Sample records for previous fall precipitation
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Global Precipitation Measurement (GPM) Core Observatory Falling Snow Estimates
Skofronick Jackson, G.; Kulie, M.; Milani, L.; Munchak, S. J.; Wood, N.; Levizzani, V.
2017-12-01
Retrievals of falling snow from space represent an important data set for understanding and linking the Earth's atmospheric, hydrological, and energy cycles. Estimates of falling snow must be captured to obtain the true global precipitation water cycle, snowfall accumulations are required for hydrological studies, and without knowledge of the frozen particles in clouds one cannot adequately understand the energy and radiation budgets. This work focuses on comparing the first stable falling snow retrieval products (released May 2017) for the Global Precipitation Measurement (GPM) Core Observatory (GPM-CO), which was launched February 2014, and carries both an active dual frequency (Ku- and Ka-band) precipitation radar (DPR) and a passive microwave radiometer (GPM Microwave Imager-GMI). Five separate GPM-CO falling snow retrieval algorithm products are analyzed including those from DPR Matched (Ka+Ku) Scan, DPR Normal Scan (Ku), DPR High Sensitivity Scan (Ka), combined DPR+GMI, and GMI. While satellite-based remote sensing provides global coverage of falling snow events, the science is relatively new, the different on-orbit instruments don't capture all snow rates equally, and retrieval algorithms differ. Thus a detailed comparison among the GPM-CO products elucidates advantages and disadvantages of the retrievals. GPM and CloudSat global snowfall evaluation exercises are natural investigative pathways to explore, but caution must be undertaken when analyzing these datasets for comparative purposes. This work includes outlining the challenges associated with comparing GPM-CO to CloudSat satellite snow estimates due to the different sampling, algorithms, and instrument capabilities. We will highlight some factors and assumptions that can be altered or statistically normalized and applied in an effort to make comparisons between GPM and CloudSat global satellite falling snow products as equitable as possible.
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On the relationship between Indian monsoon withdrawal and Iran's fall precipitation onset
Babaeian, Iman; Rezazadeh, Parviz
2017-09-01
Indian monsoon is the most prominent of the world's monsoon systems which primarily affects synoptic patterns of India and adjacent countries such as Iran in interaction with large-scale weather systems. In this article, the relationship between the withdrawal date of the Indian monsoon and the onset of fall precipitation in Iran has been studied. Data included annual time series of withdrawal dates of the Indian monsoon prepared by the Indian Institute for Tropical Meteorology, and time series of the first date of 25 mm accumulated precipitation over Iran's synoptic weather stations in a 10-day period which is the basis for the cultivation date. Both time series were considered in Julian calendar with the starting date on August 1. The studied period is 1960-2014 which covers 55 years of data from 36 meteorological stations in Iran. By classifying the withdrawal dates of the Indian monsoon in three stages of late, normal, and early withdrawals, its relation with the onset of fall precipitation in western, southwestern, southern, eastern, central, and northern regions of Iran was studied. Results demonstrated that in four out of the six mentioned regions, the late withdrawal of the Indian monsoon postpones the onset of fall precipitation over Iran. No significant relation was found between the onset of fall precipitation in central region of Iran and the monsoon's withdrawal date. In the western, southwestern, southern, and eastern regions of Iran, the late monsoon delays the onset of fall's precipitation; while in the south Caspian Sea coastal area, it causes the early onset of autumnal precipitation. The lag in onset of fall precipitation in Iran which is coordinated with the late withdrawal of monsoon is accompanied with prolonged subtropical high settling over Iran's plateau that prevents the southward movement of polar jet frontal systems. Such conditions enhance northerly wind currents over the Caspian Sea which, in turn, increase the precipitation in Caspian
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Skofronick-Jackson, Gail; Munchak, Stephen J.; Ringerud, Sarah
2016-01-01
Retrievals of falling snow from space represent an important data set for understanding the Earth's atmospheric, hydrological, and energy cycles, especially during climate change. Estimates of falling snow must be captured to obtain the true global precipitation water cycle, snowfall accumulations are required for hydrological studies, and without knowledge of the frozen particles in clouds one cannot adequately understand the energy and radiation budgets. While satellite-based remote sensing provides global coverage of falling snow events, the science is relatively new and retrievals are still undergoing development with challenges remaining). This work reports on the development and testing of retrieval algorithms for the Global Precipitation Measurement (GPM) mission Core Satellite, launched February 2014.
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Meteorological features associated with unprecedented precipitation ...
Indian Academy of Sciences (India)
Unprecedented precipitation along with heavy falls occurred over many parts of India from 28th February to 2nd March 2015. Many of the stations of northwest and central India received an all time high 24 hr cumulative precipitation of March during this period. Even the national capital, New Delhi, broke all the previous ...
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Precipitation Sedimentation and Advection in GFS
Sun, R.; Tallapragada, V.
2016-12-01
Zhao and Carr microphysics scheme as implemented in the NCEP Global Forecasting System (GFS) predicts only the total cloud condensate (cloud water or ice). The precipitation generated in the column fall to the ground instantly. This mean precipitation sedimentation and advection are not considered. As resolution increases the lack of the two physical processes creates problems. The slowly falling precipitation (snow) falls to the wrong surface grid box, which may have led to the observed spotty-precipitation pattern. To solve the problem two prognositic variables, snow and rain, are added. Addition of the two precipitation variable allows their advection. The corresponding sedimentation process are also added. In this study we examine the effect of precipitation advection and sedimentation on the precipitation pattern, associated precipitation skills and clouds.
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Garcia, Patrícia A; Dias, João M D; Silva, Silvia L A; Dias, Rosângela C
2015-01-01
The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. (i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa = 0.595) and recurrent fallers (Kappa = 0.589). The limits of agreement were 0.35 ± 1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning.
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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.
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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.
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Lee, Dong-In; Kim, Dong-Kyun; Kim, Ji-Hyeon; Kang, Yunhee; Kim, Hyeonjoon
2017-04-01
During a summer monsoon season each year, severe weather phenomena caused by front, mesoscale convective systems, or typhoons often occur in the southern Korean Peninsula where is mostly comprised of complex high mountains. These areas play an important role in controlling formation, amount, and distribution of rainfall. As precipitation systems move over the mountains, they can develop rapidly and produce localized heavy rainfall. Thus observational analysis in the mountainous areas is required for studying terrain effects on the rapid rainfall development and its microphysics. We performed intensive field observations using two s-band operational weather radars around Mt. Jiri (1950 m ASL) during summertime on June and July in 2015-2016. Observation data of DSD (Drop Size Distribution) from Parsivel disdrometer and (w component) vertical velocity data from ultrasonic anemometers were analyzed for Typhoon Chanhom on 12 July 2015 and the heavy rain event on 1 July 2016. During the heavy rain event, a dual-Doppler radar analysis using Jindo radar and Gunsan radar was also conducted to examine 3-D wind fields and vertical structure of reflectivity in these areas. For examining up-/downdrafts in the windward or leeward side of Mt. Jiri, we developed a new scheme technique to estimate vertical velocities (w) from drop size and fall velocity spectra of Parsivel disdrometers at different stations. Their comparison with the w values observed by the 3D anemometer showed quite good agreement each other. The Z histogram with regard to the estimated w was similar to that with regard to R, indicating that Parsivel-estimated w is quite reasonable for classifying strong and weak rain, corresponding to updraft and downdraft, respectively. Mostly, positive w values (upward) were estimated in heavy rainfall at the windward side (D1 and D2). Negative w values (downward) were dominant even during large rainfall at the leeward side (D4). For D1 and D2, the upward w percentages were
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Roth, Aurora; Hock, Regine; Schuler, Thomas V.; Bieniek, Peter A.; Pelto, Mauri; Aschwanden, Andy
2018-03-01
Assessing and modeling precipitation in mountainous areas remains a major challenge in glacier mass balance modeling. Observations are typically scarce and reanalysis data and similar climate products are too coarse to accurately capture orographic effects. Here we use the linear theory of orographic precipitation model (LT model) to downscale winter precipitation from a regional climate model over the Juneau Icefield, one of the largest ice masses in North America (>4000 km2), for the period 1979-2013. The LT model is physically-based yet computationally efficient, combining airflow dynamics and simple cloud microphysics. The resulting 1 km resolution precipitation fields show substantially reduced precipitation on the northeastern portion of the icefield compared to the southwestern side, a pattern that is not well captured in the coarse resolution (20 km) WRF data. Net snow accumulation derived from the LT model precipitation agrees well with point observations across the icefield. To investigate the robustness of the LT model results, we perform a series of sensitivity experiments varying hydrometeor fall speeds, the horizontal resolution of the underlying grid, and the source of the meteorological forcing data. The resulting normalized spatial precipitation pattern is similar for all sensitivity experiments, but local precipitation amounts vary strongly, with greatest sensitivity to variations in snow fall speed. Results indicate that the LT model has great potential to provide improved spatial patterns of winter precipitation for glacier mass balance modeling purposes in complex terrain, but ground observations are necessary to constrain model parameters to match total amounts.
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Linkages between Icelandic Low position and SE Greenland winter precipitation
Berdahl, M.; Rennermalm, A. K.; Hammann, A. C.; Mioduszewski, J.; Hameed, S.; Tedesco, M.; Stroeve, J. C.; Mote, T. L.
2015-12-01
Greenland's largest flux of precipitation occurs in its Southeast (SE) region. An understanding of the mechanisms controlling precipitation in this region is lacking despite its disproportionate importance in the mass balance of Greenland and the consequent contributions to sea level rise. We use weather station data from the Danish Meteorological Institute to reveal the governing influences on precipitation in SE Greenland during the winter and fall. We find that precipitation in the fall is significantly correlated to the longitude of the Icelandic Low and the NAO. Winter precipitation is correlated with the strength and longitude of the Icelandic Low, as well as the NAO. We show that in years of extreme high precipitation, onshore winds dominate, thereby advecting more moisture inland. In low precipitation years, winds are more westerly, approaching the stations from land. Understanding the controls of SE Greenland precipitation will help us predict how future precipitation in this key region may change in a warming climate.
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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
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Characteristics and seasonal variations of precipitation phenomena at Syowa Station
Directory of Open Access Journals (Sweden)
Hiroyuki Konishi
1997-03-01
Full Text Available Long-term observations of precipitating clouds were carried out by a vertical pointing radar, PPI radar and a 37 GHz microwave radiometer at Syowa Station (69°00′S, 39°35′E, Antarctica in 1989. It is concluded from the observations that precipitation near Syowa Station, Antarctica is mainly brought by cloud vortices associated with extratropical cyclones which advance to high latitude while developing to a mature stage. The seasonal variations of clouds and precipitation were analyzed corresponding to the seasonal changes of air temperature and sea ice area. The occurrence frequencies of cloud vortices which brought snowfall to Syowa Station increased in the fall and spring seasons corresponding to activity of the circumpolar trough. However, the activities of cloud systems that bring precipitation weaken in spring when the sea ice area expands to low latitudes, because of less supply of heat and vapor. In 1989,the amount of precipitation in spring brought by a few snowfall events was as large as the amount of precipitation in fall brought by frequent snowfall events. Radar observations revealed that there were three abundant snowfall seasons at Syowa Station and the amount of snowfall was uniform in all seasons except summer. The amounts of precipitation in fall, winter and spring were 74,74 and 53mm respectively.
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Falls: epidemiology, pathophysiology, and relationship to fracture.
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.
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Falls and Fear of Falling After Stroke: A Case-Control Study.
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
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Densmore-McCulloch, Justine A; Thompson, Donald L; Fraser, Lauchlan H
2016-01-01
Climate change is expected to alter precipitation patterns. Droughts may become longer and more frequent, and the timing and intensity of precipitation may change. We tested how shifting precipitation patterns, both seasonally and by frequency of events, affects soil nitrogen availability, plant biomass and diversity in a shrub-steppe temperate grassland along a natural productivity gradient in Lac du Bois Grasslands Protected Area near Kamloops, British Columbia, Canada. We manipulated seasonal watering patterns by either exclusively watering in the spring or the fall. To simulate spring precipitation we restricted precipitation inputs in the fall, then added 50% more water than the long term average in the spring, and vice-versa for the fall precipitation treatment. Overall, the amount of precipitation remained roughly the same. We manipulated the frequency of rainfall events by either applying water weekly (frequent) or monthly (intensive). After 2 years, changes in the seasonality of watering had greater effects on plant biomass and diversity than changes in the frequency of watering. Fall watering reduced biomass and increased species diversity, while spring watering had little effect. The reduction in biomass in fall watered treatments was due to a decline in grasses, but not forbs. Plant available N, measured by Plant Root Simulator (PRS)-probes, increased from spring to summer to fall, and was higher in fall watered treatments compared to spring watered treatments when measured in the fall. The only effect observed due to frequency of watering events was greater extractable soil N in monthly applied treatments compared to weekly watering treatments. Understanding the effects of changing precipitation patterns on grasslands will allow improved grassland conservation and management in the face of global climatic change, and here we show that if precipitation is more abundant in the fall, compared to the spring, grassland primary productivity will likely be
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Seasonal and annual precipitation time series trend analysis in North Carolina, United States
Sayemuzzaman, Mohammad; Jha, Manoj K.
2014-02-01
The present study performs the spatial and temporal trend analysis of the annual and seasonal time-series of a set of uniformly distributed 249 stations precipitation data across the state of North Carolina, United States over the period of 1950-2009. The Mann-Kendall (MK) test, the Theil-Sen approach (TSA) and the Sequential Mann-Kendall (SQMK) test were applied to quantify the significance of trend, magnitude of trend, and the trend shift, respectively. Regional (mountain, piedmont and coastal) precipitation trends were also analyzed using the above-mentioned tests. Prior to the application of statistical tests, the pre-whitening technique was used to eliminate the effect of autocorrelation of precipitation data series. The application of the above-mentioned procedures has shown very notable statewide increasing trend for winter and decreasing trend for fall precipitation. Statewide mixed (increasing/decreasing) trend has been detected in annual, spring, and summer precipitation time series. Significant trends (confidence level ≥ 95%) were detected only in 8, 7, 4 and 10 nos. of stations (out of 249 stations) in winter, spring, summer, and fall, respectively. Magnitude of the highest increasing (decreasing) precipitation trend was found about 4 mm/season (- 4.50 mm/season) in fall (summer) season. Annual precipitation trend magnitude varied between - 5.50 mm/year and 9 mm/year. Regional trend analysis found increasing precipitation in mountain and coastal regions in general except during the winter. Piedmont region was found to have increasing trends in summer and fall, but decreasing trend in winter, spring and on an annual basis. The SQMK test on "trend shift analysis" identified a significant shift during 1960 - 70 in most parts of the state. Finally, the comparison between winter (summer) precipitations with the North Atlantic Oscillation (Southern Oscillation) indices concluded that the variability and trend of precipitation can be explained by the
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Seasonal Analysis of Microbial Communities in Precipitation in the Greater Tokyo Area, Japan
Directory of Open Access Journals (Sweden)
Satoshi Hiraoka
2017-08-01
Full Text Available The presence of microbes in the atmosphere and their transport over long distances across the Earth's surface was recently shown. Precipitation is likely a major path by which aerial microbes fall to the ground surface, affecting its microbial ecosystems and introducing pathogenic microbes. Understanding microbial communities in precipitation is of multidisciplinary interest from the perspectives of microbial ecology and public health; however, community-wide and seasonal analyses have not been conducted. Here, we carried out 16S rRNA amplicon sequencing of 30 precipitation samples that were aseptically collected over 1 year in the Greater Tokyo Area, Japan. The precipitation microbial communities were dominated by Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria and were overall consistent with those previously reported in atmospheric aerosols and cloud water. Seasonal variations in composition were observed; specifically, Proteobacteria abundance significantly decreased from summer to winter. Notably, estimated ordinary habitats of precipitation microbes were dominated by animal-associated, soil-related, and marine-related environments, and reasonably consistent with estimated air mass backward trajectories. To our knowledge, this is the first amplicon-sequencing study investigating precipitation microbial communities involving sampling over the duration of a year.
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An approach to balance problems and falls in elderly persons
de Villiers, L; Kalula, S Z
2015-01-01
Gait instability and falls are common in elderly persons and have devastating consequences, with substantial morbidity and mortality. Furthermore, they are a precipitant for functional decline, increasing frailty and institutionalisation. The rate of falls and severity of complications increase with age and frailty. A consequence of falls with or without injury is that at least a third of persons develop a fear of falling, which leads to functional decline and a progressive decline in gait. T...
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Validation of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm
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
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Liu, T.; Schmitt, R. W.; Li, L.
2017-12-01
Using 69 years of historical data from 1948-2017, we developed a method to globally search for sea surface salinity (SSS) and temperature (SST) predictors of regional terrestrial precipitation. We then applied this method to build an autumn (SON) SSS and SST-based 3-month lead predictive model of winter (DJF) precipitation in southwestern United States. We also find that SSS-only models perform better than SST-only models. We previously used an arbitrary correlation coefficient (r) threshold, |r| > 0.25, to define SSS and SST predictor polygons for best subset regression of southwestern US winter precipitation; from preliminary sensitivity tests, we find that |r| > 0.18 yields the best models. The observed below-average precipitation (0.69 mm/day) in winter 2015-2016 falls within the 95% confidence interval of the prediction model. However, the model underestimates the anomalous high precipitation (1.78 mm/day) in winter 2016-2017 by more than three-fold. Moisture transport mainly attributed to "pineapple express" atmospheric rivers (ARs) in winter 2016-2017 suggests that the model falls short on a sub-seasonal scale, in which case storms from ARs contribute a significant portion of seasonal terrestrial precipitation. Further, we identify a potential mechanism for long-range SSS and precipitation teleconnections: standing Rossby waves. The heat applied to the atmosphere from anomalous tropical rainfall can generate standing Rossby waves that propagate to higher latitudes. SSS anomalies may be indicative of anomalous tropical rainfall, and by extension, standing Rossby waves that provide the long-range teleconnections.
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Rajczak, Jan; Schär, Christoph
2017-10-01
Projections of precipitation and its extremes over the European continent are analyzed in an extensive multimodel ensemble of 12 and 50 km resolution EURO-CORDEX Regional Climate Models (RCMs) forced by RCP2.6, RCP4.5, and RCP8.5 (Representative Concentration Pathway) aerosol and greenhouse gas emission scenarios. A systematic intercomparison with ENSEMBLES RCMs is carried out, such that in total information is provided for an unprecedentedly large data set of 100 RCM simulations. An evaluation finds very reasonable skill for the EURO-CORDEX models in simulating temporal and geographical variations of (mean and heavy) precipitation at both horizontal resolutions. Heavy and extreme precipitation events are projected to intensify across most of Europe throughout the whole year. All considered models agree on a distinct intensification of extremes by often more than +20% in winter and fall and over central and northern Europe. A reduction of rainy days and mean precipitation in summer is simulated by a large majority of models in the Mediterranean area, but intermodel spread between the simulations is large. In central Europe and France during summer, models project decreases in precipitation but more intense heavy and extreme rainfalls. Comparison to previous RCM projections from ENSEMBLES reveals consistency but slight differences in summer, where reductions in southern European precipitation are not as pronounced as previously projected. The projected changes of the European hydrological cycle may have substantial impact on environmental and anthropogenic systems. In particular, the simulations indicate a rising probability of summertime drought in southern Europe and more frequent and intense heavy rainfall across all of Europe.
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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.
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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.
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Inorganic nitrogen in precipitation and atmospheric sediments
Energy Technology Data Exchange (ETDEWEB)
Matheson, D H
1951-01-01
In an investigation covering 18 months, daily determinations were made of the inorganic nitrogen contained in precipitation and atmospheric sediments collected at Hamilton, Ont. The nitrogen fall for the whole period averaged 5.8 lb. N per acre per year. Sixty-one per cent of the total nitrogen was collected on 25% of the days when precipitation occurred. The balance, occurring on days without precipitation, is attributable solely to the sedimentation of dust. Ammonia nitrogen averaged 56% of the total, but the proportion for individual days varied widely.
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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.
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Late-Eighteenth-Century Precipitation Reconstructions from James Madison's Montpelier Plantation.
Druckenbrod, Daniel L.; Mann, Michael E.; Stahle, David W.; Cleaveland, Malcolm K.; Therrell, Matthew D.; Shugart, Herman H.
2003-01-01
This study presents two independent reconstructions of precipitation from James Madison's Montpelier plantation at the end of the eighteenth century. The first is transcribed directly from meteorological diaries recorded by the Madison family for 17 years and reflects the scientific interests of James Madison and Thomas Jefferson. In his most active period as a scientist, Madison assisted Jefferson by observing the climate and fauna in Virginia to counter the contemporary scientific view that the humid, cold climate of the New World decreased the size and number of its species. The second reconstruction is generated using tree rings from a forest in the Montpelier plantation and connects Madison's era to the modern instrumental precipitation record. These trees provide a significant reconstruction of both early summer and prior fall precipitation. Comparison of the dendroclimatic and diary reconstructions suggests a delay in the seasonality of precipitation from Madison's era to the mid-twentieth century. Furthermore, the dendroclimatic reconstructions of early summer and prior fall precipitation appear to track this shift in seasonality.
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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.
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Successes with the Global Precipitation Measurement (GPM) Mission
Skofronick-Jackson, Gail; Huffman, George; Stocker, Erich; Petersen, Walter
2016-01-01
Water is essential to our planet Earth. Knowing when, where and how precipitation falls is crucial for understanding the linkages between the Earth's water and energy cycles and is extraordinarily important for sustaining life on our planet during climate change. The Global Precipitation Measurement (GPM) Core Observatory spacecraft launched February 27, 2014, is the anchor to the GPM international satellite mission to unify and advance precipitation measurements from a constellation of research and operational sensors to provide "next-generation" precipitation products. GPM is currently a partnership between NASA and the Japan Aerospace Exploration Agency (JAXA). Status and successes in terms of spacecraft, instruments, retrieval products, validation, and impacts for science and society will be presented. Precipitation, microwave, satellite
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Community College Estimated Growth: Fall 2010
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,…
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Major mechanisms of atmospheric moisture transport and their role in extreme precipitation events
Digital Repository Service at National Institute of Oceanography (India)
Gimeno, L.; Dominguez, F.; Nieto, R.; Trigo, R.; Drumond, A.; Reason, C.J.C.; Taschetto, A.S.; Ramos, A.M.; RameshKumar, M.R.; Marengo, J.
in Figure 2, several other locations are affected by ARs as previously detected and analysed, and these are further addressed in Section 3 together with their impacts. Figure 2 shows that ARs also have a high impact in regions such as the Gulf of Mexico... anomalies in terms of the number of ARs are seen over the northeastern Pacific, the north Atlantic, and the Gulf of Mexico. The impact of land falling systems is stronger in terms of precipitation in northwest USA and western Canada, but shows a decrease...
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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...
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Fragoso, M.; Trigo, R. M.; Zêzere, J. L.; Valente, M. A.
2009-04-01
On 18 February 2008 the city of Lisbon had its rainiest day on record, i.e. since the establishment of the D. Luís Observatory in 1853 (continuous observations of meteorological variables are only available since 1864). Fortunately a Portuguese funded project (SIGN) allowed to digitize all the data between 1864 and 1941, allowing a proper comparison with previous extreme events and also to compute more significant return periods. We can now state that a new absolute maximum of daily precipitation at this station occurred last 18 February, when 118.4 mm were registered, surpassing the previous maximum of 110.7 mm (observed on 5 December 1876). Interestingly, these record breaking characteristics were confined to the city of Lisbon, not being observed in rural and suburban neighborhoods, where the anterior maxima recorded in 26 November 1967 or 18 November 1983 were not achieved. In fact, this extreme event was relatively uncharacteristic when compared with typical extreme precipitation events in southern Portugal (Fragoso and Tildes Gomes, 2008). These extreme episodes tend to occur preferably in fall (late September until early December) and covering a wider area. In this work we present an extensive analysis of the large-scale and synoptic atmospheric circulation environment leading to this extreme rainstorm as well as the consequences, namely floods and landslides that produced relevant socio-economic impacts (including 4 casualties). This will be achieved through the characterization of the extreme precipitation episode, describing its temporal structure and the geographic incidence of the event and also assessing statistically the exceptionality of the daily rainfall. The study of the atmospheric context of the episode will be performed with Satellite and radar data, complemented by several large-scale fields obtained from the NCAR/NCEP Reanalyses dataset, including sea level pressure, 500 hPa Geopotential height, precipitation rate, CAPE index. FRAGOSO, M
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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
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Falls and Fall-Related Injuries among Community-Dwelling Adults in the 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
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Water supply impacts of nuclear fall
International Nuclear Information System (INIS)
Hobbs, B.F.; Luo, Y.; Maciejowski, M.E.; Chester, C.V.
1989-01-01
“Nuclear winter,” more properly called “nuclear fall,” could be caused by injection of large amounts of dust into the atmosphere. Besides causing a decrease in temperature, it could be accompanied by “nuclear drought,” a catastrophic decrease in precipitation. Dry land agriculture would then be impossible, and municipal, industrial, and irrigation water supplies would be diminished. It has been argued that nuclear winter/fall poses a much greater threat to human survival than do fall out or the direct impacts of a conflict. However, this does not appear to be true, at least for the U.S. Even under the unprecedented drought that could result from nuclear fall, water supplies would be available for many essential activities. For the most part, ground water supplies would be relatively invulnerable to nuclear drought, and adequate surface supplies would be available for potable uses. This assumes that conveyance facilities and power supplies survive a conflict largely intact or can be repaired
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a Study of Precipitation Using Dual-Frequency and Interferometric Doppler Radars.
Chilson, Phillip Bruce
The primary focus of this dissertation involves the investigation of precipitation using Doppler radar but using distinctly different methods. Each method will be treated separately. The first part describes an investigation of a tropical thunderstorm that occurred in the summer of 1991 over the National Astronomy and Ionosphere Center in Arecibo, Puerto Rico. Observations were made using a vertically pointing, dual-wavelength, collinear beam Doppler radar which permits virtually simultaneous observations of the same pulse volume using transmission and reception of coherent UHF and VHF signals on alternate pulses. This made it possible to measure directly the vertical wind within the sampling volume using the VHF signal while using the UHF signal to study the nature of the precipitation. The observed storm showed strong similarities with systems observed in the Global Atmospheric Research Program's (GARP) Atlantic Tropical Experiment (GATE) study. The experiment provided a means of determining various parameters associated with the storm, such as the vertical air velocity, the mean fall speeds of the precipitation, and the reflectivity. Rogers proposed a means of deducing the mean fall speed of precipitation particles using the radar reflectivity factor. Using the data from our experiment, the mean precipitation fall speeds were calculated and compared with those that would be inferred from Rogers' method. The results suggest the Rogers method of estimating mean precipitation fall speeds to be unreliable in turbulent environments. The second part reports observations made with the 50 MHz Middle and Upper Atmosphere (MU) radar located at Shigaraki, Japan during May of 1992. The facility was operated in a spatial interferometry (SI) mode while observing frontal precipitation. The data suggest that the presence of precipitation can produce a bias in the SI cross-spectral phase that in turn creates an overestimation of the horizontal wind. The process is likened to
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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.
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Safeeq, M.; Hunsaker, C. T.; Bales, R. C.
2016-12-01
In a mediterranean climate, dry season runoff sustains water supply and supports aquatic habitat and other ecosystems. Precipitation and temperature directly, by regulating recharge and evapotranspiration (ET), and indirectly, by regulating amount and timing of snowmelt, control the dry season runoff in the Sierra Nevada. Here, we explored relative impacts of precipitation and temperature variability on dry season runoff using path analysis. Specific objectives include: (i) to quantify the direct and indirect impacts of precipitation and temperature on 7-day average minimum flow (Qmin) and (ii) to explore the role of preceding year Qmin on fall season runoff (QF). We used daily runoff, air temperature, precipitation, and snow water equivalent (SWE) over 2004-2015 for the ten catchments in the Kings River Experimental Watersheds. For path analysis model of Qmin, we defined annual precipitation and temperature as exogenous variables and peak SWE, day of snow disappearance, and Qmin as endogenous variables. For QF, we defined current year fall precipitation and preceding year Qmin as exogenous variables and current year QF as an endogenous variable. Path analysis results for Qmin show precipitation as a dominant driver when compared to temperature, peak SWE, and day of snow disappearance. However, in half of the catchments that are mostly located at higher elevations the impact of temperature on Qmin was either comparable or exceeded that of precipitation. This relatively high sensitivity of Qmin to air temperature in high elevation catchments is consistent with the earlier findings of increased ET in proportion to warming. The direct effects of peak SWE and day of snow disappearance on Qmin were limited, and indirect effects of temperature and precipitation via peak SWE and day of snow disappearance were not significant. The preceding year Qmin and fall precipitation showed comparable impacts on QF, indicating that the storage in the preceding year modulates current
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Akahane, Manabu; Maeyashiki, Akie; Yoshihara, Shingo; Tanaka, Yasuhito; Imamura, Tomoaki
2016-06-20
People aged 65 years or older accounted for 25.1% of the Japanese population in 2013, and this characterizes the country as a "super-aging society." With increased aging, fall-related injuries are becoming important in Japan, because such injuries underlie the necessity for nursing care services. If people could evaluate their risk of falling using a simple self-check test, they would be able to take preventive measures such as exercise, muscle training, walking with a cane, or renovation of their surroundings to remove impediments. Loco-check is a checklist measure of early locomotive syndrome (circumstances in which elderly people need nursing care service or are at high risk of requiring the service within a short time), prepared by the Japanese Orthopaedic Association (JOA) in 2007, but it is unclear if there is any association between this measure and falls. To investigate the association between falls during the previous year and the 7 "loco-check" daily activity items and the total number of items endorsed, and sleep duration. We conducted an Internet panel survey. Subjects were 624 persons aged between 30 and 90 years. The general health condition of the participants, including their experience of falling, daily activities, and sleep duration, was investigated. A multivariate analysis was carried out using logistic regression to investigate the relationship between falls in the previous year and difficulties with specific daily activities and total number of difficulties (loco-check) endorsed, and sleep duration, adjusting for sex and age. One-fourth of participants (157 persons) experienced at least one fall during the previous year. Fall rate of females (94/312: 30.1%) was significantly higher than that of males (63/312: 20.2%). Fall rate of persons aged more than 65 years (80/242: 33.1%) was significantly higher than that of younger persons (77/382: 20.2%). Logistic regression analysis revealed that daily activities such as "impossibility of getting
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Response of South American Ecosystems to Precipitation Variability
Knox, R. G.; Kim, Y.; Longo, M.; Medvigy, D.; Wang, J.; Moorcroft, P. R.; Bras, R. L.
2009-12-01
The Ecosystem Demography Model 2 is a dynamic ecosystem model and land surface energy balance model. ED2 discretizes landscapes of particular terrain and meteorology into fractional areas of unique disturbance history. Each fraction, defined by a shared vertical soil column and canopy air space, contains a stratum of plant groups unique in functional type, size and number density. The result is a vertically distributed representation of energy transfer and plant dynamics (mortality, productivity, recruitment, disturbance, resource competition, etc) that successfully approximates the behaviour of individual-based vegetation models. In previous exercises simulating Amazonian land surface dynamics with ED 2, it was observed that when using grid averaged precipitation as an external forcing the resulting water balance typically over-estimated leaf interception and leaf evaporation while under estimating through-fall and transpiration. To investigate this result, two scenario were conducted in which land surface biophysics and ecosystem demography over the Northern portion of South America are simulated over ~200 years: (1) ED2 is forced with grid averaged values taken from the ERA40 reanalysis meteorological dataset; (2) ED2 is forced with ERA40 reanalysis, but with its precipitation re-sampled to reflect statistical qualities of point precipitation found at rain gauge stations in the region. The findings in this study suggest that the equilibrium moisture states and vegetation demography are co-dependent and show sensitivity to temporal variability in precipitation. These sensitivities will need to be accounted for in future projections of coupled climate-ecosystem changes in South America.
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International Nuclear Information System (INIS)
Singh, B.P.
2015-01-01
An attempt has been made to analyze the data to find the original precipitate on GMWL, when there is seasonal variation and variations in intensity of rain fall at the same longitude, latitude and altitude. This has been done using the data as available for each month, weighted average of month and individual year for δ 2 H and δ 18 O for a 10-year periods. Correlation equations between δ 2 H and δ 18 O are available giving slopes and intercepts on the δ 2 H axis for 10-year periods. The data of slope versus intercept for each month, weighted monthly average value and individual year are plotted to arrive at isotope composition of meteoric water δ 18 O and δ 2 H, the method suggested by (Singh B.P. 2013, Isotopic composition of water in precipitation in a region or place, Applied Radiation and Isotopes, vol. 75, pp. 22–25; Singh B.P. 2014, Isotopic composition of river water across a continent, Applied Radiation and Isotopes, vol. 85, pp. 14–18). The results of the original meteoric isotopic composition of water are within the experimental errors as analyzed on a yearly basis, the average of each month of yearly basis and on the basis of each month and also some different amounts of precipitation giving the same value of δ 18 O=−16.72 and δ 2 H=−129.86 on GMWL. - Highlights: • New pattern, plot of slope versus intercept between δ 18 O and δ 2 H at the same location for seasons and rainfall are given. • These patterns are analyzed to arrive at the original isotopic composition to be on GMWL. • It is found that the original isotopic composition is same for different seasons and amount of rainfall
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Falls in patients with chronic obstructive pulmonary disease: a call for further research
Roig, M; Eng, JJ; MacIntyre, DL; Road, JD; Reid, WD.
2012-01-01
Summary Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in airflow limitation and respiratory distress. The effects of COPD, however, are not exclusively limited to respiratory function and people with COPD face many non-respiratory manifestations that affect both function and mobility. Deficits in function and mobility have been associated with an increased risk for falling in older adults. The purpose of this study was to provide a theoretical framework to identify risks factors for falls in people with COPD. We have analyzed the literature to identify possible relationships between pathophysiological changes observed in COPD and common risk factors for falls. Well-established fall risk factors in people with COPD include lower limb muscle weakness and impaired activities of daily living. Other intrinsic risk factors such as gait and balance deficits, nutritional depletion, malnutrition, depression, cognitive impairments and medications are possible risk factors that need to be confirmed with more studies. There is no evidence that visual deficits are common in COPD. The role that precipitating factors such as syncope and postural hypotension may have on fall risk is unclear. Exacerbations and dyspnea do not have a precipitating effect on fall risk but they contribute to the progressive physical deterioration that may theoretically increase the risk for falls. While these results suggest that people with COPD might have an increased susceptibility to fall compared to their healthy peers, further research is needed to determine the prevalence of falls and specific risk factors for falls in people living with COPD. PMID:19419852
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Mercury Wet Scavenging and Deposition Differences by Precipitation Type.
Kaulfus, Aaron S; Nair, Udaysankar; Holmes, Christopher D; Landing, William M
2017-03-07
We analyze the effect of precipitation type on mercury wet deposition using a new database of individual rain events spanning the contiguous United States. Measurements from the Mercury Deposition Network (MDN) containing single rainfall events were identified and classified into six precipitation types. Mercury concentrations in surface precipitation follow a power law of precipitation depth that is modulated by precipitation system morphology. After controlling for precipitation depth, the highest mercury deposition occurs in supercell thunderstorms, with decreasing deposition in disorganized thunderstorms, quasi-linear convective systems (QLCS), extratropical cyclones, light rain, and land-falling tropical cyclones. Convective morphologies (supercells, disorganized, and QLCS) enhance wet deposition by a factor of at least 1.6 relative to nonconvective morphologies. Mercury wet deposition also varies by geographic region and season. After controlling for other factors, we find that mercury wet deposition is greater over high-elevation sites, seasonally during summer, and in convective precipitation.
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Matsuda, Patricia N; Shumway-Cook, Anne; Bamer, Alyssa M; Johnson, Shana L; Amtmann, Dagmar; Kraft, George H
2011-07-01
To examine incidence, associated factors, and health care provider (HCP) response to falls in persons with multiple sclerosis (MS). Cross-sectional retrospective design. Community setting. Four hundred seventy-four persons with MS. Mailed survey questionnaire examined incidence, risk factors, and HCP response to falls in persons with MS who were dwelling in the community. Univariate and multiple ordinal regression analysis identified variables associated with single and multiple falls. Falls, causes and perceived reasons for falls, and HCP response. A total of 265 participants (58.2%) reported one or more falls in the previous 6 months, and 58.5% of falls were medically injurious. Trips/slips while walking accounted for 48% of falls. Factors associated with falls included use of a cane or walker (odds ratio [OR] 2.62; 95% confidence interval [CI] 1.66-4.14), income falls; recommended strategies included safety strategies (53.2%), use of gait assistive devices (42.1%), exercise/balance training (22.2%), and home modifications (16.6%). Factors associated with falls in persons with MS are similar to those in other populations with neurologic diseases. Despite the high incidence of falls, fewer than 50% of people with MS receive information about prevention of falls from an HCP. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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Martial arts fall techniques decrease the impact forces at the hip during sideways falling.
Groen, B.E.; Weerdesteijn, V.G.M.; Duysens, J.E.J.
2007-01-01
Falls to the side and those with impact on the hip are risky for hip fractures in the elderly. A previous study has indicated that martial arts (MA) fall techniques can reduce hip impact force, but the underlying mechanism is unknown. Furthermore, the high impact forces at the hand used to break the
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van Schooten, Kimberley S; Yang, Yijian; Feldman, Fabio; Leung, Ming; McKay, Heather; Sims-Gould, Joanie; Robinovitch, Stephen N
2018-05-09
Although a fall is a necessary prerequisite to a fall-related injury, previous studies suggest that frequent fallers are at lower injury risk for a given fall. We tested the hypotheses that differences in protective responses or the circumstances of falls underlie differences in injury risk with fall frequency. We analyzed video footage of 897 falls experienced by 220 long-term care residents (mean age 82 ± 9 years) to identify the cause of imbalance, activity leading to falling, direction of fall initiation, balance recovery and fall protective responses, and occurrence of impact to the head or hip. We further obtained injury information from the facilities' fall registration. We used generalized estimating equation models to examine the association between quartiles of fall frequency, injury risk, and fall characteristics. Residents with the highest fall frequency group (Q4; ≥5.6 falls/year) were less likely to sustain an injury per fall. They were less likely to fall during walking and more likely to fall during stand-to-sit transfers. Residents in the lowest fall frequency group (Q1; falls/year) were more likely to fall during walking, and walking was associated with an increased risk for injury. When compared to less frequent fallers, more frequent fallers had a lower risk for injury per fall. This appeared to be explained by differences in the circumstances of falls, and not by protective responses. Injury prevention strategies in long-term care should target both frequent and infrequent fallers, as the latter are more mobile and apt to sustain injury.
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International Nuclear Information System (INIS)
Estevez, J.; Betancourt, M.
1988-01-01
A method for the determination of thorium in phosphorites, that includes a previous separation of some interfering elements was elaborated. Thorium was precipitated with fluoride ions and the insoluble compound formed was separated by using nuclear filters. Latter and extraction was made with Xilene-TOPO and colour was developed with Ars III in organic phase. 19 refs
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Spatiotemporal variation of stable isotopic composition in precipitation
DEFF Research Database (Denmark)
Müller, Sascha; Stumpp, Christine; Sørensen, Jens Havskov
2017-01-01
influences the isotopic composition at the study site. A simple model of evaporation on falling rain was applied with the aim to reproduce observational data and show the potential influence of changing humidity conditions on precipitation compositions. The rather simple model approach did not fully explain...
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Comment on Origin of Groundwater Discharge at Fall River Springs
Energy Technology Data Exchange (ETDEWEB)
Rose, T
2006-10-20
I'm writing at the request of the Pit River Tribe to offer my professional opinion as a geochemist regarding the origin of groundwater discharge at the Fall River Springs, Shasta Co., California. In 1997, I conducted a study of the large volume cold springs associated with the Cascade Volcanoes in northern California, in collaboration with one of my colleagues. This work was published as a Lawrence Livermore National Laboratory report (Davisson and Rose, 1997). The Fall River Springs emerge from the distal end of the Giant Crater Lava Field, a laterally extensive basalt flow that stretches from the southern flank of Medicine Lake Volcano southward for a distance of 40 km. Both Medicine Lake Volcano and the Giant Crater Lava Field have virtually no surface water drainages. Precipitation that falls in these areas is inferred to seep into fractures in the rock, where it is carried down gradient under the force of gravity. Mean annual precipitation rates on Medicine Lake Volcano and the Giant Crater Lava field are adequate to account for the {approx}1200 ft{sup 3}/sec discharge of the Fall River Springs. To evaluate the origin of the springs using geochemical methods, water samples were collected from the Fall River Springs and the Medicine Lake highlands and analyzed for oxygen and hydrogen isotope ratios. The isotope ratios measured for a groundwater sample are diagnostic of the average composition of the precipitation from which the water was derived. The isotope ratios of rain and snow also vary systematically with elevation, such that groundwater derived from recharge at higher elevations can be distinguished from that which originated at lower elevations. The stable isotope data for the Fall River Springs are consistent with groundwater recharge on the Medicine Lake Volcano and adjacent lava field. Mass balance calculations suggest that approximately half of the Fall River Springs flow is derived from the volcanic edifice. Rose and Davisson (1996) showed
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Frailty and Fear of Falling: The FISTAC Study.
Esbrí-Víctor, M; Huedo-Rodenas, I; López-Utiel, M; Navarro-López, J L; Martínez-Reig, M; Serra-Rexach, J A; Romero-Rizos, L; Abizanda, P
2017-01-01
To analyze the association between frailty and Fear of Falling (FoF) in a cohort of older adults with previous falls. Cross-sectional study (FISTAC). Falls Unit, Complejo Hospitalario Universitario of Albacete (Spain). 183 adults older than 69 years, from the Falls Unit, with a history of a previous fall in the last year. FoF was assessed at baseline using the Falls Efficacy Scale International (FES-I) and three questions previously validated. Frailty was assessed with the frailty phenotype criteria. Age, gender, comorbidity, nutritional status, cognitive status and risk of depression were determined. Mean age 78.4, 80.3% women. FoF was present in 140 (76.5%) participants with the three questions and 102 (55.7%) presented high concern of falling with the FES-I. 88.8% of frail older adults presented FoF compared to 62.4% of those who were not frail, and only 37.8% of non frail had a high concern of falling, compared to 77.2% of those who were frail measured with the FES-I. Frail participants had an adjusted risk of FoF that was 3.18 (95% CI 1.32 to 7.65) higher compared to those who were not frail assessed with the three questions and 3.93 (95% CI 1.85 to 8.36) higher concern of falling when using the FES-I scale. Only female sex and depression risk were also associated to FoF in the final adjusted models. Frailty is independently associated with the FoF syndrome in older faller subjects.
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Precipitation of uranium concentrates by hydrogen peroxide
International Nuclear Information System (INIS)
Barbosa Filho, O.
1986-12-01
An experimental study on the (UO 4 .xH 2 ) uranyl peroxide precipitation from a uranium process strip solution is presented. The runs were performed in a batch reactor, in laboratory scale. The main objective was to assess the possibility of the peroxide route as an alternative to a conventional ammonium diuranate process. The chemical composition of process solution was obtained. The experiments were conducted according to a factorial design, aiming to evaluate the effects of initial pH, precipitation pH and H 2 O 2 /UO 2 2+ ratio upon the process. The responses were measured in terms of the efficiency of U precipitation, the content of U in the precipitates and the distribution of impurities in the precipitates. The results indicated that the process works is satisfactory on the studied conditions and depending on conditions, it is possible to achieve levels of U precipitation efficiency greater than 99.9% in reaction times of 2 hours. The precipitates reach grades around 99% U 3 O 8 after calcination (900 0 C) and impurities fall below the limit for penalties established by the ASTM and the Allied Chemical Standards. The precipitates are composed of large aggregates of crystals of 1-4 μm, are fast settling and filtering, and are free-flowing when dry. (Author) [pt
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Oh, Dong Hyun; Park, Ji Eun; Lee, Eon Sook; Oh, Sang Woo; Cho, Sung Il; Jang, Soong Nang; Baik, Hyun Wook
2012-12-01
Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p falling, more participants in the EG than in the CG responded "not at all" or "a little." The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.
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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.
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Stable Isotopic Composition of Precipitation from 2015-2016 Central Texas Rainfall Events
Maupin, C. R.; McChesney, C. L.; Roark, B.; Gorman, M. K.; Housson, A. L.
2016-12-01
Central Texas lies within the Southern Great Plains, a region where rainfall is of tremendous agricultural and associated socioeconomic importance. Paleoclimate records from speleothems in central Texas caves may assist in placing historical and recent drought and pluvial events in the context of natural variability. Effective interpretation of such records requires the nature and origin of variations in the meteoric δ18O signal transmitted from cloud to speleothem to be understood. Here we present a record of meteoric δ18O and δD from each individual precipitation event (δ18Op and δDp), collected by rain gauge in Austin, Texas, USA, from April 2015 through 2016. Backwards hybrid single-particle Lagrangian integrated trajectories (HYSPLITs) indicate the broader moisture source for each precipitation event during this time was the Gulf of Mexico. The local meteoric water line is within error of the global meteoric water line, suggesting minimal sourcing of evaporated continental vapor for precipitation. Total monthly rainfall followed the climatological pattern of a dual boreal spring and fall maximum, with highly variable event δ18Op and δDp values. Surface temperature during precipitation often exerts control over continental and mid latitude δ18Op values, but is not significantly correlated to study site δ18Op (p>0.10). Amount of rain falling during each precipitation event ("amount effect") explains a significant 18% of variance in δ18Op. We hypothesize that this relationship can be attributed to the following: 1) minimal recycling of continental water vapor during the study period; 2) the presence of synoptic conditions favoring intense boreal spring and fall precipitation, driven by a developing, and subsequently in-place, strong ENSO event coupled with a southerly flow from the open Gulf of Mexico; and 3) the meteorological nature of the predominant precipitating events over Texas during this time, mesoscale convective systems, which are known to
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Winter precipitation particle size distribution measurement by Multi-Angle Snowflake Camera
Huang, Gwo-Jong; Kleinkort, Cameron; Bringi, V. N.; Notaroš, Branislav M.
2017-12-01
From the radar meteorology viewpoint, the most important properties for quantitative precipitation estimation of winter events are 3D shape, size, and mass of precipitation particles, as well as the particle size distribution (PSD). In order to measure these properties precisely, optical instruments may be the best choice. The Multi-Angle Snowflake Camera (MASC) is a relatively new instrument equipped with three high-resolution cameras to capture the winter precipitation particle images from three non-parallel angles, in addition to measuring the particle fall speed using two pairs of infrared motion sensors. However, the results from the MASC so far are usually presented as monthly or seasonally, and particle sizes are given as histograms, no previous studies have used the MASC for a single storm study, and no researchers use MASC to measure the PSD. We propose the methodology for obtaining the winter precipitation PSD measured by the MASC, and present and discuss the development, implementation, and application of the new technique for PSD computation based on MASC images. Overall, this is the first study of the MASC-based PSD. We present PSD MASC experiments and results for segments of two snow events to demonstrate the performance of our PSD algorithm. The results show that the self-consistency of the MASC measured single-camera PSDs is good. To cross-validate PSD measurements, we compare MASC mean PSD (averaged over three cameras) with the collocated 2D Video Disdrometer, and observe good agreements of the two sets of results.
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DEFF Research Database (Denmark)
Sørup, Hjalte Jomo Danielsen
-correlation lengths for sub-daily extreme precipitation besides having too low intensities. Especially the wrong spatial correlation structure is disturbing from an urban hydrological point of view as short-term extremes will cover too much ground if derived directly from bias corrected regional climate model output...... of precipitation are compared and used to rank climate models with respect to performance metrics. The four different observational data sets themselves are compared at daily temporal scale with respect to climate indices for mean and extreme precipitation. Data density seems to be a crucial parameter for good...... happening in summer and most of the daily extremes in fall. This behaviour is in good accordance with reality where short term extremes originate in convective precipitation cells that occur when it is very warm and longer term extremes originate in frontal systems that dominate the fall and winter seasons...
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Oberle, Brad; Ogle, Kiona; Zanne, Amy E; Woodall, Christopher W
2018-01-01
When standing dead trees (snags) fall, they have major impacts on forest ecosystems. Snag fall can redistribute wildlife habitat and impact public safety, while governing important carbon (C) cycle consequences of tree mortality because ground contact accelerates C emissions during deadwood decay. Managing the consequences of altered snag dynamics in changing forests requires predicting when snags fall as wood decay erodes mechanical resistance to breaking forces. Previous studies have pointed to common predictors, such as stem size, degree of decay and species identity, but few have assessed the relative strength of underlying mechanisms driving snag fall across biomes. Here, we analyze nearly 100,000 repeated snag observations from boreal to subtropical forests across the eastern United States to show that wood decay controls snag fall in ways that could generate previously unrecognized forest-climate feedback. Warmer locations where wood decays quickly had much faster rates of snag fall. The effect of temperature on snag fall was so strong that in a simple forest C model, anticipated warming by mid-century reduced snag C by 22%. Furthermore, species-level differences in wood decay resistance (durability) accurately predicted the timing of snag fall. Differences in half-life for standing dead trees were similar to expected differences in the service lifetimes of wooden structures built from their timber. Strong effects of temperature and wood durability imply future forests where dying trees fall and decay faster than at present, reducing terrestrial C storage and snag-dependent wildlife habitat. These results can improve the representation of forest C cycling and assist forest managers by helping predict when a dead tree may fall.
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Lee, Hsuei-Chen; Chang, Ku-Chou; Tsauo, Jau-Yih; Hung, Jen-Wen; Huang, Yu-Ching; Lin, Sang-I
2013-04-01
To evaluate effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults. Multicenter randomized controlled trial. Three medical centers and adjacent community health centers. Community-dwelling older adults (N=616) who have fallen in the previous year or are at risk of falling. After baseline assessment, eligible subjects were randomly allocated into the intervention group (IG) or the control group (CG), stratified by the Physiological Profile Assessment (PPA) fall risk level. The IG received a 3-month multifactorial intervention program including 8 weeks of exercise training, health education, home hazards evaluation/modification, along with medication review and ophthalmology/other specialty consults. The CG received health education brochures, referrals, and recommendations without direct exercise intervention. Primary outcome was fall incidence within 1 year. Secondary outcomes were PPA battery (overall fall risk index, vision, muscular strength, reaction time, balance, and proprioception), Timed Up & Go (TUG) test, Taiwan version of the International Physical Activity Questionnaire, EuroQol-5D, Geriatric Depression Scale (GDS), and the Falls Efficacy Scale-International at 3 months after randomization. Participants were 76±7 years old and included low risk 25.6%, moderate risk 25.6%, and marked risk 48.7%. The cumulative 1-year fall incidence was 25.2% in the IG and 27.6% in the CG (hazard ratio=.90; 95% confidence interval, .66-1.23). The IG improved more favorably than the CG on overall PPA fall risk index, reaction time, postural sway with eyes open, TUG test, and GDS, especially for those with marked fall risk. The multifactorial fall prevention program with exercise intervention improved functional performance at 3 months for community-dwelling older adults with risk of falls, but did not reduce falls at 1-year follow-up. Fall incidence might have been decreased simultaneously in both
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A spatial approach to the modelling and estimation of areal precipitation
Energy Technology Data Exchange (ETDEWEB)
Skaugen, T
1996-12-31
In hydroelectric power technology it is important that the mean precipitation that falls in an area can be calculated. This doctoral thesis studies how the morphology of rainfall, described by the spatial statistical parameters, can be used to improve interpolation and estimation procedures. It attempts to formulate a theory which includes the relations between the size of the catchment and the size of the precipitation events in the modelling of areal precipitation. The problem of estimating and modelling areal precipitation can be formulated as the problem of estimating an inhomogeneously distributed flux of a certain spatial extent being measured at points in a randomly placed domain. The information contained in the different morphology of precipitation types is used to improve estimation procedures of areal precipitation, by interpolation (kriging) or by constructing areal reduction factors. A new approach to precipitation modelling is introduced where the analysis of the spatial coverage of precipitation at different intensities plays a key role in the formulation of a stochastic model for extreme areal precipitation and in deriving the probability density function of areal precipitation. 127 refs., 30 figs., 13 tabs.
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Sharifi, Ehsan; Steinacker, Reinhold; Saghafian, Bahram
2016-04-01
Precipitation is a critical component of the Earth's hydrological cycle. The primary requirement in precipitation measurement is to know where and how much precipitation is falling at any given time. Especially in data sparse regions with insufficient radar coverage, satellite information can provide a spatial and temporal context. Nonetheless, evaluation of satellite precipitation is essential prior to operational use. This is why many previous studies are devoted to the validation of satellite estimation. Accurate quantitative precipitation estimation over mountainous basins is of great importance because of their susceptibility to hazards. In situ observations over mountainous areas are mostly limited, but currently available satellite precipitation products can potentially provide the precipitation estimation needed for meteorological and hydrological applications. One of the newest and blended methods that use multi-satellites and multi-sensors has been developed for estimating global precipitation. The considered data set known as Integrated Multi-satellitE Retrievals (IMERG) for GPM (Global Precipitation Measurement) is routinely produced by the GPM constellation satellites. Moreover, recent efforts have been put into the improvement of the precipitation products derived from reanalysis systems, which has led to significant progress. One of the best and a worldwide used model is developed by the European Centre for Medium Range Weather Forecasts (ECMWF). They have produced global reanalysis daily precipitation, known as ERA-Interim. This study has evaluated one year of precipitation data from the GPM-IMERG and ERA-Interim reanalysis daily time series over West of Iran. IMERG and ERA-Interim yield underestimate the observed values while IMERG underestimated slightly and performed better when precipitation is greater than 10mm. Furthermore, with respect to evaluation of probability of detection (POD), threat score (TS), false alarm ratio (FAR) and probability
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Renfro, Mindy Oxman; Fehrer, Steven
2011-01-01
Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and
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Risk factors for falls and fall-related injuries in adults 85 years of age and older.
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.
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Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.
Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-Ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi
2018-01-01
To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.
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Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults
Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi
2018-01-01
Abstract To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults. Cross-sectional study between 2011 and 2013. Community in which residents voluntarily attended a health examination. We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination. We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance. The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P < .01), had longer 5 times chair stand time (P < .01), and more falls in the previous year (P < .05), pain (P < .01), and comorbidity (P < .05). Multivariate logistic regression analysis identified advanced age (odds ratios [OR], 1.57; 95% confidence interval [CI], 1.03–2.39), falls in the previous year (OR, 2.44; 95%CI, 1.29–4.64), and pain (OR, 1.82; 95%CI, 1.03–3.22) in men, and advanced age (OR, 1.59; 95%CI, 1.13–2.24), longer 5 times chair stand times (OR, 1.28; 95%CI, 1.04–1.59), falls in the previous year (OR, 2.59; 95%CI, 1.54–4.34), and pain (OR, 1.65; 95%CI, 1.06–2.55) in women as being independently associated with fear of falling. The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling. PMID:29369207
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Identification of fall risk factors in older adult emergency department patients.
Carpenter, Christopher R; Scheatzle, Mark D; D'Antonio, Joyce A; Ricci, Paul T; Coben, Jeffrey H
2009-03-01
Falls represent an increasingly frequent source of injury among older adults. Identification of fall risk factors in geriatric patients may permit the effective utilization of scarce preventative resources. The objective of this study was to identify independent risk factors associated with an increased 6-month fall risk in community-dwelling older adults discharged from the emergency department (ED). This was a prospective observational study with a convenience sampling of noninstitutionalized elders presenting to an urban teaching hospital ED who did not require hospital admission. Interviews were conducted to determine the presence of fall risk factors previously described in non-ED populations. Subjects were followed monthly for 6 months through postcard or telephone contact to identify subsequent falls. Univariate and Cox regression analysis were used to determine the association of risk factors with 6-month fall incidence. A total of 263 patients completed the survey, and 161 (61%) completed the entire 6 months of follow-up. Among the 263 enrolled, 39% reported a fall in the preceding year, including 15% with more than one fall and 22% with injurious falls. Among those completing the 6 months of follow-up, 14% reported at least one fall. Cox regression analysis identified four factors associated with falls during the 6-month follow-up: nonhealing foot sores (hazard ratio [HR] = 3.71, 95% confidence interval [CI] = 1.73 to 7.95), a prior fall history (HR = 2.62, 95% CI = 1.32 to 5.18), inability to cut one's own toenails (HR = 2.04, 95% CI = 1.04 to 4.01), and self-reported depression (HR = 1.72, 95% CI = 0.83 to 3.55). Falls, recurrent falls, and injurious falls in community-dwelling elder ED patients being evaluated for non-fall-related complaints occur at least as frequently as in previously described outpatient cohorts. Nonhealing foot sores, self-reported depression, not clipping one's own toenails, and previous falls are all associated with falls after
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Dual-stiffness flooring: can it reduce fracture rates associated with falls?
Knoefel, Frank; Patrick, Louise; Taylor, Jodie; Goubran, Rafik
2013-04-01
Falls cause significant morbidity and mortality in long term care facilities. Dual-stiffness flooring (DSF) has previously shown promise in reducing such morbidity in experimental models. This study set out to measure the impact of SmartCell flooring on falls-related morbidity in a nursing home. All falls occurring at an Arizona nursing home between July 1, 2008, and December 31, 2010, were reviewed for age, sex, diagnosis of osteoporosis, number of medications, history of previous falls, type of flooring (normal vs DSF), time of day, type of injury, and resulting actions. Fall-related outcomes were compared across room types using chi-square and logistic regression methods. Eighty-two falls on the DSF were compared with 85 falls on the regular floor. There was a tendency for residents falling on DSF to have less bruising and abrasions, while having more redness and cuts. There were 2 fractures on regular flooring (2.4% fracture rate) and none on the DSF flooring (0% fracture rate). The fracture rate of 2.4% of falls on the regular floor is consistent with previous reports in the literature, whereas a 0% rate found on the DSF floor is a clinically significant improvement. This suggests that DSF may be a practical approach for institutions and consumers to reduce fall-related injuries. A larger scale controlled study to confirm these encouraging preliminary findings is warranted. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
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History of falls, gait, balance, and fall risks in older cancer survivors living in the community.
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.
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McMurdie, L. A.; Houze, R.
2017-12-01
Measurements of global precipitation are critical for monitoring Earth's water resources and hydrological processes, including flooding and snowpack accumulation. As such, the Global Precipitation Measurement (GPM) Mission `Core' satellite detects precipitation ranging from light snow to heavy downpours in a wide range locations including remote mountainous regions. The Olympic Mountains Experiment (OLYMPEX) during the 2015-2016 fall-winter season in the mountainous Olympic Peninsula of Washington State provide physical and hydrological validation for GPM precipitation algorithms and insight into the modification of midlatitude storms by passage over mountains. The instrumentation included ground-based dual-polarization Doppler radars on the windward and leeward sides of the Olympic Mountains, surface stations that measured precipitation rates, particle size distributions and fall velocities at various altitudes, research aircraft equipped with cloud microphysics probes, radars, lidar, and passive radiometers, supplemental rawinsondes and dropsondes, and autonomous recording cameras that monitored snowpack accumulation. Results based on dropsize distributions (DSDs) and cross-sections of radar reflectivity over the ocean and windward slopes have revealed important considerations for GPM algorithm development. During periods of great precipitation accumulation and enhancement by the mountains on windward slopes, both warm rain and ice-phase processes are present, implying that it is important for GPM retrievals be sensitive to both types of precipitation mechanisms and to represent accurately the concentration of precipitation at the lowest possible altitudes. OLYMPEX data revealed that a given rain rate could be associated with a variety of DSDs, which presents a challenge for GPM precipitation retrievals in extratropical cyclones passing over mountains. Some of the DSD regimes measured during OLYMPEX stratiform periods have the same characteristics found in prior
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Content of nitrogen in atmospheric precipitation in Sweden
Energy Technology Data Exchange (ETDEWEB)
Angstroem, A; Hoegberg, L
1952-01-01
In the present paper an attempt is made to give a general idea of the geographical distribution of fixed nitrogen (NH/sub 4/-N) transferred to the soil through precipitation in Sweden. Further a map is given showing the distribution af alpha, a quantity proportional to the nitrogen concentration in the precipitation at the beginning of a rain and, it is assumed, representative for the content of fixed nitrogen in the atmosphere before the rain is falling. A discussion of different causes of the concentration of fixed nitrogen in precipitation is presented and a photochemical process is suggested, which would explain the almost constant ratio between NH/sub 4//sup -n/ and NO/sub 3//sup -n/ frequently found within the temperate zones. It is evident, however, that other causes also are at work, especially at lower latitudes. The need of laboratory experiments is emphasized.
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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.
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A Bulk Microphysics Parameterization with Multiple Ice Precipitation Categories.
Straka, Jerry M.; Mansell, Edward R.
2005-04-01
A single-moment bulk microphysics scheme with multiple ice precipitation categories is described. It has 2 liquid hydrometeor categories (cloud droplets and rain) and 10 ice categories that are characterized by habit, size, and density—two ice crystal habits (column and plate), rimed cloud ice, snow (ice crystal aggregates), three categories of graupel with different densities and intercepts, frozen drops, small hail, and large hail. The concept of riming history is implemented for conversions among the graupel and frozen drops categories. The multiple precipitation ice categories allow a range of particle densities and fall velocities for simulating a variety of convective storms with minimal parameter tuning. The scheme is applied to two cases—an idealized continental multicell storm that demonstrates the ice precipitation process, and a small Florida maritime storm in which the warm rain process is important.
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Early experience of a fall and fracture prevention clinic at Mayo General Hospital.
LENUS (Irish Health Repository)
Hanley, A
2010-06-01
Falls in the elderly are a significant public health problem. Previous studies have shown that most falls are multifactorial and an efficacious way of reducing the risk of falling is provided by a falls clinic.
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Precipitation Dynamical Downscaling Over the Great Plains
Hu, Xiao-Ming; Xue, Ming; McPherson, Renee A.; Martin, Elinor; Rosendahl, Derek H.; Qiao, Lei
2018-02-01
Detailed, regional climate projections, particularly for precipitation, are critical for many applications. Accurate precipitation downscaling in the United States Great Plains remains a great challenge for most Regional Climate Models, particularly for warm months. Most previous dynamic downscaling simulations significantly underestimate warm-season precipitation in the region. This study aims to achieve a better precipitation downscaling in the Great Plains with the Weather Research and Forecast (WRF) model. To this end, WRF simulations with different physics schemes and nudging strategies are first conducted for a representative warm season. Results show that different cumulus schemes lead to more pronounced difference in simulated precipitation than other tested physics schemes. Simply choosing different physics schemes is not enough to alleviate the dry bias over the southern Great Plains, which is related to an anticyclonic circulation anomaly over the central and western parts of continental U.S. in the simulations. Spectral nudging emerges as an effective solution for alleviating the precipitation bias. Spectral nudging ensures that large and synoptic-scale circulations are faithfully reproduced while still allowing WRF to develop small-scale dynamics, thus effectively suppressing the large-scale circulation anomaly in the downscaling. As a result, a better precipitation downscaling is achieved. With the carefully validated configurations, WRF downscaling is conducted for 1980-2015. The downscaling captures well the spatial distribution of monthly climatology precipitation and the monthly/yearly variability, showing improvement over at least two previously published precipitation downscaling studies. With the improved precipitation downscaling, a better hydrological simulation over the trans-state Oologah watershed is also achieved.
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Roth, A. C.; Hock, R.; Schuler, T.; Bieniek, P.; Aschwanden, A.
2017-12-01
Mass loss from glaciers in Southeast Alaska is expected to alter downstream ecological systems as runoff patterns change. To investigate these potential changes under future climate scenarios, distributed glacier mass balance modeling is required. However, the spatial resolution gap between global or regional climate models and the requirements for glacier mass balance modeling studies must be addressed first. We have used a linear theory of orographic precipitation model to downscale precipitation from both the Weather Research and Forecasting (WRF) model and ERA-Interim to the Juneau Icefield region over the period 1979-2013. This implementation of the LT model is a unique parameterization that relies on the specification of snow fall speed and rain fall speed as tuning parameters to calculate the cloud time delay, τ. We assessed the LT model results by considering winter precipitation so the effect of melt was minimized. The downscaled precipitation pattern produced by the LT model captures the orographic precipitation pattern absent from the coarse resolution WRF and ERA-Interim precipitation fields. Observational data constraints limited our ability to determine a unique parameter combination and calibrate the LT model to glaciological observations. We established a reference run of parameter values based on literature and performed a sensitivity analysis of the LT model parameters, horizontal resolution, and climate input data on the average winter precipitation. The results of the reference run showed reasonable agreement with the available glaciological measurements. The precipitation pattern produced by the LT model was consistent regardless of parameter combination, horizontal resolution, and climate input data, but the precipitation amount varied strongly with these factors. Due to the consistency of the winter precipitation pattern and the uncertainty in precipitation amount, we suggest a precipitation index map approach to be used in combination with
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The relationship between orthostatic hypotension and falling in older adults.
Shaw, Brett H; Claydon, Victoria E
2014-02-01
Falls are devastating events and are the largest contributor towards injury-related hospitalization of older adults. Orthostatic hypotension (OH) represents an intrinsic risk factor for falls in older adults. OH refers to a significant decrease in blood pressure upon assuming an upright posture. Declines in blood pressure can reduce cerebral perfusion; this can impair consciousness, lead to dizziness, and increase the likelihood of a fall. Although theoretical mechanisms linking OH and falls exist, the magnitude of the association remains poorly characterized, possibly because of methodological differences between previous studies. The use of non-invasive beat-to-beat blood pressure monitoring has altered the way in which OH is now defined, and represents a substantial improvement for detecting OH that was previously unavailable in many studies. Additionally, there is a lack of consistency and standardization of orthostatic assessments and analysis techniques for interpreting blood pressure data. This review explores the previous literature examining the relationship between OH and falls. We highlight the impact of broadening the timing, degree, and overall duration of blood pressure measurements on the detection of OH. We discuss the types of orthostatic stress assessments currently used to evaluate OH and the various techniques capable of measuring these often transient blood pressure changes. Overall, we identify future solutions that may better clarify the relationship between OH and falling risk in order to gain a more precise understanding of potential mechanisms for falls in older adults.
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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.
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Predicting first fall in newly diagnosed Parkinson's disease: Insights from a fall-naïve cohort.
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.
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Life-threatening neonatal epidural hematoma caused by precipitous vaginal delivery.
Josephsen, Justin B; Kemp, Joanna; Elbabaa, Samer K; Al-Hosni, Mohamad
2015-01-30
Neonatal in-hospital falls occur relatively frequently, although they are likely underreported. Significant intracranial head trauma from a fall or birth injury is not common in the immediate newborn period. Furthermore, intracranial bleeding requiring surgical intervention is exceedingly rare. We present an unusual case of an in-hospital fall in the delivery room requiring neurosurgical intervention. A term infant, appropriate for gestational age, delivered precipitously from a maternal standing position. The vertex neonate struck the linoleum floor after an approximate 80-cm fall, landing headfirst. The physical and neurological exams were initially normal, and skull films did not demonstrate an obvious fracture. The baby was closely observed, undergoing continuous cardiorespiratory monitoring. After the patient had an episode of apnea, a scalp hematoma was noted. A computed tomography (CT) scan revealed a left parietal fracture with an acute epidural hematoma, which required emergent craniotomy. The infant had an unremarkable post-operative course and had a normal neurodevelopmental assessment at 15 months of age. Close, continuous observation is recommended for infants following an in-hospital fall or after significant birth trauma. A high degree of suspicion for intracranial hemorrhage must be maintained. Fall prevention strategies should focus on careful baby handling by the convalescing mother.
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A long-term variation of chemical composition in precipitation
International Nuclear Information System (INIS)
Yoshioka, Ryuma; Okimura, Takashi; Okumura, Takenobu
1991-01-01
Precipitation samples are collected at the six localities in the southwestern Japan weekly or monthly over a long period of time (1978-1989) in order to estimate chemical weathering rates and amount of weathered materials through chemical composition in natural waters. Major chemical composition is determined for the precipitation samples. Together with the data available in the literature, the following characteristics are recognized : 1) Most pH values fall in the narrow range of 4.4 to 5.4, 2) Systematic variations in pH values are observed among the precipitation samples of different geologic environments, 3) pH values become almost constant from 1984 to 1989, 4) NO 3 - concentrations gradually decrease to an almost constant value with time, and 5) ΔSO 4 2- concentrations gradually have a tendency to decrease from 1978 to 1985. The mechanism of phenomena described above is also presented. (author)
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Fall prevention in central coast community pharmacies.
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.
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Ylitalo, Kelly R; Karvonen-Gutierrez, Carrie A
2016-10-01
Falls are an important health concern because they are associated with loss of independence and disability, particularly among women. We determined the age- and sex-specific prevalence of injurious falls among adults in the United States and examined the impact of obesity on fall risk. Self-reported falls, injurious falls, and health histories were obtained from 280,035 adults aged 45-79years in the 2014 Behavioral Risk Factor Surveillance System. Body mass index was categorized as underweight (fall in the previous 12months. Mid-life women 55-59years reported the highest prevalence of injurious falls (15.4%). Among mid-life women, overweight was associated with injurious falls (RR=1.17; 95% CI: 1.08, 1.28), but overweight was not associated with falling among other age-sex groups. Class II/III obesity was associated with injurious falls among all age-sex groups. After considering the mediators like health conditions (depression, cardiovascular disease, diabetes, arthritis) and behaviors (physical activity, sleep), the association of class II/III obesity and injurious fall risk persisted only among mid-life women (RR=1.23; 95% CI: 1.12, 1.36). Not only are mid-life women at high risk for falls, but the class II/III obesity is a risk factor for injurious falls. Targeting mid-life women for fall and injury prevention is an important aim for practitioners, particularly given unique correlates of falling for this group. Copyright © 2016 Elsevier Inc. All rights reserved.
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Wilcox, Kevin R; Shi, Zheng; Gherardi, Laureano A; Lemoine, Nathan P; Koerner, Sally E; Hoover, David L; Bork, Edward; Byrne, Kerry M; Cahill, James; Collins, Scott L; Evans, Sarah; Gilgen, Anna K; Holub, Petr; Jiang, Lifen; Knapp, Alan K; LeCain, Daniel; Liang, Junyi; Garcia-Palacios, Pablo; Peñuelas, Josep; Pockman, William T; Smith, Melinda D; Sun, Shanghua; White, Shannon R; Yahdjian, Laura; Zhu, Kai; Luo, Yiqi
2017-10-01
Climatic changes are altering Earth's hydrological cycle, resulting in altered precipitation amounts, increased interannual variability of precipitation, and more frequent extreme precipitation events. These trends will likely continue into the future, having substantial impacts on net primary productivity (NPP) and associated ecosystem services such as food production and carbon sequestration. Frequently, experimental manipulations of precipitation have linked altered precipitation regimes to changes in NPP. Yet, findings have been diverse and substantial uncertainty still surrounds generalities describing patterns of ecosystem sensitivity to altered precipitation. Additionally, we do not know whether previously observed correlations between NPP and precipitation remain accurate when precipitation changes become extreme. We synthesized results from 83 case studies of experimental precipitation manipulations in grasslands worldwide. We used meta-analytical techniques to search for generalities and asymmetries of aboveground NPP (ANPP) and belowground NPP (BNPP) responses to both the direction and magnitude of precipitation change. Sensitivity (i.e., productivity response standardized by the amount of precipitation change) of BNPP was similar under precipitation additions and reductions, but ANPP was more sensitive to precipitation additions than reductions; this was especially evident in drier ecosystems. Additionally, overall relationships between the magnitude of productivity responses and the magnitude of precipitation change were saturating in form. The saturating form of this relationship was likely driven by ANPP responses to very extreme precipitation increases, although there were limited studies imposing extreme precipitation change, and there was considerable variation among experiments. This highlights the importance of incorporating gradients of manipulations, ranging from extreme drought to extreme precipitation increases into future climate change
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Mobility, balance and falls in persons with multiple sclerosis.
Directory of Open Access Journals (Sweden)
Jacob J Sosnoff
Full Text Available BACKGROUND: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS. This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS. METHODS: 52 ambulatory persons with MS (PwMS participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS. Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. RESULTS: Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. CONCLUSIONS: The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established.
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Mobility, Balance and Falls in Persons with Multiple Sclerosis
Sosnoff, Jacob J.; Socie, Michael J.; Boes, Morgan K.; Sandroff, Brian M.; Pula, John H.; Suh, Yoojin; Weikert, Madeline; Balantrapu, Swathi; Morrison, Steven; Motl, Robert W.
2011-01-01
Background There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). Methods 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. Results Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. Conclusions The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established. PMID:22132196
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Dance movement therapy and falls prevention.
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.
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Study of fallout by precipitation around an oil-fired power plant
Energy Technology Data Exchange (ETDEWEB)
Granat, L; Rodhe, H
1973-01-01
An investigation into the distribution of deposition by precipitation around an oil-fired power plant on the west coast of Sweden is presented. The measurements cover seven precipitation events during late fall. The samples have been analyzed for sulfur, pH, alkalinity, and sodium. In most precipitation events an additional deposition (above the regional background level) of sulfur and acid has been identified on the leeward side of the source. Compared with the background values, the observed increase was generally less than about 100 percent. As a long-term average the additional deposition of acid by precipitation, due to the power plant, is estimated to be not larger than 10-15 percent within 15 km of the plant. A comparison with emitted quantities shows that 1-6 percent of the sulfur emittted during the precipitation has been deposited within the first 15 km, corresponding to a travel time of 20-60 min. If the comparison is made using the total emission, including the dry periods, this fraction is only a few per mille.
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Greene, Barry R; Redmond, Stephen J; Caulfield, Brian
2017-05-01
Falls are the leading global cause of accidental death and disability in older adults and are the most common cause of injury and hospitalization. Accurate, early identification of patients at risk of falling, could lead to timely intervention and a reduction in the incidence of fall-related injury and associated costs. We report a statistical method for fall risk assessment using standard clinical fall risk factors (N = 748). We also report a means of improving this method by automatically combining it, with a fall risk assessment algorithm based on inertial sensor data and the timed-up-and-go test. Furthermore, we provide validation data on the sensor-based fall risk assessment method using a statistically independent dataset. Results obtained using cross-validation on a sample of 292 community dwelling older adults suggest that a combined clinical and sensor-based approach yields a classification accuracy of 76.0%, compared to either 73.6% for sensor-based assessment alone, or 68.8% for clinical risk factors alone. Increasing the cohort size by adding an additional 130 subjects from a separate recruitment wave (N = 422), and applying the same model building and validation method, resulted in a decrease in classification performance (68.5% for combined classifier, 66.8% for sensor data alone, and 58.5% for clinical data alone). This suggests that heterogeneity between cohorts may be a major challenge when attempting to develop fall risk assessment algorithms which generalize well. Independent validation of the sensor-based fall risk assessment algorithm on an independent cohort of 22 community dwelling older adults yielded a classification accuracy of 72.7%. Results suggest that the present method compares well to previously reported sensor-based fall risk assessment methods in assessing falls risk. Implementation of objective fall risk assessment methods on a large scale has the potential to improve quality of care and lead to a reduction in associated hospital
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Jensen, A. A.; Harrington, J. Y.; Morrison, H.
2017-12-01
A quasi-idealized 3D squall line (based on a June 2007 Oklahoma case) is simulated using a novel bulk microphysics scheme called the Ice-Spheroids Habit Model with Aspect-ratio Evolution (ISHMAEL). In ISHMAEL, the evolution of ice particle properties, such as mass, shape, maximum diameter, density, and fall speed, are tracked as these properties evolve from vapor growth, sublimation, riming, and melting. Thus, ice properties evolve from various microphysical processes without needing separate unrimed and rimed ice categories. Simulation results show that ISHMAEL produces both a squall-line transition zone and an enhanced stratiform precipitation region. The ice particle properties produced in this simulation are analyzed and compared to observations to determine the characteristics of ice that lead to the development of these squall-line features. It is shown that rimed particles advected rearward from the convective region produce the enhanced stratiform precipitation region. The development of the transition zone results from hydrometer sorting: the evolution of ice particle properties in the convective region produces specific fall speeds that favor significant ice advecting rearward of the transition zone before reaching the melting level, causing a local minimum in precipitation rate and reflectivity there. Microphysical sensitivity studies, for example turning rime splintering off, that lead to changes in ice particle properties reveal that the fall speed of ice particles largely determines both the location of the enhanced stratiform precipitation region and whether or not a transition zone forms.
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AlSowailmi, Banan Abdullah; AlAkeely, Maha Heshaam; AlJutaily, Hayat Ibrahim; Alhasoon, Mohammad Abdulaziz; Omair, Amir; AlKhalaf, Hamad Abdullah
2018-01-01
Fall injuries among children during hospital stay is a major patient safety issue. Inpatient pediatric falls can lead to numerous negative consequences. In contrast to adults, there is a paucity of information on the prevalence and risk factors associated with children's falls during hospitalization. Identify the prevalence of fall injuries among hospital.ized children and describe the demographic and environmental factors that could predict a higher risk of severe outcomes of fall. Descriptive, cross-sectional prevalence study. Specialized children's hospital. Data was obtained through the electronic Safety Reporting System (SRS). All reported fall events during hospitalization in children less than or equal 14 years of age for the period from 1 April 2015 to 30 April 2016 were included. Fall events that occurred in the day care unit and the outpatient clinic were excluded. Prevalence and possible risk factors for fall events. 48. The prevalence of falls among the 4860 admitted children was 9.9 (95% CI=7.5, 13.1) per 1000 patients (48/4860). A majority of the falls were among boys (n=26, 54%), in the age group from 1-5 years old (n=22, 46%), in children at high risk of falling (n=35, 73%), with normal mobility status (n=21, 44%), and with no history of previ.ous falls (n=33, 69%). Severe injuries accounted for 25% of falls (n=12). However, falls among the moderate risk category (n=9, 69%) were more often severe than falls among the high risk category of children (n=12, 34%) (P=.03). Risk factor identification is required to prevent falls and their severe outcomes. Underreporting and single-centered study. None.
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Rock-fall potential in the Yosemite Valley, California
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.
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Energy Technology Data Exchange (ETDEWEB)
Hin, C
2005-12-15
The precipitation of niobium carbides in industrial steels is commonly used to control the recrystallization process or the amount of interstitial atoms in solid solution. It is then important to understand the precipitation kinetics and especially the competition between homogeneous and heterogeneous precipitation, since both of them have been observed experimentally, depending on they alloy composition, microstructure and thermal treatments. We propose Monte Carlo simulations of NbC precipitation in {open_square}-iron, based on a simple atomic description of the main parameters which control the kinetic pathway: - Realistic diffusion properties, with a rapid diffusion of C atoms by interstitial jumps and a slower diffusion of Fe and Nb atoms by vacancy jumps; - A model of grain boundaries which reproduces the segregation properties of Nb and C; - A model of dislocation which interacts with solute atoms through local segregation energies and long range elastic field; - A point defect source which drives the vacancy concentration towards its equilibrium value. Depending on the precipitation conditions, Monte Carlo simulations predict different kinetic behaviors, including a transient precipitation of metastable carbides, an early segregation stage of C, wetting phenomena at grain boundaries and on dislocations and a competition between homogeneous and heterogeneous NbC precipitation. Concerning the last point, we highlight that long range elastic field due to dislocation favors clearly the heterogeneous precipitation on dislocations. To understand this effect, we have developed a heterogeneous nucleation model including the calculation of the local concentration of solute atoms around the dislocation, the change of the solubility limit relative to the solubility limit in bulk and the energy of precipitates in an elastic field. We have concluded that elastic field favors the heterogeneous precipitation through the fall in nucleation barrier. (author)
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Impaired perceived timing of falls in the elderly.
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.
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Engineering analysis of the two-stage trifluoride precipitation process
International Nuclear Information System (INIS)
Luerkens, D.w.W.
1984-06-01
An engineering analysis of two-stage trifluoride precipitation processes is developed. Precipitation kinetics are modeled using consecutive reactions to represent fluoride complexation. Material balances across the precipitators are used to model the time dependent concentration profiles of the main chemical species. The results of the engineering analysis are correlated with previous experimental work on plutonium trifluoride and cerium trifluoride
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Using a multifactorial approach to determine fall risk profiles in portuguese older adults.
Moniz-Pereira, Vera; Carnide, Filomena; Ramalho, Fátima; André, Helô; Machado, Maria; Santos-Rocha, Rita; Veloso, António P
2013-01-01
The aim of this study was to use a multifactorial approach to characterize episodic and recurrent fallers risk profiles in Portuguese older adults. To accomplish the mentioned purpose, 1416 Portuguese older adults above 65 years were tested with three different field measurements: 1) health and falls questionnaire; 2) Physical Activity questionnaire and 3) a set of functional fitness tests. The subjects were divided in three different groups according to fall prevalence: non-fallers, subjects who did not report any falls during the previous year, episodic fallers, those who reported to have fallen only once during the previous year, and recurrent fallers, the ones that fell twice or more times during the previous year. Episodic and Recurrent fallers risk profiles were established using multifactorial logistic regression models in order to avoid confounding effects between the variables. The results showed that age was not a risk factor for either episodic or recurrent falling. In addition, health parameters were shown to be the factors distinguishing recurrent from episodic fallers. This may imply that, comparing with episodic falls, recurrent falls are more associated with higher presence of chronic conditions and are less likely to occur due to external factors. Furthermore, being a woman, having fear of falling and lower functional fitness levels were determinant factors for both episodic and recurrent falls. It is also important to note that, although total physical activity was only related with episodic falling, promoting physical activity and exercise may be the easiest and cheapest way to improve functional fitness and health levels and therefore, its role in fall prevention should not be underestimated. The results of this study reinforce the importance of using a multifactorial approach, not only focusing on cognitive-behavioral factors, but also on promoting physical activity and healthy lifestyles, when assessing fall risk or planning an intervention
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Synoptic Drivers of Precipitation in the Atlantic Sector of the Arctic
Cohen, L.; Hudson, S.; Graham, R.; Renwick, J. A.
2017-12-01
Precipitation in the Arctic has been shown to be increasing in recent decades, from both observational and modelling studies, with largest trends seen in autumn and winter. This trend is attributed to a combination of the warming atmosphere and reduced sea ice extent. The seasonality of precipitation in the Arctic is important as it largely determines whether the precipitation falls as snow or rain. This study assesses the spatial and temporal variability of the synoptic drivers of precipitation in the Atlantic (European) sector of the Arctic. This region of the Arctic is of particular interest as it has the largest inter-annual variability in sea ice extent and is the primary pathway for moisture transport into the Arctic from lower latitudes. This study uses the ECMWF ERA-I reanalysis total precipitation to compare to long-term precipitation observations from Ny Ålesund, Svalbard to show that the reanalysis captures the synoptic variability of precipitation well and that most precipitation in this region is synoptically driven. The annual variability of precipitation in the Atlantic Arctic shows strong regionality. In the Svalbard and Barents Sea region, most of the annual total precipitation occurs during autumn and winter (Oct-Mar) (>60% of annual total), while the high-Arctic (> 80N) and Kara Sea receives most of the annual precipitation ( 60% of annual total) during summer (July-Sept). Using a synoptic classification developed for this region, this study shows that winter precipitation is driven by winter cyclone occurrence, with strong correlations to the AO and NAO indices. High precipitation over Svalbard is also strongly correlated with the Scandinavian blocking pattern, which produces a southerly flow in the Greenland Sea/Svalbard area. An increasing occurrence of these synoptic patterns are seen for winter months (Nov and Jan), which may explain much of the observed winter increase in precipitation.
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Sankaré, Housseyni; Thériault, Julie M.
2016-11-01
Winter precipitation types can have major consequences on power outages, road conditions and air transportation. The type of precipitation reaching the surface depends strongly on the vertical temperature of the atmosphere, which is often composed of a warm layer aloft and a refreezing layer below it. A small variation of the vertical structure can lead to a change in the type of precipitation near the surface. It has been shown in previous studies that the type of precipitation depends also on the precipitation rate, which is directly linked to the particle size distribution and that a difference as low as 0.5 °C in the vertical temperature profile could change the type of precipitation near the surface. Given the importance of better understanding the formation of winter precipitation type, the goal of this study is to assess the impact of the snowflake habit aloft on the type of precipitation reaching the surface when the vertical temperature is near 0 °C. To address this, a one dimensional cloud model coupled with a bulk microphysics scheme was used. Four snowflake types (dendrite, bullet, column and graupel) have been added to the scheme. The production of precipitation at the surface from these types of snow has been compared to available observations. The results showed that the thickness of the snow-rain transition is four times deeper when columns and graupel only fall through the atmosphere compared to dendrites. Furthermore, a temperature of the melting layer that is three (four) times warmer is required to completely melt columns and graupel (dendrites). Finally, the formation of freezing rain is associated with the presence of lower density snowflakes (dendrites) aloft compared to the production of ice pellets (columns). Overall, this study demonstrated that the type of snowflakes has an impact on the type of precipitation reaching the surface when the temperature is near 0 °C.
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International Nuclear Information System (INIS)
Rapp, Anita D; Lebsock, Matthew; L’Ecuyer, Tristan
2013-01-01
A climatology of low cloud surface precipitation occurrence and intensity from the new CloudSat 2C-RAIN-PROFILE algorithm is presented from June 2006 through December 2010 for the southeastern Pacific region of marine stratocumulus. Results show that over 70% of low cloud precipitation falls as drizzle. Application of an empirical evaporation model suggests that 50–80% of the precipitation evaporates before it reaches the surface. Segregation of the CloudSat ascending and descending overpasses shows that the majority of precipitation occurs at night. Examination of the seasonal cycle shows that the precipitation is most frequent during the austral winter and spring; however there is considerable regional variability. Conditional rain rates increase from east to west with a maximum occurring in the region influenced by the South Pacific Convergence Zone. Area average rain rates are highest in the region where precipitation rates are moderate, but most frequent. The area average surface rain rate for low cloud precipitation for this region is ∼0.22 mm d −1 , in good agreement with in situ estimates, and is greatly improved over earlier CloudSat precipitation products. These results provide a much-needed quantification of surface precipitation in a region that is currently underestimated in existing satellite-based precipitation climatologies. (letter)
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Directory of Open Access Journals (Sweden)
Matthews Fiona E
2008-03-01
Full Text Available Abstract Background The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Methods Design: Re-survey of over-90-year-olds in a longitudinal cohort study – cross-sectional interview and intensive 12-month follow-up. Participants and setting: 90 women and 20 men participating in a population-based cohort (aged 91–105 years, in care-homes and community-dwelling recruited from representative general practices in Cambridge, UK Measurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. Results 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%, as were fall rates (1.6 and 2.8 falls/person-year respectively. Repeated falls in the past year were more highly predictive of falls during the following year – IRR 4.7, 95% CI 2.6–8.7 – than just one – IRR 3.6, 95% CI 2.0–6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Conclusion Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions
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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.
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Ibrahim, Azianah; Singh, Devinder Kaur Ajit; Shahar, Suzana; Omar, Mohd Azahadi
2017-01-01
Early detection of falls risk among older adults using simple tools may assist in fall prevention strategies. The aim of this study was to identify the best parameters associated with previous falls, either the timed up and go (TUG) test combined with sociodemographic factors and a self-rated multifactorial questionnaire (SRMQ) on falls risk or the TUG on its own. Falls risk was determined based on parameters associated with previous falls. This was a retrospective cohort study. The study was conducted in a community setting. The participants were 1,086 community-dwelling older adults, with mean age of 69.6±5.6 years. Participants were categorized into fallers and nonfallers based on their history of falls in the past 12 months. Participants' sociodemographic data was taken, and SRMQ consisting of five falls-related questions was administered. Participants performed the TUG test twice, and the mean was taken as the result. A total of 161 participants were categorized as fallers (14.8%). Multivariate logistic regression analysis showed that the model ( χ 2 (6)=61.0, p factors (gender, cataract/glaucoma and joint pain), as well as the SRMQ items "previous falls history" (Q1) and "worried of falls" (Q5), was more robust in terms of falls risk association compared to that with TUG on its own ( χ 2 (1)=10.3, p factors and SRMQ with TUG is more favorable as an initial falls risk screening tool among community-dwelling older adults. Subsequently, further comprehensive falls risk assessment may be performed in clinical settings to identify the specific impairments for effective management.
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Differing approaches to falls and fracture prevention between Australia and Colombia
Gomez, Fernando; Curcio, Carmen Lucia; Suriyaarachchi, Pushpa; Demontiero, Oddom; Duque, Gustavo
2013-01-01
Falls and fractures are major causes of morbidity and mortality in older people. More importantly, previous falls and/or fractures are the most important predictors of further events. Therefore, secondary prevention programs for falls and fractures are highly needed. However, the question is whether a secondary prevention model should focus on falls prevention alone or should be implemented in combination with fracture prevention. By comparing a falls prevention clinic in Manizales (Colombia) versus a falls and fracture prevention clinic in Sydney (Australia), the objective was to identify similarities and differences between these two programs and to propose an integrated model of care for secondary prevention of fall and fractures. A comparative study of services was performed using an internationally agreed taxonomy. Service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE) and previous reports in the literature. Comparison included organization, administration, client characteristics, and interventions. Several similarities and a number of differences that could be easily unified into a single model are reported here. Similarities included population, a multidisciplinary team, and a multifactorial assessment and intervention. Differences were eligibility criteria, a bone health assessment component, and the therapeutic interventions most commonly used at each site. In Australia, bone health assessment is reinforced whereas in Colombia dizziness assessment and management is pivotal. The authors propose that falls clinic services should be operationally linked to osteoporosis services such as a “falls and fracture prevention clinic,” which would facilitate a comprehensive intervention to prevent falls and fractures in older persons. PMID:23378748
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Women's perspectives on falls and fall prevention during pregnancy.
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.
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Short-term risk of falling after cochlear implantation.
Stevens, Madelyn N; Baudhuin, Jacqueline E; Hullar, Timothy E
2014-01-01
Cochlear implantation is a highly effective intervention for hearing loss, but insertion of an implant into the cochlea is often accompanied by loss of residual hearing function. Sometimes, postoperative testing also shows loss of function in the semicircular canals or otolith organs. The effect of this loss on equilibrium, particularly in the short term following surgery, and the risk of falling due to this loss is unknown. We prospectively measured balance in 16 consecutive adult cochlear implant patients before and 2 weeks after surgery. Subjects stood on a foam pad with eyes closed, feet together and arms at the side. The length of time over which this posture could be maintained was recorded up to a maximum value of 30 s indicating normal performance. Ten of 16 subjects reached a maximal time on preoperative testing. Nine of 16 subjects lost balance function after surgery. Four of the 10 subjects with normal preoperative balance function lost function. Subjects older than the age of 60 were more likely to lose balance function than younger subjects. We used previously published values relating balance performance on foam to risk of falling to calculate the fall risk among our subjects. The relative risk of falling increased after surgery by more than threefold in some patients. Imbalance after cochlear implantation may be much more common, particularly in the short term, than previously appreciated. This imbalance is accompanied by an increased risk of falling in many patients. Careful preoperative counseling before implantation and postoperative therapeutic intervention to improve comfort and reduce the chance of falling may be warranted, particularly in patients at a risk for injuries from falls (level of evidence: 2b). © 2014 S. Karger AG, Basel.
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Sri-On, Jiraporn; Tirrell, Gregory Philip; Kamsom, Anucha; Marill, Keith A; Shankar, Kalpana Narayan; Liu, Shan W
2018-03-25
The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall. We conducted a prospective study at two urban, teaching hospitals. We included patients aged ≥ 65 years who presented to the ED for an accidental fall. Data were gathered for fall-relevant comorbidities, high-risk medications for falls, and the responses to 12 questions from the STEADI guideline recommendation. Our outcomes were the number of 6-month adverse events that were defined as mortality, ED revisit, subsequent hospitalization, recurrent falls, and a composite outcome. There were 548 (86.3%) patients who completed follow-up and 243 (44.3%) patients experienced an adverse event after a fall within 6 months. In multivariate analysis, seven questions from the STEADI guideline predicted various outcomes. The question "Had previous fall" predicted recurrent falls (odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.52 to 3.97), the question "Feels unsteady when walking sometimes" (OR = 2.34, 95% CI = 1.44 to 3.81), and "Lost some feeling in their feet" predicted recurrent falls. In addition to recurrent falls risk, the supplemental questions "Use or have been advised to use a cane or walker," "Take medication that sometimes makes them feel light-headed or more tired than usual," "Take medication to help sleep or improve mood," and "Have to rush to a toilet" predicted other outcomes. A STEADI score of ≥4 did not predict adverse outcomes although seven individual questions from the STEADI guidelines were associated with increased adverse outcomes within 6 months. These may be organized into three categories (previous falls, physical activity, and high-risk medications) and may assist emergency physicians to evaluate and refer high-risk fall patients for a comprehensive
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Complex precipitation pathways in multicomponent alloys
Energy Technology Data Exchange (ETDEWEB)
Clouet, Emmanuel; Nastar, Maylise [Service de Recherches de Metallurgie Physique, CEA/Saclay, 91191 Gif-sur-Yvette (France); Lae, Ludovic; Deschamps, Alexis [LTPCM/ENSEEG, UMR CNRS 5614, Domaine Universitaire, BP 75, 38402 St Martin d' Heres (France); Epicier, Thierry [Groupe d' Etudes de Metallurgie Physique et de Physique des Materiaux, UMR CNRS 5510, INSA, 69621 Villeurbanne (France); Lefebvre, Williams [Groupe de Physique des Materiaux, UMR CNRS 6634, Universite de Rouen, 76801 Saint Etienne du Rouvray (France)
2006-07-01
One usual way to strengthen a metal is to add alloying elements and to control the size and the density of the precipitates obtained. However, precipitation in multicomponent alloys can take complex pathways depending on the relative diffusivity of solute atoms and on the relative driving forces involved. In Al - Zr - Sc alloys, atomic simulations based on first-principle calculations combined with various complementary experimental approaches working at different scales reveal a strongly inhomogeneous structure of the precipitates: owing to the much faster diffusivity of Sc compared with Zr in the solid solution, and to the absence of Zr and Sc diffusion inside the precipitates, the precipitate core is mostly Sc-rich, whereas the external shell is Zr-rich. This explains previous observations of an enhanced nucleation rate in Al - Zr - Sc alloys compared with binary Al - Sc alloys, along with much higher resistance to Ostwald ripening, two features of the utmost importance in the field of light high-strength materials. (authors)
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Assessment of risk of falls in elderly living at home
Directory of Open Access Journals (Sweden)
Adriana de Azevedo Smith
Full Text Available ABSTRACT Objective: to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. Method: cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS version 19 was used for statistical analysis. Results: there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001, age (0.054, cognitive status (<0.001 and history of falls (<0.001. All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment. Conclusion: female gender, older elderly (over 80 years old, with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases.
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[Development of a portable fall risk index for elderly people living in the community].
Toba, Kenji; Okochi, Jiro; Takahashi, Tai; Matsubayashi, Kozo; Nishinaga, Masanori; Yamada, Shizuru; Takahashi, Ryutaro; Nishijima, Reiko; Kobayashi, Yoshio; Machida, Ayako; Akishita, Masahiro; Sasaki, Hidetada
2005-05-01
To develop a portable risk index for falls. Risk factors were chosen from previously established factors then we added several environmental factors to the risk index; previous falls in the last 12 month, trippig or stumbling, inability to ascend or descend stairs without help, decreased walking speed, inability to cross a road within the green signal interval, inability to walk 1km without a break, inability to stand on one leg for 5 seconds (eyes open), using a cane, inability to wring out a towel, dizziness or faintness, stooped or rounded back, knee joint pain, visual disturbance, hearing disturbance, cognitive decline, fear of falling, receiving 5 or more prescribed drugs, sensation of darkness at home, obstacles inside, barrier on the carpet or floor, using steps daily at home, steep slopes around home. The questionnaire sheet was completed by 2,439 community-dwelling elderly subjects (76.3 +/- 7.4 years old). The frequency of each items of fall risk index was compared between fallers (history of fall within one year) and non-fallers. Multiple regression analysis was performed to identify independent risk factors for previous falls. Except barrier, step use and steep slope around home, all items in the fall risk index were more frequent in fallers. Multivariate analysis revealed that tripping or stumbling, inability to cross a road within the green signal interval, dizziness or faintness, obstacles inside, inability to wring out a towel, cane use and knee joint pain were independent risk factors for previous falls. These 7 selected items were further analyzed as predictors. The maximum sum of sensitivity and specificity was reached at the cut-off point of 2/3 (sensitivity 0.65, specificity 0.72) by receiver operating curve. Portable fall risk index is useful for clinical settings to identify high-risk subjects.
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Testing and development of transfer functions for weighing precipitation gauges in WMO-SPICE
Directory of Open Access Journals (Sweden)
J. Kochendorfer
2018-02-01
Full Text Available Weighing precipitation gauges are used widely for the measurement of all forms of precipitation, and are typically more accurate than tipping-bucket precipitation gauges. This is especially true for the measurement of solid precipitation; however, weighing precipitation gauge measurements must still be adjusted for undercatch in snowy, windy conditions. In WMO-SPICE (World Meteorological Organization Solid Precipitation InterComparison Experiment, different types of weighing precipitation gauges and shields were compared, and adjustments were determined for the undercatch of solid precipitation caused by wind. For the various combinations of gauges and shields, adjustments using both new and previously existing transfer functions were evaluated. For most of the gauge and shield combinations, previously derived transfer functions were found to perform as well as those more recently derived. This indicates that wind shield type (or lack thereof is more important in determining the magnitude of wind-induced undercatch than the type of weighing precipitation gauge. It also demonstrates the potential for widespread use of the previously developed transfer functions. Another overarching result was that, in general, the more effective shields, which were associated with smaller unadjusted errors, also produced more accurate measurements after adjustment. This indicates that although transfer functions can effectively reduce measurement biases, effective wind shielding is still required for the most accurate measurement of solid precipitation.
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Testing and development of transfer functions for weighing precipitation gauges in WMO-SPICE
Kochendorfer, John; Nitu, Rodica; Wolff, Mareile; Mekis, Eva; Rasmussen, Roy; Baker, Bruce; Earle, Michael E.; Reverdin, Audrey; Wong, Kai; Smith, Craig D.; Yang, Daqing; Roulet, Yves-Alain; Meyers, Tilden; Buisan, Samuel; Isaksen, Ketil; Brækkan, Ragnar; Landolt, Scott; Jachcik, Al
2018-02-01
Weighing precipitation gauges are used widely for the measurement of all forms of precipitation, and are typically more accurate than tipping-bucket precipitation gauges. This is especially true for the measurement of solid precipitation; however, weighing precipitation gauge measurements must still be adjusted for undercatch in snowy, windy conditions. In WMO-SPICE (World Meteorological Organization Solid Precipitation InterComparison Experiment), different types of weighing precipitation gauges and shields were compared, and adjustments were determined for the undercatch of solid precipitation caused by wind. For the various combinations of gauges and shields, adjustments using both new and previously existing transfer functions were evaluated. For most of the gauge and shield combinations, previously derived transfer functions were found to perform as well as those more recently derived. This indicates that wind shield type (or lack thereof) is more important in determining the magnitude of wind-induced undercatch than the type of weighing precipitation gauge. It also demonstrates the potential for widespread use of the previously developed transfer functions. Another overarching result was that, in general, the more effective shields, which were associated with smaller unadjusted errors, also produced more accurate measurements after adjustment. This indicates that although transfer functions can effectively reduce measurement biases, effective wind shielding is still required for the most accurate measurement of solid precipitation.
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Improved simulation of Antarctic sea ice due to the radiative effects of falling snow
Li, J.-L. F.; Richardson, Mark; Hong, Yulan; Lee, Wei-Liang; Wang, Yi-Hui; Yu, Jia-Yuh; Fetzer, Eric; Stephens, Graeme; Liu, Yinghui
2017-08-01
Southern Ocean sea-ice cover exerts critical control on local albedo and Antarctic precipitation, but simulated Antarctic sea-ice concentration commonly disagrees with observations. Here we show that the radiative effects of precipitating ice (falling snow) contribute substantially to this discrepancy. Many models exclude these radiative effects, so they underestimate both shortwave albedo and downward longwave radiation. Using two simulations with the climate model CESM1, we show that including falling-snow radiative effects improves the simulations relative to cloud properties from CloudSat-CALIPSO, radiation from CERES-EBAF and sea-ice concentration from passive microwave sensors. From 50-70°S, the simulated sea-ice-area bias is reduced by 2.12 × 106 km2 (55%) in winter and by 1.17 × 106 km2 (39%) in summer, mainly because increased wintertime longwave heating restricts sea-ice growth and so reduces summer albedo. Improved Antarctic sea-ice simulations will increase confidence in projected Antarctic sea level contributions and changes in global warming driven by long-term changes in Southern Ocean feedbacks.
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Kuptniratsaikul, Vilai; Praditsuwan, Rungnirand; Assantachai, Prasert; Ploypetch, Teerada; Udompunturak, Suthipol; Pooliam, Julaporn
2011-01-01
To study the effectiveness of simply-performed balancing exercises in fall prevention. Pre- and post-trial. University hospital from January 2009 to May 2010. Elderly with falls in the previous year. Simple balancing exercise was performed at home every day and was recorded in the booklet. New falling events and a battery of balancing abilities including the Timed Up and Go Test (TUGT), chair stand, functional reach, and Berg balance scale-short form were evaluated at baseline, 3-, 6-, 9-, and 12-month periods. Fear of falling and quality of life scores were assessed at baseline and 12-month periods. 146 subjects were recruited, 116 female (79.5%) with a mean age of 67.1 years. At the end of the study, 49% of participants had not fallen. All of the balancing abilities were compared between frequent and infrequent fallers and were significantly improved (Pfall group. Most subjects (72%-79%) complied well with the exercise program. However, compliance had no effect on balancing abilities. About 36.4% of participants had adverse events from exercise, of which knee pain was the top ranked. The quality of life and the fall efficacy scores increased significantly at the end of the study. Factors affecting falling were compliance with exercise (adjusted odds ratio [OR]: 2.55, 95% confidence intervals [CI]: 1.04, 6.30) and a history of falling ≥3 times in the previous year (adjusted OR: 3.76, 95% CI: 1.18, 11.98). Performing simply-designed balancing exercises, at least 3 days per week, can increase balancing abilities, and decrease fall rates in the elderly with a history of previous falls. However, strategies to encourage elderly compliance may prevent falling.
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Re-examining the Non-Linear Moisture-Precipitation Relationship over the Tropical Oceans.
Rushley, S S; Kim, D; Bretherton, C S; Ahn, M-S
2018-01-28
Bretherton et al. (2004) used the Special Sensor Microwave Imager (SSM/I) version 5 product to derive an exponential curve that describes the relationship between precipitation and column relative humidity (CRH) over the tropical oceans. The curve, which features a precipitation pickup at a CRH of about 0.75 and a rapid increase of precipitation with CRH after the pickup, has been widely used in the studies of the tropical atmosphere. This study re-examines the moisture-precipitation relationship by using the version 7 SSM/I data, in which several biases in the previous version are corrected, and evaluates the relationship in the Coupled Model Intercomparison Project phase 5 (CMIP5) models. In the revised exponential curve derived using the updated satellite data, the precipitation pick-up occurs at a higher CRH (~0.8), and precipitation increases more slowly with CRH than in the previous curve. In most CMIP5 models, the precipitation pickup is too early due to the common model bias of overestimated (underestimated) precipitation in the dry (wet) regime.
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Fall risk screening protocol for older hearing clinic patients.
Criter, Robin E; Honaker, Julie A
2017-10-01
The primary purposes of this study were (1) to describe measures that may contrast audiology patients who fall from those who do not fall and (2) to evaluate the clinical performance of measures that could be easily used for fall risk screening in a mainstream audiology hearing clinic. Cross-sectional study Study sample: Thirty-six community-dwelling audiology patient participants and 27 community-dwelling non-audiology patients over 60 years of age. The Hearing Handicap Inventory for the Elderly (HHIE) most accurately identified patients with a recent fall (sensitivity: 76.0%), while the Dizziness Handicap Inventory (DHI) most accurately identified patients without a recent fall (specificity: 90.9%). A combination of measures used in a protocol-including HHIE, DHI, number of medications, and the Timed Up and Go test-resulted in good, accurate identification of patients with or without a recent history of falls (92.0% sensitivity, 100% specificity). This study reports good sensitivity and excellent specificity for identifying patients with and without a recent history of falls when measures were combined into a screening protocol. Despite previously reported barriers, effective fall risk screenings may be performed in hearing clinic settings with measures often readily accessible to audiologists.
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Precipitation-generated oscillations in open cellular cloud fields.
Feingold, Graham; Koren, Ilan; Wang, Hailong; Xue, Huiwen; Brewer, Wm Alan
2010-08-12
Cloud fields adopt many different patterns that can have a profound effect on the amount of sunlight reflected back to space, with important implications for the Earth's climate. These cloud patterns can be observed in satellite images of the Earth and often exhibit distinct cell-like structures associated with organized convection at scales of tens of kilometres. Recent evidence has shown that atmospheric aerosol particles-through their influence on precipitation formation-help to determine whether cloud fields take on closed (more reflective) or open (less reflective) cellular patterns. The physical mechanisms controlling the formation and evolution of these cells, however, are still poorly understood, limiting our ability to simulate realistically the effects of clouds on global reflectance. Here we use satellite imagery and numerical models to show how precipitating clouds produce an open cellular cloud pattern that oscillates between different, weakly stable states. The oscillations are a result of precipitation causing downward motion and outflow from clouds that were previously positively buoyant. The evaporating precipitation drives air down to the Earth's surface, where it diverges and collides with the outflows of neighbouring precipitating cells. These colliding outflows form surface convergence zones and new cloud formation. In turn, the newly formed clouds produce precipitation and new colliding outflow patterns that are displaced from the previous ones. As successive cycles of this kind unfold, convergence zones alternate with divergence zones and new cloud patterns emerge to replace old ones. The result is an oscillating, self-organized system with a characteristic cell size and precipitation frequency.
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Mobile Phone Based Falling Detection Sensor and Computer-Aided Algorithm for Elderly People
Directory of Open Access Journals (Sweden)
Lee Jong-Ha
2016-01-01
Full Text Available Falls are dangerous for the elderly population; therefore many fall detection systems have been developed. However, previous methods are bulky for elderly people or only use a single sensor to isolate falls from daily living activities, which makes a fall difficult to distinguish. In this paper, we present a cost-effective and easy-to-use portable fall-detection sensor and algorithm. Specifically, to detect human falls, we used a three-axis accelerator and a three-axis gyroscope in a mobile phone. We used the Fourier descriptor-based frequency analysis method to classify both normal and falling status. From the experimental results, the proposed method detects falling status with 96.14% accuracy.
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Epidemiology of falls in older adults in Texas.
Alamgir, Hasanat; Wong, Nicole J; Hu, Yueha; Yu, Mo; Marshall, Amanda; Yu, Shicheng
2015-02-01
The expected increase in the US older adult population implies an increased risk of fall-related injury among these individuals. We describe the epidemiology of fall morbidity among older adults in Texas, a large US state with a diverse population base. Texas Behavioral Risk Factor Surveillance System 2010 data were analyzed. The falls outcome was defined as falling: any fall in the past 3 months and a serious fall: a fall resulting in limited activities for at least 1 day or requiring medical attention. A total of 5996 subjects were included in this analysis; 17.6% (n = 1055) reported falling 1 to 5 times in the previous 3 months, and 361 (6%) experienced serious falls. Risk of falling had a significant positive association among respondents who rated their general health as fair to poor (relative risk [RR] 2.39, 95% confidence interval [CI] 1.55-3.68) and a negative association for those who reported regular physical activity (RR 0.59, 95% CI 0.42-0.82). A similar model examined the risk of serious falls and found statistically positive associations in respondents who reported fair or poor general health (RR 3.29, 95% CI 2.00-5.43). Negative associations were found for those who reported regular physical activity (RR 0.56, 95% CI 0.38-0.83) and for men (RR 0.62, 95% CI 0.39-0.98). No statistically significant correlations for either of the fall outcomes were found with residence, obesity, education, income, age, ethnicity, employment, marital status, diabetes mellitus, or cardiovascular disease. Interventions aimed at the prevention of falls should focus on maintaining and improving general health and promoting physical activity among older adults.
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Xu, Tianma; O'Loughlin, Kate; Clemson, Lindy; Lannin, Natasha A; Dean, Catherine; Koh, Gerald
2017-12-25
Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants' experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Semi-structured interviews were conducted in Singapore with community-dwelling stroke survivors with a previous fall (n = 9), family caregivers (n = 4), and domestic helpers (n = 4) who have cared for a stroke survivor with a previous fall. Purposive sampling was used for recruitment; all interviews were audio-recorded with permission and transcribed. Thematic analysis was conducted using NVivo (v10) software. All participants shared their self-perceived intrinsic and extrinsic fall risk factors and main challenges after a fall. For stroke participants and family caregivers, motivational factors in developing safety strategies after a previous fall(s) include social connectedness, independent living and community participation. For family caregivers and domestic helpers, the stroke survivor's safety is their top priority, however this can also lead to over-protective behavior outside of the rehabilitation process. Reducing the risk of falls in community-dwelling stroke survivors seems to be more important than promoting community participation among caregivers. The study findings highlight that a structured and client-centered fall prevention program targeting stroke survivors and caregivers is needed in Singapore. Implications for rehabilitation Falls after stroke can lead to functional decline in gait and mobility and restricted self-care activities. Community-dwelling stroke survivors develop adaptive safety strategies after a fall and want to be socially connected. However, caregivers see the safety of the stroke survivors as their top priority and demonstrate over-protective behaviors. Fall prevention programs for community-dwelling stroke survivors should target both stroke
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Young, C. B.
2002-05-01
Accurate observation of precipitation is critical to the study and modeling of land surface hydrologic processes. NEXRAD radar-based precipitation estimates are increasingly used in field experiments, hydrologic modeling, and water and energy budget studies due to their high spatial and temporal resolution, national coverage, and perceived accuracy. Extensive development and testing of NEXRAD precipitation algorithms have been carried out in the Southern Plains. Previous studies (Young et al. 2000, Young et al. 1999, Smith et al. 1996) indicate that NEXRAD operational products tend to underestimate precipitation at light rain rates. This study investigates the performance of NEXRAD precipitation estimates of high-intensity rainfall, focusing on flood-producing storms in the Missouri River Basin. NEXRAD estimates for these storms are compared with data from multiple raingage networks, including NWS recording and non-recording gages and ALERT raingage data for the Kansas City metropolitan area. Analyses include comparisons of gage and radar data at a wide range of temporal and spatial scales. Particular attention is paid to the October 4th, 1998, storm that produced severe flooding in Kansas City. NOTE: The phrase `NEXRAD operational products' in this abstract includes precipitation estimates generated using the Stage III and P1 algorithms. Both of these products estimate hourly accumulations on the (approximately) 4 km HRAP grid.
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Correlates of falling during 24 h among elderly Danish community residents
DEFF Research Database (Denmark)
Larsen, Erik Roj; Mosekilde, Leif; Foldspang, Anders
2004-01-01
Objectives. To identify dietary, medical, and environmental correlates of falling during the last 24 h among elderly community residents. The limited accuracy of recall of falls in the elderly in previous studies was the reason for a 24-h time frame. Methods. The study composes 4281 community res...
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Patient centered fall risk awareness perspectives: clinical correlates and fall risk
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
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Kader, Manzur; Iwarsson, Susanne; Odin, Per; Nilsson, Maria H
2016-06-02
There is limited knowledge concerning fall-related activity avoidance in people with Parkinson's disease (PD); such knowledge would be of importance for the development of more efficient PD-care and rehabilitation. This study aimed to examine how fall-related activity avoidance relates to a history of self-reported falls/near falls and fear of falling (FOF) as well as to disease severity in people with PD. Data were collected from 251 (61 % men) participants with PD; their median (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A self-administered postal survey preceded a home visit which included observations, clinical tests and interview-administered questionnaires. Fall-related activity avoidance was assessed using the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) as well as by using a dichotomous (Yes/No) question. Further dichotomous questions concerned: the presence of FOF and the history (past 6 months) of falls or near falls, followed by stating the number of incidents. Disease severity was assessed according to the Hoehn and Yahr (HY) stages. In the total sample (n = 251), 41 % of the participants reported fall-related activity avoidance; the median mSAFFE score was 22. In relation to a history of fall, the proportions of participants (p fall-related activity avoidance were: non-fallers (30 %), single fallers (50 %) and recurrent fallers, i.e. ≥ 2 falls (57 %). Among those that reported near falls (but no falls), 51 % (26 out of 51) reported fall-related activity avoidance. Of those that reported FOF, 70 % reported fall-related activity avoidance. Fall-related activity avoidance ranged from 24 % in the early PD-stage (HY I) to 74 % in the most severe stages (HY IV-V). Results indicate that fall-related activity avoidance may be related to a history of self-reported falls/near falls, FOF and disease severity in people with PD. Importantly, fall-related activity avoidance is
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Silver precipitation from electrolytic effluents
International Nuclear Information System (INIS)
Rivera, I.; Patino, F.; Cruells, M.; Roca, A.; Vinals, J.
2004-01-01
The recovery of silver contained in electrolytic effluents is attractive due to its high economic value. These effluents are considered toxic wastes and it is not possible to dump them directly without any detoxification process. One of the most important way for silver recovery is the precipitation with sodium ditionite, sodium borohidride or hydrazine monohidrate. In this work, the most significant aspects related to the use of these reagents is presented. Results of silver precipitation with sodium ditionite from effluents containing thiosulfate without previous elimination of other species are also presented. silver concentration in the final effluents w <1 ppm. (Author) 15 refs
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Mitigating fall risk: A community fall reduction program.
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.
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Scaling and clustering effects of extreme precipitation distributions
Zhang, Qiang; Zhou, Yu; Singh, Vijay P.; Li, Jianfeng
2012-08-01
SummaryOne of the impacts of climate change and human activities on the hydrological cycle is the change in the precipitation structure. Closely related to the precipitation structure are two characteristics: the volume (m) of wet periods (WPs) and the time interval between WPs or waiting time (t). Using daily precipitation data for a period of 1960-2005 from 590 rain gauge stations in China, these two characteristics are analyzed, involving scaling and clustering of precipitation episodes. Our findings indicate that m and t follow similar probability distribution curves, implying that precipitation processes are controlled by similar underlying thermo-dynamics. Analysis of conditional probability distributions shows a significant dependence of m and t on their previous values of similar volumes, and the dependence tends to be stronger when m is larger or t is longer. It indicates that a higher probability can be expected when high-intensity precipitation is followed by precipitation episodes with similar precipitation intensity and longer waiting time between WPs is followed by the waiting time of similar duration. This result indicates the clustering of extreme precipitation episodes and severe droughts or floods are apt to occur in groups.
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Person-Centered Fall Risk Awareness Perspectives: Clinical Correlates and Fall Risk.
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.
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A Precipitation Climatology of the Snowy Mountains, Australia
Theobald, Alison; McGowan, Hamish; Speirs, Johanna
2014-05-01
The precipitation that falls in the Snowy Mountains region of southeastern Australia provides critical water resources for hydroelectric power generation. Water storages in this region are also a major source of agricultural irrigation, environmental flows, and offer a degree of flood protection for some of the major river systems in Australia. Despite this importance, there remains a knowledge gap regarding the long-term, historic variability of the synoptic weather systems that deliver precipitation to the region. This research aims to increase the understanding of long-term variations in precipitation-bearing weather systems resulting in runoff into the Snowy Mountains catchments and reservoirs, and the way in which these are influenced by large-scale climate drivers. Here we present initial results on the development of a climatology of precipitation-bearing synoptic weather systems (synoptic typology), spanning a period of over 100 years. The synoptic typology is developed from the numerical weather model re-analysis data from the European Centre for Medium-Range Weather Forecasts (ECMWF), in conjunction with regional precipitation and temperature data from a network of private gauges. Given the importance of surface, mid- and upper-air patterns on seasonal precipitation, the synoptic typing will be based on a range of meteorological variables throughout the depth of the troposphere, highlighting the importance of different atmospheric levels on the development and steering of synoptic precipitation bearing systems. The temporal and spatial variability of these synoptic systems, their response to teleconnection forcings and their contribution to inflow generation in the headwater catchments of the Snowy Mountains will be investigated. The resulting climatology will provide new understanding of the drivers of regional-scale precipitation variability at inter- and intra-annual timescales. It will enable greater understanding of how variability in synoptic scale
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Solubility limit and precipitation kinetics of iron-phosphide in ferritic iron
International Nuclear Information System (INIS)
Suzuki, Shigeru
1992-01-01
The solubility limit of iron-phosphide in ferritic iron was examined with electrical resistivity measurements by using the relationship between resistivity and the amount of dissolved phosphorous. The temperature dependence of the solubility obtained was in good agreement with previous results. The kinetics of precipitation of the phosphide from a supersaturated Fe-3.75 at.% P alloy was also investigated with changes of the resistivity by isochronal and isothermal annealing. The activation energy for the precipitation process of the phosphide was about 2.6 eV. Diffusivities of phosphorus were estimated from the annealing behaviour and the morphology of the precipitates, which were comparable to those obtained with the tracer method previously. This suggests that the precipitation process of phosphide is rate controlled by diffusion of phosphorus in ferritic iron-phosphorus alloys. (orig.) [de
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Fear of falling as seen in the Multidisciplinary falls consultation.
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.
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Pedrozo-Acuña, A.; Magos-Hernández, J. A.; Sánchez-Peralta, J. A.; Blanco-Figueroa, J.; Breña-Naranjo, J. A.
2017-12-01
This contribution presents a real-time system for issuing warnings of intense precipitation events during major storms, developed for Mexico City, Mexico. The system is based on high-temporal resolution (Dt=1min) measurements of precipitation in 10 different points within the city, which report variables such as intensity, number of raindrops, raindrop size, kinetic energy, fall velocity, etc. Each one of these stations, is comprised of an optical disdrometer to measure size and fall velocity of hydrometeors, a solar panel to guarantee an uninterrupted power supply, a wireless broadband access to internet, and a resource constrained device known as Raspberry Pi3 for the processing, storage and sharing of the sensor data over the world wide web. The self-made developed platform follows a component-based system paradigm allowing users to implement custom algorithms and models depending on application requirements. The system is in place since July 2016, and continuous measurements of rainfall in real-time are published over the internet through the webpage www.oh-iiunam.mx. Additionally, the developed platform for the data collection and management interacts with the social network known as Twitter to enable real-time warnings of precipitation events. Key contribution of this development is the design and implementation of a scalable, easy to use, interoperable platform that facilitates the development of real-time precipitation sensor networks and warnings. The system is easy to implement and could be used as a prototype for systems in other regions of the world.
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Kumar, Naresh; Mohapatra, M.; Jaswal, A. K.
2017-07-01
Unprecedented precipitation along with heavy falls occurred over many parts of India from 28th February to 2nd March 2015. Many of the stations of northwest and central India received an all time high 24 hr cumulative precipitation of March during this period. Even the national capital, New Delhi, broke all the previous historical 24 hr rainfall records of the last 100 years to the rainfall record in March 2015. Due to this event, huge loss to agricultural and horticultural crops occurred in several parts of India. In the present study, an attempt is made to understand the various meteorological features associated with this unprecedented precipitation event over India. It occurred due to the presence of an intense western disturbance (WD) over Afghanistan and neighbouring areas in the form of north-south oriented deep trough in westerlies in middle and upper tropospheric levels with its southern end deep in the Arabian Sea, which pumped huge moisture feed over Indian region. Also, there was a jet stream with core wind speed up to 160 knots that generated high positive divergence at upper tropospheric level over Indian region; along with this there was high magnitude of negative vertical velocity and velocity convergence were there at middle tropospheric level. It caused intense upward motion and forced lower levels air to rise and strengthen the lower levels cyclonic circulations (CCs)/Lows. Moreover, the induced CCs/Lows at lower tropospheric levels associated with WD were more towards south of its normal position. Additionally, there was wind confluence over central parts of India due to westerlies in association with WD and easterlies from anticyclone over north Bay of Bengal. Thus, intense WD along with wind confluence between westerlies and easterlies caused unprecedented precipitation over India during the 1st week of March 2015.
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International Nuclear Information System (INIS)
Grimm, J.W.; Lynch, J.A.
2005-01-01
Daily precipitation nitrate and ammonium concentration models were developed for the Chesapeake Bay Watershed (USA) using a linear least-squares regression approach and precipitation chemistry data from 29 National Atmospheric Deposition Program/National Trends Network (NADP/NTN) sites. Only weekly samples that comprised a single precipitation event were used in model development. The most significant variables in both ammonium and nitrate models included: precipitation volume, the number of days since the last event, a measure of seasonality, latitude, and the proportion of land within 8 km covered by forest or devoted to industry and transportation. Additional variables included in the nitrate model were the proportion of land within 0.8 km covered by water and/or forest. Local and regional ammonia and nitrogen oxide emissions were not as well correlated as land cover. Modeled concentrations compared very well with event chemistry data collected at six NADP/AirMoN sites within the Chesapeake Bay Watershed. Wet deposition estimates were also consistent with observed deposition at selected sites. Accurately describing the spatial distribution of precipitation volume throughout the watershed is important in providing critical estimates of wet-fall deposition of ammonium and nitrate. - A linear least-squares regression approach was used to develop daily precipitation nitrate and ammonium concentration models for the Chesapeake Bay Watershed
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Falling and fall risk in adult patients with severe haemophilia.
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.
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Formiga, F; Ruiz, D; López-Soto, A; Duaso, E; Chivite, D; Pérez-Castejón, J M
2006-01-01
The majority of hip fractures are produced because of a fall. We examined the characteristics associated with falls causing hip fracture in elderly patients. Characteristics of falls owing to hip fracture were analyzed in 410 consecutive patients admitted in 6 hospitals during the 2004. We evaluated the location, time and the possible cause of fall: intrinsic risk factor, extrinsic or combined. We evaluated 316 women (77%) and 94 men, mean age 81.9 years. Previous to the hip fracture, the mean BI was 77.5. The mean value of falls during the last year was 1.9. Previously to the fall that caused hip fracture, we found that 24% of the patients had fallen repeatedly (more than two falls). Usually falls were at home (68%) and during daytime (80%). In 45% of patients an intrinsic risk factor was considered the most likely cause, in 33% an extrinsic risk factor and in 22% a combination. The majority of falls owing to hip fracture in elderly people happen in daytime, at home and due to intrinsic risk factors. Efforts to identify elderly people at risk of fall should be stressed in order to establish preventive measures.
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African aerosol and large-scale precipitation variability over West Africa
International Nuclear Information System (INIS)
Huang Jingfeng; Zhang Chidong; Prospero, Joseph M
2009-01-01
We investigated the large-scale connection between African aerosol and precipitation in the West African Monsoon (WAM) region using 8-year (2000-2007) monthly and daily Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol products (aerosol optical depth, fine mode fraction) and Tropical Rainfall Measuring Mission (TRMM) precipitation and rain type. These high-quality data further confirmed our previous results that the large-scale link between aerosol and precipitation in this region undergoes distinct seasonal and spatial variability. Previously detected suppression of precipitation during months of high aerosol concentration occurs in both convective and stratiform rain, but not systematically in shallow rain. This suggests the suppression of deep convection due to the aerosol. Based on the seasonal cycle of dust and smoke and their geographical distribution, our data suggest that both dust (coarse mode aerosol) and smoke (fine mode aerosol) contribute to the precipitation suppression. However, the dust effect is evident over the Gulf of Guinea while the smoke effect is evident over both land and ocean. A back trajectory analysis further demonstrates that the precipitation reduction is statistically linked to the upwind aerosol concentration. This study suggests that African aerosol outbreaks in the WAM region can influence precipitation in the local monsoon system which has direct societal impact on the local community. It calls for more systematic investigations to determine the modulating mechanisms using both observational and modeling approaches.
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[Risk factors for falls in the elderly: systematic review].
Gama, Zenewton André da Silva; Gómez-Conesa, Antonia
2008-10-01
To systematize results of prospective cohort studies on multiple risk factors for falls in the elderly and to assess their methodological quality. Systematic review of epidemiological studies from Medline, SciELO and Lilacs database. We included prospective cohort studies with samples of more than 100 subjects of both sexes, older than 64 years, and living either in the community or a nursing home. Of 726 studied identified, 15 met the inclusion criteria of being published between 1988 and 2005. The methodology of the studies varied. The main factors associated with increased risk of falls include: previous falls, altered gait, functional impairment, cognitive impairment, psychotropic medication use and excessive physical activity. Despite contradictory findings, being a woman at an advanced age may also be a predictor of falls. Methodological limitations were identified in prospective cohort studies on falls. There is a need for further studies on extrinsic determinants, including evaluator blinding and closer monitoring during follow-up with reduced time of recall.
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Grimm, J W; Lynch, J A
2005-06-01
Daily precipitation nitrate and ammonium concentration models were developed for the Chesapeake Bay Watershed (USA) using a linear least-squares regression approach and precipitation chemistry data from 29 National Atmospheric Deposition Program/National Trends Network (NADP/NTN) sites. Only weekly samples that comprised a single precipitation event were used in model development. The most significant variables in both ammonium and nitrate models included: precipitation volume, the number of days since the last event, a measure of seasonality, latitude, and the proportion of land within 8km covered by forest or devoted to industry and transportation. Additional variables included in the nitrate model were the proportion of land within 0.8km covered by water and/or forest. Local and regional ammonia and nitrogen oxide emissions were not as well correlated as land cover. Modeled concentrations compared very well with event chemistry data collected at six NADP/AirMoN sites within the Chesapeake Bay Watershed. Wet deposition estimates were also consistent with observed deposition at selected sites. Accurately describing the spatial distribution of precipitation volume throughout the watershed is important in providing critical estimates of wet-fall deposition of ammonium and nitrate.
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Falls event detection using triaxial accelerometry and barometric pressure measurement.
Bianchi, Federico; Redmond, Stephen J; Narayanan, Michael R; Cerutti, Sergio; Celler, Branko G; Lovell, Nigel H
2009-01-01
A falls detection system, employing a Bluetooth-based wearable device, containing a triaxial accelerometer and a barometric pressure sensor, is described. The aim of this study is to evaluate the use of barometric pressure measurement, as a surrogate measure of altitude, to augment previously reported accelerometry-based falls detection algorithms. The accelerometry and barometric pressure signals obtained from the waist-mounted device are analyzed by a signal processing and classification algorithm to discriminate falls from activities of daily living. This falls detection algorithm has been compared to two existing algorithms which utilize accelerometry signals alone. A set of laboratory-based simulated falls, along with other tasks associated with activities of daily living (16 tests) were performed by 15 healthy volunteers (9 male and 6 female; age: 23.7 +/- 2.9 years; height: 1.74 +/- 0.11 m). The algorithm incorporating pressure information detected falls with the highest sensitivity (97.8%) and the highest specificity (96.7%).
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[Prevalence and associated factors of falls in community-dwelling elderly].
Lavedán Santamaría, Ana; Jürschik Giménez, Pilar; Botigué Satorra, Teresa; Nuin Orrio, Carmen; Viladrosa Montoy, Maria
2015-01-01
To estimate the prevalence of falls and to identify their associated factors in community-dwelling elderly. A descriptive, cross-sectional study. Primary Health Care, Lleida. Six hundred and forty people aged 75 and older were included, in possession of a health card and living in single-family houses, through random sampling. Main measurements Data source comes from the survey of frailty in Lleida (FRALLE Survey). The variables used were the occurrence of falls, sociodemographic factors, health status, quality of life related to health and fear of falling. The prevalence of falls was 25.0% (95% CI 24.8-25.1). After multivariate analysis, basic disability (OR=2.17; 95% CI 1.32-3.58), depressive symptoms (OR=1.67; 95% CI 1.07-2.59) and fear of falling (OR=2.53; 95% CI 1.63-3.94) were the only factors independently associated with falls in the last year. One out of 4 older people reported at least a fall in the last year. This study demonstrates that fear of falling, depressive symptoms and basic disability are independent variables associated with previous falls. These 3 factors can lead to a flattering spiral of falling and may be potential targets for effective functioning in the context of falls. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
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VHF signal power suppression in stratiform and convective precipitation
Directory of Open Access Journals (Sweden)
A. J. McDonald
2006-03-01
Full Text Available Previous studies have indicated that VHF clear-air radar return strengths are reduced during periods of precipitation. This study aims to examine whether the type of precipitation, stratiform and convective precipitation types are identified, has any impact on the relationships previously observed and to examine the possible mechanisms which produce this phenomenon. This study uses a combination of UHF and VHF wind-profiler data to define periods associated with stratiform and convective precipitation. This identification is achieved using an algorithm which examines the range squared corrected signal to noise ratio of the UHF returns for a bright band signature for stratiform precipitation. Regions associated with convective rainfall have been defined by identifying regions of enhanced range corrected signal to noise ratio that do not display a bright band structure and that are relatively uniform until a region above the melting layer. This study uses a total of 68 days, which incorporated significant periods of surface rainfall, between 31 August 2000 and 28 February 2002 inclusive from Aberystwyth (52.4° N, 4.1° W. Examination suggests that both precipitation types produce similar magnitude reductions in VHF signal power on average. However, the frequency of occurrence of statistically significant reductions in VHF signal power are very different. In the altitude range 2-4 km stratiform precipitation is related to VHF signal suppression approximately 50% of the time while in convective precipitation suppression is observed only 27% of the time. This statistical result suggests that evaporation, which occurs more often in stratiform precipitation, is important in reducing the small-scale irregularities in humidity and thereby the radio refractive index. A detailed case study presented also suggests that evaporation reducing small-scale irregularities in humidity may contribute to the observed VHF signal suppression.
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VHF signal power suppression in stratiform and convective precipitation
Directory of Open Access Journals (Sweden)
A. J. McDonald
2006-03-01
Full Text Available Previous studies have indicated that VHF clear-air radar return strengths are reduced during periods of precipitation. This study aims to examine whether the type of precipitation, stratiform and convective precipitation types are identified, has any impact on the relationships previously observed and to examine the possible mechanisms which produce this phenomenon. This study uses a combination of UHF and VHF wind-profiler data to define periods associated with stratiform and convective precipitation. This identification is achieved using an algorithm which examines the range squared corrected signal to noise ratio of the UHF returns for a bright band signature for stratiform precipitation. Regions associated with convective rainfall have been defined by identifying regions of enhanced range corrected signal to noise ratio that do not display a bright band structure and that are relatively uniform until a region above the melting layer.
This study uses a total of 68 days, which incorporated significant periods of surface rainfall, between 31 August 2000 and 28 February 2002 inclusive from Aberystwyth (52.4° N, 4.1° W. Examination suggests that both precipitation types produce similar magnitude reductions in VHF signal power on average. However, the frequency of occurrence of statistically significant reductions in VHF signal power are very different. In the altitude range 2-4 km stratiform precipitation is related to VHF signal suppression approximately 50% of the time while in convective precipitation suppression is observed only 27% of the time. This statistical result suggests that evaporation, which occurs more often in stratiform precipitation, is important in reducing the small-scale irregularities in humidity and thereby the radio refractive index. A detailed case study presented also suggests that evaporation reducing small-scale irregularities in humidity may contribute to the observed VHF signal
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Anode Fall Formation in a Hall Thruster
International Nuclear Information System (INIS)
Dorf, Leonid A.; Raitses, Yevgeny F.; Smirnov, Artem N.; Fisch, Nathaniel J.
2004-01-01
As was reported in our previous work, accurate, nondisturbing near-anode measurements of the plasma density, electron temperature, and plasma potential performed with biased and emissive probes allowed the first experimental identification of both electron-repelling (negative anode fall) and electron-attracting (positive anode fall) anode sheaths in Hall thrusters. An interesting new phenomenon revealed by the probe measurements is that the anode fall changes from positive to negative upon removal of the dielectric coating, which appears on the anode surface during the course of Hall thruster operation. As reported in the present work, energy dispersion spectroscopy analysis of the chemical composition of the anode dielectric coating indicates that the coating layer consists essentially of an oxide of the anode material (stainless steel). However, it is still unclear how oxygen gets into the thruster channel. Most importantly, possible mechanisms of anode fall formation in a Hall thruster with a clean and a coated anodes are analyzed in this work; practical implication of understanding the general structure of the electron-attracting anode sheath in the case of a coated anode is also discussed
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Directory of Open Access Journals (Sweden)
Jesper Sjolte
2014-09-01
Full Text Available The relation between δ 18O of precipitation and temperature has been used in numerous studies to reconstruct past temperatures at ice core sites in Greenland and Antarctica. During the past two decades, it has become clear that the slope between δ 18O and temperature varies in both space and time. Here, we use a general circulation model driven by changes in orbital parameters to investigate the Greenland δ 18O–temperature relation for the previous interglacial, the Eemian. In our analysis, we focus on changes in the moisture source regions, and the results underline the importance of taking the seasonality of climate change into account. The orbitally driven experiments show that continental evaporation over North America increases during summer in the warm parts of the Eemian, while marine evaporation decreases. This likely flattens the Greenland δ 18O response to temperature during summer. Since the main climate change in the experiments occurs during summer this adds to a limited response of δ 18O, which is more strongly tied to temperature during winter than during summer. A south–west to north–east gradient in the δ 18O–temperature slope is also evident for Greenland, with low slopes in the south–west and steeper slopes in the north–east. This probably reflects the proportion of continental moisture and Arctic moisture arriving in Greenland, with more continental moisture in the south–west and less in the north–east, and vice versa for the Arctic moisture.
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Detection Thresholds of Falling Snow From Satellite-Borne Active and Passive Sensors
Skofronick-Jackson, Gail M.; Johnson, Benjamin T.; Munchak, S. Joseph
2013-01-01
There is an increased interest in detecting and estimating the amount of falling snow reaching the Earths surface in order to fully capture the global atmospheric water cycle. An initial step toward global spaceborne falling snow algorithms for current and future missions includes determining the thresholds of detection for various active and passive sensor channel configurations and falling snow events over land surfaces and lakes. In this paper, cloud resolving model simulations of lake effect and synoptic snow events were used to determine the minimum amount of snow (threshold) that could be detected by the following instruments: the W-band radar of CloudSat, Global Precipitation Measurement (GPM) Dual-Frequency Precipitation Radar (DPR)Ku- and Ka-bands, and the GPM Microwave Imager. Eleven different nonspherical snowflake shapes were used in the analysis. Notable results include the following: 1) The W-band radar has detection thresholds more than an order of magnitude lower than the future GPM radars; 2) the cloud structure macrophysics influences the thresholds of detection for passive channels (e.g., snow events with larger ice water paths and thicker clouds are easier to detect); 3) the snowflake microphysics (mainly shape and density)plays a large role in the detection threshold for active and passive instruments; 4) with reasonable assumptions, the passive 166-GHz channel has detection threshold values comparable to those of the GPM DPR Ku- and Ka-band radars with approximately 0.05 g *m(exp -3) detected at the surface, or an approximately 0.5-1.0-mm * h(exp -1) melted snow rate. This paper provides information on the light snowfall events missed by the sensors and not captured in global estimates.
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Directory of Open Access Journals (Sweden)
Kuptniratsaikul V
2011-05-01
Full Text Available Vilai Kuptniratsaikul1, Rungnirand Praditsuwan2, Prasert Assantachai3, Teerada Ploypetch1, Suthipol Udompunturak4, Julaporn Pooliam41Department of Rehabilitation Medicine, 2Department of Medicine, 3Department of Preventive Medicine, 4Office for Research and Development, Siriraj Hospital, Mahidol University, ThailandObjective: To study the effectiveness of simply-performed balancing exercises in fall prevention.Design: Pre- and post-trial.Setting: University hospital from January 2009 to May 2010.Participants: Elderly with falls in the previous year.Intervention: Simple balancing exercise was performed at home every day and was recorded in the booklet.Measurements: New falling events and a battery of balancing abilities including the Timed Up and Go Test (TUGT, chair stand, functional reach, and Berg balance scale-short form were evaluated at baseline, 3-, 6-, 9-, and 12-month periods. Fear of falling and quality of life scores were assessed at baseline and 12-month periods.Results: 146 subjects were recruited, 116 female (79.5% with a mean age of 67.1 years. At the end of the study, 49% of participants had not fallen. All of the balancing abilities were compared between frequent and infrequent fallers and were significantly improved (P < 0.001 except for functional reach in the frequent fall group. Most subjects (72%–79% complied well with the exercise program. However, compliance had no effect on balancing abilities. About 36.4% of participants had adverse events from exercise, of which knee pain was the top ranked. The quality of life and the fall efficacy scores increased significantly at the end of the study. Factors affecting falling were compliance with exercise (adjusted odds ratio [OR]: 2.55, 95% confidence intervals [CI]: 1.04, 6.30 and a history of falling ≥3 times in the previous year (adjusted OR: 3.76, 95% CI: 1.18, 11.98.Conclusion: Performing simply-designed balancing exercises, at least 3 days per week, can increase
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Satellite passive microwave rain rate measurement over croplands during spring, summer and fall
International Nuclear Information System (INIS)
Spencer, R.W.
1984-01-01
Rain rate algorithms for spring, summer and fall that have been developed from comparisons between the brightness temperatures measured by the Nimbus-7 Scanning Multichannel Microwave Radiometer (SMMR) and rain rates derived from operational WSR-57 radars over land are described. Data were utilized from a total of 25 SMMR passes and 234 radars, resulting in ∼12 000 observations of ∼1600 km 2 areas. Multiple correlation coefficients of 0.63, 0.80 and 0.75 are achieved for the spring, summer and fall algorithms, respectively. Most of this information is in the form of multifrequency contrast in brightness temperature, which is interpreted as a measurement of the degree to which the land-emitted radiation is attenuated by the rain systems. The SMMR 37 GHz channel has more information on rain rate than any other channel. By combining the lower frequency channels with the 37 GHz observations, variations in land and precipitation thermometric temperatures can be removed, leaving rain attenuation as the major effect on brightness temperature. Polarization screening at 37 GHz is found to be sufficient to screen out cases of wet ground, which is only important when the ground is relatively vegetation free. Heavy rain cases are found to be a significant part of the algorithms' success, because of the strong microwave signatures (low brightness temperatures) that result from the presence of precipitation-sized ice in the upper portions of heavily precipitating storms. If IR data are combined with the summer microwave data, an improved (0.85) correlation with radar rain rates is achieved
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Factors perceived as being related to accidental falls by persons with multiple sclerosis.
Nilsagård, Ylva; Denison, Eva; Gunnarsson, Lars-Gunnar; Boström, Katrin
2009-01-01
This study explores and describes factors that persons with multiple sclerosis (MS) perceive as being related to accidental falls. A qualitative content analysis with primarily deductive approach was conducted using the International Classification of Functioning, Disability and Health. Twelve persons with MS, and identified as fallers, were interviewed. Factors perceived to cause accidental falls that had not previously been targeted in MS populations in relation to falls were identified as divided attention, reduced muscular endurance, fatigue and heat sensitivity. Previously reported risk factors such as changed gait pattern, limited walking ability, impaired proprioception, vision and spasticity were supported. Activities involving walking, recreation and leisure, maintaining and changing body position, lifting or carrying, taking care of the home, washing the body, moving around, preparing meals and housekeeping were limited and considered to be risk activities. Supportive persons and assistive device reduced falls, and unsuitable physical environments and climate conditions induced falls. Several preventative strategies were described as partially compensating for the impairments, limitations and restrictions. Investigating accidental falls using the perspective of the patient gave important information about variables not earlier targeted in MS research.
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Precipitation reconstruction using ring-width chronology
Indian Academy of Sciences (India)
ring samples of two adjacent homogeneous sites, has been used to reconstruct precipitation for the non-monsoon months (previous year October to concurrent May) back to AD 1171. This provides the first record of hydrological conditions for the ...
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Pérez-Ros, Pilar; Martínez-Arnau, Francisco; Tormos Miñana, Immaculada; López Aracil, Aranzazu; Oltra Sanchis, M Carmen; Pechene Mera, Leidy E; Tarazona-Santabalbina, Francisco José
2014-01-01
To evaluate the results of a fall prevention programme designed to be applied to the elderly living in the community. The sample consisted of 249 participants ≥70 years of age, who were randomly assigned to one of three groups. The monthly intervention group (GIM): instructions on fall prevention and healthy exercises to improve physical function and balance at beginning of the study, and a monthly theoretical and practical refresher session. The quarterly intervention group (GIT), with the same beginning intervention and a refresher session every three months. The control group (GC), the same beginning intervention but no refresher sessions. The mean age of the sample was 74.47 years (SD 5.33), with 64% women. The incidence of falls was reduced from 0.64 per patient year in the previous year to 0.39 in the post-intervention year in GIM, from 0.49 to 0.47 in GIT, and in the GC it remained at 0.47 before and twelve months after, but with no significant differences in the reduction between groups (P=.062). At the end of the study there was a decrease in Rizzo scale of 0.72 points (95% CI: 0.57-0.88, Pfalls. Further studies are required to continue research into the incidence of falls in the elderly living in the community. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.
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Factors associated with falls in older patients with diffuse polyneuropathy.
Richardson, James K
2002-11-01
To identify clinical factors associated with falls by older persons with polyneuropathy (PN). A cross-sectional study of 82 subjects aged 50 to 85 with clinical and electrodiagnostic evidence of PN. Electrodiagnostic and biomechanical research laboratories. Patients referred to the electrodiagnostic laboratory. History and physical examination, including semiquantitative methods of peripheral nerve function, and clinical balance testing. Falls were defined by retrospective self-report over a 2-year period. Forty (48.8%), 28 (34.1%), and 18 (22.0%) subjects reported a history of at least one fall, multiple falls, and injurious falls, respectively. Factors associated with single and multiple falls were similar, so only results for multiple and injurious falls are reported. Bivariate analysis showed that an increased body mass index (BMI) and more severe PN (as determined by the Michigan Diabetes Neuropathy Score) were associated with both fall categories. Men reporting falls also demonstrated a decreased unipedal stance time. Age, sex, nerve conduction study parameters, Romberg testing, medications, and comorbidities were not consistently associated with either fall category. Logistic regression demonstrated that multiple and injurious falls were associated with an increased BMI and more severe PN, controlling for age, sex, medications, and comorbidities (pseudo R2 = 0.458 and 0.484, respectively). Although previous work has demonstrated that all older persons with PN are at increased risk for falls, patients with increased BMI and more severe PN are at particularly high risk and should be targeted for intervention.
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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.
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Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn
2017-12-21
Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .
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Causes and risk factors of falls in patients with Parkinson's disease.
Rudzińska, Monika; Bukowczan, Sylwia; Banaszkiewicz, Krzysztof; Stozek, Joanna; Zajdel, Katarzyna; Szczudlik, Andrzej
2008-01-01
Falls are a common and serious problem among Parkinson's disease (PD) patients. However, knowledge about the causes and risk factors of falls is limited. There have been a few attempts to classify the causes of falls. The classification suggested by Olanow seems to be the most comprehensive one. The aim of this study was to analyze retrospectively the causes of falls and risk factors of falls in PD patients. One hundred and four patients with moderately advanced PD were included in the study. The patients were asked to describe the circumstances and consequences of falls which occurred during 12 months preceding the examination. The falls were classified according to the Olanow classification of causes of falls. Fifty-two patients (50%) reported at least one fall during the previous year with a mean number of 1.5 falls per year. The most common causes of falls were environmental factors, sudden falls and postural instability. There were no falls caused by severe dyskinesia, drugs or cardiovascular disorders. The only independent risk factors of the recurrent falls identified in this study were UPDRS part II score (OR 1.17, 95% CI: 1.02-1.37) and Mini Mental State Examination score (OR 0.85, 95% CI: 0.72-0.99). Considering these results we may be able to prevent most falls by means of the education of patients about environmental factors and using adequate rehabilitation techniques concentrating on postural stability and gait.
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Heterogeneous precipitation of niobium carbide in the ferrite by Monte Carlo simulations
International Nuclear Information System (INIS)
Hin, C.
2005-12-01
The precipitation of niobium carbides in industrial steels is commonly used to control the recrystallization process or the amount of interstitial atoms in solid solution. It is then important to understand the precipitation kinetics and especially the competition between homogeneous and heterogeneous precipitation, since both of them have been observed experimentally, depending on they alloy composition, microstructure and thermal treatments. We propose Monte Carlo simulations of NbC precipitation in □-iron, based on a simple atomic description of the main parameters which control the kinetic pathway: - Realistic diffusion properties, with a rapid diffusion of C atoms by interstitial jumps and a slower diffusion of Fe and Nb atoms by vacancy jumps; - A model of grain boundaries which reproduces the segregation properties of Nb and C; - A model of dislocation which interacts with solute atoms through local segregation energies and long range elastic field; - A point defect source which drives the vacancy concentration towards its equilibrium value. Depending on the precipitation conditions, Monte Carlo simulations predict different kinetic behaviors, including a transient precipitation of metastable carbides, an early segregation stage of C, wetting phenomena at grain boundaries and on dislocations and a competition between homogeneous and heterogeneous NbC precipitation. Concerning the last point, we highlight that long range elastic field due to dislocation favors clearly the heterogeneous precipitation on dislocations. To understand this effect, we have developed a heterogeneous nucleation model including the calculation of the local concentration of solute atoms around the dislocation, the change of the solubility limit relative to the solubility limit in bulk and the energy of precipitates in an elastic field. We have concluded that elastic field favors the heterogeneous precipitation through the fall in nucleation barrier. (author)
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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.
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Directory of Open Access Journals (Sweden)
Juan Manuel Laguna-Parras
2011-12-01
the term falls as the result of any event which precipitate someone to the ground against their will. Aims: to analyze the incidence of falls, the profile of patients who fall in the hospital and to identify causes and effects. Methodology: design: Descriptive study on falls reported in Jaen's Hospital, which includes any fall (36 that has taken place at some time of hospital stay. Data collection was performed by each unit supervisors developed a data collection sheet. Data were transcribed to a database. Variables collected were: demographic data, date and time of the fall event, unit which produces the fall, Morse scale score, previous falls, fall circumstances, factors such as medication, cognitive, functional factors environment, care after the fall and need for assistive devices. Results: during the period under review there were a total of 36 falls, representing an incidence of 0.18%. Higher frequency of falls occurred in mental health units and palliative care. Conclusions: after analyzing the result we state that patients who fall in our hospital have an average age of 63 years, there are no differences regarding sex of patients, according to the morse score scale most patiens had low risk of falling, most have no history of previous falls and the mayority of falls ocurred in patient's room.
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Factors associated with developing a fear of falling in subjects with primary open-angle glaucoma.
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.
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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.
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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.
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Atmospheric Rivers and Their Role in Extreme Precipitation in the Midwest U.S.
2013-03-01
located in the warm sector of extratropical cyclones (warm conveyor belt) and can be characterized by strong winds (low level jet) and large water...the associated synoptic-scale extratropical cyclone and subsequent frontal processes of each planetary wave, resulting in narrow regions of moisture...normal falls during AR storms during the winter on the West Coast. During the summer, precipitation enhancements were not as significant (mostly due
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Clinical history and biologic age predicted falls better than objective functional tests.
Gerdhem, Paul; Ringsberg, Karin A M; Akesson, Kristina; Obrant, Karl J
2005-03-01
Fall risk assessment is important because the consequences, such as a fracture, may be devastating. The objective of this study was to find the test or tests that best predicted falls in a population-based sample of elderly women. The fall-predictive ability of a questionnaire, a subjective estimate of biologic age and objective functional tests (gait, balance [Romberg and sway test], thigh muscle strength, and visual acuity) were compared in 984 randomly selected women, all 75 years of age. A recalled fall was the most important predictor for future falls. Only recalled falls and intake of psycho-active drugs independently predicted future falls. Women with at least five of the most important fall predictors (previous falls, conditions affecting the balance, tendency to fall, intake of psychoactive medication, inability to stand on one leg, high biologic age) had an odds ratio of 11.27 (95% confidence interval 4.61-27.60) for a fall (sensitivity 70%, specificity 79%). The more time-consuming objective functional tests were of limited importance for fall prediction. A simple clinical history, the inability to stand on one leg, and a subjective estimate of biologic age were more important as part of the fall risk assessment.
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Mahoney, Kelly M.; Ralph, F. Martin; Walter, Klaus; Doesken, Nolan; Dettinger, Michael; Gottas, Daniel; Coleman, Timothy; White, Allen
2015-01-01
The climatology of Colorado’s historical extreme precipitation events shows a remarkable degree of seasonal and regional variability. Analysis of the largest historical daily precipitation totals at COOP stations across Colorado by season indicates that the largest recorded daily precipitation totals have ranged from less than 60 mm day−1 in some areas to more than 250 mm day−1 in others. East of the Continental Divide, winter events are rarely among the top 10 events at a given site, but spring events dominate in and near the foothills; summer events are most common across the lower-elevation eastern plains, while fall events are most typical for the lower elevations west of the Divide. The seasonal signal in Colorado’s central mountains is complex; high-elevation intense precipitation events have occurred in all months of the year, including summer, when precipitation is more likely to be liquid (as opposed to snow), which poses more of an instantaneous flood risk. Notably, the historic Colorado Front Range daily rainfall totals that contributed to the damaging floods in September 2013 occurred outside of that region’s typical season for most extreme precipitation (spring–summer). That event and many others highlight the fact that extreme precipitation in Colorado has occurred historically during all seasons and at all elevations, emphasizing a year-round statewide risk.
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Orces, Carlos H
2013-01-01
The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.
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Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey
Directory of Open Access Journals (Sweden)
Carlos H. Orces
2013-01-01
Full Text Available The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.
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Predictors of the risk of falls among elderly with chronic atrial fibrillation
Directory of Open Access Journals (Sweden)
Angela Cristina Silva dos Santos
2012-01-01
Full Text Available OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 107 took part in this study. Their age was 77.9±6.4 years, and 62 were female. They were divided into two groups: a no history of falls in the previous year and b a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%. Among them, 27 (49.1% presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that selfreported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.
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[Unipedal stance time and fall risk in the elderly].
Domínguez-Carrillo, Luis Gerardo; Arellano-Aguilar, Gregorio; Leos-Zierold, Héctor
2007-01-01
We undertook this study to relate unipodal stance time (UST) as a falls indicator in the elderly and to corroborate with UST exercise increments. One hundred sixty eight elderly subjects (age >70 years) with two or more falls during the previous 12 months were compared with 150 similar subjects without falls. UST chronometry and quadriceps and triceps brachialis strength dynamometry were used. Equilibrium and antigravity muscle-strengthening exercise program with 20 work sessions were carried out. Results were analyzed with chi(2), Student's t-test, and Fisher tests. UST of the control group showed 28.84 +/- 4.73 sec (mean +/- SD). The UST sample showed 19.18 +/- 4.24 sec. The test was initially impossible to carry out in 42 cases (p = 0.05). The final evaluation showed 142 cases with 30 sec of UST (p = 0.00001), isometric force increased in 70% and 30%, respectively (p = 0.05). At 6-month follow-up, 53 falls were reported, 29 were in patients who could not accomplish UST measurement on initial evaluation. UST falls in elderly people, and exercise programs increase UST.
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Optimal fall indicators for slip induced falls on a cross-slope.
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.
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Development and validation of fall risk screening tools for use in residential aged care facilities.
Delbaere, Kim; Close, Jacqueline C T; Menz, Hylton B; Cumming, Robert G; Cameron, Ian D; Sambrook, Philip N; March, Lyn M; Lord, Stephen R
2008-08-18
To develop screening tools for predicting falls in nursing home and intermediate-care hostel residents who can and cannot stand unaided. Prospective cohort study in residential aged care facilities in northern Sydney, New South Wales, June 1999-June 2003. 2005 people aged 65-104 years (mean +/- SD, 85.7+/-7.1 years). Demographic, health, and physical function assessment measures; number of falls over a 6-month period; validity of the screening models. Ability to stand unaided was identified as a significant event modifier for falls. In people who could stand unaided, having either poor balance or two of three other risk factors (previous falls, nursing home residence, and urinary incontinence) increased the risk of falling in the next 6 months threefold (sensitivity, 73%; specificity, 55%). In people who could not stand unaided, having any one of three risk factors (previous falls, hostel residence, and using nine or more medications) increased the risk of falling twofold (sensitivity, 87%; specificity, 29%). These two screening models are useful for identifying older people living in residential aged care facilities who are at increased risk of falls. The screens are easy to administer and contain items that are routinely collected in residential aged care facilities in Australia.
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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...
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Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults.
Jung, Dukyoo; Kang, Younhee; Kim, Mi Young; Ma, Rye-Won; Bhandari, Pratibha
2016-02-01
The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults. © The Author(s) 2014.
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Stock, Greg M.; Luco, Nicolas; Collins, Brian D.; Harp, Edwin L.; Reichenbach, Paola; Frankel, Kurt L.
2014-01-01
Rock falls are common in Yosemite Valley, California, posing substantial hazard and risk to the approximately four million annual visitors to Yosemite National Park. Rock falls in Yosemite Valley over the past few decades have damaged structures and caused injuries within developed regions located on or adjacent to talus slopes highlighting the need for additional investigations into rock-fall hazard and risk. This assessment builds upon previous investigations of rock-fall hazard and risk in Yosemite Valley and focuses on hazard and risk to structures posed by relatively frequent fragmental-type rock falls as large as approximately 100,000 (cubic meters) in volume.
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Abrams, Joseph Y; Blase, Jennifer L; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu
2018-06-01
Kawasaki disease (KD) is an acute febrile vasculitis, which primarily affects children. The etiology of KD is unknown; while certain characteristics of the disease suggest an infectious origin, genetic or environmental factors may also be important. Seasonal patterns of KD incidence are well documented, but it is unclear whether these patterns are caused by changes in climate or by other unknown seasonal effects. The relationship between KD incidence and deviations from expected temperature and precipitation were analyzed using KD incidence data from Japanese nationwide epidemiologic surveys (1991-2004) and climate data from 136 weather stations of the Japan Meteorological Agency. Seven separate Poisson-distributed generalized linear regression models were run to examine the effects of temperature and precipitation on KD incidence in the same month as KD onset and the previous 1, 2, 3, 4, 5 and 6 months, controlling for geography as well as seasonal and long-term trends in KD incidence. KD incidence was negatively associated with temperature in the previous 2, 3, 4 and 5 months and positively associated with precipitation in the previous 1 and 2 months. The model that best predicted variations in KD incidence used climate data from the previous 2 months. An increase in total monthly precipitation by 100 mm was associated with increased KD incidence (rate ratio [RR] 1.012, 95% confidence interval [CI]: 1.005-1.019), and an increase of monthly mean temperature by 1°C was associated with decreased KD incidence (RR 0.984, 95% CI: 0.978-0.990). KD incidence was significantly affected by temperature and precipitation in previous months independent of other unknown seasonal factors. Climate data from the previous 2 months best predicted the variations in KD incidence. Although fairly minor, the effect of temperature and precipitation independent of season may provide additional clues to the etiology of KD.
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California Wintertime Precipitation in Regional and Global Climate Models
Energy Technology Data Exchange (ETDEWEB)
Caldwell, P M
2009-04-27
In this paper, wintertime precipitation from a variety of observational datasets, regional climate models (RCMs), and general circulation models (GCMs) is averaged over the state of California (CA) and compared. Several averaging methodologies are considered and all are found to give similar values when model grid spacing is less than 3{sup o}. This suggests that CA is a reasonable size for regional intercomparisons using modern GCMs. Results show that reanalysis-forced RCMs tend to significantly overpredict CA precipitation. This appears to be due mainly to overprediction of extreme events; RCM precipitation frequency is generally underpredicted. Overprediction is also reflected in wintertime precipitation variability, which tends to be too high for RCMs on both daily and interannual scales. Wintertime precipitation in most (but not all) GCMs is underestimated. This is in contrast to previous studies based on global blended gauge/satellite observations which are shown here to underestimate precipitation relative to higher-resolution gauge-only datasets. Several GCMs provide reasonable daily precipitation distributions, a trait which doesn't seem tied to model resolution. GCM daily and interannual variability is generally underpredicted.
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Can echocardiographic findings predict falls in older persons?
Directory of Open Access Journals (Sweden)
Nathalie van der Velde
Full Text Available BACKGROUND: The European and American guidelines state the need for echocardiography in patients with syncope. 50% of older adults with syncope present with a fall. Nonetheless, up to now no data have been published addressing echocardiographic abnormalities in older fallers. METHOD AND FINDINGS: In order to determine the association between echocardiographic abnormalities and falls in older adults, we performed a prospective cohort study, in which 215 new consecutive referrals (age 77.4, SD 6.0 of a geriatric outpatient clinic of a Dutch university hospital were included. During the previous year, 139 had experienced a fall. At baseline, all patients underwent routine two-dimensional and Doppler echocardiography. Falls were recorded during a three-month follow-up. Multivariate adjustment for confounders was performed with a Cox proportional hazards model. 55 patients (26% fell at least once during follow-up. The adjusted hazard ratio of a fall during follow-up was 1.35 (95% CI, 1.08-1.71 for pulmonary hypertension, 1.66 (95% CI, 1.01 to 2.89 for mitral regurgitation, 2.41 (95% CI, 1.32 to 4.37 for tricuspid regurgitation and 1.76 (95% CI, 1.03 to 3.01 for pulmonary regurgitation. For aortic regurgitation the risk of a fall was also increased, but non-significantly (hazard ratio, 1.57 [95% CI, 0.85 to 2.92]. Trend analysis of the severity of the different regurgitations showed a significant relationship for mitral, tricuspid and pulmonary valve regurgitation and pulmonary hypertension. CONCLUSIONS: Echo (Doppler cardiography can be useful in order to identify risk indicators for falling. Presence of pulmonary hypertension or regurgitation of mitral, tricuspid or pulmonary valves was associated with a higher fall risk. Our study indicates that the diagnostic work-up for falls in older adults might be improved by adding an echo (Doppler cardiogram in selected groups.
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Increasing fall risk awareness using wearables: A fall risk awareness protocol.
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.
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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...
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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.
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The clinical practice guideline for falls and fall risk
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...
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Corrie, Heather; Brooke-Wavell, Katherine; Mansfield, Neil J; Cowley, Alison; Morris, Robert; Masud, Tahir
2015-01-01
whole-body vibration training may improve neuromuscular function, falls risk and bone density, but previous studies have had conflicting findings. this study aimed to evaluate the influence of vertical vibration (VV) and side-alternating vibration (SV) on musculoskeletal health in older people at risk of falls. single-blind, randomised, controlled trial comparing vibration training to sham vibration (Sham) in addition to usual care. participants were 61 older people (37 women and 24 men), aged 80.2 + 6.5 years, referred to an outpatient falls prevention service. participants were randomly assigned to VV, SV or Sham in addition to the usual falls prevention programme. Participants were requested to attend three vibration sessions per week for 12 weeks, with sessions increasing to six, 1 min bouts of vibration. Falls risk factors and neuromuscular tests were assessed, and blood samples collected for determination of bone turnover, at baseline and following the intervention. chair stand time, timed-up-and-go time, fear of falling, NEADL index and postural sway with eyes open improved in the Sham group. There were significantly greater gains in leg power in the VV than in the Sham group and in bone formation in SV and VV compared with the Sham group. Conversely, body sway improved less in the VV than in the Sham group. Changes in falls risk factors did not differ between the groups. whole-body vibration increased leg power and bone formation, but it did not provide any additional benefits to balance or fall risk factors beyond a falls prevention programme in older people at risk of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.
Solis, Guillermina R; Champion, Jane Dimmitt
2017-03-01
Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.
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van Vliet, Rob; Hoang, Phu; Lord, Stephen; Gandevia, Simon; Delbaere, Kim
2015-01-01
Concern about falling can have devastating physical and psychological consequences in people with multiple sclerosis (MS). However, little is known about physical and cognitive determinants for increased concern about falling inthis group. To investigate direct and indirect relationships between MS severity and concern about falling using structural equation modelling (SEM). Two hundred and ten community-dwelling people (21-73 years) with MS Disease Steps 0-5 completed several physical, cognitive and psychological assessments. Concern about falling was assessed using the Falls Efficacy Scale-International. Concern about falling was significantly associated with MS Disease Step and also balance, muscle strength, disability, previous falls, and executive functioning. SEM revealed a strong direct path between MS Disease Step and concern about falling (r = 0.31, p concern about falling in people with MS and had an excellent goodness-of-fit. The relationship between MS severity and increased concern about falling was primarily mediated by reduced physical ability (especially if this resulted in disability and falls) and less so by executive functioning. This suggests people with MS have a realistic appraisal of their concern about falling.
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Wang, Yuan
2015-10-01
The recent study "Trends of Extreme Precipitation in Eastern China and Their Possible Causes" attributed the observed decrease/increase of light/heavy precipitation in eastern China to global warming rather than the regional aerosol effects. However, there exist compelling evidence from previous long-term observations and numerical modeling studies, suggesting that anthropogenic pollution is closely linked to the recent changes in precipitation intensity because of considerably modulated cloud physical properties by aerosols in eastern China. Clearly, a quantitative assessment of the aerosol and greenhouse effects on the regional scale is required to identify the primary cause for the extreme precipitation changes.
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Hyperglycemic crisis precipitated by Lassa fever in a patient with ...
African Journals Online (AJOL)
Hyperglycemic crisis precipitated by Lassa fever in a patient with previously undiagnosed type 2 diabetes mellitus. ... Nigerian Journal of Clinical Practice ... To report a rare case of HC unmasked by Lassa fever in a patient previously not ...
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Withdrawal of fall-risk-increasing drugs in older persons: Effect on mobility test outcomes
N. van der Velde (Nathalie); B.H.Ch. Stricker (Bruno); H.A.P. Pols (Huib); T.J.M. van der Cammen (Tischa)
2007-01-01
textabstractBackground: Previously, we have shown that withdrawal of fall-risk-increasing drugs (FRIDs) as a single intervention reduces falls incidence. Improvement of mobility may be an important factor in this finding and we therefore tested whether mobility tests improved after FRID withdrawal.
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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.
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Precipitates and boundaries interaction in ferritic ODS steels
Energy Technology Data Exchange (ETDEWEB)
Sallez, Nicolas, E-mail: nicolas.sallez@simap.grenoble-inp.fr [Univ. Grenoble Alpes, SIMAP, F-38000 Grenoble (France); Hatzoglou, Constantinos [Groupe de Physique des Matériaux, Université et INSA de Rouen, UMR CNRS 6634, Normandie Université (France); Delabrouille, Fredéric [EDF–EDF R& D, Les Renardières, 77818 Moret-sur-Loing (France); Sornin, Denis; Chaffron, Laurent [CEA, DEN, Service de Recherches Métallurgiques Appliqué, 91191 Gif-sur-Yvette (France); Blat-Yrieix, Martine [EDF–EDF R& D, Les Renardières, 77818 Moret-sur-Loing (France); Radiguet, Bertrand; Pareige, Philippe [Groupe de Physique des Matériaux, Université et INSA de Rouen, UMR CNRS 6634, Normandie Université (France); Donnadieu, Patricia; Bréchet, Yves [Univ. Grenoble Alpes, SIMAP, F-38000 Grenoble (France)
2016-04-15
Based on the previous observations, a dissolution mechanism of the metastable yttrium precipitates at the grain boundaries is proposed.
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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.
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Unipedal stance testing as an indicator of fall risk among older outpatients.
Hurvitz, E A; Richardson, J K; Werner, R A; Ruhl, A M; Dixon, M R
2000-05-01
To test the hypothesis that a decreased unipedal stance time (UST) is associated with a history of falling among older persons. Fifty-three subjects underwent a standardized history and physical examination and three trials of timed unipedal stance. The electroneuromyography laboratories of tertiary care Veterans Administration and university hospitals. Ambulatory outpatients 50 years and older referred for electrodiagnostic studies. UST and fall histories during the previous year. Twenty subjects (38%) reported falling. Compared with the subjects who had not fallen, those who fell had a significantly shorter UST (9.6 [SD 11.6] vs 31.3 [SD 16.3] seconds, using the longest of the three trials, p risk of having fallen on univariate analysis and in a regression model (odds ratio 108; 95% confidence interval 3.8, >100; p falls. UST of falling, while a UST of > or = 30sec is associated with a low risk of falling.
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Shifts in Summertime Precipitation Accumulation Distributions over the US
Martinez-Villalobos, C.; Neelin, J. D.
2017-12-01
Precipitation accumulations, i.e., the amount of precipitation integrated over the course of an event, is a variable with both important physical and societal implications. Previous observational studies show that accumulation distributions have a characteristic shape, with an approximately power law decrease at first, followed by a sharp decrease at a characteristic large event cutoff scale. This cutoff scale is important as it limits the biggest accumulation events. Stochastic prototypes show that the resulting distributions, and importantly the large event cutoff scale, can be understood as a result of the interplay between moisture loss by precipitation and changes in moisture sinks/sources due to fluctuations in moisture divergence over the course of a precipitation event. The strength of this fluctuating moisture sink/source term is expected to increase under global warming, with both theory and climate model simulations predicting a concomitant increase in the large event cutoff scale. This cutoff scale increase has important consequences as it implies an approximately exponential increase for the largest accumulation events. Given its importance, in this study we characterize and track changes in the distribution of precipitation events accumulations over the contiguous US. Accumulation distributions are calculated using hourly precipitation data from 1700 stations, covering the 1974-2013 period over May-October. The resulting distributions largely follow the aforementioned shape, with individual cutoff scales depending on the local climate. An increase in the large event cutoff scale over this period is observed over several regions over the US, most notably over the eastern third of the US. In agreement with the increase in the cutoff, almost exponential increases in the highest accumulation percentiles occur over these regions, with increases in the 99.9 percentile in the Northeast of 70% for example. The relationship to changes in daily precipitation
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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.
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Withdrawal of fall-risk-increasing drugs in older persons: effect on mobility test outcomes
van der Velde, Nathalie; Stricker, Bruno H. Ch; Pols, Huibert A. P.; van der Cammen, Tischa J. M.
2007-01-01
BACKGROUND: Previously, we have shown that withdrawal of fall-risk-increasing drugs (FRIDs) as a single intervention reduces falls incidence. Improvement of mobility may be an important factor in this finding and we therefore tested whether mobility tests improved after FRID withdrawal. METHODS: In
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Precipitation-strengthening effects in iron-aluminides
Energy Technology Data Exchange (ETDEWEB)
Maziasz, P.J.; McKamey, C.G.; Goodwin, G.M. [Oak Ridge National Laboratory, TN (United States)] [and others
1995-05-01
The purpose of this work is to produce precipitation to improve both high-temperature strength and room-temperature ductibility in FeAl-type(B2 phase) iron-aluminides. Previous work has focused on primarily wrought products, but stable precipitates can also refine the grain size and affect the properties of as-cast and/or welded material as well. New work began in FY 1994 on the properties of these weldable, strong FeAl alloys in the as-cast condition. Because the end product of this project is components for industry testing, simpler and better (cheaper, near-net-shape) processing methods must be developed for industrial applications of FeAl alloys.
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Microsphere formation in droplets using antisolvent vapour precipitation technique
Chew, Sean Jun Liang
2017-01-01
In previous studies, the antisolvent vapour precipitation method has been proven to produce uniformly sized lactose microspheres (1.0 µm) from a single droplet (1.2 mm diameter) at atmospheric pressure. These types of particles have potential applications in the pharmaceutical industry, especially due to their high dissolution rate. This project looked into the possibility of using antisolvent vapour precipitation to produce microspheres from finely atomised droplets. Microspheres in the sub-...
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Deprey, Sara M; Biedrzycki, Lynda; Klenz, Kristine
2017-12-01
Fall-related deaths continue to be the leading cause of accidental deaths in the older adult (65+ year) population. However, many fall-related fatalities are unspecified and little is known about the fall characteristics and personal demographics at the time of the fall. Therefore, this report describes the characteristics, circumstances and injuries of falls that resulted in older adult deaths in one U.S. County and explores the variables associated with fatal injuries from falls. This is a continued retrospective analysis of 841older adults whose underlying cause of death was due to a fall over an 8-year period (2005-2012). Demographics and logistic regression of fall characteristics and injuries were analyzed. Falls that led to death most often occurred when walking in one's own home. Most of the residents in this study were community-dwellers who had previous comorbidities taking an average of six medications prior to their fall. Survival after a fall was on average 31 days. The two most common injuries after a fatal fall were hip fractures (54%), and head injuries (21%). A logistic regression identified two variables associated with hip fracture, advancing age (OR = 1.05, 95% confidence interval [CI] = 1.02-1.08) and diagnosis of a prior neurological condition (OR = 2.1, 95% CI = 1.4-3.1). Variables associated with head injuries included younger age (OR = .91, 95% CI = .89-.94), male gender (OR = 2.5, 95% CI = 1.7-3.8), prescribed anticoagulants (OR = 2.4, 95% CI = 1.5-3.9) and negative musculoskeletal comorbidity (OR = 1.9. 95% CI = 1.1-3.0). Hip fractures and head injuries were the most common injury after a fall that led to death in older adults greater than 65 years. There are opposing risk factors for older adults who incur a hip fracture compared to a head injury. Thus, health professionals will need to individualize prevention efforts to reduce fall fatalities.
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Welch, Sarah A; Ward, Rachel E; Kurlinski, Laura A; Kiely, Dan K; Goldstein, Richard; VanSwearingen, Jessie; Brach, Jennifer S; Bean, Jonathan F
2016-08-01
Most falls among community-dwelling older adults occur while walking. Simple walking tests that require little resources and can be interpreted quickly are advocated as useful screening tools for fall prone patients. To investigate 2 clinically feasible walking tests consisting of straight- and curved-path walking and examine their associations with history of previous falls and fall-related outcomes among community-living older adults. A cross-sectional analysis was performed on baseline data from a longitudinal cohort study. Participants were recruited through primary care practices. Participants included 428 primary care patients ≥65 years of age at risk for mobility decline. Participants had a median age of 76.5 years, 67.8% were women, and 82.5% were white. Straight-path walking performance was measured as the time needed to walk a 4-meter straight path at usual pace from standstill using a stopwatch (timed to 0.1 second). Curved-path walking performance was timed while participants walked from standstill in a figure-of-8 pattern around two cones placed 5 feet apart. Multivariable negative binomial regression analyses were performed to assess the relationship between straight-path walking or curved-path walking and self-reported history of number of falls. For fall-related injuries, and fall-related hospitalizations, logistic regression models were used. In the fully adjusted model, an increase of 1 second in straight path walking time was associated with 26% greater rate of falls (rate ratio 1.26, 95% confidence interval 1.10-1.45). An increase in curved-path walking time was associated with 8% greater rate of falls (rate ratio 1.08, 95% confidence interval = 1.03-1.14). Neither walk test was associated with history of fall-related injuries or hospitalizations. Poor performance on straight- and curved-path walking performance was associated with a history of greater fall rates in the previous year but not with a history of fall-related injuries or
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Modeling Parkinson’s Disease Falls Associated With Brainstem Cholinergic Systems Decline
Kucinski, Aaron; Sarter, Martin
2015-01-01
In addition to the primary disease-defining symptoms, approximately half of patients with Parkinson’s disease (PD) suffer from postural instability, impairments in gait control and a propensity for falls. Consistent with evidence from patients, we previously demonstrated that combined striatal dopamine (DA) and basal forebrain (BF) cholinergic cell loss causes falls in rats traversing dynamic surfaces. Because evidence suggests that degeneration of brainstem cholinergic neurons arising from t...
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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.
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A savanna response to precipitation intensity.
Directory of Open Access Journals (Sweden)
Ryan S Berry
Full Text Available As the atmosphere warms, precipitation events are becoming less frequent but more intense. A three-year experiment in Kruger National Park, South Africa, found that fewer, more intense precipitation events encouraged woody plant encroachment. To test whether or not these treatment responses persisted over time, here, we report results from all five years of that experiment. Grass growth, woody plant growth, total fine root number and area and hydrologic tracer uptake by grasses and woody plants were measured in six treated plots (8 m by 8 m and six control plots. Treatment effects on soil moisture were measured continuously in one treated and one control plot. During the fourth year, increased precipitation intensity treatments continued to decrease water flux in surface soils (0-10 cm, increase water flux in deeper soils (20+ cm, decrease grass growth and increase woody plant growth. Greater root numbers at 20-40 cm and greater woody plant uptake of a hydrological tracer from 45-60 cm suggested that woody plants increased growth by increasing root number and activity (but not root area in deeper soils. During the fifth year, natural precipitation events were large and intense so treatments had little effect on precipitation intensity or plant available water. Consistent with this effective treatment removal, there was no difference in grass or woody growth rates between control and treated plots, although woody plant biomass remained higher in treated than control plots due to treatment effects in the previous four years. Across the five years of this experiment, we found that 1 small increases in precipitation intensity can result in large increases in deep (20-130 cm soil water availability, 2 plant growth responses to precipitation intensity are rapid and disappear quickly, and 3 because woody plants accumulate biomass, occasional increases in precipitation intensity can result in long-term increases in woody plant biomass (i.e., shrub
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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
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Impact of Fall Prevention on Nurses and Care of Fall Risk Patients.
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.
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Effect of a Multidisciplinary Fall Risk Assessment on Falls Among Neurology Inpatients
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
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Report summary. Seniors' Falls in Canada: Second Report: key highlights.
Stinchcombe, A; Kuran, N; Powell, S
2014-07-01
Injury in Canada is a serious public health concern. Injuries are a leading cause of hospitalization for children, young adults and seniors and a major cause of disability and death. Falls remain the leading cause of injury-related hospitalizations among Canadian seniors, and data from the Canadian Community Health Survey - Healthy Aging indicate that 20% of seniors living in the community reported a fall in the previous year, with a higher prevalence among older seniors, i.e., those aged over 80 years. Falls and associated outcomes not only harm the injured individuals but also affect their families, friends and care providers; they also place considerable pressure on the health care system. However, we do know that these personal and economic costs can be avoided through injury prevention activities. The Seniors' Falls in Canada: Second Report provides policy makers, researchers, community programmers and practitioners with current data and trends on falls, injuries and hospitalizations among Canadian adults aged 65 years and over. This report is intended for use in public health research, policy development and practice.
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Duan, Limin; Fan, Keke; Li, Wei; Liu, Tingxi
2017-12-01
Daily precipitation data from 42 stations in Inner Mongolia, China for the 10 years period from 1 January 2001 to 31 December 2010 was utilized along with downscaled data from the Tropical Rainfall Measuring Mission (TRMM) with a spatial resolution of 0.25° × 0.25° for the same period based on the statistical relationships between the normalized difference vegetation index (NDVI), meteorological variables, and digital elevation models (https://en.wikipedia.org/wiki/Digital_elevation_model) (DEM) using the leave-one-out (LOO) cross validation method and multivariate step regression. The results indicate that (1) TRMM data can indeed be used to estimate annual precipitation in Inner Mongolia and there is a linear relationship between annual TRMM and observed precipitation; (2) there is a significant relationship between TRMM-based precipitation and predicted precipitation, with a spatial resolution of 0.50° × 0.50°; (3) NDVI and temperature are important factors influencing the downscaling of TRMM precipitation data for DEM and the slope is not the most significant factor affecting the downscaled TRMM data; and (4) the downscaled TRMM data reflects spatial patterns in annual precipitation reasonably well, showing less precipitation falling in west Inner Mongolia and more in the south and southeast. The new approach proposed here provides a useful alternative for evaluating spatial patterns in precipitation and can thus be applied to generate a more accurate precipitation dataset to support both irrigation management and the conservation of this fragile grassland ecosystem.
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Precipitation and measurements of precipitation
Schmidt, F.H.; Bruin, H.A.R. de; Attmannspacher, W.; Harrold, T.W.; Kraijenhoff van de Leur, D.A.
1977-01-01
In Western Europe, precipitation is normal phenomenon; it is of importance to all aspects of society, particularly to agriculture, in cattle breeding and, of course, it is a subject of hydrological research. Precipitation is an essential part in the hydrological cycle. How disastrous local
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Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.
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.
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Miller, Martin F.
2018-01-01
The relative abundance of 17O in meteoric precipitation is usually reported in terms of the 17O-excess parameter. Variations of 17O-excess in Antarctic precipitation and ice cores have hitherto been attributed to normalised relative humidity changes at the moisture source region, or to the influence of a temperature-dependent supersaturation-controlled kinetic isotope effect during in-cloud ice formation below -20 °C. Neither mechanism, however, satisfactorily explains the large range of 17O-excess values reported from measurements. A different approach, based on the regression characteristics of 103 ln (1 +δ17 O) versus 103 ln (1 +δ18 O), is applied here to previously published isotopic data sets. The analysis indicates that clear-sky precipitation ('diamond dust'), which occurs widely in inland Antarctica, is characterised by an unusual relative abundance of 17O, distinct from that associated with cloud-derived, synoptic snowfall. Furthermore, this distinction appears to be largely preserved in the ice core record. The respective mass contributions to snowfall accumulation - on both temporal and spatial scales - provides the basis of a simple, first-order explanation for the observed oxygen triple-isotope ratio variations in Antarctic precipitation, surface snow and ice cores. Using this approach, it is shown that precipitation during the last major deglaciation, both in western Antarctica at the West Antarctic Ice Sheet (WAIS) Divide and at Vostok on the eastern Antarctic plateau, consisted essentially of diamond dust only, despite a large temperature differential (and thus different water vapour supersaturation conditions) at the two locations. In contrast, synoptic snowfall events dominate the accumulation record throughout the Holocene at both sites.
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The Association Between Anxiety and Falls: A Meta-Analysis.
Hallford, David John; Nicholson, Geoff; Sanders, Kerrie; McCabe, Marita P
2017-09-01
Falls occur frequently among older adults and can lead to a range of adverse and debilitating outcomes. Although symptoms of clinical anxiety have been implicated as risk factors for falls, there is no current consensus on the empirical association between anxiety and falls. The current study aimed to address this gap in the literature by conducting a quantitative, meta-analytic review of findings from previous studies. A systematic literature search of bibliographic databases was conducted, yielding 18 studies that fit the criteria for inclusion in the meta-analysis. A random-effects model of all 18 studies showed a significant overall odds ratio of 1.53 (95% CI 1.28-1.83, p anxiety were associated with a 53% increased likelihood of falls. A high amount of variance among effect sizes was observed. Only age was identified as a moderator of this relationship in a subgroup of the samples. Clinical anxiety is associated with falls, however, further research is required to elucidate the factors that might moderate or mediate this relationship, the casual pathways through which they are related, and the associations between different types of anxiety and falls. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Home ownership and fall-related outcomes among older adults in South Korea.
Do, Young Kyung; Kim, Cheong-Seok
2013-10-01
Many of the previously identified environmental risk factors for fall-related outcomes (e.g. flooring, stairs and steps, kitchen, and bathrooms) are amenable to change, but the extent of the changes on these home-related risk factors are conditional on home ownership of the elderly. This study aims to test whether lack of home ownership is associated with a higher risk of falls, and a higher likelihood of reporting fear of falling and activity limitations due to fear of falling among older adults in South Korea. Using data from the first two waves (2006 and 2008) of the Korean Longitudinal Study of Aging, the associations between home ownership variables and three fall-related outcomes were examined in two regression models. A logistic regression model of any falls in the past 2 years was estimated to examine whether older adults living in short-term rental homes based on monthly rent have an increased risk of falls. A probit model accounting for sample selection was estimated to examine whether the two related outcomes, fear of falling and limiting activities due to fear of falling, are associated with home ownership status. Compared with owned home, short-term rental home predicted a higher likelihood of incident of falls and activity limitation due to fear of falling. The study findings suggest that the lack of home ownership with unstable housing tenure is an important risk factor for fall-related outcomes among older adults in South Korea. © 2012 Japan Geriatrics Society.
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Factors associated with occasional and recurrent falls in Mexican community-dwelling older people
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
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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.
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Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles
2010-02-01
The aim of this predictive study was to test a structural model to establish predictors of fall risk in elderly cancer survivors. An aging and nursing model of care was synthesized and used to examine the Minimum Data Set for 6,912 low-income older adult participants in a community setting in the midwestern United States. Data analysis established relationships among fall risk and age, race/ethnicity, history of a previous fall, depression, pain, activities of daily living, instrumental activities of daily living, incontinence, vision, and cognitive status. Factors leading to fall risk can direct nursing activities that have the potential to prevent falls, thus improving older adults' quality of life. Copyright 2010, SLACK Incorporated.
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Falls prevention in community care: 10 years on
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Burton E
2018-02-01
Full Text Available Elissa Burton,1 Gill Lewin,2 Hilary O’Connell,3 Keith D Hill1 1School of Physiotherapy and Exercise Science, Curtin University, 2School of Nursing, Midwifery and Paramedicine, Curtin University, 3Independent Living Centre WA, Perth, WA, Australia Background: A million older people living in Australia receive community care services each year due to experiencing functional or mental health difficulties. This group may be at greater risk of falling than similar-aged people not receiving services. However, there is limited falls prevention research for this population.Purpose: The aim of this study was to identify the falls prevalence rates of older people from 10 Australian community care organizations and compare current falls prevention data to a study 10 years prior that utilized the same 10 organizations. This study also identified factors associated with falling for this population.Patients and methods: This is a cross-sectional descriptive study, in which 5,338 questionnaires were mailed to a random sample of community care recipients aged ≥65 years. Results: A total of 1,991 questionnaires were returned (37.3%, with 47.7% of respondents having fallen in the previous year, and 32.7% in the month prior to completing the questionnaire, similar to 10 years prior. Community care clients had a 50% higher falls rate than that reported for similar-aged people not receiving services, and this remained unchanged over the last 10 years. Eighty-six per cent of fallers had fallen once or twice, and 60% reported being injured. Thirty-six per cent of respondents reported not being able to get up independently, and only 27.4% of fallers were referred to a falls prevention program (significantly fewer than 10 years ago; 95% CI: 0.821–6.366, p=0.01. Balance issues (odds ratio [OR]: 2.06, 95% CI: 1.288–3.290, p=0.003 and perceived risk of falling in the future being “definite” (OR: 6.42, 95% CI: 1.890–21.808, p=0.003 or “unsure” (OR: 3
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Effect of Fear of Falling on Turning Performance in Parkinson's Disease in the Lab and at Home.
Haertner, Linda; Elshehabi, Morad; Zaunbrecher, Laura; Pham, Minh H; Maetzler, Corina; van Uem, Janet M T; Hobert, Markus A; Hucker, Svenja; Nussbaum, Susanne; Berg, Daniela; Liepelt-Scarfone, Inga; Maetzler, Walter
2018-01-01
Background: Parkinson's disease (PD) is a neurodegenerative movement disorder associated with gait and balance problems and a substantially increased risk of falling. Falls occur often during complex movements, such as turns. Both fear of falling (FOF) and previous falls are relevant risk factors for future falls. Based on recent studies indicating that lab-based and home assessment of similar movements show different results, we hypothesized that FOF and a positive fall history would influence the quantitative turning parameters differently in the laboratory and home. Methods: Fifty-five PD patients (43 underwent a standardized lab assessment; 40 were assessed over a mean of 12 days at home with approximately 10,000 turns per participant; and 28 contributed to both assessments) were classified regarding FOF and previous falls as "vigorous" (no FOF, negative fall history), "anxious" (FOF, negative fall history), "stoic" (no FOF, positive fall history) and "aware" (FOF, positive fall history). During the assessments, each participant wore a sensor on the lower back. Results: In the lab assessment, FOF was associated with a longer turning duration and lowered maximum and middle angular velocities of turns. In the home evaluations, a lack of FOF was associated with lowered maximum and average angular velocities of turns. Positive falls history was not significantly associated with turning parameters, neither in the lab nor in the home. Conclusion: FOF but not a positive fall history influences turning metrics in PD patients in both supervised and unsupervised environments, and this association is different between lab and home assessments. Our findings underline the relevance of comprehensive assessments including home-based data collection strategies for fall risk evaluation.
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Exploring Older Adult ED Fall Patients' Understanding of Their Fall: A Qualitative Study.
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.
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Medication as a risk factor for falls in older women in Brazil
Directory of Open Access Journals (Sweden)
Rozenfeld Suely
2003-01-01
Full Text Available OBJECTIVE: To assess the prevalence of falls and their association with the use of medications among elderly women in the city of Rio de Janeiro, Brazil. Falls among the elderly are likely to gain additional public health importance in Brazil and many other developing countries given the rapid growth of the elderly populations in those nations. METHODS: A cross-sectional study was carried out with women who were participating in the educational, cultural, and medical care activities of the Open University of the Third Age (OUTA, a group that works to promote the welfare of elderly people in the city of Rio de Janeiro. The women in the study were all 60 years old or older, were able to walk, had no cognitive impairment, and were living in the community (rather than living in a facility exclusively for older persons. A questionnaire was used that asked about falls within the 12 months prior to the interview, medications used in the previous 15 days, current and past health problems, and demographic characteristics. Women who were interviewed face-to-face also had their blood pressure checked. Two outcome variables were defined: (1 "fallers," who had suffered one or more falls (contrasted with "nonfallers" and (2 "recurrent fallers," who had had two or more falls (contrasted with those who had had one or no falls, called "nonrecurrent fallers". RESULTS: A total of 634 women were interviewed face-to-face at the OUTA facilities. Among these in-person interviewees, 23.3% reported one fall in the previous year, and 14.0% reported two or more falls in that period. Considering both prescribed drugs and over-the-counter drugs, only 9.1% of these women were not using any medications, 52.7% were using 1 to 4 medications, 34.4% were using 5 to 10, and 3.8% were using 11 to 17 medications. In comparison to nonusers, users of diuretics who also suffered from musculoskeletal disease were 1.6 times as likely to report having suffered a single fall in the
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Utilizing the Vertical Variability of Precipitation to Improve Radar QPE
Gatlin, Patrick N.; Petersen, Walter A.
2016-01-01
Characteristics of the melting layer and raindrop size distribution can be exploited to further improve radar quantitative precipitation estimation (QPE). Using dual-polarimetric radar and disdrometers, we found that the characteristic size of raindrops reaching the ground in stratiform precipitation often varies linearly with the depth of the melting layer. As a result, a radar rainfall estimator was formulated using D(sub m) that can be employed by polarimetric as well as dual-frequency radars (e.g., space-based radars such as the GPM DPR), to lower the bias and uncertainty of conventional single radar parameter rainfall estimates by as much as 20%. Polarimetric radar also suffers from issues associated with sampling the vertical distribution of precipitation. Hence, we characterized the vertical profile of polarimetric parameters (VP3)-a radar manifestation of the evolving size and shape of hydrometeors as they fall to the ground-on dual-polarimetric rainfall estimation. The VP3 revealed that the profile of ZDR in stratiform rainfall can bias dual-polarimetric rainfall estimators by as much as 50%, even after correction for the vertical profile of reflectivity (VPR). The VP3 correction technique that we developed can improve operational dual-polarimetric rainfall estimates by 13% beyond that offered by a VPR correction alone.
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Dizziness and Falls in Obese Inpatients Undergoing Metabolic Rehabilitation.
Directory of Open Access Journals (Sweden)
Stefano Corna
Full Text Available The relationship between dizziness and falls in the obese population is a relatively unexplored issue. The aims of the present study were to define the 1-year prevalence of dizziness in an obese inpatient population undergoing metabolic rehabilitation and to investigate possible correlations with fall events.We recruited 329 obese subjects: 203 female (BMI 43,74 kg/m2 ± 0.5 SE; age 17-83 years, 58.33 ± 0.9 SE and 126 male (BMI 44,27kg/m2 ± 0.7 DE age 27-79 years, 58.84 ± 1 SE. To assess dizziness we used the validated Italian version (38 of the Dizziness Handicap Inventory (DHI.Out of the experimental sample, 100 subjects did not complain of dizziness and felt confident about their balance control, while 69.6% reported some degree of dizziness. Their mean DHI score was 22.3, which corresponds to mild dizziness. Twenty-one percent reported more severe dizziness (DHI score > 40. The majority of our sample reported minor dizziness and its perception appears to be independent from BMI: DHI scores were consistent across classes of obesity.The rate of dizziness and falls (30.1% in an this obese population was higher than that previously reported in a general matched population. However, obese subjects, in our sample, seem to underestimate their risk of fall and DHI score does not appear a reliable predictor of falls. Since complications associated with falls in obese persons generally require longer treatments than in lean individuals, our findings should be taken into account in order to identify other predictors, including cognitive and perceptual, of risk of fall and to implement fall prevention programs.
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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
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Medication use and fall-risk assessment for falls in an acute care hospital.
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.
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Falling and fall risk factors in adults with haemophilia: an exploratory study.
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.
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The circumstances, orientations, and impact locations of falls in community-dwelling older women.
Crenshaw, Jeremy R; Bernhardt, Kathie A; Achenbach, Sara J; Atkinson, Elizabeth J; Khosla, Sundeep; Kaufman, Kenton R; Amin, Shreyasee
2017-11-01
We sought to characterize the circumstances, orientations, and impact locations of falls in community-dwelling, ambulatory, older women. For this longitudinal, observational study, 125 community-dwelling women age≥65years were recruited. Over 12-months of follow-up, fall details were recorded using twice-monthly questionnaires. More than half (59%) of participants fell, with 30% of participants falling more than once (fall rate=1.3 falls per person-year). Slips (22%) and trips (33%) accounted for the majority of falls. Approximately 44% of falls were forward in direction, while backward falls accounted for 41% of falls. About a third of all falls were reported to have lateral (sideways) motion. Subjects reported taking a protective step in response to 82% of forward falls and 37% of backward falls. Of falls reporting lateral motion, a protective step was attempted in 70% of accounts. Common impact locations included the hip/pelvis (47% of falls) and the hand/wrist (27%). Backwards falls were most commonly reported with slips and when changing direction, and increased the risk of hip/pelvis impact (OR=12.6; 95% CI: 4.7-33.8). Forward falls were most commonly reported with trips and while hurrying, and increased the risk of impact to the hand/wrist (OR=2.6; 95% CI: 1.2-5.9). Falls in older ambulatory women occur more frequently than previously reported, with the fall circumstance and direction dictating impact to common fracture locations. Stepping was a common protective recovery strategy and that may serve as an appropriate focus of interventions to reduce falls in this high risk population. Copyright © 2017 Elsevier B.V. All rights reserved.
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Which Fall Ascertainment Method Captures Most Falls in Pre-Frail and Frail Seniors?
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.
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Gazibara, Tatjana; Kisic Tepavcevic, Darija; Svetel, Marina; Tomic, Aleksandra; Stankovic, Iva; Kostic, Vladimir S; Pekmezovic, Tatjana
2017-10-01
To describe circumstances of near-falls among persons with Parkinson's disease (PD), assess factors associated with near-falling and assess whether near-falls in the first 6 months are associated with falling in the latter 6 months over one year of follow-up. In the period August 2011-December 2012, 120 consecutive persons with PD, who denied having fallen in the past 6 months, were recruited at Clinical center of Serbia in Belgrade. Occurrence of falling and near-falls was followed for one year. A total of 31 persons with PD (25.8%) experienced near-falls, but did not fall. Of 42 fallers, 32 (76.2%) experienced near-falls. Tripping was the most common cause of near-falls among fallers, whereas postural instability was the most common in non-fallers. Regardless of falling experience, the most common manner to avoid fall was holding onto furniture or wall. After adjustment for multiple motor and non-motor PD features, more severe freezing of gait was associated with occurrence of near-falls over one year of follow-up (odds ratio [OR]=1.08, 95% confidence interval [CI] 1.01-1.16; p=0.043). Adjusted regression analysis did not show associations between near-falling in the first 6 months and falling in the latter 6 months of follow-up. Near-falls commonly occur in persons with PD. More severe freezing of gait appears to predispose near-falling. Fall prevention programs focusing on balance maintenance when experiencing freezing of gait could potentially be useful in reduction of near-falls. Copyright © 2017 Elsevier B.V. All rights reserved.
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The Contribution of Extreme Precipitation to the Total Precipitation in China
Institute of Scientific and Technical Information of China (English)
SUN Jian-Qi
2012-01-01
Using daily precipitation data from weather stations in China, the variations in the contribution of extreme precipitation to the total precipitation are analyzed. It is found that extreme precipitation accounts for approximately one third of the total precipitation based on the overall mean for China. Over the past half century, extreme precipitation has played a dominant role in the year-to-year variability of the total precipitation. On the decadal time scale, the extreme precipitation makes different contributions to the wetting and drying regions of China. The wetting trends of particular regions are mainly attributed to increases in extreme precipitation; in contrast, the drying trends of other regions are mainly due to decreases in non-extreme precipitation.
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Design a Learning-Oriented Fall Event Reporting System Based on Kirkpatrick Model.
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.
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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.
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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
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International Nuclear Information System (INIS)
Molinaroli, E.; Pistolato, M.; Rampazzo, G.; Guerzoni, S.
1999-01-01
The chemical characteristics of the mineral fractions of aerosol and precipitation collected in Sardinia (NW Mediterranean) are highlighted by means of two multivariate statistical approaches. Two different combinations of classification and statistical methods for geochemical data are presented. It is shown that the application of cluster analysis subsequent to Q-Factor analysis better distinguishes among Saharan dust, background pollution (Europe-Mediterranean) and local aerosol from various source regions (Sardinia). Conversely, the application of simple cluster analysis was able to distinguish only between aerosols and precipitation particles, without assigning the sources (local or distant) to the aerosol. This method also highlighted the fact that crust-enriched precipitation is similar to desert-derived aerosol. Major elements (Al, Na) and trace metal (Pb) turn out to be the most discriminating elements of the analysed data set. Independent use of mineralogical, granulometric and meteorological data confirmed the results derived from the statistical methods employed. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)
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Diabetic Ketoacidosis: Pattern of Precipitating Causes
Directory of Open Access Journals (Sweden)
Ashraf Uddin Ahmed
2014-05-01
Full Text Available Background: Diabetic ketoacidosis (DKA is one of the most common acute complications of diabetes mellitus (DM. DKA is a recognised presenting feature of type 1 DM, but it commonly complicates previously diagnosed diabetic patients of all types, specially if they get infection or discontinue treatment. Objective: To describe the precipitating causes of DKA. Materials and Methods: This cross-sectional study was done from September to November, 2010 in Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM. Diagnosed DKA cases were evaluated clinically and by laboratory investigations for identification of precipitating causes. Results: Out of 50 patients, 28 were female. Mean age was 38.3 years. Forty patients (80% were known diabetics and 10 (20% were detected diabetic first time during this admission. Severe DKA cases were less common. Infection (20, 40% was the commonest precipitating cause followed by noncompliance (14, 28%. In 7 (14% cases no cause could be identified. Other less common causes included acute myocardial infarction, acute pancreatitis, stroke and surgery. Conclusion: Infection and noncompliance were the major precipitants of DKA. So, it is assumed that many DKA cases might be prevented by proper counselling regarding adherence to medication and sick days’ management.
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Instrumental neutron activation analysis of dry atmospheric fall-out and rain-water
International Nuclear Information System (INIS)
Schutyser, P.; Maenhaut, W.; Dams, R.
1978-01-01
An automated precipitation sampler and an instrumental neutron activation analysis (i.n.a.a.) method for the determination of some major and trace elements in dry atmospheric fall-out and rain-water are presented. The sampler features a rain detector which makes separate collections of dry atmospheric fall-out and rain-water possible. The sampler is equipped with u.v. lamps in order to avoid algal growth during extended collection periods. After collection, the samples are separated into water-soluble and insoluble fractions. The soluble fraction is preconcentrated before analysis by freeze-drying. The i.n.a.a. method involves the measurement of both short- and long-lived radioactivities so that a total of 35 elements can be determined. The possibility of losses during freeze-drying and the accuracy of the i.n.a.a. method were investigated for 7 elements by analysis of a soluble fraction with an independent method, viz. inductively coupled plasma atomic emission spectrometry. (Auth.)
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Precipitation evolution and kinetics in a magnesium-neodymium-zinc alloy
International Nuclear Information System (INIS)
Sanaty-Zadeh, A.; Xia, X.; Luo, A.A.; Stone, D.S.
2014-01-01
Highlights: • Precipitation sequence and kinetics in Mg–3Nd–0.2Zn wt.% alloy were studied. • Lower amount of zinc than 0.5 wt.% does not change the sequence of precipitation. • A new orientation with respect to the matrix was detected for β″ precipitates. • β″ Precipitates contribute to the age hardening of the alloy. • Quenched-in vacancies play an important role in early stage of precipitation. -- Abstract: In this research, the precipitation sequence investigation and phase identification in Mg–3Nd–0.2Zn–0.46Zr (wt.%) system were performed using differential scanning calorimetry (DSC) and transmission electron microscopy (TEM) techniques. The results showed the precipitation sequence to be: Super saturated solid solution (SSSS) → Clustering of atoms/short range ordering → β″ → β′ → β which shows that low zinc content (less than 0.5 %wt) does not influence the precipitation sequence. TEM studies revealed that in addition to prismatic planes, β′′ precipitates lie on pyramidal planes in Mg matrix, which has not been reported previously in this system. Further investigation using TEM and aging experiments showed that these precipitates are responsible for the age hardening of the alloy. Furthermore, the kinetic studies showed that quenched-in vacancies play an important role in the early stage of precipitation and formation of β′′ while formation of β′ is dominantly diffusion controlled process and quenched-in vacancies are no longer effective
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Responses of Seasonal Precipitation Intensity to Global Warming
Lan, Chia-Wei; Lo, Min-Hui; Chou, Chia
2016-04-01
Under global warming, the water vapor increases with rising temperature at the rate of 7%/K. Most previous studies focus on the spatial differences of precipitation and suggest that wet regions become wetter and dry regions become drier. Our recent studies show a temporal disparity of global precipitation, which the wet season becomes wetter and dry season becomes drier; therefore, the annual range increases. However, such changes in the annual range are not homogeneous globally, and in fact, the drier trend over the ocean is much larger than that over the land, where the dry season does not become drier. Such precipitation change over land is likely because of decreased omega at 500hPa (more upward motion) in the reanalysis datasets from 1980 to 2013. The trends of vertical velocity and moist static energy profile over the increased precipitation regions become more unstable. The instability is most likely attributed to the change in specific humility below 400hPa. Further, we will use Coupled Model Intercomparison Project Phase 5 (CMIP5) archives to investigate whether the precipitation responses in dry season are different between the ocean and land under global warming.
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Qin, Zijian; Baccaglini, Lorena
2016-01-01
Falls in the geriatric population are a major public health issue. With the anticipated aging of the population, falls are expected to increase nationally and globally. We estimated the prevalence and determinants of falls in adults aged ≥65 years and calculated the proportion of elderly who fell and made lifestyle changes as a result of professional recommendations. We included adults aged ≥65 years from the 2011-2012 California Health Interview Survey (CHIS) and categorized them into two groups based on whether or not they had had at least two falls in the previous 12 months. We performed logistic regression analysis adjusted for the complex survey design to determine risk factors for falls and compare the odds of receiving professional recommendations among elderly with vs. without falls. Of an estimated 4.3 million eligible elderly participants in the CHIS (2011-2012), an estimated 527,340 (12.2%) fell multiple times in the previous 12 months. Of those, 204,890 (38.9%) were told how to avoid falls by a physician and 211,355 (40.1%) received medical treatment, although fewer than 41.0% had made related preventive changes to avoid future falls. Falls were associated with older age, less walking, and poorer physical or mental health. Non-Asians had higher odds of falling compared with Asians (adjusted odds ratio = 1.69, 95% confidence interval 1.16, 2.45). Most participants reported changing medications, home, or daily routines on their own initiative rather than after professional recommendations. Patients with a history of falls did not consistently receive professional recommendations on fall prevention-related lifestyle or living condition changes. Given the high likelihood of a serious fall, future interventions should focus on involving primary care physicians in active preventive efforts before a fall occurs.
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[Evaluation of risk factors of falls in early postmenopausal women].
Nahas, Eliana Aguiar Petri; Omodei, Michelle Sako; Cangussu, Luciana Mendes; Nahas-Neto, Jorge
2013-11-01
It was to evaluate the frequency and the risk factors of falls in early postmenopausal women. A cross-sectional study was conducted on 358 women (age: 45-65 years and amenorrhea >12 months) with time since menopause fall was identified as an unexpected unintentional change in position which causes an individual to remain in a lower level in relation to the initial position. The history of self-reported falls during the previous 24 months, and clinical and anthropometric data (body mass index (BMI) and waist circumference (WC)) and bone densitometric measures were analyzed. For statistical analysis, c² trend test and the logistic regression method (odds ratio (OR)) were used for the comparison between groups of women with and without falls. Of the 358 women, 48.0% (172/358) had a history of falls and 17.4% (30/172) had fractures. The fall occurred indoors (at home) in 58.7% (101/172). The mean age was 53.7 ± 6.5 years, time since menopause 5.8 ± 3.5 years, BMI 28.3 ± 4.6 kg/m² and WC 89.0 ± 11.4 cm. There were differences as the occurrence of smoking and diabetes, with greater frequency among fallers vs. non-fallers, 25.6 versus 16.1% and 12.8 versus 5.9%, respectively (prisk of falls in the presence of influential variables, it was observed that risk increased with current smoking status (OR 1.93; 95%CI 1.01-3.71), whereas other clinical and anthropometric variables did not influence this risk. In early postmenopausal women there was higher frequency of falls. Current smoking was clinical indicators of risk for falls. With the recognition of factors for falling, preventive measures become important, as the orientation of abolishing smoking.
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Gell, Nancy M.; Wallace, Robert B.; LaCroix, Andrea Z.; Mroz, Tracy M.; Patel, Kushang V.
2015-01-01
OBJECTIVES To examine mobility device use prevalence among community-dwelling older adults in the U.S. and to investigate the incidence of falls and worry about falling by the type and number of mobility devices used. DESIGN Analysis of cross-sectional and longitudinal data from the 2011–2012 National Health and Aging Trends Study SETTING In-person interviews in the homes of study participants PARTICIPANTS Nationally representative sample of Medicare beneficiaries(N=7609). MEASUREMENTS Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, one-year fall history and worry about falling. RESULTS Twenty-four percent of adults age ≥65 reported mobility device use in 2011 and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with non-White race/ethnicity, female sex, lower education level, greater multi-morbidity, and obesity (all P-values falls and recurrent falls were not associated with the use of multiple devices or any one particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users, compared with non-users. CONCLUSION The percentage of older adults reporting mobility device use is higher compared to results from previous national surveys and multiple device use is common among those who use any device. Mobility device use is not associated with increased incidence of falls compared to non-device users. Cane-only users may compensate for worry about falling by limiting activity. PMID:25953070
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Co-precipitation and solubility studies of cesium, potassium and sodium tetraphenylborate
International Nuclear Information System (INIS)
Peterson, R.A.
1999-01-01
This report contains the results from a study requested by High Level Waste Division on the co-precipitation and solubility of cesium, potassium, and sodium tetraphenylborate. Co-precipitation of cesium (Cs), potassium (K), and sodium (Na) tetraphenylborate (TPB) helps determine the efficiency of reagent usage in the Small Tank Precipitation Process. This process uses NaTPB to remove cesium from waste by means of precipitation. Previous studies by McCabe suggested that if the sodium ion concentration [Na+] increased the rate at which cesium tetraphenylborate (KTPB) in the presence of high [Na+] (∼5M) appears to produce a mixed solid phase composed of NaTPB and KTPB together in the crystal lattice
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Xie, Y.; Wilson, A. M.
2017-12-01
Plant phenology studies typically focus on the beginning and end of the growing season in temperate forests. We know too little about fall foliage peak coloration, which is a bioindicator of plant response in autumn to environmental changes, an important visual cue in fall associated with animal activities, and a key element in fall foliage ecotourism. Spatiotemporal changes in timing of fall foliage peak coloration of temperate forests and the associated environmental controls are not well understood. In this study, we examined multiple color indices to estimate Land Surface Phenology (LSP) of fall foliage peak coloration of deciduous forest in the northeastern USA using Moderate Resolution Imaging Spectroradiometer (MODIS) daily imagery from 2000 to 2015. We used long term phenology ground observations to validate our estimated LSP, and found that Visible Atmospherically Resistant Index (VARI) and Plant Senescence Reflectance Index (PSRI) were good metrics to estimate peak and end of leaf coloration period of deciduous forest. During the past 16 years, the length of period with peak fall foliage color of deciduous forest at southern New England and northern Appalachian forests regions became longer (0.3 7.7 days), mainly driven by earlier peak coloration. Northern New England, southern Appalachian forests and Ozark and Ouachita mountains areas had shorter period (‒0.2 ‒9.2 days) mainly due to earlier end of leaf coloration. Changes in peak and end of leaf coloration not only were associated with changing temperature in spring and fall, but also to drought and heat in summer, and heavy precipitation in both summer and fall. The associations between leaf peak coloration phenology and climatic variations were not consistent among ecoregions. Our findings suggested divergent change patterns in fall foliage peak coloration phenology in deciduous forests, and improved our understanding in the environmental control on timing of fall foliage color change.
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Top Five Physical Design Factors Contributing to Fall Initiation.
Pati, Debajyoti; Lee, Jaehoon; Mihandoust, Sahar; Kazem-Zadeh, Mahshad; Oh, Youngha
2018-01-01
To develop a prioritized list of physical design questions/interventions to reduce patient falls by conducting expanded analysis (Phase II) of data generated from a completed study phase. Patient falls continue to be a critical concern for healthcare providers, patients, and families. While substantial literature exist on intrinsic factors, scientific evidence on the role of the physical environment is scarce. Expanded analysis of data from 180 videos of trials conducted in a physical mock-up of a medical-surgical inpatient room in a previously completed study phase. The odds of subject's exhibited postures (predictors) on fall initiation (outcome) were examined in a series of generalized linear mixed effects models. Physical design elements and attributes associated with postures exhibiting statistical significance were examined. Turning, pulling, pushing, and bending forward exhibited the highest odds of contributing to fall initiation in the bathroom. Grabbing, pushing, and sitting exhibited the highest odds of contributing to fall initiation around the patient bed. Physical design elements/attributes associated with the above postures are the (1) bathroom door; (2) bathroom spatial configuration-relative locations of door, toilet bowl, and the sink; (3) door, toilet, and sink hardware; (4) space availability/tightness inside the clinician zone; and (5) spatial configuration around patient bed-relative locations of bed, patient chair, and overbed table, in relation to bathroom door, and resulting obstructions originating from the configuration. Patient falls during unassisted ambulation may be reduced through appropriate examination of these five physical elements/attributes.
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Effect of Fear of Falling on Turning Performance in Parkinson’s Disease in the Lab and at Home
Directory of Open Access Journals (Sweden)
Linda Haertner
2018-03-01
Full Text Available Background: Parkinson’s disease (PD is a neurodegenerative movement disorder associated with gait and balance problems and a substantially increased risk of falling. Falls occur often during complex movements, such as turns. Both fear of falling (FOF and previous falls are relevant risk factors for future falls. Based on recent studies indicating that lab-based and home assessment of similar movements show different results, we hypothesized that FOF and a positive fall history would influence the quantitative turning parameters differently in the laboratory and home.Methods: Fifty-five PD patients (43 underwent a standardized lab assessment; 40 were assessed over a mean of 12 days at home with approximately 10,000 turns per participant; and 28 contributed to both assessments were classified regarding FOF and previous falls as “vigorous” (no FOF, negative fall history, “anxious” (FOF, negative fall history, “stoic” (no FOF, positive fall history and “aware” (FOF, positive fall history. During the assessments, each participant wore a sensor on the lower back.Results: In the lab assessment, FOF was associated with a longer turning duration and lowered maximum and middle angular velocities of turns. In the home evaluations, a lack of FOF was associated with lowered maximum and average angular velocities of turns. Positive falls history was not significantly associated with turning parameters, neither in the lab nor in the home.Conclusion: FOF but not a positive fall history influences turning metrics in PD patients in both supervised and unsupervised environments, and this association is different between lab and home assessments. Our findings underline the relevance of comprehensive assessments including home-based data collection strategies for fall risk evaluation.
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Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G
2016-08-01
Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.
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Gell, Nancy M; Wallace, Robert B; LaCroix, Andrea Z; Mroz, Tracy M; Patel, Kushang V
2015-05-01
To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used. Analysis of cross-sectional and longitudinal data from the 2011-12 National Health and Aging Trends Study. In-person interviews in the homes of study participants. Nationally representative sample of Medicare beneficiaries (n=7,609). Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, 1-year fall history and worry about falling. Twenty-four percent of adults aged 65 and older reported mobility device use in 2011, and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with nonwhite race and ethnicity, female sex, lower education level, greater multimorbidity, and obesity (all Pfalls and recurrent falls was not associated with the use of multiple devices or any particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users than in nonusers. The percentage of older adults reporting mobility device use is higher than results from previous national surveys, and multiple device use is common in those who use any device. Mobility device use is not associated with greater incidence of falls. Cane-only users may compensate for worry about falling by limiting activity. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.
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Khiri, Fouad; Ibhi, Abderrahmane; Saint-Gerant, Thierry; Medjkane, Mohand; Ouknine, Lahcen
2017-10-01
The study of meteorites provides insight into the earliest history of our solar system. From 1800, about the year meteorites were first recognized as objects falling from the sky, until December 2014, 158 observed meteorite falls were recorded in Africa. Their collected mass ranges from 1.4 g to 175 kg with the 1-10 kg cases predominant. The average rate of African falls is low with only one fall recovery per 1.35-year time interval (or 0.023 per year per million km2). This African collection is dominated by ordinary chondrites (78%) just like in the worldwide falls. The seventeen achondrites include three Martian meteorite falls (Nakhla of Egypt, Tissint of Morocco and Zagami of Nigeria). Observed Iron meteorite falls are relatively rare and represent only 5%. The falls' rate in Africa is variable in time and in space. The number of falls continues to grow since 1860, 80% of which were recovered during the period between 1910 and 2014. Most of these documented meteorite falls have been recovered from North-Western Africa, Eastern Africa and Southern Africa. They are concentrated in countries which have a large surface area and a large population with a uniform distribution. Other factors are also favorable for observing and collecting meteorite falls across the African territory, such as: a genuine meteorite education, a semi-arid to arid climate (clear sky throughout the year most of the time), croplands or sparse grasslands and possible access to the fall location with a low percentage of forest cover and dense road network.
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Falls in institutionalized older adults: risks, consequences and antecedents.
Araújo, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias Dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da
2017-01-01
To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents. 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 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 risks of falls. Analisar a ocorrência de quedas em idosos institucionalizados quanto aos riscos, consequências e antecedentes. Estudo transversal, realizado com 45 idosos em Instituições de Longa Permanência para Idosos em João Pessoa/PB, Brasil, em junho e julho de 2016. Aplicou-se questionário sociodemográfico e Escala de Equilíbrio de Berg classificando risco de quedas quando escore inferior a 45. Realizou-se estatística descritiva e testes: t independente, Anova (Tukey), Qui-quadrado, Mann Whitney. Considerado significativamente estatístico p < 0,05 e processados no SPSS versão 19.0. As quedas ocorreram em 66,7% (30), sendo 20% (9) na área externa, 66,7% (30) com doença prévia hipertensão e como consequência destacou-se fratura com 11,2% (5). A Escala de Berg avaliou pontuações diferentes (p < 0,05) quando comparadas às quedas sofridas pelos idosos, e as doenças prévias influenciaram ocorrência de quedas (p < 0,05). Necessita-se implementar políticas públicas de financiamento ou parcerias que possibilitem adaptação dos ambientes visando a redução dos riscos de quedas.
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Multifactorial assessment of the risk of falls in low bone density older women
Directory of Open Access Journals (Sweden)
Patrícia Azevedo Garcia
Full Text Available Abstract Introduction: Identifying effective assessment instruments for predicting falls, specifically in older women with low bone mineral density (BMD that are more susceptible to fractures remains a challenge. Objective: To evaluate risk factors for falls at baseline, to identify the falls occurrence over six months of follow-up and to investigate the predictive validity of the Quickscreen Clinical Falls Risk Assessment for predicting multiple falls among low BMD older women. Methods: A methodological study with 110 older women with diagnosis of osteoporosis or osteopenia (70.26 ± 6.24 years. The presence of two or more of the eight risk factors assessed by the QuickScreen characterized the risk of falling (baseline and monthly phone calls identified the occurrence of falls during the six months of follow-up. Results: The most prevalent falls risk factors were self-reported previous falls, polypharmacy and impairment in shifting weight and lateral instability. Most of the older women (67.3% had two or more risk factors, 24.5% reported a single fall and 13.6% reported multiple falls over the six months. The QuickScreen (cutoff ≥ 2 risk factors showed good sensitivity (73.3% and high negative predictive value (88.89% for predicting multiple falls among low BMD older women. Conclusions: The results indicated a high frequency of falls among low BMD older women. Additionally, the results highlighted that the QuickScreen instrument was able to predict multiple falls in the six months of follow-up among these older women.
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Directory of Open Access Journals (Sweden)
Ali A. Assani
2016-01-01
Full Text Available We compared the spatiotemporal variability of temperatures and precipitation with that of the magnitude and timing of maximum daily spring flows in the geographically adjacent L’Assomption River (agricultural and Matawin River (forested watersheds during the period from 1932 to 2013. With regard to spatial variability, fall, winter, and spring temperatures as well as total precipitation are higher in the agricultural watershed than in the forested one. The magnitude of maximum daily spring flows is also higher in the first watershed as compared with the second, owing to substantial runoff, given that the amount of snow that gives rise to these flows is not significantly different in the two watersheds. These flows occur early in the season in the agricultural watershed because of the relatively high temperatures. With regard to temporal variability, minimum temperatures increased over time in both watersheds. Maximum temperatures in the fall only increased in the agricultural watershed. The amount of spring rain increased over time in both watersheds, whereas total precipitation increased significantly in the agricultural watershed only. However, the amount of snow decreased in the forested watershed. The magnitude of maximum daily spring flows increased over time in the forested watershed.
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Falling through the black hole horizon
International Nuclear Information System (INIS)
Brustein, Ram; Medved, A.J.M.
2015-01-01
We consider the fate of a small classical object, a “stick”, as it falls through the horizon of a large black hole (BH). Classically, the equivalence principle dictates that the stick is affected by small tidal forces, and Hawking’s quantum-mechanical model of BH evaporation makes essentially the same prediction. If, on the other hand, the BH horizon is surrounded by a “firewall”, the stick will be consumed as it falls through. We have recently extended Hawking’s model by taking into account the quantum fluctuations of the geometry and the classical back-reaction of the emitted particles. Here, we calculate the strain exerted on the falling stick for our model. The strain depends on the near-horizon state of the Hawking pairs. We find that, after the Page time when the state of the pairs deviates significantly from maximal entanglement (as required by unitarity), the induced strain in our semiclassical model is still parametrically small. This is because the number of the disentangled pairs is parametrically smaller than the BH entropy. A firewall does, however, appear if the number of disentangled pairs near the horizon is of order of the BH entropy, as implicitly assumed in previous discussions in the literature.
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Schwinzerl, Martin; Schönhuber, Michael; Lammer, Günter
2015-04-01
The requirement to estimate for each individual hydrometeor precipitation parameters such as shape, equi-voluminous diameter, fall velocity, height to width ratio, and canting angle gave rise to the development of the family of 2D-Video-Distrometer (2DVD) measurement devices. The measurement principle of the 2DVD is based upon the ability to acquire a side- and front view onto each particle by virtue of two orthogonally arranged high-speed line-scan cameras. The cameras are displaced vertically towards each other by a precisely determined distance in the ballpark of 6 mm, thus allowing the estimation of the vertical fall velocity in-situ on a per-particle basis. The geometrical and velocity information, sampled over a measurement surface of approx. 100 x 100 mm in this way, is then used to derive observables like rain rate and the accumulated equivalent amount of precipitation with a high degree of statistical relevance. One of the biggest assets of this measurement principle is the ability to perform measurements without relying on any externally provided model or phenomenological relationship between observables like particle shape and velocity. For liquid precipitation in the form of natural rain, this allows for example to verify whether established relationships - like, for example, the tabulated values for diameter vs. vertical velocity provided by Gunn & Kinzer - can be reproduced in sampled datasets. For mixed-phase and solid precipitation, different types of hydrometeors like for example different snow flake families, hail and graupel yield - depending on parameters like for example the water content and therefor, in turn, the density of the particle - very diverse results with respect to expected fall velocity, oblateness, or general shape for a given diameter class. The ability of the 2DVD to capture these parameters directly and without reliance on externally provided relationships, has contributed to the attractiveness of this measurement device for in
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Preventing falls and fractures.
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.
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A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.
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.
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Salts-based size-selective precipitation: toward mass precipitation of aqueous nanoparticles.
Wang, Chun-Lei; Fang, Min; Xu, Shu-Hong; Cui, Yi-Ping
2010-01-19
Purification is a necessary step before the application of nanocrystals (NCs), since the excess matter in nanoparticles solution usually causes a disadvantage to their subsequent coupling or assembling with other materials. In this work, a novel salts-based precipitation technique is originally developed for the precipitation and size-selective precipitation of aqueous NCs. Simply by addition of salts, NCs can be precipitated from the solution. After decantation of the supernatant solution, the precipitates can be dispersed in water again. By means of adjusting the addition amount of salt, size-selective precipitation of aqueous NCs can be achieved. Namely, the NCs with large size are precipitated preferentially, leaving small NCs in solution. Compared with the traditional nonsolvents-based precipitation technique, the current one is simpler and more rapid due to the avoidance of condensation and heating manipulations used in the traditional precipitation process. Moreover, the salts-based precipitation technique was generally available for the precipitation of aqueous nanoparticles, no matter if there were semiconductor NCs or metal nanoparticles. Simultaneously, the cost of the current method is also much lower than that of the traditional nonsolvents-based precipitation technique, making it applicable for mass purification of aqueous NCs.
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Medication use and associated risk of falling in a geriatric outpatient population.
Freeland, Kathryn N; Thompson, Amy N; Zhao, Yumin; Leal, Julie E; Mauldin, Patrick D; Moran, William P
2012-09-01
Studies have shown that approximately one third of community-dwelling people aged 65 years and older will experience a fall each year. Many studies indicate that use of multiple medications may put patients at an increased risk of falling, but few studies have been conducted to correlate the number of medications with the risk of falls. To determine the medications most frequently used in patients aged 65 years or older who have experienced a fall within the past year, with particular attention to type or number of medications most commonly associated with multiple falls or a fall with injury. We conducted a chart review in an outpatient internal medicine clinic over a 13-month period. A total of 118 patients 65 years of age or older who were taking 4 or more medications and had experienced at least 1 fall in the previous 12 months were included. Data relating to sex, age, race, diagnoses, medications, and number and type of falls were obtained during the chart review. The primary end point of the study was number and type of medications most commonly used in patients experiencing a fall. A total of 116 patients were examined for trends in fall risk. A logistic regression model and receiver operating characteristic curve demonstrated significant fall risk with the addition of medications, with patients experiencing a 14% increase in fall risk with the addition of each medication beyond a 4-medication regimen (OR 1.14; 95% CI 1.02 to 1.27; p = 0.027). The addition of medications is associated with a significant increase in risk of falls in elderly patients, regardless of drug class. Further studies are needed to assess the possible increased risk of falls with increasing number of medications.
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The Global Precipitation Climatology Project (GPCP) Combined Precipitation Dataset
Huffman, George J.; Adler, Robert F.; Arkin, Philip; Chang, Alfred; Ferraro, Ralph; Gruber, Arnold; Janowiak, John; McNab, Alan; Rudolf, Bruno; Schneider, Udo
1997-01-01
The Global Precipitation Climatology Project (GPCP) has released the GPCP Version 1 Combined Precipitation Data Set, a global, monthly precipitation dataset covering the period July 1987 through December 1995. The primary product in the dataset is a merged analysis incorporating precipitation estimates from low-orbit-satellite microwave data, geosynchronous-orbit -satellite infrared data, and rain gauge observations. The dataset also contains the individual input fields, a combination of the microwave and infrared satellite estimates, and error estimates for each field. The data are provided on 2.5 deg x 2.5 deg latitude-longitude global grids. Preliminary analyses show general agreement with prior studies of global precipitation and extends prior studies of El Nino-Southern Oscillation precipitation patterns. At the regional scale there are systematic differences with standard climatologies.
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Predictive value of stabilometry and fear of falling on falls in postmenopausal women.
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.
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Association between falls in elderly women and chronic diseases and drug use: cross sectional study
Lawlor, Debbie A; Patel, Rita; Ebrahim, Shah
2003-01-01
OBJECTIVE: To assess the associations between having had a fall and chronic diseases and drug use in elderly women. DESIGN: Cross sectional survey, using data from the British women's heart and health study. SETTING: General practices in 23 towns in Great Britain. PARTICIPANTS: 4050 women aged 60-79 years. MAIN OUTCOME MEASURE: Whether women had had falls in the previous 12 months. RESULTS: The prevalence of falling increased with increasing numbers of simultaneously occurring chronic disease...
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2008-01-01
/fracture. A search was performed in OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), The Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published between January 2000 and September 2007. Furthermore, all studies included in a 2003 Cochrane review were considered for inclusion in this analysis. Abstracts were reviewed by a single author, and studies meeting the inclusion criteria outlined above were obtained. Studies were grouped based on intervention type, and data on population characteristics, fall outcomes, and study design were extracted. Reference lists were also checked for relevant studies. The quality of the evidence was assessed as high, moderate, low, or very low according to the GRADE methodology. The following 11 interventions were identified in the literature search: exercise programs, vision assessment and referral, cataract surgery, environmental modifications, vitamin D supplementation, vitamin D plus calcium supplementation, hormone replacement therapy (HRT), medication withdrawal, gait-stabilizing devices, hip protectors, and multifactorial interventions. Exercise programs were stratified into targeted programs where the exercise routine was tailored to the individuals' needs, and untargeted programs that were identical among subjects. Furthermore, analyses were stratified by exercise program duration (entry, while high-risk participants had had at least one fall in the previous year. A total of 17 studies investigating multifactorial interventions were identified in the literature search. Of these studies, 10 reported results for a high-risk population with previous falls, while 6 reported results for study participants representative of the general population. One study provided stratified results by fall risk, and therefore results from this study were included in each stratified analysis. Executive Summary
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Convolutional LSTM Network: A Machine Learning Approach for Precipitation Nowcasting
Shi, Xingjian; Chen, Zhourong; Wang, Hao; Yeung, Dit-Yan; Wong, Wai-kin; Woo, Wang-chun
2015-01-01
The goal of precipitation nowcasting is to predict the future rainfall intensity in a local region over a relatively short period of time. Very few previous studies have examined this crucial and challenging weather forecasting problem from the machine learning perspective. In this paper, we formulate precipitation nowcasting as a spatiotemporal sequence forecasting problem in which both the input and the prediction target are spatiotemporal sequences. By extending the fully connected LSTM (F...
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Winters-Stone, Kerri M; Moe, Esther; Graff, Julie N; Dieckmann, Nathan F; Stoyles, Sydnee; Borsch, Carolyn; Alumkal, Joshi J; Amling, Christopher L; Beer, Tomasz M
2017-07-01
To compare the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). Cross-sectional. Mail and electronic survey. PCSs (N = 280; mean age 72 ± 8). Cancer history, falls, and frailty status (robust, prefrail, frail) using traditionally defined and obese phenotypes. Current (37%) or past (34%) ADT users were more than twice as likely to have fallen in the previous year as never users (15%) (P = .002). ADT users had twice as many recurrent falls (P users were more likely to be classified as prefrail or frail than never users (15%) (P users than never users (25%) (P < .001). Traditional and obese frailty significantly increased the likelihood of reporting falls in the previous year (odds ratio (OR) = 2.15, 95% CI = 1.18-3.94 and OR = 2.97, 95% CI = 1.62-5.58, respectively) and was also associated with greater risk of recurrent falls (OR = 3.10, 95% CI = 1.48-6.5 and OR = 3.99, 95% CI = 1.79-8.89, respectively). Current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment. PCSs should be appropriately counseled on fall prevention strategies, and approaches to reduce frailty should be considered. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
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Modulation of Precipitation in the Olympic Mountains by Trapped Gravity Waves
Heymsfield, G. M.; Tian, L.; Grecu, M.; McLinden, M.; Li, L.
2017-12-01
Precipitation over the Olympic Mountains was studied intensely with multiple aircraft and ground-based measurements during the Olympic Mountains Experiment (OLYMPEX) during the fall-winter season 2015-2016 as part of validation for the Global Precipitation Mission (GPM) (Houze et al. 2017) and the Radar Definition Experiment (RADEX) supported by the Aerosol Chemistry, Ecosystem (ACE) NASA Decadal Mission. This presentation focuses on observations of a broad frontal cloud system with strong flow over the mountains on 5 December 2015. Unique observations of trapped waves were obtained with in the three Goddard Space Flight Center nadir-looking, X- through W-band, Doppler radars on the NASA high-altitude ER-2: the High-altitude Wind and Rain Airborne Profiler (HIWRAP) at Ku and Ka-band, the W-band Cloud Radar System (CRS), and the ER-2 X-band Radar (EXRAD). Analysis of the aircraft measurements showed the presence of deep, trapped gravity waves on a scale ranging from 10-25 km in the nadir-looking Doppler and reflectivity observations. These waves cause localized vertical up/down motions on the order of 1-2 ms-1 and they are superimposed on the widespread south-southwest flow over the Olympic Mountains. While much of this widespread flow over the mountains produces copious amounts of snowfall, the gravity waves play an important role in modulating this precipitation indirectly through microphysical processes in the ice region. We will describe analyses of the interactions between the air motions and precipitation structure for this case and other cases we observed similar waves. We will present preliminary results from precipitation retrievals based on optimal estimation (Grecu et al. 2011).
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iFall: an Android application for fall monitoring and response.
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.
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A break-even analysis of a community rehabilitation falls prevention service.
Comans, Tracy; Brauer, Sandy; Haines, Terry
2009-06-01
To identify and compare the minimum number of clients that a multidisciplinary falls prevention service delivered through domiciliary or centre-based care needs to treat to allow the service to reach a 'break-even' point. A break-even analysis was undertaken for each of two models of care for a multidisciplinary community rehabilitation falls prevention service. The two models comprised either a centre-based group exercise and education program or a similar program delivered individually in the client's home. The service consisted of a physiotherapist, occupational therapist and therapy assistant. The participants were adults aged over 65 years who had experienced previous falls. Costs were based on the actual cost of running a community rehabilitation team located in Brisbane. Benefits were obtained by estimating the savings gained to society from the number of falls prevented by the program on the basis of the falls reduction rates obtained in similar multidisciplinary programs. It is estimated that a multi-disciplinary community falls prevention team would need to see 57 clients per year to make the service break-even using a centre-based model of care and 78 clients for a domiciliary-based model. The service this study was based on has the capability to see around 300 clients per year in a centre-based service or 200-250 clients per year in a home-based service. Based on the best available estimates of costs of falls, multidisciplinary falls prevention teams in the community targeting people at high risk of falls are worthwhile funding from a societal viewpoint.
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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.
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The Neighborhood Environment: Perceived Fall Risk, Resources, and Strategies for Fall Prevention.
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.
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Motoric Cognitive Risk Syndrome and Falls Risk: A Multi-Center Study
Callisaya, Michele L.; Ayers, Emmeline; Barzilai, Nir; Ferrucci, Luigi; Guralnik, Jack M.; Lipton, Richard B.; Otahal, Petr; Srikanth, Velandai K.; Verghese, Joe
2016-01-01
Background The Motoric Cognitive Risk Syndrome (MCR) is characterized by slow gait speed and cognitive complaints. Objectives The objective of this study was to determine if the presence of MCR increases the risk of falls in older people. Methods Individual participant data (n = 6,204) from five longitudinal studies from three countries were used for this analysis. MCR diagnosis was defined as both the presence of objectively measured slow gait speed and subjective cognitive complaints in those without dementia or mobility disability. Falls were prospectively ascertained using phone calls or questionnaires. Log binomial regression was performed to determine if MCR increased the risk of falls separately in each cohort. Random effects meta-analysis was used to pool results from all cohorts. Results The mean age of participants was 74.9 (SD 6.8) years and 44% (n = 2728) were male. Overall 33.9% (n = 2104) reported a fall over follow-up. Pooled relative risk of MCR with any falls was RR 1.44 95% CI 1.16, 1.79. The components of MCR, slow gait (RR 1.30 95% CI 1.14, 1.47) and cognitive complaint (RR 1.25, 95% CI 1.07, 1.46) were also associated with an increased risk of any falls. In sub-analyses MCR was associated with any fall independent of previous falls (RR 1.29 95% CI 1.09, 1.53) and with multiple falls (RR 1.77, 95% CI 1.25, 2.51). Conclusion MCR is associated with an increased risk of falls. The increase in risk was higher than for its individual components. The simplicity of the MCR makes it an attractive falls risk screening tool for the clinic. PMID:27340851
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Generating spatial precipitation ensembles: impact of temporal correlation structure
Rakovec, O.; Hazenberg, P.; Torfs, P. J. J. F.; Weerts, A. H.; Uijlenhoet, R.
2012-09-01
Sound spatially distributed rainfall fields including a proper spatial and temporal error structure are of key interest for hydrologists to force hydrological models and to identify uncertainties in the simulated and forecasted catchment response. The current paper presents a temporally coherent error identification method based on time-dependent multivariate spatial conditional simulations, which are conditioned on preceding simulations. A sensitivity analysis and real-world experiment are carried out within the hilly region of the Belgian Ardennes. Precipitation fields are simulated for pixels of 10 km × 10 km resolution. Uncertainty analyses in the simulated fields focus on (1) the number of previous simulation hours on which the new simulation is conditioned, (2) the advection speed of the rainfall event, (3) the size of the catchment considered, and (4) the rain gauge density within the catchment. The results for a sensitivity analysis show for typical advection speeds >20 km h-1, no uncertainty is added in terms of across ensemble spread when conditioned on more than one or two previous hourly simulations. However, for the real-world experiment, additional uncertainty can still be added when conditioning on a larger number of previous simulations. This is because for actual precipitation fields, the dynamics exhibit a larger spatial and temporal variability. Moreover, by thinning the observation network with 50%, the added uncertainty increases only slightly and the cross-validation shows that the simulations at the unobserved locations are unbiased. Finally, the first-order autocorrelation coefficients show clear temporal coherence in the time series of the areal precipitation using the time-dependent multivariate conditional simulations, which was not the case using the time-independent univariate conditional simulations. The presented work can be easily implemented within a hydrological calibration and data assimilation framework and can be used as an
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Global Precipitation Responses to Land Hydrological Processes
Lo, M.; Famiglietti, J. S.
2012-12-01
Several studies have established that soil moisture increases after adding a groundwater component in land surface models due to the additional supply of subsurface water. However, impacts of groundwater on the spatial-temporal variability of precipitation have received little attention. Through the coupled groundwater-land-atmosphere model (NCAR Community Atmosphere Model + Community Land Model) simulations, this study explores how groundwater representation in the model alters the precipitation spatiotemporal distributions. Results indicate that the effect of groundwater on the amount of precipitation is not globally homogeneous. Lower tropospheric water vapor increases due to the presence of groundwater in the model. The increased water vapor destabilizes the atmosphere and enhances the vertical upward velocity and precipitation in tropical convective regions. Precipitation, therefore, is inhibited in the descending branch of convection. As a result, an asymmetric dipole is produced over tropical land regions along the equator during the summer. This is analogous to the "rich-get-richer" mechanism proposed by previous studies. Moreover, groundwater also increased short-term (seasonal) and long-term (interannual) memory of precipitation for some regions with suitable groundwater table depth and found to be a function of water table depth. Based on the spatial distributions of the one-month-lag autocorrelation coefficients as well as Hurst coefficients, air-land interaction can occur from short (several months) to long (several years) time scales. This study indicates the importance of land hydrological processes in the climate system and the necessity of including the subsurface processes in the global climate models.
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Characteristics and fall experiences of older adults with and without fear of falling outdoors.
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.
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Rainy Days in the New Arctic: A Comprehensive Look at Precipitation from 8 Reanalysis
Boisvert, L.; Webster, M.; Petty, A.; Markus, T.
2017-12-01
Precipitation in the Arctic plays an important role in the fresh water budget, and is the primary control of snow accumulation on sea ice. However, Arctic precipitation from reanalysis is highly uncertain due to differences in the atmospheric physics and use/approaches of data assimilation and sea ice concentrations across the different products. More specifically, yearly cumulative precipitation in some regions can vary by 100-150 mm across reanalyses. This creates problems for those modeling snow depth on sea ice, specifically for use in deriving sea ice thickness from satellite altimetry. In recent years, this new Arctic has become warmer and wetter, and evaporation from the ice-free ocean has been increasing, which leads to the question: is more precipitation falling and is more of this precipitation rain? This could pose a big problem for model and remote sensing applications and studies those modeling snow accumulation because rain events will can melt the existing snow pack, reduce surface albedo, and modify the ocean-to-atmosphere heat flux via snow densification. In this work we compare precipitation (both snow and rain) from 8 different reanalysis: MERRA, MERRA2, NCEP-R1, NCEP-R2, ERA-Interim, ERA-5, ASR and JRA-55. We examine the annual, seasonal, and regional differences and compare with buoy data to assess discrepancies between products during observed snowfall and rainfall events. Magnitudes and frequencies of these precipitation events are evaluated, as well as the "residual drizzle" between reanalyzes. Lastly, we will look at whether the frequency and magnitude of "rainy days" in the Arctic have been changing over recent decades.
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Baccaglini, Lorena
2016-01-01
Objectives Falls in the geriatric population are a major public health issue. With the anticipated aging of the population, falls are expected to increase nationally and globally. We estimated the prevalence and determinants of falls in adults aged ≥65 years and calculated the proportion of elderly who fell and made lifestyle changes as a result of professional recommendations. Methods We included adults aged ≥65 years from the 2011–2012 California Health Interview Survey (CHIS) and categorized them into two groups based on whether or not they had had at least two falls in the previous 12 months. We performed logistic regression analysis adjusted for the complex survey design to determine risk factors for falls and compare the odds of receiving professional recommendations among elderly with vs. without falls. Results Of an estimated 4.3 million eligible elderly participants in the CHIS (2011–2012), an estimated 527,340 (12.2%) fell multiple times in the previous 12 months. Of those, 204,890 (38.9%) were told how to avoid falls by a physician and 211,355 (40.1%) received medical treatment, although fewer than 41.0% had made related preventive changes to avoid future falls. Falls were associated with older age, less walking, and poorer physical or mental health. Non-Asians had higher odds of falling compared with Asians (adjusted odds ratio = 1.69, 95% confidence interval 1.16, 2.45). Most participants reported changing medications, home, or daily routines on their own initiative rather than after professional recommendations. Conclusion Patients with a history of falls did not consistently receive professional recommendations on fall prevention-related lifestyle or living condition changes. Given the high likelihood of a serious fall, future interventions should focus on involving primary care physicians in active preventive efforts before a fall occurs. PMID:26957668
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Drobinski, P.; Alonzo, B.; Bastin, S.; Silva, N. Da; Muller, C.
2016-04-01
Expected changes to future extreme precipitation remain a key uncertainty associated with anthropogenic climate change. Extreme precipitation has been proposed to scale with the precipitable water content in the atmosphere. Assuming constant relative humidity, this implies an increase of precipitation extremes at a rate of about 7% °C-1 globally as indicated by the Clausius-Clapeyron relationship. Increases faster and slower than Clausius-Clapeyron have also been reported. In this work, we examine the scaling between precipitation extremes and temperature in the present climate using simulations and measurements from surface weather stations collected in the frame of the HyMeX and MED-CORDEX programs in Southern France. Of particular interest are departures from the Clausius-Clapeyron thermodynamic expectation, their spatial and temporal distribution, and their origin. Looking at the scaling of precipitation extreme with temperature, two regimes emerge which form a hook shape: one at low temperatures (cooler than around 15°C) with rates of increase close to the Clausius-Clapeyron rate and one at high temperatures (warmer than about 15°C) with sub-Clausius-Clapeyron rates and most often negative rates. On average, the region of focus does not seem to exhibit super Clausius-Clapeyron behavior except at some stations, in contrast to earlier studies. Many factors can contribute to departure from Clausius-Clapeyron scaling: time and spatial averaging, choice of scaling temperature (surface versus condensation level), and precipitation efficiency and vertical velocity in updrafts that are not necessarily constant with temperature. But most importantly, the dynamical contribution of orography to precipitation in the fall over this area during the so-called "Cevenoles" events, explains the hook shape of the scaling of precipitation extremes.
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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.
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DEFF Research Database (Denmark)
Kendall, Julie C; Boyle, Eleanor; Hartvigsen, Jan
2016-01-01
(Short Physical Performance Battery), self-reported psychological concerns related to falling (Falls Efficacy Scale International), depression (Major Depression Inventory), cognitive function (Mini Mental State Examination), self-reported low-back pain and self-reported history of falls. Associations...... physical performance (unadjusted OR 2.26, 95% CI 1.09-4.69). However, these relationships became nonsignificant after adjusting for potential confounders. Bothersome neck pain and concerns of falling is attenuated by depression, and the relationship between bothersome neck pain and decreased physical...... performance is attenuated by concerns of falling, depression and previous history of falls. CONCLUSIONS: Bothersome neck pain in older people is associated with increased concerns of falling and decreased physical performance that are two known risk factors for falls in older people. However...
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Nassar, Nada; Helou, Nancy; Madi, Chantal
2014-06-01
To assess the predictive value of two instruments (the Morse Fall Scale (MFS) and the Heindrich II Fall Risk Model (HFRM)] in a Middle Eastern country (Lebanon) and to evaluate the factors that are related to falls. A prospective observational cross-sectional design was used. Falls and fall-related injuries in the acute care settings contribute a substantial health and economic burden on patients and organisations. Preventing falls is a priority for most healthcare organisations. While the risk of falling cannot be eliminated, it can be significantly reduced through accurate assessment of patients' risk of falling. Data from 1815 inpatients at the American University of Beirut Medical Center (AUBMC) in Lebanon were evaluated using two instruments to predict falls: the MFS and the HFRM. The incidence of falls was 2·7% in one year. The results indicate that while the instruments were significantly correlated, the HFRM was more sensitive in predicting falls than the MFS. The internal consistency of both scales was moderate, but inter-rater reliability was high. Patients using antiepileptic drugs and assistance devises had higher odds of falling. Although both instruments were easy to use in a Middle Eastern country, the HFRM rather than the MFS is recommended for inpatients in an acute care setting as it had higher sensitivity and specificity. It is recommended that while the HFRM had adequate sensitivity, it is not seamless, and as such, nurses should not rely entirely on it. Rather, nurses should use their expert clinical judgement, their ethical obligations and cultural considerations to implement a safer environment of care for the patient. © 2013 John Wiley & Sons Ltd.
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Risk Profiles for Falls among Older Adults: New Directions for Prevention
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William A. Satariano
2017-08-01
Full Text Available ObjectiveTo address whether neighborhood factors, together with older adults’ levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM analysis to conduct this descriptive analysis.MethodThis is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC. Interviews focused on neighborhood characteristics, physical and cognitive function, walking, and falls and injuries. Four risk profiles (higher order interactions of individual and neighborhood factors were derived from GoM analysis.ResultsProfiles 1 and 2 reflect previous results showing that frail older adults are likely to fall indoors (Profile 1; healthy older adults are likely to fall outdoors (Profile 2. Profile 3 identifies the falls risk for older with mild cognitive impairment living in moderately walkable neighborhoods. Profile 4 identifies the risk found for healthy older adults living in neighborhoods with low walkability.DiscussionNeighborhood walkability, in combination with levels of health and functioning, is associated with both indoor and outdoor falls. Descriptive results suggest possible research hypotheses and new directions for prevention, based on individual and neighborhood factors.
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Raindrop fall velocities from an optical array probe and 2-D video disdrometer
Bringi, Viswanathan; Thurai, Merhala; Baumgardner, Darrel
2018-03-01
We report on fall speed measurements of raindrops in light-to-heavy rain events from two climatically different regimes (Greeley, Colorado, and Huntsville, Alabama) using the high-resolution (50 µm) Meteorological Particle Spectrometer (MPS) and a third-generation (170 µm resolution) 2-D video disdrometer (2DVD). To mitigate wind effects, especially for the small drops, both instruments were installed within a 2/3-scale Double Fence Intercomparison Reference (DFIR) enclosure. Two cases involved light-to-moderate wind speeds/gusts while the third case was a tornadic supercell and several squall lines that passed over the site with high wind speeds/gusts. As a proxy for turbulent intensity, maximum wind speeds from 10 m height at the instrumented site recorded every 3 s were differenced with the 5 min average wind speeds and then squared. The fall speeds vs. size from 0.1 to 2 and > 0.7 mm were derived from the MPS and the 2DVD, respectively. Consistency of fall speeds from the two instruments in the overlap region (0.7-2 mm) gave confidence in the data quality and processing methodologies. Our results indicate that under low turbulence, the mean fall speeds agree well with fits to the terminal velocity measured in the laboratory by Gunn and Kinzer from 100 µm up to precipitation sizes. The histograms of fall speeds for 0.5, 0.7, 1 and 1.5 mm sizes were examined in detail under the same conditions. The histogram shapes for the 1 and 1.5 mm sizes were symmetric and in good agreement between the two instruments with no evidence of skewness or of sub- or super-terminal fall speeds. The histograms of the smaller 0.5 and 0.7 mm drops from MPS, while generally symmetric, showed that occasional occurrences of sub- and super-terminal fall speeds could not be ruled out. In the supercell case, the very strong gusts and inferred high turbulence intensity caused a significant broadening of the fall speed distributions with negative skewness (for drops of 1.3, 2 and 3 mm). The
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Walking Distance as a Predictor of Falls in People With Multiple Sclerosis.
Nilsagård, Ylva; Westerdahl, Elisabeth; Wittrin, Anna; Gunnarsson, Martin
2016-06-01
People with multiple sclerosis (PwMS) experience falls, usually when walking and transferring. The aim was to investigate if walking distance and patient overestimate of walking distance are predictors of falls in PwMS. A prospective study was conducted, with a single test occasion followed by prospective registration of falls for 3 months. All PwMS in Region Örebro County with a previously registered Expanded Disability Status Scale score between 3.0 and 7.0 in the Swedish MS Registry were invited to participate (n = 149). Altogether, data from 49 PwMS being relapse free for at least 3 months and with a confirmed Expanded Disability Status Scale between 1.5 and 7.0 upon study entry were analysed. Twenty-two PwMS (45%) fell during the study period, providing information of 66 falls. Walking distance or overestimate of one's walking distance, as compared with test results, did not predict falls in this MS sample. Walking and standing activities are associated with numerous falls in PwMS. Our data do not clearly support routine measurements of walking distance in assessing individual fall risk. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd.
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Iowa Department of Education, 2014
2014-01-01
This report summarizes and analyzes fall enrollment in Iowa's community colleges. Each year, Iowa's 15 community colleges submit data on enrollment on the 10th business day of the fall semester. Some highlights from this report include: (1) Fall 2014 enrollment was 93,772 students--a decline of 0.49 percent from last fall; (2) Enrollment continues…
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Tomita, Yoshihito; Arima, Kazuhiko; Kanagae, Mitsuo; Okabe, Takuhiro; Mizukami, Satoshi; Nishimura, Takayuki; Abe, Yasuyo; Goto, Hisashi; Horiguchi, Itsuko; Aoyagi, Kiyoshi
2015-01-01
Abstract Our aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women. The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured. The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts. Maintaining physical functioning and managing pain may be important for elderly women with fear of falling. PMID:26334906
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Precipitation, landsliding, and erosion across the Olympic Mountains, Washington State, USA
Smith, Stephen G.; Wegmann, Karl W.
2018-01-01
In the Olympic Mountains of Washington State, landsliding is the primary surface process by which bedrock and hillslope regolith are delivered to river networks. However, the relative importance of large earthquakes versus high magnitude precipitation events to the total volume of landslide material transported to valley bottoms remains unknown in part due to the absence of large historical earthquakes. To test the hypothesis that erosion is linked to precipitation, approximately 1000 landslides were mapped from Google Earth imagery between 1990 and 2015 along a 15 km-wide × 85 km-long (1250 km2) swath across the range. The volume of hillslope material moved by each slide was calculated using previously published area-volume scaling relationships, and the spatial distribution of landslide volume was compared to mean annual precipitation data acquired from the PRISM climate group for the period 1981-2010. Statistical analysis reveals a significant correlation (r = 0.55; p landslide volume and mean annual precipitation, with 98% of landslide volume occurring along the windward, high-precipitation side of the range during the 25-year interval. Normalized to area, this volume yields a basin-wide erosion rate of 0.28 ± 0.11 mm yr- 1, which is similar to previous time-variable estimates of erosion throughout the Olympic Mountains, including those from river sediment yield, cosmogenic 10Be, fluvial terrace incision, and thermochronometry. The lack of large historic earthquakes makes it difficult to assess the relative contributions of precipitation and seismic shaking to total erosion, but our results suggest that climate, and more specifically a sharp precipitation gradient, plays an important role in controlling erosion and landscape evolution over both short and long timescales across the Olympic Mountains.
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On the Precipitation and Precipitation Change in Alaska
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Gerd Wendler
2017-12-01
Full Text Available Alaska observes very large differences in precipitation throughout the state; southeast Alaska experiences consistently wet conditions, while northern Arctic Alaska observes very dry conditions. The maximum mean annual precipitation of 5727 mm is observed in the southeastern panhandle at Little Port Arthur, while the minimum of 92 mm occurs on the North Slope at Kuparuk. Besides explaining these large differences due to geographic and orographic location, we discuss the changes in precipitation with time. Analyzing the 18 first-order National Weather Service stations, we found that the total average precipitation in the state increased by 17% over the last 67 years. The observed changes in precipitation are furthermore discussed as a function of the observed temperature increase of 2.1 °C, the mean temperature change of the 18 stations over the same period. This observed warming of Alaska is about three times the magnitude of the mean global warming and allows the air to hold more water vapor. Furthermore, we discuss the effect of the Pacific Decadal Oscillation (PDO, which has a strong influence on both the temperature and precipitation in Alaska.
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Students fall for Fall Meeting
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.
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Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review.
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.
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Optimization of precipitation conditions of thorium oxalate precipitate
International Nuclear Information System (INIS)
Pazukhin, Eh.M.; Smirnova, E.A.; Krivokhatskij, A.S.; Pazukhina, Yu.L.; Kiselev, P.P.
1986-01-01
Thorium precipitation in the form of difficultly soluble oxalate has been investigated. The equation binding the concentration of metal with the nitric acid in the initial solution and quantity of a precipitator necessary for minimization of desired product losses is derived. The graphical solution of this equation for a case, when the oxalic acid with 0.78 mol/l concentration is the precipitator, is presented
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Balance confidence and falls in nondemented essential tremor patients: the role of cognition.
Rao, Ashwini K; Gilman, Arthur; Louis, Elan D
2014-10-01
To examine (1) the effect of cognitive ability on balance confidence and falls, (2) the relationship of balance confidence and falls with quantitative measures of gait, and (3) measures that predict falls, in people with essential tremor (ET). Cross-sectional study. General community. People with ET (n=132) and control subjects (n=48). People with ET were divided into 2 groups based on the median score on the Modified Mini-Mental State Examination: those with lower cognitive test scores (ET-LCS) and those with higher cognitive test scores (ET-HCS). Not applicable. Six-item Activities of Balance Confidence (ABC-6) Scale and falls in the previous year. Participants with ET-LCS had lower ABC-6 scores and a greater number of falls than those with ET-HCS (Pcontrol subjects (Pfalls. Gait speed (Pfalls. Receiver operating characteristic curve analysis revealed that gait speed balance confidence and a higher number of falls than their counterparts (ET-HCS) and than control subjects. We have identified assessments that are easily administered (gait speed, ABC-6 Scale) and are associated with falls in ET. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Hill KD
2014-11-01
Full Text Available Keith D Hill,1,2 Lesley Day,3 Terry P Haines4,5 1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2National Ageing Research Institute, Royal Melbourne Hospital, Parkville, VIC, Australia; 3Falls Prevention Research Unit, Monash Injury Research Institute, Monash University, VIC, Australia; 4Allied Health Research Unit, Southern Health, Cheltenham, VIC, Australia; 5Physiotherapy Department, Faculty of Medicine, Nursing, and Health Sciences, Monash University, VIC, Australia Purpose: To investigate previous, current, or planned participation in, and perceptions toward, multifactorial fall prevention programs such as those delivered through a falls clinic in the community setting, and to identify factors influencing older people’s intent to undertake these interventions.Design and methods: Community-dwelling people aged >70 years completed a telephone survey. Participants were randomly selected from an electronic residential telephone listing, but purposeful sampling was used to include equal numbers with and without common chronic health conditions associated with fall-related hospitalization. The survey included scenarios for fall prevention interventions, including assessment/multifactorial interventions, such as those delivered through a falls clinic. Participants were asked about previous exposure to, or intent to participate in, the interventions. A path model analysis was used to identify factors associated with intent to participate in assessment/multifactorial interventions.Results: Thirty of 376 participants (8.0% reported exposure to a multifactorial falls clinic-type intervention in the past 5 years, and 16.0% expressed intention to undertake this intervention. Of the 132 participants who reported one or more falls in the past 12 months, over one-third were undecided or disagreed that a falls clinic type of intervention would be of benefit to them. Four elements
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Safety and feasibility of modified chair-yoga on functional outcome among elderly at risk for falls
Directory of Open Access Journals (Sweden)
Mary Lou Galantino
2012-01-01
Full Text Available Falls are among the most common problems affecting older adults. At least 50% of those over the age of 80 fall annually. The goal of this pilot study was to assess the safety and feasibility of structured yoga in an elderly population with fall risk. Seniors at risk for falls were identified and enrolled in a single arm pilot trial. A chair based yoga program was provided twice a week for 8 weeks. The program was designed from previously published pilot data. A battery of validated instruments was administered at baseline and week eight and was used to identify which instruments may be sensitive to change as a result of a yoga program. Among sixteen seniors (median age of 88 with a previous history of falls, 87% provided data for assessment at the end of the intervention. Two patients withdrew, one due to a fall outside the institution and the other due to lack of time and interest. There were no adverse events during the yoga sessions. Paired-t tests compared pre-post changes and gains were noted in Fear of Falling (5.27 to 2.60; P = 0.029 and SPPB sit to stand subscale (0.31 to 1.00; P =.022. Improved trends were noted in anxiety and the timed up and go assessments. We found the modified chair-yoga program is safe and recruitment is feasible. Our data suggests that yoga may be beneficial in improving mobility and reducing fear of falling which warrants additional research via randomized controlled trial.
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Exploring the relationship between fall risk-increasing drugs and fall-related fractures.
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
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Modeling Parkinson's disease falls associated with brainstem cholinergic systems decline.
Kucinski, Aaron; Sarter, Martin
2015-04-01
In addition to the primary disease-defining symptoms, approximately half of patients with Parkinson's disease (PD) suffer from postural instability, impairments in gait control and a propensity for falls. Consistent with evidence from patients, we previously demonstrated that combined striatal dopamine (DA) and basal forebrain (BF) cholinergic cell loss causes falls in rats traversing dynamic surfaces. Because evidence suggests that degeneration of brainstem cholinergic neurons arising from the pedunculopontine nucleus (PPN) also contributes to impaired gait and falls, here we assessed the effects of selective cholinergic PPN lesions in combination with striatal DA loss or BF cholinergic cells loss as well as losses in all 3 regions. Results indicate that all combination losses that included the BF cholinergic system slowed traversal and increased slips and falls. However, the performance of rats with losses in all 3 regions (PPN, BF, and DA) was not more severely impaired than following combined BF cholinergic and striatal DA lesions. These results confirm the hypothesis that BF cholinergic-striatal disruption of attentional-motor interactions is a primary source of falls. Additional losses of PPN cholinergic neurons may worsen posture and gait control in situations not captured by the current testing conditions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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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
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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
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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
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Falls, a fear of falling and related factors in older adults with complex chronic disease.
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.
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[Characteristics of precipitation pH and conductivity at Mt. Huang].
Shi, Chun-e; Deng, Xue-liang; Wu, Bi-wen; Hong, Jie; Zhang, Su; Yang, Yuan-jian
2013-05-01
To understand the general characteristics of pH distribution and pollution in precipitation at Mt. Huang, statistical analyses were conducted for the routine measurements of pH and conductivity (K) at Mt. Huang during 2006-2011. The results showed that: (1) Over the period of study, the annual volume weighted mean (VWM) precipitation pH varied from 4.81 to 5.57, with precipitation acidity strengthening before 2009 and weakening thereafter. The precipitation acidity showed evident seasonal variations, with the VWM pH lowest in winter (4.78), and highest in summer (5.33). The occurrence frequency of acid rain was 46% , accounting for 45% of total rainfalls and with the most frequent pH falling into weak acid to neutral rain. (2) The annual VWM K varied from 16.91 to 27.84 microS x cm(-1), with no evident trend. As for ions pollution, the precipitation was relatively clean at Mt. Huang, with the most frequent K range being below 15 microS x cm(-1), followed by 15-25 microS x cm(-1). From February 2010 to December 2011, precipitation samples were collected on daily basis for ions analysis, as well as pH and K measurement in lab. Detailed comparisons were conducted between the two sets of pH and K, one set from field measurement and the other from lab measurement. The results indicated: (1) The lab measured pH (K) was highly correlated with the field pH (K); however, the lab pH tended to move towards neutral comparing with the corresponding field pH, and the shift range was closely correlated with the field pH and rainfall. The shift range of K from field to lab was highly correlated with the total ion concentration of precipitation. The field K showed evident negative correlation with the field pH with a correlation coefficient of -0.51. (2) When sampling with nylon-polyethylene bags, the statistics showed smaller bias between two sets of pH, with higher correlation coefficient between two sets of K. Furthermore, the lab K also showed evident negative correlation with
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Directory of Open Access Journals (Sweden)
Charlton RWilliam
2011-03-01
Full Text Available Graves' disease is less common in prepubertal than pubertal children, and initial presentation with thyroid storm is rare. We report an 11-year-old prepubertal Hispanic girl who presented with a one-day history of respiratory distress, fever, and dysphagia. She had exophthalmos, a diffuse bilateral goiter and was agitated, tachycardic, and hypertensive. Nasal swab was positive for respiratory syncytial virus (RSV. She was diagnosed with thyroid storm and admitted to the pediatric intensive care unit. While infection is a known precipitant of thyroid storm and RSV is a common pediatric infection, to the best of our knowledge, this is the first reported case of RSV infection apparently precipitating thyroid storm in a prepubertal child.
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Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.
Honaker, Julie A; Shepard, Neil T
2011-01-01
Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.
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New horizons in fall prevention.
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.
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Masculinity and preventing falls: insights from the fall experiences of men aged 70 years and over.
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.
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Factors related to falls among community dwelling elderly.
Kuhirunyaratn, Piyathida; Prasomrak, Prasert; Jindawong, Bangonsri
2013-09-01
Falls among the elderly can lead to disability, hospitalization and premature death. This study aimed to determine the factors related to falls among community dwelling elderly. This case-control study was conducted at the Samlium Primary Care Unit (SPCU), Khon Kaen, Thailand. Cases were elderly individuals who had fallen within the previous six months and controls were elderly who had not fallen during that same time period. Subjects were taken from elderly persons registered at the SPCU. The sample size was calculated to be 111 cases and 222 controls. Face to face interviews were conducted with subjects between May and June, 2011. The response rate was 100%. On bivariate analysis, the statistically significant factors related to falls were: regular medication use, co-morbidities, mobility, depression, cluttered rooms, slippery floors, unsupported toilets (without a hand rail), sufficient exercise, rapid posture change and wearing slippers. When controlling for others significant factors, multiple logistic regression revealed significant factors were: regular medication use (AOR: 2.22; 95%CI: 1.19 - 4.12), depression (AOR: 1.76, 95% CI: 1.03 - 2.99), sufficient exercise (AOR: 0.34; 95% CI: 0.19 - 0.58) and wearing slippery shoes (AOR: 2.31; 95% CI: 1.24 - 4.29). Interventions need to be considered to modify these significant factors associated with falls and education should be provided to these at risk.
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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.
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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.
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Diagnosis and Tests: Evaluating a Fall or Risk of Falling
... 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 ...
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Influence of fall related factors and bone strength on fracture risk in the frail elderly.
Sambrook, P N; Cameron, I D; Chen, J S; Cumming, R G; Lord, S R; March, L M; Schwarz, J; Seibel, M J; Simpson, J M
2007-05-01
When subjects are selected on the basis of fall risk alone, therapies for osteoporosis have not been effective. In a prospective study of elderly subjects at high risk of falls, we investigated the influence of bone strength and fall risk on fracture. At baseline we assessed calcaneal bone ultrasound attenuation (BUA) as well as quantitative measures of fall risk in 2005 subjects in residential care. Incident falls and fractures were recorded (median follow-up 705 days). A total of 6646 fall events and 375 low trauma fracture events occurred. The fall rate was 214 per 100 person years and the fracture rate 12.1 per 100 person years. 82% of the fractures could be attributed to falls. Although fracture rates increased with decreasing BUA (incidence rate ratio 1.94 for lowest vs. highest BUA tertile, pfalls also affected fracture incidence. Subjects who fell frequently (>3.15 falls/per person year) were 3.35 times more likely to suffer a fracture than those who did not fall. Some fall risk factors such as balance were associated with the lowest fracture risk lowest in the worst performing group. Multivariate analysis revealed higher fall rate, history of previous fracture, lower BUA, lower body weight, cognitive impairment and better balance as significant independent risk factors for fracture. In the frail elderly, both skeletal fragility and fall risk including the frequency of exposure to falls are important determinants of fracture risk.
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Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study
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
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The evening diffuse radio aurora, field-aligned currents and particle precipitation
International Nuclear Information System (INIS)
Unwin, R.S.
1980-01-01
The relationship of the afternoon/evening diffuse radio aurora, proton and electron precipitation and field-aligned currents is studied with data from the auroral radar at Slope Point, New Zealand, and the ISIS 2 satellite. It is shown that there is a very close association between the radio aurora and (primarily downward) field-aligned currents, which confirms and extends previous work, but that there is no clear relation with either proton or electron precipitation. (author)
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Recent and future extreme precipitation over Ukraine
Vyshkvarkova, Olena; Voskresenskaya, Elena
2014-05-01
of Atlantic multidecadal oscillation. Typical space distribution of extreme precipitation (R95p) for seasons and for year is characterized by their southward intensity increasing from North-East and North-West. Summer precipitation extremes are characterized by quite homogeneous distribution. Linear trends of indices of precipitation extremes (R95p, R20mm and R30mm) for period 1951 - 2005 are mainly negative in winter season and positive in summer. To analyze the possible changes of extreme precipitation it was calculated the R95p index for recent climate period (1986 - 2005) and for periods 2046 - 2065 and 2081 - 2100 (as it was recommended by IPCC). Its difference between 1986 - 2005 and 2046 - 2065 shows that intensity of extreme precipitation will decrease in the north-east and increase in the south-west regions, especially in summer season. Magnitude of intensity changes of extreme precipitation will be ± 4 - 5 mm/day. The intensity changes of extreme precipitation since the recent climate period till the end of the century will be some less (2 - 3 mm/day) than in previous period, except summer months. Number of cases with precipitation extremes will be increase in southern regions of Ukraine in summer seasons. In other seasons it will be at the recent climate level.
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de Boer, Michiel R; Pluijm, Saskia M F; Lips, Paul; Moll, Annette C; Völker-Dieben, Hennie J; Deeg, Dorly J H; van Rens, Ger H M B
UNLABELLED: Visual impairment has been implicated as a risk factor for falling and fractures, but results of previous studies have been inconsistent. The relationship between several aspects of vision and falling/fractures were examined in a prospective cohort study in 1,509 older men and women. The
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Influence of cognitive impairment on fall risk among elderly nursing home residents.
Seijo-Martinez, M; Cancela, J M; Ayán, C; Varela, S; Vila, H
2016-12-01
Information relating the severity of cognitive decline to the fall risk in institutionalized older adults is still scarce. This study aims to identify potential fall risk factors (medications, behavior, motor function, and neuropsychological disturbances) depending on the severity of cognitive impairment in nursing home residents. A total of 1,167 nursing home residents (mean age 81.44 ± 8.26 years; 66.4% women) participated in the study. According to the MEC, (the Spanish version of the Mini-Mental State Examination) three levels of cognitive impairment were established: mild (20-24) "MCI", moderate (14-19) "MOCI", and severe (≤14) "SCI". Scores above 24 points indicated the absence cognitive impairment (NCI). Information regarding fall history and fall risk during the previous year was collected using standardized questionnaires and tests. Sixty falls (34%) were registered among NCI participants and 417 (43%) among people with cognitive impairment (MCI: 35%; MOCI: 40%; SCI: 50%). A different fall risk model was observed for MCI, MOCI, SCI, and NCI patients. The results imply that the higher the level of cognitive impairment, the greater the number of falls (F1,481 = 113.852; Sig = 0.015), although the level of significance was not maintained when MOCI and SCI participants were compared. Depression, neuropsychiatric disturbances, autonomy constraints in daily life activity performance, and low functional mobility were factors closely associated with fall risk. This study provides evidence indicating that fall risk factors do not hold a direct correlation with the level of cognitive impairment among elderly nursing home care residents.
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Fall risk profile and quality-of-life status of older chiropractic patients.
Holt, Kelly R; Noone, Paul L; Short, Krystal; Elley, C Raina; Haavik, Heidi
2011-02-01
The primary aim of this study was to estimate the prevalence of fall risk factors in older chiropractic patients. The secondary aim was to investigate the quality-of-life status of older chiropractic patients and to see whether a history of falling was related to quality-of-life status. A cross-sectional study was conducted at 12 chiropractic practices throughout Auckland, New Zealand, and Melbourne, Australia. The study involved gaining a profile of health status, fall history, and fall risk from active chiropractic patients who were 65 years or older. One hundred ten older chiropractic patients were approached, and 101 agreed to participate in this study (response rate, 91.8%). Thirty-five percent of participants had experienced at least 1 fall in the previous 12 months. Of those that had fallen, 80% had at least a minor injury, with 37% of fallers requiring medical attention and 6% suffering a serious injury. The prevalence of most fall risk factors was consistent with published data for community-dwelling older adults. Quality of life of older chiropractic patients appeared to be good, but fallers reported a lower physical component summary score compared with nonfallers (P = .04). A portion of the older chiropractic patients sampled in this study had a substantial risk of falling. This risk could be assessed on a regular basis for the presence of modifiable fall risk factors, and appropriate advice, given when fall risks are identified. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.
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An underestimated role of precipitation frequency in regulating summer soil moisture
International Nuclear Information System (INIS)
Wu Chaoyang; Chen, Jing M; Pumpanen, Jukka; Cescatti, Alessandro; Marcolla, Barbara; Blanken, Peter D; Ardö, Jonas; Tang, Yanhong; Magliulo, Vincenzo; Georgiadis, Teodoro; Soegaard, Henrik; Cook, David R; Harding, Richard J
2012-01-01
Soil moisture induced droughts are expected to become more frequent under future global climate change. Precipitation has been previously assumed to be mainly responsible for variability in summer soil moisture. However, little is known about the impacts of precipitation frequency on summer soil moisture, either interannually or spatially. To better understand the temporal and spatial drivers of summer drought, 415 site yr measurements observed at 75 flux sites world wide were used to analyze the temporal and spatial relationships between summer soil water content (SWC) and the precipitation frequencies at various temporal scales, i.e., from half-hourly, 3, 6, 12 and 24 h measurements. Summer precipitation was found to be an indicator of interannual SWC variability with r of 0.49 (p < 0.001) for the overall dataset. However, interannual variability in summer SWC was also significantly correlated with the five precipitation frequencies and the sub-daily precipitation frequencies seemed to explain the interannual SWC variability better than the total of precipitation. Spatially, all these precipitation frequencies were better indicators of summer SWC than precipitation totals, but these better performances were only observed in non-forest ecosystems. Our results demonstrate that precipitation frequency may play an important role in regulating both interannual and spatial variations of summer SWC, which has probably been overlooked or underestimated. However, the spatial interpretation should carefully consider other factors, such as the plant functional types and soil characteristics of diverse ecoregions. (letter)
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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
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Prevalence and Determinants of Fall-Related Injuries among Older Adults in Ecuador
Directory of Open Access Journals (Sweden)
Carlos H. Orces
2014-01-01
Full Text Available Objectives. To estimate the prevalence and determinants of fall-related injuries in the previous year among adults aged 60 years or older in Ecuador. Methods. The prevalence of fall-related injuries was estimated using cross-sectional data from the first national survey of Health, Wellbeing, and Aging study. Logistic regression models were used to examine the associations between participants’ demographic characteristics and fall-related injuries. Results. Of 5,227 participants with a mean age of 72.6 years, 11.4% (95% CI, 10.3%–12.7% reported a fall-related injury in Ecuador, representing an estimated 136,000 adults aged 60 years or older. Fall-related injuries were more frequently reported among older adults residing in the most urbanized and populated provinces of the country. After controlling for potential confounders, self-reported race as Indigenous (OR 2.2; 95% CI, 2.11–2.31, drinking alcohol regularly (OR 2.54; 95% CI, 2.46–2.63, subjects with greater number of comorbid conditions (OR 2.03; 95% CI, 1.97–2.08, and urinary incontinence (OR 1.83; 95% CI, 1.79–1.87 were factors independently associated with increased odds of sustaining fall-related injuries. Conclusions. Fall-related injuries represent a considerable burden for older adults in Ecuador. The present findings may assist public health authorities to implement fall prevention programs among subjects at higher risk for this type of injury.
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Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.
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.
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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
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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.
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Weather warnings predict fall-related injuries among older adults.
Mondor, Luke; Charland, Katia; Verma, Aman; Buckeridge, David L
2015-05-01
weather predictions are a useful tool for informing public health planning and prevention strategies for non-injury health outcomes, but the association between winter weather warnings and fall-related injuries has not been assessed previously. to examine the association between fall-related injuries among older adults and government-issued winter weather warnings. using a dynamic cohort of individuals ≥65 years of age who lived in Montreal between 1998 and 2006, we identified all fall-related injuries from administrative data using a validated set of diagnostic and procedure codes. We compared rates of injuries on days with freezing rain or snowstorm warnings to rates observed on days without warnings. We also compared the incidence of injuries on winter days to non-winter days. All analyses were performed overall and stratified by age and sex. freezing rain alerts were associated with an increase in fall-related injuries (incidence rate ratio [IRR] = 1.20, 95% confidence interval [CI]: 1.08-1.32), particularly among males (IRR = 1.31, 95% CI: 1.10-1.56), and lower rates of injuries were associated with snowstorm alerts (IRR = 0.89, 95% CI: 0.80-0.99). The rate of fall-related injuries did not differ seasonally (IRR = 1.00, 95% CI: 0.97-1.03). official weather warnings are predictive of increases in fall-related injuries among older adults. Public health agencies should consider using these warnings to trigger initiation of injury prevention strategies in advance of inclement weather. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk?
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
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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.
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Annual Precipitation Fluctuation and Spatial Differentiation Characteristics of the Horqin Region
Directory of Open Access Journals (Sweden)
Liangxu Liu
2017-01-01
Full Text Available Precipitation is the main water source for vegetation survival in arid and semi-arid areas. However, previous studies always focus on the effects of precipitation in different time scales, but ignore the effects of precipitation in different spatial scales. To further study the effects of precipitation fluctuation in different spatial scales, we used the wavelet analysis method to analyze its temporal and spatial change based on data from eighteen meteorological stations during 1961–2015 in Horqin region. Results showed that: (1 from the overall tendency of precipitation changes, the precipitation inter-annual variations in Horqin region had the tendency of gradually decreasing from the southeast (District IV to the northwest; (2 the precipitation anomalies of District I–IV between 1960 and 1980 were small and approximate to the normal value; (3 in the time scale of 23–32 years, the cyclical fluctuations were very significant and the annual precipitation underwent two cyclical fluctuations from a period of low precipitation to a period of high precipitation; and (4 as results of analyzing the spatial wavelet variance of sub-region, the main cycle of precipitation in District I, District II and District III was between 10 and 11 years, while the main cycle of precipitation in District IV was 25 years. The main conclusions include the following. (1 This region tended to be arid, and the precipitation gradually decreased from the southeast (District IV to northwest (District I. (2 The influence of spatial differentiation characteristics on precipitation fluctuation in this region was cyclical fluctuation, which gradually decreased from the southeast to the northwest. The length of the cyclical change period gradually shortened. In the first main cycle, whose annual precipitation changes were most significant, the changing characteristic was District IV and District I decreased from 25 years to 10 years. (3 Predicated from the cyclical
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Objective assessment of fall risk in Parkinson's disease using a body-fixed sensor worn for 3 days.
Weiss, Aner; Herman, Talia; Giladi, Nir; Hausdorff, Jeffrey M
2014-01-01
Patients with Parkinson's disease (PD) suffer from a high fall risk. Previous approaches for evaluating fall risk are based on self-report or testing at a given time point and may, therefore, be insufficient to optimally capture fall risk. We tested, for the first time, whether metrics derived from 3 day continuous recordings are associated with fall risk in PD. 107 patients (Hoehn & Yahr Stage: 2.6±0.7) wore a small, body-fixed sensor (3D accelerometer) on lower back for 3 days. Walking quantity (e.g., steps per 3-days) and quality (e.g., frequency-derived measures of gait variability) were determined. Subjects were classified as fallers or non-fallers based on fall history. Subjects were also followed for one year to evaluate predictors of the transition from non-faller to faller. The 3 day acceleration derived measures were significantly different in fallers and non-fallers and were significantly correlated with previously validated measures of fall risk. Walking quantity was similar in the two groups. In contrast, the fallers walked with higher step-to-step variability, e.g., anterior-posterior width of the dominant frequency was larger (p = 0.012) in the fallers (0.78 ± 0.17 Hz) compared to the non-fallers (0.71 ± 0.07 Hz). Among subjects who reported no falls in the year prior to testing, sensor-derived measures predicted the time to first fall (p = 0.0034), whereas many traditional measures did not. Cox regression analysis showed that anterior-posterior width was significantly (p = 0.0039) associated with time to fall during the follow-up period, even after adjusting for traditional measures. These findings indicate that a body-fixed sensor worn continuously can evaluate fall risk in PD. This sensor-based approach was able to identify transition from non-faller to faller, whereas many traditional metrics were not successful. This approach may facilitate earlier detection of fall risk and may in the future, help reduce high costs associated with falls.
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Objective Assessment of Fall Risk in Parkinson's Disease Using a Body-Fixed Sensor Worn for 3 Days
Weiss, Aner; Herman, Talia; Giladi, Nir; Hausdorff, Jeffrey M.
2014-01-01
Background Patients with Parkinson's disease (PD) suffer from a high fall risk. Previous approaches for evaluating fall risk are based on self-report or testing at a given time point and may, therefore, be insufficient to optimally capture fall risk. We tested, for the first time, whether metrics derived from 3 day continuous recordings are associated with fall risk in PD. Methods and Materials 107 patients (Hoehn & Yahr Stage: 2.6±0.7) wore a small, body-fixed sensor (3D accelerometer) on lower back for 3 days. Walking quantity (e.g., steps per 3-days) and quality (e.g., frequency-derived measures of gait variability) were determined. Subjects were classified as fallers or non-fallers based on fall history. Subjects were also followed for one year to evaluate predictors of the transition from non-faller to faller. Results The 3 day acceleration derived measures were significantly different in fallers and non-fallers and were significantly correlated with previously validated measures of fall risk. Walking quantity was similar in the two groups. In contrast, the fallers walked with higher step-to-step variability, e.g., anterior-posterior width of the dominant frequency was larger (p = 0.012) in the fallers (0.78±0.17 Hz) compared to the non-fallers (0.71±0.07 Hz). Among subjects who reported no falls in the year prior to testing, sensor-derived measures predicted the time to first fall (p = 0.0034), whereas many traditional measures did not. Cox regression analysis showed that anterior-posterior width was significantly (p = 0.0039) associated with time to fall during the follow-up period, even after adjusting for traditional measures. Conclusions/Significance These findings indicate that a body-fixed sensor worn continuously can evaluate fall risk in PD. This sensor-based approach was able to identify transition from non-faller to faller, whereas many traditional metrics were not successful. This approach may facilitate earlier detection of fall
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[Risk factors for falls and survival after falling in elderly people in a community].
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.
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Geriatric fall-related injuries.
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.
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Thermoelectrical power analysis of precipitation in 6013 aluminum alloy
International Nuclear Information System (INIS)
Abdala, M.R.W.S.; Garcia de Blas, J.C.; Barbosa, C.; Acselrad, O.
2008-01-01
The 6013 aluminum alloy was first developed for application in the aircraft industry and, more recently, as a replacement option for the use of the 6061 alloy in the automotive industry. The present work describes the evolution of the process of formation and dissolution of different kinds of precipitates in 6013 aluminum alloy, subjected to different conditions of heat treatment, using for this purpose measurements of thermoelectrical power, Vickers microhardness and differential scanning calorimeter (DSC). Although in the last years many works have been published on the use of thermoelectrical power (TEP) measurements for the analysis of precipitation process in traditional alloys such as 6061, there is still little information related to 6013 alloy. The results obtained are compared with a previous characterization work on the same alloy using transmission electron microscopy. It was observed that TEP measurements are very sensitive to precipitation phenomena in this alloy, and it has been found that there is an inverse relation between TEP and Vickers microhardness values, which allowed proposing a precipitation sequence for 6013 aluminum alloy
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Fall prevention walker during rehabilitation
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.
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Tundra water budget and implications of precipitation underestimation.
Liljedahl, Anna K; Hinzman, Larry D; Kane, Douglas L; Oechel, Walter C; Tweedie, Craig E; Zona, Donatella
2017-08-01
Difficulties in obtaining accurate precipitation measurements have limited meaningful hydrologic assessment for over a century due to performance challenges of conventional snowfall and rainfall gauges in windy environments. Here, we compare snowfall observations and bias adjusted snowfall to end-of-winter snow accumulation measurements on the ground for 16 years (1999-2014) and assess the implication of precipitation underestimation on the water balance for a low-gradient tundra wetland near Utqiagvik (formerly Barrow), Alaska (2007-2009). In agreement with other studies, and not accounting for sublimation, conventional snowfall gauges captured 23-56% of end-of-winter snow accumulation. Once snowfall and rainfall are bias adjusted, long-term annual precipitation estimates more than double (from 123 to 274 mm), highlighting the risk of studies using conventional or unadjusted precipitation that dramatically under-represent water balance components. Applying conventional precipitation information to the water balance analysis produced consistent storage deficits (79 to 152 mm) that were all larger than the largest actual deficit (75 mm), which was observed in the unusually low rainfall summer of 2007. Year-to-year variability in adjusted rainfall (±33 mm) was larger than evapotranspiration (±13 mm). Measured interannual variability in partitioning of snow into runoff (29% in 2008 to 68% in 2009) in years with similar end-of-winter snow accumulation (180 and 164 mm, respectively) highlights the importance of the previous summer's rainfall (25 and 60 mm, respectively) on spring runoff production. Incorrect representation of precipitation can therefore have major implications for Arctic water budget descriptions that in turn can alter estimates of carbon and energy fluxes.
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Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women.
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.
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Bhatt, Tanvi; Yang, Feng; Wang, Edward
2014-01-01
Background. Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults’ annual falls risk in their everyday living. Methods. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). Results. With this single session of repeated-slip exposure, training cut older adults’ annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. Conclusion. A single session of repeated-slip exposure could improve community-dwelling older adults’ resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. PMID:24966227
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Lord, Stephen R; Sherrington, Catherine; Cameron, Ian D; Close, Jacqueline C T
2011-12-01
Falls in older Australians are a significant public health issue with one in three older people falling one or more times each year. Many fall prevention randomized controlled trials have been conducted in Australia as well as across the world. The findings of these studies now constitute a substantial evidence base that can provide direction for health and lifestyle interventions for preventing falls in older people. This research evidence has contributed to health policy in Australia to some extent, but is yet to be widely implemented into practice. This opinion piece overviews previous policy initiatives and describes a new Partnership research program funded by the Australian National Health and Medical Research Council (NHMRC), which seeks to further influence health policy and address the ongoing research-practice gap. Copyright © 2011. Published by Elsevier Ltd.
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Falls and fear of falling in vertigo and balance disorders: A controlled cross-sectional study.
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.
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Generating spatial precipitation ensembles: impact of temporal correlation structure
Directory of Open Access Journals (Sweden)
O. Rakovec
2012-09-01
Full Text Available Sound spatially distributed rainfall fields including a proper spatial and temporal error structure are of key interest for hydrologists to force hydrological models and to identify uncertainties in the simulated and forecasted catchment response. The current paper presents a temporally coherent error identification method based on time-dependent multivariate spatial conditional simulations, which are conditioned on preceding simulations. A sensitivity analysis and real-world experiment are carried out within the hilly region of the Belgian Ardennes. Precipitation fields are simulated for pixels of 10 km × 10 km resolution. Uncertainty analyses in the simulated fields focus on (1 the number of previous simulation hours on which the new simulation is conditioned, (2 the advection speed of the rainfall event, (3 the size of the catchment considered, and (4 the rain gauge density within the catchment. The results for a sensitivity analysis show for typical advection speeds >20 km h−1, no uncertainty is added in terms of across ensemble spread when conditioned on more than one or two previous hourly simulations. However, for the real-world experiment, additional uncertainty can still be added when conditioning on a larger number of previous simulations. This is because for actual precipitation fields, the dynamics exhibit a larger spatial and temporal variability. Moreover, by thinning the observation network with 50%, the added uncertainty increases only slightly and the cross-validation shows that the simulations at the unobserved locations are unbiased. Finally, the first-order autocorrelation coefficients show clear temporal coherence in the time series of the areal precipitation using the time-dependent multivariate conditional simulations, which was not the case using the time-independent univariate conditional simulations. The presented work can be easily implemented within a hydrological calibration and data assimilation
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Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT).
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.
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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.
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Co-precipitation and solubility studies of cesium, potassium and sodium tetraphenylborate
International Nuclear Information System (INIS)
Peterson, R.A.
2000-01-01
This report contains the results from a study requested by High Level Waste on the co-precipitation and solubility of cesium, potassium, and sodium tetraphenylborate. Co-precipitation of cesium (Cs), potassium (K), and sodium (Na) tetraphenylborate (TPB) helps determine the efficiency of reagent usage in the Small Tank Precipitation Process. This process uses NaTPB to remove cesium from waste by means of precipitation. Previous studies by McCabe suggested that if the sodium ion concentration [Na + ] increased the rate at which cesium tetraphenylborate (CsTPB) precipitates also increases. Serkiz also demonstrated that the precipitation of potassium tetraphenylborate (KTPB) in the presence of high [Na + ] (∼5M) appears to produce a mixed solid phase composed of NaTPB and KTPB together in the crystal lattice. In the crystallographic structure of these three tetraphenylborate salts (Cs,K,NaTPB), the tetraphenylborate ion dominates the size of the crystals. Also, note that the three crystals have nearly identical structures with the exception of two additional peaks in the cesium pattern. Given these similarities, TPB precipitation in the presence of Na + , Cs + and K + likely produces an impure isomorphic crystalline mixture of CsTPB, KTPB and NaTPB. The authors speculate that the primary crystalline structure resembles that of KTPB with NaTPB and CsTPB mixed throughout the crystal structure. The precipitation of NaTPB makes some of the anticipated excess tetraphenylborate relatively unavailable for precipitation of cesium. Thus, the amount of excess tetraphenylborate required to completely precipitate all of the potassium and cesium may increase significantly
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Properties of Extreme Precipitation and Their Uncertainties in 3-year GPM Precipitation Radar Data
Liu, N.; Liu, C.
2017-12-01
Extreme high precipitation rates are often related to flash floods and have devastating impacts on human society and the environments. To better understand these rare events, 3-year Precipitation Features (PFs) are defined by grouping the contiguous areas with nonzero near-surface precipitation derived using Global Precipitation Measurement (GPM) Ku band Precipitation Radar (KuPR). The properties of PFs with extreme precipitation rates greater than 20, 50, 100 mm/hr, such as the geographical distribution, volumetric precipitation contribution, seasonal and diurnal variations, are examined. In addition to the large seasonal and regional variations, the rare extreme precipitation rates often have a larger contribution to the local total precipitation. Extreme precipitation rates occur more often over land than over ocean. The challenges in the retrieval of extreme precipitation might be from the attenuation correction and large uncertainties in the Z-R relationships from near-surface radar reflectivity to precipitation rates. These potential uncertainties are examined by using collocated ground based radar reflectivity and precipitation retrievals.
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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.
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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
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Kao, Senyeong; Wang, Yun-Chang; Tzeng, Ya-Mei; Liang, Chang-Kuo; Lin, Fu-Gong
2012-09-01
It is well documented that fall risk among elderly people is associated with poor health and depression. In this study, we set out to examine the combined effects of medical condition and depression status on fall incidents among community-dwelling elderly people. A cross-sectional study was carried out to investigate the fall history of community-dwelling elders involving 360 participants. Those who had experienced at least two falls over the previous year, or one injurious fall, were defined as "fallers." The Geriatric Depression Scale-15 was used as a screening instrument for depression status. Based on a multivariate logistic regression and stratification analysis, depression was found to interact with various medical conditions on fall risk. In comparison with the non-depressive reference group, a six-fold fall risk was discernible among depressed elders with polypharmacy, while a five-fold risk was found among depressive elders using ancillary devices, along with a four-fold risk among depressive elders with diabetes or cardiovascular disease. Finally, arthritis was found to produce a nine-fold risk of falls among such populations. These findings suggest that greater emphasis should be placed on the integration of depression screening as an element of fall risk assessment in elderly people.
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Chaotic Dynamics of Falling Disks: from Maxwell to Bar Tricks.
Field, Stuart
1998-03-01
Understanding the motion of flat objects falling in a viscous medium dates back to at least Newton and Maxwell, and is relevant to problems in meteorology, sedimentology, aerospace and chemical engineering, and nori/disks/pub.html>bar wagering strategies. Recent theoretical studies have emphasized the role played by deterministic chaos. Here we nori/falling.html>report(S. B. Field, M. Klaus, M. G. Moore, and F. Nori, Nature 388), 252 (1997) experimental observations and theoretical analysis of the dynamics of disks falling in water/glycerol mixtures. We find four distinct types of motion, and map out a ``phase diagram'' in the appropriate variables. The apparently complex behavior of the disks can be reduced to a series of one-dimensional maps which display a discontinuity at the crossover from periodic and chaotic motion. This discontinuity leads to an unusual intermittency transition between the two behaviors, which has not previously been observed experimentally in any system.
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Bender, L.C.; Weisenberger, M.E.
2005-01-01
Understanding the determinants of population size and performance for desert bighorn sheep (Ovis canadensis mexicana) is critical to develop effective recovery and management strategies. In arid environments, plant communities and consequently herbivore populations are strongly dependent upon precipitation, which is highly variable seasonally and annually. We conducted a retrospective exploratory analysis of desert bighorn sheep population dynamics on San Andres National Wildlife Refuge (SANWR), New Mexico, 1941-1976, by modeling sheep population size as a function of previous population sizes and precipitation. Population size and trend of desert bighorn were best and well described (R 2=0.89) by a model that included only total annual precipitation as a covariate. Models incorporating density-dependence, delayed density-dependence, and combinations of density and precipitation were less informative than the model containing precipitation alone (??AlCc=8.5-22.5). Lamb:female ratios were positively related to precipitation (current year: F1,34=7.09, P=0.012; previous year: F1,33=3.37, P=0.075) but were unrelated to population size (current year. F1,34=0.04, P=0.843; previous year: F1,33 =0.14, P=0.715). Instantaneous population rate of increase (r) was related to population size (F1,33=5.55; P=0.025). Precipitation limited populations of desert bighorn sheep on SANWR primarily in a density-independent manner by affecting production or survival of lambs, likely through influences on forage quantity and quality. Habitat evaluations and recovery plans for desert bighorn sheep need to consider fundamental influences on desert bighorn populations such as precipitation and food, rather than focus solely on proximate issues such as security cover, predation, and disease. Moreover, the concept of carrying capacity for desert bighorn sheep may need re-evaluation in respect to highly variable (CV =35.6%) localized precipitation patterns. On SANWR carrying capacity for desert
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International Nuclear Information System (INIS)
Hoyt, R.C.
1978-04-01
A mathematical model describing the kinetics of continuous precipitation was developed which accounts for crystal nucleation, crystal growth, primary coagulation, and secondary coagulation. Population density distributions, average particle sizes, dominant particle sizes, and suspension density fractions of the crystallites, primary agglomerates, and secondary agglomerates leaving the continuous precipitator can be determined. This kinetic model was applied to the continuous precipitation of ammonium polyuranate, which consists of: (1) elementary crystals, (2) clusters or primary coagulated particles, and (3) agglomerates or secondary coagulated particles. The crystallites are thin, submicron, hexagonal platelets. The clusters had an upper size limit of about 7 μ in diameter and contained numerous small voids (less than 0.3 μm) due to the packing of the crystallites. The agglomerates had an upper size limit of about 40 μm in diameter and contained large voids (approximately 1 μm). The particle size distribution and particle structure of the ammonium polyuranate precipitate can be controlled through proper regulation of the precipitation conditions. The ratio of clusters to agglomerates can be best controlled through the uranium concentration, and the cohesiveness or internal bonding strength of the particles can be controlled with the ammonium to uranium reacting feed mole ratio. These two conditions, in conjunction with the residence time, will determine the nucleation rates, growth rates, and size distributions of the particles leaving the continuous precipitator. With proper control of these physical particle characteristics, the use of pore formers, ball-milling, and powder blending can probably be eliminated from the nuclear fuel fabrication process, substantially reducing the cost
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Energy Technology Data Exchange (ETDEWEB)
Hoyt, R.C.
1978-04-01
A mathematical model describing the kinetics of continuous precipitation was developed which accounts for crystal nucleation, crystal growth, primary coagulation, and secondary coagulation. Population density distributions, average particle sizes, dominant particle sizes, and suspension density fractions of the crystallites, primary agglomerates, and secondary agglomerates leaving the continuous precipitator can be determined. This kinetic model was applied to the continuous precipitation of ammonium polyuranate, which consists of: (1) elementary crystals, (2) clusters or primary coagulated particles, and (3) agglomerates or secondary coagulated particles. The crystallites are thin, submicron, hexagonal platelets. The clusters had an upper size limit of about 7 ..mu.. in diameter and contained numerous small voids (less than 0.3 ..mu..m) due to the packing of the crystallites. The agglomerates had an upper size limit of about 40 ..mu..m in diameter and contained large voids (approximately 1 ..mu..m). The particle size distribution and particle structure of the ammonium polyuranate precipitate can be controlled through proper regulation of the precipitation conditions. The ratio of clusters to agglomerates can be best controlled through the uranium concentration, and the cohesiveness or internal bonding strength of the particles can be controlled with the ammonium to uranium reacting feed mole ratio. These two conditions, in conjunction with the residence time, will determine the nucleation rates, growth rates, and size distributions of the particles leaving the continuous precipitator. With proper control of these physical particle characteristics, the use of pore formers, ball-milling, and powder blending can probably be eliminated from the nuclear fuel fabrication process, substantially reducing the cost.
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Identification of Elderly Falling Risk by Balance Tests Under Dual Tasks Conditions
Directory of Open Access Journals (Sweden)
Mohammad Ali Aslankhani
2010-03-01
Full Text Available Objectives: This study aimed to identify elderly fallers and non-fallers by balance test under dual tasks conditions. Methods & Materials: This study was an analyze-comparative study. Subjects were from three park of Tehran. Subjects were 20 older adults with outhistory of falls (aged 75.95±6.28 years and 21 older adults with a history of 2 or more falls in the previous one year (aged 72.50±7.31 Years . All subjects performed Timed Up & Go test under 3 conditions (TimedUp & Go, Timed Up & Go with numbers counter randomly [TUG cognitive], and Timed Up & Go while carrying a full cup of water [TUG manual]. A multivariate analysis of variance and logistic regression analyses were performed. Results: The results showed significant difference between elderly fallers and non fallers in fall risk composed dependent variable (P=0.0005, as the non fallers had greater score than the elderly fallers. Also, results showed that TUG cognitive has prediction capacity of elderly fall (P=0.013. Conclusion: Consequently, balance under cognitive dual task conditions could be useful method in identification of risk of falling and planning dual task exercise program and physiotherapy to preventfalls.
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Film boiling heat transfer from a hot sphere falling in two-phase pool
International Nuclear Information System (INIS)
Bang, K. H.; Kim, K. Y.
1998-01-01
The purpose of the present study is to experimentally investigate film boiling heat trasfer from a hot sphere falling in steam-water two-phase pool, which is the key heat transfer mode in molten fuel and coolant mixing. To measure film boiling heat transfer coefficients on a spere falling in two-phase pool, a heated sphere with a thermocouple embedded at the center is dropped in a vertical tube filled with steam-water mixture. The present experiment is unique in making the heated sphere fall through the two-phase pool while the previous experiments were performed with stationary spheres in flowing fluid. The falling speed of the sphere is measured using a set of magnet pickup coils distributed along the tube. The ranges of the experimental conditions are: spere fall speed 0-0.5 m/s, average void fraction 0-25,% steam superficial velocity 0-0.25 m/s. The results show that the forced convection film boiling heat transfer coefficient decrease slightly as the steam superficial velocity (void fraction) is increased
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Land Use in LCA: Including Regionally Altered Precipitation to Quantify Ecosystem Damage.
Lathuillière, Michael J; Bulle, Cécile; Johnson, Mark S
2016-11-01
The incorporation of soil moisture regenerated by precipitation, or green water, into life cycle assessment has been of growing interest given the global importance of this resource for terrestrial ecosystems and food production. This paper proposes a new impact assessment model to relate land and water use in seasonally dry, semiarid, and arid regions where precipitation and evapotranspiration are closely coupled. We introduce the Precipitation Reduction Potential midpoint impact representing the change in downwind precipitation as a result of a land transformation and occupation activity. Then, our end-point impact model quantifies terrestrial ecosystem damage as a function of precipitation loss using a relationship between woody plant species richness, water and energy regimes. We then apply the midpoint and end-point models to the production of soybean in Southeastern Amazonia which has resulted from the expansion of cropland into tropical forest, with noted effects on local precipitation. Our proposed cause-effect chain represents a complementary approach to previous contributions which have focused on water consumption impacts and/or have represented evapotranspiration as a loss to the water cycle.
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Energy Technology Data Exchange (ETDEWEB)
Garrigue, H
1951-01-01
Aerial observations on the rapid increase of the 20- to 30-h radioactive substance (labelled A) on February 3, 1951 leave no doubt as to its origin in atomic explosions. A large part of the radioactive cloud must enter the stratosphere and fall back to earth very slowly. The portion of the cloud diffusing into the troposphere supplies abundant condensation nuclei which profoundly affect the processes of precipitation.
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[Fear of falling in a fall clinic for geriatric patients: a pilot study
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
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Issues in Geriatric Care: Falls.
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.
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[Water sources of Nitraria sibirica and response to precipitation in two desert habitats].
Zhou, Hai; Zhao, Wen Zhi; He, Zhi Bin
2017-07-18
Nitraria sibirica usually exists in a form of nebkhas, and has strong ecological adaptability. The plant species has distinctive function for wind prevention and sand fixation, and resistance drought and salt. However, the water condition is still a limiting factor for the plant survival and development. In order to understand the water use strategy of the plant in different desert habitats, we selected the N. sibirica growing in sandy desert habitat and gravel desert habitat to study the seaso-nal variation of plant water sources and response to precipitation at the edge of the oasis of Linze in the Hexi Corridor. We measured the oxygen stable isotope of the plant stem water and the different potential water sources (precipitation, soil water and ground water), and used the IsoSource model to calculate the proportion of water sources from the potential water. The results showed that there were significant seasonal variation characteristics of δ 18 O value and water source of stem water for the plant in the two habitats. In the sandy habitat, the plant used more ground water in the less precipitation seasons including spring and fall, and more than 50% of the water sources absorbed from ground water. However, under the condition of gravel habitat, the plant could not achieve the ground water level depth of 11.5 m, and its water source was controlled by precipitation, which had large seasonal variability. The water sources of N. sibirica had significant responses to the change of precipitation in the two desert habitats. Following the rapid decrease of soil water content after the precipitation events, the plant in the sandy habitat turned to use the abundant ground water as the main sources of water, while the plant in the gravel habitat only used the less water from precipita-tion infiltration to the deep soil. Therefore, different water use strategies of the plant in the two habitats were the main reason for the difference in growth characteristics, and it had a
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Rossetin, Liliana Laura; Rodrigues, Elisangela Valevein; Gallo, Luiza Herminia; Macedo, Darla Silvério; Schieferdecker, Maria Eliana Madalozzo; Pintarelli, Vitor Last; Rabito, Estela Iraci; Gomes, Anna Raquel Silveira
2016-01-01
Abstract Introduction: Musculoskeletal aging can impair functional performance increasing the risk of falls. Objective: To analyze the correlation between sarcopenia and the intrinsic and extrinsic factors involved in falls among community-dwelling elderly women. Method: A cross-sectional study evaluated the number of falls of 85 active community-dwelling elderly women in the previous year and then divided them into two groups: non-fallers (n=61) and fallers (n=24). The sarcopenia indic...
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Buchner, David M; Rillamas-Sun, Eileen; Di, Chongzhi; LaMonte, Michael J; Marshall, Stephen W; Hunt, Julie; Zhang, Yuzheng; Rosenberg, Dori E; Lee, I-Min; Evenson, Kelly R; Herring, Amy H; Lewis, Cora E; Stefanick, Marcia L; LaCroix, Andrea Z
2017-11-01
To examine whether moderate to vigorous physical activity (MVPA) measured using accelerometry is associated with incident falls and whether associations differ according to physical function or history of falls. Prospective study with baseline data collection from 2012 to 2014 and 1 year of follow-up. Women's Health Initiative participants living in the United States. Ambulatory women aged 63 to 99 (N = 5,545). Minutes of MVPA per day measured using an accelerometer, functional status measured using the Short Physical Performance Battery (SPPB), fall risk factors assessed using a questionnaire, fall injuries assessed in a telephone interview, incident falls ascertained from fall calendars. Incident rate ratios (IRRs) revealed greater fall risk in women in the lowest quartile of MVPA compared to those in the highest (IRR = 1.18, 95% confidence interval = 1.01-1.38), adjusted for age, race and ethnicity, and fall risk factors. Fall rates were not significantly associated with MVPA in women with high SPPB scores (9-12) or one or fewer falls in the previous year, but in women with low SPPB scores (≤ 8) or a history of frequent falls, fall rates were higher in women with lower MVPA levels than in those with higher levels (interaction P Falls in women with MVPA above the median were less likely to involve injuries requiring medical treatment (9.9%) than falls in women with lower MVPA levels (13.0%) (P falls are not more common or injurious in older women who engage in higher levels of MVPA. These findings support encouraging women to engage in the amounts and types of MVPA that they prefer. Older women with low physical function or frequent falls with low levels of MVPA are a high-risk group for whom vigilance about falls prevention is warranted. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
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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.
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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.
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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.
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Hoffmann, V S; Neumann, L; Golgert, S; von Renteln-Kruse, W
2015-12-01
Prevention of in-hospital falls contributes to improvement of patient safety. However, the identification of high-risk patients remains a challenge despite knowledge of fall-risk factors. Hence, objective was to prospectively validate the performance of the LUCAS (Longitudinal Urban Cohort Ageing Study) fall-risk screening, based on routine data (fall history, mobility, mental status) and applied by nurses. Observational study comparing two groups of patients who underwent different fall-risk screenings; the LUCAS screening (2010 - 2011) and the STRATIFY (St. Thomas's Risk Assessment Tool In Falling Elderly Inpatients) (2004 - 2006). Urban teaching hospital. Consecutively hospitalized patients (≥ 65 years old) were screened on admission; LUCAS n = 2,337, STRATIFY n = 4,735. The proportions of fallers were compared between the STRATIFY and the LUCAS time periods. The number of fallers expected was compared to that observed in the LUCAS time period. Standardized fall-incidence recording included case-note checks for unreported falls. Plausibility checks of fall-risk factors and logistic regression analysis for variable fall-risk factors were performed. The proportions of fallers during the two time periods were LUCAS n = 291/2,337 (12.5%) vs. STRATIFY n = 508/4,735 (10.7%). After adjustment for risk-factor prevalence, the proportion of fallers expected was 14.5% (334/2,337), the proportion observed was 12.5% (291/2,337) (p = 0.038). In-hospital fall prevention including systematic use of the LUCAS fall-risk screening reduced the proportion of fallers compared to that expected from the patients' fall-risk profile. Raw proportions of fallers are not suitable to evaluate fall prevention in hospital because of variable prevalence of patients' fall-risk factors over time. Continuous communication, education and training is needed to sustain in-hospital falls prevention.
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G-phase precipitation in austenitic stainless steel deformed by high pressure torsion
International Nuclear Information System (INIS)
Shuro, I.; Kuo, H.H.; Sasaki, T.; Hono, K.; Todaka, Y.; Umemoto, M.
2012-01-01
Highlights: ► Using TEM and APT analyses, G-phase precipitation was observed in HPTed SUS304 with no trace of spinodal decomposition. ► G-phase precipitation occurred much shorter time than previous studies probably due to the elimination of prior SD and enhanced diffusion by severe plastic deformation. ► G-phase composition is a function of aging time. ► Tensile tests showed that in SUS304 embrittlement occurs solely due to G-phase precipitation. - Abstract: G phase an intermetallic silicide has been observed in martensite of precipitation hardened stainless steels and in the ferrite of dual (austenite and ferrite) phase stainless steels. In both cases, before G-phase precipitates, the matrix composition changes due to spinodal decomposition and solute partitioning between ferrite and austenite. Thus in the present study, single bcc phase and high Ni content stainless steel, was selected to study G-phase precipitation expecting elimination of the interference from spinodal decomposition and solute partitioning. Fe–18Cr–8Ni (SUS304) austenitic stainless steel samples were deformed at room temperature by high pressure torsion to obtain 100% volume fraction of deformation induced martensite (α′). HPT deformation was chosen due to its ability to induce high strength by grain refinement and also attain 100% α′ at room temperature. After annealing at 400 °C for 500 h, G-phase precipitation was observed in the fully martensitic matrix without spinodal decomposition. Crystallographic analysis of annealed samples using high resolution transmission electron microscopy (HRTEM) and energy dispersive spectroscopy (EDS) detected a Mn–Ni–Si rich G-phase with fcc crystal structure with lattice parameter of 1.16 nm. The value of lattice parameter corresponds well with previously reported values. Chemical analysis by atom probe tomography (APT) showed G-phase of composition Mn 21 Ni 50 Si 24 Fe 4 Cr. Tensile tests showed that G-phase precipitation leads to
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G-phase precipitation in austenitic stainless steel deformed by high pressure torsion
Energy Technology Data Exchange (ETDEWEB)
Shuro, I., E-mail: innoshuro@martens.me.tut.ac.jp [Functional Materials Engineering, Toyohashi University of Technology, 1-1, Toyohashi, Aichi 441-8580 (Japan); Kuo, H.H. [Functional Materials Engineering, Toyohashi University of Technology, 1-1, Toyohashi, Aichi 441-8580 (Japan); Sasaki, T.; Hono, K. [National Institute for Materials Sciences, Sengen 1-2-1, Tsukuba 305-0047 (Japan); Todaka, Y.; Umemoto, M. [Functional Materials Engineering, Toyohashi University of Technology, 1-1, Toyohashi, Aichi 441-8580 (Japan)
2012-08-30
Highlights: Black-Right-Pointing-Pointer Using TEM and APT analyses, G-phase precipitation was observed in HPTed SUS304 with no trace of spinodal decomposition. Black-Right-Pointing-Pointer G-phase precipitation occurred much shorter time than previous studies probably due to the elimination of prior SD and enhanced diffusion by severe plastic deformation. Black-Right-Pointing-Pointer G-phase composition is a function of aging time. Black-Right-Pointing-Pointer Tensile tests showed that in SUS304 embrittlement occurs solely due to G-phase precipitation. - Abstract: G phase an intermetallic silicide has been observed in martensite of precipitation hardened stainless steels and in the ferrite of dual (austenite and ferrite) phase stainless steels. In both cases, before G-phase precipitates, the matrix composition changes due to spinodal decomposition and solute partitioning between ferrite and austenite. Thus in the present study, single bcc phase and high Ni content stainless steel, was selected to study G-phase precipitation expecting elimination of the interference from spinodal decomposition and solute partitioning. Fe-18Cr-8Ni (SUS304) austenitic stainless steel samples were deformed at room temperature by high pressure torsion to obtain 100% volume fraction of deformation induced martensite ({alpha} Prime ). HPT deformation was chosen due to its ability to induce high strength by grain refinement and also attain 100% {alpha} Prime at room temperature. After annealing at 400 Degree-Sign C for 500 h, G-phase precipitation was observed in the fully martensitic matrix without spinodal decomposition. Crystallographic analysis of annealed samples using high resolution transmission electron microscopy (HRTEM) and energy dispersive spectroscopy (EDS) detected a Mn-Ni-Si rich G-phase with fcc crystal structure with lattice parameter of 1.16 nm. The value of lattice parameter corresponds well with previously reported values. Chemical analysis by atom probe tomography
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Epidemiology of falls in older age.
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.
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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.
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Fall Prevention Hits Stumbling Blocks.
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.
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MAP3S precipitation chemistry network: fourth periodic summary report (1980)
Energy Technology Data Exchange (ETDEWEB)
1981-12-01
This, the fourth in a series of summary reports, contains complete field and chemical data from the MAP3S/RAINE (Multistate Atmospheric Power Production Pollution Studies) Precipitation Chemistry Network for the year 1980. The 1980 data were added to the previous data base, and an update of the previous statistical summary completed. Included are basic statistics, time trend analyses, and monthly averages.
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Modeling seasonal migration of fall armyworm moths
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.
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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
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Ku/Ka/W-band Antenna for Electronically-Scanned Cloud and Precipitation Radar
National Aeronautics and Space Administration — Previously, cloud radars such as CloudSat have been separated from precipitation radars such as TRMM (Tropical Rainfall Measurement Mission) and GPM (Global...
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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.
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Head and neck injury patterns in fatal falls: epidemiologic and biomechanical considerations.
Freeman, Michael D; Eriksson, Anders; Leith, Wendy
2014-01-01
base and lower cervical spine fracture in falls from a height are consistent with prior observations that the risk of such injuries is related to the degree of victim inversion at impact. The finding that C0-C1 dislocations are most common in falls from more than 3 m is unique, an indication that the injuries likely result from high energy shear forces rather than pure tension, as previously thought. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
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The association between primary open-angle glaucoma and fall: an observational study.
Tanabe, Sachiko; Yuki, Kenya; Ozeki, Naoki; Shiba, Daisuke; Tsubota, Kazuo
2012-01-01
Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG) who were more than 45 years old, compared with comparably aged healthy subjects. This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years) who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years) were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye). The self-reported prevalence of injurious fall was 0.9% (1/117) in the control group and 6.9% (7/101) in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test). Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with the better visual field (odds ratios 0.75; 95% confidence intervals: 0.57 to 0.99; P = 0.036) was a significant risk factor for injurious falls in subjects with POAG. POAG was significantly associated with injurious falls.
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New methods for fall risk prediction.
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.
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... 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 ...
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Majcher, Emily H.; Woytowitz, Ellen L.; Reisinger, Alexander J.; Groffman, Peter M.
2018-03-30
Factors affecting water-quality trends in urban streams are not well understood, despite current regulatory requirements and considerable ongoing investments in gray and green infrastructure. To address this gap, long-term water-quality trends and factors affecting these trends were examined in the Gwynns Falls, Maryland, watershed during 1998–2016 in cooperation with Blue Water Baltimore. Data on water-quality constituents and potential factors of influence were obtained from multiple sources and compiled for analysis, with a focus on data collected as part of the National Science Foundation funded Long-Term Ecological Research project, the Baltimore Ecosystem Study.Variability in climate (specifically, precipitation) and land cover can overwhelm actions taken to improve water quality and can present challenges for meeting regulatory goals. Analysis of land cover during 2001–11 in the Gwynns Falls watershed indicated minimal change during the study time frame; therefore, land-cover change is likely not a factor affecting trends in water quality. However, a modest increase in annual precipitation and a significant increase in winter precipitation were apparent in the region. A higher proportion of runoff producing storms was observed in the winter and a lower proportion in the summer, indicating that climate change may affect water quality in the watershed. The increase in precipitation was not reflected in annual or seasonal trends of streamflow in the watershed. Nonetheless, these precipitation changes may exacerbate the inflow and infiltration of water to gray infrastructure and reduce the effectiveness of green infrastructure. For streamflow and most water-quality constituents examined, no discernable trends were noted over the timeframe examined. Despite the increases in precipitation, no trends were observed for annual or seasonal discharge at the various sites within the study area. In some locations, nitrate, phosphate, and total nitrogen show downward
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Relation between risk of falling and postural sway complexity in diabetes.
Morrison, S; Colberg, S R; Parson, H K; Vinik, A I
2012-04-01
For older individuals with diabetes, any decline in balance control can be especially problematic since it is often a precursor to an increased risk of falling. This study was designed to evaluate differences in postural motion dynamics and falls risk for older individuals with type 2 diabetes (T2DM) classified as fallers/non-fallers and, to assess what impact exercise has on balance and falls risk. The results demonstrated that the risk of falling is greater for those older individuals with multiple risk factors including diabetes and a previous falls history. The postural motion features of the high-risk individuals (T2DM-fallers) were also different, being characterized by increased variability and complexity, increased AP-ML coupling, less overall COP motion and increased velocity. One suggestion is that these individuals evoked a stiffening strategy during the more challenging postural tasks. Following training, a decline in falls risk was observed for all groups, with this effect being most pronounced for the T2DM-fallers. Interestingly, the COP motion of this group became more similar to controls, exhibiting decreased complexity and variability, and decreased velocity. The reciprocal changes in COP complexity support the broader view that age/disease-related changes in physiological complexity are bi-directional. Overall, these results show that, even for older T2DM individuals at greater risk of falling, targeted interventions can positively enhance their postural dynamics. Further, the finding that the pattern of postural motion variability and complexity was altered highlights that a decline in physiological complexity may not always be negatively associated with aging and/or disease. Copyright © 2011 Elsevier B.V. All rights reserved.
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Examination of sustainability indicators for fall prevention strategies in three 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.
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Directory of Open Access Journals (Sweden)
Chung-Hao Lin
Full Text Available BACKGROUND: Falls are very common among the older people. Nearly one-third older people living in a community fall each year. However, few studies have examined factors associated with falls in a community-dwelling population of older Taiwanese adults. OBJECTIVES: To identify the associated factors for falls during the previous 12 months among the community-dwelling Taiwanese older people receiving annual geriatric health examinations. PARTICIPANTS: People aged sixty-five years or older, living in the community, assessed by annual geriatric health examinations METHODS: 1377 community-dwellers aged ≥65 years who received annual geriatric health examinations at one hospital in northern Taiwan between March and November of 2008. They were asked about their history of falls during the year prior to their most recent health examination. RESULTS: The average age of the 1377 participants was 74.9±6.8 years, 48.9% of which were women. Three-hundred and thirteen of the participants (22.7% had at least one fall during the previous year. Multivariate analysis showed that odds ratio for the risk of falling was 1.94 (95% CI 1.36-2.76 when the female gender group is compared with the male gender group. The adjusted odds ratios of age and waist circumference were 1.03 (95% CI 1.00-1.06 and 1.03 (95% CI 1.01-1.05 respectively. The adjusted odds ratios of visual acuity, Karnofsky scale, and serum albumin level were 0.34 (95% CI 0.15-0.76, 0.94 (95% CI 0.89-0.98, and 0.37 (95% CI 0.18-0.76 respectively. Larger waist circumference, older age, female gender, poorer visual acuity, lower score on the Karnofsky Performance Scale, and lower serum albumin level were the independent associated factors for falls. CONCLUSION: In addition to other associated factors, waist circumference should be included as a novel risk factor for falls.
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LENUS (Irish Health Repository)
Mazur, Artur
2009-01-01
The aim of the study was to determine the level of functional independence in adult patients with previously undiagnosed or untreated phenylketonuria (PKU). The study was conducted among 400 intellectually impaired adult residents of Social Welfare Homes in South-Eastern Poland born prior to the introduction of neonatal PKU screening programs. PKU was screened by filter paper test using tandem mass spectrometry methods, and confirmed by gas chromatography-mass spectrometric analysis of PKU organic acids in urine. Degree of functional independence included the assessment of activities of daily living (Barthel Index) and measures of balance and gait (Tinetti scale). Eleven individuals with previously untreated PKU were identified whereby eight presented with moderate disability and three with mild disability. Six had a high risk of falls and five had a moderate risk of falls. This study indicates that there is considerable number of undiagnosed PKU patients within the Polish population who require assessment and management in order to reduce the impact of the neurological and neuropsychiatric problems associated with the condition. Appropriate therapy for those with undiagnosed PKU should, in particular, address the risk of falls.
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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
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Bjerk, Maria; Brovold, Therese; Skelton, Dawn A; Bergland, Astrid
2017-08-14
Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services. A secondary aim is to explore the mediating factors between falls prevention and health-related quality of life. The study is a single-blinded randomised controlled trial. Participants are older adults, aged 67 or older, receiving home help services, who are able to walk with or without walking aids, who have experienced at least one fall during the last 12 months and who have a Mini Mental State Examination of 23 or above. The intervention group receives a programme, based on the Otago Exercise Programme, lasting 12 weeks including home visits and motivational telephone calls. The control group receives usual care. The primary outcome is health-related quality of life (SF-36). Secondary outcomes are leg strength, balance, walking speed, walking habits, activities of daily living, nutritional status and falls efficacy. All measurements are performed at baseline, following intervention at 3 months and at 6 months' follow-up. Sample size, based on the primary outcome, is set to 150 participants randomised into the two arms, including an estimated 15-20% drop out. Participants are recruited from six municipalities in Norway. This trial will generate new knowledge on the effects of an exercise falls prevention programme among older fallers receiving home help services. This knowledge will be useful for clinicians, for health managers in the primary health care service
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Prevention of falls in nursing homes: subgroup analyses of a randomized fall prevention trial.
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.
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Fall risk factors in Parkinson's disease.
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.
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Inspection of four-sensor falls detector
Directory of Open Access Journals (Sweden)
Bartłomiej Wójtowicz
2015-06-01
Full Text Available The studies presented in this article are the continuation of previous work to develop a mobile fall detector. The algorithm is based on a discrete wavelet transform of the signals from the sensors available at the detector and a linear support vector machine as a classifier. Fisher score method is used for feature selection in the proposed algorithm. As a result of reducing the number of features, the number of support vectors has been also reduced — it has a direct impact on the upper estimate of the classification error. On the basis of the obtained results, the classifier parameters have been calculated. This allows presenting the developed concept in the field of ROCROCROC curves (Receiver Operating Characteristics and their comparison with the results obtained for individual sensors. The developed concept gives much better results than each of the sensors acting independently. The findings of this study have given very good results in comparison with the previous findings, with a significant reduction in the number of required features. Due to the close relationship between the number of training data and the number of support vectors which directly affect the upper estimate of the classification error, the number of features has been reduced. Finally, satisfactory results have been obtained with the reduction of the number of features from 38 to just six, ensuring that the upper estimation of the classification error in the set of the new test data does not exceed 5.3%.[b]Keywords[/b]: falls detection, data fusion, discrete wavelet transform, support vector machine
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International Nuclear Information System (INIS)
Van Boxel, John H
2001-01-01
Precipitation is one of the most, if not the most important climate parameter In most studies on climate change the emphasis is on temperature and sea level rise. Often too little attention is given to precipitation. For a large part this is due to the large spatial en temporal variability of precipitation, which makes the detection of changes difficult. This paper describes methods to detect changes in precipitation. In order to arrive at statistically significant changes one must use long time series and spatial averages containing the information from several stations. In the Netherlands the average yearly precipitation increased by 11% during the 20th century .In the temperate latitudes on the Northern Hemisphere (40-60QN) the average increase was about 7% over the 20th century and the globally averaged precipitation increased by about 3%. During the 20th century 38% of the land surface of the earth became wetter, 42% experienced little change (less than 5% change) and 20% became dryer. More important than the average precipitation is the occurrence of extremes. In the Netherlands there is a tendency to more extreme precipitations, whereas the occurrence of relatively dry months has not changed. Also in many other countries increases in heavy precipitation events are observed. All climate models predict a further increase of mean global precipitation if the carbon dioxide concentration doubles. Nevertheless some areas get dryer, others have little change and consequently there are also areas where the increase is much more than the global average. On a regional scale however there are large differences between the models. Climate models do not yet provide adequate information on changes in extreme precipitations
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Pediatric falls from buildings: defining the burden of injury in Hawai'i.
Sarkar, Joy; Wolfe, Stacey Q; Speck, Cora; Woods, Elizabeth; Lustik, Michael B; Edwards, Kurt D; Edwards, Mary J
2014-05-01
Falls from buildings, including houses, are an important cause of childhood injury in the United States; however, no study has previously examined the impact of this problem in Hawai'i. The objective of this study is to categorize the demographics and injury circumstances of pediatric falls from buildings in Hawai'i and compare to other US cities. Patients age 10 and under who were injured in nonfatal accidental falls from buildings in Hawai'i between 2005 and 2011 were identified retrospectively from a statewide repository of hospital billing data. The Hawai'i death certificate database was searched separately for deaths in children age 10 and under due to falls from buildings, with data available from 1991 through 2011. Data was reviewed for demographics, circumstances surrounding the injury, and level of hospital treatment. During the 7-year period for nonfatal injuries, 416 fall-related injuries were identified in children age 10 and younger. Of these, 86 required hospitalization. The rate of nonfatal injury in Hawai'i County was twice that of Honolulu and Maui Counties, and three times that of Kaua'i County. There were 9 fatal falls over a 21-year period. The population based incidence for nonfatal injuries was three-fold higher than that reported in the city of Dallas. The rate of hospitalizations following building falls was more than twice as high as the national average, and that of New York City, but similar to that of California. Strategies for education and environmental modification are reviewed, which may be helpful in reducing the incidence of pediatric falls from buildings in Hawai'i.
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Advances on reverse strike co-precipitation method of uranium-plutonium mixed solutions
International Nuclear Information System (INIS)
Menghini, Jorge E.; Marchi, Daniel E.; Orosco, Edgardo H.; Greco, Luis
2000-01-01
The reverse strike coprecipitation of uranium-plutonium mixed solutions, is an alternative way to obtain MOX fuel pellets. Previous tests, carried out in the Alpha Laboratory, included a stabilization step for transforming 100 % of plutonium into Pu +4 . Therefore, the plutonium precipitated as Pu(OH) 4 . In this second step, the stabilization process was suppressed. In this way, besides Pu(OH) 4 , a part of the precipitated is composed of a mixed salt: AD(U,Pu). Then, a homogeneous solid solution is formed in the early steps of the process. The powders showed higher tap density, better performance during the pressing and lower sinterability than the powders obtained in previous tests. The advantageous and disadvantageous effects of the stabilization step are analyzed in this paper. (author)
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Directory of Open Access Journals (Sweden)
Jennifer Yee
2017-09-01
Full Text Available Audience: This scenario was developed to educate emergency medicine residents on the management of a precipitous birth in the emergency department (ED. The case is also appropriate for teaching of medical students and advanced practice providers, as well as reviewing the principles of crisis resource management, teamwork, and communication. Introduction: Patients with precipitous birth require providers to manage two patients simultaneously with limited time and resources. Crisis resource management skills will be tested once baby is delivered, and the neonate will require assessment for potential neonatal resuscitation. Objectives: At the conclusion of the simulation session, learners will be able to manage women who have precipitous deliveries, as well as perform neonatal assessment and management. Method: This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on precipitous birth management and neonatal evaluation.
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Verduzco, Vivian S.; Garatuza-Payán, Jaime; Yépez, Enrico A.; Watts, Christopher J.; Rodríguez, Julio C.; Robles-Morua, Agustin; Vivoni, Enrique R.
2015-10-01
Due to their large extent and high primary productivity, tropical dry forests (TDF) are important contributors to atmospheric carbon exchanges in subtropical and tropical regions. In northwest Mexico, a bimodal precipitation regime that includes winter precipitation derived from Pacific storms and summer precipitation from the North American monsoon (NAM) couples water availability with ecosystem processes. We investigated the net ecosystem production of a TDF ecosystem using a 4.5 year record of water and carbon fluxes obtained from the eddy covariance method complemented with remotely sensed data. We identified a large CO2 efflux at the start of the summer season that is strongly related to the preceding winter precipitation and greenness. Since this CO2 efflux occurs prior to vegetation green-up, we infer that respiration is mainly due to decomposition of soil organic matter accumulated from the prior growing season. Overall, ecosystem respiration has an important effect on the net ecosystem production but can be overwhelmed by the strength of the primary productivity during the NAM. Precipitation characteristics during NAM have significant controls on sustaining carbon fixation in the TDF into the fall season. We identified that a threshold of ~350 to 400 mm of monsoon precipitation leads to a switch in the annual carbon balance in the TDF ecosystem from a net source (+102 g C/m2/yr) to a net sink (-249 g C/m2/yr). This monsoonal precipitation threshold is typically exceeded one out of every 2 years. The close coupling of winter and summer periods with respect to carbon fluxes suggests that the annual carbon balance is dependent on precipitation amounts in both seasons in TDF ecosystems.
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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.
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Defect investigations of micron sized precipitates in Al alloys
Klobes, B.; Korff, B.; Balarisi, O.; Eich, P.; Haaks, M.; Kohlbach, I.; Maier, K.; Sottong, R.; Staab, T. E. M.
2011-01-01
A lot of light aluminium alloys achieve their favourable mechanical properties, especially their high strength, due to precipitation of alloying elements. This class of age hardenable Al alloys includes technologically important systems such as e.g. Al-Mg-Si or Al-Cu. During ageing different precipitates are formed according to a specific precipitation sequence, which is always directed onto the corresponding intermetallic equilibrium phase. Probing the defect state of individual precipitates requires high spatial resolution as well as high chemical sensitivity. Both can be achieved using the finely focused positron beam provided by the Bonn Positron Microprobe (BPM) [1] in combination with the High Momentum Analysis (HMA) [2]. Employing the BPM, structures in the micron range can be probed by means of the spectroscopy of the Doppler broadening of annihilation radiation (DBAR). On the basis of these prerequisites single precipitates of intermetallic phases in Al-Mg-Si and Al-Cu, i.e. Mg2Si and Al2Cu, were probed. A detailed interpretation of these measurements necessarily relies on theoretical calculations of the DBAR of possible annihilation sites. These were performed employing the DOPPLER program. However, previous to the DBAR calculation the structures, which partly contain vacancies, were relaxed using the ab-initio code SIESTA, i.e. the atomic positions in presence of a vacancy were recalculated.
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Defect investigations of micron sized precipitates in Al alloys
Energy Technology Data Exchange (ETDEWEB)
Klobes, B; Korff, B; Balarisi, O; Eich, P; Haaks, M; Kohlbach, I; Maier, K; Sottong, R [Helmholtz-Institut fuer Strahlen- und Kernphysik, Nussallee 14-16, D-53115 Bonn (Germany); Staab, T E M, E-mail: klobes@hiskp.uni-bonn.de [Fraunhofer ISC, Neunerplatz 2, D-97082 Wuerzburg (Germany)
2011-01-01
A lot of light aluminium alloys achieve their favourable mechanical properties, especially their high strength, due to precipitation of alloying elements. This class of age hardenable Al alloys includes technologically important systems such as e.g. Al-Mg-Si or Al-Cu. During ageing different precipitates are formed according to a specific precipitation sequence, which is always directed onto the corresponding intermetallic equilibrium phase. Probing the defect state of individual precipitates requires high spatial resolution as well as high chemical sensitivity. Both can be achieved using the finely focused positron beam provided by the Bonn Positron Microprobe (BPM) in combination with the High Momentum Analysis (HMA). Employing the BPM, structures in the micron range can be probed by means of the spectroscopy of the Doppler broadening of annihilation radiation (DBAR). On the basis of these prerequisites single precipitates of intermetallic phases in Al-Mg-Si and Al-Cu, i.e. Mg{sub 2}Si and Al{sub 2}Cu, were probed. A detailed interpretation of these measurements necessarily relies on theoretical calculations of the DBAR of possible annihilation sites. These were performed employing the DOPPLER program. However, previous to the DBAR calculation the structures, which partly contain vacancies, were relaxed using the ab-initio code SIESTA, i.e. the atomic positions in presence of a vacancy were recalculated.
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Baisden, W Troy; Keller, Elizabeth D; Van Hale, Robert; Frew, Russell D; Wassenaar, Leonard I
2016-01-01
Predictive understanding of precipitation δ(2)H and δ(18)O in New Zealand faces unique challenges, including high spatial variability in precipitation amounts, alternation between subtropical and sub-Antarctic precipitation sources, and a compressed latitudinal range of 34 to 47 °S. To map the precipitation isotope ratios across New Zealand, three years of integrated monthly precipitation samples were acquired from >50 stations. Conventional mean-annual precipitation δ(2)H and δ(18)O maps were produced by regressions using geographic and annual climate variables. Incomplete data and short-term variation in climate and precipitation sources limited the utility of this approach. We overcome these difficulties by calculating precipitation-weighted monthly climate parameters using national 5-km-gridded daily climate data. This data plus geographic variables were regressed to predict δ(2)H, δ(18)O, and d-excess at all sites. The procedure yields statistically-valid predictions of the isotope composition of precipitation (long-term average root mean square error (RMSE) for δ(18)O = 0.6 ‰; δ(2)H = 5.5 ‰); and monthly RMSE δ(18)O = 1.9 ‰, δ(2)H = 16 ‰. This approach has substantial benefits for studies that require the isotope composition of precipitation during specific time intervals, and may be further improved by comparison to daily and event-based precipitation samples as well as the use of back-trajectory calculations.
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International Nuclear Information System (INIS)
Chang, T.P.
1987-02-01
Cerium, a nonradioactive, common stand-in for plutonium in development work, has been used to simulate several plutonium precipitation processes at the Savannah River Laboratory. There are similarities between the plutonium trifluoride and the cerium oxalate precipitations in particle size and extent of plating, but not particle morphology. The equilibrium solubility, precipitation kinetics, particle size, extent of plating, and dissolution characteristics of cerium oxalate have been investigated. Interpretations of particle size and plating based on precipitation kinetics (i.e., nucleation and crystal growth) are presented. 16 refs., 7 figs., 6 tabs
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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.
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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.
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Decadal Variation of Precipitation in Saudi Arabia induced by Agricultural Irrigation
Lo, M. H.; Wey, H. W.; Wada, Y.; IM, E. S.; Chien, R. Y.; Wu, R. J.
2017-12-01
Decadal variation of wet-season precipitation has been found in the arid region of central Saudi Arabia. 1980s has been a rather wet decade compared with the decades before. Previous studies have mentioned that the irrigation moisture may contribute to the precipitation anomalies in Saudi Arabia. In the current study, we show from observational data that the contribution of the variation comes mostly from February to May. As the irrigation is a localized forcing, we therefore use the Weather Research and Forecasting (WRF) Model to simulate the response of the land-atmosphere interaction to the wet soil moisture resulted from additional irrigation moisture supply. Preliminary result shows in the irrigated simulation that precipitation in central Saudi Arabia is enhanced, indicating the possible link between irrigation expansion in the 1980s and the decadal precipitation variation over central Saudi Arabia. We propose it is the anomalous convergence induced by irrigation as well as additional moisture that contribute to the enhanced precipitation over heavily irrigation region in the central Saudi Arabian. In addition, analysis on the daily precipitation from the WRF outputs indicates that positive rainfall anomalies tend to happen when there is rainfall originally; that is, irrigation enhances rainfall but not creates rainfall.
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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.
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Michell, R. G.; Samara, M.; Grubbs, G., II; Ogasawara, K.; Miller, G.; Trevino, J. A.; Webster, J.; Stange, J.
2016-01-01
We present a description of the Acute Precipitating Electron Spectrometer (APES) that was designed and built for the Ground-to-Rocket Electron Electrodynamics Correlative Experiment (GREECE) auroral sounding rocket mission. The purpose was to measure the precipitating electron spectrum with high time resolution, on the order of milliseconds. The trade-off made in order to achieve high time resolution was to limit the aperture to only one look direction. The energy selection was done by using a permanent magnet to separate the incoming electrons, such that the different energies would fall onto different regions of the microchannel plate and therefore be detected by different anodes. A rectangular microchannel plate (MCP) was used (15 mm x 100 mm), and there was a total of 50 discrete anodes under the MCP, each one 15 mm x 1.5 mm, with a 0.5 mm spacing between anodes. The target energy range of APES was 200 eV to 30 keV.
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Zhang, Aoqi; Fu, Yunfei; Chen, Yilun; Liu, Guosheng; Zhang, Xiangdong
2018-04-01
The distribution and influence of precipitation over the southern Himalayas have been investigated on regional and global scales. However, previous studies have been limited by the insufficient emphasis on the precipitation triggers or the lack of droplet size distribution (DSD) data. Here, precipitating systems were identified using Global Precipitation Mission dual-frequency radar data, and then categorized into five classes according to surface flow from the European Centre for Medium-Range Weather Forecast Interim data. The surface flow is introduced to indicate the precipitation triggers, which is validated in this study. Using case and statistical analysis, we show that the precipitating systems with different surface flow had different precipitation characteristics, including spatio-temporal features, reflectivity profile, DSD, and rainfall intensity. Furthermore, the results show that the source of the surface flow influences the intensity and DSD of precipitation. The terrain exerts different impacts on the precipitating systems of five categories, leading to various distributions of precipitation characteristics over the southern Himalayas. Our results suggest that the introduction of surface flow and DSD for precipitating systems provides insight into the complex precipitation of the southern Himalayas. The different characteristics of precipitating systems may be caused by the surface flow. Therefore, future study on the orographic precipitations should take account the impact of the surface flow and its relevant dynamic mechanism.
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Intrinsic factors associated with pregnancy falls.
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.
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Fall Risk Assessment Predicts Fall-Related Injury, Hip Fracture, and Head Injury in Older Adults.
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.
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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%.
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Spatial correlation in precipitation trends in the Brazilian Amazon
Buarque, Diogo Costa; Clarke, Robin T.; Mendes, Carlos Andre Bulhoes
2010-06-01
A geostatistical analysis of variables derived from Amazon daily precipitation records (trends in annual precipitation totals, trends in annual maximum precipitation accumulated over 1-5 days, trend in length of dry spell, trend in number of wet days per year) gave results that are consistent with those previously reported. Averaged over the Brazilian Amazon region as a whole, trends in annual maximum precipitations were slightly negative, the trend in the length of dry spell was slightly positive, and the trend in the number of wet days in the year was slightly negative. For trends in annual maximum precipitation accumulated over 1-5 days, spatial correlation between trends was found to extend up to a distance equivalent to at least half a degree of latitude or longitude, with some evidence of anisotropic correlation. Time trends in annual precipitation were found to be spatially correlated up to at least ten degrees of separation, in both W-E and S-N directions. Anisotropic spatial correlation was strongly evident in time trends in length of dry spell with much stronger evidence of spatial correlation in the W-E direction, extending up to at least five degrees of separation, than in the S-N. Because the time trends analyzed are shown to be spatially correlated, it is argued that methods at present widely used to test the statistical significance of climate trends over time lead to erroneous conclusions if spatial correlation is ignored, because records from different sites are assumed to be statistically independent.
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Distinguishing the causes of falls in humans using an array of wearable tri-axial accelerometers.
Aziz, Omar; Park, Edward J; Mori, Greg; Robinovitch, Stephen N
2014-01-01
Falls are the number one cause of injury in older adults. Lack of objective evidence on the cause and circumstances of falls is often a barrier to effective prevention strategies. Previous studies have established the ability of wearable miniature inertial sensors (accelerometers and gyroscopes) to automatically detect falls, for the purpose of delivering medical assistance. In the current study, we extend the applications of this technology, by developing and evaluating the accuracy of wearable sensor systems for determining the cause of falls. Twelve young adults participated in experimental trials involving falls due to seven causes: slips, trips, fainting, and incorrect shifting/transfer of body weight while sitting down, standing up from sitting, reaching and turning. Features (means and variances) of acceleration data acquired from four tri-axial accelerometers during the falling trials were input to a linear discriminant analysis technique. Data from an array of three sensors (left ankle+right ankle+sternum) provided at least 83% sensitivity and 89% specificity in classifying falls due to slips, trips, and incorrect shift of body weight during sitting, reaching and turning. Classification of falls due to fainting and incorrect shift during rising was less successful across all sensor combinations. Furthermore, similar classification accuracy was observed with data from wearable sensors and a video-based motion analysis system. These results establish a basis for the development of sensor-based fall monitoring systems that provide information on the cause and circumstances of falls, to direct fall prevention strategies at a patient or population level. Copyright © 2013 Elsevier B.V. All rights reserved.
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Preventing Falls in Older Persons.
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.
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Salmén, Timo; Heikkinen, Anna-Mari; Mahonen, Anitta; Kröger, Heikki; Komulainen, Marja; Saarikoski, Seppo; Honkanen, Risto; Partanen, Juhani; Mäenpää, Pekka H
2002-01-01
Several factors may increase fracture risk, among them reduced bone mineral density (BMD), increased bone resorption, microarchitectural deterioration of bone, increased fall risk, and decreased muscle strength. We have previously reported that PvuII polymorphism of the estrogen receptor-alpha (ER alpha) gene is associated with bone loss rate, fracture risk, and response to hormone replacement therapy (HRT) in early postmenopausal Finnish women. We studied the influence of the ER alpha genotype on fall risk and muscle strength in a 5-year randomized HRT trial of 331 early postmenopausal women (subgroup of the population-based OSTPRE study, Kuopio, Finland). A 5-year postal inquiry in May 1994 included questions on falls during the previous 12 months. Grip strength was measured with dynamometer. The ER alpha gene polymorphism was analysed using PCR and PvuII restriction enzyme digestion. RESULTS. In all, 97 out of the 331 women reported falls. Half of those (56%) were slip falls, mostly during the winter season. In the HRT group, the ER alpha genotype was associated with fall risk (P = 0.002, logistic regression). The risk of falls (RR) was higher in women with the PP genotype than in those with the Pp (RR = 5.26, 95% CI 1.98-13.94, P = 0.001) or the pp (RR = 3.84, 95% CI 1.46-10.12, P = 0.007) genotype. When the falls were divided into slip (environment-related) and non-slip (endogenous) falls, the non-slip falls were associated with the genotype (P = 0.004), but the slip falls were not so clearly (P = 0.061). When all falls and non-slip falls were adjusted to the number of chronic health disorders and the variable time-since-menopause, the difference between the genotypes persisted (P = 0.003 and P = 0.010, respectively). In the non-HRT group, the ER alpha genotype was not associated with fall risk. The baseline or the 5-year grip strength values were not influenced by the ER alpha genotype. In conclusion, ER alpha polymorphism is associated with fall risk
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Spinal sagittal contour affecting falls: cut-off value of the lumbar spine for falls.
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.
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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.
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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
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Directory of Open Access Journals (Sweden)
S. C. Lewis
2010-06-01
Full Text Available Water isotope records such as speleothems provide extensive evidence of past tropical hydrological changes. During Heinrich events, isotopic changes in monsoon regions have been interpreted as implying a widespread drying through the Northern Hemisphere tropics and an anti-phased precipitation response in the south. Here, we examine the sources of this variability using a water isotope-enabled general circulation model, Goddard Institute for Space Studies ModelE. We incorporate a new suite of vapour source distribution tracers to help constrain the impact of precipitation source region changes on the isotopic composition of precipitation and to identify nonlocal amount effects. We simulate a collapse of the North Atlantic meridional overturning circulation with a large freshwater input to the region as an idealised analogue to iceberg discharge during Heinrich events. An increase in monsoon intensity, defined by vertical wind shear, is modelled over the South American domain, with small decreases simulated over Asia. Simulated isotopic anomalies agree well with proxy climate records, with lighter isotopic values simulated over South America and enriched values across East Asia. For this particular abrupt climate event, we identify which climatic change is most likely linked to water isotope change – changes in local precipitation amount, monsoon intensity, water vapour source distributions or precipitation seasonality. We categorise individual sites according to the climate variability that water isotope changes are most closely associated with, and find that the dominant isotopic controls are not consistent across the tropics – simple local explanations, in particular, fall short of explaining water isotope variability at all sites. Instead, the best interpretations appear to be site specific and often regional in scale.
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Preventing Falls and Related Fractures
... 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 ...
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Abundance of sea kraits correlates with precipitation.
Directory of Open Access Journals (Sweden)
Harvey B Lillywhite
Full Text Available Recent studies have shown that sea kraits (Laticauda spp.--amphibious sea snakes--dehydrate without a source of fresh water, drink only fresh water or very dilute brackish water, and have a spatial distribution of abundance that correlates with freshwater sites in Taiwan. The spatial distribution correlates with sites where there is a source of fresh water in addition to local precipitation. Here we report six years of longitudinal data on the abundance of sea kraits related to precipitation at sites where these snakes are normally abundant in the coastal waters of Lanyu (Orchid Island, Taiwan. The number of observed sea kraits varies from year-to-year and correlates positively with previous 6-mo cumulative rainfall, which serves as an inverse index of drought. Grouped data for snake counts indicate that mean abundance in wet years is nearly 3-fold greater than in dry years, and this difference is significant. These data corroborate previous findings and suggest that freshwater dependence influences the abundance or activity of sea kraits on both spatial and temporal scales. The increasing evidence for freshwater dependence in these and other marine species have important implications for the possible impact of climate change on sea snake distributions.
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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.
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Comparison of precipitation measurements by OTT Parsivel2 and Thies LPM optical disdrometers
Angulo-Martínez, Marta; Beguería, Santiago; Latorre, Borja; Fernández-Raga, María
2018-05-01
Optical disdrometers are present weather sensors with the ability of providing detailed information on precipitation such as rain intensity, radar reflectivity or kinetic energy, together with discrete information on the particle size and fall velocity distribution (PSVD) of the hydrometeors. Disdrometers constitute a step forward towards a more complete characterization of precipitation, being useful in several research fields and applications. In this article the performance of two extensively used optical disdrometers, the most recent version of OTT Parsivel2 disdrometer and Thies Clima Laser Precipitation Monitor (LPM), is evaluated. During 2 years, four collocated optical disdrometers, two Thies Clima LPM and two OTT Parsivel2, collected up to 100 000 min of data and up to 30 000 min with rain in more than 200 rainfall events, with intensities peaking at 277 mm h-1 in 1 minute. The analysis of these records shows significant differences between both disdrometer types for all integrated precipitation parameters, which can be explained by differences in the raw PSVD estimated by the two sensors. Thies LPM recorded a larger number of particles than Parsivel2 and a higher proportion of small particles than OTT Parsivel2, resulting in higher rain rates and totals and differences in radar reflectivity and kinetic energy. These differences increased greatly with rainfall intensity. Possible causes of these differences, and their practical consequences, are discussed in order to help researchers and users in the choice of sensor, and at the same time pointing out limitations to be addressed in future studies.
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Risk factors for geriatric patient falls in rehabilitation hospital settings: a systematic review.
Vieira, Edgar Ramos; Freund-Heritage, Rosalie; da Costa, Bruno R
2011-09-01
To review the literature to identify and synthesize the evidence on risk factors for patient falls in geriatric rehabilitation hospital settings. Eligible studies were systematically searched on 16 databases from inception to December 2010. The search strategies used a combination of terms for rehabilitation hospital patients, falls, risk factors and older adults. Cross-sectional, cohort, case-control studies and randomized clinical trials (RCTs) published in English that investigated risks for falls among patients ≥65 years of age in rehabilitation hospital settings were included. Studies that investigated fall risk assessment tools, but did not investigate risk factors themselves or did not report a measure of risk (e.g. odds ratio, relative risk) were excluded. A total of 2,824 references were identified; only eight articles concerning six studies met the inclusion criteria. In these, 1,924 geriatric rehabilitation patients were followed. The average age of the patients ranged from 77 to 83 years, the percentage of women ranged from 56% to 81%, and the percentage of fallers ranged from 15% to 54%. Two were case-control studies, two were RCTs and four were prospective cohort studies. Several intrinsic and extrinsic risk factors for falls were identified. Carpet flooring, vertigo, being an amputee, confusion, cognitive impairment, stroke, sleep disturbance, anticonvulsants, tranquilizers and antihypertensive medications, age between 71 and 80, previous falls, and need for transfer assistance are risk factors for geriatric patient falls in rehabilitation hospital settings.
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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
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Development and feasibility of falls prevention advice.
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.
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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.
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Sensitivity of precipitation statistics to urban growth in a subtropical coastal megacity cluster.
Holst, Christopher Claus; Chan, Johnny C L; Tam, Chi-Yung
2017-09-01
This short paper presents an investigation on how human activities may or may not affect precipitation based on numerical simulations of precipitation in a benchmark case with modified lower boundary conditions, representing different stages of urban development in the model. The results indicate that certain degrees of urbanization affect the likelihood of heavy precipitation significantly, while less urbanized or smaller cities are much less prone to these effects. Such a result can be explained based on our previous work where the sensitivity of precipitation statistics to surface anthropogenic heat sources lies in the generation of buoyancy and turbulence in the planetary boundary layer and dissipation through triggering of convection. Thus only mega cities of sufficient size, and hence human-activity-related anthropogenic heat emission, can expect to experience such effects. In other words, as cities grow, their effects upon precipitation appear to grow as well. Copyright © 2017. Published by Elsevier B.V.
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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...
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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...
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Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla
2011-06-01
This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.
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Low-level precipitation sublimation on the coasts of East Antarctica
Grazioli, Jacopo; Genthon, Christophe; Madeleine, Jean-Baptiste; Lemonnier, Florentin; Gallée, Hubert; Krinner, Gerhard; Berne, Alexis
2017-04-01
The weather of East Antarctica is affected by the peculiar morphology of this large continent and by its isolation from the surroundings. The high-elevation interior of the continent, very dry in absolute terms, originates winds that can reach the coastal areas with very high speed and persistence in time. The absence of topographic barriers and the near-ground temperature inversion allow these density-driven air movements to fall from the continent towards the coasts without excessive interaction and mixing with the atmosphere aloft. Thus, the air remains dry in absolute terms, and very dry in relative terms because of the higher temperatures near the coast and the adiabatic warming due to the descent. The coasts of Antarctica are less isolated and more exposed to incoming moist air masses than the rest of the continent, and precipitation in the form of snowfall more frequently occurs. Through its descent, however, snowfall encounters the layer of dry air coming from the continent and the deficit in humidity can lead to the partial or complete sublimation of the precipitating flux. This phenomenon is named here LPS (Low-level Precipitation Sublimation) and it has been observed by means of ground-based remote sensing instruments (weather radars) and atmospheric radio-sounding balloons records in the framework of the APRES3 campaign (Antarctic Precipitation: REmote Sensing from Surface and Space) in the coastal base of Dumont d' Urville (Terre Adélie), and then examined at the continental scale thanks to numerical weather models. LPS occurs over most of the coastal locations, where the total sublimated snowfall can be a significant percentage of the total snowfall. For example, in Dumont d' Urville the total yearly snowfall at 341 m height is less than 80% of the snowfall at 941 m height (the height of maximum yearly accumulation), and at shorter time scales complete sublimation (i.e. virga) often occurs. At the scale of individual precipitation events, LPS is
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Energy Technology Data Exchange (ETDEWEB)
Jia, Z. [Center for Structural and Functional Materials, University of Louisiana at Lafayette, P.O. Box 44130, Lafayette, LA 70503 (United States); Misra, R.D.K., E-mail: dmisra@louisiana.edu [Center for Structural and Functional Materials, University of Louisiana at Lafayette, P.O. Box 44130, Lafayette, LA 70503 (United States); O' Malley, R. [Nucor Steel Decatur, LLC, 4301 Iverson Blvd., Trinity, AL 35673 (United States); Jansto, S.J. [CBMM-Reference Metals Company, 1000 Old Pond Road, Bridgeville, PA 15017 (United States)
2011-08-25
Highlights: {yields} Precipitation and mechanical behavior of Ti-Nb and Ti-Nb-Mo-V steels were elucidated. {yields} Distribution of precipitates was analyzed with microscopy and diffraction pattern. {yields} During austenite-ferrite transformation, interface precipitation of NbC was observed. {yields} Epitaxial precipitation of NbC on TiC surface results in mixed precipitates Ti(Nb)C. - Abstract: We describe here the precipitation behavior and mechanical properties of 560 MPa Ti-Nb and 770 MPa Ti-Nb-Mo-V steels. The precipitation characteristics were analyzed in terms of chemistry and size distribution of precipitates, with particular focus on the crystallography of precipitates through an analysis of electron diffraction patterns. In addition to pure carbides (NbC, TiC, Mo{sub 2}C, and VC), Nb containing titanium-rich carbides were also observed. These precipitates were of a size range of 4-20 nm. The mechanism of formation of these Ti-rich niobium containing carbides is postulated to involve epitaxial nucleation of NbC on previously precipitated TiC. Interface precipitation of NbC was an interesting observation in compact strip processing which is characterized by an orientation relationship of [0 0 1]{sub NbC}//[0 0 1]{sub {alpha}-Fe}, implying that the precipitation of NbC occurred during austenite-ferrite transformation.
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International Nuclear Information System (INIS)
Jia, Z.; Misra, R.D.K.; O'Malley, R.; Jansto, S.J.
2011-01-01
Highlights: → Precipitation and mechanical behavior of Ti-Nb and Ti-Nb-Mo-V steels were elucidated. → Distribution of precipitates was analyzed with microscopy and diffraction pattern. → During austenite-ferrite transformation, interface precipitation of NbC was observed. → Epitaxial precipitation of NbC on TiC surface results in mixed precipitates Ti(Nb)C. - Abstract: We describe here the precipitation behavior and mechanical properties of 560 MPa Ti-Nb and 770 MPa Ti-Nb-Mo-V steels. The precipitation characteristics were analyzed in terms of chemistry and size distribution of precipitates, with particular focus on the crystallography of precipitates through an analysis of electron diffraction patterns. In addition to pure carbides (NbC, TiC, Mo 2 C, and VC), Nb containing titanium-rich carbides were also observed. These precipitates were of a size range of 4-20 nm. The mechanism of formation of these Ti-rich niobium containing carbides is postulated to involve epitaxial nucleation of NbC on previously precipitated TiC. Interface precipitation of NbC was an interesting observation in compact strip processing which is characterized by an orientation relationship of [0 0 1] NbC //[0 0 1] α-Fe , implying that the precipitation of NbC occurred during austenite-ferrite transformation.
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[Six-months outcomes after admission in acute geriatric care unit secondary to a fall].
Dickes-Sotty, Hélène; Chevalet, Pascal; Fix, Marie-Hélène; Riaudel, Typhaine; Serre-Sahel, Caroline; Ould-Aoudia, Vincent; Berrut, Gilles; De Decker, Laure
2012-12-01
Fall in elderly subject is a main event by its medical and social consequences, but few studies were dedicated to the prognosis from hospitalization in geriatric acute care unit. Describe the outcome of elderly subjects hospitalized after a fall in geriatric acute care unit. Longitudinal study of 6 months follow-up, 100 patients of 75 and more years old hospitalized after a fall in acute care geriatric unit. On a total of 128 patients hospitalized for fall, 100 agreed to participate in the study, 3 died during the hospitalization, so 97 subjects were able to be followed. During 6 months after the hospitalization, 14 patients died (14.9%), 51 (58%) have fallen again (58%) and 11 (22%) of them suffer from severe injuries. Thirty seven (39.7%) were rehospitalized and 10 of them related to fall. Among the patients coming from their home, 25 had been institutionalized. The main risk factor which have been identified to be associated with a new fall during the follow-up was a known dementia at the entry. The medical and social prognosis of an elderly subject hospitalized in an acute care unit is severe. The main comorbidity which influences the medical and social outcome is a known dementia, in addition to a history of previous fall.
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Dust and Biological Aerosols from the Sahara and Asia Influence Precipitation in the Western US
Energy Technology Data Exchange (ETDEWEB)
Creamean, Jessie; Suski, Kaitlyn; Rosenfeld, Daniel; Cazorla, Alberto; DeMott, Paul J.; Sullivan, Ryan C.; White, Allen B.; Ralph, F. M.; Minnis, Patrick; Comstock, Jennifer M.; Tomlinson, Jason M.; Prather, Kimberly
2013-03-29
Winter storms in California’s Sierra Nevada increase seasonal snowpack and provide critical water resources for the state. Thus, the mechanisms influencing precipitation in this region have been the subject of research for decades. Previous studies suggest Asian dust enhances cloud ice and precipitation (1), while few studies consider biological aerosols as an important global source of ice nuclei (IN). Here, we show that dust and biological aerosols transported from as far as the Sahara were present in glaciated high-altitude clouds coincident with elevated IN concentrations and ice-induced precipitation. This study presents the first direct cloud and precipitation measurements showing that Saharan and Asian dust and biological aerosols likely serve as IN and play an important role in orographic precipitation processes over the western United States.
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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
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Precipitation behavior and effect of new precipitated β phase in AZ80 magnesium alloy
Institute of Scientific and Technical Information of China (English)
TANG Wei; HAN En-hou; XU Yong-bo; LIU Lu
2006-01-01
Granular precipitate that was a new kind of β-Mg17Al12 phase found in aged AZ80 wrought Mg alloy at all aging temperature was studied. The structure and precipitation behavior of this granular β-Mg17Al12 precipitate were studied by environmental scanning electron microscopy (ESEM) and transmission electron microscopy (TEM). The effect of the granular precipitate on mechanical properties of AZ80 alloy was also studied. The new precipitate that was granular and nucleated both on grain boundaries (GBs) and twin boundaries, has the same crystal structure and lattice parameter as those of the continuous or discontinuous precipitated β-Mg17Al12. And the nucleation and growth of the granular precipitate are faster than those of the other two precipitates at higher temperatures (above 583 K), but are suppressed at lower temperatures (below 423 K). At lower temperatures, the discontinuous β-Mg17Al12 precipitates firstly and the granular β-Mg17Al12 precipitates after aged more than 40 h. The crack is easily nucleated on the phase boundaries of granular phase and matrix because of the weak binding force. As a result, the strength and ductility of AZ80 Mg alloy are decreased by the granular β-Mg17Al12 precipitate.
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Pai, Yi-Chung; Bhatt, Tanvi; Yang, Feng; Wang, Edward
2014-12-01
Previous studies indicated that a single session of repeated-slip exposure can reduce over 40% of laboratory-induced falls among older adults. The purpose of this study was to determine to what degree such perturbation training translated to the reduction of older adults' annual falls risk in their everyday living. Two hundred and twelve community-dwelling older adults (≥65 years old) were randomly assigned to either the training group (N = 109), who then were exposed to 24 unannounced repeated slips, or the control group (N = 103), who merely experienced one slip during the same walking in the same protective laboratory environment. We recorded their falls in the preceding year (through self-reported history) and during the next 12 months (through falls diary and monitored with phone calls). With this single session of repeated-slip exposure, training cut older adults' annual risk of falls by 50% (from 34% to 15%, p fall during the same 12-month follow-up period (p falls. A single session of repeated-slip exposure could improve community-dwelling older adults' resilience to postural disturbances and, hence, significantly reduce their annual risk of falls. © 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.
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Neri, Silvia Gonçalves Ricci; Gadelha, André Bonadias; de David, Ana Cristina; Ferreira, Aparecido Pimentel; Safons, Marisete Peralta; Tiedemann, Anne; Lima, Ricardo M
2017-12-07
Recent investigations demonstrate an association between obesity and the propensity of older adults to fall. The aim of this study was to investigate the association between body adiposity measures, postural balance, fear of falling, and risk of falls in older women. One hundred forty-seven volunteers took part in this cross-sectional study. Participants underwent body composition assessment using dual-energy x-ray absorptiometry and had body mass index, waist circumference (WC), and body adiposity index measured. Postural balance was assessed using a force platform, while fear of falling and risk of falls were, respectively, evaluated by the Falls Efficacy Scale-International and the QuickScreen Clinical Falls Risk Assessment. All adiposity measures were correlated to at least 1 postural stability parameter and to fear of falling (ρ= 0.163, P risk of falls (ρ= 0.325; P falling (28.04 vs 24.59; P = .002) and had a higher proportion of individuals with increased fall risk (72% vs 35%; P risk of falls in older women, which might be mediated by reduced postural balance and increased fear of falling. Among these indices, WC, an easy and low-cost assessment, demonstrated the strongest association with falls-related outcomes.
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[Falls of older individuals: medical assessment].
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.
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Directory of Open Access Journals (Sweden)
Sungmin Lee
2017-02-01
Full Text Available Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS. Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA were analyzed at the census tract level (n = 264. Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.
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Lee, Sungmin; Lee, Chanam; Rodiek, Susan
2017-02-08
Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.
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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.
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Childhood Falls With Occipital Impacts
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
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Preliminary Studies on Summer Precipitation Patterns in China%我国夏季降水类型初探
Institute of Scientific and Technical Information of China (English)
李鸾
2008-01-01
[Objective]Study on the spatial distribution of summer precipitation patterns and interannnal and interdacadal variability.[Method]The summer precipitation patterns were obtained from standard field of summer precipitation data for 160 observation stations in China during 1951-2000 by the utilization of empirical orthogonal function(EOF),and characteristics of interannual and interdecadal variability were analyzed.[Result]The summer precipitation mainly distributes in eastern part of China;The Ist,2nd and 3rd EOF modes of spatial distribution are especially remarkable as well consistent with the results of previous reports about three rainfall patterns from analysis on the percentages of precipitation anomaly of summer.[Conclusion]There exists interannnal and interdecadal variability for summer precipitation in China.
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10Be in desert sands, falling dust and loess in China
International Nuclear Information System (INIS)
Shen, C.D.; Beer, J.; Kubik, P.W.; Sun, W.D.; Liu, T.S.; Liu, K.X.
2010-01-01
Cosmogenic 10 Be is produced in the atmosphere, and deposits onto the surface of the earth mainly through wet precipitation and dust. Based on the analysis of 10 Be in Chinese loess, we believe that 10 Be in loess is composed of two components: locally precipitated atmospheric 10 Be, and windblown 10 Be adsorbed on the surface of silt grains. On the Loess Plateau, 10 Be concentrations in loess and paleosol range from (1.4 to 2.8) x 10 8 atoms/g and (2.7 to 4.5) x 10 8 atoms/g, respectively. To investigate the sources of 10 Be in loess, we measured 10 Be in sand grains from deserts in western China and falling dust from the deposition regions. The results show that the 10 Be concentrations in sand and dust are (1.1-5.1) x 10 7 atoms/g and (1.3-2.8) x 10 8 atoms/g, respectively. Loess and paleosol on the Loess Plateau both contain inherited 10 Be adsorbed on silt grains from dust; most of the windblown deposited loess materials do not directly come from the Gobi and other sand deserts, but mainly from the loess-desert transitional zones, which are characterized by silt and dust holding areas.
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Kim, Oksoo; Kim, Jung-Hee
2015-01-01
This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis. The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence. The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices. Stroke patients with fall experience and walking aids might be considered at increased risk of falling. Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients. © 2014 Association of Rehabilitation Nurses.
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Ashouri, Hamed; Sorooshian, Soroosh; Hsu, Kuo-Lin; Bosilovich, Michael G.; Lee, Jaechoul; Wehner, Michael F.; Collow, Allison
2016-01-01
This study evaluates the performance of NASA's Modern-Era Retrospective Analysis for Research and Applications (MERRA) precipitation product in reproducing the trend and distribution of extreme precipitation events. Utilizing the extreme value theory, time-invariant and time-variant extreme value distributions are developed to model the trends and changes in the patterns of extreme precipitation events over the contiguous United States during 1979-2010. The Climate Prediction Center (CPC) U.S.Unified gridded observation data are used as the observational dataset. The CPC analysis shows that the eastern and western parts of the United States are experiencing positive and negative trends in annual maxima, respectively. The continental-scale patterns of change found in MERRA seem to reasonably mirror the observed patterns of change found in CPC. This is not previously expected, given the difficulty in constraining precipitation in reanalysis products. MERRA tends to overestimate the frequency at which the 99th percentile of precipitation is exceeded because this threshold tends to be lower in MERRA, making it easier to be exceeded. This feature is dominant during the summer months. MERRA tends to reproduce spatial patterns of the scale and location parameters of the generalized extreme value and generalized Pareto distributions. However, MERRA underestimates these parameters, particularly over the Gulf Coast states, leading to lower magnitudes in extreme precipitation events. Two issues in MERRA are identified: 1) MERRA shows a spurious negative trend in Nebraska and Kansas, which is most likely related to the changes in the satellite observing system over time that has apparently affected the water cycle in the central United States, and 2) the patterns of positive trend over the Gulf Coast states and along the East Coast seem to be correlated with the tropical cyclones in these regions. The analysis of the trends in the seasonal precipitation extremes indicates that
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Prevalence of falls in elderly women.
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.
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Ageing vision and falls: a review.
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.
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Photometric evidence of electron precipitation induced by first hop whistlers
International Nuclear Information System (INIS)
Doolittle, J.H.; Carpenter, D.L.
1983-01-01
Electron precipitation events induced by discrete VLF whistler mode waves have previously been detected by photometers at Siple Station, Antarctica. This paper presents the first observations of ionospheric optical emissions correlated with VLF waves at the conjugate location, near Roberval, Quebec. Since most whistlers recorded at Siple or Roberval originate in the north, Roberval affords a clear perspective on the direct precipitation induced during the first pass of the wave as it propagates southward. For such a wave the direct precipitation and that induced in the ''mirrored mode'' by the returning two-hop wave should differ in arrival time by roughly twice the wave propagation time between hemispheres, while at Siple the effects of the direct and mirrored modes may overlap in time. A well defined series of observations of structured lambda4278 optical emissions was observed on August 30, 1979 in the aftermath of an intense magnetic storm. The optical emissions were found to lead the arrival time of the two-hop waves by about 0.7 s instead of lagging the local waves by about 1--2 s as had been previously observed for whistler driven events at Siple. The observed arrival time relationships are consistent with the predictions of a cyclotron resonance interaction model, and thus support previous observations of x-rays at Roberval. The importance of the first pass of the wave is further emphasized by an approximate proportionality between the amplitude of the VLF waves recorded at Siple and the intensity of the optical emission bursts at Roberval. Although structured optical emissions correlated with wave bursts can clearly be detected at Roberval, relatively large magnetospheric particle fluxes may be required to produce such events
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Scheffer, Alice C; van Hensbroek, Pieter Boele; van Dijk, Nynke; Luitse, Jan S K; Goslings, Johannes C; Luigies, René H; de Rooij, Sophia E
2013-07-26
Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a population that visited the A&E Department after a fall (A&E group) and in a community-dwelling population of elderly individuals with a fall history who did not visit the A&E Department after a fall (non-A&E group). Two cohorts were included in this study. The first cohort included 547 individuals 65 years and older who were visited at home by a mobile fall prevention team. The participants in this cohort had fall histories but did not visit the A&E Department after a previous fall. These participants were age- and gender-matched to persons who visited the A&E Department for care after a fall. All participants were asked to complete the CAREFALL Triage Instrument. The mean number of modifiable risk factors in patients who did not visit the A&E Department was 2.9, compared to 3.8 in the group that visited the A&E Department (pfalling, impaired vision, mood and high risk of osteoporosis were all independently associated with visiting the A&E Department. All modifiable risk factors for falling were found to be shared between community-dwelling elderly individuals with a fall history who visited the A&E Department and those who did not visit the Department, although the prevalence of these factors was somewhat lower in the A&E group. Preventive strategies aimed both at patients presenting to the A&E Department after a fall and those not presenting after a fall could perhaps reduce the number of recurrent falls, the occurrence of injury and the frequency of visits to the A&E Department.
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Institute of Scientific and Technical Information of China (English)
无
2007-01-01
The large scale character of the interannual variation of precipitation and the urban effect on local annual precipitation anomaly are investigated in this paper based on the 1960-2000 annual precipitation observations at 20 stations in the Beijing region. The results show that: the annual precipitation in the Beijing region possesses the large scale variation character with the linear trend of - 1.197/10 yr, which corresponds to a total reduction of 27.82 mm in annual precipitation in the 41 years; the local annual precipitation anomalies (percent of the normal 1960-2000) show a positive center near the urban area, i.e. urban precipitation island (UPI), whose intensity increases with the linear trend of 0. 6621%/10 yr, opposite to the interannual trend of large scale precipitation over the Beijing region; changes in the UPI are also associated with the intensity of synoptic processes of precipitation, and when the synoptic processes are strong (wet years), the intensity of UPI strengthens, while the synoptic processes are weak (dry years), and the UPI disappears in the Beijing region.
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Characteristics of daily life gait in fall and non fall-prone stroke survivors and controls
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
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Honeycutt, Claire F.; Nevisipour, Masood; Grabiner, Mark D.
2016-01-01
Falls are the most common and expensive medical complication in stroke survivors. There is remarkably little information about what factors lead to a fall in stroke survivors. With few exceptions, the falls literature in stroke has focused on relating metrics of static balance and impairment to fall outcomes in the acute care setting or in community. While informative, these studies provide little information about what specific impairments in a stroke-survivor’s response to dynamic balance challenges lead to a fall. We identified the key kinematic characteristics of stroke survivors’ stepping responses following a balance disturbance that are associated with a fall following dynamic balance challenges. Stroke survivors were exposed to posteriorly-directed translations of a treadmill belt that elicited a stepping response. Kinematics were compared between successful and failed recovery attempts (i.e. a fall). We found that the ability to arrest and reverse trunk flexion and the ability to perform an appropriate initial compensatory step were the most critical response contributors to a successful recovery. We also identified 2 compensatory strategies utilized by stroke survivors to avoid a fall. Despite significant post-stroke functional impairments, the biomechanical causes of trip-related falls by stroke survivors appear to be similar to those of unimpaired older adults and lower extremity amputees. However, compensatory strategies (pivot, hopping) were observed. PMID:27614614
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Flabeau, O; Laurendeau, G; Laksir, H; Castaings-Pelet, S; Harston, S; Bourdel-Marchasson, I
2013-02-01
Multidisciplinary interventions for fallers have provided conflicting results in part due to the diversity of fallers' profiles. to determine the characteristics of the subgroup of patients with a positive response to a multidisciplinary fall prevention program initiated in a geriatric day hospital. Prospective observational study in day hospital. Patients > 75 years referred for falls during the last 3 months benefited from a multidisciplinary assessment to record their characteristics at baseline and to tailor a risk-based multidisciplinary intervention for fall prevention. Patients free from falls at the 3rd or 6th month were compared to persistent fallers for baseline characteristics. Sixty-nine patients were assessed at baseline (mean age 85.2 y (SD=0.6)), 44 at the 3rd month and 21 at the 6th month. Baseline characteristics of the patients free from falls at the 3rd month were the lower number of previous non-serious falls (p=0.013), living in nursing home (p=0.045), a higher Berg balance score (p=0.02) and a better mental health-related quality of life (M HQol, p=0.045). On multivariate analysis restricted to home-dwelling patients, the positive predictive factors were less isolation at home (OR=0.028, 95%CI [0-0.813], p=0.037), a lower number of non-serious previous falls (OR= 0.526 [0.309- 0.894], p=0.018), a better M HQol (OR=1.205 [1.000-1.452], p=0.050) and a trend for younger age (OR= 0.662, [0.426-1.027], p=0.066). Being able to call upon a support person (familial or institutional) to apply advice and a less serious risk of falling may be preliminary conditions for success in a multidisciplinary intervention initiated in a day hospital.
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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....
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Home Improvements Prevent Falls
... 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 ...
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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.
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Fall Prevention in a Primary Care Setting.
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.
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Stivala, Adam; Hartley, Greg
2014-01-01
Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.
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Trevisan, Caterina; Di Gregorio, Patrizia; Debiasi, Eugenio; Pedrotti, Martina; La Guardia, Mario; Manzato, Enzo; Sergi, Giuseppe; March, Albert
2017-10-01
While the relevance of falls in raising the risk of fractures, hospitalization and disability in older age is well recognized, the factors influencing the onset of fractures and the need for ward admission after a fall have yet to be fully elucidated. We investigated which factors and fall dynamics were mainly associated with fall-related injuries and hospitalization among elderly persons accessing the Emergency Department (ED) following a fall. The study involved 2144 older subjects who accessed the ED after a fall. Data on the fall´s nature and related injuries, ward admissions, history of falls, dementia, and medical therapies were examined for all patients. Considering dynamics, we distinguished accidental falls (due to interaction with environmental hazards while in motion) and falls from standing (secondary to syncope, lipothymia, drop attack, or vertigo). The overall prevalence of fractures in our population did not differ significantly with advancing age, though hip fractures were more common in the oldest, and upper limb fractures in the youngest patients. Falls from standing were associated with polypharmacy and with higher ward admission rate despite a lower fractures´ prevalence than accidental falls. The chances of fall-related fractures were more than fourfold as high for accidental dynamics (OR=4.05, 95%CI:3.10-5.29, pfall-related fractures (OR=6.84, 95%CI:5.45-8.58, pfall dynamics. Outcomes of falls in older age depend not only on any fall-related injuries, but also on factors such as polypharmacy, cognitive status and fall dynamics. Copyright © 2017 Elsevier B.V. All rights reserved.
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Wetterhall, F.; He, Y.; Cloke, H.; Pappenberger, F.; Freer, J.; Wilson, M.; McGregor, G.
2009-04-01
Local flooding events are often triggered by high-intensity rain-fall events, and it is important that these can be correctly modelled by Regional Climate Models (RCMs) if the results are to be used in climate impact assessment. In this study, daily precipitation from 16 RCMs was compared with observations over a meso-scale catchment in the Midlands Region of England. The RCM data was provided from the European research project ENSEMBLES and the precipitation data from the UK MetOffice. The RCMs were all driven by reanalysis data from the ERA40 dataset over the time period 1961-2000. The ENSEMBLES data is on the spatial scale of 25 x 25 km and it was disaggregated onto a 5 x 5 km grid over the catchment and compared with interpolated observational data with the same resolution. The mean precipitation was generally underestimated by the ENSEMBLES data, and the maximum and persistence of high intensity rainfall was even more underestimated. The inter-annual variability was not fully captured by the RCMs, and there was a systematic underestimation of precipitation during the autumn months. The spatial pattern in the modelled precipitation data was too smooth in comparison with the observed data, especially in the high altitudes in the western part of the catchment where the high precipitation usually occurs. The RCM outputs cannot reproduce the current high intensity precipitation events that are needed to sufficiently model extreme flood events. The results point out the discrepancy between climate model output and the high intensity precipitation input needs for hydrological impact modelling.
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[Effects of a fall prevention program on falls in frail elders living at home in rural communities].
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.
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Fall prevention in the elderly
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
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Fall prevention in the elderly.
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
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Dockx, Kim; Alcock, Lisa; Bekkers, Esther; Ginis, Pieter; Reelick, Miriam; Pelosin, Elisa; Lagravinese, Giovanna; Hausdorff, Jeffrey M; Mirelman, Anat; Rochester, Lynn; Nieuwboer, Alice
2017-01-01
Virtual reality (VR) technology is a relatively new rehabilitation tool that can deliver a combination of cognitive and motor training for fall prevention. The attitudes of older people to such training are currently unclear. This study aimed to investigate: (1) the attitudes of fall-prone older people towards fall prevention exercise with and without VR; (2) attitudinal changes after intervention with and without VR; and (3) user satisfaction following fall prevention exercise with and without VR. A total of 281 fall-prone older people were randomly assigned to an experimental group receiving treadmill training augmented by VR (TT+VR, n = 144) or a control group receiving treadmill training alone (TT, n = 137). Two questionnaires were used to measure (1) attitudes towards fall prevention exercise with and without VR (AQ); and (2) user satisfaction (USQ). AQ was evaluated at baseline and after intervention. USQ was measured after intervention only. The AQ revealed that most participants had positive attitudes towards fall prevention exercise at baseline (82.2%) and after intervention (80.6%; p = 0.144). In contrast, only 53.6% were enthusiastic about fall prevention exercise with VR at baseline. These attitudes positively changed after intervention (83.1%; p < 0.001), and 99.2% indicated that they enjoyed TT+VR. Correlation analyses showed that postintervention attitudes were strongly related to user satisfaction (USQ: r = 0.503; p < 0.001). Older people's attitudes towards fall prevention exercise with VR were positively influenced by their experience. From the perspective of the user, VR is an attractive training mode, and thus improving service provision for older people is important. © 2017 S. Karger AG, Basel.
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Sb interactions with TaC precipitates and Cu in ion-implanted α-Fe
International Nuclear Information System (INIS)
Follstaedt, D.M.; Myers, S.M.
1980-01-01
The interactions of Sb with the other species implanted into Fe to form Fe-Ta-C-Sb and Fe-Cu-Sb alloys have been examined with transmission electron microscopy and Rutherford backscattering following annealing at 873 0 K. Trapping of Sb at TaC precipitates is observed in the former alloy just as was previously observed in Fe-Ti-C-Sb. In Fe-Cu-Sb, Sb interactions are governed by the atomic ratio of Sb to Cu. For ratios between 0.2 to 0.4, the compound β-Cu 3 Sb was observed to form. For Sb to Cu ratios approx.< 0.1, fcc Cu precipitates were observed. In addition to the expected Sb dissolution in Cu, Sb trapping by Cu precipitates is also observed. The binding enthalpy of Sb at both TaC and Cu precipitates with respect to a solution site in the bcc Fe is the same as observed for TiC, approx. 0.4 eV. The constancy of the binding enthalpy at such chemically dissimilar precipitates supports the hypothesis that the trapping is due to the structural discontinuity of the precipitate-host interface. The observed Sb trapping at precipitates is of potential significance for the control of temper embrittlement in bcc steels
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Falls and patient safety for older adults.
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.
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Obuchi, Shuichi
2008-06-01
Kaigoyobou, prevention of long-term care use, is a comprehensive approach, including physical, nutritional, and social, to maintain independent living in the elderly. Prevention of falling is one useful method of Kaigoyobou. From literature review, post-fall syndrome should be primarily eliminated in the elderly since falling rate of the elderly with the falling history reported significantly greater falling rate than the other community dwelling elderly. The ability to avoid falling when they trip or slip during walking may be the most important physical function needed to be intervened. In order to train elderly person successfully, nutritional intervention need to be considered into fall prevention program.
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Older persons afraid of falling reduce physical activity to prevent outdoor falls
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
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Wetherbee, Gregory A.; Shaw, Michael J.; Latysh, Natalie E.; Lehmann, Christopher M.B.; Rothert, Jane E.
2010-01-01
Precipitation chemistry and depth measurements obtained by the Canadian Air and Precipitation Monitoring Network (CAPMoN) and the US National Atmospheric Deposition Program/National Trends Network (NADP/NTN) were compared for the 10-year period 1995–2004. Colocated sets of CAPMoN and NADP instrumentation, consisting of precipitation collectors and rain gages, were operated simultaneously per standard protocols for each network at Sutton, Ontario and Frelighsburg, Ontario, Canada and at State College, PA, USA. CAPMoN samples were collected daily, and NADP samples were collected weekly, and samples were analyzed exclusively by each network’s laboratory for pH, H + , Ca2+ , Mg2+ , Na + , K + , NH+4 , Cl − , NO−3 , and SO2−4 . Weekly and annual precipitation-weighted mean concentrations for each network were compared. This study is a follow-up to an earlier internetwork comparison for the period 1986–1993, published by Alain Sirois, Robert Vet, and Dennis Lamb in 2000. Median weekly internetwork differences for 1995–2004 data were the same to slightly lower than for data for the previous study period (1986–1993) for all analytes except NO−3 , SO2−4 , and sample depth. A 1994 NADP sampling protocol change and a 1998 change in the types of filters used to process NADP samples reversed the previously identified negative bias in NADP data for hydrogen-ion and sodium concentrations. Statistically significant biases (α = 0.10) for sodium and hydrogen-ion concentrations observed in the 1986–1993 data were not significant for 1995–2004. Weekly CAPMoN measurements generally are higher than weekly NADP measurements due to differences in sample filtration and field instrumentation, not sample evaporation, contamination, or analytical laboratory differences.
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[Relationship between fall and frailty index in elderly adults of urban community in Beijing].
Zhou, B Y; Yu, D N; Tao, Y K; Shi, J; Yu, P L
2018-03-10
Objective: To evaluate the frailty status and understand the relationship between the incidence of fall and frailty status in the elderly in Beijing. Methods: A cross-sectional study was conducted in old people aged ≥60 years in Longtan community of Dongcheng district in Beijing from November 2015 to January 2016. The information about any fall during the past year and frailty status of the elderly were collected with a standardized structured questionnaire in face-to-face interviews. The frailty status of elderly people was assessed with frailty index (FI) method. Logistic regression analysis was used to explore the relationship between fall and frailty status among the elderly. Results: Among 1 557 old people surveyed, the incidence of fall was 17.8% (277/1 557) during the past year. The incidence of fall in women (21.0%, 192/277) was statistically higher than that in men (13.3%, 85/277) ( χ (2)=15.288, P =0.000). The median (quartile) value of FI of the elderly surveyed was 0.09 (0.08); and women had a higher FI median value than men [0.10 (0.08) versus 0.08 (0.07)]( Z =5.376, P =0.000). The median FI value (quartile range) of 277 old people with history of fall in previous year was 0.12 (0.11), which was higher than the median FI value of 0.08 (0.07) of 1 280 old people without fall history ( Z =7.501, P =0.000). Logistic regression analysis showed that higher FI value was associated with more risks for fall; and FI value showed the greatest impact on the incidence and frequency of fall ( OR =1.093, 2.234) compared with other related factors of fall, such as age and gender. Conclusion: Frailty status has a greater impact on both incidence and frequency of fall compared with other factors in elderly people in Beijing; more attention should be paid to weak and old adults in the prevention of fall.
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Relationship between muscle strength and fall episodes among the elderly: the Yilan study, Taiwan.
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.
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Lin, Sang-I; Chang, Ku-Chou; Lee, Hsuei-Chen; Yang, Yi-Ching; Tsauo, Jau-Yih
2015-05-01
Determine quality of life and its association with fall risk factors in older adults with increased risk of falling. A total of 597 community-dwelling Taiwanese older adults who were screened to have increased risk of falling participated in the present study. The fall risk factors included sociodemographics, physical and psychological function, Timed Up and Go, past fall/medical histories, fear of falling and medications. The Euro QOL EQ-5D was used to measure health-related quality of life. Pain/discomfort was the EQ-5D dimension most frequently reported to be impaired (35%), regardless of the level of fall risk or age groups, followed by mobility (25%). Hierarchical regression analysis showed that Geriatric Depression Scale, Mini-Mental State Examination, physiological function, up-and-go, fear of falling and psychotropic medication were independent predictors for total EQ-5D, explaining 68.37% of the variance. Logistic regression analysis showed that for the five EQ-5D dimensions, Geriatric Depression Scale and Up and Go time were the most common determinants. Pain/discomfort was the leading impairment, and greater Geriatric Depression Scale and longer up-and-go time were the main contributing factors in declines in quality of life in older adults with increased risk of falling. These factors are often modifiable, and their management might be considered a priority in falls prevention. © 2014 Japan Geriatrics Society.
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The association between primary open-angle glaucoma and fall: an observational study
Directory of Open Access Journals (Sweden)
Tanabe S
2012-03-01
Full Text Available Sachiko Tanabe1,2*, Kenya Yuki1*, Naoki Ozeki1, Daisuke Shiba1, Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Tokyo, Japan; 2Tanabe Eye Clinic, Kai City, Yamanashi, Japan*These authors contributed equally to this workPurpose: Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG who were more than 45 years old, compared with comparably aged healthy subjects.Methods: This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye.Results: The self-reported prevalence of injurious fall was 0.9% (1/117 in the control group and 6.9% (7/101 in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test. Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with
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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
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Yu-Ning Hu; Yu-Ju Chung; Hui-Kung Yu; Yu-Chi Chen; Chien-Tsung Tsai; Gwo-Chi Hu
2016-01-01
Background: Falls among the elderly is a major public health concern. Tai Chi exercise appears to prevent the risk of falls among the elderly. Previous reviews found that there is insufficient evidence to conclude whether Tai Chi is effective in fall prevention. Our review was performed to update the current evidence on the effect of this intervention. Methods: We systematically searched Medline, PubMed, Embase, and Cochrane Library for studies published up to 2013. Randomized controlled t...
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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.
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Silver precipitation from electrolytic effluents; Precipitacion de plata de efluentes electroliticos
Energy Technology Data Exchange (ETDEWEB)
Rivera, I.; Patino, F.; Cruells, M.; Roca, A.; Vinals, J.
2004-07-01
The recovery of silver contained in electrolytic effluents is attractive due to its high economic value. These effluents are considered toxic wastes and it is not possible to dump them directly without any detoxification process. One of the most important way for silver recovery is the precipitation with sodium ditionite, sodium borohidride or hydrazine monohidrate. In this work, the most significant aspects related to the use of these reagents is presented. Results of silver precipitation with sodium ditionite from effluents containing thiosulfate without previous elimination of other species are also presented. silver concentration in the final effluents w <1 ppm. (Author) 15 refs.
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Isotopic evidence of boron in precipitation originating from coal burning in Asian continent
International Nuclear Information System (INIS)
Sakata, Masahiro; Natsumi, Masahiro; Tani, Yukinori
2010-01-01
The boron concentration and isotopic composition (δ 11 B) of precipitation collected from December 2002 to March 2006 at three sites on the Japan Sea coast were measured. Those sites have been considerably affected by the long-range transport of air pollutants from the Asian continent during winter and spring when the airflows from the Asian continent are predominant. The boron concentration in the precipitation increased primarily during winter whereas the δ 11 B decreased during winter or spring. It is assumed that this decrease in δ 11 B is not associated with a Rayleigh distillation process, because the previous δD values of the precipitation collected at a site on the Japan Sea coast did not decrease in the same manner. A weak correlation (r 2 =0.13-0.24, P 11 B and the nonsea-salt sulfate (nss-SO 4 2- )/B ratio at each site, suggesting that boron in the precipitation originate primarily from two sources. The first source, which is characterized by high δ 11 B and nss-SO 4 2- /B=0, is seawater. At the northern site, the enrichment factor for boron in the precipitation relative to seawater approached unity during winter. This implies that much of the boron in the precipitation is derived from unfractionated sea salts rather than gaseous boron evaporated from seawater. The second source is characterized by low δ 11 B and high nss-SO 4 2- /B ratio. Most of the nss-SO 4 2- in the precipitation originates from anthropogenic combustion activities in the Asian continent based on the previous model calculations. Coal accounts for a major portion of the total primary energy supply in China. Moreover, coal enriches boron and represents generally negative δ 11 B values. Hence, we propose that the emission of boron from coal burning is the most likely second source. Thus, boron isotopes may be useful as tracers of coal-burning plumes from the Asian continent. (author)
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Free Falling in Stratified Fluids
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.
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Fasano, Alfonso; Plotnik, Meir; Bove, Francesco; Berardelli, Alfredo
2012-12-01
Falling is a major clinical problem; especially, in elderly population as it often leads to fractures, immobilization, poor quality of life and life-span reduction. Given the growing body of evidences on the physiopathology of balance disorders in humans, in recent years the approach of research on falls has completely changed and new instruments and new definitions have been formulated. Among them, the definition of "idiopathic faller" (i.e. no overt cause for falling in a given subject) represented a milestone in building the "science of falling". This review deals with the new determinants of the neurobiology of falling: (1) the role of motor impairment and particularly of those "mild parkinsonian signs" frequently detectable in elderly subjects, (2) the role of executive and attentive resources when coping with obstacles, (3) the role of vascular lesions in "highest level gait disorder" (a condition tightly connected with senile gait, cautious gait and frailty), (4) the role of the failure of automaticity or inter-limbs coordination/symmetry during walking and such approach would definitely help the development of screening instrument for subjects at risk (still lacking in present days). This translational approach will lead to the development of specific therapeutic interventions.
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Fall Prevention: Simple Tips to Prevent Falls
... 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 ...
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Insights into changes in precipitation patterns in Brazil from oxygen isotope ratios on speleothems
Cruz, F.; Mathias, V.; Stephen, B. J.; Wang, X.; Cheng, H.; Werner, M.; Edwards, R. L.; Karmann, I.; Auler, A. S.
2008-12-01
Variations in tropical precipitation on millennial and orbital time scales can reflect a Hadley-cell-related anti- phasing between the Northern and Southern hemispheres due to the influence of insolation on the global summer monsoons. A new δ18O speleothem record from northeastern Brazil shows that insolation- driven changes in monsoon intensity are capable of producing a similar, zonally oriented anti-phasing within the same hemisphere. Comparison of our speleothem record with other precipitation-sensitive proxies from the central Andes and southeastern Brazil shows that precipitation in Northeastern Brazil has been out of phase with insolation and rainfall in the rest of tropical South America south of the equator since the Last Glacial Maximum. Northeastern Brazil experienced humid conditions when summer insolation was reduced and arid conditions when insolation was high. While previous interpretations of past climate change in NE South America have commonly invoked meridional displacements in ITCZ location as the main mechanism for changes in precipitation on millennial time scales, our results suggest that remote monsoon forcing is responsible for much of the observed precipitation changes on orbital time scales during the Holocene. These results demonstrate that orbitally driven out-of-phase relationships in precipitation are not limited to interhemispheric anti-phasing as demonstrated previously, but may well occur within the same hemisphere. Speleothem records also indicate contrasting climatic conditions around the Last Glacial Maximum in Brazil, characterized by marked dry and wet climates in the Nordeste and in southeastern Brazil, respectively. It is likely, however, that these regional differences primarily reflect more distant extratropical teleconnections from the Atlantic Ocean and high northern latitude changes during glacial conditions.
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Fall speed measurement and high-resolution multi-angle photography of hydrometeors in free fall
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...
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Harper, K.
2015-12-01
At the end of World War II, Nobel Prize-winning chemist Irving Langmuir and his team at the General Electric Research Laboratory in Schenectady, New York, were doing advanced research on cloaking smokes and aircraft icing for the US military. Trying to determine why some clouds precipitated while others did not, Langmuir concluded that non-precipitating clouds were lacking "ice nuclei" that would gather up cloud droplets until they became large enough to fall out of the cloud. If they could find an artificial substitute, it would be possible to modify clouds and the weather. Dry ice particles did the trick, military funding followed, and cloud busting commenced. But a handful of entrepreneurial meteorologists saw a different purpose: enhancing precipitation and preventing hail damage. The commercialization of weather modification was underway, with cloud seeding enhancing rainfall east of the Cascades, in the Desert Southwest, and even in the watersheds serving New York City. Hail busting took off in the Dakotas, and snowpack enhancement got a boost in Montana. Basic cloud physics research very quickly became commercial weather modification, fulfilling a postwar desire to use science and technology to control nature and creating an opening for meteorologists to provide a variety of specialized services to businesses whose profits depend on the weather.
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Directory of Open Access Journals (Sweden)
Ferrer A
2014-02-01
Full Text Available Assumpta Ferrer,1 Francesc Formiga,2,3 Héctor Sanz,4 Oscar J de Vries,5 Teresa Badia,6 Ramón Pujol2,3 On behalf of the OCTABAIX Study Group 1Primary Healthcare Centre "El Plà" CAP-I, Sant Feliu de Llobregat, 2Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, 3Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, 4Support Research Unit, Primary Health Department Costa Ponent, IDIAP Jordi Gol, Barcelona, Spain; 5Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands; 6Primary Healthcare Centre Martorell, Barcelona, Spain Background: The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. Methods: A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona. Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat. Results: Sixty-five (39.6% subjects in the intervention group and 48 (29.3% in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94–1.75. Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03–2.09 and that functional impairment (HR 1.42, 95% CI 0.97–2.12, previous falls (HR 1.09, 95% CI 0.74–1.60, and cognitive impairment (HR 1.08, 95% CI 0.72–1.60 had no effect on the
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Agrawal, Yuri; Carey, John P; Della Santina, Charles C; Schubert, Michael C; Minor, Lloyd B
2010-12-01
Patients with diabetes are at increased risk both for falls and for vestibular dysfunction, a known risk factor for falls. Our aims were 1) to further characterize the vestibular dysfunction present in patients with diabetes and 2) to evaluate for an independent effect of vestibular dysfunction on fall risk among patients with diabetes. National cross-sectional survey. Ambulatory examination centers. Adults from the United States aged 40 years and older who participated in the 2001-2004 National Health and Nutrition Examination Survey (n = 5,86). Diagnosis of diabetes, peripheral neuropathy, and retinopathy. Vestibular function measured by the modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces and history of falling in the previous 12 months. We observed a higher prevalence of vestibular dysfunction in patients with diabetes with longer duration of disease, greater serum hemoglobin A1c levels and other diabetes-related complications, suggestive of a dose-response relationship between diabetes mellitus severity and vestibular dysfunction. We also noted that vestibular dysfunction independently increased the odds of falling more than 2-fold among patients with diabetes (odds ratio, 2.3; 95% confidence interval, 1.1-5.1), even after adjusting for peripheral neuropathy and retinopathy. Moreover, we found that including vestibular dysfunction, peripheral neuropathy, and retinopathy in multivariate models eliminated the significant association between diabetes and fall risk. Vestibular dysfunction may represent a newly recognized diabetes-related complication, which acts as a mediator of the effect of diabetes mellitus on fall risk.
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Stable Isotopes of Precipitation During Tropical Sumatra Squalls in Singapore
He, Shaoneng; Goodkin, Nathalie F.; Kurita, Naoyuki; Wang, Xianfeng; Rubin, Charles Martin
2018-04-01
Sumatra Squalls, organized bands of thunderstorms, are the dominant mesoscale convective systems during the intermonsoon and southwest monsoon seasons in Singapore. To understand how they affect precipitation isotopes, we monitored the δ value of precipitation daily and continuously (every second and integrated over 30 s) during all squalls in 2015. We found that precipitation δ18O values mainly exhibit a "V"-shape pattern and less commonly a "W"-shape pattern. Variation in δ18O values during a single event is about 1 to 6‰ with the lowest values mostly observed in the stratiform zone, which agrees with previous observations and modeling simulations. Reevaporation can significantly affect δ values, especially in the last stage of the stratiform zone. Daily precipitation is characterized by periodic negative shifts in δ value, largely associated with the squalls rather than moisture source change. The shifts can be more than 10‰, larger than intraevent variation. Initial δ18O values of events are highly variable, and those with the lowest values also have the lowest initial values. Therefore, past convective activities in the upwind area can significantly affect the δ18O, and convection at the sampling site has limited contribution to isotopic variability. A significant correlation between precipitation δ18O value and regional outgoing longwave radiation and rainfall in the Asian monsoon region and western Pacific suggests that regional organized convection probably drives stable isotopic compositions of precipitation. A drop in the frequency of the squalls in 2015 is related to weak organized convection in the region caused by El Niño.
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Chuan, Zun Liang; Ismail, Noriszura; Shinyie, Wendy Ling; Lit Ken, Tan; Fam, Soo-Fen; Senawi, Azlyna; Yusoff, Wan Nur Syahidah Wan
2018-04-01
Due to the limited of historical precipitation records, agglomerative hierarchical clustering algorithms widely used to extrapolate information from gauged to ungauged precipitation catchments in yielding a more reliable projection of extreme hydro-meteorological events such as extreme precipitation events. However, identifying the optimum number of homogeneous precipitation catchments accurately based on the dendrogram resulted using agglomerative hierarchical algorithms are very subjective. The main objective of this study is to propose an efficient regionalized algorithm to identify the homogeneous precipitation catchments for non-stationary precipitation time series. The homogeneous precipitation catchments are identified using average linkage hierarchical clustering algorithm associated multi-scale bootstrap resampling, while uncentered correlation coefficient as the similarity measure. The regionalized homogeneous precipitation is consolidated using K-sample Anderson Darling non-parametric test. The analysis result shows the proposed regionalized algorithm performed more better compared to the proposed agglomerative hierarchical clustering algorithm in previous studies.
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Amorphization of Laves-Phase Precipitates in Zircaloy-4 by Neutron Irradiation
Energy Technology Data Exchange (ETDEWEB)
Peters, H.R.; Taylor, D.F.; Yang, Walter J.S.
1999-04-23
Examination of corrosion coupons by transmission electron microscopy after their exposure in the Idaho Advanced Test Reactor (ATR) has broadened the Zircaloy-4 precipitate-amorphization database and validated a new kinetic model for previously unavailable values of temperature and fast-neutron flux. The model describes the amorphization of Zr(Fe,Cr){sub 2} intermetallic precipitates in zirconium alloys as a dynamic competition between radiation damage and thermal annealing that leaves some iron atoms available for flux-assisted diffusion to the zirconium matrix. It predicts the width of the amorphous zone as a function of neutron flux (E>1 MeV), temperature, and time. In its simplest form, the model treats the crystalline/amorphous and precipitate/matrix interfaces as parallel planes, and its accuracy decreases for small precipitates and high fluence as the amorphous-zone width approaches precipitate dimensions. The simplest form of the model also considers diffusion to be rate-determining. This is an accurate approximation for steady-state conditions or slow changes in flux and temperature, but inappropriate for the analysis of faster transients. The paper addresses several difficulties inherent in measuring amorphous-zone width, and utilizes the expanded database to evaluate the improvements in predictive accuracy available through both conversion of the model to spherical coordinates and extension of its time dependency.
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Hars, Mélany; Audet, Marie-Claude; Herrmann, François; De Chassey, Jean; Rizzoli, René; Reny, Jean-Luc; Gold, Gabriel; Ferrari, Serge; Trombetti, Andrea
2018-05-01
Falls are common among older inpatients and remain a great challenge for hospitals. Despite the relevance of physical impairments to falls, the prognostic value of performance-based functional measures for in-hospital falls and injurious falls remains unknown. This study aimed to determine the predictive ability and accuracy of various functional tests administered at or close to admission in a geriatric hospital to identify in-hospital fallers and injurious fallers. In this prospective study, conducted in a geriatric hospital in Geneva, Switzerland, 807 inpatients (mean age 85.0 years) were subjected to a battery of functional tests administered by physiotherapists within 3 days (interquartile range 1 to 6) of admission, including Short Physical Performance Battery (SPPB), simplified Tinetti, and Timed Up and Go tests. Patients were prospectively followed up for falls and injurious falls until discharge using mandatory standardized incident report forms and electronic patients' records. During a median length of hospital stay of 23 days (interquartile range 14 to 36), 329 falls occurred in 189 (23.4%) patients, including 161 injurious falls of which 24 were serious. In-hospital fallers displayed significantly poorer functional performances at admission on all tests compared with non-fallers (p performances on all functional tests predicted in-hospital falls and injurious falls (p poor functional performances, as assessed by SPPB, are independent predictors of in-hospital falls, injurious falls, and fractures in patients admitted to a geriatric hospital. These findings should help to design preventive strategies for in-hospital falls and support the adoption of objective performance-based functional measures into routine hospital practice. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.
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Global Analysis of Ecosystem Evapotranspiration Response to Precipitation Deficits
He, Bin; Wang, Haiyan; Guo, Lanlan; Liu, Junjie
2017-12-01
Changes in ecosystem evapotranspiration (ET) due to precipitation deficits (PD) can relieve or aggravate soil moisture shortages, thus impacting drought severity. Previous findings have conflicted with regard to response of ET to PD. The present study relies on a global land ET synthesis data set (ETsyn) and observations from eddy-covariance towers (ETobs) to thoroughly examine the sensitivity of ET to PD, which is represented by the standardized precipitation index. There was a contrast in the response to PD between arid and humid ecosystems. ETsyn of arid ecosystems was typically reduced promptly in response to a reduction of precipitation, while ETsyn in humid ecosystems experienced a two-staged change: First, there was an enhancement, and then a reduction associated with persisting PD. Compared with ETsyn, ETobs suggests the occurrence of a more significant ET transition in response to PD. In arid ecosystems, ET typically negatively correlated with low PD, but this was limited by a large PD. Findings from this study are crucial for understanding the role of ET in drought evolution.
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Almeida, Cláudio W L; Castro, Charlles H M; Pedreira, Paulo G; Heymann, Roberto E; Szejnfeld, Vera L
2011-06-01
Falls are a serious health problem for aged people, causing social and economic burden. Despite being an important determinant of balance, the positioning of the center of mass (COM) has not been evaluated as a risk factor for falls. This study examined the association between the percentage height of COM (%COM) and the risk of falls in the elderly. Healthy women aged 60 years and older were consecutively selected in a case-control study. Forty-eight individuals classified as "fallers" (having suffered two or more falls in the previous year) were the cases while 48 age and weight-matched women with one fall or no falls in the previous year were the controls ("non-fallers"). Body composition and bone mineral density (BMD) by DXA, 30-second chair stand test, abdominal circumference, Berg's balance scale and %COM using the reaction board method were evaluated in all participants. Body composition parameters were not significantly different between groups. Spine and hip BMD tended to be lower in the fallers, but the difference was significant only at the femoral neck (0.80±0.10g/cm(2) versus 0.87±0.76g/cm(2); pfalls. Further work is needed in order to determine the value of board reaction measurements in a clinical setting to identify patients at high risk. Copyright © 2011 Elsevier B.V. All rights reserved.
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Kwok, Boon Chong; Mamun, Kaysar; Chandran, Manju; Wong, Chek Hooi
2011-06-18
Falls are common in frail older adults and often result in injuries and hospitalisation. The Nintendo® Wii™ is an easily available exercise modality in the community which has been shown to improve lower limb strength and balance. However, not much is known on the effectiveness of the Nintendo® Wii™ to improve fall efficacy and reduce falls in a moderately frail older adult. Fall efficacy is the measure of fear of falling in performing various daily activities. Fear contributes to avoidance of activities and functional decline. This randomised active-control trial is a comparison between the Nintendo WiiActive programme against standard gym-based rehabilitation of the older population. Eighty subjects aged above 60, fallers and non-fallers, will be recruited from the hospital outpatient clinic. The primary outcome measure is the Modified Falls Efficacy Scale and the secondary outcome measures are self-reported falls, quadriceps strength, walking agility, dynamic balance and quality of life assessments. The study is the first randomised control trial using the Nintendo Wii as a rehabilitation modality investigating a change in fall efficacy and self-reported falls. Longitudinally, the study will investigate if the interventions can successfully reduce falls and analyse the cost-effectiveness of the programme.
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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.
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Brandt, T.; Deems, J. S.; Painter, T. H.; Dozier, J.
2016-12-01
In California's Sierra Nevada, 10 or fewer winter storms are responsible for most of the annual precipitation, which falls mostly as snow. Presently, surface stations are used to measure the dynamics of mountain precipitation. However, even in places like the Sierra Nevada—one of the most gauged regions in the world—the paucity of surface stations can lead to large errors in precipitation thereby biasing both total water year and short-term streamflow forecasts. Remotely sensed snow depth and water equivalent, at a time scale that resolves storms, might provide a novel solution to the problems of: (1) quantifying the spatial variability of mountain precipitation; and (2) assessing gridded precipitation products that are mostly based on surface station interpolation. NASA's Airborne Snow Observatory (ASO), an imaging spectrometer and LiDAR system, has measured snow in the Tuolumne River Basin in California's Sierra Nevada for the past four years, 2013-2016; and, measurements will continue. Principally, ASO monitors the progression of melt for water supply forecasting, nonetheless, a number of flights bracketed storms allowing for estimates of snow accumulation. In this study we examine a few of the ASO recorded storms to determine both the basin and subbasin orographic effect as well as the spatial patterns in total precipitation. We then compare these results to a number of gridded climate products and weather models including: Daymet, the Parameter-elevation Regressions on Independent Slopes Model (PRISM), the North American Land Data Assimilation System (NLDAS-2), and the Weather Research and Forecasting (WRF) model. Finally, to put each ASO recorded storm into context, we use a climatology produced from snow pillows and the North American Regional Reanalysis (NARR) for 2014-2016 to examine key accumulation events, and classify storms based on their integrated water vapor flux.
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A simple strategy for fall events detection
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.
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Methodological challenges in a study on falls in an older population of Cape Town, South Africa.
Kalula, Sebastiana Z; Ferreira, Monica; Swingler, George H; Badri, Motasim; Sayer, Avan A
2017-09-01
Falls are a major cause of disability, morbidity and mortality in older persons, but have been under researched in developing countries. To describe challenges encountered in a community-based study on falls in a multi-ethnic population aged ≥65 years in a low-income setting. The study was conducted in four stages: A pilot study (n=105) to establish a sample size for the survey. An equipment validation study (n=118) to use for fall risk determination. A cross-sectional baseline (n=837) and a 12-month follow-up survey (n=632) to establish prevalence and risk factors for falls. Prevalence rate of 26.4% (95% CI 23.5-29.5%) and risk factors for recurrent falls: previous falls, self-reported poor mobility and dizziness were established. Adaptations to the gold standard prospective fall research study design were employed: 1) to gain access to the study population in three selected suburbs, 2) to perform assessments in a non-standardised setting, 3) to address subjects' poverty and low literacy levels, and high attrition of subjects and field workers. Studies on falls in the older population of low- to middle-income countries have methodological challenges. Adaptive strategies used in the Cape Town study and the research experience reported may be instructive for investigators planning similar studies in such settings.
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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
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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.
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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.
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Reducing falls among older people in general practice: The ProAct65+ exercise intervention trial.
Gawler, S; Skelton, D A; Dinan-Young, S; Masud, T; Morris, R W; Griffin, M; Kendrick, D; Iliffe, S
2016-01-01
Falls are common in the older UK population and associated costs to the NHS are high. Systematic reviews suggest that home exercise and group-based exercise interventions, which focus on progressively challenging balance and increasing strength, can reduce up to 42% of falls in those with a history of falls. The evidence is less clear for those older adults who are currently at low risk of falls. ProAct65+, a large, cluster-randomised, controlled trial, investigated the effectiveness of a home exercise programme (Otago Exercise Programme (OEP)) and a group-based exercise programme (Falls Management Exercise (FaME)) compared to usual care (UC) at increasing moderate to vigorous physical activity (MVPA). This paper examines the trial's secondary outcomes; the effectiveness of the interventions at reducing falls and falls-related injuries. 1256 community-dwelling older adults (aged 65+) were recruited through GP practices in two sites (London and Nottingham). Frequent fallers (≥3 falls in last year) and those with unstable medical conditions were excluded, as were those already reaching the UK Government recommended levels of physical activity (PA) for health. Baseline assessment (including assessment of health, function and previous falls) occurred before randomisation; the intervention period lasted 24 weeks and there was an immediate post-intervention assessment; participants were followed up every six months for 24 months. Falls data were analysed using negative binomial modelling. Falls data were collected prospectively during the intervention period by 4-weekly diaries (6 in total). Falls recall was recorded at the 3-monthly follow-ups for a total of 24 months. Balance was measured at baseline and at the end of the intervention period using the Timed Up & Go and Functional Reach tests. Balance confidence (CONFbal), falls risk (FRAT) and falls self-efficacy (FES-I) were measured by questionnaire at baseline and at all subsequent assessment points. 294
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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.
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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.
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Effective Assimilation of Global Precipitation
Lien, G.; Kalnay, E.; Miyoshi, T.; Huffman, G. J.
2012-12-01
Assimilating precipitation observations by modifying the moisture and sometimes temperature profiles has been shown successful in forcing the model precipitation to be close to the observed precipitation, but only while the assimilation is taking place. After the forecast start, the model tends to "forget" the assimilation changes and lose their extra skill after few forecast hours. This suggests that this approach is not an efficient way to modify the potential vorticity field, since this is the variable that the model would remember. In this study, the ensemble Kalman filter (EnKF) method is used to effectively change the potential vorticity field by allowing ensemble members with better precipitation to receive higher weights. In addition to using an EnKF, two other changes in the precipitation assimilation process are proposed to solve the problems related to the highly non-Gaussian nature of the precipitation variable: a) transform precipitation into a Gaussian distribution based on its climatological distribution, and b) only assimilate precipitation at the location where some ensemble members have positive precipitation. The idea is first tested by the observing system simulation experiments (OSSEs) using SPEEDY, a simplified but realistic general circulation model. When the global precipitation is assimilated in addition to conventional rawinsonde observations, both the analyses and the medium range forecasts are significantly improved as compared to only having rawinsonde observations. The improvement is much reduced when only modifying the moisture field with the same approach, which shows the importance of the error covariance between precipitation and all other model variables. The effect of precipitation assimilation is larger in the Southern Hemisphere than that in the Northern Hemisphere because the Northern Hemisphere analyses are already accurate as a result of denser rawinsonde stations. Assimilation of precipitation using a more comprehensive
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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.
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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.
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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.
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Energy Technology Data Exchange (ETDEWEB)
Tiffan, Kenneth F.; Rondorf, Dennis W.
2001-01-01
This report summarizes results of research activities conducted in 1999 and years previous. In an effort to provide this information to a wider audience, the individual chapters in this report have been submitted as manuscripts to peer-reviewed journals. These chapters communicate significant findings that will aid in the management and recovery of fall chinook salmon in the Columbia River Basin. Abundance and timing of seaward migration of Snake River fall chinook salmon was indexed using passage data collected at Lower Granite Dam for five years. We used genetic analyses to determine the lineage of fish recaptured at Lower Granite Dam that had been previously PIT tagged. We then used discriminant analysis to determine run membership of PIT-tagged smolts that were not recaptured to enable us to calculate annual run composition and to compared early life history attributes of wild subyearling fall and spring chinook salmon. Because spring chinook salmon made up from 15.1 to 44.4% of the tagged subyearling smolts that were detected passing Lower Granite Dam, subyearling passage data at Lower Granite Dam can only be used to index fall chinook salmon smolt abundance and passage timing if genetic samples are taken to identify run membership of smolts. Otherwise, fall chinook salmon smolt abundance would be overestimated and timing of fall chinook salmon smolt passage would appear to be earlier and more protracted than is the case.
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Precipitation in partially stabilized zirconia
International Nuclear Information System (INIS)
Bansal, G.K.
1975-01-01
Transmission electron microscopy was used to study the substructure of partially stabilized ZrO 2 (PSZ) samples, i.e., 2-phase systems containing both cubic and monoclinic modifications of zirconia, after various heat treatments. Monoclinic ZrO 2 exists as (1) isolated grains within the polycrystalline aggregate (a grain- boundary phase) and (2) small plate-like particles within cubic grains. These intragranular precipitates are believed to contribute to the useful properties of PSZ via a form of precipitation hardening. These precipitates initially form as tetragonal ZrO 2 , with a habit plane parallel to the brace 100 brace matrix planes. The orientation relations between the tetragonal precipitates and the cubic matrix are brace 100 brace/sub matrix/ 2 parallel brace 100 brace /sub precipitate/ or (001)/sub precipitate/ and broken bracket 100 broken bracket/sub matrix/ 2 parallel broken bracket 100 broken bracket/sub precipitate/ or [001]/sub precipitate/. (U.S.)
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Directory of Open Access Journals (Sweden)
Lawton Beverley
2007-07-01
Full Text Available Abstract Background Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care. Methods Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used – waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels. Results 312 participants were recruited (69% women. Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05. Mean age of all participants was 81 years (SD 5. On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics with a median of 2 falls (interquartile range 1, 3 in the previous year. Conclusion The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a
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Fear of falling and gait parameters in older adults with and without fall history.
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.