embody scientific consensus and thus inform the public and policy makers. But this is not always the case. The potential for creating public misunderstanding is ever present. Therefore, the process leading to a policy statement needs to be deliberative, inclusive to the extent possible, and circumspect. In contrast to advocacy organizations or trade groups, as a learned society AGU and members acting on its behalf should only advocate positions on political or social issues that are based solely on available geophysical data and recognized scientific debate. That does not mean that AGU and other scientific societies must refrain from entering a political debate. AGU has a responsibility to its members to adopt positions of advocacy on geophysical science issues based on their intrinsic merits and needs. However, a learned society like AGU should state only what is credible about the scientific aspects of a political debate and not overstep its authority as an objective source of analysis and commentary for the geophysical sciences. Before adopting an advocacy position, AGU's volunteers follow a process that includes checks and balances so that the final statement is based on sound scientific issues and reflects the interests of the Union as a whole. Any AGU member or committee can propose a position statement, but the Committee on Public Affairs (COPA) decides whether the proposal fall within the guidelines for advocacy. If it does and if COPA considers the issue worthy of an

The efficacy of treadmill training with and without projected visual context for improving walking ability and reducing fall incidence and fear of falling in older adults with fall-related hip fracture: a randomized controlled trial.

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van Ooijen, Mariëlle W; Roerdink, Melvyn; Trekop, Marga; Janssen, Thomas W J; Beek, Peter J

2016-12-28

The ability to adjust walking to environmental context is often reduced in older adults and, partly as result of this, falls are common in this population. A treadmill with visual context projected on its belt (e.g., obstacles and targets) allows for practicing step adjustments relative to that context, while concurrently exploiting the great amount of walking practice associated with conventional treadmill training. The present study was conducted to compare the efficacy of adaptability treadmill training, conventional treadmill training and usual physical therapy in improving walking ability and reducing fear of falling and fall incidence in older adults during rehabilitation from a fall-related hip fracture. In this parallel-group, open randomized controlled trial, seventy older adults with a recent fall-related hip fracture (83.3 ± 6.7 years, mean ± standard deviation) were recruited from inpatient rehabilitation care and block randomized to six weeks inpatient adaptability treadmill training (n = 24), conventional treadmill training (n = 23) or usual physical therapy (n = 23). Group allocation was only blind for assessors. Measures related to walking ability were assessed as the primary outcome before and after the intervention and at 4-week and 12-month follow-up. Secondary outcomes included general health, fear of falling, fall rate and proportion of fallers. Measures of general walking ability, general health and fear of falling improved significantly over time. Significant differences among the three intervention groups were only found for the Functional Ambulation Category and the dual-task effect on walking speed, which were in favor of respectively conventional treadmill training and adaptability treadmill training. Overall, adaptability treadmill training, conventional treadmill training and usual physical therapy resulted in similar effects on walking ability, fear of falling and fall incidence in older adults rehabilitating

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

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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.

Randomized controlled trial comparing tailoring methods of multimedia-based fall prevention education for community-dwelling older adults.

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

2011-01-01

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

Biomechanics of fall arrest using the upper extremity: age differences.

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

2003-05-01

This study tried to isolate critical biomechanical factors in fall arrests using the upper extremity during simulated forward falls. This study also attempted to find the differences in those factors between young and old age groups. The role of the upper extremity is not well defined despite its primary usage as a local shock absorber during fall impact. Comparative study in which two age groups underwent motion analysis.Methods. Ten healthy older males (mean age, 66.4 years) and 10 young males (mean age, 24.1 years) volunteered to perform self-initiated and cable-released falls at selected falling distances, while the joint motion and impact forces at the hand were recorded. Significant age differences were demonstrated in joint kinematics and impact force parameters at close distances. Excessive reflexive responses of the upper extremity in cable-released falls for the older adults resulted in 10-15 times higher peak impact forces and 2-3 times shorter body braking time than in self-initiated falls. Pre-impact activities of the upper extremity predispose the post-impact response during fall arrests. Suppressing excessive pre-impact reflexive activation of the arms could efficiently decrease the risk of fall-related injuries, which calls for securing sufficient arm movement time. Any fall prevention strategy that can increase arm movement time would be effective against injuries of the upper extremity during falling in the older adults. The findings will help to understand underlying mechanisms of fall arrest using the upper extremity for prevention of fall-related fractures.

Fall episodes in elderly patients with asthma and COPD - a pilot study.

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Bozek, Andrzej; Jarzab, Jerzy; Hadas, Ewa; Jakalski, Marek; Canonica, Giorgio Walter

2018-05-08

Evidence of an increased risk of falls in patients with chronic obstructive pulmonary disease (COPD) exists; however, this has not been studied in elderly asthmatic patients. The aim of the study was to determine the incidence of falls in elderly patients who were diagnosed with bronchial asthma compared to subjects with COPD. A 12 - month prospective observational study in elderly outpatients with diagnosis of either asthma or COPD was conducted. All of the participants were monitored on the following parameters: falls, comorbidities, drug therapy and The Berg Balance Scale. The rate of falls was shown as an incidence ratio. Cluster analysis for subgroups with similar features was performed on all patients included in the study. Two clusters of frequent fallers were determined. The fall incidence rate in falls per person per year was 1.41 (95% CI: 0.86-1.96) in asthmatic patients and 1.49 (95% CI: 1.05-2.11) in the COPD group. Frequent fallers were more prevalent in the COPD group, with 32% in this group compared to 28% in the groups of patients with asthma. In cluster analysis, frequent fallers were grouped into two models characterized by polytherapy, depression symptoms, hospitalizations, coronary disease, dementia and diagnosis of COPD or asthma. Elderly asthmatic patients presented a high rate of falls, which is comparable to that of patients with COPD.

Sidi Ali Ou Azza (L4): A New Moroccan Fall

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Chennaoui Aoudjehane, H.; Agee, C. B.; Aaranson, A.; Bouragaa, A.

2016-08-01

Sidi Ali Ou Azza is the latest meteorite fall in Morocco, it occurred on 28 July 2015 very close (about 40 km) to Tissint martian shergottite fall that occurred on 18 July 2011. It's one of the small group of 23 L4 ordinary chondrite falls.

[Fall risk assessment and knee extensor muscle activity in elderly people].

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Oya, Yukiko; Nakamura, Masumi; Tabata, Emi; Morizono, Ryo; Mori, Sachiko; Kimuro, Yukari; Horikawa, Etsuo

2008-05-01

The purpose of this study was to analyze relationships between the history of falls, tripping, sway, and knee extensor muscle strengths as a tool for fall risk assessment in elderly people. We examined effective fall prevention measures. We investigated 102 elderly volunteers in the community. The subjects were classified according to history of falls, tripping, sway and 5 performance tests conducted to assess fall risk including Timed up-and-go test (TUG), Functional Reach test (FR), Hand grip and Reaction time (RT). In addition, the time serial data of the knee extensor muscle strength were acquired using a hand-held dynamometer. In comparison to the non-faller group, the faller group showed a significantly higher incident rate of tripping and sway. A frequency analysis using the Maximum Entropy Method revealed that the fallers group showed lower peak frequency (p=0.025). Also, the slope of the logarithmical spectrum was less steep in the fallers group (p=0.035). Also results from analysis of the peak force latency from the beginning of measurement to 50%, 80%, and 100% muscle strength, also showed that the faller group took more time for maximal voluntary contraction. The frequency analysis of the time series date of peak force latency of knee extensor muscle strength revealed that the muscle activity differs in faller compared to non-fallers. This study suggested that knee extensor muscle isometric performance could possibly be used as a new tool for fall risk assessment. We concluded that exercises to raise maximal muscle strength and muscle response speed are useful for the prevention of falls.

Relationship of Prescribed Drugs with the Risk of Fall in Inpatients.

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Kozono, Aki; Isami, Keisuke; Shiota, Kimiko; Tsumagari, Kyouichi; Nagano, Masahisa; Inoue, Daisuke; Adachi, Rui; Hiraki, Yoichi; Nakagawa, Yoshihiro; Kamimura, Hidetoshi; Yamamichi, Ken

2016-01-01

Falls are common in elderly patients and are often serious. Several drugs have been associated with an increased risk of fall. Older adults often take multiple drugs for chronic diseases, and thus may be at increased risk from drugs associated with fall. We investigated the association between drug use and falling in hospitalized older people, with the goal of identifying medications that may increase the risk of a fall. A retrospective case control study was performed at the National Hospital Organization Kumamoto Saishunso Hospital in Japan. Medications taken by patients who fell (n=57) were compared with those taken by patients who did not fall (n=63). The median age (interquartile range; IQR) of the fall and non-fall groups were 75.0 (67.0-83.0) and 80.0 (70.3-84.5) years, respectively. The characteristics of the two groups were similar, with no significant differences in age, sex, or body weight. The probability of falling increased when the patients used zolpidem [odds ratio (OR)=2.47; 95%CI: 1.09-5.63; pfall due to sleepiness, and blood pressure control may be important to prevent orthostatic high blood pressure. In the treatment of elderly people, medical staff should try to choose drugs that prevent fall or are not associated with falling.

Intrinsic Risk Factors of Falls in Elderly

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Yasmin Amatullah

2016-09-01

Full Text Available Background: Falls are common geriatric problems. The risk factors of falls are the intrinsic and extrinsic risk factors. Studies on falls are scarcely conducted in Indonesia, especially in Bandung. Therefore, this study was conducted to identify the intrinsic risk factors of falls among elderly. Methods: A descriptive study was carried out from August to October 2013 at the Geriatric Clinic of Dr. Hasan Sadikin General Hospital Bandung. Fifty three participants were selected according to the inclusion and exclusion criteria using consecutive sampling. The determined variables in this study were classification of the risk of falls, demographic profile, history of falls, disease, and medications. After the selection, the participants were tested by Timed up-and-go test (TUGT. Moreover, an interview and analysis of medical records were carried out to discover the risk factors of falls. The collected data were analyzed and presented in the form of percentages shown in tables. Results: From 53 patients, women (35.66% were considered to have higher risk of fall than men (18.34%. The majority of patients (66% with the risk of fall were from the age group 60–74 years. The major diseases suffered by patients were hypertension, osteoarthritis and diabetes mellitus. Drugs that were widely used were antihypertensive drugs; analgesic and antipyretic drugs and antidiabetic drugs. Conclusions: There are various intrinsic risk factors of falls in elderly and each of the elderly has more than one intrinsic risk factor of falls.

Relationship between muscle strength and fall episodes among the elderly: the Yilan study, Taiwan.

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Yang, Nan-Ping; Hsu, Nai-Wei; Lin, Ching-Heng; Chen, Hsi-Chung; Tsao, Hsuan-Ming; Lo, Su-Shun; Chou, Pesus

2018-04-13

Fall episodes are not unusual among community residents, especially the elderly, and lower muscle strength is an important issue to address in order to prevent falls. A community health survey was conducted in a suburban area of Taiwan, and 1067 older adults were selected for enrollment in the present study. All the enrolled subjects had been visited at their homes; the subjects' strength of both hands and muscle mass of both legs were measured and well-established questionnaires were finished by certificated paramedic staffs. The incidence of fall episodes in the previous 1 year in the Yilan elderly population was 15.1%, and the female predominance was significant. A significantly higher prevalence of cataracts was found in group who experienced a fall in the past year (64% vs. 54.9% in the non-fall group). Mild or more severe dementia was much more prevalent in the group who experienced a recent fall (33.8% vs. 25.7% in the non-fall group). The strength of both hands tested as the physical function was 17.6 ± 8.0 kg in the recent fall group, significantly weaker than that in the non-fall group (20.7 ± 8.7 kg). Multivariate regression analysis revealed a greater weekly exercise duration and greater strength of both hands reduced the occurrence of falls among the whole and the female population. The standardized effect sizes of hand grip strength between both groups, not trivial, were 0.29 and 0.37 for the total population and the female subpopulation respectively. Less weekly exercise duration and weaker muscle strength were f ound to be independent risk factors of fall episode(s) in an elderly Taiwanese population, especially in the female sub-population. Muscle strength, measured by average of both hands grip strength, was the most significantly factor of one-year fall episode(s) accessed retrospectively.

Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study.

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Delbaere, Kim; Close, Jacqueline C T; Brodaty, Henry; Sachdev, Perminder; Lord, Stephen R

2010-08-18

To gain an understanding of elderly people's fear of falling by exploring the prevalence and determinants of perceived and physiological fall risk and to understand the role of disparities in perceived and physiological risk in the cause of falls. Prospective cohort study. Community sample drawn from eastern Sydney, Australia. 500 men and women aged 70-90 years. Baseline assessment of medical, physiological, and neuropsychological measures, with physiological fall risk estimated with the physiological profile assessment, and perceived fall risk estimated with the falls efficacy scale international. Participants were followed up monthly for falls over one year. Multivariate logistic regression analyses showed that perceived and physiological fall risk were both independent predictors of future falls. Classification tree analysis was used to split the sample into four groups (vigorous, anxious, stoic, and aware) based on the disparity between physiological and perceived risk of falling. Perceived fall risk was congruent with physiological fall risk in the vigorous (144 (29%)) and aware (202 (40%)) groups. The anxious group (54 (11%)) had a low physiological risk but high perceived fall risk, which was related to depressive symptoms (P=0.029), neurotic personality traits (P=0.026), and decreased executive functioning (P=0.010). The stoic group (100 (20%)) had a high physiological risk but low perceived fall risk, which was protective for falling and mediated through a positive outlook on life (P=0.001) and maintained physical activity and community participation (P=0.048). Many elderly people underestimated or overestimated their risk of falling. Such disparities between perceived and physiological fall risk were primarily associated with psychological measures and strongly influenced the probability of falling. Measures of both physiological and perceived fall risk should be included in fall risk assessments to allow tailoring of interventions for preventing falls in

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

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

2017-04-01

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

A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.

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Weerdesteyn, Vivian; Rijken, Hennie; Geurts, Alexander C H; Smits-Engelsman, Bouwien C M; Mulder, Theo; Duysens, Jacques

2006-01-01

Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people. A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores. The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores. The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments. Copyright (c) 2006 S. Karger AG, Basel.

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

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Verghese, Joe

2016-01-01

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

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

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

2018-01-01

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

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

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

2016-06-02

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

Mitigating fall risk: A community fall reduction program.

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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.

The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis.

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Arnold, C M; Faulkner, R A; Gyurcsik, N C

2011-01-01

Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. EE participants with low baseline falls efficacy demonstrated significantly (pfalls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (pfalls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes.

Work-related falls among union carpenters in Washington State before and after the Vertical Fall Arrest Standard.

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

2003-08-01

Washington State enacted a change in their fall standard for the construction industry in 1991, preceding the Safety Standard for Fall Protection in the Construction Industry promulgated by Federal OSHA in 1994. We evaluated changes in the rate of falls from elevations and measures of severity among a large cohort of union carpenters after the fall standard change in Washington State, taking into account the temporal trends in their overall injury rates. There was a significant decrease in the rate of falls from height after the standard went into effect, even after adjusting for the overall decrease in work-related injuries among this cohort. Much of the decrease was immediate, likely representing the publicity surrounding fatal falls and subsequent promulgation of the standard. The greatest decrease was seen between 3 and 3(1/2) years after the standard went into effect. There was a significant reduction in mean paid lost days per event after the standard change and there was a significant reduction in mean cost per fall when adjusting for age and the temporal trend for costs among non-fall injuries. Through the use of observational methods we have demonstrated significant effects of the Washington State Vertical Fall Arrest Standard among carpenters in the absence of a control or comparison group. Without controlling for the temporal trend in overall injury rates, the rate of decline in falls appeared significantly greater, but the more pronounced, but delayed, decline was not seen. The analyses demonstrate potential error in failing to account for temporal patterns or assuming that a decline after an intervention is related to the intervention. Copyright 2003 Wiley-Liss, Inc.

Effectiveness of Exergaming Training in Reducing Risk and Incidence of Falls in Frail Older Adults With a History of Falls.

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Fu, Amy S; Gao, Kelly L; Tung, Arthur K; Tsang, William W; Kwan, Marcella M

2015-12-01

To use Nintendo's Wii Fit balance board to determine the effectiveness of exergaming training in reducing risk and incidence of falls in older adults with a history of falls. Randomized controlled trial. Nursing home for older adults. Adults aged 65 years and older (N=60). Participants who lived in a nursing home had 6 weeks of balance training with either Wii Fit equipment or conventional exercise. Physiological Profile Assessment scores and incidence of falls were observed with subsequent intention-to-treat statistical analyses. Physiological Profile Assessment scores and incidence of falls improved significantly in both groups after the intervention (all Pfalls, Wii Fit balance training was more effective than conventional balance training in reducing the risk and incidence of falls. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis

Science.gov (United States)

Faulkner, R.A.; Gyurcsik, N.C.

2011-01-01

ABSTRACT Purpose: Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Method: Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. Results: EE participants with low baseline falls efficacy demonstrated significantly (pbalance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (pbalance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Conclusions: Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes. PMID:22942514

Nutritional strategies to reduce falls risk in older people.

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Nash, Louise; Bergin, Nick

2018-03-23

A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Identifying nursing home residents at risk for falling.

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

1998-05-01

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

Falling and fall risk in adult patients with severe haemophilia.

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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.

Albeni Falls wildlife mitigation project: annual report of mitigation activities

International Nuclear Information System (INIS)

Terra-Burns, Mary

2002-01-01

The Albeni Falls Interagency Work Group was actively engaged in implementing wildlife mitigation activities in 2001. The Work Group met quarterly to discuss management and budget issues affecting the Albeni Falls Wildlife Mitigation Program. Work Group members protected 851 acres of wetland habitat in 2001. Wildlife habitat protected to date for the Albeni Falls project is approximately 5,248.31 acres (∼4,037.48 Habitat Units). Approximately 14% of the total wildlife habitat lost has been mitigated. Administrative activities increased as funding was more evenly distributed among Work Group members and protection opportunities became more time consuming. In 2001, Work Group members focused on development and implementation of the monitoring and evaluation program as well as completion of site-specific management plans. With the implementation of the monitoring and evaluation program, and as management plans are reviewed and executed, on the ground management activities are expected to increase in 2002

Falls and depression in older people.

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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

“The balancing act”— Licensed practical nurse experiences of falls and fall prevention: a qualitative study

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Häggqvist Beatrice

2012-10-01

Full Text Available Abstract Background Falls are common in old age and may have serious consequences. There are many strategies to predict and prevent falls from occurring in long-term care and hospitals. The aim of this study was to describe licensed practical nurse experiences of predicting and preventing further falls when working with patients who had experienced a fall-related fracture. Licensed practical nurses are the main caretakers that work most closely with the patients. Methods A qualitative study of focus groups interviews and field observations was done. 15 licensed practical nurses from a rehabilitation ward and an acute ward in a hospital in northern Sweden were interviewed. Content was analyzed using qualitative content analysis. Results The result of the licensed practical nurse thoughts and experiences about risk of falling and fall prevention work is represented in one theme, “the balancing act”. The theme includes three categories: “the right to decide”, “the constant watch”, and “the ongoing negotiation” as well as nine subcategories. The analysis showed similarities and differences between rehabilitation and acute wards. At both wards it was a core strategy in the licensed practical nurse work to always be ready and to pay attention to patients’ appearance and behavior. At the rehabilitation ward, it was an explicit working task to judge the patients’ risk of falling and to be active to prevent falls. At the acute ward, the words “risk of falling” were not used and fall prevention were not discussed; instead the licensed practical nurses used for example “dizzy and pale”. The results also indicated differences in components that facilitate workplace learning and knowledge transfer. Conclusions Differences between the wards are most probably rooted in organizational differences. When it is expected by the leadership, licensed practical nurses can express patient risk of falling, share their observations with others

Rural older people had lower mortality after accidental falls than non-rural older people

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Huang JW

2017-01-01

Full Text Available Jen-Wu Huang,1,2 Yi-Ying Lin,2,3 Nai-Yuan Wu,4 Yu-Chun Chen5–7 1Department of Surgery, National Yang-Ming University Hospital, National Yang-Ming University, Yilan, Taiwan; 2Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 3Department of Pediatrics, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan; 4Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; 5Department of Medical Research and Education, National Yang-Ming University Hospital, Yilan, Taiwan; 6Faculty of Medicine and School of Medicine, National Yang-Ming University, Taipei, Taiwan; 7Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan Objective: This study aimed to investigate the mortality rate after falls of rural and non-rural older people and to explore the risk factors of mortality after falls among older people. Patients and methods: This population-based case–control study identified two groups from a nationwide claim database (National Health Insurance Research Database in Taiwan: a rural group and a non-rural group, which included 3,897 and 5,541 older people, respectively, who were hospitalized for accidental falls (The International Classification of Diseases, Ninth Revision, Clinical Modification: E880–E888 during 2006–2009. Both groups were followed up for 4 years after falls. Four-year cumulative all-cause mortality rate after falls was calculated, and the demographic factor, comorbidity, and medications were considered as the potential risk factors of mortality after falls. Results: The rural group had a significantly higher frequency of fall-related hospitalizations (7.4% vs 4.3%, P<0.001, but a lower 4-year cumulative all-cause mortality rate after falls than the non-rural group (8.8% vs 23.4%, P<0.001. After adjusting for age, gender, comorbidity, and medication use, the rural group had

Ankle dorsiflexion may play an important role in falls in women with fibromyalgia.

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Góes, Suelen M; Leite, Neiva; Stefanello, Joice M F; Homann, Diogo; Lynn, Scott K; Rodacki, André L F

2015-07-01

Fibromyalgia is a chronic pain condition, which involves reduced range of motion. This leads to gait changes and high incidence of falls. The understanding of the gait patterns in subjects with fibromyalgia and their relationship with falls may be useful when designing intervention programs. The purpose of this study was to evaluate the range of motion of the hip and ankle joints during gait in women with and without fibromyalgia. Further, we determined the relationship between joint range of motion and falls in this population. Middle-aged women (16 with fibromyalgia and 16 as control group) were recruited. Pain intensity, physical activity level, and fall prevalence were assessed. Three dimensional gait analysis provided temporal and joint kinematic variables. In general, hip and ankle range of motion were similar between groups, except that fibromyalgia group showed higher plantar flexion during toe-off (Pfibromyalgia group the higher number of falls was correlated to reduced dorsiflexion during stance phase. This limitation in dorsiflexion was related to longer length of time with fibromyalgia symptoms. Women with fibromyalgia showed a higher number of falls, reduced dorsiflexion during stance phase, and increased plantar flexion during toe-off. Also, the higher number of falls reported in the fibromyalgia group was related to reduced dorsiflexion during stance phase, which was correlated to a longer length of time living with fibromyalgia symptoms. These data suggest that improving ankle kinematics in patients with fibromyalgia may help prevent falls and improve mobility. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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

2015-01-01

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

Comparing the Musculoskeletal Profile of the Elderly With and Without History of Falling

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Hamzeh Hasanvand

2015-10-01

Full Text Available Objectives: The purpose of current study was to study and compare the musculoskeletal profile of the elderly with and without the history of falling living at nursing homes in Rasht, Iran. Methods & Materials: A total of 54 elderly men and women, aged 60 years and older participated in this study. Of them, 16 (fall group experienced a fall in the previous year [Mean(SD of age: 79(9.90 years; height: 1.51(0.103 m; and weight: 60.03(11.12 kg] and 38 (no fall group had no history of falling [Mean(SD of age: 70.16(8.16 years; height: 1.56(0.11 m; and weight 65.6(14.93 kg]. The foot arch, distance between femoral condyles, kyphosis, lordosis, flexibility and the ability to walk were measured by ruler, caliper, flexible ruler, sit and reach test, and functional gait assessment questionnaires, respectively. Data analysis was done through independent t-test using SPSS. Study significance level was set at 0.05. Results: In the fall group the mean(SD of measured variables were as follows: body mass index (BMI: 25.95(3.35 kg/m2; foot arch: 9.94(4.34 mm; flexibility: 8.25(6.38 cm, lordosis: 20.86(9.48 degree; kyphosis: 35.07(14.98 degree. And in no fall group, the same variables were as follows: BMI: 26.87(5.12 kg/m2; foot arch: 10.95(5.60 mm; flexibility: 8.16(5.24 cm; lordosis 26.66(14.78 degree; and kyphosis: 41.11(9.84 degree. These variables were not significantly different between the groups; however, the functional gait assessment and distance between femoral condyles test showed significant differences. In the group with a history of fall, the functional gait assessment and distance between femoral condyles were 12.50(7.07 and 2.74(2.38 cm and in the group without a history of fall functional gait assessment and distance between femoral condyles were 23.63(5.49 and 1.20(1.4 cm, respectively. According to the results, in the fall group, the distance between femoral condyles was more and the performance level was less (P≤0.05. Conclusion

Anxiety disorders and falls among older adults.

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Holloway, K L; Williams, L J; Brennan-Olsen, S L; Morse, A G; Kotowicz, M A; Nicholson, G C; Pasco, J A

2016-11-15

Falls are common among older adults and can lead to serious injuries, including fractures. We aimed to determine associations between anxiety disorders and falls in older adults. Participants were 487 men and 376 women aged ≥60 years enrolled in the Geelong Osteoporosis Study, Australia. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Non-patient edition (SCID-I/NP), lifetime history of anxiety disorders was determined. Falls were determined by self-report. In men, a falls-risk score (Elderly Falls Screening Test (EFST)) was also calculated. Among fallers, 24 of 299 (8.0%) had a lifetime history of anxiety disorder compared to 36 of 634 (5.7%) non-fallers (p=0.014). Examination of the association between anxiety and falls suggested differential relationships for men and women. In men, following adjustment for psychotropic medications, mobility and blood pressure, lifetime anxiety disorder was associated with falling (OR 2.96; 95%CI 1.07-8.21) and with EFST score (OR 3.46; 95%CI 1.13-10.6). In women, an association between lifetime anxiety disorder and falls was explained by psychotropic medication use, poor mobility and socioeconomic status. Sub-group analyses involving types of anxiety and anxiety disorders over the past 12-months were not performed due to power limitations. Although anxiety disorders were independently associated with a 3-fold increase in likelihood of reported falls and high falls risk among men, an independent association was not detected among women. These results may aid in prevention of falls through specific interventions aimed at reducing anxiety, particularly in men. Copyright © 2016 Elsevier B.V. All rights reserved.

The association between primary open-angle glaucoma and fall: an observational study.

Science.gov (United States)

Tanabe, Sachiko; Yuki, Kenya; Ozeki, Naoki; Shiba, Daisuke; Tsubota, Kazuo

2012-01-01

Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG) who were more than 45 years old, compared with comparably aged healthy subjects. This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years) who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years) were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye). The self-reported prevalence of injurious fall was 0.9% (1/117) in the control group and 6.9% (7/101) in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test). Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with the better visual field (odds ratios 0.75; 95% confidence intervals: 0.57 to 0.99; P = 0.036) was a significant risk factor for injurious falls in subjects with POAG. POAG was significantly associated with injurious falls.

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

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Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-11-01

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

The falls and the fear of falling among elderly institutionalized

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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.

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

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

2017-12-21

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

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

Science.gov (United States)

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

2016-11-04

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

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

Directory of Open Access Journals (Sweden)

Suzanne Polinder

2016-11-01

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

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

Science.gov (United States)

Hanger, H Carl

2017-07-01

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

A regression tree for identifying combinations of fall risk factors associated to recurrent falling: a cross-sectional elderly population-based study.

Science.gov (United States)

Kabeshova, A; Annweiler, C; Fantino, B; Philip, T; Gromov, V A; Launay, C P; Beauchet, O

2014-06-01

Regression tree (RT) analyses are particularly adapted to explore the risk of recurrent falling according to various combinations of fall risk factors compared to logistic regression models. The aims of this study were (1) to determine which combinations of fall risk factors were associated with the occurrence of recurrent falls in older community-dwellers, and (2) to compare the efficacy of RT and multiple logistic regression model for the identification of recurrent falls. A total of 1,760 community-dwelling volunteers (mean age ± standard deviation, 71.0 ± 5.1 years; 49.4 % female) were recruited prospectively in this cross-sectional study. Age, gender, polypharmacy, use of psychoactive drugs, fear of falling (FOF), cognitive disorders and sad mood were recorded. In addition, the history of falls within the past year was recorded using a standardized questionnaire. Among 1,760 participants, 19.7 % (n = 346) were recurrent fallers. The RT identified 14 nodes groups and 8 end nodes with FOF as the first major split. Among participants with FOF, those who had sad mood and polypharmacy formed the end node with the greatest OR for recurrent falls (OR = 6.06 with p falls (OR = 0.25 with p factors for recurrent falls, the combination most associated with recurrent falls involving FOF, sad mood and polypharmacy. The FOF emerged as the risk factor strongly associated with recurrent falls. In addition, RT and multiple logistic regression were not sensitive enough to identify the majority of recurrent fallers but appeared efficient in detecting individuals not at risk of recurrent falls.

The effectiveness of Pilates on balance and falls in community dwelling older adults.

Science.gov (United States)

Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

2016-10-01

The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

A piece of paper falling faster than free fall

International Nuclear Information System (INIS)

Vera, F; Rivera, R

2011-01-01

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

A piece of paper falling faster than free fall

Energy Technology Data Exchange (ETDEWEB)

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

2011-09-15

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

[Fall prevention counselling for patients with hearing and balance disorders].

Science.gov (United States)

Ptok, M; Ptok, A; Jungheim, M; Kühn, D; Miller, S

2014-09-01

Otolaryngologists caring for patients with hearing and balance disorders are also responsible for advising patients about their increased risk of falling and informing them of fall prevention measures. This review will give a brief overview of appropriate programs. This systematic review is based on a selective literature search. Intrinsic and extrinsic fall risk factors can be distinguished. The former include not only hearing and balance disorders, but also increasing age, nocturia, dementia, limited mobility and poor nutritional status. Extrinsic factors include, for example, unfixed carpet edges, poor lighting and poor footwear. Fall prevention can be achieved through appropriate counselling about risk factors and fall prevention courses. The frequency of falls--with potentially very adverse consequences--increases continuously beyond the age of 60 years. Furthermore, the risk of falling is significantly increased in patients with hearing and balance disorders. Otolaryngologists caring for this patient group should inform them about their fall risk and advise appropriate countermeasures during counselling. A basal knowledge of fall prevention measures is therefore helpful.

Falls prevention in the elderly: translating evidence into practice.

Science.gov (United States)

Luk, James K H; Chan, T Y; Chan, Daniel K Y

2015-04-01

Falls are a common problem in the elderly. A common error in their management is that injury from the fall is treated, without finding its cause. Thus a proactive approach is important to screen for the likelihood of fall in the elderly. Fall assessment usually includes a focused history and a targeted examination. Timed up-and-go test can be performed quickly and is able to predict the likelihood of fall. Evidence-based fall prevention interventions include multi-component group or home-based exercises, participation in Tai Chi, environmental modifications, medication review, management of foot and footwear problems, vitamin D supplementation, and management of cardiovascular problems. If possible, these are best implemented in the form of multifactorial intervention. Bone health enhancement for residential care home residents and appropriate community patients, and prescription of hip protectors for residential care home residents are also recommended. Multifactorial intervention may also be useful in a hospital and residential care home setting. Use of physical restraints is not recommended for fall prevention.

[Correlation between gait speed and muscular strength with balance for reducing falls among elderly].

Science.gov (United States)

García-Flores, Fabián Ituriel; Rivera-Cisneros, Antonio Eugenio; Sánchez-González, Jorge Manuel; Guardado-Mendoza, Rodolfo; Torres-Gutiérrez, Jorge Luis

2016-01-01

Evidence of the benefit on propioceptive neuromuscular facilitation for reducing falls in older people does not exist. The aim of this study is to evaluate the effects of propioceptive facilitation over falls and biomechanical variables, in comparison to standard treatment and control groups. Series cases comparative for the 24 participants were recruited and randomnly assigned to 3 groups. Group 1, propioceptive neuromuscular facilitation, group 2, standard treatment, and 3 control. Falls and biomechanic variables were measured before and after. Chi(2) was used for falls and multiple regression for biomechanical variables, Participants had similar falls in previous year. Women had higher falls in a relation 7:1 women-men. After intervention, there was no difference between 3 groups. A correlation exista between muscular strength and gait speed with one foot position time r(2) = 0.67, p = 0.02. Improving 1kilogram-force of muscular strength of pelvic limb and 0.1meter/second in gait speed, balance (unipodal position time) increases balance by 11.3%. After 3 months of intervention group 2 got 7.9kg-force and 0.26m/s of profit, while group 1 had 4.1kg-force and 0.15m/s and control group 2.4kg-force and 0.1m/s. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Identifying predictive motor factors for falls in post-menopausal breast cancer survivors.

Directory of Open Access Journals (Sweden)

Marek Zak

Full Text Available Breast cancer treatment, including radical surgery, is also pursued as late as the 7th - 8th decade of women's lives. Standard physical rehabilitation procedures offered to those women are predominantly focused on attenuating specific functional deficits of the upper limb and trunk. Seldom do they entail any regimens specifically aimed at recovering overall functionality, and reducing exposure to falls-risk. The study aimed to assess potential interrelationships between the self-reported falls, individual functional capabilities and appreciably reducing exposure to falls-risk in a group of post-menopausal, post-surgical breast cancer survivors.The study recruited 102 women (aged 65-79; mean age 70.2, post-surgical breast cancer survivors. The subjects were stratified by age into three groups: Group 1 (65-69 years; Group 2 (70-74 years, and Group 3 (75-79 years. Individual functional capabilities were assessed with Eight-foot up & go test (8UG, chair stand test (CST, and 2-minute step test (2ST. Tinetti POMA test was applied to assess gait and balance disorders. Self-reported falls in the past year were ascertained through a questionnaire.Assessment of individual aerobic endurance (2ST also demonstrated a clear deficit in the mean scores category in all respective age sub-groups, as compared against the reference values. The deficits ranged from 4.86 to 15.90 steps less than the normative values; the oldest subjects demonstrating the largest deficit. The aerobic endurance tests results significantly impacted the ultimate assessment of an individual falls-risk in the oldest group. The analysis of the number of falls sustained within the recent year indicated that 43.67% of the subjects fell victim of such incidents.An individual exposure to falls-risk was found to be appreciably more dependent upon individual aerobic endurance rather than overall strength of the lower part of the body in the breast cancer survivors over 75.

Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density.

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Pang, M Y C; Eng, J J

2008-07-01

Chronic stroke survivors with low hip bone density are particularly prone to fractures. This study shows that fear of falling is independently associated with falls in this population. Thus, fear of falling should not be overlooked in the prevention of fragility fractures in these patients. Chronic stroke survivors with low bone mineral density (BMD) are particularly prone to fragility fractures. The purpose of this study was to identify the determinants of balance, mobility and falls in this sub-group of stroke patients. Thirty-nine chronic stroke survivors with low hip BMD (T-score fall-related self-efficacy. Any falls in the past 12 months were also recorded. Multiple regression analysis was used to identify the determinants of balance and mobility performance, whereas logistic regression was used to identify the determinants of falls. Multiple regression analysis revealed that after adjusting for basic demographics, fall-related self-efficacy remained independently associated with balance/mobility performance (R2 = 0.494, P fall-related self-efficacy, but not balance and mobility performance, was a significant determinant of falls (odds ratio: 0.18, P = 0.04). Fall-related self-efficacy, but not mobility and balance performance, was the most important determinant of accidental falls. This psychological factor should not be overlooked in the prevention of fragility fractures among chronic stroke survivors with low hip BMD.

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

Science.gov (United States)

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

2008-06-01

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

Racial and Ethnic Difference in Falls Among Older Adults: Results from the California Health Interview Survey.

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Kwon, Simona C; Han, Benjamin H; Kranick, Julie A; Wyatt, Laura C; Blaum, Caroline S; Yi, Stella S; Trinh-Shevrin, Chau

2018-04-01

Research suggests that fall risk among older adults varies by racial/ethnic groups; however, few studies have examined fall risk among Hispanics and Asian American older adults. Using 2011-2012 California Health Interview Survey data, this study examines falling ≥2 times in the past year by racial/ethnic groups (Asian Americans, Hispanics, and Blacks) aged ≥65, adjusting for socio-demographic characteristics, body mass index, co-morbidities, and functional limitations. A secondary analysis examines differences in fall risk by English language proficiency and race/ethnicity among Asian Americans and Hispanics. Asian Americans were significantly less likely to fall compared to non-Hispanic whites, individuals with ≥2 chronic diseases were significantly more likely to fall than individuals with fall risk, when adjusting for all factors. African Americans and Hispanics did not differ significantly from non-Hispanic whites. Analysis adjusting for race/ethnicity and English language proficiency found that limited English proficient Asian Americans were significantly less likely to fall compared to non-Hispanic whites, individuals with ≥2 chronic diseases were significantly more likely to fall than individuals with fall risk, when adjusting for all factors. No differences were found when examining by racial/ethnic and English proficient/limited English proficient groups. Further research is needed to explore factors associated with fall risks across racial/ethnic groups. Culturally relevant and targeted interventions are needed to prevent falls and subsequent injuries in the increasingly diverse aging population in the USA.

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

Science.gov (United States)

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

2016-08-01

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

Risk of falling in patients with a recent fracture

Directory of Open Access Journals (Sweden)

Willems Gittie

2007-06-01

Full Text Available Abstract Background Patients with a history of a fracture have an increased risk for future fractures, even in short term. The aim of this study was to assess the number of patients with falls and to identify fall risk factors that predict the risk of falling in the first three months after a clinical fracture. Methods Prospective observational study with 3 months of follow-up in a large European academic and regional hospital. In 277 consenting women and men aged ≥ 50 years and with no dementia and not receiving treatment for osteoporosis who presented to hospital with a clinical fracture, fall risk factors were assessed according to the guidelines on fall prevention in the Netherlands. Follow-up information on falls and fractures was collected by monthly telephone interview. Incidence of falls and odds ratio's (OR, with 95% confidence intervals were calculated. Results 512 consecutive patients with a fracture were regarded for analysis, 87 were not eligible for inclusion and 137 patients were excluded. No follow-up data were available for 11 patients. Therefore full analysis was possible in 277 patients. A new fall incident was reported by 42 patients (15%, of whom five had a fracture. Of the 42 fallers, 32 had one new fall and 10 had two or more. Multivariate analysis in the total group with sex, age, ADL difficulties, urine incontinence and polypharmacy showed that sex and ADL were significant fall risk factors. Women had an OR of 3.02 (95% CI 1.13–8.06 and patients with ADL-difficulties had an OR of 2.50 (95% CI 1.27–4.93. Multivariate analysis in the female group with age, ADL difficulties, polypharmacy and presence of orthostatic hypotension indicated that polypharmacy was the predominant risk factor (OR 2.51; 95% CI: 1.19 – 5.28. The incidence of falls was 35% in women with low ADL score and polypharmacy compared to 15% in women without these risk factors (OR 3.56: CI 1.47 – 8.67. Conclusion 15% of patients reported a new fall

Audiology patient fall statistics and risk factors compared to non-audiology patients.

Science.gov (United States)

Criter, Robin E; Honaker, Julie A

2016-10-01

To compare fall statistics (e.g. incidence, prevalence), fall risks, and characteristics of patients who seek hearing healthcare from an audiologist to individuals who have not sought such services. Case-control study. Two groups of community-dwelling older adult patients: 25 audiology patients aged 60 years or older (M age: 69.2 years, SD: 4.5, range: 61-77) and a control group (gender- and age-matched ±2 years) of 25 non-audiology patients (M age: 69.6, SD: 4.7, range: 60-77). Annual incidence of falls (most recent 12 months) was higher in audiology patients (68.0%) than non-audiology patients (28.0%; p = .005). Audiology patients reported a higher incidence of multiple recent falls (p =.025) and more chronic health conditions (p = .028) than non-audiology patients. Significantly more audiology patients fall on an annual basis than non-audiology patients, suggesting that falls are a pervasive issue in general hearing clinics. Further action on the part of healthcare professionals providing audiologic services may be necessary to identify individuals at risk for falling.

Falling chains

OpenAIRE

Wong, Chun Wa; Yasui, Kosuke

2005-01-01

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

The effect of hemodialysis on balance measurements and risk of fall.

Science.gov (United States)

Erken, Ertugrul; Ozelsancak, Ruya; Sahin, Safak; Yılmaz, Emine Ece; Torun, Dilek; Leblebici, Berrin; Kuyucu, Yunus Emre; Sezer, Siren

2016-10-01

Patients with end-stage renal disease (ESRD) have increased risk of falls and fall-related complications. Other than aging and factors related to chronic kidney disease, treatment of hemodialysis may also contribute to this increased risk. The aim of this study was to demonstrate the impairment of balance after a session of hemodialysis with a quantitative assessment and reveal an increased fall risk that would possibly be related to treatment of hemodialysis for patients on maintenance hemodialysis. Fifty-six patients with ESRD on chronic hemodialysis program and 53 healthy individuals were involved in this study. Fall Index percentages were calculated, and fall risk categories were determined for all patients and healthy controls using Tetrax posturography device (Sunlight Medical Ltd Israel). The patient group was evaluated twice for balance, before and after a routine session of hemodialysis. Fall Index scores of healthy controls were lower than that of ESRD patients (p = 0.001). In the patient group, we found the mean Fall Index to be significantly higher at the post-dialysis assessment compared to the pre-dialysis assessment (p = 0.003). The number of patients with high risk of falling also increased at the post-dialysis assessment yet the difference did not reach significance. Fall Index was correlated with the increase in age only at the pre-dialysis balance measurement (p = 0.038). Patients with better dialysis adequacy had significantly lower Fall Index scores than the others at the pre-dialysis balance measurement (p = 0.004). The difference was not significant at the post-dialysis measurement. In the current study, we evaluated the balance of ESRD patients before and after a routine session of hemodialysis treatment. This is the first study to investigate the effect of hemodialysis on balance, using an electronic posturographic balance system. We found the Fall Index score to be significantly higher after hemodialysis, indicating a negative

Understanding fall meaning and context in marketing balance classes to older adults.

Science.gov (United States)

Clark, Lauren; Thoreson, Sallie; Goss, Cynthia W; Zimmer, Lorena Marquez; Marosits, Mark; DiGuiseppi, Carolyn

2013-02-01

This study explored older, community-dwelling adults' attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥ 60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their "comfort zones" to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success.

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.

Effect of stroke on fall rate, location and predictors: a prospective comparison of older adults with and without stroke.

Directory of Open Access Journals (Sweden)

Lisa A Simpson

Full Text Available BACKGROUND: The literature suggests that stroke is a major risk factor for falls, but there is a lack of prospective, controlled studies which quantify fall-risk after stroke. The purpose of this study was to compare the rates, location and predictors among individuals recently discharged home from stroke rehabilitation to age and sex matched controls. METHODOLOGY/PRINCIPAL FINDINGS: A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differences in fall rates and contribution of clinical measures to falls were determined using negative binomial regression. Fall location was compared between groups using χ(2 statistics. The rate of falls for individuals with stroke was 1.77 times the rate for the control group. People with stroke were more likely to fall at home. Poorer balance (Berg Balance Scale was associated with greater falls for both stroke and control groups (incidence rate ratio [IRR]: 0.908 and IRR: 0.877 respectively. A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955 while better walking endurance (Six Minute Walk Test was associated with greater falls for the controls (IRR: 1.004. Balance confidence was not an independent predictor in either group. CONCLUSIONS: Individuals recently discharged home are at greater risk of falling than individuals without stroke. Attention to home environment is warranted. Balance function can predict falls for both people with stroke and age and sex matched controls. Increased mobility may increase exposure to fall opportunities.

Effect of Stroke on Fall Rate, Location and Predictors: A Prospective Comparison of Older Adults with and without Stroke

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Simpson, Lisa A.; Miller, William C.; Eng, Janice J.

2011-01-01

Background The literature suggests that stroke is a major risk factor for falls, but there is a lack of prospective, controlled studies which quantify fall-risk after stroke. The purpose of this study was to compare the rates, location and predictors among individuals recently discharged home from stroke rehabilitation to age and sex matched controls. Methodology/Principal Findings A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differences in fall rates and contribution of clinical measures to falls were determined using negative binomial regression. Fall location was compared between groups using χ2 statistics. The rate of falls for individuals with stroke was 1.77 times the rate for the control group. People with stroke were more likely to fall at home. Poorer balance (Berg Balance Scale) was associated with greater falls for both stroke and control groups (incidence rate ratio [IRR]: 0.908 and IRR: 0.877 respectively). A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955) while better walking endurance (Six Minute Walk Test) was associated with greater falls for the controls (IRR: 1.004). Balance confidence was not an independent predictor in either group. Conclusions Individuals recently discharged home are at greater risk of falling than individuals without stroke. Attention to home environment is warranted. Balance function can predict falls for both people with stroke and age and sex matched controls. Increased mobility may increase exposure to fall opportunities. PMID:21559367

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

Science.gov (United States)

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

2016-10-01

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

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

OpenAIRE

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

2011-01-01

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

Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls

Directory of Open Access Journals (Sweden)

Sang Chul Kim

2016-10-01

Full Text Available Introduction: Work-related traumatic brain injury (TBI caused by falls is a catastrophic event that leads to disabilities and high socio-medical costs. This study aimed to measure the magnitude of the preventive effect of safety helmets on clinical outcomes and to compare the effect across different heights of fall. Methods: We collected a nationwide, prospective database of work-related injury patients who visited the 10 emergency departments between July 2010 and October 2012. All of the adult patients who experienced work-related fall injuries were eligible, excluding cases with unknown safety helmet use and height of fall. Primary and secondary endpoints were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs of safety helmet use and height of fall for study outcomes, and adjusted for any potential confounders. Results: A total of 1298 patients who suffered from work-related fall injuries were enrolled. The industrial or construction area was the most common place of fall injury occurrence, and 45.0% were wearing safety helmets at the time of fall injuries. The safety helmet group was less likely to have intracranial injury comparing with the no safety helmet group (the adjusted odds ratios (ORs (95% confidence interval (CI: 0.42 (0.24–0.73, however, there was no statistical difference of in-hospital mortality between two groups (the adjusted ORs (95% CI: 0.83 (0.34–2.03. In the interaction analysis, preventive effects of safety helmet on intracranial injury were significant within 4 m height of fall. Conclusions: A safety helmet is associated with prevention of intracranial injury resulting from work-related fall and the effect is preserved within 4 m height of fall. Therefore, wearing a safety helmet can be an intervention for protecting fall-related intracranial injury in the workplace.

Electronic Out-fall Inspection Application - 12007

Energy Technology Data Exchange (ETDEWEB)

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

2012-07-01

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

Fall Protection Introduction, #33462

Energy Technology Data Exchange (ETDEWEB)

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

2016-06-23

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

The clinical practice guideline for falls and fall risk

OpenAIRE

Vance, Jacqueline

2011-01-01

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

Risk factors associated with visiting or not visiting the accident & emergency department after a fall.

Science.gov (United States)

Scheffer, Alice C; van Hensbroek, Pieter Boele; van Dijk, Nynke; Luitse, Jan S K; Goslings, Johannes C; Luigies, René H; de Rooij, Sophia E

2013-07-26

Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a population that visited the A&E Department after a fall (A&E group) and in a community-dwelling population of elderly individuals with a fall history who did not visit the A&E Department after a fall (non-A&E group). Two cohorts were included in this study. The first cohort included 547 individuals 65 years and older who were visited at home by a mobile fall prevention team. The participants in this cohort had fall histories but did not visit the A&E Department after a previous fall. These participants were age- and gender-matched to persons who visited the A&E Department for care after a fall. All participants were asked to complete the CAREFALL Triage Instrument. The mean number of modifiable risk factors in patients who did not visit the A&E Department was 2.9, compared to 3.8 in the group that visited the A&E Department (pfalling, impaired vision, mood and high risk of osteoporosis were all independently associated with visiting the A&E Department. All modifiable risk factors for falling were found to be shared between community-dwelling elderly individuals with a fall history who visited the A&E Department and those who did not visit the Department, although the prevalence of these factors was somewhat lower in the A&E group. Preventive strategies aimed both at patients presenting to the A&E Department after a fall and those not presenting after a fall could perhaps reduce the number of recurrent falls, the occurrence of injury and the frequency of visits to the A&E Department.

The association between primary open-angle glaucoma and fall: an observational study

Directory of Open Access Journals (Sweden)

Tanabe S

2012-03-01

Full Text Available Sachiko Tanabe1,2*, Kenya Yuki1*, Naoki Ozeki1, Daisuke Shiba1, Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Tokyo, Japan; 2Tanabe Eye Clinic, Kai City, Yamanashi, Japan*These authors contributed equally to this workPurpose: Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG who were more than 45 years old, compared with comparably aged healthy subjects.Methods: This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye.Results: The self-reported prevalence of injurious fall was 0.9% (1/117 in the control group and 6.9% (7/101 in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test. Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with

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

Directory of Open Access Journals (Sweden)

Beata Lindholm

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

Fall-grown oat to extend the fall grazing season for replacement dairy heifers.

Science.gov (United States)

Coblentz, W K; Brink, G E; Hoffman, P C; Esser, N M; Bertram, M G

2014-03-01

Our objective was to assess the pasture productivity and forage characteristics of 2 fall-grown oat (Avena sativa L.) cultivars, specifically for extending the grazing season and reducing reliance on harvested forages by replacement dairy heifers. A total of 160 gravid Holstein heifers (80 heifers/yr) were stratified by weight, and assigned to 1 of 10 identical research pens (8 heifers/pen). Initial body weights were 480 ± 43.5 kg in 2011 and 509 ± 39.4 kg in 2012. During both years of the trial, four 1.0-ha pasture replicates were seeded in August with Ogle oat (Schumitsch Seed Inc., Antigo, WI), and 4 separate, but similarly configured, pasture replicates were seeded with Forage Plus oat (Kratz Farms, Slinger, WI). Heifer groups were maintained as units, assigned to specific pastures, and then allowed to graze fall-oat pastures for 6h daily before returning to the barn, where they were offered a forage-based basal total mixed ration. Two heifer groups were retained in confinement (without grazing) as controls and offered the identical total mixed ration as pasture groups. During 2011, available forage mass increased with strong linear and quadratic effects for both cultivars, peaking at almost 9 Mg/ha on October 31. In contrast, forage mass was not affected by evaluation date in 2012, remaining ≤ 2,639 kg/ha across all dates because of droughty climatic conditions. During 2012, Ogle exhibited greater forage mass than Forage Plus across all sampling dates (2,678 vs. 1,856 kg/ha), largely because of its more rapid maturation rate and greater canopy height. Estimates of energy density for oat forage ranged from 59.6 to 69.1% during 2011, and ranged narrowly from 68.4 to 70.4% during 2012. For 2011, responses for both cultivars had strong quadratic character, in which the most energy-dense forages occurred in mid November, largely due to accumulation of water-soluble carbohydrates that reached maximum concentrations of 18.2 and 15.1% for Forage Plus and Ogle

Addressing the issue of falls off playground equipment: an empirically-based intervention to reduce fall-risk behaviors on playgrounds.

Science.gov (United States)

Morrongiello, Barbara A; Matheis, Shawn

2007-08-01

The present study evaluated the impact of an intervention to reduce fall-risk behaviors on playgrounds among children 6-11 years of age. Children completed posters indicating risky playground behaviors they would and would not do. In the intervention group, video and audio presentations were used to expose children to injury occurrences so that injury vulnerability was communicated in a fear-evoking way. In the control group, children only completed the pre- and post-intervention measures. Significant decreases in intentions to risk-take were obtained in the intervention, but not the control group. Effectiveness did not vary with children's age or sex, but was greater for those scoring high in sensation-seeking. A fear-appeals approach proved successful to reduce intended fall-risk behaviors, particularly for children high in sensation-seeking whose risk-taking is motivated by affect arousal.

Medication-Related Fall Incidents in an Older, Ambulant Population: The B-PROOF Study

NARCIS (Netherlands)

Ham, Annelies C.; Swart, Karin M. A.; Enneman, Anke W.; van Dijk, Suzanne C.; Oliai Araghi, Sadaf; van Wijngaarden, Janneke P.; van der Zwaluw, Nikita L.; Brouwer-Brolsma, Elske M.; Dhonukshe-Rutten, Rosalie A. M.; van Schoor, Natasja M.; van der Cammen, Tischa J. M.; Lips, Paul; de Groot, Lisette C. P. G. M.; Uitterlinden, André G.; Witkamp, Renger F.; Stricker, Bruno H.; van der Velde, Nathalie

2014-01-01

Background Medication use is a potentially modifiable risk factor for falling; psychotropic and cardiovascular drugs have been indicated as main drug groups that increase fall risk. However, evidence is mainly based on studies that recorded falls retrospectively and/or did not determine medication

Hayes Receives 2012 Ronald Greeley Early Career Award in Planetary Science: Citation

Science.gov (United States)

Leshin, Laurie A.

2013-10-01

Alexander G. Hayes Jr. received the 2012 Ronald Greeley Early Career Award in Planetary Science at the 2012 AGU Fall Meeting, held 3-7 December in San Francisco, Calif. The award recognizes significant early-career contributions to planetary science.

The Earth story: a facebook world in the geo-blogosphere

OpenAIRE

Redfern, Simon

2013-01-01

Presented at AGU 2013 Fall Meeting, San Francisco, December 10th 2013. In session: PA012. Social Media for Science: Challenges, Opportunities, and Maximizing Impact: PA31B-1829 "The Earth story ... a facebook world in the geo blogosphere"

Predictors of the risk of falls among elderly with chronic atrial fibrillation

Directory of Open Access Journals (Sweden)

Angela Cristina Silva dos Santos

2012-01-01

Full Text Available OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 107 took part in this study. Their age was 77.9±6.4 years, and 62 were female. They were divided into two groups: a no history of falls in the previous year and b a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%. Among them, 27 (49.1% presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that selfreported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

Effects of Pedalo® training on balance and fall risk in stroke patients.

Science.gov (United States)

Kim, Do-Yeon; Lim, Chae-Gil

2017-07-01

[Purpose] This study sought to examine the effects of Pedalo ® training on balance and fall risk in stroke patients. [Subjects and Methods] Thirty-one subjects with stroke were recruited and randomly allocated into two groups: the Pedalo ® group (n=15) and the Treadmill group (n=16). The Pedalo ® group performed conventional physical therapy program with Pedalo ® training for 30 minutes, five times a week, for 8 weeks, while the Treadmill group conducted conventional physical therapy programs and treadmill gait training for 30 minutes, five times a week, for 8 weeks. [Results] After intervention, both groups showed a significant improvement in balance. A significant greater balance improvement was found in the Pedalo ® group compared to the Treadmill group. Also, a significant reduction in risk of fall was seen in both group but this reduction was not significantly different between the two groups. [Conclusion] Pedalo ® training may be used to improve balance and reduce fall risk in stroke patients.

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

Science.gov (United States)

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

2017-04-01

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

Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial.

Science.gov (United States)

Taylor, Denise; Hale, Leigh; Schluter, Philip; Waters, Debra L; Binns, Elizabeth E; McCracken, Hamish; McPherson, Kathryn; Wolf, Steven L

2012-05-01

To compare the effectiveness of tai chi and low-level exercise in reducing falls in older adults; to determine whether mobility, balance, and lower limb strength improved and whether higher doses of tai chi resulted in greater effect. Randomized controlled trial. Eleven sites throughout New Zealand. Six hundred eighty-four community-residing older adults (mean age 74.5; 73% female) with at least one falls risk factor. Tai chi once a week (TC1) (n = 233); tai chi twice a week (TC2) (n = 220), or a low-level exercise program control group (LLE) (n = 231) for 20 wks. Number of falls was ascertained according to monthly falls calendars. Mobility (Timed-Up-and-Go Test), balance (step test), and lower limb strength (chair stand test) were assessed. The adjusted incident rate ratio (IRR) for falls was not significantly different between the TC1 and LLE groups (IRR = 1.05, 95% confidence interval (CI) = 0.83-1.33, P = .70) or between the TC2 and LLE groups (IRR = 0.88, 95% CI = 0.68-1.16, P = .37). Adjusted multilevel mixed-effects Poisson regression showed a significant reduction in logarithmic mean fall rate of -0.050 (95% CI = -0.064 to -0.037, P leg) and lower limb strength (P leg), P = .66 (left leg), P = .21, and P = .44, respectively). There was no difference in falls rates between the groups, with falls reducing similarly (mean falls rate reduction of 58%) over the 17-month follow-up period. Strength and balance improved similarly in all groups over time. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people.

Science.gov (United States)

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

2018-01-01

Reduced ability to adapt gait, particularly under challenging conditions, may be an important reason why older adults have an increased risk of falling. This study aimed to identify cognitive, psychological and physical mediators of the relationship between impaired gait adaptability and fall risk in older adults. Fifty healthy older adults (mean±SD: 74±7years) were categorised as high or low fall risk, based on past falls and their performance in the Physiological Profile Assessment. High and low-risk groups were then compared in the gait adaptability test, i.e. an assessment of the ability to adapt gait in response to obstacles and stepping targets under single and dual task conditions. Quadriceps strength, concern about falling and executive function were also measured. The older adults who made errors on the gait adaptability test were 4.76 (95%CI=1.08-20.91) times more likely to be at high risk of falling. Furthermore, each standard deviation reduction in gait speed while approaching the targets/obstacle increased the odds of being at high risk of falling approximately three fold: single task - OR=3.10,95%CI=1.43-6.73; dual task - 3.42,95%CI=1.56-7.52. Executive functioning, concern about falling and quadriceps strength substantially mediated the relationship between the gait adaptability measures and fall risk status. Impaired gait adaptability is associated with high risk of falls in older adults. Reduced executive function, increased concern about falling and weaker quadriceps strength contribute significantly to this relationship. Training gait adaptability directly, as well as addressing the above mediators through cognitive, behavioural and physical training may maximise fall prevention efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

[Vestibular function, falls and hip fracture in elderly--a relationship study].

Science.gov (United States)

Zur, Oz; Carmeli, Eli; Himellfarb, Mordechi; Berner, Yitshal N

2004-03-01

Falling is the main reason for which people over 70 arrive at emergency rooms. Over 90% of hip fractures occur as a direct result of falling. To examine the relationship between the function of the vestibular system and hip fractures following falls in elderly. The research group (n = 84) undergone hip surgery as a result of a fall and were then hospitalized in a rehabilitative geriatric care unit at the Meir Hospital in Kfar Sava. The control group (n = 85)--without any history of a hip fracture and living in a retirement home. Four clinical tests were given to each examinee in order to locate any impairment of the vestibular system. Three of the clinical examinations concentrated on testing the VOR while the fourth test was especially used to locate BPPV (Benign Paroxysmal Positional Vertigo). Sociodemographic status and medical history were taken. A significant difference was found between the two groups (those with a hip fracture and those without any hip fracture) with regard to the functioning of the VOR, age, endocrine disease and medications for treating diabetic. However, there was no significant difference found in the appearance of the BPPV. It is important to locate the elderly who are at risk of falling in nursing homes and the community at large by performing the four simple clinical tests. Correct diagnosis and early treatment of the vestibular impairment in elderly patient can prevent the next fall.

Falling Less in Kansas: Development of a Fall Risk Reduction Toolkit

Directory of Open Access Journals (Sweden)

Teresa S. Radebaugh

2011-01-01

Full Text Available Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas.

Cost of falls in old age: a systematic review.

Science.gov (United States)

Heinrich, S; Rapp, K; Rissmann, U; Becker, C; König, H-H

2010-06-01

The purpose of this study was to review the evidence of the economic burden of falls in old age. This review showed that falls are a relevant economic burden. Efforts should be directed to fall-prevention programmes. Falls are a common mechanism of injury and a leading cause of costs of injury in the elderly. The purpose of this study was to review for the first time the evidence of the economic burden caused by falls in old age. A systematic review was conducted in the databases of PubMed, of the Centre for Reviews and Dissemination and in the Cochrane Database of Systematic Reviews until June 2009. Studies were assessed for inclusion, classified and synthesised. Costs per inhabitant, the share of fall-related costs in total health care expenditures and in gross domestic products (GDP) were calculated. If appropriate, cost data were inflated to the year 2006 and converted to US Dollar (USD PPP). A total of 32 studies were included. National fall-related costs of prevalence-based studies were between 0.85% and 1.5% of the total health care expenditures, 0.07% to 0.20% of the GDP and ranged from 113 to 547 USD PPP per inhabitant. Direct costs occurred especially in higher age groups, in females, in hospitals and long-term care facilities and for fractures. Mean costs per fall victim, per fall and per fall-related hospitalisation ranged from 2,044 to 25,955; 1,059 to 10,913 and 5,654 to 42,840 USD PPP and depended on fall severity. A more detailed comparison is restricted by the limited number of studies. Falls are a relevant economic burden to society. Efforts should be directed to economic evaluations of fall-prevention programmes aiming at reducing fall-related fractures, which contribute substantially to fall-related costs.

Falls and Postural Control in Older Adults With Eye Refractive Errors

Directory of Open Access Journals (Sweden)

Afsun Nodehi-Moghadam

2016-04-01

Conclusion: Vision impairment of older adults due to refractive error is not associated with an increase in falls. Furthermore, TUG test results did not show balance disorders in these groups. Further research, such as assessment of postural control with advanced devices and considering other falling risk factors is also needed to identify the predictors of falls in older adults with eye refractive errors.

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.

A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial.

Science.gov (United States)

Bjerk, Maria; Brovold, Therese; Skelton, Dawn A; Bergland, Astrid

2017-08-14

Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service

Some aspects of the role of intergranular fluids in the compositional ...

Indian Academy of Sciences (India)

R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

fluid, solubility in the fluid and mass balance between the various reservoirs. The model ... It is shown that a coupling of thermodynamics and kinetics controls the evolution of the system and the ...... systems. AGU Fall Meeting; EOS 78 F833.

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

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

Science.gov (United States)

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

2018-03-19

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

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

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

2011-01-01

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

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

LENUS (Irish Health Repository)

O'Halloran, Aisling M

2011-12-19

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

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

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

2015-10-01

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

The Impact of a Training Intervention Program on Fall-related Psychological Factors Among Male Older Adults in Arak

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Daryoush Khajavi

2014-04-01

Full Text Available Objectives: Falls and fall-related physiological and psychological events are major problems for elderly people. The objective of this research was to examine the effect of an interventional training program on fall-related psychological factors among the elderly men in Arak. Methods & Materials: In this quasi experiment research on male older adults in Arak, 27 participants randomly assigned to Control group (mean age=70.21±6.65 and Experimental group (mean age=66.07±4.38. Experimental group members participated in a 12 week interventional training program. Results: The findings showed that training intervention program improved fall-related psychological factors (Fall Self-Efficacy/Fear of Fall and Activities-specific Balance Confidence/Balance Self-Efficacy in experimental group. No significant changes appeared in fall-related psychological factors in control group members who did not perform any regular training program. Conclusion: According to the findings, regular interventional training program can decrease fear of fall and increase balance confidence in performing the activities of everyday life by improving physical and motor fitness levels. These improvements can lead to physical and psychological health, increase in quality of life among older adults, and eventually successful aging.

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

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

2015-01-01

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

Cost-effectiveness in fall prevention for older women.

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Hektoen, Liv F; Aas, Eline; Lurås, Hilde

2009-08-01

The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the > or = 80-year age group in Norway. The impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. We found that the reduction in healthcare costs per individual for treating fall-related injuries was 1.85 times higher than the cost of implementing a fall prevention programme. The reduction in healthcare costs more than offset the cost of the prevention programme for women aged > or = 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.

Artificial neural network and falls in community-dwellers: a new approach to identify the risk of recurrent falling?

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Kabeshova, Anastasiia; Launay, Cyrille P; Gromov, Vasilii A; Annweiler, Cédric; Fantino, Bruno; Beauchet, Olivier

2015-04-01

Identification of the risk of recurrent falls is complex in older adults. The aim of this study was to examine the efficiency of 3 artificial neural networks (ANNs: multilayer perceptron [MLP], modified MLP, and neuroevolution of augmenting topologies [NEAT]) for the classification of recurrent fallers and nonrecurrent fallers using a set of clinical characteristics corresponding to risk factors of falls measured among community-dwelling older adults. Based on a cross-sectional design, 3289 community-dwelling volunteers aged 65 and older were recruited. Age, gender, body mass index (BMI), number of drugs daily taken, use of psychoactive drugs, diphosphonate, calcium, vitamin D supplements and walking aid, fear of falling, distance vision score, Timed Up and Go (TUG) score, lower-limb proprioception, handgrip strength, depressive symptoms, cognitive disorders, and history of falls were recorded. Participants were separated into 2 groups based on the number of falls that occurred over the past year: 0 or 1 fall and 2 or more falls. In addition, total population was separated into training and testing subgroups for ANN analysis. Among 3289 participants, 18.9% (n = 622) were recurrent fallers. NEAT, using 15 clinical characteristics (ie, use of walking aid, fear of falling, use of calcium, depression, use of vitamin D supplements, female, cognitive disorders, BMI 4, vision score 9 seconds, handgrip strength score ≤29 (N), and age ≥75 years), showed the best efficiency for identification of recurrent fallers, sensitivity (80.42%), specificity (92.54%), positive predictive value (84.38), negative predictive value (90.34), accuracy (88.39), and Cohen κ (0.74), compared with MLP and modified MLP. NEAT, using a set of 15 clinical characteristics, was an efficient ANN for the identification of recurrent fallers in older community-dwellers. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Elderly individuals with increased risk of falls show postural balance impairment

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Márcio Rogério de Oliveira

Full Text Available Introduction Falls are a serious public health problem. Objective The aim of this study was to evaluate whether elderly individuals with increased risk of falls have a postural balance deficit, evaluated using a force platform during a one-leg stance. Materials and methods The sample consisted of 94 physically independent elderly individuals from the EELO project. The instruments used were the Downton scale, in order to assess the risk as well as the history of falls, and the force platform to measure postural balance through parameters from the center of pressure (COP. Results Elderly individuals were split into two groups according to the score observed with the Downton scale: G1 — low fall risk (score ≤ 2 — and G2 — high fall risk (score > 2. No differences were observed between the groups concerning gender (P > 0.05, Chi Square test. On the other hand, individuals from G2 showed postural instability when compared to individuals from G1, and individuals from G2 showed higher values in all COP parameters analysed (Mann-Whitney test, P < 0.05. Conclusion It can be concluded that the Downton scale has sensitivity for identifying individuals with balance impairment as well as a risk of falls. Therefore, it may be suggested that this scale may be useful in primary health care for detecting falls in the elderly.

Electron energy distribution function in a cathode fall region of DC-glow discharge

International Nuclear Information System (INIS)

Elakshar, F.F.; Garamoon, A.A.; Hassouba, M.A.

1997-01-01

Recently a substantial effort has been devoted towards the development of a quantitative microscopic measurements in the cathode fall region of the DC-glow discharge magnetron sputtering unit. The electron energy distribution function (EEDF) has been measured using a single Langmuir probe at the edge of the cathode fall. Two groups of electrons are observed in helium and argon gas discharges. The two groups have no chance to be thermalized since they leave the cathode fall region fast. The electron temperature measurements have been compared with spectroscopic determination. Plasma density has been computed and compared with probe measurements. Sources of the two groups of electrons are also discussed. (author)

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

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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

Attempts to Prevent Falls and Injury: A Prospective Community Study.

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Reinsch, Sibylle; And Others

1992-01-01

At 16 senior centers, studied effectiveness of exercise and cognitive-behavioral programs, compared to discussion control program, in reducing falls and injuries among 230 older adults. After one year of programs, observed no significant difference in time to first fall among groups. Secondary outcome measures such as strength, balance, fear of…

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

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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.

Does Perturbation Training Prevent Falls after Discharge from Stroke Rehabilitation? A Prospective Cohort Study with Historical Control.

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Mansfield, Avril; Schinkel-Ivy, Alison; Danells, Cynthia J; Aqui, Anthony; Aryan, Raabeae; Biasin, Louis; DePaul, Vincent G; Inness, Elizabeth L

2017-10-01

Individuals with stroke fall frequently, and no exercise intervention has been shown to prevent falls post stroke. Perturbation-based balance training (PBT), which involves practicing reactions to instability, shows promise for preventing falls in older adults and individuals with Parkinson's disease. This study aimed to determine if PBT during inpatient stroke rehabilitation can prevent falls after discharge into the community. Individuals with subacute stroke completed PBT as part of routine inpatient rehabilitation (n = 31). Participants reported falls experienced in daily life for up to 6 months post discharge. Fall rates were compared to a matched historical control group (HIS) who did not complete PBT during inpatient rehabilitation. Five of 31 PBT participants, compared to 15 of 31 HIS participants, reported at least 1 fall. PBT participants reported 10 falls (.84 falls per person per year) whereas HIS participants reported 31 falls (2.0 falls per person per year). When controlled for follow-up duration and motor impairment, fall rates were lower in the PBT group than the HIS group (rate ratio: .36 [.15, .79]; P = .016). These findings suggest that PBT is promising for reducing falls post stroke. While this was not a randomized controlled trial, this study may provide sufficient evidence for implementing PBT in stroke rehabilitation practice. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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

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

2018-03-01

Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited. To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems. Randomized controlled trial. University of Malaya Medical Centre. Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds. Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated. Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months. Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES

Balance training reduces falls risk in older individuals with type 2 diabetes.

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Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

2010-04-01

This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

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

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Santosh K Verma

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

The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials.

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El-Khoury, Fabienne; Cassou, Bernard; Charles, Marie-Aline; Dargent-Molina, Patricia

2013-10-29

To determine whether, and to what extent, fall prevention exercise interventions for older community dwelling people are effective in preventing different types of fall related injuries. Electronic databases (PubMed, the Cochrane Library, Embase, and CINAHL) and reference lists of included studies and relevant reviews from inception to July 2013. Randomised controlled trials of fall prevention exercise interventions, targeting older (>60 years) community dwelling people and providing quantitative data on injurious falls, serious falls, or fall related fractures. Based on a systematic review of the case definitions used in the selected studies, we grouped the definitions of injurious falls into more homogeneous categories to allow comparisons of results across studies and the pooling of data. For each study we extracted or calculated the rate ratio of injurious falls. Depending on the available data, a given study could contribute data relevant to one or more categories of injurious falls. A pooled rate ratio was estimated for each category of injurious falls based on random effects models. 17 trials involving 4305 participants were eligible for meta-analysis. Four categories of falls were identified: all injurious falls, falls resulting in medical care, severe injurious falls, and falls resulting in fractures. Exercise had a significant effect in all categories, with pooled estimates of the rate ratios of 0.63 (95% confidence interval 0.51 to 0.77, 10 trials) for all injurious falls, 0.70 (0.54 to 0.92, 8 trials) for falls resulting in medical care, 0.57 (0.36 to 0.90, 7 trials) for severe injurious falls, and 0.39 (0.22 to 0.66, 6 trials) for falls resulting in fractures, but significant heterogeneity was observed between studies of all injurious falls (I(2)=50%, P=0.04). Exercise programmes designed to prevent falls in older adults also seem to prevent injuries caused by falls, including the most severe ones. Such programmes also reduce the rate of falls leading

Improving Fall Risk Factor Identification and Documentation of Risk Reduction Strategies by Rehabilitation Therapists through Continuing Education

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Karnes, Michele J.

2011-01-01

This static group comparison study determined that an educational intervention was effective in increasing fall risk factor assessment, documentation of fall risk factors, and strategies devised to reduce fall risk factors by rehabilitation therapists for their older adult outpatients in clinics. Results showed that experimental group identified…

Falls in multiple sclerosis.

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

2011-07-01

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

Reactive Balance in Individuals With Chronic Stroke: Biomechanical Factors Related to Perturbation-Induced Backward Falling.

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Salot, Pooja; Patel, Prakruti; Bhatt, Tanvi

2016-03-01

An effective compensatory stepping response is the first line of defense for preventing a fall during sudden large external perturbations. The biomechanical factors that contribute to heightened fall risk in survivors of stroke, however, are not clearly understood. It is known that impending sensorimotor and balance deficits poststroke predispose these individuals to a risk of fall during sudden external perturbations. The purpose of this study was to examine the mechanism of fall risk in survivors of chronic stroke when exposed to sudden, slip-like forward perturbations in stance. This was a cross-sectional study. Fourteen individuals with stroke, 14 age-matched controls (AC group), and 14 young controls (YC group) were exposed to large-magnitude forward stance perturbations. Postural stability was computed as center of mass (COM) position (XCOM/BOS) and velocity (ẊCOM/BOS) relative to the base of support (BOS) at first step lift-off (LO) and touch-down (TD) and at second step TD. Limb support was quantified as vertical hip descent (Zhip) from baseline after perturbation onset. All participants showed a backward balance loss, with 71% of the stroke group experiencing a fall compared with no falls in the control groups (AC and YC groups). At first step LO, no between-group differences in XCOM/BOS and ẊCOM/BOS were noted. At first step TD, however, the stroke group had a significantly posterior XCOM/BOS and backward ẊCOM/BOS compared with the control groups. At second step TD, individuals with stroke were still more unstable (more posterior XCOM/BOS and backward ẊCOM/BOS) compared with the AC group. Individuals with stroke also showed greater peak Zhip compared with the control groups. Furthermore, the stroke group took a larger number of steps with shorter step length and delayed step initiation compared with the control groups. Although the study highlights the reactive balance deficits increasing fall risk in survivors of stroke compared with healthy

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

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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.

Determining Whether a Dosage-Specific and Individualized Home Exercise Program With Consults Reduces Fall Risk and Falls in Community-Dwelling Older Adults With Difficulty Walking: A Randomized Control Trial.

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Gallo, Estelle; Stelmach, Maria; Frigeri, Fernanda; Ahn, Dong-Hyun

The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program. This was a randomized controlled trial. Sixty-nine participants who were independent community dwellers, were 65 years or older, had difficulty walking or complaints of instability, and had 1 or more risk of falls were randomly assigned into a usual care group (UCG, n = 43) or an experimental group (EG, n = 26). Both groups received PT 2 times per week for 30 minutes for 10 to 32 visits. The UCG received the usual PT delivered at Rusk. The EG was instructed in a moderate- to high-intensity home exercise program designed after completing the mini-Balance Evaluation Systems Test to assist with exercise prescription. The EG was educated on performing a recommended dosage of exercise over 6 months using a diary. The EG received 4 additional 30-minute consults every 2 to 4 weeks postdischarge to reinforce compliance. Self-report of number of falls, number of minutes of exercise per week, and performance on outcome measures (Timed Up and Go, 5-times sit-to-stand, Berg Balance Scale, and Activity Balance Confidence Scale) were monitored at evaluation, 2, 4, and 6 months. Thirty-five participants completed the study (UCG n = 22; EG n = 13). Both groups were similar at baseline on outcome measures and number of visits. Random effect model analyses demonstrated that both groups made significant reductions in fall risk over 6 months

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

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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.

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

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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.

Prediction of Risk of Falling among Institutionalized Elderly People in Iran

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Ahmad Ali Akbari Kamrani

2005-09-01

Full Text Available Aging declines abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly. In order to accomplish this aim, two functional assessment methods, Berg Scale and Tinetti Scale, were used and the validity indices of these methods were calculated. Prospective non-interventional methodological discriminative-validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using/without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use/nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases; independent variable was history of falling; and dependent variables were the results of the two functional assessment methods. Independent t-test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (P=0.0001 and Tinetti Scale (P=0.0001. The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

Prediction of Risk of Falling Among Institutionalized Elderly People in Iran

Directory of Open Access Journals (Sweden)

Ahmad Ali Akbari-Kamrani

2003-07-01

Full Text Available Objective: Aging decline abilities and leads to increased risk of falling and subsequently poorer quality of life. The objective of this study was to identify a proper assessment for risk of falling among institutionalized elderly people. Materials & Methods: Prospective non–interventional methodological discriminative–validation study in order to make a comparative assessment of the discriminative validity of the two clinical assessment methods among the elderly people with/ without history of falling. The frequency of falls within 6 months among institutionalized elderly individuals was prospectively studied. Finally, those having had two or more falls within 6 months were enrolled in the faller group and those having no falls within 6 months were enrolled in the non-faller group. Twenty-one women and 33 men (mean age: 75.79, standard deviation [SD]: 8.47, range: 61-98 independent in their daily activities and able to walk 10 meters using / without assistive devices volunteered to participate in the study with awareness. Background variables included age, gender, use / nonuse of assistive devices, height, weight, number of the drugs used, and number of the diseases independent variable was history of falling and dependent variables were the results of the two functional assessment methods. In order to accomplish the aim of study, two functional assessment methods, Berg scale and Tinetti scale, were used and the validity indices of these methods were calculated. Results: Independent t test indicated a significant difference between the two groups of fallers and non-fallers in the mean scores on Berg Balance Scale (p=0.00l and Tinetti Scale (p=0.00l. Conclusion: The results of logistic regression test indicated much more discriminative validity for Berg Balance Scale test than Tinetti Scale test. Studying the validity of Berg Balance Scale assessment method showed that all validity indices should be regarded as bases for clinical decision.

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

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

2016-01-01

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

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

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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.

Vibration perception threshold in relation to postural control and fall risk assessment in elderly.

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de Mettelinge, Tine Roman; Calders, Patrick; Palmans, Tanneke; Vanden Bossche, Luc; Van Den Noortgate, Nele; Cambier, Dirk

2013-09-01

This study investigates (i) the potential discriminative role of a clinical measure of peripheral neuropathy (PN) in assessing postural performance and fall risk and (ii) whether the integration of a simple screening vibration perception threshold (VPT) for PN in any physical (fall risk) assessment among elderly should be recommended, even if they do not suffer from DM. One hundred and ninety-five elderly were entered in a four-group model: DM with PN (D+; n = 75), DM without PN (D-; n = 28), non-diabetic elderly with idiopathic PN (C+; n = 31) and non-diabetic elderly without PN (C-; n = 61). Posturographic sway parameters were captured during different static balance conditions (AMTI AccuGait, Watertown, MA). VPT, fall data, Mini-Mental State Examination and Clock Drawing Test were registered. Two-factor repeated-measures ANOVA was used to compare between groups and across balance conditions. The groups with PN demonstrated a strikingly comparable, though bigger sway, and a higher prospective fall incidence than their peers without PN. The indication of PN, irrespective of its cause, interferes with postural control and fall incidence. The integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. Implications for Rehabilitation The indication of peripheral neuropathy (PN), irrespective of its cause, interferes with postural control and fall incidence. Therefore, the integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended. It might be useful to integrate somatosensory stimulation in rehabilitation programs designed for fall prevention.

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

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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.

Falls' problematization and risk factors identification through older adults' narrative.

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Morsch, Patricia; Myskiw, Mauro; Myskiw, Jociane de Carvalho

2016-11-01

Falling is an important event for older adults as they might cause physical and psychological impairment, institutionalization and increased mortality risk. Adherence in falls prevention programs depends on older adults' perceptions in relation to falling. The current study aims to investigate the fall problematization and older adults' perception about the risk factors for falls. This is an exploratory qualitative research, conducted through content analysis approach. The sample consisted of older adults aged 60 years and older who participate in community groups in Porto Alegre (Brazil), and professors from two local universities. Final sample consisted of 22 participants, mean age was 70.2 ± 7.1. Coding and interpretation of data resulted in two thematic categories, named: falls' problematization and the perception of the risk factors for falling. The first category highlights that many older adults do not realize falling as a potential problem, which suggests that current preventive measures may not be reaching the target population. The second category shows that older adults' perceptions in relation to the risk factors exist, but often they are not avoided, because older adults consider their ability to "take care" as the main method of prevention, and due to the multifactorial nature of falls, this cannot be considered an efficient solution.

Randomized Controlled Trial of Screening, Risk Modification, and Physical Therapy to Prevent Falls Among the Elderly Recently Discharged From the Emergency Department to the Community: The Steps to Avoid Falls in the Elderly Study.

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Matchar, David B; Duncan, Pamela W; Lien, Christopher T; Ong, Marcus Eng Hock; Lee, Mina; Gao, Fei; Sim, Rita; Eom, Kirsten

2017-06-01

To evaluate the effectiveness of a multifactorial, tailored program of physical therapy to reduce the occurrence of falls among a heterogeneous group of high-risk elderly Singaporeans recently discharged from the emergency department (ED). Randomized controlled trial. Communities. Adults (N=354) aged ≥65 years who were seen in the ED for a fall or fall-related injuries and discharged home. The intervention primarily consisted of a tailored program of physical therapy focused on progressive training in strength, balance, and gait for a period of 3 months. Participants in the intervention group also received screening and follow-up for vision, polypharmacy, and environmental hazards. Participants in the control group received usual care prescribed by a physician and educational materials on falls prevention. The primary outcome measure was experiencing at least 1 fall during the 9-month study period (a 3-mo active intervention phase and a 6-mo maintenance phase). Secondary outcome measures were the occurrence of at least 1 injurious fall during the study period and a change in the Short Physical Performance Battery (SPPB) score. Participants were assessed both after 3 and 9 months. During the 9-month study period, 37.8% of the control group and 30.5% of the intervention group fell at least once, which was not statistically significantly different (odds ratio [OR]=.72; 95% confidence interval [CI], .46-1.12; P=.146). The intervention group had statistically significantly fewer individuals with injurious falls (OR=.56; 95% CI, .32-.98; P=.041) and less deterioration in physical performance, reflected by a mean difference of 0.6 in SPPB scores (P=.029). Multivariate analyses indicated a strong interaction effect between the intervention and the presence of 2 or more major comorbidities; after accounting for this effect, the intervention program reduced the number of people experiencing at least 1 fall (OR=.34; 95% CI, .17-.67; P=.002). We observed that in this

Trends in fall-related injuries among older adults treated in emergency departments in the USA.

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Orces, Carlos H; Alamgir, Hasanat

2014-12-01

To examine national trends in fall-related injuries among older adults treated in emergency departments (ED) and project these injuries until the year 2030. The Web-based Injury Statistics Query and Reporting System was used to generate data on fall-related injuries treated in ED. Joinpoint regression analysis was used to examine the average annual change in injury rates over time. Fall-related injury and hospitalisation rates increased on average by 2% (95% CI 1.5% to 2.7%) and by 4% (95% CI 2.9% to 5.0%) per year, respectively. Assuming the increase in fall-related injury rates remains unchanged, the number of fall-related injuries may increase to 5.7 million by the year 2030. Fall-related injuries among older adults treated in ED increased in the USA during the study period. Moreover, a marked increase in the number of these injuries may occur over the next decades. 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.

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.

Effects of rapid maxillary expansion on head posture, postural stability, and fall risk

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Fatih Celebi

2017-01-01

Full Text Available Objective: The aim of this study was to investigate the effects of rapid maxillary expansion (RME on head posture, postural stability, and fall risk. Materials and Methods: A sample of 51 adolescent patients was randomly divided into two groups. In the first group, which consisted of 28 patients (15 females and 13 males, RME was performed as a part of routine orthodontic treatment. The remaining 23 individuals (12 females and 11 males served as the control group. Lateral cephalometric radiographs taken in natural head position, postural stability, and fall risk scores were obtained during the first visit. They were repeated on average 3.8 months and 3.5 months later for the study and control groups, respectively. The changes were analyzed using the Wilcoxon signed-rank test, paired samples t-test, Mann–Whitney U-test, and independent samples t-test. Results: As a result of RME, a statistically significant decrease was detected in the fall risk score (P < 0.05 in the study group, while the head position and postural stability remained unchanged. For the control group, no significant changes were observed in all measurements. Conclusions: The result of the present study suggests that RME has a capacity of improving fall risk.

Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in wards for older people.

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Drahota, Amy Kim; Ward, Derek; Udell, Julie E; Soilemezi, Dia; Ogollah, Reuben; Higgins, Bernard; Dean, Taraneh P; Severs, Martin

2013-09-01

falls disproportionately affect older people, who are at increased risk of falls and injury. This pilot study investigates shock-absorbing flooring for fall-related injuries in wards for frail older people. we conducted a non-blinded cluster randomised trial in eight hospitals in England between April 2010 and August 2011. Each site allocated one bay as the 'study area', which was randomised via computer to intervention (8.3-mm thick Tarkett Omnisports EXCEL) or control (2-mm standard in situ flooring). Sites had an intervention period of 1 year. Anybody admitted to the study area was eligible. The primary outcome was the fall-related injury rate. Secondary outcomes were injury severity, fall rate and adverse events. during the intervention period, 226 participants were recruited to each group (219 and 223 were analysed in the intervention and control group, respectively). Of 35 falls (31 fallers) in the intervention group, 22.9% were injurious, compared with 42.4% of 33 falls (22 fallers) in the control group [injury incident rate ratio (IRR) = 0.58, 95% CI = 0.18-1.91]. There were no moderate or major injuries in the intervention group and six in the control group. The fall IRR was 1.07 (95% CI = 0.64-1.81). Staff at intervention sites raised concerns about pushing equipment, documenting one pulled back. future research should assess shock-absorbing flooring with better 'push/pull' properties and explore increased faller risk. We estimate a future trial will need 33,480-52,840 person bed-days per arm.

Albeni Falls Wildlife Mitigation Project, 2008 Annual Report.

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Soults, Scott [Kootenai Tribe of Idaho

2009-08-05

The Albeni Falls Interagency Work Group (AFIWG) was actively involved in implementing wildlife mitigation activities in late 2007, but due to internal conflicts, the AFIWG members has fractionated into a smaller group. Implementation of the monitoring and evaluation program continued across protected lands. As of 2008, The Albeni Falls Interagency Work Group (Work Group) is a coalition comprised of wildlife managers from three tribal entities (Kalispel Tribe, Kootenai Tribe, Coeur d Alene Tribe) and the US Army Corps of Engineers. The Work Group directs where wildlife mitigation implementation occurs in the Kootenai, Pend Oreille and Coeur d Alene subbasins. The Work Group is unique in the Columbia Basin. The Columbia Basin Fish and Wildlife Authority (CBFWA) wildlife managers in 1995, approved what was one of the first two project proposals to implement mitigation on a programmatic basis. The maintenance of this kind of approach through time has allowed the Work Group to implement an effective and responsive habitat protection program by reducing administrative costs associated with site-specific project proposals. The core mitigation entities maintain approximately 9,335 acres of wetland/riparian habitats in 2008.

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

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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

Development of STEADI: a fall prevention resource for health care providers.

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Stevens, Judy A; Phelan, Elizabeth A

2013-09-01

Falls among people aged ≥65 years are the leading cause of both injury deaths and emergency department visits for trauma. Research shows that many falls are preventable. In the clinical setting, an effective fall intervention involves assessing and addressing an individual's fall risk factors. This individualized approach is recommended in the American and British Geriatrics Societies' (AGS/BGS) practice guideline. This article describes the development of STEADI (Stopping Elderly Accidents, Deaths, and Injuries), a fall prevention tool kit that contains an array of health care provider resources for assessing and addressing fall risk in clinical settings. As researchers at the Centers for Disease Control and Prevention's Injury Center, we reviewed relevant literature and conducted in-depth interviews with health care providers to determine current knowledge and practices related to older adult fall prevention. We developed draft resources based on the AGS/BGS guideline, incorporated provider input, and addressed identified knowledge and practice gaps. Draft resources were reviewed by six focus groups of health care providers and revised. The completed STEADI tool kit, Preventing Falls in Older Patients-A Provider Tool Kit, is designed to help health care providers incorporate fall risk assessment and individualized fall interventions into routine clinical practice and to link clinical care with community-based fall prevention programs.

Older Adults' Perceptions of Clinical Fall Prevention Programs: A Qualitative Study

Directory of Open Access Journals (Sweden)

Rebecca Calhoun

2011-01-01

Full Text Available Objective. To investigate motivational factors and barriers to participating in fall risk assessment and management programs among diverse, low-income, community-dwelling older adults who had experienced a fall. Methods. Face-to-face interviews with 20 elderly who had accepted and 19 who had not accepted an invitation to an assessment by one of two fall prevention programs. Interviews covered healthy aging, core values, attributions/consequences of the fall, and barriers/benefits of fall prevention strategies and programs. Results. Joiners and nonjoiners of fall prevention programs were similar in their experience of loss associated with aging, core values they expressed, and emotional response to falling. One difference was that those who participated endorsed that they “needed” the program, while those who did not participate expressed a lack of need. Conclusions. Interventions targeted at a high-risk group need to address individual beliefs as well as structural and social factors (transportation issues, social networks to enhance participation.

Falls prevention and balance rehabilitation in multiple sclerosis: a bi-centre randomised controlled trial.

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Cattaneo, Davide; Rasova, Kamila; Gervasoni, Elisa; Dobrovodská, Gabriela; Montesano, Angelo; Jonsdottir, Johanna

2018-03-01

People with Multiple Sclerosis (PwMS) have a high incidence of accidental falls that have a potentially detrimental effect on their daily life participation. The effect of balance specific rehabilitation on clinical balance measures and frequency of falls in PwMS was studied. A bi-centre randomised rater-blinded controlled trial. Participants in both groups received 20 treatment sessions. Participants in the intervention group received treatment aimed at improving balance and mobility. Participants in the control group received treatments to reduce limitations at activity and body function level. Primary measures were frequency of fallers (>1 fall in two months) and responders (>3 points improvement) at the Berg Balance Scale (BBS). Data was analysed according to an intention to treat approach. One hundred and nineteen participants were randomised. Following treatment frequency of fallers was 22% in the intervention group and 23% in the control group, odds ratio (OR) and (confidence limits): 1.05 (0.41 to 2.77). Responders on the BBS were 28% in the intervention group and 33% in the control group, OR = 0.75 (0.30 to 1.91). At follow up ORs for fallers and responders at BBS were 0.98 (0.48 to 2.01) and 0.79 (0.26 to 2.42), respectively. Twenty sessions 2-3 times/week of balance specific rehabilitation did not reduce fall frequency nor improve balance suggesting the need for more frequent and challenging interventions. Implications for Rehabilitation Programs for balance rehabilitation can improve balance but their effects in fall prevention are unclear. Twenty treatments sessions 2/3 times per week did not reduced frequency of falls in MS. The comparison with similar studies suggests that higher intensity of practice of highly challenging balance activities appears to be critical to maximizing effectiveness.

Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis.

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Khalaj, Nafiseh; Abu Osman, Noor Azuan; Mokhtar, Abdul Halim; Mehdikhani, Mahboobeh; Wan Abas, Wan Abu Bakar

2014-01-01

Balance is essential for mobility and performing activities of daily living. People with knee osteoarthritis display impairment in knee joint proprioception. Thus, the aim of this study was to evaluate balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. Sixty subjects aged between 50 and 70 years volunteered in this study. They were categorized into three groups which were healthy (n = 20), mild (n = 20) and moderate (n = 20) bilateral knee osteoarthritis groups. Dynamic and static balance and risk of fall were assessed using Biodex Stability System. In addition, Timed Up and Go test was used as a clinical test for balance. Results of this study illustrated that there were significant differences in balance (dynamic and static) and risk of fall between three groups. In addition, the main (most significant) difference was found to be between healthy group and moderate group. Furthermore, on clinical scoring of balance, the "Timed Up and Go" test, all three groups showed significant difference. In conclusion, bilateral knee osteoarthritis impaired the balance and increased the risk of fall, particularly in people with moderate knee osteoarthritis.

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

Cost-effectiveness in fall prevention for older women

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Hektoen, Liv F.; Aas, Eline; Lurås, Hilde

2009-01-01

Artikkelen beskriver en studie hvor hensikten var å estimere kostnadseffekten av fallforebygging for hjemmeboende eldre kvinner i Norge. The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the 80-year age group in Norway. Methods: the impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimate...

Functional neural correlates of reduced physiological falls risk

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Hsu Chun

2011-08-01

Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

Characteristics of Traumatic Brain Injury among Accident and Falling Down Cases

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Kamran Aghakhani

2015-10-01

Full Text Available Motor vehicle and falling down are responsible for the most number of traumatic injuries. This study aimed to compare the characteristics of traumatic brain injury among accident and falling down cases. In this analytical cross- sectional study, data were collected from the records of cadavers who died due to accident or falling down and referred to Kahrizak dissection hall, Tehran forensic medicine organization during 2013. A total of 237 subjects (183 (77.2% accident and 54 (22.8% falling down with a mean age of 35.62 (SD=15.75 were evaluated. A number of 213 (89.9% were male. From accident group, scalp injury was seen in 146 (79.8%, scalp abrasion in 122 (66.7%, scalp laceration in 104 (56.8%, sub skull bruising in 176 (96.3%, skull fracture in 119 (65%, hemorrhage in 166 (90.7%, Subdural hemorrhage (SDH in 155 (84.7%, Subarachnoid hemorrhage (SAH in 161 (88%, Epidural hemorrhage (EDH in 41 (22.4%, contusion in 140 (76.5%, and skull base fracture in 140 (76.5% of cases. In falling down group scalp injury was seen in 42 (77.8% cadavers, scalp abrasion in 38 (70.4%, scalp laceration in 30 (55.6%, sub skull bruising in 49 (90.7%, skull fracture in 39 (72.2%, Hemorrhage in 49 (90.7%, SDH in 43 (79.6%, SAH in 47 (87%, EDH in 10 (18.5%, contusion in 33 (61.1%, and skull base fracture in 39 (72.2% of cases. There was no significant difference between these two groups (P Value> 0.05. Accident and falling down had no difference in terms of any injury or hemorrhage.

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

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

2016-08-01

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

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

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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.

Steady As You Go (SAYGO): A Falls-Prevention Program for Seniors Living in the Community.

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Robson, Ellie; Edwards, Joy; Gallagher, Elaine; Baker, Dorothy

2003-01-01

In a randomized trial of Steady as You Go, a falls-prevention program for the elderly, the treatment group (n=235) reduced eight of nine risk factors. Over a 4-month follow-up, the treatment group fell less than controls (n=236) and significantly fewer treatment group participants who had fallen before experienced falls (20%) compared to 35% of…

Meteorite falls in Africa

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

2017-10-01

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

Can echocardiographic findings predict falls in older persons?

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Nathalie van der Velde

Full Text Available BACKGROUND: The European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers. METHOD AND FINDINGS: In order to determine the association between echocardiographic abnormalities and falls in older adults, we performed a prospective cohort study, in which 215 new consecutive referrals (age 77.4, SD 6.0 of a geriatric outpatient clinic of a Dutch university hospital were included. During the previous year, 139 had experienced a fall. At baseline, all patients underwent routine two-dimensional and Doppler echocardiography. Falls were recorded during a three-month follow-up. Multivariate adjustment for confounders was performed with a Cox proportional hazards model. 55 patients (26% fell at least once during follow-up. The adjusted hazard ratio of a fall during follow-up was 1.35 (95% CI, 1.08-1.71 for pulmonary hypertension, 1.66 (95% CI, 1.01 to 2.89 for mitral regurgitation, 2.41 (95% CI, 1.32 to 4.37 for tricuspid regurgitation and 1.76 (95% CI, 1.03 to 3.01 for pulmonary regurgitation. For aortic regurgitation the risk of a fall was also increased, but non-significantly (hazard ratio, 1.57 [95% CI, 0.85 to 2.92]. Trend analysis of the severity of the different regurgitations showed a significant relationship for mitral, tricuspid and pulmonary valve regurgitation and pulmonary hypertension. CONCLUSIONS: Echo (Doppler cardiography can be useful in order to identify risk indicators for falling. Presence of pulmonary hypertension or regurgitation of mitral, tricuspid or pulmonary valves was associated with a higher fall risk. Our study indicates that the diagnostic work-up for falls in older adults might be improved by adding an echo (Doppler cardiogram in selected groups.

Preventing falls and fractures.

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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.

Epidemiology, morbidity and mortality from fall-related injuries in the United Arab Emirates

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2014-01-01

Background Unintentional falls are a major cause of morbidity and mortality with a significant burden on victims, families, and societies. We aimed to study the mechanism, risk factors, and outcome of hospitalized patients with fall-related injuries in order to propose preventive measures. Methods Fall-related injured patients who were admitted to Al Ain Hospital, United Arab Emirates (UAE) for more than 24 hours or who died after arrival to the hospital, were studied over 3 years. Demography, location and time of injury, affected body regions, hospital and ICU stay, and outcome were analyzed. Results 882 patients were studied, 82% were males, and 22% were less than 19 years old. Majority were from the Indian subcontinent. The most common location for fall injuries was work. Patients injured at work were older and mainly non-UAE nationals (p < 0.0001) when compared with those injured at home. Patients falling from height, when compared with those falling from same level, were older (p = 0.017), had more males (p < 0.001), were mainly from the Indian subcontinent (p < 0.001), had higher ISS (p = 0.011) and longer total hospital stay (p < 0.001). Conclusions Falls are a major health problem in the UAE. Falls at work can be prevented by safety education tailored to different ethnic groups, and proper legislation and regulation. Environmental modification using evidence-based architectural design may prevent falls among vulnerable risk groups. PMID:25178823

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

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

2016-11-01

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

Slip, trip and fall accidents occurring during the delivery of mail.

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Bentley, T A; Haslam, R A

1998-12-01

This study sought to identify causal factors for slip, trip and fall accidents occurring during the delivery of mail. Analysis of in-house data produced information about accident circumstances for 1734 fall cases. The most common initiating events in delivery falls were slips and trips. Slips most often occurred on snow, ice or grass, while trips tended to involve uneven pavements, obstacles and kerbs. Nearly one-fifth of falls occurred on steps, with step falls requiring longer absence from work than falls on the level. Half of all falls occurred during November-February and three-quarters of falls occurred between 7 and 9 a.m. Incidence rates for female employees were 50% higher than for their male colleagues. Accident-independent methods included interviews with safety personnel and managers, discussion groups with delivery employees, and a questionnaire survey of employees and managers. These techniques provided data on risk factors related to the task, behaviour, footwear and equipment. Arising from these accident-independent investigations, it is suggested that unsafe working practices, such as reading addresses while walking and taking shortcuts, increase the risk of falls. Organizational issues include management safety activities, training and equipment provision. Measures are discussed that might lead to a reduction in the incidence of delivery fall accidents.

The risk assessment of a fall in patients with lumbar spinal stenosis.

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Kim, Ho-Joong; Chun, Heoung-Jae; Han, Chang-Dong; Moon, Seong-Hwan; Kang, Kyoung-Tak; Kim, Hak-Sun; Park, Jin-Oh; Moon, Eun-Su; Kim, Bo-Ram; Sohn, Joon-Seok; Shin, Seung-Yup; Jang, Ju-Woong; Lee, Kwang-Il; Lee, Hwan-Mo

2011-04-20

A prospective case control study. To investigate the risk of a fall by using functional mobility tests in patients with lumbar spinal stenosis (LSS) via a comparison with patients with knee osteoarthritis (KOA). LSS is a degenerative arthritic disease in the spine that results in decreasing function, impaired balance, and gait deficit, with increased levels of leg and back pain. This physical impairment may result in an increased risk of fall later in the disease process, as shown in KOA. However, there has been no study regarding the association between the risk of a fall and LSS. The study was an age- and weight-matched case control study consisting of two groups: one group consisting of 40 patients with LSS who were scheduled to undergo spine surgery (LSS group) and the other group consisting of 40 patients with advanced osteoarthritis in both knees, scheduled to undergo TKA on both knees (KOA group). For both groups, four functional mobility tests, such as a Six-Meter-Walk Test (SMT), Sit-to-Stand test (STS), Alternative-Step Test (AST), and Timed Up and Go Test (TUGT), were performed. There was no difference in demographic data between both groups except for body mass index. For the SMT and STS, the patients in the LSS group spent significantly more time performing these tests than the patients in the KOA. For the AST, however, patients in the KOA group presented a statistically worse performance in functional mobility, compared with the LSS group. The mean TUGT time was not statistically different between the two groups. The current study highlights that patients with symptomatic LSS have a risk of a fall comparable with the patients who had degenerative KOA based on the results of functional mobility tests (SMT, STS, AST, and TUGT).

The development of a fear of falling interdisciplinary intervention program

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Fernando Gomez

2008-01-01

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

Fear of falling: efficacy of virtual reality associated with serious games in elderly people.

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Levy, Fanny; Leboucher, Pierre; Rautureau, Gilles; Komano, Odile; Millet, Bruno; Jouvent, Roland

2016-01-01

Fear of falling is defined as an ongoing concern about falling that is not explained by physical examination. Focusing on the psychological dimension of this pathology (phobic reaction to walking), we looked at how virtual reality associated with serious games can be used to treat this pathology. Participants with fear of falling were randomly assigned to either a treatment group or a waiting list. The therapy consisted of 12 weekly sessions of virtual reality exposure therapy associated with serious games. Sixteen participants were included. The mean age of the treatment group was 72 years and that of the control group was 69 years. Participants' scores on the fear of falling measure improved after treatment with virtual reality associated with serious games, leading to a significant difference between the two groups. Virtual reality exposure therapy associated with serious games can be used in the treatment of fear of falling. The two techniques are complementary (top-down and bottom-up processes). To our knowledge, this is the first time that a combination of the two has been assessed. There was a specific effect of this therapy on the phobic reaction. Further studies are needed to confirm its efficacy and identify its underlying mechanism.

iFall: an Android application for fall monitoring and response.

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Sposaro, Frank; Tyson, Gary

2009-01-01

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

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

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Cristina Rosa Soares Lavareda Baixinho

2015-12-01

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

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

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Chippendale, Tracy; Boltz, Marie

2015-08-01

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

President's message: We must remain committed to scientific integrity

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McPhaden, Michael

2012-02-01

During the third week of February our global community of Earth and space scientists witnessed the shocking fall from grace of an accomplished AGU member who betrayed the principles of scientific integrity. In doing so he compromised AGU's credibility as a scientific society, weakened the public's trust in scientists, and produced fresh fuel for the unproductive and seemingly endless ideological firestorm surrounding the reality of the Earth's changing climate. Peter Gleick resigned as chair of AGU's Task Force on Scientific Ethics on 16 February, prior to admitting in a blog post that he obtained documents from the Heartland Institute under false pretenses. His transgression cannot be condoned, regardless of his motives. It is a tragedy that requires us to stop and reflect on what we value as scientists and how we want to be perceived by the public. Here are a few things that come immediately to mind:

Relation between visual function index and falls-related factors in patients with age-related cataract

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Mei-Na Huang

2016-01-01

Full Text Available AIM:To investigate the relation between vision function index and falls-related factors in patients with age-related cataract.METHODS:Ninety-six patients with age-related cataract were interviewed using a seven-item visual function questionnaire(VF-7, then classified into poor, moderate, or good visual function group. The differences of the three groups on visual acuity, balance and mobility function, cognition, depressive symptoms, self-reported fear of falling were analyzed. RESULTS:The patients in poor visual function group had older age, tendency to depression, was more afraid of falling, compared with groups with higher score in VF-7, and they had worse visual acuity, performed worse on all balance and mobility tests. CONCLUSION:Poor visual function is related to worse visual acuity, weaker balance and mobility performance in patients with age-related cataract. The VF-7, as a simple and convenient self-reported method, can be used as a falling risk monitoring in patients with age-related cataract.

Fall related hospital admissions among seniors in Poland in 2010.

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Buczak-Stec, Elzbieta; Goryński, Paweł

2013-01-01

Falls among elderly people causing hospitalization are considered one of the most important public health problems. Our objective was to analyse fall related hospital admissions among seniors (> or = 65 years old) in Poland in 2010. The analyses were conducted with regard to gender, place of residence and age. Additionally, the health consequences of falls among elderly people were studied. Injuries and other consequences of external causes, were expressed in the form of three-character ICD-10 codes representing the underlying disease (S00-T98). Data on hospital admissions resulting from falls among seniors were obtained from the database held at the Department - Centre for Monitoring and Analyses of Population Health Status and Health Care System by the National Institute of Public Health - National Institute of Hygiene. Analysis has shown that the hospitalization ratio due to falls is much higher for women than for men. On average, 1 024 per 100 000 women are hospitalized due to a fall, while the number for men is 649. For every analysed age group women are at a higher risk of hospitalization due to a fall than men. In 2010 nearly 70% of hospital admissions of elderly people due to a fall were caused by a fall on the same level as a result of tripping or slipping (31 712 hospitalizations). No differences in relation to gender were observed. Risk of hospitalization due to a fall increases with age. For people over 80 years of age it is 2.5 times higher than for people in the 65-69 age group (1 459 and 570 per 100 000 respectively). It was observed that the length of hospital stay increases with age. There were no significant differences between the number of hospitalizations depending on the place of residence. The analysis showed that differences in the length of stay for women and men are statistically significant. However, there was no statistically significant difference between the lengths of stay depending on a place of residence. Almost one-third of

[Unipedal stance time and fall risk in the elderly].

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Domínguez-Carrillo, Luis Gerardo; Arellano-Aguilar, Gregorio; Leos-Zierold, Héctor

2007-01-01

We undertook this study to relate unipodal stance time (UST) as a falls indicator in the elderly and to corroborate with UST exercise increments. One hundred sixty eight elderly subjects (age >70 years) with two or more falls during the previous 12 months were compared with 150 similar subjects without falls. UST chronometry and quadriceps and triceps brachialis strength dynamometry were used. Equilibrium and antigravity muscle-strengthening exercise program with 20 work sessions were carried out. Results were analyzed with chi(2), Student's t-test, and Fisher tests. UST of the control group showed 28.84 +/- 4.73 sec (mean +/- SD). The UST sample showed 19.18 +/- 4.24 sec. The test was initially impossible to carry out in 42 cases (p = 0.05). The final evaluation showed 142 cases with 30 sec of UST (p = 0.00001), isometric force increased in 70% and 30%, respectively (p = 0.05). At 6-month follow-up, 53 falls were reported, 29 were in patients who could not accomplish UST measurement on initial evaluation. UST falls in elderly people, and exercise programs increase UST.

COAL Conference Poster

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Brown, Taylor Alexander; McGibbney, Lewis John

2017-01-01

COAL Conference Poster This archive contains the COAL conference poster for the AGU Fall Meeting 2017 by Taylor Alexander Brown. The Inkscape SVG source is available at https://github.com/capstone-coal/coal-conference-poster/ under the Creative Commons Attribution-ShareAlike 4.0 International license.

Effects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomized controlled trial.

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Batchelor, Frances A; Hill, Keith D; Mackintosh, Shylie F; Said, Catherine M; Whitehead, Craig H

2012-09-01

To determine whether a multifactorial falls prevention program reduces falls in people with stroke at risk of recurrent falls and whether this program leads to improvements in gait, balance, strength, and fall-related efficacy. A single blind, multicenter, randomized controlled trial with 12-month follow-up. Participants were recruited after discharge from rehabilitation and followed up in the community. Participants (N=156) were people with stroke at risk of recurrent falls being discharged home from rehabilitation. Tailored multifactorial falls prevention program and usual care (n=71) or control (usual care, n=85). Primary outcomes were rate of falls and proportion of fallers. Secondary outcomes included injurious falls, falls risk, participation, activity, leg strength, gait speed, balance, and falls efficacy. There was no significant difference in fall rate (intervention: 1.89 falls/person-year, control: 1.76 falls/person-year, incidence rate ratio=1.10, P=.74) or the proportion of fallers between the groups (risk ratio=.83, 95% confidence interval=.60-1.14). There was no significant difference in injurious fall rate (intervention: .74 injurious falls/person-year, control: .49 injurious falls/person-year, incidence rate ratio=1.57, P=.25), and there were no significant differences between groups on any other secondary outcome. This multifactorial falls prevention program was not effective in reducing falls in people with stroke who are at risk of falls nor was it more effective than usual care in improving gait, balance, and strength in people with stroke. Further research is required to identify effective interventions for this high-risk group. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

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Niko M. Perttila

2017-06-01

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

Head and neck injury patterns in fatal falls: epidemiologic and biomechanical considerations.

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Freeman, Michael D; Eriksson, Anders; Leith, Wendy

2014-01-01

Fatal falls often involve a head impact, which are in turn associated with a fracture of the skull or cervical spine. Prior authors have noted that the degree of inversion of the victim at the time of impact is an important predictor of the distribution of skull fractures, with skull base fractures more common than skull vault fractures in falls with a high degree of inversion. The majority of fatal fall publications have focused on skull fractures, and no research has described the association between fall circumstances and the distribution of fractures in the skull and neck. In the present study, we accessed data regarding head and neck fractures resulting from fatal falls from a Swedish autopsy database for the years 1992-2010, for the purposes of examining the relationships between skull and cervical spine fracture distribution and the circumstances of the fatal fall. Out of 102,310 medico-legal autopsies performed there were 1008 cases of falls associated with skull or cervical spine fractures. The circumstances of the falls were grouped in 3 statistically homogenous categories; falls occurring at ground level, falls from a height of stairs, and falls from ≥3 m. Only head and neck injuries and fractures that were associated with the fatal CNS injuries were included for study, and categorized as skull vault and skull base fractures, upper cervical injuries (C0-C1 dislocation, C1 and C2 fractures), and lower cervical fractures. Logistic regression modeling revealed increased odds of skull base and lower cervical fracture in the middle and upper fall severity groups, relative to ground level falls (lower cervical <3 m falls, OR = 2.55 [1.32, 4.92]; lower cervical ≥3 m falls, OR = 2.23 [0.98, 5.08]; skull base <3 m falls, OR = 1.82 [1.32, 2.50]; skull base ≥3 m falls, OR = 2.30 [1.55, 3.40]). C0-C1 dislocations were strongly related to fall height, with an OR of 8.3 for ≥3 m falls versus ground level. The findings of increased odds of skull

Perturbation Training Can Reduce Community-Dwelling Older Adults’ Annual Fall Risk: A Randomized Controlled Trial

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Bhatt, Tanvi; Yang, Feng; Wang, Edward

2014-01-01

Background. Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults’ annual falls risk in their everyday living. Methods. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). Results. With this single session of repeated-slip exposure, training cut older adults’ annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. Conclusion. A single session of repeated-slip exposure could improve community-dwelling older adults’ resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. PMID:24966227

Spatial analysis of falls in an urban community of Hong Kong

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Wong Wing C

2009-03-01

Full Text Available Abstract Background Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. Results This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh and Standard Deviational Ellipse (SDE techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. Conclusion The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies.

Spatial analysis of falls in an urban community of Hong Kong

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Lai, Poh C; Low, Chien T; Wong, Martin; Wong, Wing C; Chan, Ming H

2009-01-01

Background Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. Results This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh) and Standard Deviational Ellipse (SDE) techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. Conclusion The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies. PMID:19291326

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

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Nassar, Nada; Helou, Nancy; Madi, Chantal

2014-06-01

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

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

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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).

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

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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

Fall Enrollment Report. 2014

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Iowa Department of Education, 2014

2014-01-01

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

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

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

2015-01-01

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

Meta-analysis of the Effect of Medication on Falls in the Elderly

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Daniel K. Y. Chan

2008-10-01

Full Text Available The objective of this study was to carry out a systematic quality review and meta-analysis of all literature published in years 1981-1997 which studied the effect of drugs in the elderly and which had analyzable data on major groups of drugs. The sources of data were reports of surveys, case-control, prospective and retrospective studies, published in English. Identified studies were assessed for (i ecological, (ii methodological and (iii statistical features. The drugs were classified into four main groups, namely (a antidepressants (b antipsychotics, (c diuretics, and (d hypnosedatives. Increasing risk of falls were related in order to diuretics, hypnosedatives, antidepressants and antipsychotics: the odd ratios with antipsychotics was 42% higher than with diuretics. The conclusion was that, clinically, the following classes of drugs show a significant positive relationship with falls: antipsychotics, antidepressants and hypnosedatives. The relationship with diuretics and falls is less clear; at best, it has a weak relationship with falls.

Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people.

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Barker, Anna L; Talevski, Jason; Bohensky, Megan A; Brand, Caroline A; Cameron, Peter A; Morello, Renata T

2016-10-01

To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Pilot Randomized controlled trial. Community physiotherapy clinic. A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61-84). A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks. Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P fall injury rates. A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820). © The Author(s) 2015.

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

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

2017-05-01

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

Does osteoporosis predispose falls? a study on obstacle avoidance and balance confidence

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Duysens Jacques

2011-01-01

Full Text Available Abstract Background Osteoporosis is associated with changes in balance and physical performance and has psychosocial consequences which increase the risk of falling. Most falls occur during walking; therefore an efficient obstacle avoidance performance might contribute to a reduction in fall risk. Since it was shown that persons with osteoporosis are unstable during obstacle crossing it was hypothesized that they more frequently hit obstacles, specifically under challenging conditions. The aim of the study was to investigate whether obstacle avoidance ability was affected in persons with osteoporosis compared to a comparison group of a community sample of older adults. Methods Obstacle avoidance performance was measured on a treadmill and compared between persons with osteoporosis (n = 85 and the comparison group (n = 99. The obstacle was released at different available response times (ART to create different levels of difficulty by increasing time pressure. Furthermore, balance confidence, measured with the short ABC-questionnaire, was compared between the groups. Results No differences were found between the groups in success rates on the obstacle avoidance task (p = 0.173. Furthermore, the persons with osteoporosis had similar levels of balance confidence as the comparison group (p = 0.091. The level of balance confidence was not associated with the performance on the obstacle avoidance task (p = 0.145. Conclusion Obstacle avoidance abilities were not impaired in persons with osteoporosis and they did not experience less balance confidence than the comparison group. These findings imply that persons with osteoporosis do not have an additional risk of falling because of poorer obstacle avoidance abilities.

Factors associated with the completion of falls prevention program.

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Batra, Anamica; Page, Timothy; Melchior, Michael; Seff, Laura; Vieira, Edgar Ramos; Palmer, Richard C

2013-12-01

Falls and fear of falling can affect independence and quality of life of older adults. Falls prevention programs may help avoiding these issues if completed. Understanding factors that are associated with completion of falls prevention programs is important. To reduce fear of falling and increase activity levels, a Matter of Balance (MOB) and un Asunto de Equilibrio (ADE) workshops were offered to 3420 older adults in South Florida between 1 October 2008 and 31 December 2011. Workshops were conducted in English or Spanish over eight, 2-hour sessions. Participants completed a demographic and a pre-post questionnaire. Factors associated with program completion were identified using logistic regression. For MOB, females were more likely to complete the program (OR = 2.076, P = 0.02). For ADE, females, moderate and extreme interference by falls in social activities were found to affect completion (OR = 2.116, P = 0.001; OR = 2.269, P = 0.003 and OR = 4.133, P = 0.008, respectively). Different factors predicted completion of both programs. Awareness of these factors can help lower the attrition rates, increase benefits and cost effectiveness of program. Future research needs to explore why certain groups had a higher likelihood of completing either program.

Evaluation of Postural Stability and Fall Risk in Patients with Ankylosing Spondylitis

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Ahmet Inanir

2013-02-01

Full Text Available Purpose: The purpose of this study is to evaluate the influences of Ankylosing spondylitis on postural balance and the risk of falls. Methods: A total of 73 sobjects were recruited for the study, including 36 with AS (17 men, 19 women and 37 healthy controls (19 men, 18 women. Patients were evaluated in terms of balance and risk of falls. Balance and risk of falls was assessed with the Biodex Stability System. Results: The mean age, gender and body mass index of the participants did not differ significantly between (p=0.308, p=0.724, p=0.766, respectively. When groups were evaluated in terms of postural stability indexes Overall Stability Index (OSI, Antero-Posteior Stability Index (APSI and Medio-Lateral Stability Index (MLSI had no statistically significant difference (p=0.190, p=0.437 ve p=0.144, respectively. Fall Risk Index (FRI evaluations showed that as patients’ test scores were higher than control group (p=0.001. (Table 1. Conclusions: In this study, we present numerical data that suggests that AS are associated with risk of falling. [Cukurova Med J 2013; 38(1.000: 86-91

Balance Training Reduces Falls Risk in Older Individuals With Type 2 Diabetes

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Morrison, Steven; Colberg, Sheri R.; Mariano, Mira; Parson, Henri K.; Vinik, Arthur I.

2010-01-01

OBJECTIVE This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50–75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. RESULTS Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also e...

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

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

2017-12-01

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

Falls prevention in community care: 10 years on

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Burton E

2018-02-01

Full Text Available Elissa Burton,1 Gill Lewin,2 Hilary O’Connell,3 Keith D Hill1 1School of Physiotherapy and Exercise Science, Curtin University, 2School of Nursing, Midwifery and Paramedicine, Curtin University, 3Independent Living Centre WA, Perth, WA, Australia Background: A million older people living in Australia receive community care services each year due to experiencing functional or mental health difficulties. This group may be at greater risk of falling than similar-aged people not receiving services. However, there is limited falls prevention research for this population.Purpose: The aim of this study was to identify the falls prevalence rates of older people from 10 Australian community care organizations and compare current falls prevention data to a study 10 years prior that utilized the same 10 organizations. This study also identified factors associated with falling for this population.Patients and methods: This is a cross-sectional descriptive study, in which 5,338 questionnaires were mailed to a random sample of community care recipients aged ≥65 years. Results: A total of 1,991 questionnaires were returned (37.3%, with 47.7% of respondents having fallen in the previous year, and 32.7% in the month prior to completing the questionnaire, similar to 10 years prior. Community care clients had a 50% higher falls rate than that reported for similar-aged people not receiving services, and this remained unchanged over the last 10 years. Eighty-six per cent of fallers had fallen once or twice, and 60% reported being injured. Thirty-six per cent of respondents reported not being able to get up independently, and only 27.4% of fallers were referred to a falls prevention program (significantly fewer than 10 years ago; 95% CI: 0.821–6.366, p=0.01. Balance issues (odds ratio [OR]: 2.06, 95% CI: 1.288–3.290, p=0.003 and perceived risk of falling in the future being “definite” (OR: 6.42, 95% CI: 1.890–21.808, p=0.003 or “unsure” (OR: 3

Relation between risk of falling and postural sway complexity in diabetes.

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Morrison, S; Colberg, S R; Parson, H K; Vinik, A I

2012-04-01

For older individuals with diabetes, any decline in balance control can be especially problematic since it is often a precursor to an increased risk of falling. This study was designed to evaluate differences in postural motion dynamics and falls risk for older individuals with type 2 diabetes (T2DM) classified as fallers/non-fallers and, to assess what impact exercise has on balance and falls risk. The results demonstrated that the risk of falling is greater for those older individuals with multiple risk factors including diabetes and a previous falls history. The postural motion features of the high-risk individuals (T2DM-fallers) were also different, being characterized by increased variability and complexity, increased AP-ML coupling, less overall COP motion and increased velocity. One suggestion is that these individuals evoked a stiffening strategy during the more challenging postural tasks. Following training, a decline in falls risk was observed for all groups, with this effect being most pronounced for the T2DM-fallers. Interestingly, the COP motion of this group became more similar to controls, exhibiting decreased complexity and variability, and decreased velocity. The reciprocal changes in COP complexity support the broader view that age/disease-related changes in physiological complexity are bi-directional. Overall, these results show that, even for older T2DM individuals at greater risk of falling, targeted interventions can positively enhance their postural dynamics. Further, the finding that the pattern of postural motion variability and complexity was altered highlights that a decline in physiological complexity may not always be negatively associated with aging and/or disease. Copyright © 2011 Elsevier B.V. All rights reserved.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

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Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won

2018-01-01

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

Exercise for falls prevention in older people: assessing the knowledge of exercise science students.

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Sturnieks, Daina L; Finch, Caroline F; Close, Jacqueline C T; Tiedemann, Anne; Lord, Stephen R; Pascoe, Deborah A

2010-01-01

Participation in appropriate exercise can help reduce the risk of falls and falls injury in older people. Delivery of population-level exercise interventions requires an expert workforce with skills in development and delivery of group exercise programs and prescription of individually targeted exercise. This study assessed the current knowledge of university exercise science students (as future exercise professionals) across different levels of study. A structured survey designed to assess knowledge in relation to falls in older people and exercise prescription for falls prevention was administered during second, third and fourth year lectures in seven Australian universities. Students' knowledge was assessed as the percent of correct responses. Overall, 566 students completed the survey and knowledge levels increased significantly with study year. Mean knowledge levels were significantly knowledge. They were lowest for falls risk factor questions and highest for issue/cost related questions in second and third year students. Fourth year students had best knowledge about falls interventions and this was the only group and topic with a mean score >70%. In conclusion, knowledge about falls and exercise prescription for falls prevention in current students does not meet a desired competency level of 70% and is therefore insufficient to ensure an adequately equipped future workforce in this area. There is a clear need for the development and widespread delivery of an evidence-based "exercise for falls prevention" curriculum module for exercise professionals. Copyright (c) 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Gait asymmetry, ankle spasticity, and depression as independent predictors of falls in ambulatory stroke patients.

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Ta-Sen Wei

Full Text Available Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed.This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1 status of cognition, depression, fear of fall and limb spasticity; (2 functional assessments [walking velocity and the Functional Independence Measure (FIM]; and (3 objective, computerized gait and balance analyses. The outcome variable was the number of accidental falls during the 6-month follow-up period after baseline measurements.The non-faller group exhibited significantly better walking velocity and FIM scale compared to the faller group (P < .001. The faller group exhibited higher levels of spasticity in the affected limbs, asymmetry of gait parameters in single support (P < .001, double support (P = .027, and step time (P = .003, and lower stability of center of gravity in the medial-lateral direction (P = .008. Psychological assessments revealed that the faller group exhibited more severe depression and lower confidence without falling. A multivariate logistic regression model identified three independent predictors of falls with high sensitivity (82.6% and specificity (86.5%: the asymmetry ratio of single support [adjusted odds ratio, aOR = 2.2, 95% CI (1.2-3.8], the level of spasticity in the gastrocnemius [aOR = 3.2 (1.4-7.3], and the degree of depression [aOR = 1.4 (1.2-1.8].This study revealed depression, in additional to gait asymmetry and spasticity, as another independent factor for predicting falls. These results suggest that appropriate gait training, reduction of ankle spasticity, and aggressive management of depression may be critical to prevent falls in stroke patients.

Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial.

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Trombetti, Andrea; Hars, Mélany; Herrmann, François R; Kressig, Reto W; Ferrari, Serge; Rizzoli, René

2011-03-28

Falls occur mainly while walking or performing concurrent tasks. We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk in elderly individuals. We conducted a 12-month randomized controlled trial involving 134 community-dwelling individuals older than 65 years, who are at increased risk of falling. They were randomly assigned to an intervention group (n = 66) or a delayed intervention control group scheduled to start the program 6 months later (n = 68). The intervention was a 6-month multitask exercise program performed to the rhythm of piano music. Change in gait variability under dual-task condition from baseline to 6 months was the primary end point. Secondary outcomes included changes in balance, functional performances, and fall risk. At 6 months, there was a reduction in stride length variability (adjusted mean difference, -1.4%; P Balance and functional tests improved compared with the control group. There were fewer falls in the intervention group (incidence rate ratio, 0.46; 95% confidence interval, 0.27-0.79) and a lower risk of falling (relative risk, 0.61; 95% confidence interval, 0.39-0.96). Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention. The benefit of the intervention on gait variability persisted 6 months later. In community-dwelling older people at increased risk of falling, a 6-month music-based multitask exercise program improved gait under dual-task condition, improved balance, and reduced both the rate of falls and the risk of falling. Trial Registration clinicaltrials.gov Identifier: NCT01107288.

Accidents due to falls from roof slabs.

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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.

Accidents due to falls from roof slabs

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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.

Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects.

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Carlsson, Lena M S; Sjöholm, Kajsa; Ahlin, Sofie; Jacobson, Peter; Andersson-Assarsson, Johanna C; Karlsson Lindahl, Linda; Maglio, Cristina; Karlsson, Cecilia; Hjorth, Stephan; Taube, Magdalena; Carlsson, Björn; Svensson, Per-Arne; Peltonen, Markku

2018-05-24

Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was ≥ 34 kg/m 2 in men and ≥38 kg/m 2 in women. The surgery per-protocol group (n = 2007) underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365), and controls (n = 2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07-1.36; P = 0.002). The incidence differed between treatment groups (P < 0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50-0.52, P < 0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.

New horizons in fall prevention.

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Lord, Stephen R; Close, Jacqueline C T

2018-04-25

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

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

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Ferrer A

2014-02-01

Full Text Available Assumpta Ferrer,1 Francesc Formiga,2,3 Héctor Sanz,4 Oscar J de Vries,5 Teresa Badia,6 Ramón Pujol2,3 On behalf of the OCTABAIX Study Group 1Primary Healthcare Centre "El Plà" CAP-I, Sant Feliu de Llobregat, 2Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, 3Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, 4Support Research Unit, Primary Health Department Costa Ponent, IDIAP Jordi Gol, Barcelona, Spain; 5Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands; 6Primary Healthcare Centre Martorell, Barcelona, Spain Background: The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. Methods: A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona. Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat. Results: Sixty-five (39.6% subjects in the intervention group and 48 (29.3% in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94–1.75. Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03–2.09 and that functional impairment (HR 1.42, 95% CI 0.97–2.12, previous falls (HR 1.09, 95% CI 0.74–1.60, and cognitive impairment (HR 1.08, 95% CI 0.72–1.60 had no effect on the

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

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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.