WorldWideScience

Sample records for niagara falls area

  1. Intelligent transportation system (ITS) study for the Buffalo and Niagara Falls metropolitan area, Erie and Niagara Counties, New York : functional requirements, working paper #4

    Science.gov (United States)

    1997-06-18

    This paper is the fourth in a series that together will comprise an Intelligent Transportation System (ITS) Study for the Buffalo / Niagara Falls region. This document presents the market packages for the deployment of the Buffalo/Niagara Falls area ...

  2. 76 FR 20532 - Safety Zone; Boom Days, Niagara River, Niagara Falls, NY

    Science.gov (United States)

    2011-04-13

    ...-AA00 Safety Zone; Boom Days, Niagara River, Niagara Falls, NY AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a temporary safety zone on the Niagara River... Marina and a portion of the Niagara River, Niagara Falls, NY during the Boom Days Fireworks on April 16...

  3. Niagara Falls Storage Site, Lewiston, New York: geologic report

    International Nuclear Information System (INIS)

    1984-06-01

    This report is one of a series of engineering and environmental reports planned for the US Department of Energy's properties at Niagara Falls, New York. It describes the essential geologic features of the Niagara Falls Storage Site. It is not intended to be a definitive statement of the engineering methods and designs required to obtain desired performance features for any permanent waste disposal at the site. Results are presented of a geological investigation that consisted of two phases. Phase 1 occurred during July 1982 and included geologic mapping, geophysical surveys, and a limited drilling program in the vicinity of the R-10 Dike, planned for interim storage of radioactive materials. Phase 2, initiated in December 1982, included excavation of test pits, geophysical surveys, drilling, observation well installation, and field permeability testing in the South Dike Area, the Northern Disposal Area, and the K-65 Tower Area

  4. Niagara Falls Storage Site, Lewiston, New York: geologic report

    Energy Technology Data Exchange (ETDEWEB)

    1984-06-01

    This report is one of a series of engineering and environmental reports planned for the US Department of Energy's properties at Niagara Falls, New York. It describes the essential geologic features of the Niagara Falls Storage Site. It is not intended to be a definitive statement of the engineering methods and designs required to obtain desired performance features for any permanent waste disposal at the site. Results are presented of a geological investigation that consisted of two phases. Phase 1 occurred during July 1982 and included geologic mapping, geophysical surveys, and a limited drilling program in the vicinity of the R-10 Dike, planned for interim storage of radioactive materials. Phase 2, initiated in December 1982, included excavation of test pits, geophysical surveys, drilling, observation well installation, and field permeability testing in the South Dike Area, the Northern Disposal Area, and the K-65 Tower Area.

  5. Results of radiological measurements taken in the Niagara Falls, New York, area (NF002)

    International Nuclear Information System (INIS)

    Williams, J.K.; Berven, B.A.

    1986-11-01

    The results of a radiological survey of 100 elevated gamma radiation anomalies in the Niagara Falls, New York, area are presented. These radiation anomalies were identified by a mobile gamma scanning survey during the period October 3-16, 1984, and were recommended for an onsite survey to determine if the elevated levels of radiation may be related to the transportation of radioactive waste material to the Lake Ontario Ordnance Works for storage. In this survey, radiological measurements included outdoor gamma exposure rates at 1 m above the surface; outdoor gamma exposure rates at the surface, range of gamma exposure rates during scan; and uranium, radium, and thorium concentrations in biased surface soil samples. The results show 38 anomalies (35 located along Pletcher Road and 3 associated with other unreleated locations) were found to exceed Formerly Utilized Sites Remedial Action Program (FUSRAP) remedial action guidelines and were recommended for formal characterization surveys. (Since the time of this survey, remedial actions have been conducted on the 38 anomalies identified as exceeding FUSRAP guidelines, and the radioactive material above guidelines has been removed.) The remaining 62 anomalies are associated with asphalt driveways and parking lots, which used a phosphate slag material (previously identified as cyclowollastonite, synthetic CaSiO 3 ). This rocky-slag waste material was used for bedding under asphalt surfaces and in general gravel applications. Most of the contaminated soil and rock samples collected at the latter anomalies had approximately equal concentrations of 226 Ra and 238 U and, therefore, are not related to materials connected with the Niagara Falls Storage Site (NFSS), including material that was transported to the NFSS. 13 refs., 7 figs., 14 tabs

  6. Natural Wonder Notebook. Niagara Falls and Other Super Waterfalls.

    Science.gov (United States)

    Markle, Sandra

    1983-01-01

    Facts about the geological formation and modern functions of Niagara Falls are given in this article, the second in a series about natural wonders. Questions for class discussion, directions for making a model waterfall, possible writing topics, and resources for further information about waterfalls are included. (PP)

  7. Intelligent transportation system (ITS) study for the Buffalo and Niagara Falls metropolitan area, Erie and Niagara Counties, New York : objectives, performance criteria & user service plan, working paper #3

    Science.gov (United States)

    1997-06-18

    This paper is the third in a series that together will comprise an Intelligent Transportation System Study (ITS) for the Buffalo/Niagara Falls region. In this document, the problems identified in Working Paper #1 are critically reviewed to develop go...

  8. Niagara Falls Storage Site annual environmental report for calendar year 1991, Lewiston, New York. [Niagara Falls Storage Site

    Energy Technology Data Exchange (ETDEWEB)

    1992-09-01

    This document describes the environmental monitoring program at the Niagara Falls Storage Site (NFSS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at NFSS began in 1981. The site is owned by the US Department of Energy (DOE) and is assigned to the DOE Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water, sediments, and groundwater. Additionally, several nonradiological parameters including seven metals are routinely measured in groundwater. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.

  9. The Canadian Niagara Power Company story

    International Nuclear Information System (INIS)

    Ball, N.R.

    2005-01-01

    This book chronicles the history and contributions of the Canadian Niagara Power Company and its employees toward the establishment of electricity generation and distribution in Niagara Falls and Fort Erie, Ontario, dating back to its founding in 1892. Through historical photographs, maps and drawings, the book demonstrates the impact of electricity on the Niagara region. It emphasizes the many skills and jobs required to run the company that generated electricity and maintained a complete system to deliver power, metering, and billing services through the depression, wars, and postwar booms, even during lightning, snow and ice storms. The company began producing power in 1905 with what had been the world's largest-capacity turbines and generators that supplied power to both sides of the Niagara River. Initially, most of the electricity was exported to New York State. The company eventually expanded its Canadian customer service area from Niagara Falls, Ontario, to Fort Erie, Bridgeburg, Amigari, Ridgeway, Stevensville, Crystal Beach and Point Abino. Throughout its history, the Canadian Niagara Power Company provided power at a lower cost than its neighbouring competitors. The William Birch Rankine Generating Station became an important tourist attraction, showcasing the latest electrical appliances of the time in an effort to promote the use of electricity in homes and offices. Today, the station remains a tribute to the fact that natural beauty can coincide with industry. The book also chronicles the difficult business challenges caused by restructuring in the electric power industry in the 1990s, repairing aging equipment and applying the latest in automation and remote sensing technology. Today, the company as FortisOntario is expanding to other communities around Ontario. refs., tabs., figs

  10. Massive Niagara Falls power generation project uses unique concrete locking system

    Energy Technology Data Exchange (ETDEWEB)

    Polski, A. [Con Cast Pipe, Niagara Falls, ON (Canada)

    2006-09-15

    A 512 metre long accelerating wall and a 360 metre-long approach wall in the Niagara River are being built using a novel locking system to withstand the forces of nature. The walls have been designed to direct continuous flow to a new diversion tunnel below the City of Niagara Falls, Ontario. The walls are made of a single row of pre-cast concrete boxes that lock together in a special configuration to prevent movement from extreme load combinations in the Niagara River. The system was designed as part of a larger project to increase the power generating capabilities of the Sir Adam Beck 2 power generation station. Water channelled into the new tunnel will provide an estimated additional 1.6 terawatt-hours of renewable electricity annually and expand capacity at the station by about 15 per cent. The pre-cast reinforced concrete box design was chosen for the walls as it allowed fast and simple assembly of the structures. The basic structural system for each box is 4 vertical panels that form an open rectangular wall. The boxes are filled with clean rock fragments that are uniformly graded. Once the boxes are installed, cast-in-place concrete slabs will be poured to a depth of approximately 600 mm on top of the wall to cap the entire structure. The value of the design-build contract for the Niagara project is nearly $600 million out of an estimated $985 million budget. Commonly used for the design of culverts, the concrete box technology holds promise for applications including the stabilization of shorelines and the construction of small dams. 3 figs.

  11. Comprehensive characterization and hazard assessment of the DOE-Niagara Falls storage site

    International Nuclear Information System (INIS)

    Anderson, T.L.; Dettorre, J.F.; Jackson, D.R.; Ausmus, B.S.

    1981-06-01

    A comprehensive radioecological and nonradiological characterization and hazards assessment was conducted on DOE-Niagara Falls Storage Site. Pitchblende residues and other low-level nuclear waste have been stored on the site since 1944. The most highly radioactive residues were stored in four abandoned buildings, while other wastes were deposited in pits or piled on surface soils on the Site. Several ditches were constructed on the Site to facilitate drainage or excess precipitation. Results of the study will permit the US DOE to form an appropriate remedial action plan for the Site

  12. Niagara Falls Storage Site environmental surveillance report for calendar year 1993

    International Nuclear Information System (INIS)

    1994-06-01

    This report summarizes the results of environmental surveillance activities conducted at the Niagara Falls Storage Site (NFSS) during calendar year 1993. It includes an overview of site operations, the basis for radiological and nonradiological monitoring, a summary of the results, and the estimated dose to the offsite population. Environmental surveillance activities were conducted in accordance with the site environmental monitoring plan, which describes the rationale and design criteria for the surveillance program, the frequency of sampling and analysis, specific sampling and analysis procedures, and quality assurance requirements. NFSS is in compliance with National Emission Standards for Hazardous Air Pollutants (NESHAPs) Subpart H of the Clean Air Act as well as the requirements of the National Pollutant Discharge Elimination System (NPDES) under the Clean Water Act. Located in northwestern New York, the site covers 191 acres. From 1944 to the present, the primary use of NFSS has been storage of radioactive residues that were by-products of uranium production. Most onsite areas of residual radioactivity above regulatory guidelines were remediated during the early 1980s. Additional isolated areas of onsite contamination were remediated in 1989, and the materials were consolidated into the waste containment structure in 1991. Remediation of the site has now been completed

  13. Stability analysis of waterfall cliff face at Niagara Falls: An implication to erosional mechanism of waterfall

    OpenAIRE

    Hayakawa, Yuichi S.; Matsukura, Yukinori

    2010-01-01

    Although recession of waterfalls or knickpoints in bedrock rivers is a common geomorphological process, detailed mechanics of waterfall recession has only been examined in a few cases. Caprock recession model at Niagara Falls, in which gravitational collapse of caprock induced by undercutting notch plays a significant role, has been one of the well-known models describing the waterfall erosion, but the validity of the model has hardly been examined in a quantitative context. Here we assess th...

  14. Sustainable power and scenic beauty: The Niagara River Water Diversion Treaty and its relevance today

    International Nuclear Information System (INIS)

    Sedoff, Andrei; Schott, Stephan; Karney, Bryan

    2014-01-01

    Niagara Falls and the Niagara River have always attracted great public interest due to their natural beauty, their enormous potential for electricity generation, their recreational value and as an important ecosystem. There have been simultaneous efforts to preserve this unique natural wonder and harness its power through hydroelectric development projects by both the United States and Canada. This paper explores the evolution of these efforts that culminated with the signing of the 1950 Niagara River Water Diversion Treaty that established minimum water flow rates to protect the “scenic beauty” of the falls, allowing the remaining water to be diverted for power production. We examine the rationale that led to specific water flow restrictions and question to what extent they are relevant today, as water intake capacity on the Canadian side has just been extended by around 25%. We find that current restrictions under the Niagara River Water Treaty (that expired in 2000) are not based on sound scientific evidence and estimate the upper limit of potential foregone benefits from clean electricity generation and greenhouse gas reductions. We identify a number of important issues that emerged in the last decades and that would justify an exploration of new treaty rules. - Highlights: • We examine the history of water diversion at Niagara Falls. • We examine the rationale that led to water flow restrictions over Niagara Falls and its relevance today. • We estimate the opportunity cost of foregone energy generation with the new Canadian intake capacity. • Water flow stipulations were not based on the sound scientific or ecosystem analysis. • A renegotiation of the 1950 Niagara River Water Diversion Treaty is overdue

  15. Niagara Falls Storage Site annual environmental report for calendar year 1991, Lewiston, New York

    International Nuclear Information System (INIS)

    1992-09-01

    This document describes the environmental monitoring program at the Niagara Falls Storage Site (NFSS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at NFSS began in 1981. The site is owned by the US Department of Energy (DOE) and is assigned to the DOE Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water, sediments, and groundwater. Additionally, several nonradiological parameters including seven metals are routinely measured in groundwater. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment

  16. The grand leap of the whale up the Niagara Falls: converting philosophical conclusions into policy prescriptions.

    Science.gov (United States)

    Holm, Søren

    2015-04-01

    This article analyzes a neat conjuring trick employed in bioethics, that is, the immediate conversion of a philosophical conclusion into a policy prescription, and compares it to the "grand leap of the whale up the Niagara Falls" mentioned by Benjamin Franklin. It is shown that there is no simple and easy way to achieve the conversion, by considering arguments falling under four headings: (1) reasonable disagreement about values and theories, (2) general jurisprudential arguments, (3) the differences between policymaking and philosophy, and (4) the messy world of implementation. The particular issue used to illustrate the difficulties in moving from philosophical conclusion to policy description is infanticide of healthy infants, but the analysis is general, and the conclusion that the immediate move to policy is illegitimate is quite general.

  17. 33 CFR 110.85 - Niagara River, Youngstown, N.Y.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Niagara River, Youngstown, N.Y... ANCHORAGES ANCHORAGE REGULATIONS Special Anchorage Areas § 110.85 Niagara River, Youngstown, N.Y. (a) Area 1... of the Niagara River at latitude 43°14′33″ N, longitude 79°03′7.5″ W; thence westerly to a point at...

  18. The Niagara Falls Storage Site Remedial Action Project. Status update and summary of special features

    International Nuclear Information System (INIS)

    Campbell, L.F.; Coxon, G.D.

    1986-01-01

    The U.S. Department of Energy (DOE) and its Project Management Contractor, Bechtel National, Inc., are conducting remedial action at the Niagara Falls Storage Site (NFSS) near Lewiston, New York to stabilize low-level radioactive wastes stored at the site and to decontaminate over two dozen contaminated vicinity properties. Over the past 4 years a 10-acre interim waste containment facility has been developed at the site to hold the approximately 250,000 yd/sup 3/ of contaminated soil and rubble from the cleanup operations. Several existing buildings were demolished or modified for burial inside the containment area. In addition, residues inside a 165-ft-high concrete tower were transferred to one of the buildings inside the containment area using hydraulic mining techniques. The residues were dewatered and covered with clay to minimize radom emanation; the tower was demolished and the rubble disposed of in the containment area. Environmental monitoring will continue throughout the interim storage period. In addition, the surface and subsurface condition of the containment structure will be monitored to ensure that undesirable trends are detected in time for corrective action to be taken. The DOE Record of Decision on the long-term disposition of the NFSS is expected to be made by the end of April, 1986

  19. Niagara Falls Storage Site environmental report for calendar year 1989, Lewiston, New York

    International Nuclear Information System (INIS)

    1990-05-01

    The environmental monitoring program, which began in 1981, was continued during 1989 at the Niagara Falls Storage Site (NFSS), a United States Department of Energy (DOE) surplus facility located in Niagara County, New York, that is currently used for interim storage of radioactive residues, contaminated soils, and rubble. The monitoring program is being conducted by Bechtel National, Inc. The monitoring program at NFSS measures radon concentrations in air; external gamma radiation levels; and uranium and radium concentrations in surface water, groundwater, and sediment. Additionally, several nonradiological parameters are measured in groundwater. To verify that the site is in compliance with the DOE radiation protection standard and to assess its potential effect on public health, the radiation dose was calculated for a hypothetical maximally exposed individual. Based on the conservative scenario described in this report, this hypothetical individual receives an annual external exposure equivalent to approximately 2 percent of the DOE radiation protection standard of 100 mrem/yr. This exposure is less than a person receives during a one-way flight from New York to Los Angeles (because of the greater amounts of cosmic radiation at higher altitudes). The cumulative dose to the population within an 80-km (50-mi) radius of NFSS that results from radioactive materials present at the site is indistinguishable from the dose that the same population receives from naturally occurring radioactive sources. Results of the 1989 monitoring show that NFSS is in compliance with applicable DOE radiation protection standards. 18 refs., 26 figs., 18 tabs

  20. 76 FR 51885 - Safety Zone; Thunder on Niagara, Niagara River, North Tonawanda, NY

    Science.gov (United States)

    2011-08-19

    ... River, North Tonawanda, NY. This temporary safety zone is intended to restrict vessels from a portion of the Niagara River during the Thunder on Niagara powerboat races. This temporary safety zone is...-AA00 Safety Zone; Thunder on Niagara, Niagara River, North Tonawanda, NY AGENCY: Coast Guard, DHS...

  1. Effectiveness of interim remedial actions at the Niagara Falls Storage Site

    International Nuclear Information System (INIS)

    Devgun, J.S.; Beskid, N.J.; Seay, W.M.; McNamee, E.

    1990-01-01

    There are 190,000 m 3 of contaminated soils, wastes, and residues stored at the Niagara Falls Storage Site (NFSS). The residues have a volume of 18,000 m 3 and contain about 1,930 Ci of 226 Ra, which accounts for most of the radioactivity. Since 1980, actions have been taken to minimize potential radiological risks and prevent radionuclide migration. Interim actions included capping vents, sealing pipes, relocating the perimeter fence (to limit radon risk), transferring and consolidating wastes, upgrading storage buildings, constructing a clay cutoff wall (to limit potential ground-water transport of contaminants), treating and releasing contaminated water, using a synthetic liner, and using an interim clay cap. An interim waste containment facility was completed in 1986. Environmental monitoring showed a decrease in radon concentrations and in external gamma radiation from 1982 to 1986; levels have been stable since 1986. Uranium and radium concentrations in surface water have decreased; very low concentrations have been detected in stream sediments, and concentrations in ground water have remained stable. Recent monitoring showed that NFSS is in compliance with the U.S. Department of Energy's (DOE's) radiation protection standards

  2. Design report for the interim waste containment facility at the Niagara Falls Storage Site

    International Nuclear Information System (INIS)

    1986-05-01

    Low-level radioactive residues from pitchblende processing and thorium- and radium-contaminated sand, soil, and building rubble are presently stored at the Niagara Falls Storage Site (NFSS) in Lewiston, New York. These residues and wastes derive from past NFSS operations and from similar operations at other sites in the United States conducted during the 1940s by the Manhattan Engineer District (MED) and subsequently by the Atomic Energy Commission (AEC). The US Department of Energy (DOE), successor to MED/AEC, is conducting remedial action at the NFSS under two programs: on-site work under the Surplus Facilities Managemnt Program and off-site cleanup of vicinity properties under the Formerly Utilized Sites Remedial Action Program. On-site remedial action consists of consolidating the residues and wastes within a designated waste containment area and constructing a waste containment facility to prevent contaminant migration. The service life of the system is 25 to 50 years. Near-term remedial action construction activities will not jeopardize or preclude implementation of any other remedial action alternative at a later date. Should DOE decide to extend the service life of the system, the waste containment area would be upgraded to provide a minimum service life of 200 years. This report describes the design for the containment system. Pertinent information on site geology and hydrology and on regional seismicity and meteorology is also provided. Engineering calculations and validated computer modeling studies based on site-specific and conservative parameters confirm the adequacy of the design for its intended purposes of waste containment and environmental protection

  3. Niagara Falls storage site annual environmental report for calendar year 1990, Lewiston, New York

    International Nuclear Information System (INIS)

    1991-08-01

    Environmental monitoring of the US DOE Niagara Falls Storage Site (NFSS) and surrounding area began in 1981. NFSS is part of a DOE program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial, operations causing conditions the Congress has authorized DOE to remedy. Environmental monitoring systems at NFSS include sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water sediments, and groundwater. Additionally, several nonradiological parameters are routinely measured in groundwater. During 1990, the average ambient air radon concentration (including background) at NFSS ranged from 0.3 to 0.7 pCi/L (0.01 to 0.03 Bq/L); the maximum at any location for any quarter was 1.6 pCi/L (0.06 Bq/L). The average on-site external gamma radiation exposure level was 69 mR/yr; the average at the property line was 68 mR/yr (including background). The average background radiation level in the area was 66 mR/yr. Average annual concentrations of radium-226 and total uranium in surface water ranged from 0.4E-9 to 0.9E-9 μCi/m1 (0.02 to 0.03 Bq/L) and from 5E-9 to 9E-9 μCi/m1 (0.2 to 0.3 Bq/L), respectively. Routine analyses of groundwater samples from NFSS included the indicator parameters total organic carbon, total organic halides, pH, and specific conductivity

  4. Niagara Falls storage site annual environmental report for calendar year 1990, Lewiston, New York

    Energy Technology Data Exchange (ETDEWEB)

    1991-08-01

    Environmental monitoring of the US DOE Niagara Falls Storage Site (NFSS) and surrounding area began in 1981. NFSS is part of a DOE program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial, operations causing conditions the Congress has authorized DOE to remedy. Environmental monitoring systems at NFSS include sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water sediments, and groundwater. Additionally, several nonradiological parameters are routinely measured in groundwater. During 1990, the average ambient air radon concentration (including background) at NFSS ranged from 0.3 to 0.7 pCi/L (0.01 to 0.03 Bq/L); the maximum at any location for any quarter was 1.6 pCi/L (0.06 Bq/L). The average on-site external gamma radiation exposure level was 69 mR/yr; the average at the property line was 68 mR/yr (including background). The average background radiation level in the area was 66 mR/yr. Average annual concentrations of radium-226 and total uranium in surface water ranged from 0.4E-9 to 0.9E-9 {mu}Ci/m1 (0.02 to 0.03 Bq/L) and from 5E-9 to 9E-9 {mu}Ci/m1 (0.2 to 0.3 Bq/L), respectively. Routine analyses of groundwater samples from NFSS included the indicator parameters total organic carbon, total organic halides, pH, and specific conductivity.

  5. 40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... Quality Control Region. 81.24 Section 81.24 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

  6. Niagara Falls Storage Site, Annual site environmental report, Lewiston, New York, Calendar year 1986: Surplus Facilities Management Program (SFMP)

    International Nuclear Information System (INIS)

    1987-06-01

    During 1986, the environmental monitoring program was continued at the Niagara Falls Storage Site (NFSS), a US Department of Energy (DOE) surplus facility located in Niagara County, New York, presently used for the interim storage of radioactive residues and contaminated soils and rubble. The monitoring program is being conducted by Bechtel National, Inc. The monitoring program at the NFSS measures radon gas concentrations in air; external gamma radiation levels; and uranium and radium concentrations in surface water, groundwater, and sediment. To verify that the site is in compliance with the DOE radiation protection standard and to assess its potential effect on public health, the radiation dose was calculated for the maximally exposed individual. Based on the conservative scenario described in the report, this individual would receive an annual external exposure approximately equivalent to 6% of the DOE radiation protection standard of 100 mrem/yr. By comparison, the incremental dose received from living in a brick house versus a wooden house is 10 mrem/yr above background. The cumulative dose to the population within an 80-km (50-mi) radius of the NFSS that would result from radioactive materials present at the site would be indistinguishable from the dose that the same population would receive from naturally occurring radioactive sources. Results of the 1986 monitoring show that the NFSS is in compliance with the DOE radiation protection standard. 14 refs., 11 figs., 14 tabs

  7. Niagara Falls Storage Site, Annual site environmental report, Lewiston, New York, Calendar year 1986: Surplus Facilities Management Program (SFMP)

    Energy Technology Data Exchange (ETDEWEB)

    1987-06-01

    During 1986, the environmental monitoring program was continued at the Niagara Falls Storage Site (NFSS), a US Department of Energy (DOE) surplus facility located in Niagara County, New York, presently used for the interim storage of radioactive residues and contaminated soils and rubble. The monitoring program is being conducted by Bechtel National, Inc. The monitoring program at the NFSS measures radon gas concentrations in air; external gamma radiation levels; and uranium and radium concentrations in surface water, groundwater, and sediment. To verify that the site is in compliance with the DOE radiation protection standard and to assess its potential effect on public health, the radiation dose was calculated for the maximally exposed individual. Based on the conservative scenario described in the report, this individual would receive an annual external exposure approximately equivalent to 6% of the DOE radiation protection standard of 100 mrem/yr. By comparison, the incremental dose received from living in a brick house versus a wooden house is 10 mrem/yr above background. The cumulative dose to the population within an 80-km (50-mi) radius of the NFSS that would result from radioactive materials present at the site would be indistinguishable from the dose that the same population would receive from naturally occurring radioactive sources. Results of the 1986 monitoring show that the NFSS is in compliance with the DOE radiation protection standard. 14 refs., 11 figs., 14 tabs.

  8. Formerly utilized MED/AEC sites, Remedial Action Program: radiological survey of the Hooker Chemical Company, Niagara Falls, New York. Final report

    International Nuclear Information System (INIS)

    1977-01-01

    Results of a radiological survey of a portion of the Hooker Chemical Company, Niagara Falls, New York, are presented. The survey was conducted over 5.5-acres in which uranium-bearing materials were handled in the early 1940's. The survey included direct measurements of alpha, beta-gamma, and external gamma radiation throughout the site, measurement of transferable alpha and beta contamination levels in the buildings, determination of uranium and radium concentrations in the soild on the site, measurement of radon and radon daughter concentrations in the buildings, and determination of radionuclide concentrations in surface water samples. The results of the survey indicate that radiation levels throughout the site are within pertinent guidelines for unrestricted release of the property

  9. Niagara Falls Storage Site environmental report for calendar year 1992, 1397 Pletcher Road, Lewiston, New York

    International Nuclear Information System (INIS)

    1993-05-01

    This report describes the environmental surveillance program at the Niagara Falls Storage Site (NFSS) and provides the results for 1992. From 1944 to the present, the primary use of NFSS has been storage of radioactive residues produced as a by-product of uranium production. All onsite areas of residual radioactivity above guidelines have been remediated. Materials generated during remediation are stored onsite in the 4-ha (10-acre) waste containment structure (WCS). The WCS is a clay-lined, clay-capped, and grass-covered storage pile. The environmental surveillance program at NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water, sediments, and groundwater. Several chemical parameters, including seven metals, are also routinely measured in groundwater. This surveillance program assists in fulfilling the DOE policy of measuring and monitoring effluents from DOE activities and calculating hypothetical doses. Monitoring results are compared with applicable Environmental Protection Agency (EPA) and New York State Department of Environmental Conservation (NYSDEC) standards, DOE derived concentration guides (DCGs), dose limits, and other DOE requirements. Results of environmental monitoring during 1992 indicate that levels of the parameters measured were in compliance with all but one requirement: Concentrations of iron and manganese in groundwater were above NYSDEC groundwater quality standards. However, these elements occur naturally in the soils and groundwater associated with this region. In 1992 there were no environmental occurrences or reportable quantity releases

  10. Performance monitoring report for the Niagara Falls Storage Site Waste Containment Structure, Lewiston, New York: Calendar year 1987 and January--June of 1988

    International Nuclear Information System (INIS)

    Blanke, J.A.; Johnson, R.T.; Stanley, W.F.

    1989-01-01

    A performance monitoring program has been developed for the Niagara Falls Storage Site (NFSS) Waste Containment Structure (WCS). The WCS contains soils contaminated with residual radioactive materials, rubble, and radioactive residues removed from various areas of the NFSS and vicinity properties during remedial action conducted by the Department of Energy (DOE) from 1982 through 1986. The NFSS is a part of the DOE Surplus Facilities Management Program (SFMP). The purpose of the performance monitoring program is to verify that the WCS main engineering elements are functioning to minimize infiltration of rainfall; prevent pollution of groundwater; preclude formation of leachate; and prevent radon emanation. This report presents the findings of performance monitoring conducted at the WCS during calendar year 1987, and January through June of 1988. the data received during the initial performance monitoring period in 1986 (Ref. 3) established a baseline for interpretation contained in this report. The period covered by this report has been expanded to include 6 months in 1988 because the impact of the winter is most evident in the spring growing season. 5 refs., 12 figs., 8 tabs

  11. Approaches to the Cataract: Butor's Niagara

    Directory of Open Access Journals (Sweden)

    Elinor S. Miller

    1977-09-01

    Full Text Available Michel Butor's 6 810 000 litres d'eau par seconde bears certain similarities to each of his earlier stereophonic works, but is much more than a reworking of established techniques. Generally thought to be difficult, as indicated by the title, which arouses interest without revealing the subject matter, the work has a complex and masterful structure. Against a background of gradually accelerated time, emphasized by appropriate sound effects, an Announcer leads a tour of Niagara Falls. Alphabetically identified characters play out predictable roles as newlyweds, second honeymooners, and the lonely ones. A Reader recites throughout Chateaubriand's classic description of the Falls, constantly recombining the original words in canon form. The initially forbidding typography with three typefaces and three margins creates the possibility of multiple readings. Each part is preceded by directions enabling the reader to alter the text, increasing the volume for some characters, drowning out others. Thus, theoretically, one could read any one of ten texts: "mobile readings," revealing each a different work. This mobility, with the typography, creates an "intellectual chord," not possible otherwise except in music. The subtly colored polyphonic mobile brilliantly serves to express Butor's view of the human condition, reflected in his stereophonic vision of the Falls.

  12. Niagara falls storage site: Annual site environmental report, Lewiston, New York, Calendar Year 1988: Surplus Facilities Management Program (SFMP)

    International Nuclear Information System (INIS)

    1989-04-01

    The monitoring program at the Niagara Falls Storage Site (NFSS) measures radon concentrations in air; external gamma radiation levels; and uranium and radium concentrations in surface water, groundwater, and sediment. To verify that the site is in compliance with the DOE radiation protection standard and to assess its potential effect on public health, the radiation dose was calculated for a hypothetical maximally exposed individual. Based on the conservative scenario described in this report, this hypothetical individual receives an annual external exposure approximately equivalent to 6 percent of the DOE radiation protection standard of 100 mrem/yr. This exposure is less than a person receives during two round-trip flights from New York to Los Angeles (because of the greater amounts of cosmic radiation at higher altitudes). The cumulative dose to the population within an 80-km (50-mi) radius of the NFSS that results from radioactive materials present at the site is indistinguishable from the dose that the same population receives from naturally occurring radioactive sources. Results of the 1988 monitoring show that the NFSS is in compliance with applicable DOE radiation protection standards. 17 refs., 31 figs., 20 tabs

  13. Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program -12184

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, Christopher [U.S Department of Energy Office of Legacy Management, Washington, DC; Kothari, Vijendra [U.S Department of Energy Office of Legacy Management, Morgantown, West Virginia; Starr, Ken [U.S Department of Energy Office of Legacy Management, Westminster, Colorado; Widdop, Michael; Gillespie, Joey [SM Stoller Corporation, Grand Junction, Colorado

    2012-02-26

    The U. S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collection adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS&M) program: Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. DOE must continue to maintain constructive relationships with the U

  14. Nuclear at Niagara. 32nd Annual Canadian Nuclear Society conference and 35th CNS/CNA student conference

    International Nuclear Information System (INIS)

    2011-01-01

    The 32nd Annual Canadian Nuclear Society Conference and 35th CNS/CNA Student Conference was held in Niagara Falls, Ontario, Canada on June 5-8, 2011. The theme of the conference, 'Nuclear at Niagara', brought together scientists, engineers, technologists, senior management, government officials, and students interested in all aspects of nuclear science and technology and its applications, including nuclear power generation, fuel production, uranium mining and refining, management of radioactive wastes and used fuel. Other topics include medical and industrial uses of radionuclides, occupational and environmental radiation protection, the science and technology of nuclear fusion, and associated activities in research and development. and applications of energy from the atom. The central objective of this conference was to exchange views on how nuclear science and technology can best serve the needs of humanity, now and in the future. Over 400 delegates from across Canada and other nuclear countries were in attendance.

  15. Engineering evaluation of alternatives for the disposition of Niagara Falls Storage Site, its residues and wastes

    International Nuclear Information System (INIS)

    1984-01-01

    The final disposition scenarios selected by DOE for assessment in this document are consistent with those stated in the Notice of Intent to prepare an Environmental Impact Statement (EIS) for the Niagara Falls Storage Site (NFSS) (DOE, 1983d) and the modifications to the alternatives resulting from the public scoping process. The scenarios are: take no action beyond interim remedial measures other than maintenance and surveillance of the NFSS; retain and manage the NFSS as a long-term waste management facility for the wastes and residues on the site; decontaminate, certify, and release the NFSS for other use, with long-term management of the wastes and residues at other DOE sites; and partially decontaminate the NFSS by removal and transport off site of only the more radioactive residues, and upgrade containment of the remaining wastes and residues on site. The objective of this document is to present to DOE the conceptual engineering, occupational radiation exposure, construction schedule, maintenance and surveillance requirements, and cost information relevant to design and implementation of each of the four scenarios. The specific alternatives within each scenario used as the basis for discussion in this document were evaluated on the bases of engineering considerations, technical feasibility, and regulatory requirements. Selected alternatives determined to be acceptable for each of the four final disposition scenarios for the NFSS were approved by DOE to be assessed and costed in this document. These alternatives are also the subject of the EIS for the NFSS currently being prepared by Argonne National Laboratory (ANL). 40 figures, 38 tables

  16. Niagara Falls Storage Site environmental report for calendar year 1992, 1397 Pletcher Road, Lewiston, New York. Formerly Utilized Sites Remedial Action Program (FUSRAP)

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    This report describes the environmental surveillance program at the Niagara Falls Storage Site (NFSS) and provides the results for 1992. From 1944 to the present, the primary use of NFSS has been storage of radioactive residues produced as a by-product of uranium production. All onsite areas of residual radioactivity above guidelines have been remediated. Materials generated during remediation are stored onsite in the 4-ha (10-acre) waste containment structure (WCS). The WCS is a clay-lined, clay-capped, and grass-covered storage pile. The environmental surveillance program at NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water, sediments, and groundwater. Several chemical parameters, including seven metals, are also routinely measured in groundwater. This surveillance program assists in fulfilling the DOE policy of measuring and monitoring effluents from DOE activities and calculating hypothetical doses. Monitoring results are compared with applicable Environmental Protection Agency (EPA) and New York State Department of Environmental Conservation (NYSDEC) standards, DOE derived concentration guides (DCGs), dose limits, and other DOE requirements. Results of environmental monitoring during 1992 indicate that levels of the parameters measured were in compliance with all but one requirement: Concentrations of iron and manganese in groundwater were above NYSDEC groundwater quality standards. However, these elements occur naturally in the soils and groundwater associated with this region. In 1992 there were no environmental occurrences or reportable quantity releases.

  17. Nuclear at Niagara. 32nd Annual Canadian Nuclear Society conference and 35th CNS/CNA student conference

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    The 32nd Annual Canadian Nuclear Society Conference and 35th CNS/CNA Student Conference was held in Niagara Falls, Ontario, Canada on June 5-8, 2011. The theme of the conference, 'Nuclear at Niagara', brought together scientists, engineers, technologists, senior management, government officials, and students interested in all aspects of nuclear science and technology and its applications, including nuclear power generation, fuel production, uranium mining and refining, management of radioactive wastes and used fuel. Other topics include medical and industrial uses of radionuclides, occupational and environmental radiation protection, the science and technology of nuclear fusion, and associated activities in research and development. and applications of energy from the atom. The central objective of this conference was to exchange views on how nuclear science and technology can best serve the needs of humanity, now and in the future. Over 400 delegates from across Canada and other nuclear countries were in attendance.

  18. Assessment of alternatives for long-term management of uranium ore residues and contaminated soils located at DOE's Niagara Falls Storage Site

    International Nuclear Information System (INIS)

    Merry-Libby, P.

    1985-01-01

    About 11,000 m 3 of uranium ore residues and 180,000 m 3 of slightly contaminated soils (wastes) are consolidated within a diked containment area at the Niagara Falls Storage Site located about 30 km north of Buffalo, New York. The residues account for less than 6% of the total volume of contaminated materials but almost 99% of the radioactivity. The average radium-226 concentration in the residues is 67,000 pCi/g. The US Department of Energy is considering several alternatives for long-term management of the wastes and residues, including: improvement of the containment at NFSS, modification of the form of the residues, management of the residues separately from the wastes, management of the wastes and residues at another humid site (Oak Ridge, Tennessee) or an arid site (Hanford, Washington), and dispersal of the wastes in the ocean. Potential radiological risks associated with implementation of any of the alternatives are expected to be smaller than the nonradiological risks of occupational and transportation-related injuries and deaths. Dispersal of the slightly contaminated wastes in the ocean is not expected to result in any significant radiological risk to humans. The residues and wastes will remain hazardous for thousands of years. After controls cease, the radioactive materials will eventually be dispersed in the environment. Loss of the earthen covers over the buried materials is predicted to occur from several hundred to more than two million years, depending primarily on the use of the land surface. Groundwater will eventually be contaminated in all alternatives; however, the groundwater pathway is relatively insignificant with respect to radiological risks to the general population. 2 references, 2 figures, 6 tables

  19. Long-term management of the existing radioactive wastes and residues at the Niagara Falls Storage Site. Draft Environmental Impact Statement

    International Nuclear Information System (INIS)

    1984-08-01

    The statement assesses and compares several alternatives for long-term management of the existing radioactive wastes and residues at the Niagara Falls Storage Site (NFSS), Lewiston, New York. The alternatives include: (1) no action (continued interim storage at NFSS within a diked and capped containment area), (2) long-term management at NFSS (improved containment, with or without modified form of the residues), (3) long-term management at other DOE sites (Hanford, Washington, or Oak Ridge, Tennessee), and (4) offsite management of the residues at Hanford or Oak Ridge and either leaving the wastes at NFSS or removing them for disposal in the ocean. In addition to alternatives analyzed in depth, several options are also considered, including: other modifications of residue form, modification of the basic conceptual designs, other containment design options, transportation routes, and transportation modes. The radiological health effects (primarily increased risk of cancer) associated with long-term management of the wastes and residues are expected to be smaller than the nonradiological risks of occupational and transportation-related injuries and deaths. During the action period, the risk is highest for workers if all wastes and residues are moved to Hanford. The risk is highest for the general public if the residues are moved to Hanford and the wastes are moved to the ocean. Dispersal of the slightly contaminated wastes in the ocean is not expected to result in any significant impacts on the ocean environment or pose any significant radiological risk to humans. For all alternatives, if controls ceased, there would be eventual dispersion of the radioactive materials to the environment. If it is assumed that all controls cease, predicted time for loss of covers over the buried materials ranges from several hundred years to more than two million years, depending on the use of the land surface

  20. 77 FR 38486 - Safety Zone; City of Tonawanda July 4th Celebration, Niagara River, Tonawanda, NY

    Science.gov (United States)

    2012-06-28

    ... 1625-AA00 Safety Zone; City of Tonawanda July 4th Celebration, Niagara River, Tonawanda, NY AGENCY... safety zone on the Niagara River, Tonawanda, New York. This safety zone is intended to restrict vessels from a portion of the Niagara River during the City of Tonawanda July 4th Celebration fireworks on July...

  1. Modifications to an existing waste containment structure at Niagara Falls Storage Site

    International Nuclear Information System (INIS)

    Paez-Restrepo, A.; Darby, J.W.

    1992-01-01

    The Niagara Falls Storage Site (NFSS), located near Lewiston, New York, is an interim waste containment facility for low-level radioactive waste. The facility was completed in 1986 and is managed for the Department of Energy (DOE) by Bechtel National, Inc. (BNI) as part of the Formerly Utilized Sites Remedial Action Program (FUSRAP). The waste containment structure (WCS) at NFSS is approximately 297 m (975 ft) long and 137 m (450 ft) wide and reaches a maximum height of 10.4 m (34 ft). The peripheral slopes rise at an angle of 3:1 (h:v) for a width of about 16.8 m (55 ft), where the inclination decreases to 7.5%. The apex of the pile is higher at the south end, sloping about 1.2 m (4 ft) to the north. The interim layered cap consists of 0.9 m (3 ft) of clay overlain by 0.45 m (1.5 ft) of topsoil. The uppermost 15 cm (6 in.) of soil was loosely compacted to permit the development of a grass cover. In the summer of 1991, approximately 2,677 m 3 (3,500 yd 3 ) of additional contaminated soil and material in temporary storage elsewhere at NFSS was incorporated into the WCS. To accommodate the waste, a portion of the cap roughly centered with the pile [including 0.45 m (1.5 ft) of topsoil and 0.6 m (2 ft) of clay cap] was removed from an area 99 m (325 ft) long and 58.5 m (192 ft) wide, leaving a minimum of 0.3 m (I ft) of clay over the old waste as a radiation and radon barrier. The newly incorporated waste forms a layer 0.6 m (2 ft) thick, replacing the clay portion of the excavated cap. The waste is contained laterally by the old cap and sealed by a new cap, which also consists of 0.9 m (3 ft) of compacted clay and 0.45 m (1.5 ft) of topsoil. A transition zone about 6.1 m (20 ft) wide feathers the new cap to the old cap (see Fig. 3). Except for the uppermost 10.5 to 15.2 cm (4 to 6 in.) of vegetated topsoil, the excavated cap materials were stockpiled and reused in constructing the new cap. Additional material required to complete cap construction was imported from

  2. 77 FR 30242 - Safety Zone; City of Tonawanda July 4th Celebration, Niagara River, Tonawanda, NY

    Science.gov (United States)

    2012-05-22

    ...-AA00 Safety Zone; City of Tonawanda July 4th Celebration, Niagara River, Tonawanda, NY AGENCY: Coast... vessels from a portion of the Niagara River during the City of Tonawanda July 4th Celebration fireworks... read as follows: Sec. 165.T09-0352 Safety Zone; City of Tonawanda July 4th Celebration, Niagara River...

  3. New technology and organizational innovation: Niagara Mohawk Power Corporation and nuclear power

    International Nuclear Information System (INIS)

    Stacey, J.E. Jr.

    1981-01-01

    Questions with regard to organization behavior and decision theory are explored in relation to the decision-making process of a major private electric utility, Niagara Mohawk Power Corp., that chose to innovate with nuclear power. The character of the firm is such, relative to size, service area, organizational structure, and socio-political environment, that its experience is important for the further development of theories of organizational innovation. The research attempts to understand the political, economic, and social constraints that limited the set of solutions available to the utility in its search for a suitable electricity-generating mode from the early 1950's to the early 1960's. Two contrasting models of organizational decision-making behavior are used to interpret case-study findings. The initial model is from the electric-utility literature and consists essentially of an economic or benefit/cost model of organizational decision making. The second model is developed from the organizational theory literature and is more complex in the sense that factors other than economics such as organizational inertia, the corporate structure of the utility, fuel-supply history and fuel diversification, electricity-demand-growth expectations, the financial environment, and the psychological appeal of the new technology had important influences on Niagara Mohawk's decision to build Nine Mile Point One. Findings of the case study tend to support the second model in that economics was a necessary but not sufficient reason for Niagara Mohawk to have innovated with nuclear power plants

  4. 33 CFR 117.803 - Niagara River.

    Science.gov (United States)

    2010-07-01

    ... Canadian National Railway bridge, mile 33.0 at Buffalo, need not be opened for the passage of vessels. ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Niagara River. 117.803 Section 117.803 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES...

  5. Dynamics of turbidity plumes in Lake Ontario. [Welland Canal and Niagara, Genesee, and Oswego Rivers

    Science.gov (United States)

    Pluhowski, E. J. (Principal Investigator)

    1975-01-01

    The author has identified the following significant results. Large turbidity features along the 275 km south shore of Lake Ontario were analyzed using LANDSAT-1 images. The Niagara River plume, ranging from 30 to 500 sq km in area is, by far, the largest turbidity feature in the lake. Based on image tonal comparisons, turbidity in the Welland Canal is usually higher than that in any other water course discharging into the lake during the shipping season. Less turbid water enters the lake from the Port Dalhousie diversion channel and the Genesee River. Relatively clear water resulting from the deposition of suspended matter in numerous upstream lakes is discharged by the Niagara and Oswego Rivers. Plume analysis corroborates the presence of a prevailing eastward flowing longshore current along the entire south shore. Plumes resulting from beach erosion were detected in the images. Extensive areas of the south shore are subject to erosion but the most severely affected beaches are situated between Fifty Mile Point, Ontario and Thirty Mile Point, New York along the Rochester embayment, and between Sodus Bay and Nine Mile Point.

  6. Report on the performance monitoring system for the interim waste containment at the Niagara Falls Storage Site, Lewiston, New York

    International Nuclear Information System (INIS)

    1985-10-01

    The Niagara Falls Storage Site (NFSS) is an interim storage site for low-level radioactive waste, established by the US Department of Energy (DOE) at Lewiston, New York. The waste containment structure for encapsulating low-level radioactive waste at the NFSS has been designed to minimize infiltration of rainfall, prevent pollution of groundwater, preclude formation of leachate, and prevent radon emanation. Accurately determining the performance of the main engineered elements of the containment structure will be important in establishing confidence in the ability of the structure to retain the wastes. For this purpose, a waste containment performance monitoring system has been developed to verify that these elements are functioning as intended. The key objective of the performance monitoring system is the early detection of trends that could be indicative of weaknesses developing in the containment structure so that corrective action can be taken before the integrity of the structure is compromised. Consequently, subsurface as well as surface monitoring techniques will be used. After evaluating several types of subsurface instrumentation, it was determined that vibrating wire pressure transducers, in combination with surface monitoring techniques, would satisfactorily monitor the parameters of concern, such as water accumulation inside the containment facility, waste settlement, and shrinkage of the clay cover. Surface monitoring will consist of topographic surveys based on predetermined gridlines, walkover surveys, and aerial photography to detect vegetative stress or other changes not evident at ground level. This report details the objectives of the performance monitoring system, identifies the elements of the containment design whose performance will be monitored, describes the monitoring system recommended, and outlines the costs associated with the monitoring system. 5 refs., 4 figs., 3 tabs

  7. Radiological Survey Results for the Niagara Mohawk Right-of-Way, Tonawanda, New York (TNY004)

    International Nuclear Information System (INIS)

    McKenzie, S.P.; Uziel, M.S.

    1998-01-01

    At the request of the U.S. Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted a radiological survey of a small portion of the Niagara Mohawk Power Corporation right-of-way in Tonawanda, New York. The purpose of the survey was to determine if radioactive residuals had migrated from or been redistributed onto the Niagara Mohawk right-of-way from the former Linde property to the west. The Linde Air Products Division of Union Carbide Corporation, Tonawanda New York, had used radioactive materials at that location for work performed under government contract from 1942 through 1948. The survey was performed in May 1996 in response to Formerly Utilized Sites Remedial Action Program (FUSRAP) requirements. These requirements dictate that the radiological status of certain vicinity properties shall be assessed and documented according to prescribed procedures prior to certification of the property for release for unrestricted use. Such release can only be granted if the property is found to be within current applicable authorized limits. The survey included a gamma scan of accessible areas and the collection and radionuclide analysis of soil samples from the portion of right-of-way located east of the former Linde plant site and north of the railway spur entrance gate. Results of the survey indicate that radioactive material probably originating from the Linde plant is located on the Niagara Mohawk right-of-way in the area surveyed. Surface gamma exposure rates were elevated above typical background levels. Four scattered surface soil samples exceeded DOE guideline values for 238 U, and 8 of 13 surface soil samples exceeded DOE guideline values for 226 Ra. The radionuclide distribution in these samples was similar to that found in materials resulting from former processing activities at the Linde site. It is recommended that the property be designated for remedial action by DOE

  8. The impact of the Cyanamid Canada Co. discharges to benthic invertebrates in the Welland River in Niagara falls, Canada.

    Science.gov (United States)

    Dickman, M; Rygiel, G

    1993-06-01

    : In 1986, the International Joint Commission (IJC) recommended that the Niagara River watershed should be declared an Area of Concern (AOC). This IJC recommendation was ratified by the 4 signatories of the Great Lakes Water Quality Agreement. In order to delist an AOC, it is necessary to locate any areas of impairment within the watershed and carry out remediation projects that permit uses that were previously impaired. To this end we attempted to determine whether or not the sediments at 7 study sites near the Cyanamid Canada (Chemical) Co. were contaminated at levels that would result in the impairment of the natural biota which inhabit the watershed.The Cyanamid Canada (Chemical) Co. discharges ammonia wastes, cyanide, arsenic and a variety of heavy metals into treatment systems which ultimately discharge to the Welland River, the major Canadian tributary to the Niagara River. This portion of the Welland River near the factory was designated a Provincially significant (Class one) wetlands by the Ontario Ministry of Natural Resources. In 1986, the mean discharge to a creek from Cyanamid Canada Co. was 27,342 m(3) per day (MOE, 1987). Similar discharge volumes occurred in 1989. In 1991, the total discharge was 25,000 m(3) per day (MOE, 1991).The majority of the benthic invertebrates collected from the study area were pollution tolerant taxa (e.g., sludge worms constituted 68% of all the organisms collected). The lowest chironomid densities were observed at stations 1, 2, and 4, which were the only stations situated close to Cyanamid's discharge pipes. The absence, of clams and mayflies which burrow to greater depths than do chironomids and sludge worms, probably reflects the inability of the deeper dwelling burrowers to tolerate the contaminants which we recorded at these 3 stations. The absence of all crustaceans from these same 3 stations (stations 1, 2 and 4) when coupled with their low biotic diversity and the elevated heavy metal concentrations in the

  9. Determination of potential sources of PCBs and PBDEs in sediments of the Niagara River

    Energy Technology Data Exchange (ETDEWEB)

    Samara, Fatin [Department of Chemistry, 611 Natural Science Complex, University at Buffalo, State University of New York, Buffalo, NY 14260-3000 (United States); Tsai, Christina W. [Department of Civil, Structural and Environmental Engineering, 233 Jarvis Hall, University at Buffalo, State University of New York, Buffalo, NY 14260-4400 (United States); Aga, Diana S. [Department of Chemistry, 611 Natural Science Complex, University at Buffalo, The State University of New York, Buffalo, NY 14260-3000 (United States)]. E-mail: dianaaga@buffalo.edu

    2006-02-15

    Sediments from Niagara River, an important waterway connecting two of the Great Lakes (Lake Erie to Lake Ontario), were analyzed for 14 congeners of polychlorinated biphenyls (PCBs) and 9 congeners of polybrominated diphenyl ethers (PBDEs) using accelerated solvent extraction and gas chromatography/mass spectrometry. Total concentrations of PCBs ranged from 1.7 to 124.6 ng/g were PCBs 138 and 153 were found in all samples. All sites but one showed PBDE in sediments with total concentrations as high as 148 ng/g, suggesting that PBDE is becoming an important class of POP. A land-use and coverage map was used to trace potential localized sources of PCB and PBDE contamination. Results indicate that the highest levels of PCBs and PBDEs were found in sediments collected from areas closest to the discharge locations of municipal wastewater treatment plants (WWTP) and local industries. This is the first study that suggests the importance of WWTP discharges as a potential source of PBDE contamination in the Great Lakes. - Wastewater treatment plant discharges are a main source of PCBs and PBDEs to Niagara River sediments.

  10. Targeted Health Assessment for Wastes Contained at the Niagara Falls Storage Site to Guide Planning for Remedial Action Alternatives - 13428

    Energy Technology Data Exchange (ETDEWEB)

    Busse, John; Keil, Karen; Staten, Jane; Miller, Neil; Barker, Michelle [U.S. Army Corps of Engineers, Buffalo District, 1776 Niagara Street, Buffalo, NY (United States); MacDonell, Margaret; Peterson, John; Chang, Young-Soo; Durham, Lisa [Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Ave., Argonne, IL 60439 (United States)

    2013-07-01

    The U.S. Army Corps of Engineers (USACE) is evaluating potential remedial alternatives at the 191-acre Niagara Falls Storage Site (NFSS) in Lewiston, New York, under the Formerly Utilized Sites Remedial Action Program (FUSRAP). The Manhattan Engineer District (MED) and Atomic Energy Commission (AEC) brought radioactive wastes to the site during the 1940's and 1950's, and the U.S. Department of Energy (US DOE) consolidated these wastes into a 10-acre interim waste containment structure (IWCS) in the southwest portion of the site during the 1980's. The USACE is evaluating remedial alternatives for radioactive waste contained within the IWCS at the NFSS under the Feasibility Study phase of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) process. A preliminary evaluation of the IWCS has been conducted to assess potential airborne releases associated with uncovered wastes, particularly during waste excavation, as well as direct exposures to uncovered wastes. Key technical issues for this assessment include: (1) limitations in waste characterization data; (2) representative receptors and exposure routes; (3) estimates of contaminant emissions at an early stage of the evaluation process; (4) consideration of candidate meteorological data and air dispersion modeling approaches; and (5) estimates of health effects from potential exposures to both radionuclides and chemicals that account for recent updates of exposure and toxicity factors. Results of this preliminary health risk assessment indicate if the wastes were uncovered and someone stayed at the IWCS for a number of days to weeks, substantial doses and serious health effects could be incurred. Current controls prevent such exposures, and the controls that would be applied to protect onsite workers during remedial action at the IWCS would also effectively protect the public nearby. This evaluation provides framing context for the upcoming development and detailed

  11. Leading Change: A Case Study of Leadership Practices from the Development of the Niagara County Community College Culinary Institute

    Science.gov (United States)

    Caton, Jazmin; Mistriner, Mark

    2016-01-01

    The purpose of this case study was to evaluate the lessons learned from the development of a project that set out to revitalize an economically depressed area with an innovative approach to workforce development through partnerships. The focus was to utilize the development of the Niagara County Community College Culinary Institute as an example…

  12. Ultraviolet radiation (UV-C) on the post harvest control of Colletotrichum gloeosporioides in 'niagara rosada' grapes;Radiacao ultravioleta no controle pos-colheita de Colletotrichum gloeosporides em uva 'niagara rosada'

    Energy Technology Data Exchange (ETDEWEB)

    Cia, Patricia; Sanches, Juliana, E-mail: pcia@iac.sp.gov.b [Instituto Agronomico de Campinas (IAC), Jundiai, SP (Brazil). Centro de Engenharia e Automacao; Benato, Eliane Aparecida; Valentini, Silvia Regina de Toledo; Anjos, Valeria Delgado de Almeida [Instituto de Tecnologia de Alimentos (ITAL), Campinas, SP (Brazil). Grupo de Engenharia e Pos-Colheita; Ponzo, Francine Scolfaro [Instituto Agronomico de Campinas (IAC), SP (Brazil); Terra, Maurilo Monteiro [Instituto Agronomico de Campinas (IAC), SP (Brazil). Centro de Ecofisiologia e Biofisica

    2009-07-01

    Most of the post harvest losses of 'Niagara Rosada' grapes are caused by rot and detached berries. Recently, many researches on alternative methods, such as physical treatments, have been carried out in order to control rots and extend the shelf life of fruits. The objective of this research was to evaluate the effect of ultraviolet radiation (UV-C) on the control of C. gloeosporioides in 'Niagara Rosada' grapes stored at room condition and under refrigeration. Clusters of 'Niagara Rosada' grapes were inoculated with the pathogen and submitted 2 hours later to different doses of UV-C, 0, 1.05, 2.09, 4.18, and 8.35 kJ m{sup -}2, during the periods of 0, 1, 2, 4, and 8 min, respectively. Then, the clusters were stored under two conditions: 25 +- 1 deg C / 80 +- 5 % RH for 7 days, and at 1 +- 1 deg C / 90 +- 5 % RH for 16 days followed by storage at 25 +- 1 deg C / 80 +- 5 %RH for 5 more days. The grapes were evaluated for rot incidence, stem browning, color of the berries, percentage of detached berries, titratable acidity, total soluble solids, and ratio. It was observed that UV-C radiation was effective in reducing the incidence of C. gloeosporioides on inoculated 'Niagara Rosada' grapes and did not change the physicochemical characteristics of the grapes. (author)

  13. 2007 Federal Emergency Management Agency (FEMA) New York Lidar: Niagara County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The spring 2007 LiDAR Flight Acquisition required the collection of approximately 526 square miles of Niagara County and approximately 30 square miles of the...

  14. Investment recovery program at Niagara Mohawk Power Corporation

    International Nuclear Information System (INIS)

    Kotcamp, R.T.

    1993-01-01

    Niagara Mohawk Power Company's pioneering investment recovery program was initiated in 1984, Its mission is to dispose of company assets classified as obsolete, scrap, surplus, or retired capital equipment that results from company operations or work projects. These assets include items such as scrap wire, pipe, line hardware, transformers, power station equipment, crates of dusty telephone modems and computer monitors, pallets of residential gas and electric meters, a box of toilet paper holders, burned-out light bulbs, chunks of electric cable, brass and copper valves, electric bills from 1952, and a dozen tattered office chairs. It was risky for Niagara Mohawk to commit money to a program that created a scrap company inside a utility and is not the core business. No one regrets the decision to create and expand investment recovery. The program has contributed more than $35,000,000 ($8,140,585 nuclear division) of cash receipts with an additional $5,000,000 of cost avoidance since its inception. The program has credited these dollars back to the operating departments, which has reduced operating costs thereby improving the open-quotes bottom line.close quotes

  15. Sedimentological reconstruction of the recent pattern of mercury pollution in the Niagara River

    International Nuclear Information System (INIS)

    Breteler, R.J.; Bowen, V.T.; Schneider, D.L.; Henderson, R.

    1984-01-01

    Since 1952 there have been a number of sharp changes in the rates of delivery, or in the ratios delivered, of several long-lived artificial radionuclides distributed worldwide from atmospheric nuclear tests. Analyses of these nuclides in suitably selected, and collected, aquatic sediment cores indicate several dated horizons that can yield more refined estimates of recent pollution history than are otherwise available. This approach has been applied to several cores in eastern Lake Erie, the Niagara River, and its delta in Lake Ontario, and a selection of the sediments so dated have been analyzed for total mercury. On the basis of the assigned, and verified, data horizons of several sediment cores, the history of mercury pollution in the Niagara River has been reconstructed

  16. Split double factorial with additional treatment and the post-harvest of Niagara grapes

    Directory of Open Access Journals (Sweden)

    Pórtya Piscitelli Cavalcanti

    2015-09-01

    Full Text Available ABSTRACTThis study aims to discuss and explain how to deal with the analysis of experiments conducted in completely randomized design (CRD and subdivided into double factorial with additional treatment in the plot. In addition it was illustrate the discussion by analyzing data from an experiment on post-harvest of Niagara grapes. The sums of squares for each source of variation are presented, while discussing how the additional treatment affects the whole variation. Niagara grapes were treated in the pre-harvest with three preservatives (calcium chloride, calcium nitrate and calcium lactate at 0%, 0.5%, 1% and 2% and stored for 0, 10, 20 and 30 days.All the preservatives evaluated at 0% represented the control (additional treatment.

  17. Accessibility and use of primary healthcare for immigrants living in the Niagara Region.

    Science.gov (United States)

    Lum, Irene D; Swartz, Rebecca H; Kwan, Matthew Y W

    2016-05-01

    Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. 77 FR 60901 - Safety Zone; Battle of Queenston Heights Bicentennial, Niagara River, Lewiston, NY

    Science.gov (United States)

    2012-10-05

    ..., Docket Operations, telephone 202-366-9826. SUPPLEMENTARY INFORMATION: Table of Acronyms DHS Department of... Lower Niagara River near the Silo Restaurant, Lewiston, NY. The Captain of the Port Buffalo has...

  19. Towards an adaptation action plan : climate change and health in the Toronto-Niagara region : summary for policy makers

    International Nuclear Information System (INIS)

    Chiotti, Q.; Morton, I.; Maarouf, A.

    2002-10-01

    The current science regarding climate change and its potential health effects was assessed in an effort to provide information to decision-makers dealing with health infrastructure in the Toronto-Niagara region. This report also presents an assessment of how the health care system can adapt to handle the increased demand for services resulting from the projected negative human health effects of climate change. The first part of the report presents some background information on climate change and health issues and demonstrates how the current health care infrastructure cannot deal effectively with the full range of health effects that may occur in heavily populated areas such as the Toronto-Niagara region. The second part of the report summarizes the scientific knowledge about the expected impacts of climate change and associated health effects, such as heat stress, extreme weather events, poor air quality, vector-borne diseases, food and water-borne diseases, and increased exposure to ultra-violet radiation. It was noted that children and the elderly are most vulnerable. The final part of the report outlines an adaptation action plan to improve the health care infrastructure through public education and communication, surveillance and monitoring, ecosystem intervention, infrastructure development, technical engineering, and medical intervention. 100 refs., 1 fig

  20. Niagara pumping generation station inundation mapping and consequence analysis with ArcGIS and Mike 21

    Energy Technology Data Exchange (ETDEWEB)

    Grover, Patrick; Khayer, Yasmin; Naumov, Aleksey [4DM Inc., Toronto, (Canada); Zhang, Yibing [Ontario Power Generation, Toronto, (Canada)

    2010-07-01

    Inundation mapping is a key factor of Ontario Power Generation's dam safety program. It is the basis for determining the hazard potential classification of the dam by modelling the consequences of a hypothetical dam failure. This paper presented the project for updating the inundation mapping and consequence analysis study at the Niagara Pump generating station (PGS) reservoir. A complete hydrotechnical assessment of the Niagara PGS reservoir was conducted. The modelling of various breach scenarios was carried out using the 2-D hydrodynamic software MIKE 21 in order to provide the hydraulic data necessary for producing the inundation maps. Updated EPRP maps were produced and a consequence analysis was performed which confirmed the existing hazard classification. The ArcGIS system was used as the underlying framework for all major components of the project. It was found that the use of GIS technologies improve the efficiency of both modelling and analysis.

  1. Solid images generated from UAVs to analyze areas affected by rock falls

    Science.gov (United States)

    Giordan, Daniele; Manconi, Andrea; Allasia, Paolo; Baldo, Marco

    2015-04-01

    The study of rock fall affected areas is usually based on the recognition of principal joints families and the localization of potential instable sectors. This requires the acquisition of field data, although as the areas are barely accessible and field inspections are often very dangerous. For this reason, remote sensing systems can be considered as suitable alternative. Recently, Unmanned Aerial Vehicles (UAVs) have been proposed as platform to acquire the necessary information. Indeed, mini UAVs (in particular in the multi-rotors configuration) provide versatility for the acquisition from different points of view a large number of high resolution optical images, which can be used to generate high resolution digital models relevant to the study area. By considering the recent development of powerful user-friendly software and algorithms to process images acquired from UAVs, there is now a need to establish robust methodologies and best-practice guidelines for correct use of 3D models generated in the context of rock fall scenarios. In this work, we show how multi-rotor UAVs can be used to survey areas by rock fall during real emergency contexts. We present two examples of application located in northwestern Italy: the San Germano rock fall (Piemonte region) and the Moneglia rock fall (Liguria region). We acquired data from both terrestrial LiDAR and UAV, in order to compare digital elevation models generated with different remote sensing approaches. We evaluate the volume of the rock falls, identify the areas potentially unstable, and recognize the main joints families. The use on is not so developed but probably this approach can be considered the better solution for a structural investigation of large rock walls. We propose a methodology that jointly considers the Structure from Motion (SfM) approach for the generation of 3D solid images, and a geotechnical analysis for the identification of joint families and potential failure planes.

  2. Variações na anatomia foliar de videira Niagara em diferentes sistemas de condução

    Directory of Open Access Journals (Sweden)

    Rachel Benetti Queiroz-Voltan

    2011-01-01

    Full Text Available Alterações na anatomia de folhas são causadas por diversos fatores ambientais, principalmente a disponibilidade de radiação, podendo causar mudanças na capacidade fotossintética e afetando a produção final. Este trabalho objetivou identificar alterações na estrutura anatômica de folhas de videiras 'Niagara Rosada' e 'Niagara Branca' em três diferentes sistemas de condução: espaldeira (ESP, manjedoura em 'Y' (Y e manjedoura em 'Y' coberto com plástico (YPLA. Os estudos anatômicos foram realizados em folhas, externas em relação ao dossel, retiradas em três diferentes alturas da planta (superior, mediana e inferior. Para a caracterização anatômica, as amostras foram fixadas em FAA, emblocadas em parafina, seccionadas em micrótomo e coradas com safranina e azul de alciã. As lâminas foram analisadas com o auxílio de um microscópio óptico acoplado a uma câmera de captura de imagens. As espessuras da epiderme das faces adaxial e abaxial, dos parênquimas paliçádico e esponjoso, da espessura total da folha e da razão entre parênquimas paliçádico e esponjoso foram estimadas em uma amostra ao acaso de dez segmentos de cada tratamento, totalizando 1800 observações. Realizaram as análises de variância pelo teste F, sendo as médias dos tratamentos comparadas pelo Tukey a 5% de probabilidade. Observaram-se nas cultivares Niagara Branca e Niagara Rosada conduzidas em ESP uma espessura média de limbo maior, porém foram menos produtivas, quando comparados com Y e YPLA; folhas expostas a maiores intensidades luminosas tiveram limbo mais espesso devido ao maior desenvolvimento do parênquima paliçádico, independentemente do sistema de condução.

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

    Science.gov (United States)

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

    2011-12-01

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

  4. 77 FR 62510 - Niagara Wind Power, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Science.gov (United States)

    2012-10-15

    ... Wind Power, LLC's application for market-based rate authority, with an accompanying rate schedule... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER13-17-000] Niagara Wind Power, LLC; Supplemental Notice That Initial Market- Based Rate Filing Includes Request for Blanket...

  5. Balanço de energia em vinhedo de 'Niagara Rosada' Energy balance on 'Niagara Rosada' vineyard

    Directory of Open Access Journals (Sweden)

    José Ricardo Macedo Pezzopane

    2003-01-01

    Full Text Available O método do balanço de energia foi utilizado para caracterizar a variação horária do saldo de radiação e dos fluxos de calor latente, sensível e no solo, em vinhedo cultivado com a cultivar NiagaraRosada', conduzida no sistema de espaldeira, em Jundiaí (SP. Além disso, foram determinadas as relações entre o saldo de radiação (SR no vinhedo e a radiação solar global (RG e a partição da energia disponível ao sistema nos fluxos de calor latente (LE, sensível (H e no solo (G. Em um dia característico de período seco, o LE representou 44% do SR e o H, 48%. Em um dia chuvoso, o LE representou 86% do SR e o H, 21%. Em um dia ensolarado, após um período de chuvas, LE e H foram, respectivamente, 68% e 29% do SR. O G foi, em média, 5,7% e 1,3% do SR para as ruas mantidas capinadas e com forro, respectivamente.The energy balance method was used to characterize the hourly variation of the net radiation, latent and sensible fluxes and soil heat flux on a mature vineyard grown at Jundiaí, São Paulo, Brazil. The grapevines, cv. Niagara Rosada, in the vineyard were wrapped to trellis wires, creating compact hedgerows 2 m apart, 1.7 m height and 0.4 wide, with the foliage 1m above the soil surface. Also, the net and incoming radiation relationships and the partioning of the available energy to the system into latent and heat flux, and soil heat flux were determined for the vineyard. During a sunny day (dry period the latent heat flux was 44% of the net radiation and the sensible heat flux, 48%. However during a rainy day, the latent heat flux was 86% of the net radiation and the sensible heat flux, 21%. During a sunny day, after the occurrence of rain, the latent and sensible heat fluxes were, respectively, 68% and 29% of the net radiation. The soil heat flux was 5.7 an 1.3% of the net radiation, for bare soil and mulched rows, respectively.

  6. Photosynthetic capacity of 'Niagara Rosada' grapes grown under transparent plastic covering

    Directory of Open Access Journals (Sweden)

    Bruna Corrêa da Silva de Deus

    2016-06-01

    Full Text Available ABSTRACT: New techniques in tropical regions such as use of transparent plastic covering (TPC, have been employed in grapes to avoid the wetting leaves and fruits, which can reduce the occurrence of fungal diseases, reduce the use of sprays, and reduce damage caused by hail and high winds. TPC may significantly affect the photosynthetic rates of grapevines cultivated in tropical regions, and thus have strong effects on plant productivity and improve fruit quality. However, in the North of Rio de Janeiro region there are lacks of studies related to TPC effects on photosynthetic capacity. The objective of this study was to evaluate the photosynthetic capacity in 'Niagara Rosada' vines grown under TPC and without transparent plastic covering (WTPC. The experiment was conducted between April and June 2013, on Tabuinha farm, located in the 3rd district of São Fidélis, Rio de Janeiro State, Brazil. A completely randomized block design was used with two treatments (TPC and WTPC and twelve replications. Evaluations consisted of climatological variables, gas exchange and maximum quantum efficiency of open photosystem II centers-quantum yield (Fv/Fm It was possible to observe that under TPC maximum temperature increase of 2.3°C, relative humidity reduced 1.5%, vapor pressure deficit increase 0.4kPa, and light intensity reduced 47.7%. These changes did not cause photochemical damage to the leaves. The TPC promoted higher net photosynthetic rate at 800h, which was associated with higher stomatal conductance. Thus, the TPC used in the northern region of Rio de Janeiro State did not impair the photosynthetic capacity of 'Niagara Rosada' vines.

  7. Drilling through Conservation Policy: Oil Exploration in Murchison Falls Protected Area, Uganda

    Directory of Open Access Journals (Sweden)

    Catrina A MacKenzie

    2017-01-01

    Full Text Available Approximately 2.5 billion barrels of commercially-viable oil, worth $2 billion in annual revenue for 20 years, were discovered under the Ugandan portion of the Albertine Rift in 2006. The region also contains seven of Uganda's protected areas and a growing ecotourism industry. We conducted interviews and focus groups in and around Murchison Falls Protected Area, Uganda's largest, oldest, and most visited protected area, to assess the interaction of oil exploration with the three primary conservation policies employed by Uganda Wildlife Authority: protectionism, neoliberal capital accumulation, and community-based conservation. We find that oil extraction is legally permitted inside protected areas in Uganda, like many other African countries, and that the wildlife authority and oil companies are adapting to co-exist inside a protected area. Our primary argument is that neoliberal capital accumulation as a conservation policy actually makes protected areas more vulnerable to industrial exploitation because nature is commodified, allowing economic value and profitability of land uses to determine how nature is exploited. Our secondary argument is that the conditional nature of protected area access inherent within the protectionist policy permits oil extraction within Murchison Falls Protected Area. Finally, we argue that community-based conservation, as operationalized in Uganda, has no role in defending protected areas against oil industrialisation.

  8. A fast atom bombardment study of the lead isotope ratios in early nineteenth century Niagara Peninsula pottery glazes

    International Nuclear Information System (INIS)

    Miller, J.M.; Jones, T.R.B.; Kenney, Tina; Rupp, D.W.

    1986-01-01

    The application of fast atom bombardment (FAB) mass spectrometry to the determination of lead isotope ratios in nineteenth century pottery glazes from the Niagara Peninsula has been investigated with the aim of determining the source of the lead used in the glazes. Methods of sampling have been compared, including direct analysis of glass chips, analysis of powdered glaze scrapings, analysis of acid extracts of the former, and simple acid leaching of the surface of a piece of pottery. The latter method gave the best results. The FAB data, as obtained on an older mass spectrometer, can distinguish lead from igneous vs. sedimentary deposits, but is not adequate to determine specific mining locations. Although newer FAB instrumentation can narrow this range, the overlap of data from the Niagara Peninsula and England precludes a simple answer to the archeological question as to English vs. Canadian origin of the lead used in the Jordan pottery glazes. However, the data do suggest that the potter used a local source for the lead

  9. Prevalence and correlates of fear of falling among elderly population in urban area of Karnataka, India.

    Science.gov (United States)

    Mane, Abhay B; Sanjana, T; Patil, Prabhakar R; Sriniwas, T

    2014-07-01

    Falls are a major public health problem in the elderly population. Fear of falling (FOF) among elderly persons can compromise quality of life by limiting mobility, diminished sense of well-being and reduced social interactions. India is undergoing a demographic transitional phase with urban elderly population of 6.72% in 2001. The major challenge would be on the prevention of falls among them. Hence there is a need to highlight the problems related to fall faced by the elderly in India. To study the prevalence of FOF and its correlates among the elderly population in urban area. 250 elderly subjects above 60 years were randomly selected from urban area and interviewed for FOF using Short Fall Efficacy Scale-I (FES-I), history of falls and risk factors. The prevalence of FOF among the elderly was 33.2%. The significant correlates of FOF were educational status, family type, associated health problems, history of fall in past 6 months, worried of fall again among fallers, fearfulness of fall again among fallers, restriction of daily activities and depression among them. The insignificant correlates were gender and socio-economic status. FOF is a health problem among the elderly living in urban India needs urgent attention. It represents a significant threat to socialization, independence and morbidity or mortality. Knowledge of correlates of FOF may be useful in developing multidimensional strategies to reduce it among elderly.

  10. Results of the radiological survey at the Niagara-Mohawk property, Railroad Avenue, Colonie, New York (AL218)

    International Nuclear Information System (INIS)

    Marley, J.L.; Carrier, R.F.

    1987-12-01

    A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The Niagara-Mohawk property on Railroad Avenue in Colonie, New York, was the subject of a radiological investigation initiated June 11, 1987. This commercial property is an irregularly shaped lot partially occupied by an electric power substation and associated transmission lines. Portions of the property that were swampy and heavily vegetated were inaccessible to the survey team. There are no buildings on the property. A diagram showing the approximate boundaries and the 15-m grid network established for measurements on the property is shown. The lot included in the radiological survey was /approximately/45 m wide by 246 m deep. Two views of the property are shown. 13 refs., 6 figs., 4 tabs

  11. PRODUCTION COSTS AND PROFITABILITY OF ‘NIAGARA ROSADA’ TABLE GRAPE GROWN IN DIFFERENT REGIONS OF SÃO PAULO STATE

    Directory of Open Access Journals (Sweden)

    FERNANDO PEREZ CAPPELLO

    2017-10-01

    Full Text Available ABSTRACT Niagara Rosada is the main cultivar of table grapes produced in São Paulo state. Its production is concentrated mainly in the regions of Campinas, Itapetininga and Jales, where it is grown under different production systems. The aim of this study was to analyze the economic viability of cv. Niagara Rosada at main regions producers of São Paulo State. Therefore, case studies were made with grape growers for each region to assess the production cost and calculate profitability. In the Campinas region, for two cycles per year, the main crop and the second crop were evaluated, and the Total Cost (TC obtained was US$ 0.81/Kg, with US$ 0.23/Kg of Total Net Revenue (TNR. Considering only the main crop, the decrease of grape production increased the production cost and reduced profitability, the TC reached was US$ 0.93/Kg and TNR US$ 0.08/Kg. In the Itapetininga region, for two cycles per year, in main crop the TC was US$ 0.68/Kg and the TNR was US$ 0.32/Kg. Meanwhile, in the second crop, the lower productivity increased TC to US$ 1.05/Kg, but the higher price caused a TNR of US$ 0.38/Kg. In the Jales region, only one cycle per year, TC was increased to US$ 1.21/Kg, however, the high selling prices in the off-season in São Paulo State resulted in TNR of US$ 0.43/Kg. According to the results, the production of cv. Niagara Rosada in different regions of São Paulo State is profitable and has a positive return for family agriculture. Nevertheless, each region has its own characteristics in terms of production and commercialization of table grapes.

  12. Factors Impacting Student Service Utilization at Ontario Colleges: Key Performance Indicators as a Measure of Success: A Niagara College View

    Science.gov (United States)

    Veres, David

    2015-01-01

    Student success in Ontario College is significantly influenced by the utilization of student services. At Niagara College there has been a significant investment in student services as a strategy to support student success. Utilizing existing KPI data, this quantitative research project is aimed at measuring factors that influence both the use of…

  13. Spatial variability of leaf wetness duration in a 'Niagara Rosada' vineyard Variabilidade espacial da duração do período de molhamento em vinhedo de 'Niagara Rosada'

    Directory of Open Access Journals (Sweden)

    Jorge Lulu

    2008-03-01

    Full Text Available Despite considerable efforts to develop accurate electronic sensors to measure leaf wetness duration (LWD, little attention has been given to studies about how is LWD variability in different positions of the crop canopy. In order to evaluate the influence of 'Niagara Rosada' (Vitis labrusca grapevine structure on the spatial variability of LWD, the objective of this study was to determine the canopy position of the ‘Niagara RosadaÂ’ table grape with longer LWD and its correlation with measured standard LWD over turfgrass. LWD was measured in four different canopy positions of the vineyard (sensors deployed at 45º with the horizontal: at the top of the plants, with sensors facing southwest and northeast (Top-SW and Top-NE, and at the grape bunches height, with sensors facing southwest and northeast (Bottom-SW and Bottom-NE. No significant difference was observed between the top (1.6 m and the bottom (1.0 m of the canopy and also between the southwest and northeast face of the plants. The relationship between standard LWD over turfgrass and crop LWD in different positions of the grape canopy showed a define correlation, with R² ranging from 0.86 to 0.89 for all period, from 0.72 to 0.77 for days without rain, and from 0.89 to 0.91 for days with rain.Apesar dos esforços consideráveis para se desenvolverem sensores eletrônicos acurados para medir a duração do período de molhamento (DPM, pouca atenção tem sido dada às pesquisas sobre a variabilidade da DPM no interior do dossel das culturas. A fim de avaliar a influência da estrutura da cobertura vegetal da videira 'Niagara Rosada' (Vitis labrusca na variabilidade espacial da DPM, o objetivo do presente estudo foi determinar a posição da videira com a maior DPM e sua relação com a DPM medida em condição-padrão (no gramado. Para tanto, a DPM foi medida em quatro diferentes posições da planta, com os sensores inclinados em 45º em relação à horizontal: topo da planta

  14. Estimation of heavy metals in dust fall samples from three different industrial areas of Karachi

    International Nuclear Information System (INIS)

    Hashmi, D.R.; Khan, F.A.; Shareef, A.; Bano, A.B.; Munshi, A.B.

    2010-01-01

    The study of accumulation of heavy metals, Fe, Cu, Mn, Zn, Pb and Cd, in the dust fall samples, collected from three selected industrial areas of Karachi, showed the level of heavy metals to decrease gradually from sites of high activity to those of low activity such as from roundabouts to main roads to side roads. Concentration of heavy metal showed a variation of the order Fe>Zn>Pb>Mn>Cu>Cd. Iron had the highest concentration in all the sampling areas in the range of 1.947 +- 0.00 to 30.039 +- 0.01 mg/g. Lower values were observed for Cd with respective ranges of 0.001 +- 0.00 to 0.009 +- 0.01 mg/g. The results suggested that heavy metal pollution in the dust fall samples of industrial areas may be due to automobile and industrial exhaust from different industrial units. (author)

  15. 75 FR 33239 - Rangeland Allotment Management Planning on the Fall River West and Oglala Geographic Areas, Fall...

    Science.gov (United States)

    2010-06-11

    ...The USDA, Forest Service, will prepare an environmental impact statement (EIS) analyzing the management of rangeland vegetation resources, which includes livestock grazing, on the National Forest System (NFS) lands within the Oglala Geographic Area (OGA) of the Oglala National Grassland on the Pine Ridge Ranger District and the West Geographic Area (WGA) of the Buffalo Gap National Grassland on the Fall River Ranger District of the Nebraska National Forest (Analysis Area) areas as mapped by the 2001 Nebraska National Forest Revised Land and Resource Management Plan (Forest Plan). A Notice of Intent (NOI) for this project was published February 22, 2008 (73 No. 36 FR 9760- 9762). More than six months have elapsed since the projected draft environmental impact statement (DEIS) date in that original NOI. This revised NOI is being issued to update the project schedule. There will be a record of decision (ROD) for each geographic area. Proposed management actions would be implemented beginning in the year 2012. The agency gives notice of the full environmental analysis and decision-making process that will occur on the proposal so interested and affected people may become aware of how they may participate in the process and contribute to the final decision.

  16. CONTROLE QUÍMICO E CULTURAL DAS PLANTAS DANINHAS NA VIDEIRA 'NIAGARA ROSADA'

    Directory of Open Access Journals (Sweden)

    PAULO EDISON MARTINS

    1997-01-01

    Full Text Available Estudou-se o controle das plantas daninhas e a seletividade dos herbicidas diclobenil, diuron e simazine à cultura da videira `Niagara Rosada', procurando-se separar os efeitos da cobertura morta sobre os fatores de produção e o teor de sólidos solúveis do suco da uva. O delineamento experimental utilizado foi de blocos ao acaso com quatro repetições. Verificou-se que os herbicidas diuron (2,0 kg/ha, simazine (2,4 kg/ha e diclobenil (3,04; 4,05 e 5,06 kg/ha foram seletivos à cultura da videira e eficientes no controle das plantas daninhas capim-colchão (Digitaria horizontalis Willd., caruru (Amaranthus hibridus L., guanxuma (Sida spp. e picão-preto (Bidens pilosa L.. A cobertura vegetal de capim-gordura (Melinis minutiflora L. foi eficiente no controle das plantas daninhas.

  17. Estimating leaf wetness duration over turfgrass, and in a 'Niagara Rosada' vineyard, in a subtropical environment Estimativa da duração do período de molhamento sobre o gramado e em vinhedo de 'Niagara Rosada' em condição subtropical

    Directory of Open Access Journals (Sweden)

    Jorge Lulu

    2008-12-01

    Full Text Available Leaf wetness duration (LWD is a key parameter in agrometeorology because it is related to plant disease occurrence. As LWD is seldomly measured in a standard weather station it must be estimated to run warning systems for schedule chemical disease control. The objective of the present study was to estimate LWD over turfgrass considering different models with data from a standard weather station, and to evaluate the correlation between estimated LWD over turfgrass and LWD measured in a 'Niagara Rosada' vineyard, cultivated in a hedgerow training system, in Jundiaí, São Paulo State, Brazil. The wetness sensors inside the vineyard were located at the top of the plants, deployed at an inclination angle of 45º and oriented southwest, with three replications. The methods used to estimate LWD were: number of hours with relative humidity above 90% (NHRH > 90%, dew point depression (DPD, classification and regression tree (CART and Penman-Monteith (PM. The CART model had the best performance to estimate LWD over turfgrass, with a good precision (R² = 0.82 and a high accuracy (d = 0.94, resulting in a good confidence index (c = 0.85. The results from this model also presented a good correlation with measured LWD inside the vineyard, with a good precision (R² = 0.87 and a high accuracy (d = 0.96, resulting in a high confidence index (c = 0.93, showing that LWD in a 'Niagara Rosada' vineyard can be estimated with data from a standard weather station.A duração do período de molhamento (DPM é uma variável agrometeorológica chave para a ocorrência de doenças de plantas. Como a DPM é raramente medida nas estações meteorológicas, ela deve ser estimada quando se pretende empregar sistemas de alerta de controle químico. Desse modo, o objetivo do presente estudo foi avaliar a estimativa da DPM sobre gramado por diferentes modelos a partir de dados meteorológicos obtidos em uma estação meteorológica padrão e verificar as relações entre a DPM

  18. Black-footed ferret areas of activity during late summer and fall at Meeteetse, Wyoming

    Science.gov (United States)

    Fagerstone, K.A.; Biggins, D.E.

    2011-01-01

    Radiotelemetry was used during 1983 and 1984 to collect information on short-term areas of activity for black-footed ferrets (Mustela nigripes) near Meeteetse, Wyoming. This population ultimately provided ferrets for the captive-breeding program that bred and released offspring into the wild since 1991. We fitted 5 adult ferrets and 13 juveniles with radiotransmitters and followed their movements during late summer and fall. Adult males had 7-day areas of activity that were >6 times as large as those of adult females. Activity areas of adult males varied little in coverage or location on a weekly basis, but females sequentially shifted their areas. Unlike juvenile females, juvenile males tended to leave their natal colonies. ?? 2011 American Society of Mammalogists.

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

    Directory of Open Access Journals (Sweden)

    G. F. Wieczorek

    2008-05-01

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

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

    Science.gov (United States)

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

    2008-05-01

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

  1. Estimativa de área foliar da videira 'Niagara Rosada' conduzida em sistema de latada, região norte fluminense

    Directory of Open Access Journals (Sweden)

    Miquéias Permanhani

    2014-12-01

    Full Text Available Com o objetivo de estabelecer um modelo matemático para estimar de forma precisa a área foliar da videira 'Niagara Rosada' na região de Cardoso Moreira-RJ, realizou-se este trabalho em vinhedo particular do sítio pioneiro, implantado no ano de 2002, em sistema de latada. Foram coletadas aleatoriamente, no ciclo de produção iniciado em 2011, 70 folhas de diversos tamanhos, completamente expandidas e sem danos aparentes para determinar a relação entre a área foliar (AF e a área do círculo (AC, considerando seu diâmetro igual à largura da folha. Por meio da análise de regressão, obteve-se a equação linear (AFes = 0,82*AC + 16,12 que, juntamente com mais outras duas, foram utilizadas para comparar a área foliar estimada com a área foliar medida em 30 folhas do ciclo de produção posterior (Março de 2012. Constatou-se que as equações apresentadas permitem estimar de forma precisa a área foliar da videira 'Niagara Rosada/IAC 572' conduzida em sistema de latada, na região de Cardoso Moreira-RJ, com apenas uma dimensão foliar: a largura da folha, sendo que o modelo de regressão obtido (AFes = 0,82*AC + 16,12 foi o que menos subestimou a área da folha comparada (coeficiente angular = 0,99, seguido pelo modelo indicado por Pedro Jr. et al. (1986.

  2. Influência da cobertura vegetal do solo na qualidade dos frutos de videira 'Niagara Rosada' Influence of soil cover with grass and leguminous plants on fruit characteristics of table grape variety Niagara Rosada

    Directory of Open Access Journals (Sweden)

    Elaine Bahia Wutke

    2005-12-01

    Full Text Available Devido ao aumento no custo de produção com a utilização de cobertura morta com capim nas ruas da videira 'Niagara Rosada' e à dificuldade para sua aquisição, objetivou-se a possibilidade de substituí-la por plantas de cobertura intercalares. Em experimentos realizados em Indaiatuba e Jundiaí-SP, de 1999-2000 a 2003-2004, instalaram-se seis tratamentos nas entrelinhas, em blocos ao acaso e quatro repetições, constando de área no limpo; vegetação espontânea roçada; cobertura com capim seco de Brachiaria decumbens; cobertura verde de aveia preta (Avena strigosa; cobertura verde de chícharo (Lathyrus sativus; cobertura verde de tremoço (Lupinus albus, de março a outubro, seguidas de cobertura verde de mucuna anã (Mucuna deeringiana de outubro a março. Determinaram-se massa, comprimento e largura do cacho, engaço e bagas, número total de bagas por cacho e diâmetro do pedicelo de bagas, comparando-se os valores médios pelo teste de Duncan ao nível de 5%. Na média dos anos, os resultados com a cobertura verde foram similares ou mais favoráveis que os da cobertura com braquiária seca, podendo-se substituí-la por coberturas vegetais intercalares com gramínea e leguminosas, o ano todo, sem interferência negativa na qualidade comercial dos frutos.Grape vineyard in Southern Brazil utilize a large amount of mulch during autumn-winter season demanding extra efforts and costs, being its acquisition very difficult nowadays. In order to evaluate the possibility of replacing the tradicionally mulch by green cover species in the inter-row strip, two experiments were carried out in Indaiatuba and Jundiaí, SP, Brazil, from 1999/00 to 2003/04, with the table variety Niagara Rosada. The experimental design was a randomized block with four replications and six treatments: 1 no weeded area; 2 cut spontaneous local vegetation; 3 mulch of Brachiaria decumbens; 4 green cover of Avena strigosa from March to October followed by green cover of

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

    Science.gov (United States)

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

    2017-05-01

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

  4. Support technologies to cater for rockbursts and falls of ground in the immediate face area, volume 1.

    CSIR Research Space (South Africa)

    Daehnk, A

    2000-03-01

    Full Text Available Final Project Report Support technologies to cater for rockbursts and falls of ground in the immediate face area Volume I A. Daehnke, E. Acheampong, N. Reddy, K.B. Le Bron and A.T. Haile Research agency: CSIR Mining Technology Project number: GAP...

  5. 77 FR 32117 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Science.gov (United States)

    2012-05-31

    ...: Winchester Engineering and Analytical Center (Winchester, MA), Weldon Spring Plant (Weldon Spring, MO...), Clarksville Facility (Clarksville, TN), Mound Plant, Titanium Alloys Manufacturing (Niagara Falls, NY), and... and should be submitted to the contact person below well in advance of the meeting. Policy on...

  6. Efeito do ethephon sobre a brotação e vigor dos ramos da videira 'Niagara Rosada' (Vitis labrusca L. Effect of ethephon on sprout and vigor of branch of 'Niagara Rosada' (Vitis labrusca L.

    Directory of Open Access Journals (Sweden)

    Antonio Augusto Fracaro

    2004-12-01

    Full Text Available A produção da videira 'Niagara Rosada' em regiões tropicais e subtropicais do Brasil tem sido freqüentemente prejudicada, principalmente devido à dificuldade de emissão e desenvolvimento das brotações após a poda de produção, realizada nos meses de ocorrência de temperaturas mais baixas, o que tem causado redução nas produções e desestímulo aos viticultores. Para solucionar esse problema, foram conduzidos três experimentos, em pomares comerciais localizados na região Noroeste do Estado de São Paulo, com o objetivo de estudar o efeito do Ethephon, aplicado antes da poda de produção, na emissão e desenvolvimento das novas brotações e na duração do período da poda até a floração. Foram testadas quatro doses de ethephon (0 mg.L-1; 720 mg.L-1; 1.440 mg.L-1; 2.160 mg.L-1 aplicadas via foliar antes da poda de produção, nos meses de junho e julho de 2002. Observou-se que a aplicação de Ethephon proporcionou maior número de gemas brotadas, maior comprimento e diâmetro do ramo e não alterou o período da poda à floração. Especialmente quando da ocorrência de condições climáticas desfavoráveis e quando as plantas apresentaram satisfatório grau de enfolhamento, a aplicação de ethephon, na dose de 2.160 mg.L-1, foi a mais efetiva.The production of ' Niagara Rosada ' in tropical and subtropical regions of Brazil has been frequentmently reduced, mainly due to difficulty of emission and development of sprout after the yield prune carried out in the months of occurrence of lower temperatures, what caused reduction in yields and discourage of farmers. Three experiments was carried out to solve this problem, in commercial areas located in northwest region of São Paulo State, with the objective to verify the effect of Ethephon, applied before the yield prune, in emission and development of sprout and in duration of the period of pruning until the flowering. Four levels of Ethephon (0 mg.L-1; 720 mg.L-1; 1,440 mg.L-1

  7. Air contaminants and litter fall decomposition in urban forest areas: The case of São Paulo - SP, Brazil.

    Science.gov (United States)

    Lamano Ferreira, Maurício; Portella Ribeiro, Andreza; Rodrigues Albuquerque, Caroline; Ferreira, Ana Paula do Nascimento Lamano; Figueira, Rubens César Lopes; Lafortezza, Raffaele

    2017-05-01

    Urban forests are usually affected by several types of atmospheric contaminants and by abnormal variations in weather conditions, thus facilitating the biotic homogenization and modification of ecosystem processes, such as nutrient cycling. Peri-urban forests and even natural forests that surround metropolitan areas are also subject to anthropogenic effects generated by cities, which may compromise the dynamics of these ecosystems. Hence, this study advances the hypothesis that the forests located at the margins of the Metropolitan Region of São Paulo (MRSP), Brazil, have high concentrations of atmospheric contaminants leading to adverse effects on litter fall stock. The production, stock and decomposition of litter fall in two forests were quantified. The first, known as Guarapiranga forest, lies closer to the urban area and is located within the MRSP, approximately 20km from the city center. The second, Curucutu forest, is located 70km from the urban center. This forest is situated exactly on the border of the largest continuum of vegetation of the Atlantic Forest. To verify the reach of atmospheric pollutants from the urban area, levels of heavy metals (Cd, Pb, Ni, Cu) adsorbed on the litter fall deposited on the soil surface of the forests were also quantified. The stock of litter fall and the levels of heavy metals were generally higher in the Guarapiranga forest in the samples collected during the lower rainfall season (dry season). Non-metric multidimensional scaling multivariate analysis showed a clear distinction of the sample units related to the concentrations of heavy metals in each forest. A subtle difference between the units related to the dry and rainy seasons in the Curucutu forest was also noted. Multivariate Analysis of Variance revealed that both site and season of the year (dry or rainy) were important to differentiate the quantity of heavy metals in litter fall stock, although the analysis did not show the interaction between these two

  8. Meteorite falls in Africa

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  10. Effects of hyporheic exchange flows on egg pocket water temperature in Snake River fall Chinook salmon spawning areas

    Energy Technology Data Exchange (ETDEWEB)

    Hanrahan, T. P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Geist, D. R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Arntzen, E. V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Abernethy, C. S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2004-09-01

    The development of the Snake River hydroelectric system has affected fall Chinook salmon smolts by shifting their migration timing to a period (mid- to late-summer) when downstream reservoir conditions are unfavorable for survival. Subsequent to the Snake River Chinook salmon fall-run Evolutionary Significant Unit being listed as Threatened under the Endangered Species Act, recovery planning has included changes in hydrosystem operations (e.g., summer flow augmentation) to improve water temperature and flow conditions during the juvenile Chinook salmon summer migration period. In light of the limited water supplies from the Dworshak reservoir for summer flow augmentation, and the associated uncertainties regarding benefits to migrating fall Chinook salmon smolts, additional approaches for improved smolt survival need to be evaluated. This report describes research conducted by the Pacific Northwest National Laboratory (PNNL) that evaluated relationships among river discharge, hyporheic zone characteristics, and egg pocket water temperature in Snake River fall Chinook salmon spawning areas. This was a pilot-scale study to evaluate these relationships under existing operations of Hells Canyon Dam (i.e., without any prescribed manipulations of river discharge) during the 2002–2003 water year.

  11. Emprego da poda verde para a obtenção de duas safras por ciclo vegetativo em 'Niagara Branca' Green pruning to obtain two harvests by vegetative cicle on Niagara grapevine

    Directory of Open Access Journals (Sweden)

    Paulo Vitor Dutra de Souza

    2007-01-01

    Full Text Available Avaliou-se o efeito de épocas de poda verde em dois anos consecutivos visando obter a segunda safra de uva em um mesmo ciclo vegetativo na cv. Niágara Branca (Vitis labrusca L., cultivada no sistema em espaldeira. O experimento foi realizado na Estação Experimental Agronômica da UFRGS, em Eldorado do Sul (RS, nas safras de 2003/2004 e 2004/2005. Os tratamentos constaram de três épocas de poda verde, realizadas imediatamente após a quarta folha acima do último cacho, e dois anos consecutivos de avaliação. Todas as plantas foram submetidas à superação de dormência mediante aplicação de cianamida hidrogenada a 2%. Analisou-se a duração dos estádios fenológicos, o período de maturação, a produção por planta, a massa fresca do cacho, o teor de sólidos solúveis totais e a acidez total titulável. Observou-se que a época de realização da poda verde não afetou a quantidade, nem a qualidade da uva produzida na primeira colheita, apenas atrasando-a em uma semana. A poda verde realizada no início de novembro possibilitou a segunda colheita de uva, realizada entre março e abril, sendo uma alternativa de ampliação do período de oferta do produto no mercado.The aim of this study was to evaluate the effects of green prunings on two consecutive years to obtain a second harvest of 'Niagara Branca' (Vitis labrusca grapevine in the same season. The experiment was carried out at Estação Experimental Agronômica of Universidade Federal do Rio Grande do Sul, located at Eldorado do Sul, State of Rio Grande do Sul, Brazil in 2003/2004 and 2004/2005 growth seasons. The grapevines were conducted by cordon training. The treatments involved three dates of green pruning, performed at fourth leaf situated above the last grape, and two seasons. All the plants were sprayed with hidrogenate cianamide (2% to overcome dormency. Fenology, plant production, weight of grapes, °Brix and titratable acid were evaluated. The green pruning time

  12. Putting on the green

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Michelle H. Cameron

    2013-01-01

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

  14. Characterization of children hospitalized with traumatic brain injuries after building falls.

    Science.gov (United States)

    Loftus, Kirsten V; Rhine, Tara; Wade, Shari L; Pomerantz, Wendy J

    2018-04-10

    Unintentional falls cause a substantial proportion of pediatric traumatic brain injury (TBI), with building falls carrying particularly high risk for morbidity and mortality. The cohort of children sustaining building fall-related TBI has not been well-examined. We sought to characterize children hospitalized with building fall-related TBIs and evaluate if specific factors distinguished these children from children hospitalized with TBI due to other fall mechanisms. We secondarily assessed if TBI severity among children injured due to a building fall varied between children from urban versus non-urban areas. This was a secondary analysis of the Pediatric Health Information System (PHIS), an administrative database from pediatric hospitals. We identified children codes. Urban versus non-urban status was determined using PHIS-assigned Rural-Urban Commuting Area codes. Injury severity (i.e. Injury Severity Score (ISS) and head Abbreviated Injury Scale (AIS) score) were calculated. Head AIS scores were dichotomized into minor/moderate (1-2) and serious/severe (3-6) for analysis. Frequencies, descriptive statistics, Chi-square analysis, and Mann-Whitney U analysis characterized populations and determined group differences. The study cohort included 23,813 children, of whom 933 (3.9%) fell from buildings. Within the building fall cohort, 707 (75.8%) resided in urban areas, 619 (66.3%) were male, 513 (55.0%) were white, and 528 (56.6%) had government insurance; the mean age was 3.8 years (SD 2.9). There was a larger proportion of children with serious/severe TBI among those injured from building falls relative to other falls (63.4% vs 53.9%, p building falls, those from non-urban areas were more likely to sustain a serious/severe TBI relative to urban children (58.9% vs 53.6%, p buildings falls with TBI sustained more severe injuries relative to other fall types. Although a majority of children hospitalized with building fall related-TBIs were from urban areas, those

  15. FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

    OpenAIRE

    Michaela Dingová; Eva Králová

    2017-01-01

    Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged...

  16. A simple strategy for fall events detection

    KAUST Repository

    Harrou, Fouzi

    2017-01-20

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

  17. 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.

  18. Rock-fall potential in the Yosemite Valley, California

    Science.gov (United States)

    Wieczorek, G.F.; Morrissey, M.M.; Iovine, Giulio; Godt, Jonathan

    1999-01-01

    We used two methods of estimating rock-fall potential in the Yosemite Valley, California based on (1) physical evidence of previous rock-fall travel, in which the potential extends to the base of the talus, and (2) theoretical potential energy considerations, in which the potential can extend beyond the base of the talus, herein referred to as the rock-fall shadow. Rock falls in the valley commonly range in size from individual boulders of less than 1 m3 to moderate-sized falls with volumes of about 100,000 m3. Larger rock falls exceeding 100,000 m3, referred to as rock avalanches, are considered to be much less likely to occur based on the relatively few prehistoric rock-fall avalanche deposits in the Yosemite Valley. Because the valley has steep walls and is relatively narrow, there are no areas that are absolutely safe from large rock avalanches. The map shows areas of rock-fall potential, but does not predict when or how frequently a rock fall will occur. Consequently, neither the hazard in terms of probability of a rock fall at any specific location, nor the risk to people or facilities to such events can be assessed from this map.

  19. 76 FR 59737 - In the Matter of Certain Digital Photo Frames and Image Display Devices and Components Thereof...

    Science.gov (United States)

    2011-09-27

    ..., Somerset, NJ 08875. Sony Corporation, 1-7-1 Konan, Minato-ku, Tokyo 108-0075, Japan. Sony Corporation of.... Aluratek, Inc., 14831 Myford Road, Tustin, CA 92780. Audiovox Corporation, 180 Marcus Boulevard, Happauge...., 4080 Montrose Road, Niagara Falls, L2H 1J9, Canada. Coby Electronics Corporation, 1991 Marcus Avenue...

  20. Landslides and rock fall processes in the proglacial area of the Gepatsch glacier, Tyrol, Austria - Quantitative assessment of controlling factors and process rates

    Science.gov (United States)

    Vehling, Lucas; Rohn, Joachim; Moser, Michael

    2013-04-01

    Due to the rapid deglaciation since 1850, lithological structures and topoclimatic factors, mass movements like rock fall, landslides and complex processes are important contributing factors to sediment transport and modification of the earth's surface in the steep, high mountain catchment of the Gepatsch reservoir. Contemporary geotechnical processes, mass movement deposits, their source areas, and controlling factors like material properties and relief parameters are mapped in the field, on Orthofotos and on digital elevation models. The results are presented in an Arc-Gis based geotechnical map. All mapped mass movements are stored in an Arc-Gis geodatabase and can be queried regarding properties, volume and controlling factors, so that statistical analyses can be conducted. The assessment of rock wall retreat rates is carried out by three different methods in multiple locations, which differ in altitude, exposition, lithology and deglaciation time: Firstly, rock fall processes and rates are investigated in detail on five rock fall collector nets with an overall size of 750 m2. Rock fall particles are gathered, weighed and grain size distribution is detected by sieving and measuring the diameter of the particles to distinct between rock fall processes and magnitudes. Rock wall erosion processes like joint formation and expansions are measured with high temporal resolution by electrical crack meters, together with rock- and air temperature. Secondly, in cooperation with the other working groups in the PROSA project, rock fall volumes are determined with multitemporal terrestrial laserscanning from several locations. Lately, already triggered rock falls are accounted by mapping the volume of the deposit and calculating of the bedrock source area. The deposition time span is fixed by consideration of the late Holocene lateral moraines and analysing historical aerial photographs, so that longer term rock wall retreat rates can be calculated. In order to limit

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Precisely locating the Klamath Falls, Oregon, earthquakes

    Science.gov (United States)

    Qamar, A.; Meagher, K.L.

    1993-01-01

    The Klamath Falls earthquakes on September 20, 1993, were the largest earthquakes centered in Oregon in more than 50 yrs. Only the magnitude 5.75 Milton-Freewater earthquake in 1936, which was centered near the Oregon-Washington border and felt in an area of about 190,000 sq km, compares in size with the recent Klamath Falls earthquakes. Although the 1993 earthquakes surprised many local residents, geologists have long recognized that strong earthquakes may occur along potentially active faults that pass through the Klamath Falls area. These faults are geologically related to similar faults in Oregon, Idaho, and Nevada that occasionally spawn strong earthquakes. 

  3. Efeito do porta-enxerto e da época de poda na duração das fases fenológicas e no acúmulo de graus-dia pela videira 'Niagara Rosada'

    Directory of Open Access Journals (Sweden)

    Marco Antonio Tecchio

    2013-12-01

    Full Text Available Avaliaram-se a influência dos porta-enxertos 'IAC 766', 'IAC 572', 'IAC 313', 'IAC 571-6' e 'Ripária do Traviú' e da época de poda na duração dos estádios fenológicos e no acúmulo de graus-dia pela videira 'Niagara Rosada'. O experimento foi realizado em Louveira-SP. Os tratamentos consistiram na combinação de cinco porta-enxertos e três épocas de poda, sendo utilizado o delineamento experimental em blocos inteiramente casualizados, com parcelas subdivididas e cinco repetições, sendo as parcelas representadas pelos porta-enxertos,e as subparcelas, pelas épocas de poda. Após a poda da videira, foram realizadas avaliações dos estádios fenológicos, utilizando-se do critério de Eichhon e Lorenz (1984. Nas três épocas de poda, baseado nos estádios fenológicos, calculou-se a duração dos períodos: poda ao início da brotação; poda ao pleno florescimento; poda ao início da frutificação; poda ao início da maturação dos cachos, e poda à colheita. Tomando-se por base a duração do ciclo da videira e as temperaturas médias diárias, calculou-se o acúmulo de graus-dia. Os dados foram submetidos à análise de variância e teste Tukey, a 5% de significância. Obteve-se, na poda de verão, redução na duração dos estádios fenológicos da videira 'Niagara Rosada' enxertada sobre o porta-enxerto 'Ripária do Traviú. A maior duração do ciclo e do acúmulo de graus-dia da cultivar Niagara Rosada foi obtida com os porta-enxertos 'IAC 572' e 'IAC 313' nas podas de inverno.

  4. A Wavelet-Based Approach to Fall Detection

    Directory of Open Access Journals (Sweden)

    Luca Palmerini

    2015-05-01

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

  5. Dust Full Study In The Surrounding Area Of A Cement Factory And Determination Of The Major Elements Of The Dust Fall Using Neutron Activation Analysis (NAA)

    International Nuclear Information System (INIS)

    Meslmani, Y.; Al-Oudat, M.

    2004-01-01

    Dust fall of the Tartous cement factory and the surrounding area at the Syrian coast were measured. The results show that the dust fall concentrations were higher than the World Health Organization (WHO) Standard in the factory site as well as in the surrounding area within 5 to 6 km in the diameter. The value of the dust fall at the Reference sites was abut 4.5 t/km 2 /month and in the surrounding area of the factory values reached between 18 and 120 t/km 2 /month. This means the values exceed the standard around 3 and 13 times. The Neutron Activation Analysis (NAA) of cement dust showed a percentage of 27.5% ± 1.6 of calcium. By the presence of humidity calcium silicate occurs, which immediately dries and becomes a hard salt crust. Therefore in the regions near by the factory cement dust formed this kind of salt coat on the surface of the leaves. (Authors)

  6. Climate change, energy and sustainability: lessons from the Toronto-Niagara region

    International Nuclear Information System (INIS)

    Chiotti, Q.

    2001-01-01

    (electricity and natural gas), and the demand for energy. Climate factors considered include changes in the mean, but more importantly variability in temperatures and changes in extreme weather events. This part of the discussion draws upon extensive research in the Toronto-Niagara Region, which has been supported through the Federal Interdepartmental Panel on Energy Research and Development (PERD). Emphasis is placed on identifying what aspects of current climate have had the greatest impact on the energy sector, and the adaptation options that will be necessary to reduce future vulnerability in face of inevitable climate variability and change. In section three, the emphasis shifts towards actions to reduce GHG plus related emissions, within the context of environmental and health benefits. The co-benefits of reducing GHG plus related emissions includes the implications for ecosystems and biodiversity, environmental health (managed (forestry) and unmanaged (agriculture) systems), social welfare and human health. This discussion is based on research conducted on co-benefits as part of the multi-stakeholder process to develop a national strategy on climate change. The paper concludes by providing a preliminary assessment of the various mitigation options currently being proposed to help reach emission targets set out in the Kyoto Protocol, as they apply to the Toronto-Niagara Region. The assessment, which will be undertaken in greater depth as part of Phases III through V of the PERD supported project, considers the vulnerability of an altered energy system to climate change impacts, and the potential co-benefits for environment and health This includes changes brought about by fossil fuel switching, the inter-provincial transmission of electricity, alternative technologies, and energy efficiency, amongst other mitigation actions. (author)

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

    Science.gov (United States)

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

    2013-06-01

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

  8. Fall Bottom Trawl Survey

    Data.gov (United States)

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

  9. [REAL AND UNREAL BACKLASHES OF AEROSPACE ACTIVITY FOR THE HEALTH OF POPULATION RESIDING NEAR AREAS OF FALL OF BEING SEPARATED PARTS OF CARRIER ROCKETS].

    Science.gov (United States)

    Meshkov, N A; Valtseva, E A; Kharlamova, E N; Kulikova, A Z

    2015-01-01

    Since the late 1990s, the ongoing debate about the consequences of the rocket-space activities for the health of people residing near areas offall ofseparatingfrom parts of rockets. Some scientists (Kolyado IB et al., 2001, 2013; Shoikhet YN et al., 2005, 2008; Skrebtsova NV 2005, 2006, Sidorov PI et al., 2007) argue that the main cause of morbidity is the effect of unsymmetrical dimethyl hydrazine (UDMH). However, environmentalists find it only in areas offalling fragments of separated parts of carrier rockets. Presented in the article data were obtained as a result of perennial epidemiological and hygienic research. There was performed a hygienic assessment of the content of chemical substances in water soil andfood, nutritional status and health risk near areas of the district of falling 310 and 326. There were studied conditions of work and the health of military personnel at the sites of storage of propellant components. The relationship between revealed diseases and UDMH was not established, but there was their causality due to the influence of environmental factors characteristic of territories and living conditions. In the settlements near the area of falling district 310 the share of extremely anxious persons was shown to be 1.8 times higher than in controls, which is caused by cases of falling fragments stages of carrier rockets in the territory of settlements.

  10. Scholarship in Teaching and Learning: An Interview with John Mitterer

    Science.gov (United States)

    Daniel, David B.

    2009-01-01

    John Mitterer earned his PhD in cognitive psychology from McMaster University. Like many teaching professors, his career took an unexpected turn early on when he was hired to teach introductory psychology at Brock University, near Niagara Falls, in Ontario, Canada. It was love at first lecture. He never left the course and now, as a full professor…

  11. Disease state fingerprint for fall risk assessment.

    Science.gov (United States)

    Similä, Heidi; Immonen, Milla

    2014-01-01

    Fall prevention is an important and complex multifactorial challenge, since one third of people over 65 years old fall at least once every year. A novel application of Disease State Fingerprint (DSF) algorithm is presented for holistic visualization of fall risk factors and identifying persons with falls history or decreased level of physical functioning based on fall risk assessment data. The algorithm is tested with data from 42 older adults, that went through a comprehensive fall risk assessment. Within the study population the Activities-specific Balance Confidence (ABC) scale score, Berg Balance Scale (BBS) score and the number of drugs in use were the three most relevant variables, that differed between the fallers and non-fallers. This study showed that the DSF visualization is beneficial in inspection of an individual's significant fall risk factors, since people have problems in different areas and one single assessment scale is not enough to expose all the people at risk.

  12. The nurse as bricoleur in falls prevention: learning from a case study of the implementation of fall prevention best practices.

    Science.gov (United States)

    Kirkpatrick, Helen; Boblin, Sheryl; Ireland, Sandra; Robertson, Kim

    2014-04-01

    Falls prevention in "real-life" clinical practice is a complex undertaking. Nurses play an active and essential role in falls prevention. This discussion paper presents a picture of the nurse as a bricoleur in falls prevention, requiring knowledge in many areas and the ability to perform multiple diverse tasks. Building on a qualitative case study with nurses at various levels in three acute care facilities, this paper posits that the concept of nurse as bricoleur has the potential to broaden our understanding of the complexity of falls prevention. The nurse as bricoleur within the Promoting Action Research in Health Services framework as the provider of person- or patient-centered evidence-based care is conceptualized. Within this framework, the nurse uses his or her professional knowledge or clinical experience while considering research, local data, and information, and the patient's experience and preferences to provide this care, the bricolage. Each of these areas is discussed as well as the impact on the nurse when a fall does occur. Recognizing this complexity of the nurses' world has important implications for both service delivery and education, including preparation of students, and the implementation of new organizational initiatives and supports for nurses when falls do occur despite the best efforts of all involved. © 2014 Sigma Theta Tau International.

  13. FEAR OF FALLING AMONG COMMUNITY DWELLING OLDER ADULTS

    Directory of Open Access Journals (Sweden)

    Michaela Dingová

    2017-03-01

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

  14. Reguladores vegetais influenciando número e tamanho de células das bagas da uva 'Niagara Rosada' Plant regulators influencing number and size of berry cells of 'Niagara Rosada' grapes

    Directory of Open Access Journals (Sweden)

    Cássia Regina Yuriko Ide Vieira

    2008-03-01

    Full Text Available O objetivo do trabalho foi avaliar o efeito do ácido giberélico, thidiazuron e quinmerac na anatomia das bagas de uvas cultivar 'Niagara Rosada', provenientes de vinhedo localizado em Dourados - MS. Realizaram-se três experimentos. No primeiro ensaio, utilizaram-se soluções aquosas de ácido giberélico (AG3 0; 15; 30; 45; 60; 75 e 90 mg.l-1, aplicadas no florescimento e repetidas aos 14 dias após (E1E2 e, no outro tratamento, o mesmo composto e doses aplicados uma única vez aos 14 dias após o florescimento (E2; no segundo experimento, thidiazuron (TDZ 0; 5; 10; 15; 20; 25 e 30 mg.l-1, aplicados quatro dias antes da antese e repetidos aos seis dias após o florescimento (E1E2; e no outro tratamento, o mesmo composto e doses aplicados uma única vez aos seis dias após o florescimento (E2; e, no terceiro, quinmerac 0; 10; 20; 30; 40; 50 e 60 mg.l-1, aplicados no florescimento e repetidos aos 14 dias após (E1E2, e, no outro tratamento, o mesmo composto e doses aplicados uma única vez, 14 dias após o florescimento (E2. As variáveis avaliadas foram: número e dimensões das células das bagas. Pelos resultados obtidos, verificou-se que duas aplicações de ácido giberélico, thidiazuron e quinmerac promoveram a divisão celular, enquanto a expansão celular foi observada com uma única aplicação de thidiazuron e quinmerac.The objective of this investigation was to evaluate the effect of the gibberellic acid, thidiazuron and quinmerac on grape berries anatomy of grapevine 'Niagara Rosada', in a vineyard located in Dourados - MS. Three trials were carried out. In the first trial, it was used gibberellic acid (AG3 0, 15, 30, 45, 60, 75 and 90 mg.l-1, applied in the bloom and repeated 14 days later (E1E2 and in the other treatment, the same compound and doses applied only once, 14 days after the bloom (E2; in the second experiment, thidiazuron (TDZ 0, 5, 10, 15, 20, 25 and 30 mg.l-1, applied four days before antesis and repeated six days

  15. Viabilidade econômica do cultivo de videira Niágara Rosada = Economic feasibility of grapevine Niagara Rosada production

    Directory of Open Access Journals (Sweden)

    Meyriele Pires de Camargo

    2017-04-01

    Full Text Available O estado de São Paulo é o terceiro maior produtor de uvas do Brasil e o maior produtor nacional de uvas de mesa, sendo a variedade Niágara Rosada (Vitis labrusca a mais plantada no estado. O objetivo do trabalho foi verificar a viabilidade econômica do cultivo de Niágara Rosada. O projeto foi dimensionado para uma área de três hectares implantada no município de Piracicaba, SP. As plantas foram conduzidas no sistema em espaldeira em uma densidade de 5000 plantas ha-1. O fluxo de caixa foi dimensionado para um período de 13 anos. Estimaram-se os custos para implantação e manutenção do vinhedo, financiamento bancário, pagamento do Fundo de Apoio ao Trabalhador Rural [Funrural] e o custo de oportunidade da terra. A taxa mínima de atratividade [TMA] foi fixada em 11,45% e os indicadores econômicos calculados foram Valor Presente Líquido [VPL], Taxa Interna de Retorno [TIR], payback simples, payback descontado e relação benefício-custo. Obtiveram-se valores positivos de VPL (R$ 398.951,36 e relação custo-benefício (1,81. A TIR foi estimada em 27,34%, superior à TMA. Os valores de payback simples e descontado foram de cinco anos e de seis anos, respectivamente, indicando que o tempo de retorno do capital inicial investido foi inferior ao período do projeto. Os indicadores econômicos estimados constataram a viabilidade financeira do empreendimento em análise. = São Paulo State is the third largest grapevine producer in Brazil and the largest national producer of table grapes. Niagara Rosada (Vitis labrusca is the most planted cultivar in the State. This study aimed to verify the economic feasibility of Niagara Rosada production. The project was designed for an area of tree hectares to be implemented in Piracicaba, SP. Plants were conducted in vertical trellis system with 5000 plants ha-1. The cash flow was dimensioned for a period of 13 years. Costs with implantation and maintenance of the vineyard, bank financing, payment

  16. Falls following discharge after an in-hospital fall

    Directory of Open Access Journals (Sweden)

    Kessler Lori A

    2009-12-01

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

  17. 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.

  18. 78 FR 70895 - Proposed Establishment and Modification of Area Navigation (RNAV) Routes; Atlanta, GA

    Science.gov (United States)

    2013-11-27

    ... Management Facility (see ADDRESSES section for address and phone number). You may also submit comments...), Buffalo Niagara International (BUF) and Toronto Pearson International (TOR) airports. Additionally, Q-69...

  19. 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.

  20. Optimising a fall out dust monitoring sampling programme at a ...

    African Journals Online (AJOL)

    GREG

    Key words: Fall out dust monitoring, cement plant, optimising, air pollution sampling, fall out dust sampler locations. .... applied for those areas where controls are in place. Sampling ..... mass balance in the total cement manufacturing process.

  1. 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.

  2. Klamath falls 10 x 20 NTMS area: Oregon. Data report

    International Nuclear Information System (INIS)

    Koller, G.R.

    1980-08-01

    Surface sediment samples were collected at 1413 sites, at a target sampling density of one site per 13 square kilometers. Ground water samples were collected at 150 sites. Neutron activation analysis results are given for uranium and 16 other elements in sediments, and for uranium and 9 other elements in ground water. Mass spectrometry results are given for helium in ground water. Field measurements and observations are reported for each site. Analytical data and field measurements are presented in tables and maps. Data from ground water sites include (1) water chemistry measurements (pH, conductivity, and alkalinity, (2) physical measurements where applicable (water temperature, well description, and scintillometer reading), and (3) elemental analyses (U, Al, Br, Cl, Dy, F, He, Mg, Mn, Na, and V). Data from sediment sites include (1) stream water chemistry measurements from sites where water was available (pH, conductivity, and alkalinity), and (2) elemental analyses for sediment samples (U, Th, Hf, Al, Ce, Dy, Eu, Fe, La, Lu, Mn, Sc, Sm, Na, Ti, V, and Yb). Areal distribution maps, histograms, and cumulative frequency plots for most elements; U/Th and U/Hf ratios; and scintillometer readings at sediment sample sites are included. Uranium concentrations in sediments of the Klamath Falls quadrangle are relatively low, with a maximum value of 17 ppM. Highest values occur in tertiary volcanic rocks in the uranium-producing area near the town of Lakeview and in Quaternary volcanics in the north-central part of the quadrangle

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

    Science.gov (United States)

    Verghese, Joe

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-06-02

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

  5. Mitigating fall risk: A community fall reduction program.

    Science.gov (United States)

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

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

  6. 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.

  7. Social and psychologic factors related to falls among the elderly.

    Science.gov (United States)

    Mossey, J M

    1985-08-01

    Studies on falls are reviewed. Little information exists on which social or psychologic factors predispose an older person to fall or to sustain a fall-related injury. Risk of falling appears to be greater among females, the cognitively impaired, and those who use hypnotics, tranquilizers, and diuretics. The potential significance of depression and senile dementia of the Alzheimer's type on the risk of falling is explored. It is suggested that because of the associated impaired judgment, distraction, and psychomotor retardation, the presence of either clinical condition may increase an individual's risk of falling. In the final section of the article, directions for future research are discussed. Development of a systematic research program is suggested including epidemiologic studies of all falls and of medically treated falls. Such studies should be multidisciplinary and include assessment of social and psychologic factors as well as physical and functional health status, ambulatory function, perceptual acuity, and the circumstances surrounding the fall. The psychologic consequences of falling, particularly in the absence of a serious fall-related injury, is identified as an important research area.

  8. 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

  9. 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.

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

    Science.gov (United States)

    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.

  11. Falling and fall risk in adult patients with severe haemophilia.

    Science.gov (United States)

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

    2017-05-10

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

  12. Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

    Science.gov (United States)

    Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

    2017-03-01

    To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely

  13. The falls and the fear of falling among elderly institutionalized

    Directory of Open Access Journals (Sweden)

    Patrícia Almeida

    2013-06-01

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

  14. Chocolate das bagas e clorose foliar: anomalia da videira causada por deficiência de boro Internal browning ("chocolate" and leaf chlorosis of the 'pink Niagara' grafe, a boron deficiency anomaly

    Directory of Open Access Journals (Sweden)

    Hugo Kuniyuki

    1985-01-01

    Full Text Available A anomalia do cultivar de videira Niagara Rosada, caracterizada por sintomas de clorose nas folhas, chocolate das bagas e cachos malformados, não é de natureza virótica, de acordo com resultados de testes de transmissão e de perpetuação. Essa anomalia, presente em áreas definidas de alguns vinhedos de Indaiatuba e Jundiaí (SP, está associada à deficiência nutricional de boro. O teor médio de boro em amostras de plantas afetadas de 'Niagara Rosada' (18 ppm no limbo e 7 ppm nos frutos foi menor do que nas de plantas normais (24 ppm no limbo e 10 ppm nos frutos das mesmas plantaçoes; um material coletado de um vinhedo bastante afetado mostrou 13 e 1 ppm respectivamente no limbo e nos frutos de plantas deficientes contra 20 e 6 ppm nos de plantas sem sintomas. Amostras de três vinhedos vizinhos sem essa anomalia apresentaram um teor médio de 35 ppm no limbo. As do porta-enxerto 'Traviú' com clorose e sem clorose mostraram 16 ppm e 43 ppm de boro respectivamente. A aplicação de bórax, nas doses de 5, 10 e 20g por planta, 1ogo após a poda de inverno, ou pulverização de ácido bórico nas concentraçoes de 0,3% e 0,6% sobre a folhagem, durante o início do florescimento e durante a fase de uva chumbinho, permitiram controlar a anomalia nas condições de campo. Foi notada resposta favorável por um ciclo vegetativo, pelo menos, indicando controle por efeito residual de uma aplicação.The 'pink Niagara' grape (V. labrusca L. x V. vinifera L. anomaly characterized by leaf chlorosis and "chocolate" (internal browning of the young fruit, at first thought to be a virus disease, has been found to be a result of boron deficiency. The anomaly was first recorded in 1974. It occurs in patches in vineyards of Indaiatuba and Jundiaí, two grape-growing counties of the State of São Paulo, Brazil. Affected plants show yellowing between the primary and secondary veins of the upper leaves and malformed clusters, with normal-sized berries and

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

    Science.gov (United States)

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

    2017-12-21

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

  16. Lidar-Based Rock-Fall Hazard Characterization of Cliffs

    Science.gov (United States)

    Collins, Brian D.; Greg M.Stock,

    2017-01-01

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

  17. Modeling seasonal migration of fall armyworm moths

    Science.gov (United States)

    Westbrook, J. K.; Nagoshi, R. N.; Meagher, R. L.; Fleischer, S. J.; Jairam, S.

    2016-02-01

    Fall armyworm, Spodoptera frugiperda (J.E. Smith), is a highly mobile insect pest of a wide range of host crops. However, this pest of tropical origin cannot survive extended periods of freezing temperature but must migrate northward each spring if it is to re-infest cropping areas in temperate regions. The northward limit of the winter-breeding region for North America extends to southern regions of Texas and Florida, but infestations are regularly reported as far north as Québec and Ontario provinces in Canada by the end of summer. Recent genetic analyses have characterized migratory pathways from these winter-breeding regions, but knowledge is lacking on the atmosphere's role in influencing the timing, distance, and direction of migratory flights. The Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model was used to simulate migratory flight of fall armyworm moths from distinct winter-breeding source areas. Model simulations identified regions of dominant immigration from the Florida and Texas source areas and overlapping immigrant populations in the Alabama-Georgia and Pennsylvania-Mid-Atlantic regions. This simulated migratory pattern corroborates a previous migratory map based on the distribution of fall armyworm haplotype profiles. We found a significant regression between the simulated first week of moth immigration and first week of moth capture (for locations which captured ≥10 moths), which on average indicated that the model simulated first immigration 2 weeks before first captures in pheromone traps. The results contribute to knowledge of fall armyworm population ecology on a continental scale and will aid in the prediction and interpretation of inter-annual variability of insect migration patterns including those in response to climatic change and adoption rates of transgenic cultivars.

  18. 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.

  19. 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.

  20. Comportamento produtivo da videira 'Niagara Rosada' em diferentes sistemas de condução, com e sem cobertura plástica, durante as safras de inverno e de verão

    Directory of Open Access Journals (Sweden)

    José Luiz Hernandes

    2013-03-01

    Full Text Available Na região de Jundiaí (SP, os produtores de uva de mesa utilizam principalmente a cultivar Niagara Rosada. Atualmente, para aumentar a renda, o viticultor usa algumas alternativas tecnológicas que têm sido preconizadas, como o cultivo em manjedoura na forma de Y, em substituição ao sistema de condução em espaldeira; a poda extemporânea que permite duas safras por ano (de verão e de inverno e o uso de cobertura plástica para a proteção dos cachos contra intempéries e doenças. Portanto, foi desenvolvido um experimento visando a caracterizar a influência do sistema de condução, do uso de cobertura plástica e da poda extemporânea na produção e no tamanho dos cachos de 'Niagara Rosada'. Os resultados obtidos durante as safras de verão (2008 e 2009 e de inverno (2009 e 2010 permitiram verificar que, no sistema de condução em Y, foram obtidas maiores produções e tamanho de cacho em relação ao espaldeira. O uso de cobertura plástica no sistema em Y propiciou aumento de produção devido ao incremento em número e massa dos cachos. Também foi verificado que tanto a produção quanto a massa do cacho foram superiores na safra de verão em comparação à de inverno.

  1. Rock-fall Hazard In The Yosemite Valley, California

    Science.gov (United States)

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

    Rock slides and rock falls are the most frequent slope movements in Yosemite Na- tional Park, California. In historical time (1851-2001), more than 400 rock falls and rock slides have been documented in the valley, and some of them have been mapped in detail. We present the preliminary results of an attempt to assess rockfall hazard in the Yosemite Valley using STONE, a 3-dimensional rock-fall simulation computer program. The software computes 3-dimensional rock-fall trajectories starting from a digital terrain model (DTM), the location of rock-fall release points (source areas), and maps of the dynamic rolling coefficient and of the coefficients of normal and tan- gential energy restitution. For each DTM cell the software also calculates the number of rock falls passing through the cell, the maximum rock-fall velocity and the maxi- mum flying height. For the Yosemite Valley, a DTM with a ground resolution of 10 x 10 m was prepared using topographic contour lines from USGS 1:24,000-scale maps. Rock-fall release points were identified as DTM cells having a slope steeper than 60 degrees, an assumption based on the location of historical rock falls. Maps of the nor- mal and tangential energy restitution coefficients and of the rolling friction coefficient were produced from a surficial geologic map. The availability of historical rock falls mapped in detail allowed us to check the computer program performance and to cali- brate the model parameters. Visual and statistical comparison of the model results with the mapped rock falls confirmed the accuracy of the model. The model results are also compared with a geomorphic assessment of rock-fall hazard based on potential energy referred to as a "shadow angle" approach, recently completed for the Yosemite Valley.

  2. Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis.

    Science.gov (United States)

    2008-01-01

    In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To identify interventions that may be effective in reducing the probability of an elderly person's falling and/or sustaining a fall-related injury. Although estimates of fall rates vary widely based on the location, age, and living arrangements of the elderly population, it is estimated that each year approximately 30% of community-dwelling individuals aged 65 and older, and 50% of those aged 85

  3. Maple sugaring with vacuum pumping during the fall season

    Science.gov (United States)

    H. Clay Smith; Alan G., Jr. Snow

    1971-01-01

    Vacuum pumping of sugar maple trees during the late fall and early winter months is not advisable in northern Vermont. However, fall pumping may be profitable in other areas of the sugar maple range. It is recommended that the weather pattern in a given locale be observed; and if conditions are favorable, vacuum pumping should be tried on a small scale before...

  4. 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.

  5. 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...

  6. Atmosfera modificada e refrigeração para conservação pós-colheita de uva 'Niagara Rosada' Modified atmosphere and cold storage for postharvest conservation of 'Niagara Rosada' table grape

    Directory of Open Access Journals (Sweden)

    Patrícia Cia

    2010-10-01

    Full Text Available O objetivo deste trabalho foi avaliar os efeitos da atmosfera modificada na conservação pós-colheita da uva 'Niagara Rosada' armazenada sob refrigeração, em dois experimentos. No primeiro experimento avaliou-se o acondicionamento de cachos nas seguintes embalagens: papelão ondulado (testemunha; tereftalato de polietileno (PET; cloreto de polivinila (PVC 17 μm; polietileno linear de baixa densidade (PELBD 25 μm; e PELBD 50 μm. Em outro experimento, avaliaram-se os sistemas de acondicionamento: sacolas de plástico abertas (testemunha; polietileno de baixa densidade (PEBD 25 μm; PEBD 25 μm, com injeção de mistura gasosa (21% O2/5% CO2; PEBD 25 μm (21% O2/10% CO2; PEBD 25 μm (21% O2/20% CO2. Os cachos foram armazenados a 1±1°C e 90±5% de umidade relativa (UR por 28 dias, seguido de armazenamento em condições do ambiente (25±2°C e 80±5% UR. Os cachos foram avaliados quanto à perda de massa de matéria fresca, firmeza, cor das bagas, esbagoamento, sólidos solúveis totais (SST, acidez titulável (AT, relação SST/AT e incidência de podridões. O filme PELBD 50 μm, a partir do 14º dia a 1°C, seguido por mais três dias a 25°C, causou a fermentação dos cachos. As embalagens PELBD 25 μm, com ou sem injeção de mistura gasosa, e PVC 17 μm reduzem a perda de massa de matéria fresca dos cachos, mas não reduzem o esbagoamento e a incidência de podridões.The objective of this work was to evaluate the effect of the modified atmosphere, on the storage life of 'Niagara Rosada' Table grape kept under refrigeration in two experiments. In the first one, grape clusters stored in different package materials were evaluated: corrugated cardboard boxes, polyethylene tereftalate (PET; 17-μm polyvinyl chloride (PVC; 25-μm low density linear polyethylene film (PELDB; and 50-μm PELDB. On a second assay, different packaging systems were evaluated: opened plastic bags; 25-μm low density polyethylene film (PEBD; 25-μm PEBD, with

  7. 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.

  8. 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...

  9. 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.

  10. 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...

  11. Human-Structure Dynamic Interaction during Short-Distance Free Falls

    Directory of Open Access Journals (Sweden)

    E. Shahabpoor

    2016-01-01

    Full Text Available The dynamic interactions of falling human bodies with civil structures, regardless of their potentially critical effects, have sparsely been researched in contact biomechanics. The physical contact models suggested in the existing literature, particularly for short-distant falls in home settings, assume the human body falls on a “rigid” (not vibrating ground. A similar assumption is usually made during laboratory-based fall tests, including force platforms. Based on observations from a set of pediatric head-first free fall tests, the present paper shows that the dynamics of the grounded force plate are not always negligible when doing fall test in a laboratory setting. By using a similar analogy for lightweight floor structures, it is shown that ignoring the dynamics of floors in the contact model can result in an up to 35% overestimation of the peak force experienced by a falling human. A nonlinear contact model is suggested, featuring an agent-based modelling approach, where the dynamics of the falling human and the impact object (force plate or a floor structure here are each modelled using a single-degree-of-freedom model to simulate their dynamic interactions. The findings of this research can have wide applications in areas such as impact biomechanics and sports science.

  12. Alternative Treatment Technologies for Low-Cost Industrial and Municipal Wastewater Management

    OpenAIRE

    Hodges, Alan J.

    2017-01-01

    Roughly the same volume of water that rushes over the Niagara Falls is produced as wastewater in North America. This wastewater is treated through a variety of means to ensure that it can be safely returned to the natural ecosystem. This thesis examines two novel means for this treatment, one biological and one physical-chemical in nature, namely, Rotating Algae Biofilm Reactor treatment and expanded shale augmented coagulation-flocculation. Rotating algae biofilm reactors (RABRs) support ...

  13. The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation.

    Science.gov (United States)

    Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

    2014-12-01

    To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Not applicable. Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales' classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p Fall Harm Risk Screen, area under the curve was 0.56, positive predictive value was 0.19, and negative predictive value was 0.86. Sensitivity and specificity of the SAFR (0.78 and 0.63, respectively) was higher than the Fall Harm Risk Screen (0.57 and 0.48, respectively). An evidence-derived, population-specific fall risk assessment may more accurately predict fallers than a general fall risk screen for stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. © The Author(s) 2014.

  14. 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.

  15. 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.

  16. 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.

  17. Evaluate the Restoration Potential of Snake River Fall Chinook Salmon Spawning Habitat, Status Report 2006.

    Energy Technology Data Exchange (ETDEWEB)

    Hanrahan, T.P. [Pacific Northwest National Laboratory

    2009-01-08

    The Bonneville Power Administration (BPA) Project 2003-038-00, Evaluate the restoration potential of Snake River fall Chinook salmon spawning habitat, began in FY04 (15 December 2003) and continues into FY06. This status report is intended to summarize accomplishments during FY04 and FY05. Accomplishments are summarized by Work Elements, as detailed in the Statement of Work (see BPA's project management database PISCES). This project evaluates the restoration potential of mainstem habitats for fall Chinook salmon. The studies address two research questions: 'Are there sections not currently used by spawning fall Chinook salmon within the impounded lower Snake River that possess the physical characteristics for potentially suitable fall Chinook spawning habitat?' and 'Can hydrosystem operations affecting these sections be adjusted such that the sections closely resemble the physical characteristics of current fall Chinook salmon spawning areas in similar physical settings?' Efforts are focused at two study sites: (1) the Ice Harbor Dam tailrace downstream to the Columbia River confluence, and (2) the Lower Granite Dam tailrace. Our previous studies indicated that these two areas have the highest potential for restoring Snake River fall Chinook salmon spawning habitat. The study sites will be evaluated under existing structural configurations at the dams (i.e., without partial removal of a dam structure), and alternative operational scenarios (e.g., varying forebay/tailwater elevations). The areas studied represent tailwater habitat (i.e., riverine segments extending from a dam downstream to the backwater influence from the next dam downstream). We are using a reference site, indicative of current fall Chinook salmon spawning areas in tailwater habitat, against which to compare the physical characteristics of each study site. The reference site for tailwater habitats is the section extending downstream from the Wanapum Dam tailrace on the

  18. 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.

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

    Science.gov (United States)

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

    2013-11-18

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

  20. 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.

  1. Beyond the Brink: Indigenous Women’s Agency and the Colonisation of Knowledge in the Maid of the Mist Myth

    Directory of Open Access Journals (Sweden)

    Robinder Kaur Sehdev

    2012-11-01

    Full Text Available The myth of the Maid of the Mist of Niagara Falls is a settler story of an Indigenous woman who kills herself by piloting her canoe over the cataract. This is presented not as a tragedy, but as a cultural necessity. So compelling was this settler myth that until recently it was the focus of settler cultural production at Niagara. I argue that the creation and subsequent fixation upon the myth attempted to displace Indigenous stories, and the centrality of Indigenous women to Indigenous epistemologies and in decolonial action. The recent move to banish the myth from tourist audiences does further violence by moving colonial cultural production to the fringes of visibility and away from critical interrogation. The myth and the ways it is called upon and subsequently banished indicates the normalizing practices of settler colonialism and must be pulled from the brink of unnameability and unknowability into critical discourse.

  2. 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

  3. 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.

  4. Comparison of Simple Versus Performance-Based Fall Prediction Models

    Directory of Open Access Journals (Sweden)

    Shekhar K. Gadkaree BS

    2015-05-01

    Full Text Available Objective: To compare the predictive ability of standard falls prediction models based on physical performance assessments with more parsimonious prediction models based on self-reported data. Design: We developed a series of fall prediction models progressing in complexity and compared area under the receiver operating characteristic curve (AUC across models. Setting: National Health and Aging Trends Study (NHATS, which surveyed a nationally representative sample of Medicare enrollees (age ≥65 at baseline (Round 1: 2011-2012 and 1-year follow-up (Round 2: 2012-2013. Participants: In all, 6,056 community-dwelling individuals participated in Rounds 1 and 2 of NHATS. Measurements: Primary outcomes were 1-year incidence of “ any fall ” and “ recurrent falls .” Prediction models were compared and validated in development and validation sets, respectively. Results: A prediction model that included demographic information, self-reported problems with balance and coordination, and previous fall history was the most parsimonious model that optimized AUC for both any fall (AUC = 0.69, 95% confidence interval [CI] = [0.67, 0.71] and recurrent falls (AUC = 0.77, 95% CI = [0.74, 0.79] in the development set. Physical performance testing provided a marginal additional predictive value. Conclusion: A simple clinical prediction model that does not include physical performance testing could facilitate routine, widespread falls risk screening in the ambulatory care setting.

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

    Science.gov (United States)

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

    2011-01-01

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

  6. 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

  7. Blood Falls: A novel management approach for a subglacial feature of outstanding scientific importance

    Science.gov (United States)

    Carr, J. R.; Penhale, P. A.; Dahood, A.; Biletnikoff, N.; Harris, C. M.

    2012-04-01

    Blood Falls is a subglacial feature located in the ablation zone of the Taylor Glacier, Taylor Valley, McMurdo Dry Valleys, Antarctica. Blood Falls has a unique physical configuration, microbial ecology and geochemistry and consists of a subglacial brine reservoir and an iron-rich, saline surface discharge at the Taylor Glacier terminus. The feature provides a rare opportunity to sample properties of a subglacial reservoir and its ecosystem without the need for direct contact and is a key site for exobiological studies. The Blood Falls subglacial feature is globally unique and of outstanding scientific importance. As such, it warrants special protection from potential damage by drilling and/or surface activities. Moreover, currently subglacial environments are not represented in the Antarctic protected area network. To address these points, the United States National Science Foundation is working with the scientific community to develop at Blood Falls the first subglacial protected area in Antarctica. The protected area aims to maintain the integrity of the Blood Falls system, whilst allowing continued access for scientific and management purposes. Novel management approaches are being designed to protect the values of the site in three dimensions. Specific guidelines on activities conducted within the area, most notably drilling and coring, are being defined in a management plan. This new approach incorporates uncertainties in the location of the Blood Falls brine reservoir and the connectivity of the subglacial hydrological system of the Taylor Glacier. The management approaches employed at Blood Falls draw on the experience of the subglacial research community and potentially offer an effective framework for the protection of other subglacial environments.

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

    Science.gov (United States)

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

    2012-07-01

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

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

    Science.gov (United States)

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

    2017-09-04

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

  10. Falls in institutionalized older adults: risks, consequences and antecedents

    Directory of Open Access Journals (Sweden)

    Antonio Herculano de Araújo Neto

    Full Text Available ABSTRACT Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey, Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0. Results: A total of 66.7% (30 falls occurred, 20% (9 of them in the external area, with 66.7% (30 of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5. The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05. Conclusion: It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls.

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

    Directory of Open Access Journals (Sweden)

    Santosh K Verma

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

  12. A simple strategy for fall events detection

    KAUST Repository

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

    2017-01-01

    the multivariate exponentially weighted moving average (MEWMA) control chart to detect fall events. Towards this end, a set of ratios for five partial occupancy areas of the human body for each frame are collected and used as the input data to MEWMA chart

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

    Science.gov (United States)

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

    2018-05-09

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

  14. Annual International DIC Society Conference and SEM Fall Conference

    CERN Document Server

    Reu, Phillip

    2017-01-01

    This collection represents a single volume of technical papers presented at the Annual International DIC Society Conference and SEM Fall Conference organized by the Society for Experimental Mechanics and Sandia National Laboratories and held in Philadelphia, PA, November 7-10, 2016. The volume presents early findings from experimental, standards development and various other investigations concerning digital image correlation - an important area within Experimental Mechanics. The area of Digital Image Correlation has been an integral track within the SEM Annual Conference spearheaded by Professor Michael Sutton from the University of South Carolina. In 2016, the SEM and Sandia joined their collaborative strengths to launch a standing fall meeting focusing specifically on developments in the area of Digital Image Correlation. The contributed papers within this volume span numerous technical aspects of DIC including standards development for the industry. .

  15. Falls in multiple sclerosis.

    Science.gov (United States)

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

    2011-07-01

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

  16. Prevention of Falls Network Europe: a thematic network aimed at introducing good practice in effective falls prevention across Europe.

    Science.gov (United States)

    Skelton, D A; Becker, C; Lamb, S E; Close, J C T; Zijlstra, W; Yardley, L; Todd, C J

    2004-12-01

    The Prevention of Falls Network Europe (ProFaNE) aims to improve quality of life of the ageing population by focussing on a major cause of disability and distress: falls. The thematic network is funded by the European Commission and brings together scientists, clinicians and other health professionals from around Europe to focus on four main themes: taxonomy and coordination of trials, clinical assessment and management of falls, assessment of balance function, and psychological aspects of falling. There are 24 members across Europe as well as network associates who contribute expertise at workshops and meetings. ProFaNE, a 4-year project which started in January 2003, aims to improve and standardise health care processes, introducing and promoting good practice widely across Europe. ProFaNE undertakes workshops that bring together experts and observers around specific topics to exchange knowledge, expertise and resources on interventions that reduce falls. A key document for policy makers around Europe, written by ProFaNE members, was published by the World Health Organisation in March 2004. ProFaNE's website has both public and private areas with resources (web links to falls prevention, useful documents for policy makers, researchers and practitioners) and a discussion board to encourage informal networking between members and the public. The ultimate aim of ProFaNE is to submit a collaborative bid to undertake a multi-centre, randomised controlled trial of a multi-factorial fall prevention intervention with peripheral fracture as the primary outcome. The success of the networking and relationship building in the first year and a half of ProFaNE's work makes this an achievable goal.

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2015-07-01

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

  19. 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.

  20. Occurrence of anthropogenic organic compounds and nutrients in source and finished water in the Sioux Falls area, South Dakota, 2009-10

    Science.gov (United States)

    Hoogestraat, Galen K.

    2012-01-01

    Anthropogenic organic compounds (AOCs) in drinking-water sources commonly are derived from municipal, agricultural, and industrial wastewater sources, and are a concern for water-supply managers. A cooperative study between the city of Sioux Falls, S. Dak., and the U.S. Geological Survey was initiated in 2009 to (1) characterize the occurrence of anthropogenic organic compounds in the source waters (groundwater and surface water) to water supplies in the Sioux Falls area, (2) determine if the compounds detected in the source waters also are present in the finished water, and (3) identify probable sources of nitrate in the Big Sioux River Basin and determine if sources change seasonally or under different hydrologic conditions. This report presents analytical results of water-quality samples collected from source waters and finished waters in the Sioux Falls area. The study approach included the collection of water samples from source and finished waters in the Sioux Falls area for the analyses of AOCs, nutrients, and nitrogen and oxygen isotopes in nitrate. Water-quality constituents monitored in this study were chosen to represent a variety of the contaminants known or suspected to occur within the Big Sioux River Basin, including pesticides, pharmaceuticals, sterols, household and industrial products, polycyclic aromatic hydrocarbons, antibiotics, and hormones. A total of 184 AOCs were monitored, of which 40 AOCs had relevant human-health benchmarks. During 11 sampling visits, 45 AOCs (24 percent) were detected in at least one sample of source or finished water, and 13 AOCs were detected in at least 20 percent of all samples. Concentrations of detected AOCs were all less than 1 microgram per liter, except for two AOCs in multiple samples from the Big Sioux River, and one AOC in finished-water samples. Concentrations of AOCs were less than 0.1 microgram per liter in more than 75 percent of the detections. Nutrient concentrations varied seasonally in source

  1. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  3. High-resolution three-dimensional imaging and analysis of rock falls in Yosemite valley, California

    Science.gov (United States)

    Stock, Gregory M.; Bawden, G.W.; Green, J.K.; Hanson, E.; Downing, G.; Collins, B.D.; Bond, S.; Leslar, M.

    2011-01-01

    We present quantitative analyses of recent large rock falls in Yosemite Valley, California, using integrated high-resolution imaging techniques. Rock falls commonly occur from the glacially sculpted granitic walls of Yosemite Valley, modifying this iconic landscape but also posing signifi cant potential hazards and risks. Two large rock falls occurred from the cliff beneath Glacier Point in eastern Yosemite Valley on 7 and 8 October 2008, causing minor injuries and damaging structures in a developed area. We used a combination of gigapixel photography, airborne laser scanning (ALS) data, and ground-based terrestrial laser scanning (TLS) data to characterize the rock-fall detachment surface and adjacent cliff area, quantify the rock-fall volume, evaluate the geologic structure that contributed to failure, and assess the likely failure mode. We merged the ALS and TLS data to resolve the complex, vertical to overhanging topography of the Glacier Point area in three dimensions, and integrated these data with gigapixel photographs to fully image the cliff face in high resolution. Three-dimensional analysis of repeat TLS data reveals that the cumulative failure consisted of a near-planar rock slab with a maximum length of 69.0 m, a mean thickness of 2.1 m, a detachment surface area of 2750 m2, and a volume of 5663 ?? 36 m3. Failure occurred along a surfaceparallel, vertically oriented sheeting joint in a clear example of granitic exfoliation. Stress concentration at crack tips likely propagated fractures through the partially attached slab, leading to failure. Our results demonstrate the utility of high-resolution imaging techniques for quantifying far-range (>1 km) rock falls occurring from the largely inaccessible, vertical rock faces of Yosemite Valley, and for providing highly accurate and precise data needed for rock-fall hazard assessment. ?? 2011 Geological Society of America.

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

    Science.gov (United States)

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

    2017-10-01

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

  5. From Fall to Spring, or Spring to Fall? Seasonal Cholera Transmission Cycles and Implications for Climate Change

    Science.gov (United States)

    Akanda, A. S.; Jutla, A. S.; Huq, A.; Colwell, R.; Islam, S.; WE Reason

    2010-12-01

    Cholera remains a major public health threat in many developing countries around the world. The striking seasonality and the annual recurrence of this infectious disease in endemic areas continues to be of considerable interest to scientists and public health workers. Despite major advances in the ecological, and microbiological understanding of Vibrio cholerae, the causative agent, the role of underlying macro-scale hydroclimatic processes in propagating the disease in different seasons and years is not well understood. The incidence of cholera in the Bengal Delta region, the ‘native homeland’ of cholera, shows distinct biannual peaks in the southern floodplains, as opposed to single annual peaks in coastal areas and the northern parts of Bangladesh, as well as other cholera-endemic regions in the world. A coupled analysis of the regional hydroclimate and cholera incidence reveals a strong association of the spatio-temporal variability of incidence peaks with seasonal processes and extreme events. At a seasonal scale, the cycles indicate a spring-fall transmission pattern, contrary to the prevalent notion of a fall-spring transmission cycle. We show that the asymmetric seasonal hydroclimatology affects regional cholera dynamics by providing a coastal growth environment for bacteria in spring, while propagating transmission to fall by flooding. This seasonal interpretation of the progression of cholera has important implications, for formulating effective cholera intervention and mitigation efforts through improved water management and understanding the impacts of changing climate patterns on seasonal cholera transmission. (Water Environental Research Education Actionable Solutions Network)

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    M. Mikoš

    2005-01-01

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

  8. Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study.

    Science.gov (United States)

    Bayen, Eleonore; Jacquemot, Julien; Netscher, George; Agrawal, Pulkit; Tabb Noyce, Lynn; Bayen, Alexandre

    2017-10-17

    Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool. The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care. A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents' falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice. Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents. Video monitoring offers high potential to support conventional care in memory care facilities. ©Eleonore Bayen, Julien Jacquemot, George Netscher, Pulkit Agrawal, Lynn Tabb Noyce, Alexandre Bayen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.10.2017.

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

    Directory of Open Access Journals (Sweden)

    Fields J

    2015-06-01

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

  10. Evaluation of Fall Chinook and Chum Salmon Spawning below Bonneville Dam; 2003-2004 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    van der Naald, Wayne; Duff, Cameron; Brooks, Robert (Oregon Department of Fish and Wildlife, Columbia River Section, John Day, OR)

    2005-01-01

    In 2003 a total of 253 adult fall chinook and 113 chum were sampled for biological data in the Ives and Pierce islands area below Bonneville Dam. Vital statistics were developed from 221 fall chinook and 109 chum samples. The peak redd count for fall chinook was 190. The peak redd count for chum was 262. Peak spawning time for fall chinook was set at approximately 24 November. Peak spawning time for chum occurred approximately 24 November. There were estimated to be a total of 1,533 fall chinook spawning below Bonneville Dam in 2003. The study area's 2003 chum population was estimated to be 688 spawning fish. Temperature unit data suggests that below Bonneville Dam 2003 brood bright stock, fall chinook emergence began on January 6, 2004 and ended 28 April 2004, with peak emergence occurring 13 April. 2003 brood juvenile chum emergence below Bonneville Dam began 22 February and continued through 15 April 2004. Peak chum emergence took place 25 March. A total of 25,433 juvenile chinook and 4,864 juvenile chum were sampled between the dates of 20 January and 28 June 2004 below Bonneville Dam. Juvenile chum migrated from the study area in the 40-55 mm fork length range. Migration of chum occurred during the months of March, April and May. Sampling results suggest fall chinook migration from rearing areas took place during the month of June 2004 when juvenile fall chinook were in the 65 to 80 mm fork length size range. Adult and juvenile sampling below Bonneville Dam provided information to assist in determining the stock of fall chinook and chum spawning and rearing below Bonneville Dam. Based on observed spawning times, adult age and sex composition, juvenile emergence timing, juvenile migration timing and juvenile size at the time of migration, it appears that in 2003 all of the fall chinook using the area below Bonneville Dam were of a late-spawning, bright stock. Observed spawning times, adult age and sex composition, GSI and DNA analysis, juvenile emergence

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Abdallah, C.

    2010-10-01

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

  13. Local fall-out and the animal food chain

    International Nuclear Information System (INIS)

    Prat, G.; Mercier, F.J.

    1967-01-01

    The local consequences of fresh fall-out, especially in the case of atmospheric nuclear explosions, are reviewed from the point of view of the internal contamination of the consumer of foodstuffs of animal origin. The edibility of foodstuffs derived from animals having grazed in the presence of fall-out is evaluated both from the wholesome and radio-toxicological points of view. The contamination level of these foodstuffs is calculated as a function of the ground fall-out, and of agronomical and ecological parameters for each radio-nuclide of the animal food chain. The internal exposure of the human consumer is calculated from this level as a function of the diet and of various parameters especially temporal. The equivalent dose to each critical organ, including the digestive tract is deduced from the burdens of each organ. From this a nutritional hygiene in the areas affected by fall-out is obtained, in relationship to the action levels fixed by the responsible authorities in exceptional circumstances. Criteria for these action levels are given as function of the food rations. (authors) [fr

  14. Analysis of Android Device-Based Solutions for Fall Detection

    Directory of Open Access Journals (Sweden)

    Eduardo Casilari

    2015-07-01

    Full Text Available Falls are a major cause of health and psychological problems as well as hospitalization costs among older adults. Thus, the investigation on automatic Fall Detection Systems (FDSs has received special attention from the research community during the last decade. In this area, the widespread popularity, decreasing price, computing capabilities, built-in sensors and multiplicity of wireless interfaces of Android-based devices (especially smartphones have fostered the adoption of this technology to deploy wearable and inexpensive architectures for fall detection. This paper presents a critical and thorough analysis of those existing fall detection systems that are based on Android devices. The review systematically classifies and compares the proposals of the literature taking into account different criteria such as the system architecture, the employed sensors, the detection algorithm or the response in case of a fall alarms. The study emphasizes the analysis of the evaluation methods that are employed to assess the effectiveness of the detection process. The review reveals the complete lack of a reference framework to validate and compare the proposals. In addition, the study also shows that most research works do not evaluate the actual applicability of the Android devices (with limited battery and computing resources to fall detection solutions.

  15. Analysis of Android Device-Based Solutions for Fall Detection.

    Science.gov (United States)

    Casilari, Eduardo; Luque, Rafael; Morón, María-José

    2015-07-23

    Falls are a major cause of health and psychological problems as well as hospitalization costs among older adults. Thus, the investigation on automatic Fall Detection Systems (FDSs) has received special attention from the research community during the last decade. In this area, the widespread popularity, decreasing price, computing capabilities, built-in sensors and multiplicity of wireless interfaces of Android-based devices (especially smartphones) have fostered the adoption of this technology to deploy wearable and inexpensive architectures for fall detection. This paper presents a critical and thorough analysis of those existing fall detection systems that are based on Android devices. The review systematically classifies and compares the proposals of the literature taking into account different criteria such as the system architecture, the employed sensors, the detection algorithm or the response in case of a fall alarms. The study emphasizes the analysis of the evaluation methods that are employed to assess the effectiveness of the detection process. The review reveals the complete lack of a reference framework to validate and compare the proposals. In addition, the study also shows that most research works do not evaluate the actual applicability of the Android devices (with limited battery and computing resources) to fall detection solutions.

  16. Analysis of Android Device-Based Solutions for Fall Detection

    Science.gov (United States)

    Casilari, Eduardo; Luque, Rafael; Morón, María-José

    2015-01-01

    Falls are a major cause of health and psychological problems as well as hospitalization costs among older adults. Thus, the investigation on automatic Fall Detection Systems (FDSs) has received special attention from the research community during the last decade. In this area, the widespread popularity, decreasing price, computing capabilities, built-in sensors and multiplicity of wireless interfaces of Android-based devices (especially smartphones) have fostered the adoption of this technology to deploy wearable and inexpensive architectures for fall detection. This paper presents a critical and thorough analysis of those existing fall detection systems that are based on Android devices. The review systematically classifies and compares the proposals of the literature taking into account different criteria such as the system architecture, the employed sensors, the detection algorithm or the response in case of a fall alarms. The study emphasizes the analysis of the evaluation methods that are employed to assess the effectiveness of the detection process. The review reveals the complete lack of a reference framework to validate and compare the proposals. In addition, the study also shows that most research works do not evaluate the actual applicability of the Android devices (with limited battery and computing resources) to fall detection solutions. PMID:26213928

  17. Effects of Hyporheic Exchange Flows on Egg Pocket Water Temperature in Snake River Fall Chinook Salmon Spawning Areas, 2002-2003 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Hanrahan, T.; Geist, D.; Arntzen, C. (Pacific Northwest National Laboratory)

    2004-09-01

    The development of the Snake River hydroelectric system has affected fall Chinook salmon smolts by shifting their migration timing to a period (mid- to late-summer) when downstream reservoir conditions are unfavorable for survival. Subsequent to the Snake River Chinook salmon fall-run Evolutionary Significant Unit being listed as Threatened under the Endangered Species Act, recovery planning has included changes in hydrosystem operations (e.g., summer flow augmentation) to improve water temperature and flow conditions during the juvenile Chinook salmon summer migration period. In light of the limited water supplies from the Dworshak reservoir for summer flow augmentation, and the associated uncertainties regarding benefits to migrating fall Chinook salmon smolts, additional approaches for improved smolt survival need to be evaluated. This report describes research conducted by the Pacific Northwest National Laboratory (PNNL) that evaluated relationships among river discharge, hyporheic zone characteristics, and egg pocket water temperature in Snake River fall Chinook salmon spawning areas. This was a pilot-scale study to evaluate these relationships under existing operations of Hells Canyon Dam (i.e., without any prescribed manipulations of river discharge) during the 2002-2003 water year. The project was initiated in the context of examining the potential for improving juvenile Snake River fall Chinook salmon survival by modifying the discharge operations of Hells Canyon Dam. The potential for improved survival would be gained by increasing the rate at which early life history events proceed (i.e., incubation and emergence), thereby allowing smolts to migrate through downstream reservoirs during early- to mid-summer when river conditions are more favorable for survival. PNNL implemented this research project at index sites throughout 160 km of the Hells Canyon Reach (HCR) of the Snake River. The HCR extends from Hells Canyon Dam (river kilometer [rkm] 399

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

    Science.gov (United States)

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

    2016-08-01

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

  19. Environmental health: an analysis of available and proposed remedies for victims of toxic waste contamination

    International Nuclear Information System (INIS)

    Hurwitz, W.J.

    1981-01-01

    Past and present residents of the Love Canal area near Niagara Falls, New York, fear that they and their homes have been contaminated by toxic wastes seeping out from nearby chemical disposal sites. Hundreds of landfills nationwide are as potentially dangerous as Love Canal. In the absence of a statutory remedy, victims of contamination must rely upon common law theories of lability in order to recover damages for injuries suffered as a result of toxic waste contamination. This Note examines the merits and deficiencies of four common law theories: negligence, strict liability, nuisance and trespass. The Note concludes that none of these remedies is adequate to assure recovery to a person injured by toxic waste disposal, and recommends that legislation be adopted to ensure that victims of toxic waste contamination can be compensated for their injuries

  20. Effects of Hyporheic Exchange Flows on Egg Pocket Water Temperature in Snake River Fall Chinook Salmon Spawning Areas

    Energy Technology Data Exchange (ETDEWEB)

    Hanrahan, Timothy P.; Geist, David R.; Arntzen, Evan V.; Abernethy, Cary S.

    2004-09-24

    The development of the Snake River hydroelectric system has affected fall chinook salmon smolts by shifting their migration timing to a period when downstream reservoir conditions are unfavorable for survival. Subsequent to the Snake River chinook salmon fall-run Evolutionary Significant Unit being listed as Threatened under the Endangered Species Act, recovery planning has included changes in hydrosystem operations to improve water temperature and flow conditions during the juvenile chinook salmon summer migration period. In light of the limited water supplies from the Dworshak reservoir for summer flow augmentation, and the associated uncertainties regarding benefits to migrating fall chinook salmon smolts, additional approaches for improved smolt survival need to be evaluated. This report describes research conducted by PNNL that evaluated relationships among river discharge, hyporheic zone characteristics, and egg pocket water temperature in Snake River fall chinook salmon spawning areas. The potential for improved survival would be gained by increasing the rate at which early life history events proceed (i.e., incubation and emergence), thereby allowing smolts to migrate through downstream reservoirs during early- to mid-summer when river conditions are more favorable for survival. PNNL implemented this research project throughout 160 km of the Hells Canyon Reach (HCR) of the Snake River. The hydrologic regime during the 2002?2003 sampling period exhibited one of the lowest, most stable daily discharge patterns of any of the previous 12 water years. The vertical hydraulic gradients (VHG) between the river and the riverbed suggested the potential for predominantly small magnitude vertical exchange. The VHG also showed little relationship to changes in river discharge at most sites. Despite the relatively small vertical hydraulic gradients at most sites, the results from the numerical modeling of riverbed pore water velocity and hyporheic zone temperatures

  1. Preventing falls and fractures.

    Science.gov (United States)

    Ulfarsson, J; Robinson, B E

    1994-11-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  3. Role of environmental hazards in fall of community dwelling elderly

    International Nuclear Information System (INIS)

    Shabbir, M.; Shah, S.I.H.

    2013-01-01

    Evidence linking home hazards to falls has not been well established. Falls and fall injury are a major public health concern for the elderly. Fall of elderly is very much affected by environmental hazards. Falls are a major cause of morbidity and mortality in persons older than 60. There is a greater-than-linear increase in the rate of falls with environmental hazards. This cross section survey will not only lay the foundation for further study on this topic but also provide the basis for the development of preventive program of falls for the elders of Pakistan. Objective: To explore the role of environmental hazards of fall in the community dwelling elders is the area which is lacking in research. Methods: This cross sectional study was conducted from October to December 2010 in Lahore and its peripheries and also the patients in hospital settings come after fractures or fall injuries. The total number of people included was 100. Community dwelling Elders above 60 years having recent history of at least one fall were included regardless of gender. The data were entered and analyzed using SPSS 11.5. Results: There were 71 people out of 100 who fell inside the home, 10 fell outside the home and 18 were not applicable to this question. There were 19% people, who fell repeatedly at one place, 31 people replied about hazard environment where fallen that contribute to fall. According to 24 people they had Safety checks of their home yard and/ or neighborhood which will assist to avoid future fall. Conclusion: Most elderly persons live in a risky home setting. It is vital that environmental hazard be recognized and removed for wellbeing of elderly. (author)

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

    Science.gov (United States)

    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.

  5. Frequency-volume Statistics of Rock Falls: Examples From France, Italy and California

    Science.gov (United States)

    Dussauge-Peisser, C.; Guzzetti, F.; Wieczorek, G. F.

    There is accumulating evidence that the distribution of rock-fall volume exhibits power law (fractal) statistics in different physiographic and geologic environments. We have studied the frequency-volume statistics of rock falls in three areas: Grenoble, France; Umbria, Italy; and Yosemite Valley, California, USA. We present a compari- son of the datasets currently available. For the Grenoble area a catalogue of rock falls between 1248 and 1995 occurred along a 120 km long limestone cliff. The dataset contains information on 105 rock-fall events ranging in size from 3xE-2 to 5xE8 m3. Only the time window 1935-1995 is considered in the study, involving 87 events from 1E-2 to 1E6 m3. The cumulative frequency-volume statistics follow a power-law (frac- tal) relationship with exponent b = -0.4 over the range 50 m3 Yosemite Valley the database contains information on historical (1851-2001) rock falls (122), rock slides (251) and prehistoric rock avalanches (5). For Yosemite, the non-cumulative frequency-volume statistics of rock falls and rock slides are very sim- ilar and correlate well with a power-law (fractal) relation with exponent beta = -1.4, over the range 30 m3 fall hazard assessment. We also discuss the variation of the b and beta exponents for natural events and earthquake triggered events.

  6. iFall: an Android application for fall monitoring and response.

    Science.gov (United States)

    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.

  7. Falling in the elderly: Do statistical models matter for performance criteria of fall prediction? Results from two large population-based studies.

    Science.gov (United States)

    Kabeshova, Anastasiia; Launay, Cyrille P; Gromov, Vasilii A; Fantino, Bruno; Levinoff, Elise J; Allali, Gilles; Beauchet, Olivier

    2016-01-01

    To compare performance criteria (i.e., sensitivity, specificity, positive predictive value, negative predictive value, area under receiver operating characteristic curve and accuracy) of linear and non-linear statistical models for fall risk in older community-dwellers. Participants were recruited in two large population-based studies, "Prévention des Chutes, Réseau 4" (PCR4, n=1760, cross-sectional design, retrospective collection of falls) and "Prévention des Chutes Personnes Agées" (PCPA, n=1765, cohort design, prospective collection of falls). Six linear statistical models (i.e., logistic regression, discriminant analysis, Bayes network algorithm, decision tree, random forest, boosted trees), three non-linear statistical models corresponding to artificial neural networks (multilayer perceptron, genetic algorithm and neuroevolution of augmenting topologies [NEAT]) and the adaptive neuro fuzzy interference system (ANFIS) were used. Falls ≥1 characterizing fallers and falls ≥2 characterizing recurrent fallers were used as outcomes. Data of studies were analyzed separately and together. NEAT and ANFIS had better performance criteria compared to other models. The highest performance criteria were reported with NEAT when using PCR4 database and falls ≥1, and with both NEAT and ANFIS when pooling data together and using falls ≥2. However, sensitivity and specificity were unbalanced. Sensitivity was higher than specificity when identifying fallers, whereas the converse was found when predicting recurrent fallers. Our results showed that NEAT and ANFIS were non-linear statistical models with the best performance criteria for the prediction of falls but their sensitivity and specificity were unbalanced, underscoring that models should be used respectively for the screening of fallers and the diagnosis of recurrent fallers. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Cristina Rosa Soares Lavareda Baixinho

    2015-12-01

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

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

    Science.gov (United States)

    Chippendale, Tracy; Boltz, Marie

    2015-08-01

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

  10. Assessment of the fish tumor beneficial use impairment in brown bullhead (Ameiurus nebulosus) at selected Great Lakes Areas of Concern

    Science.gov (United States)

    Blazer, Vicki; Mazik, Patricia M.; Iwanowicz, Luke R.; Braham, Ryan P.; Hahn, Cassidy M.; Walsh, Heather L.; Sperry, Adam J.

    2014-01-01

    A total of 878 adult Brown Bullhead were collected at 11 sites within the Lake Erie and Lake Ontario drainages from 2011 to 2013. The sites included seven Areas of Concern (AOC; 670 individuals), one delisted AOC (50 individuals) and three non-AOC sites (158 individuals) used as reference sites. These fish were used to assess the “fish tumor or other deformities” beneficial use impairment. Fish were anesthetized, weighed, measured and any external abnormalities documented and removed. Abnormal orocutaneous and barbel tissue, as well as five to eight pieces of liver, were preserved for histopathological analyses. Otoliths were removed and used for age analyses. Visible external abnormalities included reddened (raised or eroded), melanistic areas and raised growths on lips, body surface, fins and barbels. Microscopically, these raised growths included papilloma, squamous cell carcinoma, osteoma and osteosarcoma. Proliferative lesions of the liver included bile duct hyperplasia, foci of cellular alteration, bile duct (cholangioma, cholangiocarcinoma) and hepatocellular (adenoma, hepatic cell carcinoma) neoplasia. The two reference sites (Long Point Inner Bay, Conneaut Creek), at which 30 or more bullhead were collected had a skin tumor prevalence of 10% or less and liver tumor prevalence of 4% or less. Presque Isle Bay, recently delisted, had a similar liver tumor prevalence (4%) and slightly higher prevalence (12%) of skin tumors. The prevalence of skin neoplasms was 15% or less at sites in the Black River, Cuyahoga River and Maumee AOCs, while more than 20% of the bullheads from the Rochester Embayment, Niagara River, Detroit River and Ashtabula River AOCs had skin tumors. The prevalence of liver tumors was greater than 4% at all AOC sites except the Old Channel site at the Cuyahoga River AOC, Wolf Creek within the Maumee AOC and the upper and lower sites within the Niagara River AOC.

  11. 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.

  12. Study on Gas-liquid Falling Film Flow in Internal Heat Integrated Distillation Column

    Science.gov (United States)

    Liu, Chong

    2017-10-01

    Gas-liquid internally heat integrated distillation column falling film flow with nonlinear characteristics, study on gas liquid falling film flow regulation control law, can reduce emissions of the distillation column, and it can improve the quality of products. According to the distribution of gas-liquid mass balance internally heat integrated distillation column independent region, distribution model of heat transfer coefficient of building internal heat integrated distillation tower is obtained liquid distillation falling film flow in the saturated vapour pressure of liquid water balance, using heat transfer equation and energy equation to balance the relationship between the circulating iterative gas-liquid falling film flow area, flow parameter information, at a given temperature, pressure conditions, gas-liquid flow falling film theory makes the optimal parameters to achieve the best fitting value with the measured values. The results show that the geometric gas-liquid internally heat integrated distillation column falling film flow heat exchange area and import column thermostat, the average temperature has significant. The positive correlation between the heat exchanger tube entrance due to temperature difference between inside and outside, the heat flux is larger, with the increase of internal heat integrated distillation column temperature, the slope decreases its temperature rise, which accurately describes the internal gas-liquid heat integrated distillation tower falling film flow regularity, take appropriate measures to promote the enhancement of heat transfer. It can enhance the overall efficiency of the heat exchanger.

  13. Risco climático de ocorrência de doenças fúngicas na videira 'Niagara Rosada' na região do Polo Turístico do Circuito das Frutas do estado de São Paulo

    Directory of Open Access Journals (Sweden)

    Ludmila Bardin

    2010-12-01

    Full Text Available O Polo Turístico do Circuito das Frutas do Estado de São Paulo congrega municípios produtores de uva comum de mesa, principalmente a cultivar "Niagara Rosada"�. Observa-se que no processo produtivo ocorre severa influência de doenças fúngicas foliares e seu controle chega a 30% do custo de produção. Nesse contexto, o objetivo foi determinar o risco climático (RC de ocorrência das doenças fúngicas na 'Niagara Rosada' por meio da análise de séries históricas de dados pluviométricos diários para estimativa do número de pulverizações necessárias (NPchuva. O RC, assim como o NPchuva, foram calculados em cada época de poda, e para os diferentes municípios da região. A regionalização das áreas em função da necessidade de pulverização para controle de doenças fúngicas determinada pela ocorrência de chuvas, foi feita por meio de sistemas de informações geográficas (SIG utilizando os valores médios de RC estimados, por equações de regressão linear, obtidas em função da altitude. Nas podas efetuadas em setembro, o RC foi mais elevado que nas de julho, sendo os valores mais elevados superiores a 70% e os menores, inferiores a 20% respectivamente.

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

    Science.gov (United States)

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

    2013-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Niko M. Perttila

    2017-06-01

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

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

    Science.gov (United States)

    Nassar, Nada; Helou, Nancy; Madi, Chantal

    2014-06-01

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

  17. Fall Enrollment Report. 2014

    Science.gov (United States)

    Iowa Department of Education, 2014

    2014-01-01

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

  18. Worldwide Weather Radar Imagery May Allow Substantial Increase in Meteorite Fall Recovery

    Science.gov (United States)

    Fries, Marc; Matson, Robert; Schaefer, Jacob; Fries, Jeffery; Hankey, Mike; Anderson, Lindsay

    2014-01-01

    Weather radar imagery is a valuable new technique for the rapid recovery of meteorite falls, to include falls which would not otherwise be recovered (e.g. Battle Mountain). Weather radar imagery reveals about one new meteorite fall per year (18 falls since 1998), using weather radars in the United States alone. However, an additional 75 other nations operate weather radar networks according to the UN World Meteorological Organization (WMO). If the imagery of those radars were analyzed, the current rate of meteorite falls could be improved considerably, to as much as 3.6 times the current recovery rate based on comparison of total radar areal coverage. Recently, the addition of weather radar imagery, seismometry and internet-based aggregation of eyewitness reports has improved the speed and accuracy of fresh meteorite fall recovery [e.g. 1,2]. This was demonstrated recently with the radar-enabled recovery of the Sutter's Mill fall [3]. Arguably, the meteorites recovered via these methods are of special scientific value as they are relatively unweathered, fresh falls. To illustrate this, a recent SAO/NASA ADS search using the keyword "meteorite" shows that all 50 of the top search results included at least one named meteorite recovered from a meteorite fall. This is true even though only 1260 named meteorite falls are recorded among the >49,000 individual falls recorded in the Meteoritical Society online database. The US NEXRAD system used thus far to locate meteorite falls covers most of the United States' surface area. Using a WMO map of the world's weather radars, we estimate that the total coverage of the other 75 national weather radar networks equals about 3.6x NEXRAD's coverage area. There are two findings to draw from this calculation: 1) For the past 16 years during which 18 falls are seen in US radar data, there should be an additional 65 meteorite falls recorded in worldwide radar imagery. Also: 2) if all of the world's radar data could be analyzed, the

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

    Science.gov (United States)

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

    2012-09-01

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

  20. Students fall for Fall Meeting

    Science.gov (United States)

    Smedley, Kara

    2012-02-01

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

  1. Factors associated with occasional and recurrent falls in Mexican community-dwelling older people

    Science.gov (United States)

    Mino-León, Dolores; Cruz-Arenas, Esteban

    2018-01-01

    Falls are a frequent event among older adults that can cause wounds, disability, psychological disorders, and premature death. Although the large number of existing studies on the issue, few have been conducted in middle- and low-income countries. The objective of the present study is to identify the sociodemographic, medical, and functional performance factors associated with occasional and recurrent falls in Mexican older adults dwelling in community. Cross-sectional analysis of 9 598 adults ≥60 years old who participated in the fourth round (2015) of the Mexican Health and Aging Study. Bivariate tests were performed to evaluate the differences between covariates by distinct fall groups (no falls, occasional falls, and recurrent falls). Multiple logistic regressions with unadjusted and adjusted models were estimated. Approximately 46% of older adults had had at least one fall during the previous two years (one fall 16% and recurrent falls 30%). Occasional falls were only associated with being a woman; in addition to the sex, recurrent falls were strongly associated with advanced age, rural residence, bad and very bad self-perception of health status, activity-limiting pain, urinary incontinence, depression, arthritis, limitations in basic activities of daily living, and limitations in advanced activities of daily living. Falls, primarily recurrent falls, deserve to be addressed through multifactorial strategies that include different areas of intervention. PMID:29462159

  2. Factors associated with occasional and recurrent falls in Mexican community-dwelling older people.

    Directory of Open Access Journals (Sweden)

    Marcela Agudelo-Botero

    Full Text Available Falls are a frequent event among older adults that can cause wounds, disability, psychological disorders, and premature death. Although the large number of existing studies on the issue, few have been conducted in middle- and low-income countries. The objective of the present study is to identify the sociodemographic, medical, and functional performance factors associated with occasional and recurrent falls in Mexican older adults dwelling in community. Cross-sectional analysis of 9 598 adults ≥60 years old who participated in the fourth round (2015 of the Mexican Health and Aging Study. Bivariate tests were performed to evaluate the differences between covariates by distinct fall groups (no falls, occasional falls, and recurrent falls. Multiple logistic regressions with unadjusted and adjusted models were estimated. Approximately 46% of older adults had had at least one fall during the previous two years (one fall 16% and recurrent falls 30%. Occasional falls were only associated with being a woman; in addition to the sex, recurrent falls were strongly associated with advanced age, rural residence, bad and very bad self-perception of health status, activity-limiting pain, urinary incontinence, depression, arthritis, limitations in basic activities of daily living, and limitations in advanced activities of daily living. Falls, primarily recurrent falls, deserve to be addressed through multifactorial strategies that include different areas of intervention.

  3. 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

  4. 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

  5. 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

  6. 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

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

    Science.gov (United States)

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

    2017-12-01

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

  8. 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.

  9. New horizons in fall prevention.

    Science.gov (United States)

    Lord, Stephen R; Close, Jacqueline C T

    2018-04-25

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

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

    Science.gov (United States)

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

    2018-01-11

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

  11. Predictive validity of the Hendrich fall risk model II in an acute geriatric unit.

    Science.gov (United States)

    Ivziku, Dhurata; Matarese, Maria; Pedone, Claudio

    2011-04-01

    Falls are the most common adverse events reported in acute care hospitals, and older patients are the most likely to fall. The risk of falling cannot be completely eliminated, but it can be reduced through the implementation of a fall prevention program. A major evidence-based intervention to prevent falls has been the use of fall-risk assessment tools. Many tools have been increasingly developed in recent years, but most instruments have not been investigated regarding reliability, validity and clinical usefulness. This study intends to evaluate the predictive validity and inter-rater reliability of Hendrich fall risk model II (HFRM II) in order to identify older patients at risk of falling in geriatric units and recommend its use in clinical practice. A prospective descriptive design was used. The study was carried out in a geriatric acute care unit of an Italian University hospital. All over 65 years old patients consecutively admitted to a geriatric acute care unit of an Italian University hospital over 8-month period were enrolled. The patients enrolled were screened for the falls risk by nurses with the HFRM II within 24h of admission. The falls occurring during the patient's hospital stay were registered. Inter-rater reliability, area under the ROC curve, sensitivity, specificity, positive and negative predictive values and time for the administration were evaluated. 179 elderly patients were included. The inter-rater reliability was 0.87 (95% CI 0.71-1.00). The administration time was about 1min. The most frequently reported risk factors were depression, incontinence, vertigo. Sensitivity and specificity were respectively 86% and 43%. The optimal cut-off score for screening at risk patients was 5 with an area under the ROC curve of 0.72. The risk factors more strongly associated with falls were confusion and depression. As falls of older patients are a common problem in acute care settings it is necessary that the nurses use specific validate and reliable

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

    Directory of Open Access Journals (Sweden)

    Faulkner Robert A

    2007-07-01

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

  13. Diagnosis and Tests: Evaluating a Fall or Risk of Falling

    Science.gov (United States)

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

  14. SoNeUCON_{ABC}Pro: an access control model for social networks with translucent user provenance

    OpenAIRE

    González Manzano, Lorena; Slaymaker, Mark; Fuentes García Romero de Tejada, José María de; Vayenas, Dimitris

    2018-01-01

    Proceedings of: SecureComm 2017 International Workshops, ATCS and SePrIoT, Niagara Falls, ON, Canada, October 22–25, 2017 Web-Based Social Networks (WBSNs) are used by millions of people worldwide. While WBSNs provide many benefits, privacy preservation is a concern. The management of access control can help to assure data is accessed by authorized users. However, it is critical to provide sufficient flexibility so that a rich set of conditions may be imposed by users. In this paper we coi...

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  17. Fall detection using supervised machine learning algorithms: A comparative study

    KAUST Repository

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

    2017-01-01

    Fall incidents are considered as the leading cause of disability and even mortality among older adults. To address this problem, fall detection and prevention fields receive a lot of intention over the past years and attracted many researcher efforts. We present in the current study an overall performance comparison between fall detection systems using the most popular machine learning approaches which are: Naïve Bayes, K nearest neighbor, neural network, and support vector machine. The analysis of the classification power associated to these most widely utilized algorithms is conducted on two fall detection databases namely FDD and URFD. Since the performance of the classification algorithm is inherently dependent on the features, we extracted and used the same features for all classifiers. The classification evaluation is conducted using different state of the art statistical measures such as the overall accuracy, the F-measure coefficient, and the area under ROC curve (AUC) value.

  18. Fall detection using supervised machine learning algorithms: A comparative study

    KAUST Repository

    Zerrouki, Nabil

    2017-01-05

    Fall incidents are considered as the leading cause of disability and even mortality among older adults. To address this problem, fall detection and prevention fields receive a lot of intention over the past years and attracted many researcher efforts. We present in the current study an overall performance comparison between fall detection systems using the most popular machine learning approaches which are: Naïve Bayes, K nearest neighbor, neural network, and support vector machine. The analysis of the classification power associated to these most widely utilized algorithms is conducted on two fall detection databases namely FDD and URFD. Since the performance of the classification algorithm is inherently dependent on the features, we extracted and used the same features for all classifiers. The classification evaluation is conducted using different state of the art statistical measures such as the overall accuracy, the F-measure coefficient, and the area under ROC curve (AUC) value.

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

    Science.gov (United States)

    Zhou, Sicheng; Kang, Hong; Gong, Yang

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  1. Falls in Parkinson's disease.

    NARCIS (Netherlands)

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

    2004-01-01

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

  2. Snake River Fall Chinook Salmon Life History Investigations, Annual Report 2008.

    Energy Technology Data Exchange (ETDEWEB)

    Tiffan, Kenneth F. [U.S. Geological Survey; Connor, William P. [U.S. Fish and Wildlife Service; Bellgraph, Brian J. [Pacific Northwest National Laboratory

    2009-09-15

    This study was initiated to provide empirical data and analyses on the dam passage timing, travel rate, survival, and life history variation of fall Chinook salmon that are produced in the Clearwater River. The area of interest for this study focuses on the lower four miles of the Clearwater River and its confluence with the Snake River because this is an area where many fish delay their seaward migration. The goal of the project is to increase our understanding of the environmental and biological factors that affect juvenile life history of fall Chinook salmon in the Clearwater River. The following summaries are provided for each of the individual chapters in this report.

  3. 1998-1999 evaluation of fall chinook and chum salmon spawning below Bonneville, The Dalles, John Day and McNary dams

    International Nuclear Information System (INIS)

    Naald, W.D. van der

    2001-01-01

    This report describes work conducted by the Oregon Department of Fish and Wildlife (ODFW) and the Washington Department of Fish and Wildlife (WDFW) from 1 October 1998 to 30 September 1999. The work is part of studies to evaluate spawning of fall chinook salmon (Oncorhynchus tshawytscha) and chum salmon (O. keta) below the four lowermost Columbia River dams under the Bonneville Power Administration's Project 99-003. The purpose of this project is twofold: (1) Document the existence of fall chinook and chum populations spawning below Bonneville Dam (river mile (RM) 145), The Dalles Dam (RM 192), John Day Dam (RM 216), and McNary Dam (RM 292) (Figure 1) and estimate the size of these populations; and (2) Profile stocks for important population characteristics; including spawning time, genetic make-up, emergence timing, migration size and timing, and juvenile to adult survival rates. Specific tasks conducted by ODFW and WDFW during this period were: (1) Documentation of fall chinook and chum spawning below Bonneville, The Dalles, John Day and McNary dams using on-water observations; (2) Collection of biological data to profile stocks in areas described in Task 1; (3) Determination of spawning population estimates and age composition, average size at return, and sex ratios in order to profile stocks in areas described in Task 1; (4) Collection of data to determine stock origin of adult salmon found in areas described in Task 1; (5) Determination of possible stock origins of adult salmon found in areas described in Task 1 using tag rates based on coded-wire tag recoveries and genetic baseline analysis; (6) Determination of emergence timing and hatching rate of juvenile fall chinook and chum below Bonneville Dam; (7) Determination of migration time and size for juvenile fall chinook and chum rearing in the area described in Task 6; (8) Investigation of feasibility of determining stock composition of juvenile fall chinook and chum rearing in the area described in Task 6

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Risk factors of falls among elderly living in urban Suez--Egypt.

    Science.gov (United States)

    Kamel, Mohammed Hany; Abdulmajeed, Abdulmajeed Ahmed; Ismail, Sally El-Sayed

    2013-01-01

    Falling is one of the most common geriatric syndromes threatening the independence of older persons. Falls result from a complex and interactive mix of biological or medical, behavioral and environmental factors, many of which are preventable. Studying these diverse risk factors would aid early detection and management of them at the primary care level. This is a cross sectional study about risk factors of falls was conducted to 340 elders in Urban Suez. Those are all patients over 60 who attended two family practice centers in Urban Suez. When asked about falling during the past 12 months, 205 elders recalled at least one incident of falling. Of them, 36% had their falls outdoors and 24% mentioned that stairs was the most prevalent site for indoor falls. Falls were also reported more among dependant than independent elderly. Using univariate regression analysis, almost all tested risk factors were significantly associated with falls in the studied population. These risk factors include: living alone, having chronic diseases, using medications, having a physical deficit, being in active, and having a high nutritional risk. However, the multivariate regression analysis proved that the strongest risk factors are low level of physical activity with OR 0.6 and P value 0.03, using a cane or walker (OR 1.69 and P value 0.001) and Impairment of daily living activities (OR 1.7 and P value 0.001). Although falls is a serious problem among elderly with many consequences, it has many preventable risk factors. Health care providers should advice people to remain active and more research is needed in such an important area of Family Practice.

  7. Risk factors of falls among elderly living in Urban Suez - Egypt

    Science.gov (United States)

    Kamel, Mohammed Hany; Abdulmajeed, Abdulmajeed Ahmed; Ismail, Sally El-Sayed

    2013-01-01

    Introduction Falling is one of the most common geriatric syndromes threatening the independence of older persons. Falls result from a complex and interactive mix of biological or medical, behavioral and environmental factors, many of which are preventable. Studying these diverse risk factors would aid early detection and management of them at the primary care level. Methods This is a cross sectional study about risk factors of falls was conducted to 340 elders in Urban Suez. Those are all patients over 60 who attended two family practice centers in Urban Suez. Results When asked about falling during the past 12 months, 205 elders recalled at least one incident of falling. Of them, 36% had their falls outdoors and 24% mentioned that stairs was the most prevalent site for indoor falls. Falls were also reported more among dependant than independent elderly. Using univariate regression analysis, almost all tested risk factors were significantly associated with falls in the studied population. These risk factors include: living alone, having chronic diseases, using medications, having a physical deficit, being in active, and having a high nutritional risk. However, the multivariate regression analysis proved that the strongest risk factors are low level of physical activity with OR 0.6 and P value 0.03, using a cane or walker (OR 1.69 and P value 0.001) and Impairment of daily living activities (OR 1.7 and P value 0.001). Conclusion Although falls is a serious problem among elderly with many consequences, it has many preventable risk factors. Health care providers should advice people to remain active and more research is needed in such an important area of Family Practice. PMID:23504298

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

    Science.gov (United States)

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

    2012-05-01

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

  9. Geriatric fall-related injuries.

    Science.gov (United States)

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

    2016-06-01

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

  10. Microclima em vinhedos de 'Niagara rosada' em diferentes sistemas de condução durante safras de inverno e de verão Microclimate in 'Niagara Rosada' vineyards under different trellis systems during the winter and the summer crops

    Directory of Open Access Journals (Sweden)

    Mário José Pedro Júnior

    2013-03-01

    Full Text Available Na região vitícola de Jundiaí, o tradicional sistema de condução das plantas em espaldeira vem sendo paulatinamente substituído pela manjedoura na forma de Y. Alguns produtores têm lançado mão do uso de cobertura plástica para conferir maior proteção aos cachos de uva. Como esses diferentes sistemas de condução provocam alterações no microclima dos vinhedos, foram feitas medições de radiação solar global, umidade relativa, temperaturas máxima e mínima do ar no ambiente externo e na altura dos cachos de vinhedos de 'Niagara Rosada' conduzidos em espaldeira a céu aberto e em Y, com e sem cobertura de plástico, durante o período das safras de inverno e de verão. Verificou-se, que durante a safra de verão, as diferenças entre os valores diários de radiação solar, temperatura máxima do ar e umidade relativa foram mais elevadas em relação às da safra de inverno na comparação entre os sistemas de condução e o ambiente externo. Os vinhedos conduzidos em espaldeira apresentaram menores valores de radiação solar e umidade relativa do ar, na altura dos cachos. As temperaturas máximas e mínimas do ar foram semelhantes em todos os sistemas de condução e durante as diferentes safras. O uso de cobertura plástica no sistema de condução em Y não influiu na umidade relativa do ar e na temperatura mínima, porém propiciou aumento nos valores de temperatura máxima do ar.At the grapevine growing region of Jundiaí (State of São Paulo - Brazil the trellis system with single unilateral cordon and vertical upward branches is the most used by the growers. Nowadays it is been gradually replaced by the Y shaped trellis system. Still, some producers have been using plastic overhead cover for protection of the grape clusters. The different trellis systems cause modifications in the microclimate of the vineyard, so measurements of daily values of solar radiation, relative humidity, maximum and minimum air temperatures were

  11. Fall prevention walker during rehabilitation

    Science.gov (United States)

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

    2017-09-01

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

  12. Summary of the engineering assessment of inactive uranium mill tailings: Falls City site, Falls City, Texas

    International Nuclear Information System (INIS)

    1981-10-01

    Ford, Bacon and Davis Utah Inc. has reevaluated the Falls City site in order to update the December 1977 engineering assessment of the problems resulting from the existence of radioactive uranum mill tailings at Falls City, Texas. This engineering assessment has included the preparation of topographic maps, the performance of core drillings and radiometric measurements sufficient to determine areas and volumes of tailings and radiation exposures of individuals and nearby populations, the investigations of site hydrolgy and meteorology, and the evaluation and costing of alternative corrective actions. Radon gas released from the 2.5 million tons of tailings at the Falls City site constitutes the most significant environmental impact, although windblown tailings and external gamma radiation also are factors. The four alternative actions presented in this engineering assessment range from millsite decontamination with the addition of 3 m of stabilization cover material, to removal of the tailings to remote disposal sites and decontamination of the tailings site. Cost estimates for the four options range from about $21,700,000 for stabilization in place, to about $35,100,000 for disposal at a distance of about 15 mi. Three principal alternatives for the reprocessing of the Falls City tailings were examined: heap leaching; treatment at an existing mill; reprocessing at a new conventional mill constructed for tailings reprocessing. The tailings piles are presently being rewashed for uranium recovery by Solution Engineering, Inc. The cost for further reprocessing would be about $250/lb of U 3 O 8 . The spot market price for uranium was $25/lb early in 1981. Therefore, reprocessing the tailings for uranium recovery does not appear to be economically attractive for the foreseeable future

  13. Investigation and analysis of osteoporosis, falls, and fragility fractures in elderly people in the Beijing area: a study on the bone health status of elderly people ≥ 80 years old with life self-care.

    Science.gov (United States)

    Zhou, Jian; Qin, Ming-Zhao; Liu, Qian; Liu, Jin-Ping

    2017-12-06

    Among ≥ 80 years old and under life self-care in the Beijing area, the prevalences of osteoporosis, falls, and fragility fracture were high; and these prevalences were even higher in women. The treatment rate of osteoporosis is very low. Therefore, comprehensive and standardized prevention and treatment should be promoted. The purpose of this study is to investigate prevalence of osteoporosis, falls, and fragility fractures in this population, and analyze related factors, in order to provide a basis for standardized prevention and treatment. From August 2015 to August 2016 in Beijing City, a total of 175 elderly individuals, who were ≥ 80 years old and had good self-care ability, were included into this study. The questionnaire, risk of falls, grip force, and walking speed were measured, and the Timed Up and Go test (TUG) and chair-rising test (CRT) were performed. Compared to women, men have higher rates of smoking, drinking, drinking strong tea, longer outdoor activity time, as well as larger muscle strength and pace, and lower consumption of dairy products, fall risk assessment scale (FRA) score, 25OHD, administration rates of calcium and anti-osteoporosis drugs (P fall after 80 years old, and this rate was higher in women than in men (77 vs. 55.3%, P Risk factors included falls after age 80, high FRA score, and reduction in bone density of lumbar vertebrae 1-4, and odds ratio (OR) was 12.195, 1.339, and 0.076, respectively (P falls, prior fracture, and low BMD were high among ≥ 80 years old and under life self-care in the Beijing area. Therefore, a comprehensive approach to assessment and treatment should be promoted.

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  17. Postural stability and history of falls in cognitively able older adults: the Canton Ticino study.

    Science.gov (United States)

    Merlo, Andrea; Zemp, Damiano; Zanda, Enrica; Rocchi, Sabrina; Meroni, Fabiano; Tettamanti, Mauro; Recchia, Angela; Lucca, Ugo; Quadri, Pierluigi

    2012-09-01

    Falls are common events in the elderly and represent the main risk factor for fractures and other injuries. Strategies for fall prevention rely on the multifactorial assessment of the risk of falling. The contribution of instrumented balance assessment to the prediction of falls remains unclear in the literature. In this study, we analyzed the association between the fall-history of a wide sample of older people without dementia and the values of a set of posturographic parameters acquired in different visual, proprioceptive and mental conditions. A consecutive sample of 130 cognitively able elderly subjects, age≥70 years, was analyzed. Based on their fall-history in the last year, subjects were categorized into non-fallers (NF), fallers (F) and recurrent fallers (RF>2 falls). Each subject was assessed by measurements of cognition and functional ability. Static posturography tests were performed in five conditions: with eyes open/close (EO/EC) on a firm/compliant (FS/CS) surface and while performing a cognitive task. The center of pressure (COP) mean position referred to the mid-point of the heels, area of the 95% confidence ellipse, sway mean velocities and RMS displacements in the antero-posterior (AP) and medio-lateral (ML) directions were computed and their association with the fall-history was assessed. The mean position of the COP in the AP direction and the confidence ellipse area were associated with the fall-history in the EOFS, ECFS and EOCS conditions (Pfall-history in the EOCS condition (Pcontrol balance while standing with eyes open on a compliant surface showed a high degree of association with the fall-history of older people with no or mild cognitive impairment. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Falls in older people

    NARCIS (Netherlands)

    van Dieën, Jaap H.; Pijnappels, Mirjam

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  2. Issues in Geriatric Care: Falls.

    Science.gov (United States)

    Patel, Dipesh; Ackermann, Richard J

    2018-05-01

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

  3. Radioactive fall-out in Norway after the Chernobyl accident

    Energy Technology Data Exchange (ETDEWEB)

    Skjerve, Eystein [Dept. of Food Hygiene, Norwegian College of Veterinary Medicine (Norway)

    1986-07-01

    During the fall-out from the atmosphere during the fifties and sixties, a system of local control of radioactive contamination of food was built up. (LORACON - LOcal RAdioactivity COntrol). The different Meat and Food Inspection Services were equipped with Geiger Mueller instruments. The system was in operation until late seventies. From 1977 there was no testing and calibration of the instruments. The development towards a reduction of the state of readiness was accelerated when the Norwegian Parliament decided that Norway should not establish any nuclear power plants (1979). Only the universities and special institutions as the National Institute of Radiation Hygiene and the Institute for Energy Technique were still able to analyse on radioactive isotopes. The confusion about how much radioactive fall-out from the Chernobyl reactor accident Norway received lasted for some weeks in Norway. Partially, this was due to the lack of instruments, but also many experts rejected the idea that an accident so far away might cause these amounts of fall-out consisted of Iodine and Cesium. The fall-out followed a very irregular pattern both nationally and locally with the mountain areas in Middle Norway most affected.

  4. Radioactive fall-out in Norway after the Chernobyl accident

    International Nuclear Information System (INIS)

    Skjerve, Eystein

    1986-01-01

    During the fall-out from the atmosphere during the fifties and sixties, a system of local control of radioactive contamination of food was built up. (LORACON - LOcal RAdioactivity COntrol). The different Meat and Food Inspection Services were equipped with Geiger Mueller instruments. The system was in operation until late seventies. From 1977 there was no testing and calibration of the instruments. The development towards a reduction of the state of readiness was accelerated when the Norwegian Parliament decided that Norway should not establish any nuclear power plants (1979). Only the universities and special institutions as the National Institute of Radiation Hygiene and the Institute for Energy Technique were still able to analyse on radioactive isotopes. The confusion about how much radioactive fall-out from the Chernobyl reactor accident Norway received lasted for some weeks in Norway. Partially, this was due to the lack of instruments, but also many experts rejected the idea that an accident so far away might cause these amounts of fall-out consisted of Iodine and Cesium. The fall-out followed a very irregular pattern both nationally and locally with the mountain areas in Middle Norway most affected

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

    Science.gov (United States)

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

    2017-11-08

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

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

    Directory of Open Access Journals (Sweden)

    D. Collado-Mateo

    2015-01-01

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

  7. Effects of Hydroelectric Dam Operations on the Restoration Potential of Snake River Fall Chinook Salmon (Oncorhynchus tshawytscha) Spawning Habitat Final Report, October 2005 - September 2007.

    Energy Technology Data Exchange (ETDEWEB)

    Hanrahan, Timothy P.; Richmond, Marshall C.; Arntzen, Evan V. [Pacific Northwest National Laboratory

    2007-11-13

    This report describes research conducted by the Pacific Northwest National Laboratory for the Bonneville Power Administration (BPA) as part of the Fish and Wildlife Program directed by the Northwest Power and Conservation Council. The study evaluated the restoration potential of Snake River fall Chinook salmon spawning habitat within the impounded lower Snake River. The objective of the research was to determine if hydroelectric dam operations could be modified, within existing system constraints (e.g., minimum to normal pool levels; without partial removal of a dam structure), to increase the amount of available fall Chinook salmon spawning habitat in the lower Snake River. Empirical and modeled physical habitat data were used to compare potential fall Chinook salmon spawning habitat in the Snake River, under current and modified dam operations, with the analogous physical characteristics of an existing fall Chinook salmon spawning area in the Columbia River. The two Snake River study areas included the Ice Harbor Dam tailrace downstream to the Highway 12 bridge and the Lower Granite Dam tailrace downstream approximately 12 river kilometers. These areas represent tailwater habitat (i.e., riverine segments extending from a dam downstream to the backwater influence from the next dam downstream). We used a reference site, indicative of current fall Chinook salmon spawning areas in tailwater habitat, against which to compare the physical characteristics of each study site. The reference site for tailwater habitats was the section extending downstream from the Wanapum Dam tailrace on the Columbia River. Fall Chinook salmon spawning habitat use data, including water depth, velocity, substrate size and channelbed slope, from the Wanapum reference area were used to define spawning habitat suitability based on these variables. Fall Chinook salmon spawning habitat suitability of the Snake River study areas was estimated by applying the Wanapum reference reach habitat

  8. 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.

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Geothermal District Heating System City of Klamath Falls

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, Paul J; Rafferty, Kevin

    1991-12-01

    The city of Klamath Falls became interested in the possibility of a establishing geothermal district heating system for downtown government buildings in January 1977. Since that time, the project has undergone some controversial and interesting developments that may be of educational value to other communities contemplating such a project. The purpose and content of this article is to identify the historical development of the project; including the design of the system, well owner objections to the project, aquifer testing, piping failure, and future expansion and marketing incentives. The shallow geothermal reservoir in Klamath falls extends for at least 6.8 miles in a northwest-southeast direction, as shown on Figure 1, with a width of about 2 miles. More than 550 thermal wells ranging in depth from about 10 to 2,000 ft, and obtaining or contacting water from 70 to 230oF, have been drilled into the reservoir. The system is not geologically homogeneous. Great variations in horizontal permeability and many vertical discontinuities exist because of stratigraphy and structure of the area. Basalt flows, eruptive centers, fluvial and lacustrine deposits, diatomite and pyroclastic materials alternate in the rock column. Normal faults with large throw (estimated up to 1,700 ft) are spaced less than 3,300 ft apart and appear to be the main avenue of vertical movement of hot fluids. In order to more effectively utilize this resource, the city of Klamath Falls decided in 1978 to apply for a federal grant (Program Opportunity Notice to cost share field experiment projects) to construct a geothermal district heating system that would deliver geothermal fluids to areas not located on the resource. In 1977, several Geo-Heat Center staff members visited Reykjavik, Iceland, to study the design of their geothermal district heating systems. This was in part the basis for the conceptual design and feasibility study (Lund, 1979) of a downtown commercial district. The main difference

  12. Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males.

    Science.gov (United States)

    Imagama, Shiro; Ito, Zenya; Wakao, Norimitsu; Seki, Taisuke; Hirano, Kenichi; Muramoto, Akio; Sakai, Yoshihito; Matsuyama, Yukihiro; Hamajima, Nobuyuki; Ishiguro, Naoki; Hasegawa, Yukiharu

    2013-06-01

    Risk factors for falling in elderly people remain uncertain, and the effects of spinal factors and physical ability on body balance and falling have not been examined. The objective of this study was to investigate how factors such as spinal sagittal alignment, spinal range of motion, body balance, muscle strength, and gait speed influence falling in the prospective cohort study. The subjects were 100 males who underwent a basic health checkup. Balance, SpinalMouse(®) data, grip strength, back muscle strength, 10-m gait time, lumbar lateral standing radiographs, body mass index, and fall history over the previous year were examined. Platform measurements of balance included the distance of movement of the center of pressure (COP) per second (LNG/TIME), the envelopment area traced by movement of the COP (E AREA), and the LNG/E AREA ratio. The thoracic/lumbar angle ratio (T/L ratio) and sagittal vertical axis (SVA) were used as an index of sagittal balance. LNG/TIME and E AREA showed significant positive correlations with age, T/L ratio, SVA, and 10-m gait time; and significant negative correlations with lumbar lordosis angle, sacral inclination angle, grip strength and back muscle strength. Multiple regression analysis showed significant differences for LNG/TIME and E AREA with T/L ratio, SVA, lumbar lordosis angle and sacral inclination angle (R (2) = 0.399). Twelve subjects (12 %) had experienced a fall over the past year. Age, T/L ratio, SVA, lumbar lordosis angle, sacral inclination angle, grip strength, back muscle strength, 10-m gait time, height of the intervertebral disc, osteophyte formation in radiographs and LNG/E AREA differed significantly between fallers and non-fallers. The group with SVA > 40 mm (n = 18) had a significant higher number of subjects with a single fall (6 single fallers/18: p = 0.0075) and with multiple falls (4 multiple fallers/18: p = 0.0095). Good spinal sagittal alignment, muscle strength and 10-m gait speed improve body balance

  13. Distinguishing natural hydrocarbons from anthropogenic contamination in ground water

    International Nuclear Information System (INIS)

    Lesage, S.; Xu, H.; Novakowski, K.S.

    1997-01-01

    Differentiation between natural and anthropogenic sources of ground-water contamination by petroleum hydrocarbons is necessary in areas where natural hydrocarbons may be present in the subsurface. Because of the similarity in composition between natural and refined petroleum, the use of statistical techniques to discern trends is required. In this study, both multivariate plotting techniques and principal component analysis were used to investigate the origin of hydrocarbons from a variety of study sites. Ground-water and gas samples were collected from the Niagara Falls area and from three gasoline stations where leaking underground storage tanks had been found. Although soil gas surveys are used to indicate the presence of hydrocarbons, they were not useful in differentiating between natural and anthropogenic sources of contamination in ground water. Propane and pentene were found to be the most useful chemical parameters in discriminating between the natural and anthropogenic sources. These chemicals are not usually measured in investigations of ground-water contamination, yet analysis can be conducted by most environmental laboratories using conventional methods

  14. Epidemiology of falls in older age.

    Science.gov (United States)

    Peel, Nancye May

    2011-03-01

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

  15. 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.

  16. Fall Prevention Hits Stumbling Blocks.

    Science.gov (United States)

    Huff, Charlotte

    2018-03-01

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

  17. Albeni Falls Wildlife Management Plan - preliminary environmental assessment

    International Nuclear Information System (INIS)

    1996-04-01

    Bonneville Power Administration (BPA) proposes to fund the development and implementation of the Albeni Falls Wildlife Management Plan. Approved by the Northwest Power Planning Council (Council) in 1990, the project is a cooperative effort with the Interagency Work Group that includes the Idaho Department of Fish and Game (IDFG); United States Fish and Wildlife Service (USFWS); United States Forest Service (USFS); United States Army Corps of Engineers (COE); the Kalispel Tribe; and the Upper Columbia United Tribes (UCUT). The proposed action would enable the Interagency Work Group to protect and enhance a variety of wetland and riparian habitats, restore 28,587 habitat units lost as a result of the construction and operation of Albeni Falls Dam, and implement long-term wildlife management activities at selected sites within the overall study area. This Environmental Assessment (EA) examines the potential environmental effects of protecting and enhancing wildlife habitat in selected portions of a 225,077 hectare (556,160 acre) study area surrounding Lake Pend Oreille in Bonner County, and 7,770 hectare (19,200 acre) area surrounding Spirit and Twin lakes, in Kootenai County, Idaho. Four proposed activities are analyzed: habitat protection; habitat enhancement; operation and maintenance (O ampersand M); and monitoring and evaluation (M ampersand E)

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

    Science.gov (United States)

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

    2012-01-01

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

  19. [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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Hudson Azevedo Pinheiro

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

  2. New methods for fall risk prediction.

    Science.gov (United States)

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

    2014-09-01

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

  3. First Aid: Falls

    Science.gov (United States)

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

  4. Water quality, Multivariate statistical techniques, submarine out fall, spatial variation, temporal variation

    International Nuclear Information System (INIS)

    Garcia, Francisco; Palacio, Carlos; Garcia, Uriel

    2012-01-01

    Multivariate statistical techniques were used to investigate the temporal and spatial variations of water quality at the Santa Marta coastal area where a submarine out fall that discharges 1 m3/s of domestic wastewater is located. Two-way analysis of variance (ANOVA), cluster and principal component analysis and Krigging interpolation were considered for this report. Temporal variation showed two heterogeneous periods. From December to April, and July, where the concentration of the water quality parameters is higher; the rest of the year (May, June, August-November) were significantly lower. The spatial variation reported two areas where the water quality is different, this difference is related to the proximity to the submarine out fall discharge.

  5. Stratifying Risk of Falls in Community-Dwelling Elderly Adults Through a Simple Tool

    Directory of Open Access Journals (Sweden)

    Schettino Ludmila

    2016-12-01

    Full Text Available Purpose. Falls are among the main disabling events for elderly adults and the identification of old people prone to falls enables the development of preventive and rehabilitative strategies. This study aimed to develop a simple tool, based on easily obtained variables (anthropometric measurements, motor performance tests and sociodemographic characteristics, to early identify community-dwelling old people prone to falls. Methods. The population-based household study was conducted among 316 elders (≥ 60 years old of both sexes, living in the urban area of Lafaiete Coutinho in Brazil. History of falls in the previous 12 months (dependent variable, sociodemographic characteristics, anthropometric measurements and motor performance tests results (explanatory variables were recorded, and a multivariate logistic regression was applied to identify the association between the explanatory variables and the history of falls. Fall probability for each elderly adult was calculated from the logistic regression parameters, and the predictive power of the final model and the cutoff for higher propensity to fall were evaluated on the basis of the receiver operating characteristic curve. Results. The prevalence of falls was 25.8% and the final model was influenced by the variables of sex (female and poor performance in the balance test. The estimated probability model predicted approximately 66.5% (95% CI, 61-72% of the falls. The sensitivity and specificity were 58 and 70%, respectively. Conclusions. We conclude that there is a high prevalence of falls among the studied elderly individuals, and the proposed method allowed to construct a simple tool for screening old adults prone to fall.

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

    Directory of Open Access Journals (Sweden)

    Hill AM

    2013-06-01

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

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

    Science.gov (United States)

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

    2008-06-01

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

  8. Fall risk factors in Parkinson's disease.

    Science.gov (United States)

    Gray, P; Hildebrand, K

    2000-08-01

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

  9. Phase II, Title I engineering assessment of inactive uranium mill tailings, Falls City Site, Falls City, Texas

    International Nuclear Information System (INIS)

    1977-12-01

    An engineering assessment was performed of the problems resulting from the existence of radioactive uranium mill tailings at Falls City, Texas. Services included taking soil samples, the performance of radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 2.5 million tons of tailings at the Falls City site constitutes the most significant environmental impact. Windblown tailings, external gamma radiation and localized contamination of surface waters are other environmental effects. The two alternative remedial action options presented include on-site and off-site cleanup, fencing, and hydrological monitoring, and in addition, stabilization of pile 2 with 2 ft of cover material. The costs are $1.84 million for Option I and $2.45 million for Option II

  10. 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.

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

    Science.gov (United States)

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

    2005-07-01

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

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

    Science.gov (United States)

    Lee, Justin Yusen; Holbrook, Anne

    2017-02-20

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

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

    LENUS (Irish Health Repository)

    Stone, Carol A

    2012-06-10

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

  14. The Stroke Assessment of Fall Risk (SAFR): predictive validity in inpatient stroke rehabilitation

    Science.gov (United States)

    Breisinger, Terry P; Skidmore, Elizabeth R; Niyonkuru, Christian; Terhorst, Lauren; Campbell, Grace B

    2014-01-01

    Objective To evaluate relative accuracy of a newly developed Stroke Assessment of Fall Risk (SAFR) for classifying fallers and non-fallers, compared with a health system fall risk screening tool, the Fall Harm Risk Screen. Design and setting Prospective quality improvement study conducted at an inpatient stroke rehabilitation unit at a large urban university hospital. Participants Patients admitted for inpatient stroke rehabilitation (N = 419) with imaging or clinical evidence of ischemic or hemorrhagic stroke, between 1 August 2009 and 31 July 2010. Interventions Not applicable. Main outcome measure(s) Sensitivity, specificity, and area under the curve for Receiver Operating Characteristic Curves of both scales’ classifications, based on fall risk score completed upon admission to inpatient stroke rehabilitation. Results A total of 68 (16%) participants fell at least once. The SAFR was significantly more accurate than the Fall Harm Risk Screen (p stroke rehabilitation patients. While the SAFR improves upon the accuracy of a general assessment tool, additional refinement may be warranted. PMID:24849795

  15. Community College Estimated Growth: Fall 2010

    Science.gov (United States)

    Phillippe, Kent; Mullin, Christopher M.

    2011-01-01

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

  16. 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

  17. Intrinsic factors associated with pregnancy falls.

    Science.gov (United States)

    Wu, Xuefang; Yeoh, Han T

    2014-10-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  19. Preventing falls in hospital.

    Science.gov (United States)

    Pearce, Lynne

    2017-02-27

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

  20. Preventing Falls in Older Persons.

    Science.gov (United States)

    Moncada, Lainie Van Voast; Mire, L Glen

    2017-08-15

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Justin Yusen Lee

    2017-02-01

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

  3. Preventing Falls and Related Fractures

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Alejandro Rodríguez-Molinero

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

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

    Science.gov (United States)

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

    2017-01-01

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

  7. Approach to Fall in Elderly Population

    Directory of Open Access Journals (Sweden)

    Mehmet Ilkin Naharci

    2009-10-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  9. Development and feasibility of falls prevention advice.

    Science.gov (United States)

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

    2011-10-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

  11. 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...

  12. Fall prevention in nursing homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Hauge, Johnny

    2014-01-01

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

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

    Science.gov (United States)

    Berry, Sarah D; Miller, Ram R

    2008-12-01

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

  14. 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.

  15. Validation of Fall Risk Assessment Specific to the Inpatient Rehabilitation Facility Setting.

    Science.gov (United States)

    Thomas, Dan; Pavic, Andrea; Bisaccia, Erin; Grotts, Jonathan

    2016-09-01

    To evaluate and compare the Morse Fall Scale (MFS) and the Casa Colina Fall Risk Assessment Scale (CCFRA) for identification of patients at risk for falling in an acute inpatient rehabilitation facility. The primary objective of this study was to perform a retrospective validation study of the CCFRAS, specifically for use in the inpatient rehabilitation facility (IRF) setting. Retrospective validation study. The study was approved under expedited review by the local Institutional Review Board. Data were collected on all patients admitted to Cottage Rehabiliation Hospital (CRH), a 38-bed acute inpatient rehabilitation hospital, from March 2012 to August 2013. Patients were excluded from the study if they had a length of stay less than 3 days or age less than 18. The area under the receiver operating characteristic curve (AUC) and the diagnostic odds ratio were used to examine the differences between the MFS and CCFRAS. AUC between fall scales was compared using the DeLong Test. There were 931 patients included in the study with 62 (6.7%) patient falls. The average age of the population was 68.8 with 503 males (51.2%). The AUC was 0.595 and 0.713 for the MFS and CCFRAS, respectively (0.006). The diagnostic odds ratio of the MFS was 2.0 and 3.6 for the CCFRAS using the recommended cutoffs of 45 for the MFS and 80 for the CCFRAS. The CCFRAS appears to be a better tool in detecting fallers vs. nonfallers specific to the IRF setting. The assessment and identification of patients at high risk for falling is important to implement specific precautions and care for these patients to reduce their risk of falling. The CCFRAS is more clinically relevant in identifying patients at high risk for falling in the IRF setting compared to other fall risk assessments. Implementation of this scale may lead to a reduction in fall rate and injuries from falls as it more appropriately identifies patients at high risk for falling. © 2015 Association of Rehabilitation Nurses.

  16. Predicting falls in elderly patients with chronic pain and other chronic conditions.

    Science.gov (United States)

    Lazkani, Aida; Delespierre, Tiba; Bauduceau, Bernard; Benattar-Zibi, Linda; Bertin, Philippe; Berrut, Gilles; Corruble, Emmanuelle; Danchin, Nicolas; Derumeaux, Geneviève; Doucet, Jean; Falissard, Bruno; Forette, Francoise; Hanon, Olivier; Pasquier, Florence; Pinget, Michel; Ourabah, Rissane; Piedvache, Celine; Becquemont, Laurent

    2015-10-01

    The aim was to identify fall predictors in elderly suffering from chronic pain (CP) and to test their applicability among patients with other chronic conditions. 1,379 non-institutionalized patients aged 65 years and older who were suffering from CP (S.AGE CP sub-cohort) were monitored every 6 months for 1 year. Socio-demographic, clinical and pain data and medication use were assessed at baseline for the association with falls in the following year. Falls were assessed retrospectively at each study visit. Logistic regression analyses were performed to identify fall predictors. The derived model was applied to two additional S.AGE sub-cohorts: atrial fibrillation (AF) (n = 1,072) and type-2 diabetes mellitus (T2DM) (n = 983). Four factors predicted falls in the CP sub-cohort: fall history (OR: 4.03, 95 % CI 2.79-5.82), dependency in daily activities (OR: 1.81, 95 % CI 1.27-2.59), age ≥75 (OR: 1.53, 95 % CI 1.04-2.25) and living alone (OR: 1.73, 95 % CI 1.24-2.41) (Area Under the Curve: AUC = 0.71, 95 % CI 0.67-0.75). These factors were relevant in AF (AUC = 0.71, 95 % CI 0.66-0.75) and T2DM (AUC = 0.67, 95 % CI 0.59-0.73) sub-cohorts. Fall predicted probability in CP, AF and T2DM sub-cohorts increased from 7, 7 and 6 % in patients with no risk factors to 59, 66 and 45 % respectively, in those with the four predictors. Fall history was the strongest predictor in the three sub-cohorts. Fall history, dependency in daily activities, age ≥75 and living alone are independent fall predictors in CP, AF and T2DM patients.

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

    Science.gov (United States)

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

    2017-05-01

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

  18. Evaluation of Fall Chinook and Chum Salmon Spawning below Bonneville Dam; 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    van der Naald, Wayne; Duff, Cameron; Friesen, Thomas A. (Oregon Department of Fish and Wildlife, Clackamas, OR)

    2006-02-01

    Pacific salmon Oncorhynchus spp. populations have declined over the last century due to a variety of human impacts. Chum salmon O. keta populations in the Columbia River have remained severely depressed for the past several decades, while upriver bright (URB) fall Chinook salmon O. tschawytscha populations have maintained relatively healthy levels. For the past seven years we have collected data on adult spawning and juvenile emergence and outmigration of URB fall Chinook and chum salmon populations in the Ives and Pierce islands complex below Bonneville Dam. In 2004, we estimated 1,733 fall Chinook salmon and 336 chum salmon spawned in our study area. Fall Chinook salmon spawning peaked 19 November with 337 redds and chum salmon spawning peaked 3 December with 148 redds. Biological characteristics continue to suggest chum salmon in our study area are similar to nearby stocks in Hardy and Hamilton creeks, and Chinook salmon we observe are similar to upriver bright stocks. Temperature data indicated that 2004 brood URB fall Chinook salmon emergence began on 6 January and ended 27 May 2005, with peak emergence occurring 12 March. Chum salmon emergence began 4 February and continued through 2 May 2005, with peak emergence occurring on 21 March. Between 13 January and 28 June, we sampled 28,984 juvenile Chinook salmon and 1,909 juvenile chum salmon. We also released 32,642 fin-marked and coded-wire tagged juvenile fall Chinook salmon to assess survival. The peak catch of juvenile fall Chinook salmon occurred on 18 April. Our results suggested that the majority of fall Chinook salmon outmigrate during late May and early June, at 70-80 mm fork length (FL). The peak catch of juvenile chum salmon occurred 25 March. Juvenile chum salmon appeared to outmigrate at 40-55 mm FL. Outmigration of chum salmon peaked in March but extended into April and May.

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

    NARCIS (Netherlands)

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

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

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

    Science.gov (United States)

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

    2017-12-07

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

  1. [Falls of older individuals: medical assessment].

    Science.gov (United States)

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

    2007-01-01

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

  2. Childhood Falls With Occipital Impacts

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  4. Hazard assessment due to falling stones on a reach of the regional road in the Trenta valley, Slovenia

    Directory of Open Access Journals (Sweden)

    Urška Petje

    2005-12-01

    Full Text Available In the framework of the new Slovenian methodology for determining hazard areas and the classification of land parcels into hazard classes due to land slides and rock falls, a pilot project was carried out on the regional road between Bovec and Vr{i~ pass in theTrenta valley. For this around 20 km long road in a typical alpine environment, a hazard assessment of falling rocks was carried out, even tough the road also passes through snow avalanches hazard areas. The performed hazard assessment of falling rocks is based onan expert knowledge taking into account the field mapping, and classifies the road into three hazard classes: 9811 m is classified into the low hazard class, 7233 m is classifiedinto the medium hazard class, and 1301 m is classified into high hazard class of falling rocks.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Science.gov (United States)

    Kim, Oksoo; Kim, Jung-Hee

    2015-01-01

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

  7. 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.

  8. Ageing vision and falls: a review.

    Science.gov (United States)

    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.

  9. Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program.

    Science.gov (United States)

    LaStayo, Paul; Marcus, Robin; Dibble, Leland; Wong, Bob; Pepper, Ginette

    2017-07-17

    Addressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period. Randomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis. The MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up fall or near fall. There were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival. NCT01080196 ; March 2, 2010 (retrospectively registered).

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pierpaolo Palumbo

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Falls and comorbidity

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2018-02-13

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

  17. Home Improvements Prevent Falls

    Science.gov (United States)

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

  18. 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.

  19. The impact of industrial oil development on a protected area landscape: A case study on human population growth and landscape level change in Murchison Falls Conservation Area, Uganda.

    Science.gov (United States)

    Dowhaniuk, Nicholas; Hartter, Joel; Congalton, Russell G.; Palace, Michael W.; Ryan, Sadie J.

    2016-04-01

    Protected areas in Sub-Saharan Africa are sanctuaries for rich biodiversity and are important economic engines for African nations, but they are becoming increasingly threatened by discoveries of mineral deposits within and nearby their boundaries. In 2006, viable oil reserves were discovered in Murchison Falls Conservation Area (MFCA) in northern Uganda. Exploratory and appraisal activities concluded in 2014, and production is expected to begin in 2016. The oil development is associated with a substantial increase in human population outside MFCA, with people seeking jobs, land, and economic opportunity. Concomitant with this change is increased truck traffic, a sprawling and denser road network, and infrastructure within the park, which could have large impacts on both the flora and fauna. We examined the broader protected area landscape and the potential feedbacks from resource development on the ecosystem and local livelihoods. Our analysis combines a land cover analysis using Object Based Image Analysis of Landsat data (2002 and 2014), migration patterns and population change (1959-2014), and qualitative interview data. Our results suggest that most of the larger-scale impacts on the landscape and people are occurring in the western and northern sections, both inside and outside of the park. Additionally, oil development is not the only factor in the region influencing population growth and landscape change. Post conflict regrowth in the north, sugarcane production in the south, and migration to this region from conflict-ridden neighboring countries are also playing a vital role in human migration shaping the MFCA Landscape. Understanding the social and environmental changes and impacts in the MFCA and its surrounding areas will add to limited literature on the impacts of resource extraction on local, subsistence communities and landscape level change, which will be important as access and pressure for oil and minerals within protected areas continues to rise.

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

    Science.gov (United States)

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

    2017-10-01

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

  1. Fall prevention in central coast community pharmacies.

    Science.gov (United States)

    Stuart, Gina M; Kale, Helen L

    2018-04-19

    Fall injuries among people aged 65 years and over (older people) cause substantial health decline and cost to the health system. In 2009 in New South Wales, 25.6% of older people fell in the previous year, and 10.7% (32 000) were hospitalised. Pharmacists are trusted professionals, who interact extensively with older people and have potential to augment fall prevention in pharmacies. This brief report describes how professional development improved pharmacist's knowledge and confidence in fall prevention, encouraged implementation of fall prevention plans and facilitated the provision of brief fall prevention interventions for older clients, after identification of fall risk. In 2014, pharmacists from all Central Coast pharmacies (n = 76) were invited to free, continuing professional development (CPD) in fall prevention. It provided education and resources to identify clients' fall risk, conduct brief fall prevention interventions and implement fall prevention health promotion plans (FPHPP). Pharmacists completed written: Baseline and post-workshop questionnaires to assess changes in pharmacist's knowledge and confidence, and existing fall prevention in pharmacies. Logs of client fall risk and brief fall prevention interventions offered to clients. Four-month follow-up questionnaires to assess implementation of FPHPPs and pharmacy practice changes. Pharmacists representing 36% of pharmacies participated. At four-month follow-up, 67% had implemented FPHPPs, and 62% delivered brief interventions determined by client fall risk. Fall prevention in pharmacies can be augmented through locally provided CPD tailored for pharmacists. SO WHAT?: This model could increase fall prevention reach. It is transferable to settings where health professionals provide services to older adults and require reregistration through professional development. © 2018 Australian Health Promotion Association.

  2. [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.

  3. Fall prevention in the elderly

    Science.gov (United States)

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

    2013-01-01

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

  4. Fall prevention in the elderly.

    Science.gov (United States)

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

    2013-05-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  6. Falls and patient safety for older adults.

    Science.gov (United States)

    Aronovitch, Sharon A

    2006-10-01

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

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

    Science.gov (United States)

    Obuchi, Shuichi

    2008-06-01

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

  8. FRAT-up, a Web-based fall-risk assessment tool for elderly people living in the community.

    Science.gov (United States)

    Cattelani, Luca; Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Becker, Clemens; Chesani, Federico; Chiari, Lorenzo

    2015-02-18

    About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. FRAT-up is based on the assumption that a subject's fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    Science.gov (United States)

    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.

  11. 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

  12. Free Falling in Stratified Fluids

    Science.gov (United States)

    Lam, Try; Vincent, Lionel; Kanso, Eva

    2017-11-01

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

  13. The neurobiology of falls.

    Science.gov (United States)

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

    2012-12-01

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

  14. Fall Prevention: Simple Tips to Prevent Falls

    Science.gov (United States)

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

  15. Quantitative rock-fall hazard and risk assessment for Yosemite Valley, California

    Science.gov (United States)

    Stock, G. M.; Luco, N.; Collins, B. D.; Harp, E.; Reichenbach, P.; Frankel, K. L.

    2011-12-01

    Rock falls are a considerable hazard in Yosemite Valley, California with more than 835 rock falls and other slope movements documented since 1857. Thus, rock falls pose potentially significant risk to the nearly four million annual visitors to Yosemite National Park. Building on earlier hazard assessment work by the U.S. Geological Survey, we performed a quantitative rock-fall hazard and risk assessment for Yosemite Valley. This work was aided by several new data sets, including precise Geographic Information System (GIS) maps of rock-fall deposits, airborne and terrestrial LiDAR-based point cloud data and digital elevation models, and numerical ages of talus deposits. Using Global Position Systems (GPS), we mapped the positions of over 500 boulders on the valley floor and measured their distance relative to the mapped base of talus. Statistical analyses of these data yielded an initial hazard zone that is based on the 90th percentile distance of rock-fall boulders beyond the talus edge. This distance was subsequently scaled (either inward or outward from the 90th percentile line) based on rock-fall frequency information derived from a combination of cosmogenic beryllium-10 exposure dating of boulders beyond the edge of the talus, and computer model simulations of rock-fall runout. The scaled distances provide the basis for a new hazard zone on the floor of Yosemite Valley. Once this zone was delineated, we assembled visitor, employee, and resident use data for each structure within the hazard zone to quantitatively assess risk exposure. Our results identify areas within the new hazard zone that may warrant more detailed study, for example rock-fall susceptibility, which can be assessed through examination of high-resolution photographs, structural measurements on the cliffs, and empirical calculations derived from LiDAR point cloud data. This hazard and risk information is used to inform placement of existing and potential future infrastructure in Yosemite Valley.

  16. Examination of sustainability indicators for fall prevention strategies in three states.

    Science.gov (United States)

    Smith, Matthew Lee; Durrett, Nicholas K; Schneider, Ellen C; Byers, Imani N; Shubert, Tiffany E; Wilson, Ashley D; Towne, Samuel D; Ory, Marcia G

    2018-06-01

    With 1-in-4 older adults suffering a fall each year, fall prevention efforts have emerged as a public health priority. Multi-level, evidence-based fall prevention programs have been promoted by the CDC and other government agencies. To ensure participants and communities receive programs' intended benefits, organizations must repeatedly deliver the programs over time and plan for program sustainability as part of 'scaling up' the initiative. The State Falls Prevention Project (SFPP) began in 2011 when the CDC provided 5 years of funding to State Departments of Health in Colorado, New York, and Oregon to simultaneously implement four fall prevention strategies: 1) Tai Chi: Moving for Better Balance; 2) Stepping On; 3) Otago Exercise Program; and 4) STEADI (STopping Elderly Accidents, Deaths, and Injuries) toolkit. Surveys were performed to examine systems change and perceptions about sustainability across states. The purposes of this study were to: 1) examine how funding influenced the capacity for program implementation and sustainability within the SFPP; and 2) assess reported Program Sustainability Assessment Tool (PSAT) scores to learn about how best to sustain fall preventing efforts after funding ends. Data showed that more organizations offered evidence-based fall prevention programs in participants' service areas with funding, and the importance of programming implementation, evaluation, and reporting efforts were likely to diminish once funding concluded. Participants' reported PSAT scores about perceived sustainability capacity did not directly align with previously reported perceptions about PSAT domain importance or modifiability. Findings suggest the importance of grantees to identify potential barriers and enablers influencing program sustainability during the planning phase of the programs. Copyright © 2018. Published by Elsevier Ltd.

  17. Environmental Assessment for Construction of an Armed Forces Reserve Center Complex and Implementation of BRAC 05 Realignment Actions in Niagara Falls, New York

    Science.gov (United States)

    2007-07-01

    improve the management of the coast and inland waterways. New York State’s Coastal Area has been divided into four geographic regions: Long Island, New...Justice in Minority and Low-Income Populations. The EO is designed to focus the attention of federal agencies on the human health and environmental...alteration on an area designated as an IRP site needs a waiter from Headquarters, Air Force Reserve Command. Table 4-12. Summary of IRP Sites at

  18. Dance movement therapy and falls prevention.

    Science.gov (United States)

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

    2017-08-01

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

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

    Science.gov (United States)

    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.

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

    Hars, Mélany; Audet, Marie-Claude; Herrmann, François; De Chassey, Jean; Rizzoli, René; Reny, Jean-Luc; Gold, Gabriel; Ferrari, Serge; Trombetti, Andrea

    2018-05-01

    Falls are common among older inpatients and remain a great challenge for hospitals. Despite the relevance of physical impairments to falls, the prognostic value of performance-based functional measures for in-hospital falls and injurious falls remains unknown. This study aimed to determine the predictive ability and accuracy of various functional tests administered at or close to admission in a geriatric hospital to identify in-hospital fallers and injurious fallers. In this prospective study, conducted in a geriatric hospital in Geneva, Switzerland, 807 inpatients (mean age 85.0 years) were subjected to a battery of functional tests administered by physiotherapists within 3 days (interquartile range 1 to 6) of admission, including Short Physical Performance Battery (SPPB), simplified Tinetti, and Timed Up and Go tests. Patients were prospectively followed up for falls and injurious falls until discharge using mandatory standardized incident report forms and electronic patients' records. During a median length of hospital stay of 23 days (interquartile range 14 to 36), 329 falls occurred in 189 (23.4%) patients, including 161 injurious falls of which 24 were serious. In-hospital fallers displayed significantly poorer functional performances at admission on all tests compared with non-fallers (p performances on all functional tests predicted in-hospital falls and injurious falls (p poor functional performances, as assessed by SPPB, are independent predictors of in-hospital falls, injurious falls, and fractures in patients admitted to a geriatric hospital. These findings should help to design preventive strategies for in-hospital falls and support the adoption of objective performance-based functional measures into routine hospital practice. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.

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

    Science.gov (United States)

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

    2011-06-18

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

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

    Science.gov (United States)

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

    2016-06-20

    People aged 65 years or older accounted for 25.1% of the Japanese population in 2013, and this characterizes the country as a "super-aging society." With increased aging, fall-related injuries are becoming important in Japan, because such injuries underlie the necessity for nursing care services. If people could evaluate their risk of falling using a simple self-check test, they would be able to take preventive measures such as exercise, muscle training, walking with a cane, or renovation of their surroundings to remove impediments. Loco-check is a checklist measure of early locomotive syndrome (circumstances in which elderly people need nursing care service or are at high risk of requiring the service within a short time), prepared by the Japanese Orthopaedic Association (JOA) in 2007, but it is unclear if there is any association between this measure and falls. To investigate the association between falls during the previous year and the 7 "loco-check" daily activity items and the total number of items endorsed, and sleep duration. We conducted an Internet panel survey. Subjects were 624 persons aged between 30 and 90 years. The general health condition of the participants, including their experience of falling, daily activities, and sleep duration, was investigated. A multivariate analysis was carried out using logistic regression to investigate the relationship between falls in the previous year and difficulties with specific daily activities and total number of difficulties (loco-check) endorsed, and sleep duration, adjusting for sex and age. One-fourth of participants (157 persons) experienced at least one fall during the previous year. Fall rate of females (94/312: 30.1%) was significantly higher than that of males (63/312: 20.2%). Fall rate of persons aged more than 65 years (80/242: 33.1%) was significantly higher than that of younger persons (77/382: 20.2%). Logistic regression analysis revealed that daily activities such as "impossibility of getting

  4. Summary of the Phase II, Title I engineering assessment of inactive uranium mill tailings, Falls City Site, Falls City, Texas

    International Nuclear Information System (INIS)

    1977-12-01

    An engineering assessment was performed of the problems resulting from the existence of radioactive uranium mill tailings at Falls City, Texas. Services included taking soil samples, the performance of radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 2.5 million tons of tailings at the Falls City site constitutes the most significant environmental impact. Windblown tailings, external gamma radiation and localized contamination of surface waters are other environmental effects. The two alternative remedial action options presented include on-site and off-site cleanup, fencing, and hydrological monitoring and, in addition, stabilization of pile 2 with 2 ft of cover material. The costs are $1.84 million and $2.45 million

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  6. [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.

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

    Science.gov (United States)

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

    2016-12-01

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

  8. An update on falls

    NARCIS (Netherlands)

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

    2003-01-01

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

  9. An update on falls.

    NARCIS (Netherlands)

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

    2003-01-01

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

  10. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

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

  11. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  14. Motor dual-tasking deficits predict falls in Parkinson's disease: A prospective study.

    Science.gov (United States)

    Heinzel, Sebastian; Maechtel, Mirjam; Hasmann, Sandra E; Hobert, Markus A; Heger, Tanja; Berg, Daniela; Maetzler, Walter

    2016-05-01

    Falls severely affect lives of Parkinson's disease (PD) patients. Cognitive impairment including dual-tasking deficits contribute to fall risk in PD. However, types of dual-tasking deficits preceding falls in PD are still unclear. Walking velocities during box-checking and subtracting serial 7s were assessed twice a year in 40 PD patients over 2.8 ± 1.0 years. Fourteen patients reported a fall within this period (4 excluded fallers already reported falls at baseline). Their dual-task costs (DTC; mean ± standard deviation) 4.2 ± 2.2 months before the first fall were compared with 22 patients never reporting falls. ROC analyses and logistic regressions accounting for DTC, UPDRS-III and disease duration were used for faller classification and prediction. Only walking/box-checking predicted fallers. Fallers showed higher DTC for walking while box-checking, p = 0.029, but not for box-checking while walking, p = 0.178 (combined motor DTC, p = 0.022), than non-fallers. Combined motor DTC classified fallers and non-fallers (area under curve: 0.75; 95% confidence interval, CI: 0.60-0.91) with 71.4% sensitivity (95%CI: 41.9%-91.6%) and 77.3% specificity (54.6%-92.2%), and significantly predicted future fallers (p = 0.023). Here, 20.4%-points higher combined motor DTC (i.e. the mean difference between fallers and non-fallers) was associated with a 2.6 (1.1-6.0) times higher odds to be a future faller. Motor dual-tasking is a potentially valuable predictor of falls in PD, suggesting that avoiding dual task situations as well as specific motor dual-task training might help to prevent falls in PD. These findings and their therapeutic relevance need to be further validated in PD patients without fall history, in early PD stages, and with various motor-motor dual-task challenges. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Chandran Manju

    2011-06-01

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

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    2011-01-01

    Abstract Background Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contri...

  1. Seismicity and neotectonic uplift in the Augrabies Falls National Park, Namaqualand, Northern Cape, South Africa

    Science.gov (United States)

    Madi, Kakaba

    2016-10-01

    Gneissic rocks in the Augrabies Falls National Park are part of the Proterozoic Namaqua-Natal mobile belt. Finding neotectonic evidence in old terranes is always not an easy task. In South Africa, the mid-Miocene is believed to be the beginning of neotectonics. This study investigated the occurrence and recurrence of earthquake activity, occurrence of faulting, jointing, uplift, and potholes in the gneisses cropping out around the Augrabies Falls area that may account for neotectonics. A historic seismic event obtained from the United States Geological Survey (USGS), and seismic epicenters downloaded in October 2015 from IRIS earthquake browser and overlaid on a satellite image with digitised faults and lineaments, indicates that the area is seismically active and is a zone of seismic risk. Potholes occurring today on a dry surface at approximately 613 m above sea level are a direct consequence of the Griqualand-Transvaal neotectonic uplift, which generated a major fault along which water flows continuously. It is concluded that the Augrabies Falls National Park area is a zone of neotectonics. This zone should not be considered for the storage of nuclear wastes.

  2. 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.

  3. Determination of Swimming Speeds and Energetic Demands of Upriver Migrating Fall Chinook Salmon (Oncorhynchus Tshawytscha) in the Klickitat River, Washington.

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Geist, David R.; Confederated Tribes and Bands of the Yakama Nation, Washington

    2002-08-30

    This report describes a study conducted by Pacific Northwest National Laboratory for the Bonneville Power Administration's Columbia Basin Fish and Wildlife Program during the fall of 2001. The objective was to study the migration and energy use of adult fall chinook salmon (Oncorhynchus tshawytscha) traveling up the Klickitat River to spawn. The salmon were tagged with either surgically implanted electromyogram (EMG) transmitters or gastrically implanted coded transmitters and were monitored with mobile and stationary receivers. Swim speed and aerobic and anaerobic energy use were determined for the fish as they attempted passage of three waterfalls on the lower Klickitat River and as they traversed free-flowing stretches between, below, and above the falls. Of the 35 EMG-tagged fish released near the mouth of the Klickitat River, 40% passed the first falls, 24% passed the second falls, and 20% made it to Lyle Falls. None of the EMG-tagged fish were able to pass Lyle Falls, either over the falls or via a fishway at Lyle Falls. Mean swimming speeds ranged from as low as 52.6 centimeters per second (cm s{sup -1}) between falls to as high as 189 (cm s{sup -1}) at falls passage. Fish swam above critical swimming speeds while passing the falls more often than while swimming between the falls (58.9% versus 1.7% of the transmitter signals). However, fish expended more energy swimming the stretches between the falls than during actual falls passage (100.7 to 128.2 kilocalories [kcals] to traverse areas between or below falls versus 0.3 to 1.0 kcals to pass falls). Relationships between sex, length, and time of day on the success of falls passage were also examined. Average swimming speeds were highest during the day in all areas except at some waterfalls. There was no apparent relationship between either fish condition or length and successful passage of waterfalls in the lower Klickitat River. Female fall chinook salmon, however, had a much lower likelihood of

  4. Falls from height: A retrospective analysis.

    Science.gov (United States)

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

    2018-01-01

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

  5. Thinking like a duck: fall lake use and movement patterns of juvenile ring-necked ducks before migration.

    Science.gov (United States)

    Roy, Charlotte L; Fieberg, John; Scharenbroich, Christopher; Herwig, Christine M

    2014-01-01

    The post-fledging period is one of the least studied portions of the annual cycle in waterfowl. Yet, recruitment into the breeding population requires that young birds have sufficient resources to survive this period. We used radio-telemetry and generalized estimating equations to examine support for four hypotheses regarding the drivers of landscape scale habitat use and movements made by juvenile ring-necked ducks between the pre-fledging period and departure for migration. Our response variables included the probability of movement, distances moved, and use of different lake types: brood-rearing lakes, staging lakes, and lakes with low potential for disturbance. Birds increased their use of staging areas and lakes with low potential for disturbance (i.e., without houses or boat accesses, >100 m from roads, or big lakes with areas where birds could sit undisturbed) throughout the fall, but these changes began before the start of the hunting season and their trajectory was not changed by the onset of hunting. Males and females moved similar distances and had similar probabilities of movements each week. However, females were more likely than males to use brood-rearing lakes later in the fall. Our findings suggest juvenile ring-necked ducks require different lake types throughout the fall, and managing solely for breeding habitat will be insufficient for meeting needs during the post-fledging period. Maintaining areas with low potential for disturbance and areas suitable for staging will ensure that ring-necked ducks have access to habitat throughout the fall.

  6. Fear of Falling in Older Adults: Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Dukyoo Jung, PhD, RN

    2008-12-01

    Full Text Available Fear of falling has been reported in a high percentage of community-dwelling elderly who both do and don't have a history of falling. The aims of this review are to: (a elucidate the definition of fear of falling; (b clarify measurements of fear of falling based on its definition; and (c describe the risk factors for fear of falling. Despite the importance of the percentage and the consequences of fear of falling, its definition is still vague and warrants clarification. Based on a literature review, major fear of falling measurements involve the evaluation of fear of falling and use of a fall efficacy scale. Using a correct definition of fear of falling, nurses working close with older adults need to identify the different definitions of fear of falling and fall efficacy scale. In addition, nurses who work closely with older adults should encourage them to increase or maintain modifiable factors by maximizing their basic health status and enhancing their physical activity to decrease fear of falling.

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

    Science.gov (United States)

    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.

  8. Occurence of thrips on Niagara table grape and its control with the insecticides thiacloprid and methiocarb associated with Metarhizium anisopliae Ocorrência de tripes em uva Niagara e seu controle com os inseticidas thiacloprid e methiocarb associados com Metarhizium anisopliae

    Directory of Open Access Journals (Sweden)

    ROGÉRIO BIAGGIONI LOPES

    2002-04-01

    Full Text Available Thrips are reported as important pests on table grapes in United States and several countries of Europe. Damage caused by thrips, particulary Frankliniella occidentalis, was observed on niagara table grape crop in Limeira-SP, Brazil. During the blooming period, high thrips densities were observed feeding on pollen and small berries. The symptoms left were more visible after the development of the berries and were characterized by dark scars and suberized surface on berries, sometimes causing the berry to crack, and the seed to prolapse. The effect of insecticides thiacloprid or methiocarb, associated or not with the entomopathogenic fungus Metarhizium anisopliae were evaluated during the blooming period. For evaluation of thrips damage on fruits, the treatments were applied three additional times, 7, 14 and 21 days after the first application. The treatments were: a M. anisopliae (strain 1037 1x10(7 conidia/mL; b thiacloprid 20mL/100L; c-d methiocarb 100 and 150mL/100L; e methiocarb 100mL/100L + M. anisopliae 1x10(7 conidia/mL. Only methiocarb, associated or not with the fungus, was effective in reducing thrips infestation, and no phytotoxic damage was observed. The efficiency of methiocarb 150mL/100L and the insecticide associated with the fungus for the control of the thrips population was 84.2 and 95.5%, respectively. In both cases, there was a reduction of approximately 70% in the number of berries with scars symptoms. For control of thrips on table grapes, chemical insecticides associated or not with M. anisopliae should be applied during the blooming period of the crop.Os tripes são mencionados como importantes pragas da cultura da uva de mesa em diversos países da Europa e Estados Unidos. Em área de cultivo da uva Niagara localizada na região de Limeira-SP verificou-se a ocorrência de danos provocados por Frankliniella occidentalis. Essa praga foi observada, principalmente, durante a fase de florescimento, alimentando-se de pólen e

  9. Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.

    Science.gov (United States)

    Ishimoto, Yasuko; Wada, Taizo; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wenling; Hirosaki, Mayumi; Nakatsuka, Masahiro; Fujisawa, Michiko; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Otsuka, Kuniaki; Matsubayashi, Kozo

    2012-10-01

    The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk. The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers. FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons. © 2012 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Schwenk Michael

    2012-04-01

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

  11. Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan

    OpenAIRE

    Chang, Hsiao-Ting; Chen, Hsi-Chung; Chou, Pesus

    2016-01-01

    Background Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored. Objectives To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan. Methods This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ? 65 years. The measurements inc...

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

    Science.gov (United States)

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

    2003-08-01

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

  13. There is more to life than risk avoidance - elderly people's experiences of falls, fall-injuries and compliant flooring.

    Science.gov (United States)

    Gustavsson, Johanna; Jernbro, Carolina; Nilson, Finn

    2018-12-01

    Falls are the most common cause of injury in all ages and are especially difficult to prevent among residential care residents. Compliant flooring that absorbs energy generated within the fall, has been proposed as a measure to prevent fall-injury, however little is known regarding the implementation aspects in clinical settings. The aim of this study is to explore the experiences of falls, the risk of fall-injury, prevention in general and specifically compliant flooring as an injury preventative measure amongst frail elderly people living in a residential care facility with compliant flooring. Through this, generate a theory that further explains the underlying barriers of active prevention amongst elderly people. We used the grounded theory method and conducted semi-structured in-depth interviews with eight elderly people in residential care (data collected between February and December 2017). The identified categories were Falling as a part of life, Fearing the consequences and A wish to prevent falls and injuries. Through the results it was clear that There is more to life than risk avoidance, permeated the interviews, therefore forming the grounded theory. The interviewees viewed falls as something common and normal, and were uninterested in focusing on the risk of falls. Although they wanted to prevent falls, it was often difficult to integrate preventative measures into their everyday life. They embraced the idea of an injury-reducing compliant flooring, however their main interests lay elsewhere, preferring to focus on social interaction and issues concerning daily activities. The theory generated in this paper proposes explanations on the obstacles of implementing fall prevention measures in an elderly frail population. The findings give insights as to why interest and compliance for active fall prevention measures are low. We conclude that complaint flooring, from the perspective of the residents, can work well in residential care.

  14. Falls: Epidemiology, Pathophysiology, and Relationship to Fracture

    OpenAIRE

    Berry, Sarah D.; Miller, Ram

    2008-01-01

    Falls are common in the elderly, and frequently result in injury, disability, and institutionalization. Although the causes of falls are complex, most falls result from an interaction between individual characteristics that increase an individual's propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, age-associated comorbidities such as osteoarthritis, visual impairment and d...

  15. Determinants of Falls and Fear of Falling in Ambulatory Persons With Late Effects of Polio.

    Science.gov (United States)

    Brogårdh, Christina; Flansbjer, Ulla-Britt; Lexell, Jan

    2017-05-01

    Falls and fear of falling (FOF) are common in persons with late effects of polio, but there is limited knowledge of associated factors. To determine how knee muscle strength, dynamic balance, and gait performance (adjusted for gender, age, and body mass index) are associated with falls and FOF in persons with late effects of polio. A cross-sectional study. A university hospital outpatient clinic. Eighty-one ambulatory persons with verified late effects of polio (43 men; mean age 67 years). Number of falls the past year, Falls Efficacy Scale-International to assess FOF, a Biodex dynamometer to measure knee muscle strength, the Timed Up & Go test to assess dynamic balance, and the 6-Minute Walk test to assess gait performance. Univariate and multivariate logistic regression analyses were used for falls (categorical data) and linear regression analyses for FOF (continuous data) as dependent variables. Fifty-nine percent reported at least 1 fall during the past year, and 79% experienced FOF. Reduced knee muscle strength in the more affected limb and gait performance were determinants of falls. An increase of 10 Nm in knee flexor and knee extensor strength reduced the odds ratio between 0.70 and 0.83 (P = .01), and an increase of 100 m in 6-Minute Walk test reduced the odds ratio to 0.41 (P = .001). All factors were determinants of FOF; reduced knee muscle strength in the more and less affected limbs explained 17%-25% of the variance in FOF, dynamic balance 30%, and gait performance 41%. Gender, age, and body mass index only marginally influenced the results. Reduced gait performance, knee muscle strength, and dynamic balance are to a varying degree determinants of falls and FOF in ambulatory persons with late effects of polio. Future studies need to evaluate whether rehabilitation programs targeting these factors can reduce falls and FOF in this population. IV. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All

  16. Identifying nursing home residents at risk for falling.

    Science.gov (United States)

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

    1998-05-01

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

  17. Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in elderly care units: study protocol.

    Science.gov (United States)

    Drahota, Amy; Gal, Diane; Windsor, Julie; Dixon, Simon; Udell, Julie; Ward, Derek; Soilemezi, Dia; Dean, Taraneh; Severs, Martin

    2011-12-01

    Falls are an issue disproportionately affecting older people who are at increased risk of falls and injury. This protocol describes a pilot study investigating shock-absorbing flooring for fall-related injuries in wards for older people. To inform future research by evaluating fall-related injuries on the intervention and existing flooring, assessing the sustainability of the flooring in ward environments, estimating the cost-effectiveness of the floor and assessing how the floor affects patients and other users. This study uses mixed methods a pilot cluster randomised controlled trial, observation via mechanical testing and interviews. Eight participating wards (clusters) are randomised using a computer-generated list. No blinding is incorporated into the study. Each site has a baseline period of approximately 6 months. Then, four sites receive the intervention floor, while four continue using standard floors. Sites are then followed up for approximately 1 year. Any person admitted to a bed in the 'study area' of a participating ward can be entered into the trial. Orientated patients, visitors and any hospital staff who use the floor in a study area are eligible for inclusion in an interview. An 8.3 mm thick vinyl floor covering with polyvinyl chloride foam backing (Tarkett Omnisports EXCEL). The primary outcome is fall-related injuries. Severity of injuries, falls, cost-effectiveness, user views and mechanical performance (shock absorbency and slip resistance) are also being assessed.

  18. Intrinsic Risk Factors of Falls in Elderly

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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

  1. 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...

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

    Science.gov (United States)

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

    2017-03-01

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

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

    OpenAIRE

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

    2015-01-01

    Objective. To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. Methods. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb stre...

  4. Falls among older adults in the South of Brazil: prevalence and determinants.

    Science.gov (United States)

    Vieira, Luna S; Gomes, Ana Paula; Bierhals, Isabel O; Farías-Antúnez, Simone; Ribeiro, Camila G; Miranda, Vanessa I A; Lutz, Bárbara H; Barbosa-Silva, Thiago G; Lima, Natália P; Bertoldi, Andréa D; Tomasi, Elaine

    2018-01-01

    OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p falls among older adults in the last year was 28.1% (95%CI 25.9-30.5), and most occurred in the person's own residence. Among the older adults who fell, 51.5% (95%CI 46.6-56.4) had a single fall and 12.1% (95%CI 8.9-15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.

  5. Validity of the performance-oriented mobility assessment in predicting fall of stroke survivors: a retrospective cohort study.

    Science.gov (United States)

    An, SeungHeon; Lee, YunBok; Lee, GyuChang

    2014-06-01

    Falling is one of the most common complications in stroke survivors. It is therefore important to evaluate the risk of falls. In this study, we investigated the usability of the performance-oriented mobility assessment (POMA) for predicting falls in stroke patients. The POMA examines the level of balance and mobility. Data were collected on the number of falls and physical functions from 72 stroke survivors. Physical functions were measured using the POMA balance subscale, One Leg Stand test (OLS), Sit To Stand test (STS), 10-m Walk Test (10WT), Fugl-Meyer assessment (FM), and Trunk Impairment Scale (TIS). Since the accuracy of the POMA balance subscale was moderate, the cutoff value used for predicting falls was 12.5 points (sensitivity: 72%; specificity: 74%), and the area under the curve was 0.78 (95% confidence interval: 0.66-0.91, p risk of falling increased by 0.304 times more than the group over 12.5 points. The POMA balance subscale is a valid tool for assessing the physical function and fall risk of stroke survivors.

  6. Effects of combined-sewer overflows and urban runoff on the water quality of Fall Creek, Indianapolis, Indiana

    Science.gov (United States)

    Martin, Jeffrey D.

    1995-01-01

    In 1986, the U.S. Geological Survey and the Indianapolis Department of Public Works began a study to evaluate the effects of combined-sewer overflows and urban runoff discharging to Fall Geek on the White River. This report describes the effects of combined-sewer overflows and urban runoff on the water quality of Fall Creek during summer 1987 by comparing the water quality during base flow with that during storm runoff and by comparing water quality in the urbanized area with that in the less urbanized area upstream from the combined-sewer overflows. Data were collected at three streamflow-gaging stations located upstream from, downstream from, and in the middle of 27 combined-sewer overflows on Fall Creek. The most downstream station also was immediately downstream from the discharge of filter backwash from a water-treatment plant for public supply.

  7. [Fall risk assessment in regular exercising elderly women].

    Science.gov (United States)

    Kikuchi, Reiko; Kozaki, Koichi; Kawashima, Yumiko; Iwata, Akiko; Hasegawa, Hiroshi; Igata, Akihiro; Toba, Kenji

    2008-09-01

    Fall prevention is important for elderly people to maintain their functional independence. We made a longitudinal fall-risk assessment using our "Fall-predicting score" of women who are 60 years or older and who exercised regularly. We sent "fall-predicting questionnaires" to 632 elderly women aged 60 years or older (mean 65.0+/-4.3), members of "Miishima gymnastics program", and asked about their fall history of falling in the past year in 2004 and 2005. We performed a logistic regression analysis to determine the future risk factor of falling in 2005. The number of people who fell was 134 (21.2%) in 2004 and 121 (19.1%) in 2005. The number of people who fell decreased in the seventh decade, but increased in the eighth decade, and members for 6-10 years showed most decreased fall rates. Logistic regression analysis revealed that age, falls in 2004, "tripping", "cannot squeeze a towel", and "walk steep slope around the house" were significant independent risk factors of "falls in 2005". Logistic regression analysis of non-fallers in 2004 showed that age and "tripping" were the significant independent risk factors of "falls in 2005", and the analysis of people who fell in 2004 showed that age, "tripping", "cannot squeeze a towel", "walk steep slope around the house", and "taking more than 5 medicines" were significant independent risk factors for falls in 2005. In regular exercising elderly women, exercise appears to prevent falls in people in the seventh decade and in the members of 6-10 years. Age, past history of falls, and fall-predicting questionnaire were important risk predictors of future falls.

  8. 50 CFR 226.205 - Critical habitat for Snake River sockeye salmon, Snake River fall chinook salmon, and Snake River...

    Science.gov (United States)

    2010-10-01

    ... salmon, Snake River fall chinook salmon, and Snake River spring/summer chinook salmon. 226.205 Section... Snake River sockeye salmon, Snake River fall chinook salmon, and Snake River spring/summer chinook salmon. The following areas consisting of the water, waterway bottom, and adjacent riparian zone of...

  9. Cesium-137 and potassium contents in low-teens in areas of different fall-out levels in Japan

    International Nuclear Information System (INIS)

    Ueda, Keiko; Anzai, Ikuro; Togo, Masami; Katsunuma, Haruo

    1977-01-01

    Comparative measurements were made by a whole body counter equipped in the University of Tokyo with regard to the 137 Cs body burden of 88 Japanese male low-teens in Akita and Tokyo. In spite of the heavy fall-out level in Akita, the mean 137 Cs body burden was significantly lower than that in Tokyo where the fall-out deposition was about half. The major cause of the difference in the body burden was considered to be the difference in the daily volume of milk consumption in the two groups which was disclosed from the results of an interview with each subject. The 137 Cs content showed a very low correlation with the potassium content in each group. The fact raised an important question concerning the effectiveness of the concept of ''cesium unit'' for describing the level of internal contamination in man. (auth.)

  10. Cesium-137 and potassium contents in low-teens in areas of different fall-out levels in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Ueda, K; Anzai, I; Togo, M; Katsunuma, H [Tokyo Univ. (Japan). Faculty of Medicine

    1977-05-01

    Comparative measurements were made by a whole body counter equipped in the University of Tokyo with regard to the /sup 137/Cs body burden of 88 Japanese male low-teens in Akita and Tokyo. In spite of the heavy fall-out level in Akita, the mean /sup 137/Cs body burden was significantly lower than that in Tokyo where the fall-out deposition was about half. The major cause of the difference in the body burden was considered to be the difference in the daily volume of milk consumption in the two groups which was disclosed from the results of an interview with each subject. The /sup 137/Cs content showed a very low correlation with the potassium content in each group. The fact raised an important question concerning the effectiveness of the concept of ''cesium unit'' for describing the level of internal contamination in man.

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

    Science.gov (United States)

    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.

  12. Impaired perceived timing of falls in the elderly.

    Science.gov (United States)

    Lupo, Julian; Barnett-Cowan, Michael

    2018-01-01

    Falls are the leading cause of injury-related deaths and hospitalizations, with older adults at an increased risk. As humans age, physical changes and health conditions make falls more likely. While we know how the body reflexively responds to prevent injury during a fall, we know little about how people perceive the fall itself. We previously found that young adults required a fall to precede a comparison sound stimulus by approximately 44ms to perceive the two events as simultaneous. This may relate to common anecdotal reports suggesting that humans often describe distortions in their perception of time - time seems to slow down during a fall - with very little recollection of how and when the fall began. Here we examine whether fall perception changes with age. Young (19-25y) and older (61-72y) healthy adults made temporal order judgments identifying whether the onset of their fall or the onset of a comparison sound came first to measure the point of subjective simultaneity. Results show that fall perception is nearly twice as slow for older adults, where perturbation onset has to precede sound onset by ∼88ms to appear coincident, compared to younger adults (∼44ms). We suggest that such age-related differences in fall perception may relate to increased fall rates in older adults. We conclude that a better understanding of how younger versus older adults perceive falls may identify important factors for innovative fall prevention strategies and rehabilitative training exercises to improve fall awareness. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Evaluation of fall chinook salmon spawning adjacent to the In-Situ Redox Manipulation treatability test site, Hanford Site, Washington

    International Nuclear Information System (INIS)

    Mueller, R.P.; Geist, D.R.

    1998-10-01

    The In Situ Redox Manipulation (ISRM) experiment is being evaluated as a potential method to remove contaminants from groundwater adjacent to the Columbia River near the 100-D Area. The ISRM experiment involves using sodium dithionate (Na 2 O 6 S 2 ) to precipitate chromate from the groundwater. The treatment will likely create anoxic conditions in the groundwater down-gradient of the ISRM treatability test site; however, the spatial extent of this anoxic plume is not exactly known. Surveys were conducted in November 1997, following the peak spawning of fall chinook salmon. Aerial surveys documented 210 redds (spawning nests) near the downstream island in locations consistent with previous surveys. Neither aerial nor underwater surveys documented fall chinook spawning in the vicinity of the ISRM treatability test site. Based on measurements of depth, velocity, and substrate, less than 1% of the study area contained suitable fall chinook salmon spawning habitat, indicating low potential for fall chinook salmon to spawn in the vicinity of the ISRM experiment

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

    Directory of Open Access Journals (Sweden)

    Elizabeth A Phelan

    2016-09-01

    Full Text Available A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ with a history of repeated falls or fall-related healthcare use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79±8 years; 68% were female, and 10% were non-white. They averaged 6 primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall risk factors varied from 24% (for home safety to 78% (for vitamin D. An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21% and home safety (24%. Use of a structured visit note template independently predicted assessment of fall risk factors (P=0.003. Geriatrics specialists were more likely to use a structured note template (p=.04 and perform more fall risk factor assessments (4.6 vs. 3.6, p=.007 than general internists. These results suggest opportunities for improving multifactorial fall risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

  15. The nursing staff's opinion of falls among older persons with dementia. a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Slaasletten Randi

    2011-06-01

    Full Text Available Abstract The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs and enrolled nurses (ENs and staff with ≤5 and >5 years of employment in the care units in question. Background Falls are common among older people and persons with dementia constitute an additional risk group. Methods The study had a cross-sectional design and included nursing staff (n = 63, response rate 66% working in four special care units for older persons with dementia. Data collection was conducted with a questionnaire consisting of 64 questions. Results The respondents reported that the individuals' mental and physical impairment constitute the most frequent causes of falls. The findings also revealed a lack of, or uncertainty about, routines of documentation and reporting fall-risk and fall-preventing interventions. Respondents who had been employed in the care units more than five years reported to a higher degree that colours and material on floors caused falls. RNs considered the residents' autonomy and freedom of movement as a cause of falls to a significantly higher degree than ENs. RNs also reported a significantly longer time than ENs before fall incidents were discovered, and they used conversation and closeness as fall-preventing interventions to a significantly higher degree than ENs. Conclusions Individual factors were the most common causes to falls according to the nursing staff. RNs used closeness and dialog as interventions to a significantly higher degree to prevent falls than ENs. Caring of for older people with dementia consisted of a comprehensive on-going assessment by the nursing staff to balance the residents' autonomy-versus-control to minimise fall

  16. Falling into the Light-using music and poetry as complementary modes of understanding falls in old age

    DEFF Research Database (Denmark)

    Evron, Lotte; Clausen, Nina

    that a broader understanding of falls in old age in the health care system might help health professionals to understand the complexity of falls and by this inspire older persons to prevent falls in different ways. Using poetry and music in our performance we seek to open up for a broader understanding of falls......: irresponsible behavior, disease, destiny, desire to remain independent in old age, appearing elegant/aesthetical and being physical active. One of the interviews was selected and transformed it into a poem (2-3). The poem was then translated into music by the second author. First we present the six...... understandings of falls in old age then we read the poem and finally a musical interpretation of the poem is performed by song and cello. The music is written for soprano and cello and created with direct inspiration from the poem. The fall is reproduced in a series of descending tones coming back as a "chorus...

  17. 29 CFR 1917.41 - House falls.

    Science.gov (United States)

    2010-07-01

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

  18. 29 CFR 1926.760 - Fall protection.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Fall protection. 1926.760 Section 1926.760 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Steel Erection § 1926.760 Fall protection. (a... protection from fall hazards in accordance with paragraph (a)(1) of this section. (c) Controlled Decking Zone...

  19. Falls prevention for the elderly

    Directory of Open Access Journals (Sweden)

    Dagmar Lühmann

    2012-04-01

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

  20. Falls in Parkinson's disease and Huntington's disease

    NARCIS (Netherlands)

    Grimbergen, Yvette Anna Maria

    2012-01-01

    Falls in Parkinson’s (PD) and Huntington’s disease (HD) are common. 50 % of moderately affected PD patients sustained two or more falls during a prospective follow-up of 6 months. During a 3 month period 40 % of HD patients reported one or more fall. Many falls resulted in minor injuries and 42 % of

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

    Science.gov (United States)

    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.

  2. Sunn hemp as a ground cover to manage fall armyworm populations

    Science.gov (United States)

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

  3. Factors Associated with Fear of Falling among Community-Dwelling Older Adults in the Shih-Pai Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Hsiao-Ting Chang

    Full Text Available Fear of falling is an important risk indicator for adverse health related outcomes in older adults. However, factors associated with fear of falling among community-dwelling older adults are not well-explored.To explore the quality of life and associated factors in fear of falling among older people in the Shih-Pai area in Taiwan.This community-based survey recruited three thousand eight hundred and twenty-four older adults aged ≥ 65 years. The measurements included a structured questionnaire, including quality of life by using Short-Form 36, and information of fear of falling, fall history, demographics, medical conditions, insomnia, sleep quality, depression and subjective health through face-to-face interviews.A total of 53.4% of participants reported a fear of falling. The rate of fear of falling was higher in female subjects. Subjects with fear of falling had lower Short Form-36 scores both for men and women. Falls in the previous year, older age, insomnia, depression and worse subjective health were correlates of fear of falling for both sexes. Male-specific associations with fear of falling were the accessibility of medical help in an emergency, diabetes mellitus and stroke. In parallel, cardiovascular diseases were a female-specific correlate for fear of falling.Fear of falling is prevalent among community-dwelling older adults. It is seems that there are gender differences in fear of falling with respect to the prevalence and associated factors in older adults. Gender differences should be considered when planning prevention and intervention strategies for fear of falling among older people.

  4. The Effects of the A Matter of Balance Program on Falls and Physical Risk of Falls, Tampa, Florida, 2013

    OpenAIRE

    Chen, Tuo-Yu; Edwards, Jerri D.; Janke, Megan C.

    2015-01-01

    Introduction This study investigated the effects of the A Matter of Balance (MOB) program on falls and physical risk factors of falling among community-dwelling older adults living in Tampa, Florida, in 2013. Methods A total of 110 adults (52 MOB, 58 comparison) were enrolled in this prospective cohort study. Data on falls, physical risk of falling, and other known risk factors of falling were collected at baseline and at the end of the program. Multivariate analysis of covariance with repeat...

  5. [Vertigo and falls in the elderly: Part 2: Fall diagnostics, prophylaxis and therapy].

    Science.gov (United States)

    Walther, L E; Nikolaus, T; Schaaf, H; Hörmann, K

    2008-09-01

    In many acute or chronic vestibular diseases in old age, the risk of falling is increased. A fear of falling often develops together with further limitations to physical activity and subsequent physical and psychological consequences. Falls represent a substantial health-related risk factor. A regular balance, walking and muscle training is an effective prophylaxis. Components of the treatment of vestibular diseases in old age are counselling and encouragement (psychotherapy), treatment of the specific organic disease, specific vestibular rehabilitation and a symptomatic medication therapy. Vertigo in old age is a multifactorial process. The differential diagnosis of disorders of the equilibrium function in old age represents a challenge which can only be overcome by interdisciplinary cooperation.

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

    Science.gov (United States)

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

    2011-01-01

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

  7. Collective Fall Protection for Construction Workers

    Directory of Open Access Journals (Sweden)

    Sulowski, A. C.

    2014-03-01

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

  8. Anxiety disorders and falls among older adults.

    Science.gov (United States)

    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.

  9. Frequency and circumstances of falls in people with inclusion body myositis: a questionnaire survey to explore falls management and physiotherapy provision.

    Science.gov (United States)

    Hiscock, A; Dewar, L; Parton, M; Machado, P; Hanna, M; Ramdharry, G

    2014-03-01

    To survey the incidence and circumstances of falls for people with inclusion body myositis (IBM) in the UK, and to investigate the provision of physiotherapy and falls management. Postal questionnaire survey. Participants completed questionnaires at home. Ninety-four people diagnosed with IBM were screened against the inclusion criteria. Seventy-two potential participants were sent a questionnaire, and 62 were completed and returned. Invited participants were sent an adapted Falls Event Questionnaire pertaining to falls, perceived causes of falls and the provision of physiotherapy. Questionnaires were returned anonymously. The proportions of respondents who reported a fall or a near fall, along with the frequencies of falls and near falls were calculated. Descriptive data of falls were collected pertaining to location and cause. Data analysis was performed to investigate provision of physiotherapy services. The response rate was 86% [62/72, mean (standard deviation) age 68 (8) years]. Falls were reported by 98% (61/62) of respondents, with 60% (37/62) falling frequently. In this study, age was not found to be an indicator of falls risk or frequency. Twenty-one percent (13/62) of respondents had not seen a physiotherapist in relation to their IBM symptoms, and of those that had, 31% (15/49) had not seen a physiotherapist until more than 12 months after IBM was diagnosed. Only 18% (11/61) of fallers reported that they had received falls management input. Falls are a common occurrence for people with IBM, independent of age and years since symptoms first presented, and are poorly addressed by appropriate physiotherapy management. National falls guidelines are not being followed, and referral rates to physiotherapy need to improve. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  10. DNR Division of Enforcement Officer Patrol Areas

    Data.gov (United States)

    Minnesota Department of Natural Resources — This theme shows the DNR Division of Enforcement Office Patrol Areas as of January 1, 2003. Patrol areas were defined and verified by Patrol Officers during the fall...

  11. Role of physical activity in the occurrence of falls and fall-related injuries in community-dwelling adults over 50 years old.

    Science.gov (United States)

    Pereira, Catarina L N; Baptista, Fátima; Infante, Paulo

    2014-01-01

    This study examined the effect of the type, level and amount of physical activity in falls and fall-related injuries. Participants were 506 community-dwelling adults aged >50 years (390 women: 67.7 ± 6.8 years and 116 men: 69.6 ± 6.6 years). Falls, fall-related injuries (slight and severe), and physical activity (type, level and energy expenditure) were evaluated by questionnaires. Confounders included co-morbidities, fear of falling, environmental hazards and physical fitness. After adjustment for confounders, logistic analysis revealed that the likelihood of falling decreased by 2% for each 100 metabolic expenditure (MET-min/week) of total physical activity and increased by 5% for each 100 MET-min/week of vigorous-intensity physical activity; total physical activity >1125 MET-min/week and vigorous physical activity physical activity level, increased physical activity levels diminished the likelihood of the occurrence of severe fall-related injuries by 76% (moderate) and 58% (high; p active, especially sufficiently active, reduces fall-related injuries by decreasing falls and by safeguarding against severe injuries when falls occur. At least 1125 MET-min/week of total physical activity including >500 MET-min/week of vigorous intensity seems to prevent falls and, therefore, fall-related injuries.

  12. Reducing falls and improving mobility in multiple sclerosis.

    Science.gov (United States)

    Sosnoff, Jacob J; Sung, JongHun

    2015-06-01

    Falls are common in persons with multiple sclerosis (MS), and are related to physical injury and reduce the quality of life. Mobility impairments are a significant risk factor for falls in persons with MS. Although there is evidence that mobility in persons with MS can be improved with rehabilitation, much less is known about fall prevention. This review focuses on fall prevention in persons with MS. Ten fall prevention interventions consisting of 524 participants with a wide range of disability were systematically identified. Nine of the 10 investigations report a reduction in falls and/or proportion of fallers following treatment. The vast majority observed an improvement in balance that co-occurred with the reduction in falls. Methodological limitations preclude any firm conclusions. Numerous gaps in the understanding of fall prevention in persons with MS are discussed. Well-designed randomized control trials targeting mobility and falls are warranted.

  13. Fall prevention in high-risk patients.

    Science.gov (United States)

    Shuey, Kathleen M; Balch, Christine

    2014-12-01

    In the oncology population, disease process and treatment factors place patients at risk for falls. Fall bundles provide a framework for developing comprehensive fall programs in oncology. Small sample size of interventional studies and focus on ambulatory and geriatric populations limit the applicability of results. Additional research is needed. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Risk of Falling in Older Women

    OpenAIRE

    Laura Armas; Joan Lappe; Veronica J. Slavik; Kellan Slattery; Shih-Chuan Cheng; Davender S. Malik; John N. Mordeson

    2015-01-01

    We propose a weighted average approach to measure the risk of falling in older women. We consider four causal variables of falling, namely serum 25-OHD levels, medication use, fracture, and age. We use five methods to derive linear equations with these four factors as independent variables in the linear equations with risk of falling as the dependent variable.

  15. Osteosarcopenic obesity and fall prevention strategies.

    Science.gov (United States)

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

    2015-02-01

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

  16. Incidence of fall-related injuries in Iran: A population-based nationwide study.

    Science.gov (United States)

    Saadat, Soheil; Hafezi-Nejad, Nima; Ekhtiari, Yalda Soleiman; Rahimi-Movaghar, Afarin; Motevalian, Abbas; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Radgoodarzi, Reza; Hefazi, Mitra; Eslami, Vahid; Karimi, Hasti; Mohammad, Kazem; Rahimi-Movaghar, Vafa

    2016-07-01

    Fall-related injuries are considered to be a leading cause of morbidity and disability worldwide. The aim of this study was to investigate the incidence of fall-related injuries and its determinants in Iran. A cross-sectional household survey of a representative sample of 15-64 years old Iranians was carried out in 2011. A three-stage cluster sampling design was used. Total of 1525 clusters were randomly selected. Six households in each cluster were randomly selected, and one member of each household was interviewed. Data on the demographics and history of fall-related injury were obtained using the previously validated and reliability tested Short Form Injury Questionnaire 7 (SFIQ7). In all, 7886 subjects responded to the survey. The incidence rate of all fall-related injuries was 59 (95%CI: 45-72) per 1000 person-year. The incidence rate of First Aid Fall-Related Injuries (FAFRIs) and Medical Attended Fall-Related Injuries (MAFRIs) were 30±5 and 28±12, respectively. Homes were the most common place of falls (52.5%). For all and MAFRIs, the most common activity leading to fall injury was walking (37.8% and 47.6%, respectively) whereas for FAFRIs was playing (31.9%). For all and FAFRIs, the most common description was as follows: upper limb as the injured organ (52.0% and 61.2%, respectively) and superficial wound as the most prevalent type of injury (39.0% and 61.8%, respectively). However, for MAFRIs, lower limb injuries (52.9%) and fracture (43.6%) were more pronounced. Risk factors for MAFRI were as follows: paid work activity (OR: 3.11; 95%CI: 2.07-4.67), playing (OR: 14.64; 95%CI: 6.34-33.80), walking (OR: 57.09; 95%CI: 28.95-112.59), driving (OR: 2.86; 95%CI: 1.23-6.63), and recreation activities (OR: 44.11; 95%CI: 14.04-138.54). Higher age and education were the other risk factors for MAFRI, as well as residing in rural areas. This study revealed considerable incidence of fall injuries in Iranian population especially in rural regions who need access to

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

    Directory of Open Access Journals (Sweden)

    C. Dussauge-Peisser

    2002-01-01

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

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

    Science.gov (United States)

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

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

  19. The FLASSH study: protocol for a randomised controlled trial evaluating falls prevention after stroke and two sub-studies

    Directory of Open Access Journals (Sweden)

    Mackintosh Shylie F

    2009-03-01

    Full Text Available Abstract Background Falls are common in stroke survivors returning home after rehabilitation, however there is currently a lack of evidence about preventing falls in this population. This paper describes the study protocol for the FLASSH (FaLls prevention After Stroke Survivors return Home project. Methods and design This randomised controlled trial aims to evaluate the effectiveness of a multi-factorial falls prevention program for stroke survivors who are at high risk of falling when they return home after rehabilitation. Intervention will consist of a home exercise program as well as individualised falls prevention and injury minimisation strategies based on identified risk factors for falls. Additionally, two sub-studies will be implemented in order to explore other key areas related to falls in this population. The first of these is a longitudinal study evaluating the relationship between fear of falling, falls and function over twelve months, and the second evaluates residual impairment in gait stability and obstacle crossing twelve months after discharge from rehabilitation. Discussion The results of the FLASSH project will inform falls prevention practice for stroke survivors. If the falls prevention program is shown to be effective, low cost strategies to prevent falls can be implemented for those at risk around the time of discharge from rehabilitation, thus improving safety and quality of life for stroke survivors. The two sub-studies will contribute to the overall understanding and management of falls risk in stroke survivors. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN012607000398404.

  20. Fall prevention in older persons

    African Journals Online (AJOL)

    weak muscles, poor vision, psychotropic medications ... with increased risk of falls.[3]. Building on the .... [8] First eye cataract surgery has ... of users of bifocals in which half the subjects .... falls of providing single lens distance vision glasses.

  1. Falls among older adults in the South of Brazil: prevalence and determinants

    Directory of Open Access Journals (Sweden)

    Luna S Vieira

    2018-02-01

    Full Text Available ABSTRACT OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p < 0.05 were considered to be associated with the outcome. RESULTS The prevalence of falls among older adults in the last year was 28.1% (95%CI 25.9–30.5, and most occurred in the person’s own residence. Among the older adults who fell, 51.5% (95%CI 46.6–56.4 had a single fall and 12.1% (95%CI 8.9–15.3 had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.

  2. Rehabilitation after falls and fractures.

    Science.gov (United States)

    Dionyssiotis, Y; Dontas, I A; Economopoulos, D; Lyritis, G P

    2008-01-01

    Falls are one of the most common geriatric problems threatening the independence of older persons. Elderly patients tend to fall more often and have a greater tendency to fracture their bones. Fractures occur particularly in osteoporotic people due to increased bone fragility, resulting in considerable reduction of quality of life, morbidity, and mortality. This article provides information for the rehabilitation of osteoporotic fractures pertaining to the rehabilitation of the fractured patient, based on personal experience and literature. It also outlines a suggested effective and efficient clinical strategy approach for preventing falls in individual patients.

  3. Falling-sphere radioactive viscometry

    International Nuclear Information System (INIS)

    Souza, R. de.

    1987-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

    A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79 ± 8 years; 68% were female, and 10% were non-white. They averaged six primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall-risk factors varied from 24% (for home safety) to 78% (for vitamin D). An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21%) and home safety (24%). Use of a structured visit note template independently predicted assessment of fall-risk factors (p = 0.003). Geriatrics specialists were more likely to use a structured note template (p = 0.04) and perform more fall-risk factor assessments (4.6 vs. 3.6, p = 0.007) than general internists. These results suggest opportunities for improving multifactorial fall-risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice. PMID:27660753

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Incidence of in-hospital falls in geriatric patients before and after the introduction of an interdisciplinary team-based fall-prevention intervention.

    Science.gov (United States)

    von Renteln-Kruse, Wolfgang; Krause, Tom

    2007-12-01

    Falls are among the most common unwanted events in older hospital inpatients, but evidence of effective prevention is still limited compared with that in the community and in long-term care facilities. This article describes a prevention program and its effects on the incidence of falls in geriatric hospital wards. It was a prospective cohort study with historical control including all 4,272 patients (mean age 80, 69% female) before and 2,982 (mean age 81, 69% female) after introduction of the intervention. The intervention included fall-risk assessment on admission and reassessment after a fall; risk alert; additional supervision and assistance with the patients' transfer and use of the toilet; provision of an information leaflet; individual patient and caregiver counseling; encouragement of appropriate use of eyeglasses, hearing aids, footwear, and mobility devices; and staff education. Measurements included standardized fall-incidence reporting, activity of daily living and mobility status, number of falls and injurious falls, and number of patients who fell. Before the intervention was introduced, 893 falls were recorded. After the intervention was implemented, only 468 falls were recorded (incidence rate ratio (IRR)=0.82, 95% confidence interval (CI)=0.73-0.92), 240 versus 129 total injurious falls (IRR=0.84, 95% CI=0.67-1.04), 10 versus nine falls with fracture (IRR=1.40, 95% CI=0.51-3.85) and 611 versus 330 fallers. The relative risk of falling was significantly reduced (0.77, 95% CI=0.68-0.88). A structured multifactorial intervention reduced the incidence of falls, but not injurious falls, in a hospital ward setting with existing geriatric multidisciplinary care. Improvement of functional competence and mobility may be relevant to fall prevention in older hospital inpatients.

  7. The Effect of Personalization on Smartphone-Based Fall Detectors

    Directory of Open Access Journals (Sweden)

    Carlos Medrano

    2016-01-01

    Full Text Available The risk of falling is high among different groups of people, such as older people, individuals with Parkinson's disease or patients in neuro-rehabilitation units. Developing robust fall detectors is important for acting promptly in case of a fall. Therefore, in this study we propose to personalize smartphone-based detectors to boost their performance as compared to a non-personalized system. Four algorithms were investigated using a public dataset: three novelty detection algorithms—Nearest Neighbor (NN, Local Outlier Factor (LOF and One-Class Support Vector Machine (OneClass-SVM—and a traditional supervised algorithm, Support Vector Machine (SVM. The effect of personalization was studied for each subject by considering two different training conditions: data coming only from that subject or data coming from the remaining subjects. The area under the receiver operating characteristic curve (AUC was selected as the primary figure of merit. The results show that there is a general trend towards the increase in performance by personalizing the detector, but the effect depends on the individual being considered. A personalized NN can reach the performance of a non-personalized SVM (average AUC of 0.9861 and 0.9795, respectively, which is remarkable since NN only uses activities of daily living for training.

  8. The impact of care recipient falls on caregivers.

    Science.gov (United States)

    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

  9. A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries.

    Science.gov (United States)

    Franse, Carmen B; Rietjens, Judith Ac; Burdorf, Alex; van Grieken, Amy; Korfage, Ida J; van der Heide, Agnes; Mattace Raso, Francesco; van Beeck, Ed; Raat, Hein

    2017-06-30

    The rate of falling among older citizens appears to vary across different countries, but the underlying aspects causing this variation are unexplained. We aim to describe between-country variation in falling and explore whether intrinsic fall risk factors can explain possible variation. Prospective study on data from the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Twelve European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, The Netherlands, Spain, Sweden, Switzerland). Community-dwelling persons aged ≥65 years (n=18 596). Socio-demographic factors (age, gender, education level and living situation) and intrinsic fall risk factors (less than good self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression and impaired cognition) were assessed in a baseline interview. Falling was assessed 2 years later by asking whether the participant had fallen within the 6 months prior to the follow-up interview. There was significant between-country variation in the rate of falling (varying from 7.9% in Switzerland to 16.2% in the Czech Republic). The prevalence of intrinsic fall risk factors varied twofold to fourfold between countries. Associations between factors age ≥80 years, less than good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (pfalling largely persisted after adjusting for socio-demographic differences but strongly attenuated after adjusting for differences in intrinsic fall risk factors. There is considerable variation in the rate of falling between European countries, which can largely be explained by between-country variation in the prevalence of intrinsic fall risk factors. There are also country-specific variations in the association between these intrinsic risk factors and falling. These findings emphasise the importance of addressing

  10. A comparison of automatic fall detection by the cross-product and magnitude of tri-axial acceleration

    International Nuclear Information System (INIS)

    Chao, Pei-Kuang; Chan, Hsiao-Lung;